OBJECTIVE To enhance the rational usage of antibiotics by comprehensive interventional measures in clinics.METHODS Several interventional measures have been adopted in our hospital since January 2001: to(establish) expert team on antibiotics usage and administration consultation;constitute antibiotics use criteria(suitable) for each clinical specialty;train and examine the usage of antibiotics;censor the distribution of pathogen and drug-resistance variance.Then 10% of the discharged medical records in 2000,2002 and 2004 were drawn out respectively to analyze the usage of antibiotics and the isolation of pathogen from nosocomial infection cases.(RESULTS) The proportion of the patients with prophylactic and remedial indications was increased remarkably((P

Adult ; Female ; Fibula ; injuries ; physiopathology ; Humans ; Joint Dislocations ; diagnosis ; therapy ; Leg ; Male ; Tendons ; Treatment Outcome

Objective: To study the expression of transmembrane protein CMTM2 in the testis and sperm of adult males and to approach the potential function of the protein in the male reproductive system.Methods: The expression of CMTM2 in human testis and sperm was confirmed by Western blot.Immunohistochemical staining was used for detecting CMTM2 localization in the testis tissue, TRITC-CMTM2 and FITC-Hoechst double immunofluorescence staining was performed to examine the subcellular localization of CMTM2 in the human sperm before and after acrosome reaction, that is, immunofluorescent staining was used for detecting CMTM2 localization in both the testis and sperm before and after the acrosome reaction.Results: CMTM2 was presented in both human testis and sperm.In the testis, CMTM2 immunoreactive particles were observed mainly in the membrane of the different stages of spermatogenic cells.In the human sperm, its immunoreactivity was restrictively localized to the posterior head where sperm-egg fusion occurred, and the CMTM2 localization was not affected by sperm acrosome reaction.CMTM2 was widely expressed in seminiferous tubules of the human testis, mainly in the cell membranes of spermatogenic cells, which was consistent with the previous reports.The immunofluorescence performed on frozen human testis slides showed similar findings with immunohistochemistry, which gave weight to the localization of CMTM2 in the cell membranes of spermatogenic cells at different stages.TRITC-CMTM2 and FITC-Hoechst double immunofluorescence staining was performed to examine the subcellular localization of CMTM2 in the human sperm before and after acrosome reaction.CMTM2 was localized at the posterior head of sperm before and after acrosome reaction.The localization and expression of CMTM2 were not affected by sperm acrosome reaction.Conclusion: Expression of CMTM2 in the male reproductive system of the adult human exhibits cell-and region-specific patterns, which suggests that they may play an important role in spermatogenesis and sperm-egg fusion.The expression of CMTM2 in the male reproductive system of the adult human exhibits cell-and region-specific patterns, which suggests that they may play an important role in spermatogenesis and sperm-egg fusion.However, it still remains to be further elucidated about the definite role of CMTM2 in male reproductive system and the process of spermatogenesis.And in vitro fertilization experiments are needed to confirm the role of CMTM2 in fertilization in future.

BACKGROUND: Magnalium which is potential to be the medical biodegraded metal implant is more and more interesting,but it must be well biocompatibility to human body.OBJECTIVE: To evaluate the sensitization of magnalium (AZ31B).METHODS: A total of 35 guinea pigs were randomly divided into saline group (negative control group,n=10),5% volume of formaldehyde (positive control group,n=10),and AZ31B group (n=15).Sensitization test at the maximal dosage was performed according to "Biological evaluation of medical devices-Part 10: Tests for irritation and delayed-type hypersensitivity",including intracutaneous induction,local induction,and provocation.Patch was removed after 6,24,48,and 72 hours,and the skin response was classified accordingto Magnusson and Kligman criteria.Patch was removed after 72 hours,and skin was performed with biopsy,stained with FIE staining,and observed under optic microscope.RESULTS AND CONCLUSION: Sensitization response was not tested in both negative control group and AZ31B group at 24,48,and 72 hours after patch removal; however,moderate erythema was observed in the positive control group.Optic microscope demonstrated that criteria of allergy such as spongiosis,edema,and diffuse as well as perivascular mononuclear infiltration was not observed in the AZ31B group,but a few basophilic calls ware observed.This suggested that AZ31B was biologically safe for sensitization.

Objective To investigate the relationship between the white matter fiber connectivity of the anterior commissure (AC) and schizophrenia, and to explore the role of AC connectivity in cognitive functions in first-episode schizophrenia. Methods Twenty-four patients with first-episode schizophrenia and 29 healthy controls underwent diffu-sion tensor imaging (DTI) to measure fractional anisotropy (FA). Fiber tracking was then used to reconstruct the white matter fiber connectivity of AC to examine the white matter integrity. We also analyzed the relationship between AC integ-rity and cognitive function. Results Compared to healthy controls, patients with first-episode schizophrenia had a signifi-cant reduction in mean FA of AC tracts [(0.48±0.07) vs. (0.54±0.05),P=0.002],longer completion time in trail making test(TMT)[TMT_A: (55.19 ± 19.15) vs. (36.61 ± 11.72), P<0.001;TMT_B: (88.84 ± 38.92) vs. (53.75 ± 23.41), P<0.001] and worse performance in logical memory test [immediate logical memory score:(6.12±3.85) vs. (11.69±3.68), P<0.001;delay logical memory score:(3.33±3.16) vs. (9.83±4.15), P<0.001]. In addition, there was negatively correlation of mean FA of AC tracts with TMT_A completion time (r=-0.458, P=0.037) or TMT_B completion time (r=-0.541, P=0.011) in patients with schizophrenia, but not in controls. Conclusion This study supports the disconnection hypothesis of schizo-phrenia. The deficit of AC microstructure integrity may be partly responsible for impaired executive functions in schizo-phrenia, suggesting that the integrity of white matter fiber is an important endophenotype of schizophrenia.

Objective To explore the functioning and disability and individualized rehabilitation strategies for children with cerebral pal-sy using ICF-CY. Methods ICF-CY core set for children with cerebral palsy was used, and literatures of functioning and disability (motor function) and physical activity and exercise rehabilitation for children with cerebral palsy were reviewed systematically. Based on the theo-retical framework of ICF-CY and the theories of children's development, the rehabilitation strategies for children with cerebral palsy were discussed. Results The main functioning and disability for children with cerebral palsy were impairment of brain structure and nerve system-and motor function at body level;activity limitation and participation restriction in cognition, mobility and self-care, and restriction in partic-ipation in games, leisure and educational activities at individual level and related environmental factors. The rehabilitation strategies of chil-dren with cerebral palsy should be based on the physical structure and function, activities and participation, as well as environmental factors, to develop programs that met the characteristics of the individual. Conclusion The characteristics of functioning and disability for children with cerebral palsy were analyzed using ICF-CY. Individualized rehabilitation strategies should be developed to promote the overall develop-ments for children with cerebral palsy.

OBJECTIVETo investigate the difference of the antigenicity of xenogenic acellular dermal matrix (ADM) implants prepared by different methods.

METHODSThe split-thickness skin sheet from swine was processed by trypsin and Triton X-100 to make xeno-ADM. Twenty-five Japanese white rabbits were divided into 5 groups, i.e. xeno-ADM(1) (conjugated with glutaraldehyde), xeno-ADM(2) (conjugated with network) and xeno-ADM(3) (no conjugation, as control), in which the ADMs were and xeno-ADM(4) (conjugated) and allo-ADM (no conjugated as control), in which the ADMs were embedded into the subcutaneous place of rabbit ear and back after that the rabbits were pre-sensitized by xeno-ADM soluble protein antigen injections. The titers of anti ADMs antibody in rabbit serum were monitored during 2 - 32 post-operative weeks and the histological changes of the embedded ADMs were observed grossly and microscopically.

RESULTSThe serum titers of anti-xeno-ADM in xeno-ADM(4) group was the highest. Whereas regardless of the sensitizing effects, the titers in all groups ranged as follows: xeno-ADM(3) > xeno-ADM(2) > xeno-ADM(1) (P < 0.05 - 0.01). About 40% serum samples in allo-ADM group exhibited positive anti-allo-ADM protein antibodies. Histologically, Evident and lasting inflammatory reaction could be found in the xeno-ADM grafting sites, which was much stronger than that in allo-ADM group. The degradation and absorption gradient of ADM was ranked as follow: xeno-ADM(3) > xeno-ADM(2) > xeno-ADM(4) > xeno-ADM(1) > Allo-ADM. Foreign body megalocytic reaction might evoke in the surrounding of conjugated ADM.

CONCLUSIONThe immunogenicity in xeno-ADM was stronger than that in allo-ADM, which could induce the host to develop immune reaction restricted by IgG. Large sheets of degenerated ADM implants could lower down the antigen-antibody reaction and ameliorate the structural destroying and degeneration absorption of ADM induced by inflammatory immune reaction.

Animals ; Antigen-Antibody Reactions ; Dermis ; immunology ; transplantation ; Male ; Rabbits ; Skin Transplantation ; Swine ; Transplantation, Heterologous

Objective To explore the current profile of drowning related high risk behaviors among the floating children inNingbo City and to identify the risk factors on these behaviors.Methods A total of 7 600 students from grade 1 -9 ineight urban migrant workers'children schools were recruited and surveyed by the questionnaires.And the logistic regressionmodel was used for the analysis of risk factors.Results In last one year,without adult supervision,the incidence rate ofdrowning related high risk behaviors was 27.53%.The results of multivariate logistic regression showed that males (OR =2.30,95%CI:1.99 ~2.65),senior grade (OR =1.23,95%CI:1.18 ~1.27),other juvenile companion on the way toschools (OR =1.26,95%CI:1.06 ~1.51),being able to swim (OR =2.09,95%CI:1.77 ~2.46)and there being theopen water around school and home (OR =1.75,95%CI:1.52 ~2.00)could increase the incidence of drowning relatedhigh risk behaviors.And higher awareness of drowning prevention (OR =0.99,95%CI:0.98 ~0.99),higher rate ofcorrect attitude (OR =0.99,95%CI:0.98 ~0.99),getting along well with schoolmates (OR =0.69,95%CI:0.51 ~0.95)and with family members (OR =0.33,95%CI:0.24 ~0.46)could reduce the incidence of drowning related highrisk behaviors.Conclusion The incidence rate of drowning related high risk behaviors was high among the floatingchildren in Ningbo City,and males,being able to swim might increase the occurrence of high risk behaviors.

As propose of organ repair stem cell therapy technology, articular cartilage cannot be repaired by itself has become one of the research hotspots, repair of articular cartilage with mesenchymal stem cells has shown obvious advantages for the treatment. The scholars have made a preliminary study on the role of mesenchymal stem cells from different sources in the repair of knee articular cartilage, and with the combination of transplantation and cartilage tissue engineering, these technologies improved the human cartilage repair effect of bone marrow, adipose, synovium, cord blood derived stem cells, which achieved good clinical curative effect. Due to the different sources, the dominant and recessive factors, each stem cell will have certain advantages and disadvantages. At present, the clinical research is still in the experimental stage, there is no definite conclusion on which kind of stem cell or technology is more suitable for human cartilage repair. This requires the validation of large-scale or combining with new processing technology clinical trials and the long-term clinical effect, it also provides for the basis for further clinical research.

Objective:To explore the training mode of continuing education for clinical engineers, and provide reference for the training of clinical engineers.Methods:A total of 31 clinical engineers were selected as the two-stage training mode combined with short-term centralized intensive basic training and standardized post professional training. Comparative analysis of assessment scores before and after training was performed, and the satisfaction of comprehensive effect and post competency improvement after training was evaluated. SPSS 19.0 was used for t-test. Results:The assessment scores after training (85.06±7.31) were significantly higher than those before (69.55±6.74) training ( P = 0.001). The comprehensive training effect of clinical engineers and the satisfaction rate of post competency improvement reached a high level, which were 70.97% (22/31) and 83.87% (26/31), respectively. Conclusion:The two-stage training mode combined with short-term centralized basic intensive training and standardized post professional training can not only effectively improve the theoretical knowledge level, practical ability and post competency of clinical engineers, but also shorten the centralized training time, which is conducive to solving the practical problems that affect the continuing education training program due to the lack of human resources of clinical engineers.