OBJECTIVETo determine the incidence and risk factors for nosocomial infection in child epilepsy.

METHODSA retrospective study was conducted among all (292 cases) hospitalized children epilepsy patients in First Affiliated Hospital of Fujian Medical University from 1996 to 2000 in Fuzhou city. With all patients with nosocomial infection as cases and all patients without nosocomial infection as controls, a case-control study on risk factors for nosocomial infection was carried out. Available data were analyzed by one-way Chi-square test and unconditional logistic multiple regression model.

RESULTSOne hundred fourteen cases of nosocomial infection were identified among 292 cases with epilepsy with an incidence of 39.0% (114/292). The one-way Chi-square test showed that nosocomial infection was significantly associated with age below 3 years (OR = 2.55, P < 0.01), length of hospitalization over 14 days (OR = 4.75, P < 0.01), low intelligence (OR = 3.13, P < 0.01), receiving antibiotic unreasonably (OR = 3.51, P < 0.01), using gastrogarage (OR = 3.12, P < 0.01), other invasive operation (OR = 1.85, P < 0.05) dyskinesia or palsy (OR = 3.51, P < 0.01), and urinary nitrogen beyond normal range (OR = 5.00, P < 0.05), etc. Unconditional logistic multiple regression analysis revealed that the length of hospitalization over 14 days (OR = 4.30, OR 95% CI: 2.48 - 7.46, P < 0.01), taking antibiotic unreasonably (OR = 2.74, OR 95% CI: 1.30 - 5.77, P < 0.01), using gastrogarage (OR = 3.04, OR 95% CI: 1.28 - 7.18, P < 0.05), and low intelligence (OR = 2.32, OR 95% CI: 1.34 - 4.01, P < 0.01) were independent risk factors for nosocomial infection. The tendency chi-square test showed that the longer stay in the hospital with more kinds of antibiotic used and more gastrogarage they used, the greater the risk of nosocomial infection was.

CONCLUSIONData suggested that occurrence of the nosocomial infection of children epilepsy patients was correlated with the length of hospitalization over 14 days, unreasonable using antibiotic, using gastrogarage and low intelligence.

Case-Control Studies ; Child ; Child, Hospitalized ; Child, Preschool ; Cross Infection ; etiology ; Epilepsy ; complications ; Female ; Humans ; Infant ; Length of Stay ; Logistic Models ; Male ; Retrospective Studies ; Risk Factors

AIMTo investigate the effect of preparation technique on in vitro release mechanism of huperzine A-PLGA microspheres.

METHODSHuperzine A-PLGA microspheres were prepared by two kinds of O/O emulsion solvent evaporation method (method A and B). In vitro release mechanism was explained by release profile, degradation rate and swelling rate of microspheres in vitro. The microspheres morphology and drug distribution within microspheres were observed in order to explain further the drug release mechanism.

RESULTSThe encapsulation efficiency of huperzine A microspheres prepared by method A and B was 47.60% and 83.50% respectively. Microspheres prepared by method A could sustain release for 35 days with nearly no initial burst release. The release profile fitted well to zero order equation and drug release mainly through degradation and diffusion mechanism. Huperzine A microspheres prepared by method B could sustain release for 21 days with some evidence of initial burst release. The release profile fitted well to the Higuchi equation and drug release was mainly through diffusion mechanism.

CONCLUSIONHuperzine A microspheres prepared by method A had more desirable release profile.

Alkaloids ; Cholinesterase Inhibitors ; chemistry ; pharmacokinetics ; Drug Compounding ; methods ; Lactic Acid ; chemistry ; Microscopy, Confocal ; Microscopy, Electron, Scanning ; Microspheres ; Particle Size ; Polyglycolic Acid ; chemistry ; Polymers ; chemistry ; Sesquiterpenes ; chemistry ; pharmacokinetics

AIMTo study the protection of casein and protamine against degradation of insulin (INS) by proteolysis enzymes and the effect of these two kinds of protein on the hypoglycemic action of INS solution and enteric-microspheres after administrated orally to rats.

METHODSHPLC was used to determine the remained INS in the solution of alpha-chymotrypsin and trypsin with or without casein or protamine; INS solution and enteric-microspheres were prepared and adiministrated orally to rats together with the absorption enhancer sodium N-[8-(2-hydroxybenzoyl) amino] caprylate (SNAC). At the same time, casein or protamine or both of these two kinds of protein were administrated together in order to study their influence on the hypoglycemic effect of INS and microspheres.

RESULTSCasein had a good protection against degradation of INS by alpha-chymotrypsin, but protamine had no protection effect. However, the degradation of INS by trypsin is concerned, the protection effect of protamine on INS was better that of casein. Both of protamine and casein can increase the hypoglycemic effect of INS solution and enteric-microspheres. Co-administrated these two kinds of protein had a better effect. In addition, co-administrated with SNAC, casein and protamine, INS enteric-microspheres had a longer and more potent hypoglycemic effect than that of the solution.

CONCLUSIONCasein and protamine can increase the stability of INS in the intestinal fluid by the mechanism of competition and combine with proteolysis enzymes, which will benefit to INS oral administration.

Administration, Oral ; Animals ; Blood Glucose ; metabolism ; Caprylates ; Caseins ; pharmacology ; Chymotrypsin ; antagonists & inhibitors ; Drug Delivery Systems ; Hypoglycemic Agents ; administration & dosage ; pharmacokinetics ; Insulin ; administration & dosage ; pharmacokinetics ; Male ; Microspheres ; Protamines ; pharmacology ; Rats ; Rats, Sprague-Dawley ; Solutions ; Trypsin ; pharmacology

The purpose of this study was to detect the minimal residual disease (MRD) in peripheral blood of newly diagnosed patients with acute myeloid leukemia (AML) on day 8 of induction chemotherapy and analyze the correlation between day 8 MRD (D8RD) and therapeutic effectiveness. 29 adult patients (13 males and 16 females, aged 16 - 75 years, median 41 years) with AML diagnosed and treated in West China Hospital from September 2009 to June 2010 were analyzed and followed up in the study. The leukemia-associated aberrant immunophenotype (LAIP) of all the patients were detected by multiparameter flow cytometry (FCM) before therapy. The level of MRD in the peripheral blood at day 8 of induction chemotherapy was detected by FCM based on the LAIP. The overall survival curve was drawn by calculation using Kaplan-Meier method using, and the comparison between different groups was carried out by Log-rank test. The results indicated that after first course therapy, the levels of peripheral D8RD in 7 out of 29 AML cases were lower than 0.01% (negative group), and that in another 22 cases were higher than 0.01% (0.08% - 55%, positive group). The sex, age, WBC, LDH, percentage of bone marrow blasts at diagnosis in these groups were not statistically different. 6 cases achieved CR (86%) in D8RD negative group, and also 6 cases achieved CR (27%) in D8RD positive group, CR rate in D8RD negative group was higher than in D8RD positive group (86% vs 27%, P < 0.05). The median follow-up of 29 cases lasted for 15 months; the 1-year overall survival rate of D8RD negative and D8RD positive groups was 100% and 39.4%, respectively (P < 0.01). It is concluded that MRD level in peripheral blood at day 8 of induction chemotherapy is an early index to predict clinical efficacy of induction therapy in AML.
Adolescent ; Adult ; Aged ; Early Diagnosis ; Female ; Flow Cytometry ; Humans ; Leukemia, Myeloid, Acute ; blood ; drug therapy ; mortality ; Male ; Middle Aged ; Neoplasm, Residual ; diagnosis ; drug therapy ; mortality ; Prognosis ; Survival Rate ; Treatment Outcome ; Young Adult

Immunophenotype is critical for diagnosing common B-cell acute lymphoblastic leukemia (common ALL) and detecting minimal residual disease. We developed a protocol to explore the immunophenotypic profiles of common ALL based on the expression levels of the antigens associated with B lymphoid development, including IL-7Rα (CD127), cytoplasmic CD79a (cCD79a), CD19, VpreB (CD179a), and sIgM, which are successive and essential for progression of B cells along their developmental pathway. Analysis of the immunophenotypes of 48 common ALL cases showed that the immunophenotypic patterns were highly heterogeneous, with the leukemic cell population differing from case to case. Through the comprehensive analysis of immunophenotypic patterns, the profiles of patient-specific composite leukemia cell populations could provide detailed information helpful for the diagnosis, therapeutic monitoring, and individualized therapies for common ALL.
Adult ; Antigens, CD19 ; metabolism ; B-Lymphocytes ; immunology ; metabolism ; CD79 Antigens ; metabolism ; Female ; Humans ; Immunoglobulin Light Chains, Surrogate ; metabolism ; Immunophenotyping ; Male ; Middle Aged ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; immunology ; pathology ; Receptors, Interleukin-7 ; metabolism

BACKGROUNDSurgical treatment of acetabular fracture has long been a challenging area in the field of orthopedic trauma. The aim of this research was to investigate the operative methods for delayed acetabular fractures and to assess the operation results.

METHODSThe operative approaches, procedures, results, and complications of the delayed acetabular fractures between 1995 and 2005 were retrospectively evaluated at Beijing Jishuitan Hospital. Quality of life was assessed for each patient with the Merle d'Aubingne and Postel fracture function rating scale and the radiological result was assessed using the Matta radiological score.

RESULTSSixty-eight cases (70 hips) were followed up with a minimal duration of five years (average of 5.8 years). Excellent functional results were observed in 10 hip joints, good results in 40, fair results in 11, and poor results in nine. The risks of poor prognosis include impact fracture or osteochondral fracture of femoral head, a time beyond 42 days from injury to operative management, and dislocation of femoral head during the injury. Some of the problems, which were observed included postoperative infection in two hips, iatrogenic sciatic nerve injury in eight hips, traumatic arthritis in 15 hips, heterotopic ossification in 17 hips, and necrosis of the femoral head in six hips.

CONCLUSIONA careful selection of operative indications for delayed acetabular fractures in combination with a proper operative approach and appropriate reduction and fixation could guarantee relatively good results.

Acetabulum ; injuries ; surgery ; Adolescent ; Adult ; Female ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Treatment Outcome

Objective To discuss the effect of further education of rehabilitation nursing based on network classroom on nurses' rehabilitation knowledge and skills in geriatric wards.Methods Network classroom for further education of rehabilitation nursing was built.And all of the 251 nurses in 15 wards of Institute of Geriatric Medicine of Guangdong Province were provided with further education for 2 months.Selfdesigned test paper for geriatric rehabilitation nursing knowledge was used to compare nurses' grasp of related knowledge and skills before and after education.Results Three out of 251 nurses did not finish the education.After further education of rehabilitation nursing through network classroom,the score of 248 nurses' general instructions,rehabilitation nursing for dysphagia,cardio-pulmonaryfunction evaluation,rehabilitation nursing for cognitive disorder,prevention for complication in bed and total score of rehabilitation knowledge was respectively (8.24±1.54),(6.12±1.87),(6.34±1.49),(7.66±1.94),(7.8 ±1.59)and(44.32±3.68),higher than (2.56±1.47),(4.23 ±1.53),(2.78 ±1.25),(4.5 ±1.87),(4.56 ±1.89),(26.31 ±3.56)before education,and the differences were statistically significant (t =4.31,2.67,3.22,3.13,2.88,3.82,respectively; P ＜0.01).The score of rehabilitation nursing for rectovesical function was (8.16 ± 1.69) after education and (7.68 ± 1.55) before education,and the difference was not statisticallysignificant (t =0.95 ;P ＞ 0.05).The score of good limb position,training of activity of daily living,training of position change,training of balance and total score of rehabilitation skills was respectively (6.26 ± 2.06),(8.19 ± 1.58),(7.89 ± 2.06),(6.18 ± 2.69) and (28.52 ± 3.58) after network classroom,higher than (2.39 ± 1.59),(5.15 ± 2.68),(4.23 ± 2.36),(1.89 ± 1.56),(13.66 ± 3.12) before education,and the differences were statistically significant (t =3.56,2.69,2.76,4.56,3.98,respectively; P ＜ 0.05).Conclusions Training of rehabilitation knowledge and skills through network classroom for nurses in geriatric wards can effectively improve their level of rehabilitation nursing.

BACKGROUNDThe N400 component of event-related potentials (ERP) has recently drawn widespread attention at home and abroad. This study was to explore the relationship between N400 changes and risperidone treatment and rehabilitation infirst-episode schizophrenia (FES).

METHODSERP component N400 was recorded by Guangzhou Runjie WJ-1 ERP instruments, in 58 FES before and 6 months, 15 months after risperidone treatment, and in 62 normal controls. The patients' syndromes were assessed by Positive and Negative Syndrome Scale (PANSS). And the stimuli are Chinese sentences with matching (congruent) or mismatching (incongruent) ending words.

RESULTSN400 latencies were prolonged, and amplitudes were decreased in Cz, Pz, Fz, C3, C4, in FES compared with in NC, before treatment. The prolonged N400 latencies and decreased amplitudes were negatively correlated with the patients' positive scale and total scale of PANSS. There are significant differences of N400 amplitudes and latencies in 6 months and 15 months follow-up after treatment. Before treatment, 6 months and 15 months after treatment, N400 latencies are 446 ± 35 ms, 440 ± 37 ms, 414 ± 31 ms (F = 9.72, P < 0.01) in incongruent situation; N400 amplitudes are 5.2 ± 4.6 μV, 5.7 ± 4.8 μV, 7.3 ± 5.0 μV (F = 2.06, P > 0.05) in congruent situation, and 8.5 ± 5.9 μV, 10.1 ± 5.0 μV, 11.9 ± 7.0 μV (F = 3.697, P < 0.05) in incongruent situation.

CONCLUSIONSN400 could be used to predict the effects of treatment of schizophrenia to some degree. The linguistic and cognitive impairment in schizophrenia can be improved by antipsychotic drugs.

Adult ; Evoked Potentials ; Follow-Up Studies ; Humans ; Middle Aged ; Risperidone ; therapeutic use ; Schizophrenia ; drug therapy ; rehabilitation

To evaluate the significance of bone marrow (BM) and peripheral blood (PB) cells with clonal gene rearrangement of the third complementary determining region of immunoglobulin heavy chain (IgHCDR3) in the diagnosis, clinical staging, determination of treatment effects and prediction of relapse in B-NHL, clonal IgH gene rearrangement of BM from 46 and PB from 38 cases with B-NHL were tested by semi-nested polymerase chain reaction (SnPCR) and polyacrylamide gel electrophoresis before treatment, and ten of them were tested in complete remission after treatment. Results showed that this method was applicable to detecting one clonal IgHCDR3 gene rearrangement positive cell from up to 1 000 normal cells. Specificity of detection was 97%. Clonal IgHCDR3 rearrangement was shown in all 3 cases of BM and 2 of PB specimens with morphologic involvement. The clonal IgHCDR3 was detected in 65.1% of the BM and 44.4% of the PB without morphologic involvement in untreated patients with B-NHL, independent of Ann Arbor staging and systemic symptoms. In 10 cases of B-NHL with clonal IgHCDR3 rearrangement in diagnostic tissues, the molecular marker became negative in 7 patients who entered and remained in complete remission. Two cases relapsed in whom clonal IgHCDR3 rearrangements were detected in serial samples of BM or PB after autologous PBSCT. One patient in whom clonal IgHCDR3 rearrangement was detected at 10 months post-PBSCT remained in complete remission up to now. It was concluded that clonal IgHCDR3 gene rearrangements were found in BM and PB from B-NHL patients without morphologic abnormality. Persistence of molecular marker-positive may be associated with relapse for patients in complete remission, and the patients without clonal IgHCDR3 rearrangement will be in continuous complete remission. Little is known about a few patient who was a long-term disease-free survivor despite the presence of PCR-IgH rearrangement in the marrow.

The cases of feeling comfort during acupuncture and moxibustion treatment in literature were summarized and its biological basis was explored. A simple classification of comfort was made, and the importance of obtaining comfort in acupuncture treatment was pointed out. Considering the pursuit of less pain and harmlessness in modern clinical treatment, sugar needle should be advocated and popularized in current clinical practice of acupuncture and moxibustion.
Sugars ; Moxibustion ; Acupuncture Therapy ; Emotions ; Needles