Adult ; Aged ; Aged, 80 and over ; Brain Injuries ; surgery ; Dilatation ; methods ; Female ; Humans ; Intensive Care Units ; Male ; Middle Aged ; Tracheostomy ; methods

Objective To evaluate risk factors for central venous catheter-related bloodstream infection(CRBSI)in intensive care unit(ICU)patients by Meta analysis. Methods Literatures about risk factors of CRBSI in ICU pa-tients were retrieved from databases of Cochrane Library,PubMed,Embase,CBM,CNKI,and WanFang Data,RevMan 5.3 software was used for Meta analysis.Results There are 12 literatures in accordance with the inclusion criteria,with a total sample size of 14 422 cases,5 cohort studies and 7 case-control studies,the Newcastle-Ottawa Scale(NOS)scores were 4-6 points. According to Meta analysis,duration of indwelling catheter(WMD,12.25 [95%CI,5.55-18.94]),multi-cavity catheter(OR,3.52[95% CI,1.46-8.52]),femoral vein catheterization (OR,2.44[95%CI,1.34-4.46]),parenteral nutrition(O R,2.47[95% CI,1.18-5.21]),length of stay in ICU(WMD,10.01[95%CI,4.17-15.85]),APACHE II score(WMD,4.46[95%CI,1.25-7.66]),and dia-betes mellitus(OR,1.83[95% CI,1.08-3.09])were significantly different in each group(all P<0.05). Conclusion Risk factors for CRBSI in ICU patients are duration of indwelling catheter,multi-cavity catheter,femo-ral vein catheterization,parenteral nutrition,length of stay in ICU,APACHE II score,and diabetes mellitus. However,due to the limitation of methodological quality of included studies,more strictly designed and large sam-ple prospective studies are needed to verify the result.

Objective To observe the CT findings of hypoplasia of cochlear nerve foramen. Methods CT findings of cochlear nerve foramen were observed in 50 volunteers (100 ears)and in 9 cases with hypoplasia of cochlear nerve foramen.The width of the bony canal for the cochlear nerve were measured in both groups.Results The fissure in the cribriform area were seen in every volunteers.The width of the bony canal for the cochlear nerve was (2.32?0.25)mm in normal group.The stenosis of cochlear nerve foramen were shown in 9 cases (10 ears),the lacking of fissure in the cribriform area were seen in 8 ears, while the fissure were shown in 2 cases.The stenosis of internal auditory canal was shown in 4 cases. Abnormality of vestibule and horizontal semicircular canal was shown in one case.The maximum value of the width of the bony canal for the cochlear nerve was 1.5mm,the minimum value was 0.9 mm.Conclusions The typical CT findings of hypoplasia of cochlear nerve foramen were stenosis of cochlear nerve foramen,the lacking of fissure in the cribriform area and cochlear nerve foramen without helix shape.The hypoplasia of cochlear nerve foramen may be a subtype of cochlear dysplasia.

Objective To study the effect and safety of conversion from calcineurin inhibitors to rapamycin in kidney transplantation recipients with chronic allograft nephropathy.Methods In 82 kidney transplant recipients enrolled in this study,72 cases were diagnosed as having chronic allograft nephropathy by biopsy.Recipients (SRL group) were administered with rapamycin after withdrawal of calcineurin inhibitors.The doses of CNI in other recipients (non-SRL group) were not changed.Renal function,proteinuria,blood pressure,blood fat,hepatic function and hemogram were observed for 24 months in each group.Results During the follow-up period,serum creatinine level was dropped significantly in SRL group (P＜0.05),but it was increased in non-SRL group (P＜0.05).SRL group showed increased proteinuria,serum cholesterol and triglycerides (P＜0.05),and reduced Plt (P＜0.05).According to the renal function before conversion,the recipients who were administered rapamycin divided into four groups.In group A (Scr ＜ 120 μmol/L),there was no significant difference in diverse variables before and after conversion.In group B (Scr 120-200 μmol/L and Banff Ⅰ-Ⅱ),renal function was improved,and proteinuria alleviated.In group C (Scr 120-200 μmol/L and Banff ＞ Ⅱ),and group D (Scr ＞200 μmol/L),renal function was damaged to varying degrees and proteinuria was deteriorated.Conclusion It is safe and effective for patients with chronic allograft nephropathy to convert from calcineurin inhibitors to rapamycin.

BackgroundReactive oxygen intermediate products lead to the oxidative injury of cells.Retinal pigment epithelial(RPE) cells produce lots of reactive oxygen intermediate products during the swallow of out disc,but how this procedure cause the persistent oxidative injury of RPE cells is poorly understood.Objective The present study was to evaluate the effect of non-lethal H2 O2 -induced persistent oxidative injury on RPE barrier in vitro.MethodsARPE-19 cell links were inoculated on 96 well plate at the density of 8×104 cells/L and the cell climbing slice of 24 well at the density of 4× 104 cells/L.The cells were cultured in DMEM/F12 medium,and the cells cultured for 24 hours in free-serum medium were used in the experiment.0-0.6 mmol/L of H2O2 were added into the medium.Cellular viability was assessed using 3- ( 4,5-dimethylthiazol-2-yl ) -5- ( 3-carboxymethoxyphenyl ) -2- ( 4-sulfophenyl ) 2H-tetrazolium(MTS) assays.Transepithelial electrical resistance (TER) was used to detect cell monolayer forming time after cultureinTrsnswellchamber.Thepermeabilityof cellmonolayer was examinedbyrhodamine isothiocyanate-dextran transepithelial flux,and immunofluorescence was used to investigate the distribution of the junction protein zonula occludens (ZO-1).ResultsThe total difference was found in the cell vitality(A490) among the different concentrations of H2 O2 ( F =991.501,P =0.000 ).Compared with 0 mmoL/L H2 O2 group,the A490 values was gradually lowed from 0.20 mmol/L H2O2 group to 0.60 mmol/L H2O2 group (P ＜ 0.05 ).H2O2 at the concentrations of ＞0.20 mmol/L lowed the viability of RPE cells.The TER value was ( 24.9 ± 1.3 ) Ω · cm2 in 11 days,( 17.8± 1.4)Ω · cm2 in 7 days after inoculation on transwell chamber,showing a significant difference between them (t=5.228,P=0.014).RPE formed the stable tight junction on day 15 with the TER value (25.9±0.9 ) Ω · cm2.The leakage amount ( relative fluorescence intensity ) of the dextran was 255.39 ± 16.44 in non-H2 O2 control group,exhibiting a significant lowing in comparison with free-cell blank group (433.08±51.53)( t =12.515,P =0.006 ),and that of H2 O2 group was significant increased in comparison with non-H2 O2 control group ( t =14.412,P=0.005).Immunofluyorescence assay showed intact intercellular ZO-1 junction in non-H2O2 control group,but the breakage of ZO-1 junction was seen in H2O2 group.ConclusionsThe results indicate that non-lethal H2O2 can destroy RPE barrier and further lead to the persistent oxidative injury of RPE cells.

A method for the determination of three volatile elements (mercury, arsenic and selenium) in soils by one-time digestion was established.The digestion of samples was carried out in an automatic program temperature controlled graphite digestion instrument by aqua regia + hydrofluoric acid+boric acid.Hydride generation atomic fluorescence spectrometry (HG-AFS) was used to determine the contents of mercury, arsenic and selenium in the same digestion solution.The accuracy of the method was verified by the results of the soil environment samples of certified reference materials GSS-1-GSS-8 from the Center of the National Standard.The contents of soil mercury, arsenic and selenium obtained by this method were consistent with the standard values of these elements provided by the Center of the National Standard.In comparison with the current standard methods, the one-time digestion method was simplified, the pre-processing time was saved, and the reagent consumption was reduced.The method had wide range of application, high sensitivity, low detection limit, which was especially suitable for trace analysis of bulk samples, and also it could be used as a rapid digestion method for the measurement and governance of heavy metals in polluted soils.

Objective To explore the temporal and spatial expression pattern of tenascin-c(tnc) and tenascin-w(tnw) in zebrafish early development,to further explore the role of tenacsin in zebrafish embryo development,and the association between them.Methods Zebrafish embryos at 2 hours post fertilization(hpf),4 hpt,8 hpt,10 hpf,24 hpt,48 hpr,72 hpf and 7 days post fertilization(dpf) were collected to extract RNA for reverse transcription-polymerase chain reaction(RT-PCR) and fix the embryos at different stages for in situ hybridization.Temporal and spatial expression pattern of tnc and tnw on different stages of zebrafish early development was observed.Results tnc and tnw all expressed in zebrafish from 24 hpf to 7 dpf,but did not expressed from 2 hpf to 10 hpf.Tnc expressed at pharyngeal arch,notochord,somite in 24 hpf,then weakly expressed at somite,but highly expressed at otic vesicle,pectoral fin and hindbrain in 48 hpf,and tnc was expressed at hindbrain,pharyngeal and notochord and disappeared at somite and pectoral.tnw expressed at hindbrain,midbrain and otic vesicle in 24 hpf,expressed at somite,notochord,hindbrain,otic vesicle and pharyngeal in 48 hpf.In 72 hpf,tnw expressed weakly at somite and notochord.Conclusions Zebrafish tnc and tnw have special temporal and spatial expression pattern,and share partial overlapping expression pattern.

Objective To explore the expression pattern of tenascin-c(tnc)gene in zebrafish embryo abnormal development which was induced by ethanol,and to further understand the function of tnc gene in embryo develepment.Methods Zebrafish were treated with ethanol at different concentration from 100 to 500 mmol/L,and embryos at 24 and 48 hours were collected and fixed,then tnc expression pattern was observed by in situ hybridization and reverse transcriptase-polymerase chain reaction(RT-PCR).Results The result of RT-PCR showed that ethanol at 100 and 200 mmol/L could increase the expression of tnc,while the result of in situ hybridization showed that,while ethanol at 300 mmol/L and above decrease the expression of tnc in presumptive position at 24 hours,and ethanol at 100 mmol/L and above caused increase expression of tnc in zebrafish heart.Conclusions tnc is increased when treated with 100 and 200 mmol/L ethanol and is presented in the abnormal development of hearts of zebrafish,which can promote the normal development of embryos in some degrees.The expression pattern of tnc in pathologic state is highly conserved in all vertebrate,and in adult and embryos as well.

Objective To analyze the relationship between the genetic polymorphisms of uridinediphosphate glucuronosyltransferase 1A9 (UGT1A9) and mycophenolic acid (MPA)pharmacokinetics in Chinese kidney recipients.Methods Gene mutations (C-440T/T-331C,C-2152T,T-275A,T98C) were detected in 196 recipients by PCR-LDR.On the 28th day after transplantation,the plasma samples which were obtained at the time points of predose,0.5 h and 2 h after administration were measured by an immunoassay method (Emit Mycophenolic Acid Assay,Dade Behring).MPA-AUC0-12 was calculated based on these three data.Correlation between single nucleotide polymorphisms (SNPs) and MPA pharmacokinetics was analyzed.Results C-2152T,T-275A and T98C genotypes of UGT1A9 were not found in 196 recipients.The frequency of C-440T/T-331C gene mutation was 14.29% (28/196).The mean value of MPA-AUC0-12 was 40.6±11.8 wild genotype,respectively (P＞0.05).Conclusion C-2152T,T-275A and T98C genotypes of UGT1A9 are scarce in Chinese kidney recipients.In this study,there is no distinct relationship between -440/-331 SNPs and MPA pharmacokinetics in Chinese allograft recipients.

OBJECTIVETo evaluate the outcome of Titanium elastic intramedullary nailing (TEN) for the treatment of displaced midclavicular fractures.

METHODSBetween February 2010 and February 2013, 62 patients with displaced midclavicular fractures were treated by TEN, including 27 males and 35 females with an average age of 37.6 years old ranging from 15 to 67 years. The course of disease was from 1 to 9 days (means 2.7 days). Thirty-nine cases were treated by closed reduction and 23 cases by assistant small incision. Based on OTA (the Orthopaedic Trauma Association classification) classification, 31 cases of simple fractures involved 5 cases of 06-A1,15 cases of 06-A2,11 cases of 06-A3; 31 cases of wedge fractures involved 4 cases of 06-B1,12 cases of 06-B2,15 cases of 06-B3. Postoperative pain relief were evaluated by VAS score,and operation time,fracture healing time were recorded. After 6 weeks and after removing internal fixation shoulder joint function was evaluated by Constant score, and shoulder joint function were assessed by Herscovici score after 6 weeks.

RESULTSExcept 2 cases were lost to follow-up, 2 cases did not remove internal fixation, 3 cases' fractures were nonunion, the remaining 55 patients received follow-up for an average time of 11.4 months. The average preoperative VAS score was 5.20±0.71, and it turned to be 1.550.59 at 3 days after operation. The average operative duration was 40 min (15 to 65 min). The average bone healing time was (2.71±0.54) months (2 to 5 months). No difference about bone healing time was found between simple fractures and wedge fractures,and between the patients treated by closed reduction and assistant small incision. According to Herscovici standard, the shoulder function was excellent in 49 cases, good in 4, fair in 1, and poor in 1. Simple fractures achieved better Constant score than wedge fractures at 6 weeks postoperatively, whereas no difference was found at 4 weeks after fixation removal.

CONCLUSIONTitanium elastic nails (TEN) for treatment of displaced midclavicular fractures has advantages of good clinical effect,rapid pain relief,fast recovery of shoulder joint function. For OTA classification type B patients with comminuted fracture can replace steel to achieve very good effect, but to grasp the appropriate.

Adolescent ; Adult ; Clavicle ; injuries ; surgery ; Female ; Fracture Fixation, Intramedullary ; methods ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged