Objective To screen the prevalence of nutritional risk in cirrhotic inpatients by Nutritional Risk Screening 2002 (NRS 2002) and explore the relationship between nutritional risks and outcomes.Methods NRS 2002 was used to identify the nutritional risk of 200 cirrhotic inpatients between May 2010 and May 2011.The Child-Turcotte-Pugh (CTP) grade,fatality,complications,and length of stay within 6 months were followed up to explore the relationship between nutritional risks and outcomes.Results The prevalence of nutritional risk screened by NRS 2002 was 53.5％ in cirrhotic patients.The prevalence of nutritional risk was 39.0％,59.4％,and 60.0％ respectively in patients with CTP grade A,B,and C (P =0.029).Compared with those without nutritional risks,patients with nutritional risks had significantly higher incidences of complications and fatality (P =0.000 and 0.013) and longer hospital stay (P =0.001).Conclusion The nutritional risk increases along with the CTP grade.Patients with nutritional risks tend to have poorer outcomes.The influence of nutrition support on the outcome of patients with liver diseases needs further research.

OBJECTIVETo apply the classic leakage integrate-and-fire models, based on the mechanism of the generation of physiological auditory stimulation, in the information processing coding of cochlear implants to improve the auditory result.

METHODSThe results of algorithm simulation in digital signal processor (DSP) were imported into Matlab for a comparative analysis.

RESULTSCompared with CIS coding, the algorithm of membrane potential integrate-and-fire (MPIF) allowed more natural pulse discharge in a pseudo-random manner to better fit the physiological structures.

CONCLUSIONThe MPIF algorithm can effectively solve the problem of the dynamic structure of the delivered auditory information sequence issued in the auditory center and allowed integration of the stimulating pulses and time coding to ensure the coherence and relevance of the stimulating pulse time.

Acoustic Stimulation ; Algorithms ; Cochlear Implantation ; Cochlear Implants ; Humans ; Membrane Potentials ; Models, Theoretical ; Signal Processing, Computer-Assisted ; Speech Discrimination Tests

OBJECTIVETo assess the efficacy and safety of modified ligation of the intersphincteric fistula tract for simple transsphincteric perianal fistula.

METHODSSeventy patients with simple transsphincteric perianal fistula between October 2012 and January 2014 in our department were prospectively enrolled. According to the random number table, patients were divided into two groups: modified-LIFT group (37 cases, from the external opening close to the fistula, dissect the external sphincter fistula to the intersphincteric groove by tunneling technique, resect the lateral free fistula) and LIFT group (33 cases). Clinical parametres before and after operation were compared, and results of pelvic electromyogram (EMG) and anorectal manometry three months after operation were analyzed to evaluated anal function.

RESULTSThe operative time, pain score, hospital stay, and healing time were not significantly different between the two groups (all P>0.05). During the median follow-up of 12 months (3-20 months), the healing rate in modified-LIFT group was 83.8% (31/37), which was significantly higher than 60% (20/33) in LIFT group (P=0.029). After operation, 4 patients had persistent unhealed wound, 2 recurred in modified-LIFT group, while 8 patients had persistent unhealed wound, and 5 recurred in LIFT group. No patients developed anal incontinence. By the pelvic EMG and anorectal manometry 3 months after operation, the duration of motor unit potential, occurrence of simple phase, mean resting pressure and maximun squeeze pressure were not significantly different.

CONCLUSIONModified-LIFT procedure for the management of simple transsphincteric perianal fistulas is a simple and effective operation with higher healing rate and similar anal function as LIFT.

Anus Diseases ; surgery ; Humans ; Ligation ; Operative Time ; Pelvis ; Pressure ; Rectal Fistula ; surgery ; Recurrence ; Treatment Outcome ; Wound Healing

OBJECTIVETo investigate the development of the electrophysiological property of bushy cells in the anterior ventral cochlear nucleus (AVCN) of neonatal Sprague Dawley (SD) rats.

METHODSThe development of action potential and spontaneous miniature excitatory postsynaptic currents (mEPSCs) in AVCN bushy cells were investigated by whole-cell patch-clamp technique in SD rats during the postnatal days 5-21 (P5-21). The half band width of the action potential (AP), 10%-90% risetime and decay tau of the mEPSCs were analyzed.

RESULTSThe AP of the bushy cells became faster with age from P5 to P21 and stopped changing around the period of hearing onset, as evidenced by the alteration of half band width of the AP. The time accuracy of mEPSCs of the bushy cells also increased with age and stabilized around hearing onset as shown by briefer 10%-90% rise time and decay tau of mEPSCs in P14/P21 than in P7.

CONCLUSIONThe functional refinement of the bushy cells in the AVCN precedes hearing onset in neonatal rats.

Action Potentials ; Animals ; Cochlear Nucleus ; cytology ; Excitatory Postsynaptic Potentials ; Hearing ; Neurons ; cytology ; Patch-Clamp Techniques ; Rats ; Rats, Sprague-Dawley ; Synapses

Objective To investigate the development of the electrophysiological property of bushy cells in the anterior ventral cochlear nucleus (AVCN) of neonatal Sprague Dawley (SD) rats. Methods The development of action potential and spontaneous miniature excitatory postsynaptic currents (mEPSCs) in AVCN bushy cells were investigated by whole-cell patch-clamp technique in SD rats during the postnatal days 5-21 (P5-21). The half band width of the action potential (AP), 10%-90%risetime and decay tau of the mEPSCs were analyzed. Results The AP of the bushy cells became faster with age from P5 to P21 and stopped changing around the period of hearing onset, as evidenced by the alteration of half band width of the AP. The time accuracy of mEPSCs of the bushy cells also increased with age and stabilized around hearing onset as shown by briefer 10%-90%rise time and decay tau of mEPSCs in P14/P21 than in P7. Conclusion The functional refinement of the bushy cells in the AVCN precedes hearing onset in neonatal rats.

Objective To investigate the development of the electrophysiological property of bushy cells in the anterior ventral cochlear nucleus (AVCN) of neonatal Sprague Dawley (SD) rats. Methods The development of action potential and spontaneous miniature excitatory postsynaptic currents (mEPSCs) in AVCN bushy cells were investigated by whole-cell patch-clamp technique in SD rats during the postnatal days 5-21 (P5-21). The half band width of the action potential (AP), 10%-90%risetime and decay tau of the mEPSCs were analyzed. Results The AP of the bushy cells became faster with age from P5 to P21 and stopped changing around the period of hearing onset, as evidenced by the alteration of half band width of the AP. The time accuracy of mEPSCs of the bushy cells also increased with age and stabilized around hearing onset as shown by briefer 10%-90%rise time and decay tau of mEPSCs in P14/P21 than in P7. Conclusion The functional refinement of the bushy cells in the AVCN precedes hearing onset in neonatal rats.

Objective To investigate the antimicrobial resistance of clinical strains of K lebsiella spp .isolated from 15 hospitals in China CHINET during 2012 .Methods Kirby-Bauer method and automatic microbiology analysis system were employed to study the antimicrobial resistance . WHONET 5 .6 software was applied for data analysis according to Clinical and Laboratory Standards Institute (CLSI) 2012 breakpoints .Results A total of 9 621 clinical K lebsiella isolates were analyzed ,including 8 772 strains of K . pneumoniae and 804 strains of K . oxytoca . About 54 .9% (5 285/9 621) of the K lebsiella strains were isolated from sputum ,and 16 .3% (1 564/9 621) were isolated from pediatric patients .Antimicrobial susceptibility testing showed that about 8 .9% ,10 .8% and 12 .9% of the strains were resistant to imipenem ,meropenem and ertapenem ,respectively .About 14 .1% and 17 .0% of the strains were resistant to piperacillin-tazobactam and cefoperazone-sulbactam , respectively . Carbapenem-resistant K lebsiella strains were identified from all the 15 hospitals ,including 945 strains of K .pneumoniae and 45 strains of K .oxytoca ,which were resistant to either imipenem ,meropenem or ertapenem .Conclusions The Klebsiella isolates collected from 15 hospitals in China during 2012 are relatively sensitive to carbapenems ,cefoperazone-sulbactam and piperacillin-tazobactam .The prevalence of carbapenem-resistant strains is still increasing in China ,about 10 .3% in 2012 ,and relatively higher in Eastern China .More efforts should be made to control the superbug .

Objective To investigate the resistance of clinical Stenotrophomonas maltophilia isolates from 15 hospitals in several regions of China during 2011.Methods Fifteen repre-sentative general hospitals were involved in this program. Bacterial susceptibility testing was carried out by means of a unified protocol using Kirby-Bauer method and MIC determi-nation.Results were analyzed according to CLSI 2011 break-points.Results Majority (93.3%) of the 1 889 clinical strains of S.maltophilia were isolated from inpatients.On-ly 6.7% of the isolates were from outpatients.About 62.9% of these S .maltophilia strains were isolated from old patients whose age was 60 years or older.Only 8.2% of the strains were from the patients younger than 18 years old.Sputum and re-spiratory tract secretion were the most common specimen source,accounting for 82.6%.Another 4.2% isolates were from blood,abdominal fluid and other sterile body fluids.The percentage of the S .maltophilia strain resistant to trimethoprim-sul-famethoxazole,levofloxacin and minocycline was 16.6%,10.0% and 1.8%,respectively.The strains resistant to cefopera-zone-sulbactam accounted for 19.0%.About 37.1% of the strains isolated from blood or sterile body fluids were resistant to trimethoprim-sulfamethoxazole,significantly higher than the strains from urine or wound specimens (P < 0.01).Conclusions S.maltophilia strains are mainly isolated from inpatients.The most common source is sputum and other respiratory speci-mens.Most of the patients with S.maltophilia isolate are 60 years of age or older.The S.maltophilia strains are constitu-tively resistant to several antibacterial agents,but showed relatively lower resistance to trimethoprim-sulfamethoxazole,levo-floxacin and minocycline.Cefoperazone-sulbactam is still active against these strains.The antimicrobial therapy targeting S. maltophilia infections should be selected cautiously according to the results of antimicrobial resistance surveillance.

Objective To assess the efficacy and safety of modified ligation of the intersphincteric fistula tract for simple transsphincteric perianal fistula. Methods Seventy patients with simple transsphincteric perianal fistula between October 2012 and January 2014 in our department were prospectively enrolled. According to the random number table , patients were divided into two groups:modified-LIFT group (37 cases, from the external opening close to the fistula, dissect the external sphincter fistula to the intersphincteric groove by tunneling technique, resect the lateral free fistula) and LIFT group (33 cases). Clinical parametres before and after operation were compared, and results of pelvic electromyogram (EMG) and anorectal manometry three months after operation were analyzed to evaluated anal function. Results The operative time, pain score, hospital stay, and healing time were not significantly different between the two groups (all P>0.05). During the median follow-up of 12 months ( 3-20 months ) , the healing rate in modified-LIFT group was 83 . 8%( 31/37 ) , which was significantly higher than 60%(20/33) in LIFT group (P=0.029). After operation, 4 patients had persistent unhealed wound, 2 recurred in modified-LIFT group, while 8 patients had persistent unhealed wound, and 5 recurred in LIFT group. No patients developed anal incontinence. By the pelvic EMG and anorectal manometry 3 months after operation, the duration of motor unit potential, occurrence of simple phase, mean resting pressure and maximun squeeze pressure were not significantly different. Conclusion Modified-LIFT procedure for the management of simple transsphincteric perianal fistulas is a simple and effective operation with higher healing rate and similar anal function as LIFT.

Objective To assess the efficacy and safety of modified ligation of the intersphincteric fistula tract for simple transsphincteric perianal fistula. Methods Seventy patients with simple transsphincteric perianal fistula between October 2012 and January 2014 in our department were prospectively enrolled. According to the random number table , patients were divided into two groups:modified-LIFT group (37 cases, from the external opening close to the fistula, dissect the external sphincter fistula to the intersphincteric groove by tunneling technique, resect the lateral free fistula) and LIFT group (33 cases). Clinical parametres before and after operation were compared, and results of pelvic electromyogram (EMG) and anorectal manometry three months after operation were analyzed to evaluated anal function. Results The operative time, pain score, hospital stay, and healing time were not significantly different between the two groups (all P>0.05). During the median follow-up of 12 months ( 3-20 months ) , the healing rate in modified-LIFT group was 83 . 8%( 31/37 ) , which was significantly higher than 60%(20/33) in LIFT group (P=0.029). After operation, 4 patients had persistent unhealed wound, 2 recurred in modified-LIFT group, while 8 patients had persistent unhealed wound, and 5 recurred in LIFT group. No patients developed anal incontinence. By the pelvic EMG and anorectal manometry 3 months after operation, the duration of motor unit potential, occurrence of simple phase, mean resting pressure and maximun squeeze pressure were not significantly different. Conclusion Modified-LIFT procedure for the management of simple transsphincteric perianal fistulas is a simple and effective operation with higher healing rate and similar anal function as LIFT.