OBJECTIVE:To investigate the application of antibiotics in 2009 so as to provide reference for rational use of antibiotics in our hospital. METHODS:3 500 cases were randomly collected from our hospital in 2009 for statistical analysis of antibacterials application. RESULTS:Of 3 500 cases,2 580 cases involve antibacterials,accounting for 73.7%. Prophylactic application of antibiotics accounted for 39.6% and therapeutic application accounted for 60.4%. CONCLUSION:The application of antibacterials was improved to some extent and bacteria examination rate was increased significantly. However,there were still many problems,such as the abuse of antibacterials,unreasonable combination of antibacterials,low rate of bacterial detection.

Objective To improve the operative outcome of parasagittal meningiomas in central area. Methods Twenty patients with parasagittal meningiomas were treated with microsurgery. Of them, 16 cases were taken DSA exzamination before operation to evaluate the blood supplies of the tumor, compensation of venus return around the tumor after obstruction of the sagittal sinus. During the operation, the parasagittal blood supplies were blocked first, the tumors were resected piece by piece. Rolandic veins, other compensative venous pathways and normal brains around the tumors were protected, and the involved sagittal sinuses were appropriately treated. Results Total removal of the tumor was reached in 17 cases, nearly total removal in 3 cases, no death. Postoperatively, 1 patient developed hemiparesis, 2 had paresis of both lower extremities. No tumor recurrence was found in 13 patients during the follow-up of 3～7 years. Conclusion Using microsurgical techniques in the resection of parasagittal meningioma in central area may improve the percentage of total tumor resection, decrease the injuries of important functional area of the brain, reduce complications and improve survival outcome.

Objective To investigate the changes of serum soluble factor-related apoptosis (sFas) and soluble Fas ligand (sFasL) and their relations with cognition disorders in the patients with vascular dementia (VaD). Methods Serum concentrations of sFas and sFasl were detected by enzyme-linked immunosorbent assay (ELISA) and compared between 70 patients with VaD aged (72.5± 7.5)years and 50 healthy elderly people aged(72.5 ± 7.5)years.The VaD patient's cognitive functions were evaluated by activity of daily living scale (ADL),mini mental state examination (MMSE) and hachinski ischemia score (Hachinski). Results The serum levels of sFas and sFasL in VaD patients were (228.0±60.7)μg/L and (146.8±30.1)μg/L,and in the healthy elderly were (62.4±22.6)μg/L and (82.3 ± 18.7)μg/L,respectively.The serum levels of apoptosis factors in VaD patients were significantly higher than in the healthy controls (t=20.883,14.453,P＜0.01).sFas level was negatively correlated with age,the scores of ADL and Hachiuski while positively with the scores of MMSE (r=-0.956,-0.943,-0.950 and 0.904,all P＜0.01). sFasL level was negatively correlated with the scores of MMSE while positively with age,the scores of ADL and Hachinski (r=-0.899,0.963,0.948 and 0.939,a11 P＜0.01). Conclusions Apoptosis may be involved in the pathological change during VaD and the serum levels of sFas and sFasL might be related with cognition disorders.

Due to its great clinical significance, brain injury following cardiac arrest (CA) has attracted more attention now. Meanwhile, there are currently no approved real time objective methods used to monitor brain injury following CA. In this study, we adopt the method of nonextensive Kullback-Leibler Entropy in investigating the HRV signals from brain injury and compare the result with that of corresponding EEG analysis. The comparative analysis shows that Kullback-Leibler Entropy can reveal the injury level of brain following CA. And we propose a novel quantitative approach for monitoring brain injury.
Algorithms ; Brain ; pathology ; physiopathology ; Brain Ischemia ; physiopathology ; Electroencephalography ; Heart Arrest ; complications ; Heart Rate ; physiology ; Humans

OBJECTIVETo summarize the experience in applying acupunctural anesthesia (AA) with new combination principle (NCP) of acupoints in supratentorial craniocerebral operation of tumor in functional area or deep site of brain.

METHODSWith the acupoints selection of AA changed from the previous combination principle of near segmental and peri-operational region to the NCP of near-remote along corresponding meridian, craniotomy was carried out under AA in 23 patients.

RESULTSOperation was performed successfully in all the patients, 82.6% of them with the effectiveness reaching I A grade. In those operated on the vital functional area, such as central anterior/posterior gyrus and language center, the accidental functional injury could be well prevented.

CONCLUSIONAA with NCP of acupoints has satisfactory effect in supratentorial craniocerebral operation of functional area or deep site of brain, it is especially valuable in monitoring the effect of operation on function of around normal cerebral area to avoid accident injury.

Acupuncture Analgesia ; methods ; Acupuncture Points ; Adolescent ; Adult ; Electroacupuncture ; Female ; Glioma ; surgery ; Humans ; Male ; Middle Aged ; Supratentorial Neoplasms ; surgery

Objective To investigate the expressions and clinical significance of Toll like receptor (TLR) 3 and TLR4 in peripheral blood mononuclear cells and renal tissues of children with primary IgA nephropathy.Methods A total of 34 children with primary IgA nephropathy were selected as the IgA nephropathy group,who were confirmed by renal biopsy,from the Department of Pediatrics,the First Affiliated Hospital of Xinxiang Medical University,from September 2014 to June 2016.In the same period,7 cases of renal tumor who underwent nephrectomy in Pediatric Surgery became control group A,and 10 cases of healthy children became control group B,and the expressions of TLR3 and TLR4 in renal tissue were detected by adopting immunohistochemistry between IgA nephropathy group and control group A,and the positive expression rate of TLR3 and TLR4 in peripheral blood mononuclear cells were detected by using flow cytometry in IgA nephropathy group.The expression of TLR3 and TLR4 in peripheral blood mononuclear cells of IgA nephropathy group and control group B were observed and compared.Results The expressions of TLR3 and TLR4 in renal tissue of IgA nephropathy group were respectively (68.28 ±6.37)％ and 0.048 ±0.018,which were significantly higher than TLR3 [(9.69 ±11.02)％] and TLR4 (0.003 ±0.001) in the control group A,and the differences were statistically significant (t =50.080,14.374,all P ＜ 0.01).The positive expressions of TLR3 and TLR4 in peripheral blood mononuclear cells of IgA nephropathy group were respectively (17.62 ± 8.33)％ and (23.85 ± 11.82)％,while the expressions were (0.31 ± 0.06) ％ and (3.02 ± 0.09) ％ respectively in the control group B,and the differences were statistically significant (t =12.109,11.612,all P ＜ 0.05).Conclusion The expressions of TLR3 and TLR4 in renal tissue and peripheral blood mononuclear cells of IgA nephropathy are increased,suggesting that the abnormal activation of TLR3 and TLR4 may be involved in the pathogenesis of IgA nephropathy.

Objective: To explore the research focus on Chinese medicine intervene stem cells in the treatment of ischemic heart disease and provide reference for the future research in this field by retrieving, co-occurrence analyzing and cluster analyzing of quantitative analysis the related literature. Methods: The literatures related to this study were retrieved from the China Knowledge Resource Integrated Database (CNKI) and PubMed database. The high frequency words were cooccurrence analyzing and cluster analyzing by bibliographic item co-occurrence matrix builder (BICOMB) software, Cytoscape3.6.1 drawing software and SPSS statistical analysis software. Results: In CNKI, there were 116 literatures published and 43 high frequency words (frequency＞ 3 times), and it had 226 co-occurrence relation among high frequency words. The high-frequency words were clustered into 7 categories. In PubMed, there were 44 literature published and 35 high frequency words (frequency＞3 times), and it had 355 co-occurrence relation among high frequency words. The high-frequency words are clustered into 8 categories. Conclusion: The research of Chinese medicine intervene stem cells in the treatment of ischemic heart disease was more and more popular in the world after2005. The hot researches on traditional Chinese medicine are 6 aspects of Chinese herbal medicine, Yiqi Wengyang Huoxue Formula, Panax notoginseng, Rehmannia glutinosa oligosaccharides, Danshen injection and Radix Salviae Miltiorrhizae.

Objective:To construct and verify the nomogram prediction model based on inflammatory indicators, underlying diseases, etiology and the British Thoracic Society modified pneumonia score (CURB-65 score) in adults with severe community acquired pneumonia (CAP).Methods:The clinical data of 172 adult inpatients first diagnosed as CAP at Taikang Xianlin Drum Tower Hospital from January 2018 to December 2021 were divided into severe and non-severe diseases groups according to the severity of their conditions. The baseline conditions (including gender, age, past history, comorbidities and family history), clinical data (including chief symptoms, onset time, CURB-65 score), first laboratory results on admission (including whole blood cell count, liver and kidney function, blood biochemistry, coagulation function, microbiological culture results) and whether the antimicrobial therapy was adjusted according to the microbiological culture results were recorded in both groups. Univariate analysis was used to screen for differential indicators between severe and non-severe patients. After covariate analysis, multi-factor Logistic regression analysis was performed based on the Aakaike information criterion (AIC) forward stepwise regression method to rigorously search for risk factors for constructing the model. Based on the results of the multi-factor analysis, a nomogram prediction model was constructed, and the discriminatory degree and calibration degree of the model were assessed using the receiver operator characteristic curve (ROC curve) and calibration curve.Results:A total of 172 adult CAP patients were included, 48 in severe group and 124 in non-severe group. The median age was 74 (57, 83) years old, onset time was 5.0 (3.0, 10.0) days, total number of comorbidities was 3 (2, 5), including 58 cases (33.7%) with hypertension and 17 (9.9%) with heart failure, 113 (65.7%) with CURB-65 score≤1, 34 cases (19.8%) had a CURB-65 score = 2 and 25 cases (14.5%) had a CURB-65 score≥3. Univariate analysis showed that there were statistically significant differences between the two groups in age, smoking history, CURB-65 score, heart rate, onset time, total comorbidity, pathogenic microorganisms, fibrinogen (FIB), D-dimer, C-reactive protein (CRP), procalcitonin (PCT), platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), and alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Multi-factor Logistic regression analysis showed that hypertension [odds ratio ( OR) = 3.749, 95% confidence interval (95% CI) 1.411 to 9.962], heart failure ( OR = 4.616, 95% CI was 1.116 to 19.093), co-infection ( OR = 2.886, 95% CI was 1.073 to 7.760), history of smoking ( OR = 8.268, 95% CI was 2.314 to 29.537), moderate to high CURB-65 score ( OR = 4.833, 95% CI was 1.892 to 12.346), CRP ( OR = 1.012, 95% CI was 1.002 to 1.022), AST ( OR = 1.015, 95% CI was 1.001 to 1.030) were risk factors for severe CAP (all P < 0.05). The filtered indicators were included in the nomogram model, and the results showed that the area under the ROC curve (AUC) for the model to identify patients with severe adult CAP was 0.896, 95% CI was 0.840 to 0.937 ( P < 0.05), and the calibration curve showed that the predicted probability of severe CAP was in good agreement with the observed probability (Hosmer-Lemeshow test: χ2 = 6.088, P = 0.665). Conclusions:The nomogram model has a good ability to identify patients with severe adult CAP and can be used as a comprehensive and reliable clinical diagnostic tool to provide a evidence for timely intervention in the treatment of adults with severe CAP.

A case of primary amoebic meningoencephalitis (PAM) treated in the First Affiliated Hospital of Xinxiang Medical University in March 6, 2022 was reported.The proband was a 14-year-old boy, who was admitted to the hospital because of " fever, headache and vomiting for 2 days" . Metagenomic next-generation sequencing (mNGS) was consequently conducted to examine the pathogens in cerebrospinal fluid.Naegleria infection was detected, so the child was diagnosed with PAM.The disease developed rapidly, and the patient died 29 hours after admission.In the paper, a total of 13 studies were reviewed, and 15 children with PAM were reported.Of the reported cases, only 1 case survived, 14 cases died.PAM had a low incidence, a dangerous condition, and high mortality.Most cases were diagnosed by autopsy or pathogen diagnosis in cerebrospinal fluid.This case is confirmed by mNGS of pathogens, and it is rarely reported at home and abroad.

Objective:To explore the accuracy and clinical effect of computer navigation system in locating the tunnel position in anterior cruciate ligament (ACL) reconstruction.Methods:A retrospective case-control study was conducted to analyze clinical data of 60 patients with ACL rupture treated in Daping Hospital of Army Military Medical University from March 2017 to March 2018, including 44 males and 16 females, aged 15-48 years (mean, 26.3 years). Computer navigation system was used to locate the internal orifice of intra-articular femoral and tibial tunnel in 30 patients (navigation group), and artificial location of intra-articular femoral and tibial tunnel in 30 patients (control group). The operation time and complications of two groups were recorded after operation. The tunnel position was evaluated by CT three-dimensional reconstruction, and the ratio of the tunnel position on the lateral surface of the femoral condyle to the tibial platform was evaluated by the grid method. The proportion sites from the deep posterior edge of lateral intercondylar surface of the femur to the shallow anterior edge (DS) and from the upper edge to the lower edge (HL) were used to represent the position of the femoral tunnel, and the proportion sites of the line connecting the anterior and posterior edge of the tibial plateau were used to represent the tibial tunnel position. The postoperative tunnel position was compared between the two groups. The knee joint stability (Lachman test, pivot shift test) and knee joint function score (Lysholm score, Tegner score) were compared between the two groups before operation and 12 months after operation.Results:All patients were followed up for 12-24 months (mean, 15 months). The operation time was (56.1±8.1)minutes in control group versus (76.0±6.7)minutes in navigation group ( P<0.05). In navigation group, 2 patients had skin edge necrosis at the place where the navigation needle was installed. The proportion of DS in femoral tunnel was (27.2±3.7)% in navigation group versus (33.9±4.4)% in control group ( P<0.05). HL proportion site was (36.6±4.8)% in navigation group versus (38.9±4.9)% in control group ( P<0.05). Proportion of the tibial tunnel at the anterior and posterior edge of the tibial plateau was (44.9±1.8)% in navigation group and (44.7±3.0)% in control group ( P>0.05). Both groups showed significant improvements in Lysholm score, Tegner score, Lachman test and pivot shift test 12 months after operation compared to the preoperative levels ( P<0.05), but the knee joint function score and knee joint stability score had no significant difference between the two groups 12 months after operation ( P>0.05). Conclusions:No significant differences are found between computer navigated and manually navigated ACL reconstruction with regards to knee joint stability, knee joint function, and tibial tunnel localization. However, computer assisted navigation enables the location of the lateral femoral tunnel closer to the anatomical position.