RESUMO
OBJECTIVE: Comparisons between patellar eversion (PE) and lateral retraction (LR) in total knee arthroplasty (TKA) are still inconclusive. To determine the most suitable procedure, we aimed to evaluate the safety and efficacy of PE and LR in TKA in this meta-analysis. MATERIALS AND METHODS: This meta-analysis complied with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Web-based literature databases, including WANFANG, VIP, CNKI, the Cochrane Library, Embase, and PubMed, were utilized to conduct a comprehensive literature search for studies published until June 2022 that compared PE with LR in primary TKA. The quality of the selected randomized controlled trials (RCTs) was evaluated using guidelines of the Cochrane Reviews Handbook 5.0.2. RESULTS: A total of 10 RCTs, including 782 patients and 823 TKAs, were selected in this meta-analysis. Our results showed that using LR improved postoperative knee extensor function and range of motion (ROM). In addition, PE and LR resulted in similar clinical benefits in terms of Knee Society Function score, pain, length of hospital stay, Insall-Salvati ratio, the occurrence of patella baja, and complications related to the operation. CONCLUSIONS: Existing evidence suggested that using LR in TKA improved early postoperative knee function. Similar clinical and radiographic outcomes were obtained 1 year after the procedures were performed. Based on these findings, we recommended the use of LR in TKA. However, studies with large sample sizes are needed to validate these findings.
Assuntos
Artroplastia do Joelho , Artropatias , Humanos , Artroplastia do Joelho/efeitos adversos , Patela/cirurgia , Articulação do Joelho/cirurgia , Artropatias/complicações , Artropatias/cirurgia , Dor Pós-Operatória/cirurgia , Amplitude de Movimento ArticularRESUMO
Objective: To analyze molecular epidemiological characteristics of drug resistance genes and carbapenem resistance of Pseudomonas aeruginosa (PA) in rural well water. Methods: According to Citation of Natural Mineral Water Inspection (GB 8538-2016), a total of 112 well water samples were tested in Juye county of Shandong province, and PFGE and drug susceptibility test were conducted for the identified PA strains. After PCR identification of carbapenem resistance genes, S1-PFGE and Southern blotting were used to determine the location of drug resistance genes, and combined experiments were used to determine gene transferability. Results: The detection rate of PA in rural well water samples in Juye county of Shandong province was 54.46% (61/112). The 61 strains could be divided into 56 PFGE types. There were 2 strains with 100.00% consistent band types, and there was no obvious predominant band type. The results of drug susceptibility experiments showed that 93.44% (57/61) were multi-drug resistant strains, and there were 2 strains carrying blaVIM-2, both of which were located on the plasmid, and both of them were transferred horizontally with the plasmid. Conclusion: PA carrying carbapenem resistance genes was detected in well water of rural communities in Juye country, and there is the possibility of horizontal transmission of such resistance genes.
Assuntos
Pseudomonas aeruginosa , Água , Carbapenêmicos/farmacologia , Resistência a Medicamentos , Humanos , Testes de Sensibilidade Microbiana , Epidemiologia Molecular , Pseudomonas aeruginosa/genética , População Rural , beta-LactamasesRESUMO
Objective: To evaluate the diagnostic value of platelet count(PC),PC to mean platelet volume(MPV) ratio(PC/MPV) and plateletcrit(PCT) in chronic periprosthetic joint infection(PJI). Method: The medical records of 159 patients who underwent hip or knee revisions at Department of Joint Surgery,Affiliated Hospital of Qingdao University from August 2013 to June 2019 were retrospectively reviewed. There were 51 patients(26 knees and 25 hips) in the PJI group,which included 28 males and 23 females,aged (68.0±11.8)years (range:32 to 84 years)with a body mass index(BMI)of (26.1±3.6) kg/m².There were 116 patients(19 knees and 97 hips) in the aseptic loosening(AL) group,including 67 males and 49 females,aged (70.3±8.9)years(range:49 to 89 years)with a BMI of (25.0±3.6)kg/m².The plasma C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),PC,MPV,PC/MPV and PCT levels of the two groups were recorded and analyzed. Receiver operating characteristic curve was used to calculate the sensitivity and specificity of each biomarker,expect for MPV,and the diagnostic value of each biomarker was compared according to the area under the curve(AUC).Independent-sample t test or Mann-Whitney U test were used for comparison between groups. Result: Compared with AL group,AJI group had significantly higher levels of CRP,ESR,PC,PC/MPV and PCT(all P<0.05),but lower level of MPV (P<0.05).The AUCs for CRP,ESR,PC,PC/MPV and PCT were 0.820, 0.829, 0.689, 0.668 and 0.676,respectively. Based on the Youden index,the optimal predictive cutoff for CRP was 11.12 mg/L,with a sensitivity of 74.4% and a specificity of 87.1%.The optimal predictive cutoff for ESR was 17.60 mm/1 h,with a sensitivity of 81.4% and a specificity of 75.3%.The optimal predictive cutoff for PC was 243.00×109/L,with a sensitivity of 60.6% and a specificity of 71.8%.The optimal predictive cutoff for PC/MPV was 24.95,the sensitivity was 58.1% and the specificity was 74.1%.And the optimal predictive cutoff for PCT was 0.24%,with a sensitivity of 69.8% and a specificity of 63.5%. Conclusion: PC,PC to MPV ratio and PCT were of limited value to diagnose PJI.
RESUMO
Objective: To compare the clinical efficacy and the level of muscle and soft tissue damage between modified posteromedial approach via lateral side of flexor hallucis longus and modified posteromedial approach in the treatment of posterior Pilon fracture. Methods: Total of 43 patients (27 males and 16 females, aged from 19 to 71 years) diagnosed with posterior Pilon fracture from June 2016 to June 2018 in Foshan Hospital of Traditional Chinese Medicine were randomly divided into observation group (modified posteromedial approach via lateral side of flexor hallucis longus, 21 cases) and control group (modified posteromedial approach, 22 cases) according to the operation approach. The preoperative waiting time, intraoperative time, intraoperative blood loss, hospitalization time and the complications were recorded and compared between the two groups. The differences of blood creatine kinase (CK), myoglobin (Myo) and C-reactive protein (CRP) at different time points before and after operation were compared between the two groups to elevate the level of muscle and soft tissue damage. The fracture reduction qualities of the two groups were compared by Burwell-Charnley criteria. The differences of fracture healing time, range of motion of metatarsophalangeal joint of the great toe (MTP-ROM), ankle range of motion (Ankle-ROM), American Orthopaedic Foot & Ankle Society (AOFAS) score and visual analogue scale (VAS) score of pain were compared between the two groups at the last follow-up. Results: The observation group and the control group were followed-up for (19±6) months and (16±8) months, respectively; there was no significant difference between the two groups (P>0.05). There were no significant differences in preoperative waiting time, intraoperative blood loss, hospitalization time and fracture healing time between the two groups (all P>0.05). At the last follow-up, there was no significant difference in the MTP-ROM and Ankle-ROM between the two groups (both P>0.05); the AOFAS score of the observation group was 88.2±7.8 and it was 84.5±7.6 in the control group (P>0.05); the VAS score of the observation group was (0.9±1.0) and it was (1.3±0.8) in the control group(P>0.05). Anatomical reduction rate in observation group was higher than that in control group (90.5% vs 81.8%, P>0.05). The operation time in the observation group was (87±16) min and it was (98±11) min in the control group (P<0.05). CK, Myo and CRP were increased in both groups after surgery, but there was no statistical significance between groups at the same time point (all P>0.05). There was no nerve injury in the observation group, while 2 cases (9.0%) of nerve paralysis occurred in the control group. No incision infection and checkrein deformity of the Hallux was found in the two groups. Conclusion: The modified posteromedial approach via lateral side of flexor hallucis longus can obtain good operative field exposure, and does not increase muscle and soft tissue injury, with shorter operative time and fewer complications, without nerve injury and checkrein deformity, it is a safe approach for the treatment of posterior Pilon fracture.
Assuntos
Fraturas do Tornozelo , Fraturas da Tíbia , Adulto , Idoso , Fraturas do Tornozelo/cirurgia , Articulação do Tornozelo , Feminino , Fixação Interna de Fraturas , Consolidação da Fratura , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fraturas da Tíbia/cirurgia , Resultado do Tratamento , Adulto JovemRESUMO
Objective: To compare the clinical outcome of posterior cruciate ligament (PCL) retention type and PCL substituting type using Advance(®) Medial Pivot (AMP) inner-axis knee prosthesis. Methods: A retrospective analysis was conducted on the cases of total knee arthroplasty (TKA) with AMP prosthesis in the Affiliated Hospital of Qingdao University from January 2011 to September 2016. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), American Knee Society Knee Score (KSS) clinical scores, KSS functional scores and knee-joint range of motion (ROM) before and after TKA, and Forgotten Joint Scores (FJS) after TKA were collected. The matching group was obtained by 1â¶1 propensity score matching (PSM). Results: Complete scoring data were obtained in 47 knees of CR group and 1 059 knees of CS group, there were statistical differences in age, sex, body mass index, preoperative WOMAC score, preoperative KSS function score and ROM between the two groups (all P<0.05), except preoperative KSS clinical score (25±4 and 24±7, respectively, t=0.82, P=0.41). With the PSM matching, 37 knees in CR group and 37 knees in CS group were obtained. No significant differences in preoperative indexes were found between the matching groups (all P>0.05). The WOMAC, KSS clinical scores, KSS functional scores and ROM after TKA in each matching group were all much better than those before TKA (all P<0.05); no statistical differences existed in WOMAC, KSS clinical scores, KSS functional scores, ROM and FJS after TKA between the matching groups (all P>0.05). One PCL injury was found in CR matching group after TKA. Incidence of complications in the CR matching group (8.1%) was higher than that in the CS matching group (2.7%), but there was no statistical difference (χ(2)=1.04, P=0.31). Conclusions: When using AMP prosthesis, both CR insert and CS insert can obtain good clinical results in TKA. The potential risk of PCL injury and other complications after CR TKA makes it necessary for surgeons to carefully select an appropriate type of prosthesis.
Assuntos
Artroplastia do Joelho/métodos , Articulação do Joelho/cirurgia , Prótese do Joelho , Osteoartrite do Joelho/cirurgia , Ligamento Cruzado Posterior/cirurgia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Articulação do Joelho/fisiopatologia , Masculino , Pessoa de Meia-Idade , Pontuação de Propensão , Desenho de Prótese , Amplitude de Movimento Articular , Estudos Retrospectivos , Resultado do TratamentoRESUMO
Objective: To analyze the etiology and epidemiological characteristics of gastroenteritis virus in foodborne diseases from three cities in Shandong. Methods: From January to December 2017, six sentinel hospitals in Jinan, Yantai and Linyi city of Shandong Province were selected as the research sites. Stool samples of 1 397 diarrhea patients were collected, as well as basic information and clinical symptoms. Duplex quantitative RT-PCR was used to detect Norovirus genogroupâ (Nov Gâ ) and genogroupâ ¡ (Nov Gâ ¡), Sapovirus (SAV) and Human astrovirus (HAstV), respectively, quantitative RT-PCR was used to detect group A Rotavirus (RVA), and quantitative PCR was used to detect Enteric adenovirus (EAdV). The specific gene of the virus were sequenced and typed. It was compared that the gastroenteritis virus rate in cases with different characteristics and the clinical symptoms difference between the virus positive and negative cases. Results: The median age (P(25), P(75)) was 23 (1, 42) , mainly male, 57.48% with 803 cased and children under 5 years old, 36.36% with 508 cases. The positive rate of gastroenteritis virus was 33.93% (474 cases), and that of Jinan, Linyi and Yantai City were 32.03% (147/459), 41.54% (189/455) and 28.57% (138/483), respectively (P<0.001). Nov Gâ ¡ had the highest positive rate, 16.54% (231 cases), which, mainly Gâ ¡.P16/Gâ ¡.2 (48.28%, 56/116), peaked in May (24.75%, 50/202) and June (19.59%, 38/194). In patients of gastroenteritis virus positive, 44.51% (211/474) had vomiting symptoms, higher than that of patients of gastroenteritis virus negative (34.13%, 315/923). The difference was statistically significant (P<0.001). Conclusion: In Shandong Province, the majority of gastroenteritis patients were male and children under 5 years old. Nov Gâ ¡ possessed highest epidemic intensity, and peaked in spring and summer. Viral gastroenteritis had atypical clinical symptoms.
Assuntos
Diarreia/epidemiologia , Diarreia/virologia , Doenças Transmitidas por Alimentos/epidemiologia , Doenças Transmitidas por Alimentos/virologia , Gastroenterite/epidemiologia , Gastroenterite/virologia , Adenoviridae/genética , Adenoviridae/isolamento & purificação , Adolescente , Adulto , Criança , Pré-Escolar , China/epidemiologia , Cidades , Enterovirus/genética , Enterovirus/isolamento & purificação , Feminino , Humanos , Lactente , Masculino , Rotavirus/genética , Rotavirus/isolamento & purificação , Adulto JovemRESUMO
OBJECTIVE: We aimed to investigate the heart rate variability in children with myocarditis presenting with ventricular arrhythmias. PATIENTS AND METHODS: The study compared the characteristics of heart rate variability (HRV) among 67 children with viral myocarditis (VMC), presenting with (n=35) and without (n=32) ventricular arrhythmias and a control group of 30 healthy children. RESULTS: Compared with the control group, the HRV time-domain indicators of children with VMC were significantly lower (p<0.05); also, the indicators of children with ventricular arrhythmias were significantly lower than those of children without ventricular arrhythmias (p<0.05). Equally, during both the lucid and sleep periods, the time-domain indicators of HRV were significantly lower in patients with VMC and arrhythmias than in either the control group (p<0.05) or the group with VMC but no ventricular arrhythmias (p<0.05). CONCLUSIONS: We conclude that the HRV of children with VMC probably decreased because of impaired vagal nerve function, with ventricular arrhythmias developing only when the decrease was most significant. Thus, HRV can be a useful predictive indicator for ventricular arrhythmias in children with VMC.
Assuntos
Frequência Cardíaca/fisiologia , Miocardite/diagnóstico , Miocardite/fisiopatologia , Fibrilação Ventricular/diagnóstico , Fibrilação Ventricular/fisiopatologia , Arritmias Cardíacas/complicações , Arritmias Cardíacas/diagnóstico , Arritmias Cardíacas/fisiopatologia , Criança , Pré-Escolar , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Miocardite/complicações , Fibrilação Ventricular/complicaçõesRESUMO
Taking cetyltrimethylammonium bromide (CTAB) as the template and using TiO2 as the substrate, coral-globular-like composite Ag/TiO2-SnO2 (CTAB) was successfully synthesized by the sol-gel combined with a temperature-programmed treatment method. X-ray diffraction, scanning electron microscopy (SEM), UV-vis diffuse reflectance spectroscopy, X-ray photoelectron spectroscopy, SEM combined with X-ray energy dispersive spectroscopy, and N2 adsorption-desorption tests were employed to characterize samples' crystalline phase, chemical composition, morphology and surface physicochemical properties. Results showed that composites not only had TiO2 anatase structure, but also had some generated SnTiO4, and the silver species was metallic Ag0. Ag/TiO2-SnO2 (CTAB) possessed a coral-globular-like structure with nanosheets in large quantities. The photocatalytic activity of Ag/TiO2-SnO2 (CTAB) had studied by degrading organic dyes under multi-modes, mainly using rhodamine B as the model molecule. Results showed that the coral-globular-like Ag/TiO2-SnO2 (CTAB) was higher photocatalytic activity than that of commercial TiO2, Ag/TiO2-SnO2, TiO2-SnO2 (CTAB), and TiO2-SnO2 under ultraviolet light irradiation. Moreover, Ag/TiO2-SnO2 (CTAB) composite can significantly affect the photocatalytic degradation under multi-modes including UV light, visible light, simulated solar light and microwave-assisted irradiation. Meanwhile, the photocatalytic activity of Ag/TiO2-SnO2 (CTAB) was maintained even after three cycles, indicating that the catalyst had good usability.
Assuntos
Processos Fotoquímicos , Rodaminas/química , Prata/química , Compostos de Estanho/química , Adsorção , Animais , Catálise , Luz , Microscopia Eletrônica de Varredura , Estrutura Molecular , Espectroscopia Fotoeletrônica , Espectrometria por Raios X , Propriedades de Superfície , Titânio , Raios Ultravioleta , Difração de Raios XRESUMO
OBJECTIVE: To invstigate the mechanism of new mechanically-activated cation channel protein (Piezo1) can cause the apoptosis of the human chondrocytes under compressive loading, using a Flexercell unit by activating classical Mitogen-activated protein kinase (MAPK) signal pathyway(ERK1/2). METHODS: Primary human chondrocytes were isolated, cultured, and then subjected to the static compressive loading for 0, 2, 12, 24, 48 h, respectively.The expressions of Piezo1 and the ERK1/2 were assessed by reverse transcription-polymerase chain reaction(PT-PCR), as well as the apoptosis gene B cell lymphoma/leukemia-2(Bcl-2) Bel-associated X protein(Bax). In addition, Piezo1inhibitor, Grammostola spatulata mechanotoxin 4(GsMTx4), was used to block Piezo1, served as a positive control.The immunofluorescence was used to locate the expression of Piezo1 protein and ERK1/2.AnnexinV-PI was used to detect the apoptosis of chondrocytes. RESULTS: The expression of the Piezo1 in chondrocytesis was weak, the 12 h group was significant increased(0.198 1 vs 0.021 4, P<0.05), the 24 h group was the highest expression while the expression of the 48 h group was lower than the 24 h group, as well as the ERK1/2, Bcl-2 and caspase3.The result of AV-PI had shown that the 2 h group had increased early stage of apoptosis.The 12 h group had increased late stage of apoptosis, and the 24 h group's apoptotic rate was the highest, while the apoptotic rate of the 48 h group was lower than the 24 h group(0.497 1 vs 0.743 1, q=0.035 9). The GsMTx4 could inhibit the late stage of apoptosis, and the location of the Piezo1 was expressed in the nucleus and cytoplasm of the chondrocytes. CONCLUSIONS: Piezo1 plays an important role in the apoptosis of the human chondrocyte through the classic MAPK/ERK1/2 signal pathway.
Assuntos
Apoptose , Condrócitos , Sistema de Sinalização das MAP Quinases , Proteína Quinase 1 Ativada por Mitógeno , Caspase 3 , Humanos , Canais IônicosRESUMO
OBJECTIVE: To observe the changes of phosphatase and tensin homolog deleted on chromosome ten(PTEN)/ phosphatidyl Inositol 3-kinase(PI3K)/ vascular endothelial growth factor(VEGF)signaling pathway in a rabbit Kawasaki disease model. METHODS: Model of Kawasaki disease was established in weanling Japanese big-eared rabbits with 10% bovine serum venous injection (2.5 ml/kg, 2 times, and 2 week's interval) through the ear. Twenty four rabbits were divided into 4 groups: control group (without injection of 10% bovine serum albumin, six rabbits); 1 day group (sacrificed a the second day after the establishment of Kawasaki disease models, six rabbits); 7 day group (sacrificed at the seventh day after establishment of Kawasaki disease model, six rabbits); 30 day group (sacrificed at the thirtieth day after establishment of Kawasaki disease model, six rabbits). Pathological analysis was performed on coronary artery tissue samples. The express of PTEN and PI3K were detected by immunohistochemistry. The levels of VEGF and CK were also examined with ELISA and white blood cells were counted. RESULTS: (1) Coronary artery of model groups was thinner, distorted and had enlarged lumen. (2) PTEN expression in 1 d group, 7 d group and 30 d group were 58.5 ± 12.9, 73.2±9.9 and 109.6 ± 24.4, respectively, significantly higher than in the control group (25.5 ± 6.9, P<0.01 or 0.05). (3) The express of PI3K was significantly upregulated in 1 d group(57.2±11.1)and 7 d group(39.9±4.8) compared to control group(19.1±3.5, P<0.01 or 0.05). The expression level of PI3K in 30 d group was 18.8 ± 7.5, which was similar as control group (P>0.05) and significantly lower than 1 d and 7 d group (both P<0.05). (4) Similarly, the level of VEGF in 1 d group, 7 d group ((89.1 ± 15.5) ng/L, (76.9±9.9) ng/L) were significantly higher while it was significantly lower in 30 d group ((19.8 ± 4.4)ng/L) compared with the control group ((33.9 ± 6.7) ng/L, P<0.01 or 0.05). The level of VEGF in 7 d group was significantly lower than in 1 d group (P<0.05) and the level of VEGF was significantly lower in 30 d group than in 7 d group (P<0.01). (5)Creatine kinase levels were significantly higher in 30 d group than in control group (P<0.05) and there were no significantly different between control group, 1 d group and 7 d group(all P>0.05). (6)White blood cell count were significantly higher in 1 d group, 7 d group and 30 d group than in control group (all P<0.01). CONCLUSION: The level of PTEN/PI3K/VEGF signaling pathway change after establishment of rabbit Kawasaki disease model and the signaling pathway might be involved in this model.
Assuntos
Cromossomos , Síndrome de Linfonodos Mucocutâneos , Transdução de Sinais , Animais , Vasos Coronários , Proteínas dos Microfilamentos , PTEN Fosfo-Hidrolase , Fosfatidilinositol 3-Quinase , Fosfatidilinositol 3-Quinases , Coelhos , Tensinas , Fator A de Crescimento do Endotélio VascularRESUMO
OBJECTIVE: To investigate the clinical effect of double dose of valsartan combined with tacrolimus in the treatment of diabetic nephropathy (DN). PATIENTS AND METHODS: HA total of 86 cases diagnosed with DN were selected from October 2013 to October 2014 in Zaozhuang Municipal Hospital, China. The study was approved by our hospital Ethics Committee and written consent was obtained from patients and their family members. Patients were randomly divided into three groups according to the sequence of admission, group A (conventional dose of valsartan group, n = 28 cases), group B (double dose of valsartan group, n = 29 cases) and group C (double dose of valsartan combined with tacrolimus group, n = 29). Clinical effects were compared by analyzing the renal function tests after 8 weeks. RESULTS: 24h urine protein, serum creatinine level of patients in group B and group C were significantly lower than that of group A. Those in group C was much lower. The glomerular filtration rates were significantly higher for group B and C than that of group A, and those in group C were much higher. The difference is statistically significant (p < 0.05). High-sensitivity C-reactive protein (hs CRP) and adiponectin levels of patients in group B and C of were significantly lower than that of group A and those in group C were much lower. The difference is statistically significant (p < 0.05). The high mobility group protein 1 (HMGB1) and renal tubular and interstitial damage index (TDI) of patients in B and C groups were significantly lower than those in the A group, and those in C group were significantly lower. The difference was statistically significant p < 0.05). The clinical effective rates of patients in group B and C were significantly higher than that in group A, and those of group C were much higher. The difference is statistically significant (p < 0.05). The recurrence rates of patients in group B and group C were significantly lower than those of group A and those in group C were much lower. The difference is statistically significant (p < 0.05). Patients in three groups showed no obvious drug complications. CONCLUSIONS: Double dose of valsartan combined with tacrolimus treatment of DN patients can improve clinical symptoms, reducing inflammation, inhibiting or even reversing the interstitial fibrosis, which will improve the curative effect and reduce the recurrence, as to provide a new theoretical basis for the clinical treatment of the disease.
Assuntos
Nefropatias Diabéticas/tratamento farmacológico , Fármacos Renais/administração & dosagem , Tacrolimo/administração & dosagem , Valsartana/administração & dosagem , Adulto , Idoso , Nefropatias Diabéticas/fisiopatologia , Relação Dose-Resposta a Droga , Quimioterapia Combinada , Feminino , Taxa de Filtração Glomerular/efeitos dos fármacos , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
BACKGROUND: Fourteen postoperative infections caused by Serratia marcescens were detected in patients on the neurosurgical wards and spinal surgery ward of a 2640-bed hospital between 26th December 2012 and 5th June 2013. AIM: To investigate the source of the outbreak, identify risk factors and implement infection control measures. METHODS: Cultures were collected from healthcare workers and potential environmental sources. S. marcescens isolates were characterized by antibiotic susceptibility testing and pulsed-field gel electrophoresis (PFGE). A retrospective case-control study was performed to identify the risk factors. FINDINGS: The outbreak involved 14 patients, five of whom required more than one surgical procedure. S. marcescens was isolated from cerebrospinal fluid, brain tissue, sputum and other secretions. S. marcescens was also cultured from samples taken from the hands of two barbers and their razors. Exposure to the two barbers [odds ratio (OR) 78.0, P < 0.0001] and wound drainage (OR 4.889, P = 0.028) were risk factors. Pre-operative shaving by the barbers was the only independent risk factor (OR 78.0, P < 0.0001). Isolates of S. marcescens from patients, barbers and razors were indistinguishable by PFGE and antibiotic susceptibility pattern. The outbreak ended after removal of the implicated barbers, extensive re-inforcement of infection control procedures and re-education. CONCLUSION: These results underscore the risk of postoperative infection associated with pre-operative wet shaving.
Assuntos
Infecção Hospitalar/epidemiologia , Surtos de Doenças , Infecções por Serratia/epidemiologia , Serratia marcescens/isolamento & purificação , Infecção da Ferida Cirúrgica/epidemiologia , Adolescente , Adulto , Idoso , Estudos de Casos e Controles , Criança , Infecção Hospitalar/microbiologia , Eletroforese em Gel de Campo Pulsado , Feminino , Hospitais , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Tipagem Molecular , Estudos Retrospectivos , Serratia marcescens/classificação , Serratia marcescens/genética , Infecção da Ferida Cirúrgica/microbiologia , Adulto JovemRESUMO
A diode-pumped actively Q-switched Raman laser employing BaWO4 as the Raman active medium and a ceramic Nd:YAG laser operating at 1444 nm as the pump source is demonstrated. The first-Stokes-Raman generation at 1666 nm is achieved. With a pump power of 20.3 W and pulse repetition frequency rate of 5 kHz, a maximum output power of 1.21 W is obtained, which is the highest output power for a 1.6 µm Raman laser. The corresponding optical-to-optical conversion efficiency is 6%; the pulse energy and peak power are 242 µJ and 8.96 kW, respectively.
Assuntos
Transferência de Energia , Lasers de Estado Sólido , Análise Espectral Raman/instrumentação , Cerâmica/efeitos da radiação , Desenho de Equipamento , Análise de Falha de Equipamento , Doses de RadiaçãoRESUMO
We report on a diode-pumped Nd:YAG ceramic laser operating at 1442.8 nm for the first time. In our experiment, two different Nd:YAG ceramics with the Nd-doped concentrations of 1.0 and 0.6 at. % and a Nd:YAG with the Nd-doped concentration of 1.0 at. % were used as the laser gain mediums, respectively. At a pump power of 20.7 W, a maximum output power of up to 3.96 W with optical-to-optical efficiency of up to 19.1% was obtained by using the 1.0 at. % Nd-doped ceramic as the laser gain medium. To the best of our knowledge, this is the highest output power of a LD-pumped 1.44 µm Nd:YAG ceramic laser and the highest optical-to-optical efficiency of a LD-pumped 1.44 µm Nd-doped crystal laser.
Assuntos
Cerâmica , Olho , Lasers , SegurançaRESUMO
A GC/MS method was developed and successfully validated for the determination of adipate plasticizers in ham sausage migrated from polyvinylidene chloride (PVDC) packaging film. The sample pretreatment includes liquid extraction, solvent evaporation, and reconstitution before and after solid phase extraction (SPE). For the 5 adipate plasticizers studied, the SPE process with Oasis MAX cartridge showed an extraction efficiency from 85.7% to 106%, and the calibration curves are all linear in the range of 5 to 1000 ng/g with correlation coefficients greater than 0.998. The method proved to be accurate and precise; the average intraday recovery ranges from 85.4% to 114.6% with a %CV value from 2.5 to 11.3, and the average interday recovery from 83.6% to 118.5% with a %CV value from 2.8 to 15.6, respectively, for the adipate plasticizers. The method is sensitive and was effectively applied in the kinetic and penetration studies of the adipate plasticizers migrating from food-grade PVDC packaging film into ham sausage. The experimental data showed that approximately 6.8% of dibutyl adipate (DBA) in the packaging film migrated into the ham sausage in 4 mo and the migration reached the innermost portion of the sausage in 6 mo.
Assuntos
Adipatos/análise , Contaminação de Alimentos/análise , Embalagem de Alimentos/métodos , Cromatografia Gasosa-Espectrometria de Massas/métodos , Produtos da Carne/análise , Plastificantes/análise , Animais , Cinética , Permeabilidade , Cloreto de Polivinila/análogos & derivados , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Extração em Fase Sólida , SuínosRESUMO
Chemical-induced seizures up-regulated brain-derived neurotrophic factor (BDNF) mRNA expression. Intracerebroventricular (i.c.v.) administration of endogenous opioids preferentially activating mu opioid receptor (MOR) could also increase BDNF mRNA expression. The aim of this study was to determine to what extent i.c.v. administration of synthetic MOR-selective agonists in rats can modulate both seizure activity and up-regulation of BDNF mRNA expression. Effects and potencies of i.c.v. administration of morphine and [D-Ala(2), N-Me-Phe(4), Gly(5)-ol]-enkephalin (DAMGO), were directly investigated by scoring behavioral seizures and measuring BDNF mRNA expression. In addition, effects of the opioid receptor antagonist naloxone and antiepileptic drugs, diazepam, phenobarbital, and valproate, on i.c.v. MOR agonist-induced behavioral seizures and up-regulation of BDNF mRNA expression were determined. A single i.c.v. administration of morphine (10-100 microg) or DAMGO (0.15-1.5 microg) dose-dependently elicited behavioral seizures and increased BDNF mRNA expression in the widespread brain regions. However, s.c. administration of MOR agonists neither produced behavioral seizures nor increased BDNF mRNA expression. Pretreatment with naloxone 1 mg/kg significantly reduced behavioral seizure scores and the up-regulation of BDNF mRNA expression elicited by i.c.v. morphine or DAMGO. Similarly, diazepam 10 mg/kg and phenobarbital 40 mg/kg significantly blocked i.c.v. MOR agonist-induced actions. Pretreatment with valproate 300 mg/kg only attenuated behavioral seizures, but it did not affect morphine-induced increase of BDNF mRNA expression. This study provides supporting evidence that seizure activity plays an important role in the up-regulation of BDNF mRNA expression elicited by central MOR activation and that decreased inhibitory action of GABAergic system through the modulation on GABA receptor synaptic function by central MOR activation is involved in its regulation of BDNF mRNA expression.
Assuntos
Fator Neurotrófico Derivado do Encéfalo/biossíntese , RNA Mensageiro/biossíntese , Receptores Opioides mu/agonistas , Convulsões/metabolismo , Animais , Anticonvulsivantes/farmacologia , Fator Neurotrófico Derivado do Encéfalo/genética , Sinergismo Farmacológico , Ala(2)-MePhe(4)-Gly(5)-Encefalina/administração & dosagem , Ala(2)-MePhe(4)-Gly(5)-Encefalina/farmacologia , Injeções Intraventriculares , Masculino , Morfina/administração & dosagem , Morfina/farmacologia , Naloxona/farmacologia , Ratos , Ratos Sprague-Dawley , Receptores Opioides mu/antagonistas & inibidores , Convulsões/fisiopatologia , Regulação para CimaRESUMO
Cell volume can be altered by two different ways, swelling and shrinkage. Cell swelling is regulated by volume-regulated Cl- channel (VRC). It is not well understood whether shrinkage is regulated by VRC. We previously found that antisense oligonucleotide specific to ClC-3 (ClC-3 antisense) prevented cell proliferation, which was related to cell swell volume regulation. In the present study, we further studied the role of ClC-3 Cl- channel in cell apoptosis which was related to cell shrinkage volume regulation by using antisense oligonucleotide specific to ClC-3 (ClC-3 antisense) and ClC-3 cDNA transfection techniques. We found that thapsigargin (TG), a specific inhibitor of the endoplasmic reticulum calcium ATPase, evoked apoptotic morphological changes (including cytoplasmic blebbing, condensation of nuclear chromatin, and the formation of apoptotic bodies), DNA laddering, and caspase-3 activation in PC12 cells (Pheochromocytoma-derived cell line). TG increased the cell apoptotic population with a decrease in cell viability. These effects were consistent with the decrease in endogenous ClC-3 protein expression, which was also induced by TG. Overexpression of ClC-3 significantly inhibited TG effect on PC12 cell apoptosis, whereas the ClC-3 antisense produced opposite effects and facilitated apoptosis induced by TG. Our data strongly suggest that ClC-3 channel in PC12 cells mediates TG-induced apoptotic process through inhibitory mechanism. Thus, it appears that ClC-3 Cl- channel mediates both cell proliferation and apoptosis through accelerative and inhibitory fashions, respectively.
Assuntos
Apoptose/fisiologia , Canais de Cloreto/metabolismo , Inibidores Enzimáticos/metabolismo , Tapsigargina/metabolismo , Animais , Caspase 3/metabolismo , Forma Celular , Tamanho Celular , Canais de Cloreto/genética , Fragmentação do DNA , Ativação Enzimática , Oligonucleotídeos Antissenso/genética , Oligonucleotídeos Antissenso/metabolismo , Células PC12 , RatosRESUMO
In order to investigate the relationship between Ganhuo shangyanzheng and Can-shengyin xuzheng in herpes simplex karatitis patients, we observed corneal pathologic changes and examined blood levels of prostaglandin F2 (PGF2), prostaglandin E2 (PGF2), tumor necrosis factor (TNF), arginine vasopressin (AVP), norepinephrine (NR), epinephrine (E) in sixty herpes simplex karatitis patients with Ganhou shangyanzheng or Gan-shengyinxuzheng. The results showed that the corneal pathologic changes were corneal ulcer infiltrating to stroma of cornea in Ganhuo shangyanzheng patients, and refractary corneal ulcer with large amount of corneal neovascularizaton and infiltration of corneal stroma in Gan-shengyinxuzheng patients, the blood levels of PGF2, PGE2, TNF, AVP, NE, E in Ganhuo shangyanzheng patients were higher than those in Gan-shengyinxuzheng patients or healthy persons. The results suggest that these parameters may be objective parameters for differential diagnosis of traditional Chinese medicine Zheng types in patients with herpes simplex karatitis.