Prophylactic fasciotomy of the anterolateral thigh donor site in head and neck reconstruction.

INTRODUCTION: The free anterolateral thigh (ALT) flap is a versatile reconstructive option for head and neck defects. Donor site complications are rare but severe; with wound dehiscence, need for secondary closure, and compartment syndrome reported. OBJECTIVES: We propose prophylactic thigh fasciotomy as a surgical technique to facilitate primary closure while preventing donor site complications during ALT flap harvest. METHODS: We examined donor site wound characteristics, recipient site wound characteristics, and clinical outcomes for 24 consecutive ALT flaps performed for head and neck reconstruction from 2016 to 2018. All ALT donor sites underwent prophylactic fasciotomy. RESULTS: There were no incidents of thigh compartment syndrome or wound dehiscence of donor site; one patient underwent primary donor site skin grafting. CONCLUSION: Prophylactic thigh fasciotomy allows mobilization of soft tissue to facilitate primary tension-free closure of the ALT donor site even for free flaps with a large skin component, while reducing the possibility of compartment syndrome.

Retrospective analysis of 14 cases of disseminated Penicillium marneffei infection with osteolytic lesions.

BACKGROUND: Penicillium marneffei disseminates hematogenously and can infect most organs, though infection leading to osteolysis is extremely rare. We describe the clinical and laboratory features, management, and outcomes of patients with penicilliosis marneffei (PSM) with osteolytic lesions. METHODS: This retrospective study was conducted between January 1, 2003 and May 1, 2014 at the First Affiliated Hospital of Guangxi Medical University. Patients who presented with culture and/or histopathologic proof of disseminated PSM within osteolytic lesions were included. RESULTS: P. marneffei infection was diagnosed in 100 patients (65 HIV-infected and 35 HIV-negative). Fourteen patients, all HIV-negative, (14/35, 40%) had osteolytic lesions. The most common comorbidity was diabetes mellitus, though previous glucocorticoid therapy, ß-thalassemia, breast cancer, and Langerhans cell histiocytosis also occurred. Five patients had no comorbidity. Fever, malaise, ostealgia, weight loss, and anemia were the most common symptoms, followed by cutaneous lesions, lymphadenopathy, hepatosplenomegaly, cough, sputum, and stethalgia. Ostealgia, joint pain, and joint disorders were also recorded. White blood cell and neutrophil counts were increased (mean 22.3 ± 7.4 × 10(9) cells/L; mean 18.84 ± 4.5 × 10(9) cells/L, respectively). The most common sites were the vertebrae, skull and femur, ribs and ilium, though the clavicle, scapula, humerus, and tibia were also involved. Radiography and computed tomography (CT) showed multiple radiolucencies with moth-eaten bone destruction, periosteal proliferation, bone fracture, and surrounding soft-tissue swelling. Emission CT showed significantly increased uptake in many skeletal regions. Positron emission tomography/CT showed generalized lymphadenopathy, bone metabolic activity, and bone destruction. The (18) F-FDG standard uptake value was increased in the entire skeleton (mean 6.16). Twelve patients received antifungal therapy, four of whom died during treatment, and eight recovered, though four of these eight relapsed within 3-24 months. Two patients discontinued treatment because of severe multiple organ failure and died. CONCLUSIONS: Osteolysis is often overlooked in HIV-negative individuals with disseminated P. marneffei infection. However, P. marneffei involving the bone and leading to osteolysis may indicate severe systemic disturbance, and is characterized by a poor prognosis, high recurrence rate, and the need for prolonged antifungal treatment.

A case of Penicillium marneffei infection involving the main tracheal structure.

BACKGROUND: Penicillium marneffei is the only dimorphic member of the genus and is an emerging pathogenic fungus that can cause fatal systemic mycosis. Penicillium marneffei disseminates hematogenously to other locations. Penicillium marneffei infection most commonly involves the skin, lungs, and reticuloendothelial system, including the bone, bone marrow, joints, lymph nodes, pericardium, liver, and spleen. Involvement of the mesenteric and central nervous systems has also been reported. Infection involving the trachea has not been previously reported. CASE PRESENTATION: We herein report a previously healthy 28-year-old male farmer from Guangxi Province without HIV who became infected with P. marneffei. The infection primarily affected the trachea, resulting in structural damage to the cartilage, tracheal stenosis, and tracheal absence. The infection also involved the lungs and lymph nodes. After antifungal treatment and surgery, his symptoms, signs, and lung imaging findings showed significant improvement. This is the first such case report. CONCLUSION: Penicillium marneffei infection in normal hosts is characterized by an insidious onset, various clinical manifestations, and common misdiagnosis, leading to high mortality rates. Penicillium marneffei hematogenously disseminates throughout the whole body. This is the first reported case of P. marneffei infection involving the main trachea with subsequent structural damage to the tracheal cartilage, severe tracheostenosis, and tracheal absence.

Differential Diagnosis of Pathological Type of Peripheral Lung Cancer with Multimodal Contrast-Enhanced Ultrasound.

OBJECTIVE: The goal of the work described here was to investigate the role of multimodal contrast-enhanced ultrasound in the differential diagnosis of peripheral lung cancer. METHODS: From April 2017 to July 2021, 109 patients with confirmed pulmonary malignant lesions who underwent CEUS examination were involved in our study. Seven patients were excluded because of the short duration of CEUS video or unsatisfactory imaging. Finally,102 patients with peripheral lung cancer were enrolled in this study. The maximum diameter of the lesions ranged from 1.6 to 13.0 cm (mean 6.2 ± 2.3 cm). On the basis of the pathological results, the patients were divided into the small cell lung cancer (SCLC) group and non-small cell lung cancer (NSCLC) group (including adenocarcinoma, lung squamous cell carcinoma and large cell neuroendocrine carcinoma). A Logiq E9 ultrasonic machine equipped with a 3.5 to 5.0 MHz C5-1 probe was used. Patient clinical information, CEUS features, CPI patterns and TIC parameters were analyzed and compared between different groups. Statistical analyses were performed with SPSS software and MedCalc software. The receiver operating characteristic curve was plotted. RESULTS: In the differential diagnosis of SCLC and NSCLC, color parametric imaging indicated great performance. NSCLC exhibited a centripetal enhancement pattern more frequently (72.7%), while SCLC exhibited an eccentric enhancement pattern more frequently (92.9%) (p < 0.001). In the differential diagnosis of adenocarcinoma and squamous cell carcinoma, logistic regression analysis revealed that patient age of onset ≤60 y, difference in arrival time between lung and tumor ≤3.8 s, drop time of the time-intensity curve >23.2 s and absence of internal necrosis on CEUS were independent predictors for adenocarcinoma (area under the curve = 0.861). CONCLUSION: In our study, multimodal contrast-enhanced ultrasound provided useful information in the differential diagnosis between small cell lung cancer and non-small cell lung cancer, especially between adenocarcinoma and squamous cell carcinoma.

Advances in long non-coding RNA regulating drug resistance of cancer.

Drug resistance is one of the main challenges in cancer treatment. Long non coding RNAs (lncRNAs) play a complex and precise regulatory role in regulating drug resistance of cancer. The common ways of lncRNA regulating drug resistance of cancer involve ATP binding transporter overexpression, abnormal DNA damage response, tumor cell apoptosis, accumulation of epithelial mesenchymal transformation and cancer stem cell formation. Moreover, studies on exosomal lncRNAs regulating cancer drug resistance are developed in recent years. Further study on the role and mechanism of lncRNAs drug resistance in cancer will help clinical cancer treatment program and explore new treatment methods. This paper reviews recent advances in lncRNAs regulating drug resistance of cancer, especially the role of exosomal lncRNAs.

The role of brain natriuretic peptide and serum triiodothyronine in the diagnosis and prognosis of chronic heart failure.

OBJECTIVE: The objective of this paper was to investigate the diagnostic and prognostic value of plasma B type natriuretic peptide (BNP) and serum triiodothyronine (T3) in chronic congestive heart failure (CHF). METHODS: 156 cases of CHF patients and 75 cases of cardiac function I patients hospitalized over the same period were utilized in this study. On admission, the patient's BNP and T3 plasma concentrations were measured. The correlation analysis of plasma BNP and T3 in CHF patients with cardiac function classification was conducted. RESULTS: According to the NYHA grading systems, the plasma BNP levels in patients with II, III, and IV grade CHF were significantly higher than those with cardiac function I (P < 0.05); BNP levels and NYHA grading of cardiac function correlated positively. The BNP concentrations increased with CHF progression (P < 0.01). The T3 level and NYHA grading of cardiac function correlated negatively.TheT3 level decreased as the degree of heart failure increased. Using CHF in combination with BNP to predict the occurrence of CHF had a sensitivity value of 90.8% with 95.5% specificity, 86.3% accuracy, and a negative predictive value of 87.7%. CONCLUSIONS: Plasma BNP was more sensitive than T3 in the diagnosis of CHF. The T3 was more meaningful than the BNP in the prognosis of CHF. The BNP and T3 combination detection was more valuable in determining the severity of CHF and prognosis.

Circular RNA_0033596 aggravates endothelial cell injury induced by oxidized low-density lipoprotein via microRNA-217-5p /chloride intracellular channel 4 axis.

In recent years, the modulatory functions of some circular RNAs (circRNAs) in the pathogenesis of atherosclerosis (AS) have been reported. Nonetheless, the role of circular RNA_0033596 (circ_0033596) in AS and its mechanism remains unclarified. In this study, oxidized low-density lipoprotein (ox-LDL) was applied to treat human umbilical vein endothelial cells (HUVECs) to establish a cell model of endothelial cell injury. Western blot and quantitative real-time polymerase chain reaction (qRT-PCR) were employed to detect the expression of circ_0033596, microRNA-217-5p (miR-217-5p), and chloride intracellular channel 4 (CLIC4) in HUVECs. The binding sites between circ_0033596 and miR-217-5p, as well as between miR-217-5p and CLIC4 mRNA 3'UTR were determined through a dual-luciferase reporter gene assay. It was found that circ_0033596 expression was increased in ox-LDL-induced HUVECs. After ox-LDL stimulation, HUVEC viability and cell cycle progression were inhibited, and the apoptosis was promoted, while circ_0033596 overexpression aggravated these effects. MiR-217-5p was identified as a downstream target of circ_0033596, and circ_0033596 negatively regulated miR-217-5p expression. CLIC4 was identified as miR-217-5p's downstream target gene and could be positively modulated by circ_0033596. All in all circ_0033596 aggravates ox-LDL-induced HUVEC apoptosis by regulating the miR-217-5p/CLIC4 axis, by which circ_0033596 participates in the pathogenesis of AS.

Cellulosic hydrocarbons production by engineering dual synthesis pathways in Corynebacterium glutamicum.

BACKGROUND: Lignocellulose provides the only practical carbohydrates feedstock for sustainable bioproduction of hydrocarbons as future alternative of fossil fuels. Production of hydrocarbons from lignocellulose is achieved by a biorefinery process chain including pretreatment to breakdown the crystalline structure for cellulase-catalyzed hydrolysis, detoxification of inhibitory compounds generated during pretreatment, enzymatic hydrolysis to fermentable monosaccharide sugars, and fermentation to hydrocarbon products. The major barriers on fermentative production of hydrocarbons from lignocellulose include two aspects: one is the inherent stress of pretreatment-derived inhibitors on microbial cells, the other is the toxicity of hydrocarbons to cell membranes. The microbial cell factory should be tolerant to both inhibitor stress and hydrocarbons toxicity. RESULTS: Corynebacterium glutamicum was selected as the starting strain of hydrocarbons synthesis since it is well adapted to lignocellulose hydrolysate environment. The dual hydrocarbon synthesis pathways were constructed in an industrial C. glutamicum S9114 strain. The first pathway was the regular one in microalgae composed of fatty acyl-acyl carrier protein (fatty acyl-ACP) reductase (AAR) and aldehyde deformylating oxygenase (ADO) with fatty acyl-ACP as precursor. The second pathway was the direct decarboxylation of free fatty acid by fatty acid decarboxylase (OleT) using the rich fatty acids from the disruption of the transcriptional regulator fasR gene. The transmembrane transportation of hydrocarbon products was avoided by secretively expressing the fatty acid decarboxylase (OleT) to the extracellular space. The hydrocarbons generation from glucose reached 29.2 mg/L, in which the direct decarboxylation pathway contributed more than 70% of the total hydrocarbons generation, and the AAR-ADO pathway contributed the rest 30%. CONCLUSION: The dual hydrocarbon synthesis pathways (OleT and AAR-ADO pathways) were constructed in the inhibitors tolerant C. glutamicum S9114 strain for hydrocarbon production using lignocellulose feedstock as the starting feedstock. When corn stover was used for hydrocarbons production after dry acid pretreatment and biodetoxification, the hydrocarbons generation reached 16.0 mg/L. This study provided a new strategy for hydrocarbons synthesis using microbial cell factory suitable for lignocellulose feedstock.

[Effects of simulated rainfall enhancement on sediment CO2 flux in dry lakebed of Barkol Lake, China]. / 模拟增雨对巴里坤湖干涸湖底沉积物CO2通量的影响.

Understanding the responses of lake sediment carbon process to climate change is an important part of a comprehensive understanding of lake carbon budget. To explore the effects of future rainfall increase on sediment carbon flux, undisturbed sediment samples were collected from the bottom of dry lake Barikun in Hami, Xinjiang for the incubation experiment. Based on the increase rate of precipitation (4 mm·10 a-1) and the distribution characteristics of rainfall in the plant growing season in Hami, Xinjiang since 1960, five rainfall treatments were set (86 mm, T0; 94 mm, T1; 102 mm, T2; 110 mm, T3; 126 mm, T4) based on the rainfall in growing season of 2016 (86 mm). We analyzed the effects of rainfall increase on sediment CO2 flux. Results showed that compared with that before rainfall, the sediment CO2 flux increased after 1 day of rainfall in the study area. Compared with that during May to July, the CO2 flux of sediments in August to October decreased. There was no variation of CO2 accumulative emission among the T0-T3 treatments from May to October. However, the average CO2 emission rate under the T3 treatment (0.22 µmol·m-2·s-1) was significantly higher than that under the T4 treatment (0.14 µmol·m-2·s-1). All treatments showed CO2 sink at the first day of rainfall (1 d), with T4 treatment (-0.13 µmol·m-2·s-1) having the highest "carbon sink" capacity. After 1 day, the CO2 sink converted to CO2 source under the five rainfall treatments, with the CO2 emission rate under T3 treatment (0.34 µmol·m-2·s-1) being significantly higher than those under other treatments. Compared with May, the CO2 emission fluxes of T2-T4 treatments were significantly higher than those at the time from August to October. Under the condition with relatively stable temperature, the CO2 flux of sediments was significantly correlated with the sediment moisture and air humidity. In the next 60 years, the continuous increase of future rainfall may be an important factor promoting CO2 emission from lake sediment in arid regions, and thus affecting global warming.

Bis[µ(2)-bis-(diphenyl-phosphan-yl)methane-κP:P']bis-(µ(4)-diphenyl-phosphinato-κO:O:O':O')bis-(µ(2)-trifluoro-acetato-κO:O')tetra-silver(I) acetonitrile disolvate.

In the cation of the title compound, [Ag(4)(C(2)F(3)O(2))(2)(C(12)H(10)O(2)P)(2)(C(25)H(22)P(2))(2)]·2CH(3)CN, the two independent Ag(+) cations are four-coordinated in a distorted tetra-hedral geometry by one P atom from a bis-(diphenyl-phosphan-yl)methane (dppm) ligand, one O atom from a trifluoro-acetate anion and two O atoms from two diphenyl-phosphinate (dpp) ligands. Two dppm ligands, two dpp ligands and two trifluoro-acetate anions bridge four metal atoms, forming a centrosymmetric tetra-nuclear complex. Intra-molecular C-H⋯O hydrogen bonds and a weak π-π inter-action [centroid-centroid distance = 3.9804 (13) Å] are also observed.

IGF-1R anti-idiotypic antibody antagonist exhibited anti-ovarian cancer bioactivity and reduced cisplatin resistance.

Ovarian cancer is the most deadly gynecological malignant tumor in the world today. Previous studies have shown that insulin-like growth factor-1 receptor (IGF-1R) is closely related to the occurrence and development of ovarian cancer, and ovarian cancer cells endogenously express high IGF-1R. Therefore, IGF-1R could be used as a target for ovarian cancer treatment. In the past, the strategy for preparing IGF-1R antagonists was to use IGF-1R antibody and small-molecule inhibitor. In the current research, we use a new method to prepare IGF-1R antagonists. We prepared a series of IGF-1 internal imaging anti-idiotypic antibodies by anti-idiotypic antibody strategy. After a series of screening and identification, one of the anti-idiotypic antibodies (B003-2A) was selected for further evaluation, and the results showed that B003-2A could not only inhibit the binding of IGF-1 to IGF-1R but also inhibit the signaling mediated by IGF-1R. Further work showed that B003-2A inhibited the proliferation of ovarian cancer cells in vivo and in vitro. In addition, the current study also indicates that B003-2A could enhance the sensitivity of cisplatin in cisplatin-resistant ovarian cancer cell lines. In summary, our research shows that B003-2A can be used to treat ovarian cancer. The current study also laid the foundation for the development of IGF-1R antagonist.

[Nutrient resorption patterns of Phragmites australis leaves and its response to soil moisture in Yangguan wetland, Dunhuang, Northwest China]. / æ•¦ç Œé˜³å ³æ¹¿åœ°èŠ¦è‹‡å¶ç‰‡å »åˆ†é‡å¸æ”¶æ¨¡å¼åŠå ¶å¯¹åœŸå£¤æ°´åˆ†çš„å“åº”.

Nutrient resorption of leaves is an important nutrient conservation mechanism for plants in nutrient-poor habitats. Understanding the responses of leaf nutrient resorption to soil moisture is helpful to reveal the adaptation strategies of plants to the environment. In this study, the dominant plant in the Yangguang wetland of Dunhuang Phragmites australis was used as research material, to explore nitrogen and phosphorus resorption patterns of P. australis leaves and their responses to soil moisture under different moisture regimes, i.e. high (33.5%±1.9%), medium (26.4%±1.3%) and low (11.3%±1.5%). The results showed that: 1) With the decreases of soil moisture, soil N concentration decreased significantly, and N concentrations in mature and senescent leaves increased significantly, the P concentration in mature and senescent leaves as well as in soil did not change. 2) N resorption efficiency of leaves under high moisture condition was 76.1%, which was significantly higher than the medium (65.5%) and low (62.5%) moisture conditions. P resorption efficiency varied among different moisture conditions. 3) The N concentrations of mature and senescent leaves were negatively correlated with N resorption efficiency. There was no significant correlation between P concentration and P resorption efficiency in mature leaves, but the P concentration of senescent leaves was negatively correlated with P resorption efficiency of leaves. As a result, water scarcity is not conducive to leaf N resorption.

Study on syndrome element characteristics and its correlation with coronary angiography in 324 patients with coronary heart disease.

OBJECTIVE: Recently, a new traditional Chinese medicine differentiation theory "Syndrome Element (SE)" has been raised. In this study, the main syndrome element types and their correlations with the results of coronary angiography (CAG) in patients with coronary heart disease (CHD) were investigated. METHODS: Epidemiology cross-sectional study method was employed and 324 patients with CHD were enrolled, and their syndrome element types as well as the CAG results were analyzed. The correlations among syndrome element types, Gensini score, and the number of abnormal branches were also analyzed based on the distribution characteristics of syndrome element and coronary angiography results in the 324 cases. RESULTS: According to their occurrence frequency in 324 CHD patients, the top eight major heart syndrome elements were Xin () blood stasis (85.8%), Xin qi deficiency (79.6%), Xin heat blockage (41.1%), Xin phlegm with turbid fluid (38.0%), Xin qi stagnation (24.7%), Xin yang deficiency (18.9%), Xin yin deficiency (17.5%) and Xin cold coagulation (4.4%), respectively, which suggested that Xin blood stasis and Xin qi deficiency were the two most common syndrome elements. Also, as coronary artery Gensini score increased, the changing trend of the syndrome element was "Xin yang deficiency with blood stasis" to "Xin phlegm obstruction with heat blockage" to "Xin yin deficiency with blood stasis" to "Xin qi deficiency with blood stasis" to "Xin cold coagulation with phlegm and turbid fluid, "Xin cold coagulation with blood stasis" to "Xin deficiency of qi, yin and yang". As the number of abnormal branches increased, the syndrome element changing trend was "simultaneous occurrence of cold and heat syndrome" to "Xin qi and yang deficiency with blood stasis" to "Xin retention of phlegm with turbid fluid" to "Xin cold coagulation in the heart meridian", "Xin deficiency of both qi and yin". The result of this study shows that Xin qi deficiency and Xin blood stasis were the major syndrome elements in patients with CHD. CONCLUSION: As the severity and extent of coronary artery lesion increased, there were some apparent correlations among syndrome elements, Gensini score and number of abnormal coronary artery branches.

Enzymatic synthesis of human blood group P1 pentasaccharide antigen.

The enzymatic synthesis of biologically important and structurally unique human P1PK blood group type P1 pentasaccharide antigen is described. This synthesis features a three-step sequential one-pot multienzyme (OPME) glycosylation for the stepwise enzymatic chain elongation of readily available lactoside acceptor with cheap and commercially available galactose and N-acetylglucosamine as donor precursors. This enzymatic synthesis provides an operationally simple approach to access P1 pentasaccharide and its structurally related Gb3 and P1 trisaccharide epitopes.

[Clinical study on compatibility and dismantlement of Xuefu Zhuyu decoction].

OBJECTIVE: To investigate the regularity of traditional Chinese compound prescription by observing the clinical effect of the compatibility and dismantlement of Xuefu Zhuyu decoction on blood stasis and stagnation of qi syndrome of angina. METHOD: 123 outpatients were randomly divided into Xuefu Zhuyu group(XF), Jingzhi Xuefu Zhuyu group(JZ), Yaodui group(YD) and placebo group and treated. RESULT: The array of angina effect and blood stasis and qi stagnation of syndrome effect was XF group, JZ group, YD group, placebo group( P < 0.01). The levels of blood viscosity, platelet adhesiveness, RED transfigure were significantly different before and after treatment in XF group (P < 0.05). The levels of blood viscosity, platelet adhesiveness were significant different before and after treatment in JZ group ( P < 0.05). The levels of blood plasma viscosity, platelet adhesiveness were significantly different before and after treatment in YD group ( P < 0.05). The levels of platelet adhesiveness, RED transfigure were significantly different before and after treatment in placebo group (P < 0.05). There are no difference among levels of blood lipoprotein and ET of four groups ( P > 0.05). Significant difference was found among four groups in increase of NO and t-PA and decrease of IL-6 (P < 0.05). CONCLUSION: The clinical effect and indexes amelioration are correlated to the combination of prescription and the corresponding degree of prescription to syndrome. There are same material foundation in the series of Xuefu Zhuyu dismantle decoction, but the function degree and targets are different with the change of herbs. The method of conjugating disease and syndromes, and prescription to syndromes are a practical pattern to expound the relationship between disease and syndrome.

[Research on quantified diagnosis and combining diseases with syndrome of blood stasis].

OBJECTIVE: To explore the way of quantified diagnosis of blood stasis syndrome (BSS) and the essence of BSS. METHODS: Using t-test and logistic regression to analyze the symptoms, signs, and objective indexes of BSS in clinical test. RESULTS: (1) The levels of endothelin, nitric oxide, and t-PA between 182 patients with BSS and non-BSS had notable difference. (2) The stepwise regression analysis about hemoglobin, triglyceride, total cholesterol, endothelin, nitric oxide, and t-PA in 170 patients with BSS or non-BSS revealed that the order of these indexes considering their importance was: endothelin, hemoglobin, t-PA, nitric oxide. However, the triglyceride and total cholesterol could not enter the regression equations. (3) The stepwise regression analysis about 40 symptoms and signs in 601 patients with BSS or non-BSS revealed that the 18 items had the very contribution to diagnose the BSS when the F value was 6, and so a regression equation was available. The total coincidence ratio was 94.24% when the other quantified data about BSS were tested in the equation. CONCLUSION: The standardized TCM syndrome, which accorded with the criteria of combining diseases with syndrome, was made up of symptoms, signs, and objective indexes. The standard could be obtained by multi-center, prospective, random and controlled clinical epidemiological survey and clinical test.

[Effects of short-action hypnotics triazolam and zopiclone on simulated flight performance].

OBJECTIVE: To evaluate the effects of short-action hypnotics triazolam and zopiclone on simulated flight performance so as to provide experimental evidences for the use of these drugs in aircrew. METHOD: Six healthy young male volunteers served as the subjects. They were asked to take triazolam (0.25 mg), zopiclone (7.5 mg) or placebo at noon time (13:00) and sleep for 1 h. Simulated flight performances were tested in a simulator 1 h, 2 h, 3 h, 4 h, 6 b, 8 h, 10 h and 20 h (next morning 9:00) after taking the drugs. The experiments were done once a week for 3 weeks. RESULT: No significant difference was found between simulated flight performances before or after triazolam while simulated flight performances at 2 h and 3 h after taking zopiclone showed significant decrease (P<0.05), but restored to normal 4 h after taking the drug. CONCLUSION: Short-action hypnotics triazolam had no significant effect on simulated flight performance, while zopiclone had significant adverse effects on simulated flight performance at 2 h and 3 h after taking the drug.

Audits of the quality of perioperative antibiotic prophylaxis in Shandong Province, China, 2006 to 2011.

BACKGROUND: A prospective multicenter survey was conducted to assess the rational use of antibiotics in clean and clean-contaminated elective surgical procedures applied in 53 grade III first class hospitals in Shandong Province, China, from 2006 to 2011. The survey was designed to examine the prevalence of antibiotic prophylaxis, evaluate the quality of perioperative antibiotic prophylaxis (PAP) prescriptions, and investigate the risk factors associated with inappropriate indication for antibiotic prophylaxis. METHODS: Medication charts and medical, anesthetic, and nursing records were reviewed. Antibiotic prescriptions were compared with the Chinese National Antibiotic Guideline on indication, antibiotic combination, antibiotic choice, dose, dosing interval, route of administration, timing of first administration, and duration of prophylaxis. RESULTS: 14,261 of 14,525 procedures (98.2%) receiving antibiotic prophylaxis. The most frequently encountered noncompliance types were PAP indications (18.6%), duration of prophylaxis (26.7%), and timing of first administration (30.3%). The steps of PAP were justified and correct only in 9.4% of procedures. Risk factors independently associated with inappropriate indication for antibiotic prophylaxis were seen in age, hospital type, hospital size, surgical disciplines, and surgical duration. CONCLUSION: Results showed a significantly high rate of antibiotic prophylaxis in clean and clean-contaminated elective surgery and also a high prevalence of inappropriate indication prescriptions. These findings suggest important areas for intervention and implementation of antibiotic stewardship policies in Shandong Province hospitals.