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Objective: To summarize the research progress of adipose-derived stem cells (ADSCs) in promoting the repair of peripheral nerve injury. Methods: The related literature at home and abroad in recent years was widely reviewed, the mechanism of ADSCs promoting the repair of peripheral nerve injury was introduced, and its basic research progress was analyzed and summarized. Finally, the clinical transformation application of ADSCs in the treatment of peripheral nerve injury was introduced, the existing problems were pointed out, and the new treatment regimen was prospected. Results: ADSCs have the function of differentiation and paracrine, and their secreted neurotrophic factors, antiapoptosis, and antioxidant factors can promote the repair of peripheral nerve injury. Conclusion: ADSCs are rich in content and easy to obtain, which has a definite effectiveness on the repair of peripheral nerve injury with potential clinical prospect.
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Objective@#To investigate the clinical effects of free superficial femoral artery femoral triangle perforator flap in the repair of skin and soft tissue defects in extremities.@*Methods@#From January 2016 to November 2017, 14 patients (9 males and 5 females, aged 19 to 54 years) with skin and soft tissue defects in extremities accompanied with tendon and bone exposure were admitted to our unit. The size of skin and soft tissue defects after debridement ranged from 7 cm×3 cm to 10 cm×7 cm. The defects were repaired with free superficial femoral artery femoral triangle perforator flaps, with size ranging from 13.0 cm×2.0 cm to 20.0 cm×4.5 cm. The medial femoral cutaneous nerve was applied to the flap. The perforator flap was grafted onto the medial femoral cutaneous nerve in 6 patients. The donor sites were sutured directly. The survival of flaps and the follow-up of patients were observed.@*Results@#All flaps of 14 patients survived successfully. The recipient sites and donor sites were healed completely in 13 patients, and 1 patient with partial skin necrosis at the edge of flap was healed after treatment. All patients were followed up for 6 months to 1 year after the operation. The flaps were in good shape, with nearly normal color and soft texture and no cicatrix contracture deformity. The flaps recovered protective sense in 6 patients who had medial femoral cutaneous nerve grafting, and the sensory recovery of the flap was slightly worse in the remaining 8 patients. There was no significant complications on the appearance and walking of the donor thigh in 14 patients, only a linear scar was left on the inner thigh, and no numbness was felt in the donor sites of patients.@*Conclusions@#The free superficial femoral artery femoral triangle perforator flap is an ideal therapy for repairing skin and soft tissue defects in extremities.
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Objective To understand the distribution characteristics of clinical multi-drug resistant bacteri-a,provide a scientific evidence for control of infection and rational use of antibiotics.Methods The distribu-tion of multi-drug resistant bacteria in the hospital for three years was analyzed retrospectively.Results There were 19 354 non-repeating strains from 2014 to 2016,and 21.9%(4 234)of the total strains were multi-ple resistant strains.Among them,ESBLs-producing Escherichia coli was the most,followed by carbapene-re-sistant Acinetobacter baumannii(MDR-AB),ESBLs-producing Klebsiella pneumoniae,multidrug-resistant Pseudomonas aeruginosa(MDR-AB),Production of carbapene-enzyme Enterobacteriaceae bacteria(CRE), vancomycin-resistant enterococci(VRE),concentrate mainly on the ICU for high-risk areas of infection.The most were from the respiratory system specimens,followed by the urinary system specimens.Conclusion Multiple resistant bacteria are growing critical.There should be more attention to be paid in bacteriological ex-amination for clinic,the clinical isolation of pathogenic microorganisms in the hospital should be grasped.The antimicrobial agents should be rationally applied according to the results of bacterial susceptibility,in addition the management of antimicrobial agents and multi-drug monitoring should be strengthened.
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Objective To determine the triterpenoid content in Loquat leaf by using HPLC method and to explore the feasibility of ursolic acid and oleanolic acid as the quantitative markers for determination of Loquat leaf and its preparations.Methods Two desugaring methods of Loquat leaf extracts were compared.The contents of ursolic acid and oleanolic acid in Loquat leaf as well as preparations were measured based on a system of HPLC,with a Dumas Diamonsil C18 column (250 mm×4.6 mm,5 μm) was used as analytical column.The mobile phase was consisted of acetonitrile-0.1% phosphoric acid (95∶5) with the flow rate of 0.5 mL·min-1.The column temperature was 30 ℃,the injection volume was 10 μL, the detective wavelength was 210 nm.Results Ursolic acid and oleanolic acid were measured in both Loquat leaf and its preparations,and their contents were fairy stable and comparable.Conclusion Ursolic acid and oleanolic acid can be served as quantitative markers for the determination of Loquat leaf and its preparations.
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Objective To establish a homothermal and fast detecting method on pathogenic bacteria by combining recombinase-aid amplification (RAA) with molecular beacon.Methods The establishment of the methodology.Staphylococcus aureus specific primers were designed from the relative region of the staphylococcal protein A (SPA).Asymmetry amplification was optimized by adjusting the primer concentration ratios.The results of amplification and hybridization were visualized and analyzed by agarose gel electrophoresis and fluorescence detection.The sensitivity was identified by detecting dilute positive plasmids.And the specificity was determined using RAA method by detecting 72 pathogenic bacteria,including Staphylococcus aureus and other Staphylococcus spp.from the Department of Clinical Laboratory of Daping Hospital in December 2016.Besides,the Kappa analysis and the clinical diagnosis efficiency were investigated by analyzing 39 extra strains in the laboratory in December 2016.Results When the concentration ratio of restrictive and non-restrictive primer was 1:20,the yield efficiency of single-stranded DNA (ssDNA) reached the peak.And as for the hybridization efficiency,the asymmetry amplification was higher than symmetry amplification.Twenty copies/μl was proposed as the limits of detection by testing dilute plasmids.And the RAA hybridization method could distinguish Staphylococcus aureus with other Staphylococcus spp.Comparing with traditional detection methods with a Kappa index of 0.860,this method shows a good consistency.By analyzing the 111 bacteria,the sensitivity of the method is 92.5％ (37/40),the specificity is 97.2％ (69/71),the positive predictive value is 94.9％ (37/39),the negative predictive value is 95.8％ (69/72),the positive likelihood radio is 33.04,the negative likelihood radio is 0.077,the Youden index is 0.897 and the Kappa index is 0.902.Conclusion Through the combination of asymmetry recombinase-aid amplification optimization and molecular beacon probe,a new method of detecting bacteria DNA with RAA hybridization technique is established,providing the foundation for its clinical application.
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Objective To investigate the interaction between rifampin(RFP)and levofloxacin(LVFX)in retreatment of smear positive pulmonary tuberculosis(TB). Methods One hundred retreated smear positive TB patients admitted to our hospital between January 2013 and December 2015 were randomly divided into two groups:the control group in 50 patients with only RFP treatment,and the treatment group in 50 patients with both RFP and LVFX treatments. The RFP plasma concentration was tested 0.5 h,1 h,and 2 h after intake of medicine. Sputum smear test was performed at the end of February,May,August and September to investigate the interaction between RFP and LVFX in retreatment of smear positive TB. Results The plasma concentration of RFP did not show significant difference(P > 0.05)between the control group and the treatment group at 0.5 h,1 h,and 2 h after intake of medicine. As the treatment time went on,the level of smear positive gradually decreased. The sputum smear positive rate after 2,5,8,and 9 months of treatment showed significant difference between the control group and the treatment group. After 8 months of treatment,the ratio of stabilized patients and patients under treatment also showed significant difference(P<0.05). Conclusion Rifampicin and levofloxacin have no antagonism effect in retreatment of smear positive TB,and RFP and LVFX can be used together to treat the repeated smear positive TB.
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Objective To compare and analyze the influencing factors of the distribution and drug resistance of blood culture positive pathogens in neonatal intensive care unit (NICU) at different altitude areas.Methods The distribution of blood culture positive pathogens and clinical susceptibility of children in NICU of two different altitude hospitals in 2015 were retrospectively analyzed.Results In 2015,children in NICU in upper elevation district hospital mainly infected with 19 strains(18.4％) of epidermis staphylococcus,18 strains(17.5 ％) of Escherichia coli,14 strains(13.6 ％) of Klebsiella pneumoniae,14 strains(13.6 ％) of Hemolysis staphylococcus,12 strains(11.7 ％) of Stenotrophomonas maltophilia;Children in NICU at low altitude hospital mainly infected with 31 strains(19.7％) of epidermis staphylococcus,27 strains(17.2％) of Achromobacter xylosoxidans,18 strains(11.5％) of Hemolysis staphylococcus,14 strains(8.9 ％) of Klebsiella pneumoniae,14 strains (8.9 ％) of Acinetobacter baumannii.The detection rate of Gram-negative bacilli in high altitude hospital was higher,and the detection rate of Gram positive cocci in low altitude hospital was higher.In high-altitude district hospital,the detection rate of methicillin-resistant coagulase negative staphylococci (MRCNS) extended-spectrum β-lactamase (ESBLs),and multidrug-resistant Acinetobacter baumannii(MDRAB) were than low altitude hospital.Conclusion Escherichia coli and Stenotrophomonas maltophilia detection rate and common antibiotics sensitive rate are relatively high at upper elevation areas;Detection rate of coagulase negative Staphylococcus aureus and common antibiotics resistance rate are high in low altitude.Different altitudes environmental factors may play an important role in pathogens distribution and drug resistance from NICU blood culture.
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Objective To investigate the distribution and changes of microorganisms on the skin of submariners under a chronically closed environment , and provide reference for targeted medical support .Methods One hundred and twenty-two samples were collected using swab.After culture and isolation, the microbes were identified by matrix-assisted laser desorption/ionization time of flight mass spectrometry ( MALDI-TOF-MS) .Results A total of 52 types of 229 bacteria and 2 types of fungi were isolated . Major opportunistic pathogens included Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter cloacae, while major dwelling bacteria included Micrococcus luteus, Oslo Mora bacteria, Acinetobacter, Staphylococcus epidermidis, and Serratia marcescens.Compared with the early period of the task, major opportunistic pathogens and dwelling bacteria were significantly increased in the middle and late period of the task .Conclusion The skin microbes of the submariners are investigated , targeted drugs need to be prepared for daily medical support and war trauma .
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By reviewing the latest published papers on palliative care, the article discussed the development and research progress of palliative care for people with advanced cancer, so as to provide reference for the development of palliative care specialty. According to the analysis, it suggested that by means of striving for more government support in both economic and education, raising funds through various channels, perfecting the social insurance system and volunteer′s regimen, promoting group working model, establishing standardized policies and regulations, increasing the publicity of palliative care, palliative care would move forward to a professional and normalized road, so that the people with incurable disease will receive better palliative care to improve the quality of life to the most.
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Objective To establish a new method for rapid detection of β-thalassemia by investigating six clinical common mutation types.Methods Fifty cases of clinical wild-type samples and 42 cases ofβ-thalassemia samples were collected, and β-globin gene was amplified by PCR.Uniform ligation probe ( ULP) specific probes were designed for hybridization reaction to increase the reaction specificity and real-time PCR was performed to increase the sensitivity.After that, PCR products were verified by agarose electrophoresis.After examining the specificity and sensitivity, Kappa test between LDR-ULP method and reverse dot blot( RDB) method was conducted.Results Hybridization efficiency was improved 2.53 times by LDR-ULP hybridization.Each mutant type showed a significant amplification curve, whereas the wild-type had no significant curve within 40 cycles.The limit of determination of this method was 5 pg.The results of 92 cases of peripheral blood samples detected by the method of LDR-ULP and RDB were completely consistent.Conclusion In this study, a simple, inexpensive, rapid new method to detect β-thalassemia were established.
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Objective To investigate the diagnostic value of 64-slice CT angiography (CTA) to head and neck artery pathological changes.Methods One hundred patients with clinical suspicion of head and neck vascular lesions were retrospectively analyzed.Sixty four cases of lesions were detected by 64-slice CTA,and were checked by Digital Subtraction Angiography (DSA) within a week.First,the correlation of 64-slice CTA and DSA diagnosis of head and neck artery stenosis grade was counted.Then DSA was taken as the gold standard.The sensitivity,specificity,positive predictive value,and negative predictive value of 64-slice CTA to diagnose head and neck arteries stenosis were calculated.Results Of 64 cases of patients,2 cases of congenital vascular dysplasia,including 1 case with internal carotid artery in 2 cases,the remaining 60 patients had different degree of stenosis.The sensitivity,specificity,positive predictive value,and negative predictive value of 64-slice CTA was 95.34％,99.48％,97.62％,and 98.98％,respectively.Among 60 narrow patients,the plaque number was 205,including 88 soft plaques,56 mixed plaques,and 61 calcified plaque.Conclusions The 64-silce CTA has multiple advantages including rapid,noninvasiveness,high accuracy and safety,and high application value in the diagnosis of head and neck vascular lesions.It is worth promoting.
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Objective To explore the relationship between quality items of chest compression for resuscitation of cardiac arrest and to identify the key points in chest compression training and practice.Method The training project was offered to 219 healthcare workers by using Laerdal ACLS advanced life support resuscitation model, and the quality issues of chest compression were monitored including compression hands placement,compression rate,compression depth,and chest wall recoil,as well as selfreported fatigue time by Laerdal Computer Skills and Reporting System.Results The quality of chest compression was related to the geuder of the practitioner.The items in males including self-reported fatigue time,the accuracy of compression depth and the compression rate,the accuracy of compression rate were higher than those in females.However,the chest recoil rate was higher in females than that in males.The quality items of chest compression were correlated with one another. The self-reported fatigue time was related to all the items except the compression rate.Conclusions It is necessary to offer cardiopulmonary resuscitation (CPR) training courses regularly. In clinical practice,it might be better to change the practitioner before fatigue,especially for female or weak practitioners.In training projects,more attention should be paid to the control of compression rate, in order to delay the fatigue, guarantee enough compression depth and improve the quality of chest compression.
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<p><b>OBJECTIVE</b>To study the chemical constituents from Lobelia chinensis.</p><p><b>METHOD</b>The constituents were extracted with 95% EtOH, partitioned with different solvents, and isolated and purified by silica gel column chromatography and crystallization, their structures were elucidated by physico-chemical properties and spectroscopic data.</p><p><b>RESULT</b>Seven compounds were isolated from the titled plant. They were identified as 5-hydroxy-4'-methoxyflavone-7-O-rutinoside (1), n-butyl-O-beta-D-fructopyranoside (2), 5,7-dimethoxycoumarin (3), cirsiumaldehyde (4), diosmetin (5), 5-hydroxymethyl-2-furancarboxaldehyde (6), and 6-hydroxy-7-methoxycoumarin (7).</p><p><b>CONCLUSION</b>Compounds 2-4, 6, and 7 were obtained from the titled plant for the first time.</p>