Knowledge and practice of nosocomial infection control among medical professionals in grassroots healthcare institutions / 预防医学

Objective@#To investigate the current status of knowledge and practice pertaining to nosocomial infection control among medical professionals in grassroots healthcare institutions, so as to provide the evidence of improving the level of infection control in grassroots healthcare institutions.@*Methods@#All medical professionals working in grassroots healthcare institutions in Pukou District, Nanjing City, were enrolled. The participants' demographic features and knowledge and practice of nosocomial infection control were collected using self-designed questionnaires and descriptively analyzed.@*Results@#A total of 402 participants were enrolled, included 116 men ( 28.86% ) and 286 women ( 71.14% ). The respondents were predominantly at ages of 41 years and older ( 187 subjects, 46.52% ), with bachelor and above as the predominant educational level ( 200 subjects, 49.75% ) and intermediate title and above as the predominant professional title ( 168 subjects, 41.79%) , and there were 236 participants ( 58.71% ) with the length of service for more than 10 years. The awareness rate of nosocomial infection control knowledge was 56.22% among medical professionals working in grassroots healthcare institutions, with the highest awareness for COVID-19 prevention and control ( 89.55% ) and the lowest awareness for the key aspects in nosocomial infection control ( 39.55% ). The formation rate of implementing nosocomial infection control practices was 84.08%, with a low rate for “Implement satisfactorily the isolation interventions for patients with multidrug resistant bacteria” ( 71.14% ) and “Implement satisfactorily the control measures for nosocomial infections in key departments and key aspects”( 64.68% ).@*Conclusions@#Low levels are seen in the awareness of nosocomial infection control, behaviors of multidrug resistance management and key aspects in nosocomial infection control among medical professionals in grassroots healthcare institutions in Pukou District.

In vitro release and in situ gastrointestinal absorption of evodiamine butyryl derivative-loaded solid lipid nanoparticles / 中国药理学通报

Aim To prepare evodiamine butyryl deriva-tive (EBD) and evodiamine butyryl derivative-loaded solid lipid nanoparticles (EBDLN), and study its re-lease in vitro,and to investigate its in situ gastrointesti-nal absorption. Methods EBD was prepared by a one-step synthetized method, and then EBDLN was prepared by a film dispersion method. Dynamic dialy-sis was used to evaluate drug release in vitro,and sin-gle-pass gastrointestinal perfusion was employed to study the gastrointestinal absorption of EDM,EBD and EBDLN. Results In identical release media, there were identical drug release tendencies of EBD and EB-DLN, but the release rate of EBDLN was faster than EBD. Compared with EDM and EBD, the Kavalues and Pappvalues of EBDLN in every perfusion segment increased significantly. The Kaof EBDLN in stomach, duodenum, jejunum, ileum and colon was 110.14-fold,56.70-fold,51.23-fold,45.70-fold and 127.23-fold of free EDM respectively. The Pappvalue of EB-DLN was 9.74-fold, 4.48-fold, 3.82-fold and 11.3-fold of that of free EDM. Conclusion EBDLN has sustained effect and can enhance the gastrointestinal absorption of EDM and EBD.

Pathogenic role of leukotriene B4 in pulmonary microvascular endothelial cell hyper- permeability induced by one lung ventilation in rabbits / 南方医科大学学报

<p><b>OBJECTIVE</b>To elucidate the pathogenic role of leukotriene B4 (LTB4) in increased pulmonary microvascular endothelial cell permeability induced by one lung ventilation (OLV) in rabbits.</p><p><b>METHODS</b>Forty-eight healthy Japanese white rabbits were randomly divided into control group (group C), saline pretreatment group (group S), bestatin (a leukotriene A4 hydrolase (LTA4H) inhibitor) plus saline pretreatment group (group B), OLV group (group O), saline pretreatment plus OLV group (group SO) and bestatin plus saline pretreatment with OLV group (group BO). ELISA was used to detect LTB4 content in the lung tissues, and LTA4H and phospholipase Cεl (PLCEl) expressions were examined by Western blotting and quantitative PCR. The wet/dry weight (W/D) ratio of the lung, lung permeability index and the expressions of myosin light chain kinase (MLCK) protein and mRNA in the lung tissues were determined to evaluate the permeability of the pulmonary microvascular endothelial cells (PMVECs). The severities of lung injury were evaluated by lung histomorphological scores.</p><p><b>RESULTS</b>No significant differences were found among groups C, S and B except that LTA4H expressions was significantly lower in group B than in groups C and S (P<0.05). OLV significantly increased the expressions of LTA4H (P<0.05) and resulted in LTB4 overproduction in the lungs (P<0.05) accompanied by significantly enhanced PLCE1 expression and PMVEC permeability (P<0.05). Pretreatment with bestatin, significantly reduced the expression of LTA4H and LTB4 production (P<0.05) and down-regulated the expression of PLCE1 in the lungs of the rabbits receiving OLV (P<0.05).</p><p><b>CONCLUSION</b>Bestatin plays a protective role in OLV-induced rabbit lung injury by downregulating LTA4H to reduce the production of LTB4 in the lungs. LTB4 can increase PMVEC permeability by up-regulating PLCE1 expression in rabbits with OLV-induced lung injury.</p>

Mechanism of ischemic postconditioning relieved brain edema and cerebral infarction after cerebral ischemia in tree shrews / 解剖学报

Objective: To observe the effects of ischemic postconditioning (PC) on changes of cerebral water content, cerebral blood flow, infarct area and hippocampal ultrastructural, and to explore the neuroprotective mechanisms of ischemic PC on undergoing thrombotic cerebral ischemic injury. Methods: Tree shrews were randomly grouped into control, ischemia 4 hours, ischemia 24 hours, ischemic postconditioning 4 hours and ischemic postconditioning 24 hours (n = 8) Eight animals were used for HE staining(n = 3) and electron microscopy(n = 5). The model of thrombotic cerebral ischemia was induced by photochemistry in tree shrews. Four hours after the model establishment, the common carotid artery on the ischemia side was clamped for 5 minutes, then perfused by removing the clamp for 5 minutes, and repeated the same management 3 times, so that the model of PC was established. The changes of the brain water content of local cortex were measured by Elliott dry-wet weight and the brain infarct area was determind by 2,3,5-triphenyl-tetrazolium chloride staining. In addition, the regional cerebral blood flow of local cortex was measured by laser doppler, and the ultrastructural changes in the CA1 area of hippocampus in different groups were observed under an electron microscope. Results: More neuron pycnosis was observed in hippocampal CA1 area. Obvious swelling of mitochondria, partial disrupt and vanish of the mitochondria cristae and more endoplasmic reticulum cisterna appeared in the neuron of hippocampus at the 24th hour after cerebral ischemia. With the time prolonging of ischemic, the brain water content was significantly increased (86. 81% ± 1. 08%) in the ischemia group at the 24th hour compared with sham group. Cerebral infarction area was maximum (33.00% ±3.03%) and regional cerebral blood flow decreased obviously [(134. 27 ±28.75) ml/min]. The brain water content was significantly decreased (81. 04% ± 1. 04%, P <0. 01) and the infarct area was significantly shrink in ischemic postconditioning group (16. 79% ± 1. 29%, P < 0. 01) than that in ischemia group. The regional cerebral'blood flow in ischemic postconditioning group was in contrast to ischemia group significantly at the 24th hour [(195. 25 ±21. 18) ml/min, P<0.01]. Conclusion: Ischemic postconditioning attenuates the edema in ischemic brain and narrow the cerebral infarction area in tree shrews. The mechanism may be related to the improvement of local cerebral blood flow.

Clinical observation for internal and external intravertebral vacuum cleft bone cement injection in treatment of K mmell disease / 中国医师进修杂志

Objective To discuss bilateral percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP) using inside and outside intravertebral vacuum cleft (IVC) respectively with bone cement injection for the treatment of Kümmell disease.Methods From January 2008 to October 2015,16 cases of Kümmell disease patients were treated with bilateral PVP or PKP with inside and outside IVC perfusion of bone cement respectively.Of 16 cases,6 were male and 10 were female,aged from 63 to 94 years,with a disease duration from 2 to 15 months.The bone mineral density of every patient was measured by dual-energy X-rayabsorptiometry.The T value ranged from-4.3 to-2.6.Fractures located from T10 to L4,including 2 cases of multiple fractures.Postoperative X-ray was used to observe the vertebral bone cement leakage and anterior height changes of affected vertebrae.Visual analogue scale (VAS) and Oswestry disability index (ODI) were used to evaluate pain status and functional activity.Results All cases were followed up for 12-96 months.Cement leakage occurred in 4 patients without nerve complications.The anterior height of affected vertebrae before operation,2 d after operation and at the last follow-up was (50.3 ± 8.3)％,(67.1 ± 8.1)％ and (65.2 ± 6.4)％.The anterior height of affected vertebrae 2 d after operation and at the last follow-up were significantly improved compared with those before operation (P ＜ 0.05),but there were no significant differences between 2 d after operation and at the last follow-up (P ＞ 0.05).The scores of VAS before operation,2 d after operation and at the last followup was (8.63-± 1.23),(2.56 ± 3.48) and (1.38 ± 0.92) scores,and the scores of ODI was (82.1 ± 6.7)％,(28.5 ± 7.3)％ and (22.1 ± 8.2)％.The scores of VAS and ODI 2 d after operation and at the last follow-up were significantly decreased compared with those before operation (P ＜ 0.05),but there were no significant difference between 2 d after operation and at the last follow-up (P ＞ 0.05).There was no postoperative in situ or adjacent vertebral fracture.Conclusions Using internal and external IVC bone cement injection for treatment of Kümmell disease has a good clinical curative effect.It can effectively relieve back pain symptoms,reduce intraoperative and postoperative bone cement leakage and recurrent adjacent or in situ vertebral fracture.

Study on mechanism of thyroid cytotoxicity of ammonium perchlorate / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To investigate the mechanism of thyroid cytotoxicity mechanism of ammonium perchlorate (AP).</p><p><b>METHODS</b>Thyroid cells were cultured in vitro to a certain stage and then exposed to AP (0, 5, 10, 20, 40, and 60 mmol/L) in culture solution; the cultured cells and supernatant were collected. Cell viability was measured by MTT assay; cell apoptosis was determined by flow cytometry; the concentration of thyroglobulin was measured by enzyme-linked immunosorbent assay; the lactate dehydrogenase (LDH) activity, superoxide dismutase (SOD) activity, malondialdehyde (MDA) level, and so on were measured by colorimetry.</p><p><b>RESULTS</b>The cells exposed to 60 mmol/L AP for 12, 24, 48, and 72 h had cell viabilities of 74.93%, 42.26%, 2.66%, and 0.99%, respectively, and the cells exposed to 40 mmol/L AP for 24, 48, and 72 h had cell viabilities of 73.15%, 30.91%, and 3.03%, respectively, all significantly lower than that of the control group (100%)(P < 0.05 or P < 0.01). The overall apoptosis rate of all AP-exposed cells was significantly higher than that of the control group; the cells exposed to 20, 40, and 60 mmol/L AP had early apoptosis rates of 15.70%, 15.84%, and 16.96%, respectively, significantly higher than that of the control group (9.54%)(P < 0.05 or P < 0.01); the cells exposed to 60 mmol/L AP had a late apoptosis rate of 16.54%, significantly higher than that of the control group (6.11%)(P < 0.05 or P < 0.01). The cells exposed to 40 mmol/L AP had a significantly higher LDH activity than the control group (0.70 U/ml vs 0.55 U/ml, P < 0.01). The cells exposed to 5 mmol/L AP had a significantly higher MDA level than the control group (1.08 mmol/L vs 2.36 mmol/L, P < 0.05).</p><p><b>CONCLUSION</b>AP can markedly change the cell morphology and decrease the cell viability of thyroid cells, which may be because AP inhibits cell proliferation, induces cell apoptosis, and destroys cell membranes. However, AP does not result in significant oxidative damage to thyroid cells.</p>

Effect of Proanthocyanidin on Motor after Spinal Cord Injury in Rats / 中国康复理论与实践

@# Objective To observe the effect of Proanthocyanidin on motor after spinal cord injury (SCI) in rats. Methods 36 healthy adult SD rats were divided into groups A, B and C (n=12), and SCI was induced with Allen's mode (250 g·mm) on T9. Proanthocyanidin 40 mg/kg was injected intraperitoneally for group A, methylprednisolone (MP) 30 mg/kg for group B and the same volume of saline for group C 30 min after SCI. 1 d, 3 d and 7 d after operation, all the rats were assessed with Basso-Beattie-Bresnahan (BBB) scale and slanting board test, and their serumal malondialdehyde (MDA) and superoxide dismutase (SOD) were detected. Results The scores of BBB and the slanting board test imporoved more in group A and group B than in group C (P<0.05). The SOD increased and MDA decreased in groups A and B significantly 1 d and 3 d after operation compared with those of group C (P<0.05), and only in group A 7 d after operation (P<0.05). Conclusion Proanthocyanidin may inhibit the lipid peroxidation and promote the recovery of motor after spinal cord injury in rats.

The effects of ammonium perchlorate on thyroid function and mRNA expression of thyroglobulin and thyroperoxidase / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To investigate the effects of ammonium perchlorate (AP) on thyroid functions and mRNA expression levels of thyroglobulin (Tg) and thyroperoxidase (TPO) genes of rats.</p><p><b>METHODS</b>Thirty SD male rats were randomly divided into six groups: control group, iodine-deficient group, low dose AP group (130 mg/kg), moderate dose AP group (260 mg/kg), high dose AP group (520 mg/kg) and high iodine-combined group. After the rats were exposed orally for 90 days, serum free-thyroxine (FT(4)), free-triiodothyronine (FT(3)) and thyroid stimulating hormone (TSH) were measured using radioimmunoassays. mRNA expression levels of thyroglobulin (Tg) and thyroperoxidase (TPO) genes were detected by real-time quantitative PCR.</p><p><b>RESULTS</b>Serum FT(4) levels in moderate dose AP group and high dose AP group were [(9.540 ± 1.327) fmol/ml] and [(6.509 ± 1.949) fmol/ml] respectively, which were significantly lower than that [(13.505 ± 1.276) fmol /ml] in control group (P < 0.05 or P < 0.01). Serum TSH level in high dose AP group was [(1.227 ± 0.295) mIU/L], which was significantly higher than that [(0.545 ± 0.282) mIU/L] in control group (P < 0.05). The mRNA expression levels of thyroglobulin (Tg) gene in all groups exposed to AP were significantly lower than that in control group (P < 0.01). The mRNA expression level of thyroperoxidase (TPO) gene in high dose AP group was significantly higher than that in control group (P < 0.05).</p><p><b>CONCLUSION</b>AP can reduce the serum FT(3) and FT(4) levels of rats, increase the serum TSH level of rats and decrease obviously the mRNA expression levels of Tg and TPO genes. In addition, high iodine can reduce the toxic effects of AP on thyroid gland of rats to some extent.</p>

The effects of ammonium perchlorate on thyroid function and testis in male rats / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To study the effects of ammonium perchlorate (AP) on the levels of thyroid hormone and the testis function of male rats.</p><p><b>METHODS</b>Twenty male rats were randomly divided into 4 groups: control group, low, middle and high AP group. The rats were exposed orally to 0, 130, 260 and 520 mg AP/kg a day for 80 days. The levels of thyroid hormone, testosterone in serum and sperm motility were measured and the testis histological change was observed as well.</p><p><b>RESULTS</b>The increase of body weight in high AP group was significantly lower than that in the control group (P < 0.01). The organ coefficients of testis and thyroid in high AP group obviously enhanced, as compared with the control group (P < 0.01). The free thyroxin (FT4) levels of serum in all AP treated groups were significantly lower than that of the control group (P < 0.05). There were no differences of serum FT3 levels between all AP groups and control group, while serum TSH levels in middle and high AP groups decreased significantly, as compared with control group (P < 0.01). In terms of sperm motility, the percentage of Grade A and B sperm in middle and high groups were 12.3% +/- 2.52% and 14.8% +/- 5.93%, 17.7% +/- 4.63%, 15.8% +/- 2.28% respectively, which were significantly lower than that (27.8% +/- 8.70%) in control group (P < 0.01). The percentage of Grade D sperm in middle and high groups were 38.0% +/- 3.61% and 40.0% +/- 8.99%, respectively, which were significantly higher than that (17.0% +/- 5.00%) in control group (P < 0.01). No difference of serum testosterone level between all AP groups and control group was observed.</p><p><b>CONCLUSION</b>AP can influence the levels of thyroid hormone and reduce the serum FT4 levels in rats. The main toxic effects on male reproductive system may decrease the sperm motility.</p>