ABSTRACT
Objective:To investigate the spectrum, drug resistance and risk factors of multidrug resistant organism (MDRO) in chronic osteomyelitis.Methods:A retrospective study was conducted by cluster sampling to analyze the 414 patients with chronic osteomyelitis who had been admitted to Department of Orthopaedics, The Second Hospital Affiliated to Shanxi Medical University, Department of Orthopaedics, The People's Hospital of Shanxi Province, Department of Traumatology, Yuncheng City Hospital, and Department of Orthopaedics, Linfen City Hospital from January 2016 to December 2021. The patients were assigned into 2 groups according to whether MDRO had been detected or not. In the MDRO infection group of 150 cases, there were 118 males and 32 females with an age of (48.8±16.2) years; in the non-MDRO infection group of 264 cases, there were 194 males and 70 females with an age of (46.0±17.8) years. The characteristics of bacterial spectrum and drug resistance in MDRO infection were described and analyzed. The 2 groups were compared in terms of clinical data like gender, age, course of disease, body mass index, history of antibiotic use before admission, combined internal diseases, combined trauma, and length of hospital stay. The items with P<0.05 were included in a multivariate logistic regression model to explore the risk factors for MDRO infection. Results:Pathogenic bacteria (331 strains) were detected in 286 of the 414 patients with chronic osteomyelitis, and infection with 168 strains of MDRO was detected in 150 of the 286 patients, yielding a detection rate of 50.8% (168/331). Of the 168 strains of MDR, 129 (76.8%, 129/168) were Gram-positive and 39 (23.2%, 39/168) Gram-negative. Staphylococcus aureus was the most frequently detected species of Gram-positive bacteria (58.1%, 75/129) and the most frequently detected pathogen (44.6%, 75/168) in this study. The resistance of Gram-positive bacteria to peptides and oxazolidinones was low (less than 10%). Multivariate logistic regression analysis showed that age ≥45 years ( OR=6.991, 95% CI: 3.525 to 13.865, P<0.001), essential hypertension ( OR=4.191, 95% CI: 2.070 to 8.485, P<0.001), trauma ( OR=4.232, 95% CI: 2.409 to 7.435, P<0.001) and length of hospital stay ( OR=1.015, 95% CI: 1.001 to 1.029, P=0.030) were the risk factors for MDRO infection in patients with chronic osteomyelitis. Conclusions:The detection rate of MDRO is at a medium to high level. Gram positive bacteria are the main pathogens and resistant to most antibiotics. Antibiotic therapy guided by bacterial culture is of great significance for patients with chronic osteomyelitis. Age≥45 years, essential hypertension, trauma, and long hospital stay are risk factors for MDRO infection in patients with chronic osteomyelitis.
ABSTRACT
Objective:To explore different surgical treatment options and effect for intraspinal cement leakage after percutaneous vertebroplasty (PVP).Methods:A retrospective case series study was carried out to analyze the clinical data of 5 patients with intraspinal cement leakage after PVP for osteoporotic vertebral compression fracture (OVCF) admitted to People's Hospital of Shanxi between May 2016 and January 2020, including 1 male and 4 females, with the age of 65-82 years [(75.4±7.5)years]. Injured segments were located at T 12-L 1 in 1 patient, L 1 in 1, L 2-4 in 1, L 3 in 1 and L 4-5 in 1. The American Spinal Injury Association (ASIA) classification was grade C in 2 patients and grade D in 3. Muscle strength was grade II in 2 patients and grade III in 3. The leakage of bone cement in the spinal canal was strip or columnar in 3 patients, leaning to one side of the spinal canal and adjacent to the nerve root, and the bone cement was removed by transforaminal endoscope for decompression. The leakage of bone cement in the dura mater and spinal canal was found in 2 patients. The intradural bone cement leakage was removed by durotomy, and the bone cement in the spinal canal was removed by transpedicular osteotomy, bone graft fusion and internal fixation. The visual analogue scale (VAS), Oswestry dysfunction index (ODI), ASIA grade and muscle strength were observed before operation, at 3 days, 3 months after operation and at the last follow-up. Results:All patients were followed up for 12-16 months [(13.6±1.8)months]. The VAS was significantly decreased at postoperative 3 days, 3 months and at the last follow-up [(2.6±0.6)points, (2.1±0.3)points, (1.9±0.5)points] when compared to (7.1±1.5)points before operation ( P<0.01). However, the VAS had no statistical difference at different time points after operation ( P>0.05). The ODI was 42.4±10.2, 25.6±6.0 and 21.4±3.6 at postoperative 3 days, 3 months and at the last follow-up, significantly different from that before operation (74.2±7.3) ( P<0.05 or 0.01). However, the ODI had no statistical difference at postoperative 3 months and at the last follow-up ( P>0.05). Two patients with preoperative ASIA grade C recovered to grade D and 3 patients with preoperative grade D recovered to grade E at the last follow-up ( P<0.05). Two patients could walk without crutches with muscle strength improved from grade II preoperatively to grade IV at the last follow-up ( P<0.01). Three patients had completed recovery of neurological function with muscle strength improved from grade III preoperatively to grade V at the last follow-up ( P<0.01). Conclusions:For OVCF patients with intraspinal canal cement leakage and neurological symptoms after PVP, if the bone cement is located on one side of the spinal canal and adjacent to the nerve root, the bone cement should be removed by foraminal endoscope for decompression; if the cement leakage occurs in the dura mater, the dura mater should be cut to remove the bone cement for decompression, which can effectively relieve pain and promote functional recovery.
ABSTRACT
BackgroundSevere acute respiratory syndrome coronavirus 2(SARS-CoV-2), a novel betacoronavirus, has caused an outburst of pneumonia cases in Wuhan, China. We report the production of specific IgM and IgG antibodies after the infection of SARS-CoV-2 and its implication for the diagnosis, pathology and the course of the disease as well as the recurrence of positive nucleic acid tests after discharge. MethodsTest results for SARS-CoV-2 IgM and IgG antibodies of 221 confirmed COVID-19 patients were retrospectively examined, and their clinical data were collected and analyzed based on various subgroups. SARS-CoV-2 IgM and IgG antibodies were determined with the chemiluminescence method. FindingsThe concentration (S/CO) of SARS-CoV-2 IgM and IgG antibodies peaked on day 19-21 after symptom onset, with a median of 17.38 (IQR 4.39-36.4) for IgM and 5.59 (IQR 0.73-13.65) for IgG. Detection rates reached highest on day 16-18 and day 19-21 for IgM and IgG, which were 73.6% and 98.6%, respectively, with significantly higher concentration of IgG in critically ill patients than in those with mild to moderate disease (P=0.027). The concentration of the antibodies on day 16-21 is not correlated with the course or outcome of the disease (Spearman r < 0.20, P > 0.05). Nasopharyngeal swabs revealed positive SARS-CoV-2 RNA in up to 52.7% of recovered patients after discharge, whose IgG proved to be significantly lower than that of those with negative RNA results (P = 0.009). IgG and IgM were tested twice within 14 days after discharge with a 7-day interval, and the second testing of these antibodies displayed a decrease in concentration of 21.2% (IQR, 11.2%,34.48%) for IgG and 23.05% (IQR, -27.96%,46.13%) for IgM, without statistical significance between the patients with re-detectable positive RNA results and those with negative RNA results after discharge. However, those with positive results experienced a count decrease in lymphocyte subsets. InterpretationThe concentration of SARS-CoV-2 IgM and IgG antibodies peaked on day 19-21 after symptom onset, and antibody testing on day 16-21 is associated with increased detection rates, but the antibody concentration does not affect the course and outcome of the infection. Recovering patients with re-detectable positive SARS-CoV-2 RNA displayed lower concentration of IgG, but the downward trend of IgG during recovery indicated its limited duration of protection, and the protective effect of IgG remains to be investigated. FundingChongqing Education Board, Chongqing Science and Technology Bureau, Famous teacher project of Chongqing talent plan
ABSTRACT
ABSTRACT:Objective To explore the role of PTEN in the suppression of neural stem cells so as to clarify whether neural stem cell proliferation can be promoted by regulating the PI3K-Akt/PTEN expression level. Methods We removed the hippocampus from neonatal 24 h Kunming mice,isolated and cultured the generation of neural stem cells,which were then identified by immunofluorescence test.We randomly grouped the cultured neural stem cells into normal group,ischemia model group,hypoxia group (hypoxia + ischemia model group),Lip2000 group (hypoxia+ ischemia model group + Lip2000 null transfection group,PTEN transfection group (hypoxia +ischemia model group+Ad5-PTEN transfection group),and PTEN interference group (hypoxia+ ischemia model group+Lip2000+PTENsiRNA interference group).We detected the proliferation of neural stem cells in the groups at different time points,and PTEN protein expression of neural stem cells in each group after PTEN transfection, and the effect on iconic protein on Akt-PI3K signaling pathway.Results (1 )Nestin identification of the neural stem cells was tested by immunofluorescence.We observed green bright and typical cell spheroids under fluorescence microscope;the clear structure could be seen within spheroids.(2)We determined the proliferation of neural stem cells at different time points by MTT.After 36 h of culture,the neural stem cells had obvious proliferation in the hypoxia group and Lip2000 group compared with the model group, the PTEN transfection group and PTEN interference group (P 0.05);(4)After PTEN plasmid transfection,there were no apparent changes in the total Akt and bad in the groups,but compared with the normal group,PI3K,p-Akt,and p-bad expressions in model group and PTEN gene transfection group reduced (P <0.05),with the more obvious changes in the PTEN transfection group.PI3K,p-Akt,and p-bad expressions in the hypoxia group, Lip2000 group and PTEN interference group increased (P < 0.05 ). Conclusion Hypoxia contributes to promoting the proliferation of neural stem cells,and the inhibition of PTEN on PI3K/Akt might be the key factor for blocked proliferation of adult neural stem cells.
ABSTRACT
BACKGROUND:As a material to repair osteochondral defect,the acellular cartilage matdx has attracted more and more researchers'attention,however,there is no comparison between two ways of decelluladzation.OBJECTIVE:To test trypsin and Triton X-100 methods for their potential of cell removal.DESIGN,TIME AND SETTING:Controlled observation was performed at the Central Laboratory of Orthopaedics in the Second Hospital of Shanxi Medical University between March and July in 2008.MATERIALS:Fresh knee and hip articular cartilages of pig were purchased from the market.METHODS:Porcine articular cartilages were treated with either 0.25%trypsin or 0.25% Triton X-100 respectively for decelluladzation,while fresh untreated articular cartilage served as control.MAIN OUTCOME MEASURES:①General observation on the morphology of acellular articular cartilage.②Immunohistochemistry and scanning electron microscopy were used to determine the effect of two decellularization methods on the extracellular matrix collagen.③Ten articular cartilage leaflets in each group were measured for breaking strength and percentage elongation through loading,unloading and breaking tests.RESULTS:①By use of trypsin and Triton X-100 methods,the acellular matrix had no significance difference in the morphology compared with untreated cartilage,only presenting slightly white color and feeling less soft.②lmmunohistochemistry and scanning electron microscopy results showed that,trypsin and Triton X-100 methods achieved complete decelluladzation.Trypsin had no significant influence in extracellular matrix and cartilage leaflets microstructure;Triton X-100 caused some tiny structural alterations,such as more collagen and disordered structure.It is possibly that Triton X-100 damaged extracellular matrix.③No significant difference was identified between untreated and trypsin,Triton X-100 groups in breaking strength and percentage elongation.CONCLUSION:Trypsin and Triton X-100 all achieve complete decellularization.but trypsin uses short time and low costs with well preservation,while Triton X-100 with long procedure and slight damage to collagen structure.They all have no significance influence to the mechanics characteristics of articular cartilage.
ABSTRACT
@#Objective To observe the effect of basic fibroblast growth factor (bFGF) on magnetic resonance spectroscopy of vascular dementia (VD) rats.Methods After the VD model was reproduced, the 12 rats were randomly divided into the therapy group and dementia group with 6 animals in each group. Another 6 rats were selected as sham operation group. The VD rats in therapy group were treated with bFGF by hypodermic injection. After 5 weeks, abilities of learning and memory of three groups' rats were tested by Morris water maze. The changes of magnetic resonance spectroscopy and N-acetyl aspartate (NAA), NAA/（Cr＋Cho） in lobus temporalis of VD rats were also observed.Results Abilities of learning and memory of rats significantly improved in the therapy group than that in the dementia group (P<0.01). The values of NAA, NAA/（Cr＋Cho） in lobus temporalis of VD rats significantly increased in the therapy group than that in the dementia group (P<0.01).Conclusion bFGF by hypodermic injection can obviously elevate abilities of learning and memory and the values of NAA, NAA/（Cr＋Cho） in lobus temporalis of VD rats.
ABSTRACT
@#Objective To observe the effect of basic fibroblast growth factor (bFGF) on magnetic resonance spectroscopy of vascular dementia (VD) rats.Methods After the VD model was reproduced, the 12 rats were randomly divided into the therapy group and dementia group with 6 animals in each group. Another 6 rats were selected as sham operation group. The VD rats in therapy group were treated with bFGF by hypodermic injection. After 5 weeks, abilities of learning and memory of three groups' rats were tested by Morris water maze. The changes of magnetic resonance spectroscopy and N-acetyl aspartate (NAA), NAA/（Cr＋Cho） in lobus temporalis of VD rats were also observed.Results Abilities of learning and memory of rats significantly improved in the therapy group than that in the dementia group (P<0.01). The values of NAA, NAA/（Cr＋Cho） in lobus temporalis of VD rats significantly increased in the therapy group than that in the dementia group (P<0.01).Conclusion bFGF by hypodermic injection can obviously elevate abilities of learning and memory and the values of NAA, NAA/（Cr＋Cho） in lobus temporalis of VD rats.
ABSTRACT
This experiment was aimed to create A20 gene site-specific zinc finger DNA-binding protein. The sequence of A20 gene promoter was analyzed with bioinformatics means and submitted to ZF Tools Server at TSRI. Using the database of the web site, we determined the A20 gene valid target sites and designed the amino acid sequence of zinc finger protein predicted to be bound to the target site. And then, the structure of the protein sequence was analyzed and homology was modeled with various bioinformatics means. Based on the characteristic of this protein, the prokaryotic expression vector pTYB11-ZFP was constructed and expressed. Thus, the artificial zinc finger protein that recognized A20 specific sequence was designed, and expressed in Escherichia coli. The results indicate that it is feasible to design engineered artificial Zinc finger proteins by means of bioinformatics.
Subject(s)
Humans , Amino Acid Sequence , Base Sequence , DNA-Binding Proteins , Chemistry , Genetics , Molecular Sequence Data , Protein Binding , Protein Engineering , Methods , Transcription Factors , Chemistry , Genetics , Zinc Fingers , GeneticsABSTRACT
0.05);between YMDD mutation and YMDD negative,there was statistical difference(P0.05),between YMDD mutation and YMDD negative, there was significant difference(t=12.76,P
ABSTRACT
In the process of cultivating TCM clinical postgraduates of TCM clinical college in Shanxi university of Chinese medicine,we emphasized the importance of clinical application ability and innovation ability in scientific research,stressed the clinical practice and check management,to formulate the objective,effective and quantified assessment index system in keeping with the real institution of our college,so as to improve the all-round quality of TCM clinical postgraduates.