Effects of long-term high-fat diet on bone mineral density and intestinal flora / 中华内分泌代谢杂志

Objective:To investigate the effects of long-term high-fat diet on bone mineral density and intestinal flora in mice.Methods:Sixteen male C57BL/6 mice were randomly divided into control group (NC group) and high-fat group (HF group). After 24 weeks of high-fat feeding, biochemical indicators such as blood glucose and blood lipids were detected, bilateral femurs were taken and bone microstructure was analyzed with micro-computered tomography (micro-CT), and changes of intestinal microbial composition and proportion were revealed using 16S rDNA sequencing technology.Results:Compared with the control group, the serum total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) in HF group were significantly increased. Micro-CT uncovered that the bone mineral density (Tb.BMD), bone volume fraction (BV/TV) and the number of trabecular bone (Tb.N) decreased, yet structural model index (SMI) and the trabecular fraction (Tb.Sp) increased in the HF group mice. The gut microbiota 16S rDNA sequence analysis showed that the proportion of Proteobacter was significantly increased and the proportions of pachycete, warty microbacterius, and actinomycete were reduced in HF group at the phyla level. The proportion of Bacteroidetes S24-7_norank in the NC group was significantly higher than that in the HF group, and the multilevel discriminant analysis of species differences (LEfSe) identified that the difference was significant, yet the proportion of Bacteroides, Pseudo-Prevotella, Desulfovibrio, Altobacter, and Helicobacter in the HF group were higher than those in the NC group, which were significant differences in Altobacter and Helicobacter at genus level.Conclusion:Long-term high-fat feeding can cause the destruction of femoral trabecular structure, decrease in the number of trabeculus bones, and bone mineral density in C57BL/6 mice. It also leads to significant changes in the composition and proportion of the intestinal flora.

Differences in the Clinical Characteristics of Early- and Late-Onset Asthma in Elderly Patients.

Differences between early-onset and late-onset asthma in elderly subjects have not been comprehensively described in China. We conducted a cross-sectional study to determine the phenotypic differences between early-onset asthma (EOA) and late-onset asthma (LOA) in elderly patients. We collected clinical and physiological data from 176 elderly patients with asthma. Participants were divided into two groups: EOA group and LOA group. Demographics, comorbidities, inflammatory parameters, lung function, severity, asthma control, and medication use among EOA and LOA elderly patients were compared. Elderly subjects with EOA had more atopic disease, a stronger positive family history of asthma, higher IgE, and exhaled nitric oxide levels as compared to those with LOA. In contrast, elderly subjects with LOA had lower lung function and more marked fixed airflow obstruction (FAO). Elderly subjects with LOA had a higher incidence of chronic obstructive pulmonary disease (COPD). No differences were observed in age, gender, BMI, history of smoking, severity, and asthma control between the two groups. Both similarities and differences exist between elderly subjects with EOA and those with LOA in China. Further work is required to determine the pathophysiological, clinical, and therapeutic implications for different asthma phenotypes in elderly subjects.

Textual Research on the Syndrome of Houpo Qiwu Decoction and Houpo Sanwu Decoction in Jingui Yaolve / 浙江中医药大学学报

[Objective]To investigate the original texts of the Syndrome of Houpo Qiwu Decoction and Houpo Sanwu Decoction in Jingui Yaolve so as to define the syndrome of these two classical prescriptions and guide clinical application.[Methods]Revised the mistakes of the original texts of Houpo Qiwu Decoction and Houpo Sanwu Decoction in Jingui Yaolve by referring to medical books written between Jin Dynasty to Tang Dynasty such as Mai Jing, Xiaopin Fang and Qianjin Fang.Shanghan Lun,Zhubing Yuanhou Lun,Zhouhou Beiji Fang and other medical books were also consulted when exploring the pathogenesis and explanation of these two prescriptions.[Results]The syndromes of Houpo Qiwu Decoction should be abdominal fullness and pain,whose pathogenesis is that indigestion caused by pathogenic cold attacking intestine and stomach will lead to cholera sicca.It should be treated by using the therapy of promoting qi,relieving abdominal fullness and pain,warming spleen and stomach,and weeding through the old to bring forth the new.The syndromes of Houpo Sanwu Decoction intend to treat should be abdominal fullness,lasting fever,floating and rapid pulse but normal intake of food,whose pathogenesis is that interaction between wine and phlegm caused by fluid retention in drinkers or undigested wine in people with dysfunctional fluid metabolism will lead to abdominal fullness.It should be treated by using the therapy of eliminating phlegm-fluid,relieving abdominal fullness,and discharging internal heat. [Conclusion]The Syndromes of Houpo Qiwu Decoction and Houpo Sanwu Decoction are converse in Jingui Yaolve,therefore re-examination of these two prescriptions and further clinical experiments are required.

The influence of implant elastic modulus on stress distributions in implant and peri-implant bone / 医用生物力学

Objective To investigate the effects of changes in elastic modulus of dental implants on stress distributions in implants and peri-implant bone by 3D finite element analysis, so as to supply experimental evidence for new implant system. Methods The model of the mandible with implant bone was constructed based on CT data. The elastic modulus of implants was set as 110, 90, 70, 55 and 40 GPa, respectively. The model was applied with static load of 300 N in vertical direction, 100 N in horizontal direction and 130 N in oblique direction, respectively, to stimulate occlusal state. The stresses on different parts of implants with different elastic modulus and peri-implant bone under 3 kinds of loads were calculated and analyzed. Results As the elastic modulus of implants declined, stresses in cortical bone around implants under horizontal and oblique loads decreased, and stresses in the implants showed a decreasing tendency as well. Conclusions The decrease in elastic modulus of implants can benefit the transferring of load from the implants to the surrounding bone, and reduce the risk of long-term implant failure.

Experimental research of neutrophil gelatinase-associated lipocalin siRNA encapsulated by urocanic acid-coupled chitosan on colon cancer cells / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the impact of neutrophil gelatinase-associated lipocalin (NGAL) knockdown by NGAL siRNA encapsulated with urocanic acid-modified chitosan nanoparticles (UAC) on the proliferation, migration and apoptosis of human colon cancer cells.</p><p><b>METHODS</b>NGAL siRNA was encapsulated by UAC and chitosan (CTS) respectively, and then was transfected into human colon cancer cell lines HT29. The NGAL mRNA was detected by real-time quantitative PCR (RT-QPCR). Relationships of NGAL gene silencing with the proliferation, migration and apoptosis of HT29 cell were analyzed.</p><p><b>RESULTS</b>Under the fluorescence microscope, the transfection efficiency of siRNA in UAC group was (37.52±7.17)%, which was significantly higher than (11.32±3.39)% in CTS group (t=6.102, P=0.005). Forty-eight hours after transfection, RT-QPCR examination showed that the level of NGAL mRNA expression was 0.350 in UAC group and 0.529 in CTS group with significant difference (t=-3.743, P=0.02), meanwhile both levels were significantly lower as compared to control group(F=163.538, P<0.001). Proliferation analysis revealed that after silencing NGAL gene, proliferation rate of UAC group and CTS group was slightly lower than control group, and no significant differences were found (F=9.520, P=0.438). However, migration assay demonstrated that the 24-hour migration rate of UAC group and CTS group was significantly lower than that of control group (F=6.756, P=0.029), meanwhile the migration rate of UAC group was slightly lower than that of CTS group [(77.90±7.14)% vs. (87.67±3.98)%, t=-1.704, P=0.164]. Apoptosis detection revealed that the apoptosis rate in UAC group was significantly higher than that in CTS group and the control group 2 days after transfection [(15.800±1.054)% vs. (12.900±0.656)%, (11.933±1.914)%, F=7.004, P=0.027].</p><p><b>CONCLUSIONS</b>The encapsulated ability and transfection efficiency of chitosan modified by urocanic acid elevate significantly. Silencing NGAL gene by UAC carrier can down-regulate the expression of NGAL mRNA in HT29 colon cell line, inhibit their migration and facilitate their apoptosis.</p>

Transcriptome analysis of Ophiocordyceps sinensis before and after infection of Thitarodes larvae.

Ophiocordyceps sinensis, also referred to as the Chinese caterpillar fungus, is a rare entomopathogenic fungus found in the Qinghai-Tibetan Plateau that is used as a traditional Chinese medicine. O. sinensis parasitizes the larvae of the ghost moth Thitarodes. Characterization of the transcriptome of O. sinensis before and after host infection may provide novel insight into the process by which the fungus interacts with Thitarodes and may help researchers understand how to sustain this valuable resource. In this study, we performed RNA-sequencing (RNA-seq) using Illumina HiSeqTM 2000 technology to generate gene expression profiles of two developmental stages of O. sinensis. Thread-like hyphae before infection and yeast-like hyphal bodies after infection of host larvae were collected for transcriptome analysis. We found that 1640 genes were differentially expressed (q-value < 0.05), of which 818 were upregulated (49.878 %) and 822 were downregulated (50.122 %). Gene ontology (GO) analysis revealed that the differentially expressed genes (DEGs) were especially enriched in terms associated with Biological Process and Molecular Function. Several genes encoding transporter and permease proteins, three glycoside hydrolases, two mycotoxin-related proteins, an antigen protein, and an allergen were identified as being significantly up- or downregulated. Collectively, our findings provide a novel resource for understanding O. sinensis during two critical developmental stages, and offer the opportunity to further investigate the functional mechanisms underlying these stage-specific molecular differences.

Detection and analysis of the characteristic expression of microRNAs of anal fistula patients / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To detect and analyze the characteristic miRNAs profile of anal fistula and explore their possible target genes and potential clinical significance.</p><p><b>METHODS</b>The anal mucosa close to the hemorrhoids were collected from three patients undergoing fistulectomy and hemorrhoidectomy (fistula group) as well as three patients receiving only hemorroidectomy(hemorrhoids group), matching with fistula group in age, gender and body weight. miRNA microarray was used to compare the expression of 1 285 human miRNAs of the anal mucosa between two groups. Cluster analysis was adopted to analyze the accumulation of the differentially expressed miRNAs(P<0.05, fold≥2.0 or ≤0.5) and their target genes were predicted with 10 softwares such as DIANAmT, miRanda, miRDB, miRWalk etc. Comprehensive scoring was performed to identify genes with highest predictive score. Gene ontology (GO) concentration technique was used to analyze the target gene-associated biological process. Immunohistochemistry was used to examine protein expression of genes with the highest score.</p><p><b>RESULTS</b>Among 1285 miRNAs in fistula group, 13 miRNAs were differentially expressed with those in hemorrhoid group, including 2 of up-regulation and 11 of down-regulation. Paired t test showed that in fistula group, miRNA-3609 up-regulation was 5.98 folds(P=0.0231) and miR-181a-2-3p down-regulation was 0.13 folds(P=0.0067) compared to those in hemorrhoid group, which had the greatest differential expression. Cluster analysis suggested that up-regulated miR-3609 and miR-6086 had similar change trend in both groups. Among 11 down-regulated miRNAs, miR-125bp-1-3p and miR-548q had similar expression and other 9 miRNAs had similar expression as well, including miR-1185-1-3p, miR-532-3p, miR-1233-5p, miR-769-5p, miR-149-5p, miR-99b-3p, miR-141-3p, miR-138-5p, and miR-181a-2-3p. Target gene prediction analysis of above 13 genes showed that 7 miRNAs(53.8%) were eligible to predict their potential target genes, yielding totally 104 possible target genes. The rest of 6 miRNAs(46.2%) failed to predict any target gene. The highest score in prediction of target gene was chitinase 1(ChIT1) and its corresponding differential miRNA was miR-769-5p(r=-0.94286, P=0.0167). Gene ontology analysis showed that the most associated biological process related with these 104 target genes was keratinization, immune response and signal transduction. Immunohistochemistry revealed ChiT1 expression of anal mucosa in fistula group was significantly higher compared to hemorrhoid group(P<0.01).</p><p><b>CONCLUSIONS</b>There is a characteristic miRNAs profile in anal fistula patients, which may play a role in the occurrence and development of anal fistula.</p>

Effects of dynamic ventilatory factors on ventilator-induced lung injury in acute respiratory distress syndrome dogs / 世界急诊医学杂志（英文）

BACKGROUND: Mechanical ventilation is a double-edged sword to acute respiratory distress syndrome (ARDS) including lung injury, and systemic inflammatory response high tidal volumes are thought to increase mortality. The objective of this study is to evaluate the effects of dynamic ventilatory factors on ventilator induced lung injury in a dog model of ARDS induced by hydrochloric acid instillation under volume controlled ventilation and to investigate the relationship between the dynamic factors and ventilator-induced lung injuries (VILI) and to explore its potential mechanisms. METHODS: Thirty-six healthy dogs were randomly divided into a control group and an experimental group. Subjects in the experimental group were then further divided into four groups by different inspiratory stages of flow. Two mL of alveolar fluid was aspirated for detection of IL-8 and TNF-α. Lung tissue specimens were also extracted for total RNA, IL-8 by western blot and observed under an electronic microscope. RESULTS: IL-8 protein expression was significantly higher in group B than in groups A and D. Although the IL-8 protein expression was decreased in group C compared with group B, the difference was not statistically significant. The TNF-α ray degree of group B was significantly higher than that in the other groups (P<0.01), especially in group C (P>0.05). The alveolar volume of subjects in group B was significantly smaller, and cavity infiltration and cell autolysis were marked with a significant thicker alveolar septa, disorder of interval structures, and blurring of collagenous and elastic fiber structures. A large number of necrotic debris tissue was observed in group B. CONCLUSION: Mechanical ventilation with a large tidal volume, a high inspiratory flow and a high ventilation frequency can cause significant damage to lung tissue structure. It can significantly increase the expression of TNF-α and IL-8 as well as their mRNA expression. Furthermore, the results of our study showed that small tidal ventilation significantly reduces the release of pro-inflammatory media. This finding suggests that greater deterioration in lung injury during ARDS is associated with high inspiratory flow and high ventilation rate.

Perioperative complications of posterior transpedicular osteotomy for patients with spinal deformity / 中华骨科杂志

Objective To analyze the perioperative complications of posterior transpedicular osteotomy (wedge osteotomy and total vertebral osteotomy) for patients with spinal deformity.Methods From January 2007 to December 2011,73 patients with spinal deformity underwent posterior transpedicular spinal osteotomy (wedge osteotomy and total vertebral osteotomy).Among them,30 patients,including 8 males and 22females,aged from 8 to 68 years (average,40.7 years),presented with at least one perioperative complication.There were 10 cases of scoliosis,9 cases of kyphoscoliosis and 11 cases of kyphosis.Twenty two patients underwent total vertebral osteotomy,and 8 patients underwent wedge osteotomy.A retrospective analysis on perioperative complications of 30 patients was performed.Results Except 1 patient dying of hemorrhagic shock after operation,29 patients were followed up for 6 to 61 months (average,17.2 months).The total perioperative complication rate was 41.1％.Neurological complications occurred in 16 patients (21.9％),bleeding complications in 2 patients (2.7％),dural injury in 6 patients (8.2％),postoperative cerebrospinal fluid leakage in 4 patients (5.5％),wound infection in 4 patients (5.5％) and pleural effusion in 4 patients (5.5％).Conclusion Posterior transpedicular osteotomy is an effective surgical technique for spinal deformity.However,perioperative complications are common,including nerve injury,bleeding,dural injury,wound infection and so on.Among them,nerve injury and bleeding are most common.

PLF versus TLIF in the treatment of degenerative lumbar scoliosis / 中华骨科杂志

Objective To compare the safety and efficacy of posterolateral lumbar fusion (PLF) and transforaminal lumbar interbody fusion (TLIF) in the treatment of degenerative lumbar scoliosis (DLS).Methods Forty DLS patients with Cobb angles of 20 to 60 degrees were divided randomly into PLF and TLIF groups.Operative time,intraoperative blood loss,imaging results,and clinical outcomes were compared.Results Complete information was available in 37 patients,including 18 patients in the PLF group and 19 in the TLIF group.There were significant differences between two groups with regard to the operative time (P=0.002) and the intraoperative blood loss (P=0.048).The incidence of early complications in the 2 groups was 11.1％ and 26.3％.There was no significant difference in the recovery rates of the Cobb angle and the spinal coronal balance between two groups.However,the recovery rates of the lumbar lordotic angle and spinal sagittal balance were significantly different between two groups (36.7％ vs.62.5％ and 44.8％ vs.64.1％,respectively).In various domains of SRS-22,the scores for pain and satisfaction with treatment in TLIF was better that those in PLF groups.There was no significant difference in ODI score between two groups.Conclusion TLIF helps to improve lumbar lordosis and sagittal balance,which leads to better clinical outcomes.For patients without significant loss of lumbar lordosis and with good spinal sagittal balance preoperatively,PLF is still an option.

The relationship between HIF-1α expression and the early lung fibrosis in rats with acute paraquat poisoning / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To explore the role of hypoxia-inducible factor 1alpha (HIF-1α) in early lung fibrosis of rats with acute paraquat (PQ) poisoning.</p><p><b>METHODS</b>Forty eight healthy SD rats were randomly divided into control group (6 rats) and paraquat poisoning group (42 rats). Control group was exposed to 1 ml normal solution by gastric gavage. The paraquat group was exposed to 1 ml paraquat solution (50 mg/kg) by gastric gavage for 2, 6, 12, 48, 72 and 120 h, respectively. The arterial blood gas analysis (PaO(2)) was detected. The pathological examinations of lung tissues were performed by HE and Mason staining. HIF-1α in lung tissues were measured by immunofluorescence. Western blot assay was used to detect the expression levels of HIF-1α protein in lung tissues.</p><p><b>RESULTS</b>PaO2 of rats exposed to paraquat for 72 h was (62.33 ± 0.22) mm Hg, which was significantly lower than that (96.00 ± 5.20) of control group (P < 0.05). Pathological examination by HE staining indicated that the acute diffuse lesion appeared in the alveolar capillary endothelium, epithelia and interstitial tissues, and there was the inflammatory cell infiltration in the alveolar of rats exposed to paraquat at 2 h after exposure. At 12 h after exposure, the interstitial edema in lung tissues of rats decreased and the alveolar space became narrow. At 120 h after exposure, there were the alveolar structure derangement, abundant cicatrix, more fibroblasts and peripheral inflammation absorption. Pathological examination by Masson staining showed that there was obvious collagen deposition in the alveolar epithelia at 2h after exposure, the increased collagen fibrosis at 24 and 48 h after exposure and the obvious damage of alveolar tissues or much more fibrous connective tissue deposition at 120 h after exposure. The results of western blot and immunofluorescence assays exhibited that the expression levels of HIF-1α in lung tissues at 2, 24 and 48 h after exposure significantly increased, as compared with control group (P < 0.05), but there were no significant differences of HIF-1α expression among sub-groups at different time points after exposure.</p><p><b>CONCLUSION</b>The results of present study shown that there were the pulmonary fibrosis and increased expression of HIF-1α in acute PQ poisoning rats at the early stage, and HIF-1α may be associated with pulmonary fibrosis.</p>

Endovascular treatment for wide-necked intracranial aneurysms with the Enterprise stent.

BACKGROUND: The development of self-expanding stents dedicated to intracranial use has significantly widened the applicability of endovascular therapy to many intracranial aneurysms OBJECTIVE: To report the angiographic and clinical outcomes of wide-necked intracranial aneurysms treated using the Enterprise stent. MATERIAL AND METHODS: Forty-six patients with 50 wide-necked and fusiform aneurysms (19 aneurysms with dissections), admitted between June 2009 and December 2010, were treated using Enterprise stents. Demographic information, procedural data, and technical complication were reviewed. Angiographic and clinical outcomes were evaluated at a 9.1-month follow-up. RESULTS: Stent deployment was successful in all the 50 lesions, and additional coil embolization was performed in 48. Complete or near-complete occlusion immediately after stent deployment was achieved in 44 aneurysms, whereas, no immediate coil embolization was chosen in two cases. There was one (2%) procedure-related complication, which resulted in death. At mean 9.1-month follow-up, the result was good (GOS ≤2) in 45 patients. Angiographic recurrences arose in two cases, one of which was re-treated completely. CONCLUSIONS: The Enterprise stent is very useful for endovascular embolization of wide-necked intracranial aneurysms, because it is easy to navigate and place precisely. The overall morbidity and mortality rates are low.

Technique of minor- caliber and long balloon in treatment of lower limb peripheral arterial disease on diabetic patients / 中国基层医药

Objective To investigate the effect of percutaneous transluminal angioplasty(PTA) by minor-caliber and long balloon on diabetic patients with below-knee artery. Methods 16 consecutive DM patients(21 limbs)were treated with PTA by minor-caliber and long balloon and followed 7 months(1 ～22 months). The success rate,complication,clinical effects and the changes of ABI were investigated and analyzed. Results The technical success rate is 90.5% (19/21) ,no serious complication occurred. The clinical symptoms of all patients improved after successful PTA. The median ABI marginally increased from the baseline value of (0.31 ±0. 15) to (0.57 ±0.23) after intervention,the difference is significant (P ＜ 0.05). Post-operative pain in patients with rest pain disappeared 9 (60.0%), relieved 4 (26.7%), reduce 2 (13.3 %). Ulcer healing in patients with foot gangrene 4 (66.7 %), Ulcer area was significantly reduced 1 (16.7%), high amputation 1 (16.7%). Postoperative follow-up, two limbs reoperation because of increased symptoms. Conclusion The treatment of percutaneous transluminal angioplasty by minorcaliber and long balloon was effective on diabetic patients with below-knee arterial disease.

[Spectral analysis of pottery-painting pigments from the Monarch Bai Tomb of Zhongli State].

Based on the analysis of Raman spectroscopy and XRD methods, the structures of different pigments on the painted pottery from the Monarch Bai Tomb of Zhongli State in the middle and late Spring and Autumn period at Shungdun Village, Bengbu City, Anhui Province were analyzed. The result shows that all the pigments, including red, yellow and black pigments, have been well preserved, and these three pigments were identified as cinnabar, goethite and carbon black respectively. Both Raman spectroscopy and XRD analysis show that the crystal composition of red pigments, cinnabar, is very pure without quartz crystal, the associated crystal of natural cinnabar, and at the same time the crystal size of cinnabar is possibly at the nanometer scale. It suggests that this red pigments perhaps were a synthetic material or processed and purified by our ancestors. The discovery of goethite shows that this mineral has been used as pigments as early as in the Spring and Autumn period. This is the earliest example that goethite was used as yellow pigments.

Surgical procedures of thoracic ossification of the ligamentum flavum / 中华骨科杂志

Objective To investigate different surgical procedures for treatment of thoracic ossification of ligamentum flavum.Methods From January 1994 to June 2008,56 cases of thoracic ossification of ligamentum flavum underwent different surgical procedures.There were 40 males and 16 females,aged from 43 to 76 years(average 58.1 years).The courses of disease were 3 months to 5 years,average 13.4 months.CT and MRI examinations were used to observe ossification involving levels,distributions,ossification nest shapes,spinal canal stenosis and spinal cord compression and so on.All patients were treated with en bloc or dissolved laminectomy combining with posterolateral fusion.Japanese Orthopaedic Association(JOA)score was used to evaluate postoperative outcomes.Results The patients were followed up for 18 to 70 months,with an average of 25 months.The mean JOA score increased from 6.25±2.47 preoperatively to 7.53±3.20 at the final follow-up.According to CT scans,the ossifications were divided into lateral type in 6 cases,diffuse type in 17 and thickened nodular type in 33 cases.Patients of lateral type was treated with en bloc laminectomy,and the excellent and good rate was 83.3%.In the patients of diffuse type,11 were treated with en bloc laminectomy and 6 with dissolved laminectomy,and the excellent and good rate was and 81.8% and 83.3% respectively.For patients of thickened nodular type,4 were treated with en bloc laminectomy and 29 with dissolved laminectomy,the excellent and good rate was 50% and 82.8% respectively,and 2 cases presented spinal cord injury aggravation.Conclusion En bloc laminectomy combining with lateral fusion is ideal surgical procedure for lateral type and diffuse type,dissolved laminectomy combining with laeral fusion is suitable for thickened nodular type.

Nosocomial Infection in ICU / 中华医院感染学杂志

OBJECTIVE To investigate the site of nosocomial infection in ICU,distribution and resistance of bacteria in order to make the intervention strategy.METHODS Antimicrobial susceptibility of pathogenic bacteria isolated from nosocomial infection patients in ICU from Jul 2006 to Jul 2008 was performed by Kirby-Bauer method.RESULTS The main pathogens of nosocomial infection in ICU were Gram-negative organisms(48.09%),Gram-positives(38.93%),and fungi(12.98%).The most common pathogens were Staphylococcus aureus,Acinetobacter baumannii,Pseudomonas aeruginosa,fungi,and S.haemolyticus.All strains of S.aureus and S.haemolyticas were antimicrobial sensitive to vancomycin,teicoplanin and linezolid.All A.baumannii strains were antimicrobial sensitive to cefoperazone/sulbactam.They were resistant to other antimicrobial agents.CONCLUSIONS Gram-negative organisms are the main pathogenic bacteria of nosocomial infection in ICU,but the percentage of Gram-positives and fungi is increasing,S.aureus is the most main pathogenic bacterium of nosocomial infection in ICU.S.haemolyticus is also a main pathogenic bacterium.The pathogenic bacteria of nosocomial infection in ICU are highly resistant to the most antimicrobial agents.

Anterior surgical treatment of type Ⅱ traumatic spondylolisthesis of the axis / 中华创伤杂志

Objective To evaluate the clinical efficacy of anterior C2-3 discectomy and fusion in treatment of type Ⅱ traumatic spondylolisthesis of the axis. Methods A total of 27 patients with type Ⅱ traumatic spondylolisthesis of the axis were treated with anterior C2-3 discectomy, fusion and plate fixa-tion. There were 19 males and 8 females, at average age of 38 years (22-67 years). The spinal cord function was at Fraukel D in four patients. Results Operation lasted for 75-95 minutes (mean 86 mi-nutes), with blood loss of 100-160 ml (mean 135 ml). Hospital stay was 9-12 days ( mean 10.8 days). Follow-up for 9-24 months (mean 14 months) showed that all patients achieved bony fusion within three months postoperatively, with no anterior displacement or kyphosis. The range of cervical movement was normal, with no chronic neck pain ocurred. Conclusions Anterior approach can minimize surgical trauma, shorten recovery time and hospital stay. Anterior C2-3 discectomy and fusion is a feasible and safe surgical technique and can get satisfactory therapeutic effect in treating type Ⅱ traumatic spondylolisthesis of the axis.

Successful treatment of a patient with severe H1N1 Flu anti multiple organ dysfunction syndrome / 中华急诊医学杂志

Objective To investigate the causes of severe H1N1 Flu with multiple organ dysfunction, and measures to reduce mortality. Method The data of the patient, who was diagnosed as severe H1N1 Flu and mul-tiple organ dysfunction syndrome in First People's Hospital Affiliated to Shanghai Jiaotong University in September 2009, were retrospectively analyzed. The patient was male, 35 year-old, obese, high fever, sore throat, cough, progressive dyspnea, severe hypoxemia and hypotension. Effective measures were carried out, including protective lung ventilation, recruitment maneuver, vasopressor support, limited fluid resuscitation, appropriate corticosteroid, anfiviral plasma, anticoagulafion and antiviral medicine (Oseltamivir)in early stage and full dose. Results After one-month intensive care, clinical symptoms was improved obviously, oxygen pressure reached 74 mmHg without oxygen supply, CT scan showed diffused interstitial ehange. Neuromyopathy developed at approximately 3 weeks after the onset of H1N1. Conclusions H1N1 Flu can develop in healthy adults, and obesity is one of the inde-pendent risk factors. Effective measures should be taken as soon as possible to reduce the mortality.

Spinal cord decompression reduces rat neural cell apoptosis secondary to spinal cord injury / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

<p><b>OBJECTIVE</b>To determine whether spinal cord decompression plays a role in neural cell apoptosis after spinal cord injury.</p><p><b>STUDY DESIGN</b>We used an animal model of compressive spinal cord injury with incomplete paraparesis to evaluate neural cell apoptosis after decompression. Apoptosis and cellular damage were assessed by staining with terminal deoxynucleotidyl transferase (TdT)-mediated deoxyuridine triphosphate nick-end labelling (TUNEL) and immunostaining for caspase-3, Bcl-2 and Bax.</p><p><b>METHODS</b>Experiments were conducted in male Sprague-Dawley rats (n=78) weighing 300-400 g. The spinal cord was compressed posteriorly at T10 level using a custom-made screw for 6 h, 24 h or continuously, followed by decompression by removal of the screw. The rats were sacrificed on Day 1 or 3 or in Week 1 or 4 post-decompression. The spinal cord was removed en bloc and examined at lesion site, rostral site and caudal site (7.5 mm away from the lesion).</p><p><b>RESULTS</b>The numbers of TUNEL-positive cells were significantly lower at the site of decompression on Day 1, and also at the rostral and caudal sites between Day 3 and Week 4 post-decompression, compared with the persistently compressed group. The numbers of cells between Day 1 and Week 4 were immunoreactive to caspase-3 and B-cell lymphoma-2 (Bcl-2)-associated X-protein (Bax), but not to Bcl-2, correlated with those of TUNEL-positive cells.</p><p><b>CONCLUSION</b>Our results suggest that decompression reduces neural cell apoptosis following spinal cord injury.</p>

Diagnosis and treatment for distractive extension injuries of the cervical vertebrae / 中华急诊医学杂志

Objective To study the diagnosis and treatment for distractive extension injuries of the cervical vertebrae.Method From 2000 to 2005.the clinical and image data of fifty-six patients in the Second Affiliated Hospital of Zhejiang University College of Medicine with distractive extension injuries of the cervical vertebrae were studied and treated with anterior discectomy or subtotal vertebrectomy in the second affiliated Hospital of zhejiang university collegeof medicine,bone grafting and internal fixation with plate.Results The follow-up period was six to seventeen months in fourty-eight patients.The neurological recovery was found after operation in five of nine case with complete spinal cord injuries and thirteen patient had complete recovery.Neck pain completely disappeared in 6 patients with oboslete injury and neurological recovery was improved in 4 patients.Condusions MRI examination is the essential approach to diagnoze distractive extension injuries of the cervical vertebran,and early operation,including anterior discectomy,bone graftillg and internal fixiation with plate,is a best choice of surgical interrention to achieve cervical stabilization and neurological improvement.