Minocycline Treatment and Bone Marrow Mononuclear Cell Transplantation After Endothelin-1 Induced Striatal Ischemia

We explored whether the modulation of microglia activation with minocycline is beneficial to the therapeutic actions of bone marrow mononuclear cells (BMMCs) transplanted after experimental stroke. Male Wistar adult rats were divided in four experimental groups: ischemic control saline treated (G1, N?=?6), ischemic minocycline treated (G2, N?=?5), ischemic BMMC treated (G3, N?=?5), and ischemic minocycline/BMMC treated (G4, N?=?6). There was a significant reduction in the number of ED1+ cells in G3 animals (51.31?±?2.41, P?<?0.05), but this effect was more prominent following concomitant treatment with minocycline (G4?=?29.78?±?1.56). There was conspicuous neuronal preservation in the brains of G4 animals (87.97?±?4.27) compared with control group (G1?=?47.61?±?2.25, P?<?0.05). The behavioral tests showed better functional recovery in animals of G2, G3, and G4, compared with G1 and baseline (P?<?0.05). The results suggest that a proper modulation of microglia activity may contribute to a more permissive ischemic environment contributing to increased neuroprotection and functional recovery following striatal ischemia.     

Tunnelled haemodialysis catheter bacteraemia: risk factors for bacteraemia recurrence, infectious complications and mortality.

BACKGROUND: Infection is a serious complication of tunnelled cuffed catheter (TCC) use and is associated with high complication and mortality rates. Although attempts at TCC salvage after bacteraemia have been associated with high rates of recurrent bacteraemia, there have been no large studies in which multivariate analysis has been performed to control for confounding factors such as infecting organisms, diabetes, etc. METHODS: A prospective observational study was performed in chronic HD patients dialyzing with a TCC at seven outpatient HD centers. All patients diagnosed with TCC bacteraemia were observed for 3 months following initial presentation and outcomes were recorded. RESULTS: During the 2.5 year study period, 226 patients had an episode of TCC bacteraemia that met inclusion criteria, and 3 month follow-up data were available in 219 episodes. Treatment failure, defined as recurrent TCC bacteraemia with the same organism or death from sepsis, occurred in 26 patients (12%). Infectious complications (such as endocarditis, osteomyelitis, etc.) occurred in 16 patients (7%), bacteraemia with a different organism occurred in 19 patients (9%), and death from sepsis occurred in eight patients (4%). Significant predictors of treatment failure (by univariate analysis) were TCC salvage, and infection with Staphylococcus aureus, (OR = 4.2, P = 0.002; and OR = 3.3, P = 0.02, respectively). TCC salvage, when used in episodes of S. aureus bacteraemia, was associated with an 8-fold higher risk of treatment failure (P = 0.001). The presence of an abnormal TCC exit site was associated with a significantly higher rate of death from sepsis, (OR = 7, P = 0.001). Outcomes (treatment failure and infectious complications) did not differ among bacteraemic episodes where the TCC was exchanged over a guidewire compared to those in which the TCC was immediately removed followed by delayed reinsertion. In the multivariate analysis, adjusted for potential confounding covariates, the only significant predictors of treatment failure after an episode of TCC bacteraemia were TCC salvage (OR = 5.4, P = 0.003), and S. aureus (OR = 4.2, P = 0.002). In a multivariate analysis, controlling for TCC management, the only variable that was significantly associated with the development of an infectious complication was infection with S. aureus (OR = 3.5, P = 0.02). CONCLUSIONS: We have shown, using multivariate analysis and adjusting for potential confounding factors, that the use of TCC salvage and S. aureus are independent risk factors for treatment failure after an episode of TCC bacteraemia, and that S. aureus is an independent risk factor for developing an infectious complication. An infected-appearing TCC exit site is associated with a higher mortality rate. Episodes of TCC bacteraemia treated using TCC salvage are associated with the highest treatment failure rates. TCC guidewire exchange can be an acceptable practice, unless severe exit site or tunnel infection is present.     

阴式子宫切除术与腹式子宫切除术的对比分析

目的:比较阴式子宫切除术(TVH)与腹式子宫切除术(TAH)的临床效果。方法:收集汾西矿业集团总医院妇产科2003年2月至2005年10月接受上述两种不同术式子宫切除术病例38例,其中阴式子宫切除术阴式组(TVH组)18例,腹式子宫切除术腹式组(TAH组)20例,比较两组术式的术中、术后情况(平均手术时间、平均出血量、肛门排气时间、住院天数、术后体温升高率)。结果:平均手术时间:阴式组(180±17)min,腹式组(96±23)min,差异无统计学意义(P>0.05);平均出血量阴式组(190±31)mL,腹式组(280±47)mL;肛门排气时间阴式组(20±6)h,腹式组(37±7)h;住院天数阴式组(5.3±1.3)d,腹式组(8.4±2.3)d;术后体温升高率阴式组5.6%,腹式组12.5%。两组比较差异均有统计学意义(P均<0.05)。结论:无明显盆腔黏连、无附件病变及子宫体积增大一般不超过12周者,行子宫切除术可首选阴式子宫切除术。     

Pulmonary Atypical Adenomatous Hyperplasia And Bronchioloalveolar Carcinoma

Objective To study the relationship between atypical adenomatous hyperplasia (AAH) and bronchioloalveolar carcinoma (BAC). Methods Morphometric, immunohistochemical and ultrastructural analyses were performed in 4 patients with low grade AAH, 5 with high grade AAH and 7 with BAC. Results The mean nuclear areas of high grade AAH and BAC were greater than those of low grade AAH (P<0.05); p53 protein expression was negative in 4 cases of low grade AAH,while the positive rates in high grade AAH and BAC were 40% (2/5) and 57% (4/7), respectively. Conclusiion The development of BAC is stepwise. AAH appears to be a lesion closely related with BAC, probably as its genuine precursor.     

Differential motility stimulation but not growth stimulation or adhesion of metastatic human colorectal carcinoma cells by target organ-derived liver sinusoidal endothelial cells

Liver is the most common distant metastatic site for colorectal cancers and when blood-borne colorectal cancer cells reach the liver, they first encounter hepatic capillary and sinusoidal endothelial cells. Thus we studied differences between highly (HT-29LMM) and poorly (HT-29P) liver-metastatic sublines of human colorectal cancer cells by examining the interactions between tumor cells and liver microvessel endothelial cells. Using hepatic sinusoidal endothelial (HSE) and lung microvessel endothelial (MLE) cell-conditioned medium we measured the growth and motility stimulating activities released from these endothelial cells and adhesion of these cancer cells to the endothelial cells. Differences in the ability of HSE-conditioned medium (HSE-CM) or MLE-conditioned medium (MLE-CM) to stimulate HT-29 cell growth were not observed. There was a small but significant increase in the rate of adhesion of highly metastatic HT-29LMM cells to HSE cell monolayers than poorly metastatic HT-29P cells, but there was no difference in adhesion to MLE cell monolayers. HSE-CM stimulated the motility of highly metastatic colorectal cancer cells to a greater extent than the poorly metastatic cells. Motility-stimulating activity for the colorectal cancer cell lines was not detected in MLE-CM. The HSE-CM motility-stimulating activity for human HT-29 cells was not removed using antibodies against hepatocyte growth factor (HGF/SF), complement component C3 or laminin, indicating that it is not related to these known liver-derived motility factors. The results suggest that the ability of highly metastatic HT-29LMM colorectal cancer cells to colonize the liver is related to their ability to respond to liver sinusoidal endothelial cell-derived motility factors and to a lesser degree to adhere to liver sinusoidal endothelial cells.     

大肠杆菌基因工程株在空气和土壤中生物特性的初步研究

本文应用气溶胶转鼓设备，观察了大肠杆菌基因工程株和标准株８０９９在空气中的稳定性。实验结果表明，在温度２０℃，相对湿度（ＲＨ）６０％的条件下，气溶胶储存６０ｍｉｎ，ＭＭ３和８０９９的平均存活率比值为０．４：１，ｔ检验，差别高度显著。     

Favourable outcomes in episodes of Pseudomonas bacteraemia when associated with tunnelled cuffed catheters (TCCs) in chronic haemodialysis patients.

BACKGROUND: Pseudomonas is regarded as a particularly lethal bacterial isolate. High mortality rates have been reported in episodes of Pseudomonas sepsis when associated with visceral infections as seen in immunosuppressed, hospitalized patients. In comparison, lower mortality rates have been reported with catheter-associated Pseudomonas bacteraemia in non-dialysis patients. The purpose of this study was to determine the risk factors and the outcomes for episodes of Pseudomonas bacteraemia associated with the use of tunnelled cuffed haemodialysis catheters (TCCs) in a chronic out-patient population. METHODS: We performed a prospective observational study in seven chronic haemodialysis units over a 2.5 year period. Patients who were diagnosed as having their initial TCC-associated bacteraemia within the study period were followed for 3 months. All episodes of Pseudomonas TCC bacteraemia were identified, and univariate analyses were performed to compare Pseudomonas bacteraemia with non-Pseudomonas bacteraemia. RESULTS: During the study period, 219 episodes of TCC bacteraemia were identified; 18 had a Pseudomonas isolate (8%). Pseudomonas bacteraemia episodes were associated with a significantly higher risk of not receiving appropriate initial antibiotics (odds ratio = 3.6, P = 0.02). There were no deaths in the Pseudomonas bacteraemia group, whereas 19% died in the non-Pseudomonas group. The TCC was removed in 89% of Pseudomonas bacteraemias. There were no significant risk factors for acquiring a Pseudomonas isolate, and no difference in recurrent bacteraemia or infectious complication rates between the groups. CONCLUSIONS: In haemodialysis patients with a TCC-associated Pseudomonas bacteraemia, outcomes are remarkably good. This may be because the source of Pseudomonas infection was removed in most cases. Initial antibiotic coverage lacking anti-Pseudomonas activity was not associated with increased mortality.     

实施卫生Ⅷ项目推行农村合作医疗的做法与体会

巫溪县是重庆市最东部的国家贫困县.全县共有57个乡镇,607个村,50.17万人,总面积4022平方公里.由于地处大巴山深处,经济、文化和交通都很落后,农民的医疗卫生问题长期以来影响着社会经济的发展.为了解决农民的看病吃药问题,我县根据<重庆市人民政府关于发展和完善合作医疗的若干意见>精神,近年来通过实施卫生Ⅷ项目,逐步推广合作医疗制度,取得了较好的成绩.     

Cerebral venous thrombosis and chronic active hepatitis as part of the antiphospholipid syndrome

A case of antiphospholipid syndrome, presenting as sinus vein thrombosis together with chronic active hepatitis, is reported in a 35-year-old woman.