Postoperative cognitive dysfunction (POCD) is a common and important complication after cardiac surgery. The pathological reactions caused by cardiac surgery, such as traumatic stress reaction, inflammation, hemodynamics disorders, and blood coagulation dysfunction, by triggering central inflammation, ischemia, hypoxia and ischemia-reperfusion injury and other mechanisms, leading to brain function-impairment, causing the development of POCD. According to the above mechanisms, taking corresponding protective measures, reducing the development of POCD, and improving the quality of life after cardiac surgery are of great importance.
Objective?To explore the difference between bone marrow edema syndrome (BMES) and avascular necrosis of femoral head (ANFH).?Methods?Recent original articles about BMES and ANFH were extensively reviewed, and were comprehensively analysed.?Results?The pathology, pathogenesis, clinical features, treatment selection, and prognosis are different between these two diseases.?Conclusion?BMES and ANFH are two different diseases. Micro-fracture may be the cause of bone marrow edema.
ObjectiveTo provide the evidence for diagnosis and treatment of the complication by describing the distribution and drug sensitivity of pathogens in patients with prosthetic joint infection (PJI) after primary total knee arthroplasty (TKA).
MethodsBetween January 2003 and June 2013,65 cases (65 knees) with PJI after primary TKA were treated.There were 28 males and 37 females with an average age of 63.2 years (range,37-80 years).The median interval between PJI and primary TKA was 2.8 years (range,2 weeks to 11 years),including 29 left knees and 36 right knees.Prosthesis loosening could be found in 27 cases by X-ray examination.The average value of C-reactive protein and erythrocyte sedimentation rate was 37.4 mg/L (range,12.5-197.0 mg/L) and 63.2 mm/1 h (range,29.3-73.8 mm/1 h) respectively.Preoperative and intraoperative synovial fluid as well as intraoperative tissue samples should be submitted for aerobic and anaerobic culture.The four types of infections were made according to the Tsukayama et al.classification standards.
ResultsThe patients were all diagnosed as having PJI.There were 5(7.69%) type I infections,4(6.15%) type ⅡA,8(12.31%) type ⅡB,3(4.62%) type Ⅲ,and 45(69.23%) type IV according to the Tsukayama et al.classification standard.Bacterial culture results were negative in 12 cases and positive in 53 cases,the main pathogen was Gram-positive cocci (39/53).The most common organism identified was Coagulase-negative Staphylococcus (24/53) followed by Staphylococcus Aureus (12/53).Resistant bacterium accounted for 61.11%(22/36) of Staphylococcus.These bacterium were all sensitive to vancomycin,linezolid,meropenem,and fluconazole;and highly resistant to erythrocin,penicillin,and cefoxitin.The main pathogenic bacteria of Coagulase-negative Staphylococcus and Staphylococcus aureus had highest resistant rate to penicillin.
ConclusionGram-positive cocci is the main pathogen in patients with PJI after primary TKA,which is highly resistant to penicillin and macrolides.Antibiotic treatment of this complication should be based on the result of drug sensitivity test,vancomycin and linezolid may be used before the result of drug sensitivity test.It is important to pay attention to rare and multiple resistant bacteria.
Objective To investigate the role of peroxisome proliferator activated receptor α （PPARα） in the pathogenesis of colorectal cancer. Method The literatures about PPARα and the pathogenesis of colorectal cancer were reviewed and analyzed. Result The relationships of PPARα to the proliferation， apoptosis， and differentiation of colorectal cancer cells in the pathogenesis of colorectal cancer were controversial. Conclusions PPARα might be involved in the regulation of proliferation， differentiation， apoptosis of colorectal cancer cells， but the pathogenesis and the up- and down-stream signal pathways are not elucidated. In additional， PPARα might partly be involved in the mechanism of drug resistance of chemotherapy drugs for colorectal cancer， but the role is not very clear yet. So more research works need to be done about the relationship of PPARα to pathogenesis of colorectal cancer.
ObjectiveTo analyze the trend of hospital infection, so as to provide a scientific basis for hospital infection prevention and control.
MethodsFrom 2011 to 2013, according to the criteria of diagnosis of nosocomial infections set up by the Ministry of Health, the prevalence rates of nosocomial infections in patients who were hospitalized on the survey day were investigated by the combination of bedside investigation and medical records checking.
ResultsThe incidence rates of nosocomial infections from 2011 to 2013 were 2.99%, 2.31% and 1.95%, respectively, presenting a downward trend. The rate of hospital infection was the highest in comprehensive Intensive Care Unit, and the main infection site was the lower respiratory tract. Gram-negative bacteria were the main pathogens causing hospital infections, including Klebliella pnermoniae, Pseudomonas aeruginosa, Staphylococcus aureus, Acinetobacter baumannii and Escherichia coli. The utilization rates of antibacterial agents in these three years were respectively 39.84%, 34.58% and 34.22%.
ConclusionTargeted surveillance and management of key departments and sites should be strengthened. It is necessary to strengthen the surveillance and management of antibiotics, raise the submission rate of pathogens, and use antibiotics appropriately.
Objective To summarize the recent pathogenetic researches on the acute pancreatitis. Methods Relevant references about the pathogenesis of acute pancreatitis, which were published recently domestic and abroad were collected and reviewed. Results Recent experimental data indicated that the synthesis and release of pro-inflammatory cytokines and chemotactic factors were responsible for local injury and systemic dissemination of the inflammatory mediators. Experimental studies also provided evidences implying that the immune system might play a role in the development of pancreatitis, such as the activation of lymphocyte and neutrophil. Additionally, the pancreas may completely recover or become fibrotic after an attack of acute pancreatitis and the presence of pancreatic stellate cell was known as a crucial factor in the fibrogenesis. Conclusion The pathogenesis of acute pancreatitis is very complicated, the factors that determine the ultimate severity of the attack are still unknown.
Objective
To probe the distribution and drug resistance of pathogens causing surgical site infection in patients after gynecologic operation, and provide reference for prevention and treatment.
Methods
Seventy patients with incision infection after gynecologic operation in West China Second University Hospital of Sichuan University from January 2010 to May 2015 were selected. Species of the pathogens from the submitted specimens and the results of the drug susceptibility testing were analyzed.
Results
Seventy-two strains of pathogens were isolated, including 36 strains (50.0%) of Gram-negative (G–) bacteria and 36 strains (50.0%) of Gram-positive (G+) bacteria. The main G– bacteria were Escherichia coli (36.1%) and Enterobacter cloacae (5.6%); the main G+ bacteria were Staphylococcus aureus (18.1%), Staphylococcus epidermidis (12.5%), and Enterococcus faecalis (8.3%). Escherichia coli showed low sensitivities to ampicillin, ceftriaxone, and gentamicin, with resistance rates of 76.9%, 61.5%, and 61.5%, respectively. Staphylococcus aureus showed low sensitivities to penicillin G, clindamycin, and erythromycin, with resistance rates of 92.3%, 69.2%, and 61.5%, respectively. Staphylococcus epidermidis showed low sensitivities to erythromycin, penicillin G, and ciprofloxacin, with resistance rates of 88.9%, 77.8%, and 77.8%, respectively. No carbapenem-resistant G– bacteria or vancomycin-resistant G+ bacteria were detected.
Conclusion
Postoperative surgical site infection is the most common nosocomial infection. The main bacteria related to postoperative incision infection in the gynecology department of the hospital are Escherichia coli, Staphylococcus aureus, Staphylococcus epidermidis, and Enterococcus faecalis, which become resistant to common antibiotics currently. Therefore more attention should be paid to bacterial isolation and drug susceptibility test results for rational use of antimicrobial drugs and effectiveness of the treatment to nosocomial infection.
Objective To study the catheter-related infection (CRI) in cancer patients treated with central venous catheterization. Methods A prospective study with 196 cancer patients was conducted to analyze the types of catheter-related infection and pathogen, as well as the relationship between CRI and the following factors: insert location, gender, age, remained time, or bone marrow suppression. Results Of the total 196 cases, 16 cases were diagnosed as CRI and the CRI rate was 8.2%. The types of CRI were five cases of pathogen colonization, four cases of insert location infection and seven cases of catheter-related bloodstream infection. Of the total 244 specimens, 20 were positive including 7 pathogenic bacteria in either Gram positive or Gram negative types, the dominating pathogens were staphylococcus aureus, staphylococcus epidermidis, acinetobacter baumannii and klebsiella pneumoniae. CRI was related to both insert location and age which were both the independent risk factors. Conclusion The concept of prevention should be set up, and the comprehensive measures should be taken to reduce CRI, such as choosing an appropriate insert location and complying with a strict catheter insert standard.
【Abstract】ObjectiveTo investigate the role of PPARδ in the pathogenesis of colorectal cancer. MethodsLiteratures about PPARδ and the pathogenesis of colorectal cancer were reviewed and analyzed.ResultsPPARδ is expressed in the nucleuses of glandular epithelia lining colon and rectum. It is normally suppressed by wild-type adenomatous polyposis coli (APC) but is up-regulated by enhanced β-catenin/T cell factor-4 (TCF-4) binding to TCF-4-responsive elements in the PPAR promoter when an inactivating APC mutation occurs, which indicates PPAR is a potential downstream target of the APC/β-catenin/TCF-4 signaling pathway in colorectal cancer. Consistent with PPAR’s role as an APC/β-catenin/TCF-4 target, some studies reported that PPAR mRNA is frequently overexpressed in colorectal cancers of both humans and rodent animals, which indicates that PPAR is relevant to the tumorigenesis of colorectal cancer. ConclusionPPARδ is closely related with the pathogenesis of colorectal cancer.
