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Open access

Wei Guo, Jie Zhang, Jing-yun Li, Yue Ma and Sheng-hui Cui

Abstract

Objective A prospective study was conducted in a tertiary care center to identify the risk factors of ventilator associated pneumonia (VAP) through phenotypic and molecular biological methods.

Methods The patients who were mechanically ventilated in the respiratory intensive care unit (RICU) and the neurological internal intensive care unit (NICU) were enrolled in our study, and samples were collected from the lower respiratory tract, oropharynx and stomach. Other samples, including the environmental air, swabs of nurses’ hands, subglottic secretion and ventilator circuit, were also collected. Microorganisms in the collected samples were recovered and identified at species level by biochemical detection. Genetic relationship of dominant species was further characterized by pulsed field gel electrophoresis (PFGE).

Results Out of 48 enrolled patients, 22 cases developed VAP and bacterial cultures were recovered from the lower respiratory tract samples of 14 cases. The average hospitalization time with VAP was significantly longer than that of patients without VAP (P < 0.05). Among the recovered bacteria cultures, multidrug-resistant Pseudomonas aeruginosa and Stenotrophomonas maltophilia were dominant. It was more likely that subglottic secretion and gastric juice samples contained the same isolates as recovered in the lower respiratory tract by PFGE analysis.

Conclusions Mechanical ventilation in RICU and NICU was a high risk factor for VAP development. Special emphasis of VAP prophylaxis should be paid on subglottic secretion and gastric juice reflux.

Open access

Xiao-ming Li, Jia-yue Yin, Hao-jun Xu, Chengqiong Bi, Li Zhu, Xiao-dong Deng and Lei-nan Ma

Open access

Heng-Jun Zhou, Yue-Hui Ma, Jian-Bo Yu, Jian-Wei Pan and Ren-Ya Zhan

Abstract

Background: Primary central nervous system lymphoma (PCNSL) involving the hypothalamus and pituitary gland is extremely rare. Therefore, no case to our knowledge has been reported to date.

Objective: We described our findings in a 48-year-old immunocompetent man, who presented with four months progressive diabetes insipidus (DI) and two months subsequent headache.

Methods and Results: A radiological study and magnetic resonance imaging (MRI) suggested a homogeneous enhancing dumbbell-shaped lesion, 2.4⃞1.2 cm in size, involving both the hypothalamus and pituitary gland. A brain biopsy was conducted through a transnasal transsphenoidal approach, and a final histopathological diagnosis of the tumor was confirmed as diffuse large B-cell malignant lymphoma. After extensive tumor surveys, including computed tomography, MRI, ultrasound, bone marrow biopsy, lumbar puncture, and positron emission tomography (PET), no evidence of other lesions found. Subsequently, he received six cycles of intravenous highdose methotrexate-based chemotherapy followed by one cycle of whole-brain radiotherapy. The progressive DI and headache completely resolved and he was in good health 11 months later.

Conclusion: Clinicians should consider the possibility of PCNSL in non specific clinical presentations.

Open access

Jie Xu, Jun Shen, Yue Ding, Hui-Yong Shen, Zhan-Peng Zeng, Ruo-Fan Ma, Chun-Hai Li and Bertram Barden

The clinical value of combined use of MR imaging and multi-slice spiral CT in limb salvage surgery for orthopaedic oncology patients: initial experience in nine patients

Background. The purpose of this prospective study was to evaluate the value of the combined use of MR imaging and multi-slice spiral CT for limb salvage surgery in orthopaedic oncology patients.

Patients and methods. Nine consecutive patients with lower/upper limb malignant bone tumours (7 osteosarcomas and 2 chondrosarcomas) were treated with limb-salvaging procedures. Preoperative planning including determination of the osteotomy plane and diameters of the prosthesis was performed basing on the preoperative CT and MR images. The histopathology was performed as golden diagnostic criteria to evaluate the accuracy of CT and MR-based determination for tumour's boundary.

Results. The tumour extension measured on MRI was consistent with the actual extension (P>0.05, paired Student's t test), while the extension measured on CT imaging was less than the actual extension. The length, offset and alignment of the affected limb were reconstructed accurately after the operation. An excellent functional outcome was achieved in all patients.

Conclusions. In the present study, MRI was found to be superior to CT for determining the tumour extension, combined use of MRI and CT measurement provided high precision for the fit of the prosthesis and excellent functional results.

Open access

Mingliang Yue, Kailin Tian and Tingcan Ma

Abstract

Purpose

This paper proposes an expert assignment method for scientific project review that considers both accuracy and impartiality. As impartial and accurate peer review is extremely important to ensure the quality and feasibility of scientific projects, enhanced methods for managing the process are needed.

Design/methodology/approach

To ensure both accuracy and impartiality, we design four criteria, the reviewers’ fitness degree, research intensity, academic association, and potential conflict of interest, to express the characteristics of an appropriate peer review expert. We first formalize the expert assignment problem as an optimization problem based on the designed criteria, and then propose a randomized algorithm to solve the expert assignment problem of identifying reviewer adequacy.

Findings

Simulation results show that the proposed method is quite accurate and impartial during expert assignment.

Research limitations

Although the criteria used in this paper can properly show the characteristics of a good and appropriate peer review expert, more criteria/conditions can be included in the proposed scheme to further enhance accuracy and impartiality of the expert assignment.

Practical implications

The proposed method can help project funding agencies (e.g. the National Natural Science Foundation of China) find better experts for project peer review.

Originality/value

To the authors’ knowledge, this is the first publication that proposes an algorithm that applies an impartial approach to the project review expert assignment process. The simulation results show the effectiveness of the proposed method.

Open access

Meng Yue, Zhan-Ying Ma, Meng-Jie Lei, Chu-Yun Cui and Yi Jin

Abstract

Background

Early mobilization (EM) is a regimen that was carried out by physiotherapists in a relatively early stage. It has been investigated by an increasing number of researchers. However, there has not been a meta-analysis concerning whether EM could benefit the clinical outcomes of critically ill patients requiring mechanical ventilation (MV). The present systematic review aims to evaluate the effect of EM compared with immobilization for mechanically ventilated patients.

Methods

A computerized literature search was performed in six databases for related articles from inception to June 2017. We included randomized controlled trials and controlled clinical trials and used the Physiotherapy Evidence Database scale to assess the quality of included studies. Primary outcomes were measures of muscle function, duration of MV, and incidence of mortality. Secondary outcomes were adverse effects and length of stay (LOS) in intensive care unit (ICU) and hospital.

Results

Eight trials were included; of those, only one study without standard EM reported that the intervention was invalid to improve the outcomes. The result of meta-analysis indicated that EM shortened the duration of MV; however, it had no positive effect on mortality and LOS in ICU.

Conclusions

This review suggests that EM improves the muscle function and ventilation duration. Further research highlighting standard intervention and specific groups is needed.

Open access

Yi-hai Gu, Xiao Zhu, Jing-yun Li, Jun Zhang, Qing-yuan Zhou, Yue Ma, Chang-qin Hu, Shao-hong Jin and Sheng-hui Cui

Abstract

Objective To identify the risk factors for imipenem resistance development and transmission of clinical Pseudomonas aeruginosa isolates.

Methods Thirty-seven imipenem unsusceptible Pseudomonas aeruginosa isolates collected from patients in absence of carbapenem treatment were characterized by antimicrobial susceptibility test, pulsed field gel electrophoresis (PFGE) and carbapenem resistant mechanism analysis.

Results Before the collection of imipenem unsusceptible Pseudomonas aeruginosa isolates, the average time of patients treated with more than one antimicrobial (20.0 ± 9.5 days, n = 16) was significantly longer than those treated with only one antimicrobial (12.6 ± 4.4 days, n = 21; t-test, Welch, t = -2.9004, P < 0.01). And 32 isolates showed resistance to more than 3 classes of antimicrobials. Six PFGE clusters were identified and 26 isolates were grouped into one dominant cluster (C2). An ISpa1328 sequence insertion in oprD was detected in 33 isolates and the function of efflux was observed in all 37 isolates in the presence of a wide spectrum efflux inhibitor.

Conclusions Our data demonstrated that exposure to non-carbapenem drug classes, especially fluoroquinolones and β-lactams, may be important risk factors for the spread of carbapenem resistant Pseudomonas aeruginosa.

Open access

Tian-wen Ma, Yue Li, Guan-ying Wang, Xin-ran Li, Ren-li Jiang, Xiao-peng Song, Zhi-heng Zhang, Hui Bai, Xin Li and Li Gao

Abstract

Introduction: The study aimed to clarify the changes in the concentration of inflammatory mediators, proteases, and cartilage degradation biomarkers in the synovial fluid of joints in an equine osteoarthritis model.

Material and Methods: Osteoarthritis was induced in eight Mongolian horses by a sterile intra-articular injection of amphotericin B, which was injected into the left carpal joint in a dose of 2 mL (25 mg/mL). The control group comprised five horses which were injected with an equal dose of sterile physiological saline into the left carpal joint. Synovial fluid was obtained at baseline and every week after injection. Test methods were based on ELISA.

Results: In the course of the osteoarthritis, the concentration of biomarkers in joint synovial fluid showed an increasing trend. IL-1, IL-6, MMP-9, MMP-13, ADAMTS-5, CS846, GAG, HA, CTX-II, and COMP concentrations sharply increased before the onset of significant symptoms of lameness, whereas TNF-α, MMP-2, and MMP-3 concentrations rose sharply after the occurrence of such symptoms.

Conclusion: The results obtained confirm that the concentrations of IL-1, IL-6, MMP-9, MMP-13, ADAMTS-5, CS846, GAG, HA, CTX-II and COMP increase substantially in equine osteoarthritis, which provides a theoretical basis for the rapid diagnosis of the disease.

Open access

James Chipperfield, John Newman, Gwenda Thompson, Yue Ma and Yan-Xia Lin

Abstract

Many statistical agencies face the challenge of maintaining the confidentiality of respondents while providing as much analytical value as possible from their data. Datasets relating to businesses present particular difficulties because they are likely to contain information about large enterprises that dominate industries and may be more easily identified. Agencies therefore tend to take a cautious approach to releasing business data (e.g., trusted access, remote access and synthetic data). The Australian Bureau of Statistics has developed a remote server, called TableBuilder, which has the capability to allow users to specify and request tables created from business microdata. The tables are confidentialised automatically by perturbing cell values, and the results are returned quickly to the users. The perturbation method is designed to protect against attacks, which are attempts to undo the confidentialisation, such as the well-known differencing attack. This paper considers the risk and utility trade-off when releasing three Australian Bureau of Statistics business collections via its TableBuilder product.