OBJECTIVE To find out epidemiological features of fulminant Acinetobacter baumannii nosocomial infection in cardiac SICU and the ways to prevent and treat this nosocomial infection. METHODS The case histories from 5 inpatients who developed A.baumannii nosocomial infection in cardiac SICU from July 8 to 26,2004 were studied retrospectively to find out the reasons of the epidemia and treatments based on the sputum culture results. RESULTS These 5 inpatients developed lower respiratory tract infection on top of their original severe disease.Within 15 days,their sputum cultures were positive for A.baumannii,4 of them recovered but one died. CONCLUSIONS The inpatients got the same nosocomial infection within the same period because of lowered resistance owing to unreasonable layout of cardiac SICU,their original weakness is due to various invasive operation like long duration mechanical ventilation,lack of isolation and sterilization,etc.

Objective:To investigate the clinical significance of dynamic analysis of plasma brain natriuretic peptide in patients with dilated cardiomyopathy with chronic heart failure.Methods:Ninety patients with dilated cardiomyopathy with chronic heart failure admitted into our hospital firom March 2012 to March 2016 were divided into group A (20 cases),group B (38 cases),and group C (32 cases) according to the NYHA grading.The plasma BNP levels and LVEF,LA,LVEDD,and LVESD in the three groups were detected and compared.The correlation of plasma BNP and cardiac function and ultrasonic cardiogram indexes were analyzed.And the capability of plasma BNP and LVEF in diagnosis of patients were analyzed and compared.Results:The plasma BNP level in group C was markedly higher than that of group A and group B (P＜0.05),and that in group B was much higher than that of group A (P＜0.05).And LA in group C was significantly higher than that of group A (P＜0.05),while differences in LVEF,LVEDD,and LVESD were not obvious (P＞0.05).The plasma BNP was positively correlated to NYHA grading,but had no significant correlation with the LVEF,LVEDD,LVESD,and LA (P＞0.05).Based on results of receiver operating characteristic curve analysis,plasma BNP =523.5 pg/mL was the threshold value for identification of patients with NYHA Ⅲ and Ⅳ (AUC=0.901,P＜0.001),while LVEF had not the capability (AUC=0.392,P=0.276).Conclusion:Detection of plasma BNP level had important clinical significance on diagnosis,screening and cardiac functional grading of patients with dilated cardiomyopathy with chronic heart failure.

Objective To investigate newborn hearing screening status in Changyuan in order to explore how to improve the rate of newborn hearing screening. Methods Newborn babies born in Henan Honliv Hospital from October 2010 to December 2012 were included. TEOAE otoacoustic emission was used for the frist and the second screening. The babies who failed in the frist tests recieved the second screening after 42 days. The newborns who did not pass the second tests were referred to the children's Hospital of Zhengzhou hearing screening center for diagnosis and follow-up tele-phone. Results A total of 8 240 babies were born in our hospital from October 2010 to December 2012. Amomg these 8 240babies, 6 908 received the hearing screening with the rate of 83.83%(6 908/8 240),in whom 6 149 passed the frist screening with a rate of 89.01%(6 149/6 908), 759 failed. 402 out of 759 finished the second screening with a rate of 52.96%(402/759), in whom 350 passed the screening with a rate of 87.06%(350/402),52 failed. 40 out of 52 finished the hearing evaluation and medical diagnosis. At last, 8 subjects was confirmed hearing loss,in whom 3 sub-jects were full-term newborns,5 subjects of high risk infants.(3 subjects of prematureinfants,2 subjects of hyperbiliru-binemia). The detection rate of congenital hearing loss was 1.16‰(8/6 908). Conclusion The detection rate of congen-ital hearing loss in Henan Honliv Hospital from October 2010 to December 2012 was 1.16‰. The tates of newborn hearing screening an rescreening in Changyuan are low, High risk infant occured in congenital hearing loss was signifi-cantly higher than that of full-term infant.

0.05).Compared with control group,the GK activity of liver cell,the expression of PEPCK and the expression of GLUT4 in model group decreased signifi cantly(P

AIM: To observe the effect of angiotensinⅡ subtype 2 receptor (AT_2 receptor) on the cultured rat aortic vascular smooth muscle cells. METHODS: The plasmid contained the cDNA of AT_2 receptor was transfected into cultured rat vascular smooth muscle cells. The effects of AngⅡ, Ang Ⅱ+losartan, Ang Ⅱ+PD123319 on the expression of PCNA, the NOS activity and the cell number were observed. RESULTS: The cell number and the expression of PCNA decreased after the cells were treated with losartan. When treated with PD123319, the cell number and the expression of PCNA increased, but the expression of NOS decreased. CONCLUSIONS: These data suggest that when being activated, AT_2 receptor inhibits the proliferation of vascular smooth muscle cells and antagonizes the effect of AT_1 receptor, such an effect may be related to the activation of NOS. [

Objective:To investigate the influence of bundled ligation of the pancreatic stump on postoperative pancreatic fistula (POPF) of distal pancreatectomy (DP).Methods:The retrospective case-control study was conducted. The clinical data of 60 patients with diseases in pancreatic body and tail who underwent DP in the Affiliated Hospital of Inner Mongolia Medical University from January 2011 to August 2018 were collected. There were 24 males and 36 females, aged from 19 to 68 years, with a median age of 45 years. Of the 60 patients, 36 cases undergoing dissection of pancreas with Endo-GIA stapler were allocated into non-bundled group, and 24 cases undergoing bundled ligation of the pancreatic stump with No.10 or No.7 suture at the site over 1 cm of the resection site before dissection of pancreas were allocated into bundled group. Observation indicators: (1) postoperative situations; (2) analysis of risk factors for POPF of DP. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed using the t test or ANOVA test. Measurement data with skewed distribution were represented as M (range).Count data were described as absolute numbers, and comparison between groups was analyzed using the chi-square test. Univariate analysis was conducted using the chi-square test and multivariate analysis was conducted using the Logistic regression model. Results:(1) Postoperative situations: the amylase concentration, cases with biochemical fistula, cases with grade B pancreatic fistula, cases with complications, time to extubation, duration of postoperative hospital stay, total hospital expenses were (2 629±592)U/L, 14, 5, 7, (11.9±0.7)days, (13.6±0.7)days, (49 430±1 626)yuan in non-bundled group and (683±312)U/L, 3, 1, 2, (9.7±0.6)days, (11.3±0.5)days, (44 767±1 163)yuan in bundled group, respectively. There were significant differences in the amylase concentration, cases with biochemical fistula, time to extubation, duration of hospital stay, total hospital expenses between the two groups ( t=2.528, χ2=1.512, t=2.341, 2.311, 2.111, P<0.05), and there was no significant difference in the cases with grade B pancreatic fistula or cases with complications between the two groups ( χ2=1.512, 1.394, P>0.05). (2) Analysis of risk factors for POPF of DP. Results of univariate analysis showed that tumor diameter and bundled ligation of the pancreatic stump were related factors of patients undergoing pancreatic fistula after DP ( χ2=4.462, 5.061, P<0.05). Results of multivariate analysis showed that bundled ligation of the pancreatic stump was an independent influencing factor of patients undergoing pancreatic fistula after DP ( odds ratio=0.187, 95% confidence interval as 0.037-0.954, P<0.05). Conclusions:Bundled ligation of the pancreatic stump was an independent influencing factor of patients undergoing pancreatic fistula after DP. Bundled ligation of the pancreatic stump can effectively reduce the incidence of POPF, especially biochemical fistula, the time to extubation, duration of postoperative hospital stay and total hospital expenses, and promote patient recovery after DP.

BACKGROUND:Currently, neural stem celltransplantation can be performed through three main approaches:local lesions, blood circulation, and cerebrospinal fluid.
OBJECTIVE:To review the transplantation of neural stem cells or neural precursor cells via the cerebrospinal fluid in the treatment of central nervous system diseases.
METHODS:A computer-based search of PubMed and CHKD databases was performed to retrieve articles concerning transplantation of neural stem cells via the cerebrospinal fluid, and its application and therapeutic mechanism in the treatment of central nervous system diseases in both animal experiment and clinic study published from 2000 to 2009.
RESULTS AND CONCLUSION:It is suitable for neural stem cellsurvival, proliferation, and differentiation in the cerebrospinal fluid. Transplantation of neural stem cells via the cerebrospinal fluid is effective and feasible to treat central nervous system diseases. However, some problems have not been solved, such as the source of neural stem cells, the optimal time window and celldose, the safety and the long-term effect. Further studies are needed to pave the way for the intrathecal injection of neural stem cells in the treatment of central nervous system diseases.

Objective:To know the clinical characteristics, seasonal pattern and influencing factors of atypical depression(AD) patients.Methods:A total of 203 depressed outpatients of Peking University Sixth Hospital from January 2021 to August 2021 were included.They were assessed with demographic questionnaire, inventory of depressive symptomatology self-report(IDS-SR30) and seasonal pattern assessment questionnaire(SPAQ). According the score of IDS-SR30, all patients were classified as atypical depression(AD) and non-atypical depression(non-AD). The data were analyzed by t-test, non-parametric test and Logistic regression using SPSS 26.0 software. Results:The prevalence of AD among depressed patients was 36.0% (95% CI=29.3%-42.6%). The IDS-30 score of the AD group was (41.59±10.59), and IDS-30 score of the non-AD group was (36.08±13.17), and the difference between the two groups was statistically significant ( t=3.062, P<0.05). The global seasonal score of the AD group was 6 (3, 9), and 17.8% of the AD group had seasonal pattren.The global seasonal score of the non-AD group was 5 (3, 8), and 14.6% of the non-AD group had seasonal pattern.There was no significant difference in the global seasonal score and the proportion of seasonal pattern between the two groups ( Z=0.389, χ2=0.359, P>0.05). Depression patients who were females ( β=1.08, OR=2.95, 95% CI=1.32-6.59, P<0.05), low self-evaluation ( β=0.82, OR=2.27, 95% CI=1.12-4.59, P<0.05)and psychomotor retardation ( β=0.93, OR=2.54, 95% CI=1.33-4.85, P<0.05) were more likely to be diagnosed as AD, and depression patients having mood variation ( β=-0.94, OR=0.39, 95% CI=0.19-0.81, P<0.05) were more likely to be diagnosed as non-AD. Conclusion:Women, low self-evaluation, psychomotor retardation and unobvious mood variation can predict and help to diagnose atypical depression in depressed patients.

How to give full play to the advantages of rehabilitation institutions, and to improve service quality and administration efficiency are some of the complex issues faced by the high-level administrators of rehabilitation institutions. This paper studied a total of 67 institutions to investigate the operation and management model of rehabilitation institutions in China, as well as their advantages and disadvantages.

The establishment of an efficient performance management system is crucial for a rehabilitation institution. This article discussed the concept of performance, performance management and ways to establish an efficient performance management system.