OBJECTIVE To investigate the etiology of ventilator-associated pneumonia(VAP) in our respiratory intensive care unit(RICU) and to explore the antimicrobial resistance of predominant pathogens in last ten years. METHODS From 1992 to 2003,totally 149 cases with VAP were collected for analyzing in our RICU.Standard disk diffusion susceptibility tests were performed on the predominant pathogens. RESULTS During this period,the incidence of VAP in RICU was 35.57%,33 cases were infected by two or more pathogens(67.35% VAP cases).The main pathogens of VAP were Gram negative organisms(65.51%) whose predominant pathogens were Pseudomonas aeruginosa and Acinetobacter.On the other hand,the main Gram positive organisms were Staphylococcus epidermidis.During the recent 10 years,the incidence of Acinetobacter rose up from 8.99% to 15.49% and the rate of Candida decreased from 13.33% to 7.04%. CONCLUSIONS The main pathogens of VAP in our RICU are P.aeruginosa and Acinetobacter,and the changes in pathogens distribution and infection spectrum have been taken place during the past 10 years.

Objective To observe the effect of Zhenganxifeng decoction and Buyanghuanwu decoction on the early rehabilitation of the stroke.Methods 101 cases with acute stroke were randomly divided into the treatment group(n=51) and control group(n=50).All patients were treated with routine medical therapy,physiotherapy and electric stimulation for a month.The treatment group was treated with Zhenganxifeng decoction while the control group with Buyanghuanwu decoction in addition.Results The motor function and Activities of Daily Living(ADL) in both groups were improved after treatment,but were better in treatment group than in control group(P<0.01).Conclusion It is better to use Zhenganxifeng decoction in the early rehabilitation of the stroke than Buyanghuanwu decoction.

OBJECTIVETo study the types of matrix metalloproteinases (MMPs) involved in dentin bonding interface degradation.

METHODSDentin slices were prepared and treated with two adhesive systems (Single Bond 2 or Clearfil S3 Bond). The dentin surface was bonded with composite resin. All specimens were immersed in sterile artificial saliva for 0 or 6 months, and their micro-shear bond strength (muSBS) were measured. The fracture modes were observed through field emission scanning electron microscope (FE-SEM). Dentin slices with 4 mm x 3 mm x 1 mm dimensions were prepared. The slices were divided into three groups according to the treatment modes (negative control, Single Bond 2, and Clearfil S3 Bond). All specimens were stored in sterile artificial saliva for 0 or 6 months. The concentrations of MMP-1, -2, -3, -8, and -9 of each group were detected through fluorescent microsphere immunoassay.

RESULTSThe muSBS of both adhesive systems significantly decreased after storage aging. Significant differences in failure modes within the four groups tested in this study were observed. Compared with the negative control, the concentrations of MMP-1 and MMP-3 in different adhesive groups showed no significant difference after storage aging. However, the concentrations of MMP-2, -8, and -9 in Single Bond 2 group and the concentrations of MMP-8 and -9 in Clearfil S3 Bond group significantly decreased after 6 months of storage aging.

CONCLUSIONSignificant degradation occur in the dentin bonding interface of both adhesive groups under 6 months aging challenge. The concentrations ofdentinal MMP-2, -8, and -9 significantly decrease after treatment with adhesives and aging, indicating that these MMPs have an important function in dentin bonding interface degradation.

Objective To evaluate the changes in the expression of Nogo-A protein in the dorsal root ganglion (DRG) and spinal dorsal horn in a rat model of inflammatory pain.Methods One hundred and twenty male Sprague-Dawley rats,weighing 250-300 g,were randomly divided into 2 groups (n =60 each):control group (group C) and formalin group (group F).The inflammatory pain was induced by injection of 3％ formalin 100 μl into the plantar surface of left hindpaw in group F.The equal volume of normal saline was given instead of formalin in group C.Mechanical withdrawal threshold to yon Frey filament stimulation was measured at 1 h and 1,2,3 and 7 days after injection.Twelve rats in each group were chosen at each time point and sacrificed.The L5 DRG and L4,5 segment of spinal cord on the operated side were removed for determination of Nogo-A protein expression by immunofluorescence and Western blot.Remlts Compared with group C,the mechanical withdrawal threshold was significantly decreased at 1 h,1,2,3 and 7 days after injection,and the expression of Nogo-A protein in the DRG and L4,5 segment of spinal cord was up-regulated at 1 h and 2,3 and 7 days after injection in group F (P ＜0.05).Conclusion Up-regulation of Nogo-A protein in the DRG and spinal dorsal horn may play an important role in the development of formalin-induced inflammatory pain in rats.

Objective To study the effects of ghrelin on action potential (AP) and transient outside K+ current (Ito) in ventricular myocytes of diabetic cardiomyopathy (DCM) rats.Methods A rat model of DCM was established by single intraperitoneal injection of streptozotocin (STZ, 60mg/kg), and whole cell patch-clamp technique was used to record the effects of 10-7mmol/L ghrelin on AP and Ito current density in the DCM rat ventricular myocytes.Results Compared to DCM group, Ghrelin of 10-7mmol/L could significantly prolong APD50 [(12.49±2.32)％;n=7, P=0.037] and APD90 [(26.29±5.13)％;n=7, P=0.006] and decrease Ito current peak value [(23.14±3.07)％;n=9, P=0.021] in DCM rat ventricular myocytes.Conclusion Exogenous ghrelin is involved in the electrophysiological reconstruction of the heart of diabetic rats by decreasing Ito current and prolonging APD in STZ-induced DCM rat ventricular myocytes.

OBJECTIVE To determine the extra-lengh of stay and the economic loss for nosocomial infections of group A rotavirus in children′s hospital. METHODS We performed a 1∶1 case-control study to determine the cost of nosocomial rotavirus infection. Data of hospitalized cases were collected from Jan 1 2007 to Dec 31 2007. RESULTS The average medical expenses in case and control group were 7589 yuan and 5319 yuan,the average increased cost per case was 2269 yuan,the expenses for medicine,treatment,laboratory test and bed accounted for 47.42%,19.96%,17.10% and 9.03%,respectively (P

AIM:To determine the effects of different-term streptozotocin(STZ)-induced diabetes on ischemia/reperfusion(I/R)injury and cell apoptosis in rats myocardial via alterations in myocardial peroxynitrite.METHODS:The models of I/R injury were induced by occlusion and reperfusion of the left descending coronary artery(LDCA)in rats.I/R-induced infarct size was determined using triphenyltetrazolium chloride(TTC)staining.Quantified caspase-3 expression was used to represent apoptosis by Western blotting analysis.Peroxynitrite formation as indicated by nitrotyrosine level was measured by morphometric analysis.RESULTS:Two weeks after STZ treatment,infarct size(35.00%?3.00%)was smaller in 2 weeks diabetic hearts(2WKD)as compared with time-matched control group(2WKC)(51.00%?3.30%),whereas after 16 weeks of diabetes(16WKD),the infarct size(61.00%?3.00%)was bigger in the diabetic hearts as compared with the 16WKC group(50.00%?2.00%,P

AIM:To explore whether YAP protein is important in induced pluripotent stem cell ( iPSC)-induced cardiovascular progenitor cell and/or vascular smooth muscle differentiation .METHODS:Using episomal vector based reprogramming , we generated human iPSCs from donor fibroblasts .We used both this iPSCs and human H 1 embryonic stem cells to differentiate into vascular smooth muscle cells (VSMCs) through cardiovascular progenitor cells (CVPC).Western blotting, qPCR and immunofluorescence microscopy were used to check the expression of YAP and related genes during this differentiation process .RESULTS:The results showed that iPSCs expressed pluripotent stem cell markers, such as Oct4, Nanog, Sox2, TRA-1-60 and SSEA3, and could form teratoma in SCID mice.YAP was highly expressed in pluripotent stem cells , but dramatically decreased when CVPC differentiation started .YAP gradually increased dur-ing CVPC three-day differentiation.The TAZ and YAP binding partner TEAD1, but not TEAD2 and TEAD4, have similar expression pattern in CVPC differentiation .Immunofluorescence result confirmed that YAP was activated and accumulated in nucleus .Interesting-ly, both YAP and phosphorylated YAP expression decreased to very low level after CVPC differentiated into VSMCs in 7 days.TEAD4 and TAZ also decreased, while TEAD1, TEAD2 and TEAD3 expression did not change during VSMC differentiation .CONCLU-SION:YAP and TEAD1 expression increased during CVPC differentiation , while YAP and TEAD4 expression decreased from CVPC to VSMCs differentiation , which suggested YAP might have different function during diverse cell differentiation .

Objective To compare the effects of smoking and non smoking on postoperative pain of laparoscopic cholecystectomy. Methods Sixty patients having underwent selective laparoscopic cholecystectom were divided into smoking group and non smoking group by random digits table with 30 cases each. In smoking group, 14 cases quitted smoking within 1 week before operation. The Fagerstrom test of nicotine dependence (FTND) was evaluated before operation in smoking group, and FTND ≥ 6 scores was in 11 cases. The visual analog score (VAS), Bruggrmarm comfort score (BCS), sedation-agitation score (SAS), immediately, 15 min, and 30 min after entering postanesthesia care unit (PACU) and leaving PACU was evaluated. The operation time, anesthesia time, wake up time, extubation time, PACU time, using rate of remedial measures and untoward reaction were recorded. Results There were no statistical differences in operation time, anesthesia time, wake up time, extubation time, SAS and incidence of untoward reaction between 2 groups (P>0.05). The PACU time and using rate of remedial measures in smoking group were significantly higher than those in non smoking group:(39.7 ± 5.1) min vs. (31.3 ± 6.1) min and 30.0% (9/30) vs. 0, and there were statistical differences (P<0.05). The VAS immediately, 15 min and 30 min after entering PACU and leaving PACU in smoking group was significantly higher than that in non smoking group: (2.90 ± 0.85) scores vs. (1.00 ± 0.83) scores, (2.70 ± 0.47) scores vs. (0.73 ± 0.69) scores, (2.60 ± 0.56) scores vs. (1.13 ± 0.73) scores, (2.23 ± 0.57) scores vs. (1.13 ± 0.73) scores; and the BCS was significantly lower than that in non smoking group:(1.80 ± 0.61) scores vs. (2.90 ± 0.99) scores, (1.90 ± 0.31) scores vs. (2.87 ± 1.00) scores, (2.10 ± 0.31) scores vs. (2.47 ± 0.82) scores, (2.17 ± 0.38) scores vs. (2.47 ± 0.82) scores, and there were statistical differences (P<0.05). The VAS immediately after entering PACU in patients of FTND ≥ 6 scores was significantly higher than that in patients of FTND<6 scores:(3.6 ± 0.7) scores vs. (2.5 ± 0.7) scores, the BCS was significantly lower than that in patients of FTND <6 scores:(1.5 ± 0.5) scores vs. (2.0 ± 0.6) scores, and there were statistical differences (P<0.05). The VAS immediately after entering PACU in patients of non- quit smoking was significantly higher than that in patients of quit smoking: (3.4 ± 0.7) scores vs. (2.4 ± 0.6) scores, and there were statistical differences (P<0.05). Conclusions Smokers have more severe postoperative pain in laparoscopic cholecystectomy and higher postoperative opioid requirement than nonsmokers. Quit smoking before surgery will reduce postoperative pain and related complications. Appropriate increase of analgesic drugs can prevent postoperative pain in patients with smoking.

Objective: To study therapeutic effects of simvastatin on vascular endothelial cell dysfunction in patients with coronary heart disease (CHD). Methods: According to LDL-C level, a total of 90 CHD patients were divided into simvastatin 20mg group (n=37, LDL-C≥2.5mmol/L), simvastatin 10mg group (n=35, 1.8mmol/L≤LDL-C<2.5mmol/L) and routine treatment group (n=18, LDL-C<1.8mmol/L). Their course of treatment was 8 weeks. Color Doppler ultrasound diagnostic instrument was used to measure flow-mediated dilation of brachial artery (FMD), and nitrate reductase method was used to measure concentration of nitric oxide (NO) in all CHD patients. Serum concentrations of TC, TG, LDL-C and HDL-C were routinely measured. Results: After treatment of eight weeks, compared with before treatment, there were significant decrease in concentrations of TC, TG and LDL-C (P<0.05 all), and significant increase in HDL-C level (P<0.05 all) in simvastatin 20mg and 10mg group, but there were no significant difference in above-mentioned all indexes between simvastatin 20mg and 10mg groups, P>0.05 all; Compared with routine treatment group, there were significant improvement in FMD [(6.01±0.49)% vs. (9.01±0.39)% vs. (9.01±0.47)%，P<0.01 all] and significant increase in serum NO concentration [(38.97±8.89)μmol/L vs. (47.67±10.89) μmol/L vs. (45.61±9.09) μmol/L，P<0.05 all] in simvastatin 20mg and 10mg group; But there were also no significant difference in serum NO and FMD between simvastatin 20mg and 10mg groups, P>0.05 all. Conclusion: Simvastatin can increase NO concentration and improve vascular endothelial cell dysfunction in CHD patients. Its mechanism may be related with lipid-lowering effect, but independent of its lipid-lowering effect