In modern society,it is very important to prevent and control abrupt public health incidents.But the current education programs lack the relevant contents.Some tendencies exist:stressing disease prevention but lacking injury prevention;stressing techniques in hospital but lacking skills on scene;stressing test method but lacking information technology;stressing ordinary prevention but lacking measures in unexpected situations;stressing ability of techniques but lacking ability of organization,etc.We should integrate the pertinent knowledge of abrupt public health incidents into training programs for students of public health.

Team building and teamwork mode have become the important parts in scientific research and clinical approach of critical care medicine (CCM). Team is a group composed of several individuals with different abilities, complementary roles and mutual dependence based on the common goal. Teamwork mode refers to that each member of the team, as a part of the community, completes the common goal through synergy based on the common knowledge system, according to the unified way of thinking. With the characteristics of CCM and the improvement of knowledge system and thinking system, the team building and teamwork mode of CCM has experienced a chaotic period, a molding period, an excitation period and a mature period. The team building and teamwork mode provide a strong internal impetus for the development of CCM.

BACKGROUND: Osteosarcoma cell OS-9607 is a cell line cultured from human osteosarcoma tissue. To construct cDNA library of this cell line so as to clone target gene from it.OBJECTIVE: To construct cDNA library of osteosarcoma cell OS-9607 by switching mechanism at 5' end of RNA transcript (SMART) technique and analyze its quality.DESIGN: Verified experimental study SETTING: Department of Orthopaedics, Changhai Hospital, Second Military Medical University of Chinese PLA MATERIALS: This experiment was carried out at the Department of Orthopaedics, Changhai Hospital, Second Military Medical University of Chinese PLA in May 2005. Osteosarcoma cell OS-9607 was cultured in CO2 incubator. Cells were pre-treated with DM for 30 minutes, recovered for 24 hours in standard culture medium. The whole RNA of osteosarcoma cell OS-9607 was isolated by RNAease reagent kit. The quantity and integrity of total RNA was detected by ultraviolet spectrometer and electrophoresis on a denaturing formaldehyde agarose gel stained by ethidium bromide (EtBr). METHODS: Total RNA was extracted from human osteosarcoma cell OS9607 and mRNA was isolated, cDNA of OS-9607 cells was acquired by in situ polymerase chain reaction (PCR) and long-distance PCR (LD-PCR),then the cDNA was ligated with dephosphorylated λ phage vector. The recombinants were constructed with SMART cDNA library construction kit.The size of cDNA inserts and the diversity of library were detected by PCR.MAIN OUTCOME MEASURES: The quality and integrity of total RNA, the titer of un-amplified and amplified library and recombination fraction; analysis of cDNA length of library RESULTS: ①The concentration of the isolated total RNA was determined and the measuring absorbance was between 260 nm and 280 nm. Its absorptance was about 1.9 A. 0.8％ denaturing formaldehyde agarose gel electrophorosis showed clear 28S rRNA and 18S rRNA,and the brightness rate of 28S rRNA and 18S rRNA (28S/18S) was 2:1. ②After linked to λ phage in vitro, packed and transfected host bacteria, the titer of unamplified library was 2.2×107 pfu/mL, and the titer of amplified 1 ibrary arrived to 4.5×1010 pfu/mL. The recombination fraction analysis showed that there were 8 blue plaques and 1 360 colorless plaques in one plate, so the recombination fraction was 99.5％. ③ The obtained cDNA library consisted of 1.6×106 recombinant bacteriophages and the average exogenous inserts of the recombinants was 1.5 kb.CONCLUSION: These results suggest that the obtained osteosarcoma cell OS-9607 cDNA library has high quality, which sets up a firm foundation for the further research on osteosarcoma cell OS-9607 and its elated genes screen.

OBJECTIVE To provide the evidence in decreasing the rate of hospital-acquired infection by studying the patients in NICU and analyzing the bacteria strains isolated from these patients.METHODS We studied 512 cases from 1027 patients in NICU of Department of Neurology,813 isolated bacteria strains and their sensitivities to antibiotics were investigated.RESULTS NICU patients had a relatively high rate of hospital-acquired infection(49.85%),respiratory and urinary systems were the most common affected.Klebsiella pneumoniae was the top one species in Gram-negative bacteria(62.61%).Pseudomonas aeruginosa was the top one species in Gram-positive bacteria(28.16%).CONCLUSIONS Laboratory examination,appropriate antibiotics and precise medical behavior are the most important factors in preventing the hospital-acquired infection in NICU.

OBJECTIVE To investigate 11200 strains isolated from the patients of our hospital between from 1 Jan 2005 to 31 Dec 2006,to detect the distribution and resistance of bacteria and provide laboratory evidence for the application of antibiotics in clinics.METHODS The sensitivities of bacterial strains to antibiotics were analyzed.RESULTS SAU was the top one in Gram-positive bacteria(G+ bacteria),the occurrence of meticillin-resistant Staphylococcus aureus(MRSA)statistically increased(from 70.0% to 76.0%).Pseudomonas aeroginosa was the top one in Gram-negative bacteria(G-bacteria)(from 11.8% to 12.9%),the occurrence of ESBLs-producing Esherichia coli statistically increased(from 30.5% to 35.5%).The percentages of fungal strains isolated in the two years of 2005 and 2006 were 13.4% and 19.2%,respectively Candida albicans was the main strain among them.CONCLUSIONS These pathogens are still the common types in the patients from our hospital.It should be noted that MRSA and ESBLs-producing E.coli strains are significantly increasing and presenting resistance to a varieties of antibiotics.

Objective To study the fatal risk factors to the patients with sepsis.Methods The data of 49 patients with sepsis were analyzed,who were consecutively admitted to intensive care unit(ICU)of Peking Union Medical College Hospital within six months.Patients' general states,clinical information,human leucocyte antigen-DR(HLA-DR)in blood monocytes and plasma level of diamine oxidase(DAO)were recorded.Simple logistic regression was done to analyze all the risk factors,and statistically significant variables were selected and used in multivariate and unconditioned Logistic regression analysis.The primary end point was hospital mortality.Results The subjects involved in present study were consisted of 49 patients with sepsis admitted to ICU of the Peking Union Medical College Hospital from Aug.2003 to Jan.2004,averagely aged 60.8?16.9 years;including 32 males(65.3%)and 17 females(34.7%);with APACHEⅡscores 18.6?8.0 and SOFA scores 5.9?3.8.Twenty-one out of the 49 patients(42.9%)were from non-operation department,and the other 28 patients(57.1%)were from operation department.ICU duration was 14.4?12.8 days;eighteen of the 49 septic patients died during hospitalization,with the 28-days mortality of 36.7%.Positive blood cultures(OR=5.237,95%CI 1.041~26.34,P=0.045),decreased platelet count and blood HLA-DR(OR=0.943,95%CI 0.901~0.98,P=0.01),and increased plasma levels of DAO(OR=2.235,95%CI 1.101~4.53,P=0.026)were obviously associated with mortality.The positive blood cultures,decreased blood HLA-DR and increased plasma levels of DAO were independent fatal risk factors for the patients with sepsis.Conclusions The positive blood cultures,decreased blood HLA-DR and increased plasma levels of DAO are high risk for the patients with sepsis at admission.

OBJECTIVE:To investigate the effects of Shuxuetong injection on related indexes of patients with acute myocardial infarction (AMI).METHODS:The data of 156 AMI patients were analyzed retrospectively,and then divided into control group (65 cases) and observation group (91 cases) according to therapy plan.Control group received routine treatment.Observation group was additionally given Shuxuetong injection 6 mL added into 5％ Glucose injection 250 mL intravenously,once a day,on the basis of control group.Both groups were given treatment for 5 d.The incidence of vascular recanalization,recanalization time,the incidence of reocclusion as well as LVEF,APTT,PT,FIB,the occurrence of adverse cardiovascular events before and after treatment as well as the occurrence of ADR were observed in 2 groups.RESULTS:The incidence of reocclusion and adverse cardiovascular events in observation group was significantly lower than control group,with statistical significance (P＜0.05).There was no statistical significance in the incidence of vascular recanalization,recanalization time or the incidence of ADR between 2 groups (P＞0.05).After treatment,the levels of LVEF,APTT and PT in 2 groups were significantly higher than before treatment,and the observation group was significantly higher than the control group.The levels of FIB in 2 groups were significantly lower than before treatment,and the observation group was significantly lower than the control group,with statistical significance (P＜0.05).CONCLUSIONS:Based on routine treatment,Shuxuetong injection can reduce the incidence of reocclusion,improve cardiac function and reduce the incidence of adverse cardiovascular events without increasing the occurrence of ADR.

The relationship between hyperlactatemia and metabolic acidosis, which may involve shock resuscitation,homoiostasis, and nutritional support, remains a hot topic. On one hand, increased production of lac-tate due to anaerobic glycolysis during tissue hypoperfusion can aggravate metabolic acidosis; on the other hand,the utilization of lactate at organ and cell levels may lower blood lactate level, and thus alleviate metabolic acidosis.The ultimate blood lactate level depends on the balance of these two action mechanisms.

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