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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.

BACKGROUND: Osteoporosis has been one of the main reasons for old people' s in decline living standard and shortening of lifespan. The onset of osteoporosis is related to the loss of functional coupling in osteoblast and osteoclast. So observation of the regulative effect of medicines on osteoblast is a good method to evaluate their preventive and therapeutical efficacy in osteoporosis.OBJECTIVE: To investigate the effects of genistein on osteoblast culture in vitro.DESIGN: A randomined, controlled and single-blind study based on rat osteoblasts.SETTING: Department of laboratory in amunicipal hospital.MATERIALS: The experiment was completed in the Room of Isotope, Department of Nuclear Medicine, China-Japan Friendship Hospital of Beijing from February to December 2001. Ten SD rats of 24 hours old were provided from Beijing Weitong Lihua Experimental Animal Ltd. Co. (license:SCXK11-00-0008 ). The laboratory was SPF grade.METHODS: Skull osteoblasts of rats were selected to culture in vitro. Microculture tetrozolium, p-nitrophenyl phosphate, atomic absorptiometry and alizarin red were used to observe the effect of genistein on proliferation,activity of alkaline phosphatase(ALP), contents of matrix calcium and the number of mineral nodes of osteoblasts cultured in vitro.MAIN OUTCOME MEASURES: Morphological observation, determination of proliferation ratio, ALP stain, determination of matrix calcium accumulation and number of mineralized nodes with alizarin red stain.RESULTS: It was found that genistein stimulated the proliferation of osteoblasts, improved the ALP activity, and increased the contents of matrix calcium and the number of mineral nodes in cultured osteoblasts.CONCLUSION: Genistein has the effects on stimulating the proliferation,differentiation, maturation and mineralization of osteoblasts cultured in vitro.

ObjectiveTo explore the effect of constraint-induced movement therapy (CIMT) for motor function of upper extremity after stroke.Methods28 stroke patients with upper-limb hemiparesis were divided into two groups, 14 cases in each group. The observation group received constraint-induced movement therapy, treated with intensive shaping training with constraint of the unaffected arms. While the control group received routine rehabilitation with no constraint of the unaffected arms. The effect was evaluated by The Fugl-Meyer Asseseement(FMA).ResultsThe scores of FMA is higher after than before treatment in the observation group, (P<0-05). The flexibility of upper extremity of the observation group improved more significantly than that of the control group after treatment (P<0-05).ConclusionCIMT can enhance the effect of rehabilitation in the function of upper extremity and the activities of daily living of hemiplegia patients.

ObjectiveTo observe the effect of motor relearning programme(MRP) training on lower Limbs function of stroke patients.MethodsSixty patients were randomly and equally allocated to training group (30 patients) and control group (30 patients). The control group was prescribed Bobath therapy while the training group received the MRP training. The lower limbs function was then assessed by the Fugl-Meyer Assessment Scale.ResultsLower limbs function improved significantly in both groups while the training group was better than the control group after three months(P<0-05). ConclusionMRP training can promote the recovery of lower limbs function of patients with stroke.

0.05).Neither pruritus nor respiratory depression was noted in both groups.CONCLUSION:At an equivalent dose,Nefopam Hydrochloride showed a similar PCSA efficacy to Fentanyl after surgery but less side effect,therefore,it can be applied in postoperative PCSA.

Objective To observe the effect of physiotherapy on knee osteoarthritis. Methods 40 knee osteoarthritis patients were dividedinto treatment group (n=20) and control group (n=20). The control group accepted conventional therapy, acupuncture and moxibustion,fumigation, massage, etc. The treatment group accepted physiotherapy in addition, including strength training and joint activity training.They were assessed with Lysholm Knee Scoring Scale (LKSS) and Visual Analogous Scale (VAS). Results The scores of LKSS and VASimproved in both groups after treatment, and improved more in the treatment group than in the control group (P<0.01). Conclusion Physiotherapycan further improve the stability of knee and release the pain in knee osteoarthritis patients.

Objective To observe the effects of ankle intensive training on the recovery of lower limbs motor in stroke patients in later stage of rehabilitation. Methods 30 stroke patients with course ≥ 3 months were divided into the treatment group (n=15) and control group (n=15). The control group received routine treatment, and the treatment group received ankle intensive training in addition. They were assessed with Fugl-Meyer Assessment (FMA) of lower extremity and 10 m walking speed. Results The scores of FMA and 10 m walking speed improved in both groups after treatment (P<0.05), and improved more in the treatment group than in the control group (P<0.05). Conclusion Ankle intensive training can promote the motor recovery of lower limbs in later stroke patients

OBJECTIVE To find the cause of lower respiratory tract infection as soon as possible and take measures to control the infection.METHODS The records of hospitalized patients in the intensive care unit(ICU) form Nov 28 to Dec 6 in 2006 were analyzed;and the disinfection efficiency,sterilization effect and the environment were monitored.RESULTS The incidence rate of lower respiratory tract infection was 54.55%.The qualified rate of disinfection and sterilization monitoring was 35.71%.The respiratory tubing,bed handle,bottle openner,computer mouse,the surface of the file cabinet and air vents were heavily infected.The Staphylococcus aureus was isolated from the quilt cover and the surface of the file cabinet.CONCLUSIONS We should put more emphasis on the management of the infective disease in the ICU,on hand washing and the cleanliness and maintenance of the devices.Disinfection and isolation guidelines should be strictly followed to reduce the incident rate of infection in the ICU.

Objective To summarize extracorporeal membrane oxygenation (ECMO) in percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) with cardiac arrest,and to evaluate the clinical efficacy comparing with literature review.Methods 5 patients of AMI with cardiac arrest who proved invalid to conventional cardio-pulmonaryresuscitation (CPR),were successfully resuscitated with ECMO support,and underwent emergency PCI with stable hemodynamic status.Results In support of ECMO,4 patients were successfully resuscitated with stable hemodynamic status,and underwent primary PCI.The duration of ECMO support ranged from 42 to 220 h (average 126.6 h).3 patients discharged with full recovery,one patient didn't wean from ECMO successfully,and one died of respiratory failure.Conclusion Although mortality of AMI with cardiac arrest is high,early ECMO-assisted cardiopulmonary resuscitation and secondary PCI treatment increase the possibility of cardiac recovery,and provide conditions for emergency revascularization treatment.This reduces mortality in critical patients with AMI,and is an effective short term life support method.