Objective To evaluate Caspofungin for the treatment of fungous infection liver transplant patients. Methods From 2003 to 2008 clinical data of 27 cases of liver transplant patients with fungal infections were reviewed retrospectively. Before 2005 (control group) fungal infections were treated with amphotericin B or Fluconazole in 13 cases. After 2005, the infection was treated with Caspofungin (observation group) in 14 cases. Liver function (AST, ALT, TBIL) and renal function (BUN, Scr) were evaluated at one and two weeks respectively. Result of treatment was evaluated 7 ～ 14 d after the treatment as for the clinical cure rate, with or without acute rejection. Result The liver function of the observation group compared with that of the control group at one week was as AST(t =8. 03 ,P <0. 01), ALT(t =9. 09, P<0.01), TBIL(t =6.01,P<0.01), and at 2 week as AST(t=5.59,P<0.01), ALT(t =6.60,P< 0. 01), TBIL(t = 8.45,P <0. 01). The renal function of the observation group compared with that of the control group after one week as for BUN(t =6. 51 ,P <0. 01), Scr(t =5.66,P <0. 01). At 2 week,as BUN (t =7.61,P <0.01), Scr(t =6.91,P <0.01). The clinical cure rate of the control group was 7/13 (53%), that of the observation group was 12/14(86%) ; Two cases in the observation group and one in the control group had acute rejection which was successfully managed by methylprednisolone pulse therapy. Conclusion Caspofungin is an ideal alternative therapy for fungal infection after fiver transplantation.

Objective To explore the modified of methods and techniques to establish a rat model of or thotopic liver transplantion effectively by a single operator, and improve the stability. Methods On the basis of two-cuff technique of Kamada, we improved the techniques of perfusing, shearing, triming donor liver, the suturation of the superior and inferior eaval veins, and so on. Operation was performed in 80 rats with modified techniques (experiment group) and conventional techniques (control group), respectively, compare the survival rates of 48 h, 1 week, lmonth were compared between the two groups. Results In contrast to conventional teehniques, the modified techniques reduced the average time of donor operation, recipient operation and anhepatie phase (P < 0. 05), elevated 1-week, 1-month survival rates, remarkably (P < 0. 05 ).Between the Iwo groups, the survival rate of 48 hour had no statistical significance (P > 0. 05). Conclusions The modified techniques may reduce the operation time of donor and receptor effectively raise the quality of donor liver, elevated the survival rate of receptor. II is a stable, reliable and effective method to establish the rat urthotopic liver transplantation model.

Objective To improve the method of orthotopic liver transplantation model in mice.Methods On the basis of "Qian SG" mothod,the techniques of perfusion,harvesting,and trimming of donor's liver,as well as the anastomosis of superior and inferior caval veins were improved.Operations were performed in 70 mice with improved technique(experiment group) and in 70 mice with conventional technique(control group),respectively.The operation time in both donors and recipients,and the survival rates of 48h,1 week and 1 month after operation were compared between the two groups.Results The operation time for both donors and recipients and the time of anhepatic phase were 37?2min,45?2min and 16?2min,respectively in experiment group,while they were 45?2min,54?2min and 23?2min,respectively,in control group,so that the average time for each procedure was significantly shorter(P0.05).Conclusions The improved technique may shorten the operation time and raise the survival rate,and is an ideal method for the establishment of orthotopic liver transplantation model in mice.

OBJECTIVE To investigate the distribution of 2916 strains and analyze the antimicrobial susceptibility of major pathogens and to provide evidences for clinical therapy.METHODS The distribution,and the antimicrobial susceptibility of pathogens,which were collected and isolated from all of the clinical specimens from Jan 2007 to Oct 2008 in our hospital,were studied restrospectively.RESULTS Totally 2916 strains(except fungi) of pathogens were isolated from patients,among which 1857 strains were Gram-negative bacteria(63.7%) and 1056 strains were Gram-positive cocci(36.2%).The five common bacteria isolated from the specimens were Escherichia coli(14.3%),Klebsiella pneumoniae(11.8%),Pseudomonas aeruginosa(10.7%),Staphylococcus aureus(10.5%),and Acinetobacter baumanii(8.7%).The ESBLs producing E.coli and K.pneumoniae accounted for 31.4% and 33.7%,respectively;meticillin-resistant S.aureus(MRSA) accounted for 53.3% and meticillin-resistant coagulase-negative staphylococci(MRCNS) accounted for 49.6%;vancomycin-resistant S.aureus was not isolated Gram-negative bacilli had the lowest resistance to carbapenems,and then to piperacillin/tazobactam(TZP) and cefoperazone/sulbactam(CFS),showing multi-resistantce.Gram-positive cocci were more sensitive to vancomycin,rifampicin,nitrofurantoin than to other antibacterials.CONCLUSIONS The drug resistance of the isolated bacteria is common.It is very important to monitor the drug resistance of the bacteria regularly,for guiding the clinic use of antibiotics rationally,and infection control.

Objective To intervene and appraise the health literacy of diabetic patients entering contracts with family doctors in pilot communities,and learn the effect and feasibility of health literacy management by family doctors for diabetic patients.Methods By means of community intervention study and questionnaire survey,560 diabetic patients as mentioned above in Shanghai were subject to a baseline assessment on their health literacy,followed by management and routine follow-up on their diabetic health literacy.At the end of six months of comprehensive intervention,their health literacy was appraised again to observe the effects of such management.Results Six months of guidance and management found the average scoring of the health literacy of these patients 23.46 over the baseline,an increase of 36.8% of the patients in their compliance of the four basic diabetic diet behaviors,and an increase of 27.8% of them in regular and quantitative exercises.Conclusions It is feasible for community family doctors to carry out the health literacy management for diabetic patients contracted,and health literacy management can change the awareness and behaviors of such patients to some extent.

Objective To study the surgical technique of construction of orthopic liver transplantation model in mice by a single operator.Methods On the basis of two-cuff technique,running suture was used to reestablish the suprahepatic vena cava(SHVC),"two-cuff"technology to reestablish the portal vein(PV)and infrahepatic vena cava(IHVC),and"stent"to reestablish the bile duct.Operation was performed in 70 mice,the 24 h,1 week,1M postoperative survival rate were noted,and hepatic function and pathological change were observed.Results The 24 h,1 week and 1M survival rate was 95.7%,90.9%,85.1%,respectively.The ALT increased gradually in the first postoperative week,and dropped to normal level in the first month.Pathology showed the structure of liver tissue was fine.Conclusions The method is an ideal mothod to establish the orthotopic liver transplantation model in mice,because it has high survival rate,good stability and is easily replicated.

The paper covered the development, structure, functionality, effectiveness and goals of the community health information system in the district. It is found that Zhabei district has developed the standard electronic health archives which can be collected by various sources and renewed instantly;regional health information sharing and collaboration platform has been established as well; a sharing and joint service platform has been built for regional health information sharing between communities and secondary hospitals shared; "Health key" has been developed as a model for self-service health management for residents.

Objective To develop two-grille latrines with the effect of non-hazardous treatment. Methods According to the result of the pretest, one type of two-grille latrines was selected and constructed and its effect of non-hazardous treatment was evaluated. Results The faces-treatment pool, with cement-prefab structure and obturation, had a total cubage of 1.32 m3. The average total amount of faces in the pool was 1.05 m3 per family per month, and the pool could store the faces for over 34 days. The “reaching criteria rate” of the parasite ova sediment and the value of the fecal coliform bacteria were 100% among the excrement in the outlet. Conclusions The prefab two-grille latrines can reach the criteria of non-hazardous treatment, and they can be used in well-off rural areas without the usage of manure.

Objective To understand the e ff ectiveness of parasite ova sediment and non-hazardous treatment of two-grille la trines. Methods Two-grille latrines were recon n oitered in the field according to the non-hazardous treatment criteria, and th e sediment of parasite ova, the value of fecal coliform bacteria, NH 3-N, CODcr of the samples from the Grille 1 and Grille 2 of latrines were detected.Results The structure of some two-grille latrines was n o t in accord with the non-hazardous treatment criteria.Parasite ova were detecte d from the Grille 2 of one latrine. Six of 16 latrines were not eligible for non -ha zardous treatment according to the value of fecal coliform bacteria in Grille 2. Conclusion It is not suggested to popularize th e two-grille latrine yet, but it can be used as an interim form for excrement n on-hazardous treatment in rural areas. [

0. 05), but both less than that of the lower or stirring excrement (P