OBJECTIVE To investigate the risk factors of fungal ventilator associated pneumonia(FVAP) and the characteristic of pathogenic fungi.METHODS Thirty seven VAP patients were divided into FVAP group and nonfungal ventilator associated pneumonia(NFVAP) group.Risk factors were compared between the two groups and the characteristic of pathogenic fungi was analyzed.RESULTS Compared to the NFVAP group,the FVAP group showed a significant higher rate in systemic usage of glucocorticosteriod and combined application of antibiotics.The cases of FVAP appeared frequently over the period since 7th to 14th days after intubation.Twelve strains of fungi were isolated from the sputum of patients in FVAP group.Ten strains(83.3%) of the isolates belonged to Candida species included(C.albicans 6 strains(50.0%),C.tropicalis 2 strains(16.7%),C.krusei 1 strain(8.3%),and C.parapsilosis 1 strain(8.3%),and 2 strains(16.7%) of the isolates belonged to Aspergillus.CONCLUSIONS The rate of tracheal intubation should be decreased and the time of mechanical ventilation should be shortened to avoid FVAP.Identifying the strains of fungi and their sensitivity are useful to direct the treatment.

目的探讨非完全同步影像尿动力学检查的临床应用意义。方法采用Laborie尿动力学检查仪和Toshiba放射检查床,对128例患者进行非完全同步影像尿动力学检查(一般取截石位及斜坐位),其中脊髓损伤92例(71.9%)、骶裂5例(3.9%)、尿失禁8例(6.2%)、排尿困难2例(1.6%)、前列腺增生21例(16.4%)。灌注液中泛影葡胺含量为15%,灌注速度10—20ml/min,检查方法同普通尿动力学检查,记录膀胱压力(Pves)、直肠压力(Pabd)、逼尿肌压力(Pdet)、尿流率(Q)和肌电图等参数,采用膀胱储尿期及排尿期同步透视,点拍摄放射片4次,记录并保存影像。结果发现膀胱输尿管返流6例(4.7%)、膀胱结石18例(14.1%)、膀胱憩室35例(27.3%)、膀胱颈开放78例(60.9%)、逼尿肌膀胱颈协同失调23例(18.0% )、逼尿肌尿道外括约肌协同失调59例(46.1%)、外括约肌痉挛31例(24.2%)。结论非完全同步影像尿动力学检查能够利用现有设备进行影像尿动力学检查,对全面了解神经原性膀胱尿道功能障碍及LUTS患者的下尿路病理生理改变有重要价值。

Proliferation and migration of vascular smooth muscle cells (VSMC) are common pathological features of diabetic vascular complications,such as atherosclerosis and hypertension. Phenotypic modulation of VSMC is the basis for VSMC proliferation and migration. Therefore, studies on VSMC phenotypic modulation and its mechanisms in diabetes mellitus were of important significance to the prevention and therapy of diabetic vascular complications. This paper introduces VSMC phenotypic modulation and the underlying mechanisms in diabetes mellitus, and summarizes advance of studies on traditional Chinese medicine intervention upon VSMC phenotypic modulation, so as to provide reference for preventing and treating diabetic vascular complications with traditional Chinese medicines.
Atherosclerosis ; drug therapy ; prevention & control ; Cell Movement ; drug effects ; Cell Proliferation ; drug effects ; Diabetes Mellitus ; drug therapy ; pathology ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Hypertension ; drug therapy ; prevention & control ; Medicine, Chinese Traditional ; Muscle, Smooth, Vascular ; drug effects ; Myocytes, Smooth Muscle ; drug effects ; Phenotype

Objective To observe the effect of small interfering RNA(siRNA)expression plasmids targeting transforming growth factor p receptor(TαR)Ⅰ gene on the collagen synthesis of hepatic stellate cells(HSCs).Methods Three siRNA expression plasmids were designed and constructed according to TBR Ⅰ sequence.Then the plasmids were transfected into HSC-T6 using 1ipofectamine2000 reagent. The mRNA and protein expressions of TβR Ⅰ were analyzed by reverse transcription polymerase chain reaction(RT-PCR)and Western blot technique, respectively. The cell proliferation was detected using methylthiazo-lyldiphenyl-tetrazolium bromide(MTT)methods. Concentrations of haluronic acid and type Ⅲ pro-collagen in the supernatants were determined by radioimmunoassay. The data were analyzed using least significant difference(LSD).Results Three recombinant plasmids expressing siRNAs were successfully constructed and confirmed by restriction enzyme assay. Compared with the blank control,all the three recombinant plasmids could inhibit the expressions of TβR Ⅰ mRNA,of which plasmid expressing siRNA2 exhibited the strongest inhibitory effect(psiRNA1 group:t=7.354,P＜0.01;psiRNA2 group:t=9.214,P＜0.01;psiRNA3 group:t=5.967,P＜0.01).The expressions of TβR Ⅰ protein were also reduced by all the three recombinant plasmids,of which the plasmid expressing siRNA2 showed the strongest inhibitory effect(psiRNA1 group: t=6.324,P＜0.01;psiRNA2 group:t=8.741,P＜0.01;psiRNA3 group:t=4.128,P＜0.01).The proliferation activity and collagen synthesis of HSCs also decreased in all three HSC groups treated with recombinant plasmids, of which, again, plasmid expressing siRNA2 exhibited the strongest inhibitory effect. However, no significant change was observed in HSCs transfected with non-related siRNA. Conclusion Recombinant plasmids targeting TβR I can inhibit collagen synthesis, which suggests a novel target for gene therapy of liver fibrosis.

Hela is the cell line of adenocarcinoma of the uterine cervix, and human papillomavirus (HPV) 18 shows positive. We delivered siRNA with target specifically to HPV18 E7 mRNA into nude mice Hela tumor xenografts by nanopatch to inhibit the HPV gene expression, and further to study the superiority, the best action time and concentration of siRNA of using nanopatch to transfer siRNA in vivo. We designed siRNA that target specifically to HPV18 E7 mRNA (siE7) and checked the effect of siE7 in vitro. Tumor xenografts were transfected with siE7 and GenEscort III by nanopatch. Expression of HPV18 E7 mRNA and protein were detected 0 hours, 24 hours, 48 hours, 72 hours after transfection with PT-PCR and Western blot, and the best action time was analyzed using nanopatch to thansfect siRNA in vivo. We transfected GenEscort III and siE7 of Different concentration into tumor xenografts respectively by nanopatch and intraperitoneal injection. Expression of HPV18 E7 mRNA and protein was detected 72 hours after transfection by PT-PCR and Western blot, to analyze the best action concentration of siRNA and the superiority of using nanopatch to thansfect siRNA in vivo. The results proved that SiE7was efficient to inhibit expression of HPV18 E7 mRNA and to advance Hela apoptosis in vitro. SiE7 transfected by nanopatch into xenografts could inhibit effectively expression of HPV18 E7 mRNA and protein. The best action time and concentration of siRNA of using nanopatch to thansfect siRNA in vivo are 72 hour post-transfection and 2 micromol/L siE7. To compare intraperitoneal injection in delivering siRNA in vivo, the effect of nanopatch is very predominant. It can be well concluded that Nanopatch can effectively transfer siRNA in vivo, which can effectively inhibit the HPV gene expression.
Animals ; Apoptosis ; DNA-Binding Proteins ; genetics ; Female ; Gene Expression Regulation, Viral ; HeLa Cells ; Humans ; Mice ; Mice, Nude ; Nanostructures ; administration & dosage ; Oncogene Proteins, Viral ; genetics ; Papillomaviridae ; genetics ; RNA, Small Interfering ; administration & dosage ; Transfection ; Uterine Cervical Neoplasms ; therapy ; Xenograft Model Antitumor Assays

0.05).However,the level of PRG-1 protein in cerebral cortex of experimental group was significantly higher than that of control group at 7 d(t=2.347,P=0.041).Conclusion The up-regulated expression of PRG-1 in cerebral cortex may be associated with the recurrent neonatal seizure-induced brain damage.

BACKGROUND:Bacterial adhesion is closely related to the surface properties of cobalt-chromium al oys, and therefore, the surface modification technology has become the focus of research in this area. OBJECTIVE:To verify whether the cobalt-chromium al oy with zirconium nitride coating can improve the bacterial adhesion of metal denture materials. METHODS:Magnetron sputtering deposition method was used to plate zirconium nitride film on the surface of cobalt-chromium al oys (experimental group), and cobalt-chromium al oy specimens uncoated served as control group. Streptococcus mutans, Candida albicans, and Actinomyces viscosus were respectively inoculated on the two kinds of test specimen, and at end of culture, the colony counting was done. RESULTS AND CONCLUSION:In the bacterial adhesion test, the number of colonies of three kinds of bacteria in the experimental group was significantly lower than that in the control group (P<0.05). The number of bacterial adhesion in the control group was significantly higher than that in the experimental group. These findings indicate that the cobalt-chromium al oy covered with zirconium nitride coating can significantly reduce the adhesion amount of Streptococcus mutans, Candida albicans and Actinomyces viscosus, and thus improve bacterial adhesion properties of cobalt-chromium al oys.

Objective To determ ine the norm al reference values of 33 elem ents, Ag, Al, As, Au, B , B a, Be, Ca, Cd, Co, Cr, Cs, Cu, Fe, G a, H g, Li, Mg, Mn, Mo, N i, Pb, Rb, Sb, Se, Sr, Th, Ti, Tl, U , V , Zn and Zr, in the blood and urine sam ples from the general population in Sanm en County of Zhejiang province, a typical coastal area of eastern China. Methods The 33 elem ents in 272 blood and 300 urine sam ples w ere determ ined by inductively coupled plasm a-m ass spectrom etry (ICP-MS ). The norm ality test of data w as conducted using SPSS 17.0 Statistics.The data w as com pared w ith other reports. Results The norm al reference values of the 33 elem ents in the blood and urine sam ples from the general population in Sanm en County w ere obtained, w hich of som e elem ents w ere found to be sim ilar w ith other reports, such as Co, Cu, Mn and Sr, w hile As, Cd, H g and Pb w ere generally found to be higher than those previously reported. There w as a w ide variation betw een the reports from different countries in blood B a. Conclusion The norm al reference values of the 33 elem ents in the blood and urine sam ples from the general population in Sanm en County are established, and successfully applied to tw o poisoning cases.

Objective To summarize the operative experience and to study the value and efficacy of retroperitoneal laparoseopie adrenaleetomy.Methods Clinical data of 66 cases undergoing retroperitoneal laparoscopic adrenalectomy in Yijishan Hospital were retrospectively reviewed.There were 22 cases with adrenal adenoms located at left side and 44 cases at fight side.Tumor diameter was from 1.2 to 6.4 cm,with 3.3 cm as the average.There were 36 cases of nonfunctional adrenal adenoma,13 cases of primary hyperaldosteronism,10 cases of adrenal pheochromocytoma,6 cases of adrenal myelolipoma,and 1 case of adrenal cyst.Results 4 cases were converted to open surgery while the other 62 cases were completed successfully.The operation duration was from 35 to 190 min,with 90 min as the average.Intraoperative blood loss was from 20 to 800 ml,with 70 ml as the average.5 cases received blood transfusion because of massive hemorrhage.All cases were followed up for 3to 36 months.None of them had long-term complications or recurrence.Conclusion Retroperitoneal laparoscopic adrenalectomy has advantages of safety,less trauma,short hospitalization time,and quick recovery,making it the flint choice for patients with benign adrenal neoplasms.

Objective To observe the influence of chitosan on the skin and soft tissue expansion.Methods Twenty-five patients were selected,who were suitable to be embedded soft tissue expanders in the face,a 100-milliliter expander was implanted in one side of the face,and other side was used as control.A 100-milliliter expander was implanted in each group,and a slender silicon duct was embedded between the expander and subcutaneous tissue in the experimental group.About five to seven days after the operation,the negative drainage tube was removed,and then two-milliliter medical chitosan injected with the silicon duct in the experimental group,but not in the control group.Two groups were injected with normal saline in the second day.The center of expanded skin was pressed and skin elasticity and relaxation were compared between the two groups during the injection interval.The time of injection interval,the quantity of normal saline inside the expanders after two weeks and three weeks and the total time of expansion to 100 milliliters were recorded.After injection was completed in the two groups and maintained for two weeks.In the stage Ⅱ operation,the expanders were taken out,1 cm × 1 cm fibropeplos was removed from the center of the expanded skin flap from the two groups,and pathological section was prepared to measure the thickness of fibropeplos,average gray scale of collagen and the quantity of blood capillaries.The fibroblasts,collagen fiber and capillaries were observed and compared under light microscope.A matched-pairs t analysis was used to analyze the data.Results Compared with the control group,the quantity of normal saline inside the expanders in the experimental group was increased at the same time; the water injection period was shorten and tissue expansion was significantly accelerated.The number of fibroblasts in the fibropeplos decreased with the influence of chitosan.The fibroblasts were restrained to mature period and collegan decreased.The fibropeplos became thinner but the capillaries were not affected.Conclusions Chitoson can inhibit fibroblast proliferation and collagen production,and the effect of accelerating tissue expansion is significant and deserves to be recommended.