Objective To explore the morbidity, risk factors and nursing of ventilator-associated pneumonia (VAP) in comprehensive ICU. Methods It was a retrospective survey. 98 mechanical ventilation (＞ 48 h) patients from Jan to Dec, 2009 in comprehensive ICU were reviewed using questionnaires to collect the clinical data. They were divided into the VAP and the non-VAP group. Several statistically significant risk factors were screened out with univarite analysis, then independent risk factors were determined with multiple Logistic regression. Results The morbidity of VAP was 35.7%. Univariate analysis showed that the level of APACHE Ⅱ score, duration of mechanical ventilation, whether primary lung disease, whether acid-suppressing agents, whether the semi-supine, whether accidental tube removal, oral care approach, whether attracted to subglottic were statistically significant risk factors of VAP. While multivariate Logistic regression analysis showed that the duration of mechanical ventilation, whether the semi- supine,whether attracted to subglottic were the major risk factors of VAP. Conclusions The occurrence of VAP is related with multiple factors. Application of comprehensive prevention strategies in accordance with these risk factors of VAP can reduce the morbidity of VAP effectively.

Objective To explore the association of serum uric acid level with non-alcoholic fatty liver disease(NAFLD) in Han and Uyghur ethnic groups.Methods A cross-sectional study was performed in the population in 2011 in the First Affiliated Hospital of Xinjiang Medical University.The study included 2439 Uyghurs and 2285 Hans with a questionnaire survey,and body mass index (BMI),waist circumference,blood pressure,blood glucose,blood lipid,and serum uric acid (SUA) level were measured.The participants were divided into 4 groups according to the quartiles of the SUA levels within the normal range,and those with SUA levels above the normal range served as hyperuricemia group.The associations between serum uric acid level and prevalence of non-alcoholic fatty liver,hyperuricemia,and metabolic syndrome (MS,including each component of MS) were analyzed.Results Among Uyghurs and Hans,the detection rates of NAFLD were 26.7％ and 23.6％ respectively,the detection rates of hyperuricemia were 7.8％ and 18.2％,and the level of serum uric acid in Uyghur group was lower than that in Han group (P＜0.01).The detection rate of NAFLD in the hyperuricemia patients was significantly higher than that in nonhyperuricemia group.Among the Uyghurs and Hans,the detection rates of NAFLD in the hyperuricenia patients were 24.0％ and 19.9％.The detection rate of NAFLD was positively associated with concentration of serum acid even that within the normal range.Conclusion The relationship between the level of serum uric acid and the prevalence of NAFLD is more evident in Uyghur than that in Han.

Objective To investigate the association of serum uric acid level with glomerular filtration rate and explore the predictive value of the physiological uric acid levels for reduced renal function.Methods A total of 6 532 subjects from Karemary community and 2 402 subjects from the First Affiliated Hospital of Xinjiang Medical University were enrolled.All subjects were surveyed with questionnaire and their serum biochemical indices and liver functions were measured.Meanwhile,a cohort study was conducted,752 subjects with normal renal function were selected from young and middle-aged healthy people in 2008.During the 3-year follow-up,the incidence of reduced renal function and the risk factors of estimated glomerular filtration rate (eGFR) were analyzed.Results Serum uric acid (SUA) was the independent risk factor of reduced GFR in cross-sectional analysis.The 2 groups were stratified by sex and age,except for female population over 45 years old in the first group,the level of physiological serum uric acid was the risk factor for decreased eGFR in the rest of groups.During 3-year follow-up,the incidence of reduced renal function was 15.40％ and SUA was the independent risk factor of decreased eGFR.Conclusions The concentration of physiological serum uric acid was closely related with renal function,and the increase in SUA whthin normal range had an important early predictive value for decreased GFR.

Objective: To investigate the inhibitory effect of Dahuangzhechong pill to platelet activation.Methods: The blood platelet were incubated with the medicated blood plasma with Dahuangzhechong pill,and then activated with ADP and marked with PAC-1 monoclonal antibody.The activation rate of blood platelet was analyzed by flow cytometer.The patients with coronary heart disease or cerebral infarction took Dahuangzhechong pill,after one course of treatment,the patients,blood platelet were separated and then incubated with PAC-1 monoclonal antibody.The activation of blood platelet was detected by ? ow cytometer.Results: Compared with aspirin group(51.7%),the activation rate(20.82%) of blood platelet in Dahuangzhechong pill group decreased(P

Although many Chinese and international guidelines offer recommendations for the treatment of nonalcoholic fatty liver disease (NAFLD), there are also confusions in clinical practice, including the differences in drug indications, drug selection, the basic principles of lifestyle intervention, and key points in individual regimens between Chinese and international guidelines. In addition, there are also differences in many aspects including medical model and medical insurance system between the East and the West. These differences are great challenges for clinical practice, and the hepatologists in China have to face the challenges of localization when following the guidelines for the treatment of NAFLD.

Humans ; Receptor, ErbB-2 ; Staining and Labeling

OBJECTIVE: To explore the clinical and pathologic features of angioimmunoblastic T-cell lymphoma(AITL) and provide evidence for diagnosis. METHODS: Eighteen AITL patients (9 males and 9 females aged from 14 to 70 years) were retrospectively analyzed in Xiangya Hospital of Central South University from July 2002 to September 2007. RESULTS: Characteristic features at the presentation of AITL included generalized lymphadenopathy, fever, splenomegaly, and skin rashes with polyclonal hyper-gammaglobulinemia and other hematological abnormalities (such as Coombs-positive hemolytic anemia), which often involved the bone marrow and had well-described histologic features. The positive rate for CXCL13 was 93.3%. CONCLUSION Repeated lymphadenbiopsy is helpful for AITL diagnosis. Routine histological and immunohistochemical examinations (especially including CXCL13) play significant role in the diagnosis and differential diagnosis of AITL.
Adolescent ; Adult ; Aged ; Chemokine CXCL13 ; metabolism ; Female ; Humans ; Immunoblastic Lymphadenopathy ; diagnosis ; metabolism ; pathology ; Lymphoma, T-Cell, Peripheral ; diagnosis ; metabolism ; pathology ; Male ; Middle Aged ; Retrospective Studies ; Young Adult

OBJECTIVE: To explore the effect of trichostatin A (TSA) alone and combination with imatinib on the proliferation and apoptosis of K562R cells. METHODS: 3-(4,5-dimethylthiazol-2-yl) -5(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium(MTS) assay was used to observe the proliferation of K562R cells and apoptosis was analyzed by annexin-V/propidium iodide(PI) staining. RESULTS: After exposure to TSA, the proliferation of K562R cells was inhibited, and the effect was in both time- and dose-dependent manner. The apoptosis was induced. Combined with imatinib, the effect of proliferation inhibition was better. CONCLUSION TSA combined with imatinib can inhibit the proliferation of K562R cells and induce its apopotosis. TSA may become a new drug for imatinib-resistant patients.
Antineoplastic Agents ; pharmacology ; Apoptosis ; drug effects ; Benzamides ; Cell Proliferation ; drug effects ; Drug Synergism ; Humans ; Hydroxamic Acids ; pharmacology ; Imatinib Mesylate ; K562 Cells ; Piperazines ; pharmacology ; Protein-Tyrosine Kinases ; antagonists & inhibitors ; Pyrimidines ; pharmacology

Objective To discuss the clinical results and surgical method in treatment of hypertensive intracerebral hemorrhage in basal ganglia. Methods From January 2007 to June 2013, the use of surgery treatment of hypertensive intracerebral hemorrhage in basal ganglia under direct vision assisted by the deep cold light suction in 104 cases,all the cases were done through lateral fissure-brain island approach,removing the hematoma with bipolar coagulation and hemostasis at sametime. This paper analyzed the group of patients with surgical methods and clinical efficacy. Results CT scan of intreatment group showed that there were 6 cases of secondary operation because of recurrent hemorrhage, and the hematoma-cleared rate>80% in 73 cases,50%-80% in 21 cases,<50% in 10 cases before operation within 6 hours. According to ADL classification,the 92 cases were alive after operation, good recovery in 65 cases, moderate disability in 22 cases, 5 cases of severe disability, death and give up treatment 12 cases. There was 12 cases of sec-ondary operation because of recurrent hemorrhage in control group, and the hematoma-cleared rate>80% in 16 cases,50%-80%in 23 cases,<50%in 24 cases before operation within 6 hours. According to ADL classification,the 45 cases were alive after operation in control group, good recovery in 14 cases,moderate disability in 16 cases,15 cases of se-vere disability,death and give up treatment 18 cases. There were significant differences between the two groups in op-eration time, intra-operative blood loss, the volume of blood transfusion, hematoma clearance rate, postoperative sur-vival rate and the survival quality ADL grading at half a year, and the indexes mentioned above in treatment group were better than those in control group. Conclusion Surgery treatment of hypertensive intracerebral hemorrhage in basal ganglia under direct vision by lateral fissure-brain island approach assisted by the deep cold light suction will shooter the operation time and lower the surgical injury,increase hematoma-cleared rate,it aslo has reliable hemostasis and more effective,so this method is worthy of clinical use.

Objective To evaluate the clinical outcome of autologous hemopoietic stem cell transplantation (AHSCT) for hematological malignancies. Methods Data of 61 patients with hematological malignancies who underwent AHSCT in Xiangya Hospital from April 1994 to August 2008 were retrospectively analyzed. There were 30 acute non-lymphoblastic leukemias (ANLL), 25 non-Hodgkin lymphoma (NHL), 3 Hodgkin lymphoma (HL), and 3 plasmacytoma. Mel 160 mg/m2 + Ara-C 2.0/2.5 g × 2 +Cy 1.8 g/m2 × 2, or TBI 8-10 Gy + Cy 1.8 g/m2 × 2 were mainly included in pretreatment regimens. Results All patients had rapid hemopoietic reconstitution. There was one patient who died of heart failure during the transplantation process. The rate of AHSCT related death was 1.6 %. The median follow up duration was 52(2-211) months. Forty-seven of 61 patients were still alive during the analysis. The probabilities of disease free survival (DFS) at 5 years were significantly different between these two groups: (77.5±5.5) % for AHSCT groups and (31.6±7.3) % for synchronous intensive chemotherapy groups(P ＜0.01). Conclusion AHSCT can be safely performed as an important treatment constituent for hematological malignancies.