Objective To understand the incidence of hemolytic disease in newborn (HDN)among the newborns with jaundice and the coincidence degree of the blood group serological results and the clinical diagnosis in HDN.Methods The microcolumn gel method was adopted to detect the 3 serological indexes in 276 jaundice newborns of maternal fetal blood group incompatibility,in-cluding the direct antiglobulin test,free antibody test and antibody release test.Results 108 cases of HDN were clinically diagnosed with the positive rate of 39.13%.The positive detection rate in newborns with 0-2 d old was highest(50.00%).Conclusion The serological test can provide the basis for the early diagnosis and treatment of HDN.Collecting the specimen as early as possible can improve the positive diagnosis rate of HDN.

OBJECTIVE To explore the clinical and etiological characteristics in patients with ventilator-associated pneumonia(VAP) in emergency intensive care unit(EICU),and improve the prevention and treatment level of VAP.METHODS To analyze the clinical information of 54 patients with VAP,and to compare the clinical information with the incidence rate of VAP.Bacterial culture of airway secretion and drug sensitive test were used to analyze etiology.RESULTS Totally 148 patients were enrolled in this study,of which 54 were diagnosed as VAP.The incidence rate of VAP group was 36.5%.Respirator used time of VAP group was obviously longer than that of non VAP one.Antibiotic prophylaxis could not lower the incidence rate.A total of 59 pathogen strains were isolated by bacteria culture.The major pathogenic bacteria in VAP were Pseudomonas aeruginosa(22.0%),Acinetobacter baumannii(16.9%),Staphylococcus aureus(15.3%),Escherichia coli(10.1%),and Klebsiella pneumonia(10.1%).CONCLUSIONS VAP is one of the significant reasons for failed mechanical ventilation treatment.To prevent and treat VAP should pay attention to disinfection and aseptic manipulation,and make the rational use of antimicrobial agents.

Objective To assess the prostaglandin E2 (PGE2) levels in tumor mass and peripheral blood of patients with gastric cancer and explore their clinical significance. Methods The PGE2 levels in tumor mass, tumor margins of excision and peripheral blood of 40 patients with gastric cancer were measured by a kit of PGE2 ELISA. Results The PGE2 levels were higher in the tissues of gastric cancer than in tumor margins of excision [(8.225?2.425) vs (1.669?0.287) ng/g, P

Objective To study the CT and MRI characteristics of myxoid soft tissue tumours.Methods Fifty-three myxoid soft tissue tumours pathologically confirmed were retrospectively studied.MR and CT scan were performed before operation.Noncontrast T1 and T2 weighted images,fat-suppressed T2 weighted images were obtained before contrast-enhanced scan with fat-suppressed T1 weighted sequence was underwent.Plain and contrast-enhanced CT was performed with tube potential of 120 kV,matrix 512 × 512,and automatic tube current modulation technique.Results There were 18 myxoid liposarcoma,3 ganglioneuroma,8 myxofibrosarcoma,2 extraskeletal myxoid chondrosarcoma,10 intramuscular myxoma,and 2 juxta-articular myxoma.Microscopic examination showed myxoid soft tissue tumours which were consisted of abundant myxoid stroma with tumour cells and blood vessels associated with fibrous bands.Low density in CT images,hypointensity in T1 weighted images,significantly hyperintense in T2 weighted images were their common manifestations in the area of abundance of extracellular myxiod matrix.Plain CT images demonstrated equidensite,T1 weighted images isointensity,and fat-suppressed T1 weighted images significant enhancement relatively in the areas of increased number of tumor cells.Hemorrhage,necrosis and capsule of the lesion were revealed in high grade malignant tumors.The septa can be identified in most of myxoid tumours of soft tissue.Conclusion CT and MRI can definitely show the image characteristics of myxiod soft tissue tumours,which can help make a qualitative diagnosis before operation.

Objectve To detect whether the CTP(phosphocholine cytidylyltransferase) gene was expressed in the asexual erythrocytic stages of Plasmodium falciparum (FCC 1/HN )by using the RT - PCR and to construct eukaryotic expression vector of CTP. Method The erythrocytic stage parasites of Plasmodium falciparum were cultured as described by Trager and Jensen. RNA from erythrocytic stage parasite was extracted by using Trizol reagent. The complete genes coding for CTP gene isolates FCCI/HN were amplified by reverse transcriptase -polymerase chain reaction(RT- PCR). CTP gene was cloned into eukaryotic expression vector pcDNA3. Results CTP encoding gene was amplified from the erythrocytic stages of Plasmodiumfalciparum (FCC 1/HN) and eukaryotic expression vector of CTP was constructed. Conclusion CTP gene was expressed in the erythrocytic stages of Plasmodium falciparum (FCC 1/HN) and eukaryotic expression vector of CTP was successfully constructed.

Objective To elevate the achievement rate of kidney biopsy puncture through the analysis of puncture angle choice of ultrasound guided automatic kidney biopsy in 518 patients. Methods Under the guidance of color Doppler ultrasound,using the 3.5MHz probe with probe holder,we performed kidney biopsy in the degrees of 40°(group X),45°(group Y),60°(group Z) and 70°(group P) with the horizontal plane. Resnlts The total achievement ratio is 100 %. The one time success rate in group Y and group Z is 100 % (group Y, 164/164 ; group Z, 186/186) ;group X is 4.8% (22/46) ;group P is 84.4% (103/122).Conclusion The automatic kidney biopsy an- gle under the guidance of ultrasound should be between 45° and 60° with the horizontal plane which is safe and has higher achievement ratio. In the meantime, complications can be avoided.

Objective To evaluate the potential utility of PⅢpeptide in anti peritoneum metastasis in gastric carcinoma cells with high peritoneal metastasis potential(GC9811 P).Methods The adhesion and invasion inhibitory effects of PⅢpeptide on GC9811-P cells were detected by in vitro matrix adhe- sion and cell invasion experiments.By using nude mice metastatic model of human gastric cancer,the effects of PⅢpeptide on peritoneal metastasis of gastric cancer GC9811 P were evaluated.Mice were randomly divided into the experimental(GC9811-P+peptide PⅢgroup)and control groups(GC9811-P +0.9% NaCl solution group),12 mice in each group.At the exhaustion time after inoculation,mice were sacrificed to observe the incidence of peritoneal metastasis,the number of the metastasis foci and the volume of primary tumor.Results Two hours after 40?g PⅢpeptide incubation,the adhesion in hibitory rate reached 86.30%.The adhesion inhibitory effects were in a time dependent manner.The in- vasion inhibitory effects became apparent(81.4%)48 hours after PⅢpeptide insult.After the GC9811- P cells were orthotopic implanted in nude mice and treated with PⅢpeptide,the number of peritoneal metastatic nodes were significantly reduced as compared with control group(3.2?6.5 vs.26.3?5.2) ( P＜0.01).But the mass of primary tumor were (1.9?1.2) g in PⅢpeptide treated group and (2.1?1.0) g in the control group,no difference was noted between two groups(P＞0 05 ).Conclusion PⅢpeptide can markedly inhibit the adhesion,invasion and peritoneal metastasis of gastric carcinoma cell line GC29811-P with high peritoneal metastasis potential

Objective To evaluate the optimum compatibility of nalbufine combined with ropivacaine for patient-controlled epidural analgesia (PCEA) after cesarean section.Methods A total of 100 parturients who were at full term with a singleton fetus,aged 24-35 yr,with body mass index of 29-33 kg/m2,of American society of Anesthesiologists physical status Ⅱ,scheduled for elective cesarean section under combined spinal-epidural anesthesia,were divided into 4 groups (n =25 each) using a random number table method:sufentanil 0.5 μg/ml plus 0.15％ ropivacaine group (SR group),nalbufine at final concentration of 0.2 mg/ml plus 0.15％ ropivacaine group (N1 R group),nalbufine at final concentration of 0.4 mg/ml plus 0.15％ ropivacaine group (N2R group) and nalbufine at final concentration of 0.4 mg/ml plus 0.1％ ropivacaine group (N3Rgroup).PCEA solution was prepared correspondingly after surgery,and all the drugs were diluted to 100 ml in normal saline in each group.The PCA pump was set up to deliver a 0.5 ml bolus dose with a 15-min lockout interval and background infusion at 2 ml/h.Visual analog scale scores of incisional pain and anduterine contraction pain were maintained＜4.Ramsay sedation scores were recorded at 8,12,24 and 48 h after surgery.The total pressing times of PCEA were recorded within 48 h after surgery.The development of adverse reactions such as nausea,vomiting,skin itching,numbness of lower extremity,urinary retention and respiratory depression was recorded in the analgesia period.Venous blood samples were collected before surgery and at 24 and 48 h after surgery for determination of plasma prolactin concentrations,and the time of colostrum was recorded.Neonatal nerve and adaptive capacity was assessed and scored.Results Compared with group SR,the total pressing times of PCEA were significantly reduced in N2R and N3R groups (P＜0.05),and no significant change was found in the total pressing times of PCEA in group N1R (P＞0.05).Compared with group N1R,the total pressing times of PCEA were significantly reduced in N2R and N3 R groups (P＜0.05).There was no significant difference in the total pressing times of PCEA between group N2R and group N3R (P＞0.05).The Ramsay sedation score was 2 in four groups.There was no significant difference in numbness of lower extremity,plasma prolactin concentrations or neonatal nerve and adaptive capacity scores among four groups (P＞0.05).Conclusion Nalbufine at final concentraction of 0.4 mg/ml mixed with 0.1％ ropivacaine is the optimum compatibility when used for PCEA after cesarean section.

Objective: To analyze the epidemiological characteristics of varicella epidemic situation at schools and kindergartens in Fengxian district of Shanghai during 2012-2018, and to provide evidence for developing control and prevention strategies. Methods: Data of varicella epidemic situation at schools and kindergartens and varicella cases were analyzed by descriptive methods. The rates were compared with chi-square test. Results: A total of 6 727 varicella cases were reported in Fengxian during 2012-2018, for an incidence of 85.34 per 100 000 population. Totally 66 varicella epidemic outbreaks and public health emergencies caused by varicella were reported, which involved 741 varicella cases. Among them, 426 were breakthrough cases (57.49%). The average interval time of breakthrough cases were (6.78±2.79)years, and the incidence was more concentrated in the 3-9 years after vaccination with varicella vaccine. Most breakthrough cases appeared 5 years past vaccination. The peak time of varicella was from April to June and from October to December. Most of cases were in the 5-11 year-old group and 15-17 year-old group. The cases in males was higher than in females. Kindergarten childcare and primary school children were at high risk of varicella. Timeliness of reporting was positively correlated with the duration of the varicella epidemic situation( r =0.52， P <0.05). Conclusion Most varicella epidemic situation in Fengxian district of Shanghai occued in primary schools during autumn and winter, and most of the varicella cases were breakthrough cases. Emergency vaccination of varicella vaccine can effectively control the spread of the epidemic. It is suggested to increase the publicity of the immunization program of 2 doses of varicella vaccine and raise the awareness of varicella vaccination of children’s parents.

Objective To evaluate the effects of AIDET ( Acknowledge, Introduce, Duration, Explanation, Thanks ) communication mode in the modified electroconvulsive therapy. Methods Firstly, according to the procedure of the modified electroconvulsive therapy, we established the standard phrases of AIDET communication mode. Secondly, 100 cases of hospitalized psychiatric patients from August to October 2013 accepted the modified electroconvulsive therapy and were divided into the control group and the observation group, with 50 cases in each. The control group used the traditional lecture-style communication, while the observation group was given the AIDET communication processes and standard terms. The anxiety of two groups before and after the treatment was compared by the Hamilton Anxiety Scale ( HAMA ) , in addition with the treatment adherence and the satisfaction of nursing. Results Comparison of the HAMA scores in the two groups before the treatment was not significantly different (P >0. 05). After using the two different communication modes, the HAMA scores of somatic anxiety, mental anxiety and the total score of the observation group were significantly lower than those in the control group (t=5. 99, 6. 51, 10. 87, 10. 23, 6. 19, 7. 94, respectively;P<0. 05). The treatment adherence and the satisfaction with nursing of the observation group were significantly higher than those in the control group (Z =5. 77,χ2 =7. 16, respectively;P <0. 05). Conclusions The AIDET mode of communication can effectively reduce the patient′s anxiety, and improve the patients′adherence, treatment compliance and satisfaction.