Objective To investigate the risk factors and drug resistance in elderly patients with ventilator associated pneumonia(VAP).Methods From April 2012 to April 2014,the clinical data of 160 senile VAP patients in ICU were selected,the relationship of VAP with age,duration of mechanical ventilation,whether tracheotomy and the original diseases were analyzed .The drug susceptibility test was made to analyze the drug resistance .Results The incidence rates of VAP in patients with chronic obstructive pulmonary disease ,duration of mechanical ventilation more than 7d,over 65 years old (16.8%,13.4%,18.5%) were significantly increased (χ2 =11.592,11.989,13.187,all P<0.05),the incidence rate of VAP did not increase in the tracheotomy (P>0.05).The main pathogenic bacteria in elderly patients with VAP infection were Pseudomonas aeruginosa , Klebsiella pneumoniae , Escherichia coli , Enter-obacter cloacae .Drug sensitive experiment found that patients had multi-drug resistance ,the strains had higher resist-ance rate to ampicillin,piperacillin,ciprofloxacin,ofloxacin and ceftriaxone .Conclusion The original chronic lung disease,mechanical ventilation time and over 65 years old are risk factors of elderly VAP ,the patients have multi-drug resistance ,and the strains show the highest resistance to ampicillin .

Glucocorticoids have remained important anti-inflammatory agents in the treatment of chronic kidney disease (CKD).However,the use of glucocorticoids can invoke or enhance insulin resistance,which is closely associated with renal injury and serves as an independent risk of the occurrence and progression of CKD.On the other hand,CKD patients may have insulin resistance,which hampers the use of glucocorticoids in these patients.

Objective To investigate the expression of human telomerase reverse transcriptase(hTERT),Ki-67 and p27~(kip1) in pheochromocytoma and paraganglioma,and to evaluate whether the expression of hTERT,Ki-67 and p27~(kip1) could serve as diagnostic markers for predicting the biological behaviour of these tumours.Methods Expression of hTERT,Ki-67 and p27~(kip1) was determined by immunohistochemistry in 45 pheochromocytomas/paragangliomas(31 benign,7 suspected malignant and 7 malignant)and 9 normal adrenal medulla samples.Results The hTERT was expressed in 5/7 malignant tumors,5/7 suspected malignant tumours and 3/31 benign tumours.Malignant and suspected malignant tumors expressed more hTERT(P

Objective To explore the signaling pathway of AP-1 activated by epidermal growth foctor receptor(EGFR) in the rat gastric mucosal cells. Methods TGF-? stimulated freshly isolated rat gastric mucosal cells,and Western blot and EMSA detected the activation of ERK-1/2 signaling pathway. Results The exposure of the mucosal cells to 1 nmol/L TGF-? for 30 min significantly induced transcriptional activity of AP-1. This induction was associated with a concomitant activation of MEK and ERK-1/2. TGF-?-induced activation of AP-1 in gastric mucosal cells could be totally abrogated by either PD153035, a specific inhibitor of EGFR tyrosine kinase, or PD98059, a specific inhibitor of MEK. Conclusions Our findings suggest that EGFR AP-1 activates by EPK-1/2 signaling pathway in the rat gastric mucosal cells.

Diagnostic coincidence and pendency are important statistical indexes in hospital administration,they come from hospital statistical program in hospital information system.The article discusses diagnostic coincidence and pendency in hospital information system,points out the program's fatal vices and puts forward relevant method.

Objective To study the effects of acyl-coenzyme A cholesterol acyltransferase inhibitor(ACATI, 58-035) on cholesterol homeostasis in lipid-loaded human mesangial cell line (HMCL) . Methods Oil red O was used to examine the lipid droplet . MTT was performed to detect the cell proliferation . High performance liquid chromatography (HPLC) was used to measure intracellular free cholesterol (FC) and cholesterol ester (CE) . Western blot was used to demonstrate the protein level . Real-time PCR was performed to detect the mRNA expression .Results In HMCL loaded with 100 mg/L of low density lipoprotein (LDL), 10 mg/L 58-035 significantly inhibitted the formation of lipid droplets and CE mass (ratios over control, 1 .91±0 .36 and 1 .07±0 .30 respectively, P＜0 .01) without toxic effect . It further enhanced the ACAT1 protein expression (ratios over control, 1 .27 and 1 .77 respectively) without significant influence on mRNA level, since the activity of ACAT1 pl promoter by transient transfection was not affected by either LDL or ACATI . 100 mg/L LDL down-regulated the mRNA of LDL receptor (LDLR) (ratio over control, 0 .08±0 .02, P＜0 .01)and up-regulated that of ATP binding cassette transporter 1(ABCA1)(ratio over control, 2 .97±0 .39, P＜0 .01) . The mRNA expression of ABCA1 was further upregulated (ratio over control 4 .41±1 .27, compared with LDL group P＜0 .05), and LDLR was further down-regulated (ratio over control 0 .04±0 .005, compared with LDL group P＜0 .01) in the presence of 10 mg/L ACATI 58-035 . Conclusions The CE mass in lipid-loaded HMCL can be decreased in the presence of ACATI, accompanied by further down-regulation of LDLR mRNA expression and up-regulation of ABCA1 protein and mRNA expression . It is physiological feedback to inhibit free cholesterol accumulation to maintain cholesterol homeostasis .

ObjectiveTo clarify why accelarated atheroslcerosis is complicated in chronic kidney disease patients, and to investigate whether endoplasmic reticuhm (ER) stress can be observed in acetylated low density lipepmtein (ACLDL)-induced apoptosis in THP-1 macrophages differentiated by 160 nmol/L PMA for five days. Methods Hoechst 33258 stain and caspase 3,7 assay were used to detect apeptosis. Oil red O was used to examine the lipid droplet. High performance liquid chromatography was used to measure intracelhlar free cholesterol (FC) and cholesterol ester (CE). Western blot was applied to demonstrate the protein level of acylcoenzyme A cholesterol acyltransferase(ACAT)1, growth arrest and DNA damage(CHOP) and Bcl-2. Real-time PCR was used to detect the changes of mRNAs. Results ACLDL could induce THP-1 macrophages apoptosis in time-and dose-dependent manner. After exposure to 100 mg/L ACLDL for 24 hours, the level of free cholesterol and cholesterol ester mass had a significant increment by 1.5-and 2.4-fold respectively (P＜0.01). CHOP increased and Bcl-2 decreased both in protein and mRNA levels. ACLDL loading also resulted in an increase of ACAT1 protein without any change in mRNA level. ConclusionIn THP-1 macrophages foam cell, apoptosis can be induced by ACLDL accompanied by ER stress pathway activation.

Objective To observe the impact of IL-1β on the expression of lectin-like oxidized LDL receptor 1 (LOX-1) and ATP-binding cassette transporter A1 (ABCA1) in human mesangial cell line (HMCL), and its association with cholesterol homeostasis of HMCL. Methods Levels of LOX-1 and ABCA1 of HMCL induced by IL-1β were examined by using real-time PCR and Western blot. Results IL-1β up-regulated LOX-1 mRNA and protein expression. Treated with 5 μg/L IL-1β, the levels of LOX-1 mRNA and protein reached the peak after 6 h and 24 h of stimulation and were 6.87 folds and 1.88 folds of control rspectively. The expression of ABCA1 mRNA and protein of lipid-loaded HMCL was down-regulated by IL-1β Stimulated with 5 μg/L IL-1β the expression of ABCA1 mRNA and protein decreased to the lowest level, 19.0% and 50.62% of the baseline respectively. Conclusions The expression of LOX-1 can be up-regulated while the expression of ABCA1 can be decreased by the stimulation of IL-1β. IL-1β can enhance dyslipidemia and influence the balance of cholesterol homeostasis of HMCL.

BACKGROUND:Problems regarding the prosthesis in the horizontal plane and the rotation of the femur and tibia prosthesis on line are relatively weak. The distal femoral rotation axis is mainly the transepicondylar axis. Due to patient differences as wel as anatomy and intraoperative display, it is difficult to accurately locate the axis in the process of knee arthroplasty. OBJECTIVE:To investigate application of magnetic resonance technique in determining the axis of rotation of the distal femur, to provide reference and basis for femoral rotational alignment during total knee arthroplasty. METHODS:Data of 122 cases without knee joint disease, who were diagnosed and treated in the Department of Orthopedics of Nanyang City Center Hospital from September 2014 to October 2015, were analyzed. Magnetic resonance technique was used to measure femoral epicondyle axes (STEA), femoral epicondyle axes (CTEA), the anteroposterior axis (APL) and femoral shaft (PCL). Simultaneously, magnetic resonance technique was utilized to measure femoral ankle angle (PCA), ankle twist angle (CTA), axis vertical line and ankle axis angle (PAPA). Each data were tested three times, and the average value was calculatd. We analyzed the method of magnetic resonance technique to determine reference axis of distal femoral rotation. RESULTS ANDCONCLUSION: (1) Accuracy of the angle close to surgical transepicondylar axis: 3° PCL> CTEA > APL verticalline. (2) No significant difference in PCA was detected in two sets of measurements (P> 0.05). CTA and PAPA parameters in the first measurement by magnetic resonance imaging diagnosis were significantly lower than the second measurement (P< 0.05). (3) Results indicate that magnetic resonance technology provides ideal reference for distal femoral rotation, can accurately measure the CTA, PCA, PAPA andother indicators. It is a more reliable determination method and can be used in scientific determination of femoral rotational alignment reference axis in total knee arthroplasty. Except STEA, the accuracy of 3° PCL is highest.

Objective To explore the expression of phosphoinositide 3 kinase (PI3K)and Akt in gastric carcinoma tissues and the distal normal tissues,and to analyze their correlation with the clinical pathologic characteristics of gastric cancer.Methods The S-P immunohistochemistry and RT-PCR were used to detect the expression of PI3K and Akt protein and mRNA in 60 cases of gastric carcinoma tissues and 25 cases of normal gastric mucosal tissues.Results The expression of PI3K and Akt in the gastric carcinoma tissues was significantly higher than that in the distal normal gastric tissues with statistical difference (P <0.05)and their expression in gastric carcinoma tissues was significantly related with the pathologic differentiation degree,TNM stage,invasion depth and lymph node metastasis (P <0.05).Conclusion PI3k/Akt protein and mRNA participate in the occurrence,development, infiltration and metastasis process of gastric cancer,and play an important role in the canceration of gastric carcinoma.