OBJECTIVE To improve real time monitoring,and early precaution and treatment of nosocomial infection(NI) achievement ratio,increase rescue achievement ratio,and reduce mortality and boost medical quality.METHODS NI is related to the health of hospital crowd,especially inpatients′ rehabilitation.NI could aggravate patient pathogenetic condition,and increase complication and case fatality.So NI might make big economic loss to a person,even an nation.In order to prevent and control the incidence of NI,based on the hospital information system(HIS),we fully used the patient information,bacterial culture,and susceptibility test result and network to track,and to analyze the infection case and prewarning monitoring of NI by preset prewarning parameter.Therefore we could promptly discover sporadic infection case and know the infection prevalence and outbreak.RESULTS Now in our hospital we have changed retrospective investigation to prospective and targeted investigation.The hospital infection incidence rate and underreporting rate have reduced efficiently.CONCLUSIONS Real time monitoring of NI network system is a necessary method in modern hospitals.

Bacterial endotoxins (LPS) are not only the major constituents of the outer membrane of Gram-negative (G -) bacteria, but also the toxic determinants for G - infection, which is closely related to human health and the development of diseases. Pattern recognition receptors (PRR) have been considered to be the important initial steps for cellular recognition of LPS and consequent initiation of LPS responses. Scavenger receptor, CD14, toll-like receptors, ?2-integrins and L-selectin have been shown to be involved in the clearance of LPS or LPS activation. LPS receptor may be a complex of multiple components. Different individual response to LPS is related to gene background. The gene polymorphism of LPS receptors and LPS-induced cytokines have been shown to contribute to LPS sensitivity, susceptibility and prognosis of sepsis.

Objective To explore the impact of insulin secretory function of adult islet cells from barium-alginate microencapsulation in vitro. Methods After weighting the pancreas,human pancreatic islets were isolated with type V collagenase and purified by Ficoll's discontinuous density gradient centrifugation.The islet cell yield and purity were evaluated with microscope by DTZ staining.Human islets were coated by barium-alginate microencapsulation,and the viability was assessed by insulin release assay in vitro.Results After isolation,the average number of islet was about 3600 ±447 per gram pancreas.It was about 2140±207 after purification with more than 70％ purity.At day 2,4 and 6 after islet cell culture in vitro,basal insulin concentrations from the culture medium was measured,and the mean insulin concentration (mU/L) in media of the microencapsulated islet group at 2nd,4th and 6th day were 3.302±1.63、3.504±1.10 and 2.921±1.13 respectively,and those non-microencapsulated islet group were 3.814 ± 1.49、4.175 ±1.60、3.617± 1.34.There were no significant differences between these two groups (P＞0.05).Conclusions The bioartificial pancreas has effective insulin secretory function in vitro without being affected by barium-alginate microencapsulation.

Objective To propose the orientation,goals and some key issues for future research in the field of war wound/trauma through reviewing the updated literature.Methods The latest literature in the field of war wound/trauma were reviewed.Results The notion "medicine always be with soldiers" had been raised by America and the Europe military circles,with special emphasis on emergency techniques and equipments,which were used in the front of battle field.This forwarded the medical aids as quick as possible and the formation of medical rescue system without crack.Meanwhile,much attention had been paid to the pathogenesis and prevention of post-traumatic complications,wounding characteristics and mechanisms of high-tech new weapons,as well as repair and regeneration of injured tissues.In China,a great advances had been made in the filed of emergency rescue,shock resuscitation,complication treatment and wound repair.Conclusions During the coming "twelfth five-year program",the research standpoint is to meet the needs of Chinese troops to perform better in modern wars and non-military actions,and the aim is to significantly reduce the rate of mortality and disability of trauma as well as to improve the whole army's health.To fulfill this aim,a lot of work should be done to enhance the trauma emergency ability at the battle front,the organization and remedy ability at conditions of combined operations of armed forces,and the translational medical research for rescue of trauma,so as to unceasingly increase the medical service ability of our army to cope with secure threaten and to accomplish multiple military missions.

With the continuous improvement in weaponry, especially explosive weapons, blast injury has become one of the most common war injuries. Underwater blast injury is a common war injury during combat around islands or fighting for beach-head. The wounding effects of underwater blast wave and the characteristics of underblast injury are quite different from that produced in air due to special physical features of water and the underwater pressure. We have investigated the injurious effects of underwater blast wave and its dose-effect relationship. In addition, some protective measures have been tested to prevent or alleviate underwater blast injury. All of these primary results have provided both experimental and theoretical foundation evidence for further researches in respect to the diagnosis, emergency care and protection against underwater blast injury.

Objective To investigate the methods and feasibility of islets isolation and purification,and to get more islets with high purity and good function for clinical transplantation.Methods After being weighted,human pancreatic islets were isolated with type Ⅴ collagenase,and purified by Ficoll's discontinuous density gradient centrifugation.The yield and purity of islets were evaluated by dithizone(DTZ) staining under microscope,and the viability was assessed by insulin release assay in vitro.Results The average number of islets was about 3 600 ± 447 per gram pancreas after isolation and it was about 2140 ±207 after purification with more than 70％ purity.2,4,6 days after islet cell culture,the basal insulin concentration of the culture medium was measured,and it was 3.302 ± 1.63,3.504 ±1.10,and 2.921 ±1.13 (mIU/L/100 islets) respectively.Conclusion Collagenase digest and Ficoll's discontinuous density gradient centrifugation are effective methods for isolation and purification of human pancreatic islets.

Objective To review the application of trauma and injury severity score (TRISS) and a severity characterization of trauma (ASCOT) in the outcome evaluation of trauma care and their research advances.Data sources Both Chinese- and English-language literature searched by using MEDLINE/CD-ROM (1985-1996) and Index of Chinese-Language Literature (1985-1996).Study selection Over fifty papers and reviews published over the past ten years were selected.Results and conclusion TRISS can be employed for different purposes, that is, preliminary outcome-based evaluation (PRE) and definitive outcome-based evaluation (DEF). TRISS is a method which is now the most extensively used for the outcome evaluation of trauma. Even so, it still has some shortcomings, e.g., trauma can not be given the weights that should be given, and the section of age is too simple. ASCOT is also a physiologic and anatomic combined method for the evaluation of injury severity and outcome. To some extent, this method obviates the shortcomings of TRISS in the calculation of probability of survival (Ps) with injury severity score (ISS). Therefore, ASCOT is considered to be superior to TRISS in the evaluation of Ps. However, TRISS is still now more extensively used than ASCOT just because ASCOT was recently developed.

To explore the kinetics of LBP/CD14 system in patients with hemodialysis, and further to analyse its role in (he development of systemic inflammation response based on the changes of plasma endotaxin, TNF and IL-6 levels in patients with uremia treated with hemodilysis. Methods Sixteen patients with end-stage renal failure (8 cases with hemodialysis, 8 cses without hemodialysis) were selected for this study. limulus amebocyte lysate chromogenic assay, ELISA and cell in situ hybridization were used to determine the changes in endotoxin, LBP, TNF and IL-6 levels in plasma, and expression of CD14 mRNA in the monocytes. Results (l)Plasma LBP levels in patients with hemodialysis were significantly higher than those in patients without hemodialysis. The expression of CD14 mRNA in the monocytes in patients with hemodialysis was also more obvious. Both of them incresed much more in hemodialysis. (2)Plasma endotoxin levels in patients with hemodialysis, though being significantly higher than in patients without hemodialysis, were in low-level (61.7 ? 10.6 pg/ml). (3) Plasma TNF and IL-6 levels were markedly increased in patients with hemodialysis, which were significantly correlated with plasma LBP levels. Conclusion LBP/CD14 system in patients with hemodialysis is markedly up-regulated, which might be the important mechanism for low-level endotoxemia to exert its effects in hemodialysis.

This study was to investigate the changes in NO - 2/NO - 3 content in the hippocampus and brainstem and its relationship with neurobehavioral alteration after whole body blast injury (WBBI) in rats. It was found that the contents of NO - 2/NO - 3 and cGMP in the hippocampus and brainstem were significantly increased 3, 24 and 120h after WBBI, and they were markedly correlated with blast injury severity. Activeavoidance response (AAR) decreased obviously, and active avoidance response latency (AARL) and escape response latency (ERL) were significantly prolonged after WBBI. The correlation analysis indicated that the changes in NO - 2/NO - 3 in brain tissues were also significantly correlated with AAR, ERL and AARL respectively. The results suggested that NO production was significantly increased in the hippocampus and brainstem after whole body blast injury. The over release of NO might be related to the blast wave induced damage to the central nervous system.

To elucidate the signal transduction mechanism of systemic inflammatory response syndrome induced by LPS,Western blot analysis was used to assay the protein expression and phosphorylation levels of ERK, JNK,and p38 MAPK in murine KC which were stimulated by LPS. It was found that LPS treatment resulted in no significant change in their protein expression, but a rapid transient increase in their phosphorylation levels, which peaked at 30, 45,and 20 minutes,respectively; The values returned to mear baseline within 2 hours. Kinase phosphorylation levels of these three MAPKs induced by LPS were found to be dose dependent in a range of 10 pg/ml to 100ng/ml. No phosphorylation was observed in unstimulated cells. Among them, p38 MAPK shoned fastest and highest phosphorylation levels. The results show that LPS can markedly activate ERK, JNK,and p38 MAPK in KC, and p38 MAPK may play a more important role in LPS induced kupffer cell activation than ERR and JNK.