Objective To investigate the economic losses in kidney transplant patients with healthcare-associated lower respiratory tract infection(LRTI).Methods All transplant patients in a hospital from 2008 to 2012 were in-vestigated,patients with LRTI were in infection group(n=45),and patients without LRTI were in control group(n=266),hospitalization expenses and hospitalization days between two groups were compared.Results A total of 383 kidney transplant patients were included in the study,the incidence of LRTI was 11 .75% (n=45),median ex-pense of infection group and control group was ￥79 291 .82 and ￥72 185.14 respectively,the difference was not statistically significant (P >0.05).The largest increased expense in patients with LRTI was medicine (increased by￥5 429.82),medicine and examination expense in infection group were significantly higher than control group (￥39 123.17 vs ￥33 693.35;￥702.52 vs ￥593.73;P <0.05 ).The median hospitalization days in infection group and control group was 28.38 days and 21 .47 days respectively,there was significant difference between two groups(P <0.05 ).Conclusion Kidney transplant patients with LRTI suffer from a heavy financial burden,and their hospitalization days are prolonged,so measures should be taken to prevent the occurrence of LRTI and save limited medical resources.

Objective To investigate the direct economic losses caused by healthcare-associated infection(HAI)in patients with acute lymphoblastic leukemia (ALL)and acute non-lymphoblastic leukemia (ANLL).Methods All acute leukemia (AL)adult patients who were admitted to a hematology ward in a hospital between January 201 1 and December 2013 were included in the study,HAI group(case group)and non-HAI group (control group),ALL group and ANLL group were matched respectively in a 1:1 ratio,hospitalization expenses and length of hospital stay were compared.Results A total of 994 patients were included,166 were with ALL,828 with ANLL,there were 181 pairs of case group and control group,and 15 pairs of ALL group and ANLL group. Direct economic los-ses in ALL group and ANLL group were 13 089.0 ￥ and 21 565.0 ￥ respectively ;extension of length of hospital stay due to HAI were 10.5 and 10.0 days respectively,differences were statistically significant between case group and control group (both P<0.05). The total hospitalization expense,as well as fees for bed,consultation,treat-ment,laboratory examination,nursing,medicine,traditional Chinese medicine,and blood transfusion in ANLL group were all higher than ALL group,but there were no significant difference.Conclusion HAI in patients with AL can increase hospitalization cost and prolong length of hospital stay.

Objective To investigate the direct economic loss caused by oral infection in patients with acute leuke-mia.Methods Acute leukemia patients with oral infection in a tertiary first-class hospital in Shandong Province be-tween January 2011 and December 2013 were investigated,the 1 :1 matched case-control method was used for com-paring hospitalization expense and length of hospital stay between oral infected (case group)and uninfected patients (control group ).Results A total of 994 patients with acute leukemia were monitored,277 had healthcare-associated infection,17 (5.56%)of whom were with oral infection.The median hospitalization expense of patients in case group and control group was￥37 327 and￥13 176 respectively,the total hospitalization expense of patients in case group was 2.83 times more than control group,difference was statistically significant (Z = -3.621 ,P <0.001).Each hospitalization expense of case group was higher than control group,especially expense for medicine, blood transfusion,laboratory examination,and therapy.The median length of hospital stay in case group and con-trol group were 17 days and 11 days respectively,rank sum test showed that difference in median length of hospital stay between two groups was statistically significant (Z =-3.627,P < 0.001 ).Conclusion Acute leukemia pa-tients with oral infection have increased hospitalization expense,prolonged length of hospital stay,and increased the financial burden.

Evolutionary psychology holds such an opinion that negative situation may threaten survival, trigger avoidance motive and have poor effects on the human-body function and the psychological quality. Both disgusted and sad situations can induce negative emotions. However, differences between the two situations on attention capture and emotion cognition during the emotion induction are still not well known. Typical disgusted and sad situation images were used in the present study to induce two negative emotions, and 15 young students (7 males and 8 females, aged 27 ± 3) were recruited in the experiments. Electroencephalogram of 32 leads was recorded when the subjects were viewing situation images, and event-related potentials (ERP) of all leads were obtained for future analysis. Paired sample t tests were carried out on two ERP signals separately induced by disgusted and sad situation images to get time quantum with significant statistical differences between the two ERP signals. Root-mean-square deviations of two ERP signals during each time quantum were calculated and the brain topographic map based on root-mean-square deviations was drawn to display differences of two ERP signals in spatial. Results showed that differences of ERP signals induced by disgusted and sad situation images were mainly manifested in T1 (120-450 ms) early and T2 (800-1,000 ms) later. During the period of T1, the occipital lobe reflecting attention capture was activated by both disgusted and sad situation images, but the prefrontal cortex reflecting emotion sense was activated only by disgusted situation images. During the period of T2, the prefrontal cortex was activated by both disgusted and sad situation images. However, the parietal lobe was activated only by disgusted situation images, which showed stronger emotional perception. The research results would have enlightenment to deepen understanding of negative emotion and to exploredeep cognitive neuroscience mechanisms of negative emotion induction.
Adult ; Attention ; Brain Mapping ; Cognition ; Electroencephalography ; Emotions ; Evoked Potentials ; Female ; Humans ; Male ; Occipital Lobe ; physiology ; Parietal Lobe ; physiology ; Prefrontal Cortex ; physiology

Objective To investigate the prognostic value of decreased vasopressin (VP)modulation in the late-phase of septic shock. Methods A prospective study was conducted. Fifty-five septic shock patients hospitalized in intensive care unit (ICU)of the First Hospital of Hebei Medical University from January 2012 to February 2014 were enrolled. All patients received 3% hypertonic saline solution infusion. Serum concentrations of sodium and VP were measured before and after hypertonic saline solution infusion. Patients with ratio of difference in sodium and VP before and after infusion of 3%hypertonic saline (△VP/△Na)≤0.5 pg/mmol were defined as non-responders,and who>0.5 pg/mmol were defined as responders. The levels of lactic acid,C-reactive protein (CRP),and vasoactive drug〔dopamine(DA)and norepinephrine(NE)〕usage between the two groups were compared. The 28-day mortality,live time in the dead,and ICU day in survivors were analyzed between the two groups. The receiver operating characteristic curve (ROC curve)was drawn to assess prognostic value of VP. Results There were 30 cases (54.5%) in non-responsive group,and 25 (45.5%)in responsive group. There were no significant differences in the age,acute physiology and chronic health evaluationⅡ (APACHEⅡ)score,central venous pressure (CVP),blood pressure, plasma albumin level,sodium level before and after hypertonic saline solution infusion between the two groups. The baseline level of VP in the non-responsive group was markedly lower than that of the responsive group (ng/L:10.66± 1.57 vs. 17.13 ±5.12,t=6.091,P<0.001). After hypertonic saline solution infusion,the VP level was also significantly decreased compared with that in the responsive group(ng/L:11.65±1.74 vs. 22.50±5.31,t=9.758,P<0.001). The non-responders showed higher lactic acid (mmol/L:3.04±0.55 vs. 2.28±0.38,t=-5.881,P<0.001) and CRP (mg/L:117.9±23.0 vs. 94.9±17.0,t=-4.143,P<0.001),and received larger dosage of vasoactive drugs〔DA(μg·kg-1·min-1):14.8±3.9 vs. 8.9±1.6,t=-5.725,P<0.001;NE(μg·kg-1·min-1):0.96±0.42 vs. 0.40± 0.09,t=-5.625,P<0.001〕for maintaining blood pressure compared with those in responders. The non-responsive group showed higher 28-day mortality(66.7%vs. 40.0%,χ2=3.911,P=0.048)and longer ICU day(days:9.9±2.3 vs. 6.7±1.7,t=-4.044,P<0.001),but the live time in the dead showed no difference between non-responsive group and responsive group(days:5.8±1.9 vs. 6.1±2.3,t=0.384,P=0.704). ROC curve showed that the area under ROC curve(AUC)forΔVP/ΔNa predicting the outcome was 0.828,and theΔVP/ΔNa threshold value of 0.5 pg/mmol had the sensitivity of 66.7%and specificity of 64.0%for prediction of the outcome(95%confidence interval:0.722-0.934). Conclusion Osmotic pressure-regulated VP secretion was impaired and decreased in the late-phase of septic shock, and made the sense in prognosis.

Objective To assess the clinic application of a new-style automated immunoassay system HISCL ( high sensitivity chemiluminescent enzyme immunoassay ) with high sensitive chemiluminescence substrate CDP-Star?, bind-free separate technology and filter conversion technology.Methods The performance verification test evaluated HISCL′s specification including reproducibility, functional sensitivity, linearity, accuracy, and sensitivity for HBsAg seroconversion.To evaluate the specificity , 1 007 HBsAg-negative specimens , 82 potentially interfering specimens were from conventional specimens in West China Hospital , Sichuan University between October and December of 2014.At the same time, with these results to determine the rate of the specimens that their results are in negative grey zone.259 HBsAg-positive specimens and 27 weakly-positive specimens were tested for the comparison between the HISCL and ECLIA ( electrochemiluminescence immunoassay ) HBsAg quantification.A linear regression model , Pearson′s correlation and Bland-Altman analysis were used as statistical methods.Results The between day and within-lot variable coefficient of two level samples are 1.55%, 2.02%, 0.34%, 1.34%separately.The functional sensitivity of the HISCL HBsAg assay reaches 0.007 IU /ml.There is a good linearity (y=3.262x+0.082,r=0.994; y=2 303.608x-33.006,r=0.999) within range of 0-2 300 IU/ml.HISCL obtain the accurate results for the CAP control material , the agreement rate is 100%.The sensitivity for the detection of HBsAg seroconversion is high.The specificity is 99.91%.The negative grey zone rate is 1.66%.The results of these two methods have good correlation and uniformity , r=0.995, LOA:-0.3 -0.19 log10 IU/ml.Conclusions HISCL HBsAg detection system shows good detection performance.Be of the function of both qualitative and quantitative detection.And the negative “grey zone”specimen rate is low.It is wholly capable of wide linearity and quick assays for quantifying serum HBsAg levels.HISCL could contribute to improve HBsAg quantitative detection process for clinical laboratory.

Objective To investigate the role of mutations in C region that may contribute to occult hepatitis B virus infection.Methods C genes were amplified from two OBI blood donor samples respectively.Plasmids with mutations in C region of hepatitis B virus were constructed by overlapping PCR.HBsAg and HBeAg in Huh7 cells and in the serum of Balb/c mice were detected by CMLA.HBcAg in liver tissue was detected by immunohistochemistry,while HBV-RNA was tested by RT-PCR.Results Mutations in C region significantly reduced the expression level of HBeAg and HBcAg,but had no significant effect on HBsAg and HBV-RNA.Conclusion The mutations in C region affect the expression level of HBeAg and HBcAg,which may play an important role in the occurrence of OBI.

Objective To study the clinical distribution and detection of the efflux pump gene in multiple drug-re?sistant acinetobacter baumannii. Methods The clinical distribution of 96 strains of multiple drug-resistant acinetobacter baumannii was analyzed. K-B method was used to detect 96 strains of multi resistant bauman resisted to 15 kinds of antibiot?ics. PCR amplification was used to detect the efflux pump gene. Results Ninety-six strains of multiple drug-resistant aci?netobacter baumannii mainly distributed in intensive care unit (ICU, 54.2%) and respiratory department (18.8%). The drug resistance rates to quinolone, cephalosporins, amino glucoside, tetracycline were above 70%. The 52 strains of multiple drug-resistant acinetobacter baumannii detected in ICU included 18 strains of adeB (34.62%), 16 strains of adeR (30.77%), 18 strains of adeS (34.62%), 18 strains of adeJ (34.62%), 0 strain of adeE and18 strains of adeM (34.62%). The18 strains of multiple drug-resistant acinetobacter baumannii detected in respiratory department included 9 strains of adeB, 8 strains of adeR, 8 strains of adeS, 8 strains of adeJ, 0 strain of adeE and 8 strains of adeM. Conclusion Efflux pump genes are impor?tant factors for multiple drug-resistant acinetobacter baumannii distributed in ICU and respiratory department.

Objective To expore multi-drug resistant Acinetobacter baumannii efflux pump phenotype and efflux pump gene expression in the resistant isolates. Methods Application of K-B method to detect 96 strains isolated from the First Hospital of Hebei Medical University multi-drug resistant Acinetobacter baumannii′ resistance to 15 kinds of antibacterial drugs, detecting multi-drug resistant Acinetobacter baumannii efflux pump phenotype with broth microdilution method by the addition of carbonyl cyanide chlorobenzene hydrazone ( CCCP) pump inhibitors,using PCR amplification and sequencing to study efflux pump protein gene sequence characteristics . Results The Acinetobacter baumannii resistance rate of 96 strains to quinolones, cephalosporins, aminoglycosides, tetracyclines were 70. 8%-94. 8%.There were 34 positive efflux pump phenotypes in 96 multi-drug resistant Acinetobacter baumannii strains, including 33 adeB strains, 32 adeR strains, 33 adeS strains, 33 adeJ strains,0 adeE strain,33 adeM strains, positive detection rate were 97. 06%, 94. 12%, 97. 06%, 97. 06%, 0, 97. 06%, respectively. By sequence comparison, adeB, adeR and adeS genes sequence homology was 100% in the GenBank. Conclusion Active efflux pump gene perturbation is one of the important factors in multi-drug resistant Acinetobacter baumannii.

Objective:To detect the expressions of survivin, galectin-3 and thyroid peroxidase in papillary thyroid microcarcinoma ( PTMC) and cancer adjacent normal tissue to explore the clinical significant.The correlations between the expressions of survivin,Gal-3 and TPO with BRAFV600E gene mutation in PTMC were analyzed.Methods: The expressions of survivin,Gal-3 and TPO were measured by immunohistochemical ( IHC ) method in 56 cases of PTMC tissue and adjacent normal tissue; BRAFV600E mutation was detected by PCR amplification and subsequently sequencing.Chi square test was used to analyse the relation in the expression rates of survivin,Gal-3 and TPO and BRAFV600E gene mutation.Results:The survivin and Gal-3 were strongly expressed but TPO was negatively expressed.The survivin and Gal-3 were negative in adjacent normal tissues but TPO was expressed.There were sig-nificant differences in the expression rates of survivin, Gal-3 and TPO between PTMC tissue and adjacent normal tissue (all P<0.001).The BRAFV600E mutation rate (32.1%) and the expression rates of survivin,Gal-3 and TPO in PTMC tissue were found to be positively related to lymph node metastases (P=0.009,P=0.025,P=0.007,P=0.008),and negatively related to gender and age (all P>0.05).There were no correlation was found between the expressions of survivin,Gal-3,TPO and the BRAFV600E gene mutation in PTMC(all P>0.05).Conclusion: The strong expressions of survivin and Gal-3,the mild expression of TPO and BRAF mutation may be important in the development of PTMC,and the detection of BRAFV600E gene mutation and the expressions of survivin, Gal-3 and TPO could be used to the judgment of pathogenetic condition and prognostic outcomes.