Objective To investigate morbidity and analyze high risk factors of nosocomial infection in patients who underwent orthotopic liver transplantation (OLT) in our ICU, in order to draft possible preventive strategies. Methods The clinical data of 56 OLT patients from Apr 2002 to Dec 2004 were analyzed. Results Significantly high APACHE Ⅱ scores and total plasma bilirubin, low platelet count were found in patients with nosocomial infection. The number of patients who had received an additional operation and broad-spectrum antibiotics before OLT were greater in nosocomial infection (NI) group than in none-nosocomial infection (NNI) group. Notably, the longer the broad-spectrum antibiotics used before OLT, the higher the morbidity rate of nosocomial infection. No significant difference was found in age, Child-Pugh grade and plasma albumin level between the two groups. In addition, APACHE Ⅱ scores and total bilirubin level were significantly higher in patients acquired enterococcal infection than in those infected with other pathogenic microorganisms. Conclusions High APACHE Ⅱ score, high total bilirubin level, low platelet count and length of use of broad-spectrum antibiotics before OLT were closely associated with nosocomial infection. As an important indicator, change in total bilirubin level not only represented the liver function ,but also was one of the high risk factors to nosocomial infection in patients undergoing OLT.

OBJECTIVE: To explore the effects of wind and dampness pathogens on cytokines in the lung tissue of rats with cold syndrome due to different gradient cold pathogens. METHODS: One hundred and four Wistar rats of SPF grade were randomly divided into 13 groups: normal temperature group, six cold pathogen groups and six cold plus wind-dampness pathogen (wind of grade 5 and 90%-100% relative humidity) groups. The cold pathogens were constant low temperature (including 10 degrees C, 0 degree C, -10 degrees C) and temperature change (including 20 to 10 degrees C, 20 to 0 degrees C, and 20 to -10 degrees C). The rats in different groups were kept in a temperature-controlled box under the corresponding condition for 2 hours on the first day of experiment. Then, the rats were all raised in normal temperature for 4 days and the rats' behaviors were observed. The contents of tumor necrosis factor alpha (TNF-alpha), interleukin-6(IL-6) and interleukin-4 (IL-4) in lung homogenate were measured by radioimmunoassay and the content of interferon-gamma (IFN-gamma) was detected by enzyme-linked immunosorbent assay. RESULTS: In comparison with cold pathogen groups, contents of TNF-alpha, IL-6 and IL-4 were obviously increased in lung homogenate of rats in cold plus wind-dampness pathogen groups (P<0.01), and the content of IFN-gamma and IFN-gamma/IL-4 ratio were obviously decreased (P<0.01). CONCLUSION: Wind-dampness pathogen can seriously aggravate the injury to lung tissue caused by cold pathogen, and the unbalance of Th(1)/Th(2) in lung homogenate of rats.

When auditory organ is stimulated by some tones,there will be a series of electric activities in our auditory systems,we call them auditory evoked potentials.we can divide them short,middle and long latency response by their latencies.Different potentials can reflect brain function activities in different pathes of auditory nerve.In forensic medicine expertise,they can be objective evaluation in audition function and handicap of pathes of auditory nerve brain function.In this article,we summarized the mechanism and characters of different auditory evoked potentials,sumed up their application value in forensic medicine.

An improved method for Ge phenotyping using sulfosalicylic acid staining after IEF is reported. Gc subtyping had been achieved and Gc variants were detected using this method without using anfi-Gc serum for immunofixation. Two new Gc variants Gc~(1c3) and Gc~(2c7) were discovered in Chinese people, and their frequencies were 0.0008 and 0.0004 respectively.

0.05).61 patients received no sedatives nor analgesics showed significantly higher incidence of SUE compared with those patients received either sedatives or analgesics(73.8% vs 37.3%,P

Objective To compare the incidences of agitation and circulatory fluctuation in mechanically ventilated patients receiving different sedatives for daily arousal,and develop a safe sedation strategy.Methods Ninety four patients in ICU,who received mechanical ventilation over 24 hours,were selected from five clinical centers.Based on the analgesia with continuous pumping of fentanyl,patients were randomly given midazolam(M group),propofol(P group)or sequential midazolam-propofol(M-P group)for sedation.The depth of sedation was maintained within SAS 2-4 by close monitoring.The administration of all sedatives and analgesics was terminated at 9:00 am till patients were fully waked up.The incidence of agitation,blood pressure,heart rate fluctuation,patients' arousal time,and their recollection to actual mechanical ventilation events after been transferred out of ICU were investigated.Results The mean SAS scores showed no difference in each group.The arousal time was significantly longer in group M than that in other two groups(P

Objective Post-operative hypoxemia occurred frequently after extubation in patients who underwent orthotopic liver transplantation (OLT) in ICU. This study is to investigate the efficiency of hyperoxia solution in improving oxygenation. Methods Ten OLT cases, who post-operatively manifested hypoxemia after extubation, were enrolled in this study. Hyperoxia Ringer's solution (500ml) prepared by Jing-Shu-Yang (an apparatus of oxygen supply, Vanform Co., Shandong) was infused at a rate of 200ml/hr. Hemodynamic parameters, blood gas, and blood lactate were determined at the beginning, end of infusion, and 1 hour after the infusion, with recording of the following data: heart rate (HR), mean arterial pressure (MAP), pulmonary arterial pressure (PAP), and pulmonary capillaries wedged pressure (PCWP). Results Compared with the levels at the beginning of infusion, SpO2 and SvO2 increased significantly at the end of the infusion of 500 ml hyperoxia Ringer's solution, and they returned to the baselines 1 hour later, although regular Ringer′s solution was coutinuously given by the same infusion rate. HR, MAP and PCWP were kept stable with the solution infusion. Notably, PAP was decreased markedly at the end of infusion, and blood lactate level remained unchanged after the intervention. Conclusion Hyperoxia Ringer's solution infusion improved oxygenation in OLT patients who suffered from acute lung injury with hypoxemia postoperatively. PAP decreased markedly as hypoxemia was corrected.

Objective To explore the biomechanical mechanism of non-erosive reflux disease(NERD).MethodsFrom October 4,2014 to September 30,2015,17 NERD patients and 17 healthy controls were recruited from the outpatients department of China-Japan Friendship Hospital.The cross-sectional area(CSA), intra-balloon pressure (IBP)and compliance(Δv/Δp)of each were measured by endoscopy in combination with EndoFlip.ResultsWith the increase of balloon volume,the compliance of gastroesophageal junction in NERD group was significantly higher than that of control group(P<0.01) while the cross sectional area and intra-balloon pressure were similar.Conclusions Increased compliance of the gastroesophageal junction may be involved in the pathogenesis of non-erosive reflux disease.

Objective To study the X-ray imaging characteristics of gouty arthritis. Methods The X-ray plates from gouty arthritis were analyzed. Results The gouty arthritis usually occurred in the first metatarsophalangeal joint. The X-ray findings were dissymmetric swellings of soft tissue,bony erosion defect with sharp and hard edge,narrowed joint space and irregular articular surface,emergence of fiber stiffness,even joint malformations and sublimation or dislocation, associated with hyperosteogeny and nearby osteoporosis. Conclusion Diversification was presented in X-ray findings of gouty arthritis, which could be easily confused with other single or multiple bone joint diseases. As a result, accurate diagnosis should be based on careful analysis about X-ray findings.

Objective To research on treament of femoral head of patients with osteoneerosis of the femoral head fracture.Methods Twenty-six patients half of femaoral head of patients with osteonecrosis of the femoral head fracture who treated with vascularzed bone graft were determined.Twenty-one hips treated with internal fixation unloaded and vascularzed bone graft after selective digital subtraction angiography (DSA) was performed to confirm the blood supply of femoral head.one case underwent total hip replacement after internal fixation unloaded.Results All patients were followed up for a mean of 23 months (range,12-38months)and were assessed clinically and radiologically according to Harris scoring.Selective digital subtraction angiography (DSA) was performed in 15 cases to confirm the blood reconstruction of femoral head.Two cases underwent total hip replacement postoperatively.Preoperative and postoperative Harris score were 54 and 86.2,clinical success rate was 92.0% and radiological success rate was 84.0%.DSA demonstrated blood supply was found reconstruction in the necrotic femoral head.Conclusion Femoral head of patients with osteonecrosis of the femoral head fracture was very much (recent 40%).Taking out of internal fixation,treatment of osteonecrosis of the femoral head by using vascularzed bone graft was confirmed,early clinical results were satisfied.