Objective To investigate the clinical characteristics and resistance of Stenotrophomona maltophila in intensive care unit.Methods 47 cases with nosocomial pneumonia by Stenotrophomona maltophila in intensive care unit from Jan 2003 to Nov 2007 were studied retrospectively.Results All patients had clinical symptoms,treatment with broad spectrum of antibiotics,the length of stay in ICU,artificial airways,mechanical ventilation,central venous catheter and usage of immunosuppressor,all the factor were obviously related with Stenotrophomona maltophila;SMITMP,ticarcillin/clavulanate,cefoperazone/sulbactam,levo-floxacin,ciprofloxacin were higher susceptive to S: maltophila,in range of 80.85%～61.7%.Conclusion The drug resistance in this kind of bacterium is extremely severe,and it mainly cause the infection of respiratory tract.Decreasing days being in hospital and ICU,using antibiotic reasonably,reducing invasive operation may decrease the infection of S.maltophila.

ObjectiveTo develop a analytical method of three phenoxyalkanoic acid herbicides,MCPA,2,4-D and dichlorprop,in grape leaf using dichloropropyl esterification and gas chromatography with electron-capture detection.MethodsSamples were pounded to pieces,added into internal standard 2,4-dichlorophenylacetic acid,acidified and extracted with ethyl ether.The extracts were cleaned up by liquid-liquid partition.The cleaned organic solutions were evaporated and the residues were dichloropropylated using sulfuric acid and 1,3-dichloropropan-2-ol.The formed esters were analysed by gas chromatography.ResultsThe detection limits of MCPA,2,4-D and dichlorprop in grape leaf were 20ng/g,20ng/g,and 30ng/g,respectively.The concentritions of herbicides in grape leaf were linear over the ranger 100~1000ng/ml.The average recoveries of MCPA,2,4-D and dichlorprop in spiked grape leaf at concentrition of 200ng/g were 98.8%,101.3% and 103.1% with the coefficients of variation 11.4%,11.0% and 9.3% respectively.ConclusionThis method is sensitive and accurate for determination of these three herbicides in poisoned grape leaf.

Objective To explore the risk factors of vascular cognitive impairment (VCI)among Chinese population, and to clarify the scientific evidences for further prevention and treatment.Methods PubMed,CNKI,CBM,VIP and Wangfang databases (from 2002.1 to 2013.1)were searched to collect case-control studies or cohort studies studying risk factors of VCI among Chinese population. Meta-analysis was performed to calculate combined odds ratio (OR)or mean difference (MD)and its 95% confidence interval (95%CI).Results A total of 42 proper papers involving 3 282 cases and 7 815 controls were included in the review.For categorical variables,pooled OR and its 95% CI were as follows:hypertension 2.56 (2.03 - 3.21 ), hyperlipidemia1.79 (1.39 - 2.30 ), hyperglycemia 2.46 (1.90-3.19),Leukoaraiosis 5.46 (2.60-11.46),cerebral infraction multiple foci 4.39 (2.61-7.38),stroke history3.79(2.35-6.11),left hemisphere lesions 2.13(1.42-3.20),smoking 1.51 (1.08-2.11),drinking 0.99(0.73-1.36),basal ganglia lesions 2.15(1.55-2.99),thalamus lesions 2.34(1.57-3.47);for continuous variables,MD and its 95%CI were as follows:level of TG 0.35(0.15-0.55),level of TC 0.44(-0.16-1.04),level of folic acid -4.10(-5.50- -2.69),vitamin B12 -130.44(-225.46--35.41).Conclusion Except for drinking and level of TC, hypertension, hyperlipidemia, hyperglycemia, leukoaraiosis,cerebral infraction multiple foci,stroke history,left hemisphere lesions,smoking,basal ganglia lesions,thalamus lesions,high level of TG,low level of folic acid and vitamin B12 might be the risk factors of VCI among Chinese population.

By combing differe nt modelin g factors and evaluation indicators of experimental animals of polycystic o-vary syndrome (PCOS), application scope, advantages and disadvantages were analyzed among various kinds of animal models, in order to screen models of etiology and pathogenesis in traditional Chinese medicine (TCM). Through the collection of 77 Chinese literatures published since 1979, the database on PCOS of modeling factors (i.e., animal species, age, modeling reagent and dose, etc.) and evaluation indicators (i.e., ovarian morphology and hormone levels) were established, analyzed and summarized. The results showed that the experimental PCOS models established by researchers both at home and abroad included androgen method, combination method of androgen with HCG, combi-nation method of progestrone with HCG, estrogen method, aromatic cyclase inhibitor method, combination method of HCG with insulin, combination method of androgen with insulin, insulin method, and etc. The SD and Wistar rats at the age of 3-50 days were commonly used. Chemicals, such as dehydroepiandrosterone (DHEA), testosterone propi-onate, sodium prasterone sulfate, dihydrotestosterone (DHT), levonorgestrel, estradiol valerate, letrozole, insulin and HCG were chosen to build the animal models. The evaluation indicators included ovarian morphology, the total num-ber of follicles at different levels, sex hormones (E2, P, T, FSH, LH) and insulin resistance (IR) index (FINS, FPG, HOMA). It was concluded that each modeling method described above had its own advantages and disadvantages, which cannot completely simulate clinical onset process of PCOS patients. Researchers should choose appropriate reagent and evaluation index according to different purpose. DHEA, DHT slow-release, progesterone combined with HCG modeling methods are more suitable for the study of the role of IR in the pathogenesis of PCOS. Kidney-defi-ciency and dampness-phlegm is fundamental etiology and pathogenesis of obese type of PCOS. DHEA method, com-bination method of levonorgestrel with HCG, aromatic cyclase inhibitor method conformed obese type of PCOS. The evaluation indicators included body weight, sex hormones, IR index and ovarian morphology. The method of kidney-tonifying and phlegm-reducing was often used in the treatment of obese type of PCOS in the clinical practice.

Objective To investigate the value of nuchal translucency(NT) thickening in the fetal chromosome abnormality screening.Methods The 14 881 pregnant women received NT measurement in 11-13 +6 weeks at Beijing Obstetrics and Gynecology Hospital from January 2010 to August 2012.The 118 fetuses whose NT≥2.5 mm were recruited.One hundred and eight (91.5％,108/118)of them accepted invasive procedure and karyotype analysis.Results (1) Chromosome karyotype analysis:113 singleton pregnancies (95.8％) and 5 twin pregnancies (4.2％) whose NT thickened from 2.5 mm to 11.0 mm were advised karyotype analysis.The 108 pregnant women accepted karyotype analysis.Among them,88 had normal chromosome karyotype,and 20 had chromosome abnormalities.The detection rate was 18.5 ％ (20/108).(2) The sensitivity,specificity,false positive rate,false negative rate,total consistent rate,positive predictive value and negative predictive value of prenatal screening of chromosome abnormalities for NT ≥ 2.5 mm were 44％,99％,1％,56％,99％,19％ and 100％,respectively.(3) Among the 88 fetuses who had normal karyotype,72 (82％) had isolated thickened NT,while 16 (18％) had fetal structural malformation or intrauterine demise.(4) Among the 10 pregnant women who did not accept fetal karyotype analysis,8 terminated pregnancy because of fetal structural malformation,and the other 2 fetuses died in uterus.(5)All of the 5 twin pregnancies were dichorionic twins,and one of the twins had thickened NT.Among the 5 twin pregnancies,one fetus was trisomy 21 and others had normal karyotype.3 twin pregnancies who had normal chromosomes gave live birth.And the other had a gastroschisis and exstrophy deformity fetuse.This fetuse died in uterus and remaining fetuse had full-term live birth.(6) 35 (29.7％) pregnant women received second trimester Down's syndrome serum screening.One was high risk and was proved a trisomy 21 pregnancy.Thirty-four were low risk and had normal chromosome karyotype.Conclusion NT thickening may indicate fetal chromosome abnormalities or other structural malformations.It is a useful prenatal screening indicator.

Objective:To assess the metabolic side effects of the following atypical antipsychoties head-to-head:amisulpride,olanzapine,aripiprazole,quetiapine,risperidone,ziprasidone.Methods:We searched the MED-LINE,EMBASE,Cochrane Library,PubMed,CNKI,Web of science,Sinomed,WANGFANG DATA databases for randomized,blineded studies comparing the above mentioned atypical antipsychoties in the treatment of schizophre-nia or related disorders.At last three reviewers extracted the data independently.All the data would be analysed with meta ananlysis and the analysis software of the RevMan 5.1 provided by Cochrane network.Results:There were 49 studies in which 45 were written in English and 4 were written in Chinese included in the review.Olanzapine pro-duced statistically significantly more weight gain than all other second-generation antipsychotics.Risperidone pro- duced significantly more weight gain than amisulpride.Olanzapine produced statistically significantly more increase in glucose levels from baseline to endpoint than all other second-genetation antipsychotics.Risperidone produced statistically significantly more increase in glucose levels from baseline to endpoint than aripiprazole,quetiap-ine.Olanzapine produced statistically significantly more increase in cholesterol than aripiprazole,risperidone and zi-prasidone.Quetiapine produced significantly more increase in cholesterol than risperidone and ziprasi-done.Risperidone produced significantly more increase in cholesterol compared to aripiprazole and ziprasidone.Conclusion:Some atypical antipsychoties lead to substantially more metabolic side effects than other a-typical antipsychoties.When choosing an atypical antipsychotic agent for an individual patient these side effects with their potential cause of secondary diseases should be weighed against efficacy and characteristics of the individual patient.

Objective To compare the effects of adjustable pressure drainage device, negative pressure ball drainage and drainage bag drainage on patients with the total hip arthroplasty. Methods The silicone drainage ball with negative pressure, the urine collection bag, the infusion set′s regulator were used to make adjustable pressure drainage device. 120 cases of total hip arthroplasties from January to December in 2015 were chosed and divided randomly into 3 groups based on the sequence of operation notifications. In 40 cases, drainage bag were used (control group 1), 40 cases with negative pressure ball drainage (control group 2) and 40 cases with adjustable pressure drainage device (experimental group). Total postoperative bleeding, the blood transfusion amount, swelling (the thickness of hematoma) and the nursing workload of the three groups were compared. Results The total postoperative bleeding, the blood transfusion amount, the thickness of hematoma and the nursing workload in the experimental group were (775.1±130.5) ml, (3.5±1.3) mm, (180.2±29.9) ml, (34.5±5.2) min. The total postoperative bleeding, the blood transfusion amount, the thickness of hematoma and the nursing workload in the control group 1 were (889.4 ± 160.8) ml, (5.2 ± 1.1) mm, (285.9 ± 30.4) ml, (40.6 ± 7.4) min and in the control group 2 were (876.2±156.7) ml, (4.3±1.2) mm,(208.3±33.3) ml, (50.3±8.5) min. Compared the data of the experimental group and the control group 1, the difference was of statistically significance (t=3.49-15.68, P < 0.01). Compared the data of the experimental group and the control group 2, the difference was of statistically significance (t=2.86-10.03, P<0.01). Conclusions The effects of adjustable pressure drainage device are better than the drainage bag and negative pressure drainage ball. It can effectively reduce the postoperative bleeding and the swelling degree, and bring a lot of relief to the patients and lots of convenience to the nursing work. The method is affordable, reliable and safe which should be promoted in the primary hospital.

Objective To evaluate the performance of ultrasonography (US) for the preoperative staging of papillary thyroid carcinoma (PTC). Methods One hundred and twenty-one patients with cytologically proven PTC were prospectively collected. Patients were recruited at the Chinese Academy of Medical Sciences Cancer Hospital from January 2014 to November 2014. Preoperative US was performed for the evaluation of primary tumor size, extrathyroidal extension and neck lymph node metastasis according to the 6th UICC TNM staging system. Results The sensitivity, specificity, positive predictive value (PPV) and negative predicative value (NPV) of US in predicting extrathyroidal extension were 89.6%(60/67), 72.2%(39/54), 80.0%(60/75), 84.8%(39/46), respectively. The accuracies of preoperative US for T1, T2, T3, T4 stage were 75.0%(36/48), 100%(1/1), 81.9%(59/72), 0, respectively. The sensitivity, specificity, PPV, and NPV of US in predicting neck lymph node metastasis were 47.5%(29/61), 90.0%(54/60), 82.9%(29/35), 62.8%(54/86), respectively. Conclusion Ultrasonography is a feasible tool for preoperative staging of PTC and is helpful for accurate prediction of extrathyroidal tumor extension and lateral neck lymph node metastasis.

Objective:To investigate the immunoregulation effect of ovalbumin immune tolerance factors (OVA ITFs).Methods:Components that were smaller than 3 kD were isolated from the splenic lymphocytes lysates of OVA tolerance mice or naive mice,respectively,named as OVA ITFs or OVA ITFs conttrol.Naive BALB/c mice were divided into 5 groups,group A,B,C,D were injected i.v.by OVA ITFs,OVA ITFs control,splenic lymphocytes from OVA tolerant mice or PBS,respectively,group E as the blank control.The percentages of CD4+CD25+ T cell subpopulation from spleens before and after adoptive transfer were measured with flow cytometer;OVA specific lymphocyte responses were assessed by MTT assay.The levels of IL-10 and TGF-?1 in the culture supernatants were tested by ELISA kits.Results:For OVA ITFs or splenic lymphocytes from OVA tolerant mice,the percentages of CD4+CD25+ T cell subpopulation from spleens after adoptive transfer were raised significantly compared with that before adoptive transfer (15.32%?1.03% and 15.35%?0.62% vs 9.97%?1.38%,P

Objective To study the changes of diamine oxidase (DAO)levels in neonates with hypoxic -is-chemic encephalopathy (HIE)treated with selective brain hypothermi,also to further evaluate Scores for Newborn Gastrointestinal Functior (SNGF).Methods 60 newborns with moderate and severe HIE who were in the NICU of our department from June 2013 to December 2014 were collected.The 60 newborns were randomly divided into hypo-thermia treatment group (HG)and conventional treatment group(CG).The serum was collected and ELISA method was used to test the consistency of DAO on admission and 7 days afterwards,respectively.Meanwhile,the SNGF level of the two groups at the two time points was compared.Results Neither the DAO and SNGF level of the two groups had statistical difference on admission(all P >0.05).Seven days later,both the DAO of the two groups and the SNGF decreased[(12.51 ±1.53)u/mL vs (7.88 ±1.87)u/mL,however,the variation of the hypothermia treatment group was apparently more significant than the change of the conventional treatment group(P =0.011).The SNGF scores of the two groups all decreased,while the hypothermia treatment group was significantly lower than the conventional treat-ment group,the difference were statistically significant (P =0.044,0.006,0.013).Besides,there was remarkably positive correlation between serum DAO level and SNGF (r1 =-0.825,r2 =-0.876,all P <0.05).Conclusion Hypothermia treatment could effectively reduce the injury of asphyxia neonatal gastrointestinal tract by inhibiting the level of DAO,thus improve the gastrointestinal function.