Urinary tract infection (UTI)is a commonly encountered disease during routine clinical care. In the mean time, it is also a commonly encountered hospital acquired infection. UTI possesses various clinical symptoms, and usually the symptoms are atypical. The detection of leukocyturia and bacteriuria is an essential index for screening and confirmatory diagnosis of UTI. This article summarized the pathogenesis of UTI, diagnostic criteria, clinical significance and application evaluation of detection of the WBC and bacteria in urine.

The incidence of gastric carcinoma is increasing and lymphatic metastasis is one of the major causes of death.Vascular endothelial growth factor-C(VEGF-C),Vascular endothelial growth factor D(VEGF-D)linking their receptor(VEGFR-3)can increase lymphangiogenesis,advance lymphatic metastasis,and relate to lymphatic vessel density of tumor.More and more studies of lymphatic vessel of gastric carcinoma cause great attention.We summarizeed the mechanism of lymphangiogenesis,the new development of relationship between lymphangiogenesis and lymphatic vessel density and their clinical significance.

BACKGROUND: Mesenchymal stem cells (MSCs) from adult bone marrow can alter alloimmune response in vitro and vivo. Their potentiality is great in solid organ transplantation.OBJECTIVE: To develop MSC antirejection therapy and identify behind mechanishm of MSCs immunomodulation ability. METHODS: We searched Pubmed (1994-Mar.2009) with the key words of "mesenchymal stem cells, solid organ transplantation, tolerance, immunosuppression, animal model". RESULTS AND CONCLUSION: Totally 262 English articles about influence and mechanism of action of adult bone marrow mesenchymal stem cells on solid organ transplantation were collected. The 49 suitable articles were included without earlier publication time, repeated and analogous study. Human mesenchymal stem cells did not express MHC2 Ⅱ antigen and T cell costimulatory molecules B7. Coculture with allogenic T lymphocytes could not induce T cell proliferation, but inhibited mixed lymphocyte reaction and mitogenstimulated T cell proliferation. Inhibitory effects of mesenchymal stem cells on T cell proliferation were not limited by major histocompatibility complex. Mesenchymal stem cells no matter from donors or recipients had similar immunoloregulation effects. Allogene mesenchymal stem cells could cause immunereaction in vivo, no complete immune privilege. The in vivo effects of mesenchymal stem cells will strongly depend on their localization and migration pattern after injection. Therefore, MSCs are interesting candidate cells for tolerance induction in clinical organ transplantation.

BACKGROUND: Anterior cruciate ligament (ACL) is the kernel of articular genu, for the past few years, the incidence rate of cruciate ligament injury increased gradually.OBJECTIVE: To review on the mechanism of the injury of ACL, the method of operation, the election of transplant, the reconstruction of equilong, the reconstruction of ligament and so on, and to look forward to providing some references on treating the ACL injury.METHODS: A computer-based research was conducted in Medine database (1996-01/2009-03), with the key words of "Anterior cruciate ligament, implant, reconstruction, repair". Chongqing VIP database and Qinghua Tongfang database (1996-01/2009-03) were retrieved with the same key words.RESULTS AND CONCLUSIONS: 200 literatures on arthroscopic ACL reconstruction were collected, excluding older, repeated and similar research, and the 18 standard literatures were included. ACL is a key structure to stabilize knee joint, and exercises and various factors during daily life could induce its injury. Unsuitable treatment would severely affect movement ability or movement loss. To recover structure and function of knee joint, damaged ACL should be reconstructed. With the development of technique and innovation of surgical instrument, arthroscopic reconstruction has presently been a popular method to treat ACL. There are many methods to treat ACL injury, but none of them can duplicate ACL anatomical relationship. It is still in doubt whether the operation can reduce the secondary damage. We have much more work to research on modus operandi, implant, postoperative rehabilitation and other adjunctive therapies.

Objective To analyze the clinical efficacy of trimetazidine in short-term treatment for dilated cardiomyopathy accompanied by heart failure. Methods Sixty seven cases of dilated cardiomyopathy patients with heart failure were recruited and divided into two groups randomly,the control group(n = 33) had conventional therapy and the treatment group (n = 34) had conventional therapy plus oral tid 20 mg trimetazidine administration for 3 months. Results The heart function improved significantly in both groups. The overall effective rate was significantly lower in the control group than the treatment group(69. 7% vs. 88.2%,P ＜ 0. 05). In the treatment group, before treating the left ventricular ejection fraction(LVEF), stroke volume (SV), cardiac output per minute (CO), 6 min walk test(6-MWT), were(28.7 ± 13. 6) %,(31.0 ± 8. 7) ml,(3. 10 ± 0. 49) L/min,(138.0 ± 30. 4) m respectively, and after treazing these indices were(38. 5 ± 9. 7) %,(48. 5 ± 6. 8) ml, (4. 90 ± 0. 98) L/min,(350. 0 ± 20. 4) m respectively, which increased significantly after treatment(Ps ＜0. 05). However,in the treatment group ,before treatment left ventricular. End-systolic dimension (LVESD), left ventricular end-diastolic dimension (LVEDD) and brain natriuretic peptide (BNP) were (68. 0 ± 8. 0)mm,(70. 0 ± 7. 8) mm,(669. 0 ± 71.4) μg/L respectively, whereas after treatment these indices were(59. 0 ± 6. 7) mm,(68.0 ± 7. 9) μg/L,(340. 0 ± 56. 0) μg/L respectively, which decreased significantly after treatment(Ps ＜ 0. 05). In the control group, before treatment LVEF, SV, CO, 6-M WT were(28. 5 ±13.9) %,(30. 0 ± 9. 9) ml,(3.00 ± 0. 48) L/min,(130. 0 ± 28. 6) m respectively, whereas after treating these indices were(34. 0 ± 8. 5) %,(34. 0±11.0) ml,(3. 90 ± 0. 56) L/min,(254. 0 ± 30. 0) m, respectively,which increased significantly after treatment(Ps ＜ 0. 05). While in the control group, before treatment LVESD,LVEDD and BNP were (67.0 ± 9. 0) mm, (70. 0 ± 8.0) mm,(666. 0 ± 70. 8) μg/L respectively, whereas after treatment these indices were(60. 0 ± 5. 5) mm,(66. 0 ± 5.7) mm,(350. 0 ± 55.3) μg/L respectively, which decreased significantly after treatment (Ps ＜ 0. 05). Moreever, the improvement of these indices in the treatment group were significantly higher than those in the control group (Ps ＜ 0. 05). Conclusion The additional administration of trimetazidine to conventional anti-failure treatment can significantly improve the heart function in patients with dilated cardiomyopathy,which is worth to be generalized clinically.

Functional gastrointestinal disorders is a common functional disease without organic pathologic changes, mainly including functional dyspepsia, irritable bowel syndrome and functional constipation.As the dissatisfaction, side effects and recurrence with drug treatment, transcutaneous electrical stimulation has taken an important role in the treatment of functional gastrointestinal disorders in recent years.This article reviewed the progress of transcutaneous electrical stimulation in treatment of functional dyspepsia, irritable bowel syndrome and functional constipation.

OBJECTIVE:To promote safe,effective,economical and proper medication.METHODS:Prescriptions in the outpatient and emergency departments of our hospital in2003were randomly selected;the irrational prescriptions were ana?lyzed with regard to drug descriptions,pharmacological knowledge and literatures.RESULTS:The irrational one amounted to4.92%of the total selected prescriptions;antibiotics drug abuses amounted to84.12%of the irrational ones.The irrational drug use problems were mainly seen in administration scheme,repeated dosage,menstruum,administration,drug combina?tion,compatibility and combined toxicity.CONCLUSIONS:Clinical pharmacist plays an important role in promoting rational drug use by checking prescriptions.

Objective To explore the clinical significance of perioperative serum N-terminal pro-BNP(NT-proBNP)testing in patients with cardiac valve replacement.Methods The content of perioperative plasma NT-proBNP in 296 patients with cardiac valve replacement was detected,the relationship between preoperative plasma NT-proBNP content and heart function classification was analyzed,the postoperative changes were observed and the plasma NT-proBNP levels were compared among the death cases, the patients with complications and without complications.Results The left ventricular ejection fraction(LVEF)and plasma NT-proBNP content had statistical differences among different cardiac functional classifications(F =5.268,8.173,P <0.05),preopera-tive serum NT-proBNP level was positively proportional to the cardiac function classification(r =-0.776,P <0.01)and inversely proportional to LVEF(r=-0.472,P <0.05);on postoperative 1 d,plasma content of NT-proBNP reached the peak,there was sta-tistically significant difference compared with before treatment,(t=20.913,P <0.05),then which was gradually declined on post-operative 3,5,7 d.The preoperative plasma NT-proBNP content and postoperative plasma NT-proBNP peak levels in the death pa-tients and the patients with complications were higher than those in the patients without complications(P <0.05 ),the difference was statistically significant(P <0.05 ).Conclusion Preoperative plasma NT-proBNP concentration in the patients with cardiac valve replacement can reflect the cardiac function condition,the postoperative plasma NT-proBNP content is increased at the early stage,then gradually decreased,The increase of plasma NT-proBNP concentration before and after operation has a certain clinical value in predicting prognosis of the patients.

Objective To investigate the clinical distribution characteristics and trend in antibacterial resistance of Acinetobacter baumannii in Pudong Hospital Affiliated to Fudan University,so as to provide the guidance for clinical rational use of antibacterial agents and infection control.Methods SPSS 1 9.0 statistical software was adopted to retrospectively analyze the specimen source, department distribution and antibacterial resistance change of the 1 678 strains of Acinetobacter baumannii in this hospital from Jan-uary 2010 to October 2014.Results Clinical isolates of Acinetobacter baumannii mainly came from respiratory tract specimens(ac-counted for 79.1%).The intensive care unit(21.1%),department of neurosurgery(1 7.7%)and department of cardiology(1 7.6%) were the top three departments from which the strains were isolated.The isolates of Acinetobacter baumannii were highly resistant to the first and second generation of cephalosporins,cephamycin,ampicillin and nitrofurantoin,and the resistance rates reached a-bove 90%.The resistance rates of these isolates against carbapenems,aztreonam,cefperazone-sulbactam and ampicillin-salbactam showed obviously uptrends,but the resistance rates of these isolates against amikacin and cotrimoxazole showed downtrends.And the resistance rates of these isolates against other antibacterial agents stayed between 30% and 50%.During the five years,the de-tection rates of multi-drug resistant strains steadied around 35.0%.Though the detection rates of pan-drug resistant strains de-clined year by year,the strains were isolated each year.Conclusion The antibacterial resistance of Acinetobacter baumannii is seri-ous in this hospital,with multi-drug and pan-drug resistance persisting.It is necessary to enhance monitoring antibacterial resist-ance,ensure rational use of antibacterial agents,and promote implementation of disinfection and isolation,so as to prevent the spread and popularity of Acinetobacter baumannii resistance in hospital.

To study the influences of the demographic evolution to government expenditure on health by using the method of generalized method of moment(GMM)by dynamic panel data of 31 provinces or cities from 1998 to 2011. The result showed that the elderly dependency ratio had a significant positive impact on government health expenditure, while the reduction of child dependency ratio would increase it. There were clear differences among regions. The elderly and child dependency ratio were both significantly positive for the eastern region, no significant effect for the central, and positive and negative respectively for the western. Therefore, it is needed to further improve the proportion of government health spending in total health expenditure, increase transfer payment, reduce regional differences and achieve the equalization of basic public health services.