OBJECTIVE: To facilitate the practice of the activity of "hospital administration year" and to improve the medical service quality. METHODS: Reformation was made actively by optimizing the administrative organization structure and introducing the model of secondary hospital service in our hospital after the trusteeship by the Shanghai 6th People's Hospital. RESULTS & CONCLUSIONS: Due to the above practice, the consciousness on medication safety, the quality of medical care services as well as the degree of patients' satisfaction had been increased gradually, which contributed to a sound, ordered and sustainable development of our hospital.

Objective To analyse the associated clinical findings of newborn infants with HIE after intrauterine asphyxia with normal Apgar scores at birth and follow-up the neurologic sequelae. Methods 30 newborn infants admitted for HIE in Jan.to Dec. 2002 were analysed,they had :(1)intra-uterine asphyxia with Apgar scores of 8～10 at birth,(2)with neurological symptoms on the first day after birth,(3)diseases of infection,genetics and metabolism,and deformity were ruled out,(4)with characteristic findings of HIE on cranial ultrasound examinations and CT scans. Results All of 30 newborn infants had signs of depression from the first day after birth,22 infants of them sometimes were irritable.17 cases (56.7%) with mild encephalopathy and 13 cases (43.3%) with moderate encephalopathy,none of severe case,compared with the infants who had HIE with birth asphyxia,there were no statistical difference. Less than 40% cases had elevated BUN and CKMB,hyponatremia,hypocalcemia,hypoglycemia,acidosis,etc The incidence of them were the same as the infants who had HIE with birth asphyxia. The findings of cranial ultrasound examinations were different between the acute and chronic hypoxic injury of intrauterine asphyxia Follow-up 28 infants at the mean age of (11.7?3.8) months. Except 1 case of cerebral palsy,all of them are normal intelligent infants. There were 4 cases of dilated lateral ventricle and 1 case of dilated 3rd ventricle at birth; 6 cases of dilated ventricles found in follow-up and 1 of them had cerebral palsy,all of those infants recovered at 12～19 months of age. Conclusion Newborn infants who had intrauterine asphyxia without birth asphyxia might suffer from HIE and cerebral palsy later. Cranial ultrasound examinations showed some of them had fetal brain damages. Therefore,intensive care of such infants,preventing and treating intrauterine asphyxia could decrease the morbidity of HIE.

120 teeth with wedge-shaped defects at subgingival depth of 0 ~2 mm were selected and divided into 3 groups(n =40).Gingival retraction code and EXPASYL gingival retraction paste were used for gingival retraction in the 2 retraction groups,and none retraction was used in the control group.After restoration of the defects,all cases were followed up for 1 year and 2 years.The results were evaluated by modified USPHS criteria.No significant difference was detected for 1 year and 2 year successful rates between the extraction groups(P >0.05).The successful rate in extraction groups was higher than that in the control group(P ＜0.05).

Objective: To explore heart rate variability (HRV) and arrhythmia in patients with resistant hypertension.
Methods: Our work included 3 groups:Resistant hypertension (RH) group, n=39, Non-resistant hypertension (NRH) group, the hypertension could be controlled by 1-3 medications, n=42 and Control group, composed of 40 healthy subjects. The 24h ambulatory blood pressure and electrocardiogram were monitored, the time-domain of HRV and arrhythmia parameters were compared among 3 groups which including standard deviation of all normal RR intervals (SDNN), standard deviation of the average normal RR intervals for all 5-min segments (SDANN), the mean of standard deviation of all 5-minute RR intervals (SDNN Index), the root mean square of the differences between adjacent R-R intervals (rMSSD) and the percentage of adjacent R-R intervals varied by more than 50 ms (pNN50).
Results: Compared with Control group, both RH and NRH groups showed decreased time-domain HRV parameters, all P<0.05. Compared with NRH group, RH group had the lower time-domain HRV parameters, all P<0. 05, while the rMSSD was similar between 2 groups (t=-1.5048, P=0.1364). The rates of arrhythmia in both RH and NRH groups were higher than Control group. The incidences of premature atrial contraction and atrial tachycardia were higher in RH group than NRH group, P<0.05, while the premature ventricular contraction, ventricular tachycardia and A-V block were similar between 2 groups, all P>0.05.
Conclusion: RH patients had decreased HRV and increased arrhythmia, especially with the higher incidence of atrial arrhythmia.

OBJECTIVE: To learn the clinical features of patients infected with Klebsiella pneumoniae in our hospital.METHODS: From 2006 and 2007,a total of 96 inpatients in our hospital that were confirmed to be infected with Klebsiella pneumoniae by sputum culture were collected for a study of their clinical features and drug susceptibility test results.RESULTS: Patients with Klebsiella pneumoniae infection represented 12.7% of the total concurrent pulmonary infection cases,of which,57 Klebsiella pneumoniae infection cases had concurrent pulmonary tuberculosis(TB),and 39 Klebsiella pneumoniae infection cases had no concurrent TB.Drug susceptibility tests showed that the resistance rates of Klebsiella pneumoniae to third generation cephalosporins and quinolones were higher than those reported in the literature,and the resistant rate of Klebsiella pneumoniae to quinolones in Klebsiella pneumoniae infection patients complicated with TB was higher than those without TB.CONCLUSION: Klebsiella pneumoniae infection was more common in patients with low body resistance,which has typical clinical manifestations.Recently,the resistance of Klebsiella pneumoniae to the third generation cephalosporin has been increasing,and its resistance to quinolones in patients with pneumonia Klebsiella infection complicated with TB was significantly higher than in those without TB.

Objective To study the relationship between reactive oxygen species (ROS) as well as total antioxidant capacity ( TAC ) within follicle fluid and body mass index ( BMI ) in patients with polycystic ovary syndrome (PCOS).Methods All patients enrolled in this study were infertile women receiving in vitro fertilization-embryo transfer (IVF-ET) treatment.55 PCOS patients were divided into over-weight group ( n =23 ) and non-over-weight group ( n =32 ).Another 55 age-matched non-PCOS women were also divided into control group ( n =30) and overweight group ( n =25 ).Plasma sex hormone,triglycerides,and total cholesterol were determined.On oocyte retrieval day after ovarian stimulation,ROS and TAC in follicular fluid were assayed.Results Subjects in over-weight and PCOS over-weight groups had higher triglycerides than those in control and PCOS non-over-weight groups [ ( 1.9 ±1.1,1.7 ± 0.9,1.0 ± 0.5,1.2 ± 0.7 ) mmol/L,respectively,all P＜0.05],so did total cholesterol [ ( 4.8 ± 1.2,5.2 ± 1.1,4.0 ± 0.6) mmol/L,respectively,all P＜0.05].In PCOS over-weight group,ROS and ROS/TAC within follicular fluid were ( 35.4 ± 6.7 ) RLU/S and 39.8 ± 22.0,both were higher than those in the other 3 groups ( all P＜0.05).TAC [ (0.8 ± 0.5 ) Mm] was lower in PCOS over-weight group than that among the other 3 groups( all P＜0.05 ).ROS/TAC was higher in PCOS non-over-weight group than that of control group ( 26.5 ± 14.5 vs 14.2 ± 12.5,P＜0.05 ).Univariate analysis showed that both ROS and ROS/TAC within follicular fluid in PCOS patients were positively correlated with BMI ( r =0.34 and r =0.32,both P＜0.05 ).Conclusion Abnormal oxidative stress exists in follicular fluid of PCOS patients,and the oxidative stress parameters show positive correlation with BMI.

PURPOSE: To produce animal models of Acanthamoeba keratitis and to evaluate the advantages and adaptation range of each of the three methods employed. MATERIALS AND METHODS: Mice and Wistar rats in three groups of 15 rats and 15 mice each were used to establish the models. Right corneas in group A were scratched and challenged with Acanthamoeba. Those in group B were scratched and covered with contact lenses incubated with Acanthamoeba. Those in group C received an intrastromal injection of Acanthamoeba. Five rats and 5 mice in each group were used for histopathological investigations and the other 10 in each group were used for clinical evaluation. The models were evaluated by slit lamp examination, microscopic examination and culture of corneal scrapings, HE staining of corneal sections, and pathological scoring of the infections. RESULTS: Four rats and 6 mice in group A, 7 rats and 8 mice in group B, and 10 rats and 10 mice in group C developed typical Acanthamoeba keratitis. CONCLUSION: Corneal scratching alone has the lowest infection rate, while scratching and then covering with contaminated contact lenses has a moderate rate of infection and most closely mimics what happens in most human infections. Intrastromal injection of Acanthamoeba gives a much higher infection rate and more severe Acanthamoeba keratitis.
Acanthamoeba/growth & development ; Acanthamoeba Keratitis/*parasitology/pathology ; Animals ; Contact Lenses/adverse effects/parasitology ; Cornea/parasitology/pathology ; Disease Models, Animal ; Female ; Male ; Mice ; Microscopy ; Rats ; Rats, Wistar

Objective To investigate fluorescence intensity of lipid ultrasound microbubbles constructed in vitro and targeted to leukaemia inhibitory factor receptor (LIFR) with a monoclonal antibody.MethodsThe LIFR-targeted ultrasound mierobubbles (MB-BSB-LIFR-AB) were constructed using a technology of biotin-avidin bridge.FITC labeled Avidin was incubated with lipid ultrasound microbubbles (MB) and biotinylated lipid microbubbles (MB-B).Two dilutions (1:4 and 1:16) of DTAF second antibody were incubated with four types of ultrasound microbubbles,including MB,MB-B,biotinavidin-MB (MB-BS),MB-BSB-LIFR-AB.The fluorescence intensity of microhubbles were graded as 0,1,2to 3.ResultsAfter incubating with FITC-avidin,MB-B displayed bright green fluorescence ( grade 3),but MB had no fluorescence ( grade 0).After incubating with two dilutions of DTAF second antibody (1:4 and 1:16),MB-BSB-LIFR-AB displayed brightest green fluorescence (grade 3) in both concentration,while MB-BS and MB-B only displayed dim green fluorescence (grade 1 ) at the dilution of 1:4,with MB displaying no fluorescence at either dilution (grade 0).Conclusions LIFR monoclonal antibody can be effectively conjugated to MB-B with biotin-avidin bridge.Fluorescence detection is a simple method for investigating the conjugation reliability of targeted lipid ultrasound microbubbles.

Objective To assess the adhesive behavior of dual-targeted microbubbles carrying both Sialyl Lewisx and anti-ICAM-1 monoclonal antibodies in vitro. Methods Selectin-targeted (with Sialyl Lewisx) microbubbles (MB-S),ICAM-1-targeted (with anti-ICAM-1 monoclonal antibodies) microbubbles (MB-Ⅰ),and dual-targeted (with both ligands) microbubbles(MB-D) were prepared by attaching the ligands to the biotinylated lipid-microbubbles via multi-step avidin biotin bridging chemistry. A parallel plate flow chamber combined with a novel automated tracking algorithm,were used to analyze the transient velocities,rolling and firmly adherent numbers of microbubbles at various shear stress (0. 6,2.0 and 4.0 dyn/cm2)over 6 min. Microbubbles detachments were tested by ramping up the shear stress at 30 s intervals. Results At 0.6 dyn/cm2 shear stress, the rolling numbers of MB-S and MB-D were remarkably more than that of MB-I( P＜0.05), while at 2.0 and 4.0 dyn/cm2 MB-S performed higher rolling efficiency as compared with either MB-I and MB-D ( P＜ 0.05). In all flow conditions, the adhesive numbers of MB-D to the targets were obviously greater than those of MB-S and MB-I ( P＜ 0.05). Half-maximal detachment decreased gradually in MB-I, MB-D and MB-S by turns ( P＜ 0.05). Conclusions MB-I, MB-S and MB-D have different adhesive behaviors. MB-I exhibites primarily firm adhesion with low rolling efficiency, while MB-S reveales unstable or transient adhesion with high rolling efficiency,and MB-D exhibites firm adhesion with high rolling efficiency. MB-D may be suitable for molecular imaging in high-flow vessels.

Objective:To investigate the expression and significance of B cell activating factor (BAFF) and a proliferation-inducing ligand ( APRIL) in children with acute lymphoblastic leukemia ( ALL).Methods:The mRNA and protein expressions in ALL.