Objective:To investigate the effect of enteral nutritional support in treating COPD patients with respiratory failure and mechanical ventilation.Methods:40 patients were randomly divided into two groups:high-fat and low-carbohydrate enteral nutritional solution group(HL group) and ordinary enteral nutritional solution group(control group).The volume of expired gas(VE),carbon dioxide production(VCO2),partial pressure of carbon dioxide(PaCO2),respiratory quotient(RQ),serum albumin,immunoglobulin,total lymphocyte count(TLC) were detected.Results:VCO2 and PaCO2 were significantly decreased in HL group compared with control group(P

OBJECTIVE To analyze the characteristics of nosocomial infections,risk factors and prevention measures in patients with chronic severe hepatitis B.METHODS A retrospective review of the medical records of 354 patients with chronic severe hepatitis B admitted between Jan 2006 and Dec 2006 was performed.RESULTS The incidence of nosocomial infection in patients with chronic severe hepatitis B was 16.67% and mainly infection sites consisted of abdominal cavity(40.32%),and upper respiratory tract(22.58%).The most common infection(47.46%) was occurred during the period of hospitalization 15-30 days after and the most commonly pathogens were Gram-negative bacilli(68.75%).The infection risk factors were associated with invasive operation,hypoalbuminemia,endotoxemia,advanced age,antibiotics application and decrease in cell immune function.CONCLUSIONS It is important for the patients with chronic severe hepatitis B to strengthen management on related risk factors in order to prevent nosocomial infection effectively.

A new method has been established for simultaneous determination of anions and cations in fertilizer sample by multimodal liquid chromatography with direct conductivity detection. An Acclaim Trinity P1 column based on nanopolymer silica hybrid technology with multimodal separation functional groups reversed-phase/anion-exchange/cation-exchange was used for the analysis. The chromatographic conditions were optimized and the effect ion of eluent on retention was discussed. Eight ions ( Li+, NH+4 , K+, HCOO-, NO-2 , Cl-, NO-3 and Br-) were separated and determined simultaneously by using 25 mmol/L CH3 COONa solution containing 50% acetonitrile at pH=5. 0 as mobile phase. The flow rate was 0. 50 mL/min and the temperature was 30 ℃. Under the optimum conditions, the linear ranges of the method were in the range of 0 . 5-200 mg/L for all the ions with correlation coefficient of 0 . 9997-0 . 9999 . Whereas the detection limits (S/N=3) were in the range of 0. 16-1. 72 mg/L and the relative standard deviations (RSD, n=9) were in the range of 1 . 3-2 . 5%. The method was applied to the determination of anions and cations in the fertilizer samples with satisfied results and the recoveries were in the range of 95 . 8%-103 . 8%.

Objective:To investigate the relationship between the gene polymorphism cluster of differentiation 14 (CD14)-159C/T (rs2569190),and interleukin-8 (IL-8)-251A/ T (rs4073)and the susceptibility of necrotizing enterocolitis (NEC),to clarify the influencing factors of susceptibility of NEC and to provide genetics theory basis for the research on the pathogenesis of NEC. Methods:Total 28 newborns with NEC and 41 newborns without NEC were selected.The amplification of peripheral blood DNA was conducted by PCR.The genotypic and allelic frequencies of CD14-159C/T and IL-8-251A/T of the patients were detected by Sanger DNA sequencing method. The relationship between them and the susceptibility of NEC was studied.Results:The distribution of genotypic frequencies of CD14-159C/T and IL-8-251A/T was consistent with Hardy-Weinberg equilibrium (P >0.05).There were no significant differences of the allelic and genotypic frequencies of CD14-159C/T,or genotypic frequencies of IL-8-251A/T between two groups (P >0.05).While in NEC group,the T allelic frequency of IL-8-251A/T site was higher than that in control group (χ2 = 4.184, P = 0.041, OR = 2.14, 95% CI: 1.03 - 4.46 ). Conclusion:The polymorphism of CD14-159C/T is irrelevant to the pathogeny of NEC,but T allelic frequency of IL-8-251A/T site might be related to the susceptibility of NEC.So T allele in IL-8-251A/T may be one of the danger factors of NEC.

Objective To investigate the infection status of nanobacteria on patients of chronic hepatopathy and hepatocellular carcinoma,and evaluate the clinical value of PCR.Methods In sera of 68 cases of chronic hepatitis B(CHB),56 chronic severe hepatitis B(CSHB),66 cirrhosis of liver(CL)and 23 hepatocellular carcinoma(HCC),nanobacteria were detected by immunohistochemistry stain(IHC),Transmission Electron Microscopy(TEM)and polymerase chain reaction(PCR),compared with 40 healthy people.Results The positive rates of PCR were 27.69%,50.00%,61.29%,52.38% and 5.00% in patients with CHB,CSHB,CL,HCC and normal control respectively(P

Objective To investigate the relationship between the variation of endothelial progenitor cells (EPC) number and cardiovascular diseases (CVD) in maintenance hemodialysis (MHD) patients ,and discuss the function of EPC in the progression of CVD in MHD. Methods One hundred and fifteen MHD patients over 18 years whose dialysis vintage was over six months from Department of Nephrology, Renji Hospital, Shanghai Jiao Tong University School of Medicine were enrolled. They were divided into CVD group and non ? CVD group by medical history, electrokardiographie (EKG), cardiac ultrasound, peripheral vascular imaging and cardiovascular imaging. Peripheral blood (5 ml) was collected for detecting EPC number by flow cytometry as CD34/CD133/vascular endothelial growth factor receptor 2 (VEGFR2) cells. The EPC number between CVD group and non?CVD group was compared. The relationship between the decrease of EPC number and CVD risks in MHD patients was analyzed by logistic regression analysis. In a three?year follow?up, the death and new CVD events of the two groups were compared in order to discuss the relationship between EPC number and adverse events. Results Among 115 MHD patients, the average age was 61.57 ± 12.76, male/female was 71/44, the average dialysis vintage was (86.24 ± 56.31) months, the average Kt/V was 1.69 ± 0.29 and average ultrafiltration volume was (2.48 ± 0.90) L. Forty?four patients in 115 (38.3%) were with concurrent CVD. The EPC number in CVD group was significantly lower than that in non CVD group (P=0.015). The CVD group had higher serum phosphate (P=0.013), higher glycosylated hemoglobin (P<0.001), but serum calcium, intact parathyroid hormone (iPTH) and other indicators had no significant difference between two groups. Multiple Logistic regression analysis showed that older age (OR=1.061), history of diabetes (OR=9.796), dialysis vintage (OR=1.015), serum phosphate (OR=3.766), decrease of EPC number (OR=0.909) were the independent impact factors of CVD events in MHD patients. There were 22 patients of the 115 MHD patients had encountered a new CVD event in a three?year follow?up between December 2012 and December 2015, 9 patients from the CVD group and 13 patients from the Non?CVD group, and there was no significant difference between two groups (P=0.776). Nine patients from the CVD group and 7 patients from the Non?CVD group died in the follow?up, and there was no significant difference (P=0.111). Seventy?one MHD patients from the non?CVD group were divided into two groups by the median of EPC number. There were 3 patients in the higher EPC number group encountered CVD events and 10 patients in the lower EPC number group encountered CVD events, which had significant difference (P=0.024). Conclusion The decrease of circulating EPC number may be related with CVD events in MHD patients. Even adjusted by age, sex, diabetes, dialysis vintage and serum phosphate, decreased EPC number is still the independent risk factor of CVD events in MHD patients. The decrease of EPC number in MHD patients may be used to predict the occurrence of cardiovascular events.

Objective To investigate the long-term prognosis and possible risk factors of acute kidney injury(AKI)following cardiac surgeries. Methods Clinical data of 941 patients undergoing open heart surgery from January 2004 to June 2007 were retrospectively analyzed.Survival and renal function of above patients were informed through telephone or clinic follow-up till February 2010.Long-term survival was analyzed using risk-adjusted Cox proportional hazards regression model. Results Of the 941 patients after cardiac surgery,275(29.2%)developed AKI and 666(70.8%)did not.Survival was worse in patients with AKI(67.8%vs 85.6%,P<0.01)and was proportional to its severity (AKIN 1,2 and 3 stages:70.7%,62.3%and 58.6%,P<0.01).Although 90.5% of patients had complete renal recovery after AKI at discharge of hospital,they still had an increased risk for death during follow-up compared with patients without AKI (69.6% vs 85.6%,P<0.01).In the Cox proportional hazards regression model,age(HR=2.238),anemia (HR=1.625),prolonged operation time (HR=1.153),AKI severity (HR=1.473)were independent risk factors for long-term prognosis after cardiac surgery.At the end of the follow-up,patients with AKI had statistically higher Scr than non-AKI patients(107.6 μmol/L vs 83.0 μmol/L,P=0.014),and among those AKI patients,34.0%progressed into CKD 3-5 stages,34.8%developed double serum creatinine. Conclusions AKI is a risk factor for the long-term prognosis of cardiac surgery.Patients with complete renal recovery after AKI still has an increased risk for death and poor renal function compared with patients without AKI.

Objective To observe the influence of insulin therapy on the short-term prognosis of patients with acute ST-elevation myocardial infarction (ASTEMI) complicated with hyperglycaemia.Methods A total of 128 patients with ASTEMI complicated with hyperglycaemia were randomized into 2 groups:treatment group and control group.There were 64 patients(50.0％ )in the treatment group and 64 patients(50.0％ ) in the control group.All of the patients were given anticoagulants,antiplatelet drugs,statins,beta-receptor blockers,nitrates and angiotensin-converting enzyme inhibitors (ACEI)or angiotensin receptor blocker (ARB) Moreover,the patients in the treatment group were given extra 50 U insulin ( Novolin R) in 50 ml saline by venous infusion.In the treatment group,Venous blood samples were obtained before and 7 days after treatment to determine the fasting blood glucose and hs-CRP in serum; the levels of fasting blood glucose and hs-CRP and short-term prognosis were compared between the 2 groups.ResultsThe levels of fasting blood glucose in the treatment group were decreased significantly after treatment ( [ 5.4 ± 0.8 ] mmol/L vs [ 11.6 ± 2.3 ] mmol/L,P ＜0.01),but there was no significant change in the control group( [ 10.7 ± 2.1 ] mmol/L vs [ 11.2 ± 2.7]mmol/L,P ＞ 0.05 ).The levels of hs-CRP in both groups were decreased significantly after treatment (P ＜0.05),but it was much more obvious in the treatment group( [ 6.2 ± 1.5 ] mg/L vs [ 8.7 ± 1.8 ] mg/L,P ＜0.05).The incidence of major adverse cardiac events(MACE) during a 3 months′ follow-up in the treatment group was significantly lower than that in the control group ( 12.50％ vs 34.38％,P ＜ 0.05 ).Conclusion Insulin therapy can improve the short-term prognosis in patients with ASTEMI complicated with hyperglycaemia.

Objective To explore the correlation of ABO blood group and serum cystatin C level and decompensated hepatitis B cirrhosis.Methods Retrospectively analysed the clinical data of 472 patients with decompensated hepatitis B cirrhosis,and compared with 681 healthy control volunteers.All the informations such as gender,age,family history of liver disease,hepatitis B virus infection,hepatic function classification,complications of portal hypertension and the distribution of ABO blood group were observed.Results The highest incidence of decompensated hepatitis B cirrhosis was found in A blood group.There was no significant difference in the distribution of ABO blood group for patients with different age (P ＞ 0.05).Significant correlations were observed between AB blood group and family history of hepatitis B patients,expansion of the portal veines ＞ 1.5 cm,esophageal varices,cirrhosis complications,hepatic function classification (P ＜ 0.01).C ystatin C expression was increased with hepatic function classification (P ＜ 0.05).Conclusions The risk of liver cirrhosis is increased in patients with A blood group.Compare with other blood group,patients with AB blood group has a serious progression.The level of nitrogen,creatinine,cystatin C in decompensated cirrhosis are significantly higher than healthy controls.The level of cystatin C expression is increased with hepatic function classification.Cystatin C may be a potential marker in the classification of hepatic function.

Objective To develop the Assessment Scale for Patient Safety Culture in ICU and do psychometric test.Methods The Assessment Scale for Patient Safety Culture in ICU was developed based on literature review,qualitative interview,and two-round Delphi consultation.The reliability and validity were tested among 235 chnical nurses and doctors in ICU.Results A 45-item questionnaire was originally developed and eleven of them were deleted after subjective screening,project analysis and exploratory factor analysis.Seven factors were extracted with cumulative contribution rate of 59.347％.The scale of total Cronbach's alpha coefficient was 0.909; the split half reliability was 0.832.Each dimension of Cronbach's alpha coefficient was between 0.481～0.909,and the split half reliability was 0.481～0.866.All had significance in statistics above.Conclusions The Assessment Scale for Patient Safety Culture in ICU has good reliability and validity,which can be used to evaluate the ICU patient safety culture atmosphere domestically.