OBJECTIVE To study commonly encountered pathogenic bacteria leading to lung infection and their drug sensitivity. METHODS In the period of Jan 2003 to Feb 2005,the pathogenic species and drug sensitivity of 233 positive samples isolated from 496 phlegm samples were analyzed.RESULTS Totally 234 strains of pathogenic bacteria were(isolated) from 233 phlegm samples.It had been found that 132 strains of Gram-negative bacilli,(accounted) for(56.4%);57 strains of Gram-positive cocci,accounted for 24.4 %;41 strains of fungi,accounted for 17.5%;and 4 strains of Gram-positive bacilli,accounted for 1.7%.The pathogens of the highest infective rate were:(Pseudomonas) aeruginosa(15.4%),Candida albicans(11.6 %),Enterobacter cloacae(6.0%),Klebsiella(pneumoniae)(5.6%),Escherichia coli(5.1%),Staphylococcus aureus(4.3 %),Streptococus pyogenes((4.3%)),Acinetobacter baumannii(3.6%),and C.tropicalis(3.6 %).Results of drug sensitivity indicated that drugs selected sensitive to Gram-negative bacilli were:imipenem(75.4%),piperacillin/tazobactam(38.9%),(ciprofloxacin)(37.3%),gentamicin(37.3%),and amikacin(36.5%).Drugs sensitive to Gram-positive cocci were:vancomycin(75%),rifampin(55%),and erythromycin(35%).CONCLUSIONS The commonly encountered pathogens of lung infection in our hospital are: P.aeruginosia,C.albicans,E.cloacae,K.pneumoniae,E.coli,S.aureus,and S.pyogenes.Infective rate of Candida is increasing evidently.Antibiotic resistance of bacteria(becomes) severe,drugs applied became less and less.Clinic should(actively) develop phlegm cultivation and drug sensitivity test,applying antibiotics reasonably,reducing production of bacteria resistant to drugs.

Objective To investigate the infection status of hepatitis virus among the perinatal women in Nanjing.Methods 523 samples of perinatal women's serum were selected.The hepatitis virus markers were detected by the ELISA kit,the quantitive detection of HBV surface-antibody was detected by electrochemiluminescence immunoassay.Results The positive rate of anti-HAV IgM was 0.19％,47 cases were HBV surface antigen-positive,accounted for 8.99％,183 cases were HBV surface antibody-positive,accounted for 35.00％,224 cases were all negative HBV markers,accounted for 42.83％.The quantitive detection of HBV surface-antibody in high concentration was significant higher than middle concentration and low concentration (all P ＜ 0.05).The positive rate of anti-HCV IgG was 1.34％,anti-HDV IgG was all negative.The positive rate of anti-HEV IgM was 0.57％.The positive rate of anti-HEV IgG was 24.28％.With the advance of age,the positive rate of anti-HEV IgG had an increasing trend,with significant difference among groups (P ＜ 0.05).Conclusion There are important significances in the detection of hepatitis virus markers in pregnancy monitoring,it can improve the quality of the population.

Objective To study the correlation between blood uric acid level and blood pressure among general population.Methods 1 694 healthy cases exclusion of hypertension,hyperuricemia and related diseases were enrolled in the study.The levels of blood uric acid,blood pressure,body mass index,fasting glucose,triglycerides,cholesterol were detected and compared.Results In prehypertension group,the levels of uric acid (344.5 ± 41.37)μ mol/L,shrink blood pressure (124.85 ± 7.52) mmHg,diastolic blood pressure (79.46 ± 6.62) mmHg,cholesterol (1.66 ± 1.10) mmol/L,triglycerides (4.69 ± 0.87) mmol/L,fasting plasma glucose (4.98 ± 1.01) mmol/L were significantly higher than those in the normal blood pressure group [(304.09 ± 63.75) μ mol/L,(106.12 ± 8.10) mmHg,(68.53 ± 6.26) mmHg,(1.30 ± 0.87) mmol/L,(4.52 ± 1.02) mmol/L,(4.78 ± 0.70) mmol/L] (t =15.32,49.14,34.81,7.48,3.57,4.67,all P ＜ 0.01).With the increase of uric acid,the levels of shrink blood pressure andthe diastolic blood pressure had an increasing trend(P ＜ 0.01).In prehypertension group,the uric acid level of men was (363.16 ± 32.05) μmol/L,which was significantly higher than female (311.35 ± 34.81) μmol/L (t =22.39,P ＜ 0.05).Conclusion Blood uric acid level and blood pressure level are closely related among general population,the serum uric acid increased in prehypertensive patients.The serum uric acid can provide useful prognostic information in subjects with the hypertension and the cardiovascular disease.

Objective To investigate the therapeutic methods for hypertrophy of nasal tip so as to create an aesthetic shape of nasal tip. Methods The “seagull-wing incision”was used in all patients. According to various nasal tip contours, trimming of soft tissues and reconstruction of alar cartilage were preformed simultaneously. Excessive soft tissue between skin and alar cartilage was removed; after exposing the domal segment of the alar cartilage, cartilage was resected from lateral crus to middle crus with a width of 0.2 cm marginal lateral crus was left. The shape of nasal tip was recontoured by middle crus suture technique. Others deformities of nose were corrected then: 10 patients with flat and low nasal tip were operated for nasal augmentation; 9 patients with thickening nasal wing were operated for thinning rim; 3 patients with wide bases of nasal wing were operated for shortening width through intraoral approach and one patient with broad nasal bone was operated with osteotome, infractured and displaced in the midline. An exteral splint was placed over the tape for 5-7 days postoperatively. Results Since 1995, follow-up for 3 to 24 months showed that 25 cases had achieved satisfactory cosmetic effects without secondary deformity except 3 early cases. Conclusion Trimming of soft tissues and reconstruction of alar cartilage are effective methods for correction of hypertrophy of nasal tip.

Objective To explore the diagnostic value and clinical significance of simultaneous detection of AFP,AFU and TSGF in patients with primary hepatic carcinoma(PHC).Methods Serum AFP,AFU and TSGF were detected simultaneously in 62 patients with PHC and 30 controls.Results The levels of AFU and TSGF in primary hepatic carcinoma were all significantly higher than that of controls(P

[Objective] To observe the clinical effect of Shenfu Decoction and Compound Red Sage Injection on new infants respiratory distress syndrome.[Method] Randomly divide 42 cases into 2 groups,control group(1)take the integrated therapy:CPAP,oxgen,warming,keeping wet and anti-bacterial;the treatment group(1)take the Shenfu Decoction and Compound Red Sage Injection.Compare their cure rates after 7d.[Result] In group 1,survivable rate was 95.23%,cure rate 71.4%;and 80.95% and 47.62% respectively for other group;the clinical symptoms,signs,blood-gas analysis and X-ray result were all better in group 1 than group 2.[Conclusion] Oral taking Shenfu Decoction and Compound Red Sage Injection for vein drip can help relieve infants clinical symptoms and pass alveolus superficial active substance lack period.

Objective To investigate the clinical application of fecal calprotectin in inflammatory bowel disease (IBD).Methods Colonoscopy took 79 patients with IBD that were diagnosed with pathology,including 47 cases of ulcerative colitis (UC) patients,32 cases of Crohn's disease (CD).Moreover,42 cases of IBD patients without abdominal pain,diarrhea and other intestinal inflammation were used as disease control group,and 34 cases of healthy people were used as healthy control group.The level of fecal calprotectin in each group was detected by enzyme-linked immunosorbent assay (ELISA).Results The positive rate of fecal Calprotectin in IBD group,disease control group and the healthy control group was 57.0％,19.0％,and 0,respectively; each positive rate in IBD group was significantly higher than the other two groups (P ＜ 0.05).The serum concentration of fecal calprotectin in IBD group [(493.86 ±204.18) μg/g] was significantly higher than the disease control group [(71.46 ± 60.51) μg/g] and the healthy control group [(36.19 ± 13.46) μg/g] (P ＜ 0.05) ; IBD active calprotection [(1015.23 ± 324.96) μg/g] was significantly higher than resting [(52.69 ±34.71) μg/g] (P ＜0.01).Conclusions Fecal calprotectin test benefits early diagnosis of IBD,and may be taken as the diagnostic index of IBD activity.It has extensively clinical value.

Objective To establish a real-time fluorescence quantitative methylation assay to investigate the methylation status of GSH-sulphur-transferase P1(GSTP1) gene promoter region in hepatocellular carcinoma(HCC) and to investigate whether which can be used as the early diagnostic indicator of HCC .Methods Ninety-five serum samples were collected from 40 patients with HCC ,30 patients with liver cirrhosis and 25 individuals with healthy physical examination as controls .The methylation level of GSTP1 gene in these serum samples were quantitatively determined by using the real-time fluorescence quantitative methylated spe-cific PCR technique .The receiver-operation characteristic(ROC) curves were adopted to evaluate its diagnostic value for HCC .Re-sults The methylation quantitative level of GSTP1 gene in HCC serum was significantly higher than that in the healthy controls (P<0 .05) .The ROC curve analysis demonstrated that the methylation quantitative analysis of GSTP1 gene could efficiently distin-guish HCC and cirrhosis from healthy controls (AUC=0 .8641) .With the methylation rate of 2% as the critical value for diagno-sing HCC ,its diagnostic specificity was 87 .5% ,the sensitivity was 69 .6% ;the combination detection of serum GSTP1 gene methy-lation and serum AFP could increase the detection rate of HCC to 75% .Conclusion The real-time fluorescence quantitative methyl-ation assay can accurately quantify the methylation level of serum GSTP1 gene ,which has certain application value for the early di-agnosis of HCC .

ObjectiveTo compare the sedative effect and safety of dexmedetomidine and midazolam in the intensive care unit (ICU) patients undergoing ventilator bundle treatment.MethodsA prospective single-blind randomized controlled trial (RCT) was conducted. Ninety patients receiving ICU ventilator-assisted therapy and ventilator bundle treatments for more than 3 days in the First Department of Critical Care Medicine of the Second Hospital of Lanzhou University from January 2013 to December 2014 were enrolled. The patients were randomly divided into two groups for sedative treatment. The patients in dexmedetomidine group (n = 42) were given dexmedetomidine 0.2-0.7μg·kg-1·h-1 to achieve a goal of satisfactory sedation [Richmond agitation-sedation scale (RASS) score 0 to - 2 during the day, and -1 to -3 at night). The patients in midazolam group (n = 48) were given midazolam 2-3 mg intravenously first, and then 0.05 mg·kg-1·h-1 for maintenance. The drug dose was adjusted according to RASS every 4 hours to maintain the appropriate sedation depth. The patients in both groups received continuous intravenous infusion of fentanyl for analgesia. Ventilator bundle treatments included the head of a bed up 30°to 45°, awaken and extubation appraisal, daily use of proton pump inhibitors for peptic ulcer prevention, prevention of deep vein thrombosis (DVT), chlorhexidine mouth nursing, and removal of sputum by suction from subglottic area. When the patients in both groups obtained satisfactory target sedation, daily awakening was conducted, and spontaneous breathing test (SBT) was carried out to determine optional weaning time. When the condition was optimal, weaning was conducted, otherwise ventilator bundle treatments were continued. The systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), respiratory frequency (RR) were monitored before and 15, 30, 60, 120, 180 minutes after the treatment, and at the moment of extubation and 30 minutes after extubation. The duration of mechanical ventilation, extubation time, length of ICU stay, and the incidence of adverse events were also recorded. Results Both dexmedetomidine and midazolam could give rise to sedation with same score of analgesia in patients in both groups, and similar effect of sedation and analgesia could be achieved. Compared with midazolam, dexmedetomidine could significantly reduce the duration of mechanical ventilation (hours: 108.33±21.96 vs. 119.85±20.29,t = -2.586, P = 0.011), earlier extubation time (hours: 112.95±22.20 vs. 128.58±26.18,t = -3.031,P = 0.003), length of ICU stay (hours: 149.21±20.47 vs. 163.88±33.59,t = -2.457,P = 0.016), the incidence of delirium [9.5% (4/42) vs. 31.2% (15/48),χ2 = 6.349,P = 0.012], but it would elevate the incidence of severe hypotension [28.6% (12/42) vs. 8.3% (4/48),χ2 = 6.277,P = 0.012] and severe bradycardia [19.0% (8/42) vs. 8.3% (4/48),χ2 = 2.225,P = 0.136]. Both drugs could lower SBP, DBP, MAP, and HR, and the effect in dexmedetomidine group was more significant from 60 minutes after treatment [SBP (mmHg, 1 mmHg = 0.133 kPa): 113.12±14.42 vs. 124.40±15.79, DBP (mmHg): 69.02±9.62 vs. 76.94±10.41, MAP (mmHg): 83.76±10.50 vs. 92.77±11.87, HR (bpm): 79.19±12.28 vs. 87.42±17.77,P< 0.05 orP< 0.01]. Both sedatives could significantly lower the rate of spontaneous breathing, and the effect of midazolam group was more significant from 60 minutes after treatment compared with dexmedetomidine group (times/min: 18.27±4.29 vs. 20.07±4.11,P< 0.05).Conclusions The sedative effects of dexmedetomidine in the ICU patients treated with ventilator bundle treatment are satisfactory, and it can shorten the duration of mechanical ventilation, extubation time and length of ICU stay, reduce the incidence of delirium. However, monitoring should be strengthened in order to prevent and control the adverse effects such as severe hypotension and severe bradycardia.

Objective To screen potential serum HCC associated proteins with low molecular weight and low abundance for better understanding the pathological mechanism of HCC and discovering new biomarkers.Methods All serum samples were collected from 81 HBV-related HCC patients,43 chronic hepatitis B patients and 36 cirrhosis patients.Serum protein fingerprint profiles were first generated by selected WCX2 protein chip integrating with SELDI-TOF-MS,and then normalized and aligned by Ciphergen SELDI Software 3.1.1 with Biomarker Wizard.Comparative analysis of the intensity of corresponding protein fingerprint peaks in normalized protein spectra was performed.Some protein peaks with significant difference among HCC,cirrhosis and chronic hepatitis B groups were found.The reproducibility of the SELDI system was assessed before serum protein fingerprint profiles analysis.Results The intra-and inter-assay CV for intensity and m/z in this SELDI system were 17.46% and 0.024%,and 17.74% and 0.024% respectively.Total 128 protein fingerprint peaks between 2 000 to 30 000 Da were identified under the condition of signal to noise＞5 and minimum threshold for cluster＞20%.Eighty-seven proteins were found to significantly expressed between HCC and cirrhosis groups(P＜0.05).Of the above differential proteins,forty-five proteins had changes greater than two fold,including 15 up-regulated proteins and 30 downregulated proteins in HCC sera.Between HCC and chronic hepatitis B groups,nine of fifty-two differential proteins(P＜0.05) had intensities of more than two folds,including 2 up-regulated proteins and 7 downregulated proteins in HCC sera.Between cirrhosis and chronic hepatitis B groups,twenty-eight of seventynine significantly differential proteins(P＜0.05) changed greater than two folds in intensity,including 17 up-regulated proteins in cirrhosis seru and 11 down-regulated proteins in chronic hepatitis B sera.Analysis of above leading differential proteins among three diseases using subtraction difference mode,the 5 common down-regulated proteins 2 870,3 941,2 688,3 165 and 5 483 m/z in HCC sera and 2 common up-regulated proteins 3 588 and 2 017 m/z in cirrhosis and HCC sera were screened.But no statistic difference in the level of protein 2 017m/z was found between HCC group and normal group inour previous study.Conclusion Because the interference of unspecific proteins from hepatitis B and cirrhosis could be eliminated partly in HCC sera through subtraction difference analysis,these 6 common differential proteins (2 870,3 941,2 688,3 165,5 483,3 588 m/z)have obvious advantages of increased specificity for evaluating the pathological state of HCC and might become promising candidate biomarkers in the diagnosis of HCC.