OBJECTIVE To investigate clinical status,distribution of the genera,and risk factors of pneumonia caused by fungi in hospitalized senile patients.METHODS The notices of hospitalized senile patients from Jan 2000 to Apr 2003 were analyzed according to Diagnosis Standard of Nosocomial Infection published by National Ministry of Health.RESULTS Totally 135 cases were collected.The isolating ratio of Candida albicans ranked first(54.8%),followed by C.tropicalis(20.0%).The risk factors included underlying diseases,invasive surgical procedure,and prolonged hormones and antibiotics therapy.CONCLUSIONS To prevent and control pneumonia caused by fungi in hospitalized senile patients,the measures such as curing the underlying diseases,reducing invasive surgical procedures,and using antibiotics reasonably should be adopted.

Multiple organ dysfunction syndrome(MODS),a hot topic worldwide,has made rapid progress with nigh mortality.MODS in pediatrics versus MODS in adults are similar but different.Due to special age-related physiological characteristics.It is difficult to carry out randomized controlled clinical study compared with adults.Diagnosis and treatment of pediatric MODS can only be obtained with reference to adult MODS.This study reviews on the epidemiology,clinical scoring system,pathogenesis,clinical features and treatment of MODS in pediatrics.

Objective To explore the temporal expressions of interleukin-10(IL-10)and interleukin-4(IL-4)and their relationship with the wound age during skin incised wound healing in mice.Methods Immunohistochemical and image-analysis techniques were employed in vital skin wounds 0.5h～168h after incision and postmortem incision 0.5h～6h after death.Results Weak expression of IL-10 was detected at 0.5h after incision,which increased subsequently,and peaked at 3h post-injury.Then decreased to the pre-incision level at 24h,but peaked again at 72h after injury.Immunostaining revealed that epidermal cells and infiltrating mononuclear cells were the major source of IL-10.IL-4-positive cells were observed in the dermis at 24h,and reached the maximum level at 96h,which maintained until 168h post-injury.IL-4 was mainly expressed in the fibroblast-like cells of the granulation tissue and dermis.In addition,faint IL-10-positive cells were merely identified in the epidermal cells in the postmortem incision skin within 1～3h after incision.No IL-4-postitive cells were found in the postmortem incision skin.Conclusion The time-dependent expressions of IL-10 and IL-4 during cutaneous wound healing may be used for the estimation of wound age.

Objective To investigate the clinical effects of open decompression drainage on acute pulpitis.Methods Totally 180 acute pulpitis patients hospitalized during January 2012 to September 2014 in our department were selected and randomly divided into control group and observation group (n=80 each).The control group was treated with pulp inactivating agent and the observation group was given open decompression drainage.The clinical effects,analgesia efficiencies at 7d after treatment,treatment course and the complications were compared between the 2 groups.Results There was significant difference in the effective rate between control and observation groups after treatment [61.3％ (49/80 cases) vs.86.3％ (69/80 cases),P＜0.05].The analgesia efficiencies at 7d after treatment was 46.3％ (37/80 cases) in control group and 73.8％ (59/80 cases)in observation group (P＜0.05).There was no significant difference in treatment course between two groups [(7.7±1.4) times vvs.(6.1± 1.2) times,P＞0.05]].6 patients developed periapical periodontitis in control group,and only 4 cases in the observation group (P＞0.05).Conclusions Early open decompression drainage has good clinical effects and analgesia efficiencies in treatment of acute pulpitis,which is worthy of clinical application.

Objective To investigate the effect of the locking plate fixation with anti-osteoporosis drug in the treatment of older patients with proximal humeral fractures. Methods Sixty-two patients with proximal humeral fractures who were treated in Yuzhou Mining Company Hospital of Kailuan Group of Hebei Province from Feb. 2011 to Oct. 2013 were divided into observation group(n=30)and control group(n=32). Patients in both groups were given locking plate fixation,and patients in the observer group were also received anti-osteoporosis treatment. The information including hospitalization periods,efficacy and bone mineral density of the two groups was recorded. Results The hospitalization periods of the observation group and control group were (6. 9 ± 1. 0)d,(9. 5 ± 1. 1)d,and the difference was statistically significant(t=8. 426,P﹤0. 05). The efficacy in observer group was excellent in 17 cases,good in 10 cases,fair in 2 cases and poor in 1 case,and the efficacy of the control group was excellent in 14 cases,good in 10 cases,fair in 5 cases and poor in 3 cases. The difference was statistically significant(χ2 =4. 617,P ﹤0. 05 ). After the anti-osteoporosis treatment,the bone mineral density of the observer group and control group were( 0. 79 ± 0. 13)g/cm2 and(0. 66 ± 0. 05)g/cm, the difference was statistically significant( t =10. 251,P ﹤0. 05 ). Conclusion The effect of locking plate fixation with anti-osteoporosis drug is better with shorter hospital stay,safe and reliable,and it is worthy of clinical application.

Objective To evaluate the accuracy of Doppler ultrasound (BUS), computer tomography (CT) and magnetic resonance imaging (MRI) in the diagnosis of hepatocellular carcinoma. Methods A total of 74 patients with hepatocellular carcinoma and cirrhosis who received a liver transplantation was included in this study. We compared the postoperative pathological results with preoperative imaging findings (BUS, CT, and MRI). An assessment was made in respect of the accuracy in tumor size (a diagnostic accordance was defined as

Objective To identify the metabolites of loganin in rat urine through using ultra high performance liquid chromatography combined with triple TOF mass spectrometry (UPLC-Q-TOF/MS/MS) after oral administration of loganin;To summarize the metabolic pathway of loganin. Methods Rats were given a gavage with loganin. The urine samples were prepared by use of solid phase extraction (SPE). The chromatographic separation was performed on an UPLC C18 column with gradient elution program of acetonitrile and 0.1% formic acid aqueous as mobile phase. Dynamic background subtraction (DBS) technology was employed to trigger information dependent acquisition (IDA) to obtain the characteristic fragment ions of metabolites. Results MetabolitePilot software including several data processing methods were employed to speculate the structures of liganin metabolites and three metabolites were identified. Then, the metabolic pathway of loganin in rats was summarized. Conclusion The analytical method was simple, credible and highly-sensible, which is useful for screening and identifying trace constituents in vivo.

Objective To discuss the effect of sIL-1RI on allograft survival after islet transplantation.Methods Islets were isolated and transfected with Ad-sIL-1RI-Ig.Mice were treated with STZ to induce insulin-dependent diabetes mellitus(IDDM) model.Islet transplantation was carried out to IDDM mice with sIL-1RI-Ig gene-modified islet cells.Then the survival time of grafts was tested by daily observing blood glucose and insulin levels.The expression of cytokines was detected in graft after transplantation by using RT-PCR. Pathological changes of the graft were also observed by chromoscopy with HE after transplantation.Results The survival time of the grafts in sIL-1RI-Ig-islet group (39±3 days) was prolonged significantly (P<0.01) as compared with controls.A down-regulation of cytokines expression was detected in grafts after transplantation.Less damage and infiltration of lymphocytes were found in sIL-1RI-Ig gene-transfected group.Conclusion The effects of islet cells modified with sIL-1RI-Ig before transplantation on the rejection of murine islet allograft were investigated.The results verified that sIL-1RI-Ig-modified islet allograft could prolong the survival of grafts significantly,and demonstrated it was possible that sIL-1RI-Ig preventedallograft rejection via reducing the expression of cytokines(TNF-α,IFN-γ,RANTES,etc.).

Objective To explore the sleep quality and its influencing factors among the patients with schizophrenia of Hui and Han populations in the rural areas in Ningxia Hui Autonomous Region.MethodsTotally 296 patients with schizophrenia of Hui and Han populations in the rural areas were selected from 2 counties of Wuzhong and Zhongwei in Ningxia Hui Autonomous Region by using cluster random sampling method.Self-made general information questionnaire was used to collect the demographic and clinical characteristics of the patients with schizophrenia.The Pittsburgh Sleep Quality Index(PSQI) was used to evaluate the sleep quality.Brief Psychiatric Rating Scale(BPRS),Hamilton Depression Scale(HAMD) and Hamilton Anxiety Scale(HAMA) were used to measure the psychotic symptoms,depressive symptoms and anxiety symptoms,respectively.ResultsIn the rural areas,the incidence of sleep disorder in the patients with schizophrenia of Hui and Han populations was 84.5%.The influencing factors of sleep disorder in the patients with schizophrenia in the rural areas were age(B=0.055,P=0.012,OR=1.057,95%CI:1.012-1.103),nationality(B=2.250,P<0.01,OR=9.485,95%CI:2.701-33.319),marital status(B=-1.506,P=0.003,OR=0.222,95%CI:0.081-0.605),course of disease(B=-0.003,P=0.089,OR=0.997,95%CI:0.993-1.001),the total score of HAMD(B=0.079,P=0.007,OR=1.083,95%CI:1.021-1.148)and the total score of HAMA(B=0.060,P=0.036,OR=1.061,95%CI:1.004-1.122).ConclusionSleep disorders are common and associated with multiple factors in patients with schizophrenia of Hui and Han populations in Ningxia rural area.In clinical practice,more attention should be paid to the identification and intervention of sleep disorders,so as to improve the sleep quality for the patients with schizophrenia.

The understanding of anatomical structures and their adjacent relationship is the founda-tion and key to the development of surgical skills and clinical thinking. In clinical teaching for residents and graduate students , we took the advantage of donor operations in organ transplantation and showed abdominal anal operations anatomical features and relationships through different view angles and compre-hensive ways. This new teaching approach was designed in accordance with processes of organ donation, procurement and back-table operation. The main contents included anatomy of abdominal wall layers, rela-tionships among abdominal organs, locations and courses of important structure, as well as medical human-istic education. In the context of organ donation becoming more and more popular and standardized after the cardiac death of Chinese citizens, this teaching approach is worth exploring.