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.

Objective This study was carried out to reveal the photocatalytic degradation characteristics of Bisphenol A,a representative endocrine disruptor,with immobilized nanometer TiO2 catalyst supported on fiberglass net.Methods The effects of photolysis under black light lamp and cold cathode low-pressure mercury lamp,and initial concentration(0.98-6.23 mg/L) on the degradation of bisphenol A(BPA) was explored by photoreactor in laboratory.Photocatalytic mineralization and intermediates under different irradiations was also investigated.Results It was found that the reaction kinetics was first order with respect to BPA concentration,and the apparent kinetic constants decreased with the increase of initial concentration.Photodecomposition of BPA under black light lamp irradiation was caused by not photolysis but photocatalysis,while that under cold cathode low-pressure mercury lamp was caused by the synergistic effect of photolysis as well as photocatalysis.Further studies showed that photocatalytic mineralization of BPA differed greatly under those different irradiations.1,4-benzoquinone,p-dihydroxybenzene,methyl p-hydroxybenzoate,D-hydroxyacetophehone,1-(4-hydroxyphenyl)-1-propanone,1-(4-hydroxyphenyl)-vinyl alcohol were identified as intermediates under black light lamp,and 3-hydroxyl-3-crotonic acid,4-hydroxybenzaldehyde,D-hydroxyacetophehone,2-acetyl-3-methoxyl-5,8-dihydroxy-1,4-naphthoquinone,3,4-di-(4-hydroxyphenyl)hexane were found under cold cathode low-pressure mercury lamp.Conclusion The differences of photocatalytic mineralization under different illumination are attributed to the molecule structure with two benzene-rings.

砄bjective:To investigate the expression of integrin ? 1 during mandibular fracture healing.Methods:Rabbit mandibular fracture model was used,the fractured bone tissues were obtained and paraffin slices were made on the day 1,3,5,7,14,30,60 and 90 after surgery respectively.Non fractured mandible was used as the control.The expression of integrin ? 1 in bone tissue, especially in osteoblasts and osteoclasts, was studied with LsAB immunohistochemical method.Results:Integrin ? 1 was widely espressed in the bone tissure close to fracture and surrounding soft tissue.In osteoblasts increased expression of integrin ? 1 was observed on day 7,maximum on day 14～30 and normal on day 90.While in osteoclasts,it was increased and kept at maximum 14～90 days aftere fracture.Conclusion:During mandibular fracture healing,the expression of integrin ? 1 in bone,especially in osteoblasts and osteoclasts,was increased.Integrin ? 1 has a critical influence on bone fracture healing.

Objective To evaluate the effect of airway pressure release ventilation (APRV) in patients with acute lung injury/acute respiratory distress syndrome (ALI/ARDS), to evaluate the extent of ventilator-induced lung injury (VILI), and to explore its possible mechanism. Methods A prospective study was conducted in the Department of Critical Care Medicine of the First Hospital of Hebei Medical University from December 2010 to February 2012. The patients with ALI/ARDS were enrolled. They were randomly divided into two groups. The patients in APRV group were given APRV pattern, while those in control group were given lung protection ventilation, synchronized intermittent mandatory ventilation with positive end-expiratory pressure (SIMV+PEEP). All patients were treated with AVEA ventilator. The parameters such as airway peak pressure (Ppeak), mean airway pressure (Pmean), pulse oxygen saturation (SpO2), mean arterial pressure (MAP), heart rate (HR), central venous pressure (CVP), arterial blood gas, urine output (UO), the usage of sedation and muscle relaxation drugs were recorded. AVEA ventilator turning point (Pflex) operation was used to describe the quasi-static pressure volume curve (P-V curve). High and low inflection point (UIP, LIP) and triangular Pflex volume (Vdelta) were automatically measured and calculated. The ventilation parameters were set, and the 24-hour P-V curve was recorded again in order to be compared with subsequent results. Venous blood was collected before treatment, 24 hours and 48 hours after ventilation to measure lung surfactant protein D (SP-D) and large molecular mucus in saliva (KL-6) by enzyme linked immunosorbent assay (ELISA), and the correlation between the above two parameters and prognosis on 28 days was analyzed by multinomial logistic regression. Results Twenty-six patients with ALI/ARDS were enrolled, and 22 of them completed the test with 10 in APRV group and 12 in control group. The basic parameters and P-V curves between two groups were similar before the test. After 24 hours and 48 hours, mechanical ventilation was given in both groups. The patients' oxygenation was improved significantly, though there were no significant changes in hemodynamic parameters. The Pmean (cmH2O, 1 cmH2O = 0.098 kPa) in APRV group was significantly higher than that in control group (24 hours: 24.20±4.59 vs. 17.50±3.48, P < 0.01; 48 hours: 18.10±4.30 vs. 15.00±2.59, P < 0.05). After ventilation for 24 hours, the ratio of patients with increased Vdelta in APRV group was higher than that in control group (90% vs. 75%), but without statistical difference (P > 0.05). The SP-D level (μg/L) in serum in APRV group showed a tendency of increase (increased from 19.70±7.34 to 27.61±10.21, P < 0.05), in contrast there was a tendency of decrease in control group (decreased from 21.83±7.31 to 16.58±2.90, P > 0.05), the difference between the two groups was statistically significant (P < 0.05). After 48-hour ventilation, SP-D in APRV group was decreased, but no change was found in control group, and no significant difference was found as compared with that of the control group (16.45±8.17 vs. 17.20±4.59, P > 0.05). There was no significant difference in serum KL-6 between the two groups before and after ventilation. The SP-D and KL-6 levels in serum were unrelated with 28-day survival rate of the patients. The odds ratio (OR) of SP-D were 0.900 [95% confidence interval (95%CI) = 0.719-1.125], 1.054 (95%CI = 0.878-1.266), 1.143 (95%CI = 0.957-1.365), and the OR of KL-6 were 1.356 (95%CI = 0.668-2.754), 0.658 (95%CI = 0.161-2.685), 0.915 (95%CI = 0.350-2.394) before the test, 24 hours and 48 hours after ventilation (all P > 0.05). Conclusions APRV was similar to lung protective ventilation strategy in oxygenation and improvements in the lung mechanics parameters. APRV with a higher Pmean can recruit alveolar more effectively, and it had no impact on hemo-dynamics, but might exacerbate VILI.

AIM: To construct a human recombinant immunoglobulin library containing D-Dimer by using phage surface display technology. METHODS: Human immunoglobulin heavy chain and light chain genes were amplified respectively by RT-PCR from different human lymphocytes using family specific primers and signal sequences of immunoglobulin as half-nested PCR primers. The heavy chain and light chain PCR products were cloned into phagemid vector pComb3H and the human immunoglobulin recombination library was generated with helper phage VCSM13. RESULTS: A human combinatorial antibody library consisting of 2.8?10~8 in dependent clones was generated with a titer of 4.1?10~(17)PFU/L. The recombinant frequency of Fab genes was 46%. CONCLUSION: A human combinatorial antibody library was generated. It will be beneficial for selecting Fab antibodies of D dimer from the library.

BACKGROUND:Studies have shown that placement, needling point, angle and length of pedicle screws for thoracic vertebral fractures have been unified. Many studies concerned axial pul-out force and biomechanical behavior of a single screw, but few reports addressed the biomechanical behavior after the replacement with three kinds of screw connecting to rods. OBJECTIVE:To further observe and compare biomechanical behavior after three kinds of thoracic screw placement connecting rod using biomechanical testing, to understand the strength of thoracic pedicle screw replacement connecting rods, and the effects of its puling out on the stress of the bone surrounding the placement site. METHODS:The fresh frozen specimens of thoracic vertebra were divided into three groups at random: the pedicle fixation group, the transverse process-vertebral body fixation group, and modified rib transverse process fixation group. Thoracic pedicle screw system was inserted by the standard placement method in each group. The experiment was measured on the mechanical equipment. During puling out, the strength that bone bore was described with dynamic curve, folowed by statistical analysis. The difference in the gripping force on the thoracic vertebra among three kinds of screw placement method was compared. RESULTS AND CONCLUSION: Among three kinds of screw placement methods and among three kinds of screw placement methods on the injured vertebral body, the gripping force was significantly bigger in the pedicle fixation group than in the transverse process-vertebral body fixation group and modified rib transverse process fixation group (P < 0.01). No significant difference in the gripping force was detected between the transverse process-vertebral body fixation group and modified rib transverse process fixation group. Results verified that the stability of loading ability was apparently better in the pedicle fixation group compared with the transverse process-vertebral body fixation group and modified rib transverse process fixation group.

Objective To compare the therapeutic effects and side effects of cisplatin-S-1 (CS) program and docetaxel-cisplatin-S-1(DCS) program on patients with malignant gastric tumor who were treated by laparoscopic gastrectomy.MethodsA total of 67 patients in our hospital from January 2010 to June 2013 were included in this study,of which 33 cases accepted cisplatin-S-1 program (CS group),34 cases accepted DCS program (DCS group).The related side effects including diarrhea,nausea and acute upper respiratory infection,change of routine blood tests,blood biochemical index,and death caused by chemotherapy were analyzed.The related index of surgery including operation time,blood loss,recovery time of gastrointestinal function,pain incidence,hospital stay,lymph nodes resection success rate,postoperative infection,obstruction,intestinal emptying delays were recorded.Meanwhile,the 3-year survival rate after operation and postoperative 3-year recurrence rate between the two groups were compared.Results There was no significant difference in operation time,intraoperative blood loss,postoperative recovery time of gastrointestinal function,the lymph nodes resection success rate,the incidence of postoperative pain,as well as the length of hospital stay,postoperative infection rate,and complications such as obstruction and intestinal emptying delays between the two groups(P>0.05).And there was no significant difference in chemotherapy-related complications between the two groups(P>0.05).But the postoperative 3-year survival rate and postoperative 3-year recurrence rate of DCS group was better than those of the CS Group(P<0.05).Conclusion There is no significant difference in complications and surgery-related index between the two preoperative chemotherapy.However,the DCS programs have more advantages in therapeutic effects.

Objective: To observe the clinical results of eyeball double perforation caused by metal foreign body treated by virectomy. Methods: By clinical examination combined with orbital CT, 12 eyes in 12 cases were diagnosed as eyeball double perforation caused by metal foreign body, all these eyes underwent vitrectomy, endocoagulation, and C_3F_8 vitreous cavity tamponade. Postoperative follow-up ranged from 6 months to 5 years. Results: Nine eyes’ retina remained attached. 3 eyes with retina detachment and PVR were reoperated with vitrectomy and silicon oil tamponade, and the retina reattached. Conclusion: Orbital CT is an accurate and sensitive method in diagnosing eyeball double perforation caused by metal foreign body, vitrectomy is an efficacious surgical method in the treatment of eyeball double perforation.

Objective:To observe the clinic effectiveness of cryoretinopexy under light fiber illumination during vitreoretinal surgery. Methods: Twenty-two patients with complex retinal detachment underwent vitrectomy,fluid-air exchange,cryoretinopexy under light fiber illumination.Postoperative vitreous cavity tamponade was accomplished with silicone oil in 14 cases,perfluoropropane gas in 8 cases,8 cases combined with sclera encircling. Results: Postoperative follow-up ranged 3 months to 1 year,retinal tear or hole closed and retina reattached in 20 cases.The success rate of operation was 90.9%. Conclusion: Cryoretinopexy under light fiber illumination during vitreoretinal surgery positioning is easy and accurate and the effect is definite.

Objective To investigate the relationship between the incidence of dysphagia and the location of brain lesions in patients with acute stroke.Methods Swallowing function was assessed by Watin drinking water test within 48 hours after admission in 226 cases with acute stroke.The location of the brain lesions was identified by CT and / or MRI.According to the US National Institutes of Health Stroke Scale (NIHSS),evaluation of nerve functions was evaluated within 24 hours after admission in stroke patients.Results The incidence of dysphagia was 50.4％ (114 /226) in 226 patients in acute stage.The degree of neurological deficit of stroke patients on admission was significantly correlated with the occurrence of dysphagia (x2 =13.35,P=0.02).The incidence of dysphagia caused by lesions in internal carotid artery trunk (hemisphere in combination with basal ganglia/internal capsule) was more common in anterior circulating territory(internal carotid artery system),dysphagia with internal carotid arterg(ICA) trunk occlusion (hemisphere in combination with basal ganglia/internal capsule) was more common than that caused by cortex branches occlusion (hemisphere-cortex) or penetrating ICA injuries (basal ganglia/internal capsule) and cortex branches occlusion (hemisphere-cortex),respectively(x2 =8.228,P＜0.05).The incidences of dysphagia induced by brain lesions of different cortex lobes had no statistic differences(x2 =0.312,P＞0.05).In posterior circulating territory (vertebro-basilar system),the incidence of swallowing disorders was significantly higher in brain stem group than in the thalamus and cerebellum (x2 =27.292,P＜0.001).The incidence of the dysphagia caused by lesions in cerebral hemispheres,combined basal ganglia / internal capsule and brain stem lesions were significantly higher than those caused by other lesions(x2 =35.639,P＜0.000).Conclusions Brain lesions of hemisphere combined basal ganglia/internal capsule and brain stem are significantly associated with the occurrence of dysphagia after acute stroke.