OBJECTIVE To evaluate the oral decontamination effect of chlorhexidine on ventilator-associated pneumonia. METHODS One hundred and eight patients needing mechanical ventilation were randomly divided into two groups.This was a double-blind and placebo-controlled trial.Placebo group decontaminated oral cavity with saline and test group with 0.5% chlorhexidine.Finally we compared difference of the incidence of VAP,oropharyngeal colonization and endotracheal colonization between two groups. RESULTS There were no statistic differences between two groups in the age,gender,constituent ratio of underlying disease,APACHEⅡ and clinical pulmonary infection scores(CPIS).The incidence of VAP,early onset VAP,oropharyngeal colonization and endotracheal colonization in test group was statistically lower than those in placebo group. CONCLUSIONS Oropharyngeal decontamination with chlorhexidine reducg and delays the development of VAP in patients receiving mechanical ventilation.It is a safe and effective antiseptic solution in oral care.

The modernization of Traditional Chinese Medicine (TCM) is urgent need of the modern theory of TCM, is a consensus. But, How to establish and what kind of modern TCM theory, is far from a consensus. Based on the summarization of the common law in the construction of scientific theory, we are trying to give a answer that are expected to form a consensus. Firstly, we have illustrated the trend that the development of TCM theory should learn from the life and medical sciences theory function and value; Secondly, we have proven that TCM and TCM theory belongs to the traditional medicine and theory and pointed out the limitation of the traditional medicine, TCM and its theory. And then we have revealed the inevitable trend of traditional medicine, TCM and its theory development at home and abroad, logically obtained the inevitable choice of constructing the modern TCM basic theory; Lastly, we have analyzed the different discipline new theory construction process and method at home and abroad and discovered the common five steps rule, put forward three principles and five steps of constructing modern TCM basic theory, demonstrated its important role during the theoretical revolution promoting Chinese Medicine theory from phenomenon description to mechanism clarification and the scientific value of Chinese Medicine theory in the domestic and foreign development trend.

Objective To explore the role of coping styles and personalities in the etiology of Graves' disease (GD). Methods All participants (581 patients and 800 normal controls) completed the general information questionnaires,trait coping style questionnaires(TCSQ) and eysenck personality questionnaires revised,short scale for Chinese(EPQ-RSC). Basic characteristics of all subjects were documented, and logistic regression analysis was used to analyze the role of coping styles and personality in etiology of GD. Results The negative coping style(OR = 1.068,P=0.000) ,concealing character(OR = 1. 121, P=0.000) and internal and external personality (OR = 1.089, P = 0.005) neurotic personality (OR > 1.000, P< 0.05) were risk factors of GD( OR = 1. 162, P = 0.000) ,positive coping style was protective factor of GD( OR < 1.000, P<0.05). Conclusion Positive coping style and specific personality adjustment can prevent effectively onset of GD.

Objective To investigate the relationship between C-reactive protein (CRP) and carotid intima-media thickness in pa-tients with impaired glucose tolerance (IGT). Methods Senan CRP was measured with immunoturhidimetry and the carotid intima-media thickness (CAIMT) was measured using color Doppler in 108 patients with impaired glucose tolerance (IGT) and 80 subjects with normal glucose tolerance(NGT).Then we observed all IGT patients for 3 years using prospective follow-up method, Oral Glucose tolerance test (OGGT) and every index were measured in follow-up 1.5 year and 3 year. Results 2 objects were lost to follow-up. IGT group showed a significant higher CAIMT and CRP compared with NGT group. After follow-up 1.5 year and 3 year, the patients with impaired glucose toler-ance (IGT) were divided into type 2 diabetes (T2DM) group and IGT group based on the level of blood glucose. Both T2DM group and IGT group showed a significant higher CAIMT and CRP, compared with NGT group. The level of serum CRP of T2DM group was higher than that of IGT group, and the level of serum CRP of IGT group was higher than that of NGT group. There were great differences between each group.Linear correlation showed that the level of blood glucose was positively correlated with CRP and CAIMT in T2DM group after follow-up 3 year. CAIMT was positively correlated with the level of blood glucose and CRP. Mulfivariant stepwise regression showed that CRP was signifi-canfly correlated with the level of blood glucose and CAIMT. Conclusion Inflammation played an important role in the development of dia-betes, and it had great vessels complication. The patients with impaired glucose tolerance, who have high level of CRP, were facilitated to be diabetes, and they were at risk of getting great vessels complication during the phase of impaired glucose tolerance. So it would be helpful to prevent IGT patients with high CRP or CAIMT with anti-inflammatory therapy.

Objective To investigate the clinical value of galectin-3 expression on fine needle aspiration (FNA) smearsandtissueslicesof thyroid tumors in distinguishing benign from malignant tumors. Methods Galectin-3 expression on FNA smears and tissue slices of thyroid tumors from 72 thyroidectomy specimens was detected by immunochemical method (SP method). Results Galectin-3 expression was high on FNA smears and tissue slices of malignant thyroid tumors, whereas there was no or low expression of galectin-3 on FNA smears and tissue slices of benign thyroid tumors. The difference of positive rates of galectin-3 expression between malignant and benign thyroid tumors was significant on both FNA smears and tissue slices (? 2=43.73 and ? 2=48.16, respectively, both P0.05). Conclusion Galectin-3 expression is different between benign and malignant tumors. Galectin-3 expression level is higher in FNA smears and tissue slices of malignant thyroid neoplasms than that of benign ones, suggesting that galectin-3 is a reliable molecular marker in distinguishing benign from malignant thyroid tumors. Galectin-3 expression with immunochemical method may be used in diagnosing benign or malignant thyroid tumors.

OBJECTIVE: To analyze the monosyllabic and sentence lists of Mandarin speech test materials (MSTMs) which have been evaluated the equivalence of difficulty, and to establish the performance-intensity function (P-I function) for people with normal hearing. METHOD: Forty subjects (the age-ranged from 18 to 25 years old) who speak Mandarin well in their daily lives with normal hearing participated in this study. Eight of them joined the pilot study, which aimed to identify an appropriate presentation level for the formal test. Thirty-two subjects participated in the formal speech perception test. The results were analyzed by Statistical Package for the Social Sciences (SPSS) software version 11.0. Seven monosyllabic lists (50 words per list) and 15 sentence lists (50 key words per list) were used. RESULT: The results showed P-I function of 3.1% per dB for monosyllabic Mandarin materials and 7.4% per dB for sentence Mandarin materials. The sound pressure level of speech corresponding to a 50% recognition score for monosyllabic lists was 30.1 dBSPL or 10.1 dBHL, and 23.1 dBSPL or 3.1 dBHL for sentence lists. CONCLUSION The study established the P-I function of the Mandarin monosyllabic and sentence materials with equal difficulty, which provides the normative data for identifying the normal hearing in a clinical setting.
Adolescent ; Adult ; Audiometry, Speech ; Female ; Humans ; Language ; Male ; Speech Discrimination Tests ; Young Adult

BACKGROUNDStatin therapy has affected glucose homoeostasis of type 2 diabetes patients, which could be related with bile acids metabolism. Whether bile acid metabolism and the expression of farnesoid X receptor (FXR), liver X receptor-α (LXR-α) and sterol regulatory element-binding protein (Srebp)-1c is regulated by hyperglycemia, or whether simvastatin therapy led to higher glucose is related with down-regulated expression of FXR in diabetic rats remained unclear.

METHODSForty male Wistar rats were randomly divided into four groups: normal control rats, insulin resistance rats, diabetic model rats, and the late simvastatin induced diabetic rats. Normal control rats were fed with standard diet, others were fed with high-fat diet. Diabetic model rats were induced by a single intraperitoneal injection of streptozotocin (STZ). The late simvastatin induced diabetic rats started simvastatin administration after STZ induced diabetic model rats. Characteristics of fasting blood glucose (FPG), lipid files and total bile acids (TBAs) were measured and the oral glucose tolerance test (OGTT) was performed after overnight fasting at the eighth weekend. RNA and protein levels of FXR, LXR-α and Srebp-1c were tested by Western blotting and reverse transcription polymerase chain reaction (RT-PCR).

RESULTSThe insulin resistance rats showed higher glucose, lipid files and lower expression of FXR compared with normal control rats (P > 0.05). The diabetic model rats showed significantly higher glucose, lipid files, TBA and lower expression of FXR compared with insulin resistance rats (P < 0.05). The late simvastatin induced diabetic rats displayed higher glucose and TBA and lower expression of FXR compared with diabetic model rats (P < 0.05).

CONCLUSIONSChanges in bile acid homeostasis, including the alterations of bile acid levels and bile acid receptors, are either a cause or a consequence of the metabolic disturbances observed during diabetic models. Statin therapy induced hyperglycemia may be related with FXR, SHP, LXR-α and Srebp-1 pathways.

Animals ; Blood Glucose ; drug effects ; metabolism ; Diabetes Mellitus, Experimental ; drug therapy ; metabolism ; Glucose Tolerance Test ; Homeostasis ; drug effects ; Insulin Resistance ; physiology ; Liver X Receptors ; Male ; Orphan Nuclear Receptors ; metabolism ; Rats ; Rats, Wistar ; Receptors, Cytoplasmic and Nuclear ; metabolism ; Reverse Transcriptase Polymerase Chain Reaction ; Simvastatin ; therapeutic use ; Sterol Regulatory Element Binding Protein 1 ; metabolism