Center vein puncture is important to the clinical infusion technology, however, its correlation infection rates rising trend year by year, especially catheter-related bloodstream infections have become one of the main reasons for primary bacteremia, seriously affected the patients survival rate, and the processing method of catheter-related bloodstream infections are intricate. The treatment and nursing of adult bloodstream infections caused by short-term central venous catheter (including peripheral central venous catheter placement) according to the provisions of the Infectious Diseases Society of America to update the catheter related infections of diagnosis and treatment guidelines are reviewed in this paper, to provide reference for management of adult short-term central venous catheter.

Hierarchical medical system is a high priority in China ’s health reform,bearing significant impacts on remolding of its healthcare system,in which tertiary public hospitals must redefine its role.Five strategies have been proposed as follows:the first is internal management;The second is high-tech;Third is paring assistance;Fourth is telemedicine;Fifth is better medical conditions.

Objective To study the preparation of quercetin compound cream and establish its standard of quality control. Methods The composition of recipe and manufacturing technique were designed.The content of components were determined by HPLC,and its stability tests were carried out.Results The product was a kind of yellow smooth cream.The linear ranges were 0.053-1.696 μg for quercetin(r=0.999 9),0.053-1.696 μg for 8-methoxypsoralen(r=0.999 8)and 0.100-1.000 μg for beta-methasone(r=0.999 9).The average recovery rate were 99.83%,99.52%,and 99.74% of quercetin,8-methoxypsoralen,and beta-methasone(n=9).After 12 months′long term stability test,all the 3 batches of sample preparations were in line with relevant regu-lations.Conclusion The designed recipe was reasonable,and the manufacturing technique was feasible,with stable and controllable quality.

AIM: To investigate the inhibitory effect of vector-based RNA interference(RNAi) on the expression of melanoma associated antigen A3(MAGEA3) protein in hepatocellular carcinoma cells and on apotposis of hepatocellular carcinoma cells.METHODS: A vector for transcribing specific small hairpin RNA(shRNA) targeting MAGEA3 gene was constructed,introduced into hepatocellular carcinoma MEL-ED1 cells by Lipofectamine 2000.The MAGEA3 protein and mRNA expression levels of MEL-ED1 cells were detected by Western blotting and RT-PCR, respectively.The cell apoptosis was studied by DNA fragmentation,electron microscopy,TUNEL assay,and annexin V/PI staining.RESULTS: The vector of RNA interference was successfully constructed and MAGEA3 expression was descreased significantly in MEL-ED1 cells.After the shRNA expression vector was transfected into the MEL-ED1 cells,the expression of MAGEA3 gene was inhibited significantly(by 90%).DNA fragmentation,electron microscopy and TUNEL assay showed classic apoptosis characters in the MEL-ED1 cells transfected with pSilencer-MAGEA3 plasmid with an apoptosis rate of 21.41% ?1.98%,significantly higher than those in the negative control group transfected with pSilencer-neo and in the non-transfected group(both P

Objective To evaluate the therapeutic effects of methamphetamine (MA) dependence and the repairment of DA neuronal function by SPECT corpus striatum DAT visual digital neural molecular imaging techniques.Methods 25 MA dependent patients (BPRS score ≥ 35) were treated by self-designed treatment program for more than 6 months.The clinical therapeutic effects were scored with reducing rate of BPRS.MA dependent patients were examined by SPECT corpus striatum DAT imaging before and after treatment,while healthy volunteers were examined only once.The SPECT corpus striatum DAT images were analyzed visually and quantitatively.Results The reducing rate of BPRS showed that the total effective rate was 80.0％.Visual analysis of SPECT corpus striatum DAT images showed that the distribution of DAT in the corpus striatum was regionally reduced or defected in various degrees before treatment,and was significantly increased after treatment.Quantitative analysis showed that the bilateral striatal V ((19.26 ± 2.85) cm3),m((20.22±2.99) g) and Ra(4.78±0.79) ％) of MA dependent patients were significantly lower compared with those of the healthy volunteers(respectively (35.39±4.42) cm3,(37.16±4.64) g and (7.93± 0.86) ％) (all P＜ 0.01) before treatment and were significantly improved (P＜ 0.01) after treatment (V:(22.80±4.28) cm3,m:(23.93± 4.49) g and Ra:(5.64 ± 0.99) ％) with a 76.0％ corpus striatum DAT improvement rate.However,the bilateral striatal V,m and Ra of MA dependent patients after treatment were still lower than those of the healthy volunteers (P＜0.01).There was no significant difference between the striatal DAT improvement rate and the BPRS reduction rate (P＞ 0.05).Conclusion SPECT corpus striatum DAT visual digital neural molecular imaging techniques are reliable in the evaluation of the treatment programs for MA dependence and the repair of DA neuronal function.

Objective To assess the efficiency of total laminectomy and transpedicular screw placement techniques and a thoroughly decompression with a three column fixation device on the early cervical spine cord injury.Methods 27 patients were operated successfully with total cervical laminectomy through transpedicular screw techniques.Precise measurements of all cervical spines were made by postoperative CT scan of pedicle dimensions,angulation,and offset relative to the lateral mass boundaries.And meanwhile,cortical integrity and neurovascular injury were then assessed by obtaining postoperative computed tomography scans of each patient.Results Using manual techniques,220 pedicles were instrumented and all the cases were followed up between three to twenty-four months.The postoperative gradations were obviously better than the preoperative evaluation.Regardless of the technique used,the vertebral artery was the structure most likely to be injured.Conclusion Insufficient correlation between different surgeons' assessments of surface landmarks attests to the inadequacy of screw insertion techniques in the cervical spine based on such specific topographic.At the early stage of cervical spinal cord injury,using total laminonectomy decompression through cervical screws techniques to reconstruct spinal alignment could improve the prognosis of patients.

Objective To investigate the effects and relations of carvedilol on heart rate turbulence and secretion of sympathetic nerve in patients with myocardial infarction. Methods Sixty-six patients selected with acute myocardial infarction were randomized to enroll into experimental group ( n = 33 ) treated with earvedilol and control group( n = 33 ) treated with metoprolol for 12 months follow-up treatment. The concenrrarions of plasma norepinephrine(NE) and epinephrine (E) and 24 hour Holter monitoring were messured respectively before the treatment ,after 6 months and 12 months; and new cardiac events were supervised for all cases. Quantification of heart rate turbulenee(HRT) were carried out by computer analyzing two factors: turbulence onset(TO) and turbulence slope(TS) from the data of 24 hour Holter monitoring. NE,E,TO,TS and the occurrence rate of new cardiac events were compared between two groups and in different times of treatment. The correlation between TO,TS and NE,E was analysed. Results Before the treatment, there was no significant differences between two groups to the comparisons of NE,E,TO and TS(P＞0.05). After treating 6 and 12 months, NE, E and TO of experimental group were all lower than control group's significantly, accordingly TS were all higher(P＜0.05). By comparing 3 times( before,after 6 and 12 months of treatment), NE, E and TO of two groups dropped, meanwhile TS rose; experimental group showed significant changes( P＜0.05 ), but control group showed no significant differences(P＞0.05 ). The occurrence rate of new cardiac events of experimental group was lower than control group's significantly (P＜0.05 ).There was significant correlation between NE, E and TO, TS (P＜0.05 ). Conclusion Carvedilol treatment can block the secretion of sympathetic nerve after myocardial infarction and prevent the occurrences of new cardiac events significantly; the changes of the secretion of sympathetic nerve can play an important role for heart rate turbulence (HRT) ,the changes of HRT would be hopeful to predict new cardiac events alter myocardial infarction.

BACKGROUND:Tripterygium hypoglaucum(Levl.)Hutch (THH) has been accurately confirmed a good clinical therapeutic effect for rheumatoid arthritis(RA).However.functionaI mechanism of THH remains unclearly.OBJECTIVE:To investigate the effect of THH on proliferation and apoptosis of macrophage-like synoviocytes and fibroblast-like synoviocytes from patients with RA and to explore its dose-effect relation.DESIGN.TIME AND SETTING:In vitro cytology grouping controlled observation was performed in the Center Laboratory of the First Clinical College of Shantou University and the Laboratory for Cellular Biology of Southern MedicaI University from August 2003 to June 2007.MATERIALS:Synovium was obtained from 6 patients with RA and 3 normaI synovial samples.All samples sourced from patients admitted in Department of Orthopaedics.the First Clinical College of Shantou University and in Spinal and Joint Surgery of Nanfang Hospital.The water extracts of THH contained 0.667 g/mL crude drug.METHODS:Synovial cells were isolated by digesting synovial tissue with collagenase.CD68+and CD68-synoviocytes were sorted from synovial cells by Dynabeads(magnetic celI sorting)from the 2~(nd)-4~(th) passages of synoviocyes.After 72 hours incubation,all groups of isolated synoviocytes were cultured in culture medium containing the flnaI concentrations of 0 mL/L,5 mL/L,1 0 mL/L and 20 mL/L of THH for 24 and 48 hours,respectively,and the common culture medium was sewed as the control. MAIN OUTCOME MEASURES:The morphology of synoviocytes were observed by inverted phase contrast microscope and studied by scanning electron microscopy(SEM).In vitro cell growth was assessed by the MTT assay,and synoviocytes apoptosis was evaluated using temlinaI deoxynucleotidyl transferase biotin-dUTP nick end labeling(TUNEL)assay and a flow cytometry.RESULTS:CD68~+ synoviocytes were appeared macrophage-like and CD68~- synoviocytes were exhibited fibroblast-like.After incubated with THH,some synoviocytes presented the volume of cells deflated,progressively destruction of cell membrane,microvillus or pseudopodium tended to be decreased even disappeared,and apoptosis bodies appeared.When incubated with 2% THH,proliferation inhibiUon and inducing apoptosis could be observed;it showed that THH had the cytotoxic effect on synoviocytes.The effect of proliferation inhibition and inducing apoptosis on CD68-and CD68+synoviocytes from RA patients was more significantly than that from normal arthritis (P<0.01).When incubated with 1%THH.proliferation inhibition and inducing apoptosis on synoviocytes from RA patients also could be found(P<0.01),but not found on normal synoviocytes(P>0.05).Compared with the negative controI group.proliferation inhibition was no significant difference On all groups with the low dose (≤5 mL/L) of THH(P>0.05).Furthermore,the effect of proliferation inhibition and inducing apoptosis on synoviocytes decreased in a dose-dependent and time-dependent manner.The inhibition rate of synoviocytes also could be found positively correlated with apoptosis rate aftat treatment of THH(r=0.497,P<0.01).CONCLUSlON:THH have cytotoxic effect on rheumatoid synoviocytes and normal synoviocytes.it can inhibit macrophage-like synoviocytes and fibroblast-like synoviocytes from RA on proliferation and induce them to apoptosis.In the some contraction of THH.proliferation Inhibition and inducing apoptosis can be occur on synoviocytes from RA but not on normal synoviocytes.

BACKGROUND: Long-term sustained release naltrexone has been reported in clinical application near one year that it can improve emotional state and relieve addiction; therefore, the effect of long-term sustained release naltrexone on memory restoration at neuropsychology level were explored. OBJECTIVE: To observe the effect of long-term sustained release naltrexone on memory ability of opioid addicts. DESIGN, TIME AND SETTING: A contrast observational study was performed at Drug Rehabilitation Centers of Wuhan, Changde, Zhengzhou, and Jiangyang between October and December 2006. Healthy controls were tested in Shenzhen Hospital of Peking University in October 2006. PARTICIPANTS: A total of 88 males with opioid addicts were divided into naltrexone group (n=35), compulsory detoxification group (n=26), and non-treatment group (n=27). Another 22 healthy subjects were considered as the controls. METHODS: At 6-12 months before testing, naltrexone (3.1 g) was subcutaneously implanted into bilateral abdominal wall in the naltrexone group; patients in the compulsory detoxification group underwent completely compulsory detoxification for 6 months, and the examination results, including diamorphine, methadone, and buprenorphine in urine, were negative on the immediately testing day. Event related potential and its wave form were recorded from the opioid addicts in the three groups and from healthy controls who finished semantic recognition between new and old words using portable-type event related potential working system. MAIN OUTCOME MEASURES: Correct rate and response time of semantic memory; latency and amplitude of language related potential-N400. RESULTS: ①There were significant differences in correct rate and response time between three expedmental groups and healthy control group (P ＜ 0.001 ); in addition, correct rate was significantly increased, and response time was significantly shortened in the naltrexone group compared to compulsory detoxification group and non-treatment group (P＜ 0.05). ② N400 latency in the three experimental groups was significantly longer than healthy control group (P ＜ 0.01), while N400 amplitude in the naltrexone group was increased, which was no significant difference compared to healthy control group (P> 0.05) but was significant difference compared to compulsory detoxification group and non-treatment group (P ＜ 0.01). CONCLUSION: Long-term sustained release naltrexone can effectively improve neural function and enhance semantic memory of the opioid addicts.

Objective:To study the changes of oral health indexes in adolescent orthodontic patients under different brushing time, and to provide basis for the orthodontists to give effective dental health promotion in clinic.Methods:A total of 123 adolescent orthodontic patients were included, and they were divided into 1-3min, 3-5 min, 5-7 min and 7-10 min groups based on the brushing time recorded in the period of orthodontic treatment.The relationship between different brushing time and oral health indexes was evaluated 1,3,and 6 months after experiment, such as sulcus bleeding index(SBI),plaque index(PLI), debris index-simplified(DI-S) and enamel demineralization index(EDI).Results:Compared with 1-3 min and 3-5 min groups, the SBI, PLI, and DI-S of the patients in 5-7 min group were significantly reduced(P<0.05).There was no significant differences of SBI, PLI, DI-S , and EDI between 5-7 min group and 7-10 min group (P>0.05).Conclusion:Brushing teeth more than 5 min can improve the oral hygiene significantly and the best time is 5-7 min;the orthodontists should require the patients to brush teeth at least for 5 min.