Objective To conduct targeted surveillance of nosocomial infections in intensive care units(ICU)to provide reference for comprehensive infection control . Methods All the 374 patients treated in ICU in 2013 were investigated by targeted surveillance methods .Results A total of 82 episodes of nosocomial infections were identified in 62 (16 .6% )of the 374 patients . The cumulative hospital stay was 2 724 days .The infection incidence per patient‐day was 22 .8‰ .The infection in ICU was primarily pneumonia (75 .6% ,including 39 ventilator‐associated pneumonia) ,bloodstream infections (including 6 central line‐associated bloodstream infections ) and catheter‐associated urinary tract infections . The incidence of ventilator‐associated pneumonia ,central line‐associated bloodstream infection and catheter‐associated urinary tract infection was 33 .3‰ ,2 .8‰ , 2 .3‰ patient‐day ,respectively .Overall ,74 strains of pathogens were isolated ,of which 93 .2% ,5 .4% and 1 .4% were gram‐negative bacilli ,gram‐positive cocci and fungi ,respectively .The top three gram‐negative bacilli were Pseudomonas aeruginosa(25 .7% ),Klebsiellapneumoniae(14 .9% ),and Acinetobacterbaumannii(10 .8% ).Conclusions Theincidenceof nosocomial infection was 16 .6 % in ICU patients ,of which device‐related infection accounted for 62 .2 % .Control of equipment‐related infections is critical for curbing the nosocomial infections in ICU . The antimicrobial regimens for ICU patients should cover gram‐negative bacilli .

Objective To evaluate the therapeutic effectiveness of echo-guided percutaneous radiofrequency ablation(RFA) by using a LeVeen needle electrode combination in the treatment of large liver tumor,and to discuss the relationship between the amount as well as the distribution pattern of the electrodes and the therapeutic effectiveness.Methods During the period of Feb.2006-Dec.2008,echo-guided RFA was performed in 113 patients with large and unresectable liver tumor,with a total of 118 lesions.According to the size of the tumor,the patients were divided into four groups.The tumor’s diameter of Group A(n = 64) was 4.0-5.0 cm,Group B(n = 28) was 5.1-6.0 cm,Group C(n = 11) was 6.1-7.0 cm and Group D(n = 10) was 7.1-9.3 cm.Based on the tumor’s diameter,the amount of the electrodes to be used and the sites to be ablated were determined.After the procedure,the follow-up checks with MRI or CT scanning were carried out to observe the necrotic extent and the local recurrence.Results Two months after the treatment,the complete necrosis rate of the tumor in Group A,B,C and D was 88.4%,78.6%,63.6% and 40.0%,respectively,with an overall necrosis rate of 79.7% in total 118 lesions.During a follow-up period of 3-36 months,the local recurrence rate in Group A,B,C and D was 5.5%,10.0%,28.6% and 50.0%,respectively.Severe complications,including intrahepatic infection(n = 2),puncture passage bleeding(n = 1),symptomatic pleural effusion(n = 4) and biloma(n = 2),occurred in 9 cases.No death related to RFA treatment occurred.Conclusion Echo-guided percutaneous radiofrequency ablation by means of multi-sites superimposition method with a LeVeen needle electrode combination is an safe and effective therapy for the hepatic tumors with the diameter over 4 cm.

Secondary lymphoid tissue chemokine (CCL21) is a double-edged sword, which exerts antitumor, anti-infection immune response by binding to the receptor CCR7 on the surface of the multiple immune cells. However, a variety of tumor cells also express the receptor CCR7, the combination of CCL21 with CCR7promotes the invasion and metastasis of tumor cells, leading to the facilitation of tumor development. Therefore,exploring the mechanism(s) of tumor invasion and metastasis might be helpful for use of CCL21 as tumor gene therapy through blocking of CCL21's promotion of tumor invasion and metastasis.

Objective　Recently,it was reported the analy sis of bone free radical by using electron spin resonance (ESR),so this article aimed to determine the changes of bone free radical in fluoresis rats.Methods　To analyze the free radical level of bone in fluoresis rats fed with different dose of calcium by ESR method.Results　The free radical of bone in the group of low ca lcium level and the group low calcium+fluorides was higher than that in the cont rol group (P<0.01),but that in normal animal feeds (calcium-rich)+fluoride group was lower than that in the control group.Conclusions　Low doses of fluoride did not resulted in the increase of free radical in calcium-rich condition at short time,but at low calcium condition,fluoride could increase the level of free radical,these suggested that simple overdose of fluoride did not change the level of free radical of bone.

Objective To analyze the application of recombinant VCA-BALF4(S) and VCA-BFRF3 proteins in serological diagnosis of nasopharyngeal carcinoma (NPC). Methods DNA extracted from the B95-8 cells was used as the templates in a polymerase chain reaction(PCR). VCA-BALF4 1008 bp (S) (aa 287-623) and VCA-BFRF3 531 bp(177 as) were generated and inserted into pPICZaA vector.The recombinant plasmids were transformed into GS115 yeast by electroporation. The yeast transformants in-duced by methanol expressed recombinant proteins. The recombinant proteins synthesized were coated to mi-croplate for detection of EBV-IgA antibody in NPC patients by ELISA. Results We have successfully se-cretly expressed the recombinant VCA-BALF4(S) and VCA-BFRF3 protein in the Pichia pastoris. The mo-lecular weight of products were approximately 37×10~3 and 18×10~3, respectively. The recombinant proteins VCA-BALF4(S) and VCA-BFRF3 in the culture supematant showed good immunoreactivity with IgA anti-bodies to EBV by Western blot. A novel ELISA was established using Pichia pastoris-expressed VCA-BALF4 (S) and VCA-BFRF3 proteins. Serum samples were collected from patients with NPC and healthy controls and using this ELISA tested. The sensitivity of VCA-BALF4(S) and VCA-BFRF3 tests in the NPC sera were 88.7% and 71.0%, whereas the specificity of normal individuals are 96.4% and 91.8% separately. Con-clusion The recombinant proteins BALF4 (S) and BFRF3 were highly secretly expressed in Pichia pastoris,the diagnostic value of two recombinant proteins in screening for NPC patients were primary evaluated and the valuable pPICZa-BALF4(S) yeast strain was obtained.

Aged ; Humans ; Lung Diseases, Fungal ; complications ; Silicosis ; complications ; microbiology ; Tuberculosis, Pulmonary ; complications

Cancer cell exfoliation,invasion and entry into circulation system is the early event with metastasis,which provide the possibility to formation of clinical metastase.Further research about the circulating cancer cells can help us to understand the mechanism of metastasis and offer the scientific proof against anti-metastasis.The detection of circulating tumor cells and clinical significance were reviewed.

Objective:To study the reversal effect of tamoxifen(TAM)on the expression of mdr1 in human pancreatic cancer cell lines.Methods:The inhibtion effect of TAM on pancreatic cancer cell line SW1999、Capan-Ⅱ and mammary cancer cell line T47D were studied;The influence of TAM on mdr1 protein/mRNA expression in SW1999、Capan-Ⅱ and T47D were studied using the method of flow cytometer and RT-PCR.Results:The high dose TAM could inhibit Capan-Ⅱ cell line.TAM could reverse the expression of mdr1 protein and mRNA in Capan-Ⅱ cell line and T47D cell line. Conclusion:The high dose TAM could inhibit Capan-Ⅱ cell line,maybe related with reduction of the expression of mdr1 protein and mRNA.

Objective:Our aim is to investigate the relationship of VEGF-C,VEGF-D and lymph node metastasis in pancreatic cancer,and to elucidate the role and significance of the cancerous peripheral lymphatic tissue.Methods: The expression of VEGF-C and VEGF-D was assayed by means of immunohistochemistry in 30 pancreatic carcinomas.Results:The positive rates of VEGF-C、VEGF-D were 73% (22/30)、57% (17/30) respectively in pancreatic cancer.The expression of VEGF-C、 VEGF-D in cancerous invasive edge was significantly higher than that in the center of cancerous tissues.There was no correlation between the expression of VEGF-C、VEGF-Dand the site,differentiation,histology types.Ⅲ~Ⅳ stages of pancreatic cancer showed strong expressions of VEGF-C、VEGF-D than that Ⅰ~Ⅱ stages of pancreatic cancer.The positive lymph node in positive VEGF-C and VEGF-D group were higher than that in the negative group.Conclusion:VEGF-C and VEGF-D induced lymphangiogenisis in pancreatic cancer,promoted the tumor cell lymph metastasis.

Objective To assess the effects of dynamic monitoring of plasma Pro-B-type Natriuretic Peptide(Pro-BNP) in the evaluation of prognostic value and myocardial dysfunction in patients with septic shock.Methods The levels of plasma Pro-BNP were tested in 102 patients with septic shock on the 1,3,and 5 days.Data on ICU mortality and 28-day mortality were collected.The patients were divided into non-dysfunction group (CI＜3.0) and cardiac dysfunction group (CI≥3.0) according to levels of hemodynamic variables ( CI level).The prognostic value of plasma Pro-BNP was analyzed.Results Plasma Pro-BNP levels on the 1,3 and 5 days in 28-day survivors have a significant declining trend [( 1649.0 ± 257.5 ) ng/L,( 1867.6 ± 291.7 ) ng/L vs.(1229.9 ± 194.5) ng/L),while plasma Pro-BNP levels in non-survivors have an increasing trend [(4128.8 ± 1051.1),( 5315.9 ± 925.4 ) vs.( 6899.9 ± 1327.9 ) ng/L].There is statistical significance of plasma Pro-BNP levels at day 1,3 and 5 for the two groups ( t=3.057,5.083,and 6.290 respectively,P＜0.01 ).The 28-day mortality and Plasma Pro-BNP levels in cardiac dysfunction group were higher than of non-dysfunction group ( 28-day mortality:62.1％ vs.20.0％;Pro-BNP1:( 1592.8 ± 362.2 )ng/L vs.( 4556.6 ±732.7 ) ng/L;Pro-BNP3:( 2933.6 ± 421.7 ) vs.( 5768.5 ± 793.7 ) ng/L,Pro-BNP5:( 3014.5 ± 587.5 ) ng/L vs.(8873.9 ± 1670.1) ng/L ( x2=20.635,P=0.000,t=3.626,3.154,3.310,P＜0.01].Pro-BNP level greater than 3053 ng/L on the 5-day was an independent prognostic indicator of 28-day mortality ( sensitivity:88.4％;specificity:91.5 ％ ).Pro-BNP level greater than 2378 ng/L on the 5-day was an independent prognostic indicator of hospital mortality ( sensitivity:84.9％;specificity:91.8％ ).In multivariate logistic regression analyses,Pro-BNP level and APACHE score were independent predictors of 28-day mortality and hospital mortality.Conclusion Plasma Pro-BNP level shows obvious significance in evaluation of sepsis-induced myocardial depression severity in patients with septic shock.Pro-BNP level in ICU at day 5 after inclusion is an independent prognostic marker of mortality in septic shock.