Acute Disease ; Adult ; Female ; Humans ; Male ; Middle Aged ; Tin Compounds ; poisoning

OBJECTIVE To approach the constituent ratio and drug-resistance of Gram-negative bacilli(GNB) in nosocomial infections and provide the scientific evidence for the clinical treatment of infectious diseases.METHODS Totally 376 GNB strains isolated from our hospital were cultured and identified according to the National Clinical Laboratory Operation Rules.The antibiotic susceptibility test was performed by K-B method and the constituent ratio of GNB was analyzed statistically.RESULTS The pathogens with strains having higher isolating rate were Pseudomonas aeruginosa(21.5%),Klebsiella pneumoniae(17.6%),Acinetobacter baumannii(14.4%),Escherichia coli(10.9%),and Stenotrophomonas maltophilia(5.9%).The drug sensitivity tests in vitro showed that these strains were multiresistant.Except for natural drug-resistant S.maltophilia,16.0% of P.aeruginosa and 24.1% of A.baumannii were resistant to imipenem.The average detection rate of the extended spectrum ?-lactamase(ELBLs) producers was 40.2%.CONCLUSIONS The resistance status of GNB is very serious.We must strengthen monitoring and controlling of drug resistance.

OBJECTIVE To investigate flora distribution and drug resistance status of nosocomial infections with Pseudomonas aeruginosa (PAE) in intensive care unit (ICU) and to provide the scientific reference for clinically reasonable use of antibiotics. METHODS PAE was isolated,cultured and identified according to the National Clinical Laboratory Operation Rules. The antibiotic susceptibility test was performed by K-B method and the results were read according to CLSI 2004-2006. RESULTS Among 254 PAE strains,the isolating rate in the lower respiratory tract samples was the highest (rriving 59.4%). Then the isolating rate in the wound and soft tissue infection samples was 13.8%. The drug-resistance supervision in vitro accounted for 17.3% and 19.7%,respectively,of PAE were resistant to imipenem and meropenem in ICU. The drug resistance rate to aztreonam,trimethoprim-sulfamethoxazole,ciprofloxacin,levofloxacin,gentamicin,cefotaxime,cefepime and piperacillin was all over 60.0%. CONCLUSIONS PAE in ICU is the mostly multi-resistant strain. We should strengthen its monitoring and controlling.

Objective To investigate the effect of biofeedback electrical stimulation and pelvic floor muscle training on the rehabilitation of pelvic floor muscle after delivery by vaginal delivery.Methods From January 2014 to June 2015,90 cases who received pelvic floor rehabilitation treatment after vaginal delivery in Department of Gynecology and Obstetrics of our hospital were selected as the research subjects.According to whether the patients received pelvic floor rehabilitation training,they were divided into the treatment group and control group,90 cases in each group.The treatment group received biofeedback electrical stimulation,pelvic floor muscle training methods of rehabilitation at 6 weeks postpartum.The control group did not take any measures of rehabilitation.Results 4 months postpartum,the bladder neck mobility,urethral rotation angle of the treatment group were significantly lower than those of the control group (t =6.052,4.400,all P ＜0.05).the vaginal muscles voltage measured values of the treatment group was significantly higher than that of the control group (t =9.524,P ＜ 0.05).4 months postpartum,in the treatment group,vaginal muscle Ⅰ grade in 24.44％,grade Ⅱ in 55.56％ and grade Ⅲ in 17.78％,grade ⅣV in 2.22％;in the control group,the vaginal muscle strength grade Ⅰ in 44.44％,grade Ⅱ in 55.56％;The vaginal muscle distribution in the treatment group was significantly better than the control group (Z =-2.865,P ＜ 0.05).Conclusion After vaginal delivery,maternal postpartum receiving biofeedback electrical stimulation,pelvic floor muscle exercise can significantly promote the recovery of pelvic floor muscle function.

The effects of different concentrations of NaF on the proliferation and differentiation of osteroblasts were observed. Osteroblasts were obtained from the calvaria of 24-h newborn Sprague Dawley (SD) rat by using enzymic degestion method and cultured in the medium containing 10-7 mol/L to 10-5( 10-4 mol/L NaF. The rate of cell proliferation, ALP activity and osterocalcin were examined by the methods of MTT, biochemical assay and radioimmunologic assay (RIA) respectively. The results showed that the effect of NaF on the proliferation of osteroblasts was regulated in a double-phase manner: low doses of NaF (10-7 mol/L, 10-6 mol/L,10 5 mol/L) increased cell proliferation by 11. 3 o, 10. 9 % and 10. 6 % (P＜0. 05) respectively, vice versa at high doses (10-4 mol/L, 5×10-4 mol/L). As compared with control group, high doses of NaF decreased the proliferation rate by 9. 6 %, 9. 7 % respectively. The response of cell differentiation to NaF was varied. The influence of NaF on ALP activity was similar to that of cell proliferation. However, all concentrations of NaF used stimulated the secretion of osterocalcin with the highest secreting rate being up to 67. 14 % at 5×10 4 mol/L NaF. It was concluded that the influence of NaF on the proliferation of rat calvarial osteroblasts regulated in a double-phase manner, but the action on cell differentiation was varied.

Cervical Vertebrae ; injuries ; Humans ; Magnetic Resonance Imaging ; Prognosis ; Spinal Cord Injuries ; diagnosis ; etiology ; therapy ; Tomography, X-Ray Computed

Objective To investigate the effects of three different effect-site concentration (Ce) of sufentanil given by TCI on the minimum alveolar concentration of sevoflurane for blunting adrenergic responses to skin incision(MAC_(BAR))in patients undergoing abdominal surgery.Methods Eighty ASAⅠ orⅡ patients,aged 20-60 yr,body mass index<30 kg/m~2,undergoing elective abdominal surgery,were randomly divided into 4 groups(n=20 each):control group(group so)and 3 sufentanil groups(group S_1,S_2,S_3).The patients were unpremedicated.Anesthesia was induced with TCI of propofol(target plasma concentration 3.5 μg/ml)and TCI of remifentanil(Ce 4 ng/ml).nacheal intubation was facilitated with rocuronium 0.6 mg/kg after the patients lost consciousness.The patients were mechanically ventilated.And then propofol and remifentanil were immediately stopped and anesthesia was maintained with inhalation of sevoflurane and a mixture of nitrous oxide and oxygen,fresh gas flow set at 10 L/min maintaining for at least 20 min.In group S_0,sufentanil was not given after intubation.In group S_1,S_2 and S_3,TCI of sufentamil was started after intubation at Ce of 0.12,0.18 and 0.24 ng/ml respectively.In group S_0,S_1,S_2 and S_3,sevoflurane inhalation was started with the initial end-tidal concentration of 3.0%,1.8%,1.3% and 1.1% respectively.The patients'response to skin incision was described as positive if MAP or HR increased by≥25%,or negative(MAP or HR increased by<25%).If the response was positive,the end-tidal concentration of sevoflurane for the next patient was increased by 1.2 times,while if negative,decreased by 1.2 times.The sevoflurane MAC_(BAR) was determined by up-and-down sequential trial.Results Compared with group S_0,the MAC_(BAR) of sevotlurane was significantly decreased in group S_1,S_2 and S_3(P<0.05).Compared with group S_1,the MACB_(BAR) of sevoflurane was significantly decreased in group S_2 and S_3(P<0.05).No significant difference was found in the MACB_(BAR) of sevoflurane between group S_2 and S_3 (P<0.05).Conclusion TCI of sufentanil at Ce of 0.12,0.18 and 0.24 ng/ml can significantly reduce MAC_(BAR) of sevoflurane and enhance the inhibitory effect of sevoflurane on stress response in a concentration-dependent manner.

　Since the statement made by the ECMFG, WFME Global Standards have been focused on by medical departments, and pre-graduate behavioral science education which is one of the requirements included in these standards has gained prominent attention in Japan. In Japan's society, where the birthrate is decreasing and the population is growing older, physicians are required to have a patient-centered viewpoint instead of focusing on specialized treatment and hospital-oriented medical care. It has been 10 years since early clinical training became mandatory, and there is a need to develop medical education that allows physicians to nurture their professionalism and clarify their types of competence. In addition, using materials and strategies necessary for medical practice, medical departments need to provide education in practical medical behavioral science that facilitates the comprehensive learning of professionalism, medical ethics, NBE, and medical safety.

Recent progress in molecular biology has enabled us to better understand the molecular mechanism underlying pathogenesis of human malignancy including lung cancer, the advent of therapies based on mechanisms that target critical molecular pathways of tumors has evoked considerable interest. The therapeutic index is high, and optimally effective treatment can be achieved at a dose below the maximal tolerated dose,giving us a better understanding of the human lung cancer. This review focuses on the advance of targeted therapy for the first-line, second-line treatment or the maintenance treatment of non-small cell lung cancer.

Lung cancer is the most common cancer and the leading cause of cancer-related deaths in the world. More than 50 % of advanced NSCLC are diagnosed in patients older than age 65 years. Aging is inextricably associated with decreases in marrow reserve, drug clearance, and lean body mass. Elderly cancer patients often present with medical and physiologic challenges that make the selection of their optimal treatment daunting. This article reviews the progress in diagnosis and treatment of lung cancer in the elderly in recent years.