OBJECTIVE To investigate the incidence of nosocomial infection in ICU patients,risk factors.and measures to prevent infection.METHODS The nosocomial infection of ICU patients in the hospitals from Nov 2005 to Jun 2009 was investigated using the method of target monitoring.The nosocomial infection rate was regulated by the method of ASA.The invasive procedure and the associated infection rate were analyzed.RESULTS Among 833 inpatients in ICU,92 suffered from nosocomial infection,The nosocomial infection rate was 11.04%.and the nosocomial infection rate per day was 4.43% after modified by the method of ASA.The incidence of patients was 5.37%.Totally 145 strains of bacteria were isolated,and the dominant pathogens were Gram-negative bacilli(56.55%).CONCLUSIONS The patients in ICU are susceptible population of nosocomial infection,A.baumannii is the dominating pathogen to cause nosocomial infection in intensive care units.Target monitoring in ICU is an effective surveillance method to reduce the prevalence of nosocomial infection.

Objective To research correlation of serum protein spectrometry and lymphoma markers for diffuse large B cell lymphoma (DLBCL) patients. Whether there is relative between the protein and prognosis will be further researched. Methods Serum protein spectrometry of 62 DLBCL patients was detected by the SELDI-TOF-MS technique and Weak cation exchange 2 (WCX2) chip. Lactate dehydrogenase (LDH) was detected by biochemistry method. Beta-2-microglobulin (β2-MG) and cancer antigen125(CA125)were detected by enzyme-linked immunosorbent assay (ELISA). The level of LDH, β2-MG and CA125 for DLBCL patients between 11×103～12×103 protein expressed positively and negatively was analyzed. Meanwhile,correlation analysis and survival analysis were done. Results LDH, β2-MG and CA125 in 11×103～12×103protein expressed positive group were (523.30±435.96)U/L, (3.23±1.24)mg/L, (81.07±61.39)U/L respectively,and they were higher than that in negative group (P＜0.05). 11×103～12×103 protein was positive correlated to LDH, β2-MG and CA125 (P＜0.01). The survival time in 11×103～12×103 protein expressed in positive group,in which median survival time was 11 months, was shorter than that in negative group(P ＜0.01). The survival time in LDH normal group was longer than that in increased group(P ＜0.01). The survival time of β2-MG and CA125 had no significant difference between increased group and normal group. Conclusion LDH and 11×103～12×103 protein are expected to be prognosis indicators for DLBCL patients.

Objective To study the incidence of positive t(14;18) and myc gene rearrangement, and the clinical features and prognosis of concurrent positive t ( 14;18 ) and myc gene rearrangement“ double-hit lymphoma” (DHL) in diffuse large B cell lymphoma.Me thods The positive t(14;18) and myc gene rearrangement in 106 cases of DLBCL were analyzed using interphase fluorescent in situ hybridization ( FISH ) technique. The expression of myc and bcl-2 proteins was determined by immunohistochemistry.The relationship of positive t ( 14;18) and myc gene rearrangement with clinical features, pathogenesis and prognosis for the patients was analyzed.SPSS 16.0 software was used for statistical analysis.Results Among the 106 cases, there were 27 (25.5%) cases with positive t(14;18) and 13 (12.3%) cases with myc gene rearrangement, and 7 cases (6.6%) of DLBCL with concurrent t(14; 18)-positive and myc gene rearrangement.A relationship was observed between positive t ( 14;18 ) and myc gene rearrangement ( P=0.019) .The follow-up data showed that the 7 DHL patients were in age of 528-4 years, the International Prognostic Index (IPI) scores were 3 in two cases, 4 in four cases and 5 in one case, and the ECOG scores were 3 in all the7 cases .Four patients had bone marrow involvement and were combined with leukemia.The survival time ranged from 0.5 to 6 months, with a median survival of 4 months.The univariate analysis showed that B symptom, Ann Arbor stage, ECOG score, LDH level, IPI score, immunophenotype, bcl-2 protein expression, myc protein expression,and myc gene rearrangement were all associated with poor prognosis ( P<0.05 for all) .The multivariate analysis using a COX proportional hazard model confirmed that ECOG score, bcl-2 protein expression, myc protein expression , myc gene rearrangement, and immunophenotype were independent prognostic factors affecting survival ( P<0.05 for all) , among them, the myc gene rearrangement was the strongest prognostic factor ( OR=4.337,P<0.001) . Conclusions “Double-hit” DLBCL is rare and can be mainly identified only by molecular detection.Perhaps positive t(14;18) and myc gene rearrangement play concurrent role in its “double-hit” pathogenesis.DHL are highly invasive, and most of DHL patients have poor prognosis.Further studies of larger case number are required to determine the pathologic features and the therapeutic strategy of this subgroup.

Objective To study the incidence of positive t(14;18) and myc gene rearrangement, and the clinical features and prognosis of concurrent positive t ( 14;18 ) and myc gene rearrangement“ double-hit lymphoma” (DHL) in diffuse large B cell lymphoma.Me thods The positive t(14;18) and myc gene rearrangement in 106 cases of DLBCL were analyzed using interphase fluorescent in situ hybridization ( FISH ) technique. The expression of myc and bcl-2 proteins was determined by immunohistochemistry.The relationship of positive t ( 14;18) and myc gene rearrangement with clinical features, pathogenesis and prognosis for the patients was analyzed.SPSS 16.0 software was used for statistical analysis.Results Among the 106 cases, there were 27 (25.5%) cases with positive t(14;18) and 13 (12.3%) cases with myc gene rearrangement, and 7 cases (6.6%) of DLBCL with concurrent t(14; 18)-positive and myc gene rearrangement.A relationship was observed between positive t ( 14;18 ) and myc gene rearrangement ( P=0.019) .The follow-up data showed that the 7 DHL patients were in age of 528-4 years, the International Prognostic Index (IPI) scores were 3 in two cases, 4 in four cases and 5 in one case, and the ECOG scores were 3 in all the7 cases .Four patients had bone marrow involvement and were combined with leukemia.The survival time ranged from 0.5 to 6 months, with a median survival of 4 months.The univariate analysis showed that B symptom, Ann Arbor stage, ECOG score, LDH level, IPI score, immunophenotype, bcl-2 protein expression, myc protein expression,and myc gene rearrangement were all associated with poor prognosis ( P<0.05 for all) .The multivariate analysis using a COX proportional hazard model confirmed that ECOG score, bcl-2 protein expression, myc protein expression , myc gene rearrangement, and immunophenotype were independent prognostic factors affecting survival ( P<0.05 for all) , among them, the myc gene rearrangement was the strongest prognostic factor ( OR=4.337,P<0.001) . Conclusions “Double-hit” DLBCL is rare and can be mainly identified only by molecular detection.Perhaps positive t(14;18) and myc gene rearrangement play concurrent role in its “double-hit” pathogenesis.DHL are highly invasive, and most of DHL patients have poor prognosis.Further studies of larger case number are required to determine the pathologic features and the therapeutic strategy of this subgroup.