OBJECTIVE To analyze the correlation factors of nosocomial infection in patients after receiving craniocerebral operation.METHODS Totally 388 hospitalized patients after receiving craniocerebral operation from Jan 2006 to Dec 2006 were studied retrospectively.RESULTS From them 45 pateints were suffering from nosocomial infection and total incidence of nosocomial infection was 11.59%.Among them,60.0% was lower respiratory tract infection,11.11% was surgical wound infection and 8.89% was upper respiratory infection.Aging,length of stay and invasive operation(deep vein needle detaining,trachea incision,tracheal intubation,urinary canal and drainage tube dwelling) were the main correlation tactors.CONCLUSIONS Minimizing invasive operation and early removing various kinds of dwelling tubes,using antibiotics correctly,improving hospitalizd environment and strengthening wards management are the measures to reduce nosocomial infection according its correlation factors.

Objective To study the effect of relaxation therapy on sleeping quality of patients with post cran- iocerebral traumatic syndrome. Methods 90 cases with sleep disorders were randomly divided into the treatment group and the control group. The control group was given routine care and the treatment group was given relaxation therapy combined with routine care. Take pittsburgh sleep quality index (PSQI) as evaluation criteria. Results There was significant difference between the two groups( P < 0.01 ). Sleep quality was more improved by relaxation therapy in the experimental group than that of the control group. Conclusion Relaxation therapy can effectively im- prove sleep quality in patients with post craniocerebral traumatic syndrome.

Objective To investigate the effects of ultrasound-targeted microbubble destructionmediated MicroRNA-21 on cardiomyocyte apoptosis after coronary microembolization (CME) in swine.Methods Twenty Bama miniature swine were randomLy (random number) divided into sham-operated,CME,CME plus gene transfection and CME plus ultrasound mediated gene transfection groups (n =5 per group).The CME model was established by microcatheter-mediated injection of microspheres into the left anterior descending artery.The sham-operated group were made by injection of saline instead.The CME plus ultrasound mediated gene transfection group was made by injection of plasmid-microbubble mixture through the marginal ear vein 4 days before CME established.Meanwhile,ultrasound treatment was given to the myocardium through chest wall.The CME plus gene transfection group was made by injection of plasmidmicrobubble mixture through the marginal ear vein 4 days before CME established without exposure to ultrasound.Left ventricular ejection fraction (LVEF) was examined by cardiac ultrasound.Tissue biopsy was stained with hematoxylin-eosin (HE) and hematoxylin basic fuchsin picric acid (HBFP) to measure the size of infarction area.Green fluorescent protein (GFP)-labeled gene expression was evaluated by fluorescent microscopy in frozen sections.Cardiomyocyte apoptosis was detected with terminal deoxynucleotidyl transferase (TdT)-mediated dUTP nick end-labeling (TUNEL staining).The expression of PTEN mRNA was measured by fluorescent quantitative PCR.The levels of PTEN protein and Caspase-3 protein was measured by western blot.Results ①Compared to CME plus gene transfection group,the CME plus ultrasound mediated gene group had over eightfold expression of exogenous genes in myocardium (P ＜ 0.05) measured by using optical density of green fluorescence protein;② Compared with shamoperated group [(67.87 ±2.36)％],the LVEF of CME group [(50.94 ±3.52)％] and CME plus gene transfection group [(52.47 ±3.71)％] were markedly decreased (P ＜ 0.05).Compared with CME group,the CME plus ultrasound mediated gene transfection group [(64.79 ± 2.95)％] improved CME-induced cardiac dysfunction as evidenced by increased LVEF (P ＜ 0.05);③Compared with sham-operated group,the expression of PTEN mRNA and levels of PTEN protein and Caspase-3 protein in the CME group increased significantly (P ＜ 0.05).Compared with CME group,the levels of PTEN protein and Caspase-3 protein and the expression of PTEN mRNA in CME plus ultrasound mediated gene transfection group was dramatically decreased (P ＜ 0.05).Conclusions Ultrasound microbubble-mediated MicroRNA-21 transfection effectively improved CME-induced cardiac dysfunction by down-regulating the expression of targeted gene PTEN in myocardial cells,mainly reducing the post-CME myocardial cell apoptosis.

Objective To develop rats model for human dilated cardiomyopathy(DCM).Methods Male Sprague-Dawley rats were administered adriamycin intraperitoneally 2.8 mg/kg? week)for 11 weeks,and then observed for 2 weeks.Plasma levels of brain natriuretic peptide(BNP)were studied by ELISA;left ventricular end diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD)and left ventricular ejection fraction(LVEF)were measured by echocardiogram;and morphology of the hearts and pathological lesions of cardiac muscle tissues were observed.Results(1)The levels of BNP of the DCM group were higher than those of the normal group(P

Objective To investigate the clinical features and the effect of gender differences on phenotype of Giteiman syndrome (GS) patients. Methods Clinical features and biochemical parameters were compared and analyzed to look for correlation between male and female GS patients. Results More male patients suffered from nocturia than female patients (P < 0.05), and there were no statistical differences in other clinical features between males and females. The level of serum creatinine was higher in male patients than that in female ones [(82.7±43.3) μmol/L vs (58.7±12.7) μmol/L], but estimated glomerular filtration rate was male patients and female patients. The urinary potassium and chloride excretion fraction were higher in male group than those in female group (33.0%±22.9% vs 17.0%±4.7%;2.30%±1.59% vs 1.23%±0.39%, P< 0.05, respectively). Statistical differences were not observed in other laberatory parameters. Three patients with impaired renal function were all male. Conclusions More male patients suffer from nocturia than female patients. Male patients seem to be prone to impaired renal function. It is speculated that different density of sodium-chloride cotransporter in renal tubule may account for gender differences.

Objective To identify the correlation between hypergnmmaglobulinemia (hyper-IgG) and renal involvement in patients with primary Sjogren's syndrome (Pss). Methods The data of all patients admitted to hospital with the diagnosis of Pss were retrospectively analyzed. One way ANOVA and Speannan's correlation analysis were used to compare the clinical characteristics, renal injuries, immunology tests and renal pathological changes between patients with or without hyper-lgG. Results One hundred and thirty Pss cases were enrolled including 8 males and 122 females. Their age ranged from 16 to 68 years with an average of (44±12) years. Forty-one patients with Pss underwent renal biopsy. The preys lenee of Drta and tubular protein was significantly higher in patients with hyper-IgG than those without(P<0.05). Spearman's correlation analysis showed a negative correlation between serum IgG levels and seral potassium level(r=-0.269,P<0.01).Protein electrophoresis results revealed predominantly tubular protein in the hyper-lgG group, on the other hand glomerular protein was found in the normal-IgG group (P<0.05). The occurrence of decreased C4 com-plement concentration was significantly higher in normal-lgG group (P<0.05); Spearman's correlation analysis for biopsied materials showed that there was no significant difference in the Tubular Index (TI) and Glomeru-lar Index(GI) between these two groups. Conclusion Tubular lesions, especially Drta, may be predominant and correlate with hypergammaglobulinemia. There is a correlation between hypergammaglo-bulinemia and the level of renal lesions. Renal acidification capacity in patients with hypergammaglobulinemia should be evaluated.

Objective To analyze the occurrence of traumatic carotid cavemons fistula (TCCF) resulted from the fracture of basilaris cranii, in order to find out the related factors to outcomes and to discuss the approaches to improving prognosis.Method Data of 312 patients with the fracture of skull base complicatcd with TCCF con-firmed angiography from 1999 to 2005 were analyzed. These patients were classified into patients with disable and patients without disabed. The factors potentially impacting on outcomes were analyzed. Results The overall inci-dence of TCCF in 312 patients with fracture of basilaris cranii was 3.8% .The incideucs of TCCF occurred in pa-tients with the fracture of anterior fossa, middle fossa and posterior fossa accounted for 2.4%, 8.3 % and 1.7 %, respectively. Between two cohorts of patients, there were no difference in age, gender, number of embelization proce-dares performed and the time from injury to appearence of the first symptom except the differencc in time from ap-pearence of the first symptom to the intravascular embohzation performed (P>0.05). Conclusions A relatively high incidence of TCCF occurs in patients with middle fossa fractures, especially those with transverse or oblique fractures. Prompt diagnosis and intervention can not be emphasized in case of patients with TCCF, and non inva-sive techniques for the early detection of TCCF under certain circumstance after brain or facial trauma should be considered so as to avoid a miss in the early diagnosis of middle fossa fracture to ensure favourable outcomes.

Objective To identify the clinical characteristics and pathological changes of patients suffered from glomerulonephritis complicating with acute interstitial nephritis (AIN) . Methods Twenty one patients of glomerulonephritis complicating with AIN diagnosed by renal biopsy were retrospectively analyzed . Thirty-five pure AIN patients were selected as controls .Results Glomerulonephritis complicating AIN accounted for 37 .5% of all the AIN cases . Βlactam antibiotics and Chinese herbs were the major causes of AIN . 76 .2% of cases received further examinations due to the elevation of serum creatinine (Scr) during their follow-up of kidney injuries or during routine exams for all kinds of discomforts . Pathological features of AIN were also detected besides glomerular leisions . The impairments of renal interstitia were severe than those of the glomeruli . Eosinophil in the renal interstitia was an important indicator for the diagnosis of AIN .The renal function returned to normal or baseline in 64 .7% of the patients of glomerulonephritis complicating with AIN whose follow-up data were available . The median period for renal function restoration was 150 days (compared with 60 days in pure AIN) . But there were no significant differences between these two groups as for the rate of irreversible renal insufficiency during a follow-up period of 2 years . Conclusions Symptoms of AIN in patients of glomerulonephritis complicating with AIN tend to be masked by their glomerular diseases . Renal biopsy is of most importance for the diagnosis . Early diagnosis and treatment leads to satisfactory prognosis .

Objective To investigate the dynamic changes of cardiomyocyte apoptosis and Caspase-12 activation after coronary microembolization (CME) in rats. Methods The CME models were produced by injection of 42 μm microspheres (3000/0.1 ml) into the left ventricle during clampinduced ascending aorta occlusion for 10 seconds in adult male Sprague-Dawley rats (CME group).The sham-operation group was injected with saline instead (S group). The survivors were randomly divided into five groups: 3 h, 6 h, 12 h, 24 h and 4 weeks (n=10, each), respectively. In addition,10 rats were designed as normal control group. Cardiomyocyte apoptosis was detected by terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) staining. The expressions of Caspase-3, 12 and procaspase-3 and 12 were detected with Western-blot analysis. The activity of Caspase-12 was determined with fluorometric assay kit. Results (1)Compared with the shamoperation group and normal control group, the apoptosis rates of cardiomyocytes in CME group were significantly increased at each time point respectively (all P＜0.05). Apoptotic cardiomyocytes were found mainly in the border zones and infarct foci. The apoptosis rates of cardiomyocytes at 3 h, 6 h,12 h, 24 h and 4 weeks after CME were (1.76±0.68)%, (3.17±1.26)%, (1.34±0.12)%,(1.07±0.65)% and (0.30±0.13)%, respectively. The apoptosis rates of cardiomyocytes increased at 3 h after CME, peaked at 6 h after CME (all P＜0.05), and then gradually decreased with lowest value at 4 weeks (all P＜0.01). (2)Compared with sham-operation group and normal control group,the relative activation level of Caspase-3 and 12 in CME group increased remarkably (all P＜0.05).The time courses of Caspase-3 and 12 expressions corresponded well to those of cardiomyocyte apoptosis after CME. Conclusions The amount of cardiomyocytes apoptosis is significantly increased after CME. Caspase-12 may be involved in the apoptosis of cardiomyocyte after CME.

Objective To investigate the effects of large dose of atorvastatin on the expression of Sprouty-1 in CD4 + T lymphocytes from unstable angina patients during perioperative period of PCI.Methods A total of 52 unstable angina patients enrolled were divided randomly (random number) into large-dose atorvastatin (80 mg/d,n =26) pretreated group and moderate-dose atorvastatin (20 mg/d,n =26) pretreated group.Circulating CD4 + T cells were obtained by magnetic cell sorting system (MACS) before PCI and 18-24h after PCI.For detecting the gene expression,the reverse transcription fluorescent quantitative polymerase chain reaction (RT-PCR) was used to measure the expression of Sprouty-1 mRNA in CD4 + T lymphocyte.The level of Sprouty-1 protein was detected with Western blot analysis and IL-2 was quantified by enzyme-linked immunosorbent assay (ELISA).Results ①Compared with large-dose group before PCI,the expression of Sprouty-1 mRNA and Sprouty-1 protein levels were dramatically increased in large-dose group after PCI (P ＜ 0.05).②Compared with moderate-dose group before PCI,the expression of Sprouty-1 mRNA and protein levels were slightly increased in moderate-dose group after PCI,but there was no statistical significance (P ＞ 0.05).③Compared with large-dose group before PCI,the serum level of IL-2 was decreased in large-dose group after PCI (P ＜ 0.05).Whereas the serum level of IL-2 was slightly increased in moderate-dose group after PCI compared to moderate-dose group before PCI,there was still no statistical significance (P ＞ 0.05).Conclusions Large-dose atorvastatin pretreatment reduced post-PCI myocardial inflammation through up-regulating the expression of Sprouty-1 mRNA and level of Sprouty-1 protein in CD4 + T lymphocytes.