OBJECTIVE To explore the causes,distribution and treatment of fungus infection after heart transplantation.METHODS The fungus species,infectious sites,clinical manifestation,treatments and results of fungus infection among 15 patients after heart transplantation were investigated.RESULTS There were 6 fungus infection cases(40.0%) with 8 fungus species found from the oral secretion,sputum and urine.From them Candida albicans was in 6 cases(75.0%),Aspergrillus were in 1 case(12.5%)and other fungus was in 1 case(12.5%).The main manifestation included candidiasis,Aspergrillus pneumonia and mycotic cystitis.The treatment included local nystatin with glycerin liniment,rinsing bladder by diluted nystatin and iv amphotericin B and fluconazole.All fungus infection cases were cured in 7-21 days.CONCLUSIONS The risk factors of fungus infection after heart transplantation include hypoimmunity,dysbacteriosis,susceptibility and some staffs misplayed during sterile processes.The main pathogenic fungal species is C.albicans.Prevention,early detection and effective medication are very important to control the fungus infection after heart transplantation.

[Objective] To evaluate the clinical effect of acusector infrared and pressed needle on spondylopathy.[Method] Randomly divide the patients into treatment group 1 with acusector infrared and pressed needle,and control group 2 with acusector and infrared.[Result] In treatment group,8 cases were cured,32 better,5 not cured,and total effective rate 88.89%; for group 2,they were 2,28,15 and 66.67% respectively.There’s marked difference between them.[Conclusion] Acusector infrared and pressed needle are better in treating spondylopathy.

The morbidity of inflammation-associated tumor is high .Prevention and treatment of inflammation play a positive role in delaying the occurrence and development of cancer .Antrodia camphorata, an endemic fungus in Tai-wan, possesses significant anti-inflammatory effect.So far, 35 anti-inflammatory active components from Antrodia camphorata have been identified , among which triterpenoids account for the most .Studies have revealed that triterpenoids , including ergostanes and lanostanes , have significant anti-inflammatory activities .Because of their structures , especially those of the ergostanes , are similar to the structures of cholesterol and steroid hormones , their anti-inflammatory mechanism may be related to mimic the steroid hormones or interfere with the effect of cholesterol .

Objective To compare the effect of insulin pump continuous subcutaneous insulin (CSII) and multiple subcutaneous insulin (short-acting insulin before meals + glargine,MSII) for the short duration of type 2 diabetes mellitus (T2DM) patients.Methods Fifty-two newly diagnosed T2DM patients were randomly divided into CSII(n =29) and MSII(n =23) group.Patients in CSII group were given insulin pump continuous subcutaneous plus metformin.And patients in MSII group were given insulin by multiple subcutaneous insulin injection plus metformin.The treating periods was 2 weeks and followed up one month.Results The periods from point of insulin injection to blood glucose back to normal level in CSII group was (4.70 ±2.01) d,shorter than that in MSII group(6.90 ± 1.50) d,and the difference was significant(t =2.056,P ＜0.05).The levels of C peptide in two hours postprandial before and after treatment in CSII group were (4.24 ± 0.25) ng/L,(6.29 ± 0.56) ng/L,and (3.20 ±0.11) ng/L and (7.33 ±0.41) ng/L respectively in MSII group.The levels of C peptide in two hours postprandial after treatment were higher than that of before treatment in two groups (t =2.018,2.436 respectively,P ＜0.05),but there were no significant differences between two groups(t =0.985,P ＞ 0.05).Nineteen cases (65.5％) in CSII group were off insulin treatment in one month,and 9 cases (39.1％) in MSII group.There were significant differences in two groups(x2 =5.11,P ＜0.05).Conclusion The two treatment plans can make the improvement in terms of glucose control.However,CSII plan showed more effective than MSII.

Objective To evaluate the effect of dexmedetomidine on brain injury in the patients undergoing cardiac surgery with cardiopulmonary bypass (CPB).Methods Eighty patients of both sexes, aged 18-64 yr, with body surface area of 1.6-2.0 m2, with left ventricular ejection fraction＞30％, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ (New York Heart Association Ⅱ or Ⅲ), scheduled for elective cardiac surgery with CPB, were equally and randomly divided into control group (group C) and dexmedetomidine group (group D) using a random number table.Before induction of anesthesia, dexmedetomidine was given as a bolus of 1 μg/kg over 10 min followed by an infusion of 0.5 μg · kg-1 · h-1 throughout the surgery in group D, and the equal volume of normal saline was given in group C.After induction and before skin incision (T0) , at 30 min after beginning of CBP (T1) , at 30 min after the end of CBP (T2) , at the end of surgery (T3) , and at 24 and 72 h after surgery (T4.5) , blood samples from jugular bulb were drawn for determination of serum concentrations of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), IL-10, S-100β protein and neuron-specific enolase (NSE).Results Compared with group C, the serum concentrations of TNF-α and S100β at T1-3 and IL-6 and NSE at T1.4 were significantly decreased, and the serum concentrations of IL-10 at T1-4 were increased in group D (P＜0.05).Conclusion Dexmedetomidine given as a bolus of 1 μg/kg over 10 min followed by an infusion of 0.5 μg · kg-1 · h-1 throughout the surgery can reduce the brain injury in the patients undergoing cardiac surgery with CPB, and the mechanism is related to inhibited inflammatory responses.

OBJECTIVE To comprehend the changes in the spectrum of clinically isolated pathogenic bacteria and their drug resistance,and to analyze their tendency.METHODS Totally 5746 pathogenic bacteria isolated from clinical samples of the inpatients in our hospital during 1997-2004 and their drug resistance was statistically(analyzed).RESULTS Most of clinically isolated pathogenic bacteria were Gram-negative.The detected rate of Gram-positive bacteria tended to rise,while the detected rate of fungi obviously increased year after year.Gram-positive cocci and Gram-negative bacilli were resistant to commonly used antibacterials in different degrees,(especially) to ampicillin.The sensitive rate of Gram-positive bacteria was high to vancomycin,while the sensitive rates of Escherichia coli and Klebsiella pneumoniae to imipenem were high.CONCLUSIONS The structure of(nosocomial) infection(pathogens) and their drug resistance patterns are changing continuously.It should be(emphasized) to inspect(bacterial) tolerance in order to select antibacterial reasonably.

Objective To analyze and research the Chinese medicine of tonifying kidney recipe on the mechanism of recurrent spontaneous abortion IL-4, IFN-gamma cytokine.Methods60 patients in accordance with the inclusion criteria with recurrent miscarriage from January 2013 to December 2015 were selected, according to the random number table method, the patients were randomly divided into Chinese medicine group, Western medicine group,Combine traditional Chinese and western medicine group, Chinese medicine group treated with traditional Chinese medicine of tonifying kidney recipe, Western Medicine group were given intramuscular injection of progesterone injection,combining traditional Chinese and Western medicine group was treated with acupuncture combined with progesterone Chinese medicine.The course of treatment was 15 days, before and after treatment in patients with pregnancy outcome and IL-4, IFN-gamma levels.ResultsThere was no significant difference between the three groups before treatment with IL-4 and IFN-.After treatment,compared with the traditional Chinese and Western medicine group, western medicine group, Chinese medicine group of IL-4, IFN-, respectively, showed a rise and fall, the difference was statistically significant(P<0.05).After treatment, compared with the traditional Chinese medicine group, the IL-4 and IFN-of the western medicine group were increased and decreased, respectively, and the difference was statistically significant (P<0.05).Combination of traditional Chinese and Western medicine to obtain a higher clinical cure rate.ConclusionThe combination of TCM and Western medicine for improving the efficacy of pregnancy outcome of recurrent spontaneous abortion and exact expression may obviously improve the IL-4 and IFN-gamma, help to improve the IL-4, reduce the expression of IFN-gamma, improve the outcome of pregnancy.

OBJECTIVE:To investigate the feasibility,safety and efficacy of domestic small waist big edge-type occluder for patients with multiple outlets sac-type membranous ventricular septal defection (VSD),and summarize its technical problems and the choice of treatment strategies.METHODS:A total of 20 patients with sac-type membranous VSD,underwent left ventricular angiography at left anterior oblique 45°-60° plus CAOD 20°-25°;the left ventricular entrance diameters were 7-21 (10.9±5.2) mm,more than 2 outlets in the right ventricular surfaces,and the largest outlet diameters were 3-10 (4.8±2.9) mm.According to the result from transthoracic echocardiography (TTE) and angiography,the sac-bag size,shape,location,extent of tissue adhesion,and stability were determined.Different types of small waist big edge-type occluder were implanted,and the occluder diameter was 5-14 (4.6±2.8) mm.Following 15 minutes of blocking,the immediate effects of occlusion were observed through repeating left ventricuiar angiography and TTE.All patients rechecked ultrasonic cardiography and electrocardiogram at 5-7 days of hospital stay,and 1,3,6 and 12 months following surgery.All patients took aspirin tablets for 6 months.RESULTS:Of 20 patients,17 cases underwent domestic small waist big edge occluder,blocked successfully through left ventricular entrance,2 cases were successful using symmetry block,and 1 case was failed.Intraoperative occlusion did not affect the aortic valve and tricuspid valve function.There were 1 case with left bundle branch block and 1 case with right bundle branch block during the operation,and all recovered within a week by using hormone therapy.After 6 months,the cardiac sizes were reduced to different degrees.CONCLUSION:It is safe and effective to treat multiple outlets sac-shaped membranous VSD with domestic small waist big edge-type occluder.The key technology,according to the sac size,shape,firmness,outlet orientation,import size,and the size of aortic stump,is to determine the block site and to select a suitable occluder.

Objective To investigate the effects of autologous blood withdrawal-reinfusion on the perioperative coagulation function in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB ) . Methods Eighty-four ASA physical status Ⅱ-Ⅳ patients ,without impairment of coagulation function ,scheduled for cardiac surgery with CPB ,were equally and randomly divided into 2 groups using a random number table :autologous blood withdrawal-reinfusion group (group ABWR , n= 44 ) and control group (group C , n= 40 ) . Decreased coagulation function was diagnosed based on the following two criteria :laboratory standard of decreased coagulation function and clinical signs .After anesthesia and before the beginning of operation (T1 ) ,at 5 min after heparin was reversed with protamine (T2 ) ,at the end of operation (T3 ) and at 24 h after the end of operation (T4 ) ,venous blood samples were obtained to measure the blood routine and parameters of coagulation function . Blood routine included the red blood cell (RBC ) , hemoglobin (Hb ) , hematocrit (Hct ) , platelet count , and plasma fibrinogen concentration (Fib) .The parameters of coagulation function included thrombelastography (TEG) variables and prothrombin time (PT ) ,activated partial thromboplastin time (APTT ) ,international normalized ratio (INR ) , and activated clotting time (ACT ) . The volume of intraoperative blood loss , amount of mediastinal drainage at 6 and 24 h after operation , consumption of tranexamic acid and heparin during operation , and consumption of fibrinogen after operation ,and requirement for transfusion of allogeneic RBCs ,fresh frozen plasma (FFP) and platelet during operation and within 24 h after operation were recorded .The development of decreased coagulation function during operation and within 24 h after operation .Results Compared with group C , perioperative consumption of allogeneic RBCs were decreased ,reaction time (R) measured by celite-activated TEG was increased at T3 (P<0.05) ,and no significant change was found in the blood routine index ,incidence of decreased coagulation function ,volume of intraoperative blood loss ,amount of mediastinal drainage ,consumption of tranexamic acid and heparin , and postoperative consumption of fibrinogen in group ABWR ( P> 0.05 ) . Conclusion Autologous blood withdrawal-reinfusion provides similar effects on coagulation function with allogeneic blood transfusion ,and does not increase the development of decreased coagulation function in patients undergoing cardiac surgery with CPB .

Objective There is a lack objective methods for the diagnosis of postoperative cognitive dysfunction (POCD).This study aimed to investigate the influence of propofol or etomidate anes-thesia on the postoperative cognitive function and serum S 100βprotein level in infants . Methods This study included 100 hernia infants aged 1-3 years treated by laparoscopic herniorrhaphy under propofol (n=50) or etomidate anesthesia (n=50).At 1 day before and 3 days after surgery, we assessed the cognitive function of the patients using Bayley Scales of Infant and Toddler Development ( BSID-Ⅲ) and further divided each group into a POCD and a non-POCD sub-group based on the results of diagnosis made according to the Z-scores.Using ELISA, we measured the levels of the serum S100βpro-tein in the iliac venous blood drawn preoperatively ( T0 ) and before PACU ( T1 ) and compared them between the POCD and non-POCD groups. Results At 3 days after operation, POCD was observed in 10 cases (20.0%) in the propofol group and 9 cases (18.0%) in the etomidate group, with no statistically significant differences between the two (P>0.05).The level of the serum S100βprotein was markedly elevated in both the propofol and etomidate groups at T 1 as compared with that at T0(P<0.05), and so was it in the POCD in comparison with that in the non-POCD group (P<0.05), with no statistically significant differences between the two groups at T1(P>0.05).A significant correlation was found between the postoperative S 100βlevel and POCD at 3 days after surgery in both the propofol (r=0.842, P=0.001) and the etomidate group (r=0.821, P=0.001). Conclusion Propofol and etomidate anes-thesia can induce different degrees of postoperative decline of cognitive function in 1-3 years old infants .The post-anesthesia elevation of the serum S100βprotein level is positively correlated with early postoperative POCD and indicates various degrees of brain damage .