Objective To investigate the difference in healthcare-associated infection (HAI)status and antimicro-bial resistance of Acinetobacterbaumannii(A.baumannii)isolated from different wards,so as to provide evidence for effective prevention and therapy for HAI caused by A.baumannii.Methods Clinical data of 446 A.baumannii isolates from hospitalized patients between January 2012 and July 2013 were analyzed retrospectively. Results The majority of 446 A.baumanniiisolates were from patients admitted to intensive care unit (ICU,n= 236,52.92% ), followed by departments of respiratory diseases(n= 55,12.33% )and neurosurgery (n= 48,10.76% ),and the strains were mainly isolated from sputum specimens (94.62% ).Antimicrobial susceptibility testing with 13 kinds of commonly used antimicrobial agents showed that antimicrobial resistance of A.baumanniifrom ICU were highest, susceptibility rates were all<20% ,the next were from department of neurosurgery,susceptibility rates were all<30% ,while susceptibility rates of A.baumanniifrom department of respiratory diseases were all >50% .Conclu-sion The difference in antimicrobial resistance of A.baumanniifrom different wards varied significantly,antimi-crobial resistance of A.baumanniifrom ICU is most serious.

[Objective]To understand the changes of children's blood lead levels and intelligence quotient (IQ) andthe effects of automobile exhaust on the prevelance rates of respiratory symptoms of children. [Methods] 151 pupilsof Y primary school in urban area were selected as exposure group, 160 pupils of Z primary school in Pudong districtwere selected as control group. The health questionaire survey and health examination were carried out amongpupils. The peripheral blood lead levels of the forth finger were determined. The IQ was determined by combinedRaven's Test. The data were statistically analzed by EPI Info and SAS statistic softwares. [Results] Significant differ-ences of blood lead levels were observed between exposure group and control group. The blood lead levels (x) negatively correlated with children's IQ (y) (y= 120. 11--0. 129x) . The prevelance rates of sore and uncomfortable feelings and foreign body sensation in throat and cough of exposure group were significantly higher than those in controlgroup. The ORs of corresponding symptoms were 1.71, 2, 64 and 2. 92 respectively. The multiple linear regressionanalysis showed that exposure to automobile exhaust and the distances from the residential region to street with heavytraffic were the main factors affecting the children's peripheral blood lead levels and the prevelance of respiratorysymptoms. [Conclusion] Further control of the emission of automobile exhaust and reasonable planning of location ofresidential areas were the main measures to control the prevelance of lead poisoning and its related diseases of children.

Objective To clarify malaria infection and the incidence in first Chinese medical team of United Nation peacekeeping mission in Democratic Republic of Congo and evaluate the effect of prevention measures so that provide reference for studying on malaria prevention and the precautionary measures for the follow-up personnel in Africa. Methods 43 cases (male 30, female 13) were observed between Apr. and Dec. 2003 when they were deployed in D.R.of Congo. Eliminating mosquito was used to decrease the density, including the usage of driving mosquito machine, killing mosquito lamp and chlorine cyanogens chrysanthemum ester, ”Prevent malaria-3”and COTECXIN as the precautionary medicines. Plasmodiums in blood were checked periodically. The cases with positive result of blood test and without clinical symptom was considered as infection, otherwise as disease with symptom appeared. Results The density of mosquito in house decreased. 3 cases (male 2, female 1) suffering from malaria, the incidence was 6.98%. Plasmodium was found in 39 individuals (male 26, female 13), the infection rate was 90.70%. The incidence was the lowest compared with contingents from other countries. Conclusion It was effective that these measures taken by reducing mosquito density and ”Prevent malaria-3”and COTECXIN usage in Chinese medical team during peacekeeping mission .

Objective To evaluated the value of hysteroscopy and dilatation and curettage (DC) in diagnosis of endometrial cancer. Methods This retrospective analysis included clinical pathologic data of 3 676 patients with endometrial cancer from Jan. 1, 2000 to Dec. 31, 2010 in hospitals of endometrial cancer prevention projects in Guangdong Province. Results A total of 3 676 patients with endometrial cancer were divided into DC group (3 211 patients) and hysteroscopy group (465 patients). Compared to the results of pathological diagnosis, the accuracy rate between DC group and in hysteroscopy group were no statistically difference was 91.00%(2 922/3 211) vs 90.75%(422/465;χ2=0.030, P=0.862). The accuracy rate, sensitivity, specificity, positive predictive value and negative predictive value of cervical involvement between DC group and hysteroscopy group were 81.28%vs 86.45%(P<0.01), 24.78%vs 23.68%(P>0.05), 93.76%vs 98.71%(P<0.01),46.75%vs 78.26%(P<0.01) and 84.95%vs 86.88%(P>0.05), respectively. Rate of positive peritoneal cytology in DC group was 4.76%(153/3 211), and the rate was 3.23%(15/465) in hysteroscopy group, which were no statistically difference (χ2=2.206, P=0.137). There were no statistically difference in 5-year overall survival (91.02% vs 92.03%;χ2=0.033, P=0.856) and 5-year progression-free survival (89.81%vs 91.83%;χ2=1.508, P=0.219) between DC group and hysteroscopy group. Conclusions Hysteroscopy and dilatation and curettage is an effective method in diagnosis of endometrial cancer, especially hysteroscopy is better in diagnosis of cervical involvement. Hysteroscopy don′t improve risks of positive peritoneal cytology and don′t affect the prognosis of patients with endometrial cancer.

Objective: To study the prevalence and pathogenesis of TT virus (TTV) in hemodialysis patients. Methods: Serum TTV DNA was tested in 69 hemodialysis patients from our hospital by nested-PCR using primers from a conservative region of TTV genenome, genetic analysis and detection of hepatitis C virus antibody (anti-HCV) and the levels of alanine aminotransferase (ALT) were also carried out simultaneously. Results: The overall prevalence of TTV viremia was 27.5%. The PCR-amplified gene fragment from one patient was sequenced, and its gene sequence homologies with GH1,TA278, TTVCHN1 and TTVCHN2 ranged from 89% to 100%, its deduced amino acid sequence ranged from 87% to 100%. There was no significant difference of TTV prevalence between anti-HCV positive and negative patients. No significant elevation of ALT was found in all patients. Conclusion: High prevalence of TTV infection is found among hemodialysis patients, and TTV infection has no significant association with HCV infection or elevation of ALT.

Objective To study the effect of combining loop electrosurgical excision procedure (LEEP) and recombinant human interferon α2b (rhIFNα-2b) suppository in treatment of cervical intraepithelial neoplasia (CIN).Methods Prospective,random and control study was conducted in 82 patients with CINⅠ-CINⅢ.Before canting out LEEP to these patients,all women were performed HPV DNA detection by the method of Hybri Max.Among these patients,41 patients were assigned to the studying group,in which the patients were given rhIFNα-2b suppository for three courses of treatment after LEEP.The other 41 patients who carried out LEEP simply were assigned to the control group.Liquid-based ThinPrep cytology test (TCT) and HPV DNA were examined in the sixth and twelfth month after treatment.Results In the studying group,the cure rate was 90.2％ when LEEP ended six months,and the cure rate was 100.0％ when LEEP ended twelve months.In the control group,the cure rate was 43.9％ when LEEP ended six months,and the cure rate was 61.0％ when LEEP ended twelve months.In the sixth and twelfth month after LEEP,the difference was significant when we compared the cure rate between the two groups (x2 =19.93,19.89,all P ＜ 0.05).Conclusion The clinical effect of combining LEEP and rhIFNα-2b suppository is better than LEEP in treatment of CIN.The method can remove or destroy the cervical lesions effectively and inhibit HPV replication and spread of HPV infection.

Clinical data were analysed in 19 patients with propylthiouracil (PTU)-induced antineutrophil cytoplasmic antibody associated vasculitis. Among them, 17 patients (89.5%) were diagnosed as Graves′ disease originally. The duration of PTU therapy in 18 patients was more than two years. Multi-organ involvement was common, with 15 patients (78.9%) involved in kidneys and 8 patients (42.1%) involved in lungs. The prevalences of arthralgia, skin rash and fever were also high. All patients withdrew PTU, and some with severe organ involvements received prednisone and immunosuppressant.

AIM: To investigate the expression of peroxisome proliferator-activated receptors (PPARs) in human endothelial cells, and their effects on plasminogen activator inhibitor-1 transcription. METHODS: The expression of three types of PPARs in mRNA level were detected in human umbilical vein endothelial cells(HUVECs) by using RT-PCR. Cultured endothelial cells line-ECV304 were transfected with PAI-1 promoter controlling CAT reporter gene and co-transfected with varying doses (250, 500, 1 000 ng) of expression vectors PPAR? or PPAR?.The transcripton activity of PAI-1 promoter were detected with ELISA. RESULTS: There were all three types of PPARs mRNA expression in HUVECs, while the expression of PPAR? was less than that of PPAR?( P

OBJECTIVE[corrected] To investigate the effect of peroxisome proliferator-activated receptors (PPARs) activators on plasminogen activator inhibitor type-1 (PAI-1) expression in human umbilical vein endothelial cells and the possible mechanism.

METHODSHuman umbilical vein endothelial cells (HUVECs) were obtained from normal fetus, and cultured conventionally. Then the HUVECs were exposed to test agents (linolenic acid, linoleic acid, oleic acid, stearic acid and prostaglandin J2 respectively) in varying concentrations with fresh media. RT-PCR and ELISA were applied to determine the expression of PPARs and PAI-1 in HUVECs.

RESULTSPPAR alpha, PPAR beta and PPAR gamma mRNA were detected by using RT-PCR in HUVECs. Treatment of HUVECs with PPARalpha and PPAR gamma activators--linolenic acid, linoleic acid, oleic acid and prostaglandin J2 respectively, but not with stearic acid could augment PAI-1 mRNA expression and protein secretion in a concentration-dependent manner. However, the mRNA expressions of 3 subclasses of PPAR with their activators in HUVECs were not changed compared with controls.

CONCLUSIONHUVECs express PPARs. PPARs activators may increase PAI-1 expression in ECs, but the underlying mechanism remains unclear. Although PPARs expression was not enhanced after stimulated by their activators in ECs, the role of functionally active PPARs in regulating PAI-1 expression in ECs needs to be further investigated by using transient gene transfection assay.

Cells, Cultured ; Endothelium, Vascular ; cytology ; metabolism ; Fatty Acids ; pharmacology ; Fetus ; Humans ; Linoleic Acid ; pharmacology ; Plasminogen Activator Inhibitor 1 ; biosynthesis ; genetics ; Prostaglandin D2 ; analogs & derivatives ; pharmacology ; RNA, Messenger ; genetics ; Receptors, Cytoplasmic and Nuclear ; biosynthesis ; genetics ; Transcription Factors ; biosynthesis ; genetics ; Umbilical Veins ; cytology ; metabolism ; alpha-Linolenic Acid ; pharmacology

Objective To investigate the learning outcome of clinical scenarios discussion im-plemented in teaching medical students before clinical probation. Methods Using standardized pa-tients (SP) to simulate the clinical common difficult situation, all eight year program clinical medicine students (84) of Grade 2008 who were about to enter the clinical probation were given clinical commu-nication education guidance. Through five classification variables questionnaire and return visit, the teaching effect was evaluate. Epidata 3.0 was used to input data, and the SPSS 15.0 was used to make descriptive analysis of the questionnaire and proportion comparison. Results We found 35.4%(29) and 63.4%(52) of subjects liked and approval this training, respectively;90.2%(74) of the subjects thought the diffi-culty of this train was moderate; 77.3% (65) of subjects believed that it was necessary to set the clinical scenarios discussion before clinical probation. Conclusions The implementation of clinical scenarios discussion before clinical probation was effective on inducing the medical students to pay attention to the doctor-patient communication, and deep thinking about the communication notice mat-ters and cop-ing styles in clinical environment.