Objective To characterize clinical features,antimicrobial susceptibility and the outcome of nosocomial Acinetobacter baumannii meningitis.Methods All patients with nosocomial meningitis due to Acinetobacter baumannii in 2nd Affiliated Hospital Medical School of Zhejiang University between January 2010 and October 2011 were retrospectively reviewed.Results During the study period,40 patients of this nosocomial infection were identified,who came from neurosurgery ward (19 cases,47.5％),neurosurgieal intensive care unit (18 cases,45.0％),emergency intensive care unit (2 cases,5.0％) or intensive care unit (1 case,2.5％).All the patients had a history of recent neurosurgical procedures. Fever and disturbance of consciousness were the major manifestations,and cerebrospinal fluid examination showed elevated white blood ceil count and protein,and reduced glucose.All isolated pathogens were resistant to the first line antibiotics.The fatality rate was high. Conclusions The most common risk factor for nosocomial Acinetobacter baumannii meningitis is neurosurgery. Resistance to the first line antibiotics is common among all pathogens isolated.The prognosis of the meningitis is poor.

Objective To investigate the effect of dysphagia screening and prospective interventional nursing in reducing the aspiration pneumonia in stroke patients.Methods 186 patients with acute stroke were randomly divided into control group and interventional group,93 cases in each group.The Watian drinking water test was used to screen dysphagia,and the routine nursing was used in the control group.The combined screening of Watian drinking water test and oxygen desaturation monitoring was used to screen dysphagia,and prospective intervention nursing in addition to the routine nursing was used in the interventional group.The detection rate of dysphagia and the incidence of aspiration pneumonia in 4 weeks were compared between the two groups.Results The detection rate of dysphagia in the intervention group was higher than that in the control group (41.9% vs 19.4%,χ2 =11.16,P <0.01),and the incidence of aspiration pneumonia was lower than that in the control group (12.9% vs 4.3%,χ2 =4.38,P <0.05).Conclusion The detection rate of dysphagia can be improved by using the combined screening of Watian drinking water test and oxygen desaturation monitoring.The incidence of aspiration pneumonia can be reduced by using combined screening with additional prospective interventional nursing.

The process of writing graduation thesis is an important pathway of cultivating clinical thoughts and research skills for medical students.But these are some problems,such as understanding insufficiently in the importance of writing graduation thesis,unsuitable selection of graduation thesis,ineffective institution of encourage and management.Strengthening the management,improving the levels of instruction,advocating the group of study,examining report in intermediate stage and enhancing the encouragement are beneficial for improving the quality of the graduation thesis.

Objective To evaluate the effect of methylene blue and visible light by FQ-PCR assay on the inactivation of plasma hepatitis B virus,and to establish a direct and impersonal basis for the surveillance of cural inactivation.Methods Four samples of plasma of HBV-DNA positive were added with methylene blue. Then the plasma was processed with visible light radiation(30 000 Lux) for 0, 5, 10, 15,30 min respectively. Moreover,the concentration of HBV-DNA samples was quantitatively detected by the method of FQ-PCR and compared with untreated samples to evaluate the effect of HBV inactivation and its relationship with the time of radiation.Results The original concentration of HBV-DNA was 5.6?107, 3.2?106, 1.8?106,3.5?105 copies/ml respectively. After being added with methyene blue, the concentration of HBV-DNA was significantly decreased(P

OBJECTIVE:To emphasis the importance to unceasingly upgrading of drug quality standard for drug quality and to arouse the attention of the related enterprises, medical institutions and governmental department to this matter. METHODS: The correlation between quality standard and drug quality was expounded systematically by citing examples and reviewing the pertinent literature, and the current status of drug quality standard in China was analyzed briefly. RESULT & CONCLUSION: Great importance should be attached to the evaluation of drug quality standard to improve drug quality standard level step by step and to ensure efficacy and safety of drugs.

Objective:To analyze the podocalyxin (PCX) expression in the kidney and the number of urinary podocytes in different pathological grades of Henoch-Sch(o)nlein purpura nephritis (HSPN),and to determine whether the number of urinary podocytes reflects the renal damage in HSPN.Methods:Fifty-six children diagnosed with HSPN in our hospital were enrolled in the study and classified into 4 groups by renal pathology:grade Ⅱ (Ⅱa+Ⅱb) (n=10),grade Ⅲ (Ⅲa+Ⅲb) (n=21),grade Ⅳ (n=16),and grade Ⅴ (n=9).Four kidney autopsy specimens without histomorphologic lesions and 8 urine samples from healthy children served as controls.With immunofluorescence assay,the PCX expression in 4 normal renal tissues and in the renal tissues of the 56 HSPN children was detected and quantitatively analyzed.Positive rate and the number of urinary podocytes were detected in the 8 healthy children and 56 HSPN children.Results:In the renal tissues of the normal control group and grade Ⅱ (Ⅱa+Ⅱb) HSPN group,the PCX expression was complete.The percentage of the PCX positive area out of the total glomerular area in the renal tissues of 2 groups had no significant difference (P＞0.05).In the renal tissues of grade Ⅲ (Ⅲa+Ⅲb),Ⅳ,and Ⅴ HSPN groups,the PCX expression showed various degrees of loss,decreasing in turn from grade Ⅱ (Ⅱa+Ⅱb),Ⅲ (Ⅲa+Ⅲb),Ⅳ to Ⅴ,with significant differences between each group (P＜0.01).For HSPN with grade Ⅲ (Ⅲa+Ⅲb) or higher,positive PCX expression was found in the urine,suggesting the presence of enough podocytes in the urine.The percentage of fluorescence positive area out of the total glomerular area of PCX in the renal tissues was negatively correlated with the total number of urinary podocytes (r=-0.637,P＜0.01).Conclusion:Podocyte injury plays a certain role in the pathological progression of HSPN.The urinary detection ofpodocytes can reflect the degrees of pathological damage in HSPN.

Objective:In this experiment we used pain-related neurons of Hb unit discharges recording asa standard to observe the effects of prostaglandin E2 (i. p. ) on Hb unit discharges. Methods :The methodsof unit discharges recording and radiant heat induced tail flick responce were used. Results :The dischargesof pain-excited neurons increased after the addition of PGE2 (i. p. ). The discharges of pain-inhibited neu-rons dec reased after the addition of PGE2(i. p. );PGE2(i. p. ) caused the pain threshold to drop after sym-pathetic nerves were destroyed by 6-OHDA. There were no changes of the pain threshold in undestroyedgroup (P＞0.05). The percentage changes of Hb neurons dropped compared with that of undestroyedgroup (P＜0. 05). Conclusion: The PGE2 could change the discharges of pain-related neurons in Hb, inwhich the sympathetic system might participate in the process.

Objective To detect the effect of oridonin(ORI)on the gene expression of human esophageal carcinoma cell SHEEC and to screen the tumor cell apoptosis target genes.Methods The gene expression of human esophageal carcinoma cell SHEEC without and with ORI induction for 1 hours and 8 hours were detected with microarray technique,respectively.The differentially expressed genes were identified and verified with fluorecent quantitative PCR.Results A total of 1011 genes showed up or down regulation more than twice after ORI induction(including 280 genes after 1 hour and 731 genes after 8 hours induction respectively).In these genes,17 genes with the top extent of up or down regulation were identified,which were involved in the cell signal transduction,transcription regulation,and cell apoptosis.These 17 differentially expressed genes were verified with real-time PCR,and 12 genes were statistically significant.Conclusion In the 12 differentially expressed genes with statistically significance,there may have tumor cell apoptosis target genes induced by ORI through mitochondrion route.

Purpose To explore CT manifestations of thyroid carcinoma and its correlation with neck lymph node metastasis. Materials and Methods CT findings of 165 patients with thyroid carcinoma confirmed by surgical pathology were studied, including number, shape, size, calcium, necrosis, surrounding invasion and enhancement of substantial part, and its correlation with neck lymph node metastasis was also analyzed. Results 107 out of 165 patients (64.85%) suffered from neck lymph node metastasis. Different tumor number, calcium and necrosis were not associated with the rate of neck lymph node metastasis (χ2=0.009, 2.606, 1.522;P>0.05);tumor shape, size, surrounding invasion and enhancement were significantly different from the rate (χ2=26.510, 75.995, 68.922, 20.819;P<0.05). Patients age, tumor shape, size, enhancement and surrounding invasion were positively correlated with lymph node metastasis (r=0.124, 0.243, 0.276, 0.287, 0.395;P<0.05);the sequence of correlation was as follows:surrounding invasion>enh ancement>shape>size>age. However, patients gender, tumor number, calcium and necrosis showed on correlation (r=0.074, 0.126, 0.005, 0.121;P>0.05). Conclusion Lymph node metastasis is mainly associated with factors like age, tumor shape, size, enhancement and surrounding invasion. It is advisable that patients with high risk rate may consider selective cervical lymph node dissection.

OBJECTIVE To investigate the risk factors and to take some useful measures to prevent and reduce infection in order to enhance medical quality,to ensure medical security,to strengthen hospital infection manangement and to prevent hospital infection effectively. METHODS We investigated the prevalence rate of hospital infection among our hospitalized patients in 2001,2003 and 2005, respectively. RESULTS The hospital infection rate was 4.6-6.42% in these years.Risk factors and the abuse of antibiotic were decreasing. CONCLUSIONS In order to control hospital infection rate,mensures should be taken including intensively monitoring the departments with high infection rate,strengthening hospital operation,rationally using the antibiotics,and studying the management for hospital infection.