Objective To explore the distribution,fundamental diseases,risk factors and drug-resistance of hospital- acquired infection caused by fungi in Department of Respiratory Medicine.Methods The clinical data of 142 patients were retrospectively reviewed,and then with statistical analysis was performed.Results The main pathogen which caused fungal hospital-acquired infection was Candida albicans. The most three possible fundamental diseases were chronic obstructive pulmonary disease,bronchiectasis and lung cancer. The main risk factors were lower resistibility of patients and invasive diagnostic and therapeutic measure. The fungus resistance was gradually rising.Conclusion The hospital infection caused by fungus should be emphasized in respiratory medicine department. In order to effectively prevent the hospital infection in respiratory medicine department,we should improve the basic conditions of patients,rationally diagnose and treat,and rationally use the drug against fungi.

ObjectiveTo investigate the feasibility of extended hepatectomy for huge hepatic carcinoma.MethodsA retrospective analysis was made on the clinical data of 28 patients with huge hepatic carcinoma who underwent extended hepatectomy from December 2006 to June 2011.Twenty-two cases were Child-Pugh grade A,6 cases were Child-Pugh grade B,19 cases were indocyanine green retention at 15 minutes (ICGR15)≤10％,5 cases were 10％ ＜ ICGR15 ≤15％,4 cases were 15％ ＜ ICGR15 ≤20％.ResultsThe operative death rate was 7.1％ (2/28) with Child-Pugh grade B,15％ ＜ ICGR15 ≤20％ and liver resection volume 60％-70％.Postoperative complications were found on 15 cases,but all recovered after treatment.ConclusionExtended hepatectomy for huge hepatic carcinoma can be feasible in the patients with enough reserve of the liver function provided.

Objective To found sensitive and reliable method to identify trophoblastic tumor cells in the peripheral blood of the patients suffered from gestational trophoblastic tumor.Methods Given numbers of JAR cell from ten to million were mixed into 10ml non pregnant peripheral blood as a model. Detection of ? hCG mRNA with fluorescence quantitative reverse transcription polymerase chain reaction (FQ RT PCR) and then estimation of the numbers of tumor cell in the blood. Nine cases of peripheral blood were collected from the pretreatment patients of gestational trophoblastic tumor to assay ? hCG mRNA with FQ RT PCR, then to estimate the numbers of tumor cell in the circulation blood. Results FQ RT PCR could detect ? hCG mRNA when ≥10 2 JAR cells were mixed into 10ml non pregnant peripheral blood. Four cases of bloods had been detected ? hCG mRNA expression in 9 cases of gestational trophoblastic tumor, and the numbers of tumor cell from 10 4 to 10 7 per 10ml blood. Conclusion FQ RT PCR of which primers and probe are designed for ? hCG had been proved to be very sensitive detection means, it could be used to detect gestational trophoblastic tumor cells from patient preipheral blood; With FQ RT PCR the tumor cells had been detected in some patients of gestational trophoblastic tumor.

Objective To discuss the characteristics of extended-spectrum beta-lactamases(ESBLs)-producing Shigella and the relation between them and drug-resistance plasmid. Methods The suspicious ESBLs-producing isolates were screened by K-B disc diffusion method, and the ESBLs-producing strains were confirmed by confirmatory test recommended by the National Committee for Clinical Laboratory Standards. Furthermore, the partial blageneof these isolates were detected by PCR using universal primers for TEM, SHV, CTX-M-1 group, CTX-M-2 group and CTX-M-9 group, respectively. The entire blaCTX-M-9 and blaTEM were amplified by PCR using the primers outside the open reading frame (ORF) of these β-1actamases and products were directly sequenced. The conjugation experiment was performed to determine whether the resistance was transferable. Minimal inhibitory concentration (MIC) was detected with double agar dilution method. Results Of the 275 isolates, 12 strains were identified as ESBLs producers. Among them, 8 strains were CTX-M-14 carriers and 4 strains were CTX-M-3 carriers. All ESBLs-producing isolates are positive for plasmid conjugative transfer test. The transconjugants are only resistance to betalactams. Conclusions High resistance to beta-laetams in Shigella is caused by production of ESBLs in the local area. The ESBLs-produeing isolates can transfer the drug resistance through lateral transfer of plasmid.

BACKGROUND:Poststroke depression is one of the most common psychological behavior disorders after stroke and its mechanism remains unclear. Studies have suggested that microRNAs (miRNAs) involved in neurogenesis and synaptogenesis may play an important role in psychology diseases. OBJECTIVE:To observe the expression of miR-137 in the blood and brain of poststroke depression rats and its effect on the behaviors of rats. METHODS:Thirty-six rats were equal y divided into six groups:control, model, agomir-137, agomir-NC, agomir-137+Grin2A and agomir-137+vector groups. Control group had no treatment. Poststroke depression models were established by ligation of middle cerebral artery and chronic mild stimulation in the latter four groups fol owed by receiving an injection of nothing, agomir-137, agomir-NC, LV-CMV-Grin2A or control plasmids into the left lateral ventricle, respectively. RESULTS AND CONCLUSION:We found significantly lower miR-137 levels in the brain and peripheral blood of post-stroke depression rats compared with normal rats. Vertical scores and horizontal scores on the behavior test were significantly higher in the agomir-137 group than the agomir-NC and model groups at 3 weeks after cerebral ischemia;while, sucrose consumption percentage was also higher in the agomir-137 group at the end of 2 weeks after cerebral ischemia. Luciferase assays showed miR-137 bound to the 3’ UTR of Grin2A, regulating Grin2A expression in a neuronal cel line. Grin2A gene overexpression in the brain of post-stroke depression rats noticeably suppressed the inhibitory effect of miR-137 on post-stroke depression. Overal , these findings show that miR-137 suppresses Grin2A protein expression through binding to Grin2A mRNA, thereby exerting an inhibitory effect on post-stroke depression and offering a new therapeutic target for poststroke depression.

OBJECTIVE To explore the effect of vacuum packaging technique for storing sterilized packs in order to extend the period of valid storing.METHODS From 420 sterilized packages 210 were randomly taken as a test group,and the other 210 packages as the control group.According to aseptic techniques the packages of test group were vacuumized and the control group was packed as by outine protocol.Two groups were simultaneously stored in aseptic closet,and then regularly taken out 30 samples from two groups respectively for microbial(culturing).RESULTS Bacterial growth was seen in the control group at first month.But none of the specimens in test group showed any microbial growth until the eighth month.There was a statistically significant difference((P

AIM: To study the effect of vascular endothelial growth factor(VEGF) on hematopoietic differentiation from mouse embryonic stem cells(ESC) in vitro.METHODS: ES-D3 was allowed to grow on mouse fetal fibroblast feeder layer,and then was developed into embryoid bodies(EB).EB cells were transferred into medium supplemented with different concentration of VEGF and VEGF+SCF for 1 week.Six groups,including.VEGF 5 ?g/L,VEGF 10 ?g/L,VEGF 20 ?g/L, VEGF 5 ?g/L+SCF,VEGF 10 ?g/L+SCF and VEGF 20 ?g/L+SCF,were designed.The group of spontaneous differentiation without cytokine(s) was used as control.Hematopoietic transcription factor GATA-2 and early hematopoietic differentiation genes(c-kit and ?-H1) were detected by RT-PCR.The content of CD34~+ cells in each group were measured by flow cytometry.The cells derived from ESC were incubated in semisolid methycellulose cultures.The numbers of total colony-forming units in culture(CFU-C) were counted by reverse microscope.RESULTS: ES-D3 grew and formed EB at day 4.VEGF had a stimulatory effect as a single factor on the expression of genes associated with early hematopoietic differentiation(GATA-2,c-kit and ?-H1),the generation of CD34~+ cells and CFU-C in EB.The effects of VEGF+SCF were the most potent in the experimental groups according to the percent of CD34~+ cells and the numbers of hematopoietic colonies.The most highest inducing efficacy was achieved in VEGF 20 ?g/L or VEGF 10 ?g/L combined with SCF.CONCLUSION: VEGF promotes the differentiation of ESC into hematopoietic cells in vitro.The strongest effect was achieved when VEGF was combined with SCF.

Objective To investigate the predictive value of pregnancy-associated plasmaprotein-A (PAPP-A) and GRACE risk score for death and nonfatal myocardial infarction (combined endpoint) in AMI patients.Methods All AMI patients hospitalized in our department during July 2011 to July 2015 were included consecutively in this prospective study.Plasma PAPP-A were measured at admission.GRACE risk score was acquired with the application of GRACE risk score calculator.Patients were followed up for at least 1 year for any nonfatal myocardial infarction or MACE.Kaplan Meier survival study was analysed according to PAPP-A and GRACE score risk stratification respectively.A cutoff value of 3.0 ng/ml of PAPP-A was chosen from pilot work in this cohort.Results A total of 220 patients were enrolled in the study.The death and nonfatal myocardial infarction during follow-up were significantly higher in patients with PAPP-A≥3.0 ng/ml compared to patients with PAPP-A<3.0 ng/ml (15.7% vs.6.0%, log-rank χ2=5.684, P=0.017).The area under ROC curve of PAPP-A was 0.796(95%CI 0.696-0.896, P<0.01) and the ROC curve of PAPP-A GRACE risk stratification was 0.715 (95%CI 0.567-0.863,P<0.01).Subgroup analysis showed that death and nonfatal myocardial infarction during follow-up was significantly higher in patients with PAPP-A≥3.0 ng/ml compared to patients with PAPP-A<3.0 ng/ml in intermediate and low risk group by GRACE risk stratifcation (log-rank χ2=14.63,P<0.001).Conclusions PAPP-A could predict mortality and nonfatal myocardial infarction in patients with AMI.PAPP-A combined with GRACE risk score can better predict outcome than GRACE risk score alone in intermediate and low risk patients by GRACE risk stratifcation.

Objective:To investigate the effects of Rad50-targeted inhibition on the radiosensitivity of head and neck squamous cell carcinoma cells.Methods:Rad50 in Tca8113 and OSCC-15 cells was down-regulated by siRNA.Then the cells were treated by a small dose of radiation(2 Gy),Western blot was used to detect the expression of Rad50 protein.Comet assay was used to evaluate the DNA double strand breaks(DSBs).Colony survival assay was performed to detect the survival rate of the cells.Telomere FISH was performed to assess the telomere length in the cells.Results:Target siRNA inhibited Rad50 protein expression in Tca8113 and OSCC-15 cells. siRNA combined with the radiation of 2 Gy produced more DSBs,decreased the proliferation and shortened the nucleus telomere length of the cells more than radiation treatment alone.Conclusion:The targeted inhibition of Rad50 may increase the radiosensitivity of Tca8113 and OSCC-15 cells.

Objective:To build a hospital bed resource allocation model, for the reference of public hospitals in optimizing their bed resource allocation.Methods:Based on ReLU activation function, a hospital bed resource allocation model was constructed by combining DRG and public hospital performance appraisal requirements, including discharge person times, average length of stay, hospital bed utilization rate, proportion of surgery, proportion of fourth level surgery, case mix index, average bed day income and other indicators. When the existing number of hospital beds available was greater than the number of hospital beds allocated for the first time, a secondary allocation should be made. A tertiary general hospital was taken as an example for a model analysis.Results:As found in the model analysis, among the 2 729 beds of the hospital in the first allocation, 110 beds were left available for secondary allocation. The results of bed allocation of 40 inpatient departments in the hospital were as follows: 15 departments need more beds, 3 departments need more beds and shorter length of stay, 2 departments need no change, 1 department needs shorter length of stay, 4 departments need less beds, and 15 departments need less beds and shorter length of stay.Conclusions:The bed resource allocation model enriches the connotation of indicators, reflects the specialty characteristics. These indicators can be flexibly adjusted in combination with hospital development planning and budget management, hence conducive to refined management of hospital bed resources in public hospitals.