OBJECTIVE:To study the compatible stability of Ceftriaxone Sodium with Compound Sodium Chloride Injection or Sodium Lactate Ringer's Injection and study the compatible stability of the simulated in vivo peak concentration of ceftriaxone sodium with instant high concentration of calcium gluconate ion injection. METHODS: The concentration of Ceftriaxone Sodium in the mixture was determined by HPLC,meanwhile,the changes of the mixture in appearance,pH value,and the insoluble particles at room temperature were observed. RESULTS: At 0～2 hours,the mixture of Ceftriaxone Sodium and Compound Sodium Chloride Injection was clear in appearance;however,at 2 hours,it was white cloudy macroscopically,and its pH valued increased,ceftriaxone sodium content decreased and insoluble particles increased. The ceftriaxone sodium content reduced when mixed with sodium lactate ringer's injection. After mixing of simulated in vivo peak concentration of ceftriaxone sodium with instant high concentration of calcium gluconate ion injection,the appearance of the mixture was stable but the concentration of Ceftriaxone Sodium reduced slightly. CONCLUSION: Ceftriaxone Sodium can't be used in combination with Compound Sodium Chloride Injection or Sodium Lactate Ringer's Injection. Whether it is suitable to infuse calcium gluconate when ceftriaxone sodium (iv gtt) reached peak concentration remains to be confirmed in future study.

Objective To investigate the efficacy and influence factors of hysteroscopic guiding endometrial resection on dysfunctional uterine bleeding.Methods One hundred and eighty women with dysfunctional uterine bleeding were selected as our subjects in Maternal and Child Health Hospital of Qinhuangdao from Jan.2009 to Jan.2011.One hundred and fifty which meet with operation indications underwent hysteroscopic guiding endometrial resection.Operation periods,blood loss,adverse effects rate were recorded.Serum follicle stimulating hormone (FSH),luteinizing hormone (LH),estradiol (E2) and progesterone (P) hormone levels were detected at preoperative and postoperative.The efficacy was recorded at 6 and 12 months after the procedure.Results The average operation time and amount of bleeding were (31.2 ± 11.0)min and (32.3 ± 10.5) ml,and no blood transfusion performed during the operation.All cases got the succeed operation.There were no significant difference in terms of serum FSH,LH,E2 and P concentrations before and after treatment(P ＞0.05).At 6 months after treatment,improvement rate was 64.0％ (96/150),and effective rate was 32.0％ (48/150).The total effective rate was 96.0％ (144/150).At 12 months after treatment,the improvement rate was 58.0％ (87/150),effective rate was 36.0％ (54/150).The total effective rate was 94.0％(141/150).There was significant different in terms of total effective rate between 6 months and 12 months after treatment(x2 =113.6,P ＞ 0.05).Postoperative complications occurred in 2 cases,including 1 cases of abdominal pain,and 1 cases of dysmenorrhea.Uterine cavity depth,age and disease duration were the main factors affect the clinical efficacy.(OR(95 ％ CI):-1.14 (-1.17 to-1.07),1.60 (1.31 to 2.08),-1.02(-1.14 to-1.08),P ＜ 0.05).Conclusion Treatment of hysteroscopic guiding endometrial resection on dysfunctional uterine bleeding is proved to be efficacy due to the less adverse reaction.

Objective To discuss the expression and clinical significance of vascular endothelial growth factor (VEGF)-C and nm23-H1 in colorectal carcinoma.Methods Immunohistochemical staining was employed to determine the expression of VEGF-C and nm23-H1 in the carcinoma tissues of 120 cases with colorectal carcinoma and in the adjacent mucosal tissues of 55 cases as control,and analyzed their correlation with cliniopathological features and prognosis.Results The positive expression of VEGF-C in the carcinoma tissues was 71.7％ (86/120),significantly higher than that in the adjacent mucosal tissues [21.8 ％ (12/55)],and there was significant difference (x2 =35.186,P ＜ 0.01).The positive expression of nm23-H1 in the carcinoma tissues was 57.5％ (69/120),significantly lower than that in the adjacent mucosal tissues [90.9％ (50/55)],and there was significant difference (x2 =18.351,P ＜ 0.01).The expression of VEGF-C was significantly correlated with lymph node metastasis (P ＜ 0.05),and the expression of nm23-H 1was significantly correlated with lymph node metastasis and pathological type (P ＜0.01 or ＜0.05).The expression of VEGF-C and nm23-H1 did not show a significant correlation with gender,age,tumor size,tumor site and depth of invasion (P ＞ 0.05).Spearman correlation analysis showed that the expression of VEGF-C was negatively correlated with the expression of nm23-H 1 in colorectal carcinoma (r =-0.472,P ＜0.01).Conclusions The joint detection of VEGF-C and nm23-H1 expression is very promising in prediction of the prognosis of patients with colorectal carcinoma.However,whether it can be used as a marker in prognosis judgment need further investigation.

0.05). But the level of HbA1c, 2 hour insulin and C peptide were significantly lower than that in CG (P 0.05). Conclusion Wei li acupuncture therapy instrument can improvement the islet ?-cell function in patients with type 2 diabetes mellitus.

Objective To investigate the timing and value of noninvasive ventilation (NIV) as a weaning tool immediately after early extubation in patients with acute respiratory distress syndrome (ARDS).Methods A prospective randomized controlled trial was conducted.The ARDS patients with surgical diseases admitted to Department of Respiratory Intensive Care Unit (RICU) of the First Affiliated Hospital of Xinjiang Medical University were enrolled.The patients were randomly divided into sequential group and control group.All patients underwent endotracheal intubation and were mechanically ventilated.Every 12 hours during the first 3 days,the lung recruitment maneuver was performed during pressure control ventilation (PCV).After lung recruitment,all patients were ventilated with synchronized intermittent mandatory ventilation (SIMV) + pressure support ventilation (PSV) + positive end-expiratory pressure (PEEP) or assistant/control ventilation (A/C).The objects in sequential group who met the following criteria including those with oxygen index (PaO2/FiO2) reaching 200-250 mmHg (1 mmHg=0.133 kPa) under PEEP of 8 cmH2O (1 cmH2O =0.098 kPa),and pressure support of 12 cmH2O,and most acute infiltrating lesions having resolved on chest imaging,received noninvasive ventilation (NIV) immediately after extubation,and patients in control group continued to have invasive mechanical ventilation via intubation or tracheostomy with an endotracheal tube.The baseline data in both groups and the number of re-intubation in the sequential group were recorded.The duration of invasive mechanical ventilation and total duration of mechanical ventilation,ICU length of stay,the incidence of ventilator-associated pneumonia (VAP),and mortality rate were compared between the two groups.Results 53 consecutive adult patients were enrolled,including 26 in sequential group and 27 cases in control group.The period of endotracheal intubation was 7.0 (6.8,9.5) days,and 7.7％ (2/26) patients underwent re-intubation in sequential group.There were significant difference in respiratory and circulatory indicators before extubation spontaneous breathing trial (SBT) ≤10 minutes in sequential group,indicating that the patients were still in the early stage of extubation sequential NIV.There was no significant difference in indices reflecting respiratory function and circulation between the two groups,except that respiratory rate at 1 hour was slightly increased in sequential group as compared with that of control group,indicating that sequential NIV could maintain invasive ventilation function.There was significant difference in duration of invasive mechanical ventilation [days:7.0 (6.8,9.5) vs.21.0 (17.0,25.0),Z=-6.048,P=0.000],duration of total mechanical ventilation (days:18.0 ± 4.1 vs.22.0 ± 7.3,t=-2.805,P=0.008),and length of ICU stay (days:21.0 ± 4.1 vs.28.0 ± 8.1,t=-4.012,P=0.000) between sequential group and control group,but there was no significant differences in the incidence of VAP [15.4％ (4/26) vs.29.6 (8/27),x2=1.535,P=0.215] and mortality rate [7.7％ (2/26) vs.18.5％ (5/27),P=0.420].Conclusion When PaO2/FiO2 reached 200-250 mmHg under the condition of low ventilation,sequential NIV facilitates the early discontinuation of mechanical ventilation in ARDS patients with surgical diseases,with shortening of duration of invasive mechanical ventilation,total mechanical ventilation,and the length of ICU stay.

ObjectiveTo investigate the efficacy of invasive-noninvasive sequential mechanical ventilation (MV) in senile patients with severe community-acquired pneumonia (CAP).Methods A prospective study was conducted. The patients with severe CAP aged≥ 75 years admitted to Department of Respiratory Intensive Care Unit (RICU) of the First Affiliated Hospital of Xinjiang Medical University from November 2012 to July 2014, with refusal to have tracheostomy, were enrolled. All patients meeting the diagnostic criteria of CAP and severe CAP were first admitted into the Department of Emergency, and they were found to need MV without absolute contraindication for noninvasive ventilation (NIV) in RICU. The patients were mechanically ventilated via endotracheal intubation (ETI), and they were randomly divided into invasive-noninvasive sequential MV group (sequential MV group) and conventional MV group. NIV was initiated immediately when patients matched the conditions for early extubation in the sequential MV group. Oxygen therapy (5 L/min) via a Venturi mask was provided when the indications of conventional extubation were met. The baseline data and clinical characteristics were recorded, the risk factors of death were analyzed by logistic regression analysis, and 60-day survival rate was analyzed by Kaplan-Meier curve. Results Ninety-one senile patients with severe CAP were enrolled, among them 28 patients died within 60 days, with a mortality rate of 30.77%. No significant difference in 60-day mortality was found between sequential MV group (n = 44) and conventional MV group [n = 47, 25.0% (11/44) vs. 36.2% (17/47),χ2 = 1.331,P = 0.249]. In the sequential MV group, the incidence of ventilator-associated pneumonia (VAP) was significantly decreased [27.3%(12/44) vs. 55.3% (26/47),χ2 = 7.350,P = 0.007], and the rate of ETI≥2 times was increased [59.1% (26/44) vs. 29.8% (14/47),χ2 = 5.095,P = 0.024] as compared with conventional MV group. Compared with survival group, the patients in non-survival group showed a higher incidence of cerebrovascular disease (60.7% vs. 25.4%,P = 0.002), higher acute physiology and chronic health evaluationⅡ (APACHEⅡ) score (26.46±2.59 vs. 24.41±2.47,P = 0.001), British Thoracic Society confusion, uremia, respiratory rate, blood pressure,≥75 years (CURB-75 score, 4.00±0.47 vs. 3.68±0.53,P = 0.013), a longer total duration of MV (days: 21.18±10.02 vs. 14.56±7.62,P = 0.002), and a higher ratio of ETI≥ 2 times (53.6% vs. 33.3%,P< 0.001). It was revealed by multivariate logistic regression analysis that ETI≥ 2 times and comorbidity of cerebrovascular infarction were independent predictors of a worse outcome in the senile patients [odds ratio (OR) = 9.677, 95% confidence interval (95%CI) = 3.075 - 30.457,P< 0.001;OR = 5.386, 95%CI = 1.781 - 6.284,P = 0.003]. It was showed by Kaplan-Meir survival analysis that ETI times and concurrent cerebrovascular infarction imparted significant effects on the 60-day survival rate (χ2 = 40.805,P= 0.000;χ2 = 4.425, P = 0.035).ConclusionInvasive-noninvasive sequential MV may not improve the outcome of senile patients with severe CAP, and ETI≥ 2 times and concurrent cerebrovascular disorders drastically lowered the survival rate.

Objective To observe the effects of permanent magnetic fields with different magnetic inductions on oxidative damage to human brain microvascular endothelial cells (HBMECs) under normal and hypoxic conditions. Methods HBMECs were cultured in vitro under normal and hypoxic conditions,then divided into a control group and groups receiving magnetic induction at 8.1,16.5,20.3,26.0,27.3,62.5,110.7 and 215.6 mT.Changes in superoxide dismutase (SOD) activity and malondialdehyde (MDA) content in each group were measured 72 h after exposure to the magnetic fields. Results Under normal conditions the SOD activities of the magnetic groups were not significantly different from that of the control group. Only the MDA content of the 215.6 mT group was statistically different (slightly higher) than that of the control group (P ＜ 0.05 ).Under hypoxic conditions,there was again no statistically significant difference in SOD activity,but the MDA content of the 110.7 mT group was significantly lower. Conclusions Under normal conditions,a 215.6 mT permanent magnetic field has an effect on MDA in HBMECs; under hypoxic conditions a 110.7 mT permanent magnetic field has such an effect.

Objective To explore the distribution and drug resistance of pathogen in hospitalized tumor patients and to provide reference for the clinical reasonable use of antibiotics and strengthening the hospital infection control. Methods 6 500 clinical speciments were tested in hospitalized tumor patients from January to December,2013.The drug susceptibilities were tested by automated microbiology system or Kirby-Bauer disk dilution method.Drug susceptibility tests were evaluated according to CLSI standard 2012.WHONET5.6 software data were used to analyze the data.The clinical distribution and the resistance results of bacterial were analyzed retrospectively. Results A total of 2 093 strains of pathogens were isolated from 6 500 clinical speciments,among these strains, the gram-negative bacteria accounted for 55.23%,the gram-positive bacteria accounted for 11.08%,and the fungi accounted for 33.68%.Klebsiella pneumoniae,Escherichia coli,Pseudomonas aeruginosa ranked the top three species of pathogens, accounting for 16.63%, 9.60%, and 7.98%, respectively. Staphylococcus aureus, Candidaalbicans ranked the first place of gram-positive bacteria and fungi,respectively.The antibiotic resistance of Escherichia coli was strong in Enterobacteriaceae, and its resistance rates to penicillins,cephalosporins, and quinolones were more than 60%.Of the Staphylococcus,the methicillin-resistant Staphylococcus aureus(MRSA) accounted for 10.00% and the coagulase-negative Staphylococcus (MRCNS)accounted for 87.10%.There was no vancomycin resistant Staphylococcus aureus and coagulase-negative Staphylococcus detected. Enterobacteriaceae strains were found most sensitive to imipenem;gram-positive bacteria were found most sensitive to vancomycin. Conclusion The hospitalized tumor patients are susceptible to pathogens, and the gram-negative bacteria are the predominant isolated pathogen.Etiology inspection and monitoring of antibiotics sensitivity provide experimental basis for clinical infection control and prevention.

Objective To detect the serum levels of folate,homocysteine (Hcy)and vitamin B12 in the patients with non-small cell lung cancer (NSCLC),and to clarify the clinical significance of folate, Hcy and vitamin B12 in the diagnosis and prognosis assessment of NSCLC.Methods 35 patients with NSCLC were chosen as NSCLC group, and 30 healthy people were selected as control group,excluding hypertension,anemia,family disease history and other related factors.The expression levels of serum folate, Hcy and vitamin B12 were examined by circulating enzymatic method and electrochemical luminescence method.The correlations between the levels of serum folate, Hcy and vitamin B12 of the objects in two groups were analyzed by Pearson test.Results The serum Hcy level of the patients in NSCLC group was significantly higher than that in control group (P <0.01).The serum folate level of the patients in NSCLC group was significantly lower than that in control group (P <0.01),while there was no significant difference in vitamin B12 levels between two groups (P > 0.05).The serum Hcy level was negatively correlated with folate level (r=-0.505,P =0.002),but was not correlated with vitamin B12 (r =-0.084,P =0.633).The serum folate level was not correlated with vitamin B12 (r=-0.039,P =0.826).Conclusion The serum Hcy level of NSCLC patient is significantly increased and it has diagnostic and prognostic values in the NSCLC patients.

Objective To evaluate the risk factors for healthcare-associated infection(HAI)in senile dementia pa-tients,so as to adopt effective nursing measures to reduce the incidence of HAI.Methods Clinical data of 82 senile dementia patients aged≥60 years and hospitalized between January 2011 and June 2013 were analyzed retrospective-ly.Results Of 82 patients,28 (34.15%)developed HAI.The main infection site was lower respiratory tract(n=15,53.57%),followed by urinary tract(n=6,21 .43%).Univariate analysis revealed that risk factors for HAI in senile dementia patients were bedridden,long length of hospital stay ,dysphagia,indwelling urinary catheter,irra-tional use of antimicrobial agents,combined with tumor,and hypoproteinemia (all P <0.05 ).The main isolated bacteria were gram-negative bacilli(n=40,62.50%),the top three pathogens were Klebsiella pneumoniae (n=12, 18.75%),Escherichia coli (n =10,15.63%),and Pseudomonas aeruginosa (n =8,12.50%).Conclusion Reali-zing the risk factors and common pathogens of HAI in senile dementia patients is helpful for taking effective meas-ures to prevent and control the incidence of HAI .