OBJECTIVE To assess the diagnostic and prognostic value of C-reactive protein(CRP) levels,body temperature and white blood cell(WBC)count for hospital-acquired pneumonia(HAP).METHODS Temperature,and concentration of CRP and WBC count of the patients were determined daily,and fixed a day for sequential organ failure assessment(SOFA).Then observed the prognosis be cured,stable out of ICU or death.Patients were divided into death and survival groups according to the prognosis and analyzed retrospectively.RESULTS There were four response modes of CRP ratio after antibacterial treatment:fast response,slow response,nonresponse and biphasic response.All patients with fast response and most patients with slow response survived,whereas all patients with nonresponse and biphasic response were died(P

[Objective]To probe the approach of supplementing Qi and nourishing Yin in the treatment of lung cancer. [Methods] With detailed research into Chinese medicine literature from recent years regarding its application in lung cancer, the basic pathogenesis of lung cancer, and relevant clinical effects and fundamental research of lung cancer are summarized.[Result]Numerous studies have shown that Qi and Yin deficiency is the basic pathogenesis of lung cancer, thus the approach of supplementing Qi and nourishing Yin can reduce the side effects and strengthen the clinical effects of radio-chemotherapy, stim-ulate immune function, improve life quality, and prolong the survival time of the patients.[Conclusion]It is significantly obvious that the approach of supple-menting Qi and nourishing Yin has shown great advantages in the treatment of lung cancer, however further clinical and basic research are expected.

Objective To study the antimicrobial susceptibility of Staphylococcus aureus isolated from children with infectious skin diseases in Beijing area and to investigate the prevalance of community acquired methicillin-resistant S.aureus (MRSA).Methods S.aureus was isolated from 600 outpatients with infectious skin diseases in Beijing Children's ospital.The susceptibility of these isolates to 14 antimi crobial agents was determined by agar dilution method according to the guidelines from Clinical and Laboratory Standards Institute (CLSI).Results Totally，451 S.aureus strains were isolated.Of them,93.8% were resistant to penicillin,87.6% to erythromycin,71.6% to lindamycin,37.3% to etracycline,13.3% to chloramphenicol,6.4% to gentamicin,1.6%to oxacillin,2.2% to ciprofloxacin,0.4% to cefazolin,0.2% to cefuroxime and mupirocin.No resistance was found to vancomycin,ceffriaxone or fusidic acid.Conclusions The results suggest that penicillin and erythromycin are no longer the appropriate agents for the treatment of S.aureus.The prevalance of MRSA iS 1.6% in children with infectious skin diseases in Beijing area.Oxacillin and cephalosporin are recommended for systemic treatment of community acquired MRSA,and mupirocin or fusidic acid for its topical treatment.

OBJECTIVE: To study the inhibitory effect of Longzhi extracts (extracts from a Chinese herbal compound) on the growth of transplanted hepatoma H22 and sarcoma S180 in mice. METHODS: Certain dosage of Longzhi extracts was dissolved into distilled water to obtain the suspension of definite concentration. The suspension of 0.2 ml was planted on the right forefoot of each mouse. The mice were randomly divided into groups 24 hours later and treated for 7 days. One day after the treatment stopped, the mice were sacrificed and the tumor masses were taken out and weighed. RESULTS: The inhibition rates of Longzhi extracts on the tumor of transplanted H22 and S180 were 63% and 41% respectively. CONCLUSION: Longzhi extracts has antitumor action.

Objective:To evaluate the role of autophagy in reduction of high glucose and hypoxia-reoxygenation (HG+ H/R) injury to isolated cardiomyocytes by dexmedetomidine in rats.Methods:The normally cultured rat H9c2 cardiomyocytes at the logarithmic growth phase were seeded in 6-well plates at a density of 1×10 6 cells/ml and divided into 4 groups ( n=15 each) using a random number table method: control group (group C), group HG+ H/R, dexmedetomidine group (group DEX) and dexmedetomidine+ autophagy inhibitor 3-methylpurine group (group 3-MA). The cells were incubated in culture medium with 1% fetal bovine serum + 1% double antibody for 24 h when the cell density reached 50%.To establish HG+ H/R injury model, the cardiomyocytes were cultured in high-glucose culture medium (glucose concentration of 33 mmol/L) for 24 h, and then incubated in a 37 ℃ incubator (95% N 2+ 5%CO 2) for 4 h followed by reoxygenation (90%O 2+ 10%CO 2) for 2 h. Dexmedetomidine was added until the final concentration reached 5 μmol/L at 1 h before hypoxia in DEX and 3-MA groups, and 3-MA was added until the final concentration reached 5 μmol/L at 1 h of incubation with dexmedetomidine.At 2 h after reoxygenation, the cell viability was recorded by the cell counting kit-8 assay, lactate dehydrogenase (LDH) activity was detected by LDH kit, the expression of autophagy-related protein LC3, P62 and Beclin-1 was detected by Western Blot, the ratio of LC3Ⅱ/LC3Ⅰwas calculated, and the expression of P62 and Beclin-1 mRNA was detected by real-time polymerase chain reaction. Results:Compared with group C, the cell viability was significantly decreased in HG+ H/R, DEX and 3-MA groups, LDH activity in the supernatant was increased and expression of P62 was decreased in HG+ H/R and 3-MA groups, ratio of LC3Ⅱ/LC3Ⅰwas decreased in group 3-MA, and the expression of Beclin-1 was down-regulated in group HG+ H/R ( P<0.05). Compared with HG+ H/R group, LDH activity in the supernatant was significantly decreased, expression of Beclin-1, P62 and its mRNA was up-regulated, and ratio of LC3Ⅱ/LC3Ⅰwas increased in DEX group, and LDH activity in the supernatant was increased in group 3-MA ( P<0.05). Compared with DEX group, cell viability were decreased, LDH activity in the supernatant was increased, Beclin-1, P62 and its mRNA was down-regulated, and ratio of LC3Ⅱ/ LC3Ⅰwas decreased in group 3-MA ( P<0.05). Conclusion:Autophagy is involved in the reduction of HG+ H/R injury to isolated cardiomyocytes by dexmedetomidine in rats.

Objective:To investigate the influence of B-lymphocyte chemoattractant on the immune response of CVB3 fusion gene vaccine pcDNA3/C3d3-sVP1.Methods:BALB/c mice were divided into 4 groups randomly, and injected intramuscularly with pcDNA3,pcDNA3/BLC,pcDNA3/C3d3-sVP1 and the combination with the plasmid pcDNA3/BLC and pcDNA3/C3d3-sVP1.At a certain time,they were measured for the titers for neutralizing antibodies,specific CTL cytotoxic activity.The protective efficacy of DNA vaccinations was evaluated by titers of blood viruses and survival rate.Results:The titers for antibodies increased with the time of inoculation.More specifically,the antibody titers (42.17±1.43) and the specific CTL cytotoxic activity (41.3%±3.51%) of the mice in the combination group were remarkably stronger than in the mice with pcDNA3/C3d3-sVP1(P＜0.05),but the virus titers of blood was lower.After lethal CVB3 challenge,the protection of mice from death in the combination group with the plasmid pcDNA3/BLC and pcDNA3/C3d3-sVP1 was 44%.Survival curves indicated that the survive state of combination group was better than others.Conclusion:BLC can strongly enhance the specific immunity induced by C3d3-sVP1.

OBJECTIVE To observe the type of nosocomial infections in our comprehensive ICU,the prevalence and the vicissitude characteristic of infection strains,and the change of antibiotic-resistance.METHODS To summarize the 10 year results of the monitoring which were divided into three stages to compare the changes with time.RESULTS Gram-negative bacilli were 987(76.4%),Gram-positive cocci 216(16.7%) strains,and 89 strains were fungi(6.9%).The top six strains were in turn:Pseudomonas aeruginosa,Acinetobacter baumannii,Staphylococcus aureus,Klebsiella pneumoniae,Escherichia coli,and Stenotrophomonas maltophilia.Distribution of infection sites: 92.3% infection was in lungs,5.2% in urinary tract infection,2.5% in other sites included lungs,abdomene,CSF,blood etc.CONCLUSIONS The main nosocomial infective pathogens in our ICU are Gram-negative bacilli(75.0%),Gram-positive bacterial infection shows a slight increasing,whereas fungi infection decreasing.In addition to S.maltophilia,the great majority of Gram-negative bacilli,ESBL-producing K.pneumoniae and E.coli maintain a higher sensitivity to carbapenem antibiotic.All Gram-positive cocci to vancomycin and teicoplanin maintain a good sensitivity.In the fungal infection,Candida albicans infection ratio is decreased,while non-C.albicans increases.

Objective To study the occurrence of nosocomial infection ( NI ) situation in the neonatal intensive care unit ( NICU ) of Xinhua Hospital affiliated to Shanghai Jiaotong University School of Medicine from January 2012 to October 2013,and analyze risk factors of NI. Methods A retrospective study was per-formed in the NICU,of which all neonates hospitalized over 48 hours were included and the occurrence situation and risk factors of NI were analyzed. Results This study included 1 357 neonates,and 175 neonates developed 202 times NI. The overall incidence of NI was 14. 89% (202/1 357),and the incidence density was 10. 44 per 1 000 NICU patient-days (202/19 355). The lower the birth weight is,or the smaller gestational age is,the higher the NI rate is. The NI rate was 75. 00% in neonates whose birth weight <1 000 g,and the NI rate was 52. 63%in neonates whose gestational age <30 weeks. The most common infection type was pneumonia[43. 07% (87/202)]and sepsis[26. 73% (54/202)]. The hospital stay of the NI neonates was longer and the cost of hospitali-zation is higher than non-NI neonates ( Median stay:20 days and 10 days. Median cost:21 045. 32 yuan and 8 108. 23 yuan)(both P<0. 01). Univariate analysis showed there were significant differences between NI neo-nates and non-NI neonates on gestational age,birth weight,5 min Apgar score,asphyxia rescue history,previons antibiotics use,mechanical ventilation,peripherelly inserted central catheter( PICC) ,closed thoracic drainage tube and chest or abdominal surgery before NI. The logistic regression analysis indicated that previous antibiotics use, mechanical ventilation and PICC were important risk factors for NI. Conclusion The NI rate in NICU is still high. Previous antibiotics use,mechanical ventilation and central venous catheter are risk factors of NI.

Over one half the patients with rheumatoid arthritis (RA) are being treated with methotrexate (MTX). Although well proven, the efficacy of MTX varies in individual patients. This study examined the metabolic biomarkers that can be used to predict the therapeutic effect of MTX by using metabolomic analysis. Rats were immunized with collagen to rapidly cause collagen-induced arthritis (CIA) and then treated with 0.1 mg/kg MTX for 4 weeks. The clinical signs and the histopathological features of CIA were observed to evaluate the therapeutic effects. Urine samples of CIA rats were collected, and analyzed by using 600 M (1)H-nuclear magnetic resonance ((1)H-NMR) for spectral binning after the therapy. The urine spectra were divided into spectral bins, and 20 endogenous metabolites were assigned by Chenomx Suite. Multivariate analyses were performed to identify the spectral pattern of endogenous metabolites related to MTX therapy. The results showed that the clustering of the spectra of the urine samples from the responsive rats (n=20) was different from that from the non-responsive rats (n=11). Multivariate analysis showed difference in metabolic profiles between the responsive and non-responsive rats by using partial least squares-discrimination analysis (PLS-DA) (R(2)=0.812, Q(2)=0.604). In targeted profiling, 13 endogenous metabolites (uric acid, taurine, histidine, methionine, glycine, etc.) were selected as putative biomarkers for predicting therapeutic response to MTX. It was suggested that (1)H-NMR-based metabolomic analysis can be used to predict the therapeutic effect of MTX, and several metabolites were found to be related to the therapeutic effects of MTX.