Objective Through the investigation and analysis,Find the influencing factors of nosocomial infection,seek to control the incidence of nosocomial infection methods and countermeasures.Methods Use retrospective study to find 293 infection cases,and 286 normal cases,then process Logistic regression analysis of the second category.Results The influencing factors of nosocomial infection are:the number of days hospitalized,ICU days,age,blood transfusion,the number of days serious ill,the sections change times.Conclusion In order to control the incidence of nosocomial infection,focus on the crowd of high-risk factors,bring in the performance appraisal,establish the HIS to realtime monitor.

4-Amino dimethyl phthalate as the hapten was coupled to carrier protein and then used to immunize New Zealand rabbits. Polyclonal antibody which showed specific binding to dimethyl phthalate ( DMP) was thus obtained, and on the basis of this, an indirect competitive chemiluminescent enzyme-linked immunoassay ( icCLEIA ) was developed. The experimental parameters of icCLEIA were optimized as follows: the concentration of coating antigen was 50 μg/L, the primary antibody concentration was 92. 5 μg/L, the secondary antibody concentration was 1μg/mL, distilled water (pH 6. 0) was used as diluent solution and the competitive reaction time was 40 min. Under the optimal conditions, the icCLEIA exhibited a linear working range from 0. 74μg/L to 30. 32μg/L with the limit of detection of 0. 29μg/L. The cross-reactivity of thirteen structural analogues was lower than 5%. The recovery of DMP from spiked liquor and soy sauce samples ranged from 80 . 2% to 116 . 0% and the average RSD was less than 3 . 6%. The detection results of the spiked liquor and soy sauce samples were consistent with those by standard gas chromatography-mass spectrometry method. The developed icCLEIA method exhibited a practical potential for detecting DMP residue in food samples.

Objective:To access the efficacy of monoenergetic imaging from spectral CT combined with metal artifact reduction for orthopedic implants (O-MAR) on reducing contrast hardening artifacts in the vein on the injection side, and determining the optimal monoenergetic spectral range to improve the display of axillary lymph node.Methods:A total of 35 patients with breast cancer who underwent chest-enhanced CT scans were enrolled in this retrospective study. The original data were reconstructed to obtain a total of 35 sets of images, including one conventional image, 17 groups of monoenergetic images, and 17 groups of monoenergetic+O-MAR images. The areas of interest were delineated in the high and low-density artifact area on the injection side of the same layer contrast agent, and the contralateral ectopectoralis. The CT value and its standard deviation (SD) were recorded respectively, the artifact area was measured, and the number of axillary lymph nodes was recorded. The difference in CT values (ΔCT 1, ΔCT 2) and the artifact index (AI1 and AI 2) of the high and low-density artifact areas relative to the contralateral ectopectoralis in the same layer were calculated respectively. Friedman test and Wilcoxon signed-rank test were used to compare the differences of ΔCT, AI, artifact area, and number of lymph nodes among the three imaging modalities, and the Kappa test was used to compare the differences in subjective evaluation. Results:As the energy level increased, compared to the conventional image, monoenergetic image, ΔCT 1 absolute value, ΔCT 2 absolute value, AI 1, and AI 2 showed a trend of initially low and then high, artifact area decreased, and the number of detected lymph nodes increased ( P<0.01). Compared to other energy levels, when the monoenergetic image was 100 keV, ΔCT 1 value, 140 keV for ΔCT 2 value, 120 keV for AI 1 value, and 130 keV for AI 2 value were close to zero, and the number of detected lymph nodes was highest at 110-200 keV. In contrast, in the monoenergetic+O-MAR images, ΔCT 1 absolute value showed a trend of initially low and then high, but, ΔCT 2 absolute value, AI 1, AI 2, and artifact area all significantly decreased, whereas the number of detected lymph nodes significantly increased (χ 2 values were 916.23, 895.93, 387.08, 519.41, 890.10, and 1027.98, respectively. All P<0.01). Compared to other energy levels, when the monoenergetic+O-MAR image was at 100 keV, ΔCT 1 value was close to zero, while ΔCT 2 value became close to zero with increasing energy level, and the number of detected lymph nodes was highest at 110-200 keV. As the energy level increased, the ΔCT 1, AI 1, AI 2, and artifact area of monoenergetic+O-MAR images were significantly smaller than those of monoenergetic images at the same energy level, and the number of detected lymph nodes was significantly higher than that of monoenergetic images ( P<0.01). The subjective scores for 110-200 keV monoenergetic images and 100-200 keV monoenergetic+O-MAR images were both higher than 4, and the score for monoenergetic+O-MAR images was significantly higher than that of single-energy spectrum images. The agreement between the two radiologists in assessing subjective scores was good. Conclusion:At 100-120 keV level, spectral CT monoenergetic combined with O-MAR imaging technique has the best performance in removing hardening-induced artifacts of chest-enhanced CT contrast agent and detecting and displaying axillary lymph nodes.

Hypercalcemic crisis (HC) is a rare but critical electrolyte disorder, which may result in death if rapid correct management is not given due to the injury of the neurologic, cardiovascular and renal systems. Severe primary hyperthyroidism (PHPT) is listed as the most common cause of hypercalcemic crisis. Prompt surgical removal of the parathyroid glands is the most effective cure for HC. Nevertheless, hypercalcemic crisis after a successful parathyroidectomy is infrequent. Now, we report a case admitted to the Department of General Surgery of the Shanghai Jiao Tong University Affiliated Sixth People’s Hospital about a successful therapy of hypercalcemic crisis postparathyroidectomy in Sep. 2019, aiming to remind clinicians of the individualized program of calcium supplement after surgery of hyperparathyroidism and emphasize the value of renal dialysis in HC.

As the most aggressive breast cancer, triple-negative breast cancer (TNBC) is still incurable and very prone to metastasis. The transform growth factor β (TGF-β)-induced epithelial-mesenchymal transition (EMT) is crucially involved in the growth and metastasis of TNBC. This study reported that a natural compound isotoosendanin (ITSN) reduced TNBC metastasis by inhibiting TGF-β-induced EMT and the formation of invadopodia. ITSN can directly interact with TGF-β receptor type-1 (TGFβR1) and abrogated the kinase activity of TGFβR1, thereby blocking the TGF-β-initiated downstream signaling pathway. Moreover, the ITSN-provided inhibition on metastasis obviously disappeared in TGFβR1-overexpressed TNBC cells in vitro as well as in mice bearing TNBC cells overexpressed TGFβR1. Furthermore, Lys232 and Asp351 residues in the kinase domain of TGFβR1 were found to be crucial for the interaction of ITSN with TGFβR1. Additionally, ITSN also improved the inhibitory efficacy of programmed cell death 1 ligand 1 (PD-L1) antibody for TNBC in vivo via inhibiting the TGF-β-mediated EMT in the tumor microenvironment. Our findings not only highlight the key role of TGFβR1 in TNBC metastasis, but also provide a leading compound targeting TGFβR1 for the treatment of TNBC metastasis. Moreover, this study also points out a potential strategy for TNBC treatment by using the combined application of anti-PD-L1 with a TGFβR1 inhibitor.