OBJECTIVE:To compare antidiuretic activity of Ootheca Mantidis before and after processing,and to explore the best medicinal part and mechanism of Ootheca Mantidis. METHODS:96 rats were randomly divided into blank group,model group,positive group,Ootheca Mantidis group,Ootheca Mantidis stir-fried with salt group,steamed Ootheca Mantidis group, crude product eggs and egg shell groups,processed product eggs and egg shell groups,with 8 rats in each group,12 groups in to-tal. Except blank group,other groups were given adenine 250 mg/kg,ig,for 4 weeks to induce kidney-yang and diuresis model. From third week,Ootheca Mantidis crude drug group and processed Ootheca Mantidis group were all given relevant medicine 0.11 g(crude drug)/ml i.g,and crude product eggs and egg shell groups and processed product eggs and egg shell groups were given rel-evant medicine,ig,once a day,by mass ratio of eggs to egg shell(cude drug 1∶2.4,salt stir-fried product 1∶1.7,steamed prod-uct 1∶2.1)for consecutive 4 weeks. The urinary volume,body weight,renal index and the serum contents of ADH and ALD were all determined. RESULTS:Compared with blank group,body weight and serum content of ADH and ALD decreased in model group,while renal index and urinary volume increased(P<0.05). After 4 weeks of treatment,compared with model group,body weight and serum content of ADH increased in Ootheca Mantidis groups,while urinary volume and renal index decreased (P<0.05);serum content of ALD increased in treatment groups;there was statistical significance in the serum content of ALD in those groups except Ootheca Mantidis group,Ootheca Mantidis stir-fried with salt group and steamed Ootheca Mantidis group (P<0.05);except for ALD,those index were in descending order of steamed Ootheca Mantidis group>Ootheca Mantidis stir-fried with salt group>Ootheca Mantidis group,and steamed Ootheca Mantidis shell group had best exchange. CONCLUSIONS:The an-tidiuretic activity of Ootheca Mantidis has been enhanced after processing. The egg shell of steamed Ootheca Mantidis is main me-dicinal part. To increase the serum content of ADH might be one of the main mechanism of arresting polyuria.

ObjectiveTo observe the changes in plasma interleukin-33 (IL-33) in patients with sepsis and its regularity, the association between IL-33 and the infection, and the significance of IL-33 in predicting the prognosis of sepsis.Methods A prospective single-center single-blind clinical study was conducted. Forty patients with sepsis in intensive care unit (ICU) of Shengjing Hospital of China Medical University from May 2012 to January 2013 were enrolled. The patients were divided into general sepsis, severe sepsis and septic shock groups according to the severity of systemic infection and presence of organ dysfunction. The sepsis patients were again divided into 28-day death group and survival group. Ten healthy volunteers and 11 patients with systemic inflammatory response syndrome (SIRS) were enrolled as healthy control and SIRS groups. The levels of procalcitonin (PCT), IL-33, IL-6, IL-1β, tumor necrosis factor-α (TNF-α), and IL-33 receptor sST2 were determined with enzyme linked immunosorbent assay (ELISA) within 3 hours, and 24 hours and 5 days after enrollment to ICU. The acute physiology and chronic health evaluationⅡ (APACHEⅡ) score was calculated. The clinical outcome, length of stay in ICU, and duration of mechanical ventilation were recorded. The relationship between IL-33 and each parameter was analyzed by Spearman analysis. Receiver operating characteristic (ROC) curve was drawn to evaluate IL-33 in predicting the outcome of sepsis.Results Plasma IL-33 in sepsis patients within 3 hours after admission was significantly increased compared with that of the healthy controls and SIRS group (ng/L: 15.43±7.22 vs. 0.67±0.24, 1.25±1.09, bothP< 0.01). Compared with SIRS group, PCT in sepsis group was significantly increased [μg/L: 52.23 (19.69, 73.37) vs. 1.22 (0.69, 3.73),Z = -2.447,P< 0.001]. With exacerbation of illness, APACHEⅡ score, the values of PCT and IL-33 were gradually increased in general sepsis, severe sepsis and septic shock groups, while the length of stay in ICU and the duration of mechanical ventilation were gradually prolonged (P< 0.05 orP< 0.01). The concentration of IL-33 (ng/L) of sepsis patients admitted to ICU within 3 hours, and 24 hours and 5 days of the illness was 15.43±7.22, 11.82±6.16, 5.55±2.25, respectively (F = 4.823,P = 0.004). There was a positive correction between IL-33 within 3 hours after ICU admission and APACHEⅡ score (r = 0.351,P = 0.031), PCT (r = 0.412,P = 0.005), IL-6 (r = 0.535,P = 0.030), IL-1β (r = 0.674,P = 0.030), TNF-α (r = 0.250,P= 0.030), sST2 (r = 0.620,P< 0.001), and length of stay in ICU (r = 0.296,P = 0.013), duration of mechanical ventilation (r = 0.385,P = 0.011). Decreased plasma IL-33 level could be found in the survivors (n = 37,F = 7.798,P< 0.01), and its level in non-survivors (n = 3) was increased (F = 37.283,P> 0.05). The area under the ROC curve (AUC) of IL-33 and PCT in ROC curve were 0.821, 0.829. When the cut-off value of IL-33 was 13.79 ng/L, the sensitivity was 74.2%, the specificity was 79.6%; when the cut-off value of PCT was 4.70μg/L, the sensitivity was 87.5%, and the specificity was 81.4%.Conclusions The concentration of IL-33 3 hours after ICU admission was obviously increased in sepsis patients, and it was positively correlated with PCT, therefore it is valuable in the diagnosis of the infection. In addition plasma IL-33 is related to the severity of sepsis. Its trend of change is valuable in predicting the outcome and in distinguishing sepsis from SIRS.

Objective To analyze the risk factors and treatment methods of postoperative complications after laparoscopic radical gastrectomy.Methods Clinical data of 117 patients with gastric cancer before and after operation were evaluated, and the possible risk factors of postoperative complications were evaluated.Results Laparoscopic BillrothⅡ gastric cancer radical postoperative complications included incision infection, infection of the lung or pleural or peritoneal infection, obstructed jejunum anastomotic ifstula, incidence of 35.04% (41/117), operation method, operation time, the tube indwelling time, postoperative life habits and postoperative complications.Conclusion Laparoscopic BillrothⅡ gastric cancer radical postoperative complications by a variety of reasons is due to a combination, except for patients with quality and disease factors, 6 risk factors are as follows: the whole stomach resection, surgery time 4 h, hemorrhage 800 ml, gastric tube indwelling time of 3d, long-term smoking, and abdominothoracic incision, more attention should be paid to the perioperative treatment. Surgery time 4 h, gastric tube indwelling time of 3 d, long-term smoking, and abdominothoracic incision are the main risk factors.

Objective To explore the interference factors of total bile acid project and 30 routine items on the Roche Modular P800 automatic biochemical analyzer,and to find the effective measures to eliminate the carry-over.Methods In accordance with the screening process,the interference factors of total bile acid project as the test item,30 regular testing projects as the observation objects,including total bilirubin,direct bilirubin and so on,and then the validation test were carried out.By means of the increasing cleaning procedures of the reagent needles or colorimetric cups and adjusting the test sequence,we compared the influence of the result of total bile acid before and after this kind of treatment.Results There were the carry-over of high density lipoprotein,uric acid and total bile acid,which could be eliminated by increasing cleaning procedures of reagent needles or colorimetric cups.There were the cross contamination of lipase and total bile acid,which could be basically eliminated by adjusting the test sequence.Conclusion There are the cross contamination among the various projects of automatic biochemical analyzer.To avoid this carry-over,we should pay attention to the order of the infectant and contaminated items in setting the analysis parameters,insert several projects in the interval,or add the cleaning procedures of the reagent needles or colorimetric cups with alkali or acid.

Enlightened by the idea of correlation of mind and body in traditional Chinese medicine and western medicine, integrating his long-term clinical experience, the author brings forward a concise and practical theory for diagnosis and treatment based on the correlation between consciousness and organ in this article. This article includes:(1)introducing the conceptions of consciousness and organ;(2) pointing out the diagnostic and remedial meaning of the four kinds of condition about the correlation of sense and organ;(3) pointing out the diagnostic and remedial meaning of the five kinds of condition about the correlation of desire and organ;(4) how to select herbal and mineral drug to treat the disorders of consciousness and organ;(5) citing some examples to prove the diagnostic and remedial effect of the theory on intractable diseases.

Objective: Provide the hardware support for the clinical diagnose and treatment and make sure that the medical instruments run safely and efficient by improving the status of medical equipment maintenance. Methods: retrospective analyze of the equipment maintenance of Shanghai pulmonary hospital. Results: 76.9% of the maintenance service is provided by the manufacturer and 23.1% of which is provided by the equipment department of the hospital. Conclusion: Medical equipment is about the life safety of patients, the manufacturer outsourcing service has its incomparable advantage in technology. It ensures the safe and efficient operation of the equipment, so outsourcing maintenance is the inevitable trend of development. But medical equipment has its particularity, it needs a short period of time to be present and service throughout the day, which requires the maintenance engineers have stronger business ability and give full play to the role. The effective combination of internal maintenance and outsourcing maintenance promotes the effect of the cooperation win-win.

Objective To observe the effect of defibrase on activated partial thromboplastin time (APTT),prothrombin time (PT)and the blood rheology at the acute stage of cerebral infarction.Methods 46 cases of cerebral infarction were selected in the Nanyang City Center Hospital.They were randomly divided into two groups;23 cases of control group,with regular treatment of 5% low molecular dextran and venoruton injection,intravenous drip,one week for a course,for two courses of treatment;23 cases of experimental group,with 10U defibrase,intravenous drip,every two days,one week for a course,for two courses of treatment.After treatment,APTT,PT and blood rheology were compared before and after treatment.Results APTT were improved in both groups after treatment,and APTT in experimental group was higher than that in control group,and the difference was statistically significant (P<0.05 );PT were improved in both groups after treatment,and the experimental group was higher than that in control group,and the difference was statistically significant (P<0.05);the blood rheology were improved in two groups after treatment (including high shear rate,low shear rate,plasma viscosity,erythrocyte deposited and fibrinogen),and the high shear rate,plasma viscosity,and fibrinogen of experimental group were lower than those of control group,and the differences was statistically significant (P<0.05 ).Conclusion Defibrase could obviously improve the APTT,PT and hemorheology indexes of cerebral infarction at the acute stage,which gives a clinical guidance.

OBJECTIVE To contrast drug-resistance of pathogenes isolated from the intensive care unit(ICU) with that from the non-ICU and understand pathogens distribution and drug-resistance characteristic in ICU in order to provide the evidence for clinical experiential theatment.METHODS The WHONET software was used to analyze the antibiotic resistant rates of 338 strains of pathogens isolated from specimens in ICU from Jan 2001 to Oct 2007.RESULTS The sputum and swallow swab specimen rated the top one(66.6%).The following was blood sample,accounted for 13.6%.The pathogens of the top three of isolating rate were the 66 strains of Klebsiella pneumoniae(19.5%),57 strains of Staphyloccus aureus(16.9%) and 51 strains of Pseudomonas aeruginosa(15.1%).Isolating rate of meticillin-resistant Staphylococcus aureus accounted for 93.8%.Except for imipenem,cefepime and tetracycline,drug-resistance of K.pneumoniae to common antibiotics in ICU was all higher than that in non-ICU.The drug-resistance of P.aeruginosa to imipenem in ICU arrived at 72.2% while that in the non-ICU was 17.9%.CONCLUSIONS ICU is one of the highly susceptible departments where the drug-resistance of the pathogens is generally higher than that in the non-ICU and possesses the particularity other than the non-ICU.

OBJECTIVE To determine the prevalence of antibiotic resistance to macrolide,lincosamide and streptograminB(MLS_B) in Staphylococcus epidermidis caused nosocomial infections and give guide for clinical antibiotics usage. METHODS Totally 126 S.epidermidis isolates were collected to test the minimal inhibitory concentrations(MIC) of erythromycin,clindamycin,clarithromycin,and azithromycin,quinupristin/dalfopristin and cefoxitin.Inducible type of MLS_B resistance(iMLS_B) and MS phenotypes were distinguished by double disk diffusion method(D test) as detailed by the NCCLS. RESULTS Among 126 S.epidermidis isolates,90(71.4%) isolates were meticillin resistant(MRSE),36(28.6%) were meticillin susceptive(MSSE).The rates of antibiotic-resistance to erythromycin,clindamycin,clarithromycin,axithromycin were 92.8%,73.8%,89.7% and 91.3%,respectively.Percentages of strains resistant to erythromycin and clindamycin were 96.7% and 85.6% in MRSE,and 83.3% and 80.6% in MSSE.Constitutive phenotype,inducible phenotype and MS phenotype were detected in 93(73.8%),13(10.3%),and 11(8.7%) isolates,respectively.In constitutive phenotype, the MRSE proportion appeared high(78.5%),in contrast,in inducible phenotype,MSSE proportion appeared high(75%).No resistance to quinupristin/dalfopristin was detected in all isolates(MIC≤1mg/L). CONCLUSIONS The prevalence of antibiotic resistance to MLS_B is high in the collected isolates.The main antibiotic phenotype is constitutive phenotype.MLS_B antibiotics should be used judiciously.

Accurate operation and installation circumstance of medical instruments and equipment directly affect their normal operation. Breakdown of medical instrument due to wrong operation accounts for 43% of all failures. This article makes a discussion on how to train staffs before operation,register utilization and maintenance,manage equipment by dedicated person and mak the best use of medical instrument.