The serum sialic acid level and its relation to stroke in syndrome X was observed in 21 syndrome X patients with history of stroke,21 syndrome X patients without history of stroke, 21 simple NIDDM patients and 21 healthy subjects matched for age, sex, duration of diabetes and HBAlc level.The results showed that the serum sialic acid level was significantly higher in all NIDDM patients than in normal subjects(P

OBJECTIVE To study the resistance of plasmid mediated AmpC ?-lactamase in Pseudomonas aeruginosa,to detect and identify the AmpC genotype,and to provide the laboratory evidence for antibiotic reasonable application in clinics.METHODS Totally 108 strains of clinically isolated P.aeruginosa were determined antibiotic-resistant phenotype by K-B disc test,and cefoxitin three dimensional test was applied to screen AmpC positive strains.Plasmids were extracted from AmpC positive strains by SDS-alkali splitting technique.The depurated plasmid was used to amplify AmpC ?-lactamase genes by PCR.Positive PCR product was sequenced by Shanghai Sangon Biological Engineering Technology Company.Gene homology of PCR product with other index sample gene sequences was compared.RESULTS There were 28 strains producing AmpC enzyme among 108 P.aeruginosa strains.AmpC Producing P.areuginosa strains displayed multidrug-resistance to antibiotics and a new P.areuginosa strain producing plasmid mediated CMY-7 type AmpC enzyme was discoverd firstly.CONCLUSIONS Presented plasmid mediated AmpC enzyme and AmpC type ?-lactamases in P.aeruginosa are its important resistant mechanism to antibiotics.A strain producing type CMY-7 plasmid mediated AmpC enzyme is found firstly in China.

Objective To explore the effect of rapid intestinal preparation combined with probiotics in bowel preparation before operation.Methods 124 colorectal cancer patients were divided into the probiotic group(65 cases) and control group(59 cases).Control group using traditional 3d bowel preparation,joint probiotic group,to give patients in the 1 d intestinal ready on the basis of probiotic oral.The two groups after patients received isonitrogenous and caloric nutritional support,were observed after the two groups of patients with body temperature and heart rate changes; detection of bacterial DNA ratio of whole blood.Observed in peripheral blood leukocyte count,and systemic inflammatory response syndrome(SIRS) and the occurrence of complications.Results Probiotic group and control group,postoperative fever duration and postoperative heart rate and leukocyte counts return to normal a short time( t =11.52,20.07,P ＜ 0.05 ) ; whole blood PCR detection of bacterial DNA after the positive test group 2 cases (3.30％),the control group was 8 cases ( 26.67％ ),the difference was statistically significant ( t =5.07,x2 =34.68,P ＜ 0.05 ).Postoperative SIRS rate and the incidence of complications showed no statistical difference ( P ＞ 0.05 ).Conclusion Probiotics could reduce colorectal cancer patients with postoperative intestinal permeability and reduce the incidence of bacterial translocation and its rapid intestinal preparation method was feasible and effective and knot the protection of the intestinal mucosal barrier function in rectal cancerconductive to knot the early postoperative inflammatory response in patients with rectal cancer recovery.

Objective To explore the two-dimensional images features and color flow characteristics of scrofula, as well as their application in the localization of scrofula. Methods A total of 110 cases of the scrofula confirmed by operation were retrospectively analyzed. Two-dimensional images and color flow characteristics, the relationship with vascular traveling and the invasion site were recorded. Results Lymph nodes of the lateral neck region along with large vessels were most commonly involved, then followed the submaxillary lymph nodes and the lymph nodes anterior neck longitudinally. There might be multiple lesions behaving differently on two-dimensional images and with different color flow characteristics. Conclusion Most of scrofula can be diagnosed clearly according to the two-dimensional images and color flow characteristics. The description of relationship between involved lymph nodes with vascular, the depth and position of scrofula make the operation safety.

Delirium is a common complication after elderly hip fracture, and is associated with high rates of mortality and morbidity. There is no enough attention for delirium compared to deep vein thrombosis, pulmonary embolism, heart failure, etc. This paper reviews the definition, diagnosis, incidence, prognosis, treatment and other aspects of delirium in order to better under?stand delirium clinically. Delirium is an acute mental disorder of consciousness, attention, perception, thinking ability, memory, mental activity, and emotion. It is characterized by the disorder of sleep or wakefulness, and these changes are difficult to explain by dementia. The confusion assessment method (confusion assessment method, CAM) is generally accepted as the current diagnos?tic tools for delirium, and mainly depends on the patient's consciousness and cognitive function. The mechanisms of delirium are unclear, and it is influenced by many factors, such as agedness, cognitive impairment, pain, sleep rhythm disorders, and theories mainly include neurotransmitter theory, the central inflammatory response theory, the theory of stress response, sleep wake cycle, et al. The delirium is difficult to explain by using single, liner factor, but is elaborated by many various factors. However, the influ?ences of delirium on outcome for hip fracture are unclear, and it is definite that these patients have poor functional recovery, poor independent living ability, longer time in bed, demand for more care. The prevention should be implemented as mainly measures for delirium. Elimination of risk factors, including correct hypoxia, reduce pain, avoid water electrolyte disorders, improve sleep rhythm, and avoid using of opioids should be tried. In addition, adequate analgesia and appropriate anesthesia should used, and some inappropriate drugs should be avoided. Multidisciplinary cooperation mode, including doctors from orthopedics, anesthesiolo?gy, and geriatric department should be conducted to reduce the incidence of delirium as far as possible. Once diagnosed, some measures should be applied, such as maintaining of airway patency, adequate nutritional support, correction of water and electro?lyte disorders, anemia and low serum albumin, to ensure adequate physical and mental support, and to create a good environment for the ward, as well as to remove the possible etiological factors, such as anemia, low protein acidosis and electrolyte disturbance.

Objective To explore the effect of pacifiers plus touching intervention on venipuncture-induced pains in newborn babies.Methods Ninety two neonates undergoing venous puncturing were randomly divided into touching intervention group and pacifiers plus touching group.During and after the venipuncture,the neonatal pain score,heart rate and blood oxygen saturation were compared between the two groups.Results The degree of pain perception in the pacifiers plus touching group was significantly lower than that in the only touching group(P<0.001).During and afterpuncturing the heart rate of the pacifiers plus touching group was significantly lower than that in the only touching group.However,the blood oxygen saturation was significantly higher(P<0.05). Conclusion Pacifiers plus touching can effectively relieve venipuncture-induced pains in neonates.

Objective To investigate the expression of Notch1 and its ligand DLL4 in human gastric carcinoma tissues and its correlation with tumor angiogenic metastasis.Methods Immunohistochemical SP method was used to detect the expression of Notch1,DLL4 and VEGF in 45 gastric carcinoma tissues and paired adjacent normal gastric mucosa,and the relationship between them and clinico-pathological parameters were analyzed.Results The positive expression rate of Notch1,DLL4 and VEGF in gastric carcinoma were higher than that in normal gastric mucosa(P

Objective To get the facts on lifestyle and bone mineral density among the community residents who are above 40 years old in Nanchang,therefore to offer reference for prevention and treatment to the community residents with abnormal bone mineral density.Methods Use Ultrasound bone mineral density detection instrument to detect the calcaneus mineral density among 10 002 community residents who were over 40 years old.The results can be classified as normal,osteopenia and osteoporosis.A questionnaire survey was conducted among all interviewees.The questionnaire consisted of basic information,general situation,lifestyle,height,weight,waistline,hipline.The body mass index was calculated.The relationship between bone mineral density and smoking,drinking,milk,sodas,sports,etc was analyzed.Results As to osteoporosis,the morbidity of male patients was 6.8％,and that of female patients was 10.4％,as to osteopenia,the morbidity of male patients was 43.8％,and that of female patients was 39.7％.Male smokers' morbidity of abnormal bone mineral density was high,there were no significant differences among the groups,female smokers' morbidity of abnormal bone mineral density was low,there were significant differences among the groups.Drinkers' morbidity of abnormal bone mineral density was low,there were no significant differences among the groups;People taking milk and sodas,taking more exercises suffered from lower morbidity of abnormal bone mineral density,there were significant differences among the groups.Conclusions Female,the elderly,povertyin movement,low intake of milk result in high morbidity of abnormal bone mineral density,while the influence of drinking and smoking on abnormal bone mineral density requires further research.

Objective:To investigate the influence of preoperative thyroid dysfunction on the 30-day postoperative mortality and complications in elderly patients with hip fracture.Methods:A retrospective analysis was conducted of the 349 elderly patients with hip fracture who had been admitted to Department of Orthopedic Trauma, Beijing Luhe Hospital Affiliated to Capital Medical University from January 2018 to December 2019. They were 108 males and 241 females, with an average age of 76.3 years (from 60 to 104 years). There were 190 femoral intertrochanteric fractures and 159 femoral neck fractures. By the preoperative level of thyroid function, the patients were divided into a normal function group of 290 cases and a dysfunction group of 59 cases. The 2 groups were compared in terms of hospital stay, mortality and incidence of complications within 30 days postoperation.Results:In this cohort, the rate of 30-day postoperative mortality was 3.4%(12/349) and the incidence of 30-day postoperative complications 14.6%(51/349). The 2 groups were comparable because there was no significant difference between them in the preoperative general data except for the preoperative comorbidity of coronary heart disease ( P>0.05). In the dysfunction group, the hospital stay averaged (10.2±6.9) d, the rate of 30-d postoperative mortality 1.7%(1/59) and the incidence of 30-day postoperative complications 16.9%(10/59), which were insignificantly different from those in the normal function group [(10.7±7.5) d, 3.8%(11/290) and 14.1%(41/290), respectively] ( P> 0.05). Conclusion:Since preoperative thyroid dysfunction does not affect the 30-day postoperative mortality and postoperative complications in the elderly patients with hip fracture but no definite thyroid disease, routine thyroid function screening is not recommended for them.

Objective To assess the risk factors of multidrug-resistant organism(MDRO)healthcare-associated pneumonia(HCAP).Methods The case-control study was conducted in patients admitted to 22 hospitals in 4 cities between April 1 ,2013 and December 31 ,2013,patients with HCAP caused by MDRO (MRSA,MDRPA,MDRAB, ESBL KP,ESBL E.coli)(drug-resistant group )and drug-sensitive organisms (MSSA,PA,AB,KP,E.coli)(drug-sensitive group )were surveyed .Univariate and multivariate statistical analysis methods were used to evaluate the risk factors for MDRO HCAP.The prognosis,cost and length of hospital stay between drug-resistant group and drug-sensitive group were compared .Results A total of 1 656 patients were included in the study ,including 43 pa-tients (2.60%)with mixed infection caused by both drug-resistant and drug-sensitive organisms ;there were 927 ca-ses (55.98%)in drug-resistant group and 772 cases(46.62%)in drug-sensitive group .Logistic regression model re-vealed that admission to ICUs (OR 95%CI :1 .55[1 .14-2.11]),mechanical ventilation (OR 95%CI :1 .45[1 .15-1 .84]),arteriovenous catheterization (OR 95%CI :1 .29 [1 .02 - 1 .63 ]),fiberbronchoscopy (OR 95%CI :1 .46 [1 .02-2.09]),antimicrobial use(OR 95%CI :1 .63[1 .20-2.22]),chronic lung diseases (OR 95%CI :1 .54[1 .13-2.10]),and chronic cardiovascular and cerebrovascular diseases (OR 95%CI :1 .42[1 .15-1 .74])were independ-ent risk factors for MDRO HCAP .Compared with drug-sensitive group ,drug-resistant group prolonged length of hospital stay by an average of 5.89 days,increased hospitalization and antimicrobial expense by ￥40 739.30 and￥2 805.80 respectively;prognoses was worse,risk factor was 1 .66-fold of drug-sensitive group(OR 95%CI :1 .16-2.35).Conclusion Admission to ICUs,invasive operations,antimicrobial use,chronic lung diseases and chronic cardiovascular and cerebrovascular diseases can increase the risk of MDRO HCAP .