Objective To find out the distribution and changing trend of pathogens in positive blood cultures. Methods To analyze 183 isolates from 2010 blood specimens then the results were compared with the relative clinical data. Results A total of 183 strains were isolated from all blood specimens, of which 139 strains (76.0%) were identified as pathogens, where 69 strains (49.6%)being Gram-positive cocci, 57 strains (41.0%) gram-negative bacilli, and 13 strains (9.4%) fungi, respectively. The other 44 strains (24.0%) were contaminated. The major pathogens in 139 strains were Coagulase-negative staphylococci (40 strains, 28.8%), Pseudomonas aeruginosa (17 strains, 12.2%), Escherichia coli (15 strains, 10.8%), fungi 13 strains (9.4%) and Staphylococcus aureus (9 strains, 6.5%). Conclusion The dominant pathogens in positive blood cultures were gram-positive cocci, while gram-negative bacilli cultures were becoming less.

[Objective]To analyze and compare the results of the posterolateral entrance and posterior laminectomy in treating thoracic disc herniation.[Method]From Nov.1998 to Feb.2006,fifty-one cases were treated with posterolateral entrance combined with the facet disectomy(Group A),and 26 patients were treated with the vertebral disectomy instead of the thoracic disc tissue disectomy.Complications occurring in the follow-up time were investigated and the improving rates were calculated.Otanni Systems was used to evaluate the clinical results.The SPSS 13.0 was used for statistic work.[Result]The operation time was 130～185 min(mean 162 min) for Group A,145～205 min(mean 168 min) for Group B.No difference existed(P=0.062).The blood lost was 400～600 ml(mean 485 ml),while in group B,it was 500～800 ml(mean 646 ml),tbere was significant difference(P=0.013).The clinical satisfaction rate of group A was 86.3%,26 patients returned to perfect results,with 18 in good,6 in fair and 1 in poor results.In group B,the clnical satisfaction rate was 69.2%.There was significant difference between 2 groups(P=0.025).Seven out of the 51 patients had complications in group A.Two patients of neurological dysfunction showed no improvement.One patient was found having spinal cord reactive edema.Internal fixation system was removed in 2 patients because of loosening and paresthesia.Anterior spinal artery syndrome was found in 1 patient.Leakage of CSF was observed in 1 patient.While in the Group B,six patients neurological dysfunction showed no improvement.One patient was found having spinal cord reactive edema.Internal fixation system was removed in 1 patient.Anterior spinal artery syndrome was found in 1 patient.Leakage of CSF was observed in 2 patients.There were obvious difference(P=0.034).[Conclusion]Posterolateral entrance is effective in treating thoracic disc herniation.Comparing with the posterior laminectomy,this operation method is safer,more effective and has less complications.

Objective To investigate the expression of the long non-coding RNA (IncRNA) H19 in the serum of patients with acute pancreatitis and its clinical significance.Methods A total of 82 patients who were diagnosed with acute pancreatitis in Emergency Department and Department of General Surgery in Shenyang Emergency Center from January 2013 to December 2015 were enrolled,and 20 healthy subjects were enrolled as normal controls.Peripheral blood samples were collected from the patients with acute pancreatitis and healthy subjects,the serum was separated,and RNA was extracted.Real-time PCR was used to measure the expression of lncRNA H19,and the correlation between the expression of H19 and other clinical and pathological parameters was analyzed.The t-test was used for comparison of continuous data between groups,and the chi-square test was used for comparison of categorical data between groups.The receiver operating characteristic (ROC) curve was used to evaluate the value of lncRNA H19 in the diagnosis of acute pancreatitis.Results The acute pancreatitis group had a significantly higher H19 expression level in serum than the healthy control group (t =2.364,P =0.020).The severe acute pancreatitis group had higher expression of lncRNA H19 than the mild acute pancreatitis group (t =2.111,P =0.037),and the patients with a Balthazar CT grade above grade C had significantly higher relative expression of lncRNA H19 than those with CT grade ≤ C (t =2.312,P =0.022).The ROC curve showed that H19 measurement helped with the diagnosis of acute pancreatitis with an area under the ROC curve of 0.752 (95％ CI:0.636-0.867,P ＜ 0.01).Conclusion Patients with acute pancreatitis have increased expression of IncRNA H19 in serum,and therefore,H19 has certain clinical significance in the diagnosis of acute pancreatitis and the evaluation of disease severity.

Objective: To investigate the effect ofintestinal trefoil factor (ITF) on the transcriptional activity of ITF promoter and to explore the regulatory mechanismofJanus kinase/signal transducersand activators of transcription(JAK/STAT) on ITF promoter. Methods: The 5' flanking sequence of the ITF gene was cloned from human whole blood genomic DNA by PCR. ITF promoter fragment was cloned and inserted into the pGL3-Basic vector to construct recombinant vector. ITF promoter vector was stimulated with ITF at various concentrations and the luciferase activity was measured. The JAK-STAT3 signal transductionpathway was then blocked by a speciifc inhibitor AG490 to determine the signal pathway involved in ITF promoter activity. Results: Restriction endonuclease analysis and DNA sequencing confirmed that the recombinant plasmid, containing ITF promoter, was constructed successfully. After transient transfection, the activity of ITF promoter was increased signiifcantly in the presence of ITF (P<0.05). Blockage of the JAK-STAT3 signal transduction pathway with AG490 signiifcantly reduced the ITF promoter activity (P<0.05). Conclusion: ITF increases the transcriptional activity of ITF promoter via the JAK-STAT3 signal transduction pathway.

The widely application of the radio knife alleviates the patient's pain and improve the medical quality.The radio knife is high frequency power equipment based on the theory that electricity concentrates on the skin.It can directly cut the tissue,homeostasis and cauterize.The safety requirement of this equipment is very strict because unsafe operation will burn the tissue,cause temporal unaware hurt and even endanger the patient's life.If the safety support system is imperfect,disastrous loss or medical conflict will be caused.Users must be cautious in using and familiar with the safety and protection of the radio knife.[Chinese Medical Equipment Journal,2008,29(2):96-98,104]

0.05).The prognosis was worse with increase in Dukes stage,negative expression of gene nm23,and positive expression of gene p53 and C-erb-2.Reverse expressions had better prognosis.Conclusions It can be likely to get a more reliable prognosis predication if a combine examination together with p53,C-erb-2,nm23 and their clinical pathology such as Dukes stages,was done in colorectal cancer patients.

Objective To study the associations between neo-adjuvant chemotherapy (NACT)sensitivity and expression of relative proliferation and apoptosis genes in cervical cancer tissues. Furthermore,the potential roles of relative genes expression as monitor in the chemotherapy against cervical cancer tissues were studied. Methods Fifteen pathologically proved Ⅱ A stage cervical cancer patients with HPV 16 positive were divided into effective group and non-effective group according to the clinical response to NACT, the changes of HPV16-E6, p53 genes and proteins expressions were measured by real-time quantitative reverse transcription polymerase chain reaction (RT-PCR) and Western blot. At the same time, MTT assay was used to detected proliferative activity to paclitaxel liposome and carboplatin (paraplatin) in HeLa cells. Results In effective group, the overall response rate was 73.3 % (11/15) and the HPV16-E6 mRNA and protein level after NACT was significantly decreased than that before NACT (t=3.359, t=3.614, P＜0.05), while p53mRNA and protein level increased significantly (t =5.852, t=2.838, P ＜0.05). However, there have no significant different between pre-NACT and Post-NACT of the two genes in the non-effective group. After using chemotherapy HeLa cells growth decreased. Conclusion HPV16-E6 and p53 expreesion level are useful paraneters in evaluating NACT response in cervical cancer tissues. The detection of the two genes expression is a method for predicting efficacy in NACT.

Objective To reveal the differences in clinical characteristics between health care associated pneumonia (HCAP) and community acquired pneumonia (CAP) in elderly patients.Methods A total of 282 elderly patients were evaluated,including 69 patients with HCAP (25.5％) and 213 with CAP (75.5％).A retrospective observational study was conducted.The baseline characteristics,comorbidities,pathogen distribution,antibiotics,and clinical outcomes between HCAP and CAP patients were compared.Results The incidence of chronic obstructive pulmonary diseases and cerebrovascular diseases were higher in HCAP group (49 cases,71.0％; 36 cases,52.2％) than in CAP group (93 cases,43.7％; 57 cases,26.8％) (x2 =15.598,15.229,all P＜0.001).The infection of Pseudomonas aeruginosa (29 cases,51.8％),Staphylococcus aureus (19cases,34.0％) and Acinetobacter baumannii (18 cases,32.1％) in HCAP group were more than in CAP group [(26 cases,27.7％),(12 cases,2.8％),(8 cases,8.5％),(x2 =8.796,9.586,13.678,all P＜0.05)],respectively.While the infection of Streptococcus pneumoniae (38 cases,40.4％) in CAP group was much more than in HCAP group (4 cases,7.1％)(x2 =19.283,P＜0.001).Initial inappropriate antibiotics treatment failure was more frequent in HCAP group (24 cases,34.8％) than in CAP group (37 cases,17.3％)(x2=9.321,P＜0.05).The mortality was higher in HCAP group (19 cases,27.5％) than in CAP group (29 cases,13.6％)(x2 =7.151,P＜0.05).Conclusions HCAP should be distinguished from CAP in elderly,which is helpful to choose appropriate empirical anti-infective regimen and improve the effect of HCAP treatment.

Objective To observe the influencing factors of polysomnography (PSG) monitoring and to evaluate the efficacy of preventive measures.Methods We selected 205 patients with sleep apnea syndrome (SAS) who accepted PSG from May 2011 to April 2012 in our hospital as the intervention group.They were administered preventive measures,including psychological counseling,intensive grease dispelling of patient skin,arrangement of sensor and electrode.One hundred and fifty-two SAS patients who were administered PSG from May 2010 to April 2011 were selected as the control group.The monitoring successful rates between groups were compared and influencing factors were investigated.Results The monitoring successful rates of control group and the intervention group were 92.1％ and 97.1％ respectively; there was a statistically significant difference between the successful rates of the two groups (x2 =4.499,P ＜ 0.05).The main causes for unsuccessful monitoring were difficulty falling asleep,electrode distortion and high impedance of electrode.Conclusion PSG monitoring has a complex operating procedure and is time-consuming and effective preventive measures can improve the successful rate of PSG.

ObjectiveTo investigate the change of the level of testosterone and CD4+/CD8+ T cell in long-term mechanical ventilation patients with chronic obstructive pulmonary disease (COPD) and their correlation.MethodsThe level of testosterone, count of CD4+ and CD8+ T cell were measured in 42 COPD patients accepted long-term mechanical ventilation and other 34 stable COPD patients. The ratio of CD4+/CD8+ was calculated.The correlation between testosterone and CD4+/CD8+ was analyzed.ResultsCompared with the stabel COPD, there were significantly differences in the level of testosterone and the ratio of CD4+/CD8+ in long-term mechanical ventilation COPD group(P<0.05), but there was not relationship between them.ConclusionThe level of testosterone and the ratio of CD4+/CD8+ were significantly decreased in COPD patients with long-term mechanical ventilation. There is no correlation between the level of testosterone and the ratio of CD4+/CD8+.