Objective To investigate the risk factors and microbial causes related to the pathogenesis of ventilator-associated pneumonia(VAP).Methods Totaly 138 intubated newborn infants for longer than 48 hours in Ningbo Women and Children's Hospital were studied,who were divided into VAP group (56 cases)and non VAP group(82 cases).Microbial causes of VAP were analyzed.Results Malnutrition,repeated tracheal intubation,repeated endotracheal suctioning,indwelling tube,posture,hyaline membrane disease,gestational age,birth weight,duration of intubation,duration of hospitalization were independent risk factors for ventilator-associated pneumonia(P<0.05).Klebsiella pneumoniae,pseudomonas aeruginosa,acinetobacter species and enterobacter cloacae were the main pathogenic bacteria of VAP.Conclusion Shortening of mechanical ventilation duration,avoiding repeated tracheal intubation and indwelling tube usage,semi-fowler positioning can lower the incidence of VAP.Pathogenic bacteria control is essential for VAP.

Objective:To study the expression of discoidin domain receptor1(DDR1) protein in esophageal squamous cell carcinoma(ESCC) tissues. Methods:The expression of DDR1 protein was detected by Western blotting in 40 cases of ESCC tissues,para-cancer tissues,and matched esophageal normal tissues,and their relation to clinical pathologic characteristics of esophageal cancer was analyzed. Results:The expressionof DDR1 in ESCC(1.201?0.348)were significantly higher than those in para-cancer tissues(0.640?0.323)and normal esophageal tissues(0.551?0.413). The positive expression rate and relative content of DDR1 in ESCC were correlated with degrees of differentiation、lymphnode metastasis and invasion depth of carcinoma (P

Due to the increase in competitive sports and some other reasons, the influence of physical activity in some extent, appeal to the essence of life care from its ethical. Excessive instrumental performance for sports ac-tivities, utilitarianism, in some ways is not pure is the activity of fitness and it happened some alienation. There-fore, the relevant state departments and the whole society starting from the height of national strategy, deal with the relationship of sport and fitness sport, promote the development of undertakings of physical culture and sports, mak-ing the sports return to nature of life care.

OBJECTIVE:To improve HPLC for the contents determination of 2-methyl-5-methoxy-indole-3-acetic acid(impuri-ty Ⅰ) and 4-chlorobenzoic (impurity Ⅱ) in Indometacin enteric-coated tablet. METHODS:The column was Phenomenex Phe-nyl-Hexyl with mobile phase of 10 g/L acetic acid solution- acetonitrile(gradient elution)at a flow rate of 1.0 ml/min,the detec-tion wavelength was 254 nm,column temperature was 40℃,injection volume was 20 μl. RESULTS:The linear range was 0.262 2-5.243 0 μg/ml for impurity Ⅰ(r=0.999 8)and 0.252 5-5.050 0 μg/ml for impurity Ⅱ(r=0.999 8);the limits of quanti-tation were 1.12 ng and 0.48 ng,limits of detection were 0.340 ng and 0.146 ng,respectively;RSDs of precision,stability and re-producibility tests were lower than 2%;recoveries were 99.71%-100.52%(RSD=0.28%,n=9) and 100.84%-102.14%(RSD=0.47%,n=9). CONCLUSIONS:The method is accurate and rapid,and can be used for the contents determination of impurity Ⅰand impurityⅡin Indometacin enteric-coated tablet.

OBJECTIVE: To establish the HPLC method for the determination of spironolactone tablets. METHODS: The determination was performed on Agilent C18 column with mobile phase of acetonitrile-water (50 ∶ 50) and detection wavelength of 238 nm. RESULTS: The linear range of spironolactone were within 5.023 1 ?g?mL-1～75.347 1 ?g?mL-1 (r=1.000 0) with an average recovery of 100.23% (RSD=0.53%). CONCLUSION: The method is reproducible, simple and convenient for the quality control of spironolactone tablets.

Objective To analyze the clinical features of rheumatic diseases patients with Glucocorticoid (GC) induced osteoporotic fractures.Methods Fourteen patients with GC induced osteoporotic fractures in Beijing Children's Hospital from January 2005 to December 2012 were retrospectively analyzed.The clinical features,spine radiographs/CT,dose of GC were analyzed.Results In various rheumatic diseases,systemic lupus erythematosus (SLE) and systemic onset juvenile idiopathic arthritis (SoJIA) were the most common related diseases.All children had no obvious causes of fracture.Eleven patients had back pain or limitation of activity.Fourteen patients had vertebral fractures.Seven cases had thoracic vertebral fracture,3 cases had fractures of lumbar vertebra.Four cases had multiple painful vertebral fractures.The time of fracture occurrence in patients received glucocorticoid therapy were between 5 months and 6.5 years.Daily minimum dose of glucocorticoid was 0.25-1.12 mg/kg and mean dose was 0.47-2.62 mg/kg.Conclusion GC induced osteo-porotic fractures is a serious complication of long-term use of glucocorticoid.Physicians taking care of children who have received long-term glucocorticoid therapy should be alert of the manifestation of osteo-porosis,such as back pain.

P2X7 receptors,belonging to purinergic P2 receptor family,are ATP-gated cation channels,which can choose the bivalent cations freely.P2X7 receptors join in cell signal conduction and the excretion of the cytokines and other physical functions.In recent years,researchers have discovered P2X7 receptors mediate the cells to live and grow by increasing oxidation and phosphorylation and intracellular ATP reserve.In breast cancer,the P2X7 receptors express abnormally,and can activate the MAPK lied in cytoplasm.The phosphorylated MAPK enter the nucleus and activates a series of protein kinases,and then affects the genesis and development of breast cancer.

Objective To compare the clearing effect between combination use of mosapride and polyethylene glycol (PEG) and polyethylene glycol only for colonoscopy preparation of patients with constipation caused by functional diseases.Methods A total of 212 adult patients who underwent colonoscopy examination were recruited to this randomized single blinded controlled study.Patients in control group received 3 liters of PEG only,whereas patients of experimental group received 10mg mosapride 30min before 3liter PEG.The patients were surveyed for the tendency of constipation.Experimental variables including time of first defecation and completion of bowel cleansing,defecation frequency,and degree of discomfort during colonoscopy preparation were recorded.Results The times of first defecation and completion of bowel cleansing of experimental group were shorter than those of control group ( P ＜ 0.05 ),but there were no significant differences in defecation frequency,the degree of discomfort and the bowel cleansing quality between 2 groups ( P ＞ 0.05 ).The percentages of patients with constipation in control and experimental groups were 26.61％ and 26.67％,respectively.The defecation frequency and the degree of discomfort of constipative patients were similar in both groups ( P ＞ 0.05 ).The time of first defecation and time of completion of bowel cleansing of constipative patients in experimental group were shorter than those in control group ( P ＜ 0.05 ).The bowel cleansing quality of constipative patients in experimental group was better than that of control group ( P ＜ 0.05 ).There was no difference in defecation frequency and adverse reaction between 2 groups (P ＜ 0.05).Conclusion Combination of mosapride and PEG for colonoscopy preparations of patients with functional constipation tends to shorten times of first defecation and completion of bowel cleansing,and to increase the bowel cleansing quality.

Objective: To discuss the effect of metal materials science for how to prevent and control adverse events of medical devices, and provide forewarning measures for preventing this kind of events. Methods: To analyze the adverse events report of medical devices, and summarize 10 kinds of fault phenomenon and clinical manifestation of adverse events came from metal materials, such as respiration device and its accessories, color ultrasonic imaging device and ultrasound intervention, intracavity diagnosis and implants, and so on. To analyze the reason of the medical equipment accidents;and provide countermeasures for monitoring and management of adverse events of medical devices. Results: The advantages of preventing and controlling adverse events of medical equipment based on metal material science were:①monitor the metal material performance changes occur in force or strain and early alarming, ②identify implanted medical consumables degradation. Conclusion: The fatigue damages and defects of metal materials were the main reason of medical device adverse events. The hospital needs to establish the medical device adverse event reporting, evaluation model, evaluation and classification of time report supervision mechanism; establish and improve the monitoring and management mechanism, technical personnel and regulations; perfect the corresponding technical support system, and achieve monitoring and risk management for adverse events of clinical medical devices.

Klebsiella Pneumoniae is a opportunity infection and nosocomial infection bacteria in Enterobacteriaceae,which can lead to serious infection or death.Klebsiella Pneumoniae leads to increased infections proportion in recent years,which resisits to many common antibiotics.Clinical drug resistant strains include Carbapenem-resistant Klebsiella Pneumoniae,Multidrug-resistant Klebsiella Pneumoniae,Extensively drug resistant bacteria and Pandrug-resistant Klebsiella Pneumoniae.Researches beared out that the risk factors of acquiring nosocomial infection of Klebsiella Pneumoniae are state of an illness,time of hospitalization,mechanical ventilation,the kind and number of antibiotics.