OBJECTIVE To investigate the clinical distribution characteristics and drug resistance of pathogens in hematology department ward during recent two years,and instruct clinical application of antibiotics reasonably.METHODS The bacteria were identified by VITEK-60 with GNI+,GPI and YBC.Drug sensitivity tests of bacteria were performed by K-B method.The results were analyzed by WHONET 5.3 software.RESULTS The results showed that 370 strains of pathogens were isolated from all detected samples.The composition ratio of Gram-positive bacteria,Gram-negative bacteria and fungi was 59.7%,32.4% and 7.8%,respectively.Coagulase negative Staphylococcus,Escherichia coli,Pseudomonas aeruginosa,Klebsiella pneumoniae and Acinetobacter baumannii were the most frequently isolated pathogens.The ESBLs producing strains in E.coli and Klebsiella spp were 59.3% and 24.2%,respectively.The MRSA in S.aureus and MRCNS in coagulase negative Staphylococcus were 18.2% and 87.8%,respectively.CONCLUSIONS Inspecting pathogens and studying the trend of their drug resistance are important to rationally select antibiotics,reduce infection incidence and mortality rate,and decrease the occurrence of drug resistant strains.

Objective This study aimed at the effect of glutamate(Glu) on rat cortical pyramidal cells in cultured brain slices treated by threohydroxyaspartate(THA),an inhibitor of glutamate transporter.Methods The brain slice cultures were prepared using 1-day-old rat.Various concentrations of THA(50,100 and(500 ?mol/L))were added into the culture medium respectively.Cortical pyramidal cells' survival was evaluated by immunohistochemistry staining monoclonal antibody SMI-32,a nonphosphorylated neurofilament marker,Glu level in the culture medium was also measured.Ultrastructural picture of neuropathology were examined by EM microscopy. Results The brain slices in the control group maintain excellent organization and a stable population of pyramidal cells.THA caused a slow dose-dependent loss of cortical pyramidal cells and an increase of Glu level in the culture medium.THA of 100 ?mol/L resulted in a significant decrease in cortical pyramidal cells after culturing for 5 weeks.Pyramidal cells appeared vacuolar degeneration.Conclu-(sions Extra-cellular) Glu caused chronic excitotoxicity to cortical pyramidal cells.

Objective To explore the pathogeny,clinical characteristics,prognosis,and summarize treatment experience of acute cerebrovascular disease combined with multiple organ failure.Methods The clinical datas of 84 cases of acute cerebrovascular disease combined with multiple organ failure were retraspectively analyzed.Results In the 84 cases there were 38 cases with 2 organs failure,and the mortality was 55.26%.There were 25 cases with 3 organs failure,and the mortality was 72%.There were 20 cases with 4 or more organs failure,and the mortality was 100%.Conclusion The mortality of this disease is very high.Death is related to the character of the disease and the patients' age.Early recognisation and effective prevention and cure are the important tache to reduce death of MOF.

Objective: To study the inhibitory effect of VEGF antisense oligonucleotides (ASODN) on growth of Lewis lung cancer in C57BL/6 mice.Methods: Lewis lung cancer cells were cultured and implanted subcutaneously into 40 C57BL/6 mice, which were then divided into 4 groups: VEGF-ASODN treatment group, VEGF-SODN treatment group, BEGF-MODN treatment,and control group (normal saline). Mice in different groups were treated 24 hours after cell inoculation. The weight and volume of subcutaneous tumors was measured and the morphological changes of tumor cells was observed under microscope. VEGF protein and microvessel density were examined by immunohistochemistry.Partial tumor tissues were kept in liguid nitrogon.Results: The average tumor weights of the control, VEGF-ASODN, VEGF-SODN and VEGF-MODN groups were (7.33?0.71)g, (4.56?0.38) g, (7.59?0.32) g, and (7.62?0.39) g, respectively. The inhibition rates of tumor growth in VEGF-ASODN, VEGF-SODN and VEGF-MODN group were 43.8%, 5.5% and 3.1%, respectively. VEGF-ASPODN obviously inhibited the tumor cell growth and decelerated the tumor cell proliferation. Immunohistochemistry results showed that the expression of VEGF in ASODN group was remarkly lower than those in SODN group, MODN group and control group (P

Objective To evaluate the platelet function in the patients with recurrent spontaneous abortion (RSA) ,to explore the correlations between Hcy and folic acid(FA)with mean platelet volume(MPV) and platelet distribution width(PDW) ,and to evalu-ate the application value of above indicators in predicting RSA .Methods Twenty-eight cases of RSA ,40 cases of healthy pregnancy and 50 healthy child-bearing women(control group) in our hospital were selected .The detection indicators included peripheral blood Hcy ,FA ,PLT ,MPV and PDW .Results The PLT and FA levels in the patients group were significantly lower compared with the normal pregnancy group and control group(P<0 .01) ,while the Hcy ,PDW and MPV were increased(P<0 .05);the various indica-tors had no statistically significant difference between the normal pregnancy group and control group (P>0 .05) .Blood Hcy was negatively correlated with PLT and FA ;Hcy and FA were negatively correlated in the normal pregnancy group ,other indicators had no obvious correlation(P>0 .05) .Conclusion The Hcy metabolism abnormality ,platelet parameter changes and their interactions may be related to RSA .The combined detection of Hcy ,FA and platelet parameters has a certain clinical significance to early diag-nosis and treatment of RSA .

Objective To study the value and the superiority of multi-slice spiral CT angiography of pulmonary artery in combination with deep vein of lower limb in diagnosing pulmonary embolism (PE). Methods CT pulmonary angiography (CTPA) and lower limb deep vein venography were performed in all suspected patients of PE with single or multi-slice spiral CT.The number and type of the embolus were calculated.Results Among the 44 patents of pulmonary embolism,34 patents had both PE and deep vein thrombo embolism (DVT) ,10 patients had only PE.The total ratio of the PE diagnosed with single slice spiral CT and multi-slice spiral CT was 12.1% and 19.0%, respectively , there were statistical significance, (P=0.004); the ratio of the PE upon deuto-segment pulmonary arteries was 25.3% and 29.7%, respectively, there was no statistical significance, (P=0.104); the ratio of the PE below deuto-segment pulmonary arteries was 1.1% and 10.2%, respectively, there was statistical significance, (P=0.000).Conclusion The technique of angiography of pulmonary artery in combination with deep vein of lower limb in diagnosing PE is a non-invasive, fast, sensitive and specific method for PE. Multi-slice spiral CT is superior to single slice spiral CT in the diagnosis of PE.

Obesity is one of the major risk factors of primary hypertension,with the dramatic increase in obesity.Obesity-induced hypertension also gradually increases.Due to promoting the occurrence and development of high blood pressure,obesity has caused wide public concern.In recent years,the pathogenesis of obesity-induced hypertension has become the study hotspot.However,fat and blood pressure relationship is complicated.This review article emphatically reviewed the activation of the sympathetic nervous system,the renin-angiotensin-aldosterone system (RAAS) activation,insulin and insulin resistance,leptin and leptin resistance,the gastrointestinal tract anomalies in the pathogenesis of obesity hypertension of the latest research progress.

Objectives: China has observed an increasing prevalence of cardiovascular diseases among its population, which is putting heavy economic burden both on individuals and the whole society.Conducting a multi-angle study of cardiovascular patients with economic burden can help adjust the health care policy to reduce the economic burden of patients.Methods: Using the baseline data (2011) and follow-up data (2013) of the China Health and Retirement Longitudinal Survey, this study selected cardiovascular patients aged 45 and above to calculate their direct medical cost, direct non-medical cost as well as self-paid cost before and after reimbursement.The total cost and self-paid cost are both calculated, and gender difference and rural-urban difference are also analyzed.Results: The prevalence of cardiovascular disease among the population age 45 and above was 13.9% in 2013 and 12.1% in 2011, while the prevalence in women was higher than in men and urban areas higher than rural areas.The average annual total costs for individual patient before reimbursement in 2013 was lower than that in 2011, but contrary to the trend of self-pay costs.Urban patients had higher amount of direct medical cost, lower co-payment rate and lower non-medical cost such as transportation and accommodation than their rural counterpart.Both urban and rural patients self-paid more on outpatient services than inpatient services.Conclusion: Based on these analyses, this paper suggests that Chinese policy makers should look deeper into patient behaviors as well as their economic burden before revising the current health policy.More practices regarding to the unbalanced distribution of health resources between urban and rural areas are needed, in order to ensure patients living in remote areas could get access to appropriate treatment without paying heavy non-medical cost.

Objective To determine the sensitivity and specificity of ramification amplification method for detecting Shiga toxin and to determine the feasibility in detecting E. coli 0157: H7 and other shiga toxin-producing E. coli isolated from food and clinical specimens. Methods The sensitivity and specificity of RAM were compared with those of PCR by detecting synthetic Shiga toxin DNA target and isolates from food and clinical specimens. Results The lowest number of targets detected by RAM assay was 10 molecules. Several clinical isolates of E. coli 0157 :H7, Shigella dysenteriae and nonpathogenic E. coli were further tested. The results showed that E. coli 0157: H7 and Shigella dysenteriae were positive for shiga toxin gene,while nonpathogenic E. coli were negative. The results of RAM and PCR by detecting isolates were same. Conclusion RAM assay could be an alternative to PCR to detect STEC in food product and clinical specimens because of its high sensitivity and specificity , simplicity and isothermal amplification.

Currently,with the increasing tension in doctor-patient relationship and medical disputes, it is of great importance to train medical students’ competence of establishing harmonious doctor-patient relationship. By analyzing the existing problems,the ways to train medical students’ competence in establishing harmonious doctor-patient relationship in clinical practice teaching hospital especially in oncology ward is discussed.