Objective To investigate the feature of pathogen distribution and antibiotic resistance of venti-lator associated pneumonia from Jan.to Dec,2007 in our ICU in order to provide a reference data guiding the appro-priate use of clinical antibiotics.Methods The 148 VAP cases of pathogen and drug sensitive tests were retrospec-tively analyzed.Results The incidence rate of VAP was 70.81%.Klebsiella pneumoniae,Pseudomonas aeruginosa,Escherichia coli,Acinetobacter sp were the top pathogen of Gram negative bacillus.Staphylococcus aureus (MBSA)was the major pathogen of Gram positive coccus.The resistance rates of Klebsiella pneumonia and Pseudomonas aeruginosa were very high.The effect rates of frequently used antibiotics were not satisfactory.The fungus infection rate was 6.76% among all the cases.Conclusion MRSA,Klebsiella pneumoniae and Pseudomonas aerugmosa are the major pathogens of VAP in our ICU with a high drug resistance rate.Gram negative bacillus is the major Pathogen of VAP with a faidy high drug resistance rate.

Objective Researches showed that matrix metalloproteinase-2 (MMP-2) has a critical role in the neovascularization of tumor,and vascular endothelial growth factor(VEGF)is a promoting factor of new blood vessel formation.There still is little literature about the effect of MMP-2 in retinal neovascularization up to now.This study tried to explore the expression and significance of MMP-2 and VEGF in retinal neovascularization.MethodsA retinal neovascularization model was established in 30 7-day-old cleaning C57BL/6J mice exposed to an environment of high concentration of oxygen for 5 days,and 30 matched mice were raised in normal air environment.Fifteen mice from hyperoxic group and control group were sacrificed in 10 days after treatment and the eyeballs were enucleated to make retinal stretched preparation.Adenosine diphosphate-ase (ADPase) stained retina flat-mounts was performed to assess the retinal vascular profiles,and H&E staining was applied to count the number of new vascular cell nuclei.The expression of MMP-2 and VEGF was detected using immunohistochemistry by calculating the intergrated value of positive cells.ResultsThe retinal stretched preparation presented more neovascularization in mice from the hyperoxic group compared with control group.The number of nuclei from the vascular endothelial cells in the new vessels breaking through the internal limiting membrane in the hyperoxic group was 33.51±2.55,indicating a significant increase in comparison with control group (7.27±0.20)(t=9.345,P＜0.05).There were stronger expression of MMP-2 protein and the VEGF protein in the ganglion cell layer,inner plexiform layer and inner nuclear layer,and neovascularization breaking through the internal limiting membrane in the hyperoxic group compared with control group (t=4.25,P＜0.05;t=6.38,P＜0.05).Expression of MMP-2 showed the positive correlation with the expression of VEGF(r=0.825,P＜0.05).ConclusionBoth MMP-2 and VEGF promote retinal neovascularization.The overexpression of MMP-2 and VEGF play a synergistic role during the formation of neovascularization.

Objective To evaluate the visual outcomes,depth of focus and safety after implantation of the Acrysof ReSTOR and the Acrysof Natural.Design Nonrandomized clinical trial.Participant 53 patients with age-related cataract(61 eyes)were divided into two groups:Acrysof ReSTOR group(MIOL)included 28 patients(31 eyes),and reference group-Acrysof Natural group(SIOL)included 25 patients(30 eyes).Method All patients underwent phacoemulsification and IOL implantation.At 1 week,1 month and 3 months postoperatively,distant and near visual acuities were observed,and depth of focus was measured 3 months postoperatively.Main Outcome Measure Uncorrected distant visual acuity(UCDVA),uncorrected near visual acuity(UCNVA),best corrected distant visual acuity(BCDVA),best corrected near visual acuity(BCNVA),distant corrected near visual acuity(DCNVA),depth of focus.Result At 3 months postoperatively,in MIOL group:UCDVA was 0.90?0.15,UCNVA was 0.70?0.19,DCNVA was 0.73?0.21 and depth of focus was 5.5D(+1.5～-4.0D),while in SIOL group:UCDVA was 0.84?0.14,UCNVA was 0.36?0.10,DCNVA was 0.26?0.08 and depth of focus was 2.5D(+1.0～-1.5D).In MIOL group,UCDVA and UCNVA at 1 month were markedly better than those at 1 week. Conclusion Acrysof ReSTOR can provide excellent outcomes both in distants and near visions and it may reduce the dependence on spectacles in near vision.(Ophthalmol CHN,2006,15:344-347)

Along with the transgenic plant planting more and more popular in the world,the influence of transgenic plants on ecological environment was widely given attention and the comprehensive research had been done on effect of transgenic plants in soil ecosystems.The latent risks of transgenic plants to the soil ecosystem were reviewed.Also,the study on decomposition of transgenic plants in soil,the vertical and horizontal transfer possibility of recombinant DNA by transformation,as well as the influence of the exogenous gene and its expression product on soil animals,soil microbes as well as soil physical and chemical properties were also discussed,all of which would provide useful information for utilization of transgenic plants more safely in future.

AIM: To study the inhibitory effect of captopril on retinal neovascularization (RNV).METHODS: Sixty seven-day-old mice were randomly divided into treated group and control group with thirty mice in each group. These mice were exposed to 750 50mL/L oxygen for 5 days and then to room air.The treated group had been injected captopril (2.7mL/kg), while control group had been injected 9g/L sodium chloride (2.7mL/kg) by intravitreal for 5 days.The mice were sacrificed at the 17th day after birth and the eyes were enucleated. Adenosine diphosphate-ase(ADPase) stained retina flat-mounts was performed to assess the retinal vascular profiles, Hematoxylin Eosin (HE)staining method was applied to count the number of new vascular cell nuclei and the expression of matrix metalloproteinase-2(MMP-2)and pigment epithelium derived factor (PEDF)was detected by immunohistochemical method.RESULTS: Comparing with control group,regular distributions and good branch and reduced density of RNV were observed in the treated group. The number of nucleus of new vessels vascular endothelial cells breaking through the internal limiting membrane was less in the treated group than in the control group (P<0.05). Stain of retinal MMP-2 was weaker in the treated group than in the control group and stain of retinal PEDF was stronger in the treated group than in the control group.CONCLUSION: Intravitreal injection of captopril (2.7mL/kg) may block the RNV in the oxygen-induced mouse model and may provide an effective method for prevent-ing RNV.

Chitosan, deacetylated derivative of chitin, is a kind of natural polysaccharide polymer. It has advantages of rich source, good biocompatibility and biodegradation. Chitosan can be processed into porous scaffolds used for cell transplantation and tissue regeneration in bone tissue engineering, control-released carrier of growth factors and delivery vector of exogenous genes. Meanwhile, it can also be processed into injectable scaffolds used in bone tissue engineering in the form of microspheres or hydrogel. Chitosan and its derivatives will have broad application prospects in the research field of bone tissue engineering. However, chitosan composite scaffold has poor mechanical function, difficult accuracy control of In vivo degradation, and low efficiency for genetic carrier, chitosan research stays in in vitro tests and in vivo animal experiments. With the development of materials science and life science, chitosan will be widely used for clinical application of bone tissue defect.

Sperm DNA fragmentation index (DFI) refers to the percentage of DNA strand breaks in the total sperm. Many studies suggest that elevated DFI can lead to male infertility and early spontaneous abortion. High-DFI patients are more likely to fail in assisted reproduction and preliminary treatment or prevention methods have been developed for this population. This review focuses on the impact of DFI on clinical pregnancy outcomes and progress in the studies of its treatment.
Abortion, Spontaneous ; Chromatin ; DNA Fragmentation ; Female ; Humans ; Infertility, Male ; Male ; Pregnancy ; Pregnancy Outcome ; Sperm Injections, Intracytoplasmic ; Spermatozoa

Objective To study the utility of inferior vena cava-collapse index (IVC-CI) for assessing fluid resuscitation for hypovolemic shock in order to look for better echocardiographic markers to assess patients' condition with hypovolemic shock,also to look for optimal guidance for the adjustment of the treatment for these patients.Methods A total of 40 patients with hypovolemic shock admitted to Emergency Department were enrolled for study.All patients were treated with 500 mL normal saline iutravenously as fluid resuscitation.The vital signs and echocardiographic findings before and after the treatment were documented.Comparison of data between pre-treatment and post-treatment was carried out.Results Of 40 patients,there were 23 male and 17 female with average age (50.00 ± 17.71) years.The time consumed for echocardiography examination was (8.68 ± 5.73) min,time required for establishing central line was (29.32 ± 8.06) min.Collapse index of inferior vena cava (IVC-CI) before and after treatment were (0.43 ± 0.16) and (0.38 ± 0.13),respectively.In hypovolemic shock group,the relationship of the peak velocity (Vpeak) of left ventricular outflow between before and after treatment was r =0.75,P =0.001.The relationship of the peak velocity of left ventricular outflow with left ventricular end diastolic volume (LEDV) before treatment was P =0.03 and after treatment was P =0.05.Conclusions (1) Between IVC-CI and the effectiveness of fluid resuscitation,there was no relationship.It was inappropriate to take IVC-CI as a marker for assessment.(2) Vpeak increased apparently after the fluid resuscitation.(3) Vpeak was proved to be associated with LEDV which supported that Vpeak is the indicator of left ventricular contractility.(4) Time consumed for echocardiography examination was shorter than that for establishing the central line in the group.

Objective To explore value of quantitative tissue velocity imaging(QTVI) in the regional systolic and diastolic myocardial function of hypertrophic cardiomyopathy(HCM) patients and healthy persons. Methods By Doppler myocardial imaging 20 HCM patients and 18 healthy subjects were collected,then the regional velocity were measured in the mid and basal segment in systolic,early diastolic and later diastolic period respectively. Results The parameters as systolic velocity(Vs),early diastolic velocity(Ve) and early systolic velocity/later diastolic velocity (Ve/Va) of the HCM group were significantly lower than those of the normal group,while later diastolic velocity(Va) showed no statistic difference between two groups. Conclusions The systolic and diastolic myocardial functions of hypertrophic cardiomyopathy patients are reduced. The abnormality of heart function in HCM patients could be accurately detected by QTVI.

In patients with a functional gut,enteral nutrition is the preferred route of nutrition support.The favorable effects of enteral nutrition include prevention of mucosal atrophy,maintaining of the integrity of gut flora,and improvement of immunocompetence.The guidlines recommend EN be withheld in patients requiring significant hemodynamic support,because of highdose catecholamine agents which could reduce EN tolerance.Splanchnic perfusion is reduced in sepsis shock,yet vasoactive agents have demonstrated both improved and diminished perfusion.Inadequate perfusion increases the risk of experiencing rare but serious adverse events.This study summarizes the tolerability and safety of enteral nutritionin in critically iH patients with hemodynamic instability and provides theoretical basis for the early administration of EN.