Objective To assess the effectiveness of continuous aspiration of subglottic secretions (CASS)in preventing ventilator-associated pneumonia.Methods The relevant randomized controlled trials were searched in the Cochrane Library,Pubmed,CNKI,VIP and Wanfang databases.The experimental group received CASS and the control group did not(NASS group).Two reviewers selected studies according to the inclusion and exclusion criteria,the quality of studies was critically appraised and data were extracted by two reviewers independently.Meta-analysis was conducted by using RevMan 5.2.Results Sixteen randomized controlled trials met the inclusion criteria and enrolled 2 576 patients.According to the meta analysis,compared with NASS,CASS reduced the incidence of ventilator-associated pneumonia,shortened the length of stay in the intensive care unit and the duration of mechanical ventilation.There was no effect on hospital mortality.Conclusions Continuous aspiration of subglottic secretions appears effective in preventing ventilator-associated pneumonia,decreasing the duration of intensive care unit length of stay and mechanical ventilation among critically ill patients with mechanical ventilation.

The management for qualification documents of medical instruments is very important work to management department of medical instruments. Because the number of qualification documents of medical instruments is very large and they have an expiry date, it is difficult to manage them. This article discussed how to manage qualification documents of medical instruments, and an information management system that has a function of traceability management has been developed. This information management system standardizes management for qualification documents of medical instruments, and ensures that qualification documents of medical instruments are available and can be traced. Besides, it can reduce the amount of work for medical instruments management.
Documentation ; standards ; Equipment and Supplies ; standards ; Information Systems

Objective To explore the effect of babies’ nutritional status on their growth and intelligence about 3 years old. Method With stratified random sampling,according to the data of height and weight,obtained from general survey of nutritional status in all infants aged 0-1 in one county of Fuyang town,Anhui Province in April 2004,we classified the infants into three groups,corresponding to≥ x + s,

Objective To investigate the association between single nucleotide polymorphisms (SNP)and expression levels ofα-adducin(ADD1)gene in coronary artery disease (CAD)patients.Methods Extracted DNA and RNA samples of peripher-al blood white cells from 114 CAD patients and 116 healthy individuals in Jan 2011 to Oct 2013 from the General Hospital of the PLA Rocket Force.SNPs of rs3775067 and rs1263359 mutations in the ADD1 gene were analyzed with allele-specific flu-orogenic oligonucleotide probes combining hybridization.The gene expression levels were analyzed with fluorescence labeled and capillary electrophoresis technology.Results The frequencies of the genotypes and alleles of the two SNPs in the ADD1 gene were not significantly different between the two groups (χ2=0.018~1.317,all P>0.05).The ADD1 gene expression levels of CAD group (0.226±0.284)were obviously higher than that of control group (0.153±0.144,P<0.05).The gene expression levels of TC genotype of rs3775067 were obviously higher in CAD group (0.250±0.319)than that of control group (0.154±0.156,P<0.05),but the levels of the other genotypes had no significant difference between the two groups (t=0.557~1.867,all P>0.05).Conclusion The elevated ADD1 gene expression level would be risk factor for CAD.The polymorphisms of rs3775067 and rs1263359 had no relevance with CAD susceptibility.

Objective To investigate the changes of lead,zinc,copper,iron and calcium in blood of chronic poisoned infantal mice.(Methods) Forty-eight 21 day-old kunzea mice were randomly divided into 4 groups,each having 12 mice.Distilled water group was as control group and other three lead acetate poisoning groups had a dose of 10,20,40 mg/kg,respectively.The poisoning was carried out by lavage once a day,and consecutively for 46 days.Eyeballs of mice were picked then for blood sampling,and BS trace element analysis grapher was used to determine level of lead,zinc,copper and iron.Level of calcium was measured by Dimentional-RXL auto-biochemistry analysis meter.Results The lead and zinc levels in poisoned mice blood were increased with increasing lead acetate level administration,while zinc level changed inversely with lead acetate level.Significant differences were shown among control group and poisoning groups in terms of lead(P0.05).Conclusion Lead posioning can lead to zinc decreasing and copper(increa)-sing,which suggests that zinc works as a poential antidote of lead poisoning.

BACKGROUND: Placenta mesenchymal stem cells have become hot spots in stem cells study in recent years because of its advantages. OBJECTIVE:To analyze the biological characteristics of amniotic mesenchymal stem cells and amnion epithelial cells, and to explore the feasibility of amniotic mesenchymal stem cells and amnion epithelial cells applied as seed cells in three-dimensional liquid culture to construct the tissue-engineered skin. METHODS:The amniotic mesenchymal stem cells and amnion epithelial cells were obtained by using multi-step digestion with trypsin and col agenase;then the flow cytometry, reverse transcription-PCR and immunofluorescent staining techniques were adopted to identify the surface molecular markers, stem cellcharacteristics and keratinocytes similarity respectively. Based on these data, amniotic mesenchymal stem cells and amnion epithelial cells used as seed cells together with rat type Ⅰ col agen matrix were adopted for three-dimensional liquid culture. RESULTS AND CONCLUSION:Flow cytometry test showed that amniotic mesenchymal stem cells and amnion epithelial cells cultured in vitro could highly express CD90, CD73 and CD105, and could not express the hemopoietic stem cellmarker of CD34 and MHC-class Ⅱ molecular HLA-DR. Reverse transcription-PCR results detected that amniotic mesenchymal stem cells could express stem cellcharacteristic genes CMCY and NANOG;amnion epithelial cells could express stem cellcharacteristic genes CMCY and KLF4, showing that both amniotic mesenchymal stem cells and amnion epithelial cells have stem cellproperties. Reverse transcription-PCR results showed that amniotic mesenchymal stem cells could express keratinocytes characteristic genes K19,β1-integrin and K8;amnion epithelial cells could express K19,β1-integrin, K5 and K8. Immunofluorescence staining results showed amnion epithelial cells could express keratinocytes proliferation related protein K14, which revealed that there was certain similarity in the mRNA expression between keratinocytes and amnion epithelial cells, and indicating that it has the potential to differentiate into keratinocytes. Tissue-engineered skin was successful y constructed by using amniotic mesenchymal stem cells and amnion epithelial cells, hematoxylin-eosin staining section showed that it has certain skin structure, and amnion epithelial cells had a preliminary differentiation. Al these prove that it is feasible to construct human skin tissues with amniotic mesenchymal stem cells and amniotic epithelial cells through the three-dimensional culture.

OBJECTIVETo explore the effects of progesterone (PROG) on learning and memory and P2X7 receptor expression in the hippocampus after global cerebral ischemia/reperfusion (I/R) injury in rats.

METHODSForty-eight male SD rats were randomly divided into four groups (n = 12) that were normal group, sham-operated group, I/R group and I/R+ PROG group. The global cerebral I/R injury models were established by improved Pulsinelli's four vessel occlusion, the learning and memory were evaluated by Y-maze, the expression of P2X7 receptor protein in the hippocampus were detected by the immunofluorescence, the activity of superoxide dismutase (SOD) in the hippocampus were detected with hydroxylamine oxidation method, the content of malondialdehyde (MDA) in the hippocampus were detected with pen-thiobarbituric acid method.

RESULTSThere was no significant difference of the learning and memory and positive expression cells of P2X7 receptor protein and the activity of SOD and the content of MDA in the hippocampus between normal group and sham-operated group. Compared with sham-operated group, the learning and memory of I/R group were significantly decreased (P < 0.01), Compared with I/R group, the learning and memory of I/R + PROG group were significantly increased (P < 0.05). Compared with sham-operated group, the positive expression cells of P2X7 receptor protein in the hippocampus of I/R group was significantly increased (P < 0.01), Compared with I/R group, the positive expression cells of P2X7 receptor protein in the hippocampus of I/R + PROG group was significantly decreased (P < 0.01). Compared with sham-operated group, the activity of SOD in the hippocampus of of I/R group was significantly decreased (P < 0.01), and the content of MDA in the hippocampus of I/R group was significantly increased (P < 0.01). Compared with I/R group, the activity of SOD in the hippocampus of I/R+ PROG group was significantly increased (P < 0.05), and the content of MDA in the hippocampus of I/R + PROG group was significantly decreased (P < 0.01).

CONCLUSIONPROG could improve the learning and memory ability following global cerebral ischemia/reperfusion injury in rats, the protective mechanism might be associated with down-regulating the expression of P2X7 receptor protein and attenuating oxygen-derived free radicals in the hippocampus.

Animals ; Brain Ischemia ; metabolism ; psychology ; Hippocampus ; drug effects ; metabolism ; Male ; Malondialdehyde ; metabolism ; Maze Learning ; drug effects ; Progesterone ; pharmacology ; Rats ; Rats, Sprague-Dawley ; Receptors, Purinergic P2X7 ; metabolism ; Reperfusion Injury ; metabolism ; psychology ; Superoxide Dismutase ; metabolism

Objective:To explore the structural characteristics of the medical service price network in the Yangtze River Delta,and provide a new management perspective for the collaborative governance of medical service prices in the Yangtze River Delta.Methods:Taking the related medical security bureaus of some core cities in the Yangtze River Delta as samples,based on the social network analysis method,the structural characteristics of price linkage network are analyzed from the perspectives of network density and correlation,individual centrality and block model analysis.Results:Firstly,the price network is not tight and has poor stability;secondly,the price network is unbalanced,with the Municipal Medical Insurance Bureau playing different roles;thirdly,the price network has obvious spatial aggregation and spatial spillover.Conclusion:The overall situation of the medical service price linkage network is not optimistic,and the network advantages should be fully integrated to promote the coordinated development of medical service prices in the Yangtze River Delta Region.

Objective:To explore the structural characteristics of the medical service price network in the Yangtze River Delta,and provide a new management perspective for the collaborative governance of medical service prices in the Yangtze River Delta.Methods:Taking the related medical security bureaus of some core cities in the Yangtze River Delta as samples,based on the social network analysis method,the structural characteristics of price linkage network are analyzed from the perspectives of network density and correlation,individual centrality and block model analysis.Results:Firstly,the price network is not tight and has poor stability;secondly,the price network is unbalanced,with the Municipal Medical Insurance Bureau playing different roles;thirdly,the price network has obvious spatial aggregation and spatial spillover.Conclusion:The overall situation of the medical service price linkage network is not optimistic,and the network advantages should be fully integrated to promote the coordinated development of medical service prices in the Yangtze River Delta Region.

Objective:To explore the structural characteristics of the medical service price network in the Yangtze River Delta,and provide a new management perspective for the collaborative governance of medical service prices in the Yangtze River Delta.Methods:Taking the related medical security bureaus of some core cities in the Yangtze River Delta as samples,based on the social network analysis method,the structural characteristics of price linkage network are analyzed from the perspectives of network density and correlation,individual centrality and block model analysis.Results:Firstly,the price network is not tight and has poor stability;secondly,the price network is unbalanced,with the Municipal Medical Insurance Bureau playing different roles;thirdly,the price network has obvious spatial aggregation and spatial spillover.Conclusion:The overall situation of the medical service price linkage network is not optimistic,and the network advantages should be fully integrated to promote the coordinated development of medical service prices in the Yangtze River Delta Region.