Objective To study the value of serum procalcitonin(PCT) to the early diagnosis of sepsis .Methods From June 2014 to June 2015 ,a total of 686 cases were enrolled in this retrospective study .PCT tests were assayed within 2 days of bacterial culture .Results In this study ,56 cases ,67cases ,and 567cases were classified into the positive blood culture group ,positive body fluid culture group ,and negative all culture group ,respectively .Median PCT values were 4 .26 2 .78 ,0 .46 ng/mL ,respectively .Me-dian PCT values in the gram-positive bacterial culture group and gram-negative bacterial culture group ,respectively ,were 2 .35 and 4 .56 ng/mL .Median PCT values in the positive hydrothorax culture group ,positive ascites culture group ,and positive bile culture group ,respectively ,were 1 .91 ,5 .23 ,3 .64 ng/mL .In all ,Median PCT values of 47 cases of sepsis and 16 cases of severe sepsis were 5 .32 and 10 .25 ng/mL ,respectively .Conclusion PCT level is correlated with the severity of sepsis ,pathogenic bacteria type ,and the site of infection ,and can be used in the early diagnosis of sepsis .

Pulsed field gel electrophoresis(PFGE)is a new type technique of gel electrophoresis which can be used to separate large DNA molecules.It has been widely applied to the karyotype analysis,identification of species groups,genetic orientation and genetic analysis for fungi.This article describes the principle,development and general manipulative procedure of PFGE,and elaborates the application in the molecular research of fungi.

Objective To learn the plague's host animals and parasitic flea composition, and to investigate the natural foci of plague in Xiji county in order to provide basic information for plague prevention and control. Methods The Citellus alaschanicus density, nocturnal rodents, the body flea, the burrow track flea, the nest flea were investigated in 8 townships (town) of Xiji county from June 11 2007 to July 25 2007. Specimens of small mammalian, fleas were collected for bacteriological and serological testing. Results The average density of the main host Citellus alaschanicus was 0.85 per hectare. The nocturnal mouse capture rate was 0.80%(24/2987).The survey found 16 species of small mammals that belonging to 3 orders, 9 families and 16 species with Citellus alaschanicus the dominant species. The Citellus alaschanicus had 2.84 fleas per body. Four families and 16 species of fleas were identified in the areas. The Citellus alaschanicus and Citellophilus Tesquorum Mongolicus were the dominant species. Plague bacteriology and serology tests were negative. Conclusions The study shows that the area is suitable for the formation of natural foci of Citellus alaschanicus plague. Surveillance is an important measure for prevention and control of the plague.

AIMTo prepare solid lipid nanoparticles (SLN) loaded with all trans retinoic acid using an ultrasonic technique with Compritol 888 ATO as matrix material, and investigate properties of nanoparticles in vitro and in vivo.

METHODSUltrasonic technique was adopted to prepare solid lipid nanoparticles in an aqueous system using all-trans retinoic acid (ATRA) as a model drug. Physicochemical proterties of SLN were investigated in detail. Drug release from two sorts of ATRA-SLN was investigated using a dialysis bag method. Compared with ATRA solution, the in vivo pharmacokinetics of two sorts of ATRA-SLN after intravenous injection to rats were studied.

RESULTSSolid lipid nanoparticles loaded with all-trans retinoic acid was readily and quickly prepared by ultrasonic technique. The morphological investigation by Transmission Electron Microscopy (TEM) showed that the particles had round and uniform shapes. The mean diameters of them were (158 +/- 9) nm and (89 +/- 11) nm separately. The SLN dispersion was stable at 4 degrees C for more than one year. Drug loading was 3.3%, drug entrapment efficiency was more than 95%, the in vitro release was well in accordance with Weibull distribution. Compared with ATRA control solution, SLN could stay in the blood circulation for a longer time after intravenous injection.

CONCLUSIONThe ultrasonic technique was appropriate for the preparation of solid lipid nanoparticles.

Animals ; Drug Carriers ; Drug Delivery Systems ; Drug Stability ; Fatty Acids ; Male ; Nanostructures ; chemistry ; Particle Size ; Poloxamer ; chemistry ; Polysorbates ; Rats ; Rats, Wistar ; Tretinoin ; administration & dosage ; pharmacokinetics ; Ultrasonics

Objective To develop training program of evidence implementation(EI) based on PARIHS model and to evaluate the effectiveness on clinical nurses for evidence-based nursing knowledge,attitudes and ability,and to understand the evaluation of participants about the methodological training.Methods A quasi-experiment design was conducted.A 6-month comprehensive evidence implementation training program was developed including methodological lecture,group discussion,EI case analysis,EI project development and implementation,and was carried out among 44 clinical nurses from 11 tertiary hospitals in Shanghai.The participants' EBN knowledge,attitudes and ability were measured by EBN knowledge,attitudes and ability questionnaire at 3 months and 6 months after training.Results Participants' EBN knowledge and ability were significantly improved at 3 months and 6 months after training(P＜0.05),and participants' EBN attitude had no significant difference before and after training (P＞0.05).The level of training satisfaction among participants was higher than 80.0％,and participants had finished 22 evidence implementation programs.Conclusion Evidence implementation training based on PARIHS can enhance clinical nurses' EBN knowledge and ability.Participants' EBN attitude hasn't been significantly improved.Participants have high satisfaction towards methodological training.

Objective To investigate the expression of macrophage migration inhibitory factor(MIF) in renal tissue of children with Henoch-Schonlein purpura nephritis(HSPN),and its correlation with clinical indexes and pathological changes,and to explore its effect on the pathogenesis of HSPN.Methods According to the clinical manifestation,60 children with HPSN were divided into only purpura group,mixed group and HSPN group.MIF concentration of Henoch-Schonlein purpura(HSP) groups and healthy control group were detected with enzyme linked immunosorbent assay(ELISA).MIF protein expression and the marker of human macrophage(CD68) in renal tissues of HSPN and normal control group were detected with immunohistochemistry method.The total urine protein for 24 hours and urinary N-acetyl-beta-D-glucosaminidase (NAG) level were detected with laboratory routine method.Results MIF concentration in mixed group and HSPN group were significantly higher than that in only purpura group and healthy control group(Pa

In order to establish a method by which the recombinant suicide plasmids integrated on the chromosome could be recircled, A simple method of transconjugative cloning was established with the helper plasmids pMT999 or pRK2013 and fusion strains of Shigella flexneri which were obtained by screening with in vivo expression technology. And the cloning efficiency with this method is very high.

Objective:To summarize our experience in perioperative anesthetic management for fulminant hepatic failure (FHF)patients receiving liver transplantation.Methods:The clinical anesthetic data of 48 FHF patients receiving orthotopic liver transplantations(OLT)from January 2006 to January 2007 were retrospectively analyzed,and the anesthetic management expe- rience was summarized.General anesthesia was applied;the hemodynamics was monitored during the operation and doses of adrenaline and phenylephrine were adjusted according to the monitoring results.Blood samples were obtained before operation, before anheptic,30 min after anhepatic phase,5 min before neohepatic phase,and 5 min,30 min and 60 min after neohepatic phase for blood gas and electrolyte analysis and for determination of coagulation function;the drugs were subsequently adjusted according to analysis results.Results:All the 48 patient underwent successful anesthetic management and there was no death dur- ing opearation.The average blood loss during operation was(5 219?478)ml.Mild alkalosis,hypokalemia,hyponatrium,and hy- pocalcemia were present before operations,pH,BE and HCO_3~- were obviously reduced 30 min after anhepatic phase and in- creased 60 min after neohepatic phase.Kalemia was obviously increased 30 min following anhepatic phase and began to increase 60 min following neohepatic phase.Calium concentration was decreased at the end of preanhepatic phase(P

Objective To investigate the efficacy and security of cypher stent(sirolimus-eluting stent)in the treatment of old patients with coronary heart disease(CHD).Methods From November 2002 to May 2005,328 elderly CHD cases(age:60-86 years)were treated with 415 Cypher stents.Among the 328 patients,66 had ST-segment elevation of myocardial infarction,21 had non ST-segment elevation of myocardial infarction,149 had unstable angina and 92 had stable angina.As for lesion characteristics,diffuse disease was found in 91 case(26.1%),bifurcation lesions in 68 cases(19.6%),chronic total occlusion lesions in 56 cases(16.0%),in-stent restenosis in 14 cases and ostial lesions in 15 case.The immediate angiographic outcome,major cardiac event(MACE) and angiographic follow-up at 6 months were assessed.Results Stent implantation was successfully achieved in 99% patients with CHD.Acute and sub-acute stent thrombosis occurred in 2 patients,late stent thrombosis with AMI occurred in 2 patients,1 died during the 6 months follow-up.The MACE rate during hospitalization was 0.6% and 3.6% during 6 months follow-up.Angiographic follow-up in 84 patients at 6 months showed that in-stent restenosis rate(ISR)was 8.3%(restenosis within the stents was 2.4%).The target vessel revascularization(TLR)rate was 5.9%.Conclusions Cypher stent implantation in CHD is safe and effective,the ISR rate and TLR rate are significantly lower than those of bare metal stents.

OBJECTIVETo evaluate the result of free transmidline bi-lobed scapular skin flap transplantation to repair massive soft tissue defects in upper and lower extremities.

METHODSFree transmidline bi-lobed scapular skin flap was designed according to the characteristics of scapular skin and its vasculature, and they were used to repair massive soft tissue defects in upper and lower extremities as a result of hot crush injury and avulsion injury in 9 patients. The survival of the flap, the blood supply, the color and elasticity of the flap, as well as scar contraction and impairment in function were observed after operation.

RESULTSThe largest flap formed with the horizontal branch and descending branch circumflex scapular artery were 31 x 14 cm and 22 x 16 cm, respectively. The horizontal branch went across the spinal midline for 10 cm. All skin flaps survived with good elasticity and without necrosis. The grafted skin was excellent in the appearance and elasticity, with no scar contracture , and function of the injured extremities recovered well 2 to14 months after the operation.

CONCLUSIONFree transmidline bi-lobed scapular skin flap is an ideal procedure for the repair of massive soft tissue defects in upper and lower extremities.

Adolescent ; Adult ; Female ; Foot Injuries ; surgery ; Hand Injuries ; surgery ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; Skin Transplantation ; methods ; Soft Tissue Injuries ; surgery ; Surgical Flaps