AIM:28 patients with congestive heart failure (CHF) were selected in this studyThe therapeutic scheme was as follows:after withdrawal of other vasodilators,urapidil was given in dose of 100～400?g/min intravenous drip;in severe case,the administration continued for 24～72 h;treatment lasted 3～6 daysThe patients'blood pressure,heart rate and LVEF were measured before and after treatmentRESULTS:The patients'clinical manifestations were markedly improved with a total effective rate of 89%LVEF was improved obviously too and the product of systolic pressure and heart rate was decreasedCONCLUSION:Urapidil is a vasodilator with slight side effects,reliable effectiveness and moderate action,and has undoubted therapeutic effect on CHF

Objective To study the imaging findings, clinical and pathological characteristics of langerhans cell histiocytosis(LCH)in limbs of children, and to improve the imaging diagnostic accuracy of LCH . Methods Imaging findings and clinical data of 12 patients with limbs LCH were analyzed retrospectively. X-ray examination was performed in 10 cases, while 9 cases underwent CT and 7 cases underwent MRI examination. All imaging findings were analyzed. Results Seven lesions were solitary, including 4 lesions in the tibia, 2 in the radius and 1in the ulna. Five cases had limbs lesion in multiple sites, which included 12 bone lesions in total, with 6 lesions in the femur, 3 in the humerus (1 case involved the epiphysis), 2 in the tibia and 1in the radius. The X-ray or CT images of the lesions showed osteolytic destruction and swelling of the bone, which was commonly associated with the reaction of periosteum. Eleven cases were with peripheral soft tissue swelling, and one case had soft tissue mass. The lesions showed low signal on T1WI and high signal or mixed signal on T2WI. Six cases were diagnosed as LCH at the first time and the other 6 cases were diagnosed as infectious lesions. Twelve cases were regularly followed up after the treatment, and the prognosis of the patients with single lesion was better. Conclusions LCH of limbs usually involves diaphyseal and metaphyseal bone. The imaging features include osteolytic destruction and swelling of the bone, with peripheral soft tissue swelling or mass of the soft tissue. Although LCH of limbs has some specific imaging features, it is difficult to differentiate it from malignant bone tumors. Multi-imaging modalities such as radiography, CT and MRI imaging may suggest the diagnosis and provide important information for evaluating prognosis.

Objective To investigate the situation of Pseudomonas aeruginosa strains carrying metallo-β-lactamases and inte-grases in the Second Affiliated Hospital of Harbin Medical University.Methods The phenotype of metallo-β-lactamases were detected by modified Hodge test,double-disc synergy and combination paper method,respectvily.PCR method was used to detecte metallo-β-lactamases genotypes and the integrationⅠ,Ⅱ and Ⅲ.The PCR products of the whole length bla-IMP gene were purified,sequenced and analyzed by Blast.Results Among 62 Pseudomonas aeruginosa strains,metallo-β-lactamases phenotype of 3 by modified hodge test,4 by double-disc synergy test,4 by combination paper method and were all positive 4 of IMP-1 type metallo-β-lactamases of Pseudomonasaeruginosa strains (10%,4/40)were positives by PCR.Inte-grase Ⅰ of 16(40 %,16/40)strains were positives by PCR method in IMP-resistant Pseudomonasaeruginosa,and integraseⅠ of 22.73 %(5/22)were positives in IMP-sensitive Pseudomonasaeruginosa.No other metallo-β-lactamases,integraseⅡandⅢ were detected in this study.Conclusion IMP-type metallo-β-lactamase existed in IMP-resistant Pseudomonasaerugi-nosa isolates of the Second Affiliated Hospital of Harbin Medical University.Most strains carried integraseⅠ,and other re-sistance mechanisms may be associated with multi-drug resistance,so it is important to prevent the Pseudomonasaeruginosa strains which carried metallo-β-lactamases and integrons widely spread in the hospital.

OBJECTIVE To understand the status of the hospital infection and risk factors,as well as the existing problems of infection management,to improve the surveillance method of incidence rate of hospital infection and strengthen the infectious precaution and control measures.METHODS By efforts of the professional staff of hospital,with cooperateion of the clinic personnel infection management group,all the patients in hospital were investigated when sampled from zero hour of the day before investigation to the zero hour of the day of investigation,according to the requirement of nosocomial infection rate to design the questionnaire.The data were analyzed.RESULTS The patients investigated in hospital were 638,from them 38 cases with hospital infections were found,the incidence and case-time rates of hospital infection were 6.0% and 7.4%,respectively.Respiratory infection was the most common.CONCLUSIONS Compared with the investigation method used previously,the current approach is easy and standardized.It also provides the credible reference to improve infection surveillance and management.

Objective Analysis the risk factors which maybe caused the cerebral hemorrhage after the liver transplantation, and then make out the counter nursing measures. Methods Selected 12 patients with cerebral hemorrhage after the liver transplantation as the experimental group, and then matching 48 patients without cerebral hemorrhage after the liver transplantation as the control group. Analysis the factor which related the cerebral hemorrhage. Results The factors which related the cerebral hemorrhage after the liver transplantation included in the Intensive Care Unite, heme level, Child level, APTT, albumin, blooding volume during the operation, operation time and the postoperative blood platelet level. The factors of Child level and the blooding volume during the operation were the independence risk factors of cerebral hemorrhage. Conclusion The factors of Child level and the blooding volume during the operation were the independence risk factors of cerebral hemorrhage, we should carry out counter nursing measures to prevent them.

Objective To investigate the effects of Pinella's ingredients on the viability of cells, morphology, microstructure, cell cycle and apoptosis in human cervical cancer cell lines. Methods The β-sitosterol and/or total protein of Pinella were incubated at different concentrations with cervical cancer cell line SiHa. The effects of β-sitosterol and/or total protein of Pinella on the viability of cells were tested by MTT assay. The effects of β-sitosterol on morphology, microstructure, cell cycle and apoptosis were studied by phase-contrast microscope, electron microscope and flowcytometry, respectively. Results β-sitosterol could obviously inhibit the viability of SiHa cells in a time-and dose-dependent manner. The total protein of Pinella had no effects on SiHa cells' viability. 20 μmol/L β-sitosterol induced the accumulation of SiHa cells in S phase in the cell cycle. And the percents of apoptosis and necrosis increased. The morphology and microstructure of SiHa cells changed significantly after treated with 20 μmol/L β-sitosterol. Conclusions The total protein of Pinella had little influence on the viability of cervical cancer cells SiHa. The viability of SiHa cells could be suppressed by β-sitosterol. β-sitosterol could induce the accumulation of cells in S phase and the percent of apoptosis and necrosis. The morphology and microstructure changed significantly after treated with β-sitosterol. Therefore, β-sitosterol might be a prospect safe and low toxicity anti-cervical cancer drug.

Objective To evaluate the diagnostic utilities of CD64,CDllb,sICAM-1 and sE-selectin in early identification of neonatal sepsis related to bacterial infection. Methods The group of sepsis consisted of 36 newboms and the control group included 26 healthy newboms. The blood samples were collected right after being admitted to hospital and at recovery stage in the group of sepsis,as for the control the blood samples were collected only once in the study. In the sepsis group,blood samples were also taken in bacterial culture before treatment CD64 and CDllb were quantified with direct immunofluorescence staining and the whole blood cell flow cytometry analysis. sICAM-1 and sE-selectin level were determined by ELJSA assay,along with CRP. Results The expression level of CD64 in neonates with sepsis was (60. 37 22. 70) .shown in MFI,which was significantly higher than that in the group of control (23. 14 ±5. 10) MFI(P <0. 01). The expression level of CDllb in neonates with sepsis was (1645. 14 ±463. 68) MFI,which was significantly higher than that in the group of control (1041.48 ±260. 34) MFI (P < 0. 01). The concentration of blood sICAM-1 in neonates with sepsis was (240. 20 ± 83.46) μg/L, which was significantly higher than that in the group of control (100. 24 ±51.03)μg/L(P <0. 01). The concentration of blood sE-selectin in neonates with sepsis was (29. 63 ±9. 88μg/L,which was significantly higher than that in the group of control (14. 12 ±5. 33)μg/L(P <0. 01). In the sepsis group,the level of CD64,CDllb,sICAM-l and sE-selectin in the primary stage was higher than the recovery stage significantly (P <0. 01). The sensitivity of above-mentioned molecular markers were 95. 7% , 82. 6% , 81. 8% and 87. 0% , respectively, and the specificity were 95. 8% , 79. 2% ,86.9% and 79.2% . CD64 was the best one. Conclusions CD64 may serve as one of the reliable biomarkers in the early diagnosis of neonatal sepsis, and it may play important role in the treatment of neonatal sepsis.

Objective To construct mutant strains of Klebsiella pneumoniae with ampG gene dele-tion by homologous recombination and to evaluate the role of ampG gene in inducing the expression of AmpC enzyme.Methods Polymerase chain reaction ( PCR) was used to amplify the upstream and downstream fragments of ampG gene.The gene splicing by overlap extension PCR ( SOE-PCR) technique was used to construct the fusion fragment , which was then ligated into the temperature sensitive suicide vector pKO 3-km after enzyme digestion as pKO3-km-ΔampG.To achieve allelic exchange , the plasmid pKO3-km-ΔampG was introduced into Kp1 and Kp NTUH-K2044 strains by electroporation .The mutant strains of Klebsiella pneu-moniae with ampG gene deletion were screened out .The plasmid pACYC184-ampCR was introduced into the Kp NTUH-K2044 wild-type strain and its mutant strain with ampG gene deletion to make them harbor the gene encoding AmpC enzyme .The disk diffusion method was used to evaluate the effects of ampG gene on the expression of AmpC enzyme in Klebsiella pneumoniae strains with cefoxitin as the inducer .Results The recombinant plasmid pKO3-km-ΔampG was constructed successfully .The mutant strains of Klebsiella pneu-moniae with ampG gene deletion were constructed as verified by PCR and DNA sequencing .Compared with the Kp1 wild type strain, no AmpC enzyme was produced by the ampG gene knock-out Kp1 strain.The Kp NTUH-K2044 strain could produce AmpC enzyme , while the mutant strain of Kp NTUH-K2044 with ampG gene deletion could not after introduced the pACYC 184-ampCR plasmid .Conclusion The mutant strain of Klebsiella pneumoniae with ampG gene deletion was successfully constructed .The Klebsiella pneumonia strain without the ampG gene could not produce the AmpC enzyme .

Objective To compare the planning quality and volume of organ at risk (OAR) between volumetric-modulated arc therapyv (VMAT) and nine-field dynamic intensity-modulated radiation therapy (IMRT) in radiotherapy for cervical cancer patients,explore the best way to cervical cancer radiotherapy,Methods Selected 20 patients with cervical cancer were divided into 2 groups,10 cases for each group.Cervical cancer patients with no surgery was performed for A group (group A),received the radical radiotherapy,prescription dose gross tumor volume (GTV) 56 Gy,clinical target volume (CTV) 50 Gy.Another group of patients with cervical cancer radical surgery (group B),giving the whole basin lymph node auxiliary radiation therapy,prescription dose CTV 50 Gy.Each cervical cancer patient received VMAT and IMRT program designs,the differences in dose volume histogram (DVH),irradiated volume of organ at risk (OAR),heterogeneity index (HI),conformity index (CI),maximum dose (PTVmax),minimum dose (PTVmin) and mean dose (PTV mean) were compared between two plans in 2 groups.Results Two kinds of radiation technology in target area dosimetry were not statistical difference between two groups (P ＞ 0.05).In endanger organs on the protection of two groups of VMAT planning groups in the small intestine V20 and left femoral head V20 had obvious advantages with statistically significance (P ＜ 0.05).Conclusions Two groups of dosimetry between VMAT and IMRT program design are similar in cervical cancer.Two groups of VMAT planning groups to protect endanger organ slightly better than that of IMRT group,but VMAT planning group shortens treatment time and improves the accuracy and efficacy of treatment.