Nosocomial infection of Pseudomonas aeruginosa is a dilemma in clinic,especially at ICU with high rate of antibiotic resistance,and lead to ventilator associated pneumonia,bloodstream infections, etc.There are difficulties in the treatment,lengthening of ICU stay,high mortality and increased treatment costs.Positive prevention,early diagnosis,reasonable antiboitics are the key to the benign prognosis of Pseud-omonas aeruginosa.

Brain injury is one of the most common diseases in PICU.Bedside electroencephalogram monitoring is the most commonly used to evaluate cerebral function.Bedside electroencephalogram monitoring includes continuous electroencephalogram,video electroencephalogram and cerebral function trends,such as amplitude integrated electroencephalogram,envelope and band power.

Objective:To do research on prediction method of medical equipment sudden fault for the requirement of medical security at sea which is away from base.Methods: Sudden fault data of the medical equipment is a random variable which often manifest as the time of sudden fault happening. The possible distribution type of fault data is hypothesized according to the engineering experience. In order to ensure the sudden fault density function of medical equipment, parameter estimation and distribution fit test are carried out for the fault data.Results: The sudden fault prediction model of medical equipment is established to get the future sudden fault probability of medical equipment based on the distribution function of fault data.Conclusion: The results of case analysis validate the rationality of sudden fault prediction model.

Objective To optimize the extraction process of Xuanfei Zhike Mixture. Methods The preparation process was investigated by L9(34) orthogonal design with content of ephedrine hydrochloride, the extraction rate of n-butanol and total extraction as indexes. The main factors influencing the extraction efficiency such as the amount of added water, the time of extraction and times of boiling were investigated. Results The optimum technical condition was as follows:8 times amount of water, extract 2 times and 60 min for each time. Conclusion The result is reliable. It can be used for mass production.

Objective To survey the effects of repetitive transcranial magnetic stimulation (rTMS) on learning,memory and the dendrite morphology of neurons in the CA1 area of the hippocampus in rats with vascular dementia.Methods Thirty-six male SD rats were divided into a control group,a model group and a rTMS group randomly,12 rats in each group.A model of vascular dementia (VaD) was established using the two vessel occlusion method.The rats in the rTMS group were given rTMS treatment.The rats in the other two groups had no therapy.The Morris water maze (MWM) test was used to evaluate the rats' learning and memory abilities on the 30th day after the operation.After the MWM test the dendrite morphology of the pyramidal cells in the CA1 area of the hippocampus was detected after Golgi-Cox staining using light microscopy and the expression of brain-derived neurotrophic factor (BDNF) was detected using immunohistochemistry methods.Results The average MWM escape latency in the rTMS group was shorter than in the model group on the 1 st,2nd,3rd and 4th day.The number of crossings of the platform quadrant in the rTMS group was significantly more than in the model group.The number of branch segments,their total length and the dendritic spine density of pyramidal cell dendrites in the CA1 area of the hippocampus were all significantly lower in the model group than in the control group,but in the rTMS group all these indicators were significantly improvedcompared with the model group.The expression of BDNF in the CA1 area in rTMS group was significantly higher than in the model group.Conclusions rTMS can improve learning and memory in VaD,at least in rats.The mechanism may be associated with rTMS promoting the expression of BDNF in the hippocampus and so improving the dendrite morphology of pyramidal cells.

Objective To investigate the expression of type Ⅱ collagen in the articular chondrocyte of osteoarthritis (OA) patients and normal human. Methods The samples of articular cartilage were obtained from the patients undergoing total joint replacement, including 8 primary OA patients, 8 secondary OA patients and 9 normal subjects. Type Ⅱ collagen expression in chondrocyte was detected by reverse transcriptase polymerase chain reaction (RT-PCR). Results The expressin of type Ⅱ collagen mRNA in normal OA group was higher than that in primary OA group and secondary OA group with a statistical difference (P=0.014), while there was no statistical difference between primary OA group and secondary OA group(P=0.716). Conclusions The reduction of type Ⅱ collagen expression leads to the change of collagen directly and possibly plays an important role in OA, which is the common pathway of the occurrence of both the primary and secondary OA.

Objective To investigate the value of the interhospital transportation and the advantage of the cooperative network to the critically ill children.Methods The clinical data of 232 critically ill chil-dren transported from other hospitals in long distances to PICU of Fudan University Affiliated Children Hos-pital cooperated with Shanghai 120 interprovincial transport Department,between Oct 2010 and Oct 2013, were analyzed retrospectively.Results At otal of 232 critically ill childrne were transported from 31 hospi-tals of Eastern China region including five provinces and the city of Shanghai.Among thse e critically ill chil-dren 141 casse were male and 91 cases were femla e,with age from 29 days ot 13 years( median age was 12 months) and weight from 2.5 to 66 kg ( median weight was 10 kg ) .The average pediatric clinical illness score was 80.4 ±7.7,155 cases(66.8%) were single organ dysfunction,55 cases(23.7%) were multiple organs dysfunction,105 cases(45.3%) were mechanical ventilation required fort ransportait on.Referral radi-us was 50-1 000 km(median).Among these patients,87 cases(37.3%) weret ransported over 200 km radius and73 cases(36%) were transop rted 101-200 km,62 cases(26.7%) were transported 100 km or less.D ur-ing the transportation,0 case died,3 cases(1.3%) received cardiopulmonary resuscitation treatment,2 cases (0.9%) received electrical conversion treatment,2 cases(0.9%) were replaced endotracheal intuab tion,the success rate of transportation was 100%.The top 4 disae ses were respiratro y id seases(90 cases,38.8%), neural diseases(43 cases,18.5%) ,cardiovascular diseases(36 cases,15.5%) and acute pediatric trauma(28 cases,12.1%) .Al l 232 cir tically ill children were admitted to our PICU for further treatment through the Green Channel.In the end, 178 cases ( 76.7%) discharged, 24 cases ( 10.3%) gave up and 32 cases (13.8%) died.Among thse e 232 rc itically ill children,30 cases(12.9%) received special organ replacement treatment,4 casse ( 1.7%) of whom were treated with extracorporeal membrane oxyg enation, 26 cases (11.1%) received blood purification therapy.Conclusion Establishing the system of transportation between PICU of hospitals will be propitious to treat the critically ill children energetically and effectively.It is worth pro-moting to master the transportation indication of children with critical illness,which is safe and reliable.

BACKGROUND:Cerebral hemorrhage can activate the proliferation and differentiation of neural stem cel s in the dentate gyrus of the hippocampus. Through continuous differentiation and proliferation, endogenous neural stem cel s can gradual y replace aging and damaged neurons, thus protecting the brain structure.
OBJECTIVE:To compare the difference of the proliferation and differentiation of neural stem cel s in the dentate gyrus of the hippocampus of rats with different ages.
METHODS:Ninety-six adult rats and 96 aged rats were randomly divided into normal group (n=18 per group), sham operation group (n=12 per group) and cerebral hemorrhage group (model group, n=66 per group), respectively. Cerebral hemorrhage models were made in the two model groups in which, the rats were subjected to cerebral hemorrhage for 6, 24, 48, 72 hours and 7 days, respectively. Then, brain tissues were col ected to measure brain water content. BrdU/NeuN and BrdU/GFAP double staining were performed at 3, 7, 14, 21, 28 days after surgery to calculate the number of positive cel s.
RESULTS AND CONCLUSION:For both adult and aged rats, the brain water content was significantly higher than that in the normal group and sham operation group (P<0.05), while in the normal and sham operation groups, the brain water content was significantly lower in the aged rats than the adult rats (P<0.05). The number of bilateral BrdU-positive cel s in the adult and aged model groups was significantly higher than that in the corresponding normal and sham operation groups (P<0.05), and moreover, the positive cel number at the hemorrhage side was significantly higher than that at the opposite side (P<0.05). In addition, the number of BrdU-positive cel s at the hemorrhage side in the adult rats was significantly higher than that in the aged rats at different time after cerebral hemorrhage (P<0.05). Results from immunohistochemical double staining showed that the BrdU/NeuN and BrdU/GFAP expression in the hippocampal dentate gyrus of adult rats with cerebral hemorrhage was significantly higher than that of normal adult rats. Al these experimental results show that there are a few neural stem cel s proliferating in the hippocampal dentate gyrus of normal rats, and the proliferation ability is stronger in the adult rats than the aged rats. Cerebral hemorrhage can significantly strengthen the proliferation of neural stem cel s in the dentate gyrus in the adult rats compared with the aged rats.

Objective Intestinal ischemia-reperfusion (I-R) is a critical and triggering event in the development of distal organ dysfunction,frequently involving the lungs.In this study we investigated the effects of edaravone on the prevention of lung injury induced by intestinal I-R in rats.Methods Eighteen male SD rats were randomly divided into 3 groups: Sham operation group (group Sham),I-R group (group IR) and edaravone group (group E).After injecting 6 mg of edaravone or the same volume of 0.9% sodium chloride,the anterior mesenteric artery was clamped with a noninvasive microvascular clip for 120 min and then reperfusion for 120 min.Sham-operated animals underwent the same surgical procedures without clamping.Lung tissues were collected for pathology tested by HE dyed,blood as collected for the analysis of TNF-α and IL-6 concentration by ELISA,small lung tissues were collected for the analysis of lung myeloperoxidase (MPO) activity and malonialdehyde (MDA) concentration.Results Compared with group Sham,the alveolar epithelial cells in group IR was widespread edema,inflammatory cell infiltration,atectasis,disruption of alveolar,and pulmonary capillary hemorrhage.The pathological changes of lung tissue in group E were significantly improved compared with those in group IR,and that of alveolar inflammatory exudate was decreased.Pathological scoring of group E (2.1±0.7),which was significantly lower than that of group IR (5.7±1.1) and group sham (1.5±0.2) score (P<0.05),so the concentration of TNF-α,IL-6,MPO activity and MDA concentration of group E were less than those of group IR (P<0.01).Conclusion Edaravone ameliorated the lung injury induced by intestinal I-R.

Objective To study the clinical effect of peritoneal and abdominal indwelling tube by ultrasound for patients with severe acute pancreatitis.Methods Sixty-eight patients with severe acute pancreatitis from January 2010 to December 2013 were analyzed retrospectively.The patients were divided into experiment group (48 cases) and control group (20 cases).The patients in control group were given the common drugs treatment,and the patients in experiment group were given the common drugs and the peritoneal and abdominal indwelling tube by ultrasound.The clinical effects and complication were compared.Results The total efficacy rate in experiment group was 93.75％(45/48),in control group was 35.00％(7/20),and there was significant difference (P ＜ 0.05).Seven patients in experiment group occurred complication,after the symptomatic treatment 6 patients recovered and 1 patient died of multiple organ failure;7 patients in control group occurred complication,after the symptomatic treatment 3 patients recovered and 4 patitents died of infection recurrence.The complication rate in experiment group was 14.58％(7/48),in control group was 35.00％ (7/20),and there was significant difference (P ＜ 0.05).Conclusion Peritoneal and abdominal indwelling tube by ultrasound could improve clinical efficacy and decrease complication rate for patients with severe acute pancreatitis.