Objective To evaluate the MDCT and MRI findings of the ovarian thecofibroma.Methods 15 patients with 16 lesions of ovarian thecofibroma confirmed by pathology after surgery were analyzed retrospectively.MDCT was performed in 1 2 patients and MRI in 8.Results 16 lesions were all unilateral,of which 1 patient had 2 lesions on the same side.10 lesions were located in the right side of ovary,while 6 ones were in the left side.The shape of more lesions was round or oval,and that of huge lesions was lobulated. 14 lesions were well-defined.These tumors were solid in 4 lesions,mixed in 9,and cystic in 3.The largest diameter of tumors ranged from 20 to 220 mm with a mean value of (89±58.29)mm.Plain MDCT showed the substantial part of tumors with iso-den-sity or slight lower density with the mean CT value of (40±8)HU.There was no or slight enhancement in comparison with the mean CT values of (49±9)HU on enhanced MDCT.5 lesions with isointensity and 3 with slight hypointensity on T1-weighted ima-ges,and all the tumors with heterogeneous signal on T2-weighted images were found.6 lesions appeared isointensity with obscure nebulous high signal on T2-weighted.The capsules of 5 lesions showed incomplete ring with lower signal.There was high signal ring outside of tumor capsule on T2-weighted in 5 lesions.All of 8 lesions were enhanced slightly,and the cystic portion was lower signal on T1-weighted images and high signal on T2-weighted images.Among all patients,ascites was found in 10 cases (66.7%)and other kinds of tumors of ovarian or uterus in 13 cases (86.7%).Conclusion MDCT and MRI findings of the ovarian thecofibroma have cer-tain characteristics,which is helpful for the diagnosis and differential diagnosis.

OBJECTIVE To decrease the infection rate in intensive care unit(ICU) effectively. METHODS To analyze the reason of infection in ICU,such as the infection of respiratory tract,the infection of urinary system,the vascular infection after therapy,and the infection of alimentary tract,and to raise the control measure of nursing. RESULTS To pay attention to the arrangement and setting in ICU,the implementation of the regulation of nursing strictly, the intravascular therapy,the correct realizing of nursing procedure,and the reinforcement of nursing management,in order to keep the low infection rate. CONCLUSIONS All nursing measure raised/above is very useful for the hospital infection control in ICU.

OBJECTIVE To reduce the nosocomial infection rate among bone marrow transplanted patients.METHODS The related factors of infection among bone marrow transplanted patients were analyzed.RESULTS The environmental microbiology pollution,carrying opportunistic pathogens,oral mucosa damage,deep venous catheterization and others were the main related factors of infection.CONCLUSIONS The proposed control of endogenous and exogenous infection and strengthening the counter measures in the oral care and deep venous catherization care could effectively prevent nosocomial infection among bone marrow transplanted patients.

OBJECTIVE To advocate the establishment of a hospital center for intravenous drug preparation,in order to control infection caused by intravenous infusion.METHODS The unsafe factors brought by traditional distributed intravenous drug preparation were analyzed and propose the necessity and importance of the establishment of pharmacy intravenous admixture center.RESULTS Without any case of transfusion reaction occurred for 3 years,the Pharmacy intravenous admixture center could ensure the safety of patients.CONCLUSIONS Pharmacy intravenous admixture center plays an important role in providing the aseptic environment,shortening the preparatory time after the liquid stored and ensuring that the liquid is not contaminated.

Objective To explore the viral etiology spectrum of different age and different seasons for neo-natal pneumonia.Methods Medical records of 1 073 cases of neonatal pneumonia in our hospital were retrospectively analyzed,line direct immunofluorescence assay were used to detect nasopharyngeal secretions of newborns,the test results were statistically analyzed.Results In 1 073 cases with neonatal pneumonia,406 cases were detected positive with virus infected,the positive rate was 37.8%,7 cases were mix infected.334 cases were infected by respiratory syncytial virus(RSV),which had the highest detection rate,accounting for 82.3%;RSV infection rate in 1 -6 month baby was 36.4%,which was higher than the >6 -12 month -old baby with RSV infection rate 26.5%,the difference was statistically significant(χ2 =12.25,P <0.05);RSV infection rate in winter and spring group was 39.7%,which was significantly higher than that in autumn and winter group(13.6%);PIV3 infection rate in winter and spring group was 1.8%,significantly lower than that in autumn and summer group(9.1%),the difference was statistically signifi-cant(χ2 =31.27,P <0.05 ).Conclusion RSV is the most common viral in neonatal pneumonia,more attention should be payed to RSV infection control in small babies and at winter and spring,pay attention to PIV3 infection at autumn and summer.

Objective To investigate the most appropriate low radiation dose in multi-slice CT (MSCT) scans for orbital trauma patients. Methods Thirty trauma patients with suspected orbital fractures who underwent helical CT scans with a 64-MSCT using regular dose were selected. Noise was artificially introduced to the axial images using an image space noise addition tool to simulate 6 sets of lower dose scans with tube current of 30, 70, 100, 140, 170 and 200 mA, respectively. The lowest tube current with adequate image quality for confident diagnosis was determined based on the evaluation of the overall image quality and fracture detection on images at different dose levels. The determined lowest tube current was then validated using clinical scans. Radiation dose related parameters CTDIvol, DLP, ED were also recorded.Image quality was evaluated according to its low-density resolution, noise and structure clarity and characterized into 5-grades of excellent, good, fair, worse and worst Rank sum test and X2 test were wsed for statistics. Results In 30 trauma patients with regular dose of 300 mA, there were 30 cases of orbital fracture, 19 cases of intraorbital emphysema, 12 cases of ocular muscle injury and 1 case of intraorbital foreign body. These changes could still be clearly observed and correctly diagnosed when the tube current was reduced to as low as 70 mA. However, the overall image quality was mostly fair. At the simulated dose of 100 mA, the majority of images were characterized as excellent or good, and there was no statistical difference compared with that of regular dose scans (P > 0.05 ) . In the clinical evaluation for 20 orbital trauma patients with the reduced tube current of 100 mA, the majority of images were judged to be excellent (9 cases) or good(17 cases) and fair (4 cases). The radiation dose(0. 29 mSv) was reduced by 70% compared with that of regular tube current of 300 mA(0. 86 mSv). Conclusion The tube current of MSCT may be used as low as 100 mA in orbital trauma patients to reduce radiation dose and keep the image quality diagnosable.

The development of clinical pathways must "start and end up with education" as put by the authors. The article discussed the objectives, significance and contents, as well as approaches in the education of clinical pathways. It recommended a tiered education for hospital leaders, medical care workers, office staff, patients and their family members, and different target groups and contents in the education for clinical pathways application.

Objective To investigate the effect of monosialoganglioside GM-1 on cardiopulmonary bypass (CPB)-induced brain injury in rats.Methods Twenty-seven adult male Sprague-Dawley rats,weighing 350-450 g,aged 15 months,were randomly divided into 3 groups (n=9 each): control group (C group),CPB group and GM-1 group.The animals were anesthetized with chloral hydrate,tracheostomized and mechanically ventilated.Right common carotid and right jugular vein were cannulated for closed-chest CPB.In groups CPB and GM-1,the rats underwent 1 h CPB.GM-1 20 mg/kg was added to the priming solution in group GM-1,while the equal volume of normal saline was given in group CPB.The animals were sacrificed at 3 h after termination of CPB or 3 h after the end of ventilation in group C,the brains were removed and the hippocampi isolated for microscopic examination and for determination of apoptosis (using TUNEL) and Bax and Bcl-2 protein expression (by immunohistochemistry and Western blot).Results Compared with group C,the number of apoptotic neurons and ratio of Bax/Bcl-2 were significantly increased,and the expression of Bcl-2 and Bax protein was up-regulated in groups CPB and GM-1 (P ＜ 0.05).Compared with group CPB,the number of apoptotic neurons and ratio of Bax/Bcl-2 were significantly decreased,the expression of Bax protein was down-regulated and the expression of Bcl-2 protein was up-regulated in group GM-1.The pathological changes were severe in group CPB and attenuated in group GM-1.Conclusion GM-1 can attenuate CPB-induced brain injury in rats and inhibition of the apoptosis in neurons may be involved in the mechanism.

Objective To evaluate the effect of monosialoganglioside (GM-1) on hippocampal protein kinase B (Akt) /glycogen synthase kinase 3β (GSK-3β) signaling pathway in the rats undergoing cardiopulmonary bypass (CPB).Methods Eighteen healthy male Sprague-Dawley rats, aged 6 months, weighing 400-500 g, were randomly divided into 3 groups (n =6 each) using a random number table:control group (group C), CPB group and GM-1 group.GM-1 20 mg/kg was added to the priming solution in group GM-1, while the equal volume of normal saline was given in group CPB.At 3 h after termination of CPB, blood samples were taken from the jugular vein for determination of plasma neuron-specific enolase (NSE) and S-100β protein concentrations using enzyme-linked immunosorbent assay.After blood sampling, the rats were sacrificed, and the hippocampi were isolated for microscopic examination of the ultrastructure of the hippocampal neurons (with electron microscope), and for detection of neuronal apoptosis (with light microscope) and phosphorylation of Akt and GSK-3β (by Western blot).Results Compared with group C, the concentrations of plasma NSE and S-100β protein, and the number of apoptotic neurons were significantly increased in CPB and GM-1 groups, the phosphorylation of Akt and GSK-3β was decreased in group CPB, and the phosphorylation of Akt and GSK-3β was increased in group GM-1 (P＜0.05).Compared with group CPB, the concentrations of plasma NSE and S-100β protein, and the number of apoptotic neurons were significantly decreased, the phosphorylation of Akt and GSK-3β was increased (P＜0.05), and the pathological changes were reduced in group GM-1.Conclusion GM-1 can reduce apoptosis in hippocampal neurons through activating Akt/GSK-3β signaling pathway, thus mitigating CPB-induced brain injury in rats.

Objective To investigate the effect of continuous renal replacement therapy ( CRRT) on the reg-ulation of Treg/Th17 in patients with severe sepsis,and related inflammatory factors IL-6,IL-17,IL-10,and TNF-α.Methods 60 patients with severe sepsis were randomly divided into two groups,30 cases in each group.The control group received conventional treatment,and the observation group was treated with CRRT on the basis of the control group.Flow cytometry was used to detect the levels of Tregs and Th17 cells,and IL-6,IL-10,IL-17 and TNF-αwere detected by ELISA method.At the same time,the APACHEII score,ICU length of hospital stay were observed and recorded.Results After treatment,APACHE Ⅱscore,ICU length of hospital of the observation group were lower than the control group,there were statistically significant differences(t=4.258,t=4.518,all P<0.05). The expression levels of Th17,Treg and Tregs/Th17 in the observation group were significantly lower than the control group,the differences were statistically significant (t=5.872,4.267,4.285,all P<0.05).The expression levels of IL-6,IL-17,TNF-αin the observation group decreased more significantly than the control group,the differences were statistically significant (t=5.829,5.257,5.983,all P<0.05).But the expression level of IL-10 in the two groups had no obvious change[(35.26 ±18.63) pg/mL vs (35.52 ±20.09) pg/mL,t=2.164,P>0.05].Conclusion CRRT can not only remove the inflammatory mediators of abnormal expression,improve the function of T cells,but also can maintain the balance between Th17 and Treg,improve the immune disorders,and improve the prognosis of sepsis.