OBJECTIVE To investigate the etiology of ventilator-associated pneumonia(VAP) in our respiratory intensive care unit(RICU) and to explore the antimicrobial resistance of predominant pathogens in last ten years. METHODS From 1992 to 2003,totally 149 cases with VAP were collected for analyzing in our RICU.Standard disk diffusion susceptibility tests were performed on the predominant pathogens. RESULTS During this period,the incidence of VAP in RICU was 35.57%,33 cases were infected by two or more pathogens(67.35% VAP cases).The main pathogens of VAP were Gram negative organisms(65.51%) whose predominant pathogens were Pseudomonas aeruginosa and Acinetobacter.On the other hand,the main Gram positive organisms were Staphylococcus epidermidis.During the recent 10 years,the incidence of Acinetobacter rose up from 8.99% to 15.49% and the rate of Candida decreased from 13.33% to 7.04%. CONCLUSIONS The main pathogens of VAP in our RICU are P.aeruginosa and Acinetobacter,and the changes in pathogens distribution and infection spectrum have been taken place during the past 10 years.

Objective To discover the distribution of ammonia nitrogen in groundwater of Shunyi District and its influencing factors. Methods 286 monitored points in low-flow period and 100 in high-flow period were chosen in 19 towns in Shunyi District. Concentrations of ammonia nitrogen, iron and manganese, and the total bacterial count of water samples were determined and evaluated based on the Guidelines for Drinking Water Quality and related standard during Jan.-Mar., Aug.-Sep., in 2005. Results All the monitored points were deep groundwater. The median of ammonia nitrogen concentration in groundwater was 0.010 mg/L in low-flow period, and 0.140 mg/L in high-flow period. The relativity was not found between the concentration of ammonia nitrogen,total bacterial count in water sample and pollution source around the well. However the concentration of ammonia nitrogen was positively correlated with the concentration of nitrite nitrogen(r=0.224, P

The inverse cancer comorbidity in schizophrenia patients may be related to the genetic factors ,involving the regu‐lation of apoptosis .The tumour suppressor gene TP53 ,involved in neural apoptosis ,is one of the potential candidate genes associat‐ed with schizophrenia which might reduce colorectal cancer risk .We recruited 270 schizophrenia patients and 312 colorectal cancer patients without schizophrenia .To examine the genetic association between schizophrenia and colorectal cancer ,we analysed eight SNPs (rs12951053 ,rs1625895 ,rs2909430 ,rs9895829 ,rs1042522 ,rs8079544 ,rs8064946 ,rs17806770) covering 14 .35 kb in the re‐gion of TP53 .We observed that one of the eight genetic polymorphisms showed statistically significant differences between the colo‐rectal cancer subjects and the schizophrenia subjects (rs12951053 ,P=0 .000 1 ,OR 1 .70 ,95% CI 1 .30-2 .23) .In addition ,the hap‐lotype of A‐G (rs12951053‐rs8064946) ,giving a global P=0 .001 8 ,was the most significant .Our data indicate that the polymor‐phisms of rs12951053 in TP53 confer reduced susceptibility to colorectal cancer and suggest a potential protective mechanism a‐gainst colorectal cancer in the schizophrenia patients of Han Chinese origin .

Objective : To analyze the screening results of Mycobacterium tuberculosis (MTB) and HIV co-infections in Ningbo City from 2012 to 2020, so as to provide insights into improving the tuberculosis control strategy. Methods : Data pertaining to HIV antibody testing among tuberculosis patients, MTB testing among HIV/AIDS patients, treatment of patients with MTB and HIV co-infections and prognosis of anti-tuberculosis therapy were collected from the annual working reports for the management of MTB and HIV co-infections in Ningbo City from 2012 to 2020, and the screening, treatment and prognosis of MTB and HIV co-infections were analyzed. Results : A total of 35 385 newly identified tuberculosis patients were reported in Ningbo City from 2012 to 2020, and there were 5 854 cases receiving HIV testing. The annual mean percentage of HIV screening was 17.57%, and the HIV screening rate appeared a tendency towards a rise in Ningbo City from 2012 to 2020 (χ2trend=4 926.309, P<0.001). Eleven patients were tested positive for HIV, with an annual mean HIV positive rate of 0.19%. A total of 26 043 HIV/AIDS patients received MTB screening, with an annual mean screening rate of 95.78%, and the annual screening rate of MTB appeared a tendency towards a rise in Ningbo City from 2012 to 2020 (χ2trend=79.077, P<0.001). A total of 81 tuberculosis patients were detected, with an annual mean detection rate of 0.31%. Among the 92 patients with MTB and HIV co-infections, there were 81 patients receiving anti-tuberculosis and antiviral therapy simultaneously (88.04%), 8 cases receiving anti-tuberculosis therapy alone (8.70%), 2 cases receiving antiviral therapy alone (2.17%) and 1 case without therapy (1.09%). Among the 89 MTB and HIV co-infected patients receiving anti-tuberculosis therapy, 27 cases were cured (30.34%), 53 cases completing the course of treatment (59.55%) and 7 cases died. Conclusions The MTB screening rate among HIV/AIDS patients and the percentage of MTB and HIV co-infected patients with successful anti-tuberculosis treatment were high in Ningbo City from 2012 to 2020; however, the HIV screening rate should be improved among tuberculosis patients.

Objective To explore the relative factors affecting the functional restoration of knee joint after the fracture of patella, and to anticipate the effect of middle term and short time rehabilitation therapy. Method 23 patients with limited flexion function of knee joint after the fracture of patella, accepted the routine rehabilitation treatment in out  patient service, and some of the patients adopted local heat therapy at the same time. The 13 factors have been selected for regression analysis step by step under the help of SPSS statistical software. Result The flexible degree of the knee joint before rehabilitation (X1), the non smooth posterior edge of patella (X2), and the immobilization time of the joint (X3) are relative factors for the flexible degree of knee joint 1 month after ehabilitation (Y1) and the flexible degree of knee joint 3 onths after rehabilitation (Y2), and Y1 can also be affected by whether surgery therapy or not (X4), (partial regression coefficient P< 0.05). The differences between theoretical mean and practical mean of Y1 and Y2 are 5.6％ and 4.2％ respectively in the 23 cases. Conclusion The flexible degree of the knee joint before rehabilitation, whether the posterior edge of patella is smooth or not, and the immobilization time of the joint are relative factors affecting the middle term and short term flexible function of knee joint after the fracture of patella, and short term restoration can also be affected by whether surgery therapy or not. The effects of middle term and short term rehabilitation can be predicted by regression equation primarily.

Objective To compare the clinical outcome of shape memory alloy (SMA) embra-cing fixator and reconstruction plate fixation in treatment of displaced or comminuted midshaft clavicle fractures. Methods There were 65 patients with displaced or comminuted midshaft clavicle fractures surgically treated with either a SMA embracing fixator or a reconstruction plate. The patients were divided into two groups according to fixation methods, ie, SMA embracing fixator group (30 patients at average age of 28.1 years) and reconstruction plate group (35 patients at average age of 26.1 years). All pa-tients were followed up for mean 12 months and shoulder function was evaluated using shoulder score. Results Compared with reconstruction plate group, SMA embracing fixator had shorter operation time, smaller wound incision and less loss blood (all P < 0.05). However, there was no statistical difference in aspects of hospital stay, cost, JOA shoulder score and bone union rate between two groups (all P > 0.05). Conclusion The internal fixation with SMA embracing fixator is better than reconstruction plate fixation in treatment of midshaft clavicle fractures.

Objective To investigate the influence of gene therapy using survivin as a gene target on biological behavior of pancreatic carcinoma cell line. Methods Chemically synthesized siRNA and shRNA in pGCSi vector were used to silence survivin expression of pancreatic carcinoma cell line PaTu8988. The therapeutical effects of survivin as a gene target were evaluated through determination of the down-regulation of survivin gene expression, cellular shape, cell apoptosis, cell viability and apoptosis signal pathway changes. Results After transfection of different arrays of siRNA and shRNA vectors to silence the survivin expression, survivin mRNA and protein levels were significantly decreased (P < 0.05) ; PI staining revealed the presence of karyopyknosis, the cell apoptosis index was more than 20%; hypodiploid DNA content before G0/G1 detected by flow cytometry ; cell viability measured by MTT assay was significantly decreased (P <0.05) ; the activity of caspase-3 remarkably increased (P < 0. 05). Conclusions The pancreatic carcinoma cell line PaTu8988 be induced to promote spontaneous apoptosis procedure through silencing survivin expression by RNAi, which could accelerate carcinoma cell apoptosis and improve therapeutic effect on pancreatic carcinoma.

Objective To investigate the effects of nasojejunal feeding plus nasogastric tube decompression in severe hypertensive intracerebral hemorrhage complicated with gastroparesis.Methods Fifty-six cases of severe hypertensive intracerebral hemorrhage complicated with gastroparesis admitted to hospital from January 2011 to June 2014 were chosen as study group, while the 52 cases of similar patients admitted to hospital from January 2007 to December 2010 were chosen as control group.Nasojejunal feeding and nasogastric tube decompression were given to the study group.Nasogastric enteral nutrition support therapy was firstly given to the control group conventionally,after 15 days if they still could to be tolerant of the enteral nutrition,then parenteral nutrition therapy were adopted.The weight, serum albumin, prealbumin and hemoglobin circumstances of the two groups were determined and the complications were recorded.The patients were followed up according to activity of daily liying(ADL) after 3 months.Results There was no significant difference on the average body weigh between two groups before treatment.The average body weight of the study group was significantly higher than that of the control group after 4 weeks treatment((57.2±5.3) kg vs.(52.8±4.9) kg,t=4.33,P＜0.01).The serum albumin, pre albumin and hemoglobin of 3 week, four week after treatment were significantly higher than those of the control group(serum albumin of 3 week: (34.5±3.3) g/L vs.(30.7±3.1) g/L;erum albumin of four week:(37.8±3.8) g/L vs.(34.1 ± 3.4) g/L;serum prealbumin of 3 week:(202.3± 16.7) g/L vs.(179.6 ±15.2) g/L;serum prealbumin of four week: (216.9±17.1) g/L vs.(203.1±15.4) g/L;hemoglobin of 3 week : (119.4± 12.1) g/L vs.(107.7 ± 11.3) g/L;hemoglobin of four week : (126.2± 12.8) g/L vs.(113.5 ±11.9) g/L).Nutritional status of study group was significantly better than that of the control group(t=6.16, 5.32,7.37,4.85,5.18,5.32;P＜0.01), and complications was significantly less than that of the control group (P＜0.05).After three months, the good prognosis rate of study group (80.36％ (45/56)) was significantly higher than that of the control group (6 1.54％ (32/52)), the difference was statistically significant (x2 =4.67, P ＜0.05).Conclusion Nasojejunal feeding plus nasogastric tube decompression for patients with severe hypertensive intracerebral hemorrhage with gastroparesis can improve nutritional status, enhance their body resistance, reduce the incidence of complications, and improve their prognosis.

Objective:To study the influence of Sinapine on the formation of microvessels in chick embryo chorioallantoic membrane(CAM).Methods: Sinapine was purified by the procedure of pressurized-solvent extraction from Semen Sinapis Albae.The inhibition effect of Sinapine on the chorioallantoic vessel was detected by the chick embryo chorioallantoic membrane model.Results: Compared with physiological saline group,large areas of blood vessels in Sinapine groups(5.0g/L and 10.0g/L) had heavy inhibition of angiogenesis on CAM,accompanied by the decreased density of vessels(P0.05).Conclusions: Sinapine can prevent the formation of microvessels of CAM and the effects depend on the concentration.