Objective To investigate bacterial distribution and antibiotic resistance pattern in NICU of Central Hospital of Anshan,Liaoning province of China.Methods We conducted a retrospective analysis of all the cases admitted to the neonatal intensive care unit(NICU) between November 2011 and November 2013.Culture and sensitivity data of organisms isolated were documented as well.Antimicrobial susceptibility of the isolated pathogens was determined with the use of the Kirby-Bauer disk-diffusion test.Results A total of 73 bacterial strains were isolated from 310 specimens with a 23.5％ positive rate.In total,37 Gram-negative strains were detected and Escherichia coli was the predominant infective organism,far more common than Klebsiella pneumoniae and Pseudomonas aeruginosa.Gram-positive organisms were isolated in 32 cases and the most common pathogen was Staphylococcus aureus,followed by Staphylococcus epidermidis.Fungal isolates were recovered in 4 cases and Candida albicans was the most frequently isolated fungal organism.Carbapenem-resistant was not encountered and Vancomycin-resistant Staphylococcus aureus was not detected.Staphylococcus epidermidis isolates were significantly more resistant than Staphylococcus aureus.Conclusion Escherichia colis,Staphylococcus aureus and Staphylococcus epidermidis were the major pathogens in NICU of our hospital,showing a steep increase in antibiotic resistance.Regular monitoring and rational evaluation of drug resistance may help reduce the spread of antibiotic resistance,and provide the basis for empirical antimicrobial use.

Objective To investigate the safe model to prevent and treat complications caused by various artificial liver support system(ALSS).Methods The complications in 191 patients with severe hepatitis during the ALSS(Including plasma exchange、plasma exchange associated with continuous venovenous hemofiltration、plasma exchange associated with hemodiafiltration、plasma exchange associated with plasma absorption、molecular absorbents recycling system) treatment were observed and analyzed. Results During the treatment 287 episodes occurred and the rate of complications was 50.44%(287/569).The clinical manifestation included rash,numbness/tetany,hypotension,blood clotting in the channel,chest distress, disequilibrium syndrome,errhysis on dwell catheter,effusion on dwell catheter.75.61% of these complications was caused by plasma exchange.The rate of complications was the lowest during the treatment of plasma exchange associated with hemodiafiltration.All of these complications got better after prompt sypotomatic therapies were taken.Conclusions Although the rate of complications was high during the treatment of ALSS,all of the complications got better after prompt sypotomatic therapies were taken.This therapeusis must be performed by intensive care.It is more safe than others during the treatment of plasma exchange associated with hemodiafiltration.

OBJECTIVE To investigate the significance of Epworth sleepiness scale(ESS)and modified Epworth sleepiness scale(MESS),and evaluate the feasibility of MESS in assessment of obstructive sleep apnea hypopnea syndrome(OSAHS).METHODS The ESS and MESS of 232 patients with OSAHS was recorded in their first visiting.The scores of ESS and MESS were analyzed with the parameters of polysomnography(PSG). RESULTS Both ESS and MESS can reflect the degree of sleepiness and anoxemia in OSAHS patients,but the MESS was more efficient than ESS.The difference of MESS score between normal group and severe OSAHS group was greater than that of ESS score.CONCLUSION MESS is concerned the living habit of Chinese,and can partly reflect the station of patient with OSAHS.MESS can also be a primary screening method for suspected patients with severe OSAHS.

Objective To compare the effects of honey dressing and silver sulfadiazine dressing for wound healing in burn patients by Meta-analysis.Methods All the randomized controlled trials were collected by searching many kinds of databases in or out of the country to compare honey dressing with silver sulfadiazine dressing for wound healing in burn patients.Review Manager 5.2 was used to analyze the effects.Results Six randomized controlled trials (RCT) were included.Honey dressing was much better than silver sulfadiazine dressing for burn wounds,while there were no significant differences in positive rate of wound swab culture and healing days.Conclusions It can be proved that honey dressing has an advantage over silver sulfadiazine dressing in the wound healing days within 21 and final outcome.Whether honey dressing is superior to silver sulfadiazine dressing in antibacterial effects and healing days remains to be studied with adequate,powerful,high quality randomized controlled trials.

Objective:To study the expression of E-cadherin and P120ctn in nasopharyngeal carcinoma tissues, and to investigate their relationship and the relation with clinico-pathological features. Methods Two-step immuno-histochemical staining was applied to detect the expression of E-cadherin and P120ctn in formalin fixation and paraffin-embedded specimens from 56 cases with nasopharyngeal carcinoma and 15 cases with normal nasopharyngeal epithelia. Result:The abnormal expression rates of E-cadherin and P120ctn in the 56 cases of NPC tissues were 64.29% and 67.86% respectively, mainly with reduction of expression membrane and with the expression of cytoplasm; 6.67% of the 15 comparative normal cases of nasopharyngitis had abnormal expression of E-cadherin and P120ctn The differences were statistically significant. The abnormal expression rates of E-cadherin and P120ctn in NPC tissues were 71.43% and 85.71% respectively in low differentiated cancer group, which was obviously higher than the rates-42.86% and 36.29%-in high and middle differentiated cancer group. The 80.00% and 85.00% abnormal expression rate in the group with cervical lymph node metastases was higher than that in the group without cervical lymph node metastases(52.78%, 58.33%). The abnormal expression rate of E-cadherin and P120ctn(76. 92%,84.62%) in the third and forth phases was higher than that in the first and second phases (46.66%, 53. 33%). The differences were statistically significant (P<0.05). There were all together 12 co-expression cases of P120ctn and E-cadherin and 28 abnormal co-expression cases in the 56 cases of NPC tissues, which was of obvious consistency and correlation, with the relevant indexes: rs=0.5217 and P<0.01. Conclusion: The abnormal expression of E-cadherin and P120ctn is closely related to the degree of differentiation, clinical stage and cervical lymph node metastasis, and they join in the process of NPC initiation, progression, invasion and metastasis.

Objective To study the clinical characteristics,pathogens,drug sensitivity and prevention measures in malignant hematological disease combined with septicemia.Methods The clinical data of 95 malignant hematological disease combined with septicemia patients from January 2009 to June 2013 were retrospectively analyzed.Results One hundred and ten episodes of septicemia occurred in all the 95 patients,among which acute leukemia patients accounted for 69.1％ (76/110),patients with neutrophil counts ＜0.5 × 109/L accounted for 82.7％ (91/110),and patients with agranulocytosis time ＞7 days accounted for 66.4％(73/110).Major pathogenic bacteria was gram negative bacteria,including Escherichia coli 30.9％(34/110),Klebsiella pneumoniae (14.5％,16/110),Pseudomonas aeruginosa (12.7％,14/110).Carbapenems and amikacin was the most sensitive in susceptibility testing.Ninety-eight episodes of septicemia cured or improved,and 12 patients died,with a mortality of 12.6％ (12/95).Fifteen patients had septic shock,of whom 7 patients were dead.Conclusions Septicemia is very serious for malignant hematological patients,which may lead to rapidly progress,high incidence to septic shock and high mortality.Early prevention and treatment is important for patients,and strong anti-infection and supportive treatment is needed.

Objective To observe the protective effect of ulinastatin (UTI) on the intestinal barrier function of septic rats.Methods Septic rat model was established using Sprague-Dawley rats by cecal ligation and puncture (CLP) method.Thirty Sprague-Dawley rats were randomly divided into 3 groups (n =10 for each grop) : sham group, septic group and UTI group.All rats received intraperitoneal injections of 0.9％ saline (10 mL/kg) after and 8 h after surgery.In UTI group, UTI (10 × 104 U/kg in 10 mL/kg saline) was injected after and 8 h after surgery.Collect blood samples after 0, 8, 12 h after surgery to examine levels of procalcitonin (PCT), intestinal fatty acid binding protein (iFABP) and diamine oxidase (DAO) by enzyme-linked immunosorbent assay (ELISA) method.Rats were killed 12 h after surgery to collect intestine tissue samples.Pathological changes of intestine were observed under microscopy, and the expression of tight junction protein-1 (ZO-1) and occludin were analyzed by Western blot.Results In sham group, the mucosa structure was complete and the shape was normal, and villi stood neatly.In septic group, intestinal was expanded, intertinal mucosal was atrophic, villi were scanty.An inflammatory infiltrate with numerous nuetrophils was found in the mucosal.In UTI group, the level of severity was relatively slight.The relative optical density of Western blot images were decreased on ZO-1 and occludin in CLP and UTI groups, and decreased more in CLP group (F =43.15 and 52.23, P ＜ 0.05).At 0h after surgery, the plasma values of PCT, iFABP and DAO were similar in three groups (F =11.17, 22.45 and 13.58, P ＞ 0.05).At 8h and 12h after surgery, values of PCT, iFABP and DAO in septic and UTI groups were much higher than those in the sham group, and those in UTI group were also significantly higher than those in septic group (F8h=85.26, 44.59 and 101.47, F12h =59.44, 49.26 and 69.57, all P＜0.05).PCT, iFABP and DAO levels were first increased and then fell down in sham group, those in septic group were keeping increasing, and those in UTI group were first increased and then kept stable.Conclusion UTI shows protective effect to intestinal barrier function in rats with sepsis.

BACKGROUND: Polyvinyl alcohol (PVA) displays limitation to cell adsorbability. Can collagen improve the adsorbability of PVA to cells?OBJECTIVE: To develop a novel type composite of PVA and collagen, and explore the feasibility to serve as soft tissue substitute.DESIGN: Single sample observation.SETTING: Guangzhou Red Cross Hospital, Jinan University Medical College, Guangzhou Institute of Traumatic Surgery.MATERIALS: Fifteen New Zealand rabbits of 2.0-3.0 kg, either male or female, were provided by Medical Experimental Animal Center of Guangdong Province. The experiment was carried out in the Laboratory of Guangzhou Institute of Traumatic Surgery, and the experimental procedure was accorded with the animal ethical standards. Bovine typeI collagen was purchased from Guangzhou Trauer Biotechnology Co., Ltd. and PVA-124 from Guangzhou Chemical Reagent and Instrumentation Co., Ltd.METHODS: The experiment was performed in Guangzhou Red Cross Hospital, Jinan University Medical College between July 2003 and December 2006. ①Preparation of PVA-collagen material: 5 g/L bovine type I collagen was mixed with 5% PVA-124 at a ratio of 1 : 1. The mixture was freeze-dried at vacuum until becoming gelatinous. The internal structure was observed under the use of scanning electron microscope. ②Cytotoxicity test: PVA-collagen composite was cut into pieces of 10 mm×5 mm× 1 mm, put into 48-well culture plate after sterilized by Y ray, cultured with 1×104 3T3 cells in each well. Cell growth was observed under scanning electron microscope and laser scanning confocal microscope. ③Embedding test in vivo: Two longitudinal incisions were cut at the two sides of spine. The subcutaneous tissue was separated bluntly to form subcutaneous lacuna. Four pieces of PVA-collagen material were implanted in the lacuna and fixed. Nine specimens and the surrounding tissues were harvested from three rabbits each at one, four, eight and sixteen weeks postoperatively for pathological observation.MAIN OUTCOME MEASURES: The internal structure of gel film under scanning electron microscope, cytotoxicity test and embedding test in vivo results.RESULTS: ①Internal structure of PVA-collagen material:PVA-collagen material showed white gel shape after freeze-drying at vacuum. Penetrating three-dimensional pores were observed in the surface and inner section under scanning electron microscope. ②Cytotoxicity test results showed that 3T3 cells grew normally on the PVA-collagen material. ? Embedding test in vivo results suggested that one week after PVA-collagen implantation, foreign body reaction occurred, and the interface between material and tissue was clear. Four weeks later, only rare lymphocyte infiltration was observed, and a great amount of fibroblast hyperplasia formed collagen fibrils and false simple cuboidal epithelium coating material. In 8 weeks, no lymphocyte infiltration, neutrophilic granulocyte infiltration or foreign body giant cell were found; dense capsule wall and capsule coating material generated from a great amount of fibroblasts were observed. In 16 weeks, extending collagen fibrils were found arranged regularly with shrank nucleus, showing long ovoid or long fusiform in shape; no new formation small vessels, lymphocyte, neutrophilic granulocyte infiltration or foreign body giant cell infiltration were observed. The capsule wall was stable and thinned. CONCLUSION: PVA-collagen composite has good cell compatibility and tissue compatibility but no toxic or adverse effect. It can serve as in vivo implant.

Objective In order to provide information for the health administration and the price authorities to establish the reasonable price,the practical cost of special nursing of the chronic wound be analyzed,and be compared with the present charge,and the deviation be studied.Methods The cost of nursing care for all items was measured,recorded and collected,then calculating the special nursing cost for chronic wound using the method of ladder sharing the project cost.Rusults The true cost on a single special care for chronic wound was (29.42±9.29)yuan,and it reached 2.5 times of present charge ( 12 yuan).Conclusions The present charge on the special care for chronic wound was seriously deviated from the practical cost,and the labor value of special care of nurses could not be embodied.

Objective To evaluate the effect on treatment of multiple myeloma complicating femoral neck fracture by surgical intervention combined with drugs.Methods Twelve patients with multiple myeloma complicating femoral neck fracture were treated by cemented total hip arthroplasty femoral head shank.All of patients were received zoledronic acid treatment,at the same time,7 cases of them treated by MPT regimen (melphalan,methylprednisolone and thalidomide),3 by bortezomib combined with dexamethasone,and 1 by autologous peripheral blood stem cell transplantation.Results Twelve patients could tolerate surgery,postoperative pain was significantly reduced.Assessed by using Harris hip function score after 6 months operation,2 cases were excellent,7 cases were good,3 cases were common,excellent and good rate was 75％ (9/12).All patients were followed up for 8 months to 3 years,1 case of local recurrence after 13 months.1-year overall survival rate was 100％,2-year overall survival rate was 83％,and 3-year overall survival rate was 67％.Conclusions Multiple myeloma complicating femoral neck fracture,using bone cement in total hip arthroplasty femoral head shank to clear the local tumor lesions,receive reconstruction capability,rapid postoperative recovery,pain relief,and opportunities for further comprehensive treatments.The bisphosphonate can promote new bone formation and prevent further fractures.The surgical intervention combined with chemotherapy could relieve the symptoms,reduce tumor cell burden,improve quality of life and prolong survival time.