Objective To connect with provincial or even national report center for adverse events of medical instruments and set up a computer-aided system for supervision.Methods By designing software,setting up database and online connecting with report center,the computer-aided system for adverse events of medical instruments was utilized to automatic report,early-warning monitoring and report.Key technologies were analyzed.Results Based on computer network,adverse events of medical instruments were automatically reported,collected and managed.Information and consultation could be provided rapidly without error.Conclusion The system not only facilitates management department in medical instruments managing,producing and application,but set a theoretic basis for development and academic teaching of new medical instruments.

Objective To develop a medical tilting-table for recovery training of paralysis patients (including paraplegia, hemiplegia and quadriplegia). Methods Renesas 16-bit microcontroller, R8C/25, was used as controller. Danish Linak31 was used to drive the bed. Nixie tube was used to display prescription, angle of tilting table, treating time and music list. Results It worked stable with well-controlled angle. The error was only 1?. The display of nixie tube was good and stable. MP3 played well. Back-up power could provide power supply timely and stably in power failure. Conclusion Medical tilting-table has been successfully applied in clinic.

Objective To explore the effect of early rehabilitation on function recovery in stroke patients.Methods 70 patients were divided into two groups, rehabilitation group (38 cases) and control group (32 cases). Rehabilitation group was given clinical treatment and early rehabilitatio therapy, while control group was given clinical treatment and unguided self-training, and the evaluation was done in pre-treatment and eight weeks after the treatment respectively. Motor function of limbs was assessed in Brunnstrom grade and Fugl-Meyer Assessment (FMA), Neurological Function would be assessed with the scale of Clinical Neurological Function Defects (CNFD), and Activities of Daily Living was assessed in Modified Barthel Index(MBI). Results All scores in the rehabilitation group were superior to that in the control group (P< 0.05). Conclusion Early rehabilitation training on stroke patients may obviously improve motor function, promote neurological function and increasing the activities of daily living.

Objective To evaluate the role of phosphatidyl-inositol 3 kinase (PI3K)-α-amino-3-hydroxy-5-methylisoxazole-4-propionic acid (AMPA) receptor subunit glutamate receptor 2 (GluR2) pathway in propofol postconditioning-induced reduction of cerebral ischemia-reperfusion (I/R) injury in rats.Methods One hundred and eighty male Sprague-Dawley rats,weighing 250-280 g,were randomly divided into 5 groups with 36 rats in each group:sham operation group (group S),I/R group,propofol postconditioning group (group P),intralipid postconditioning group (group Ⅰ),and PI3K inhibitor wortmannin + propofol postconditioning group (group W +P).The rats were anesthetized with intraperitoneal 10% chloral hydrate 350 mg/kg.Cerebral I/R was produced by 60 min middle cerebral artery occlusion followed by reperfusion.Propofol and 10% intralipid were infused via the femoral vein at a rate of 20 mg· kg-1· h-1 for 2 h starting from the onset of reperfusion in groups P and I,respectively,while the equal volume of normal saline was given instead in groups I/R and S.Wortmannin 0.6 mg/kg was injected intraperitoneally at 30 min before reperfusion in group W + P.The modified Neurological Severity Score (mNSS) was assessed and the cerebral infarct volume was detected at 12 and 24 h after operation.The hippocampi on the ischemic side were obtained at 4,6,12 and 24 h after operation for determination of expression of PI3KGluR2-containing AMPA receptor (by co-immunoprecipitation and Western blot) and activity of PI3K (by ELISA).Results Compared with group S,the mNSSs and infarct volume were significantly increased at 12 and 24 h after operation,and the activity of PI3K was decreased,and the expression of PI3K-GluR2-containing AMPA receptor was down-regulated at 4,6,12 and 24 h after operation in the other four groups (P ＜ 0.05).Compared with group I/R,the mNSSs and infarct volume were significantly decreased at 12 and 24 h after operation,and the activity of PI3K was increased,and the expression of PI3K-GluR2-containing AMPA receptor was up-regulated at 4,6,12 and 24 h after operation in group P (P ＜ 0.05).Compared with group W + P,no significant change was found in the parameters mentioned above in groups I/R and I (P ＞ 0.05),and the mNSSs and infarct volume were significantly decreased at 12 and 24 h after operation,and the activity of PI3K was increased,and the expression of PI3K-GluR2-containing AMPA receptor was up-regulated at 4,6,12 and 24 h after operation in group P (P ＜0.05).Conclusion PI3K-AMPA receptor subunit GluR2 pathway is involved in propofol postconditioning-induced reduction of cerebral I/R injury in rats.

Objective To evaluate the role of Akt-glycogen synthase kinase-3 beta (GSK3β) signaling pathway in the long-term neuroprotection induced by propofol postconditioning in a rat model of focal cerebral ischemia/reperfusion (I/R) injury.Methods Two hundred and sixteen male Sprague-Dawley rats,weighing 250-280 g,were randomly divided into 4 groups (n =54 each):sham operation group (group S),I/R group,intralipid control group (group I) and propofol postconditioning group (group P).The model of focal cerebral I/R injury was established by middle cerebral artery occlusion.Propofol 20 mg·kg-1 · h-1 was infused over 2 h starting from the onset of reperfusion in group P,the equal volume of normal saline was given in groups S and I/R and the equal volume of 10％ intralipid was given in group I.Six rats were chosen at 3,7,14 and 28 days after occlusion and sacrificed,and brains were removed for determination of the cerebral infarct size by TTC staining.Another 6 rats were chosen at 3,7,14 and 28 days after occlusion to detect the expression of Akt,GSK3β and phosphorylation of Akt and GSK3β by Western blot.The left 6 rats were chosen at 28 day after occlusion to measure the number of newly generated neurons in hippocampal dentate gyms on the ischemic side.Results Compared with group S,the cerebral infarct volume was significantly enlarged,the newly generated neurons number was increased in the other 3 groups,and the phosphorylation of Akt and GSK3β was decreased in groups I/R and I,while increased in group P (P ＜ 0.05).The cerebral infarct volume was significantly smaller,and the newly generated neurons number and phosphorylation of Akt and GSK3β were higher in group P than in group I/R (P ＜ 0.05).Conclusion The mechanism by which propofol postconditioning provides the long-term neuroprotection is related to Akt-GSK3β signaling pathway in a rat model of focal cerebral I/R injury.

Objective To observe the B- ultrasonic (B-US) renal changes of chronic aristolochic acid nephropathy (CAAN) patients and to determine its value in disease diagnosis. Methods The renal B-US data of 124 CAAN patients were retrospectively studied. The relationship between the B-US characteristics and the renal function was tested. Clinicopathological data of 19 CAAN patients underwent renal biopsy were compared with those of 18 patients with chronic tubulointerstitial nephropathy due to none-aristolochic acid causes (non-AAN-CTIN). Results The characteristics of renal B-US changes in CAAN patients included diminished parenchyma thickness (90.3%), atrophy of the kidney (62.90%) and asymmetrically shrinked kidneys (17.74%). The renal B-US markers, including the longitude, the volume and the parenchyma thickness, were closely associated with the level of Scr, eGFR and the function of renal tubules (P

Objective To investigate the clinical significance of plasma lipoprotein-associated phospholipase A2 (LP-PLA2) determination in patients with ischemic cerebral stroke(ICS).Methods 124 patients with ICS (ICS group)admitted to Dongfeng Huaguo Hospital in Shiyan City from Jan.2011 to June.2014 and 50 patients with hemorrhagic stroke (hemor-rhagic group)were as the research objects,and 50 healthy controls at the same time were as the control group,compared the plasma Lp-PLA2 levels between the three groups,and compared carotid artery atherosclerotic plaque and plasma Lp-PLA2 levels in patients with different severity of ICS.Results The levels of plasma Lp-PLA2 of the patients of the ICS group,the hemorrhage group and the control group were 58.4±9.6 g/L,30.5±9.2 g/L and 18.7±8.3 g/L,respectively.There were significant differences between the groups (F = 16.741,P = 0.000).The level of plasma Lp-PLA2 of the patients of the plaque group was higher than that of the non-plaque group (66.3 ±9.7 g/L vs 54.1±10.3 g/L,t=5.775,P =0.000),and the unstable plaque group was higher than that of the stable plate group (72.4±9.5 g/L vs 62.8±10.1 g/L,t=4.797,P =0.000).The plasma Lp-PLA2 level of patients with light,medium,heavy ICS were 48.4± 9.2 g/L,60.9 ± 9.6 g/L and 74.5±10.3 g/L,respectively,and the difference was statistically significant between the three groups (F = 13.629,P =0.000).The plasma levels of Lp-PLA2 were positively correlated with NIHSS scores in patients with ICS (r=0.716,P <0.05).Lp-PLA2 in diagnosis of ICS area under the ROC curve was 0.904,the optimal critical value was 45.2 μg/L,the sen-sitivity and specificity were 81.5% and 80.2%.Conclusion The determination of plasma LP-PLA2 has a good effect in di-agnosis of ICS,the plasma level of ICS can be responsed the severity of the patients and the stability of atherosclerotic plaque.

Tetramethylpyrazine (TMP) is a herb used widely in Traditional Chinese Medicine (TCM) as an antianginal drug. The exact mechanism whereby TMP treat ischemic heart disease is still not fully understood. The purpose of this study is to examine the anti-inflammatory effect of TMP in patients with acute coronary syndromes (ACS). Methods Thirty-two patients with acute myocardial infarction or unstable angina were randomly assigned to TMP group or control group. All patients received the same standard treatment. Patients in TMP group received TMP 3mg/kg every 12 hours for 5 days. Plasma concentrations of high-sensitivity Creactive protein (CRP), serum amyloid A (SAA) and plasminogen activator inhibitor-1 (PAI-1) were measured at baseline and after 5 days of therapy. Results Both CRP and SAA concentrations increased significantly in control group (P＜0.05) whilst in TMP group, only SAA had a significant increase (P＜0.05); the absolute increase of CRP, SAA, and PAI-1 were significantly less in TMP group than in control group (P＜0.05). Conclusion TMP has an anti-inflammatory and profibrinolytic effect in patients with ACS. These effects may contribute to the clinical benefits of TMP in ischemic heart disease.

Abstract: Objective　To analyze the genotype of carbapenemase resistance genes and their genetic homology in multidrug-resistant Acinetobacter baumannii, and to provide a theoretical basis for guiding the rational use of antibiotics and controlling the prevalence of nosocomial infections. Methods A total of 83 multidrug-resistant Acinetobacter baumannii isolated from patients in the intensive care unit (ICU) and environmental specimens in the Sixth People's Hospital of Nantong from July 2020 to December 2021 were collected. The bacteria were identified and subjected to drug sensitivity tests using the BioMérieux DL96-Ⅱ automatic bacterial identification susceptibility system. The carbapenemase-related drug resistance gene types were detected using the polymerase chain reaction (PCR) method, and clones were analyzed by pulsed field gel electrophoresis (PFGE). Results The types of 83 ICU Acinetobacter baumannii specimens include sputum (43 strains), broncholavage fluid (20 strains), and surfaces of objects such as ventilators (20 strains). The resistance rates of all strains to imipenem, tetracycline, gentamicin, amikacin and ciprofloxacin were 100%, 32.5%, 38.6%, 41.0% and 77.1% respecitively, while the resistance rates to others such as ticarcillin and clavulanate were greater than 95%. All strains carried were detected to carry OXA-23 and OXA-51 genes, while OXA-24, OXA-58, IMP-1, VIM, IMP-4, SIM and NDM-1 resistance genes were all negative. PFGE homology analysis confirmed that 83 strains of Acinetobacter baumannii, with counts of 12, 18, 12, 13, 10, 6, 7, 5 respectively, mainly A, B, C, D, E clones, the rest were sporadic clones. Conclusions The carbapenem resistant Acinetobacter baumannii isolated from our ICU are widely drug-resistant to commonly used antimicrobial drugs, with B clone strain being the major prevalent strain. Carrying OXA-23 and OXA-51 genes may be an important reason for the resistance of Acinetobacter baumannii to carbapenem antibiotics in our ICU. Rational use of antimicrobial drugs, enhanced monitoring of bacterial resistance, and effective control of the generation and further spread of drug-resistant strains should be emphasized.

Objective To investigate the effect of spirolactone on cardiac function and serum brain natriuretic peptide in patients with chronic heart failure( CHF). Methods Eighty-four patients with CHF were randomly divided into control group( n=42 )and observation group( n=42 ). The patients in the control group were given conventional therapy,while in the observation group were given spirolactone( 20 mg/times,2 times/day)based on treatment of the control group for six months. The clinical effects and left ventricular end diastolic diameter( LVEDd ),left ventricular ejection fraction( LVEF ) and serum brain natriuretic peptide( BNP ) of pretherapy and post-treatment between the two groups were recorded and compared. Results The total effective rate of observation group was 95. 2%(40/42),obviously higher than that of control group(80. 9%(34/42),χ2=6. 468,P=0. 028). The levels of LVEDd and BNP in two groups after treatment were(57. 8 ± 6. 2)mm and (62. 4 ± 7. 8)mm,(364. 4 ± 32. 8)ng/L and(457. 4 ± 43. 2)ng/L,significantly lower than those at before treatment((64. 6 ± 7. 4)mm and(64. 8 ± 7. 6)mm,(867. 8 ± 78. 5)ng/L and(864. 4 ± 74. 8)ng/L),while LVEF in two groups after treatment were( 49. 8 ± 5. 4 )% and( 42. 6 ± 4. 6 )%,significantly higher than those before treatment((35. 2 ± 3. 9)% and(35. 4 ± 3. 5)%),and the differences were significant(t = -3. 264, 4. 626,-5. 373,-3. 932,5. 438,-6. 548;P﹤0. 05). Moreover the changes in observation group were obvious than those in control group in terms of LVEDd,BNP and LVEF( t = -3. 425,3. 644,-2. 846;P ﹤0. 05 ) . Conclusion Spironolactone can effectively decrease the serum brain natriuretic peptide levels,improve the cardiac function in patients with chronic heart failure,and it is worthy of popularization and application.