OBJECTIVE To understand the status quo for hospital infection hospital infection to provide a scientific basis. METHODS A cross-sectional survey was taken combined with the hospital bedside investigation and records investigation. RESULTS In 1033 cases,the prevalence rate was 3.87%,and the infected sites were the respiratory site,superficial incision,skin and soft tissue. Utilization rate of anti-bacterial drugs was 60.31%,the pathagen detection rate before treatment was low only 7.73%. CONCLUSIONS Prevalence rate survey method is simple and reliable,it may be the basic reflect of hospital infection. Further strengthening the management of invasive operations,regulateing the rational use of antibiotics status quo,improving the detection rate of pathogens and reduceing preventive medication and antibiotic usage are all evitable.

Objective To evaluate prognostic factors for early bronchopleural fistula after pneumonectomy with non small cell lung cancer,and establish a validated clinical model to estimate the risk of early-BPF.Methods We reviewed the medical records of 429 patients who underwent pneumonectomy for NSCLC at our institution.We used univariate and multivariate analysis to identify potential independent risk factors for early-BPF after pneumonectomy for NSCLC.A model to estimate risk of early-BPF was developed by combining independent risk factors.Results The rate of early-BPF after pneumonectomy for NSCLC was 6.5％ (28/429).Three factors were independently associated with early-BPF:neoadjuvant therapy (HR:2.406),bleeding (HR:2.171)and diabetes (HR:1.144).A scoring system for early-BPF was developed by assigning 2 points for each major risk factor (neoadjuvant therapy and bleeding) and 1 point for each minor risk factor(diabetes).Scores were grouped as low (0-1),intermediate (2-3),and high (3),yielding the rate of early-BPF was 14％,27％,and 43％,respectively.Conclusion This clinical model is established on the basis of independent risk factors.This model can be used as a predictive tool for early-BPF after pneumonectomy for NSCLC.

The validity of fasting plasma glucose(FPG)combined with HbA_1c in diagnosing diabetes was assessed in patients with coronary heart disease.The results showed that the paired determination of FPG and HbA_1c helped to identify potentially diabetic subjects in patients with coronary heart disease.

Objective To investigate the clinical value of axillary ultrasound (AUS)in the identification of axillary nodal metastasis (ALNM).Methods Two hundred and eighty-two consecutive patients with stage Tis-T2 breast cancer were prospectively enrolled between December 2013 and September 2015.All the patients underwent AUS performed by two specified senior ultrasound doctors.Sonographic features of their axillary lymph nodes (longitudinal and transverse diameters,cortical and hilar thickness,blood flow form)were collected.These patients were divided into metastatic, suspicious and non-metastatic groups based on the ultrasound features by ultrasound doctors.The diagnostic accuracy of AUS was compared with results of pathology.Univariate and multivariate Logistic regression analyses were used to evaluate the relationship between sonographic features and ALNM.The area under the ROC curve was used to assess the accuracy of the multivariate Logistic regression model.Results The sensitivity,specificity,positive and negative predictive value and accuracy of AUS were respectively 85.6%,87.1%,86.4%,86.3%,and 86.3% in the metastatic and non-metastatic groups.The Kappa value was 0.727(P <0.001).The ALNM burden in the non-metastatic group was significantly lower than in the metastatic group (1.2 vs 6.9,P <0.001).The false-negative results were found only in 16 cases,fourteen of whom had only 1,and two had 2 and 3 ALNM,respectively.Univariate Logistic regression analysis showed that maximum cortical thickness was the most significant predictive factor of ALNM(the area under the ROC curve was 0.872).Multivariate Logistic regression analysis suggested that cortical thickness and the ratio of hilar thickness to cortical thickness were predictive factors of ALNM(P <0.05).The area under the ROC curve of the multivariate Logistic regression model was 0.879 and its sensitivity and specificity were 77.0% and 85.1%,respectively.Conclusion AUS is a valuable tool for detecting ALNM.Patients with false-negative results of AUS have a lower axillary metastatic burden.Maximum cortical thickness is the most significant predictive factor of ALNM.AUS may be a potential alternative method for sentinel lymph node biopsy as axillary lymph node staging in early-stage breast cancer patients.

·AlM: To investigate pathogeny and effects of surgery on paralytic strabismus.
· METHODS: A retrospective study was done in 46 patients with paralytic strabismus who underwent squint correction in our hospital from June 2010 to June 2013. Among 26 horizontal strabismus, the cases of extra rectus palsy was 16, internal rectus palsy was 10.Among all20 vertical strabismus, the cases of superior oblique palsy, superior rectus palsy, inferior rectus palsy, double elevator palsy counted for 7, 8, 2 and 3, respectively. Pathogenesis: trauma was 19 cases, followed by 10 cases that the causes could not be identified.Nine was congen ital paralytic strabismus, 8 o ccurred after nose or brain surgery. The surgery methods included rectus muscle recession, rectus muscle resection, partial rectus muscle transposition, Jensen procedure, inferior oblique myectomy and anterior transposition of inferior oblique. Statistical software SPSS10.0 was used in chi-square test between two groups, while the situation of paralysis eye movements improved by two methods in the horizontal strabismus group was compared with t test.
· RESULTS: Among all horizontal strabismus the rate of cure, improvement and inefficiency was 20 ( 77%) , 5 ( 19%) and 1 ( 4%) , respectively. Among vertical strabismus the ratio of cure, improvement and inefficiency was 15 (75%), 3 (15%) and 2 (10%).There was no significantly difference between the two groups ( P >0.05 ). The movements of paralytic eyes were improved. Two procedures used in horizontal strabismus, can improve paralysis eye movements were 3.76 ±0.91, 3.72 ±0.84mm, with no significant difference (P=0.93) statistically.
· CONCLUSlON: Paralytic strabismus in adults had complicated conditions. Choosing different operation methods in treating paralytic strabismus according to the degree of paralysis can result in satisfactory cosmetically alignment of the eyes and modify head position and diplopia.

The vitamin K epoxide reductase complex subunit 1 (VKORC1), the rate-limiting enzyme for vitamin K recycling, is significantly down-regulated in the kidneys of urolithiasis patients. This study searched for direct evidence to define the inhibitory activity of VKORC1 against calcium oxalate (CaOx) crystal formation. In the experiment of VKORC1 overexpression, HK-2 cells were transfected with the pFLAG-CMV-7.1-VKORC1 plasmid as a pFLAG-CMV-7.1-VKORC1 transfection group or the pFLAG-CMV-7.1 plasmid as a pFLAG-CMV-7.1 control group. In the experiment of VKORC1 knockdown, HK-2 cells were transfected with the PGPU6/GFP/Neo-VKORC1shRNA-2 as a PGPU6/GFP/Neo-VKORC1shRNA-2 transfection group or the PGPU6/GFP/Neo-shRNA-NC plasmid as a PGPU6/GFP/Neo-shRNA-NC control group. The expression of VKORC1 in HK-2 cells was detected by real-time quantitative PCR and Western blotting. The CaOx crystal formation was observed under the laser-scanning confocal microscope. It was found that the expression levels of VKORC1 mRNA and protein were significantly higher in the pFLAG-CMV-7.1-VKORC1 transfection group than in the pFLAG-CMV-7.1 control group (P<0.01). The number of CaOx crystals in HK-2 cells incubated in fluorescently labeled CaOx monohydrate (COM) crystal medium for 48 h was 14±4 per field (100×) in the pFLAG-CMV-7.1-VKORC1 transfection group and 26±5 per field (100×) in the pFLAG-CMV-7.1 control group respectively under the laser-scanning confocal microscope. The amount of CaOx crystal aggregation and formation in the pFLAG-CMV-7.1-VKORC1 transfection group was significantly reduced as compared with the pFLAG-CMV-7.1 control group (P<0.05). The expression levels of VKORC1 mRNA and protein were significantly lower in the PGPU6/GFP/Neo-VKORC1shRNA-2 transfection group than in the PGPU6/GFP/Neo-shRNA-NC control group (P<0.05). The number of CaOx crystals in HK-2 cells incubated in fluorescently labeled COM crystal medium was 65±11 per field (100×) in the PGPU6/GFP/Neo-VKORC1shRNA-2 transfection group and 24±6 per field (100×) in the PGPU6/GFP/Neo-shRNA-NC control group respectively under the laser-scanning confocal microscope. The amount of CaOx crystal aggregation and formation in the PGPU6/GFP/Neo-VKORC1shRNA-2 transfection group was significantly increased as compared with the PGPU6/GFP/Neo-shRNA-NC control group (P<0.05). These findings suggested that the VKORC1 protein could inhibit CaOx salt crystallization, adhesion and aggregation. This research would help us to understand the mechanisms involving the interaction between crystallization and epithelial cells and the formation of CaOx.

To prepare composite phospholipid liposomes containing total alkaloids of Strychnos nux-vomica with hydrogenated soybean phosphatidylcholine (HSPC) and 1, 2-dipalmitoyl-sn-glycero-3-phosphacholine (DPPC), and compare with normal DPPC thermosensitive liposomes for thermosensitive release property. Total alkaloids were extracted from S. nux-vomica with the impregnation method and further purified. Liposomes containing total alkaloids, thermosensitive liposomes and conventional thermosensitive liposomes without thermosensitive release property were prepared by ammonium sulfate transmembrane gradients and stealth liposome technique. Their encapsulation efficiency (EE), grain size, zeta potential and drug release behavior were compared. Their EEs and zeta potentials were almost identical; but the grain sizes of composite phospholipid liposomes and thermosensitive liposomes were significantly smaller than conventional liposomes. After comparing release behaviors of the three liposomes at 37, 43 degrees C, we found that the release of composite phospholipid liposomes was significantly lower than that of thermosensitive liposomes at 37 degrees C, but higher than that of thermosensitive liposomes at 43 degrees C. Meanwhile, conventional liposomes, with a very high phase-transition temperature, showed only slight release behavior at both temperatures. The study results showed that composite phospholipid liposomes had a better thermosensitive release behavior when the dosage of lysophosphatidic was reduced by 2. 5 times.
Alkaloids ; chemistry ; Liposomes ; chemistry ; Phospholipids ; chemistry ; Strychnos nux-vomica ; chemistry

Base Sequence ; Formaldehyde ; chemistry ; Humans ; Molecular Sequence Data ; Oncogene Proteins, Fusion ; genetics ; Paraffin Embedding ; Proto-Oncogene Protein c-fli-1 ; genetics ; RNA, Neoplasm ; genetics ; metabolism ; RNA-Binding Protein EWS ; Reverse Transcriptase Polymerase Chain Reaction ; methods ; Rhabdomyosarcoma ; genetics ; Sarcoma, Ewing ; genetics ; Sarcoma, Synovial ; genetics ; Soft Tissue Neoplasms ; genetics ; Tissue Fixation

OBJECTIVETo investigate the effect of plant growth substances on induction and culture of callus from Rhodiola quadrifida and also to analyze salidroside contents in the callus.

METHODThe optimum combination of plant growth substances in MS solid medium for induction and culture of callus was established using orthogonal design. The contents of salidroside was analyzed by HPLC.

RESULTMS medium containing 2,4-D 1 mg x L(-1), NAA 2 mg x L(-1), 6-BA 0.5 mg x L(-1) and KT 0.1 mg x L(-1) could induce the callus from R. quadrifida most effectively;the induction rate was 83.3%. The optimized combination of plant growth substances for callus subculture was 2,4-D 1 mg x L(-1), 6-BA 0.1 mg x L(-1) and KT 0.5 mg x L(-1). The dry weight could reach 11.77 g x L(-1) when the callus was cultured in the optimum medium for 30 d and salidroside content was 0.28%.

CONCLUSIONThe quantities of plant growth substances required for induction and culture of callus are different in R. quadrifida. The callus could produce salidroside.

Culture Media ; Glucosides ; metabolism ; Phenols ; metabolism ; Plant Growth Regulators ; pharmacology ; Plant Stems ; growth & development ; metabolism ; Plants, Medicinal ; growth & development ; metabolism ; Rhodiola ; growth & development ; metabolism ; Tissue Culture Techniques ; methods

ObjectiveTo probe the indication,treatment algorithm,anesthesia method,safety and efficacy ofextracorporealshockwavelithotripsy(ESWL)incombinationwithendoscopicretrograde cholangiopancreatography (ERCP) for pancreatic duct stones.MethodsThe patients with chronic pancreatitis and large pancreatic duct stones ( ＞ 5 mm diameter) and receiving ESWL and ERCP between March and July 2011 in Changhai Hospital were prospective studied.The third generation of extracorporeal shockwave lithotripsy was applied in ESWL,and the localization of stone was determined by X-ray.No more than 5000 shocks were given per session,and ESWL was performed continuously till the calculi were fragmented,and then was cleared by ERCP.ResultsA total of 100 patients underwent ESWL during the 5 months,among whom 84 patients received ERCP treatment and 41 cases failed to deep cannulation (41/84,48.8％ ).Multiple stones were seen in 83 patients.Ninety five patients had radio-opaque stones,two patients had radiolucent calculi,while three patients had both radio-opaque and radiolucent stones.Seventy five percent,14％ and 11％ stones were located in pancreatic head,pancreatic head and body,pancreatic body and tail,respectively.A total of 175 ESWL procedures were performed,43 patients needed 2 or more sessions for successful fragmentation.Anesthesia method was mainly intravenous sedation,accounting for 96％ (168/175).ERCP was successful in 96 patients after ESWL,only 4 patients failed after ESWL. Forty one cases which failed ERCP procedures before ESWL underwent ERCP,and 37 patients (90.2％) achieved successful cannulation.Successful fragmentation ratewas 100％.Complete clearance was achieved in 78 patients,and complication rate of post-ERCP pancreatitis,fever was 1.71％ (n =3 ),0.57％ (n =1 ),and the overall complication rate was 2.28％.Conclusions ESWL is an effective,safe and necessary modality for fragmentation of large PD stones in the management of minimal invasive treatment of chronic pancreatitis.