OBJECTIVE The status and risk factors of nosocomial infections in intensive care unit(ICU) were investigated to make the intervention strategy. METHODS Use prospective monitoring and retrospective investigation to analyze the 198 nosocomial infections patients. RESULTS The lower respiratory tract infection was the main infection in ICU,about 69.4%.The risk factors were old ages,long hospitalization time,the use of many antibiotics,severe underlying illness,invasive operation manipulation and so on. CONCLUSIONS General intervention strategy should be adopt in the control of ICU nosocomial infections to low the infection rate and raise the rate of rescue.

OBJECTIVE To investigate the time and dose relation of new urine bio markers in rat model of acute kidney injury induced by genta mycin (GM)to search for more sensitive,noninvasive and specific markers than traditional approaches to monitor nephrotoxicity.METHODS SD Rats were im treated with GM5,20,80 mg·kg -1 or saline once daily.Rats were randomly divided into 20 subgroups:treated for 1 ,3,7,14 d and 14 d followed with 28 d recovery period.Ten rats per group (5 rats per sex)were scarified at 24 h after the last dosing or the end of recovery period.Blood sa mples were col-lected for blood urea nitrogen (BUN)and creatinine(CRE)analysis.Urine was collected at each nec-ropsy for urine protein by dry che mistry method,for kidney injury molecule-1 (KIM-1 )analysis by ELISA, and for β2-microglobulin (β2-MG)analysis by ELISA.Kidneys were obtained for histological exa mination after HE stains.RESULTS Positive protein(3 +)was noted for several fe male animals treated for 7 or 14 d at 80 mg·kg -1 and the tendency of recovery were noted at the end of recovery period.Co mpared with those in saline control group treated for 7 d,the seru m BUN and CRE levels for fe males and the CRE level for males were significantly increased at 80 mg·kg -1 (P <0.05),and the BUN level showed the tendency of increase for males at 80 mg·kg -1 (P >0.05).When treated for 14 d,the seru m BUN and CRE levels for fe males and males at 80 mg·kg -1 and the seru m CRE level for fe males at 20 mg·kg -1 were significantly increased when compared with those in saline control group(P <0.05). The seru m BUN and CRE recovered to base line for all animals treated for 14 d followed by a 28 d recov-ery period.Histopathological observation of kidney tissues indicated that focal tubule dilatation was noted for animals treated for 3 d at 20 and 80 mg·kg -1 ,infla mmatory cell infiltration and focal tubule dilatation were noted at 20 mg·kg -1 and focal renal tubular epithelial cell degeneration,infla mmatory cell infiltra-tion,focal casts (lightly)were noted at 80 mg·kg -1 for animals treated for 7 or 14 d.For animals treated for 14 d followed by a 28 d recovery period,only basophilic tubules and renal casts were noted at 80 mg·kg -1 .New urine bio markers determination indicated that KIM-1 level was significantly increased at 20 and 80 mg·kg -1 for animals treated for 3,7 or 14 d when compared with that in saline control group (P<0.05).For animals treated for 14 d followed by a 28 d recovery period,the KIM-1 level was still significantly higher than saline control group for males and fe males at 80 mg·kg -1 and males at 20 mg·kg -1 (P <0.05 ),but there was evidence for reversal.The β2-MG level was significantly increased at 80 mg·kg -1 for animals treated for 3 d(P<0.05),at 20 or 80 mg·kg -1 for animals treated for 7 or 14 d(P<0.05 or P<0.01 ),when compared with that in the saline control group.For animals treated for 14 d followed by a 28 d recovery period,the β2-MG level was still significantly higher than saline control group for males and fe males at 80 mg·kg -1 and fe males at 20 mg·kg -1 (P <0.05),but there was also evidence for reversal.CONCLUSION Urine KIM-1 and β2-GM are more sensitive and specific markers for early diagnosis of kidney injury induced by GM when compared with the traditional approaches to monitor nephrotoxicity.

Objective To investigate the effect on the menstrual patterns and sexual quality of life of patients with adenomyosis after treated with Mirena IUD.Methods56 patients with adenomyosis who were treated with Mirena IUD were recruited from August 2009 to December 2009.We used Menstrual blood loss chart method,Dysmenorrhea score method and Brief Index of Sexual Function for Women (BISF-W) to evaluate the menstrual pattern,the volume of uterus and sexual quality after1,3,6,9,12 months.{Results53 patients were followed up,the rate was 94.6%.The condition of 56 patients became better after treated with Mirena for 3,6,9,12 months,dysmenorrhea[Placed before:(3.15±0.91)points;After placing:(1.41±0.51)points,(0.22±0.09)points,(0.07±0.01)points,0 points]and menstrual quantity[Placed before:(12.0±57.5)points;After placing:(71±23.1)points,(29±19.4)points,(18±10.5)points,(10±4.7)points]were both reduced(P＜0.05),the symptoms were not significantly improved after 1 month(P＞0.05).D2 indicators was significantly improved after 3 months of treatment (P＜0.05),sexual function was also improved after 6 months(P＜0.05～0.01).ConclusionsMirena IUD has a good effect on the menstrual pattern and sexual function for patients with adenomyosis.

Objective: To observe the clinical efficacy of heat-sensitive moxibustion for vascular dementia and explore its mechanism. Methods: A total of 70 patients with vascular dementia were randomized into an observation group and a control group, with 35 cases in each group. The control group was treated with piracetam, and the observation group was treated with heat-sensitive moxibustion on the basis of the treatment of the control group. The treatment lasted for 8 weeks. Before and after the treatment, the mini-mental state examination (MMSE), activity of daily living (ADL) and traditional Chinese medicine (TCM) symptom scores were assessed, and the levels of acetyl choline (Ach) and homocysteine (Hcy) were measured. The efficacy was evaluated after treatment. Results: The total effective rate of the observation group was significantly higher than that of the control group (P<0.05). After treatment, the MMSE and ADL scores in the observation group decreased significantly, and were lower than those in the control group (all P<0.05); the TCM symptom score of the observation group decreased significantly (P<0.05), while that of the control group had no significant change (P>0.05); the plasma Ach level in the observation group increased significantly (P<0.05), and the Hcy level decreased significantly (P<0.05), which were statistically different from those in the control group (both P<0.05). Conclusion: Heat-sensitive moxibustion plus piracetam is effective in treating vascular dementia. It can significantly improve dementia symptoms and ADL, which may be related to the correction of plasma Ach and Hcy levels.

Adult ; Benzene ; toxicity ; Chromatography, High Pressure Liquid ; Humans ; Occupational Exposure ; Reference Values ; Sorbic Acid ; analogs & derivatives ; analysis

Objective To study whether the organs besides digestive system of musca domestica Ⅲ instar larvae have the capability of produceing musca β-glucosidase.Methods Tissues of malpighian tubules,trachea,epiploon and body wall of musca domestica Ⅲ instar lar-vae were dissected under anatomic microscope,and the expression of β-glucosidase gene in these dissected tissues were detected by reverse transcription PCR.And the tissue localization of β-glucosidase mRNA was further identified by in situ hybridization.Moreover,anti-cellulase was used to determinate the tissue distribution with immunohistochemical staining.The relative mRNA expression levels of musca domesticaβ-glucosidase gene in these organs were tested by real-time quantitative PCR.Results The reverse transcription PCR showed that the ampli-fication products of β-glucosidase gene were observed in tissues of malpighian tubules,trachea and body wall.β-glucosidase mRNA was shown in the epithelium cells of malpighian tubules,trachea and body wall by in situ hybridization,and it was almost the same in the results of im-munohistochemical staining.The real-time quantitative PCR showed that the relative expression quantity of β-glucosidase gene in malpighian tubules and body wall were higher than that in foregut,while it was lower in itrachea than that in foregut.And it was of statistical difference in gene expression level of β-glucosidase among these organs (P <0.05).Conclusion Malpighian tubules,trachea and body wall of musca domestica Ⅲ instar larvae have the function of secreting β-glucosidase.Combining with the characteristics of secreting β-glucosidase in most organs of digestive system,it may provide a new biological method for the prevention and treatment of human diseases transmitted by musca domestica with the use of taget gene β-glucosidase.

Objective To explore a new model of medical humanity education in new situation. Methods Extensive survey was carried out among medical students,and discussion and consultation were hold to faculty and education administers.A new teaching model was established. Results A curriculum system with 1 or 2 core courses supported by some elective courses and social practice is under the process of implementation and achieved preliminary success.Conclusion The medical humanity education should pay attention to the development of connotation instead of pursuing the extension of quantity blindly,which means that students' school work must be eased by focusing on self-study and self-education.Medical students'life path with high-minded personality training should be strengthened.

Objective To evaluate the diagnostic value of ~(99)Tc~m-methoxyisobutylisonitrile (MIBI) SPECT scintigraphy combined Iocalizable CT in the localization of ectopic parathyroid glands in hyperparathyroidism.Methods Retrospective data of surgery,pathology and imaging were collected from 28 patients with hyperfunctioning ectopic parathyroid glands.All cases underwent CT studies.Twenty-five patients had ~(99)Tc~m-MIBI planar imaging first:SPECT scintigraphy combined localizable CT was performed for the patients with abnormal radionuclide foci immediately.The fusion images obtained after reconstruction showed the exact location of the ectopic foci.Operative histopathologic results were regarded as "gold standards".Presuming 4 parathyroid glands as normal findings,findings confirmed by operation and pathology were regarded as positive,otherwise negative.The results of CT and radionuclide imaging were compared by X~2-test of four-foId table.Results Twenty-eight ectopic parathyroid glands were found in 28 patients,all pathologically confirmed as adenomss.CT found 22 foci,of which 17 were true positive,5 false positive,11 false negative,and 79 true negative.~(99)Tc~m-MIBI SPECT scintigraphy combined localizable CT found 23 foci,no false positive,2 false negative,and 75 true negative.The results showed that the sensitivities were 61% (17/28),92%(23/25),specificities 94%(79/84),100%(75/75),accuracies 86%(96/112),98% (98/100),positive predictive values 77%(17/22),100%(23/23),and negative predictive values 88% (79190),97%(75/77),respectively,for CT and radionuclide imaging.~(99)Tc~m-MIBI SPECT scintigraphy combined localizable CT was therefore significantly higher than CT in sensitivity(X~2=6.98,P＜0.01),specificity (X~2=4.61,P＜0.05),accuracy (X~2=10.30,P＜0.01),positive predictive value(X~2=5.88,P＜0.05) and negative predictive value (X~2=5.36,P＜0.05).Conclusion ~(99)Tc~m-MIBI SPECT scintigraphy combined localizable CT is superior to CT alone in the localization of ectopic parathyroid glands in hyperparathyroidism,but false negative can be found in some patients.