Objective To investigate the microbiological and epidemiological characteristics of bloodstream infections in Peking University Third Hospital Methods The clinical, microbiological and epidemiological data of bloodstream infections in Peking University Third Hospital from January lst,2005 to December 31st, 2007 were analyzed retrospectively. Differences in proportions were compared using X2 test. Results Six thousand four hundred and eighty-eight blood culture tests for 5 138 episode of bloodstream infections of 3 795 patients were performed. The positive rate was 9.9%. The average incidence rate of nosocomial infection was 40.8 cases per 10 000 hospital admissions. In the 593 pathogens, 483 (81.5%) were pathogens causing nosocomial. The ratio of Gram-positive microbs, Gram-negative ones and fungi (all were Candida spp.) were 38.5%, 54.7%, and 6.8%, respectively. The corresponding ratio of nosocomial pathogens were 42.0%, 49.9% and 8.1%, respectively. The most frequently isolated strain was Escherichia coli (25.3 %). The coagulase negative staphylococcus was the second one (18.8%). The corresponding ratio of Staphylococcus aureus, Klebsiella pneumoniae, Enterococcus spp. , Pseudornonas aeruginosa , Acinetobacter baumannii and anaerobs were 7.1%, 7.4%, 8.3%, 3.2%, 2.2% and 0.7%, respectively. Ten patients (1.7%) had experienced polymicrobial infection. In hospital setting, Streptococcus spp. And Escherichia coli infections were more frequently in non-intensive care unit (ICU) than ICU (X2= 9.240, P= 0.002; X2= 23.609, P,<0.01; respectively). But the infection rate of Candida spp. Was significantly higher in the ICU (X2= 5.498, P= 0.019). The time interval between hospital admission and onset of infection for the most frequently isolated pathogens ranged from 15.1 days (Escherichia coli) to 29.7 days (Acinetobacter baumannii). The degree of resistance to the common antimicrobal agents had no change in the three years. Conclusions The average incidence rate of nosocomial bloodstream infection is 40.8 cases per 10 000 hospital admissions. The main pathogens are the Gram-negative microbs.

Objective Normal estimation is the key step for volume visualization. Commonly used methods for normal estimation are based on interpolation and derivative. A novel normal estimation algorithm based on approximation for visualization of medical images was presented in this paper. Method It approximated the density function in local neighborhood with a second-degree polynomial function. The coefficients of the polynomial function were solved by minimizing the error of the approximation and the gradient vector at arbitrary point was obtained directly from the analytical derivative of the density function without interpolation. Because of symmetry, the solution of this equation was simplified.This method was tested in several volume data sets. The results and the generation time by different methods were obtained and compared. Result The results showed that this algorithm produced satisfactory quality images while the computational complexity was not increased. Conclusion This approach is preferable for most applications, especially for medical images reconstruction.

Objective: To determine the optimal manipulation parameters in Liu's back tuina therapy for remission-stage cough variant asthma (CVA) in kids. Methods: A 5-factor 3-level L18(37) orthogonal design was adopted. The experimental factors and levels were selected: A, the number of times of Rou-kneading Feishu (BL 13); B, the frequency of Rou-kneading Feishu (BL 13); C, the number of times of Tui-pushing in a '介'-like pattern; D, the frequency of Tui-pushing in a '介'-like pattern; E, the intensity of red color after Ca-scrubbing Feishu (BL 13) with salt. A1, A2 and A3 stood for 10 times, 20 times and 30 times, respectively; B1, B2 and B3 stood for 200 times/min, 240 times/min and 280 times/min, respectively; C1, C2 and C3 stood for 50 times, 75 times and 100 times, respectively; D1, D2 and D3 stood for 150 times/min, 175 times/min and 200 times/min, respectively; E1, E2 and E3 stood for pinkish, bright red and dark red, respectively. A total of 108 kids with CVA in remission stage were divided into 18 groups using the random number table method, with 6 cases in each group. Changes in the cough score and fractional exhaled nitric oxide (FENO) level were observed after 15-day treatment. Results: The cough score and FENO level changed significantly in every group after treatment (all P<0.01). By the effect in improving cough score, the factors were listed as D, B, A, C and E in descending order; the most optimal manipulation parameter combination was group 17 (A3B2C1D3E1); the second optimal parameter combinations were group 7 (A3B1C2D1E3), group 13 (A2B1C2D3E1) and group 14 (A2B2C3D1E2). Regarding the effect in down-regulating the level of FENO, the factors were listed as C, A, E, B and D in descending order; the most optimal manipulation parameter combination was group 13 (A2B1C2D3E1); the second optimal parameter combinations were group 18 (A3B3C2D1E2), group 16 (A3B1C3D2E3) and group 14 (A2B2C3D1E2).Conclusion: Two most effective manipulation parameter combinations were selected out of 18 different parameter combinations in Liu's back tuina therapy for remission-stage CVA in kids. Doctors can choose an appropriate manipulation based on the symptom features of the disease.

Objective To investigate the clinical value of ~(99)Tc~m-ethylenedicysteine (EC) diuretic renography (DR) in pre-and post-operative pediatric congenital hydronephrosis.Methods The DR with injection of Furosemide at 15 min of forty children with hydronephrosis was retrospectively studied.The preoperative renal blood perfusion rate (BPR),effective renal plasma flow (ERPF),grade of hydronephrosis,renogram and renal dynamic imaging of pre- and post-operative kidneys were compared.The t-test and Mann-Whitney test were used for data analysis.Results (1) Of 40 pathological kidneys,the BPR increased 5.99% (t=-5.13,P＜0.01)from pre-operative to post-operative:(34.05±11.07)% to (40.04±8.56)%.The ERPF increased 12.48 ml/min(t=-4.35,P＜0.01) from pre-operative to post-operative:(57.81±34.32)ml/min to(70.29±5.37)ml/min.(2)The grade of hydronephrosis of 40 pathological kidneys improved significantly(Z=-2.64,P＜0.01) with the mean sum of ranks of 47.21 pre-operatively to 33.79 post-operatively.(3) As the hydronephrosis worsened,the collecting system became bigger,the renal parenchyma became thinner,the extent of intrarenal parenchymal photopenia became larger and the response to diuretic challenge in pathological kidneys decreased or became totally irresponsive.(4)Thirty-seven cases of obstruction at ureteropelvic junction (UPJO) and 3 cases at ureterovesical junction (UVJO) were diagnosed by DR,which were all confirmed by surgery.Conclusions DR is a reliable method to evaluate pediatric congenital hydronephrosis.It can accurately reflect the grade and (or) severity of the disease,guide therapy and assess the therapeutic success of operation.

Objective To study the relationship between social support and life quality of empty nest elderly,and search the effective way to improve their quality of life.Methods Social Support Review questionnaire (SSRS),and Short-Form 36 Health Survey questionnaire (SF-36) were used to investigate 91 empty nest elderly.Database was established by SPSS 17.0,and t-test and Pearson correlation analysis were used during the process.Results 91 questionnaires were given out and 91 were effectively called back,with the effective rate of 100％.The total score of quality of life of empty nest elderly was (619.12 ± 132.83).The differences of life quality between empty nest elderly of different gender,age and degree of education were not statistically significant.The score of quality of life of elderly with spouses was (637.25 ± 127.17),while that of elderly without spouses was (565.53 ± 137.53 ),and the differences were statistically significant (t =2.29,P ＜0.05).The score of quality of life of elderly who had different pensions was (652.40 ± 129.55) vs (581.98 ± 127.87),and the difference was statistically significant (t =- 2.61,P ＜ 0.05 ).In this research,the total score of social support was ( 37.46 ± 9.25 ).The difference of social support between elderly of different gender,age and pension was not statistically significant,while that between elderly of different condition of spouse and degree of education was statistically significant (P ＜0.05 ).Therefore,social support and quality of life of empty nest elderly were correlated with the related coefficient of 0.46 (P ＜ 0.05 ).Conclusions There is significant relationship between social support and quality of life of empty nest elderly,thus social support has an important effect on life quality.Caring the psychological goal of empty nest elderly and complete social support is very meaningful to improve the quality of life of empty nest elderly.

OBJECTIVETo evaluate the efficacy and safety of three different spinal rotation manipulations for the treatment of lumbar disc herniation.

METHODSFrom September 2011 to April 2013,180 patients diagnosed as lumbar disc herniation were randomly divided into seat fixed rotation group (A), lateral position rotation group (B) and supine position rotation group (C) by using a digital table. Finally 10 patients were excluded and dropped, 170 patients were included in the study. There were 57 patients in group A, 57 patients in group B and 56 patients in group C. Baseline demographic characteristics of patients, clinical findings and indexes of health status had no statistically differences among three groups (P > 0.05). The manipulation was performed every other day, and the treatment duration for all patients was 3 weeks. Body pain (BP), Physical function (PF) in SF-36, Oswestry Disability Index (ODI) and adverse reactions were observed statistically 6 weeks, 3 months, 6 months, one year and two years after finishing treatment.

RESULTSBP, PF scores in 3 groups were significantly improved and ODI scores were significantly lower than those before treatment and the differences were statistically significant (P < 0.05); However, there was no significant difference among three groups in the BP, PF and ODI scores (P > 0.05). There were no obvious and serious adverse reactions among these groups.

CONCLUSIONBased on the theory of dislocation of bone joints in TCM, three kinds of spinal rotation manipulations can be used safely for the treatment of lumbar disc herniation, and the efficacy was similar.

Adolescent ; Adult ; Case-Control Studies ; Female ; Humans ; Intervertebral Disc Displacement ; physiopathology ; therapy ; Male ; Manipulation, Spinal ; methods ; Middle Aged ; Rotation ; Treatment Outcome ; Young Adult

[Summary]_ This is a pedigree of multiple endocrine neoplasia type 1(MEN1). The proband pursuit medical assistance because of hypertension and weakness. Adrenal cortical carcinoma with possible Cushing's syndrome was diagnosed after a series of tests. During this process, the proband was found to have hypercalcemia, and he was diagnosed as primary hyperparathyroidism. Adrenal carcinoma plus primary hyperparathyroidism suggested MEN1, which was confirmed by MEN1 gene 400_401insC mutation. Pedigree investigation found six additional patients, including one with high parathyroid hormone level and two without clinical evidence of any MEN1 diseases. The proband died of metastatic malignancy 7 months after diagnosis while the other 3 patients with clinically confirmed MEN1 tumor responded well to surgery, including one with adrenal cortical carcinoma.

Objective To investigate the clinical features, laboratory findings, chest CT findings and treatment of patients with COVID-19, and to analyze their relationship with prognosis. Methods From January to February 2020, the clinical data on the 42 patients with COVID-19 admitted to the Wenzhou Sixth People′s Hospital were analyzed retrospectively. Results The clinical symptoms of the 42 cases included fever (35 cases), cough (26 cases), fatigue (14 cases), aspiration (9 cases), sore throat (4 cases), muscle ache (5 cases), headache (2 cases), nausea (4 cases), diarrhea (6 cases) and abdominal pain (1 case).The absolute number of blood lymphocyte decreased to different degrees in 22 cases.Fourteen cases had lactate dehydrogenase obviously, with no obvious change in procalcitonin.The imaging manifestations were cloud-like and ground-glass-like high density shadows scattered outside the lungs, small flaky consolidation and bronchus inflating sign were seen locally.A few images showed diffuse high density, most of the lesions showed consolidation or striate change, and local fibrosis was formed in the lower lobes of both lungs. Conclusion Fever and cough are the first symptoms of COVID-19, and a few cases are associated with shortness of breath and diarrhea, accompanied by different degrees of systemic symptoms, but most of the patients improve their conditions after active antivirus, anti-infection, systematic symptoms improvement and supportive treatment.The disease is highly infectious and its condition changes rapidly.Therefore, early detection, early diagnosis and comprehensive treatment of the whole body as soon as possible are the keys to treatment.

Background:The results of the Trial Assigning IndividuaLized Options for Treatment (TAILORx) suggested that approximately 70％ of T1-2N0M0,hormone receptor-positive,human epidermal growth factor receptor 2 (HER2)-negative breast cancer patients can avoid chemotherapy and receive only adjuvant endocrine therapy.We conducted a retrospective analysis of the clinicopathologic features and prognostic factors of patients with breast cancer who met the inclusion criteria of the TAILORx trial.Methods:According to the enrollment criteria of the TAILORx trial,a retrospective analysis was performed on patients with breast cancer who were treated from January 2008 to December 2015 at Peking University First Hospital.The clinicopathologic characteristics of all patients were analyzed,and prognoses were calculated using the Kaplan-Meier method and a Cox proportionate hazards model.Results:A total of 2430 patients with early stage breast cancer who were admitted at our hospital had complete clinicopathologic data and follow-up information.Of these patients,722 met the inclusion criteria and were enrolled in the present study,accounting for 29.7％ of all patients.Among them,417 (57.8％) patients received only adjuvant endocrine therapy (the non-chemo group),and 305 (42.2％) patients received adjuvant chemotherapy followed by adjuvant endocrine therapy (the chemo group).No statistically significant difference was observed in overall survival (OS) between the two groups (non-chemo vs.chemo:5-year OS:97.9％ vs.97.9％,x2=1.00,P =0.995;hazard ratio [HR] =1.00,95％ confidence interval [CI]:0.46-2.21).A significant difference was observed in disease-free survival (DFS) between the two groups (non-chemo vs.chemo:5-year DFS:97.9％ vs.94.7％,x2 =8.65,P =0.003;HR =3.05,95％ CI:1.40-6.67).The choice of adjuvant therapy was associated with clinicopathologic factors,such as the age at diagnosis,T stage,histologic grade,the Ki67 index,the presence of intravascular tumor thrombus (P ＜ 0.001),pathologic type,and menstrual status (P =0.014).Conclusions:In the absence of internationally recognized multigene testing methods,for patients with early hormone receptorpositive,HER2-negative breast cancer,clinicians can develop a treatment plan based on clinicopathologic features only,which can effectively screen some patients who do not need adjuvant chemotherapy.However,nearly half of patients still receive adjuvant chemotherapy,and whether these patients can be exempted from chemotherapy warrants further exploration.

AIMTo research the influence of noxious stimuli on the electric activities of pain-related neurons in several subnuclei of Amygdaloid Nucleus in rats.

METHODSTrains of the electric impulses applied to the sciatic nerve were used as noxious stimuli. The discharges of neurons were channeled off by glass microelectrode.

RESULTSPain-related neurons existed in several subnuclei of Amygdaloid Nucleus. When the noxious stimuli were administered the frequency of discharges of pain-excited neurons (PEN) was increased while the frequency of pain-inhibited neurons (PIN) was decreased to the lowest level. The electric activities of PEN and PIN were matched with each other. Intraperitoneal injection of morphine (10 mg/kg) antagonized the effects of noxious stimuli on the pain-related neurons.

CONCLUSIONSeveral subnuclei of Amygdaloid Nucleus play an essential role in perceiving, integrating and transmitting the pain impulses. They are a part of the central nervous system in which pain information is controlled and managed.

Amygdala ; physiology ; Animals ; Electrophysiology ; Neurons ; physiology ; Nociceptors ; physiology ; Rats ; Rats, Wistar