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 To investigate the relationships between serum concentration of RBP-4 and the parameters of inflammatory, lipid metabolism, insulin resistance in patients with T2DM. Methods 71 patients newly diagnosed with T2DM and 34 subjects with normal glucose tolerance (NGT) were enrolled in this cross-sectional study. Additionally, another subset analysis was performed. Subjects were divided into normal weight (NW) and overweight or obesity (OW/OB) group on the basis of BMI. Serum RBP-4 was measured with ELISA. Serum concentrations of hs-CRP, free fatty acids (FFA), triglyceride (TG), total cholesterol (TC) and insulin were measured in fasting status. Insulin resistance was assessed by HOMA-IR. Results Ln (HOMA-IR) and the concentrations of TG, FFA, In(hs-CRP) in T2DM were significant-ly higher than that of NGR group[1.20±0.38 vs 0.76±0.34,(2.74±2. 20)mmol/L vs (1.88±1.41),(0. 80±0. 29)mmol/L vs (0.61±0.22)retool/L,0.62±1.00 vs -0. 17±1.07] . InRBP-4 showed a positive relationship with In (HOMA-IR) ( r =0. 382, P <0. 05), but no association with TC, TG, FFA and In(hs-CRP). In the group of T2DM, InRBP-4 showed a positive relationship with FFA ( r =0. 242, P <0.05) and In (hs-CRP) ( r =0.346, P <0.01), but no association with TC, TG and In (HOMA-IR). There were no relationships between InRBP-4 and In (HOMA-IR), TC, TG, FFA and In (hs-CRP)in NW, while in OW/OB group, InRBP-4 showed a positive relationship with In (HOMA-IR) ( r =0. 290,P < 0. 05 ) and In (hs-CRP) ( r = 0. 295, P <0.05 ), but no association with TC, TG and FFA. In a mul-tiple linear regression analysis, In( hs-CRP), TC, TG, FFA or In(HOMA-IR) was not the independent de-terminant of InRBP-4 in any group. Conclusion In patients with T2DM, InRBP-4 is positively correlatedwith In (hs-CRP) and FFA, and it may be a new marker of inflammation.

Humans ; Male ; Middle Aged ; Polychondritis, Relapsing ; surgery ; Tracheotomy ; methods

The anisotropic diffusion equations-Perona &Malik(P&M)equations are resorted to to decrease the Rician noise introduced into the diffusion weighted(DW)images.To evaluate the efficiency of the P&M equations(with different functions)in accounting for the Rician noise,many experiments are designed.The results acquired from both Monte Carlo simulation experiments and real data based experiments proves the better performance of the reciprocal function based P&M equation in denoising the DTI images.

O bjective To introducetheosteotomyofacetabularmedialwallas a techniqueto facilitateanatomicalimplantationand securefitofacetabularcupsfordysplastichips. Methods Eighteen hipreplacementswereperformedwithuseofan osteotomyofacetabularmedialwalltostabilizethecups in 17 dysplasticpatients. The patientswere aged from35-70 years, withan averageof51.4 year. Among all thedysplastichips,4 were oftypeⅠ,7 oftypeⅡ,4 oftypeⅢ,and 3 oftypeⅣ accordingtotheCrowe criteria. A Ranawat trianglewas drawn on theX-ray film, and a supposedoptimalrotatingcenterwas located.Bothofthehorizontaland verticaldistancesbetweenfemoralhead and supposedrotatingcenterwas decreasedsignificantlyafteroperation.Results With medialwallosteotomy,alltheacetabularcomponents wereplacedinthetrueacetabulum.The diametersoftheimplantedcupswere44-56 mm withan averageof 50.78 mm . Medialbony wallwas preservedwithan averagethicknessof9.5 mm . The horizontaldistance was 21.09 mm (12-40 mm )preoperativelyand 3.73 mm (-3-10.1 mm )postoperatively,therewas statistical difference(t=7.95,P

Objective] To study Professor Wang Kungen's therapeutic principles in treating chronic constipation by data mining therapy. [Method]First, establish Wang Kungen's medical records database; then do data standardization and data mining. [Result]There are totally 207 cases that meet the demand. The major patterns of syndrome of CC in Professor Wang Kungen's medical records are as follows: gastrointestinal heat syndrome, stagnation of liver qi and spleen deficiency, Yin deficiency syndrome, Qi deficiency. The major prescriptions are as follows: Liumo Decoction, Xiao Yao San, Pi Yue Pill, Buzhong Yiqi decoction. There is close correlation between prescriptions and patterns as follows: gastrointestinal heat syndrome and Liumo Decoction; stagnation of liver qi and spleen deficiency and Xiao Yao San; Yin deficiency syndrome and Pi Yue Pill; Qi deficiency and Buzhong Yiqi decoction. There is close correlation between herbs as follows: rhizoma atractylodis macrocephalae and fructus arctii; rhizoma atractylodis macrocephalae and radix paeoniae alba; fructus cannabis and elecampane; rhizoma atractylodis and fuling; peach kernel and cortex moutan; semen raphani and fructus aurantii.[Conclusion] The evidence type of chronic constipation is relatively purging heat and keeping body fluid, soothing the liver and stomach, tonifying spleen and moistening intestines, tonifying Qi.

Objective: To evaluate the impact of fine particulate matter ( PM2.5 ) on respiratory diseases and symptoms of community residents in Chun’an County, so as to provide the basis for air pollution treatment strategies. Methods: Using the cluster random sampling method, the permanent residents in Qiandaohu Town of Chun’an County were investigated from 2017 to 2018. The demographic information, respiratory diseases and symptoms were collected by using Surveillance Plan for the Impact of Air Pollution ( Haze ) on health ( 2016 Edition ). The air pollutants and meteorological data were collected through Qiandaohu station of Hangzhou Ecology and Environment Monitoring Center and Hangzhou Meteorological Information Center. The effects of PM2.5 on respiratory diseases and symptoms of residents were analyzed with generalized estimating equation. Results: Totally 1 181 people aged 6 months to 95 years were recruited, including 557 ( 47.16% ) males and 624 ( 52.84% ) females. Acute nasopharyngitis (common cold) and tracheitis/tonsillitis occurred most frequently, with 203 cases, accounting for 3.44%. The median of daily average concentration of PM2.5 was 24 μg/m3, with the standard exceeding rate of 2.80%. The results showed that PM2.5 increased the risk of acute nasopharyngitis ( common cold ), tracheitis/tonsillitis, cough, expectoration, runny nose, sore throat and nasal congestion ( lag 3 days, OR: 1.015-1.022, 95%CI: 1.001-1.037 ); the effect of PM2.5+PM10 ( OR: 1.020-1.040, 95%CI: 1.006-1.070 ) and PM2.5+O3 ( OR: 1.017-1.024, 95%CI: 1.005-1.035 ) was greater than that of PM2.5 alone on respiratory diseases and symptoms. Conclusion Atmospheric PM2.5 exposure in Chun’an County increases the risk of respiratory diseases and symptoms among community residents.

Objective\ By inhibiting approach of apoptosis of T cells to observe if it could reduce the attacks of tumor cells upon lymphocytes and its possible role in tumor treatment. Methods\ The expressions of Fas/FasL genes in ovarian carcinoma cells were detected by using flow cytometry and RT\|PCR method.The construction of pcDNA3\|antisense Fas,the constructed vector was transfected into Jurkat cells with lipofectin,the change in expression of Fas gene was determined by flow cytometry.By means of Annexin\|V and MTT the effect of apoptosis in transduced Jurkat cells was investigated,and also using MTT cytotoxic test to investigate how 3AO cells kill Jurkat cells. Results\ Fas/FasL were expressed in 6 ovarian carcinomal cells.The expression level of Fas protein in Jurkat cells transduced with the constructed vector was decreased.Apoptosis was reduced in antisense Fas\|transfected Jurkat cells after anti\|Fas treatment. Conclusion\ FasL expression in ovarian carcinoma may be one of the reasons for ovarian carcinoma to escape immunosurveillance and attacking lymphocytes.Blocking Fas expression in lymphocytes can partially inhibit Jurkat cells apoptosis induced by anti\|Fas and reducing the attacks of tumor cells upon lymphocyte.\;

BACKGROUND: Bone defect is commonly treated in clinic with auto graft, allograft and artificial bone graft, but with the disadvantages to various extents. Therefore, how to better repair bone tissue in bone defect becomes the hot spot in surgical field.OBJECTIVE: The complex of marrow stromal stem cell (MSC) and calcium-phosphates artificial bone (CPAB) was prepared and the repair of bone defect was observed in animal experiment.DESIGN: Randomized controlled experiment was designed.SETTING: Department of Traumatic Surgery, Affiliated Hospital of Qingdao University Medical College.MATERIALS: The experiment was performed in Animal Experimental Center of Affiliated Hospital of Qingdao University Medical College from May 2002 to September 2003, in which, 24 New Zealand health normal big white adult rabbits were employed, aged varied from 6 to 14 months, mass weighted from 9 to 3.5 kg, of either sex.METHODS: (① Rabbit MSCs were differentiated and proliferated and CPAB was taken as carrier to prepare the complex of CPAB and MSCs. ②24 rabbits (48 laterals) were prepared as model of bone defect, divided into 3 groups, named complex group (24 laterals), in which, unilateral bone defect of 24 rabbits were implanted with cell + carrier complex; The rtificial bone group (12 laterals), in which, CPAB was implanted contralaterally;and blank control (12 laterals), in which, no any management was done contralaterally in bone defect of 12 rabbits. In 8, 16 and 24 weeks after surgery, 4 animals were collected at each time spot in each group for radionuclide monitoring; and the animals were sacrificed under anesthesia for X-ray picturing and histological staining analysis.MAIN OUTCOME MEASURES: ① Gross observation of bone defect in each group. ② Results of X-ray examination. ③ Results of histomorphologic observation. ④ Results of radionuclide monitoring.RESULTS: 24 rabbits all entered result analysis. ① Gross observation of bone defect in each group and results of X-ray examination: In complex group of 24 hours, the fractutred ends were connected partially, the bounder was not clear between the regenerated bone and material and reopened medullary cavity was not visible. In simple artificial bone group, the implanted material was integrated with the cross end and material volume did not change obviously compared with the initial implanting stage. In bland control, ununion fracture presented and medullary cavity was closed. ②Results of histomorphological observation: In 24 hours, the bone defect was smaller in size and the union happened on the defect area in complex group. In artificial bone group, the regenerated bone was integrated tightly with the material and grew inside partially. In blank control group,medullary cavity was closed and bones were not connected. ③ Results of radionuclide monitoring: It was remarkably distinguished with naked eye that radioactive concentration was in tendency of obvious increasing in both complex group and artificial bone group in 8-24 weeks.CONCLUSION: The complex of CPAB and MSCs regenerates bone tissue and repair radial defect in whole. In addition, the repair ability is superior remarkably to simple CPAB.

The training of airway management plays a vital role in standardized residency training plan during the rotation in the department of anesthesiology.Problem based-learning and airway simulation practice should be applied step by step based on the different requirements of standardized residency training plan.The training should be started from mask ventilation to endotracheal intubation,meanwhile clinical thinking ability and teamwork ability should be cultivated for the residents so that they can master the technique of airway management skillfully whenever and wherever.