Objective To investigate transmission routes of healthcare-associated infection(HAI)caused by methi-cillin-resistant Staphylococcus aureus (MRSA),and make effective measures for preventing and controlling the oc-currence and epidemic of HAI caused by multidrug-resistance bacteria.Methods From February 24 to March 29, 2012,12 MRSA-infected patients were performed epidemiological study,these patients underwent bronchoscopy be-cause of tracheal stenosis,strains were identified by amplifying the sequences of 16S rRNA ,femA and mecA with real-time quantitative polymerase chain reaction (PCR),homology analysis of strains were performed by Spa geno-typing.Results All 12 MRSA-infected patients were susceptible to multidrug-resistance bacterial infection,5 cases of MRSA infection occurred during this hospitalization.Detection of specimens from health care workers and envi-ronment were all negative;Spa gene of all 12 MRSA isolates was type t 030 ,which was the main epidemic strain in Asia;Spa gene of Staphylococcus aureus isolated from nurses’noses was type t1425 .Conclusion The assumption of MRSA spread among health care workers aren’t supported by the epidemiological investigation results,genotypes of 12 MRSA isolates are identical,but the result of gene typing can’t be as the evidence of homology of infection ;patients at high risk for MRSA infection should be screened as early as possible,early contact isolation should be performed,so as to prevent and control the occurrence of HAI.

Objective: To compare the contents of saikosaponin a, d and total flavonoids in different parts of Hollow bupleurum to provide reference for the clinical use of medicinal parts.Methods: The determination was performed on a SHIMADZU Inertsil C18(250 mm×4.6 mm,5 μm)column.The mobile phase consisted of acetonitrile and water with the ratio of 40∶60, and the flow rate was 1.0 ml·min-1.The detection wavelength was 210nm, the column temperature was 40℃, and the injection volume was 10 μl.A colorimetric method was used to detect total flavonoids with the detection wavelength of 500 nm.Results: The calibration curve of Saikosaponin a, d and total flavonoids showed a good linear relationship respectively over the range of 0.21-1.26 mg·ml-1(r=0.999 6),0.25-1.51 mg·ml-1(r=0.9997) and 4.00-25.00 μg·ml-1(r=0.999 6).The average recovery was 99.27%(RSD=2.15%, n=6),99.4%(RSD=2.14%,n=6)and 99.03%(RSD=1.34%,n=6), respectively.The content of saikosaponin a and d respectively was 0.31% and 0.50% in the root, while that in the other parts was low.The content of total flavonoids was as high as 8.48% in flowers, and that in leaves, stem and root reduced in turn.Conclusion: The aerial parts of Hollow bupleurum are rich in flavonoids, and the content of saikosaponin in root is higher, therefore, the whole plant with root is more reasonable in the clinical use.

Objective To observe the change of the protein and gene expression of hypoxia inducing factor-1α(HIF-1a) and vascular endothelial growth factor (VEGF) in the nude mouse tumor,which has been treated by HIFU combined with nanoscale ultrasound molecular probes with HSV1-TK gene microvascular density.Methods Sixty nude mice were implanted with HepG2 Cells to establish subcutaneous transplanted tumor.Divided this mice into six groups at random after treated by HIFU:MB+ HSV-TK+ GPC3 (group A),MB + HSV-TK (group B),HSV-TK +GPC3 (group C),HSV-TK (group D),MB + GPC3 (group E),PBS (group F).They were injected into the tail vein every after 3 days.Mice in group A,B,D and E were exposed to ultrasound by 2 W/cm2,1 MHz,5 mintues and 0.2 mL ganciclovi(GCV) was intraperitoneally injected at the first 48 hours after injection.After the treatment,immunohistoche were used to detect the microvascular density(MVD),Western blot and immunohistoche was employed to test the protein change of the VEGF and HIF-1α,Q-PCR was used to test the mRNA gene transcription of VEGF and HIF-1α in the tumor tissues.Results After 14 days,the protein expression of HIF-1α and VEGF in group A was significantly lower than that in group B,C,D,E and F (P＜0.05),the MVD level in the tumor is also like this,and the difference is statistically significant.Conclusion Anoscale ultrasound molecular probes with HSV1-TK can reduce the the level of VEGF,MVD and HIF-1α in the tumor which has been treated by HIFU,so it can inhibit tumor growth and improve the therapeutic efficacy after HIFU treatment.

Objective:To investigate the clinical features, imaging features, treatment options and prognosis of linear scleroderma with central nervous system involvement.Methods:One case of linear scleroderma " en coup de sabre" (LSES) school-age child suffering from dizziness, vomiting and blurred vision was admitted to the Department of Pediatrics, Peking University First Hospital on March 25, 2019.The curative effect was observed after treatment.The relevant literature was searched, and the characteristics of cases and therapeutic effects were reviewed.Results:The clinical features of this case included recurrent and transient dizziness, vomiting, and blurred vision.Cranial imaging indicated abnormal signals in the left frontotemporal lobe white matter, cingulate gyrus, basal ganglia region, and corpus callosum proximal pressure part, multiple soft meningeal line enhancement and abnormal brain substance enhancement on the brain surface in the lesion area.After 2 months of combined treatment with Methotrexate(MTX) and corticosteroids, some symptoms such as dizziness and vomiting disappeared.Three months after the treatment, in the primary cerebral hemisphere and multiple calcifications in the brain parenchyma, the lesions significantly reduced in cranial imaging.The child was followed up for 11 months and displayed no clinical symptoms.New hair was dense at the alopecia area, and skin color, texture and grain were close to normal at the damaged area.In the review of domestic literature, treatment and prognosis were not involved.Foreign literatures reported 5 cases of children, with the first choice of Methylprednisolone being combined with MTX treatment, significant effect was observed, and consistent with the treatment of this case.Conclusions:In order to detect and treat them as early as possible and improve the prognosis, LSES patients should undergo cranial integrity assessment and neurological imaging examination at an early stage, regardless of clinical manifestations of nervous system involvement.

Objective To investigate the effects of gabapentin(GBP) on plasma β-endorphin(β-EP) level in the patients with painful diabetic neuropathy(PDN). Methods We detected the plasma β-EP level in 24 PDN patients in the treatment with GBP, 18 PDN patients without GBP treatment, 20 diabetic mellitus patients without PDN and 24 healthy control subjects. Results (1)The level of β-EP in diabetic mellitus patients was lower than in the healthy control(P<0.01). (2)The patients who received GBP had a significant change of β-EP level after treatment(P<0. 01).. Conclusions Gabapentin is effective for the treatment of PDN and its adverse effects are mild. It can lower the plasma β-EP level in the patients with PDN.

Objective To study the pinoresinol diglucoside (PDG) on gene regulation role of ESF-1 cells in collagen secretion, to reveal PDG repair mechanisms on scalded skin.Methods The cells cultured in vitro were divided into the control group, the estradiol group and the three different PDG doses groups. The concentration of the high, medium and low dose groups were 100, 10, 1μmol/L, and that of estradiol group were 10-3μmol/L. The activity of proliferation was detected by MTT. Then collagen type I (Col I), collagen typeⅢ (ColⅢ), tissue inhibitors of metalloproteinase 1 (TIMP-1), tissue inhibitors of metalloproteinase 2 (TIMP-2) and matrix metalloproteinase 1 (MMP-1) expression levels of mRNA after administration of cells were detected by RT-PCR.Results Compared with the control group, the proliferation of ESF-1 cells (0.559 ± 0.027, 0.552 ± 0.034vs. 0.489 ± 0.027,P<0.05) in the estradiol and medium-dose PDG was significantly higher. The expression level of mRNA of ColⅠ(0.958 ± 0.021, 0.929 ± 0.031, 0.916 ± 0.015vs. 0.844 ± 0.022), ColⅢ (0.783 ± 0.038, 0.918 ± 0.021, 0.855 ± 0.017vs. 0.678 ± 0.024), TIMP-1 (0.939 ± 0.025, 0.889 ± 0.036, 0.853 ±  0.015 vs. 0.780 ± 0.023), TIMP-2 (0.507 ± 0.024, 0.655 ± 0.037, 0.572 ± 0.025vs. 0.405 ± 0.062) in the estradiol, low-, medium-dose PDG groups were significantly higher than those in the control group (P<0.05 or P<0.01). Besides, the MMP-1 (0.343 ± 0.038, 0.407 ± 0.046, 0.435 ± 0.037vs.0.519 ± 0.041) mRNA expression level in the middle and low dose PDG groups significantly decrease (P<0.05 orP<0.01). Conclusions The PDG could enhance the activity of ESF-1 cell proliferation, increase the expression of related collagen and tissue inhibitor of metalloproteinases and inhibit that of matrix metalloproteinases to repair scalded skin.

Objective To compare the effectiveness and safety of different intracranial stents assisted coil embolization of intracranial aneurysms and to discuss the selection of different stent assisted embolization of intracranial aneurysm.Methods From 2007 April to 2012 April,118 cases (a total of 128 wide-neck aneurysms) with intracranial aneurysms were analyzed retrospectively.This included the use of 70 neuroform,38 Enterprise,and 20 Solitaire AB stents forthe treatment of intracranial aneurysms.The successful use,aneurysm occlusion at the immediate post-operation,and early period of peri-operative complications were recorded from those clinical data in order to assess the effectiveness and safety of the different intracranial stents,which assisted coil embolization of intracranial aneurysms.Rank sum test and x2 test were used for statistics.Results Three aneurysms assisted with Neuroform stent were planted unsuccessfully,and the Enterprise and Solitaire stents were placed successfully.The embolism results of three stents after immediate postoperative angiography aneurysm: Neuroform stent occlusion rate was 40.0％ (28/ 70),the tumor residual rate was 38.6 ％ (27/70),and the partial embolization rate was 21.4 ％ (15/70) ; The Enterprise stent occlusion rate was 42.1％ (16/38),the tumor residual rate was 36.8 ％ (14/38),and the partial embolization rate was 21.1％ (8/38).The Solitaire AB stent occlusion rate was 40.0 ％ (8/20),the tumor residual rate was 35.0 ％ (7/20),and the partial embolization rate was 25.0 ％ (5/20).There were not significant differences in aneurismal occlusion (H =0.12,P ＞ 0.05).Early peri-operative complications results were: Neuroform stent occurred in 7,Enterprise frame in 4,and Solitaire AB stent occurred in 2.There were no significant differences in the incidence of complications in the early period after coiling (x2 =0,P ＞ 0.05).Conclusions Three kinds of intracranial stents assisted embolization of intracranial aneurysms are applied safely and effectively.The stent may be chosen according to morphology of parent artery and stent biological character.

Objective To investigate the effects of propofol on intracellular free Ca2+ concentration and nitric oxide synthase (NOS) activity in PC12 cells exposed to bupivacaine. Methods The PC12 cells were provided by Shanghai Cell Biology Research Institute, Chinese Academy of Sciences and cultured in DMEM liquid culture medium. The cultured PC12 cells were seeded in 36 well plates and randomly assigned to one of 4 groups (n=9 wells each): group Ⅰ control (C);group Ⅱ propofol (P);group Ⅲ bupivacaine (B) and group Ⅳ propofol + bupivacaine (PB). In control group D-Hank solution was added. The cells were exposed to propofol 2 mmol/L and bupivacaine 0.09 mmol/L in group P and B respectively. In group PB the cells were incubated with propofol 2 mmol/L and bupivacaine 0.09 mmol/L simultaneously. After being incubated for 6 and 24 h the apoptosis in BC12 cells was assessed by flow cytometry. Apoptotic rate was calculated. NOS activity and intracellular free Ca2+ coneentration in PC12 cells were determined. Results Bupivacaine significantly increased the apoptotic rate of PC12 cells, the intracellular free Ca2+ concentration and NOS activity in PC12 cells in group B as compared with control group. Propofol significantly decreased the toxic effects of bupivacaine on PC12 cells in group PB compared with group B. Conclusion Bupivacaine is toxic to PC12 cells by increasing apoptosis, intracellular Ca+ concentration and NOS activity in the cells. The toxic effects can be prevented to some extent by concomitant administration of propofol.

Objective To summarize the clinical experience of "One-stop" hybrid procedure that performs minimally in-vasive direct coronary artery bypass ( MII)CAB ) and percutaneous coronary intervention ( PC! ) concurrently on 35 patients with multivessel coronary artery disease (CAD). Methods Between June 2007 and May 2008, 35 patients [33 men and 2women, mean age (63.5±9.2) years] with multivessel CAD ( two-vessel CAD, n = 19; three-vessel CAD, n = 16, left main coronary artery disease, n = 7 ; coronary artery lesions, 2.5 lesions per patient) underwent "one-stop" hybrid procedure. The hybrid strategy was performed as a primary MIDCAB procedure for bypassing the left internal mammary artery ( LIMA ) to the left anterior descending artery ( LAD ), simultaneously followed by PCI ( pereutaneous transluminal coronary angioplasty (PTCA) and/or stenting) on the remaining non-LAD vessels. Concomitant diseases included hypertention in 20 patients, hy-perlipemia in 12 patients, previous myocardial infarction (MI) in 10 patients, diabetes mellitus (type 2) in 9 patients, previ-ous cerebrovascular disease in 2 patients, chronic obstructive pulmonary disease (COPD) in 1 patient, renal dysfunction in 1 patient, and ostium secundum atrial septal defect in 1 patient. The left ventricular ejection fraction (LVEF) averaged 0. 62±0.07. Results There were no reexploration for bleeding, strokes, myocardial infarctions, acute renal dysfunctions, or deaths in hospetal. Of the total 35 patients, 34 patients (97.1%) were successfully treated with "one-stop" hybrid procedure, and 1 patient (2.9%) was converted to conventional coronary artery bypass grafting ( CABG ) because of dissection of one obtuse marginal branch during PCI. One of the LIMA-LAD grafts was confirmed to be anastomotic stenosis by followed coronary angiog-raphy and was corrected immediately. The patient with ostium secundum defer underwent tranesophageal echocardiography guiding transcatheter closure after LIMA-LAD anastomosis. Catheter-based interventions were carried out in 61 coronary le-sions, including PTCA in 6 lesions and implantation of 62 drug-elating stents (DES) in the rest appropriate lesions. The mean number of DES implantation was 1.8 per patient, and the average diameter and length of implanted DES were respectively ( 3.2±0.5 )mm and 37.3 mm per patient. Of the 34 patients receiving hybrid procedure, the average mechanical ventrilation time was ( 10.8±7.9) hours, and 4 ( 11. 8% ) pateints were extubated in the operating room; length of stay in the intencive care unit averaged (33.6±33.0) hours and hospital stay (9±3) days; 24 patients (70.6%) avoided transfusion require-ment. Conclusion Our findings indicate that in high-risk patients with multivessel CAD, the "one-stop" hybrid procedure by performing MIDCAB and PCI simultaneously is a feasible and safe alternative.

Objective To study the epidemiological characteristics of the hip fractures of the inpatients so as to provide a scientific basis for strategic study on the prevention and treatment of the hip fractures. Methods The study involved 448 patients (217 males and 231 females) with hip fractures admitted to the Southwest Hospital of Third Military Medical University from January 2004 to December 2009. The characteristics, injury time and causes, fracture types and treatment approaches were collected and reviewed retrospectively. SPSS 13.0 software was used for statistical analysis. Results There were significant differences in distribution of the hip fractures in terms of age, cause, gender and treatment approach (P ＜ 0.05 ). Patients with age ≥60 years accounted for 68.8%. Slip was the leading cause of the hip fracture ( 69.6% ). As for gender distribution, femoral neck fractures usually occurred in the females while intertrochanteric hip fractures in the males. Surgery was the predominant management approaches,accounting for 83.1%. Conclusion The distribution of the hip fractures of the inpatients has unique characteristics in aspects of individual character, injury cause injury site and treatment approach, which is worthy of further strategic study on prevention and treatment of the hip fractures.