Objective To understand the related knowledge awareness rate of multi-drug resistant organisms (MDRO) infection and the implementation situation of prevention and isolation system in the medical staffs of our hospital .Methods The self -made questionnaire and on-the-spot investigation were adopted to understand the relevant knowledge and awareness of prevention and segregation of MDRO infection among medical staffs and patients in our hospital .Results The related knowledge awareness rate of MDRO in the doctor group was significantly higher than that in the nursing group ,the awareness rate in the patients and family members was very low .There was great difference in compliance to prevent isolation measures between doctors and nurses .Conclu-sion Strengthening the training of nurses ,strengthening the health education to patients and their families ,reinforcing the respon-sibility of hospital infection control group and implementing the detail management are the effective pathway for increasing the pre-vention and segregation of MDRO .

Objective To explore of the color Doppler ultrasound diagnosed choledocholithiasis.Methods 100 cases with choledocholithiasis diagnosed by color ultrasonography and cholangiography were analysed retrospectively.The sensitivity,specificity,accuracy and the inspection time of two methods were compared.Results 90 cases were diagnosed after operation,90％ in 100 patients.The diagnostic accuracy of Doppler ultrasound was 88 cases,2 false negative cases,no false positive.The diagnostic accuracy of cholangiography was 87 cases,3 false negative cases,2 false positive cases.The sensitivity,specificity and accuracy of two groups were not statistically significant (x2 =0.23,1.25,0.57,P ＞ 0.05).The inspection time of color ultrasound was 12 ～ 28 min,the average inspection time was (16.57 ±4.12)min.The inspection time of cholangiography was 12 ～37min,the average inspection time was (21.09 ± 6.24) min.The inspection times of two ways were statistically significant (t =6.53,P ＜ 0.05).Followed up between 5 months and 2 years,there was no residual gallstone patients.Conclusion Color Doppler ultrasound is a noninvasive,safe,time-saving,simple,good repeatability,high successful rate,for common bile duct stones in the main examination methods.

Objective To analyze the multiple indicators of neonates morbidity to provide reference for treatment and preven‐tion of newborns and improve the neonatal birth and survival quality .Methods Totally 3 542 neonates delivered in the obstetric de‐partment of our hospital from January 1 ,2013 to December 31 ,2014 were investigated .The multiple item data included the birth in‐formation ,clinical manifestations ,treatment and prognosis ,and so on .The data were analyzed by the SPSS17 .0 software ,the χ2 test was adopted to conduct the comparison ,P<0 .05 was considered as statistically significant difference .Results The top three neo‐natal diseases with highest incidence were neonatal pathologic jaundice (11 .06% ) ,neonatal pneumonia (10 .43% ) ,and premature (8 .13% ) .Conclusion It should be to strengthen the health care during pregnancy and neonatal monitoring ,reduce the infection in‐cidence ,find out the causes leading bilirubin increase ,actively conduct the symptomatic treatment ,prevent and treat premature de‐livery and improve the survival rate and survival quality of premature infants .

Objective To assess the effectiveness of carotid endarterectomy(CEA) in the surgical treatment of stenosis of carotid artery.Methods From December 2003 to June 2006,28 patients of carotid arteriosclerotic stenosis received CEA and vascular repair or plasty(VP).Before and after operation,the hemodynamic parameters including inner diameter of internal carotid canal,blood flow rate,blood flow and blood flow rate of middle cerebral artery of 28 patients were measured by color Doppler flow imaging(CDFI) and transcranial Doppler(TCD).Results The inner diameter of internal carotid canal in all patients recovered to normal range.Blood flow rate and blood flow after operation were improved.No postoperative complications occurred,and no aneurysms formed.Conclusion CEA is one of the effective ways to manage carotid stenosis and angioplasty can improve the long-term efficiency.

ObjectiveTo explore the effects of hemofiltration on serum enzyme (SE),endotoxin (ET) and malonaldehyde (MDA) of dogs with heat stroke caused shock.MethodsSixteen healthy male hybrid dogs were randomly divided into 2 groups,8 for each:as heat stroke group (HS group ) and hemofiltration group (HF group).Severe heat stroke model was induced with high temperature.The dogs were taken out of the heating cabin when it reached heat stroke level,and then observed under normal temperature without treatment.The dogs in HF group was immediately treated with hemofiltration.The changes of SE,ET,MDA of two groups of dogs were observed and the survival time between two groups was compared,ResultsThe time from heat exposure to shock was ( 107.00 ± 28.52 ) and ( 111.38 ± 22.24 )minutes in HS group and HF group respectively ( t =- 0.354,P =0.729 ).The SE ( CK,LDH,ALT,AST) of the dogs were all higher after heat stroke,and the dogs of two groups showed no siginificant difference (P ＞ 0.05).At three hours after heat stroke,the SE increased apparently in HS group and HF group,but the level was significantly lower in HF group. Before heat stroke,the serum ET showed no siginificant difference between two groups ( P ＞ 0.05 ).After heat stroke,the serm ET was much higher than before ( P ＜0.01 ),but there was still no siginificant difference between two groups ( P ＞0.05 ).At three hours after heat stroke,the ET increased both in HF group and HS group,but the level was lower in HF group.Before heat stroke,the serm MDA had no siginificant difference between two groups ( P ＞ 0.05 ).After heat stroke,the serm MDA was much higher than before ( P ＜ 0.0l ),but there was still no siginificant difference between two groups (P ＞ 0.05 ).After heat stroke in three hours,the MDA of HS group rose apparently while HF group slowly declined.The median survival time of HF group was 180 min while HS group was 75 min,the survival rate showed siginificant difference (P ＜ 0.01 ).Conc4usions HF can improve the prognosis of dogs with heat stroke caused shock,prolong its survival time,reduce mortality.The mechanism is probably that HF clear serum MDA,partially clear serum ET and then eventually reduce cell and tissue injury and reduce SE.

OBJECTIVETo investigate the efficacy and side effects of the consecutive chemotherapeutic protocol, Tongji-96, for adult patients with Philadelphia chromosome negative acute lymphoblastic leukemia (Ph-aALL).

METHODSA retrospective analysis was conducted on 95 cases of Ph-aALL patients treated between January 2004 and December 2012 with Tongji-96 regimen in Tongji hospital, Shanghai.

RESULTSAmong these 95 patients, the overall complete remission (CR) rate was 92.6%, 7-year overall survival (OS) and event-free survival (EFS) rates were (39.3±5.9)% and (31.5±5.3)%, respectively, with the median survival of 28 months. Based on multivariable COX proportional hazards regression model analysis, patients with the poor karyotype and failed to achieve CR after first course induction therapy had a higher risk of mortality compared to those who had good or normal cytogenetics and achieved CR after 1 course of induction treatment [the risk ratios (RR) were 3.380 (95% CI 1.530-7.463, P=0.003) and 3.005 (95% CI 1.522-5.933, P=0.002)，respectively]. By means of Kaplan-Meier analysis and Log-rank test，patients aged less than 60 years and successively achieved CR after first induction therapy had more favorable 7-year OS and EFS rates. Patients with normal karyotype and hyperdiploidy had significantly higher 2-year OS and EFS rates compared with those with complex karyotype, t(4;11) translocation and other karyotypes.

CONCLUSIONAge (60 years as the cut-off)，treatment courses for achieving CR and cytogenetics were predictive factors for the prognosis of Ph-aALL from this retrospective study. As a comprehensive and sequential therapy protocol, Tongji-96 regimen was proved to obtain long-term survival, reduce risks for relapse and improve outcomes for part Ph-aALL patients.

Adult ; Antineoplastic Combined Chemotherapy Protocols ; Chromosome Aberrations ; Disease-Free Survival ; Humans ; Kaplan-Meier Estimate ; Karyotyping ; Philadelphia Chromosome ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Prognosis ; Recurrence ; Remission Induction ; Retrospective Studies ; Translocation, Genetic

Malfunction of the ventral subiculum (vSub), the main subregion controlling the output connections from the hippocampus, is associated with major depressive disorder (MDD). Although the vSub receives cholinergic innervation from the medial septum and diagonal band of Broca (MSDB), whether and how the MSDB-to-vSub cholinergic circuit is involved in MDD is elusive. Here, we found that chronic unpredictable mild stress (CUMS) induced depression-like behaviors with hyperactivation of vSub neurons, measured by c-fos staining and whole-cell patch-clamp recording. By retrograde and anterograde tracing, we confirmed the dense MSDB cholinergic innervation of the vSub. In addition, transient restraint stress in CUMS increased the level of ACh in the vSub. Furthermore, chemogenetic stimulation of this MSDB-vSub innervation in ChAT-Cre mice induced hyperactivation of vSub pyramidal neurons along with depression-like behaviors; and local infusion of atropine, a muscarinic receptor antagonist, into the vSub attenuated the depression-like behaviors induced by chemogenetic stimulation of this pathway and CUMS. Together, these findings suggest that activating the MSDB-vSub cholinergic pathway induces hyperactivation of vSub pyramidal neurons and depression-like behaviors, revealing a novel circuit underlying vSub pyramidal neuronal hyperactivation and its associated depression.
Rats ; Mice ; Animals ; Rats, Sprague-Dawley ; Depressive Disorder, Major/metabolism* ; Basal Forebrain ; Depression ; Hippocampus/metabolism* ; Cholinergic Agents