Objective To explore the risk factors and control strategies of nosocomial infection in intensive care patients in the neurological department of internal medicine.Methods 422 intensive care patients in the neuro-logical department of internal medicine were retrospectively analyzed.Results The incidence rate of neurology ICU infection was 24.41%,which was significantly higher than 4.54%of the same period of nosocomial infection rate,the difference was statistically significant(χ2 =10.36,P<0.05).In the intensive care unit of the nervous system,the respiratory infection was mainly caused by respiratory infection,the incidence rate was 57.28%,urinary system was 25.24%,and digestive system was 9.71%.Neural medical intensive care unit patients aged 60 years old,time was more than or equal to 14 days in hospital,impaired consciousness,invasive procedures,use of antibiotics and a history of diabetes mellitus in hospital infection incidence increased significantly,and the differences were statistically signifi-cant(χ2 =7.65,10.76,16.87,9.43,9.25,9.87,all P<0.05).Conclusion Older patients,hospitalized time lon-ger,impaired consciousness,invasive procedures,antibiotic treatment and a history of diabetes mellitus were neural medical intensive care unit patients occurred nosocomial infection risk factors,clinical should strengthen nursing,to improve the work of prevention and monitoring to minimize nosocomial infection.

ObjectiveTo evaluate morphometric changes of brain in patients with alcohol addiction by voxel-based morphometry. MethodsFifteen patients with alcohol addiction and 15 health controls were recruited and underwent fluid attenuated inversion recovery (FLAIR) and 3D fast spoiled gradient echo (FSPGR) T1 -weighted sequences on a 3.0 T MRI system. 3D FSPGR T1 structure images were normalized,segmented and smoothed, and then underwent voxel-based morphometry. An ANCOVA was applied with age,body mass index ( BMI ), and education years as covariates because of exact sex match.A statistical threshold of P ＜ 0. 01 (uncorrected) and more than continuous 50 voxels were determined as significant.ResultsRegional results showed there was a significant reduction of gray matter volume in left middle frontal gyrus, superior frontal gyrus, precuneus, gyrus rectus, right medial superior frontal gyrus and orbital gyrus in patients with alcohol addiction compared with health controls, and the regional reduction of white matter volume in patients with alcohol addiction mainly located in the white matter of bilateral superior frontal gyrus. Global brain volume analysis showed there was a significant smaller volume in white matter [ (675. 14 ± 70. 62) ml]and brain parenchyma [ ( 1578. 81 ± 199. 05 ) ml]for patient group than that in white matter [ ( 841.33 :± 177. 35 ) ml]and brain parenchyma [ ( 1722. 13 ± 117.62) ml]for control group (t ＝ 11.37,5. 764, respectively, P ＜0. 05 ), but there was no difference in the gray matter volume between patient group [(903.67 ±1±9.87) ml]and control group [(880.79 ±1±7.10) ml](t ＝0.177, P＞0. 05 ). ConclusionsRegional gray and white matter atrophy can be the initial changes in patients with alcohol addiction and the frontal region is a relative specific damaged brain region.VBM has a potential value for the detection of subtle brain atrophy in patients with alcohol addiction.

OBJECTIVE:To establish the quality standard of Flemingia philippinensis. METHODS:The properties and micro-scopic characteristics were observed;TLC was adopted for qualitative identification of genistin and genistein;the moisture,total ash and extract were detected;HPLC was adopted for contents determination of genistin and genistein:the column was Thermo BE-TASIL C18 with mobile phase of Acetonitrile-0.5% glacial acetic acid(gradient elution)at a flow rate of 1.0 ml/min,the detection wavelength was 261 nm,column temperature was 25℃,and the injection volume was 10μl. RESULTS:The properties and micro-scopic characteristics of F. philippinensis and F. macrophylla showed strong specificity. TLC spots of genistin and genistein we- re clear and well separated,with no interference in negative control. The moisture was 3.69%-8.37%,total ash was 1.72%-6.74%,and extract was 5.89%-19.65%. The linear range was 0.012 9-2.588 μg for genistin(r=0.999 9)and 0.004 6-0.923 2 μg for genistein (r=0.999 9);RSDs of precision,stability and reproducibility tests were lower than 3.0%;recoveries were 99.63%-101.87%(RSD=0.82%,n=6)and 97.19%-100.34%(RSD=1.23%,n=6). CONCLUSIONS:The method is simple,accurate and specif-ic,and can be used for the quality control of F. philippinensis.

Objective To evaluate early occult brain damage by diffusion tensor imaging in patients with type Ⅱ diabetes mellitus.Methods High resolution three-dimensional T1-weighted fast spoiled gradient recalled echo MRI images and diffusion tensor imaging were obtained from 16 patients with type Ⅱ diabetes mellitus (T2DM) and 16 normal controls (NC).Average apparent diffusion coefficient (ADC) map and fractional anisotropy (FA) map were calculated and analyzed with voxel-based analysis.Analysis of covariance was performed to compare ADC and FA between T2DM and NC.Results Increased ADC values of gray matter were demonstrated in right superior temporal gyrus,middle frontal gyrus,anterior cingulate gyrus,middle cingulate gyrus,inferior occipital gyrus,and left lingual gyrus,operculum orbitale,fusiform gyrus and parahippocampal gyrus in T2DM (voxel numbers in clusters were 176-3125,P ＜ 0.01).And increased ADC values of white matter were demonstrated in the regions of right middle temporal lobe,linual lobe,middle frontal lobe,calcarine gyrus,superior parietal lobe,and left operculum orbitale in T2DM patients compared with NC (voxel numbers in clusters were 200-781,P ＜ 0.01).Decreased FA values of gray natter were mainly located in left thalamus,bilateral caudate nuclei and right cuneus in T2DM(voxel numbers in clusters were 210-1402,P ＜0.01).Decreased FA values of white matter were demonstrated in the regions of right cuneus and the body of corpus callosum in T2DM (voxel numbers in clusters were 206,253,P ＜ 0.01).Conclusions The occult brain damage is demonstrated as increased ADC values and decreased FA values in regional brain parenchyma in type Ⅱ diabetes mellitus.Voxel-based analysis of diffusion tensor indices may be a simple and effective tool for the evaluation of occult brain damage in type]][diabetes mellitus.

0\^05). Conclusion MMP\|2 and MMP\|9 may serve as indicators of invasion and malignant phenotype.Neither of them can represent the phenotype of metastasis,but both can represent that of matrix degradation.Moreover,MMP\|9 may play more important role in glioma invasion than does MMP\|2.

Objective: To establish a capillary electrophoresis (CE) with electrophoretically mediated microanalysis (EMMA) method for the determination of EDTA-2Na in Japanese encephalitis attenuated live vaccine.
Methods: The test was performed in disodium hydrogen phosphate buffer with pH 2.5, the online metal ions complexation of 1.5 mg·mL^-1 Fe³⁺ and incubation time of 3 min. The separation voltage was 25 kV, the detection wavelength was 257 nm, and. the column temperature was 25.0 ℃.
Results: The established method had a good linear relationship in the concentration range of 0.01-0.5 mg·mL^-1 (r=0.999 9), the detection limit was 5 μg·mL^-1, and the relative standard deviation (RSD) of the measured samples was less than 2.87%. The recoveries of spiked samples were between 96.49%-101.02%.
Conclusion:The optimized method was applied to the determination of EDTA-2Na in Japanese encephalitis attenuated live vaccine. The satisfactory experimental results were obtained.

Objective To describe an intelligent three-dimensional technique for automatic visualization of the fetal cranial mid-sagittal view to allow for the differential diagnosis of fetal midline anomalies.Methods Two hundred and twenty pregnant women with singleton pregnancies were imaged to display the mid-sagittal view of fetal head using a new 3D program (Smart MSP) developed by our team.Results The mid-sagittal view of the fetal head was successfully visualized in 190 normal cases (95％) and 18 abnormal cases (90％) by Smart MSP program.The total successful rate was 94.5％ (208/220).Conclusions Smart MSP is a novel and feasible method for the automatic visualization of fetal cranial midsagittal plane and may become a potential tool for routinely screening the fetal midline anomalies.

This study was aimed to develop HPLC for determination of vitexin and isovitexin inM. dodecandrum. The HPLC column was SunFireTM C18 (4.6 mm× 150 mm, 5μm). The detection wavelength was 365 nm. The mobile phase was methanol-0.2% formic acid aqueous solution. The column temperature was 40℃. The flow rate was 1.0 mL·min-1. The results showed that the regression equations of vitexin and isovitexin wereY = 1× 106X– 14 396, Y = 1× 106X– 13 900, respectively. The linear ranges were 0.210μg - 1.050μg (r = 0.999) and 0.186μg - 0.930μg (r = 1.000), respectively. The recovery rates were 97.48% and 104.64%, respectively. The RSD were 2.32%and 1.51%, respectively. The sample contents of vitexin and isovitexin were 1.25 and 1.86 mg·g1, respectively. It was concluded that the method was simple, feasible and reproducible for the content determination of vitexin and isovitexin inM. dodecandrum.

OBJECTIVE To investigate the effect of Radix Isatidis and its constituents indigo and in?dirubin on two principal subtypes of organic cation transporters(OCT)OCT1,OCT2 in vivo in mice. METHODS Decoction of Radix Isatidis (DRI) 1.6 and 6.4 g · kg-1,granules of Radix Isatidis (GRI) 0.615 and 2.460 g·kg-1,indigo 0.008 and 0.640 mg·kg-1 and indirubin 0.0192 and 1.536 mg·kg-1 were ig given to NIH mice(60 mice per group),twice a day for 5 d. Four control groups were set up,including the vehicle of water,0.5% sodium carboxymethyl cellulose(CMC),additives of sucrose plus dextrin (1.5 g · kg-1)and positive control quinidine(0.025 g · kg-1). Sixty minutes after the last dosing,all the mice were iv given metformin(Met)5 mg·kg-1,and at 1.0,2.5,5.0,7.5,10.0 and 20.0 min after Met iv,10 mice in each group were sacrificed to collect whole blood and kidneys respectively. The right kidney was homogenized for Met accumulation test and the left one used to extract total RNA for analysis of OCT1 and OCT2 mRNA expressions by real-time PCR. The contents of Met in sera and kidneys were quantified by HPLC. Major pharmacokinetic parameters of Met in sera were analyzed by pharmacokinetic software(DAS 2.0). RESULTS There was no significant difference between water control group,0.5%CMC group and sucrose plus dextrin group in any examined item. Compared with vehicle control group (water and 0.5%CMC group),all the related pharmacokinetic parameters in DRI 6.4 g · kg- 1,GRI 2.46 g · kg-1,indigo 0.640 mg · kg-1 and indirubin 1.536 mg · kg-1 groups were changed significantly (P<0.05,P<0.01). The elimination half time (t1/2β) was prolonged 13%-97%,volume of distribution reduced by 13%-72%,clearance(Cl)reduced by 9%-65%,and the area under the concentration-time curve (AUC0-20 min) increased by 13%-135%. AUC0-20 min obtained from renal Met accumulations was significantly increased(P<0.01)while Met uptake by kidney slices was reduced(P<0.05,P<0.01). The expressions of OCT1 and OCT2 mRNA were obviously down-regulated(P<0.05,P<0.01). CONCLUSION The mouse renal OCT1 and OCT2 are significantly inhibited by DRI,GRI,indigo and indirubin. The inhibitory effect of Radix Isatidis on OCT1 and OCT2 probably arises from indigo and indirubin contained.

Objective To explore the related risk factors of cerebral hemorrhage complicated with stress ulcer (SU). Methods The clinical data of 1 185 patients with cerebral hemorrhage admitted to Department of Emergency Medicine of Nanjing General Hospital from March 2006 to March 2014 were retrospectively analyzed. Patients were divided into two groups according to whether patients complicated with SU or not. Data was collected within 8 hours after admission in two groups including gender,age,amount of bleeding,the bleeding site (basal ganglia,thalamus, brainstem,brain lobe,ventricle,subarachnoid,and cerebellum),disturbance of consciousness,acute physiology and chronic health evaluationⅡ(APACHEⅡ)score,systolic blood pressure(SBP),history of hypertension,and history of cerebral hemorrhage. The statistically significant risk factors found using univariate analysis was selected and was analyzed to find independent risk factors with multivariate logistic regression analysis. The receiver operating characteristic curve (ROC curve)was plotted to analyze the independent risk factors and evaluate their power of test. Results 1 185 patients with cerebral hemorrhage were enrolled in the study,293 cases occurred SU,accounting for 24.7%,and 892 cases without SU,which accounted for 75.3%. As shown by univariate analysis,risk factors for cerebral hemorrhage complicated with SU included age,amount of bleeding,the bleeding site,disturbance of consciousness,APACHEⅡscore,SBP. As to the site of bleeding,brain,thalamus,brainstem hemorrhage complicated with SU were higher proportion,45.3%(43/95),39.1%(63/161),36.9%(48/130),which were significantly higher than those of the lobes of the brain 〔26.2% (33/126)〕,cerebellum 〔18.8% (15/80)〕,basal ganglia〔16.1%(78/485)〕,arachnoid the inferior vena cava 〔12.0% (13/108)〕. Multivariate logistic regression analysis showed that amount of bleeding 〔odds ratio (OR)=3.305,P=0.001,95%confidence interval (95%CI)2.213-48.634〕,the bleeding site (OR=1.762,P=0.008,95%CI 0.123-2.743),SBP (OR=1.223,P=0.034,95%CI 0.245-2.812) were independent risk factors of cerebral hemorrhage complicated with SU. The area under the ROC curve (AUC)of amount of bleeding and SBP were 0.846 and 0.597,suggesting that amount of bleeding has moderate diagnostic value and SBP has low diagnostic value. Conclusions Cerebral hemorrhage patients with large amount of bleeding,the bleeding site in the ventricle,thalamus or brainstem,high SBP are of great risk. We should lower blood pressure and give preventive treatment for SU as soon as possible.