Objective To study common Gram negative bacterial pathogens and their drug resistant pattern in sputum isolates from patients in pediatric intensive care unit (PICU) of Chengdu children' s hospital. Methods Comparing to the period of 2004-2006 with 2007-2009, we retrospectively reviewed eligible sputum isolates of common Gram negative bacilli and their drug resistance pattern. All specimens were processed according to standard microbiological methods for both quantitative and qualitative cultures. Pathogen was the single predominant growth after two consecutive cultures. Strict quality control was used in all test agents and paper disk for drug resistance analysis. Results Total of 598 Gram negative bacterial isolates were identified in patients over 6 years. The first 5 bacteria respectively were Escherichia coli 167 samples(27.93%), Klebsiella pneumoniae 109 samples ( 18.23% ), Enterobacter cloacae 93 samples ( 15.55% ),Acinetobacter baumannii 64 samples ( 10. 7% ), Pseudomonas aeroginosa 43 samples (7. 19% ). They were mostly sensitive to Imipenam, Amikacin, Piperacillin/Tazobactam. Most drug resistance rate was found in Amoxicillin, Ampicillin, Cephalosporin. Apart from Pseudomonas aeroginosa and Acinetobacter Baumannii,no Gram negative bacteria was found to be resistant to Imipenam. Klebsiella pneumoniae and ESBL secreting Escherichia coli isolates were obviously increasing when compared to 3 years ago. Conclusion Comparing the period of 2004-2006, the Gram negative bacterial isolates were increasing in our PICU patients during 2007 to 2009. Close monitoring of drug resistance pattern changes in PICU would guide rational use of antibiotics in these critically ill children.

Objective To observe the therapeutic effect of Yingqiling for Graves disease(GD)and to explore its therapeutic mechanism.Methods Eighty GD patients were equally randomized into two groups.The treatment group received oral use of Yingqiling Tablets(mainly composed of Radix Pseudostellafiae,Radix Astragali,Radix Ophiopogonis,Fructus Schisandrae Chinensis,Spica Prunellae,Semen Ziziphi Spinosae,Concha Ostreae, Bulbus Fritillariae Thunbergii,Radix Ranunculi Ternati,Radix Scrophulariae,Radix Paeoniae Rubra and Thiamazole 1 mg),and the control group received Thiamazole Tablets.After treatment for 2 months,the therapeutic effect was evaluated and the changes of serum levels of thyroglobulin antibodies(TGAb),thyroid peroxidase antibody(TPO-Ab),and the apoptosis-associated factors of soluble Fas(sFas)and bcl-2 were observed before and after treatment.Results Twenty-one patients were clinically effective,13 markedly effective,6 effective,0 ineffective,and the total effective rate was 100% in the treatment group;14 patients were clinically effective,13 markedly effective,7 effective,6 ineffective,and the total effective rate was 85.0% in the control group.The effect in the treatment group was superior to the control group(P

Objective To determine the therapeutic effect of insulin glargine plus insulin aspart on perioperative patients with type 2 diabetes.Methods One hundred eighty-seven perioperative patients with type 2 diabetes were treated with insulin pump(CSII group,n=64),multiple subcutaneous insulin injection(MSII group,n=61),and insulin glargine plus insulin aspart injection(G group,n=62).The blood glucose,insulin dose and the incidence rate of hypoglycemia were observed.Results The levels of blood glucose in all groups were reduced after the treatments,and the postoperative level in G group was significantly lower than that in MSII group(P0.05).Conclusion Insulin glargine can rapidly and stably control blood glucose in perioperative patients with type 2 diabetes.

Objective To overcome the disadvantages of the traditional auscultating method and design the electro-auscultating visual system integrating the monitoring and recording functions.Methods The portable system consisted of the module pre-gathering and electro-auscultating heart-sound signal,the circuit of A/D converting and MCU,as well as the device of signal LCD-displaying in real-time and the USB mass storage device.Results Portable electro-auscultating system was realized,which integrated the functions of watching,monitoring and recording.Conclusion The portable system is more convenient for clinical doctors to get correct information from patients,benefiting to the clinical pathology-statistics and profound development of the related data.

Objective To evaluate the effect of continuous blood purification (CBP) on cardiorenal syndrome (CRS) type Ⅰ.Methods Clinical data of 42 patients with CRS type [at our hospital were collected from January 2012 to June 2014.We observed and compared changes in mean arterial pressure (MAP),heart rate,respiration rate,acute physiology and chronic health evaluation (APACHE) Ⅱ score,and urinary volume before and 5 days after CBP.Meanwhile,levels of serum creatinine (Scr),cysteine proteinase inhibitor Cystatin C (CysC),serum creatinine (cTn) and B-type natriuretic peptid (BNP) were monitored.In addition,dynamic changes in cardiac index (CI),intrathoracic blood volume index (ITBI),global end-diastolic volume index (GEDI),central venous pressure (CVP),and extravascular lung water index (ELVWI) were monitored using the pulse induced contour cardic output plus monitoring system (PiCCO plus),and changes in left ventricular ejection fraction (LVEF) before and 5 days after CBP was measured by color Doppler ultrasound.Results There was no significant difference in MAP in patients with CRS type Ⅰ before and 5 days after CBP (P=0.08).Tacbycardia and tachypnea improved,while urine volume increased and the APACHE Ⅱ score decreased significantly,5 days after CBP(allP＜0.05).Plasma levels of Scr,CysC,cTn and BNP after treatment were lower than those before treatment [(126.8±68.3) μmol/L vs.(413.6±126.1) μmol/L,(1.1±0.8) g/L vs.(4.1±1.1) g/L,(2.6±0.4) μg/L vs.(3.5± 0.7) μg/L,(807.6±427.7) ng/L vs.(3300.3±567.6) ng/L,all P＜0.05)].Myocardial contractility,cardiac preload and lung related parameters also significantly improved after CBP (allP ＜0.05).Conclusions CBP can alleviate clinical symptoms of CRS type Ⅰ,improve cardiac and renal function,and is promising as an important auxiliary measure for the treatment of patients with cardiorenal syndrome type Ⅰ.

Tutorial system for undergraduate students is an education administer pattern which can afford the individuation guidance to their study,life and ideal and cultivate their innovative ability,construct individual course system and information composition so as to decrease the blindness in their course selection and study.Actualizing tutorial system for undergraduate students in medical junior college not only has the advantage of general senior education and but also accords with the feature and development advantage of medical junior college.

Objective To investigate expression of inducible nitric oxide synthase (iNOS) and production of nitric oxide(NO) in cultured vascular smooth muscle cells(SMCs)from human abdominal aortic aneurysm(AAA). Methods TypeⅠ collagenase enzyme digestion method was used to culture AAA SMC . Cell proliferation curves for AAA SMC proliferation ability were evaluated,? smooth muscle actin (? SMA) , iNOS protein expression of AAA SMC and nitrite and nitrate (NO 2 -+NO 3 -,NO X ) in cultured media were measured. Results AAA SMCs had a limited proliferation ability, with 45%?5 8% positive rate of ? SMA and 86 7%?4 6% of iNOS protein expression. High concentration of NO X existed in the cultured media. Conclusion AAA SMCs present abnormal but limited proliferation and changed phenotype; The expression of iNOS and high production of NO of AAA SMCs may play an important role in AAA pathogenesis.

AIM:We examined the efficacy ofanti-L3T4 McAb in the T cell signaling pathway in treating ex-Derimental antoimmune cardiomyopathy in BALB/c mice,as a model of the autoimmune mechanism involved in human di-latedardiomyopathy(DCM).METHODS:ADP/ATP carrier peptides were used to induce autoimmune cardiomyopathy in BALB/c mice.Afier 3 months.anti-L3T4 McAb WaS administered to deplete CD4+ T ceHs in the mice.Real-time PCR were used to detect the expression of intracellular signaling molecules(p561ck,p59fyn and Zap-70)and cytokine production(IFN-r,IL-2 and IL-4)in T cells.The expression of CIM5 was determined by immunohistochemistry a-nalysis.RESULTS:Reduced expression of p561ck,p59fyn and Zap-70 and the reduced cytokine production of IFN-r, IL-2 and IL-4 in T cells of anti-IJ3T4-treated DCM mice were found.Also,the expression of CD45 in spleen T cells was significantiv decreased in the anti-L3T4-treated group.In contrast,immunization with irrelevant Ab did not protect the mice.the expression of T cell signaling molecules,CD45,and cytokine were not inhibited.CONCLUSION:Thesestudies provide direct evidenee that anti-L3T4 McAb can be all effective immunomodulator to T cell signal molecules and 8ubsequent cytokine production events in ADP/ATP carrier-induced DCM in BALB/c mice.

Objective To investigate the effect of TIMP-2 gene that was transfected by adenovirus on extracellular matrix of abdominal aortic through assessing the changes of morphology and histopathology of the rat models with abdominal aortic aneurysm. Methods The rat models with abdominal aortic aneurysm were constructed by intraluminally perfusing porcine pancreatic elastase. Twenty-four SD rats with aneurysm were then randomly divided into 3 groups: AdTIMP-2 group (perfused locally with solution of TIMP-2 gene transfected by adenovirus vector to abdominal aorta), AdCMV group (transfected by non-viral vector), and PBS group. After 14 days, the concentrations of elastin and collagen that were collected from the samples of aortic wall were measured by image analysis system and the fixed aortic tissues were examined by light microscopy and some other specific staining methods. Results None of abdominal aortic aneurysm developed in TIMP-2 gene transfected group, with significantly higher rates of developed aneurysm in the other groups (P