Ventilator-associated pneumonia (VAP) is a common hospital acquired infection in neonatal intensive care unit with high incidence in China. There is no diagnostic gold standard of VAP. The risk factors include premature birth, low birth weight, dura-tion of mechanical ventilation, episodes of intubation, blood stream infections. The recommended precautions include rising head of bed, closed tracheal suction, sucralfate, selective decontamination in digestive tract, improvement of mechanical ventilation, oral and skin care, hand hygiene. However, it is controversial that sucralfate, selective decontamination in digestive tract, passive humidifiers, oral and skin care can reduce the incidence of VAP.

Objective: To establish an experimental autoimmune encephalomyelitis (EAE) model in C57BL/6 mice, providing a basis for studying the immunopathological mechanism and experimental therapy of multiple sclerosis. Methods: Twenty-five C57BL/6 mice were immunized with both 300μg MOG35-55 in complete Freund's adjuvant (CFA) and 109/ml Bordetella pertussis vaccine (BPV) to establish EAE model. Mice in adjuvant group (n=8) were treated with CFA, BPV and normal saline; mice in control group (n=7) were treated with normal saline. The pathologic changes of the central nervous system were studied by H-E staining and Luxol Fast Blue (LFB) staining. Results: The clinic symptoms of EAE were present in 22 mice in model group since the 11th day post-immunization, with the incidence being 88%. There was no evident EAE symptom in CFA group and control group. Light microscopy showed there were abundant inflammatory cells infiltrated in the cerebral and spinal cord tissues in EAE mice, with evident demyelination in white matter. Conclusion: This method is easy to be carried out; the model established by it is stable and worth popularizing.

Diagnostic Errors ; Female ; Humans ; Infant, Newborn ; Inhalation ; Male ; Organophosphate Poisoning ; Poisoning ; diagnosis

Objective To investigate the effect of clinical pathway implementation in the preoperative preparation of autologous blood stem cell transplantation. Methods 30 patients who would received autologous blood stem cell transplantation were divided into clinical pathway group and traditional group, each group had 15 cases. Patients in clinical pathway group were given clinical pathway, and traditional group were given the traditional method of preoperative preparation. Hospital stay, hospital charge, management of health knowledge, satisfaction rate, depressed and anxious were compared. Results Hospital charge in clinical pathway group was (100972 ±261 ) yuan,and (126374±306) yuan in traditional group,there was statistically different(t =4. 48,P ＜0. 05). In clinical pathway group about 93.3％ patients manage the health knowledge well, and the satisfaction rate was 86. 6％ ,both were higher than in traditional group 46.6％ ,33.3％ (x2 =9.3,8.7;P ＜0. 05) ; preparation time and the incidence of complication were lower in clinical pathway group ( P ＜ 0. 05 ). Conclusions The clinical pathway provides more effective guidance, it can improve patients' satisfaction, shorten preoperative preparation time, save hospitalization charge, reduce complications and improve the quality of care.

For screening the potential drugs as anti-liver fibrosis candidates, we established a high- throughput drug screening cell model based on COL1A1 promoter. The activity of COL1A1 promoter and luciferase reporter gene can be elevated by TGF-β1, and inhibited by candidate drugs. We constructed a recombined plasmid with COL1A1 promoter and luciferase reporter gene pGL4.17, the activity of COL1A1 promoter was reflected by fluorescence intensity. COL1A1 promoter activity was detected by Dual-Luciferase Reporter Assay System, it came that the relative luciferase activity of COL1A1 promoter was 15.98 times higher than that of control group induced by TGF-β1, showing the recombined plasmid could be used in cell model. The recombined plasmid was transfected into human hepatic stellate cells LX2, detected the effect of potential drugs, and obtained a stable expression system through stable transfection and monoclonal cell culture. A sample which could reduce COL1A1 promoter activity signally by our cell model, decreased collagen I mRNA and protein expression detected by real-time RT-PCR and Western blotting. It indicates this novel cell model can be used in high-throughput drug screening of potential anti-liver fibrosis drugs.
Collagen Type I ; genetics ; Drug Evaluation, Preclinical ; methods ; Genes, Reporter ; Hepatic Stellate Cells ; High-Throughput Screening Assays ; Humans ; Liver Cirrhosis ; drug therapy ; Luciferases ; Plasmids ; Promoter Regions, Genetic ; RNA, Messenger ; Transfection ; Transforming Growth Factor beta1 ; pharmacology

ObjectiveTo evaluate the clinical efficacy of cutaneous branches of reverse second and third dorsal metacarpal artery fasciocutaneous flaps for repair of distal- and middle-segment finger soft tissue defects. MethodsA total of 14 patients with distal- and middle-segment finger soft tissue defects complicated by exposure of the phalanx or tendon were repaired by using cutaneous branches of second and third dorsal metacarpal artery fasciocutaneous flaps ranging between 2.0 cm × 4.5 cm and 3.0 cm × 7.0 cm.ResuitsAll of the skin flaps survived after surgery.Follow-up data during a 6-40 month period showed that the flaps exhibited a satisfactory appearance.They were not fat or clumsy,with a 2-point discrimination of 59 mm,and there was good recovery of finger function.The donor site was able to be directly sutured without dermoplasty.Pigmented linear surgical streaks appeared in the donor site.Conclusion The cutaneous branches of Second and third dorsal metacarpal artery fasciocutaneous flaps provide a good approach for the repair of distal- and middle-segment finger soft tissue defects and functional reconstruction because of convenient dissection,little trauma,sufficient use of the dorsal metacarpal artery.

Objective To evaluate the effect of staged repair for tetralogy of Fallot (TOF) associated with pulmonary artery hy- poplasty.Methods From June 1996 to June 2006,37 patients with TOF were operated on.There were 26 males and 11 females. Their age was 5 months to 17 years(mean 3.6 years) and weight was 4.6～38.0 kg.All patients were diagnosed as TOF with pulmo- nary artery hypoplasty by cardiac catheterization.The mean pre-operative arterial saturation of the patients was (68.2?6.5) %,Mc- Coon ratio was 0.95?0.26 (0.81～1.17) and Nakata index was 82.7?21.6(71.6～97.5) mm~3/m~2.At the time of the first surgi- cal procedure,17 patients underwent central aortopulmonary shunt,13 patients received modified Blalock-Taussig shunt in the left side and 7 patients had modified Blalock-Taussig shunt in the right side.Results There were no easly operative deaths and no late deaths after the first stage repair.Pleural effusion after shunt occurred in 5 patients.The mean arterial saturation was significantly increased to (91.3?10.4) %,P

Objective To explore the status of infection, biotype and resistant background of epi-demic strains of Haemophilus influenza ( Hi ) in neonates, and the clinical features of neonatal pneumonia caused by Hi. Methods The multicenter prospective epidemiological cross-sectional design was used; four hospitals in west Sichuan China were chosen as research field,sputum bacterial culture was done and biologi-cal typing,PCR identification and drug sensitivity test of Hi epidemic strains were carried out among 0 to 28 days hospitalized neonates with infectious pneumonia in four hospitals located in west Sichuan China. The ca-ses with discharge diagnosis of neonatal infectious pneumonia with Hi positive separation were assumed as case group,and the same number of cases with Hi negative separation were assumed as control group accord-ing to 1∶1 extraction at the same time. Results Totally 757 cases with admitting diagnosis of neonatal infec-tious pneumonia in four hospitals were investigated in west Sichuan from November 2014 to October 2015, and the rate of sputum culture was 95. 51%(723/757). The total pathogenic bacteria positive rate of sputum culture was 15. 63%(113/723),and Hi positive rate was 1. 94%(14/723),Hi accounting for 12. 39%(14/113) of the pathogenic bacteria in respiratory system. All the Hi strains(100%) were non-typeable Hae-mophilus influenzae( NTHi) indentified by PCR. The main biotypes of 14 Hi strains were typeⅠwith 57. 1%(8/14),type Ⅲ with 14. 3%(2/14) and type Ⅳ with 28. 6%(4/14). The total of 35. 7%(5/14) bacterial strains of β-lactamase distributed in four hospitals,7. 1%(1/14) bacterial strains of β-lactamase-nonproduc-ing-ampicillin-resistant,and 35. 7%(5/14) bacterial strains of β-lactamase-positive-ampicillin-resistant were found in four hospitals. The rate of resistance and mediation to cefuroxime were 14. 2%(2/14) respectively, the resistance rate to cefaclor was 35. 7%( 5/14 ) , and 21. 4%( 3/14 ) to ofloxacin. None of the 14 strains was resistant to amoxicillin clavulanic acid and cefotaxime. The 1∶1 matching analysis had been done for 10 cases with discharge diagnosis of neonatal pneumonia caused by Hi. There were no statistical differences in general conditions,main symptoms, lung signs, X-ray appearance, classification of leukocyte and C-reactive protein levels between case group and control group(P>0. 05). Conclusion All the Hi isolated from spu-tum were NTHi among 0 to 28 days inpatients with neonatal pneumonia and the main biotype were typeⅠ, type Ⅲand typeⅣin west Sichuan China. There were no significant differences in the clinical manifestations of neonatal pneumonia with NTHi infection and other infectious pneumonia.

This paper describes a type of blood pressure monitor we have developed using 8031 chip microprocessor based on oscillometric method and the designs of hardware and software. Comparing the measurement results of oscillometric method with that of direct invasive measurement method, we find that the monitor is very useful in clinical applications. Finally in the paper, some improvements that can be made in the monitor are proposed.
Algorithms ; Blood Pressure Monitoring, Ambulatory ; instrumentation ; Equipment Design ; Humans ; Microcomputers ; Oscillometry ; Software Design

OBJECTIVETo study the protective effect of hyperoxia solution on acute lung injury caused by phosgene poisoning by observing the changes of PaO2 and malondialdehyde (MDA) contents, superoxide dismutase (SOD) activity in serum and Glutathione (GSH/GSSG) contents in lung tissues.

METHODSThe rabbits were divided into normal control group, hyperoxia solution (H0) and balance salt (BS) groups. Group HO and Group BS inhaled phosgene and the former was given intravenously hyperoxia solution (which was replaced by balance salt solution in Group BS). The content of MDA and the activity of SOD in serum were observed at different time points, the amount of GSH and GSSG in lung tissue were also measured.

RESULTS(1) The serum MDA contents increased and PaO2, SOD activity decreased significantly in Group HO and Group BS along with time increasing as compared with control group. The contents of GSH in lung tissue decreased in two groups compared with that in control group, however the contents of GSSG ascended instead. (2) At 3 and 8 h of the experiment, PaO2 of Group HO [(9.91 +/- 0.49), (9.15 +/- 0.46) mm Hg respectively] were significantly higher than those of Group BS [(9.03 +/- 0.76), (8.11 +/- 0.57) mm Hg respectively] (P < 0.01). The contents of MDA of Group HO (3.66 +/- 0.35), (5.31 +/- 0.15) micromol/L respectively] were lower than those of Group BS [(4.32 +/- 0.26), (7.4 +/- 0.33) micromol/L respectively] (P < 0.01). SOD activity in Group HO [(237.37 +/- 29.96), (208.10 +/- 18.80) NU/ml respectively] were higher than those of Group BS [(195.02 +/- 21.44), (144.87 +/- 21.26) NU/ml respectively] (P < 0.05 or P < 0.01). The content of GSSG lung tissue in Group HO (423.67 +/- 38.21) micromol/L were lower than those of Group BS (523.85 +/- 43.14) mol/L (P < 0.01). There were no significant differences in the content of GSH in lung tissues between Group HO and group BS.

CONCLUSIONHyperoxia solution can reduce acute lung injury of rabbits following phosgene poisoning.

Acute Lung Injury ; etiology ; metabolism ; pathology ; Animals ; Glutathione Peroxidase ; metabolism ; Hyperoxia ; Lung ; drug effects ; metabolism ; pathology ; Malondialdehyde ; analysis ; Oxygen ; administration & dosage ; pharmacology ; Phosgene ; poisoning ; Rabbits ; Superoxide Dismutase ; metabolism