Objective To explore the clinical significance of procalcitonin(PCT)in guiding the optimizing antimi-crobial treatment strategy in ventilator-associated pneumonia(VAP).Methods Sixty patients receiving mechanism ventilation for ≥48 hours in an intensive care unit between November 2011 and April 2013 were randomly divided into control group (n=29)and trail group (n=31),patients in control group stopped antimicrobial use according to guideline,patients in trail group stopped antimicrobial use according to serum procalcitonin level,duration of anti-microbial use and mechanical ventilation between two groups were compared.Results Days of mechanical ventila-tion,length of ICU stay,mortality rates between two groups were not significantly different(all P >0.05);antimi-crobial days in trail group was significantly less than control group([10.70 ±3.78]d vs [13.93 ±3.03 ]d)(t =4.484;P <0.001).Conclusion Serum procalcitonin level plays an important role in the rational use of antimicrobial agents in patient with VAP.

Objective To investigate the effect of protamine(PS)coated polylactic acid(PLA)nanocapsule on the immune response of murine bone marrow-derived dendritic cells(BMDCs).Methods PLA nanocapsules were prepared by W1/O/W2 method.Protamine was used to modify the surface of PLA nanocapsule that encapsulated ovalbumin(OVA),a model anti-gen.The prepared OVA/PLA/PS nanocapsules were used to stimulate BMDCs.Flow cytometry was used to analyze the ex-pression of surface molecules CD80,CD83,CD86,MHCⅠ,and MHC Ⅱ,and the uptake of nanocapsule.The levels of IL-12 p70 secreted by BMDCs were detected by ELISA.Results OVA/PLA/PS nanocapsules could significantly up-regulate the expres-sion of CD80,CD83,MHCⅠ,and MHC Ⅱ in BMDCs,and increase the secretion of IL-12 p70 by BMDCs.Furthermore,OVA/PLA/PS nanocapsules could enhance the uptake efficiency of OVA by BMDCs.Conclusion OVA/PLA/PS nanocapsule can en-hance the immune response of BMDCs,and may become a good drug delivery carrier.

AIM: It has been proved that transforming growth factor-?1 (TGF-?1) has a close correlation with kidney fibrosis. This study investigated the effects of TGF-?1 on stromal cell-derived factor 1 (SDF-1) in rat renal tubular epithelial cells (NRK52E). METHODS: The experiment was carried out in the Division of Molecular Neurobiology, State Key Laboratory of Biotherapy, Sichuan University from March 2006 to May 2007. ①Rat renal tubular epithelial cells (NRK-52E, Monash Medical Center, Australia) were divided into normal control group, which were not treated with TGF-?1 (Cytola), and experimental group, which were subdivided into time-dependent groups: NRK-52E cells were incubated with TGF-?1 at the same concentration (2 ?g/L) for 6, 12, and 24 hours, and dose-dependent groups: NRK-52E cells were treated with TGF-?1 at different concentrations (2, 5, and 10 ?g/L) for 24 hours. ②The semi-quantitative calculation of SDF-1 protein expression in the cells treated with TGF-?1 at the concentration of 2 ?g/L for different time was accessed by immunocytochemistry to find the best time point. Then the variances of the mRNA and protein expression level in cells treated with TGF-?1 at different concentrations for 24 hours were detected by RT-PCR and Western-Blotting. RESULTS: ①The protein expression level of SDF-1 in NRK-52E cells treated with TGF-?1 for 12 and 24 hours was higher than for 0 hour (P 0.05). This indicated the SDF-1 expression reached a flat stage, and 24 hour was the bets time to study the dose dependence. ②Both the mRNA and protein expression level analyses demonstrated that the expression of SDF-1 in NRK-52E cells treated with 2 ?g/L TGF-?1 for 24 hours was significantly higher than that in normal control group (P

[Objective] To investigate the surgical treatments and outcomes of chordomas in the mobile spine.[Methods]A series of 15 cases of chordomas arising from the mobile spine which received surgical treatments were retrospectively reviewed.According to the WBB(Weinstein-Boriani-Biagini)surgical staging system,the tumours mainly occupied the vertebral body areas,ic,4 to 9 radiating zones in 7 cases,expanded outside to 4 or 9 radiating zone in 4 cases,both to 4 and 9 radiating zones in 4 cases.Thirteen of them affected A to D layers,the other 2 affected A to C layers.One vertebra was involved in 9 cases,two vertebrae were involved in 5 cases and 3 vertebrae in 1 case.Vertebrectomies or sagittal resections were performed in 10 cases and total spondylectomies in 5 cases.Four patients underwent posterior approach operations and 3 patients underwent anterior approach operations for spinal reconstruction and stabilization.Eight patients received combined anterior and posterior operations for spinal reconstruction and stabilization.Tricortical autogenions bone grafts,some in titanium mesh,were used for reconstruction in 9 patients.While mesh and bone cement were uesd in 6 patients.Local radiation therapies were performed in all patients after surgeries.[Results]Clinical symptoms and neurologic deficits were relived in all the patients.Fusion of the bone grafts was got in all the 9 cases.The follow-up was 14 to 123 months,average 56.2 months.Local-recurrence could be observed in 7 cases and 4 cases died.No metastasis was seen in this series.[Conclusion]Eearly diagnosis and treatment have great effects on the prognosis of the chordoma arising in mobile spine.Total spondylectomy with postoperative radiation therapy can decline the local-recurrent rate.

[Objective]To evaluate the curative effects of the posterior or anterior lumbar interbody fusion for the treatment of superior position intervertebral disc herniation. [Method] Forty-seven patients with superior position intervertebral disc herniation were followed up.There were 29 males and 18 females with mean age of 53.3 years(from 35 to 67 years).Twewty-five patients were treated with posterior lumbar interbody fusion(PLIF)using facet joint autograft and cage additional of pedicle screw internal fixation(posterior way group),and 22 patients were treated with anterior disckectomy,bone graft and plates internal fixation(anterior way group).The mean follow-up time was 53.5?5 months(from 24 to 78 months).The clinical results were compared between two groups.Clinical functional assessment standard was used to evaluate the clinical curative effect.The changes of the therapeutic effects,the radiographic findings and complications were evaluated.[Result]In regard to the operation time and bleeding,the posterior way group was superior to anterior way group.There was no difference between the two groups in clinical recovery rates and nerve root injury rates.Complications included dural tear(n=3),and pedicle screw deviating(n=1) in the posterior way group;and dural tear(n=2),unilateral transient lower extremity paresthesia(n=3),and hard controlled singultation(n=1) in the anterior way group.The rates of bone fusion were 96.00% and 95.45% in the posterior and anterior way groups. [Conclusion] Operation for the superior position intervertebral disc herniation is effective.The posterior lumbar interbody fusion using facet joint autograft and cage additional of pedicle screw internal fixation to shorten the operation time and decrease bleeding is recommend for the treatment of superior position intervertebral disc herniation.

Objective To detect micronuclei (MN) induced by nickel chloride (NiCl2) using a flow cytometry-based method, so as to study the mutagenecity of this chemical. Methods The micronucleated reticulocytes (MN-RET) in peripheral blood of NIH mice exposed to 0.75 mg/kg colchicines (COL), 40.0 mg/kg of cyclophosphamide (CP) and 5.0, 10.0 and 20.0 mg/kg of NiCl2 were detected by a flow cytometry-based method, in which anti-CD71-FITC and PI were used to stain cells and malaria-infected erythrocytes were employed as biological standards of micronuclei to optimize cytometry. Results Although COL or CP induced significant increase in the frequency of MN-RET in peripheral blood, MN formation in peripheral reticulocytes was not significantly affected by exposing to different concentration of NiCl2. Conclusion The results of flow cytometric analysis in the present paper do not support that NiCl2 exposure may induce significant MN-RET increase in peripheral blood in NIH mice.

Objective　To investigate the role of suramin in inhibiting the angiogenesis of lung cancer. Methods　The protei n expression of VEGF and its receptor fms-like tyrosine kinase(Flt), kinase ins ert domain-containing receptor(KDR) in lung cancer cell A549 and ECV-304 was studied with immunohistochemical technique. The anti-angiogenesis effect of su ramin was evaluated with immunohistochemical technique and cell culture. Results　Suramin showed no effect on the production of lung cancer cel ls and their secretion of VEGF. No possitive expression of Flt, KDR in A549 was found in the suramin interfered group and non-interfered group, but VEGF w as e xpressed in both groups. The Flt and KDR expressions in ECV-304 cells were decr eased significantly after the treatment of suramin at 0.25 ng/ml and 2.5 ng/ml r espectively. There was no effect on proliferetion of A549 and ECV-304 after sur amin in terference. Conclusion　The mechanism of inhibiting-angiogenes is of suramin is pro bably due to reducing the VEGF receptor expression in vascular endothelial cells and inhibiting the binding of VEGF and its receptors.

OBJECTIVE To investigate the terminal bacterial pollution of hospital central oxygen supply system and the sanitizing effect of MX-1 disinfector. METHODS Timing many spot samples of terminal oxygen supply equipment (oxygen flowmeter, humid bottle, oxygen pipe) were quantified and cultivated through 24 hours continue supply. RESULTS Five cases of timing many spot samples testified that there were no bacteria oxygen pollution in the pipe oxygen supply in the Department of Respiratory Disease, the Second Affiliated Hospital of Dalian Medical University, and that there were no bacteria pollution in the terminal oxygen supply equipments if they were sterilized strictly, but there would be severe bacteria pollution if they were not sterilized strictly. This test found that lid of humid bottle and lapis were the main source of bacteria pollution. Connection with MX-1 disinfector in the terminal can avoid bacteria pollution. CONCLUSIONS Severe bacteria pollution will happen if the oxygen supply equipments aren't sterilized strictly; connection with MX-1 disinfector in the terminal can avoid bacteria pollution and ensure oxygen for cleanliness and safety.

Objective To investigate the operative technique and efficacy of PPH for severe hemorrhoids. Methods The clinical data of 153 cases of severe hemorrhoids treated by PPH, individualized according to size and nature of the piles, concomitant morbidities and conditions at the dentate line, and analysis of the relevance between operative technique and clinical efficacy as well as postoperative complications, were revieuled retropectively. Results All of the prolapsed tissue retracted immediately. Bleeding at the anastomotic site occurred in 49 cases, pulsatile bleeding in 12 cases, all of which were sutured under direct vision with cessation of bleeding. The width of excised-tissue was 2.1~4.6cm(average 3.5cm). The main symptoms of patients on the 1st post-operation day were abdominal distention caused by dysuria, pain, and tenesmus and burning sensation. At followup of 1-40 months, there was no stenosis of stoma, anal incontinence or recurrence of prolapse. After operation, a very satistactory result was achieved in 87 cases, satisfactory in 63 cases and mostly satisfactory in 3 cases. Conclusions In order to achieve ideal results with good retraction of tissues, avoidance of complications and improve patient satisfactory rate, the use of PPH for severe hemorrhords must be individualized and technical skill during operation are important.

Satisfaction questionnaires for emergency patients were developed in the present study and face to face surveys were conducted. The rate of effective retrieval was 96.8% and the response rate was 96.2%. The ? coefficient for internal consistency was fairly high (0.7099～0.9217) and there was a fairly strong correlation between the various items and the subordinate factors (0.744～0.912, with the exception of B15). A factor analysis indicated that the factor load and structure were basically consistent with the contents of the questionnaire. A statistical analysis showed that the satisfaction questionnaire for emergency patients, which had both credibility and validity, could be used for evaluating emergency patient satisfaction and could provide hospitals with the basis for measuring medical quality.