Objective To investigate the characteristics of pathogens and risk factors of the catheterassociated infection (CAI) in emergency ICU (EICU) in order to design an appropriately therapeutic strategy for the future.Methods From January 2008 to December 2010,a total of 1363 patients were enrolled for this retrospective study.Blood sample taken from the vein with indwelling catheterization and the tips of catheters cut in 5 cm after withdrawn from the veins in 1363 patients were collected for bacterial culture.Results Of 1363 catheters,pathogens were found in 147 (10.79％) after venous catheterization.The daily occurrences of CAI were 3.05 ones per 1000 catheters.Of 147 cases of infection,46.94％ pathogens were gram-negative bacilli,40.14％ gram-positive cocci,and 12.92％ fungi.Unconditional Logistic regression analysis suggested that repeated catheterization,femoral vein catheterization,the application of multi-lumen catheter and long-term indwelling catheterization were the independent risk factors responsible for CAI.Conclusions The risk factors responsible for catheter related infections should be controlled to prevent the occurrence of nosocomial infection.

Objective To evaluate the effectiveness of three neurological assessments in experimental autoim?mune encephalomyelitis. Methods Thirty-two female C57BL/6 mice (18-20g) were randomly divided into normal group (n=15) and immune group (n=17). Immune group were induced subcutaneously in the flank by emulsion consisted of MOG33-35 and complete Freund’s adjuvant. Mice were assessed by two investigators for 35 days after immunization in a blinded manner using Kono’s 5-point criterion, Weaver’s 15-point criterion and improved 15-point criterion. Based on H&E staining, we analyzed the accuracy, sensibility and dependency of three assessments. Results 35-day clini?cal-score plots revealed that the fluctuation of symptoms was more obvious in improved 15-point criterion compared with the other two criteria. 15-point criterion and improved 15-point criterion are more accurate than 5-point criterion in atypical-onset EAE. 15-point criterion and improved 15-point criterion could detect the neurological deficits much earli?er than 5-point criterion (P<0.001). Neurological scores assessed by improved 15-point were well correlated with the pathological findings during the peak and remission stage. Conclusion Improved 15-point criterion is better neurological score system than Kono’s 5-point criterion and Weaver’s 15-point criterion because of its accurate assessment of the neurological deficits in experimental autoimmune encephalomyelitis.

Objective To study the probability of transferring the regulatory T cells induced by TGF-β1 to prolong the allograft survival and the mechanisms involved.Methods According to the different culture conditions.three experimental groups were established:control group(T cells from C57 BL/6 mice cultured with II-2),MLR group(T cells from C57BL/6 mice activated by alloantigen)and TGF-βgroup(T cells from C57BL/6 mice activated by alloantigen and cultured with 5.0 ng/ml TGF-β1).After the culture,the ratio of CI4+CD25+T and the Foxq3 expression were measured by FACS and RT-PCR,respectively.On 9th day,the pathologic analysis was performed and the ratios of TH1,TH2 and Treg and the proliferation of lymphocytes were measured.Results The ratio of CD4+CD25+T in TGF-β group was higher than that in control group and MLR group(P<0.05),and Foxp3 was expressed in CD4+CD25+T cell from TGF-βgroup.After transferring ofthe cells,the allografi survival time in TGF-β group was prolonged and its mean survival time(MST)was(22.8±1.9)d,which was longer than that in MLR group and control group (P0.05),lower than that of control group(P<0.05). And the ratio of CD4+CD25+T in TGF-β group was higher than that in control and MLR group obviously(P

Objective: To explore the relationship between prevalence of atrial fibrillation (AF), iskhemia stoke and CHA2DS2-VASc score in patients≥65 years in order to provide prevention and treatment basis in clinical practice. Methods: A total of 5016 patients admitted in our hospital from 2013-10 to 2015-10 were enrolled. The patients were divided into 2 groups: AF group, n=437 and Non-AF patients, n=4579; according to age, the patients were further assigned into 4 subgroups as <65 years subgroup, (65-74) years subgroup, (75-84) years subgroup and ≥85 years subgroup. The risk factors for AF occurrence were retrospectively studied. Results: Compared with the Non-AF group, the patients in AF group had the elder age and more male gender, both P<0.001; more patients combining with hypertension, coronary artery disease (CAD), diabetes, sick sinus syndrome and rheumatic heart disease, all P<0.001. Age, male gender, CAD, sick sinus syndrome and rheumatic heart disease were the independent risk factors for AF occurrence. Compared with Non-AF group, AF group showed the higher prevalence rate of ischemic stroke and the elder onset age, both P<0.01. For non-valvular AF, the ratio of patients with CHA2DS2-VASc score≥2 was higher than those with CHA2DS2-VASc score<2 and the rate of anticoagulant therapy was decreasing by age increasing, all P<0.001. Conclusion: Age, male gender, CAD, sick sinus syndrome and rheumatic heart disease were independently related to AF occurrence. Non-valvular AF patients had the higher risk for ischemic stroke than non-AF patients, anticoagulation therapy should be conducted at the early stage.

Accidents, Occupational ; Acute Disease ; Adolescent ; Adult ; Arsenic Poisoning ; Chemical Industry ; China ; Female ; Humans ; Male ; Middle Aged ; Young Adult ; Zinc

Objective To explore the incidence,features and outcomes of in-hospital sudden cardiac death (SCD) in order to determine the predictors of survival. Methods The clinical data of 69 patients with cardiac arrest hospitalized from January 2008 through December 2010 were retrospectively analyzed.Information on genders,age,types of arrhythmia was collected and further analyzed to determine these factors associated with the occurrence and outcomes of in-hospital cardiac arrest. Results The overall incidence of SCD was 47.3 / 100 000 per year and 17.4％ of them.survived at discharge.The occurrence rate was higher in male than that in female (66.7％ vs.33.3％,P ＜0.01 ),whereas difference in gender did not affect the discharge rate ( P ＞ 0.05 ). Survivors from in-hospital cardiac arrest were significantly younger than non-survivors (man:62.57 ± 12.83 years vs.75.56 ± 10.55 years; women:60.36 ± 13.24years vs.69.53 ± 11.72 years,P ＜ O.01 ).From 62 ECG records of SCD patients,the incidence of nonshockable rhythms was higher than that of shockable rhythms.Compare to the non-shockable rhythms,the shockable rhythms brought a higher rate of restoration of spontaneous circulation (ROSC) (54.5％ vs.24.5％,P ＜0.05),whereas survival rates at discharge between two groups were not statistically different ( 18.2％ vs.18.4％,P ＞ 0.05 ).Conclusions Non-shockable rhythms were more common in patients suffering from in-hospital cardiac arrest.Although defibrillation treatment contributed benefit to ROSC among patients with ventricular fibrillation or pulseless ventricular tachycardia,high-quality CPR and post-cardiac arrest care may play a more critical role in the outcomes of in-hospital sudden cardiac death.

Objective To analyze the effects of Ileus tube (IT) along with somatostatin (SS) used for treatment of patients with severe acute pancreatitis (SAP).Methods Under conventional treatment,75 patients with SAP were divided into three groups as per different additional treatments,namely group A (IT and SS),group B (nasogastric decompression tube and SS),and group C (IT alone),and the therapeutic efficacies of those treatments were evaluated in respects of improvement of physical signs and symptems,dynamic changes in decompression drainage and prognosis.Results Therapeutic efficacy was 100％ in group A,84％ in group B and 80％ in group C.The difference between group A and B was x2 =8.26 (P ＜0.01) ; group B vs.C was x2 =0.38 (P ＞ 0.05).The physical signs and symptoms in group A were improved more rapid than those in group B and C (P ＜ 0.05),but there was no significant differences in those signs and symptoms between group B and group C (P ＞ 0.05).In comparison of decompression drainage,the t value of group A vs.group B was 2.14,group B vs.group C was 3.83,and group A vs.group C was 2.23 (P ＜ 0.05).As cure rate of patients with SAP in hospital on the 14th day,rate of transferring to surgical treatment as a last resort and mortality in group A were compared with group B and C,the differences were statistically significant (P ＜ 0.05),while group B vs.C,the difference was not statistically significant (P ＞ 0.05).Conclusions Application of IT combined with SS can significantly improve the condition of patients with SAP,thereby reducing the operation rate,shortening hospital stay,lowering mortality and improving the outcome,and it is worthy of clinical popularization.

Objective To explore the protective effect and possible mechanism of bone marrow mesenchymal stem cells (BMSCs) on pulmonary fibrosis induced by paraquat (PQ) in rats.Methods A total of 54 male SD rats were randomly (random number) divided into 3 groups (n =18 in each).Group A (normal control group),group B [PQ + phosphate buffer solution (PBS)],group C (PQ + BMSCs group).Rats in group B and C were induced to get pulmonary fibrosis by intragastric administration of PQ in a dosage of 120 mg/kg.In addition,BMSCs was given to rats in group C by injection in a dose of 1 × 106/mL via the vena caudalis,whereas an equal volume of PBS (1 mL) was given to rats in group B by injection instead.The survival rats in each groups were sacrificed separately at 7 days,14 days and 28 days after administration of PQ.The lower lobe of left lung were taken to observe histopathological changes with HE staining and Masson staining,and the pulmonary fibrosis was scored by using the Szapiel classification of alveolitis.At the same time,the lower lobe of right lung was harvested to detect the hydroxyproline (HYP),TGF-β1 and HGF in lung tissue by using immunohistochemistry.Results The pathological changes in lung tissue of rats were inflammatory change in alveoli space filled with massive amount of exudate obviously in group B at 7 days after exposure to PQ,but in group C,the inflammatory changes were much milder than those in group B.The exudation and edema in lunge alveoli were mitigated in group B at 14 days after exposure to PQ,but pulmonary interstitial fibers were increased.The degree of pulmonary interstitial fibrosis in group C was milder than that in group B.In group B,there were obvious pathological changes including destroyed alveoli septum,enlarged alveoli,thickened alveoli septum and the deposition of collagen fibers,disarranged alveolar structure at 28 days after exposure to PQ.The deposition off collagen fiber was slighter with well observed basic alveolar structure in group C than that in group B.The levels of HYP in lung tissue at different intervals in B group were escalating with time after exposure to PQ,and reached a peak at 28 day,which were significantly higher than those in group A (P ＜ 0.01).The levels of HYP in lung tissue at different intervals in C group were increasing with time after exposure to PQ,and reached a peak at 28 day,which were significantly lower than those in group B (P ＜ 0.01).The levels of TGF-β1 from different intervals in B group were increased greatly with wider distribution over large portion of lung structure than those in group A,and reached a peak at 7 days,then declined with time,which were significantly higher than those in group A (P ＜ 0.05).The levels of TGF-β1 at different intervals in group C were significantly lower than those in group B (P ＜ 0.05).The levels of HGF at different intervals in B group increased with time,but there was no significant difference among those at different intervals (P ＞0.05).The levels of HGF at different intervals in group B were little bit higher than those in group A,but there was no significant difference between them (P ＞ 0.05).The levels of HGF at different intervals in group C increased with time with significant differences among different intervals (P ＜ 0.05).The levels of HGF at 3 intervals in group C were significantly different from those of group A and group B group (P ＜0.05).Conclusions BMSCs can alleviate pulmonary fibrosis induced by PQ,and increase the survival rate,which may be attributed to decreasing the level of TGF-β1 and increasing the level of HGF.

Objective To investigate the effect of the calmodulin kinase Ⅱ Inhibitor KN-93 on L-typecalcium current(ICa,L)and intracellular calcium concentration([Ca2+]i)in hypertrophic cardiac myocytes.Methods Forty-eight female New Zealand white rabbits were randomized(random number)into four groups(12 animals in each group):the sham operation group(sham group),the left ventricular hypertrophy group(LVH group),the myocardial hypertrophy + KN-93 group(KN-93 group),and the myocardial hypertrophy + KN-92 group(KN-92 group).Myocardial hypertrophy in the rabbits was established by coarctation of the abdominal aorta.In the sham group,the abdominal aorta was dissociated without coarctation.Eight weeks after coarctation,single ventricular myocytes were isolated by enzymaticdissociation,and ICa,L was recorded using perforated-patch recording(PPR)techniques.[Ca2+]i was measured using single-cell calcium imaging with the fluorescence calcium indicator dye fura-2/AM.Results Cardiac hypertrophy was successfully established after 8 weeks of coarctation of the abdominal aorta.The peak ICa,L in the LVH group and the sham group was(1.38 ± 0.3)nA and(0.87 ± 0.1)nA at 0 mV,respectively(P ＜0.01,n =12).There was no significant difference in Ica,L density between the LVH group and the sham group[(6.7 ±1.0)pA/pF vs.(6.3±0.7)pA/pF; P≥0.05,n=12].The addition of either KN-92(0.5 μmol/L)or KN-93(0.5 μmol/L)to the perfusing solution caused a modest steady-state inhibition of peak ICaL(9.4％ ±2.8％,KN-92; 10.5％ ±3％,KN-93)(P≥0.05,n =12)at 0 mV.However,at a higher concentration(1 μmol/L),KN-93 more potently inhibited peak ICa,L(40％±4.9％)compared to KN-92(13.4％ ± 3.7％ ; P ＜ 0.01,n =12).Resting[Ca2+]i levels in fura-2-loaded myocytes isolated from the sham,LVH,KN-92,and KN-93 groups were(98 ± 12.3)nmol/L,(154 ± 26.2)nmol/L,(147 ± 29.6)nmol/L,and(108 ± 21.2)nmol/L,respectively.Conclusions The CaMK Ⅱ specific inhibitor,KN-93,can effectively block ICa,L and reduce intracellular calcium overload in hypertrophic cardiac myocytes.This action may account for the antiarrhythmic effect of KN-93 in hypertrophic ventricular myocardium.

Objective To summarize the characteristics of treatment and outcomes of extremely low birth weight infants (ELBWI).Methods The clinical data of 81 cases of ELBWI admitted to Bayi Children's Hospital Affiliated to General Hospital of Beijing Military Command from October 1st.2008 to August 31st.2011 were retrospectively analyzed.The survival rate and mortality of ELBWI with different gestational age and birth weight were compared with Chi-square test.Results Of 81 ELBWI,43 were male and 38 were female; the mean gestational age at birth was (28.4 ±2.1) weeks; the average birth weight was (903.5 ± 95.4) g.Complications of them included respiratory distress syndrome (68/81,84.0％),patent ductus arteriosus (47/81,58.0％),retinopathy of prematurity (41/81,50.6％),intraventricular hemorrhage (23/81,28.4％),bronchopulmonary dysplasia (17/81,21.0％),sepsis (15/81,18.5％),periventricular leukomalacia (2/81,2.5％) and necrotizing enterocolitis (1/81,1.2％).Among 81 infants,96.3％ (n =78)received oxygen inhalation with the average time was 19.1 d (median 11 d,0-121 d) ; 70.4％ (n=57)received pulmonary surfactant; 27.2％ (n =22) received nasal continuous positive airway pressure;34.6％ (n =28) received normal frequency mechanicalfrequency ventilation.All 47 ELBWI with patent ductus arteriosus received ibuprofen treatment,among which 6 cases received arterial canal ligation after failure of ibuprofen treatment.20 out of 41 cases of retinopathy of prematurity received laser surgery.Total parenteral nutrition was required in 74 infants(91.4％),the average age of beginning enteral feeding was 5.2 d (median 6 d,0-17 d)and achieved full gastrointestinal feeding time was 31 d (median 28 d,7-65 d).The survival rate of ELBWI with gestational age of ≤26,-28 and ＞28 weeks was 25.0％ (4/16),72.0％ (18/25) and 77.5％ (31/40),respectively; the corresponding mortality was 12.5％ (2/16),8.0％ (2/25) and 2.5％ (1/40),respectively.The survival rate of ELBWI with birth weight ≤800,-900 and ＞900 g was 33.3％ (4/12),58.3％ (14/24) and 77.8％ (35/45),respectively; and corresponding mortality of them was 16.7％ (2/12),8.3％ (2/24) and 2.2％ (1/45),respectively.Conclusions The outcome of ELBWI is closely related to gestational age and birth weight.Professional and sophisticated treatment might improve the survival rate and general outcome of ELBWI.