Objective To investiGate the distribution of clinical infectious pathoGens and druG resistance status of common bacteria in the Ninth Peopleˊs Hospital Affiliated to medicine School of ShanGhai Jiao TonG University in 20l2. Methods Clinical isolated bacterial strains were collected from the Ninth Peopleˊs Hospital Affiliated to medicine School of ShanGhai Jiao TonG University durinG 20l2. The identification of bacteria and antimicrobial susceptibility were determined by VITEK 2 COMPACT automatic microbioloGy analyzer. The data were analyzed by WHONET 5. 4 software. Results A total of 3456 pathoGenic strains were collected. Of them,Gram positive cocci,Gram neGative bacilli and funGus accounted for 20. 3%,76. 8% and 2. 9% respectively. Methicillin resistant strains in S. aureus( MRSA ) and coaGulase neGative Staphylococcus ( MRCNS)accounted for averaGe of 44. 4% and 85. 5% respectively. No vancomycin and linezolid resistant strains were found. Extended spectrumβ-lactamases strains accounted for 66. 4% and 30. 6% in Escherichia coli ( E. coli)and Klebsiella spp respectively. Strains of E. coli and Klebsiella spp were still hiGhly susceptible to imipenem. Resistance rates of P. aeruGinosa and A. baumannii sppstrains to imipenem were 8. 3% and 58. 4%respectively. Conclusion The major clinical pathoGenic microorGanisms in the Ninth Peopleˊs Hospital Affiliated to medicine School of ShanGhai Jiao TonG University are still Gram neGative bacilli. Baterial resistance is serious. It is important to strenGthen the detection of resistant bacteria in routine work,which is useful for rational use of antimicrobial aGents.

Objective To analyze the basics and influencing factors for the medical expenditure of poor patients of tumor and end-stage renal diseases in Hubei province,and put forward policy recommendations for the critical illness insurance and health poverty alleviation.Methods 535 patients with tumor and end-stage renal diseases in Wuhan,Xiangyan and Shiyan in Hubei province were selected for a questionnaire survey,with 415 of the questionnaires subject to data analysis.Single factor variance analysis and multiple linear regression were used to analyze the influencing factors for their medical expenditure.Results 83.9% of the patients held their medical costs as too high;84.6% of them complaining significant drop of their annual family income due to their diseases; disposable household income of urban patients higher than their rural counterparts both before and after their disease; types of medical insurance and diseases are significant influencing factors for medical expenditure.Conclusions Poverty rate is high among patients of such patients.To reduce their financial burden,the government is recommended to cover more major diseases,enhance support for those of critical illness and improve the medical assistance system.

Objective To evaluate the clinical effect of salmeterol xinafoate and fluticasone propionate powder for inhalation combined ipratropium bromide aerosol in patients with stable chronic obstructive pulmonary disease (COPD).Methods One hundred and twenty patients with stable COPD was randomly divided into control group and observation group with 60 patients each.The control group was received ipratropium bromide aerosol inhalation,and the observation group was given salmeterol xinafoate and fluticasone propionate powder for inhalation and ipratropium bromide aerosol for 6 months.BODE index,SGRQ scores,plasma cortisol and bone mineral density were compared between two groups before and after treatment.Results BODE index scores had no significant difference between two groups before treatment (P＞0.05).After treatment,BODE index scores,dyspnea scale,FEV1％,6MWD and BODE index total scores in observation group were superior to those in control group [ (1.9 ± 0.5) grades vs. (2.3 ± 0.5)grades,(58.5 ± 7.3)％ vs.(50.4 ± 6.2)％,(411.1 ± 56.8) m vs.(347.5 ± 60.4) m,(3.3 ± 1.0) scores vs.(3.8 ± 1.3 ) scores ],there were significant differences (P＜0.05 ).SGRQ scores had no significant difference between two groups before treatment (P＞0.05 ).After treatment and in SGRQ scores,respiration symptom,limitation of activity,disease influence scores in observation group were significantly lower than those in control group [ (20.7 ± 10.3 ) scores vs.(37.9 ± 14.4) scores,(20.7 ± 9.5 ) scores vs.(34.8 ± 13.0) scores,(16.3 ± 6.7) scores vs.(27.2 ± 11.8) scores,(17.5 ± 7.0) scores vs. (34.6 ± 12.3) scores],there were signiticant differences (P＜0.01 ).There were no significant difference of plasma cortisol and bone mineral density between two groups (P＞0.05).Conclusions Salmeterol xinafoate and fluticasone propionate powder for inhalation and ipratropium bromide aerosol in patients with stable COPD can greatly improve the lung function and life quality and with less adverse reaction.

Objective To analyze the importance of procalcitonin (PCT) and high-sensitivity Creactive protein (hsCRP) in assessing the severity of pneumonia and sepsis patients as well as prognostic evaluation.Methods A total of 77 patients with pneumonia complicated with sepsis were randomly (random number) selected from May 2013 to May 2016 in our hospital and 50 patients with simple pneumonia were enrolled as control group.The sepsis pneumonia patients were divided into three groups,namely sepsis group,severe sepsis group and septic shock group.The sepsis patient were further divided into survival group and death group according to the death of patient within 2 weeks.Statistics was employed to study the roles of PCT and hsCRP in evaluating the severity of pneumonia and sepsis patients as well as prognostic evaluation.Results Compared with control group,the levels of PCT and hsCRP were higher in patients of sepsis groups (P ＜ 0.05).The levels of PCT and hsCRP were gradually increased as the severity of the patient getting worse (P ＜ 0.05).The levels of PCT and hsCRP in the death group were higher than those in the survival group.The areas under ROC curve of PCT and hsCRP for diagnosis of sepsis and septic shock as the optimal cut-off point at ≥ 2 ng/mL and at ≥ 75 mg/L,had the sensitivity of 62.1％ and 81.2％,respectively,and the specificity of 89.2％ and 68.2％,respectively.Conclution PCT and hs CRP levels have a certain value in assessing the severity of pneumonia and sepsis patients as well as prognostic evaluation.

Objective To explore the relationship of delivery of parenteral fat emulsion and lipid peroxidation,and to observe the safety and effectiveness of parenteral nutrition(PN)in infants with very low birth weight(VLBWI).Methods Thirty infants with VLBWI were randomly divided into 3 groups:the preterm infants received pareneral nutrition containing amino acids and dextrose and soluvit,while intralipid provided separately,intralipid were light exposed(group A,n=10)or light protected(group B,n=10).In group C(n=10),soluvit and vitlipid were co-administered with intralipid and light protected.All the prematures received PN for 7 days and 10 cases of VLBWI not recei-ving PN were collected as control group.Anti-oxidation level,ascorbate,blood glucose,oxygen saturation,serum biochemistry index and body weight were determined before and after experiment.Results Seven days after PN,the MDA concentrations in the test groups all increased(⊿dA was the most,⊿dB was the next,⊿dC was the least).For superoxidedimutuse(SOD)reduction concentrations,⊿dA decreased sharply,then was ⊿dB,⊿dc decreased little,The blood Vit C increase in group B and C were more than group A.Significant changes of MDA,SOD and Vit C existed among the group B,C and A.In the 3 test groups,bilirubin,albumin,prealbumin concentrations were higher after the experiment,but there were no significant changes compared with control group.No significant changes in blood biochemistry,oxygen saturations were found before and after the observation in every group.Conclusions Multivitamin preparations protect fat emulsion against light-induced formation of lipid hydroperoxides,and administering multivitamins with fat emulsion via dark delivery tubing provide a practical way of preventing peroxidation of the lipid while limiting vitamin loss.Furthermore,it is relatively safe to apply fat emulsion intravenously with suitable dose and infusion rate for a few days to VLBWI from the second day of birth who require partial parenteral nutrition.

OBJECTIVETo observe the effect of Tangke Decoction (TD) on the expression of TGF-beta1/Smad4 of rats with early diabetes and to explore the effect and mechanism of TD against the renal injury induced by diabetes.

METHODSSD rats were randomly divided into the normal control group (n = 12), the model group (n = 10), the Chinese herbs prevented group (n =10), the Chinese herbs treated group (n = 10), and the Western medicine control group (n = 10). TD (18 mg/kg) was given by gastrogavage to rats in the Chinese herbs prevented group immediately after successful modeling for 12 weeks, once daily. At the 4th week of successful modeling, rats in the rest 4 groups were administered by gastrogavage. Equal volume of normal saline was given to rats in the model group and the normal control group. Benazepril suspension (1 mg/kg) was administered by gastrogavage to rats in the Western medicine control group for 8 weeks, once daily. TD (18 mg/kg) was given by gastrogavage to rats in the Chinese herbs treated group for 8 weeks, once daily. The body weight, kidney weight, index of kidney weight, fasting blood sugar, 24 h urinary albumin excretion rate were examined after experiment. The pathological changes of the renal tissue were observed by HE staining, Masson staining, and electron microscope. The expression of renal transforming growth factor-beta1, (TGF-beta1) and Smad4 were detected using immunohistochemical assay.

RESULTSCompared with the normal control group, the body weight of rats decreased significantly; the kidney weight, index of kidney weight, blood sugar, 24 h urinary protein excretion, the urinary albumin excretion rate,TGF-beta1 and Smad4 expression increased significantly in the model group (all P < 0.01). Compared with the model group, the aforesaid indices were improved in each treatment group with statistical difference (P < 0.05, P < 0.01). Compared with the Western medicine control group, the kidney weight, index of kidney weight, blood sugar, 24 h urinary protein excretion, and the urinary albumin excretion rate were obviously improved in the Chinese herbs prevented group (P < 0.01). The renal pathological changes were most obvious in the model group significantly, but they were improved in all treatment groups.

CONCLUSIONTD could obviously improve the symptoms of diabetes and down-regulate the expression of renal TGF-beta1 and Smad4 of early diabetic nephropathy rats, which suggested that TD had certain preventive effect on early diabetic nephropathy.

Animals ; Diabetes Mellitus, Experimental ; drug therapy ; metabolism ; Drugs, Chinese Herbal ; therapeutic use ; Kidney ; metabolism ; Male ; Rats ; Rats, Wistar ; Smad4 Protein ; metabolism ; Transforming Growth Factor beta1 ; metabolism

The scientific papers in "Chinese Journal of Medical Instrumentation" from 1997 to 2001 have been analysed by bibliometrics, including the characteristics of the periodical, its author's areas, units distribution and quotations. Some suggestions have been put forward to promote the biomedical engineering research.
Bibliometrics ; China ; Equipment and Supplies ; Humans ; Multivariate Analysis ; Periodicals as Topic ; statistics & numerical data

OBJECTIVETo explore the pathomorphological change of the atlanto-occipital segment of vertebral artery (V3 part) related with cervical vertigo.

METHODSFrom June 1999 to November 2011, the pathomorphological change of the atlanto-occipital segment of vertebral artery were observed in 1680 patients with cervical vertigo using 3D-CTA technology. The clinical data of these patients were analyzed. There were 783 males and 897 females, aged from 22 to 70 years old with an average of 52.8 years old. Doppler examination showed vertebral basilar artery flow velocity to speed up or slow down.

RESULTSThe blood vessel of 3360 branches were detected in 1680 patients and 2778 branches were detected out vascular anomaly. And 829 branches were in V1 segment, 421 were in V2, 328 were in V3, 1190 were in V4. The pathomorphological changes in the atlanto-occipital segment (V3) of vertebral artery included angiospasm, congenital absence, abnormal exit, localized stenosis.

CONCLUSIONThere are 4 kinds of pathomorphological changes in the atlanto-occipital segment of vertebral artery related with cervical vertigo. The 3D-CTA result can be used to judge prognosis and adopt reasonable treatment for the patients.

Adult ; Aged ; Atlanto-Occipital Joint ; Cervical Vertebrae ; Female ; Humans ; Male ; Middle Aged ; Tomography, X-Ray Computed ; Vertebral Artery ; diagnostic imaging ; pathology ; Vertigo ; pathology

Objective To evaluate the safety of modified sputum induction in moderate to very severe COPD during exacerbation. Methods Ninety patients with moderate, severe or very severe COPD during exacerbation (27 with type Ⅰ and Ⅱ respiratory failure,18 with coronary heart disease, 38 with tachycardia) were chosen as research subjects. All the patients underwent induced sputum. During induction , all patients were given electrocardiographic monitoring and pulmonary function check every 5 minutes and FEV1, HR, SpO2 in the process of testing were recorded. Results Ninety patients underwent 224 sputum inductions progress, 222 were safety. Qualified sputum samples were collected for 216 times, sputum induction was successful in 96.43% of occasions. Heart rate rising and SpO2 reducing during sputum induction mainly occurred in the beginning 5 minutes, FEV1 did not change in the whole process. Conclusion Modified sputum induction can be safe through closely monitoring in patients with moderate-to-very severe COPD with exacerbation, even with type Ⅰ or typeⅡ respiratory failure. But the risk of sputum induction will increase if patients with coronary heart disease and tachyarrhythmia, especially within beginning 5 minutes of sputum induction.

Objectives This study aimed at investigating the cellular mechanism of isoproterenol (ISO) on delayed afterdepolarizations (DADs) and triggered activity (TA) of the noninfarcted myocardium in the myocardial infarcted rabbit model.Methods Rabbits with the left anterior descending coronary artery occlusion were prepared and recovered for 8 wk (healed myocardial infarction, HMI). Myocytes were isolated from regions of the noninfarcted left ventricular free wall. ISO was added to cellular surface by perfusion way. Action potentials and ion currents were recorded with whole-cell patch clamp. Results The results showed that treatment with ISO induced more DADs and TA events in HMI myocytes. Iti and ICa-L of myocytes treated with ISO were increased significantly compared with HMI cells, which contributed to DADs-related triggered arrhythmia. Conclusions The results suggested that more arrhythmia events of DADs and TA developed in myocytes with ISO treatment. The underlying mechanism was associated with the augment of Iu and calcium influxing.