Eleven elderly patients undergoing maintenance hemodialysis without ARB or ACEI within 4 weeks were enrolled. Anti-hypertensive agents were replaced by telmisartan gradually to maintain stable blood pressure. Before and after 6 or 12 weeks of treatment, blood biochemical profiles, fasting blood glucose, fasting plasma insulin, insulin resistance index(HOMA-IR), blood pressure, and body weight were recorded. Our results showed that telmisartan did not affect body weight, high-density lipoprotein (HDL), triglyceride (TG), SCr, BUN, Alb, K+ , and PTH, although led to a significant decrease in TC and low-density lipoprotein (LDL). Following telmisartan treatment, FPG did not change significantly, but fasting insulin decreased from 13.9±3.6 mU/ml to 9.9±2.7 or 9.1±2.3 mU/ml at 6 and 12 week (P<0.01), and HOMA-IR decreased from 3.5±1.4 to 2.4±0.8 or 2.2±0.8 at 6 and 12 week (P<0.05). These results suggest that insulin resistance in elderly patients with MHD may be improved by telmisartan.

Objective To evaluate systematically the effect of ventilator circuit changes on incidence of ventilator-associated pneumonia(VAP).Methods Literatures about the effect of ventilator circuit changes on occurrence of VAP were searched from PubMed,Cochrane Library,CNKI,VIP,and Wanfang database,incidence of VAP in pa-tients who received circuit changes at different intervals was compared,odds ratio (OR)and 95%CI were as effect index of the study,RevMan 5.2 software was used for data analysis.Results A total of 12 literatures were included,including 18003 patients using ventilators.According to the interval of ventilator circuit changes,patients were divided into 1-day group (n=191),2-day group(n=8932),3-day group(n=228),and 7-day group(n=8652).Meta analysis showed that circuit changed every 7 days had a lower risk of VAP than that changed once ev-ery day (OR,3.72[95%CI,1.50,9.23]),there was no significant difference in risk of VAP between 7-day group and 2-day group (OR,1.17[95%CI,1.00,1.37])as well as 7-day group and 3-day group(OR,0.77 [95%CI, 0.49,1 .23]).Conclusion Patients who received circuit changes every 7 days have a lower risk of developing VAP than those who received circuit changes once per day,so change the ventilator circuit in patients with mechanical ventilation every 7 days is more reasonable.

0.05). The sequence of five clones from one serum which was identified precore mutation by mPCR-RFLP were all A1896 mutant strains.Another serum identified mixture infection by mPCR-RFLP , one clone was A1896 mutant strain and four were G1896 wild strains.The results of mPCR-RFLP were verified by cloning.Conclusions Comparison with sequencing, the mPCR-RFLP method is simple,accurate and can be used in large-scale surveys and clinical research.

Objective To appraise the diagnostic capability of laparoscopic ultrasonography (LUS) for urinary system injury induced by laparoscopic surgery in goats. Methods Animal models of different types of urinary system injury at different sites were established in five goats. One goat without injury was set as a negative control. LUS was used to examine the animals following randomization and single-blind principles. Results The sensitivity of LUS was 76.9% (10/13),specificity was 100%,and the false-negative rate was 23.1% (3/13). No false-positive results were detected in this study. The sham injury was accurately detected through LUS. The scan time of LUS ranged from 19 to 25 min with a mean of 21 min. Conclusions LUS is of value in the diagnosis of urinary system injury.

Object:To compare the personality and therapeutic effect in stutters with different genders Method:One hundred and fifty-nine patients with stutter and 110 normal control were included MMPI, EPQ, SAS, SDS were applied to all subjects Therapeutic effect was assessed after training Results:Compared with normal control, patients had higher scores in SAS, SDS, N score of EPQ and lower E score in EPQ Female patients had higher score in SAS and SDS than male patients After training, the SAS and SDS scores declined in both genders, with no difference between male and female patients Conclusion:Stutters are more anxious and depressed than normal, especially for female patients Special training is effective not only in symptom of stutter, but also in bad mood

Objective To investigate the effect of lectin like oxidized low density lipoprotein receptor 1 ( LOX-1 ) in NRK52E intaking lipid induced by oxidized low density lipoprotein ( ox-LDL). Methods NRK-52E was incubated with ox-LDL (0,25,50, and 100 g/ml ) for 24 hours or pre-treated with the chemical blocker of LOX-1 receptor- polyI or carrageenan, and then exposed to 50 μg/ml of ox-LDL. LOX-Ⅰ mRNA was examined by real-time PGR. LOX-1 protein was assessed by Western blot analysis. Lipid deposit was examined by oil red O. Results LOX-1 mRNA expression in 25,50,100 μg/ml ox-LDL group was 2. 13, 10. 14, 20. 81 times of that in 0 g/ml ox-LDL group ( P <0. 05 ,respectively). LOX-1 protein expression in 25,50,100 μg/ml ox-LDL group was 2. 53,12. 18,21.45 times of that in 0 μg/ml ox-LDL group( P <0. 05 ,respectively). Following the increased LOX-1, lipid intake increased. Pre-treatment with Poly Ⅰ or carrageenan, LOX-1 mRNA expression deceased by 48% or 47%, LOX-1 protein deceased by 72% or 65%, lipid intake induced by 41% or 49% ( P <0.05 ,respectively). Lipid had a close relationship with LOX-1 ( r = 0. 87, P < 0. 05). Conclusion Ox-LDL induced NRK52E to express LOX-1 and promoted NRK52E to intake lipid, and this effect could be partly blocked by LOX-1 blocker.

Objective To evaluate the analgesic effect of dexmedetomidine on the ultrasonic guidance brachial plexus block.Methods Sixty patients who underwent elective for one-side upper limb or forearm surgery were selected,they were received ultrasonic guidance brachial plexus block.The patients were divided into observation group and control group by random digits table method with 30 cases each.The observation group received 0.5％ ropivacaine 100 mg and dexmedetomidine 0.75 μg/kg,and the control group received 0.5％ ropivacaine 100 mg alone.The heart rate,mean arterial pressure (MAP),pulse oxygen saturation (SpO2) at the time of entering operating room,brachial plexus block completed,incision and the end of surgery were recorded.After brachial plexus block completed,the visual analogue score (VAS) at the time of incision,1 h during surgery and 1,2,6,12,24,48 h after surgery was recorded.Morphine was given the patients when VAS ＞ 4 scores,and the time to first prescription of morphine and total morphine consumption dose within 48 h after surgery were also detected.The adverse reaction was recorded.Results There were no statistical differences in heart rate and MAP at the time of entering operating room and brachial plexus block completed between the 2 groups (P ＞ 0.05).The heart rate and MAP at the time of incision and the end of surgery in observation group were significantly lower than those at the time of entering operating and the same time of control group,there were statistical differences (P ＜ 0.05).There was no statistical difference in SpO2 between the 2 groups (P ＞0.05).The VAS at the time of 6,12,24 and 48 h after surgery in observation group were significantly lower than those in control group [(3.0 ± 0.9) scores vs.(4.9 ± 0.5) scores,(3.0 ± 0.7) scores vs.(5.6 ± 1.2) scores,(2.2 ± 0.9) scores vs.(4.8 ± 1.8) scores,(1.7 ± 0.5) scores vs.(3.2 ± 1.0) scores],there were statistical differences (P ＜ 0.05).The time to first prescription of morphine in observation group was significantly longer than that in control group [(450 ± 37) min vs.(368 ± 42) min],the total morphine consumption dose was significantly lower than that in control group [(8.3 ± 2.8) mg vs.(15.5 ± 4.5) mg],there were statistical differences (P ＜ 0.05).There was no adverse reaction found.Conclusion Ropivacaine plus 0.75 μ g/kg dexmedetomidine for ultrasonic guidance brachial plexus block may prolong the duration of analgesia,thus reduce morphine consumption within 48 h after surgery without severe adverse reaction.

OBJECTIVE To establish a rapid method of detecting class D carbapenemase gene in Acinetobacter baumannii by multiplex PCR.METHODS Design primers according to the conservative region of blaOXA-51 and blaOXA-23,the class D carbapenemase gene were detected by Multiplex PCR.RESULTS 24 of 30 A.baumannii isolates produced two bands of blaOXA-51 and blaOXA-23;other 6 isolates showed a band of blaOXA-23.CONCLUSIONS The multiplex PCR could detect rapidly the class D carbapenemase gene.

Objective To investigate the effect of carbon monoxide (CO) inhalation on acute hypoxic pulmonary arterial hypertension and acute hypoxic lung injury. Methods Thirty Wistar rats weighing 180-250 g were anesthetized with intramuscular 3% pentobarbital 50 mg?kg-1 . Pulmonary catheter was inserted via right external jugular vein for mean pulmonary arterial pressure (MPAP) monitoring. Left common carotid artery was cannulated for BP monitoring. Tracheotomy was performed and the animals were mechanically ventilated ( RR = 80-90 bpm). PETCO2 was maintained at 35-45 mm Hg. The animals were randomly divided into 3 groups: (1) control group inhaled 21 % O2 for 30 min ( n = 10); (2) hypoxia group inhaled 10% O2 + 90% N2 for 30 min ( n = 10) and (3) CO group inhaled 100 ppm CO in 10% O2 + 90% N2 for 30 min ( n = 10) . Arterial blood 4 ml was obtained at the end of experiment for estimation of blood HbCO and plasma MDA concentration and RBC SOD activity. A piece of lung tissue was obtained immediately after the animal was sacrificed for electron microscopic examination. Results (1) In hypoxia group MPAP was markedly increased, plasma MDA level elevated and SOD activity reduced as compared with control group ( P