Objective To understand the incidence and related risk factors of healthcare-associated infection(HAI)in neu-rological patients with cerebrovascular diseases.Methods The occurrence and risk factors of HAI in patients with cerebro-vascular diseases in a hospital between Jan and December 2013 were investigated and analyzed.Results Of 3 573 investiga-ted patients,214 had HAI,the incidence of HAI was 5.99%;the main infection site was respiratory tract (54.67%),fol-lowed by urinary tract (25.23%).Univariate analysis revealed that age,length of hospitalization,disturbance of conscious-ness,chronic obstructive pulmonary disease,diabetes mellitus,invasive procedures,application of antacids,and antimicro-bial prophylaxis were all related to the occurrence of HAI (P<0.05).Multivariate logistic regression analysis revealed that disturbance of consciousness,old age,invasive procedures,chronic obstructive pulmonary disease,and diabetes mellitus were independent risk factors for the occurrence of HAI (all P <0.05).Conclusion The incidence of HAI is high in hospitalized patients of the neurology department,there are multiple risk factors associated with HAI,it is necessary to take corresponding interventions for reducing the incidence of HAI.

OBJECTIVE:To guide rational use of Heamocoagulase agkistrodon for injection,and to provide reference for phar-maceutical care. METHODS:Treatment methods and outcome of 9 cases of allergic shock induced by Heamocoagulase agkistrodon for injection were retrieved from CNKI and VIP database during 2009-2015,and then analyzed statistically,based on one case of allergic shock induced by Heamocoagulase agkistrodon for injection in the Affiliated Hospital of Zhunyi Medical College. RE-SULTS:10 pationts with allergic shock induced by Heamocoagulase agkistrodon for injection mainly used the drug for hemostasis before and after surgery,heavy menstrual bleeding,etc.,with dose of 1 or 2 U. Route of administration included intravenous injec-tion and intravenous dripping. Allergic shock often occurred within 30 min after medication. CONCLUSIONS:The use of Heamoco-agulase agkistrodon for injection in some patients belongs to off-label drug use,and route of administration is different from that stated in package inserts. Allergic shock induced by Heamocoagulase agkistrodon for injection occurs rapidly;the drug should be used strictly according to package inserts and authoritative literatures;emergency plan should be developed before medication in or-der to guarantee the safety of drug use.

Objective To investigate the effectiveness of hyperthermia of different degrees in killing tumor cells and its influence on Na+ -K+ -ATPase activities in erythrocytes. Methods Cultured low differentiated stomach gland tumor cells (SGC-170) and large intestine gland tumor cells (LOVO) (1?106?ml-1 each) were mixed with concentrated RBCs respectively and incubated in warm bath of 37℃ , 42℃, 43℃ , 45℃ or 47℃ for 40 min respectively. After hyperthermic treatment tumor cells were isolated from RBCs using density gradient centrifugation and the live tumor cells were counted by typan staining. The isolated tumor cells were then cultured and the clone formation of tumor cells was checked. The cultured tumor cells were marked with 5-bromo deoxyuridine and DNA metabolism was examined. The Na+ -K+ -ATPase activities in RBC after hyperthermic treatment were also determined. Results The amount of tumor cells was significantly decreased by 40 min hyperthermic treatment in a temperature-dependent manner from 42-471 as compared with the control group (37℃) (P

Objective To examine if high-dose glucocorticoid has any cerebral protective effects aftercardiopulmonary resuscitation. Methods Twenty-one healthy mongrel dogs of both sexes weighing 10 .5-15 kg weresubjected to cerebral ischemia using Pittsburgh standard ventricular fibrillation-cardiac arrest (VF-CA) model. Theanimals were anesthetized with intraperitoneal pentobarbital sodium 30 mg?kg~(-1) and mechanically ventilated thertracheal intubation (V_T 15 ml?kg~(-1), RR 18-20 bpm). Right femoral vein was cannulated for fluid administration(lactated Ringer's solution 0. 15 ml?kg~(-1)?min~(-1)) and right femoral artery was cannulated for BP monitoring. ECGwas continuously monitored. The animals were randomly divided into 3 groups: group A received only routineresuscitation treatment (control, n = 5); group B received dexamethasone 5 mg?kg~(-1) (n = 8) and group Cmethylprednisolone 30 mg?kg~(-1) (n = 8) after successful cardiopulmonary resuscitation. 8 hours after resuscitationthe animals were anesthetized and three pieces of brain tissue were obtained from right parietal lobe for light andelectron microscopic examination and determination of dopamine (DA) and 5-hydroxy-tryptamine (5-HT) contentsusing high-performance liquid chromatography- electrochemical technique (HPLC- ECD ). Results The DA and 5 -HT contents in parietal lobe of cortex were significantly decreased in group B and C as compared with group A (P

Objective To assess the relationship between auditory evoked potential (AAI) index and plasma concentration of propofol administered by target-controlled infusion (TCI) in Chinese.Methods Ten ASA Ⅰ～Ⅱ tumor patients (5 males,5 females) scheduled for elective abdominal surgery under general anesthesia was enrolled in this study.Age ranged from 34 to 61 years,body weight from 52 to 79 kg and height from 155 to 178 cm.Radial artery was cannulated for blood sampling.The patients were premeditated with intravenous injection Midazolam 0.06 mg/L.Anesthesia was induced by fentanyl 2μg/kg,vecuronium 0.1 mg/kg and TCI of propofol which the target plasm concentration was set at 3 mg/L.After intubation,the target plasma concentration of propofol was adjusted at 1.7～2.5 mg/L.Vecuronium was continuous infusions at 2～3mg/h.Anesthesia was maintained with fentanyl-TCI of propofol-vecuronium and inhalation of 0.5 MAC isoflurane.The TCI system was composed of Base Primea company orchestra infusion pump using,the schnider pharmacokinetics model.ECG,Bp,HR,PETCO2,SpO2 and TETISO were monitored during anesthesia.Danmeter company A-line depth of anesthesia monitor recorded AAI index.Blood samples were taken at induction of anesthesia (To baseline),1,3,5,10,15,30,60 min (T1-7) and after cessation of infusion 10 and 20 min (T9-10).Plasma propofol concentration were determinated by fluorescence photometry.Results Compared with target concentrations,the measured concentrations of propofol were significantly lower during TCI(P＜0.05).There was negative correlation between AAI and plasma propofol concentrations(r=-0.818,P＜0.01).Conclusion On base of the Schnider pharmacokinetics model,the target propofol concentrations are not paralleled to plasma propofol concentrations which is descending with time prolongation.From negative correlation between AAI index and plasma propofol concentrations,AAI index will reflect indirectly plasma propofol concentrations.

Objective To investigate whether quantitative dynamic contrast enhanced MR can predict final pathologic response in primary breast cancer patients undergoing neoadjuvant chemotherapy (NAC).Methods Forty seven patients who were pathologically proved infiltrating ductal carcinoma with core needle puncture biopsy were examined before NAC and after 2 cycles of treatment and the quantitative parameters (Ktrans,Kep and Ve) were analyzed prospectively.Histological response is categorized as non-major histological response (NMHR) and major histological response (MHR).Quantitative parameter changes measured after 2 cycles of NAC were compared between MHR and NMHR using non parametric tests (Mann-Whitney U test) and pretreatment parameters were compared using independent samples t tests.Receiver operating characteristic curve (ROC) was used to determine the best predictor and cutoff value.Results Fifteen patients were grouped into MHR and 32 patients were NMHR.Pretreatment parameters(Ktrans,Kep and Ve) were(1.51 ±0.33) /min,(2.97 ± 1.06) /min and (0.55 ±0.16) in MHR and (1.53 ±0.40) /min,(2.82 ± 0.99) /min and (0.57 ± 0.20) in NMHR.There was no significant difference between the two groups (t values were-0.123,0.450 and-0.380,respectively,P ＞ 0.05).Changes inkinetic parameters(K,Kep and Ve) were-88.2％ (-96.0％ to 1.5％),-62.5％ (-94.3％ to -8.7％) and-57.0％(-82.1％ to 55.5％) in MHRand-8.1％(-88.5％ to 32.4％),-18.2％ (-62.1％ to 145.9％) and-4.7％ (-83.1％ to 95.7％) in NMHR.There were significant difference between the two groups (Z values were 4.359,4.359 and 3.332,respectively,P ＜ 0.01).The areas under ROC curve of AKtrans,AKep and Ktrans after 2 cycles of NAC were all 0.898.Sensitivity of the three parameters for predicting NMHR were 87.5％,90.6％ and 78.1％,and specificity were 86.7％,80.0％ and 93.3％,respectively.Conclusion Quantitative dynamic contrast enhanced MRI can predict final pathologic response in primary breast cancers after 2 cycles of NAC.

ObjectiveTo investigate the diagnostic value of transbronchoscopic lung biopsy (TBLB) without X-ray fluoroscopy in patients with peripheral pulmonary lesions.Methods Fifty patients with peripheral and diffuse pulmonary lesions and without cavity lesions from January to December 2011 were selected and examined by conventional hronchoscopy.According to the anatomical orientation of CT image and bronchial tree path,TBLB was performed by electronic bronchoscope.ResultsThere were 63 cases of TBLB in 50 patients and 30 patients got confirmed diagnosis (60.0％),including 24 cases in 35patients with peripheral pulmonary lesions (68.6％),and 6 cases in 15 patients with diffuse pulmonary lesions (40.0％).There was no severe complication during and after electronic bronchoscopy.ConclusionsTBLB without X-ray fluoroscopy is a convenient,safe and repeatable operational method with fewer complications.It has higher clinic diagnostic value in pulmonary diseases.

AIM: To investigate the protecting mechanisms of adjusting blood pressure and blood fat capsule(Radix angelicae sinesis,Rhizoma alismatis,poria,Rhizoma attactylodis macrocephalae,Rhizoma Chuanxiong,Radix Paeoniae alba,semen arecae,Folium perillae) in diabetic nephropathy rats induced by streptozotocin. METHODS: Forty-eight health male Wister rats were randomly divided into normal group,diabetic nephropathy group,adjusting blood pressure and blood fat capsule group and valstatan group.After experiment urine,blood,kidney samples were taken,and immunohistochemistry were performed. RESULTS: 24 hour urinary microalbumin,creatinine clearance,?_2-microglobulin,creatinine clearance ET1 and NOS in kidneys had distinct difference among three gruops. CONCLUSION: The provention and cure of DN ' function of adjusting blood pressure and blood fat capsule bears relationship with inhibition of ET-1,NOS's expression.

Objective To observe the efficacy and adverse effect of IHDA [Idarubicin(IDA) + high-dose Cytarabine(HD-Ara-C)] as a remedy regimen in the treatment of pediatric patients with refractory acute lymphoblastic leukemia(ALL).Methods Twelve children with refractory ALL were treated by IHDA regimen as follows:IDA,10 mg/(m2·d),d1-3;Ara-C,1.0g/m2,q12h,d1-3.The children who achieved complete remission(CR)could get into the following sequential regimens or allogeneic hematopoietic stem cell transplantation (allo-HSCT).The same regimen was given to the children who didn't achieve CR when WBC ＞2.0×109/L.The efficacy and hematology or non-hematology adverse effect were evaluated.Results CR/partial remission (PR)/non-remission (NR) were respectively 4/3/5 cases after giving the first regimen,and CR/PR/NR were 5/3/4 cases after giving the second regimen,respectively.The overall remission was 66.7％ (8/12 cases),of which 5 cases(41.7％) achieved CR,3 cases (25.0％) reached PR and 4 cases(33.3％) reached NR.Grade Ⅳ myelosuppression occurred in all patients,but no severe infection and hemorrhage happened after the application of granulocyte colony stimulating factor (G-CSF),platelet transfusion and anti-infection treatment.Some reversible side effects like liver toxicity,myocardial damage and nerve injury were observed in some patients.There was no chemotherapy related mortality in all the patients.Two cases relapsed again followed up to October 2015.One achieved CR after applying chimeric antigen receptor T-cell immunotherapy and was receiving allo-HSCT now.Another was dead after applying FLAG (Prednisone+Fludarabine+Ara-C+G-CSF) save regimen.The time of the other 3 cases achieving CR was 26,10,4 months,respectively.Among the remaining 7 cases,3 cases were forced to receive hematopoietic stem cell transplantation,2 cases abandoned treatment and 2 cases failed to follow up.Conclusions The IHDA regimen is a well-effective and tolerated treatment for pediatric patients with refractory ALL,and could create an opportunity for the application of allo-HSCT.

Objective This study evaluates the effectiveness for using acute plateletpheresis (APP) as a blood conservation method to reduce the need of blood transfusion and increase coagulation function in aortic arch surgery with deep hypothermic circulatory arrest (DHCA ). Methods Thirty-six type-A aortic dissections patients (male 31,female 5,age 23-65 years,ASA physical status II-IV)undergoing frozen elephant trunk with total arch replacement (Bentall plus Sun's surgery)were enrolled in the prospective randomized trial.The patients were randomized into two groups:regular blood conservation group (group control,n = 18)and group APP (n = 18).Blood sample was collected respectively after anesthesia induction (T1 ),before heparinization (T2 ),by the end of surgery (T3 )and 24 hours after surgery (T4 ).Data was collected and reviewed in terms of perioperative transfusion needs,normal laboratory examination,clinical outcomes including blood routine analysis (Hb,Plt,MPV,P-LCR)and thrombelastography (TEG-R,TEG-K,TEG-α,TEG-A,TEG-MA,TEG-EPL).Kaolin and heparinase detections were performed for TEG.Results Com-pared with T1 ,TEG-R,TEG-K,TEG-A,TEG-MA,TEG-EPL and Plt were significantly decreased while TEG-CI,MPV,P-LCR significantly increased in T4 in group APP (P <0.05 ).TEG-A,TEG-MA and Plt were significantly greater(P <0.05)in group APP than in group control at T2 ,and TEG-K,TEG-ELP and HBG were significantly less (P <0.05)in group APP than in group control at T3 . Conclusion The utilization of APP technique was associated with the improved coagulation function in aortic arch surgery with DHCA.