Objective To analyse the pathway of infection,risk factors,clinical characteristics and pathogenic bacteria distribution of neonatal sepsis.Methods Eighty-eight neonatal with sepsis were enrooled from January 2006 to December 2011 in the First Affiliated Hospital of Lanzhou University.According to disease stage,they were divided into early-onset sepsis group and late-onset sepsis groups.Results Respiratory infections in two groups was the majority (44.7％ vs.46.0％),and there was no significant difference (P =0.906).That premature birth,low birth weight infant,amniotic fluid pollution and asphyxia were risk factors for early-onset sepsis.The most common clinical characteristics in early-onset sepsis were eating less milk(57.9％,22/38) and had fever of the late-onset sepsis(42.0％,21/50).Forty-one cases were with positive blood culture and the rate was 46.6％ (41/88),the blood culture specimens were mainly Gram-positive bacteria in two group (75.0％ (15/20),90.4％ (19/21)).The most common pathogenic bacteria were Staphylococcus aureus and Coagulase-negative staphylococci.Conclusion Premature birth,low birth weight,meconium,asphyxia are risk factors of early onset neonatal sepsis.Early-onset sepsis often shows poor feeding,and late-onset sepsis in children prone to be fever.The common pathogenic germ of early-onset and late-onset sepsis are Grampositivebacteria,Staphylococcus aureus and coagulase-negative staphylococci common.As for neonate with highrisk factors,clinical features of early pathologic examination should be performed in order to further clarify the diagnosis and taking clinical therapy.

0.05).One minute after intubation(T3),MAP and HR in the ETT group increased to(12.13?1.37) mm Hg and(96.3?4.7)/min respectively,which were significantly higher than those in the PLMA group [(9.98?1.21) mm Hg,t=6.443,P=0.000;and(88.3?5.6)/min,t=5.947,P=0.000].Three minutes after intubation(T4),the MAP and HR of the two groups were significantly different(P0.05).Five patients in the PLMA group had adverse reaction,that was significantly fewer than that in the ETT group(12 cases)(?2=4.022,P=0.045).Conclusions PLMA is applicable for posterior cervical spine surgery,since it is associated with less stimulation and adverse reaction,and stable hemodynamics.The success rate of intubation is high by using the procedure.

Objectives To study the impacts of air temperature and the other weather factors on the daily mortality of the residents in cities for targeting the preventive measures to decrease the excess mortality induced by climate change.Methods The daily mortality and weather surveillance data were provided by Chongqing Center for Disease Control and Prevention and China Meteorological Bureau respectively.The correlation between the weather factors(temperature,humidity,air pressure,rainfall,wind speed) and the daily mortality of residents in a county of Chongqing were analyzed by using the Poisson GAM of time series(increased by 1℃ for air temperate,decreased by 1% for relative humidity and one unit for air pollution index) adjusting for the secular trend,seasonal trend,short-term fluctuation and day of week.Results The excess mortality increased to 12% as the temperature increased 1℃.The excess mortality increased to 4% and 0.6% respectively as the relative humidity decreased 1% and the air pollution index increased one unit.Conclusion High temperature,with humidity and air pollution,will cause increased excess mortality of residents in this county

Objective To establish the quality standard of charred Radix et Rhizoma Rhei. Methods Kromasil-C18 column (4.6 mm?150 mm, 5 ?m) was used with mobile phase of methanol-0.1% phosphate acid (85∶15), 1.0 mL/min, and detection at 254 nm. Result Average recoveries of charred Radix et Rhizoma Rhei: Emodin was 98.43% and Chrysophanol was 98.32%, RSD was 1.17% and 1.02% respectively. Conclusion This method is simple. The result is accurate and reproducible. It can be used in the study of the processing technics of Radix et Rhizoma Rhei and the quality control of charred Radix et Rhizoma Rhei.

Objective To investigate the characteristics of cognitive dysfunction in patients with multiple sclerosis (MS), as well as the correlations between cognitive dysfunction and lesions of brain on MRI.Methods 70 patients with MS were tested with Wechsler Intelligence Scale and brain MRI.A multiple-regression analysis was carried out on the basis of related factors.Results The rate of the patients whose full intelligence quotient(FIQ) less than 90 scores was 40%(28/70), which was higher than that of normal group( P

0.05). Conclusions The effect of rocuronium can be potentiated by nitroglycerin-induced deliberate hypotension, while time for maximum depression is prolonged.However, the time course of recovery of rocuronium can not be affected markedly.

Objective To investigate the relationship between positron emission tomography (PET) and cognitive dsyfunction in patients with multiple sclerosis (MS). Methods 2 cases of MS were test with the Wechsler Intelligence Scale (WIS) or mini-mental state examination(MMSE), brain MRI and PET,then the results were analysed. Results The MMSE score of the case 1 was 19, which was lower than normal. The WIS score of the case 2 was normal. The PET of 2 patients showed that there were many hypo-metablism areas in cortex or subcortex.In addition,some cortical hypo-metablism areas of PET were not correspondingly found lesions in cortex or subcortex by MRI. Conclusions There are many hypo-metablism areas in cortex or subcortex in MS patients. The hypometablism areas may be correlated with the cognitive dysfunction of MS.

Objective To investigate the safety of endoscopic suhmucosal dissection (ESD) in elderly patients with lesions of gastroesophageal mucosa. Methods Thirty-six elderly patients with flat elevation lesion of gastroesophageal mucosa were studied from July 2007 to May 2008. There were 14 cases with dysplasia, 9 cases with early carcinoma and 13 cases with leiomyoma confirmed by pathologic biopsy and endoscopic ultrasonography. All the patients were treated under consciousness condition, and the focus of lesion were completely resected with improved hook knife, IT knife and electrocoagulation or electro-cutting technique. The wound surface was managed with noradrenaline added in ice physiological saline, argon beam coagulator and metal clips. After operation, they were treated by abrosia, acid suppression and mucosa protection. The conditions of wound healing and residual lesions were reexamined four weeks after operation. Results Among the 36 patients (19 males and 17 females), there were 29 patients(80.6%) with complete focus ablation by ESD and 7 patients (19.4%) with resection by snare. Three cases (8.3%) of perforation occurred during operation and the perforations were treated with metal clips. After inserting stomach tube for fasting and anti-infection treatment for 5-7 days, all the three cases were recovered. One case(2.8%)had hematemesis 2 hours after operation and bleeding was stopped by endoscopic metal clip. Conclusions ESD is a safe and effective therapeutic tool in elderly patients with lesions of gastroesophageal mucosa.

Objective To evaluate the diagnosis value of plasma Dickkopf-1(DKK1)in hepatocellular carcinoma (HCC)pa-tients.Methods Selected 48 patients with HCC,20 patients with liver cirrhosis (LC),20 patients with chronic hepatitis B (CHB),and all of them were clinically diagnosed in the Third People’s Hospital of Nantong City,chose 20 cases of health examination as healthy controls (HC),that were ruled out other chronic disease.Enzyme-linked immunosorbent assay (ELISA)and Abbott i2000 microparticle chemiluminescence immunoassay analyzer were used to determine the plasma DKK1 and alpha-fetoprotein (AFP)levels.At the same time,analysesed and compared the receiver operating characteristic (ROC)curve and correlation of the DKK1 and AFP results.Results The plasma level of DKK1 in patients with HCC was significantly higher than that in patients with chronic hepatitis B,cirrhosis and healthy controls (Z=-4.132~-5.828,P<0.001).The area under ROC curve (AUC)of plasma DKK1 in the diagnosis of HCC was 0.889 and 95% confidence in-terval was 0.831~0.947,when the Cut-off value of DKK1 was 565 ng/L,the sensitivity was 93.8% and specificity was 70% in diagnosing HCC.The areaunder ROC curve of AFP in the diagnosis of HCC was 0.759 and 95% confidence interval was 0.667~0.850.The AUC of DKK1 was significantly higher than that of AFP (Z=2.28,P=0.022).DKK1 and AFP in diagnosing HCC were no significantly correlated (r=0.148,P=0.316).21 patients with AFP under 20μg/L showed higer DKK1 above 565 ng/L in 48 patients with HCC.Conclusion Detection of DKK1 in plasma can be used as a complement of AFP in the diagnosis of HCC,Especially DKK1 early diagnostic value of AFP negative HCC patients is remarkable.

The clinical handover, which is associated with the observation of the changes in patients′ status and the implementation of nursing process, plays a vital role in critical care. Also, the quality of clinical hand-over has a far-reaching impact on patient safety due to the complicate condition of critical patients. Over the past few years, lots of studies have focused on the many aspects of clinical handover such as the contents of clinical handover, the standard procedure of clinical handover so as to reduce the risks associated with the unsystematic clinical handover.