Objective To understand the basic situation of healthcare-associated infection(HAI)management and prevention and control of multidrug-resistant organism(MDRO)infection in medical institutions in Hubei Province.Methods Questionnaires were used to investigate the basic situation of HAI management and MDRO infection in 47 tertiary and secondary hospitals in Hubei Province.Results 47 hospital were enrolled in this study,HAI management full-time staff was allocated with a median of 0.90/250 beds;in 2015,the isolation rates of methicillin-resistant Staphylococcus aureus,carbapenem-resistant Enterobacteriaceae,carbapenem-resistant Pseudomonas aeruginosa,carbapenem-resistant Acinetobacter baumannii,and vancomycin-resistant Enterococcus were 39.13%,4.13%,19.44%,63.60%,and 2.77%respectively.47 hospitals all carried out surveillance on MDROs,28(59.57%)hospitals were installed HAI monitoring system software,could directly obtain data through collecting with the laboratory system.The diagnosis of MDRO infection was mainly based on the combined diagnosis by HAI full-time personnel and clinicians(26 hospitals,55.32%).44(93.62%)hospitals regularly convened coordination meeting on prevention and control of MDROs,in 2015,hand hygiene compliance rate were 10.0%-89.2%by self-inspection;42(89.36%)hospitals routinely prescribed isolation orders for patients with MDRO infection,33(70.21%)hospitals conducted environmental clean and disinfection twice a day,24(51.06%)hospitals performed personal protection by using complete set of protective equipment.Conclusion This investigation is helpful for understanding the general situation of HAI management in medical institutions,as well as the detection and control of MDROs in this area,and make continual improvement on the problems and weakness found in the investigated project,so as to promote the development of HAI management in this area.

Objective To explore the ultrasonographic characteristics in craniocerebral gunshot injured areas and the value of ultrasound technology for judging the activity of wound tissues. Methods After establishment of the model of penetrated craniocerebral gunshot wound, the ultrasonographic characteristics of the tissues in the injured areas were observed by conventional ultrasound and contrastenhanced ultrasonography(CEUS) ,and compared with the pathological changes of the wound area. Results ①A straight-looking, irregular-edged, easily distinguishable pipe-shaped high-level echo can be seen by conventional ultrasound in craniocerebral gunshot injured areas. ②The pipe-shaped strong echo usually shows non-enhancement by the CEUS,or shows homogeneous hypo-enhancement in some areas. ③Tissues around the pipe-shaped echo usually appears that the homogeneous hypo-enhancing area and non-enhancing area exist together. ④Around the above-mentioned the hypo-enhancing area and non-enhancing area, a hyper-enhancing area can be seen, and appears to be a typical ring-shaped high-level echo in short-axis section of the pipe-shaped echo. ConclusionsConventional ultrasound can easily shows the distribution of craniocerebral gunshot injured areas characterized by pipe-shaped high-level echo, and CEUS can precisely demonstrate necrotic tissues in the gunshot injured areas,distinguish them from the degenerative tissues and normal tissues. The application of ultrasound technology will greatly improve the therapeutic and treatmental level of the craniocerebral gunshot wound.

OBJECTIVETo observe the analgesic effect of triptolide (TP) of high, middle and low doses on rats with adjuvant arthritis (AA), and the expressions of inducible nitric oxide synthase (iNOS) and substance P (SP) in spinal dorsal horn and dorsal root ganglion (DRG) of corresponding sections, in order to discuss the possible mechanism for the analgesic effect of TP on rats with adjuvant arthritis.

METHODFifty SD rats were selected and randomly divided into the normal group (group A), the model group (group B), and TP low (group C), middle (group D), high (group E) dose groups. Except for the group A, all of the remaining groups were injected with 0.1 mL of Freund's complete adjuvant through their right rear toes to establish the model. At 14 d after the model establishment, rats in C, D and E groups were intraperitoneally injected with different doses of TP (0.1 mg x kg(-1) for the group C, 0.2 mg x kg(-1) for the group D, 0.4 mg x kg(-1) for the group E) once a day for 9 days. Then the 50% mechanical withdraw threshold (MWT) was determined. And the expressions of iNOS and SP in lumbar5 (L5) spinal dorsal horn and DRG were detected with the immunohistochemical method.

RESULTThe 50% MWT of rats in the group B was significantly lower than that of the group A (P < 0.01). After being treated with TP, the Thermal withdrawal latencies of groups C, D and E were significantly higher than that of the group B (P < 0.01). TP could notably increase the MWT of AA rats, with a certain dose-effect relationship. The immunohistochemical results indicated that the iNOS and SP expressions significantly increased in the group B (P < 0.01), while the positive expression levels of iNOS and SP in groups C, D and E were significantly lower than that of the group B (P < 0.01), with a certain dose-effect relationship.

CONCLUSIONTP shows a good analgesic effect on AA, and could inhibit the iNOS and SP expressions in spinal dorsal horn and DRG in rats with adjuvant arthritis, which may be one of action mechanisms for the analgesic effect of TP.

Animals ; Anti-Inflammatory Agents, Non-Steroidal ; pharmacology ; Arthritis, Experimental ; drug therapy ; metabolism ; physiopathology ; Diterpenes ; pharmacology ; Dose-Response Relationship, Drug ; Epoxy Compounds ; pharmacology ; Female ; Ganglia, Spinal ; drug effects ; metabolism ; Immunohistochemistry ; Male ; Nitric Oxide Synthase Type II ; biosynthesis ; Pain Measurement ; methods ; Phenanthrenes ; pharmacology ; Phytotherapy ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Spinal Cord ; drug effects ; metabolism ; Substance P ; biosynthesis ; Time Factors ; Treatment Outcome ; Tripterygium ; chemistry

Objective To investigate the distribution of six short tandem repeats(STR) loci in Maonan in Guangxi province and to study genetic relationship among 6 minorities.Methods Two hundreds unrealated individulas were analyed by STR genescanning.Genetic distance was computed and phylogenetic tree was construted for studying genetic relationship among 6 Ethnic groups.Results The average heterozygosity(H) in the six STR loci was 0.7825;the average polymorphism information content(PIC) was 0.7324;the accumulative discrimination power(DP) was 0.99999951,and the accumulative probability of paternity exclusion(EP) was 0.994575.All 6 populations were clustered into 2 group.Conclusion Allele 16 in D3S1358,allele 11 in D5S818,allele 11 in D7S820,8 in D13S317,14 in vWA,22 in FGA are probably the most primitive alleles in repective locus.The data obtained indicate highly genetic polymorphisms.Genetic relation between Maonan and Mulao were close.

Objective To evaluate the effectiveness and side effect of MT regimen (mitoxantrone plus teniposide) in inductive chemotherapy and explore the relationship between the effectiveness and karyotype. Methods 33 patients with acute monocytic leukemia were divided into two groups according to the treatment history or risk status according to cytogenetics MRC criteria. Group A (n=23) and B (n=10) were primary treatment and no remission following one course of DA (daunorubicin plus cytarabine) or HDA (Harringtonine,daunorubicin plus cytarabine) regimen,respectively. According to MRC criteria,group C (n=29) and D (n=4) were intermediate and adverse group. All the cases received two courses MT regimen chemotherapies to induce remission. The results and side effects were analysed. Results The complete remission rate and effective rate in group A and B were 83 % (19/23) and 60 % (6/10),91 % (21/23) and 70 % (7/10) respectively. The complete remission rate and effective rate in group C and D was 83 % (24/29) and 25 % (1/4),88 % (26/29) and 50 % (2/4) respectively. In complex cytogenetic group and 11q23 abnormal without complex cytogenetic group,CR rate was 0 (0/3) and 100 % (4/4). The time point,count of WBC nadir and the duration of WBC were less than 1×109/L is (7±3) day after chemotherapy,(0.4±0.2)×l09/L,(8±5) day. Chemotherapy related mortality was 0. Conclusion MT regimen was highly effective and safe in inducing remission in acute monocytic leukemia,including the cases which achieved no remission following one course of DA or HDA regimen. The effectiveness of MT regimen relates to the cytogenetics. MT regimen may be highly effective in cases with 11q23 abnormal and poor effective in cases with complex cytogenetic.

Objective To analyze the relationship between the radiation doses to mediastinal lymph nodes regions and the regional failure patterns when involved field radiation therapy (IFRT) was used for limited-stage small cell lung cancer (SCLC).Methods The mediastinal lymph node regions (group 1 to 10) of the iimited-stage SCLC patients received definitive radiotherapy were contoured in treatment planning system.The intentional or incidental radiation doses to each lymph node regions were recorded.In-field recurrence,marginal recurrence and out-of-field recurrence were respectively defined as the volume of failed lymph nodes located within the 80％ iso-dose lines,in the 80％-20％ iso-dose lines and beyond the 20％ iso-dose lines of prescribed doses.Results A total of 1 216 lymph node regions in 76 patients were contoured.The median follow-up time was 17.4 months.At diagnosis,lymph node regions with metastatic rates ＞50％ were 4R (68.7％),4L (57.9％),10R (57.9％),2R (56.6％) and 7 (51.3％).The positive lymph node regions were all subjected to prescribed doses.The lymph node regions that received incidental radiation doses of more than 3 000 cGy were:3P,4L,7,6,4R,5,2L.The median lymph node failure-free time was 9.8 months.In this study,only 1 patient developed out-of-field mediastinal lymph nodes failure.The rest of out-of-field recurrences and marginal recurrences were developed in the supraclavicular regions or contralateral hila.Conclusions When IFRT is used to treat mediastinal lymph node regions for patients with SCLC,negative mediastinal regions can be subjected to considerable incidental radiation doses.Out-of-field recurrences of the mediastinal lymph node regions are rare.This is contributed by the incidental radiation dose to these regions.

Objective To investigate the effect of electroacupuncture at points Xiaohai and Xiajuxu on the expressions of tumour necrosis factor-α (TNF-α) and choline acetyltransferase (ChAT) in serum and nicotinic acetylcholine receptorα 7 (α 7 nAchR) in duodenal tissues in a rat model of duodenal ulcer (DU) and preliminarily explore the relative specificity of He-Sea point in “treating visceral diseases with He-Sea point”.Methods Forty healthy SD rats were randomized into blank (A), model (B), Xiaohai (C) and Xiajuxu (D) groups, 10 rats each. A rat model of DU was made by subcutaneous injection of 10% cysteamine hydrochloride at the right buttock. After successful model making, group C was given electroacupuncture at point Xiaohai and group D, at point Xiajuxu. Duodenal tissue ulcer was macroscopically observed and scored in every group of rats. Rat serum expression of TNF-α was determined by double antibody sandwich enzyme-linked immunosorbent assay (ELISA); rat serum expression of ChAT, by ultraviolet spectrophotometry & colorimetry; rat duodenal expression ofα7 nAchR, by Western blot.Results After model making, the duodenal ulcer score was significantly higher in groups B, C and D than in group A (allP<0.01) and significantly lower in groups C and D than in group B (bothP<0.01) and in group D than in group C (P<0.01). TNF-α expression was significantly higher in group B than in group A (P<0.01) and significantly lower in groups C and D than in group B (bothP<0.01) and in group D than in group C (P<0.01). ChAT expression tended to increase in group C compared with group B but there was no statistically significant difference (P>0.05) and was significantly higher in group D than in group B (P<0.01) or C (P<0.05).α7 nAchR expression was significantly higher in groups C and D than in group B (bothP<0.01). There was a positive correlation between ChAT andα7 nAchR expressions in every group (r=0.444,P=0.007).Conclusions Electroacupuncture at both points Xiaohai and Xiajuxu can reduce the duodenal ulcer score and serum TNF-α expression and increase serum ChAT and duodenalα7 nAchR expressions in DU rats. The results show that the therapeutic effect of electroacupuncture on duodenal ulcer may be produced by regulating TNF-α. Its mechanism may be activating cholinergic anti-inflammatory pathway to produce an anti-inflammatory effect. The effect being better in group D than in group C suggests that Xiajuxu has the relative specificity.

Objective To preliminarily screen the neoplastic stem cell (NSC) related surface markers combination and to under-stand the NSC distribution in hepatoblastoma(HB) .Methods The children cases of HB undergone the surgical therapy in the Jian-gxi Provincial Children′s Hospital were selected .The immunohistochemical method was adopted for observing the expression and distribution of NSC-related markers CD34 ,Thy-1 ,c-kit ,CD56 and stem cell factor(SCF) in the HB tissue and the normal hepatic tissue away from the edge of tumor tissue 3cm outside .Results Thy-1 and c-kit were sporadically distributed in the HB tissue and mainly focued on the portal area ,but did not exressed in the normal liver tissue ;the expression of CD34 and SCF in HB was signifi-cantly higher than that in the normal liver tissue(P<0 .05) ,in which CD34 was mainly distributed in the endothelial system and SCF was mainly expressed in the portal area ;CD56 was expressed in the tissue of the clustered nerve fibers ,the expression differ-ence between them had no statistical significance (P>0 .05) .Conclusion The different NSC related surface markers are distributed in the HB tissue and focus on the specific areas .The positive cells of Thy-1/c-kit expression may play a role in the HB occurrence .

AIM: To evaluate the effects of over-expression of cellular repressor of E1A-stimulated genes(CREG) mediated by retrovirus on neointima formation in injured rat carotid.METHODS: The pluronic F127 containing pLNCX/CREG or pLNCX/GFP retroviral vectors was placed around the injured rat carotid.The neointima,media areas and the intima to media ratio were calculated.Expressions of CREG,SM ?-actin and Ki-67 were detected.RESULTS: The GFP expression was observed at day 2 in pLNCX/GFP groups.The expression of exogenous CREG was also significantly increased in arteries at day 2 after pLNCX-CREG infection.Over-expression of CREG significantly suppressed neointima formation,attenuated the expression of Ki-67 and up-regulated SM ?-actin expression.CONCLUSION: Over-expression of CREG inhibits VSMCs proliferation and promotes VSMCs differentiation after vascular injury.It suggests that modulation of CREG expression or activity may be a viable approach to treat neointimal restenosis after percutaneous coronary intervention.

Objective To investigate the role and intracellular signal transduction mechanism in the injury of renal tubular cells induced by postasphyxial-serum in neonate.Methods Human renal proximal tubular cell(HK-2 cell) was used as target cell. The experiment was designed as:control group, asphyxia group ,and pyrrolidine dithiocarbamate (PDTC)blocking group. The attacking concentration of serum was 20%, and the apoptosis rate of HK-2 cells was detected by flow cytometer.Results Compared with controls[(13.3?1.70)%],after being stimulated with postasphyxial-serum, the apoptosis rate of HK-2 cells of asphyxia group [(46.73?3.68)%] and PDTC blocking group [(31.19?2.79)%]were significantly increased(P