Objective To investigate the application effect of quality control management in the prevention of indwelling catheter associated urinary tract infection in intensive care unit (ICU) patients. Methods Cases of patients stayed in the department of ICU undergoing indwelling catheter over 10 d were selected by using time stage sampling method. Totally 136 cases of patients were selected from January 1, 2012 to December 31, 2012, as the control group. A total of 145 cases of patients were selected from January 1, 2013 to December 31, 2013, as the performance group. Cases in performance group were taken standardized training and quantify the performance appraisal on the basis of measures in the control group. The urine routine was tested and bacterial was cultured at indwelling catheter 3 d, 7 d and 10 d, respectively. The indwelling catheter associated urinary tract infections of the two groups were compared. Results After the implementation of the performance appraisal management, the incidences of indwelling catheter associated urinary tract infection at 3 d, 7 d and 10 d were 4.8%(7/145), 19.3% (28/145) and 32.4% (47/145), respectively. Within each quarter, the incidence of indwelling catheter associated urinary tract infection was rising with indwelling catheter time prolonged. And the incidences of the first and second quarter were higher than three and four quarter. The incidences of indwelling catheter associated urinary tract infections at 3 d, 7 d and 10 d in the performance group were lower than the control group, the differences were statistically significant (χ2=4.494, 30.660 and 49.307, P < 0.05). Conclusions Standardized training of nursing staff in ICU and implementation of performance appraisal management could effectively improve the enthusiasm and sense of responsibility of the nurses, and effectively reduce the incidence of indwelling catheter associated urinary tract infection.

Drugs, Chinese Herbal ; administration & dosage ; therapeutic use ; Humans ; Phytotherapy ; methods ; Pulmonary Disease, Chronic Obstructive ; drug therapy

Fomentation engineering is one of the modern biotechnologies. It has been intensively studied and widely applied in edible fungi. Based on the review of research history of liquid fermentation for edible fungi, the research status of liquid fermentation about edible fungi were summarized, and its application prospects on edible fungi production of our country were described in this paper.

Streptomyces sp. A048 was cultured in a complete medium to the last stage of log phase,the hyphae were washed and collected by centrifugation. Then the hyphae were inoculated in liquid medium for chitinase production using two-step fermentation. Activity of chitinase produced by two-step fermentation was 1.1 times higher than that from one-step fermentation,and ferment cycle was for 54 hours,which was 66 hours shorter than that of one-step fermentation. The hyphae and the powder of chitin were co-immobilizated and cultured in liquid medium for 36 hours,activity of chitinase was 1.8 times higher than that from one-step fermentation,and ferment cycle was 54h shorter than that of one-step fermentation. By adding 0.4% cellulose to two-step fermentation,activity of chitinase was 18.52 U/mL that was 4 times higher than that from the control and 10 times higher than that from one-step fermentation. Two step fermentation with chitin and cellulose may be the optimal fermentation process to produce Chitinase from Streptomyces sp. A048.

BACKGROUND: Many experiments indicate that the angiogenesis of tissue engineered bone graft plays a key role in the osteogenesis.OBJECTIVE: An experimental pattern was set up designed to prepare a kind of vascularized engineered-bone graft for repairing rhesus tibia defects and analyze the relation of angiogenesis and osteogenesis in vivo by rontgenographic and morphological approaches.DESIGN: Random controlled animal experiment.SETTING: Department of Orthopaedics and Traumatology, Nanfang Hospital, Southern Medical University.MATERIALS: The composite graft was constructed by seeding the induced bone marrow stem cells (BMSCs) on to a beta-tricalcium phosphate(3-TCP) scaffold in vitro, a circular cylinder (20 mm × 8 mm diameter) with a slit (width 2 mm and length 3 mm ) open to both ends and slot. Porosity 60% and pore diameter 100-150 μm. Twenty-nine healthy rhesuses aged 4-5 years and weighted 3.5-5 kg were adopted without gender limitation.METHODS: The experiment was conducted in the Department of Orthopaedics and Traumatology, Nanfan Hospital, Southern Medical University from October 2003 to July 2005. ①Bone-periosteum defect of 20 mm was made in the middle part of right tibia of the 27 rhesuses, and randomly divided into 3 groups equally. ②The defect gaps in fascia-blood vessel group (A) were plugged with in vitro engineered composites constructed by bone marrow stem cells and 3-TCP scaffold, which were totally hugged by a sheet of pedicled deep fascia and additionally a corresponding portion of saphenous artery and veins. The gaps in fascia group (B) and control group(C), however, were inserted with fascia-coated tissue engineered bone and tissue engineered bone only, respectively. Furthermore, two rhesuses without filling materials on the defect were picked up as blanks fixed by steel pins. ③The angiogenesis and osteogenesis for each treatment was assessed by radioactive imaging, roentgenographic analyses, blocking density and vaso-area image analysis at time intervals of 4, 8 and 12 weeks postoperative.MAIN OUTCOME MEASURE: The score of radioactive imaging,roentgenographic, morphological and vaso-area image analyses RESULTS: Totally 29 rhesuses were involved in the result analysis.① General observation of samples: In group A, all the surfaces of the implanted material and the central part were wholly wrapped up or replaced by bonelike tissues which were hard and could not be broken. And 2/3 materials had been absorbed; In group B and C, partial materials of the medial surface and the front were not coated or replaced by bonelike tissues, which could be broken with force, and 1/3 material had been absorbed.②Histological observation of scaffolds: With time passing, the scaffold materials were absorbed to different degrees in group A, B and C, among which, group A was most significant; Under the microscope, the implanted materials at 12 weeks were completely coated with the bonelike tissues, while the blood vessels structures in the materials were mostly alveoli alike and multi-braches. In group B, most of the materials at 12 weeks were wrapped up by the new bone, and few blood vessels could be seen in the center of the materials. In group C, the implanted materials at 12 weeks were slightly absorbed. The new bone and the vascular structures were both increased a little, but still very few.③Analyses of vaso-area: The vaso-areas of both central and peripheral parts in group A were significantly bigger than those of group B and C (P ＜ 0.05). Furthermore, it tended to increase with the time.④X-rays observation: At 12 weeks, group A's images presented obviously decreased density which was lower than that of the normal bone in individual areas and the continual bony callus manifested. Whereas group B and C's images showed slightly decreased density and the continual bony callus appeared on the sections. ⑤The roentgenographic scores of bone defects: The results indicates that the scores of group A was better than those of group B and C at 4, 8 and 12 weeks, respectively (P ＜ 0.05).CONCLUSION: ①This study shows that a feasible and effective angiogenesis approach of tissue engineered bone can accelerate osteogenesis in vivo. ②The absorption level is positively related to local angiogenesis.

AIMTo describe an unusual symptom of benign prostatic hyperplasia (BPH).

METHODSA patient presented to our urology clinic having experienced post-coital gross hematuria for 2 years. He had not experienced lower urinary tract symptoms (LUTS). A series of examinations were performed to determine the source of bleeding.

RESULTSThe prostate was defined as the active bleeding source responsible for the patient's post-coital hematuria. Endoscopic fulguration did not alleviate the symptom. The use of dutasteride, a dual inhibitor of 5alpha-reductase, solved the problem.

CONCLUSIONThis study reports for the first time that post-coital gross hematuria is one of the clinical presentations of BPH, which can be successfully treated with 5alpha-reductase inhibitor.

5-alpha Reductase Inhibitors ; Azasteroids ; therapeutic use ; Coitus ; physiology ; Dutasteride ; Enzyme Inhibitors ; therapeutic use ; Hematuria ; drug therapy ; etiology ; physiopathology ; Humans ; Male ; Middle Aged ; Prostatic Hyperplasia ; complications ; diagnosis ; physiopathology ; Urinary Tract

AIMTo approach the protective effect of low dose gentamicin against high ototoxic dose of gentamicin.

METHODSThe guinea pigs were randomly divided into four groups: control group, low dose group, low dose protective group and high dose group. Each group received multiple intraperitoneal injections of gentamicin sulphate within different durations. Auditory brain stem response (ABR) was examined one day previous to the first and 24 h after the final injection respectively. The bulla was taken out so that the content of NO, MDA and the activity of LDH in cochlear were determined.

RESULTSThe threshold of ABR was significantly lower in low dose protective group compared with high dose group (P < 0.01). The content of NO (15.86 +/- 1.98 nmol/mg pro) and MDA (19.14 +/- 0.96 nmol/mg pro) in homogenate of high dose group was significantly higher than that of control group, low does group and low does protective group (P < 0.01). The increase of the content of NO and MDA induced by high dose GM could be significantly decreased by low dose GM administration previous to high dose injection (P < 0.01). The activity of LDH in homogenate of high dose group was significantly higher compared with control group, low dos group and low dos protective group (P < 0.01). There was no statistically significant difference of content of NO and MDA among control group, low does group and low does protective group.

CONCLUSIONThe protective effects resulting from previous low dose administration to high dose injection of GM may be related to the decrease of content of NO and MDA and activity of LDH both of which induced by high dose GM.

Animals ; Cochlea ; metabolism ; Evoked Potentials, Auditory, Brain Stem ; physiology ; Female ; Gentamicins ; administration & dosage ; adverse effects ; Guinea Pigs ; Hearing Loss ; chemically induced ; prevention & control ; Male ; Malondialdehyde ; metabolism ; Nitric Oxide ; metabolism

Objective To describe the characteristics of sexual debut among college students in China to provide appropriate sex education in that population. Methods An anonymous questionnaire survey was conducted among 33 653 college students selected by multi-stage stratified cluster sampling method in 18 provinces and cities of China. Results The percentage of students who had initiated sexual intercourse before age 14 was 1.9%. Overall, male students (2.8%) were significantly more likely to have initiated sexual intercourse before age 14, than female students (1.1%). The percentage of students who had initiated sexual intercourse from age 15 to 18 was 6.4% in males versus 2.1% in females. while the rates of students who had initiated sexual intercourse after age 19 were 6.9% in males and 2.6% in females. The first sexual intercourse was significantly associated with parental educational attainment, geographic location and family structure. Students whose parents were relatively well educated, living in the western areas of the country China, or with nucleus/extensive families were more likely to have early sex in their puberties. Conclusion Sexual education should be strengthened especially in the western areas, and targeted on the students whose parents with relatively higher educational background or who were from extensive families.

OBJECTIVETo evaluate the possibility that using intracoronary delivery of autologus bone marrow-derived mesenchymal stem cells (MSCs) to improve the cardiac function after acute myocardial infarction (AMI) in miniature pig.

METHODSMSCs were cultured in Dulbecco's modified Eagle's medium-F12 (DMEM/F12) medium. AMI model was made by blocking the blood stream of the first diagonal branch in miniature pig, and released the branch after 90 minutes. After 10-14 days, (4-6) x 10(7) culture-expanded autologus 4', 6-diamidino-2-phenylindole (DAPI)-labelled MSCs were transplanted into each host heart's AMI area through intracoronary way. Ultrasonic cardiography (UCG) was performed to observe the left ventricular function at 3 months after transplantation. The cellular transplanted hearts were harvested and investigated by immunohistochemical analysis.

RESULTSLeft ventricular function of the MSCs group was improved significantly 3 months later compared with the control group [(54.65 +/- 3.39) vs (43.98 +/- 4.21)%, (P < 0.01)]. Exogenous MSCs survived and site-differentiated into cardiomyocytes in infracted hearts.

CONCLUSIONMSCs can play a benificial role to repair damaged heart. Heart function can be improved after MSCs transplantation in porcine myocardial infarction model.

Animals ; Female ; Male ; Mesenchymal Stem Cell Transplantation ; methods ; Myocardial Infarction ; pathology ; physiopathology ; therapy ; Swine ; Swine, Miniature ; Transplantation, Autologous ; Treatment Outcome

OBJECTIVETo study and compare the accuracy and sensitivity of endoscopic ultrasonography (EUS) and CT scaning in determination of preoperative stage and vascular invasion by pancreatic and ampullary cancers.

METHODSFourty-two pancreatic cancer patients and 18 ampullary cancer patients were studied. With patients prepared according to conventional endoscopy, Olympus EUM-30 scope 1 set with a side view and 360 degrees rotate and switchable scanning probe [ultrasound frequency (7.5/12 MHz)], was introduced to the descending duodenum through the esophagus. Gas within the duodenum and stomach was aspirated. Then, in order to to facilitate ultrasound transmission, 200 ml deaerated water was injected into the duodenum and 500 ml into the stomach to distend it. The structures of each part of pancreatic head and ampullary together with surrounding vessels were scanned. Then, the scope was withdrawn to the gastric antrum, body and fundus gradually, while the pancreatic body and tail were scanned.

RESULTSBetween Apr. 1996 to May 2004, a total of 42 pancreatic cancer patients and 18 ampullary cancer patients were examined by EUS. Meanwhile, all these 58 patients received preoperative CT scaning. The results of stage and vascular invasion determined by EUS in this series were as following; pancreatic cancer group (n = 42): accuracy in T2-4 stage was 100.0% (5/5), 75.0% (9/12) and 48.0% (12/25), respectively; ampullary cancer group (n = 18): T1-4 stage was 75.0% (3/4), 66.7% (2/3), 75.0% (6/8) and 33.3% (1/3), respectively; the accuracy in N stage: P-group: 80.0% in N1 (4/5), 90.0% in N0 (9/10); A-group: 50.0% in N1 (3/6), 91.0% in N0 (10/11). The sensitivity, specificity of vascular invasion, resectability and unresectablilty determined by EUS and CT as compared with surgical findings during operation was 52.9% (9/17), 93.1% (27/29), 77.1% (27/35) and 81.8% (9/11) for EUS (n = 60), respectively; and 11.8% (2/17), 92.6% (25/27), 62.5% (25/40) and 50.0% (2/4) for CT (n = 58), respectively.

CONCLUSIONEndoscopic ultrosonography being one of the best image examinations to determine the stage and vascular invasion for pancreatic and ampullary cancer paitients is able to detect small pancreatic or ampullary cancer less than 2.0 cm in diameter due to its high resolution; but can not detect the secondary multiple distal metastases such as spread into the liver, peritonium or hepatoduodenal ligament, etc. due to its ultrasound depth limitation.

Ampulla of Vater ; diagnostic imaging ; pathology ; Common Bile Duct Neoplasms ; diagnostic imaging ; pathology ; surgery ; Endosonography ; Female ; Humans ; Lymphatic Metastasis ; Male ; Mesenteric Veins ; diagnostic imaging ; pathology ; Neoplasm Invasiveness ; Neoplasm Staging ; Pancreas ; diagnostic imaging ; pathology ; Pancreatectomy ; Pancreatic Neoplasms ; diagnostic imaging ; surgery ; Portal Vein ; diagnostic imaging ; pathology ; Preoperative Care ; Tomography, X-Ray Computed ; Vascular Neoplasms ; diagnostic imaging ; pathology