OBJECTIVE To analyze the susceptible factors to offer prevention and treatment of nosocomial pulmonary fungal infection in comprehensive ICU. METHODS The clinical materials of 82 patients with pulmonary fungal nosocomial infection in our department from May 2003 to May 2008 were reviewed. RESULTS The infection rate of total 836 patients was 9.81%.Candidiasis was the most frequent type in fungal infection,59.7% of which were due to Candida.The most clinical features were a large amount of light yellow sputum after tracheotomy and intratracheal indwelling cannula.The factors related to pulmonary fungal nosocomial infection were the severity of the underlying disease,tracheal intubations,broadspectrum antibiotics abuse,long-term use of glucocorticoid,interventional treatment,etc.Fluconazole,amphotericin B and voriconazole had better clinical effects on treatment of fungal infection than other antifungal drugs. CONCLUSIONS It′s important to eliminate the susceptible factors and to provide the early diagnosis and experimental treatment.

C and C 5457T (D1819D) were 11.1%, 5.2%, 28.2% and 31.8%, respectively. The minor allele frequency of SNPs was not same as study from Japanese or Chinese. Conclusion The distribution of SCN5A SNPs may vary between different ethnicities.

Objective To evaluate regional right ventricular longitudinal function in fetus using velocity vector imaging(VVI),and establish nomogram of right ventricle,Methods One hundreed and seventy healthy fetuses were divided into 5 groups according to the gestational age.Dynamic digital views of four chamber view were collected and analyzed offline.Velocity,strain and strain rate were calculated in systolic and diastolic period,respectively.Results Normal systolic and diastolic values for velocity,strain and strain rate were established.Tissue velocity gradually decreased from the base segment to the apical segment(P＜0.05),whereas strain and strain rate were stable(P＞0.05).Tissue velocity was gestationalage dependent(P＜0.05),whereas strain and strain rate were stable throughout gestation (P＞0.05).Conclusions Fetal myocardial velocity,strain and strain rate measurements are easy to obtain and reproducible.Increase in tissue velocity throughout gestation probably reflects the growth of the fetal heart,whereas intrinsic myocardial properties as measured by strain and strain rate do not change.

Objective To explore the clinical characteristics,relationship between treatment and prognosis of sarcoidosis and relationship of relapse to prednisone.Methods The clinical data of 165 patients with sarcoidosis were collected.The clinical characteristics,treatment process and prognosis,relationship of relapse with prednisone maintenance dose and course of treatment were retrospective analyzed.Results Among them,the most common involved systems were lung and lymph nodes.The involvement rates of lung,extra-thorax lymph nodes,cutaneous,ocular,salivary glands,liver & spleen,kidney and nervous system was 87.3％,51.5％,6.7％,6.1％,6.1％,4.2％,1.2％ and 1.2％ respectively.Unilateral tonsil,breast,ovary and bone involvement was seen in only 1 patient respectively with an involvement rate of 0.6％.A retrospective analysis was made for 114 cases with complete follow-up data.The mean follow-up period was (11.7 ± 5.7) (5-32) years.And 46 cases had no symptom on routine medical examinations.The most common consulted departments were respiratory,dermatological and general surgery departments.Among 74 patients on prednisone,48 patients (64.9％) were cured while 13 patients (17.6％) relapsed.Whereas in the observation group,25/38 patients (65.8％) remitted spontaneously and only 1 patient (2.6％) had recurrence.Relapse occurred more often in prednisone therapy group than in observation group (P ＜ 0.05).Longer prednisone 10-15 mg daily maintenance and a longer total course of treatment were associated with fewer recurrence(P ＜ 0.05).Conclusions The clinical manifestations of sarcoidosis vary and many patients have a self-limiting course.The most common involved systems are lung and lymph nodes.Stage Ⅰ / Ⅱ disease should be observed before prednisone therapy.Prednisone 10-15 mg daily for at least 6 months and a total course of treatment over 18 months may prevent relapse.

AIM To establish an HPLC method for the simultaneous content determination of chlorogenic acid,caffeic acid,luteoloside,baicalein,luteolin and rutin in Yinhuang Granules (Lonicerae japonicae Flos and Scutellariae Radix extracts).METHODS The analysis of 80％ methanol extract of this drug was performed on a 30 ℃ thermostatic SunFire-C1scolumn (250 mm × 4.6 mm,5 μm),with the mobile phase comprising of acetonitrile0.4％ phosphoric acid flowing at 1.0 mL/min in a gradient elution manner,and the detection wavelength was set at 239 nm.RESULTS All the six constituents showed good linear relationships within their own ranges (r =0.999 9),whose average recoveries were 94.56％-98.38％ with the RSDs of 0.49％-2.89％.Among fourteen batches of samples,the luteoloside content was found to be of little difference,while the other five constituents' contents were of relatively great differences.CONCLUSION The qualities of Yinhuang Granules and Lonicerae japonicae Flos extracts from different manufacturers are uneven,so supervision should be strengthened.

Objective To investigate the performance of dual source CT scanning combined with low-tube-voltage iterative reconstruction (SAFIRE) for demonstrating coronary artery calcium plaques. Methods 70 patients with clinically suspected coronary atherosclerosis and with normal BMI received SAFIRE-3 or filtered back projection (FBP) for reconstruction after undergoing CT scans with tube voltage range of 100 kV. The CT images (average CT values, noise, SNR, and CNR) and subjective scores (number of calcium plaque, calcium plaque adjacent artifacts, and image quality) were compared between the two groups. Results The average CT value of the aortic root did not differ significantly between the two procedures for reconstruction (P > 0.05). Ob jective evaluation of the images (noise, SNR, and CNR) between the two groups was statistically significant (P < 0.05 for all comparisons), so was image subjective rating (number of calcium plaque and rate of calcium plaque edge)(P < 0.05 for all comparisons). SAFIRE-3 reconstruction was markedly superior to FBP reconstruc-tion. Conclusions Low kilovoltage combined with reconstruction of SAFIRE-3 can reduce calcium plaque adja-cent artifacts and enhance quality of images , which is better than FBP in displaying the morphology and adjacent conditions of calcified plaque; therefore it is worth popularizing.

Objective Based on the teeth in vitro skull specimen to investigate the feasibility and accuracy of CARE kV CT scan for reducing radiation dose. Methods Of eight fixed and preserved skull teeth were scanned repeatedly in groups of A, B, C. In expose factors of 100 kVp/150 mAs in conventional scanning of group A, open CARE Dose 4D scan of group B and CARE kV scan of group C. We assessed the radiation dose in the group A, B and C, the average CT values of the images, noise, SNR, CNR and subjective ratings. Results Three groups of actual scan tube current, tube voltage and radiation dose were statistically significant (P < 0.05). Compared with group A, the radiation dose in the group B was reduced by about 13.76% and 26.61%reduced in the C group. The average CT values of the images and the noise SNR, CNR and subjective ratings hasd no significant difference (P > 0.05). Conclusion CARE kV technology based on the use specimens tooth can reduce the radiation dose, protect image quality, and be consistent to the reports of previous researches.

Objective To investigate the clinical value of velocity vector imaging in the assessment of regional left ventricular longitudinal myocardial function in fetuses with gestational diabetes mellitus (GDM). Methods Digital dynamic four-chamber views of 98 fetuses with GDM and 135 normal fetuses were collected and analyzed using velocity vector imaging. The regional tissue velocity, strain and strain rate of the interventricular septum and left lateral wall were measured in systole and diastole. Results Two hundred and seven of 233 cases were analyzed successfully. Systolic velocity(Vs) and diastolic velocity(Vd)were age-dependent, Vs and Vd were both gradually decreased from the basal segment to the apical segment in the left ventricle( P ＜0. 05). The Va after 32+0 weeks and Vd after 28+0 weeks and systolic strain(S),systolic strain rate(SRs) and diastolic strain rate(SRd) in left ventricle of fetuses with GDM after 24+0weeks were obviously lower than the corresponding parameters of normal fetuses ( P ＜0. 05). Conclusions Velocity vector imaging can evaluate the fetal regional left ventricular longitudinal myocardial function.

Objective To investigate the clinical significance of velocity vector imaging(VVI)in evaluating the left ventricular(LV)segmental longitudinal systolic function in patients with coronary artery disease(CAD).Methods In 25 patients with myocardial ischemia,28 patients with myocardial infarction,26 patients with coronary lumen stenosis＜50%,according to coronary arteriography and electrocardiogram,the myocardial segments of LV were divided into 4 groups:ischemic segments group,infarcted segments group,non-ischemic segments group and normal segments group.Twenty-eight healthy subjects were selected as control group.Dynamic imaging of all subjects were collected,the systolic peak strain(Smax)and strain rate(SRmax),the time to peak strain(PTs)and the time to peak strain rate(PTsr)were measured respectively.Results Smax and SRmax of the ischemic segments and infracted segments were significantly lower than those of the control group respectively,PTs and PTsr of the ischemic segments and infracted segments were significantly longer than those of the control group respectively.Smax and SRmax of infarcted segments were significantly lower than those of the ischemic segments,there were no differences of PTs and PTsr between ischemic segments and infracted segments.Smax and SRmax cutoff of -14.08%,-0.83 s-1 for detecting ischemic segments and cutoff of -6.65%,-0.38 s-1 for detecting infracted segments,respectively,gave an optimal sensitivity and specificity.Conclusions VVI is a kind of novel noninvasive-tool to quantitatively assess LV regional systolic function in CAD patients.It is competent to differentiate between the ischemic segments and infarcted segments.

Objective To observe the MRI findings of normal pancreas in piglets. Methods Eight healthy piglets underwent MR examination, and the morphology, size, signal intensity of pancreas were observed. After MR imaging, all piglets were abdominally incised to observe the anatomy of pancreas and pancreatic adjacent structures. The opening of both common bile duct and pancreatic duct were detected during operation. Two piglets were sacrificed after operation and the whole pancreases were dissected for anatomic research. Results The pancreas of piglets was composed of three parts: right lobe, median lobe and left lobe. All the lobes were displayed clearly on MRI. The signal intensity of pancreas was higher than that of liver and spleen on T1WI, whereas lower than that of liver and spleen on T2WI. On MRCP, pancreatic duct was not presented, whereas the common bile duct could be seen clearly. The opening of common bile duct located at superior part of duodenum (nearby the pylorus) and the opening of pancreatic duct situated at duodenal papilla corresponding to pancreatic right lobe. Conclusion MRI can show the pancreas of piglets very well. The morphology of pancreas and features of common bile duct conjunction with pancreatic duct in piglet are different from those in human.