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.

Adenocarcinoma ; pathology ; Carcinoma in Situ ; pathology ; Digestive System Neoplasms ; classification ; pathology ; Esophagogastric Junction ; pathology ; Humans ; Liver Neoplasms ; pathology ; Neoplasm Staging ; Neuroendocrine Tumors ; classification ; pathology ; Pancreatic Neoplasms ; pathology ; Precancerous Conditions ; pathology ; World Health Organization

Terpenoids constitute a chemically diverse family of naturally occuring compounds with pharmaceutical significance, such as artemisinin and taxin. They are synthesized in many kinds of microorganisms and plants with very low yield. Metabolic engineering, modifying metabolic pathways of terpenoids-synthesized cells by recombinant DNA techniques, has been developed and applied to improve the production of terpenoids, as well as create a novel biosynthesis pathway of terpenoids in terpenoid-free organisms. The biosynthetic pathway of terpenoids was sumed up, and recent progress of metabolic engineering aiming at raising content of terpenoids in microorganisms and plants was described.

Egr-1 is an important transcription factor, which regulates at least 30 kinds of gene expression. Egr-1 couples extracellular signals to long-term responses by altering expression of Egr-1 target genes. So egr-1 can directly or indirectly affect cell differentiation,apoptosis,immune response,injury and repair. This article reviewed the progress in Egr-1 and the lung disease.

AIM: To determine the effect of phacoemulsification and intraocular lens (IOL) implantation for angle closure glaucoma previously treated by laser iridotomy.METHODS: Thirty-nine patients(39 eyes )with angle closure glaucoma previously treated by laser iridotomy and cataract were divided into two groups according need for anti-glaucoma medications for controlling intraocular pressure (IOP) or not. All the patients underwent phacoemulsification and foldable IOL implantation and were followed up 3 months postoperatively.RESULTS: The best-corrected visual acuity(BCVA) of both groups improved significantly (P<0.05). The post-operative IOP of group I at 3 months was 15.72±3.02mmHg,and that of group Ⅱwas 16.30±3.81mmHg. The IOP of both group decreased significantly(P<0.05). The central anterior chamber depth of group I was deepened from 1.64±0.45mm preoperatively to 3.21±0.41mm at 3 months postoperatively,group Ⅱ was deepened from 1.92±0.52mm preoperatively to 3.18±0.39mm at 3 months postoperatively. The postoperative central anterior chamber depth of both groups increased significantly(P<0.05).Anterior chamber angle was much wider postoperatively.CONCLUSION: Phacoemulsification and IOL implantation was effective for angle closure glaucoma previously treated by laser iridotomy,and can improve visual acuity and completely relieve the pupillary block of angle closure glaucoma.

In order to investigate the effects of TGF-beta1 on the expression of MMP-2, -9 and TIMP-1 in human retinal pigment epithelial (RPE) cells, the third-sixth passage cultured RPE cells were treated with TGF-beta1 at different concentrations (0.01, 0.1, 1.0, 10 ng/mL), the expression of MMP-2, -9 and TIMP-1 mRNA was detected by semi-quantitative RT-PCR assays. MMP-2, -9 and TIMP-1 mRNA were expressed in the cultured RPE cells. The values of MMP-2/beta-actin in the cells treated with 0.1, 1.0, 10 ng/mL TGF-beta1 were 1.04 +/- 0.04, 1.07 +/- 0.02 and 1.11 +/- 0.03, respectively, significantly higher than in the control group (0.96 +/- 0.03, P < 0.05-0.01). The expression of MMP-2 mRNA could be up-regulated by TGF-beta1, in a dose-dependent manner. The expression of MMP-9 mRNA in the cultured RPE cells was slightly up-regulated by various TGF-beta1 concentrations treatment. The values of TIMP-1/beta-actin in the cells treated with 0.01 and 0.1 ng/ mL TGF-beta1 were 0.85 +/- 0.01 and 0.97 +/- 0.02 respectively, significantly lower than in the control group (1.07 +/- 0.04, P < 0.01), indicating that the expression of TIMP-1 mRNA was down-regulated by TGF-beta1 at low concentrations. But along with the increase of TGF-beta1 concentrations (1.0 and 10 ng/mL), the expression of TIMP-1 mRNA was slightly up-regulated, not significantly different from that in the control group (P > 0.05). It was concluded that TGF-beta1 might play an important role in the up-regulation of the expression of MMP-2 in RPE cells and result in a directional shift in the balance between MMP and TIMP. This may be facilitated for RPE cells to migrate in the pathogenesis of vitreoretinopathy.

Cerebral infarction is not only a focal damage,but also causes secondary damage in areas remote from the ischemic territory,which will retard the recovery of neurological function.Ephrin receptor B2 (EphB2) plays an important role in the development and repair mechanism of central nervous system.Blocking the effect of EphB2 in brain by using a specific inhibitor may enhance proliferation and migration of endogeneous neuronal stem cells after experimental cerebral infarc- tion,improve neurological function and influence angiogenesis and neuroplasticity in remote sites.It is expected to become a new approach for decreasing damages in areas remote from the cerebral infarction and promoting the recovery of neurological function.

Objective To study the effect of purified water on the neurobehavioral development of the offspring and the synergistic effect of the magnesium deficiency in food. Methods SD rats were divided into four groups,control food plus control water (control group),control food plus purified water,magnesium deficiency food plus control water,magnesium deficiency plus purified water,from five weeks of age of the F0 generation to five weeks of the F1 generation respectively. Morris water maze (MWM) was used to test the spatial learning and memory ability of offspring of rats. Results In the early training days of the place navigation,control group offspring of rats showed a shorter swimming time than the other groups. There were no significant differences among all experimental groups in the later training days of the place navigation,spatial probe test and visible platform trial,however the tendency was still to remain. Conclusion Purified water can damage the learning ability of offspring of rats and the learning ability delay will be more obviously when magnesium is deficient in food.

Objective To study the basic pathogenic cause,clinical characteristics,treatment methods and prognosis of sub-acute infective endocarditis (IE) ,and to improve the diagnosis and treatment against it Methods The basic cardiac disease,clinical characteristics,pathogenic bacteria,ultrasound cardiogram, therapy and prognosis of 36 cases of sub-acute IE was retrospectively analyzed. Results Compared to previous reports, the proportion of rheumatic cardiac disease was a little lower, whereas the proportion of congenital cardiac disease and not-recorded cardiac diseases were a little higher.The main clinical characteristics showed as fever, heart failure, increasing in number of neutrophile granulocyte,blood sedimentation and anemia, The positive rate of blood culture was 58. 33% with the most common pathogenic bacterium of streptococcus viridans. Endocardial vegetation has been diagnosed in 63. 89% of patients through-thoracic echo-cardiography. The short-term fatality rate was 19. 44% . Conclusions There have been significant changes in the basic pathogenic causes,clinical characteristics and pathogenic bacteria of sub-acute IE as compared to the previous reports. The fatality rate remains high even after active treatment. Early surgical operation is recommended to those suitable patients.

Using information on the Emergency Department of the Sino-Japanese Friendship Hospital-reconstructed in January of 2002-as primary data, the authors provide a general view of the model for the building, management and development of emergency departments in China in the 21" century. There are two aspects to the issue. One concerns the composition of the hardware architecture of the emergency department, including emergency medical service system(EMSS), modified layout and facilities, medico-technical departments with a complete range of functions, rational emergency medical service procedures as well as pie-hospital first aid and facilities for long-distance network medical treatment. The other concerns the composition of the software architecture of the emergency department, including the transformation of the employment system of emergency medical personnel, the change of emergency service concepts, the personnel performance and financial control of the emergency department, and the development of an emergency department culture.