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

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.

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.

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.

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.

Objective To observe the efficacy and safety of levofloxacin for the theatment of com-munity acquired pneumonia(CAP) in the elderly patients. Methods Thirty-six elderly inpatients with CAP between May 2005 and May 2007 were treated with levofloxacin at a dosage intravenously of 500 mg once a day for 5 to 14 days treatment. Results Streptococcus pneumoniae of multiple drugs-resistant were found in sputum of 22 patients,pseudomonas aeruginosa in 8 patients and haemophilus influenzae in 6 patients de-pending on the results of the sputum culture. The total clinical efficacy rate of levofloxacin was 75.0% and bacteria elimination rate was 82.1%,and 16.7% patients showed related side effect of diarrhea,skin-rash and kidney injury. Conclusions Levofloxacin is an effective with little side effect in treatment of CAP in the elderly.

Objective To compare the effect of different puncture positions in the combined spinal epidural anesthesia (CSEA)in cesarean section.Methods Ninety uterogestation women under-going elective Caesarean section were randomly divided into two groups,45 in each group.L3-4 inter-vertebral space was selected as puncture point.Group R kept right lateral position for two minutes af-ter puncture and turned 30°left tilt supine position until ready for surgery.Group L was turned to su-pine position after left lateral punctured and then turned to 30 left tilt supine position until ready for surgery.1% ropivacaine 1.5 ml+ 10% glucose 0.5 ml was used for spinal anesthesia.The sensory block level and adverse reaction within 1 5 min after the spinal anesthesia were observed,and the neo-natal Apgar score and the pH value of umbilical artery blood were recorded.Results The final block level of the group R was significantly lower than group L,and the time achieving final block height was significantly shorter than that in group L(P <0.05 ).The ephedrine dosage of group R 0 (0-6) mg was significantly lower than that of group L6 (0-12)mg (P <0.05).The PH value of umbilical artery blood in group R was significantly higher than that in group L (P <0.05).There was no sig-nificant difference in neonatal Apgar score.Conclusion In Cesarean section,keeping right lateral puncture position for two minutes after infusion and then turning 30° left tilt supine position can a-chieve better effects than 30°left tilt supine position immediately after puncturing.

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.