OBJECTIVE To study the epidemiology and the sensitivity to antibiotics of bacteremia in intensive care unit,and provide the reference for the clinical antimicrobial agents usage. METHODS 465 cases of bacteremia from Jan 2005 to Dec 2007 in the First Affiliated Hospital,Medical College of Zhejiang University were retrospectively analyzed. RESULTS Totally 1465 strains of pathogens were isolated in three years,and the positive rates were 22.6%.From them 155 strains were fungi(10.6%),611 strains were Gram-positive bacteria(57.9%) and 392 strains were Gram-negative bacteria(37.1%).G + strains mainly included coagulase-negative Staphylococcus(CNS,43.0%) and Staphylococcus aureus(2.1%);the sensitive antibiotics were vancomycin and teicoplanin.G-strains mainly included Acinetobacter baumannii(8.6%);Stenotrophomonas maltophilia(6.6%);Pseudomonas(5.1%) and Klebsiella pneumoniae(5.3%),the sensitive antibiotics were cefoperazone/sulbactam. CONCLUSIONS The positive rates of blood culture are higher in intensive care unit than in others.We should pay more attention to CNS for its high infection rate.The sensitive antibiotics of G + are vancomycin and teicoplanin.The sensitive antibiotics of G-are cefoperazone/sulbactum.Antimicrobial therapy should be conducted according to susceptibility test.The candidemia caused by non-Candida albicans(NCA) is increaseing in recent 3 year.

Air Pollutants ; toxicity ; Animals ; Female ; Lung ; drug effects ; pathology ; Male ; Nitrogen Dioxide ; toxicity ; Particulate Matter ; toxicity ; Pulmonary Surfactant-Associated Proteins ; metabolism ; Rats ; Rats, Wistar ; Sulfur Dioxide ; toxicity ; Uteroglobin ; metabolism

ObjectiveTo compare the clinical effects of the outside and under temporal muscle titanium cranioplasty in mass frontal-temporal skull defect.MethodsClinical data of forty-two frontal-temporal skull defect pa tients who had cranioplasty with digital forming titanium nets were analyzed retrospectively.Two groups were divided according to the surgical method.Twenty-two cases underwent outside temporal and twenty cases under went temporal muscle titanium mesh.Compared with two groups of surgery condition( operation time,blood loss,titanium nail dos age) and postoperative complications( wound infection,subcutaneous effusion,epilepsy,intracranial hematoma,chew limited,facial paralysis) and the satisfaction rate of appearance discharged after one month.ResultsThe operation time of outside temporal muscle group was obviously less than under temporal muscle group( t =2.42,P ＜ 0.05 ),but the under temporal muscle group patients were more satisfied with the postoperative appearance ( x2 =36.31,P ＜0.05 ).There was no obvious difference of the postoperative complication between the two groups ( x2 =1.80,P ＞0.05 ).ConclusionBoth the outside and under temporal muscle method had its advantages and disadvantages.Operation methods selection should comprehensively and individually according to the specific condition of patients,surgi cal doctor's clinical experience.

Serum creatinine was determined by enzymatic method.99mTc-GFR was measured by 99mTc-DTPA dynamic renal imaging and considered as GFR marker in 210 males and 180 females with type 2 diabetes,eGFR was calculated by Cockcroft-Gault formula,MDRD equation7,abbreviated MDRD equation,modified MDRD equation for Chinese (c-7GFR4 and c-aGFR4),and CKD-EPI equation.They were analyzed by correlation,regression,Bland-Altman analysis and receiver operating characteristic (ROC) curve analysis.The correlation coefficients for Cockcroft-Gault formula,MDRD equation7,abbreviated MDRD equation,c-7GFR4,c-aGFR4,and CKD-EPI equation were 0.79,0.76,0.77,0.76,0.76,0.81 respectively.And the differences were-14.99,-18.85,-23.79,-25.85,-32.07,and-7.16,respectively.The area under ROC curves were 0.91,0.88,0.89,0.88,0.90,and 0.92,respeetively.Kappa values were 0.67、0.52、0.39、0.49、0.46、0.54respectively.The CKD-EPI equation seams to be the most accurate measurement among the six methods when the serum creatinine was determined by enzymatic method in Chinese type 2 diabetic patients.

Objective To investigate cholecystokinin (CCK),carbachol, and vasoactive intestinal peptide(VIP)stimulating peptide chain elongation in mouse pancreatic acini in vitro and its molecular mechanism. Methods ~3H-lecucine incorporation assay was used to measure the basal and secretagogues-stimulated pancreatic acini elongation rates. Western blot was applied to analyse the effect of phosphorylation of the elongation factor 2 (eEF2) and the eEF2 kinase. MEK inhibitor (PD98059), SAPK/p38 inhibitor (SB202190), and mTOR inhibitor (rapamycin) were used to respectively block MEK, SAPK/p38, and mTOR intracellular pathways or the phosphatase inhibitor (calyculin A) pretreatment before CCK treatment. Results All secretagogues except VIP increased the peptide chain elongation in mouse pancreatic acini in vitro. All secretagogues except VIP inhibited the phosphorylation level of eEF2 on Thr-56 and increased the phosphorylation level of eEF2K on Ser-366, which might correlate with their activation status. MEK inhibitor PD98059 partially reversed the dephosphorylation of eEF2 induced by CCK, as did treatment p38 MAPK inhibitor SB202190, mTOR inhibitor rapamycin, and the phosphatase inhibitor calyculin A.Conclusion CCK increases peptide chain elongation via inducement of dephosphorylation of eEF2 and eEF2 kinase phosphorylation in pancreatic acini in vitro. CCK-induced dephosphorylation of eEF2 in pancreatic acinar cells involves MEK, SAPK/p38, and mTOR, the three intracellular pathways.

Objective To explore the characteristics of nosocomial infection and its related factors among those very low birth weight infant(VLBWI)for coming up with appropriate preventive measures.Methods Fifty-eight infants with birth weight of 1500 g or below in the hospital from January to June in 2012 were studied actively and retrospectively about their nosocomial infection and related risk factors.Results Thirty-five cases of nosocomial infection occurred among the 58 infants with a prevalence of 60.34%. The mainly pathogenic bacteria was Gram-positive bacteria(88.47%)and mostly,infections presented with lung infections(82.90%) within 21 days after birth.The risk factors included mechanical ventilation,PICC,Apga score<7,fluconazole administration and premature rupture of membranes of VLBWI.Conclusion VLBWI are prone to nosocomial infections,mostly lung infection on day 21 after birth.Management should be strengthened within 3 weeks after birth of VLBWI to minimize infections.Reduction of invasive procedures on children and antibiotic use is particularly important.On the other hand,strengthening the health care in the perinatal period and reducing the incidence of preterm birth cannot be ignored.

Objective To investigate the clinical efficacy of anterior pelvic plating plus percutaneous lumbo-iliac rod/screw fixation in the treatment of pelvic fractures which are vertically and rotationally unstable and combined with unilateral sacral fracture of Denis type Ⅱ.Methods From January 2008 to November 2012,19 patients were treated for compound injury to the anterior and posterior pelvic rings complicated with sacral fracture of unilateral Denis type Ⅱ using anterior pelvic plating plus posterior percutaneous fixation of lumbo-ilium with screws.Their improvement in neurological function,reduction outcome and clinical effectiveness were evaluated by comparing preoperation and 2 years postoperation in terms of visual analogue scale (VAS),Japanese Orthopaedic Association (JOA) score for lower back pain,MOS Item Short-form health survey (SF-36 comprehensive scale),modified Roland-Morris Disability questionnaire (RDQ),Oswestry disability index (ODI),Gibbons overall scale,Majeed total score,sacral kyphosis abnormity,bias of sagittal/coronal vertical axis (SVA/CVA),pelvic incidence,pelvic tilt,lumbar lordosis,vertical displace,and leg length discrepancy.Results The differences respectively reached statistical significance for the aforementioned clinical and imaging parameters between preoperation and 2 years postoperation (P ＜ 0.05).By Majeed scoring,13 cases were rated as excellent,4 as good and 2 as fair.By Tometta/Matto scoring postoperatively,the fracture reduction was rated as excellent in 12 cases,as good in 6 and as fair in one.The complications of incision infection or necrosis,secondary neurovascular damage,implant failure or mal-union was not observed.Perfect nerve functional recovery and sufficient imaging reduction were achieved in all but one patient who had to receive decompression and release for sacral canals or foramens.According to Mohammad criteria,15 patients were engaged in the jobs with the same intensity and property as their pre-injury ones.Conclusions The simultaneous hybrid performance of anterior reconstruction plating combined with unilateral lumbar/sacral pedicle and iliac screwing may be a safe,reliable and satisfactory treatment for pelvic fractures of AO/Tile C1 type which involve unilateral sacral Denis type Ⅱ.

Objective To evaluate the efficacy and safety of 13-cis retinoid acid (13-CRA) and all trans retinoid acid (ATAR) redifferentiation therapy in patients with poorly differentiated thyroid cancer. Methods A single-center, randomized, double-blind, parallel controlled clinical trial was preformed. All patients were randomized into three groups. 78 cases were enrolled in each group. The patients were treated by 13-CRA in A group, by ATRA in B group, and by placebo in control group. The induced effects of retinoid acid (RA) and 131I treatment efficacies were defined as primary outcome of efficacy. Results After RA induction therapy, the effective rates in A, B, and control groups were 59.72%, 52.86% and 7.69%, respectively, with statistically significant difference among 3 groups (P<0.05). Compared with control group, A and B groups revealed significant induced efficacies (P<0.017), but there was no significant difference between A group and B group. After 131I treatment, the effective rates in A, B, and control group were 70.83%, 64.29%, and 28.21% respectively, with statistically significant difference (P<0.05). Compared with control group, the effective rates of 131I treatment in A and B groups were significantly raised (P<0.017), but there was no significant difference between A group and B group. The damage of skins and mucous membranes such as desquamation, dry skin, dry lips, dry eyes, etc occurred mostly in A group. The symptoms of nervous system such as headache, dizziness, etc occurred mostly in B group. Conclusions The induced differentiation of 13-CRA or ATRA is an effective method for the treatment of poorly differentiated thyroid carcinoma.

OBJECTIVETo study the infrared (IR) fingerprint spectra of Coptis chinensis for different parts, ages, and heights, and to analyze the integrate rules about the content of berberine component in Coptis chinensis for different parts, ages, and heights.

METHODThe Fourier transform infrared (FTIR) spectroscopy was applied to detect the infrared spectra of Coptis chinensis samples rapidly and non-separately.

RESULTSThe IR spectra of the root, leafstalk, and fibre of Coptis chinesis have their unique features. The content of berberine component in Coptis chinensis was different for different parts and the sequence: root > leafstalk > fibre. When Coptis chinensis grows, the content of berberine component in leafstalk also increases. The content of berberine component in leafstalk which planting in 1 200 m was less than that in 1 300, 1 400, and 1 500 m. The ages and heights provide no obvious influences on the content of berberine in the root of Coptis chinensis.

CONCLUSIONUsing FTIR spectroscopy, the quality of Coptis chinensis can be controlled, which provides a useful method for the standardized planting of Coptis chinensis.

Altitude ; Berberine ; analysis ; Coptis ; chemistry ; Plant Leaves ; chemistry ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; Quality Control ; Spectroscopy, Fourier Transform Infrared ; Time Factors

Objective To investigate the effect of different doses valsartan on atherosclerosis in rabbits. Methods 53 white rabbits were randomly divided into control group,cholesterol group,and valsartan group of high-,middle-,and low-dose.The positive expression of pro-oncogene c-myc and c-fos mRNA was studied with in situ reverse transcription-PCR)ISRT-PCR).The histoppathological changes of aorta were observed.Results)1) Positive expression rate of pro-oncogene c-myc and c-fos mRNA was significantly higher in cholesterol than that in the qontrol group.The rate of positive expression was remarkably lower in the high-dose valsartan group than that in the cholesterol group)P