Objective To discuss the risk factors and nursing intervention of multidrug-resistant organism (MDRO) infection in patients of traditional Chinese medicine hospital (TCM). Methods By investigating the patients admitted to Beijing Xuan Wu Hospital of Traditional Chinese medicine from June 2015 to June 2016, 756 patients of them who were confirmed with clinical diagnosis of infection and pathogen detection with positive, which were divided into MDRO group including 97cases and non-MDRO group including 659 cases, then the pathogens of MRDO infection species and distributionwere counted, and analyzed risk factors for infection. Results A total of 756 cases were detected positive strains 816 strains, including 611 strains of monitoring target strains, 116 strains of MRDO. The top three were methicillin-resistant staphylococcus aurous 30.17%(35/116), Pseudomonas aeruginosa 18.97% (22/116) and Klebsiella pneumonia 18.10% (21/116). Single factor analysis results showed that the patients' age, hospitalization days, the history of other hospital admission, invasive procedure, basic chronic disease (diabetes, cerebrovascular disease, lung disease) and combined use of antibiotics were MDRO infection risk factors (χ2=9.470-198.609, P < 0.01); multivariate Logistic regression analysis showed that the independent risk factors of MDRO infection were the history of other hospital admission (OR=2.085, 95%CI1.040-4.179), invasive procedure (OR=3.063,95% CI1.526- 6.150), diabetes (OR=2.037,95% CI1.070- 3.877), cerebrovascular disease (OR=4.349,95%CI 2.035-9.293)and combined use of antibiotics (OR=18.723,95% CI9.202-38.094). Conclusions Patients of TCM have many characteristics, such as with more basic diseases, longer length of stay, elder and so on. So we should be alert to the risk of MDRO infection and take nursing interventions to prevent and strengthen the isolation prevention.

Diagnostic Errors ; Electrocardiography ; Humans ; Inferior Wall Myocardial Infarction ; Meningeal Neoplasms ; Meningioma ; Myocardial Infarction ; diagnosis

Induced the mouse embryonic stem(ES)cells into neural cells on silk fibroin via the improved 4-/4+ RA method to explore the effect of the silk fibroin to the ES-derived neurons' growth,adherence and differentiation.Suspended the ES cells into EBs and then transferred them to three different substrates-coated 35 mm dishes including gelatin,Bombyx mori silk fibroin(SF) and Tussah silk fibroin(TSF) to identify the adherence and proportion of ES cells-derived neurons under these three substrates.The results showed that the EBs adhered to the gelatin and TSF are faster than to the SF.The average adhesive rate on gelatin and TSF are 90.3% and 84.4% respectively,and only 38.5% on SF,all the proportion of ?-Ⅲ-Tubulin positive cells is approximately 40%.It may provide important experimental information for tissue engineering,in which ES cells-derived neuron cells and silk fibroin materials are scaffolds,and also offer a source for cell therapy research of neurodegenerative disease.

AIMTo explore whether dorsomedial hypothalamic nucleus (DMH) is involved in the cardiovascular responses induced by habenular nucleus (Hb) stimulation and inhibitory effect of deep peroneal nerve (DPN) stimulation on above responses or not and to analysis transmitter mechanism.

METHODSExperiments were performed on white male rabbits anesthetised with chloralose and urethan. Experimental data were collected by means of stimulating Hb and DPN, recording arterial blood pressure and ectal electrocardiogram (EECG) and microinjecting transmitter blocker.

RESULTSProminent pressor and ischemic EECG segment changes were elicited by Hb stimulation (P < 0.01) Microinjecting kynurenic acid into ipsilateral DMH had partial blocking effect on pressor and ischemic EECG-ST segment changes induced by Hb stimulation (P < 0.01). Stimulation of bilateral DPN prominently inhibited the pressor and ischemic EECG-ST changes induced by Hb stimulation (P < 0.01, P < 0.05). Microinjecting naloxone into ipsilateral DMH decreased the inhibitory effect of DPN stimulation on above cardiovascular responses elicited by Hb stimulation (P < 0.01, P < 0.05).

CONCLUSIONGlutamic acid receptor in DMH is involved in pressor and ischemic changes induced by Hb stimulation. DMH and opiate peptide receptors in DMH are involved in the inhibitory effect of DPN stimulation on pressor and ischemic changes induced by Hb stimulation.

Animals ; Cardiovascular System ; Dorsomedial Hypothalamic Nucleus ; physiology ; Electric Stimulation ; Electrocardiography ; Habenula ; physiology ; Heart Rate ; Male ; Peroneal Nerve ; physiology ; Rabbits

AIMTo investigate the effect of selective H3 receptor agonist(R)-alpha-methylhistamine and antagonist thioperamide on the respiratory response in asthmatic guinea pigs respectively.

METHODSAnesthesized guinea pigs were prepared with a implanted intracerebroventricular (icv) cannula and instrumented for the measurement of respiratory rate (RR) and diaphragmatic electric activity (DA). Substance P-like immunoreactive (SP-LI) substances in lower respiratory tract were detected by immunohistochemical method. Brain histamine contents were measured by fluorometric determination.

RESULTS(1) Intravenous injection of ovalbumin caused tachypnea and significant decrease in DA magnitude. At the same time, SP-LI substances increased in trachea, bronchus and lung. (2) Administration of selective H3 receptor agonist (R)-alpha-methylhistamine (5 microg) icv immediately after i.v. ovalbumin could significantly ameliorate the changes in RR and DA induced by ovalbumin. In accordance, SP-LI substances in lower respiratory tract markedly decreased at 5 min and 10 min after (R)-alpha-methylhistamine microinjection. (3) Icv thioperamide (20 microg) caused a significant increase in RR and a decrease in DA. (4) Brain histamine contents increased in hypothalamus and cortex during asthma. After microinjection of thioperamide (20 microg) icv significant increase of histamine contents in hypothalamus and cortex was observed.

CONCLUSIONBrain histamine H3 receptors may be related to asthmatic respiratory responses.

Animals ; Asthma ; metabolism ; Brain ; metabolism ; Guinea Pigs ; Histamine Agonists ; pharmacology ; Histamine H3 Antagonists ; pharmacology ; Lateral Ventricles ; Male ; Methylhistamines ; pharmacology ; Muscle Contraction ; Piperidines ; pharmacology ; Receptors, Histamine H3 ; metabolism ; Substance P ; metabolism ; Trachea ; physiopathology

Objective To investigate the effect of solute cartier organic anion transporter family, member 1B1 (SLCOIBI) gene variants on the response to therapy with repaglinide in type 2 diabetes. Methods 100 newly-diagnosed type 2 diabetic patients were treated with repaglinide during a course of 48 weeks. Anthropometrie parameters and indices related to glucose metabolism were measured periodically. Genotypes of SLCO1B1 D130N and V174A were detected by PCR-restriction fragment length polymorphism (RFLP) and sequencing respectively. Results Eighty-nine patients accomplished the 48-week follow-up visits. D130N variant in SLCO1B1 gene was associated with repaglinide treatment, DD genotype had better HbA1C lowering effect than N allele carrier [△HbA1C: (-2.29±0.23) % vs (-1.49±0.21)%, P<0.05]. No association was detected between D130N and the other effects of repaglinide on glucose metabolism related phenotypes. Conclusion D130N variant in SLCO1B1 gene is associated with the response to repaglinide treatment in patients with type 2 diabetes. DD homozygotes had a better effect than N allele carriers.

Objective To evaluate the extra-anatomic bypass surgery for aorto-iliac occlusive disease in the elderly. Methods From January 2005 to December 2008,33 elderly patients/39 limbs (age ranged from 70 to 87 years, mean 76.0 ± 3.0 years) with aortoiliac occlusive disease were retrospectively analyzed. According to Fontaine classification, there were 5 phase Ⅱ b cases (7 limbs), 22 phase Ⅲ cases (26 limbs), and 6 phase Ⅳ cases (6 limbs), all cases were with TASC C, D lesions. Results These 33 cases/39 limbs were tr eated with a variety of bypass, including axillobifemoral bypass (6 cases/12 limbs) ,axillofemoral bypass ( 20 cases/20 limbs ), femorofemoral bypass ( 7 cases/7 limbs ). Intermittent claudication improved in 5 cases, rest pain disappeared in 22 cases, and ulcers healed in 6 cases after operations. The mean ABI increased from 0.29 ± 0.11 to 0.66 ± 0.13 ( t = 2.69, P ＜ 0.05 ). All limbs were salvaged and there was no perioperative mortality within 30 days after operations. Postoperative complication rate was 9.1%. Patients were followed up for a median of 12 ±5 months (range, 6 to 28 months), primary patency rate was 89.7% (35/39), secondary patency rate was 94.9% (37/39), limb salvage rate was 92.3% (36/39). After dischargement the mortality was 6.1% (2/33) with one dying of myocardial infarction and another one of malignant tumor (gastric cancer). Conclusions Extra-anatomic bypass for aorto-iliac occlusive disease in the elderly is feasible, safe and effective, and the cardiopulmonary dysfunctions are the major risk factors for perioperative complications.

Objective:To research the clinical effects of ulinastatin in the treatment of sepsis induced acute renal injury and its possible mechanisms.Methods:114 cases of patients with sepsis induced acute kidney injury from 2014.02 ～ 2016.08 were selected and randomly divided into the control group (n=57) and experimental group (n=57) according to the draw method,the control group was given conventional treatment,while the experimental group was treated by ulinastatin based on the control group,the urine urinary injury molecule-1 (KIM-1),atrialnatriuretic peptide (ANP),cyscatin-c (CYS-C),interleukin l,6 (IL-1,IL-6),c-reactive protein (CRP),tumor necrosis factor-α(TNF-α),nitric oxide (NO),endothelin 1 (ET-1),immunoglobulin A,G,M (IgA,IgG,IgM) levels,APACHE-Ⅱ score were compared between two groups before and after the treatment.Results:After treatmented,the urine of KIM-1,ANP,serum of CYS-C,IL-l,IL-6,CRP,TNF-α,ET-1 levels and APACHE-Ⅱ score of experimental group were significantly lower than those of the control group (P＜0.05).The serum NO,IgA,IgG,IgM levels of experimental group were significantly higher than those of the control group (P＜0.05).Conclusion:Ulinastatin could significantly relieve sepsis induced acute renal injury,which might be related to the inhibition of inflammatory response,improvement of the renal blood flow and immune function.

In order to provide substantial scientific information for exploring the mechanism of porcine liver injury caused by Taenia asiatica (T.asiatica),the expression of Cysteine aspartyl proteinase 3 (Caspase-3) from liver tissues of porkets that were experimentally infected by T.asiatica was examined.The T.asiatica adults were collected from the taeniasis patients in Duyun,Guizhou Province and identified biologically.The eggs were harvested from gravid proglottids and prepared by repeated washing and centrifugation.Twelve 20-days old Yorkshire and Seghers hybrid porkets were randomly divided into experimental and control groups as six pigs per group.The experimental group was orally administrated with 1.5 × 106 eggs per porket at day 0 post-infection.The porkets of both groups were sacrificed on the day 15 and day 75 post-infection (three pigs per time point) respectively,and liver samples were collected for further experiments.Quantitative real-time polymerase chain reaction method was employed to detect the mRNA levels of Caspase-3,and western blotting and immunohistochemistry methods were performed to detect the level of Caspase-3 expression in both groups.At the day 15 post-infection,the mRNA level and expression level of Caspase-3 of the experimental group were significantly decreased,comparison with the control group (P =0.011,P=0.008 and P=0.004 respectively).It was positive with Caspase-3 when yellow or brown signal appeared in the cytoplasm of liver cells by immunohistochemistry.However,at the day 75 post-infection,the mRNA level and expression level of Caspase-3 of the experimental group were dramatically similar to the control group.Furthermore,in the experimental group,the mRNA level and expression level of Caspase-3 were significantly increased at day 75 post-infection than day 15 post-infection (P--0.018,P=0.003 and P=0.002 respectively).These results suggested that Caspase-3 might be involved into the regulation of the damage of porcine liver induced by T.asiatica challenge at the early infection stage and have on effect to the hepatic injury because of the dramatic recovery of Caspase-3 at the consequent infection stage.

Objective To summarize the clinical characteristics and laboratory test results of children with Henoch - Schonlein purpura(HSP),and further to analyze the risk factors for HSP combined with cardiac damage. Methods The clinical and laboratory tests findings from 707 children diagnosed as HSP at Nanjing Children's Hospi-tal were retrospectively analyzed,who were recruited from November 2011 to December 2012. The possible risk factors for HSP with cardiac damage in children were recorded,including gender,age,predisposing causes,gastrointestinal symptoms,joint pain,kidney disorders,serum electrolytes,anti - streptolysin 〝O〝 test,erythrocyte sedimentation rate, and complement level were summarized. Chi - square test and Logistic regression were performed to analyze the risk fac-tors of cardiac damage in children with HSP. Results Among 707 cases,192(27. 2% )patients were combined with car-diac damage,115 male and 77 female,and the proportion of men to women was 1. 00: 0. 67;age ranged from 11 months to 15 years and 4 months(6 years and 5 months for median age),6 patients ﹤ 3 years old occupying 3. 1% ,103 patients≥3 - 7 years old occupying 53. 7% ,82 patients≥7 - 14 years old occupying 42. 7% ,1 patient≥14 years old occupying 0. 5% ,and the age of onset in preschool and school age. Electrocardiogram(ECG)abnormalities were found in 190 patients,the main manifestations including long Q - T interval,ST - T segment falling down and sinus bradycar-dia,and one or more items of abnormal myocardial enzymes existed in 24 cases;echocardiography was performed in 35 cases of children,but no abnormality was detected,no obvious symptoms such as flustered or chest tightness or precor-dial distress. Statistical analysis showed that gender,predisposing causes,mixed HSP,complement level were related to the incidence of cardiac damage in children with HSP(P ﹤ 0. 05). Furthermore binary Logistic regression identified that in male patients,the ratio of X1 vs OR ratio was 0. 654(95% CI 0. 462 - 0. 926,P ﹤ 0. 05),for predisposing causes,the ratio of X2 vs OR ratio was 2. 63(95% CI 1. 838 - 3. 765,P ﹤ 0. 001),for mixed HSP,the ratio of X3 vs OR ratio was 2. 452(95% CI 1. 301 - 4. 621,P ﹤ 0. 01),which were independent factors for cardiac damage in chil-dren with HSP. Conclusions ECG and/ or myocardial enzyme spectrum abnormalities are the main clinical ma-nifestations of cardiac damage in children with HSP. Male patients,predisposing causes of the respiratory tract infec-tion,mixed HSP and hypocomplementemia were high risk factors in the development of cardiac damage,which require special consideration clinically,and earlier ECG and myocardial enzymes examination,early diagnosis and treatment are necessary to avoid the occurrence of severe cases.