Objective To analyze the risk factors and prognosis of Clostridium difficile infection (CDI) among hospitalized patients with inflammatory bowel disease (IBD).Methods From March 2014 to February 2015,216 first-time hospitalized patients with IBD were enrolled.Once hospitalized,stool samples were obtained for Clostridium difficile culture immediately,and at the same time toxins of Clostridium difficile (tcd) A and tcdB were detected by polymerase chain reaction(PCR).The incidence and risk factors of CDI in enrolled patients were analyzed.Chi square test and nonparametric test were performed for statistical analysis.Results Among the 216 IBD patients,there were 73 patients with ulcerative colitis(UC) and 143 patients with Crohn's disease(CD).The positive rate of CDI was 13.9 ％ (30/216) in IBD patients.The positive rate of CDI was 24.7 ％ (18/73) in UC patients,which was higher than that of CD patients (8.4％,12/143),and the difference was statistically significant (x2 =10.690,P＜0.01).As the severity of the disease increased,the rate of CDI positive patients in UC patients increased.Among three patients at remission period,17 patients at mild active stage,23 patients at moderate active stage and 30 patients at severe active stage,the CDI positive patients were zero,two,five,11,respectively,and the difference was statistically significant (x2 =4.820,P=0.028).In UC patients,the incidences of patients with hospitalization history in other hospitals within three months before admission in CDI positive group and negative group were 6/18 and 7.3％ (4/55),respectively,and the difference was statistically significant (x2 =5.740,P=0.020).In 30 days before admission,the rates of patients with proton pump inhibitor (PPI) taking history of two groups were 7/18 and 7.3％ (4/55),and the difference was statistically significant (x2=8.270,P=0.004).The length of hospital stay in CDI negative UC patients was 7.0 d (5.0 d,12.0 d),which was shorter than that of CDI positive patients (10.5 d (8.8 d,18.2 d)),and the difference was statistically significant (U=277.000,P=0.005).The rate of patients underwent intestinal operation in CDI negative CD patients within three months after CDI examination was 10.7 ％ (14/131),which was significantly lower than that of CDI positive patients (5/12) (x2 =4.520,P=0.010).Conclusions The incidence of CDI in hospitalized IBD patients was high,especially in UC patients;the risk factors included disease severity,prior hospitalization history within three months before admission and PPI taking history within 30 days before admission.CDI was correlated with poor prognosis.

This study is designed to obtain recombinant human acetylcholinesterase (rhAChE) and apply it in screening acetylcholinesterase inhibitors. The rhAChE was overexpressed in HEK293 cells transfected by plasmid of pCMV-AChE with the cationic liposome and rhAChE was found to be secreted into cell culture medium. AChE activity was assayed according to modified Ellman method to obtain kinetic parameters. IC so50 values for donepezil compounds of rhAChE were calculated to determine their activities of inhibition. The results showed that Km value was 151.9 micromol.L-1 donepezil inhibited rhAChE in a mixed competitive-noncompetitive way (Ki= 16.03 nmol.L-1, Ki = 18.36 nmol.L-1) and that most new compounds tested exhibited high activities of inhibition on rhAChE. The study suggests that rhAChE is available to be applied in screening AChE inhibitors in vitro.

Objective;To explore the relationship among parents' negative punishment,children's self-concept,and children's social behaviors.Methods;Data were collected from questionnaires given to a sample of 612 children from primary and secondary schools and their parents.Results;The structural equation modeling results showed parents' negative punishments could influence children's social behaviors directly and indirectly.In the indirect approach,through the mediating role of children's self-concept,parents' negative punishments could make a negative role on children's pro-social and aggressive behaviors,and a positive role on children's withdrawn behavior.In the direct approach,parents' negative punishments could make a positive effect on children's pro-social,aggressive and withdrawn behavior directly.Conclusion;Children's self-concept plays a mediating role between the relationship of parents' negative punishments and children's social behaviors.

With citric acid as carbon source and different amino acids as nitrogen source,the nitrogen-doped carbon was synthesized by one-step hydrothermal method under the condition of no catalyst.The pre-experiments show that arginine-doped carbon dots(CDs-Arg) with relatively high fluorescence quantum yield (33.25％) were picked out for further study.Furthermore,we studied the physical and chemical properties of CDs-Arg through a series of spectral,electric potential,particle size,X ray and elemental analysis experiments.At the same time,the stabilities of the nanoparticles towards different pH,temperatures,excitation lasers or redox conditions were studied.And the MTr and in vivo distribution experiments were also conducted for the toxicity and metabolism studies.The experimental results showed that the arginine doped carbon dots has high fluorescence efficiency,good stability,and extremely low toxicity.And the water-soluble small particles of CDs-Arg nanoparticles showed that the nanoparticles can be excreted through the glomerulus.These results show that the CDs-Arg Nanoparticles are biocompatible nanoparticles and have potential applications in biological imaging and can serve as a monitor of drug metabolism.

Objective To study the quality and effect of root cause analysis (RCA) on long-range video EEG monitoring on epilepsy patients.Methods The process of RCA long-range video EEG monitoring on patients with epilepsy was investigated to find out the root causes for quality of epilepsy capturing from pseudo differential of EEG and video effects.Then the measures were taken to improve the quality of monitoring.Result After the intervention,except canmera not clear enough,the incidences were significantly decreased compared with pre-intervention (all P ＜ 0.001).Conclusions Root cause analysis is effective in improving the quality of long-range video EEG monitoring on epilepsy patients.It is worth clinically promoting.

Objective:To investigate the clinical significance of dynamic analysis of plasma brain natriuretic peptide in patients with dilated cardiomyopathy with chronic heart failure.Methods:Ninety patients with dilated cardiomyopathy with chronic heart failure admitted into our hospital firom March 2012 to March 2016 were divided into group A (20 cases),group B (38 cases),and group C (32 cases) according to the NYHA grading.The plasma BNP levels and LVEF,LA,LVEDD,and LVESD in the three groups were detected and compared.The correlation of plasma BNP and cardiac function and ultrasonic cardiogram indexes were analyzed.And the capability of plasma BNP and LVEF in diagnosis of patients were analyzed and compared.Results:The plasma BNP level in group C was markedly higher than that of group A and group B (P＜0.05),and that in group B was much higher than that of group A (P＜0.05).And LA in group C was significantly higher than that of group A (P＜0.05),while differences in LVEF,LVEDD,and LVESD were not obvious (P＞0.05).The plasma BNP was positively correlated to NYHA grading,but had no significant correlation with the LVEF,LVEDD,LVESD,and LA (P＞0.05).Based on results of receiver operating characteristic curve analysis,plasma BNP =523.5 pg/mL was the threshold value for identification of patients with NYHA Ⅲ and Ⅳ (AUC=0.901,P＜0.001),while LVEF had not the capability (AUC=0.392,P=0.276).Conclusion:Detection of plasma BNP level had important clinical significance on diagnosis,screening and cardiac functional grading of patients with dilated cardiomyopathy with chronic heart failure.

Objective To evaluate the cause of ischemia related to myocardial bridge (MB) by using SPECT/CT MPI and CTCA.Methods A total of 294 patients with chest pain,tightness or palpitation undergoing both CTCA and MPI were retrospectively enrolled in this study from March 2008 to March 2013.Among them,49 patients (26 males,23 females,age:32-85 (55.4± 16.6) years) had MB.Locations of MB and myocardial ischemia were recorded.Fused MPI/CTCA was analyzed.If there was no mural atherosclerotic plaque-related stenosis on CAG at the same location of coronary artery where ischemic myocardium was found,then MB was considered as the ischemic cause.Myocardial ischemia rates of different MB locations were compared by x2 test.Results Among 49 patients with MB,3 cases had MB in proximal segment of LAD,34 in mid LAD,4 in distal LAD,3 in septal branch,2 in distal LCX,1 in intermedius,and 2 in mid RCA.There were 41 cases with myocardial ischemia.Myocardial ischemia in 32 cases was caused by MB,including 23 caused by MB in mid LAD.The myocardial ischemia rates of the most common MB location (mid LAD,n =34) and other locations (n =15) were not significantly different (67.6％ (23/34) vs 60.0％ (9/15),x2 =0.27,P＞0.05).Conclusions MB is commonly found in the mid LAD.The myocardial ischemia rates caused by MB is not related the MB location.Hybrid MPI/CTCA could evaluate the sites of coronary MB and myocardial ischemia simultaneously and therefore may be useful to evaluate the relationship between MB and myocardial ischemia.

OBJECTIVE:To investigate the application of key monitoring varieties among adjuvant drugs in medical institu tions of Yunnan province,and to provide reference for the formulation of related policy and the promotion of clinical rational drug use.METHODS:The related data of key monitoring varieties in medical institutions of Yunnan province during Jan.1st-Mar.31st,2015 were investigated and analyzed statistically.RESULTS:The data with highest effective rate were reported by tertiary hospi tals,being 93.94％.Among top 10 drugs in the list of consumption sum,the number of key monitoring varieties was the highest in tertiary hospitals,being (5.50 ± 2.12) varieties averagely.The consumption sum of key monitoring varieties in tertiary hospitals took up the highest proportion in total consumption sum of hospitalization drug,being(31.94 ± 16.99)％ averagely;being(26.13 ± 11.93)％ and (22.14 ± 16.39)％ in second level hospitals and first level hospitals.Among top 10 drugs in the list of consumption sum,the consumption sum of key monitoring varieties in second level hospitals took up the highest proportion in total consumption sum of hospitalization key monitoring varieties,being (50.34 ± 26.87) ％ in average,up to 98.53 ％;being (39.13 ± 22.55) ％ and (27.38 ± 27.75)％ in tertiary hospitals and first level hospital.Among top 5 key monitoring types in the list of hospitalization con sumption sum,safflower yellow pigment and omeprazole were involved in hospitals at various levels.CONCLUSIONS:Adjuvant drug use are widespread in medical institutions of Yunnan province.Key monitoring varieties are given priority to TCM injection and proton pump inhibitors.It is necessary to take effective measures,formulate and implement the corresponding supervision sys tem so as to promote rational clinical drug use.

Objective To explore the value of post processing technique of dual source CT in diagnosing peripheral PE.Methods One hundred and fifty patients with suspected PE were underwent dual source CT scan,and 20 of the all patients met the criterion. The raw CT data were reconstructed by the pulmonary embolism detection (PED)software,double energy perfusion imaging (DEPI)and CT pulmonary artery angiography (CTPA).The PED,DEPI and CTPA map were analyzed by 2 senior doctors in cardiovascular diagnosis profession.According to the diagnosis standard of PE,the location,number of the emboli in segmental and sub-segmental pulmonary arteries were respectively recorded on the PED and DEPI map.We calculated the detection rate,evaluated the significant difference and evaluated the diagnosis consistency between the DEPI and CTPA map.Results Emboli were found in 30 segmental and 40 sub-segmental arteries on the CTPA map with the detection rate of 7.50% and 5.00%,respectively.Emboli were found in 48 segmental and 62 sub-segmental arteries on PED map with the detection rate of 12.00% and 7.75%,respectively.There was significant difference between the CTPA and PED map (χ2 =4.60,5.06,P<0.05).The DEPI and PED map had higher consistency in diagnosing PE.The Kappa coefficient was 0.94 if the PED map was regarded as the reference standard,Among 48 cases with segmental PE detected by the PED map,there were 13 cases of complete filling defects and 35 cases of partial filling defects.Among 13 cases of complete filling defects,there were perfusion defect in 10, and perfusion thin in 3 on the DEPI map.Among 35 cases of partial filling defects,there were perfusion defect in 2,perfusion thin in 29,and perfusion normal in 4 on the DEPI map.Conclusion The PED map combined the DEPI map of dual source CT can significantly improve the diagnosis rate of peripheral PE and has a high clinical value.

Objective To investigate the value of 99Tcm-Duramycin SPCET/CT in the detection of vulnerable plaque (VP) in atherosclerotic (AS) rabbit models.Methods Sixteen New Zealand male rabbits were randomly divided into three groups:group A (sham-operated group,n =4),group B (stable plaque group,n =4) and group C (VP group,n =8).Group A was fed on normal diet,and the other 2groups were fed on cholesterol diet for 12 weeks.Femoral artery dissection sham-operation was done in group A and group B,while balloon-induced abdominal aorta wall injury was produced in group C after 2 weeks'feeding.Animals were injected with 99Tcm-Duramycin (74 MBq/kg) and then SPECT/CT imaging was performed at the end of 4,8,and 12 weeks,respectively.Abdominal aortas were explanted for ex vivo imaging and histological characterization of plaque.The apoptosis index (AI) was calculated.One-way analysis of variance was used to analyze data.Results There was no radioactive uptake by the abdominal aorta in each group at the end of 4 weeks and no uptake in group A and group B at the end of 8 weeks.There was slightly uptake radioactive uptake by the abdominal aorta in group B at the end of 12 weeks and in group C at the end of 8 weeks.There was intense uptake at the lesions of AS rabbits in group C at the end of 12 weeks,and the T/NT value significantly higher than that of the other two groups (3.40±0.22 vs 2.12±0.65,2.68±0.18,F=198.775,P＜0.05).The result was confirmed in the ex vivo imaging of the explanted aorta.The AI of group C was significantly higher than that of group A and B ((25.4±6.32) ％ vs (0±0.02)％,(5.3± 1.97)％,F=70.260,P＜0.05).Conclusions 99Tcm-Duramycin scimigraphy could identify the apoptosis of VP in the rabbit AS models.It is a promising non-invasive method to diagnose AS plaques.