Objective To compare sensitivity and specificity of the acute physiology,age,and chronic health evaluation system Ⅱ (APACHE Ⅱ),the acute physiology,age,and chronic health evaluation system Ⅲ (APACHE Ⅲ) system in predicting prognosis after cardiac operation.Methods A prospective study of 1 180 consecutive patients entering in a single cardiac postoperative intensive care unit of Anzhen hospital was assigned between November 2013 to January 2014.APACHE Ⅱ and APACHE Ⅲscore was calculated daily at least three days or until death,then compared the calibration and discrimination of the two different system using Hosmer-Lemeshow goodness-of-fit and receiver operating characteristic(ROC) curve.Results In discrimination analysis,ROC value of the first day after operation was(APACHE Ⅱ 0.699 、APACHE Ⅲ 0.734),ROC of the maximum(APACHE Ⅱ 0.836,APACHE Ⅲ 0.862),ROC of the maximum during the first 3 days(APACHE Ⅱ 0.814、APACHE Ⅲ 0.855),ROC of the change between the third day and the first day(APACHE Ⅱ 0.524 、APACHE Ⅲ 0.549).In calibration analysis,we compared the x2 value and overall corrected percentage of the first day value,the maximum value,the maximum value during the first 3 days,the change value between the third day and the first day of the three different system.x2 value of APACHE Ⅱ was(15.688,10.132,8.061,42.253),x2 value ofAPACHE Ⅲ was(13.608,11.196,19.310,47.576).Conclusion APACHE Ⅲ was better than APACHE Ⅱ in prediction of death risk after cardiac surgery.

Objective To prospectively evaluate the risk factors for the decline of residual renal function (RRF) in new peritoneal dialysis (PD) patients.Methods A total of 84 new PD patients in our PD center were included in this study.Clinical comprehensive assessment were made,and regression models was established to analyze the relationship between the decline of RRF and clinical indicators,which included the rate of peritonitis,systolic pressure,diastolic pressure,urine volume,24 h urinary protein,serum albumin,C-reactive protein(CRP),history of diabetes mellitus,and the use of angiotensin converting enzyme inhibitor (ACEI) or angiotensin receptor blockers (ARB) drugs,cardiac functional grading,sodium and water retention and biochemical indicators.The primary outcome was defined as two consecutive urine volume ≤ 100 ml/24 h.Results The mean follow-up time was (11.7± 1.1) months,primary outcome occurred in 20 patients,accounting for 23.8％,and their average period progressed to the primary outcome was (10.5±2.0) months.The 20 patients had higher ultrafiltration volume [(551.6±328.2) ml vs (294.1±288.0) ml,P=0.001],higher systolic blood pressure [(145.2±16.5) mmHg vs (136.0±13.8) mmHg,P=0.016],worse cardiac functional grading [(1.7±0.8) vs (1.3±0.4),P=0.000],more serious water-sodium retention [(1.0±0.7) vs (0.6±0.5),P=0.012],higher peritonitis rates (35.0％ vs 4.7％,P=0.000),lower Kt/V [(1.7 ± 0.4) vs (2.0 ± 0.3),P=0.003],lower hemoglobin levels [(89.0± 14.9) g/L vs (99.5± 17.8) g/L,P=0.020],higher C-reactive protein levels [(19.4±34.4) mg/L vs(8.7±12.6) mg/L,P=0.017],higher Scr levels [(1 004.6±291.1) μmol/L vs (753.1±254.3) μ mol/L,P=0.000],lower serum calcium levels[(1.86±0.1) mmol/UL vs (2.02±0.2) mmol/L,P=0.000],higher serum phosphorus [(2.1±0.6) mmol/L vs (1.6±0.4) mmol/L,P=0.001] and higher calcium phosphorus product [(3.8±1.1) mmol2/L2 vs (3.1±0.8) mmol2/L2,P=0.010] as compared with those of the patients without the primary outcome.Based on the results of multivariable Cox regression analysis,ultrafiltration volume,cardiac functional grading,peritonitis,Kt/V and serum phosphorus level contributed to the decline of RRF significantly.Conclusion The higher Kt/V in PD patients plays a protective role,the higher ultrafiltration volume,the worse heart function,the more peritonitis rate and higher serum phosphorus predict more rapid declination of RRF.

Objective To evaluate the clinical efficacy of mini-invasive multichannel drainage in the treatment of hypertensive cerebral hemorrhage combined with severe ventricular hemorrhage. Methods The clinical data of 76 patients with hypertensive cerebral hemorrhage combined with severe ventricular hemorrhage were analyzed. They were divided into observation group and control group by random digits table method with 38 cases each. The patients in observation group were performed intracranial hematoma catheterized drainage combined with ventricle drainage under CT positioning, and the patients in control group were performed small bone window craniotomy combined with ventricle drainage. The conditions related to surgery and prognosis were compared between 2 groups. Results The operation time, blood loss and hospital stay in observation group were (46.2 ± 25.2) min, (35.4 ± 18.1) ml and (15.2 ± 2.5) d, and those in control group were (108.5±32.5) min, (112.5 ± 35.2) ml and (18.5 ± 3.2) d, there were statistical differences between 2 groups (P<0.01). Two cases died perioperatively in each group. The Glasgow outcome score (GOS) 1 month after operative in observation:9 patients were 5 scores, 19 patients were 4 scores, and the rate of better prognosis was 73.68%(28/38);in control group: 8 patients were 5 scores, 18 patients were 4 scores, and the rate of better prognosis was 68.42% (26/38). There was no statistical difference between 2 groups (χ2 = 0.256, P = 0.613). Conclusions Mini-invasive multichannel drainage is a safe and effective method for hypertensive cerebral hemorrhage combined with severe ventricular hemorrhage, and has the minimal invision.

The hospital grade assessment is an effective approach to measure the comprehensive strength and the overall level of a hospital, and it is also an effective carrier which can promote the standardized management , improve the quality of connotation and accelerate the development of the hospital .This article aims to expound the effective and concrete methods for preparation in the hospi -tal grade assessment by introducing the practice and experience of Jinling Hospital in grade assessement .It also points out that:defi-ning the purpose of the assessment is the fundation , having a thorough grasp of the assessment criteria is the basis , having a compre-hensive knowledge of the hospital is the premise , establishing and implementing the plan strictly is the crux .All these might be helpful to promote the hospital grade assessment .

Animals ; Chickens ; physiology ; Eating ; drug effects ; Injections, Intraventricular ; methods ; Neuropeptide Y ; administration & dosage ; pharmacology

Abstract: Objective　To analyze the etiological characteristics and drug resistance of patients with bloodstream infection (BSI) in the bacterial resistance monitoring network in Hainan Province from 2018 to 2020, so as to provide laboratory data for clinical diagnosis and treatment. Methods　The clinical data of the subjects were collected, and the etiological characteristics of BSI patients and drug resistance of commonly used drugs in clinical treatment were analyzed retrospectively. SPSS 26.0 software was used for statistical analysis. Results　A total of 877 strains were isolated, including Gram-negative bacteria (584 strains, 66.6%), Gram-positive bacteria (239 strains, 27.2%) and fungi (54 strains, 6.2%); male patients (591 cases, 67.4%), female patients (286 cases, 32.6%); inpatients (780 cases, 88.9%), outpatient and emergency patients (97 cases, 11.1%); the main primary diseases of BSI patients were hypertension, cerebral infarction and type 2 diabetes, and the main primary infections were pulmonary infection and urinary system infection. Intensive care unit (25.2%, 221 cases), emergency department (10.9%, 96 cases), oncology department (9.1%, 80 cases), nephrology department (6.8%, 60 cases) and hepatobiliary and pancreatic surgery department (4.3%, 38 cases) had the highest proportion of pathogenic bacteria. Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, Pseudomonas aeruginosa, coagulase-negative Staphylococcus, Viridans group streptococci and Candida albicans were the most frequently isolated pathogens. The detection rates of carbapenem-resistant Klebsiella pneumoniae, carbapenem-resistant Pseudomonas aeruginosa and carbapenem-resistant Acinetobacter baumannii were 3.4%, 15.2% and 36.4% respectively. The carbapenem-resistant Escherichia coli was not checked out. The detection rates of methicillin resistant Staphylococcus aureus and methicillin resistant coagulase negative Staphylococcus were 18.5% and 79.1% respectively. Conclusions　Gram-negative bacteria are the most common pathogens of BSI, and inpatients are the main source of BSI. Age, underlying diseases and primary infection are the risk factors of BSI. Clinical laboratories should strengthen the etiological monitoring of high-risk patients with BSI, and the resistance analysis of common antibiotics can provide a basis for the rational use of antibiotics in clinical practice.

0.05); the levels of LL, LI, RRS in CBA group and CBA+IBT group were significantly lower than those in control group(P

The 1.23 kb DNA fragment encoding the early protein EP0 of pseudorabies virus (PRV) Ea strain was amplified by PCR technique and cloned into pBluescriptII sk+.Three sequencing plasmids containing the partial fragment of the EP0 gene were constructed and the sequences were obtained by Sanger's sequencing technique. Compared with PRV InFh strain, there were multipile site-mutations and a deleted-mutation in the EP0 gene of PRV strain Ea，and the diversity of amino acid residues also existed.Then, the EP0 gene was inserted into an expression vector, pET-28a, fused into the downstream of the 6ΧHis-Tag in frame, to yield the expression plasmid pETEP0. After induction by IPTG, a high expression of fusion protein was obtained, SDS-PAGE analysis and Western blotting showed that the fusion protein was 62kD and the protein was specific to antisera against PRV Ea strain. This indicated that the EP0 gene be expressed in BL21(DE3) and the expression products have immuno-genicity.

Objective To investigate the activity concentration of 90St in tea produced in Chinese typical regions,enrich the baseline data for 90Sr level in Chinese tea,and evaluate possible exposure doses to people.Methods Samples were carbonized,ashed,digested and leached,and then extraction chromatography method was used to separate 90Sr and 90y.After preparation of sample source,radioactivity of 90Y was measured using low-level α/β counter.Results Twenty six kinds of tea produced in 16 typical regions from 26 cities of 16 provinces were collected in 2016,and their 90Sr activity concentrations were analyzed using the separation method of di (2-ethylhexyl) phosphate (HDEHP) extraction chromatography.The results revealed that the activity concentrations in 26 kinds of tea samples ranged from 0.28 to 3.78 Bq/kg,and contributed possible exposure doses of 0.44 × 10-2-6.00 × 10-2 μSv to each people.Conclusions These doses were far less than the ICRP annual dose limit of 1 mSv for the public,suggesting less impact on people's health.

To investigate me material basis of Mahuang Fuzi Xixin decoction (MFXD) for anti-inflammation and immune-suppression based on the combined method of serum chemical and serum pharmacological. The LC-MS/MS fingerprints of MFXD, drug-containing serum and blank serum were compared to define the components in plasma. Histamine, β-hexosaminidase released from RBL-2H3 cell infulenced by drug-containing serum at different time points were measured by ELISA. The effect of drug-containing serum on lipopolysaccharide-induced splenocyte proliferation at different time points were determined by MTT. A correlation analysis was made on components of MFXD and pharmacological indexes based the stepwise regression method. After the intragastrical administration with MFXD, 32 components were discovered in rat serum, including 27 prototype components (10 from Mahuang, 13 from Fuzi and four from Xixin) and five unknown components. Compared with blank serum, drug-containing serum could reduce the release of histamine from RBL-2H3 induced by antigen at different time points (P < 0.05); except the 4-hour drug-containing serum, all of the remaining drug-containing serums could inhibit the RBL-2H3 mastocyte degranulation induced by antigen at different time points (P < 0.05). Drug-containing serum could significantly lipopolysaccharide-induced mouse splenocyte proliferation at 15 and 30 min (P < 0.05). A regression analysis was made on the chemical data of components absorbed into blood and pharmacological indexes, i. e. release rate of histamine, release rate of β-hexosaminidase and inhibition rate of splenocyte. This suggested the close correlations among methyl pseudo-ephedrine, pseudoephedrine and histamine released from RBL-2H3 induced by antigen; pseudoephedrine, hypaconine, methyl pseudoephedrine and β-hexosaminidase released from RBL-2H3 induced by antigen; as well as benzoyl hypaconine, benzoylaconine, 14-benzoyl-10-OH-mesaconine, mesaconine and lipopolysaccharide-induced mouse splenocyte proliferation. Methylpseudoephedrine, pseudoephedrine, benzoyl hypaconine, benzoylaconine and mesaconine may be part of material basis of MFXD on anti-inflammation and immune suppression.
Animals ; Anti-Inflammatory Agents ; chemistry ; pharmacology ; Cell Degranulation ; drug effects ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; Female ; Histamine ; immunology ; Immunosuppressive Agents ; chemistry ; pharmacology ; Male ; Mass Spectrometry ; Mast Cells ; drug effects ; immunology ; Mice ; Rats ; Rats, Wistar ; Serum ; chemistry