Objective To conduct targeted surveillance of nosocomial infections in intensive care units(ICU)to provide reference for comprehensive infection control . Methods All the 374 patients treated in ICU in 2013 were investigated by targeted surveillance methods .Results A total of 82 episodes of nosocomial infections were identified in 62 (16 .6% )of the 374 patients . The cumulative hospital stay was 2 724 days .The infection incidence per patient‐day was 22 .8‰ .The infection in ICU was primarily pneumonia (75 .6% ,including 39 ventilator‐associated pneumonia) ,bloodstream infections (including 6 central line‐associated bloodstream infections ) and catheter‐associated urinary tract infections . The incidence of ventilator‐associated pneumonia ,central line‐associated bloodstream infection and catheter‐associated urinary tract infection was 33 .3‰ ,2 .8‰ , 2 .3‰ patient‐day ,respectively .Overall ,74 strains of pathogens were isolated ,of which 93 .2% ,5 .4% and 1 .4% were gram‐negative bacilli ,gram‐positive cocci and fungi ,respectively .The top three gram‐negative bacilli were Pseudomonas aeruginosa(25 .7% ),Klebsiellapneumoniae(14 .9% ),and Acinetobacterbaumannii(10 .8% ).Conclusions Theincidenceof nosocomial infection was 16 .6 % in ICU patients ,of which device‐related infection accounted for 62 .2 % .Control of equipment‐related infections is critical for curbing the nosocomial infections in ICU . The antimicrobial regimens for ICU patients should cover gram‐negative bacilli .

Objective: To study the protective effects of electroacupuncture of Zusanli acupuncture on rat hepatic ischemia/reperfusion injury and the possible mechanism. Methods: Forty male SD rats were randomly divided into 4 groups (each group n=10) : sham(A) , ischemia/reperfusion(B), ischemia/reperfusion+ non-electroacupunture(C), and ischemia/ reperfusion + electroacupuncture of Zusanli acupuncture point(D). Animals in C and D groups received electroacupuncture of Zusanli acupuncture point (4 mA, 2/100 Hz) before ischemia for 45 min. Hepatic ischemia/reperfusion injury (70%) was induced by blocking blood inflow of the left transverse lobe and middle lobe for 90 min, then reperfusion was allowed for 8 h; blood samples were obtained from the inferior vena cava for determination of serum ALT. Meanwhile, real-time PCR was used to examine the heptaic expression of TNF-α and IL-10. Results: B, C, and D groups demonstrated significantly higher levels of serum ALT and hepatic TNF-α and IL-10 compared with A group(P<0.05), and the increase of ALT and TNF-α in D group was significantly lower than those in B and C group (P<0.05). Expression of IL-10 was not significantly different between the 3 groups (P>0.05). Conclusion: Electroacupuncture of Zusanli acupuncture point can effectively protect against hepatic ischemia/reperfusion injury, which is possibly related to the cholinergic anti-inflammatory pathway.

Decompression, Surgical ; adverse effects ; Humans ; Keratitis ; etiology ; Male ; Middle Aged ; Trigeminal Nerve ; surgery ; Trigeminal Nerve Diseases ; complications ; etiology

In this case-control study, the effect of insulin sensitivity on the genesis of cholesterol gallstones was not affirmed. However, raised 2h insulin level during glucose tolerance test and systolic blood pressure were risk factors in gallstone formation. Besides, less physical activity, lower serum total cholesterol and lower HDL-C concentration were found in patients with cholesterol gallstone.

Aim To investigate the effect of atorvastatin on AngⅡ-induced hypertrophic myocytes in vitro.Methods Hypertrophy in neonatal rat cardiac myocytes(MC) was established via culture with angiotensin Ⅱ(AngⅡ),then the effect of atorvastatin on the hypertrophy was detected.The surface area of MC was analyzed with the aid of NIH Image J software,and the synthetic rate of protein in MC was detected with()~3H-leucine incorporation.mRNA expression of atrial natriuretic peptide(ANP),brain natriuretic peptide(BNP) and Corin was measured using reverse transcription-polymerase chain reaction(RT-PCR).Results The surface area,()~3H-leucine incorporation and mRNA expression of ANP,BNP and Corin in hypertrophic myocytes were decreased after treatment of atorvastatin in a dose-dependent manner,but no change was found in the myocytes treated with DMSO.Conclusion Atorvastatin inhibits cardiac hypertrophy in vitro and the role might be independent of the cholesterol lowering effect of atorvastatin.

In order to investigate if there exists interaction between mitogen-activated protein kinase (MAPK) and signal transducer and activator of transcription 3 (STAT3) protein, and how the interaction regulates tumor necrosis factor-? (TNF-?) transcription activity, the human p38 and extracellular-signal regulated protein kinase 2 (ERK2) genes were amplified from human flag-p38 and flag-ERK2 by polymerase chain reaction (PCR) and cloned into pcDNA3-HA. Protein expression of the plasmids was examined by Western blotting. Co-immunoprecipitation was used to identify if there exists interaction between MAPK and STAT3 proteins. If the interaction was approved to be true, report gene system was applied to find how the interaction affect transcriptional expression of TNF-?. After STAT3 pathway was inhibited by RNA interfering, the action on TNF-? activity was determined. The results of DNA sequencing and enzyme digestion showed that the cloned p38 and ERK2 genes were correct, to be 1 080 bp or so. p38 and ERK2 proteins were expressed in 293T cell to be approximately 40 ku. Co-immunoprecipitation data showed that p38 and ERK2 proteins integrated with STAT3 protein in vivo. TNF-? reporter gene activity results found that protein complex of p38-STAT3 and ERK2-STAT3 coordinately increased TNF-? activity. After STAT3 was interfered, the TNF-? activity markedly decreased. These data indicated that there exists interaction between p38 and STAT3 protein, ERK2 and STAT3 protein. The complex of the proteins can coordinately regulate TNF-? expression. After interfereing STAT3 pathway, the coordinated action on TNF-? transcription activity might be obviously reduced.

Objective To design and develop a kind of venipuncture auxiliary device to use in the absence of light condition or patients with poor vein condition, and validate its clinical effect. Methods A total of 70 patients with shock were divided into experimental group (venipuncture auxiliary device group with 37 cases) and control group (non-device group with 42 cases) by random digits table method. The one-time puncture success rate and operating time were compared between two groups. Results The one-time puncture success rate was 94.59%(35/37) in experimental group and 78.57%(33/42) in control group, and there was significant difference, χ2=4.214, P<0.05. The time of establishing a single vein passage was (73.63±29.35) s in experimental group and (107.61±45.94) s in control group, and there was significant difference, t=3.656, P<0.05. Conclusions The device is small in size, low cost, easy to carry, the screen is clear, is a rapid infusion with explore vascular equipment. It can guide nurses accurately on vascular puncture, fast, smooth and effective transfusion puncture process.

Objective To investigate the effect of high pressure distention on the expression of stenosis-related genes of saphenous vein graft(SVG) during the coronary artery bypass grafting(CABG).Methods The biopsy specimens of saphenous vein collected from 10 patients who have undergone CABG,were divided into expansion group and no-expansion group.Real-time PCR and immunohistochemical staining were performed for examination of mRNA and protein expression of VE-cad,Egr-1,VCAN respectively.Student's t and Chi-square test were used to do statistic analysis.Results The results of RT-PCR showed that the mRNA transcription of Egr-1,VCAN in the expansion group were statistically significantly higher than those in no-expansion group(P<0.05).The mRNA transcription VE-cad in expansion group was statistically significantly lower than that in the no-expansion group(P<0.05).The immunohistochemical staining results showed that the expression of Egr-1 and VCAN in expansion group were significantly stronger than those in no-expansion group,while the expression of VE-cad was significantly lower than no-expansion group.Conclusion The intraoperative expansion of SVG can increase the expression of stenosis-related genes Egr-1 and Versican,and decrease the expression of stenosis-related gene VE-cad,which may be related with the SVG stenosis after CABG.

Objective To investigate the effect of activation of peroxisome proliferator-activated receptor β/δ ( PPARβ/δ)on protein synthesis and expression of angiotensin (Ang)Ⅱ-induced hypertrophic myocytes(MC) in vitro.Methods Hypertrophy in neonatal rat cardiac MC culture was established with AngⅡ, then the effect of GW0742 on hypertrophy was detected.The synthetic rate of protein in MC was detected by 3 H-leucine incorporation.mRNA and protein expression of atrial natriuretic IL-1βwas measured by reverse transcription-polymerase chain reaction ( RT-PCR) and Western-blotting. Results and Conclusion GW0742 could reduce the synthetic rate of protein in hypertrophic MC while down-regulating the mRNA and protein expression of IL-1β, but no changes were observed after treatment with DMSO.The result demonstrated that activation of PPAR beta/delta inhibited cardiac hypertrophy in vitro and this effect might be related to inflammatory factors.

Objective To evaluate the arc renal parenchyma incision of pelvis within renal sinus and renal posterior lib for the removal of complex staghorn renal calculi.Methods Arc renal parenchyma incision of pelvis within renal sinus and renal posterior lib was performed to remove stones in 86 cases (97 sides) with complex staghorn renal calculi.Among the 86 cases,42 had stones on the right side;33,on the left side;11,on bilateral sides.Seventeen cases had concomitantly calculi in the ureter,and 54 had calculi in upper and mid calyx or multiple renal calculi.As for comorbidity,11 cases had hypertensions;4,diabetes; and 5,hepatitis B.Twenty-five cases had renal insufficiency,with BUN of 12.3 -76.0mmol/L and Cr of 231 -1721?mol/L.The procedure was performed as follows:the kidney was dissected free and the pelvis within renal sinus was isolated.Two rows of bottom style sutures were made on the renal parenchyma with 2-0 plain catgut along mid-lower 1/3 of the dorsal surface of kidney free of vessels from the renal posterior lib to the plane of lower major calyx.The renal parenchyma was opened.Then,the incision was developed from the plane of lower through the middle major calyx to the plane of upper major calyx.The renal parenchyma and mid-low calyx along the incision were opened,suturing while incising,so that all the stones could be easily removed with hook.Results The calculi were completely removed in all 86 cases (97 sides).The opera- tive time was 105-187min ( mean,129min).The intraoperative blood loss was 120-460 ml ( mean,220 ml).Forty-three cases needed intraoperative blood transfusion of 120 -200 ml (mean,140 ml).One month after operation,KUB+IVU and ultrasonic findings were normal with improved hydronephrosis,no intrarenal stricture and no residual calculi.Conclusions This procedure has the advantages of less bleeding,slight impairment of renal function,simple handling,clear operative field,high clearance rate,therefore is indica- ted for the removal of complex staghorn calculi.