Objective To understand the status and pathogenic characteristics of healthcare-associated infection (HAI)in cardiovascular surgical intensive care unit (ICU)patients undergoing heart transplantation.Methods Pa-tients who underwent heart transplantation in a hospital between July 1 ,2013 and June 30,2014 were performed targeted monitoring.Results Of 66 patients undergoing heart transplantation,16 developed 18 times of HAI,inci-dence of HAI was 24.24%.Incidence of HAI and ventilator-associated pneumonia(VAP)in patients undergoing heart transplantation were both higher than non-transplantation patients (24.24% vs 6.24%,χ2 =33.718;7.58%vs 1 .72%,χ2 =12.199,respectively,both P <0.001 ).The infection tyes were as follows:lower respiratory tract infection(n=7),VAP (n=6),bacteremia (n=3),superficial incision infection (n =1 ),as well as skin and soft tissue infection (n = 1 ). The isolated pathogens were fungus (n = 8 ),Klebsiella pneumoniae (n = 3 ), Staphylococcus aureus (n=2),Acinetobacter baumannii (n=2),Enterobacter cloacae (n=1 ),Acinetobacter hae-molyticus (n=1 ),and Citrobacter freundii (n =1 ).Conclusion Incidence of HAI is high in patients undergoing heart transplantation,the main infection type is lower respiratory tract infection,the major pathogen is fungus.

Throughin-depth study and thinking ofthe current situation of medical education,this paper exploredtraining strategies of applied talents in medical colleges under the new situation.From the training ofapplication talents in medical colleges under new situation,we should focus on the current reality,learn experience.Combined with the characteristics of medical specialty,we should explore the model of strengthening the humanistic quality moral training of current medical application talents from the curriculum,teaching content selection,teachers' construction,environment shaping,teaching methods,assessment and evaluation,and thus to adapt to the medical mode conversion,alleviate the doctor-patient contradiction and promote medical students employments.

Aim To explore the role of Rho-kinase in remote ischemic postcondi-tioning and its possible mechanism.Methods Thirty male Sprague-Dawley rats were divided into five groups(n=6): sham group(Sham), ischemia/reperfusion group(I/R), remote ischemic postconditioning group(RIPostC), I/R with Rho-kinase inhibitor fasudil group(I/R+Fas) and RIPostC with Rho-kinase activator lysophosphatidic acid group(RIPostC+LPA).Throughout the whole process of experiment, mean arterial pressure(MAP), heart rate(HR) and Ⅱ lead electrocardiogram were continuously monitored.At the end of the reperfusion, plasma creatine kinase(CK) and lactate dehydrogenase(LDH) were measured.Myocardial histopathologic changes were observed by hematoxylin and eosin(HE) staining.Infarct size was measured using 2,3,5-triphenyltetrazolium chloride(TTC) staining.The expressions of phospho-myosin light chain(p-MLC) were detected with Western blot analysis.Results Compared with Sham group, the MAP and HR of other groups decreased, while the amplitude of ST segment increased.Compared with I/R group, MAP and HR increased, the amplitude of ST segment decreased, plasma CK and LDH activity decreased, myocardial pathological morphology and infarct size were improved significantly, infiltration of inflammatory cells was reduced, and the expression of p-MLC decreased in RIPostC and I/R+Fas group.Compared with RIPostC group, RIPostC+LPA group attenuated the effects of RIPostC, and the recovery of the above indicators were inhibited.Conclusion Rho-kinase signaling pathway might mediate remote ischemia postconditioning against myocardial ischemia/reperfusion injury.

ObjectiveTo analyze the relationship between clinical characteristic pathology and prognosis in infant with intra-abdominal solid tumor.MethodsFifty-two infants(less than 1 year old) with abdominal solid tumor from Apr.1998 to Feb.2007 in Shanghai Children's Medical Center and from Jan.2001 to Feb.2007 in Shanghai Xinhua Hospital were reviewed.The history of these children were reviewed.Features and clinical pathology of these children with their prognosis were analyzed and followed up by telephones and children return visit records from 5 months to 8 years.ResultsLess than 1 month,7 cases;1 month to 1 year old,45 cases.Teratoma 23 cases(44.23%),neuroblastoma 9 cases(17.31%),nephroblastoma 6 cases(11.54%),hepatoblastoma 5 cases(9.62%),epithelioid hemangioendothelioma of the liver 3 cases(5.77%),congenital mesoblastic nephroma 3 cases(5.77%),fusiform cell epithelioid hemangioendothelioma of pancreas 1 case(1.92%),hamartoma of the liver 1 case(1.92%),retroperitoneal small cell malignant tumor 1 case(1.92%).Benign:malignant=1:1.Among the benign tumor,male:female=1:1.Among the malignant tumor,male:female=2.33:1.0.All children were treated with tumor resection,and combined with chemotherapy for those whose tumors were malignant.ConclusionsAmong infant abdominal solid tumors,teratoma and neuroblastoma are much more than other tumors.The cases of benign tumors are almost as much as the malignant tumors.The benign tumors did not have sex differences,and had good prognosis after surgical resection.However,in malignant tumors,the incidence rate of male is obviously higher than female.Completely resection of those malignant tumors with chemotherapy would get little incidence of recrudescence and low case fatality rate.Early diagnosis and early treatment play an important role in prognosis.

AIM: To investigate whether there was nicotinic acetylcholine receptor subunit α 7 (nAChR α 7 ), choline acetyltransferase(ChAT), acetylcholinesterase(AChE) expression and its regulation in mature dendritic cells (DCs). METHODS: Bone marrow(BM) -derived DCs from healthy BALB/c mice were incubated with rmGM -CSF and rmIL-4, and stimulated to mature with LPS. Meanwhile, light microscope and flow cytometry were used to identify DCs, as well as immunocytochemistry, immunofluorescence, flow cytometry and RT - PCR methods were used to dectect expression of nAChR α 7, ChAT and AChE. Flow cytometry was also used to analyze nAChR α 7 expression with mecamylamine (MEC) in 12 h. RESULTS: Both protein and mRNA expression of cholinergic system nAChR α 7, ChAT and AChE were found in mature DCs. Furthermore, nAChR α 7 distributed principally in cell membrane, while ChAT and AChE in cytoplasm. Protein expression of AChE was stronger as compared with ChAT ( P ＜ 0. 05), and there was a trend toward increasing as compared with nAChR α 7. And then, the expression of nAChR α 7 was down regulated by MEC as compared with the group without MEC stimulation(P ＜ 0. 05 ). CONCLUSION: An innate cholinergic system was in mature DCs, which was affected by extrinsic factor ( i. e. , MEC). And it may be involved in anti - inflammation immune adjustion of cholinergic closed - circuit.

Objective To evaluate left ventricular wall motion changes after successful pereutaneous coronary artery intervention (PCI) in patients with acute myocardial infarction (MI) by velocity vector imaging (VVI). Methods Twenty patients with acute MI, 16 anterior MI and 4 inferior MI,were studied by VVI within 3 days before PCI, 1 week and 3 months after PCI. The VVI parameters included peak systolic myocardial velocity (Vsys), peak systolic strain (εsys), maximal strain (εmax), peak systolic strain rate ( SRsys), isovolumic relaxation strain rate(SRivr),segmental ejection fraction (sEF), time to peak of velocity (TPKvel),and time to peak of strain (TPKε). Results Compared with that before PCI,εsys, SRsys, sEF, PSI, SRivr/SRsys, and TPKε were improved one week after PCI,and were further significantly improved at 3 months follow-up. Conclusions The VVI parameters can be used to evaluate the effectiveness of PCI shortly after the procedure and during long-term follow-up.

Objective To compare the plasma hepatitis C virus(HCV)RNA levels detected by the fully automated viral load detection system(COBAS TaqMan)and the national real-time quantitative polymerase chain reaction(PCR)kit,and to investigate the clinical application value of these two methods in clinical practice.Methods A total of 168 serial plasma samples collected from 26 patients with chronic hepatitis C(CHC)before and at week 2,4,12,24,36 and 48 of antiviral treatment were detected by both COBAS Taqman 48 analyzing system and the national real-time quantitative PCR kit.The results of two methods were compared by chi square test and t test.Resnlts Both COBAS and national kit showed great positive detecting results when HCV RNA≥1×104IU/mL(at week O),and the virus load value detected by national kit was significantly higher than that detected by COBAS(t=2.05,P<0.05).However,when HCV RNA<1×104(at week 2-48),the positive rate of HCV detected by COBAS was significantly higher than that detected by national kit (t=3.66,P<0.01).At week 4 of treatment,the rapid virological response(RVR)rate was 46.2 % (12/26)detected by COBAS,while that was 88.5%(23/26)detected by national kit,and the difference was significant(x2=10.575,P<0.01).At week 12 of treatment,the complete early virological response(cEVR)was 95.7%(22/23)detected by COBAS,while that was 100%(17/17)detected by national kit,and the difference was not significant(x2=0.726,P>0.05).Conclusions The national TaqMan real-time quantitative PCR kits could be used to screen the suspected cases of HCV infecrion and to diagnose CHC cases with high HCV virus load.COBAS detection is more sensitive in cases with low HCV virus load and in on-treatment monitor during anti-HCV therapy.

Objective To investigate the effect of different amplification methods and probes with various length on the results of comparative genomic hybridization (CGH) analysis of pre-implanted single blastomere and to establish the basis for preimplantation genetic diagnosis.Methods Twenty blastomeres of embryo at 6-8 cells stage were randomly divided into A and B group with 10 in each.Twenty peripheral blood lymphocytes from a healthy man were similarly divided into C and D group with 10 in each.Degenerate oligonucleotide primed polymerase chain reaction (DOP-PCR) was used to amplify whole genomic DNA in group A and C,and multiple displacement amplification (MDA) was used in group B and D for whole genome amplification (WGA).The specificity of resultant products was confirmed by amplification of TBX1 gene exon 2.CGH was performed respectively with 250-750 bp and 750-2000 bp probes prepared from the amplified whole genomic DNA.The result of CGH was verified by sex-determining region of Y (SRY).Results (1) Nine of the 10 samples in group A and all in group C were amplifiable by DOP-PCR,but there were multiple non-specific bands in the amplification of TBX1 exon 2 when WGA products were used as templates.When 250～750 bp probe was used in CGH,1 of the 5 blastomeres was failed and another one had different karyotype from that analyzed by SRY.(2) All samples in group B and D were successfully amplified by MDA,and the non-specific bands were significantly less in the amplification of TBX1 exon 2.All 5 blastomeres were successful in CGH with the 250～750 bp probe.Moreover,the karyotype was in agreement with that of SRY.(3) When 750 ～ 2000 bp probe was used,the CGH results were suboptimal.Conclusions In WGA of single blastomere,MDA is superior to DOP-PCR in the stability and specificity.The karyotype image detected by CGH with the 250～750 bp probe is clear and homogenous.

Adult ; Benzene ; toxicity ; Chromatography, High Pressure Liquid ; Humans ; Occupational Exposure ; Reference Values ; Sorbic Acid ; analogs & derivatives ; analysis

Objective To observe the effects of an enriched environment (EE) on cognitive functioning and the synaptic plasticity of mice modeling post-stroke cognitive impairment (PSCI) and explore the possible mechanisms involved.Methods Mice modeling PSCI and sham-operated mice were randomly divided into 3 groups:sham-operated mice in a standard environment (the Sham+SE group),PSCI mice in a standard environment (the PSCI+SE group) and PSCI mice in an enriched environment (the PSCI+EE group).The cognitive functioning of all of the mice was quantified using a Morris water maze and their hippocampal long-term potentiation (LTP) was recorded using an electrophysiological method.The level of synaptophysin was detected using Western blotting.Synaptic ultrastructure in the hippocampus was imaged using electron microscopy.Results Compared with the Sham +SE group,the PSCI+SE group showed significantly poorer water maze performance and failed induction of contralateral LTP.Their average level of synaptophysin was significantly lower,and significant adverse changes in the synaptic ultrastructure of the hippocampus were observed,including a decreased number of synapses.The average width of the synaptic cleft,postsynaptic density and the interface curvature of the synapses were all less desirable.All of the measurements of the PSCI+EE group improved significantly compared to those of the PSCI+SE group,but were still significantly poorer than those of the Sham+SE group.Conclusions An enhanced environment can improve the cognitive functioning of mice modelling PSCI.It may be that an EE can improve synaptic plasticity in the hippocampus contralateral to the stroke.