Objective To explore the risk factors and control strategies of nosocomial infection in intensive care patients in the neurological department of internal medicine.Methods 422 intensive care patients in the neuro-logical department of internal medicine were retrospectively analyzed.Results The incidence rate of neurology ICU infection was 24.41%,which was significantly higher than 4.54%of the same period of nosocomial infection rate,the difference was statistically significant(χ2 =10.36,P<0.05).In the intensive care unit of the nervous system,the respiratory infection was mainly caused by respiratory infection,the incidence rate was 57.28%,urinary system was 25.24%,and digestive system was 9.71%.Neural medical intensive care unit patients aged 60 years old,time was more than or equal to 14 days in hospital,impaired consciousness,invasive procedures,use of antibiotics and a history of diabetes mellitus in hospital infection incidence increased significantly,and the differences were statistically signifi-cant(χ2 =7.65,10.76,16.87,9.43,9.25,9.87,all P<0.05).Conclusion Older patients,hospitalized time lon-ger,impaired consciousness,invasive procedures,antibiotic treatment and a history of diabetes mellitus were neural medical intensive care unit patients occurred nosocomial infection risk factors,clinical should strengthen nursing,to improve the work of prevention and monitoring to minimize nosocomial infection.

Objective To investigate the effect of immunoglobulin G (IgG) in bullous pempbigoid (BP) blister fluid on the secretion of chemokines by human keratinocytes. Methods IgG was obtained from the blister fluid of patients with bullous pemphigoid and sera of normal human controls, then purified by sequential precipitation with caprylic acid and ammonium sulfate. The immunological activity of blister fluid was tested before and after the purification by BP180 ELISA kit. Keratinocytes were isolated from the foreskin tissue of yong adults, and subjected to primary culture. After 3 passages, the primary keratinocytes were harvested and subcultured in the presence of purified IgG of 0.5, 1, 2, 4 and 8 g/L, respectively, for 24 hours, or IgG of 4 g/L for 3, 6, 12, 24 hours, respectively, followed by the detection of levels of eotaxin, monocyte chemoattractant protein (MCP)-1 and interleukin (IL)-8 in the supemate of keratinocytes by ELISA. Results The valence of IgG remained unchanged after the purification with caprylic acid and ammonium sulfate. Compared with IgG from the sera of normal controls, that from bullous pemphigoid blister fluid sig- nificantly enhanced the secretion of IL-8 by keratinocytes in a time- and dose-dependent manner (both P < 0.01 ). Neither eotaxin nor MCP-1 was detected in the supemate of control IgG-treated, BP IgG-treated or untreated keratinocytes. Condusions The IgG in BP blister fluid has been proved to stimulate the secretion of IL-8 by cultured human keratinocytes, which may be involved in the pathogenesis of BP.

Objective To study level of the expression of RAR? mRNA in the skin lesions of patients with psoriasis vulgaris. Methods The biopsies were taken from skin lesions in 20 patients with psoriasis vulgaris and the skin of 10 normal controls, and levels of RAR? mRNA were investigated with RT-PCR. Results The level of RAR?mRNA was significanlly lower in the epidermis of patients with psoriasis vulgaris than that in the control(P

Objective To study the level of expression of RAR?/RXR?mRNA in skin lesions of patients with psoriasis vulgaris.Methods The skin biopsies were collected fro mskin lesions in 20cases of psoriasis vulgaris and 10normal controls.Expression o f RAR?/RXR?mRNA was detected by RT -PCR.Results Expression levels of RXR?mRNA were 0.19760?0.0933in epiderm ides from psoriatic lesions,which were markedly lower than those in normal controls(0.5867?0.0132)(P0.05).Conclusion The results indicate that decreased expression of RXR?mRNA might be related to the pathogen esis of psoriasis.

Objective To explore the expression of neutrophil adhesion molecule CD11b,and plasma level of elastase in patients with anaphylactoid purpura during different clinical phases and their correlation with disease activity.Methods A total of 20 patients with anaphylactoid purpura were recruited into this study,along with 20 normal human controls.Two blood samples were collected from each patients at the first visit(active phase)and after 3～5 weeks of treatment(remission phase).The expression of CD11b was measured by flow cytometry in 12 patients and normal controls,and plasma levels of elastase by ELISA in 20 patients and normal controls.Results Increased CD11b expression and elastase level were noted in patients in active phase compared with those in patients in remission phase(3367.25±434.57 vs 2569.33±411.06.13.98±2.05 vs 4.29±0.80.both P＜0.01).No significant difference was found in CD11b expression between patients in remission phase and normal controls(P＞0.05).while the elastase level was higher in patients in remission phase than in normal controls(4.29±0.80 vs 3.67±0.54.P＜0.05).In active phase of anaphylactoid purpura,the expression of CD11b was positively correlated with the plasma level of elastase(r=0.73,P＜0.01),while no correlation was noticed between them in remission phase(r=0.20,P=0.54).Conclusion Peripheral neutrophils are activated in anaphylactoid purpura,which seems to be more obvious in active phase than in remission phase.

Objective To investigate the mRNA expression of Fc gamma RⅡA(FcγR ⅡA)on polymorphonuclear neutrophils(PMN)from patients with Beh(c)et's disease(BD).Methods Twenty-five patients with active BD and 20 healthy human controls were included in this study.Blood samples were obtained from all patients with active BD before treatment,from 15 patients with inactive BD after treatment and from healthy controls.PMN were isolated.The FcγR Ⅱ A mRNA expression on PMNs was detected by RT-PCR,and plasma myeloperoxidase (MPO)activity which represented neutrophil activation,was measured spectrophotometricaily.Results The relative expression level of FcγR Ⅱ A on PMN and plasma MPO aetivity were 1.80 1±0.829 and 32±5 U/L.respectively,in patients with active BD,0.820±0.625 and 27±4 U/L,respectively,in those with inactive BD,and 0.745 ±0.931 and 29±5 U/L,respectively,in normal controls;the differences were significant in the two parameters between the patients with active and inactive BD (both P＜0.01),while no statistical difference was observed between inactive patients and normal human controls(P＞0.05).There was a positive eorrelation between the expression level of FcγR Ⅱ A on PMN and plasma MPO activity in patients with BD(r=0.39,P＜0.0 1).Conclusions The mRNA expression of FcγR ⅡA on neutrophils is up-regulated in patients with active BD.It is likely that FcγR Ⅱ A is involved in the activation of neutrophils in BD.

Objective To detect the mRNA and protein expressions of desmoglein 1 (DSG1) and DSG3 in different types of keratinocytes (KCs).Methods Two keratinocyte cell lines HaCaT and A431,as well as primary keratinocytes from human abdomenal skin served as the object of this study.Direct immunofluorescence assay was performed to observe and quantify the expressions of DSG1 and DSG3,and quantitative PCR (qPCR) to determine the mRNA expressions of DSG1 and DSG3,in these cells.Results Both DSG1 and DSG3 were expressed in all the three types of keratinocytes,and the fluorescence intensity of DSG1 and DSG3 in HaCaT cells was higher than that in primary keratinocytes but lower than that in A431 cells.Similarly,all the keratinocytes expressed DSG1 and DSG3 mRNA,with the relative expression levels of DSG1 and DSG3 mRNA in primary keratinocytes being 291.7％ and 237.4％ of those in HaCaT cells respectively (both P ＜ 0.01),and those in A431 cells being 0.1％ and 18.8％ of those in HaCaT cells respectively (both P ＜ 0.05).Conclusions HaCaT cells,A431 cells and primary keratinocytes all can be used for the study of DSG1 and DSG3,of which,A431 cells show the strongest expressions of DSG1 and DSG3,and primary keratinocytes display the highest expressions of DSG1 and DSG3 mRNAs.

Objective To identify hot research areas of nursing human caring in PubMed from 2012 to 2016, and to explore the present research status and development directions. Methods PubMed was searched using key words human caring. BICOMB 2.0 and SPSS 11.5 software were used to analyze high-frequency keywords and conduct co-word clustering analysis. Results We searched for 3088 related articles and extracted 42 high-frequency keywords (30.97%). Seven hot research areas were identified,including:human caring in nursing practice;nursing models,nursing theories;nursing education of human caring;hospice care;relationship between human caring and nurse-patient relation;human caring of cancer patients;family system,social support and human caring. Conclusion Analysis of research areas of nursing human caring in past 5 years is beneficial to understanding the present research status and development directions,and providing references for practice,research and education of human caring.

Humans ; von Hippel-Lindau Disease ; pathology

Objective To explore sodium aescinate drug extravasation treatment method with method of evidence-based medicine. Methods According to the clinical symptoms of a patient who suffered the extravasation of sodium aescinate, electronic databases were searched to collect relevant materials of preventing extravasation of sodium aescinate. The evidence was applied to the patient after evaluating the reality, feasibility of these evidences mentioned in the literatures. Results Eventually, six random trials, five clinical experience, and two literature reviews were included. The collected evidences supported that sanyrene was safe and effective in treating the extravasation of sodium aescinate. The color and function the patient′s hand returned to normal after using sanyrene in three days, meanwhile, irreversible complication was avoided. Conclusions Sanyrene applied to sodium aescinate extravasation,easy to operate,the effect is obvious,it is worth promoting.