OBJECTIVE To understand the distribution of common pathogens and their drug resistance trend and to provide the basis of the correct selection of antibiotics for clinic.METHODS Retrospective analysis was taken for blood culture specimens during 2 years in our hospital.And statistical analysis was done.All of 4028 cases of blood culture specimens were detected on automatic BacT/Alert3D rapid blood culture system,strains isolated were taken to VITEK-2 automatic microbiological analysis/sensitivity system for identification and drug susceptibility testing.Drug susceptibility results were analyzed using WHONET 5.3 software.RESULTS Totally 435 pathogen were isolated from 4028 cases of blood culture sample and the positive rate was 10.8%.195 Gram-negative bacteria strains accounted for 44.8%,mainly Escherichia coli,Klebsiella pneumoniae,Burkholderia cepacia,Acinetobacter baumannii,and Pseudomonas aeruginosa.Gram-positive bacteria accounted for 49.9%;mainly Staphylococcus epidermidis,S.haemolyticus and S.aureus dominated.Fungi were 23 strains(5.3%),mainly Candida albicans.Among them,extended-spectrum ?-lactamases(ESBLs) produced by E.coli and K.pneumoniae strains were 43.9% and 48.8%,respectively.Meticillin-resistant S.aureus and coagulase-negative staphylococci were 35.3% and 72.9%,respectively.But vancomycin-resistant S.aureus was not found.CONCLUSIONS The bacteria identification detected in blood culture class is quite complicated,and the drug resistance is high.Laboratories should increase the detection rate of bacterial culture and provide drug monitoring results for the clinics on time based on CLSI norms.Clinicians should use the antibiotics reasonably based on the drug susceptibility results in order to reduce nosocomial infections and the emergency of multiple drug-resistant strains.

Objective To evaluate the effects of hyperbaric oxygen on the expressions of hypoxia-inducible factor 1α (HIF-1α) and insulin-like growth factor-1 receptor (IGF-1R) in the formation of hyperplastic scar in rabbit ears.Methods The ears of 20 New Zealand rabbits were used to construct an animal model for hyperplastic scar by operation.After the establishment of scar models,the rabbits were randomly divided into 4 experimental groups and one control group with 4 mice (48 wound surfaces) in each group.The mice in the 4 experimental groups were treated with hyperbaric oxygen for 7,14,21 and 28 days,respectively,and those in the control group remained in normoxic environment after operation.Scar tissues were resected from all the rabbit ears on day 29 after operation.Hematoxylin and eosin (HE) staining was conducted for the observation of morphological changes and calculation of scar elevation index,and immunohistochemistry to measure the expressions of HIF-1α and IGF-1R.Statistical analysis was carried out by one-way analysis of variance followed by least significant difference t-test.Results HE staining showed that both the number of fibroblasts and amount of collagen fibers were significantly reduced in the experimental groups compared with the control group.Scar elevation index was 4.28 ± 0.22 in the control group,3.64 ± 0.29,3.46 ± 0.21,3.29 ± 0.21,3.16 ± 0.15 in the 7-,14-,21-and 28-day experimental groups respectively,with significant differences among these groups (F =77.70,P ＜ 0.05).The expressions of HIF-1α and IGF-1R were significantly lower in these experimental groups than in the control group (all P ＜ 0.01),lower in the 14-day group than in the 7-day group (P ＜ 0.05),and lower in the 21-day group than in the 14-day group (P ＜ 0.05),with no significant differences between the 28-day group and 21-day group (both P ＞ 0.05).Conclusion Hyperbaric oxygen can effectively down-regulate the expressions of HIF-1α and IGF-1R in scar tissue,and significantly inhibit the formation of hyperplastic scar in rabbit ears.

Objective To compare the effects of remifentanil infused at different rates on median effective target plasma concentration (EC50) of propofol inhibiting responses to laryngeal mask airway (LMA) insertion and determine the optimum infusion rate of remifentanil when used for fiberoptic bronchoscopy in pediatric patients.Methods Eighty-four ASA Ⅰ or Ⅱ pediatric patients,aged 7 months-3 years,scheduled for elective fiberoptic bronchoscopy,were randomly assigned into 3 groups (n =28 each):normal saline group (group C),remifentanil infused at 3 ng· kg-1 ·min-1 group (group R1) and remifentanil infused at 5 ng· kg-1 · min-1 group (group R2).Responses to LMA insertion were defined as body movement and/or bucking during insertion.The initial target plasma concentrations of propofol were 5.2,4.8 and 4.4 μg/ml in groups C,R1 and R2,respectively.The target plasma concentration of propofol was determined by up-and-down sequential allocation.Each time the target plasma concentration increased/decreased by 0.2μg/ml.EC50 and 95 ％ confidence interval of propofol blunting responses to LMA insertion were determined by probit method.Results EC50 (95 ％ confidence interval) of propofol was 5.03 (4.92-5.12) μg/ml,4.71 (4.58-4.84) μg/rnl and 4.46 (4.20-4.94) μg/ml in groups C,R1 and R2,respectively.There was no significant difference in EC50 of propofol between groups R1 and C (P ＞ 0.05).EC50 of propofol was significantly lower in group R2 than in groups C and R1 (P ＜ 0.05).Conclusion The infusion rate of remifentanil should not be lower than 5 ng· kg-1· min-1 when combined with propofol in pediatric patients undergoing fiberoptic bronchoscopy.

Objective: To investigate the osteointegration and osteoinduction of nano hydroxyapatite/bioglass ( nHA/BG ) gradient nanofilm on the surface of titanium ( Ti) prepared by hypotherm sintering and plastic deformation. Methods:Hypotherm sintering was used to produce nHA/BG gradient coating followed by soaking in the simulated body fluid. Ti implants with gradient coatings were planted in femoral condyles at one side of 12 New Zealand rabbits and the untreated Ti implants were planted at the other side as the controls. 1, 3 and 6 months after implantation, the animals were sacrificed after X-ray examination and the tissues around the implants from the 3 month group were used for the preparation of hard tissue section and ground section. New bone formation was observed by tetracycline fluorescence staining. Von Gieson staining was used to observe the osteointegration at the interface between bone and im-plant. Results:The gradient coatings were porous and composed of irregular rod-like nano-HA crystals. Animal study showed well es-tablished osteointegration between the gradient coating and more novel bone was found around the implants with gradient coatings. Conclusion:Osteointegration and ostioinduction of Ti implant can be enhanced by nanostructured surface with gradient coatings of nHA/BG.

Heart Neoplasms ; pathology ; Heart Ventricles ; pathology ; Humans ; Infant, Newborn ; Male ; Rhabdomyoma ; pathology

Objective The incidence of post-operative hyperbilimbinemia, which is associated with poor outcomes in patients, was reported to be increased in recent years though it has been a rare complication for cardiac operations. Post-opera-tive impairment of liver function is highlighted. We evaluated the incidence and prognosis of post-operative hyperbiliruhinemia in adult patients who underwent cardiotomy with extracorporeal membrane oxygenation (ECMO) support. Methods Sixty-five adult patients who had received ECMO support after cardiac surgery from 2004 to 2008 were enrolled and evaluated retrospec-tively. Post-oporative hypethilirubinemia was defined as the serum level of the total bilirubin more than 51.3 μmol/L during postoperative period. Demographic and clinical data included gender, age, types of surgery, perioperative hemodynamic param-eters, biochemical variables, duration of the ventilation support, ICU stay and outcomes. Results The mean age of the pa-tients was (50.1 ± 13.9) years, forty-six patients(70.8%) were male. The main cardiac procedures were heart transplanta-tion for 9 patients, coronary artery bypass grafting and/or valve operations for 47 patients, congenital heart disease correction for 4 patients and other operations for 5 patients. Among all patients, fifty-one patients(78.5%) were weaned from ECMO succeas-fully and thirty-thrce patients were discharged from hospital. The overall mortality rate was 49.2%. Overall incidence of post-operative hyperbilirubinemia was 55.4%. In patients with postoperative hyperbilirubinemia, the mean peak value for serum to-tal bilirubin was 104.8 (68.5-156.7) μmol/l. The hospital mortality in the hyperbilirubinemia group was significantly higher than that in the non-hyperbilirubinemia group(66.7% vs. 27.6%, P <0.01). Moreover, postoperative hypethilirubinemia (adds ratio = 3. 895, 95% confidence interval, 1.088 - 13.947 ; P = 0.037) and SOFA score (odds ratio = 1.214, 95% confidence interval, 0.987 - 1.494, P = 0.047) and APACHE Ⅲ score (odds ratio = 1.096, 95% confidence interval, 1.028 - 1.169 ; P = 0.004) were associated with hospital mortality after adjusting for preoperative levels of the total bilirubin, direct bilirubin, gender and age. Conclusion Postoperative hyperbilirubinemia is one of the complications in adult patients who undergo cardiotomy with ECMO support, and is associated with increased hospital mortality.

This study was aimed to clone human intercellular adhesion molecule-1 (ICAM-1) gene, to transfect the constructed eukaryotic expression vector ICAM-1-GFP into CHO cells, as well as to detect ICAM-1-GFP expression in CHO cells binding with Molt-4 cells. ICAM-1 cDNA gene was amplified by RT-PCR and inserted in PMD(18)-T vector. Then ICAM-1 cDNA from pMD18-ICAM-1 vector was subcloned into eukaryotic expression vector pEGFP-C1 to construct recombinant ICAM-1-pEGFP-C1 vector. Restriction analysis and DNA sequencing were used to confirm the recombinant vector. After stable transfection of CHO-K1 cells with the recombinant vector, the expression and subcellular localization of ICAM-1-GFP were detected by RT-PCR, flow cytometry and fluorescence microscopy. The function of ICAM-1-GFP fusion protein was assessed by the binding of ICAM-1-GFP/CHO cells to Molt-4 cells. The results showed that 1622 bp full-length ICAM-1 cDNA obtained and was successfully ligated with pMD(18)-T-vector, subcloned to construct recombinant ICAM-1-pEGFP-C1 vector. Restriction analysis and DNA sequencing indicated that recombinant ICAM-1-GFP was successfully constructed and ICAM-1-GFP was expressed stably in CHO cells. ICAM-1-GFP expression was only observed in the cytoplasm of ICAM-1-GFP/CHO cells by fluorescence microscopy. The ICAM-1-GFP/CHO cells were bound to PMA-treated Molt-4 cells. The expression of MEM-148 was very weak in PMA-treated Molt-4 cells. It is concluded that the ICAM-1-GFP eukaryotic expression vector has been constructed successfully and expresses stably in CHO cells. PMA can increase the binding of Molt-4 cells to ICAM-1-GFP/CHO cells by inducing specialized form of ICAM-1 clustering.
Animals ; CHO Cells ; Cricetinae ; Cricetulus ; DNA, Complementary ; genetics ; Genetic Vectors ; Green Fluorescent Proteins ; genetics ; Humans ; Intercellular Adhesion Molecule-1 ; genetics ; Recombinant Proteins ; genetics ; Transfection

Objective To study serum level of prostate specific antigen (PSA) by age and its relationship with positive prostatic biopsy.Methods A total of 8818 adults who underwent PSA scanning at Health Chek-up Center of Beijing Hospital during July 2009 and July 2010 were retrospectively studied,40 of whom performed prostatic biopsy.Linear regression was used to assess the relation of PSA with age,while Chi-square test was used to compare positive prostatic biopsy in different PSA groups.Results Serum PSA of more than 4 μg/L was more commonly seen in the elderly group (40 ～ year-old group 1.4％,50 ～ yearold group 1.9％,60 ～ year-old group 9.2％,70 ～ year-old group 15.5％,80 year-old group 17％ ; P ＜0.001 ; RR =0.196).In those whose PSA was ＞ 20 μg/L,6 (83.3 ％) were found to have positive prostatic biopsy; and the figure was 10 (50.0％) or 24 (24.0％) when PSA was ＜4 μg/L or 4-10 μg/L group (P =0.048).Conclusions Age was positively correlated with PSA,although no linear correlation was confirmed.Higher serum PSA level (＞ 4 μg/L) may be more common in elderly people and those with a positive prostatic biopsy.

Humans ; Laryngeal Neoplasms ; pathology ; Male ; Middle Aged ; Neurilemmoma ; pathology

Objective To summarize clinical characteristics of infradiaphragmatic craniopharyngioma and explore its prognosis factors. Methods The clinical date, imaging and follow-up findings were analyzed retrospectively in 58 pa?tients with infradiaphragmatic craniopharyngioma who underwent surgical operation in our hospital. Factors related to the postoperative quality of life of patients were analyzed using multi-factors Logistic regression analysis. Results There were 45 minor cases with infradiaphragmatic craniopharyngioma, of which forty cases (88.9%) had preoperative visual im?pairment. Preoperative endocrine examination revealed that 21 cases (46.7%) had pan-hypopituitarism and 24 cases (53.3%) had pari-hypopituitarism. In addition, preoperative MRI showed that 38 cases (84.4%) had tumor involvement in/on the saddle and the average tumor size was(4.53 ± 1.71)cm. There were 13 adult cases, of which 8 cases (61.5%) had preoperative visual impairment. Only 1 case (15.4%) had pan-hypopituitarism, 7 cases had pari-hypopituitarism and 5 cases had normal pituitary function. Ten cases (76.9%) had tumor involvement in/on the saddle and average tumor size was(2.92 ±1.18)cm. Multi-factors Logistic regression analysis revealed the patient's age (OR=0.090, P=0.090) and tu?mor size (OR=8.350, P=8.350), preoperative vision loss (OR=0.086, P=0.086), preoperative hypopituitarism (OR=0.198, P=0.198) were the relative factors affecting the quality of life. Conclusion Infradiaphragmatic craniopharyngioma is
more common in minor patients. The clinical features and prognosis are significantly different between minor patients and adult patients. Age, size of tumors, preoperative vision loss and hypopituitarism of patients are associated with poor prog?nosis.