OBJECTIVE To discuss the clinical characteristics of hospital infection and countermeasures urological surgery patients.METHODS The retrospective survey methods,statistical urology hospital infection rates,infection site,pathogen test results,the impact of infection on the prognosis and the risk factors for infection were analyzed.RESULTS The incidence of hospital infection was 9.30% and the infection sites were urinary tract(43),lower respiratory tract(16),upper respiratory tract(4),wound infection(10),gastrointestinal tract(antibiotic-associated diarrhea)(6) and oral cavity(1).The main pathogens(detection rate 76.05%) were Escherichia coli 20 cases,Klebsiella pneumoniae(8),coagulase-negative staphylococci in(6),Pseudomonas aeruginosa(5),Enterococcus(4),Proteus vulgaris(3),Staphylococcus aureus(2) and Candida albicans(6).The Older,the combined underlying diseases,the implementation of indwelling catheter,especially with a long time and long operation time,and hospital infections were the risk factors.Preventive use of antibiotics could not reduce hospital infections;The dead rate(3.75%) in infection group was higher than that in non-infected group(0.38%,P

The anisotropic diffusion equations-Perona &Malik(P&M)equations are resorted to to decrease the Rician noise introduced into the diffusion weighted(DW)images.To evaluate the efficiency of the P&M equations(with different functions)in accounting for the Rician noise,many experiments are designed.The results acquired from both Monte Carlo simulation experiments and real data based experiments proves the better performance of the reciprocal function based P&M equation in denoising the DTI images.

Objective Obstructive sleep apnea hypopnea syndrome (OSAHS) often causes damage to multiple systems, especially to the central nervous system, inducing cognitive dysfunction.This study aims to explore the possible correlation of the expressions of serum hypoxia-inducible factor-1α (HIF-1α) and brain-derived neurotrophic factor (BDNF) with cognitive impairment in rats under different hypoxia conditions.Methods Twenty-four Wistar rats were equally randomized into a normal control, a chronic intermittent hypoxia (CIH), and a chronic continuous hypoxia (CCH) group.The rats of the CIH group were placed in a hypoxia chamber filled with N2 and air, the oxygen concentration switched from (7±0.5)% to 21%, 1.5 minutes for each state and 4 minutes for each cycle, while those of the CCH group were placed in another hypoxia chamber with the oxygen concentration of (7±0.5)%, 8 hours a day and all for 30 days.Then we recorded the body weight of the rats, detected the expressions of serum HIF-1α and BDNF by ELISA, and observed the changes of behavior by Morris water maze test and those of the hippocampal morphological structure by HE staining.Results At 30 days after modeling, the body weight of the rats was significantly decreased in the CIH and CSH groups as compared with the normal control ([195.75±6.497] and [180.88±12.017] vs [218.63±15.287] g, P<0.05).Positioning navigation showed that the escape latency was significantly longer in the hypoxia models than in the controls (P<0.05), even longer in the CIH than in the CCH group (P<0.05).Spatial exploration test manifested a lower frequency of crossing the platform in the CIH and CCH groups than in the control ([2.63±1.45] and [3.22±1.30] vs [4.97±0.47] times, P<0.05).The expression levels of serum HIF-1α and BDNF were significantly higher in the CIH ([36.14±9.34] and [1625.34±332.44] pg/mL) and CCH ([27.27±6.88] and [1204.07±363.81] pg/mL) than in the normal control group ([14.11±4.06] and [1036.40±124.48] pg/mL) (P<0.05), even higher in the CIH than in the CCH group (P<0.05).HE staining exhibited scattered and disorderly arrangement of hippocampal neurons in the model rats, with unclear nuclear membrane, pyknosis of the nuclei, darkly stained cytoplasm, and some damaged cells.More obvious absence and vacuolization of some cells were observed in the rats of the CIH group.Conclusion Chronic hypoxia inhibits the growth and development of rats and induces cognitive dysfunction.High-level HIF-1α in chronic intermittent hypoxia indicates hypoxia-stress of the body, while compensatory increase of serum BDNF may be involved in neuronal cell damage regulation.

Objective To investigate the corresponds between NF-κB p65 activation and k-ras mutations.Methods NF-κB p65 activation was analyzed by immunochemistry in 167 colorectal cancer specimens in which the k-ras mutation status was confirmed.Resluts Among 167 colorectal cancer specimens screened,59 (35.3 ％) had k-ras mutations and 63 (37.7 ％) had NF-κB p65 activation.k-ras mutations and NF-κB p65 nuclear expression were no significant difference in different sex,age,ECOG score,pathological types,degrees of pathological differentiation,TNM stage,and metastases on lymph nodes (P＞ 0.05).The positive nuclear expression rate of NF-κB p65 was 50.8 ％ (30/59) in specimens with k-ras mutations and 30.6 ％ (33/108) in specimens with wild type k-ras.There was obviously statistical difference between them (P =0.010).Conclusion NF-κB p65 activation in coloretal cancer was associated with k-ras mutations.

OBJECTIVE To investigate the epidemiology of bacterial infections isolated from liver disease patients with septic shock and analyze the antimicrobial susceptibility of major pathogens to provide reference for clinical therapy. METHODS A retrospective survey was conducted in 83 liver disease patients with septic shock of our hospital from Jan 2005 to Aug 2006. Identification and susceptibility of pathogens were assayed by MicroScan Auto-4 System. RESULTS The infection was frequently identified in intra-abdominal cavity (73.5%),blood stream (24.1%) or respiratory tract (13.3%). The top 3 pathogens were Escherichia coli (36.6%),Klebsiella pneumoniae (15.9%) and Staphylococcus aureus (6.1%). Gram-negative bacilli were usually resistant to multiple antimicrobial agents,but less resistant to imipenem,levofloxacin or piperacillin-tazobactam. Extended-spectrum ?-lactamases (ESBLs) positive rates of E. coli and K. pneumoniae were 53.3% and 7.7%. Asprergillus and Candida glabrata were the predominant pathogens from fungal infections,and they were mostly resistant to fluconazole. CONCLUSIONS Pathogens of liver disease patients with septic shock are mostly multi-drug resistant. The microbiological surveillance is important for guiding clinical therapy.

OBJECTIVETo explore the curative effect and adverse reactions of a convenient expiratory positive airway pressure device(EPAPD) in treatment of obstructive sleep apnea/hypopnea syndrome(OSAHS). METHODS74 subjects with OSAHS were treated by EPAPD. Polysomnography(PSG) and Epworth sleepiness scores(ESS) were performed and evaluated before, within 1 week and after 3 months using the EPAPD. The index of PSG and ESS were compared at different time. The adverse reactions were also observed at the same time.RESULTS Compared to baseline, the AHI, LSaO2, ESS were significantly improved both within 1 week and after 3 months(AHI:F=73.62,P=0.00; LSaO2:F=12.65,P=0.00; ESS:F=61.49,P=0.00). The improvement of AHI between different OSAHS groups(divided by the severity of AHI in baseline) was significantly different(within 1 week:F=15.39,P=0.00; after 3 months:F=12.60,P=0.00). There was also significant difference between different hypoxia groups which were divided by the severity of LSaO2 in baseline(within 1 week:F=3.80,P=0.03; after 3 months:F=3.27,P=0.04). Meanwhile, the ESS was significantly improved in different sleepiness groups(divided by the ESS score in baseline) within 1 week(F=6.17,P=0.00). The device-related adverse events were reported by 44.59%(33/74). There were not serious adverse reaction happened. The major adverse reactions were throat and nose dry, nasal obstruction, and nose discomfort.CONCLUSION The EPAPD is an effective, convenient device in treating OSAHS. Meanwhile, the device related adverse reactions are slight. It may be more efficient for serious OSAHS patients than mild ones.

Objective To study the relationship of accumulated dose of anthracycline(ANTH) with the cTnT level in acute leukemia patients. Methods The cTnT levels and the accumulated dose of anthracycline (ANTH) of 88 acute leukemia patients who were treated with anthracycline in our hospital from 2004-2009 who were treated with anthracycline. All the patients were divided into two groups according to a certain cTnT level,and the each incidence of elevated cTnT was obtained. Results 8 of 37 patients who received ≥200 mg/m2 of ANTH versus 1 of 51 patients who received <200 mg/m2 of ANTH had a higher incidence of elevated cTnT (P <0.05). Conclusion Incidence of elevated cTnT increases when the ANTH reaches the certain dose.

Objective To establish the quality standard for Shengxinfa Capsule. Methods TLC was used to identify Praeparata, Psoraleae Fructus and Gastrodiae Rhizoma in Shengxinfa Capsule, and 2,3,5,4’-the four-stilbene-2-O-β-D-glucoside was identified by HPLC. The column of Agilent TC-C18 (4.6 mm×250 mm, 5 μm) was used. The mobile phase was acetonitrile-water (15∶85). The flow was 1.0 mL/min and column temperature was 30 ℃. UV detecting wavelength was 320 nm. Results Praeparata, Psoraleae Fructus and Gastrodiae Rhizoma could be identified by TLC. The linear range of 2,3,5,4’-the four-stilbene-2-O-β-D-glucoside was in the range of 0.05-0.50 μg. The average recovery was 97.8% (RSD=0.39%). Conclusion The method is feasible and accurate. The quality of Shengxinfa Capsule can be controlled effectively with the established quality standard.

Objective To investigate the optimum target plasma concentration of propofol in preventing the adverse effects of carboprost tromethamine in the patients undergoing caesarean section.Methods One hundred and twenty-eight nulliparous parturients who were at full term with a singleton fetus,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,aged 24-37 yr,weighing 54-78kg,scheduled for elective caesarean section under combined spinal-epidural anesthesia,were randomly divided into 4 groups (n =32 each) using a random number table:control group (group C),and different concentrations of propofol groups (P1-3 groups).Carboprost tromethamine 250 μg was injected into the body of the uterus,and propofol with the target plasma concentrations of 0.8,1.2 and 1.6 μg/ml was simultaneously given by target-controlled infusion in P1,P2 and P3 groups,respectively,and normal saline was infused at a rate of 0.5 ml · kg-1 · h-1 in group C.The occurrence of cardiovascular events was recorded from the end of carboprost tromethamine administration until the end of surgery.The relatedadverse effects after carboprost tromethamine administration,and Ramsay sedation score at 15 mm after carboprost tromethamine administration were recorded,and satisfactory sedation was defined as Ramsay sedation score of 2.The occurrence of complications associated with combined spinal-epidural anesthesia was recorded during the postoperative follow-up.Results Compared with group C,the incidence of carboprost tromethamine-related adverse effects was significantly decreased in P2 and P3 groups,the rate of satisfactory sedation was significantly increased in P1 and P2 groups,the incidence of hypotension and tachycardia was significantly decreased in group P1 (P＜0.05),and no significant change was found in the incidence of carboprost tromethamine-related adv erse effects in group P1,and in the rate of satisfactory sedation in group P3 (P＞ 0.05).Compared with group P1,the incidence of carboprost tromethaminerelated adverse effects was significantly decreased in P2 and P3 groups,the rate of satisfactory sedation was significantly increased in group P2,and the rate of satisfactory sedation was significantly decreased in group P3 (P＜0.05).Compared with group P2,the rate of satisfactory sedation was significantly decreased (P＜0.05),and no significant change was found in the incidence of carboprost tromethamine-related adverse effects in group P3 (P＞0.05).No cardiovascular events were found in group P2,and the incidence of hypotension was 9％ in group P3.Conclusion The optimum target plasma concentration of propofol in preventing the adverse effects of carboprost tromethamine is 1.2 μg/ml in the patients undergoing caesarean section.

Objective To explore factors associated with prolonged emergency room (ER) stay of critically ill patients admitted so as to accelerate throughput of emergency patients.Methods Data of critically ill patients admitted into the emergency room of a tertiary teaching hospital in 2010 were retrospectively studied.Stepwise Cox regression analysis was used to determine factors likely associated with prolonged stay in ER.Results ( 1 ) A total of 6246 critical illnesses were admitted into emergency room,the ER length of stay [M (Qr)] was 11 h (3 ～23 h).Of them,56.6％ patients stayed in ER more than 6 h and 21.6％ over 24 h.(2) Univariate analysis showed the major factors contributing to prolonged stay in ER were insufficient inpatient bed capacity,followed by poor family finances,complicated diseases needed care from multiple departments,emergency operation,lack of specialty wards,lack of department bearing main responsibility of critical care,age,gender and arrival time to ER.(3) Multivariate analysis showed that the main factors contributing to prolonged stay were insufficient inpatient beds,poor family finances,complicated diseases needed treatment from multiple departments,emergency operation,lack of specialty wards,lack of department bearing main responsibility of treatment,gender and arrival time to ER.Age was not an independent factor.Conclusions Plenty of critically ill patients admitted to this hospital had prolonged stay in emergency room with variety of factors.The possible factors contributing to this were insufficient inpatient bed capacity,poor family finances and complicated diseases needed care from multiple departments,and this investigation deserves a further study.