Objective: To establish medical equipment rental center, not only can reduce the duplication of medical equipment purchase, and can reduce equipment maintenance cost, and improve utilization and good rates of medical equipment. Methods: Emergency rescue equipment rental center is established, which is managed by the Equipment Division with responsible for managing shared management mode, and in which the equipment is leased by Clinical departments. Results: The establishment of emergency rescue equipment rental centers, on the one hand, optimized the allocation of resources hospitals, and saved investment and maintenance expenses for the hospital; on the other hand improved the utilization of medical equipment, and protected the integrity of the rate of the device, and provided the most reliable service for clinical departments. Conclusion:By establishing emergency rescue medical equipment rental centers and improving of management mode of medical devices, sharing of resources has been achieved, and the utilization of the equipment has been improved, and equipment performance has been guaranteed.

OBJECTIVE To investigate the drug resistance and distribution of nosocomial infection(NI) pathogens.METHODS A total of 1 163 strains of NI pathogens during Jan 2002-Dec 2005 were completely surveyed and analyzed.RESULTS From them Gram-positive cocci were 376 strains(32.3%),the main pathogen was Staphylococcus aureus(12.7%),the average isolation rate of MRSA was 82.5%.Gram-negative bacilli were 474 strains(40.8%),the predominant pathogens were Escherichia coli(9.9%),Klebsiella pneumoniae(7.1%),Pseudomonas aeruginosa(5.4%),and Enterobacter cloacae(5.2%).The drug resistance of NI pathogens was markedly increased.Especially,the rates of drug resistance of P.aeruginosa to ceftazidime and imipenem were from 0 to 48.9% in 2005.CONCLUSIONS The Gram-negatives of NI pathogens are markedly increase year by year.The drug resistance rate of pathogens is higher,the clinically selected anti-bacterial drugs should be based on the bacterial culture and drug susceptibility test.

Objective To evaluate preventive and therapeutic effects of low dose of unfractioned heparin on severe sepsis. Methods 52 Patients with severe sepsis hospitalized in Intensive Care Units were randomly divided into control group and heparin group. On the basis of conventional therapy, patients with sepsis were given low dose of unfractioned heparin or isovolume physiologic saline by continuous intravenous drip infusion over 5 days. Acute Physiologic and Chronic Healthy Evaluation (APACHE-Ⅱ) score, blood platelet count(BPC), prothrombin time(PT), activated partial thromboplastin time(aPTT), thrombin time(TT), plasma fibrinogen(FDP) and D-dimer levels were assessed on admission, 3rd, 5th day after intervention. Incidence of disseminated intravascular coagulation(DIC) and 28-day mortality between heparin group and control group were compared. Results There were no significant difference in APACHE-Ⅱ, BPC, PT, aPTT, TT, and FDP levels, incidence of DIC, and 28-day mortality between heparin group and control group. D-dimer levels in both groups decreased along with time. D-dimer levels on 5th day after treatment in heparin group was markedly decreased than that of control group(740?135?g/L vs 853?179?g/L, P

In order to provide experimental fundament and theory for clinical administration, the efficacy studies of buflomedil in vitro and vivo were conducted by using rabitt's chest artery strip and rabitts acute microcirculatory disturbance model reproducted with high molecular dextran, in which peripheral vascular dilating agent tolarzoline was acted as control agent. Experimental results showed that buflomedil of 6 ? 10-5~ 6? 10-4 mol?L-1 could inhibit con-tractions of rabbit artery strip induced by NA producing concentration-dependent, and get the curves of dose-activity shift towards right, which suggests buflomedil significantly dilates microvessels and increases blood flow velocity and capillary perfusion capacity per area (P

0.05). CONCLUSIONS The pathogenic bacteria from VAP subglottic secretion are mostly Gram-negative rods, in which the dominant bacteria are A. baumannii, P. aeruginosa, S. maltophilia, K. pneumoniae and Escherichia coli. Most of them are multi-drug resistant. The kinds of pathogenic bacterial strains in subglottic secretion and lower respiratory tract secretion are not only consistent but also similar to each other in terms of composition and drug resistance.

The two pabAB genes encoding aminodeoxychorismate synthase(ADC synthase)from a L-serine producing strain Corynebacterium glutamicum SYPS-062 and model strain Corynebacterium glutamicum ATCC 13032 were ampilified by PCR.The result of nucleotide sequence analysis showed that both pabAB fragments were 1863bp,encoding 620 amino acids.16 bases differences that resulted in the changes of 7 amino acids were found in the pabAB of SYPS-062.The two pabAB were inserted into pET-28a to yield the recombinant expression vector pET-28a-pabAB and then transfromed into BL21(DE3).Upon IPTG induction,soluble ADC synthase was over-produced by E.coli BL21(DE3)harboring the expression construct.Recombinant ADC synthase purified by Ni-NTA affinity chromatography showed a single band about 67kDa on SDS-PAGE gel,and activity of aminodeoxychorismate synthase analysis show that the enzyme specific activity of SYPS-062 is 46.6% lower than ATCC 13032.

Objective To predict the length of peripherally inserted central venous catheters(PICC) with electronic chest radiograph scale measurement techniques, and observe its clinical effect. Methods A total of 185 breast cancer patients from October 2012 to December 2013 who were treated by PICC combined with MST guided by ultrasonic technology were as control group. A total of 192 breast cancer patients from January to November 2014 were as observation group. Control group adopted from the puncture point to right sternoclavicular joints impreaaion nip down again to the third floor of PICC in vitro measurement method. Observation group used to right sternoclavicular joints from the puncture point plus right sternoclavicular joints to subcarinal 1 vertebral body length, right sternoclavicular joints to subcarinal 1 vertebral body length measurement by electronic chest radiograph scale technology directly measured from the electronic chest radiographs. The accuracy rates and complications between the two measurement methods were compared. Results The accuracy rate in observation group was 97.92%(188/192), which was higher than that in control group (68.11%,126/185 ),and there was significant differencek,χ2=60.15, P<0.01. The complication rate in observation group was 6.77%(13/192), which was lower than that in control group (20.54%, 38/185) ,and there was significant difference,χ2=9.58, P<0.01. Conclusions The electronic chest radiograph scale measurement techniques could effectively improve the accuracy of PICC catheter placed, improve the quality of venipuncture, decrease the complications .

Objective To compare the efficacy and survival of patients with malignant obstructive jaundice using either endoscopic self-expandable metallic stents or surgery,and to evaluate the compounding factors influencing prognosis.Methods 56 patients with malignant obstructive jaundice treated with endoscopic self-expandable metallic stents (the endoscopic group) were compared with 90 patients who received surgery (the surgery group) during the same study period.Clinical data and survival of the 2 groups of patients were retrospectively analyzed.Results The success rate was 100％ in the endoscopic group.The serum bilirubin,alkaline phosphatase (ALP) and γ-glutamyl transferase (γ-GT) decreased significantly by using either therapeutic endoscopy or surgery (P＜0.01).There was no significant difference between the two groups in the reduction of serum total bilirubin.The mean survival of the endoscopic and surgery groups were 340 d and 795 d respectively.The accumulative survivals of the endoscopic group at 3,6 and 12 months as evaluated by the Kaplan-Meier method were 82.6 ％,61.1％ and 46.6 ％,respectively,and for the surgery group were 97.0％,90.9 ％ and 65.4％ respectively. There was a significant difference in survival between the two groups (P＜0.01).Survival after therapeutic endoscopy was similar to surgery for patients with metastasis and hilar biliary obstruction.Conclusions Self-expandable metallic stents gave similar palliation in the relief of jaundice in patients with malignant biliary obstruction.The stents had no effect on the primary tumor.Therapeutic endoscopy with self-expandable metallic stents is a safe and effective method for the relief of jaundice in patients with obstructive jaundice caused by non-resectable malignant tumors.

Objective To analyze the apoptosis mechanisms of K562 cells in a PI3K-AKT-dependent manner.Methods K562 cells were cultured in vitro for experiments below:the proliferation assay of K562 cells detected by MTT,the analysis of apoptosis rate and cell cycle of K562 cells measured by flow cytometry(FCM),the construction of chronic myeloid leukemia(CML) animal model through the subcutaneous inoculation of K562 cells to 12 BALB/c-nu/nu nude mice,the early apoptosis changes of K562 cells detected by TdT-mediated dUTP nick end labeling(TUNEL) and the in vitro and in vivo changes of N-ras,PI3K,AKT1,IKK-?,NF-?B1 at transcription level detected by RT-PCR.Results Simvastatin inhibited the proliferation of K562 cells and induced their G0/G1 arrest and significant apoptosis.N-ras and most genes of PI3K-AKT signal pathway were expressed differentially in vitro.K562 cells on nude mice could be induced to apoptosis by simvastatin and the apoptotic index increased with the dose accumulation of simvastatin(P=0.000).The differential mRNA expression changes of N-Ras and most genes of PI3K-AKT signal pathway in K562 cells were observed after treatment of simvastatin at different doses(P=0.000 or P=0.003).However,mRNA expres-sion of the genes in PI3K-AKT pathway in vitro differed to that in vivo.Conclusion The differential expression at transcription levels of N-ras and the most genes in PI3K-AKT pathway that are involved in anti-apoptosis in K562 cells,to some degree,indicates that simvastatin can induce the apoptosis of K562 cells in a PI3K-AKT pathway-dependent fashion in vitro.The animal experiments confirm that there are different mechanisms of simvastatin in inducing the apoptosis of K562 cells in vitro and in vivo.

Aim To evaluate the efficacy of TFU as a precursor of 5-FU on the growth inhibition of human gastric carcinoma cell lines SGC-7901 and MKN-45.Methods In vitro experiments,cell growth inhibition was measured by MTT assay.The rates were compared in the presence and Absence of liver microsomal enzymes.The morphology of apoptotic cells was detected by observation with a fluorescence microscope after staining by using adridine orange/ethidium bromide solution.DNA fragmentation was analyzed by agarose gel electrophoresis and flow cytometry respectively.Western blot was employed to analyze the expression of Bcl-2 and Bax.The in vivo efficacy of TFU was assessed in nude mice bearing tumours.The specimens were re-moved and the in situ cell apoptosis detection kit was employed for TUNEL staining.Results Growth of SGC-7901 and MKN-45 cells was remarkably suppressed by treatment with TFU in the presence of liver microsomal enzymes in vitro,suggesting that TFU might be converted to 5-FU by the enzymes.Similar treatment of TFU induced apoptosis of the cells,which was deduced from typical apoptotic features such as morphology,the formation of characteristic ladder pattern of DNA migration and the accumulation of sub-G1 phase.Furthermore,a significant inhibition of Bcl-2 expression and the up-regulation of Bax were observed after treatment with TFU in the presence of liver microsomal enzymes.Growth of human gastric carcinoma cells was significantly delayed by oral administration of TFU with low side effects.Apoptosis in xenografts was also observed by means of TUNEL staining method.Conclusion Treatment of TFU in the presence of liver microsomal enzymes could promote the inhibition of gastric carcinoma cell proliferation.TFU might sustain release of 5-FU mediated by liver microsomal enzymes.Low dose of 5-FU might trigger the carcinoma cells apoptosis via regulation of Bax and Bcl-2.