OBJECTIVE To analyze the direct economic loss caused by hospital infection.METHODS A case-control study was adopted to analyze the direct economic loss due to hospital infection and longer stay in hospital.RESULTS The average economic loss due to hospital infection was RMB 7 538 yuans per case.The infection of(respiratory) system disease caused the highest economic loss among the diseases of different systems with the(average) loss of RMB 15 197 yuans per case.And the loss due to septicemia was the highest than other sites of infection,with average loss of RMB 11 150 yuans per case.The average time of stay in hospital was 9.34 days per(case).CONCLUSIONS Hospital infection can increase the patients′economic burden,prolong the time of(hospitalization).Therefore,it is of great economic and social benefit to prevent and control hospital infection.

Objective To evaluate the influence of Fuzheng Huayu decoction on different pathological stages fibrotic liver tissue and activated hepatic stellate cells (HSCs). Methods Use a carbon tetrachloride (CCl4)-induced liver cirrhosis rat model system. The drug intervention was administered via oral-gastric irrigation in building, the end of week 2 and 4. Rats were batch sacrificed at the end of week 2 , 4, and 6. Liver fibrosis was evaluated by histology, and expression of a-smooth muscle actin (α-SMA) was determined by immunohistochemistry. Between-group comparisons were made by completely random design and ANOVA with Bonferroni correction. Results At the end of weeks 2, 4 and 6, the model group and drug intervention groups had significantly higher area ratio of liver fibrosis and higher expression of α-SMA than the normal group, but the three drug intervention groups had significantly less area ratio of liver fibrosis and less expression of α-SMA than the model group and the drug intervention 1 group showed the most robust decrease (P<0.05). Conclusion The Fuzheng Huayu decoction leads to down-regulated α-SMA expression and reduced degree of liver fibrosis on different pathological stages of fibrotic liver tissue, and the earlier drug intervention, the better the results.

Objective To study effect of nasal tolerance with rat-derived 97-116 peptide of AChR α-subunit(Rα97-116(V108A))on the manifestation of muscle weakness and the immunity function of experimental autoimmune myasthenia gravis(EAMG).Methods Twenty-two EAMG model Lewis rats immunized thrice with Rα97-116(V108A)were divided randomly into tolerance group and control group.They were respectively immunized with Rα97-116(V108A)and PBS buffer solution for 10 days via nasal mucous.Then the body weight and Lennon score of two group Lewis rats were measured.Their serum anti-AChR antibodies were tested by ELISA,the expression levels of CD28,CTLA4,B7-1 and B7-2 were determined by flow cytometry.Results Compared with control group at different time points.the body weight of tolerance group rats(tolerance group(228.1±5.8)g,control group(215.0±16.2)g,t=2.395,P＜0.05)increased,the mean clinical score of rats(tolerance group 1.55±0.44.control group 2.10±0.66,t=-2.20,P＜0.05)decreased and the amount of serum anti-AChR antibody(tolerance group 0.97±0.20,control group 1.27±0.26,t=-2.857,P＜0.05)decreased obviously.the amount of CD28,B7-1,B7-2,CTLA4(%)expressed on the surface of peripheral blood cells(tolerance group:27.35±7.05,4.73±0.58,2.71±0.35,1.72±0.44,control group:40.02±8.81,9.52±1.25,5.88±1.09,2.64±0.47)down-regulated markedly(t=3.479,10.861,8.755,4.403,all P＜0.01).Conclusion Nasal mucous tolerance with Rα97-116(V108A)could ameliorate muscular weakness of EAMG rats while activates T cell and inhibits B cellular immunity.

Objectives To develop a measurement for obesity assessment which could be used as a simple tool of risk screening. Methods The data of National Nutrition and Health Survey ( 2002 ) were used to analyze the relationship between body mass index ( BMI ), waist circumference (WC) and chronic diseases, based on which chronic disease index ( CRI ) was established. Receiver operating characteristic curve (ROC) was used to determine the cut-off of CRI and to compare the predictive effectiveness of CRI,BMI and WC on chronic diseases. The kappa test was chosen to estimate the consistency of different cut-off of CRI with BMI and WC. The odds ratios of chronic diseases in different cut-offs of CRI were calculated by multiple Logistic regression analysis. Results CRI was calculated as CRI = BMI + 3.5 WC. In ROC curve,the cut-off of CRI was 300. The predictive effectiveness of CRI was higher than that of BMI and WC. CRI at 300 showed the best consistency with 24 kg/m2 BMI and 85 cm WC (P <0. 05 ). In comparison with CRI <300,the risk of chronic diseases was significantly increased with an increase of 20 U CRI. Conclusion CRI shows good predietive effectiveness and could be used to identify those with higher risk of chronic diseases.

Objective To retrospectively study the clinical features in elderly patients with epilepsy.Methods Clinical data of 72 elderly patients with epilepsy aged over 60 years from outpatients and inpatients were studied.Results In the 72 cases,cerebrovascular disease associated with epilepsy occurred in 52 cases (72.2％),with partial seizures in 50 cases (69.4％),and with generalized seizures in 22 cases (30.6％).In 38 cases with epilepsy secondary to cerebral infarction,the cerebral cortex infarction occurred in 26 cases (68.4％).In 14 cases with epilepsy secondary to cerebral hemorrhage,cerebral cortex hemorrhage occurred in 11 cases (78.6％).In interictal electroencephalogram (EEG) of the 72 cases,8 cases had normal EEG (11.1％),64 cases had abnormal EEG (88.8％).31 cases (48.4％) presented with sharp wave,spikes wave or tip--slow composite wave,33 cases (51.6％) presented with low amplitude of slow wave activity,which were non-specific abnormalities.Conclusions The main cause of seizures in the elderly is cerebrovascular disease.Partial seizures is the main type of seizure.Most of seizures caused by cerebrovascular disease occur in the region near the cortex.

Objective To investigate the apoptosis effect of ischemic postconditioning on levels of IL-6 and ATP during renal ischemia/reperfusion injury in obstructive jaundice rats. Methods One hundred SD rats were randomly divided into 5 groups: the Sham control group , I/R group , OJ-Sham group , OJ-I/R group , and OJ- I/R+IPO group, with 20 cases in each group. According to the time after ischemia/reperfusion, each group was divided into four subgroups (n = 5), with reperfusion time of 0 h, 1 h, 3 h, 6 h, respectively. After 1 week of biliary obstruction , rats were sacrificed at 0 h , 1 h , 3 h , 6 h post-I/R , and the left kidneys were taken, renal tissue was used for determination of the levels of interleukin-6 (IL-6) and adenosinetriphosphate (ATP). Results Compared with the OJ-I/R group, the serum level of BUN,Cr decreased significantly in the OJ-I/R-IPO group (P < 0.05). Conclusion Ischemic postconditioning can reduce the injury of kidney ischemia-reperfusion in OJ rais , which may be related to the reduced inflammation reaction and the energy metabolism in the kidney.

Objective To observe the clinical characteristics of progressive stroke (PS) patients with vascular stenosis and the relationship between PS and cerebral blood flow (CBF). Methods Fifteen patients of PS with anterior circulation vascular stenosis were chosen, their clinical documents and CBF were analyzed with Xenon-CT when they were in progression. Results These patients mostly presented hemiparalysis and language dysfunction at the beginning ( 13/15 ) before the disease developed rapidly into a serious state. The infarction usually happens in the periventricular area (10/15). Upper limbs paralyzed more severely than low limbs(11/15). Cerebral hypoperfusion areas around the infarction in 11 patients ( 10 ml·100 g-1·min-1 < CBF < 20 ml·100 g-1·min-1 ) were found. Conclusions Patients of PS with vascular stenosis present typically clinical characteristics, Low CBF caused by cerebral artery stenosis may be one of the most important factors leading to PS.

objective To investigate the multiple early variables that influenced the 6th months prognosis of comprehensive function in patients with stroke.Methods Two hundreds and eleven patients of primary cerebral infarction and primary cerebral hemorrhage in Shanghai were divided into treated group and controlled group randomly.Patients in the treated group were given standardized tertiary rehabilitation,while those in the controlled group received normal internal medicine treatments but without standardized tertiary rehabilitation.Twenty seven early variables were collected with regard to the patients'medical history,physical examination,scores with CNFD,S-FMA and MBI at the time of enrollment.The patients'FCA scores at the ends of the 6th months after stroke were used as the comprehensive functional outcome.Stepwise multiple regression analysis applied to analyze the data.Results Stepwise multiple regression analysis revealed that therapeutic regimen,CNFD scores,age,diabetes mellitus,SFMA scores,smoking and labour intensity predicted comprehensive functional outcome at the ends of the 6th months after stroke.Conclusion Certain early variables predict the long-term comprehensive functional prognosis of stroke patients.Therapeutic regimen,CNFD scores and age were significant predictors.

Aim To investigate the protective effects of nicorandil, glutamine and metoprolol used in single and combination on the antiapoptosis ability of cardio-cytes and the expression of HSP70 after myocardial is-chemia/reperfusion injury in rats. Methods Male Wistar rats were divided randomly into seven groups:( 1 ) Sham group:in which the coronary artery was not roped;(2) I/R group:in which only 30 min ischemia and 120 min reperfusion of LAD was executed; ( 3 ) Nicorandil group; ( 4 ) Glutamine group; ( 5 ) Meto-prolol group; ( 6 ) Nic + Glu + Met ( NGM ) group;(7) low dose of Nic+Glu+Met ( NGML) group. In the pharmacological precondition groups, correspond-ing drugs were administered 30 min before I/R proto-col, and the initial drug dose in each group was 1 mg ·kg-1 . Myocardial apoptotic rates were measured with TUNEL ( terminal dexynucleotidyl transferase-mediated dUTP nick end labeling) , and the expression of apop-tosis related proteins-Bcl-2/Bax and protective pro-tein-HSP70 was detected by Western blot. ResultsIn I/R group, the apoptotic rate in ischemic region was very high ( 36.9% ± 10.3%) , and Bcl-2/Bax was very low ( 0.14 ±0.08 ) . Compared with I/R group, the apoptotic rate of pharmacological precondition groups was decreased significantly ( P <0.01 ) , and the ratio of Bcl-2 to Bax was raised ( P<0.01 ) . Com-pared with Sham group, the expression of HSP70 in-creased significantly ( P<0.01 ) in I/R group. Com-pared with IR group, the expression of HSP70 of phar-macological precondition groups was elevated ( P <0.01 ) , and the expression in NGM group was higher than in the single drug group ( P<0.01 ) . Conclusion Compared with single therapy after I/R in rat, the combination therapy of nicorandil, glutamine, meto-prolol can decrease the apoptotic rate, and the expres-sion of apoptosis related proteins is developed. In the mean time, the expression of protective protein HSP70 is elevated.

Objective To explore the changes in serum and urine electrolytes of children with neurally media-ted syncope (NMS)after oral rehydration salts (ORS)[Ⅰ]treatment.Methods The study group included 135 patients [60 male and 75 female,aged 4 -16 years,average of (10.20 ±2.68)years old]with unexplained syncope and prodro-mal symptoms of syncope in our hospital between May 2014 and April 2015.The patients underwent head -up tilt test (HUTT),and completed serum electrolytes and 24 -hour urine electrolytes,and the serum electrolytes and 24 -hour u-rine electrolytes in different hemodynamic type of HUTT were compared.Positive HUTT patients were treated with health education and ORS[Ⅰ],while negative HUTT patients were received health education.Then 21 -154(42.63 ±27.71) days later,the patients returned to hospital,for the inquiry of symptom improvement,and review of HUTT,24 -hour urine and serum electrolytes.Results (1)The total effective rate of ORS[Ⅰ]treatment was 62.96% (17 /27 cases),while negative conversion rate of HUTT was 48.15% (13 /27 cases).(2)There was no significant difference in serum electro-lytes,24 -hour urine electrolytes or 24 -hour urine volume between HUTT positive group and negative group during the first visit (all P >0.05).(3)In return visit,serum calcium [(2.30 ±0.10)mmol/L vs (2.20 ±0.09)mmol/L,t =2.72,P <0.05]and serum phosphorus [(1.73 ±0.22)mmol/L vs (1.51 ±0.23)mmol/L,t =2.671,P <0.05]in HUTT positive group were significantly higher than those in negative group.The serum sodium,potassium,chloride,mag-nesium and 24 -hour urine electrolytes,24 -hour urine volume had no statistical difference(all P >0.05).(4)24 -hour urine sodium [(159.06 ±72.76)mmol/24 h vs (118.97 ±52.75)mmol/24 h,t =2.712,P <0.05],24 -hour urine chloride [(139.08 ±66.53)mmol/24 h vs (111.34 ±47.33)mmol/24 h,t =2.116,P <0.05]and 24 -hour urine volume [(1 564.21 ±829.39)mL vs (1 058.95 ±509.92)mL,t =3.371,P <0.01]after ORS[Ⅰ]treatment were sig-nificantly higher than those before ORS[Ⅰ]treatment.The serum electrolytes and 24 -hour urine potassium,calcium, phosphorus,magnesium had no statistical difference (all P >0.05).(5)There was no significant difference in serum elec-trolytes,24 -hour urine electrolytes or 24 -hour urine volume between vasovagal syncope group and postural orthostatic tachycardia syndrome group during the first visit(all P >0.05).Conclusions ORS[Ⅰ]treatment can obviously increase the 24 -hour urine sodium,24 -hour urine chloride in children with NMS.ORS[Ⅰ]is an effective therapy for NMS.