Objective To investigate the distribution characteristic and drug resistance of respiratory tract pathogens in ICU eld‐erly patients to provide the basis for clinical medication and control of nosocomial infection .Methods The isolation situation and drug resistance of pathogens in ICU elderly patients with respiratory tract infection from January 2012 to December 2014 were ret‐rospectively analyzed .Results Among 501 cases of respiratory tract infection ,350 cases were Gram‐negative bacilli infection ,which were mainly P .aeruginosa and A .baumannii;50 cases were Gram‐positive coccus infection ,which was mainly S .aureus ;101 cases were complicating fungal infection ,which was mainly C .albicans .The resistance of P .aeruginosa to imipenem showed upward trend (P<0 .05) ,A .baumannii had higher resistance to commonly used antimicrobial drugs ,but the drug resistance trend had no obvious change(P>0 .05) .Imipenem‐resistant A .bauman(IRAB) ,ESBLs‐producing E .coli and methicillin‐resistant S .aureus (MRSA) in the elderly patients with respiratory tract infection all exceeded 50% of each constitution ratio .Conclusion Multi‐drug resistant bacteria are usually isolated from ICU elderly patients ,their drug resistance rates maintain a higher level .Therefore clinicians should rationally select antibacterial drugs by combining with the laboratory reports ,increase the prevention and management of multi‐drug resistant bacteria and reduce the nosocomial infection occurrence .

Objective:To evaluate effects of different medication forms of dexmedetomidine on perioperative cognitive function in elderly patients undergoing radical operation of gastric carcinoma, and Ramsay sedation score.Methods:A total of 150 patients aged 65 years and 75 years scheduled for elective radical operation of gastric carcinoma from December 2018 to December 2019 in Shanxi Provincial Cancer Hospital were enrolled, and they were divided into 3 groups according to random number table method: different medication forms of dexmedetomidine groups (group A, group B) and the control group (group C), 50 cases in each group. The patients in group A and group B continued to pump dexmedetomidine at a rate of 0.5 μg·kg -1·h -1 and 0.3 μg·kg -1·h -1 respectively for 15 min before induction of anesthesia. And the patients in group C were given intravenous pumping of an equal volume of 0.9% NaCl for 15 min. Subsequently, patients in group A and group B received continuous intravenous infusion of 0.3 μg·kg -1·h -1 for 30 min before the end of operation, the patients in group C received 0.9% NaCl infusion of equal volume until the end of operation. The cognitive function of the patients was measured by using the Monterey cognitive assessment scale (MoCA) the day before surgery and on day 1,3 and 7 after surgery, and the incidence of perioperative neurocognitive disorder (PND) was counted. Ramsay sedation score at 30 min, 24 h and 48 h after surgery was compared among the three groups. Results:There were 3 patients in group A and 3 patients in group C were excluded because they were transferred to ICU due to serious postoperative complications. There were significant differences in MoCA score among the three groups on day 1, 3, 7 after operation (all P < 0.01); MOCA score of group A, B and C on day 7 after operation was (26.9±0.7) scores, (26.6±1.0) scores, (26.3±1.2) scores, respectively, and the difference between group A and group C was statistically significant ( P < 0.01). The incidence of PND among the three groups on day 1, 3, 7 after surgery had statistically significant differences (all P < 0.05), and the incidence of PND in group A was lower than that in group B and C (all P < 0.05). Ramsay sedation score among the three groups at 30 min and 24 h, 48 h after operation showed statistically significant differences (all P < 0.01), and that in group C was lower than that in group A and group B, and the differences were statistically significant (all P < 0.01). Ramsay sedation score at 24 h after operation in group A was high than that in group B and group C (all P < 0.01). Conclusions:Dexmedetomidine assisted with anesthesia can reduce the incidence of PND in elderly patients undergoing radical operation of gastric carcinoma and enhance the sedative effect. What's more, the most obvious effect is the infusion of 0.5 μg·kg -1·h -1 before anesthesia induction.

Objective To investigate the interventional effect of sulforaphane (SFN) on brain Aβ deposition and oxidative stress in Alzheimer's disease model mice.Methods Eight-week old C57BL/6J mice were randomly divided into three groups (n =10,each).Mice in two groups (intervention and model)were administered by drinking water containing 0.4g aluminum /100ml water and subcutaneous injection with 200mg/kg D-galactose every other day,added with 25mg/kg SFN to the intervention group or with equivalent double-distilled water to model group by a single oral gavage daily.And equivalent vehicle were given to the control mice.After 90 days,the aluminum levels in blood,brain Aβ depositions,and indices of oxidative stress in cerebral cortex were investigated.Results Blood aluminum level was higher in the AD model and SFN intervention groups than in controls(P＜0.01),and was lower in SFN intervention group than in AD model(P＜0.01).As compared to controls,the AD model showed that brain Aβ deposition was significantly increased,GPX activity was decreased and carbonyl level was remarkable increased(P＜0.05).There were no significant differences between intervention and control group in brain Aβ deposition,GPX activity and carbonyl contents (P＞0.05).Brain Aβ deposition was lower in intervention than in model group(P＜0.05).There was no significantly differences in brain SOD activity and total hydrosulfuryl content among three groups(P＞0.05).Conclusions Sulforaphane can reduce the aluminum level in blood,attenuate Aβ deposition,and regulate the oxidative stress in cerebral cortex in AD model mice.

This paper introduces the principium and application of the embedded intelligence control platform (EICP) in the clean operating room in our hospital. It can be a master of automatic control for air decontamination, temperature, humidity, lighting lamps, shadowless lamp, etc..
Artificial Intelligence ; Automation ; instrumentation ; methods ; Environment, Controlled ; Equipment Design ; Operating Rooms ; standards

Objective To study the correlation between blood glucose variability and TOAST type of patients with acute ischemic stroke and provide new evidence which can improve the prognosis of ischemic stroke.Methods One hundred and forty-three hospitalized patients with acute ischemic stroke from August 2013 to August 2014 were included.All patients were estimated about the general state of health and performed laboratory examinations and other auxiliary examinations.Then the TOAST type of all cases was classified.The 24-hour blood glucose monitoring was done to the patients to calculate the blood glucose variability.One hundred and forty-three cases were divided into blood glucose variability group ( standard deviation of glucose ( GluSD )≥1.4 mmol/L, 85 cases ) and control group ( GluSD <1.4 mmol/L, 58 cases) according to glucose variability.We estimated the neurologic impairment of the patients with the US National Institutes of Health Stroke Scale ( NIHSS) and the activities of daily living with Barthel index.The relation between blood glucose variability and the prognosis of ischemic stroke was analysed with multivariate analysis.Results Differences were significant in age, history of diabetes and NIHSS score between blood glucose variability group and control group.The degree of neurologic impairment of large artery atherosclerosis (LAA) group (moderate and severe neurologic impairment:43/53(81.0%)) and cardio-aortic embolism ( CE) group ( moderate and severe neurologic impairment:15/17 ) was more serious than that in small artery occlusion ( SAO) group ( moderate and severe neurologic impairment:6/71 ( 8.5%) ) , especially in CE group.The differences were significant (χ2 =7.043,P<0.05).Blood glucose variability in patients with LAA was more obviously than that in other patients.NIHSS score and activities of daily living of the patients estimated on admission and after 2 weeks were not different in the blood glucose variability group, but the difference was significant in control group.The poor prognosis in blood glucose variability group was 2.821 times that in control group ( 95% CI 1.880 -4.233 ).Conclusions The people sufferd ischemic stroke with old age, diabetes or severe case are more vulnerable to abnormal blood glucose variability.Abnormal blood glucose variability is an independent risk factor for acute ischemic stroke and induces difficulty to recovery and poor prognosis.

Adult ; Aged ; Carcinoma, Non-Small-Cell Lung ; pathology ; radiotherapy ; Female ; Humans ; Lung Neoplasms ; pathology ; radiotherapy ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Radiotherapy, Conformal ; methods ; Remission Induction

The purpose of this study is to develop glipizide push-pull osmotic pump (PPOP) tablets by using a formulation design expert system and an artificial neural network (ANN). Firstly, the expert system for the formulation design of osmotic pump of poor water-soluble drug was employed to design the formulation of glipizide PPOP, taking the dissolution test results of Glucotrol XL as the goal. Then glipizide PPOP was prepared according to the designed formulations and the in vitro dissolution was carried out. And in vivo evaluation was carried out between the samples which were similar to Glucotrol XL and the Glucotrol XL in Beagle dogs. The range of the factors of formulation and procedure, which could influence the drug release, was optimized using artificial neural network. Finally, the design space was found. It was found that the target formulation which was similar to Glucotrol XL in dissolution test could be obtained in a short period by using the expert system. The samples which were similar to Glucotrol XL were bio-equivalent to the Glucotrol XL in Beagle dogs. The design space of the key parameter coating weight gain was 9.5%-12.0%. It could be concluded that a well controlled product of glipizide PPOP was developed since the dissolution test standard of our product was more strict than that of Glucotrol XL.

Objective To study the effect of different concentration of 1,25-dihydroxyvitamin D3[1,25(OH)2D3] on cell proliferation,differentiation and the expression of vitamin D receptor (VDR) in mouse MC3T3E1 osteoblast.Methods Osteoblast were cultured in medium with different concentrations of 1,25(OH)2D3.Incubated for 48 h,cell proliferation of osteoblast were examined by MTT reduction assay (mono-nuclear cell direc cytotoxicity assay),the osteocalcin (OC) levels in cell medium were detected by ELISA,and the expression of VDR mRNA and protein were examined by using SYBR Green real-time PCR and Western blot,respectively.Results 1.After incubation with 1,25(OH)2D3 for 48 h,the number of MC3T3E1 osteoblast was significantly less than that in control group(P0.05).3.SYBR Green real-time PCR and Western blot results showed that the expression of VDR mRNA as well as VDR protein of osteoblast in 10-8,10-9 mol/L experimental groups were significantly higher than those in control group (Pa0.05).Conclusions Cell proliferation of mouse osteoblast can be inhibited,while the cell differentiation was promoted by 1,25(OH)2D3.1,25(OH)2D3 up-regulated the expression of VDR in mouse osteoblast,which suggested that the VDR signal pathway may play some role in proliferation and differentiation of osteoblast.

Objective To detect the change of cerebral perfusion in pediatric patients with Leigh's syndrome (LS)by using MR perfusion technique.Methods Twelve patients with Leigh's syndrome and thirteen normal children were scanned with the sequence of flow-sensitive alternating inversion recovery exempting separate T_1 measurement (FAIREST).Their relative cerebral blood flow(rCBF)values were obtained in regions of bilateral basilar nuclei and bilateral thalami.Student t-test was used to compare them between the two groups and receiver operating characteristic(ROC)curve analysis was carried out.Results Statistical analysis revealed significant difference between two groups in the regions of bilateral basilar nuclei and right thalamus(t =3.26,P =0.002;t =2.25 ,P =0.018 ;t =2.88 ,P =0.004,respectively).The rCBF values for LS group and control group were 0.432?0.158 and 0.619?0.125 for right basilar nuclear, 0.478?0.186 and 0.621?0.123 for left basilar nuclear,0.630?0.189 and 0.833?0.160 for right thalamus,respectively.The areas under the ROC curves were 0.833 and 0.756 for the rCBF of right and left basilar nuclear,respectively.Conclusion Relative CBF maps may reveal changes of cerebral blood flow in some specific brain regions in patients with Leigh's syndrome.It can provide additional information to the clinicians in the evaluation of the disease.

Objective To evaluate enteral nutrition treatment on nutritional status of patients with esophageal cancer during radiotherapy in Chinese population. Methods We searched domestic and foreign relevant databases (PubMed, Medline, Cochrane Library, Wanfang Data, Chinese Journal Database, VMIS) by key words (esophageal cancer, chemoradiotherapy, enteral nutrition) , meeting the conditions of the clinical randomized controlled trials, and evaluated the quality of each document. We used meta-analysis method to analysis the published literatures about clinical randomized controlled trials, which were enteral nutrition treatment on nutritional status of patients with esophageal cancer during radiotherapy in Chinese population.RevMan5.1 statistical analysis software were used. Results Seven separate clinical randomized controlled trials including 503 cases were included into the meta-analysis. The following five indexes of nutritional status in enteral nutrition treatment (ENT) group were superior to routine treatment (RT) group (P<0.05): body weight, Body Mass Index (BMI), hemoglobin, serum albumin, serum prealbumin. The MD Values and 95％CI (confidence interval) were 5.54 (3.61-7.46), 2.20 (2.02-2.39), 12.46 (5.86-19.05), 4.04 (2.48-5.61), 49.53 (20.93-78.13) .The funnel plot showed no significant publication bias in each indexes. Conclusion Enteral nutrition treatment can improve the nutritional status of patients with esophageal cancer during radiotherapy compare only with routine treatment.