Objective To investigate clinical features,drug resistance,risk factors and prognosis of extended-spectrum beta-lactamases (ESBLs)-producing Escherichia coli infection in hospitalized newborns.Methods Sixty eight newborns infected with ESBLs-producing Escherichia coli admitted in Neonatal Ward of Ningbo Women and Children's Hospital during.January 2010 and January 2013 were enrolled in the study; 81 newborns infected with multiple resistant non-ESBLs-producing Escherichia coli served as controls.The drug sensitivity of the isolated ESBLs-producing Escherichia coli was tested using K-B method.Clinical data including birth weight,gestational age,mode of delivery,site of infection and disease outcome were analyzed.Logistic regression analysis was performed to study the risk factors for ESBLs-producing Escherichia coli infection.Results The highest positive rate of ESBLs-producing Escherichia coli was detected in sputum samples (49/68,72.1％),followed by blood (7/68,10.3％) and urine (6/68,8.8％) samples.Strains were highly resistant to ampicillin,cefotaxime,ceftazidime and cefepime (61.8％-100.0％),but the resistant rates to cefoxitin,cefoperazone/sulbactam and amikacin were low (2.9％-10.3％),and were completely sensitive to carbapenems.Lower respiratory tract infections were most popular in both groups,but in ESBLs-producing Escherichia coli infected group,lower respiratory tract infection rate in late newborns was higher than that in early newborns (x2 =12.879,P ＜ 0.05).Multivariate logistic regression analysis showed that gestational age ＜ 37 weeks (Exp (B) =0.352,95％ CI:0.134-0.929),cesarean section (Exp (B) =0.488,95 ％ CI:0.243-0.984),invasive procedures (Exp (B) =0.363,95 ％ CI:0.142-0.927),use of hormones and/or antibiotics one week before birth (Exp (B)=0.325,95％ CI:0.127-0.833) were independent risk factors for ESBLs-producing Escherichia coli infection.Conclusions Respiratory tract infection is popular in ESBLs-producing Escherichia coli infection in hospitalized newborns.The strains are highly resistant to most antibiotics.Reducing invasive procedures,strict control of cesarean section and prenatal use of hormones and antibiotics may reduce the infection of ESBLs-producing Escherichia coli in newborns.

To improve the solubility of quercetin ( QT) , one of flavonoids that can inhibit the proliferation of vari-ous types of cancer cells, the novel amphiphilic polymer N-( 4-methylimidazole)-hydroxyethyl-chitosan ( MHC) , synthetized by chemical derivatization from chitosan, was used as the self-assembly micelles of QT. The formed polymer was characterized by 1 H NMR, elemental analysis and pyrene fluorescence spectrometry. The formulation of MHC micelles loading quercetin was optimized through single factor experiment. Then the optimized formulation was obtained as follows:the concentration of MHC was 0. 67% and the ratio of drug and carrier was 1 ∶10. The micelles particle size was ( 99. 21 ± 1. 71) nm, Zeta potential was +( 20. 01 ± 0. 72) mV and drug loading was ( 5. 42 ± 0. 32 )%. The in vitro release curve was investigated and was found to conform to Higuchi equation of Q=0. 1101 t1/2 -0. 064. The results of in vivo experiment showed that the mean rentention time and bioavail-ability of the MHC-QT micelles were 21. 42 h and 57. 49 μg h/mL, respectively, compared to 0. 30 h and 2. 50 μg h/mL of the free QT solution. These indicated that the MHC micelles could significantly improve the solubility of QT, the drug sustained-release effect and bioavailability, which would used as carrier for the anti-tumor drugs.

Objective:To observe the clinical effects of extraoral manual reposition approach in the treatment of acute anterior disloca-tion of temporomandibular joint. Methods:98 patients with acute anterior dislocation of temporomandibular joint were divided into 2 groups(n=49) by random digit table and treated by manual reposition through intraoral and extraoral approach respectively. The suc-cess rate, success time, patient pain during treatment, SBP, DBP, HR and patient satisfaction were evaluated respectively. Results:The success rate(95. 92%) and the patient satisfaction rate(76%) of extraoral method group were higher than those of the intraoral method group (81. 63% and 66%);success time(3. 91 ± 0. 55)s and patient pain during treatment(3. 51 ± 0. 25) in extraoral method group were less than those in the intraoral method group[(5. 57 ± 0. 51) s and (6. 6 ± 0. 21)]. The degree of changes of SBP, DBP and HR in extraoral method group were less than those in the intraoral method group(P<0. 05). Conclusion:Extraoral manual reposi-tion approach is more effective than intraoral approach in the treatment of acute anterior dislocation of temporomandibular joint.

AIM: To investigate the vasorelaxant effect and mechanism of EtOAc extract from Chrysanthemum morifolium Ramat (CME). METHODS: The effects of CME on the contraction of rat thoracic a orta were examined. RESULTS: CME caused concentration-dependent relaxation of aorta rings precontricted with phenylephrine and K+. The effect in endothelium-intac t aorta was more effective than that in endothelium-deduced aorta. NG-nitro-L- arginine methylester, methylene blue and glibenclamide attenuated the effect of C ME significantly. However, indomethacin, propranolol, tetraethylammonium, BaCl 2, 4-aminopyridine and 5-hydroxydecanoate did not affect CME effect. The effect of SKF-525A combined with L-NAME had no obvious difference with that of L-NAME o n CME-induced relaxation. NOS activity in aorta was increased markedly by CME in vitro. CME did not reduced the contraction elicited by PE in Ca 2+-f ree medium, but reduced the contraction induced by PE in K+-free solution or C a 2+ free following input Ca 2+. CONCLUSION: CME induces both endothelium-dependent and independe nt relaxation. NO and cGMP are likely involved in the endothelium-dependent rela xation, inhibition of voltage-dependent or receptor-operate Ca 2+ channel a nd activation of ATP-sensitive K+ channel contribute in part to the endotheliu m-independent relaxation by CME.

Objective To measure the daily nursing workload by simplified therapeutic intervention scoring system and provide information for reasonable dynamic management of nursing manpower and improving nursing service satisfaction of patients in elderly ICU.Methods 113 patients in elderly ICU were selected from July 2012 to June 2013.The Therapeutic Intervention Scoring System 28(TISS-28) was used to measure the nursing workload,reasonably arranged the nursing staff according to the daily total nursing workload.The average daily working time and service satisfaction were compared before and after the application of dynamic management of nursing manpower.Results After the application of dynamic management of nursing manpower,the average daily working time of nurses decreased,satisfactory degree of patients with nursing service increased,and satisfactory degree of medical workers with nursing manpower management also increased.Conclusions Measurement of nursing workload by TISS-28 can provide the basis for the dynamic management of nursing manpower in elderly ICU and improve satisfaction degree of medical workers.

Objective To investigate the effect of metabolic syndrome and its components on imaging of brain impairment in subcortical ischemic vascular disease.Methods 120 patients with subcortical ischemic vascular disease (SIVD) including 25 cases without metabolic syndrome,25 cases with the risk of metabolic syndrome,70 cases with metabolic syndrome.The diagnostic criteria of metabolic syndrome was the National Cholesterol Education Program Adult Treatment Panel Ⅲ (NCEP-ATP Ⅲ).Brain MRI was assessed by the Scheltens scale,and divided into 3 regions:periventricular hyper intensities (PVH),leukoaraiosis (LA),basal ganglia hyper-intensities (BG).Results The assessment scores of PVH,LA,BG and Scheltens scores were higher in patients with the risk of metabolic syndrome and patient with metabolic syndrome than in patient without metabolic syndrome [(3.75±1.60),(4.21±1.09) us.(2.76±1.62),(10.67±5.26),(13.79±5.25) us.(6.36±3.93),(3.21±2.62),(6.90±4.25) us.(1.52±1.50),(17.62±8.32),(24.90±9.25)vs.(10.58± 5.89),respectively,all P＜0.05].Waist circumference had positive correlations with LA and Scheltens scores (r=0.185,P=0.046; r=0.488,P＜0.001).Positive correlation was found between triglyceride (TG) and LA,BG scores (r=0.188,P=0.042; r=0.311,P =0.001).The positive correlations of impaired glucose tolerance (IGT) with LA,BG and Scheltens scores were found (r=0.235,P=0.011; r=0.229,P=0.013; r=0.206,P=0.027).High density lipoproteincholesterol (HDL-C) was correlated negatively with LA,BG and Scheltens scores (r=-0.238,P=0.010;r=-0.189,P=0.042; r=-0.335,P＜0.001).The further multivariate linear regression analysis showed that IGT,HDL-C had significant correlations with LA assessment score (both P＜0.05),TG had significant correlation with BG assessment score (P＜0.05),and waist circumfernce,IGT,HDL-C had significant correlations with Scheltens scores (all P＜ 0.05).Conclusions Metabolic syndrome and its components correlate with the imagings of cerebral damage in SIVD.Abdominal obesity,TG,IGT,HDL-C are the important risk factors for SIVD.

Translational medicine,as an important form of research-based medicine,is key to research hospitals.Analysis in the paper holds that such hospitals should highlight top-level design in its medical system building,rely on characteristic and advantageous disciplines,target research outcome applications,take the pathway of overlapping and fusion,and the synergy mechanism as the guarantee. The paper introduced the efforts of the hospitals'experiences in innovative clinical practice of research during the development of the translational medicine system,in an organized,planned,targeted,and measurable manner.It is concluded that the innovative outcomes of the effort help elevate medical competence of the hospital as a whole.

OBJECTIVETo establish the steriod-induced osteoporosis model with the type of Kidney-Yin deficiency.

METHODSTotally 45 female Kunming mice were randomly divided into normal group,model group and Liuwei Dihuang pills(Chinese character: see text)group. The model was established by intramuscular injecting of Dexamethasone. Liuwei Dihuang pills (Chinese character: see text) group was administered orally with Liuwei Dihuang pills (Chinese character: see text). The signs and symptoms of mice were observed dynamically. All the animals were sacrificed at the end of the 6th weeks. The level of ACTH, cAMP, cGMP, TSH and E2 in serum were detected to evaluate deficiency of Kidney-Yin. Morphological changes and bone density were observed to evaluate osteoporosis.

RESULTS(1) Compared with control group, mice in model group appeared obvious Kidney-Yin deficiency symptoms, including hair dry, restlessness, excitability, hard stool, and yellow. (2) Compared with control group,the weight of mice in model group gained slower (P<0.01); the index of adrenal gland,liver and spleen decreased (P<0.01, P<0.01 ,P<0.01); the level of ACTH and TSH increased (P<0.01 ,P<0.01), the level of E2 decreased (P<0.01) and the ratio of cAMP/cGMP increased (P< 0.05). (3)Compared with control group,the bone density of lumbar vertebra and femur in model group were significantly decreased (P<0.01, P<0.05); HE staining revealed osteoporosis in model group mice. (4)However, the Liuwei Dihuang pills (Chinese character: see text) group can partly antagonize the inhibition of the HPA axis, alter the disordered sex hormone and the ratio of cAMP/cGMP, and reverse the osteoporosis partly.

CONCLUSIONthe model of osteoporosis with type of Kidney-Yin deficiency could be established by Dexamethasone intramuscular injection. With less interference, it wight be a stable and reliable modeling method for integration of disease and syndrome in TCM.

Animals ; Bone Density ; Dexamethasone ; toxicity ; Disease Models, Animal ; Female ; Kidney Diseases ; etiology ; Medicine, Chinese Traditional ; Mice ; Osteoporosis ; chemically induced ; Yin Deficiency ; complications

Assessing dry weight accurately is crucial in providing effective and safe haemodialysis. Biases towards dry weight assessment may bring a series of dialysis complications. This study introduces an online detection technique of relative blood volume (RBV) based on ultrasound, which analyzes the correlation between changes in blood density and sound speed. By measuring the attenuation in sound velocity, this method was employed to calculate RBV, and then to evaluate the dry weight of patients on dialysis. TDC-GP2 time measurement chip and MSP430 Single-chip Microcontroller (SCM) were used in the system to measure the ultrasonic travel time. In the clinical trials, RBV values range between 71.3% and 108.1%, showing consistent result with Fresenius 4008S blood volume monitor (BVM). This detection method possesses several advantages, such as real time, convenient, reproducible, non-invasive, and etc.
Blood Volume ; Body Weight ; Humans ; Monitoring, Physiologic ; Renal Dialysis ; Ultrasonics

Objective To investigate the therapeutic effect of Jianpi Yiqi, Bushen Fenjing combined with oxaliplatin+CF/5-FU on colorectal cancer.MethodsEighty patients with colorectal cancer who were treated in our hospital from January 2014 to December 2015 were randomly divided into observation group(40cases) and control group (40cases).The control group was given oxaliplatin+CF/5-FU treatment, the observation group in the control group based on the application of Spleen Qi, Bushen fill essence treatment, observed before and after treatment of two groups of serum tumor markers, clinical symptoms and living conditions, changes, record adverse reactions.ResultsThe observation effect of 82.50% was significantly higher than that of the control group (62.50%).The QOL score (37.8±5.6) was significantly higher than that of the control group (33.5±3.1) and the adverse reaction rate was 30.00% (P<0.05).The difference between the two groups was significant (P<0.05).ConclusionThe effect of invigorating spleen qi and tonifying siren solution combined with oxaliplatin+CF/5-FU on colorectal cancer can improve the clinical symptoms and improve the quality of life of patients.