Objective To study common Gram negative bacterial pathogens and their drug resistant pattern in sputum isolates from patients in pediatric intensive care unit (PICU) of Chengdu children' s hospital. Methods Comparing to the period of 2004-2006 with 2007-2009, we retrospectively reviewed eligible sputum isolates of common Gram negative bacilli and their drug resistance pattern. All specimens were processed according to standard microbiological methods for both quantitative and qualitative cultures. Pathogen was the single predominant growth after two consecutive cultures. Strict quality control was used in all test agents and paper disk for drug resistance analysis. Results Total of 598 Gram negative bacterial isolates were identified in patients over 6 years. The first 5 bacteria respectively were Escherichia coli 167 samples(27.93%), Klebsiella pneumoniae 109 samples ( 18.23% ), Enterobacter cloacae 93 samples ( 15.55% ),Acinetobacter baumannii 64 samples ( 10. 7% ), Pseudomonas aeroginosa 43 samples (7. 19% ). They were mostly sensitive to Imipenam, Amikacin, Piperacillin/Tazobactam. Most drug resistance rate was found in Amoxicillin, Ampicillin, Cephalosporin. Apart from Pseudomonas aeroginosa and Acinetobacter Baumannii,no Gram negative bacteria was found to be resistant to Imipenam. Klebsiella pneumoniae and ESBL secreting Escherichia coli isolates were obviously increasing when compared to 3 years ago. Conclusion Comparing the period of 2004-2006, the Gram negative bacterial isolates were increasing in our PICU patients during 2007 to 2009. Close monitoring of drug resistance pattern changes in PICU would guide rational use of antibiotics in these critically ill children.

Objective To develop a simple microfluidic chip technology for analyzing the electrotaxis of cancer cells . Methods The basic structure of the proposed microfluidic electrotaxis chip included a straight microchannel and liquid storage pools located on both sides of the microchannel .Two platinum electrodes were inserted into the liquid pools to create a controllable direct current ( DC ) field in the microchannel .The distribution and strength of the DC field in the microchannel was analyzed by the finite element analysis software COMSOL multiphysics and experiment tests .Finally, the electrotactic behavior of the rhabdomyosarcoma RD cells in the DC field of different strength was characterized using the accumulated distance, average velocity, x forward migration index ( xFMI) and y forward migration index ( yFMI) as quantitative parameters.Results The results of element analysis and experiments showed that the structure of the designed microfluidic electrotaxis chip was able to guarantee a uniform and strength-controllable DC field in the microchannel .The experiment of cell electrotaxis showed that the RD cells migrated toward the anode of the DC field .Meanwhile , the values of xFMI and accumulated distance for RD cells increased with the enlargement of the DC field , with the strength ranging from 188 to 1320 V/m.Conclusion The microfluidic chip technology developed in this paper for assaying the electrotaxis of cancer cells is simple and easily implementable , and it can be used for studies of the electrotactic behavior and underlying mechanisms of various cancer cells and normal cells in the future .

Objective Construct the reasonably effective performance assessment mode of clinical departments,which is suitable for the continuous development of modern hospital.Method Use of balanced scorecard (BSC) principle,using the analytic hierarchy process (AHP) and Rank sum ratio method (RSR)to establish a performance assessment system. Results Constructed the performance assessment mode of clinical departments,which can be dynamically adjusted based on management objectives strategy.The mode takes the BSC as the baseline,the strategy of hospital development as the guide,performance assessment index system as the key element. Conclusion The performance assessment mode of clinical departments,base on BSC,achieve the strategic performance management,and is conducive to the hospital for continuous improvement of medical care quality,in line with the long-term strategic needs of the hospital.

Objective To understand the depressive status of patients with HIV/AIDS and their family members in order to provide objective information for conducting psychological interventions among them. Method The Self-rating Depression Scale (SDS) questionnaires were used for assessing the depressive status and the SPSS software was applied for data analysis. Results The SDS values among the patients with HIV/AIDS and the family members of died AIDS patients were significantly higher than those of healthy controls. The proportion of HIV/AIDS patients with medium to severe degree of depression was 15.5%, which was higher than that of healthy controls. The SDS values among female family members of HIV/AIDS patients were higher than those in male ones. Conclusion The depression is a negative psychological status usually occurred among the patients with HIV/AIDS and their family members, and the psychological interventions should be conducted based on the characteristics of different populations.

Objective To study the diarrhea causes and nursing care after kidney transplantation from donation after cardiac death(DCD).Methods The clinical data of 91 patients undergoing kidney transplantations from DCD were retrospectively analyzed from November 2011 to May 2013 in our department,to investigate the incidence of diarrhea and the causes.Results Eighty three cases contracted diarrhea in 91 recipients,with the incidence of diarrhea 91.2%.The use of immunosuppressive agents,intestinal flora,infection and bowel movement dysfunction were all related to the diarrhea.Conclusions The incidence of diarrhea is high and the causes are complex after kidney transplantation from DCD.So nurses should take the appropriate care measures to improve the quality of nursing,avoiding complications and ensuring transplant results based on a different cause of diarrhea.

Objective To establish a method for detection of aminophylline in blood samples of preterm infants . Methods A molecularly imprinted electrochemical sensing film on the glassy carbon electrode surface was prepared by electropolymerization using aminophylline as the template molecule and pyrrole as the functional monomer in 0.2 mol/L HAc-NaAc buffer solution ( pH 4.0).The surface morphology and properties of molecularly imprinted sensing films were characterized by three dimensional laser scanning microscopy , differential pulse voltammetry ( DPV) and electrochemical impedance spectroscopy ( EIS) while the effects of scanning cycle number and incubation time were investigated by square wave voltammetry(SWV) method in 5 mmol/L K3[Fe(CN)6] -0.1 mol/L KCl solution.Results Under optimized experimental conditions ,the SWV peak current difference was linear to the negative logarithm of aminophylline concentration in the range from 1.0 ×10 -7 to 1.0 ×10 -3mol/L with a detection limit (S/N=3) of 0.5 ×10 -8mol/L.The recovery rate was 92.2% -101.4%.Also, the molecularly imprinted electrochemical sensor for aminophylline had good selectivity , stability and reproducibility .Conclusion The molecularly imprinted electrochemical sensor for aminophylline can be used for rapid and accurate detection of clinical blood concentrations of aminophylline molecules in preterm infants in the future .

OBJECTIVETo explore the feasibility of autologous burn eschar as the coverage of microskin grafting in the repair of excised severe burn wounds.

METHODSTwelve severe burn patients underwent massive escharectomy during 3 to 7 post burn days (PBD), and autologous eschar instead of alloskin was employed as the coverage of microskin. The integrity of grafted eschar and survival of microskin grafts were observed at 1 to 6 weeks after operation. The wound healing rate in grafted area was determined at 6 post operation week (POW), and the wound healing time was recorded.

RESULTSThe autologous eschar in the grafted area were integral and attached tightly to the wound during the 1 to 2 POW and began to dry and detach from the burn wound with the microskin underneath growing and fusing at 3-4 POW. This process went on until the eschar was completely detached from the burn wound and the microskin fused in large areas, with some granulation wounds left at 5 and 6 POW. The wound healing rate at the 6 POW was (87 +/- 4)%. The average wound healing time of burn patients in this group was (56 +/- 8) days.

CONCLUSIONAutologous eschar could be used as a substitute for the alloskin for microskin grafting in excised burn wounds.

Adolescent ; Adult ; Burns ; surgery ; Feasibility Studies ; Female ; Graft Survival ; Humans ; Male ; Reconstructive Surgical Procedures ; Skin Transplantation ; methods ; Surgical Flaps ; Transplantation, Homologous ; Wound Healing

BACKGROUND: Platelet endothelial cell adhesion molecule-1 (PECAM-1), also known as CD31, is mainly distributed in vascular endothelial cells. Studies have shown that PECAM-1 is a very significant indicator of angiogenesis, and has been used as an indicator for vascular endothelial cells. The present study aimed to explore the relationship between the expression of PECAM-1 and the degree of acute lung injury (ALI) and fibrosis in paraquat (PQ) induced lung injury in rabbits. METHODS: Thirty-six adult New Zealand rabbits were randomly divided into three groups (12 rabbits in each group) according to PQ dosage: 8 mg/kg (group A), 16 mg/kg (group B), and 32 mg/kg (group C). After PQ infusion, the rabbits were monitored for 7 days and then euthanized. The lungs were removed for histological evaluation. Masson staining was used to determine the degree of lung fibrosis (LF), and semi-quantitative immune-histochemistry analysis to determine the expression of PECAM-1. Pearson's product-moment correlation analysis was performed to evaluate the relationship between the expression of PECAM-1 and the extent of lung injuries expressed by ALI score and degree of LF. RESULTS: Rabbits in the three groups showed apparent poisoning. The rabbits survived longer in group A than in groups B and C (6.47±0.99 days vs. 6.09±1.04 days vs. 4.77±2.04 days) (P<0.05). ALI score was lower in group A than in groups B and C (8.33±1.03 vs. 9.83±1.17 vs. 11.50±1.38) (P<0.05), and there was statistically significant difference between group B and group C (P=0.03). LF was slighter in group A than in groups B and C (31.09％±2.05 ％ vs. 34.37％±1.62％ vs. 36.54％±0.44％) (P<0.05), and there was statistically significant difference between group B and group C (P=0.026). The PEACAM-1 expression was higher in group A than in groups B and C (20.31％±0.70％ vs. 19.34％±0.68％ vs. 18.37％±0.46％) (P<0.05), and there was statistically significant difference between group B and group C (P=0.017). Pearson's correlation analysis showed that the expression of PECAM-1 was negatively correlated to both ALI score (Coe=–0.732, P=0.001) and degree of LF (Coe=–0.779, P<0.001). CONCLUSIONS: The PECAM-1 expression significantly decreases in New Zealand rabbits after PQ poisoning, and the decrease is dose-dependent. The PECAM-1 expression is negatively correlated with ALI score and LF, showing a significant role in the development of lung injuries induced by PQ.

Objective:To observe the lipid-lowering effect of different transdermal absorption enhancers applied to the herbal cake-partitioned moxibustion in hyperlipidemia model rabbits, and to explore the possible mechanism. Methods:Forty New-Zealand rabbits were randomly divided into 5 groups using the random number table method, with 8 rats in each group. Rabbits in the blank group were fed routinely with normal diet; rabbits in the other groups were fed with high-fat diet for 12 weeks to establish the hyperlipidemia model. Rabbits in the blank and the model groups were not treated. After the model was prepared, rabbits in the non-transdermal absorption enhancer group received herbal cake-partitioned moxibustion without transdermal absorption enhancer; rabbits in the laurocapram group and the borneol group received herbal cake-partitioned moxibustion with laurocapram or borneol respectively. After 4 weeks of treatment, serum was collected for enzyme-linked immunosorbent assay (ELISA), and the liver tissues were isolated for immunohistochemistry, quantitative polymerase chain reaction (qPCR) and Western-blotting (WB) detection. Results: Serum ELISA results showed that leptin was significantly decreased in the model group compared with the blank group (P＜0.05); compared with the model group, leptin was significantly increased in the non-transdermal absorption enhancer, the laurocapram and the borneol groups (all P＜0.05); compared with the non-transdermal absorption enhancer group, leptin was significantly increased in the laurocapram group and the borneol group (both P＜0.05); there was no significant difference in leptin between the laurocapram and the borneol groups (P＞0.05). The qPCR results of rabbit liver tissues showed that the mRNA expressions of leptin, Janus kinase 2 (JAK2) and signal transducer and activator of transcription 3 (STAT3) in the model group were significantly lower than those in the blank group (all P＜0.05); compared with the model group, the mRNA expressions of leptin, leptin receptor (LR), JAK2 and STAT3 in the non-transdermal absorption enhancer, the laurocapram and the borneol groups were significantly increased (all P＜0.05); compared with the non-transdermal absorption enhancer group, the mRNA expressions of leptin, LR, JAK2 and STAT3 in the laurocapram and the borneol groups were significantly increased (all P＜0.05); compared with the laurocapram group, the mRNA expressions of leptin, LR, JAK2 and STAT3 in the borneol group were significantly increased (P＜0.05). The trend of immunohistochemistry and WB detection results was basically consistent with the qPCR assay results. The immunohistochemistry and WB detection results of phosphorylated JAK2 (phospho-JAK2) and phosphorylated STAT3 (phospho-STAT3) were basically consistent with those of JAK2 and STAT3. Conclusion: The molecular expression of Leptin/JAK2/STAT3 pathway in the hyperlipidemia model rabbits was decreased. The molecular expression of Leptin/JAK2/STAT3 pathway was significantly increased after the herbal cake-partitioned moxibustion. The application of laurocapram and borneol, as transdermal absorption enhancers, in the herbal cake-partitioned moxibustion could more obviously up-regulate the factors of the Leptin/JAK2/STAT3 lipid-regulating pathway than the herbal cake-partitioned moxibustion alone.

Objective:To observe the effect of electroacupuncture (EA) on the expressions of acetylcholine (ACh) and mucin 5AC (MUC5AC) in the lungs of rats with chronic obstructive pulmonary disease (COPD),and explore the mechanism of EA in treating COPD.Methods:Thirty Sprague-Dawley (SD) rats were randomly divided into a control group,a COPD group,and an EA group,with 10 rats in each group.The control group was a group of normal rats.The COPD rat model was induced by cigarette smoke combined with lipopolysaccharide (LPS).The COPD rats were treated with EA at bilateral Feishu (BL 13) and Zusanli (ST 36) in the EA group,30 min each time,once a day,successively for 14 d.The lung function was tested.The contents of ACh and MUC5AC in lungs and bronchoalveolar lavage fluid (BALF) were detected by enzyme-linked immunosorbent assay (ELISA).Pearson method was used to analyze the correlation between pulmonary function and the content of MUC5AC in lungs.The mRNA and protein expressions of MUC5AC in lung tissues were detected by real-time polymerase chain reaction (RT-PCR) and Western blot (WB),respectively.The immune response of MUC5AC was observed by immunohistochemistry.Results:Eight rats were left in each group,and the other two died.Compared with the control group,the total airway resistance (Raw) increased significantly and dynamic compliance (Cdyn) decreased significantly in the COPD group (P＜0.01);compared with the COPD group,the Raw level declined significantly and Cdyn increased significantly in the EA group (P＜0.01).The contents of ACh and MUC5AC in the lungs and BALF were remarkably higher in the COPD group compared with those in the control group (P＜0.01,P＜0.001);compared with the COPD group,the contents of ACh and MUC5AC were significantly lower in the EA group (P＜0.05,P＜0.001).There was a negative correlation between MUC5AC content and lung function (P＜0.001).The mRNA and protein expressions of MUC5AC in the lungs were significantly higher in the COPD group than in the control group (P＜0.001);compared with the COPD group,the expressions were significantly lower in the EA group (P＜0.01).Compared with the control group,the immune response of MUC5AC in the airway epithelium significantly increased in the COPD group (P＜0.001);the immune response of MUC5AC was significantly lower in the EA group compared with that in the COPD group (P＜0.001).Conclusion:EA treatment can improve the lung function of COPD rats,which may be related to its effect in the down-regulation of ACh and MUC5AC contents in the lungs as well as the inhibition of mucus hypersecretion.