Objective To investigate the prevalence of healthcare-associated infection(HAI)in medical institutions in Pudong New Area.Methods Ten medical institutions in Pudong New Area were selected as monitored hospitals, cross-sectional survey on HAI in each hospital at a given day of November 2013 and November 2014 were conduc-ted.Prevalence of HAI in different levels of hospitals were compared.Results The prevalence rates of HAI in 2013 and 2014 were 4.04% and 3.75% respectively,there was no significant difference between two years(χ2 =0.709,P=0.400).The prevalence rates of HAI in primary,secondary,and tertiary hospitals in 2013 were 0.66%,3.32%, and 4.60% respectively,in 2014 were 0,3.52%,and 4.01 % respectively,prevalence rates of HAI in different lev-els of hospitals of each year were significantly different (all P <0.05).Prevalence rates of HAI were high in depart-ments of neurosurgery,hematology,intensive care units(ICUs),and gerontology.The prevalence rate of infection in ICUs increased obviously,from 10.09% to 18.78% (χ2 =3.921 ,P =0.048),departments of gerontology de-creased obviously,from 10.07% to 5.02%(χ2 =5.698,P =0.017).The main HAI sites were lower respiratory tract (36.72%),upper respiratory tract (9.96%),and urinary tract (12.89%).172 pathogenic isolates were de-tected in 2013,and 177 were detected in 2014,gram-negative bacteria,gram-positive bacteria,and fungi accounted for 60.74%,26.37%,and 12.89% respectively.Constituent ratios of pathogens causing HAI between two surveys were not significantly different (χ2 =5.819,P =0.830).Conclusion Among different levels of hospitals in Pudong New Area,tertiary hospitals have the highest prevalence rate,HAI in ICU increases obviously,the main HAI site is lower respiratory tract,the main pathogens are gram-negative bacteria.

Objective To explore the potential of breast cancer stem cells in differentiating into vascular endothelial cells and participating in the angiogenesis of breast tumor.Methods The expressions of mutant P53, CD31 ,VEGF and Her-2 amplification in tumor blood vessels were detected and the single cell suspension of breast cancer was prepared.CD44+/CD24-/low cells were selected and cultured in culture system.The expressions of CD31 and CD105 on endothelial cell surface were detected by EGM-2 endothelial cell culture medium.The ability of uptake of acetylated low-density lipoprotein was measured.The endothelial cells were cultured in vitro to observe their vascular structure.Results The expressions of CD31,VEGF and mutant P53 were found in paraffin sections of breast cancer tissue samples, and they were arranged along the vessel lumen or blood vessel sphere. Immunofluorescence showed that CD31 and DAPI signals were expressed intravascularly in breast cancer tissues. Four samples of Her-2 positive amplification and 9 cases of non-amplification were detected in the samples.The successful separation of breast cancer stem cells was carried out by immunomagnetic sorting.The percentage of CD44+ cells in the pre-sorting cells was (7.5±2.6)% and that of CD44+ cells was about (94.3±4.7)% after magnetic sorting (P<0.05).The ratio of CD24+ cells was (48.2±9.4)% before sorting,and that of CD24+ cells was (4.3±1.6)% after immunomagnetic bead sorting.The proportion of CD105+ cells in mammary gland cells was (4.5±0.9)% and the proportion of CD31+ cells was (6.2±1.3)%.After cultured for three generations,the percentages of CD105+ cells and CD31+ cells were (79.6±9.3)% and (84.1±10.7)%,respectively (P<0.05). DiL-Ac-LDL could be phagocytized by endothelial cells cultured in endothelial cell culture system.Vessel-like structure was found in the endothelial cell group while the control group did not have the tendency of vascular changes.Conclusion Breast cancer stem cell-derived endothelial cells differentiate into endothelial cells in vitro and have the ability of vascular formation,suggesting that breast cancer stem cells may be involved in the formation of tumor blood vessels.

Background Proliferative vitreoretinopathy(PVR) is a tissue repair prevention and treatment of PVR in clinic.Natural delayed release microballoons are therefore becoming a hot spot for its easy manipulation,large lading dose and long acting duration.Objective This study was to evaluate the effect of 5-fluorouracil natural delayed release microballoons on the prevention of PVR.Methods The lymphocytes were collected from clean pigment rabbit to prepare the 8×107/ml cell suspension with complete culture fluid.PVR models were established in 45 healthy pigment rabbits by intravitreal injection of lymphocyte suspension.The animals were randomly divided into 3 groups and 15 rabbits for each.0.1ml normal saline,10g/L or 20g/L 5-fluorouracil natural delayed release microballoons were injected into vitreous cavity respectively.PVR was graded on Fastenberg's method under the slit lamp in 1,2,4,8 weeks.The animals were sacrificed and retinas were obtained for the histopathological and ultrastructural examination in the eighth week after administration of drug.Results The numbers of eyes with different grades of PVR were significantly different among 3 groups in 1 week,2,4,8 weeks(P＜0.05).The eye numbers with PVR was significant less in 20g/L Fu group than those of 10g/L Fu group and normal saline group(P＜0.05).There was statistical difference in PVR ranking among these 3 groups in 8 weeks after injection of drug(H=46.795,P＜0.05).The morphology and ultrastructure of retinas under the light microscope and transmission electron microscope were near normal in all of the three groups.Conclusion Implantation of 5-fluorouracil natural delayed release microballoons into vitreous cavity is effective and safe in preventing PVR in experimental model,and the therapeutic effect of microballoons with 20g/L 5-Fu is better.

Stress urinary incontinence is one of the most common diseases in urinary system.At present,the major methods for treating stress urinary incontinence include medication,physico-behavior therapy and operation.However,for various reasons,the current methods do not yield satisfactory results.As a newly emerging technique,tissue engineering provides a new concept and method to treat stress urinary incontinence.The application of tissue engineering in the treatment of stress urinary incontinence is reviewed in this article.

Objective To explore the method of culture of rat adipose-derived stem cells(ADSCs) and differentiation induction into myoblasts. Methods Adipose tissues were obtained from SD rats,and were isolated by enzyme digestion and cultured into ADSCs.The expression of surface antigen CD90,CD105 and CD34 was detected by immunofluorescence and flow cytometry.ADSCs of the second passage with logarithmic growth were obtained,and culture media containing 5-azacytidine(5-aza) and basic culture media were employed for cells in induction group and control group,respectively.The induction lasted for 7 d,14 d,21 d,28 d and 35 d,respectively.Cell growth and cell morphology were observed by inverted phase contrast microscope,and immunofluorescence and flow cytometry were utilized to detect the expression of myoblast specific antigens desmin and myosin. Results ADSCs were successfully isolated and cultured,and were identified to be stem cells.On the 28th day of induction,cells in induction group displayed "swirl" morpholgy,and multinucleation was observed.It was revealed by immunofluorescence and flow cytometry that the highest expression rates of desmin and myosin were 52.57% and 50.04%,respectively on the 28th day of induction,while there was no expression before induction and in control group. Conclusion ADSCs can be isolated and cultured from rat adipose tissues,and can further differentiate into myoblasts after induction by culture media with 5-aza.The expression of myoblast specific antigen is the highest on the 28th day of induction.

To develop a method to estimate the anti-Aspergilli activity of active ingredients of Chinese herbs. With the broth microdilution testing procedure proposed by NCCLS, anti-Aspergilli activity of active ingredients ( cinnamalde-hyde, cinn. and citral) of Chinese herbs was determined.The MIC values of cinn. to Aspergillus flavus, A.fumigatus were 0.100?g /mL , 0.050?g/mL.The MIC values of citral to A. flaws, A.fumigatus were 2.600?g/mL, 0.650?g/ mL.These results demonstrate that citral and cinn. have high potency activity against Aspergillus spp. .The research may provide references to establishing a standard for evaluating the effect of anti-Aspergilli Chinese herbs.

OBJECTIVE:To provide reference for further development of Internet drug transaction services in China. METH-ODS:The data of online drugstores with top 20 approvals data and sales amount were collected bu the Internet,the normative man-agement was evaluated. Meanwhile,questionnaire was conducted to survey and analyze the cognition,buying drugs and correspond-ing requirements of some Shanghai citizens for Internet drug retail. RESULTS:By Jun. 12,2015,totally 307 retail chain drug-stores(online drugstores)had got the License of Internet Drugs Transaction,only 62 online drugstores(20.2%)were in full compli-ance with the normative management;the top 19 online drugstores supplied averagely 1 072±815 OTC medicines,including 259± 165 chemical drugs and 813 ± 650 Chinese traditional medicines,and the top 3 were jianke.com (3 658 species),J1.com (2 071 species)and 360 kad.com(1 523 species). Totally 216 questionnaires were sent out,and 183 were effectively received with effec-tive recovery of 84.7%. The 183 surveyed citizens showed high cognition in distinguishing the authenticity of online drugstores (75.4%) and the authenticity of drugs (67.1%),but low cognition in online drugstore opening qualifications and Internet selling drugs;only 22.4% had the experience of buying drugs online,the degree of satisfaction towards online shopping,from the highest to the lowest,were drug price(62.5%),professional consultation of pharmacists(50.0%),variety of drugs(45.0%),quality of drugs(37.5%),delivery time(35.0%),etc.;the most probably purchased medicine category were vitamins and minerals(63.9%) and medicines for common diseases(40.4%). CONCLUSIONS:Currently the demands and confidence of online drugs shopping of Shanghai citizens are still scarce. Though the access of retailing prescription drugs would spur the Internet drug business,the condi-tion is still immature. It is suggested to sell prescription drugs in a limited way and improve their access threshold,promote Medi-care settlement to multi-faceted promote the orderly development of Internet drug transaction services.

Objective　To study the MRI diagnosis of spinal metastasis.Methods　The MRI appearances of 128 cases of spinal metastasis proved clinically were retrospectively analyzed.Results　(1)The MRI signal was T1WI low in 87.5% and 12.5% was mixed or equal.(2)Multi-focus in 80.5%.The "jump up sign"occurred in 52.3%,the accessory parts destructed in 64.1%,in which root of vertebral destructed with expanded in 57%.(3)The masses of paravertebral occurred in 31.3%.The disc of vertebral was not destructed.(4)The patients associated with vertebral compresion fracture such as "wedge","disc"or"wedge of rear"in 52.3%.Conclusion　The MRI findings of spinal metastasis is of high sensitivity and spectivity.The method is advanced than X-ray and CT.

Objective To investigate the infection sites,the offending species,diagnosis and prognosis of deep fungal infections (DFI) in patients with systemic lupus erythcmatosus (SLE).Methods Fifty-one patients with fungal infections in 1466 SLE patients admitted to Peking Union Medical College (PUMC) Hospital from 2000 to 2006 were reviewed retrospectively.Results Candida albicans was ranked the first pathogen,followed by ncoformans and Aspergillus species.The infection sites were lungs,cerebral meninges and blood in the order of prevalence.The overall mortality was 20%(10/51).Aspergillasis carried the highest mortality which couht be as high as 80%.Hypoproteinemia,multiple focus of fungal infections,Aspergillasis and fungemia might he the independent risk factor for mortality.Conclusion Candida albicans is the most frequent species of fungal infections in SLE patients.Iungs are the most prevalent location of infection.Earlier diagnosis is important.Special attention should be paid to aspergillasis.

Objective To develop a network system for radiotherapy.Methods Delphi 6.0 lan- guage was used to program the system based on PACS through the model of client-server machine and local network.Data of different facilities were transferred among each other through Dicom 3.0 and Dicom RT pro- tocol.Results The main function of this system was a management software for radiotherapy,a PACS sys- tem,a TPS system and a therapeutic machine system.Conclusion The network system operates steadily with data safe and reliable,and is an important part of the information construction in the department of radio- therapy