OBJECTIVE To study the epidemiological features of hospital lower respiratory tract infection in order to adopt effective control methods.METHODS We investigated and analyzed the 45 patients suffered from hospital lower respiratory tract infections among the 9 449 hospitalizd patients between Jan 2000 and Jun 2002.RESULTS The rate of total hospital lower respiratory tract infection was 0.48%,the composition rate was 23.56%,the average bacteria resistance rate was 57.17%.CONCLUSIONS In order to prevent hospital lower respiratory tract infection,immune support therapy should be strengthened and risk factors should also be controlled.

Objective To evaluate the implementation effect of continuous nursing care in patients after percutaneous coronary intervention. Methods Totally 200 patients underwent coronary intervention were equally divided into the control group and the experimental group. Randomization was done by sealed envelopes. Routine nursing was applied inthe control group while the patients inthe experimental group werenursed continuously. Compliance of taking medication, the incidence of major adverse cardiac events (MACE events), satisfactory rate of the patients and the occurrence of stent restenosis were compared between the two groups. Results There was a significant difference between the experimental group and the control group in compliance of taking medication from the 6th month. According to the Morisky measurement, the score of the 6th month in the experimental group was 8.00 ± 0.00, while the control group was 7.66 ± 0.82. There was a statistical significance between the two groups (t=-4.086, P<0.01); the score of the 12th month in the experimental group was 7.94 ± 0.48, and for the control group, the score was 7.28 ± 1.58, the difference was statistically significant (t=-3.899, P<0.01). The major adverse cardiac events (MACE events) were 1% (1/100) and 4%(4/100) for the experimental and control group respectively. The satisfactory rate of the patients in the experimental group and the control group were 98%(98/100) and 81%(81/100) separately. The difference between the two groups was of statistical significance (χ2=36.39, P<0.01). The restenosis rate of the two groups was 1.2% (1/82) and 2.5% (2/79) separately, which was of no significance (χ2=0.392, P=0.613). Conclusions Continuous nursing can significantly improve the patients′ medication compliance, reduce the occurrence of MACE events, and improve the satisfaction of nursing care.

Objective To investigate the role of RhoA-Rock signaling pathway in the process of rat peritoneal mesothelial cells (RPMCs) epithelial-mesenchymal transition (EMT) induced by transforming growth factor β1 (TGF-β1). Methods Primary RPMCs were cultured in vitro. After synchronization for 24 hours, RPMCs were randomly assigned to 4 groups: group A (control), group B (TGF-β1, 10 μg/L), group C (10 μg/L TGF-β1+10 μmol/L Y-27632, an inhibitor of Rock, pretreated for 2 hours with Y-27632 before TGF-β1 stimulation), group D (Y-27632 alone, 10 μmol/L). Growth arrested and synchronized RPMCs were stimulated by 10 μg/L TGF-β1 for different time. The mRNA and protein expression levels of E-eadherin, α-SMA and collagen Ⅰ were measured by RT-PCR and Western blotting respectively. The protein expression level of vimentin was measured by Western blotting. Active RhoA was extracted by Plasma Membrane Protein Extraction Kit, then it was assessed by Western blotting. Results (1) TGF-β1 stimulation elicited a robust increase in RhoA activity in time-dependent manner, which was (2.57±0.52) folds compared with control group (P<0.05) after 10 min stimulation. RhoA activity peaked at 1 hour, which was (4.35±0.41) folds compared with control group (P<0.05). (2) TGF-β1 up-regulated mRNA and/or protein expression of α-SMA, vimentin and collagen Ⅰ , and down-regnlated mRNA and protein expression of E-cadherin in RPMCs. (3) The Rock inhibitor Y-27632 effectively revered TGF-β1-induced expression of α-SMA, collagen Ⅰ and vimentin. The mRNA levels of α-SMA and collagen Ⅰ decreased by 53.8% and 55.7%, and the protein levels of α-SMA, vimentin and collagen Ⅰ decreased by 42.6%, 60.1% and 58.1% compared with TGF-β1-stimulated groups (P< 0.05). But Y-27632 had no effect on the level of E-cadherin. Conclusions RhoA-Bock signaling pathway may mediate EMT induced by TGF-β1 in rat peritoneal mesothelial cells. RhoA-Rock pathway may be the potential therapeutic target in the progress of peritoneal fibrosis.

Objective To explore the effect of transforming growth factor β1 (TGF-β1) on epithelial-mesenchymal transition in rat peritoneal mesothelial cells(RPMCs) and its mechanism.Methods Primary peritoneal mesothelial cells of SP rats were cultured in vitro. After synchronization for 24 h, RPMCs were randomly divided into 2 groups: Group A (control), Group B (TGF-β1, 10 μg/L). RPMCs were stimulated by 10 μg/L TGF-β1 for different time. The mRNA and protein expression levels of E-cadherin, α-smooth muscle actin (α-SMA) and collagenⅠwere measured by RT-PCR and Western blot, respectively. The protein expression level of total RhoA was measured by Western blot. Active RhoA was extracted by Plasma Membrane Protein Extraction Kit, and assessed by Western blot. Results TGF-β1 down-regulated mRNA and protein expression of E-cadherin in RPMCs, and upregulated mRNA and protein expression of α-SMA and CollagenⅠ. TGF-β1 stimulation elicited a robust increase in RhoA activity in a time-dependent manner. RhoA activity peaked at 1 h.Conclusion RPMCs can be transdifferentiated into myofibroblast under the effect of TGF-(β1,)and the mechanism may be related to the activation of RhoA associated signal pathway.

BACKGROUND: Logistic analysis of multi-ordered response-variable is used to probe into from another view the interrelationship between lead content in fetus faeces and neurobehavioral development under exposure to low-level lead in uterus.OBJECTIVE: To probe into multi-factors of neurobehavioral development in neonates and the sensibility.DESIGN: The total score of neurobehavior in neonates was taken as dependent variable and 24 indexes were as independent variables, such as induced factors, lead in umbilicus blood and lead in fetus faeces in questionnaire. Logistic progressive regression of multi-ordered response-variables was used in analysis and corresponding factors were screened at level of P=0.10.SETTING: Wuhan University of Science and Technology, Laboratory Room of Occupation Disease and Epidemic disease in Tongji Medical College of Huazhong University of Science and Technology and Occupation Hospital of China First Metallurgical Construction General Company.PARTICIPANTS: Totally 103 full-month borne and healthy neonates were randomized in Department of Gynecology of one occupation hospital in Qingshan District of New-type Industry Area of Huanhan City from January to October 1999 as the objects. The relatives agreed with topic research and questionnaire investigation and they provided neonatal faeces and received neonatal tests on time.off the umbilicus and preserved in freezing in refrigerator at -4 ℃. The faeces in 24 hours after birth was collected and the lead contents of umbilicus blood and faeces were assayed with graphite furnace atomic absorpBehavioral Neurological Assessment (NBNA) was used in examination on the 3rd day after delivery. Simultaneously, the self-designed questionnaire was adopted in the investigation for parturients. The questionnaire involved other possible factors of neonatal neurobehavioral development, including dependent variables, concerning to states of family, society, environment and health that affected neurological development in neonates and lead contents in umbilicus blood and faeces. Scores of neonatal neurobehavior were taken as response variables. Finally, the corresponding factors were screened.MAIN OUTCOME MEASURES: To screen the factors of neurobehavioral development of neonates.RESULTS: Totally 103 cases entered result analysis. Six factors were selected in the model, named pregnant weeks, the month of drug administration in pregnancy, hemoglobin, emotions in pregnancy, lead level in fetus faeces and drug administration.CONCLUSION: Neonatal neurobehavioral development was related to multiple factors. Good nutrient in pregnancy, long pregnant weeks and good emotions in pregnancy benefit neurobehavioral development of neonates. Drug administration during pregnancy is disadvantageous in neonatal neurobehavioral development, especially the medication at the early phase of pregnancy. The increased lead content in neonatal faeces does not benefit neonatal neurobehavioral development.

BACKGROUND: In the past, a lot of researches used one-time lead level in umbilical cord blood at birth for investigations,however, one-time lead level in umbilical cord blood at birth can not represent lead caused cumu lative injury to neonatal nervous system during the whole period of preg nancy. Lead in meconium is mainly from digestive juice secreted by fetal alimentary tract, exfoliative epithelia from neonatal intestinal tract and am niotic fluid and sebum cutaneum swallowed by fetus, which is excreted from the very start of pregnancy to 24 hours after birth of neonates and re flects the lead deposit in neonatal intestinal tract during the whole period of pregnancy. OBJECTIVE: To explore the relationship between neurobehavioral devel opment in neonates with intrauterine exposure to lead at low level and the lead level in umbilical cord blood (CBPb) and meconium (MPb). DESIGN: Take lead levels in umbilical cord blood and meconium as neonatal intrauterine exposure indicators and scores of neonatal neurobe havioral development as effect indicators, and descriptive analysis is used to evaluate the correlativity. SETTING: Wuhan University of Science and Technology; Laboratory of Occupation Disease and Epidemiology, Tongji Medical College, Huazhong University of Science and Technology; Wuhan First Metallurgical Con struction Company Hospital for Workers and Staff. PARTICIPANTS: A total of 103 cases of full-term and healthy neonates were selected as objects of observation. The neonates were born in Depart ment of Gynecology and Obstetrics, Wuhan First Metallurgical Constrction Company Hospital, Qingshan District of New Industrial District of Wuhan from January to October 1999. Their parents were agreed to participate in the study and filled in the questionnaire, and provided neonatal meconium and performed neonatal tests on schedule. METHODS: ① Collection and assay of sample: 5 mL umbilical cord blood were collected and reserved in refrigerator at -4 ℃. Meconium with in 24 hours after birth, with dry weight between 5 to 10 g was collected, the lead levels in umbilical cord blood and meconium were assayed with the method of graphite furnace atomic absorption spectroscopy. ② Group ing: The neonates were divided into two groups with high and low-exposure to lead based on the cutoff value of CBPb of 0.483 μmol/L and MPb of 127.78 mg/kg. ③ Neonatal neurobehavioral development examination: Neonatal neurobehavioral development examination method was used for examination 3 days before delivery. Meanwhile, self-designed questionnaire was used to conduct a survey in puerperas. MAIN OUTCOME MEASURES: ① Lead levels in neonatal umbilical cord blood and meconium. ② Scores of neurobehavioral development of neonates with different lead levels of umbilical cord blood and meconium. RESULTS: All the 103 cases of neonates entered results analysis. ①There was significant difference only in scores of neonatal behavioral neurological assessment (NBNA) and biological visual and auditory orientation reaction (BVAOR)between groups with high and low-exposure to lead in umbilical cord blood (P ＜ 0.05). However, there was no rank correlativity between lead level in umbilical cord blood and scores of NBNA,non-biological auditory orientation reaction (NBAOR), non-biological visual orientation reaction (NBVOR) and biological visual and auditory orientation reaction (NBVOR). ②here was significant difference in scores of NBNA,NBAOR, NBVOR and BVAOR between groups with high and low-exposure to lead in meconium (P ＜ 0.05-0.01). The lead level in meconium clearly correlated reversely with scores of NBNA, NBVOR and BVAOR.CONCLUSION: Lead level in meconium is more sensitively related to the scores of neonatal neurobehavioral development, which could be used as indicator for lead deposit in the fetal body during the period of pregnancy.

BACKGROUND: Studies have confirmed that RhoA/ROCK signaling pathway plays an important role in the process of epithelial-mesenchymal transition. OBJECTIVE: To investigate the effect of Y-27632 (inhibition of rhodopsin kinase of 4-aminopyridines compounds) on the epithelial-mesenchymal transition of rat peritoneal mesothelial cells (RPMCs) induced by transforming growth factor ?1 (TGF-?1). DESIGN,TIME AND SETTING: An animal observational experiment was performed at the Laboratory of Nephrology in the First Affiliated Hospital of Sun Yat-sen University from March 2007 to March 2008. MATERIALS: A total of ten healthy male Sprague Dawley rats were provided by the Animal Experimental Center of Sun Yat-sen University. Y-27632 was the product of Calbiochem Company (German). TGF-?1 was the product of R&D Company (USA). METHODS: Primary RPMCs were cultured in vitro. After synchronization for 24 hours, RPMCs were randomly divided into 4 groups: control group (RPMCs cultured in the DMEM/F12 without serum), TGF-?1 group (RPMCs cultured in the DMEM/F12 without serum, and then added 10 ?g/L TGF-?1), Y-27632 group (RPMCs cultured in the DMEM/F12 without serum, and then added 10 ?g/L Y-27632), TGF-?1 +Y-27632 group (RPMCs cultured in the DMEM/F12 without serum, and then added 10 ?g/L Y-27632. 2 hours later, 10 ?g/L TGF-?1 were added). The cells were collected 48 hours after culture. MAIN OUTCOME MEASURES: The mRNA and protein expression of E-cadherin and ?-Smooth muscle actin (?-SMA) were measured by RT-PCR. The protein expression level of E-cadherin, ?-SMA and vimentin was measured by Western blotting. RESULTS: Compared to control group, the expression of E-cadherin significantly decreased in the TGF-?1 group, and the expression of ?-SMA and vimentin significantly increased (P

Objective To explore the related risk factors of severe mycoplasma pneumonia in children.Methods 86 children with mycoplasma pneumonia were selected as the observation group.At the same time,30 normal children were selected as the control group.The observation group included 33 cases of mild mycoplasma pneumo nia(A group) and 53 cases of severe mycoplasma pneumonia(B group).The clinical data of the three groups were ret rospectively analyzed,and the related risk factors of severe mycoplasma pneumonia in children were analyzed.Results The risk factors of severe mycoplasma pneumonia in children were age ＞ 5 years (x2 =28.776,P ＜ 0.05),immunoglobulin IgG(x2 =3.004,P ＜ 0.05),immunoglobulin IgM (x2 =2.147,P ＜ 0.05),immunoglobulin IgA (x2 =2.036,P ＜ 0.05),WBC (x2 =6.119,P ＜ 0.05),neutrophil percentage (x2 =8.374,P ＜ 0.05),the positive rate of CD8(x2 =11.665,P＜0.05),the positive rate of CD4(x2 =12.901,P＜0.05).Conclusion For children with risk factors of severe mycoplasma pneumonia should be early diagnosed,prevented and treated,thereby reducing the burden on patients.

AIM:To investigate the differentiation from rat mesenchymal stem cells (rMSC) into neuron-like cells. METHODS:rMSC were separated from femur marrow and expanded in L-DMEM culture medium supplemented with 10% FSC. rMSC were induced to differentiate into neurons with L-DMEM/adrenaline,L-DMEM/noradrenaline and L-DMEM/isoprenaline, respectively. Meanwhile, rMSC were cultured in L-DMEM in control group. Nestin, neuron-specific enclose (NSE), glial fibrillary acidic protein (GFAP) were detected by immunocytochemistry. RESULTS: rMSC were expanded as undifferentiated cells in culture from 5 to 22 passages, indicating their differentiated capacity. Simple method induced rMSC to exhibit a neuronal phenotype, expressing positive NSE,nestin, and GFAP, at 5 hours in all group. The undifferentiating cells (control group 53.1%?4.3%), and differentiating cells (treated group: adrenaline 74.7%?2.6%; noradrenaline 75.9%?2.4%; isoprenaline 72.1%?4.4%), expressed characteristics of various neuronal cells, from 5 hours to 6 days. There were neuron-like cells in rMSC cultured in L-DMEM/10%FBS from 7 to 13 passage(66.5%?6.4%). CONCLUSION: It suggests that rat neural stem cells (rNSC) exist in bone marrow, rMSC can be differentiated into various neural cells with adrenaline hormones in vitro.

Objective To study the difference between intensity-modulated radiation therapy (IMRT) and three dimensional conformal radiation therapy (3D-CRT) for pelvic radiation of post-operative treatment with gynecologic malignant tumor. Methods A prospective investigation study was conducted on 183 patients of post-operative patients with whole pelvic radiation therapy of cervical cancer or endometrial cancer in Zhejiang Cancer Hospital [IMRT group (n=85) and 3D-CRT group (n=98)] from Oct. 2015 to Oct. 2016. The two groups received same dose (45 Gy in 25 fractions). Comparison of two groups with radiation dosimetry:the score according to the Radiation Therapy Oncology Group (RTOG) acute radiation injury grading standards before and after radiotherapy reaction, the score from functional assessment of cancer therapy scale-cervix (FACT-Cx) scale and expanded prostate cancer index composite for clinical practice (EPIC-CP) scale were also analyzed. Results (1) There were no significant effect with age, culture level, family economic condition and ratio of radiochemotherapy between two groups (all P>0.05). (2) Dosimetric comparison for IMRT vs 3D-CRT:the average dose of planning target volume (PTV) decreased(46.1 ± 0.4) vs(46.4 ± 0.5)Gy, V45 dose percentage increased(95.2 ± 1.0)%vs (93.3 ± 2.0)%, intestinal bag dose of V40 decreased(24.4 ± 6.8)%vs (36.5 ± 15.9)%, rectal V40 dose percentage decreased(73.9 ± 12.3)%vs (85.4 ± 8.4)%, and lower rectal V45 dose percentage(32.8 ± 13.4)%vs (71.5 ± 13.7)%, bladder V40 dose percentage decreased(55.5 ± 13.0)% vs (84.4 ± 13.0)%. Bone marrow V20 lower:(67.9 ± 5.4)% vs (79.5 ± 6.6)%, V10 lower:(82.1 ± 6.0)% vs (86.3 ± 6.6)%; there were significant differences (all P<0.05). There was no significant difference between the dose of V45 in the intestinal pouch and bladder (P>0.05). (3) Acute radiation injury classification for IMRT vs 3D-CRT:big or small intestine:Ⅱ-Ⅲreaction [13%(11/85) vs 24% (24/98); χ2=3.925, P=0.048], there was significant difference. Bladder: Ⅲ reaction [19% (16/85) vs 26% (25/98); χ2=1.171, P=0.279], there was no significant difference. Radiochemotherapy of bone marrow suppression:Ⅲ-Ⅳreaction (14/20), the incidence rate [26%(14/54) vs 31%(20/65);χ2=0.339, P=0.562], the difference was not statistically significant. (4) Quality of life scale by FACT-Cx scale in IMRT vs 3D-CRT:there were no significant difference before radiotherapy (82 ± 16 vs 85 ± 16;t=1.279, P=0.203), while there was significant difference after radiotherapy (76 ± 14 vs 71 ± 18;t=-2.160, P=0.032). EPIC-CP scale score:before radiotherapy they were (16±7 vs 15±6;t=-0.174, P=0.862) ,but after radiotherapy (18±7 vs 22± 7; t=3.158, P=0.002), there was significant difference between them. Before and after radiotherapy, the increased EPIC-CP scale of the IMRT group vs 3D-CRT group were 3 ± 4 and 6 ± 4, the 3D-CRT group was significantly higher, the difference was statistically significant (t=5.500, P=0.000). Conclusion IMRT has shown that there are a significant benefit for the post-operative patients with cervical cancer and endometrial cancer compared to 3D-CRT.