OBJECTIVE To investigate the incidence of hospital acquired infection among cirrhosis patients and analyze its correlated factors.METHODS The whole case history was analyzed retrospectively.RESULTS The incidence of hospital acquired infection was 21.33%,obviously higher than the average hospital infection rate(9.1%).It contained mainly respiratory tract infections and spontaneous bacterial peritonitis.It was positively correlated with patient's age,hospitalization time,liver function,hypoalbuminemia,leukocyte count,acute upper gastrointestinal bleeding and the invasive operations(P

The morphometry of the intramembranous particles (IMP) of the dog sinus node cells was studied with freeze-cleaved specimens under H-500 electron microscope. The photographs of IMP of the P cells and transitional cells were analysed with imaging analytical system (IBAS Ⅰ+Ⅱ type). The results are as follows. The mean area of IMP: on PF and EF faces of P cells are 25.800nm~2 and 17.816nm~2. The mean values of IMP on PF and EF faces of the transitional cells are 46.041nm~2 and 88.633nm~2. The averages of the perimeter of IMP on the PF and EF faces of P cells are 20.735 nm and 18.078 nm, respectively. And those of the transitional cells are 28.780 nm and 43.901 nm. The diameters of circles of IMP of PF and EF faces of P cells are 5.220 nm and 4.402 nm. Those of PF and EF faces of the transitional cells are 7.010 nm and 10.476 nm. The mean values of form factor of IMP on PF and EF faces of P cells are 0.653 and 0.643, and those of transitional cells are 0.627 and 0.573. The mumbers of IMP are 1325/?m~2 and 345/?m~2 on PF and EF faces of P cells, and the mumbers of IMP of the transitional cells are 3225/?m~2 on PF face and 590/?m~2 on EF face.

Aquaporin (AQP)is a molecular weight of about 28 kD of the four polymer structure membrane channel protein. In mammals,there are 1 3 different AQP,expressed in different tissues and organs,regulating waterand glycerol and urea and other small molecules transmembrane transport of major proteins.AQP-1 is mainly expressed in the renal proximal tubule and Henle’s loop drop bronchiole epithelial cell apical membrane and basement membrane,is responsible for the reabsorption of renal tubular water molecules.The expression of AQP-1 can be changed when the kidney is damaged or damaged,so it is very important to study the mechanism of AQP-1 for understanding the pathogenesis of water metabolism and the treatment of clinical water metabolism.

Objective To investigate the effect of propofol on autophagy in SD rat heart during myocar-dial ischemia-reperfusion (I/R) injury. Methods Twenty-one male SD rats were randomly divided into three groups as follows (n = 7): the sham operation group, in which rats underwent sham operation without tightening of the coronary artery sutures; the myocardial ischemia-reperfusion group , in which rats were induced by occlud-ing the left anterior descending coronary artery for 30 min , followed by 120 min reperfusion and 0.9% NaCl in-fusion at 3 mL/(kg·h) at 10 min before occluding the left anterior descending coronary artery; the myocardial ischemia- reperfusion- propofol group, in which rats underwent I/R and propofol infusion at 6 mg/(kg·h) at 10 min before occluding the left anterior descending coronary artery. Before tightening of the coronary artery, at 30 min post-tightening of the coronary artery and at 120 min post-reperfusion, HR、 LVSP and ± dp/dtmax of rats were recordedin each group. Atter 120 min post-reperfusion, the serum concentrations of cTnT was measured. The in-jured cardiac tissue was collected to investigate the ultrastructure change under the TEM and to determine the levels of mTOR and p-mTOR. Results No signifcant differences in HR, LVSP and ± dp/dtmax before tighten-ing of the coronary artery. But, at 30 min post- tightening of the coronary artery, compared with groupⅠ, the HR, LVSP and ±dp/dtmax were significantly decresed in groupⅡ and Ⅲ(P < 0.05). Then, at 2 h post-reper-fusion, compared with groupⅠ, the HR, LVSP, ±dp/dtmax and the level of p-mTOR were significantly de-creased, but the serum concentration of cTnT was significantly increased in groupⅡ(P < 0.05); but, compared with groupⅡ, the HR, LVSP, ± dp/dtmax and the level of p-mTOR were significantly increased, the serum concentration of cTnT and the level of mTOR were significantly decreased in group Ⅲ(P < 0.05). Conclusions These data suggest that propofol could heighten the level of p-mTOR, and attenuate the expression of mTOR dur-ing the myocardial ischemia-reperfusion injury in SD rats.

The fine structure of the biomembrane of the sinus node cells in the dog wasstudied with the replicas of freezecleaved specimens.The intramembranous particles.(IMP)in the PF and EF faces of the plasma mcmbrane of the sinus node cells,were present.The density of the IMP on the PF faces was more dense than those ofEF faces,In general,the shape of the IMP of the plasma membrane(PF and EFfaces)exhibited spherical or spheroidal.The IMP of PF faces may be divided into,three groups,i.e.the larger,medium and small size.Numerous endocytotic vesicles.found on the PF faces appeared as circular depressions and as small walled craterson EF faces.No regular array of the vesicles had been observed on both faces,TheIMP of the mitochondrial cristae were more dense than those of the depression.TheIMP of PF face of the nuclear membrane were observed.Their size and shapepresent a uniform appearance.There were many nuclear pores in the surface of thenuclear membrance.In the cytoplasm,longitudinal and transverse sections of the myofibrils werefound.On the transverse section,the myofilaments of A and I band werepresent.The intercalated disk was observed.The gap junctions present between thesinus node cells were proved by Masson-Pevet et al in the rabbits but were notfound in our specimens.

Objective To explore the clinical effectiveness of pressure-controlled ventilation-volume guar-anteed(PCV-VG)in obese patients with obstructive sleep apnea syndrome(OSAS)during uvulopalatopharyngo-plasty. Methods 40 obese patients(BMI≥30 kg/m2)with OSAS scheduled for uvulopalatopharyngoplasty under general anesthesia were randomly divided into two groups of volume-controlled ventilation(group V,n = 20)and pressure-controlled ventilation-volume guaranteed(group P,n=20). The heart rate(HR),mean arterial pressure (MAP),arterial partial pressure of oxygen(PaO2)and arterial partial pressure of carbondioxide(PaCO2)were recorded before induction of anesthesia without oxygen inhalation(T0),30 min(T1)and 1 h(T2)after tracheal intubation,and 30 min after extubation(T3). The peak airway pressure(Ppeak),airway resistance(Raw),thoracic compliance (CL),oxygenation index (OI) and respiratory index (RI) were also calculated at T1 and T2 under observation of recovery. Results There were no obvious differences between the two groups of patients before anesthesia and after recovery. Compared with the group V ,PaCO2 ,PPEAK ,Raw at T1 ,T2 and RI at T1 ~ T3 of the group P decreased(P<0.05),while CL at T1,T2 and PaO2,OI at T1~T3 increased(P<0.05). There were no sig-nificant differences in HR ,MAP at the above time points. Conclusions Compared with volume-controlled venti-lation,PCV-VG can effectively enhance thoracic compliance,lower inspiratory pressure and airway resistance ,and decrease intrapulmonary shunt ,which is conductive to improve arterial oxygenation and gas exchange in obese patients with OSAS.

OBJECTIVE:To observe the clinical efficacy and safety of Fuyankang combined with azithromycin in the treat-ment of pelvic inflammatory disease. METHODS:90 patients with pelvic inflammatory disease were selected and randomly divided into observation group and control group,with 45 cases in each group. Control group was given Lactose acid azithromycin for injec-tion 500 mg,ivgtt,qd,and then Azithromycin capsule 250 mg,po,qd;observation group was additionally given Fuyankang Tab-let 1.56 g,tid,on the basis of control group. A treatment course of 2 groups lasted for 7 d,and both received 3 courses of treat-ment. Clinical efficacies of 2 groups were observed as well as the level of CRP,IL-2 and life quality score before and after treat-ment,and the occurrence of ADR was compared between 2 groups. RESULTS:Total effective rate of observation group was 97.78%,which was significantly higher than that of control group (86.67%),with statistical significance (P<0.05). The level of CRP,IL-2 and life quality score of 2 groups were improved significantly after treatment,and the observation group was more better than the control group,with statistical significance (P<0.05). No obvious ADR was found in 2 groups during treatment. CONCLUSIONS:Fuyankang combined with Azithromycin is effective for pelvic inflammatory disease,and can improve the quali-ty of life,reduce inflammation cytokines infiltration and the generation of inflammatory medium with good safety.

BACKGROUND: As a pain-related peptide, substance P is closely related with sustained pain in low back and lower extremities caused by lumbar spinal stenosis. However, the expression of substance P in the rat with cauda equina compression rat is not reported.OBJECTIVE: To investigate the content of substance P in spinal cord of rat with lumbar spinal stenosis at different stages.DESIGN: A randomized and controlled experimental study.SETTING: The Orthopedic Department of the First Affiliated Hospital of China Medical University.MATERIALS: The trial was conducted in the Experimental Animal Center of China Medical University within the period from February 2003 to December 2004. Thirty mature male SD rats were randomly and averagely assigned into five groups. One group served as control and in the other four experimental groups the content of substance P of the rats were examined in the 2nd, 4th, 8th and 12th respect week respectively.METHODS: The model of lumbar spinal stenosis was established by compressing cauda equina in rats. The spinal cords were harvested in the 2nd,4th, 8th and 12th respect week respectively for immunohistochemical determination of the expression of substance P (SP) in the posterior horn.MAIN OUTCOME MEASURES: The expression of substance P in the posterior horn at different times. Deeply-stained neurons in the 2nd week group. The mean positive neuron group varied within a certain range and were less than that of the 2nd week group. But they were all more than that of the controls[(5.08 ±0.41),(4.02±0.35), (2.58±0.33), (3.45±0.22) vs(0.85±0.23), t=6.85,5.90,3.49,6.85,P ＜0.05 or P ＜0.01].CONCLUSION: The expression of substance P increases when the cauda equina is compressed. Whether this is because the harmful stimuli increases SP expression and the latter in turn protects spinal cord by reducing the edema of spinal cord warrants more studies.

Objective To investigate and analyze the adverse effect(AE) of methotrexate(MTX)in rheumatoid arthritis(RA).MethodsThree hundred and twenty-five RA patients were investigated with a questionnaire in clinical service of department of Rheumatology and Immunology, Peking University People's Hospital. SPSS 11.5 software was used for statistical analysis. Results① The total prevalence of AE was 34.2％. Among these, gastrointestinal AE were the most common, others included elevated liver enzymes,leucocytopenia,alopecia and dental ulcer. The incidence of drug withdrawal of MTX was 13.2％, elevated liver enzymes was the most common reason of withdrawal, other reasons were gastrointestinal AE, leucocytopenia,dental ulcer and alopecia. The gastrointestinal AE and dental ulcer occurred within one week after initiating the medication in average, while elevated liver enzymes and leucocytopenia usually occurred at about 1～2 months after the medication. ②The incidence of AE increased with the dosage. ③ Folic acid could significantly decrease the total incidence of AE(P＜0.05). The incidence of gastrointestinal AE, elevated liver enzymes,leucocytopenia and dental ulcer couldbe reduced by folic acid supplementation(P＜0.05).Conclusion The AE of MTX in RA treatment are common, many of which are slight and could be improved by reducing the dosage or symptomatic treatment. The AEs of MTX can be improved by folic acid supplement treatment.

Objective To evaluate the role of spinal AMP-activated protein kinase (AMPK) signaling pathway in reduction of neuropathic pain (NP) by dexmedetomidine in rats.Methods One hundred twenty adult male Sprague-Dawley rats, weighing 180-220 g, were randomly divided into 4 groups (n=30 each) using a random number table: sham operation group (group S);group NP;dexmedetomidine group (group Dex) and AMPK inhibitor group (group AI).The animals were anesthetized with intraperitoneal 10％ chloral hydrate 350 mg/kg.The right sciatic nerve was exposed, and 4 loose ligatures were placed on the sciatic nerve at 1 mm intervals with 4-0 silk thread in NP and Dex groups.In group Dex, dexmedetomidine 50 μg/kg was injected intraperitoneally once a day starting from the end of operation until the animals were sacrificed.In group AI, AMPK inhibitor Compound C 20 mg/kg was injected intraperitoneally at the end of operation, and the other treatments were similar to those previously described in group Dex.The equal volume of normal saline was given instead of dexmedetomidine in S and NP groups.The mechanical paw withdrawal threshold to von Frey filament stimulation (MWT) and thermal paw withdrawal latency (TWL) were measured at 1 day before operation (baseline) and 2, 8 and 14 days after operation (T0-3).Results Compared with group S, the MWT was significantly decreased, and the TWL was shortened at T1-3 in NP, Dex and AI groups (P＜0.05).Compared with group NP, the MWT was significantly increased, and the TWL was prolonged at T1-3 in group Dex (P＜0.05) , and no significant change was found in MWT and TWL in group AI (P＞0.05).Conclusion Spinal AMPK signaling pathway is involved in reduction of NP by dexmedetomidine in rats.