OBJECTIVE To study the cause of bacterial infection of ventilator-associated pneumonia(VAP) in intensive care unit(ICU) and summarize effective methods to prevent and control the infection.METHODS Epidemiologic study on 300 patients with VAP in ICU from Dec 1,2003 to Jul 13,2006.Preventing and controlling strategy was as follows.RESULTS Pathogenic bacteria of VAP in ICU mostly were multidrug-resistant ones,of which the G-were 56.3%,G+ were 23% and fungi were 13.7%.CONCLUSIONS To control VAP in ICU proper technique and method are important.Management of hospital infection and related training of staff in ICU are the basic way.

Animals ; Hypoxia ; classification ; metabolism ; Male ; Oxygen Consumption ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo establish genetic method in detecting Cryptosporidium parvum and Giardia lamblia which often coinfected with AIDS patients.

METHODSCryptosporidium oocysts and Giardia cysts were isolated and purified from fecal samples of the individuals infected with C. parvum and G. lamblia, respectively. Genomic DNAs were extracted. Two pairs of specific primers were designed or synthesized according to the 18S rRNA gene from C. parvum or the triose phosphate isomerase (tim ) gene from G. lamblia. Polymerase chain reaction(PCR) technique was used to amplify the DNA samples from the oocysts and the cysts, and those from the 6 control samples, including Schitosoma japonicum, Toxoplasma gondii , Entamoeba histolytica, Trichinella spiralis, Trichomonas vaginalis and human blood cells. DNA samples from 30 fecal samples of AIDS patients were detected with the same method.

RESULTSOne fragment of 500 bp was amplified with the primer of C. parvum, and the other one of 683 bp was amplified with the primer of G. lamblia. Twenty pg and 0.4 pg DNA of C. parvum and G. lamblia could be detected separately. The specificity of these two pairs of PCR primers was confirmed by the failure in the amplification of the control DNA samples. Out of 30 cases of AIDS patients, 7 showed C. parvum positive, while non Giardia was detected.

CONCLUSIONGenetic detection method for C. parvum and G. lamblia detection was established which was more sensitive and specific.

Acquired Immunodeficiency Syndrome ; microbiology ; Cryptosporidiosis ; diagnosis ; Cryptosporidium parvum ; genetics ; DNA, Bacterial ; Giardia lamblia ; genetics ; Giardiasis ; diagnosis ; Humans ; Polymerase Chain Reaction ; methods ; Sensitivity and Specificity

Objective To observe the effects of a motor relearning programme (MRP) combined with different early acupuncture interventions on muscle tension and motor function recovery after cerebral infarction.MethodsA total of 90 patients with cerebral infarction who met the inclusion criteria were divided into three groups at random:a YANGMING meridian acupuncture and MRP group ( group A),an anti-spasm acupuncture and MRP group ( group B),and an MRP group ( group C ).All of the patients in all three groups were treated with routine medication.The National Institute of Health stroke scale (NIHSS),the composite spasticity scale (CSS),Fugl-Meyer assessment (FMA),the Fugl-Meyer balance scale (FM-B) and the modified Barthel index (MBI) were used to measure performance before treatment and after 4 weeks of treatment.Another comparison was intra-group between before and after treatment. ResultsThere were significant differences in the assessment results in all of the groups after treatment compared with those before treatment.After treatment,group B was superior to group C only in terms of NIHSS scores.There was no significant NIHSS score difference between groups A and C.The FMA,CSS and MBI results revealed significant differences among all three groups,with the scores of group A consistently the highest.The average FMA score in group B was significantly higher than in group C but there was no statistically significant difference in FM-B scores among the three groups. ConclusionMRP therapy combined with early acupuncture intervention can improve motor function and muscular tension after cerebral infarction.Anti-spasm acupuncture can improve motor function and control muscular tension effectively at the same time,making it beneficial for MRP training.

Objective To explore the influence to nursing efficiency using exposed wound care ( EWC) at different time point after finger replantation. Methods 60S patients after finger replantation were recruited according to selection criteria and were randomly divided into 4 groups. 136 cases in group A were treated with EWC without gauze dressing cover 1 to 2 hours after operation. 183 cases in group B were treated with EWC 6 to 8 hours after operation. 159 cases group C were treated with EWC 12 to 24 hours after operation. 127 cases in group D were treated with gauze dresssing cover all the time until taking the stiches out ( 14 days). Blood circulation, wound infection, finger survival rate, medical costs were observed and compared among 4 groups. Results Compared with the other 3 groups, group B had better outcomes including blood circulation, wound infection, survival rate and medical costs of replanted finger. The EWC therapy could decrease expenditures of inpatient, length of stay, and incidence of complications. Conclusions The EWC therapy should be used 6 to 8 hours after operation when dressing oozing did not dry completely. That therapy can decrease the incidence of blood vessel crisis of replanted finger, reduce medical expenditures and improve survival rate of replanted finger.

Objective To explore the intervention effect and mechanism of sitagliptin on renal injury in type 1 diabetic (T1DM) mice.Methods The modeling group was intraperitoneally injected with streptozotocin (150 mg· kg-1) once and blood glucose ≥ 16.7 mmol · L-1 was considered as diabetes mellitus (DM).DM mice were randomly divided into two groups:model group and experimental group.Experimental group was treated with sitagliptin (15 mg · kg-1 · d-1) via intragastric administration for 4 weeks while the mice in model group and normal group treated with equal volume of ultrapure water.The 24 h microalbuminuria(ALB) was determined after administration.At the end of the experiment,urea nitrogen (BUN) and creatinine (SCr) in serum was detected.The protein expression levels of transforming growth factor-β1 (TGF-β1),Smad2,Smad3 were measured by Western blot.Results After administration sitagliptin for 4 weeks,the contents of ALB in model group and experimental group were (11.96 ± 3.36) (2.46 ±0.97) mg/24 h with significantly(P ＜0.001).The index of kidney weight/body weight(KW/BW) in normal group,model group and experimental group were 15.20 ±2.24,21.43 ±2.16,15.14 ±4.14;compared with normal group,the difference was significantly increased (P ＜ 0.05);compared with model group,the difference was significantly increased (P ＜0.05).The SCr in model group and experimental group were (352.58 ±47.09),(238.51 ± 53.03) μmol · L-1;the BUN in the two groups were(26.08 ±4.65),(10.40 ±2.47)mmol · L-1;compared with model group,the difference was significantly increased (P ＜0.01,P ＜0.001).The expression levels of TGF-β1,Smad2/3 and p-Smad2/3 in normal group,model group and experimental group were 0.19 ±0.02,0.12 ±0.02,0.07 ±0.01;0.23 ±0.02,0.27 ±0.04,0.13 ±0.01;0.18 ±0.01,0.14 ±0.01,0.11 ±0.00,compared with normal group,the difference was significantly increased (P＜0.05,P＜0.01);compared with model group,the difference was significantly increased (P ＜0.05,P ＜0.01).Conclusion Experimental delaying the progression of T1DM nephropathy without not decreasing blood glucose can effect partly through inhibiting TGF-β1/Smad2/3 pathway.

Recent years have seen an increasing incidence of prostate cancer (PCa) and a more frequent occurrence of the disease in younger men. Damage to cavernous nerves caused by radical prostatectomy is the main reason for post-operative erectile dysfunction. So reconstruction of cavernous nerves at the time of radical prostatectomy may restore the patient's erectile function. At present, clinical studies of using autologous sural nerve grafts to bridge transected cavernous nerves have achieved modest success, and laparoscopic sural nerve grafting during radical prostatectomy has also been proved safe and feasible. Besides, various grafts have been used to reconstruct cavernous nerves in animal models, among which biodegradable conduits containing growth-promoting factors or cells are a promising option for the repair of damaged cavernous nerves.
Animals ; Erectile Dysfunction ; etiology ; surgery ; Humans ; Male ; Nerve Regeneration ; Neurosurgical Procedures ; methods ; Penis ; innervation ; Prostatectomy ; adverse effects ; Prostatic Neoplasms ; surgery ; Rats ; Sural Nerve ; transplantation

OBJECTIVETo explore the short-term effects of ambient PM10 pollution on mortality due to circulatory diseases, and to study the modifying effect of season on the association between ambient PM10 concentration and mortality in Nanjing.

METHODSDaily mortality, air pollution, and meteorological data from 1 January 2009 to 31 December 2013 in Nanjing were collected; Time-stratified case-crossover design was used to analyze the associations between daily average concentration of inhalable particle (PM10) and mortality due to circulatory diseases; Odds ratios (OR) and 95% confidence intervals (CI) were calculated; And stratified analysis was conducted to compare the mortality risks of circulatory diseases exposed to outdoor PM10 in warm season (May-October) with that in cool season (November-April).

RESULTSThe mean daily average concentrations of PM10, NO2, and SO2 from 2009 to 2013 in Nanjing were 109.1, 51.5, and 35.4 µg/m(3), respectively. During our study period, a total of 78 299 circulatory disease deaths were recorded. On average, there were approximately 43 circulatory disease deaths per day; and deaths due to cardiac diseases, ischemic heart disease and cerebrovascular diseases were 19, 10 and 24 per day, respectively. After adjusting for the meteorological variables such as daily temperature, relative humidity and air pressure, a10 µg/m(3) increment of PM10 was associated with the mortality on values of (OR) 1.002 4 (95% CI: 1.000 1-1.004 8) for total circulatory diseases, 1.004 8 (95% CI: 1.001 3-1.008 3) for cardiac diseases, 1.007 3 (95% CI: 1.002 4-1.012 3) for ischemic heart disease and 1.000 5 (95% CI: 0.998 5-1.002 4) for cerebrovascular diseases, respectively. In summer season, the OR values of daily mortality for total circulatory diseases and cerebrovascular diseases were 1.008 0 (95% CI: 1.003 9-1.012 2) and 1.005 7 (95% CI: 1.002 0-1.009 4), respectively, the corresponding OR values in cool season were 1.001 4 (95% CI: 0.998 5-1.004 2) and 0.998 8 (95% CI: 0.996 4-1.001 2), respectively; The effect estimates in warm season were higher than that in cool season.

CONCLUSIONThe elevated levels of ambient PM10 were positively associated with the increase of mortality due to circulatory diseases, and season may modify the effects of outdoor PM10 pollution on mortality.

Air Pollutants ; adverse effects ; Air Pollution ; Cardiovascular Diseases ; mortality ; Cerebrovascular Disorders ; mortality ; China ; Cross-Over Studies ; Humans ; Particulate Matter ; adverse effects ; Seasons ; Temperature

OBJECTIVETo observe and investigate the risk factors and pathogen diversification of nosocomial lower respiratory infections in patients with hematological malignancy after chemotherapy.

METHODSRespiratory tract microbial population of fifty patients with different kinds of hematological malignancy and para-prepared to chemotherapy was quantitatively analyzed before and after chemotherapy at an arranged time from April, 2004 to December, 2005. Susceptibility test was determined for bacterium of nosocomial infection, and the homology of the same species of the bacteria was analyzed by a pulsed field gel electrophoresis (PFGE).

RESULTSIncidence rate of lower respiratory infections in patients with the hematological malignant after chemotherapy was 16%. The major nosocomial infectious pathogens were Acinetobacter spp; Escherichia coil and Fungus. Among them, Acinetobacter spp, were highly resistant to cephalosporins, quinolones, aminoglycosides, carbapenems and antibiotic with enzyme inhibitor, respectively but susceptible to Cefoperazone/Sulbactam belonging to antibiotic with enzyme inhibitor. And it was shown that there were two clones by the pulsed field gel electrophoresis (PFGE).

CONCLUSIONFollowing-up of nosocomial lower respiratory infection in patients with hematological malignancy after chemotherapy might offer theoretical evidence for the rational use of antibiotics and the control of nosocomial infections.

Acinetobacter baumannii ; drug effects ; isolation & purification ; Adult ; Aged ; Antineoplastic Agents ; therapeutic use ; Cross Infection ; epidemiology ; Escherichia ; drug effects ; isolation & purification ; Female ; Follow-Up Studies ; Hematologic Neoplasms ; drug therapy ; immunology ; Humans ; Leukocyte Count ; Male ; Middle Aged ; Opportunistic Infections ; epidemiology ; Respiratory Tract Infections ; epidemiology