Objective: To analyze the capability to overcome the major outbreak of epidemics in different regions of China, it supports the future public health emergency management stratigies in theory and technology. Methods: Based on the data of 31 regions of China, it evaluates the social vulnerability of two major epidemics (SARS in 2003 and H1N1 influence in 2009) by using factor analysis method. Results: In the middle and eastern regions of China, social vulnerability is relatively low, and comparing to SARS in 2003, it decreases in 2009; while the western and southwesternregions are the opposite. Conclusion: Infrastructure construction of health institution, the cultivation of medical and health personnel and the development of commercial health insurance are the key factors to reduce social vulnerability and enhance the ability of emergency.

OBJECTIVE:To analyze the risk factors,pathogens and drug sensitivity test of ventilator-associated pneumonia (VAP) in ICU. METHODS:A case-control study was conducted to analyze the clinical data of 190 patients receiving mechanical ventilatory support in ICU. RESULTS:The incidence of VAP in our hospital was 48.4%;elderly patients(>65 years),duration of mechanical ventilation(>5 d),use of corticosteroids,antacid drugs,indwelling stomach tube,and combined use of antibiotics were the risk factors of VAP;among the 162 pathogens,39 were Gram-positive bacteria(24.07%),102 were Gram-negative bacte-ria (62.96%),21 were fungi (12.96%);multi-drug resistance existed in most pathogens. CONCLUSIONS:A variety of factors are closely associated with the incidence of VAP;the main pathogens of VAP are Gram-negative bacteria;the phenomenon of multi-drug resistance is common. Some measures are adopted to decrease the incidence of VAP,such as strengthen monitoring of el-derly patients,to improve their immunity;use hormonal drugs reasonably;shorten the course of mechanical ventilation as much as possible,and plan ventilator removal;elevate the head of the bed and clean the oral for patients receiving gastric canal implantation and enteral nutrition;clean hands in accordance with asepsis principle strictly,and use antibacterials reasonalbly.

OBJECTIVE:To put forward some suggestion to improve drug bidding system in China.METHODS:The process of drug bidding system reform and its common problems were analyzed.Game theory and information asymmetry theory were adopted to analyze the root of the problems and to put forward suggestions.RESULTS:Governments indiscriminately expanded the goals of bidding policy and strengthen price factor.They neglected important steps such as logistics distribution.Current single evaluation system can not count the medication order exactly.Delayed received payment of medical institution resulted in many problems of drug purchase.CONCLUSION:Centralized drug bidding system should be improved and enhanced.It also should be connected with relevant medical system reform to standardize drug circulation channels,reduce drug price and reduce the burden of patient.

Objective:To investigate the effect of Matrine on inhibiting lipopolysaccharide( lipopolysaccharide ,LPS) -induced macrophages to secrete inflammatory cytokines,including tumor necrosis factor-α( TNF-α) ,leukocyte mediated element 1β( IL-1β) on Toll like receptor 4 ( TLR4 ) , c-jun expression. Methods: Cultured macrophage RAW264. 7 of mouse and divided into four groups, including blank control group,matrine group,LPS group,matrine intervention group. Incubated by the concentration was 100 μg/L LPS DMEM for 1 h,then the LPS was discard. Added free serum DMEM or 125. 25 mg/L matrine DMEM to culture. The cells and culture solution of 5,30,60,120 min after the treatment of the above four groups were collected respectively. Detected of mouse RAW264. 7 macrophage TLR4 and c-jun mRNA expression by PCR. Detected of mouse macrophage RAW264. 7 cells c-jun protein expression by immunocytochemical. Measured secretion in cultured solution of TNF-α and IL-1β by ELISA. Results:Expression TLR4 mRNA,c-jun mRNA and c-jun protein and TNF -α and IL-1β secretion quantity indexes of matrine induced and blank group had no statistical significant differences ( P>0. 05 ) . TLR4 mRNA, c-jun mRNA and c-jun protein expression secretion of and TNF-α and IL-1β LPS group at each time point were significantly higher than that of blank group,and the high level to maintain more than 2 h (P<0. 05);matrine intervention group could effectively inhibit LPS induced macrophage TLR4 mRNA,c-jun mRNA and c-jun protein expression and reduce the secretion of inflammatory cytokines TNF-α and IL-1β. Conclusion: Matrine may inhibit LPS induced macrophage mitogen activated protein kinase signal pathway of TLR4 and c-jun expression so that it can effectively reduce the end inflammatory cytokines TNF-α and IL-1β release,effectively inhibit the inflammatory reaction and reduce the degree of endotoxin inflammatory re-sponse.

With the development of medical sciences, the concept of prevention and treatment of ischemic stroke is being updated continuously. However, there are still some gaps between the available evidence and clinical practice in its strategies of prevention and treatment. The article performs evidence-based analysis for the available evidence in the prevention and treatment of ischemic stroke in accordance with the scientific levels of evidence classification so as to narrow the gaps between the evidence in this field and clinical practice.

Air ; analysis ; Alkenes ; analysis ; Butadienes ; analysis ; Chromatography, Gas ; methods ; Environmental Monitoring ; methods ; Workplace

Objective To summarize the principle and structure of objective structured clinical examination(OSCE)in the graduation practice examination of undergraduate nursing students.Methods A OSCE model was designed with a case running through the whole process of it by referring to the classic model of OSCE and applied it to the graduation practice examination of undergraduate nursing students of grade 2004.Results 75.0%students believed that the setup of OSCE location was reasonable and 78.1%of them thought that they were used to this kind of examination.100.0%of them considered that this examination model could objectively evaluate the general clinical capacity and at the same time make clear the future purpose of next internship stage. Conclusion The OSCE model could objectively evaluate the general clinical ability of students and truly reflect the existing problems,thus provide benefitable reforrences for the next internship stage.

Objective To design and produce specific stealth siRNAs and detect their inhibitive effects on TGF-?1 expression.Methods Three stealth siRNAs aimed directly at different sequences(stealth-48,stealth-166,stealth-594) in TGF-?1 mRNA were made.These siRNAs were transfected into BALB/c mouse lung fibroblast in vitro,then the TGF-?1 expression in those lung fibroblasts was detected by immunohistochemistry.Results In different time periods,the TGF-?1 expression was differently depressed by three stealth siRNAs in vitro.The inhibitory effects of stealth-166 was better than the other two stealth siRNAs.The inhibition could be detected in 48 h,reached the highest level in 72 h and began to attenuate 96 h later.Conclusion The TGF-?1 expression of mouse lung fibroblasts in vitro can be depressed by synthetic stealth siRNAs.It seems possible to provide a new way for the treatment of pulmonary interstitial fibrosis.

Objective To define a suitable and adequate sample volume for the detection of bacterial contamination in cord blood (CB) via BacT/ALERT system. Methods A total of 1 376 cord blood units were routinely screened for aerobic and anaerobic microorganisms by culturing the erythrocyte fraction(EF) or plasma fraction(PF) with 20 ml and 10 ml sample volume. The microbial contamination was detected by BacT/ALERT 3D system, and the results of this method were compared with the improved Martin/thiogly collate broth(22 ℃) and thioglycollate broth(35 ℃).Results The rates of positive BacT/ALERT results were 1.16%(10 ml) and 1.24%(20 ml) for PF, and 3.20%(20 ml) for EF. The positive rate of Martin/thiogly collate broth(22 ℃/35 ℃) was 1.00% for EF. Conclusion Using BacT/ALERT system for microbial detection in cord blood bank can enhance the security of umbilical cord blood transplantation.

Objective To establish a method for determination of 3’-chloromethylacetophenone in the air of ketoprofen workplaces. Methods The 3’-chloromethylacetophenone was sampled using activated carbon tube and then desorbed by ethyl acetate. All the components were determined by gas chromatograph with FID after complete separation with FFAP capillary column. Results This method presented a linear relation within 5-1 000 ?g/ml, r value was 0.999 2. The detection limit was 1.67 mg/m3. Desorption efficiencies were 92.2%-101.5%. The break through volume of 100 mg of activated carbon was 5.0 mg. Conclusions The present method is feasible for determination of 3’-chloromethylacetophenone in workplace air.