90 years old patients was 13.04%.The longer the hospitalization time the incidence among inpatients longer than 60d was 43.51%,the higher was the hospital infection rate.CONCLUSIONS There are many risk factors inducing hospital infections among elderly,there fore the monitoring must be strengthened,and the disinfection isolation and asepsis must be strictly conducted,with limited invasive manipulations,reasonable use of antibiotics,and active treatment of the primary affection,all above can effectively reduce the occurrence of hospital infection among ellerly patients.

OBJECTIVE To explore the effective methods for medical personnel preventing and controlling the infection of HIV after occupational exposure. METHODS The 7 cases contacted the AIDS patients had been analyzed and a set of institutions and monitoring methods were established. RESULTS Because of the emergency measures,the 7 medical personnels hadn′t infected HIV for the 2 follow-up years. CONCLUSIONS To think highly of the safety education of occupational exposure and enhance the monitoring and management of HIV infection can decrease the occupational exposure rate and ensure the occupational safety of medical personnels.

OBJECTIVE To investigate the reasonable use of antibacterial in department of orthopedics.METHODS The patients in our department were registered according to the inventory of antibacterial use made by the hospital infection monitoring network of Medical Administration Bureau,Ministry of Health of the People′s Republic of China,the(operative) incision was classified according to Clinical Surgery.The data of reasonable use of antibacterial were(obtained) after evaluation and(analysis).RESULTS Of the 257 patients in our study,79.37% of them were used antibacterial,20.62% were not used antibacterial,24.50% were used antibacterial for therapy,75.49% were used antibacterial for infection(prevention);95.09% were used systematically;74.50% were reasonable(usage,) 25.49% were unreasonable usage;of the 204 patients who were used antibacterial,only 34 patients were tested by drug sensitivity trial,and the others were used by experience.CONCLUSIONS In order to use antibacterial reasonably,we suggest two points,one is that the medicine management department should workout a feasible antibacterial use institution and mass(evaluation) criterion,take mass examination regurally,and connect the bonus to the examination result;the other is that we should enhance the management of antibacterial market,avoid the improper competition,rise the morality view of the doctor,and suggest them to use antibacterial reasonably(according) to the scientific theory.

OBJECTIVE To study the characteristic of the lower respiratory tract infection in patients with the cerebral hemorrhage and hypertension,and find out the measures of prevention and control. METHODS The discharged patients with the cerebral hemorrhage and hypertension from Jan 2002 to Dec 2004 underwent retrospective investigation and analysis for the sites and reasons and the results of bacterial culture. RESULTS The incidence of the lower respiratory tract infection in patients with the cerebral hemorrhage and hypertension was 55.55%.Major infection factors correlated with neurogenic pulmonary edema, irritable hyperglycemia,bulbar paralysis,etc.The Gram-nagative bacteria were predominant among the pathogens. CONCLUSIONS The infections are interrelated with many factors.Abiding by the principle of using antibiotic and the strict aseptic manipulation may reduce the occurrence of the infection,but treating the primary affection and the comprehensive therapy are important measures for reducing infection.

OBJECTIVE To explore the occurring characteristic and curing measures of hospital infection for inpatients with cardiovascular disease.METHODS The data of hospital infection for inpatients with cardiovascular disease from Jan to Dec,2004 were analyzed retrospectively.RESULTS The total incidence of hospital infection was 3.38% for inpatients with cardiovascular disease.The infection located as follows: 157 patients were in lower respiratory tract(48.2%);66 patients in upper respiratory tract(20.2%);40 patients in urinary tract(12.3%);33 patients in gastrointestinal tract(10.1%);and 18 patients were in cutis tissue ((5.5%).) CONCLUSIONS Pneumonia is one of the inducing factors to heart failure for patients with cardiovascular disease.Applying antibiotics reasonably,aseptic operation and treating the primary affection could decrease the incidence of hospital infection.

OBJECTIVE To discuss the relation between the fungal infection and differential leukocyte count,fever and death rate,for progressing clinical diagnosis and therapy in fungal infection. METHODS The patients were divided into septicemia groups,lung infection groups,biliary tract infection groups,nerve center and local urinary tract groups,intestinal tract groups,and normal control groups.And the differential leukocyte count,and fever and death rate were analyzed. RESULTS The Aspergillus,Candida and Cryptococcus were occupied 90.8% for deep fungal infection,and the Aspergillus caused patients death rate to 88.9%;fungal infection for septicemia,lungs,biliary tract caused patients fever rate was to 100%,but urinary tract,intestinal tract and nerve center behaved variously.For lungs the Aspergillus and Penicillium caused differential leukocyte WBC count had high than the control signficant difference,P0.05. CONCLUSIONS The deep fungal infection caused higher patients fever rate,and the Aspergillus and Penicillium caused higher differential leukocyte count,but deep and local yeast was not.Currently the Aspergillus,Candida and Cryptococcus are three main opportunistic infected fungi.

Objective To investigate the effect of stromal cell-derived factor-1α( SDF-1α) and interleukin ( IL-1β) on inducing vascular endothelial cells to express lymphatic phenotype .Methods The CRL-1730 cell line was cultured and treated with SDF-1αor IL-1β.The expression of endothelial cell markers and lymphatic endothelial cell markers were investigated with Real-time PCR, Western blotting and immunocytochemistry .Results In CRL-1730 cell line, endothelial cell markers such as voln willebrand factor ( vWF ) , VE-cadherin , vascular endothelial growth factor receptor(VEGFR)2, were dose dependently down-regulated after SDF-1αstimulation, while lymphatic phenotypes such as Prox-1, podoplanin and lymphatic vessel endothelial hyaluronan receptor-1(LYVE-1), were dose-dependently up-regulated after SDF-1αstimulation.The changes of vWF, VEGFR2 and podoplanin, Prox-1, LYVE-1 expression after IL-1βstimulation was similar to that after SDF-1αwhile expression of VE-cadherin changed slightly .Conclusion SDF-1αand IL-1βare able to induce vascular endothelial cell expressing lymphatic phenotype .

Objective To investigate the application of radial endobronchial ultrasound (R-EBUS)-guided bronchoscopy in the diagnosis of peripheral pulmonary lesions (PPLs),assess its safety and diagnostic value,and explore the influencing factors.Methods Clinical data of 140 patients who underwent R-EBUS transbronchial biopsy (TBB) and brush biopsy in our department of respiratory endoscopy from January 2015 to March 2017 were collected and retrospectively analyzed in the study.Eighty-three cases were diagnosed as PPLs.The detection rate,ability to locate the peripheral lesions,and influencing factors of EBUS were analyzed.The incidence rate of complications was observed to assess its safety.Results Of the 83 PPLs patients,they were 55 males and 28 females,and at a mean age of 59.81 ± 11.85 years.The total success rate of EBUS-guided bronchoscopic diagnosis was 59.04％ (49/83),and the diagnostic rate was 50.94％ (27/53) for malignant lesions,and 73.33％ (22/30) for benign diseases.The rate of EBUS-TBB (56.92％,37/65) was significantly higher than that of brush biopsy (30.12％,25/83,Chi square =10.76,P =0.001).EBUS-guided diagnostic methods had an accuracy of 60.00％ (45/75),while the EBUS-guided bronchoscopy had a rate of 50.0％ (4/8),but no significant difference was seen between the 2 methods (Chi square =0.03,P =0.87).The sizes of the lesions ranged from 10.0 to 52.4 mm,and the diagnostic yield for PPLs ≤20 mm in diameter (36.84％,7/19) was lower than that for those ＞20 mm (65.62％,42/64,Chi square =5.02,P =0.003).There was no significant difference (Chi square =10.05,P =0.07)in the diagnostic yield for different sites,with that of right upper lobe of 46.15％ (12/26),right middle lobe 100.00％ (8/8),right lower lobe 53.85％ (7/13),left upper lobe 37.50％ (3/8),left lingula lobe 63.64％ (7/11),left lower lobe 70.59％ (12/17).But the detection rate was obviously lower in the upper lobe (22/45,48.89％) than the middle/lower lobe (27/38,71.05％,Chi square =5.02,P =0.003).Of all the 83 patients,74 ones (89.16％) were successfully identified using radial probe EBUS,but the lesions were not found in 9 patients.When the radial probe position was within the target lesion,the diagnostic yield was 81.58％ (31/38),notably higher than that when the probe was positioned adjacent to the lesion (50.00％,18/36,Chi square =8.24,P =0.004).Mild bleeding was observed when performing biopsy under bronchoscope,and no pneumothorax,or other serious complications were observed.Conclusion Radial EBUS is a safe and feasible nethod to accurately identify PPLs and improve its diagnostic rate.EBUS-guided bronchoscopy has higher positive detection rate for PPLs,and is cost saving.The relationship of the probe and the site of lesion is the main factor influencing the diagnostic rate.

Objective: To study the influence of inflammatory cytokine TNF-? on the expression of adhesion molecules and specific markers of rat MSCs, and to study the optimal stimulation of MSCs with inflammatory factors in inducing adhesion molecule expression which promotes migration of MSCs to the ischemic area in liver. Methods: The MSCs stimulated with different concentration of TNF-? were detected for adhesion molecules and stem cells markers on cell surface with the method of flow-cytometry, MSCs which were stimulated with the optimal concentration of TNF-? and labeled with 1, 1-Dioctadecyl-3, 3, 3, 3-tetramethylindocarbocyanine Iodade(DiI)were delivered intravenously to the rats whose liver was injured by ischemia, the liver function of the experimented animals were tested, and liver samples in the ischemic area were obtained, the number of MSCs was counted under a fluorescent microscope. Results: Stimulated with TNF-?, MSC ex-pression of VCAM-1 increased, while that of stem cell markers did not change markedly. Exposed to lower concentration of TNF-?, the adhesion ability of MSCs obviously increased and more MSCs rested in the ischemic areas in the rat liver, compared to the control groups. Conclusions: TNF-? can increase the expression of VCAM-1 on rat MSCs while exert little effect on the stem cell character of MSCs. Suitable concentration of TNF-? can promote MSCs migration to the damaged tissue, which provides rationale for the treatment of liver disease.

Objective:To investigate the relationship between the volume ratio of ischemic leukoaraiosis (LA) and cognitive level and arterial perfusion.Methods:Fifty-four patients, who was hospitalized in Dalian Central Hospital and diagnosed as LA clinically during the time of March to December in 2012, were selected to collect the information of the volume ratio of white matter disease, MoCa score and the average flow rate of carotid artery. The correlation between the volume ratio of white matter disease and MoCa score, cognitive impairment and the average flow rate of carotid artery were analyzed.Results:The volume ratio of LA lesions was negatively correlated with MOCA score ( r = -0.59, P<0.01); the volume ratio of LA lesions was negatively correlated with the mean flow rate of internal carotid artery ( r = -0.37, P<0.01). Quantity order of the area under receiver operating characteristic (ROC) curve of MoCA cognitive subgroup was as following: delayed memory (1.000)> visual space/executive function (0.970) = abstract force (0.970)> language ability (0.960)> attention (0.888). Conclusions:The larger the volume ratio of leukopathy in LA patients, the more serious the cognitive impairment, especially the cognitive impairment of impairment of memory delay, visual space/executive function, abstract ability and language ability.