0.05 ) . The patients in both groups all recovered from CABG and discharged from hospital without serious complication such as brain infarct. The MMSE scores after operation were significandy lower than that before operation in both groups ( P

Objective The aim was to investigate the manupulation and the localization of LV Lead, and to evaluate LV Lead usefulness in biventricular pacing.Methods 9 Patients with enlarged left ventricle, chronic heart failure, CLBBB and refractory to chemical therapy were selected in this study, including 8 males and 1 female. Coronary sinus venography was performed by injecting contrast medium retrogradely at coronary sinus ostium in 7 cases or antegradely into left coronary artery in 2 cases. LV lead was introduced to CS and localized at targeting vein of LV through a "peel away" guiding sheath, which was placed in CS via left subclavian vein route. Results Coronary sinus and its tributaris were clearly visualized by both antegrate cardiac venography and retrograte cardiac venography. 2187 leads were implanted into targeting veins through "peel away" guiding sheaths in 6 cases and directly introduced in 2 cases, while in other case the lead was inserted into coronary sinus directly after a failed procedure via a "peel away" guiding sheath. The leads were placed in great cardiac vein in 1 case, lateral LV vein in 2 cases, left posterior LV vein in 2 case and left posterolateral veins in 4 cases. The acute pacing and sensing thresholds measuered during the implanting procedure were in normal limits. 2187 leads were still fully functional without dislocalization during follow up of average 253 days. Conclusion CS and its tributaries can be clearly shown by antegrate and retrograte venographies. The introduction of 2187 left ventricular pacing is easily performed directly or through a preformed "peel away" guiding sheath. LV epicardium pacing by 2187 LV lead implanted through CS is feasible and reliable.

OBJECTIVE To analyze the current situation of the hospital.and the community-acquired infections due to Staphylococcus aureus(SAU) and provide the reference for clinical reasonable use of drugs.METHODS The clinically isolated S.aureus strains during 2004-2006 were collected,cultured and identified.Their susceptibilily to 16 kinds of antibacterials was detected by K-B or MIC and WHONET5 software was used to analyze the result.RESULTS From 440 S.aureus strains,the meticillin-resisstant S.aureus(MRSA) was 260 accounting for 59.1%;the meticillin-sensitive S.aureus(MSSA) was 180 accounting for 40.9%.The resistant rate of SAU to penicillin G was the highest(85.5%),that to vancomscin was 0.CONCLUSIONS MSSA still keeps fairly good sensibility to most antibacterial medicine,but MRSA shows the multidrug resistance,except to vancomycin.For this studying the resistance mechcnism of Staphylococcus and continuously detecting the emergence of vancomycin-intermediat and vancomycin-resistante S.aureus have a significant clinicil importance.

OBJECTIVE To investigate the distribution and resistance of Pseudomonas aeruginosa isolated during Jan-Dec 2006.METHODS The clinically isolated P.aeruginosa strains were collected cultured and identified by paper diffusing method or trace dilution method(MIC),the results were evaluated according to the relevant documents of NCCLS of USA.RESULTS The in vitro susceptibility test of 244 P.aeruginosa isolates to 16 kinds of antibacterials indicated the resistance rate to SMZ was the highest(98.8%);then to minocycline,tetracycline and ticarcillin/clavulanicacid(70.1%,58.6% and 54.5% respectively).CONCLUSIONS To strengthen the continuous survezillance of drug resistance of P.aeruginosa,to sum up the resistance rules of main pathogens of departments in hospital and to reduce of production of resistant bacterica have the important significance.

OBJECTIVE To understand the antibiotic resistance of Pseudemonas aeruginosa isolated from ICU and give advices to clinicians.METHODS The antibiotic susceptibility of P.aeruginosa isolated from ICU to 12 kinds of antibiotics were tested by disc diffusion method.RESULTS The antibiotic susceptibility of 472 P.aeruginosa strains to imipenem,piperacillin/sulbactam,piperacillin,amikacin,ceftazidime,tobramycin,cefepime,ciprofloxacin,ceftriaxone,gentimicin,aztreonam and cefotaxime were 82.2%,74.94%,69.92%,64.87%,59.95%,52.93%,49.88%,49.65%,44.50%,41.92%,38.17%,and 35.60%,respectively.CONCLUSIONS P.aeruginosa isolated from ICU of our hospital is suscepitable to imipenem,piperacillin/sulbactam,piperacillin,amikacin and the cephalosporins,but show lower susceptibility to other antibiotics.

Objective To quantitatively detect circulating DNA levels in the plasma of patients withcervical lesion and to determine the value for diagnosis of cervical lesion and cervical cancer . Methods Preoperative blood samples were collected from 53 cases of low-grade lesions, 49 cases of high-grade lesions, 44 cases of cervical invasive cancer and 70 cases of healthy women. Plasma DNA was extracted by magnetic bead method (BILATEST DNA kit). The quantity of plasma DNA was determined by duplex real-time quantitative PCR. Results Median plasma DNA level of invasive cervical cancer patients was 61. 59 mg/L (32. 06 - 162. 16 mg/L) , which was significantly higher than that of healthy women [16. 35 mg/L(11. 98 -22.71 mg/L), P < 0.01]. Among invasive cervical cancer patients, median plasma DNA level of squamous carcinoma patients was slightly higher than that of adenocarcinoma (50. 43 versus 47. 31 mg/L,P>0. 05). Median plasma DNA level of stage I patients was lower than that of stage Ⅱ- Ⅲ patients (46. 02 versus 71. 35 mg/L, P <0. 05). Conclusion Quantitatively detecting plasma circulating DNA may be with some application prospect in the diagnosis of cervical diseases.

Objective To study the effects of medicated serum with total saponins from Rhizoma Dioscreae Nipponicae (RDN) on VEGF mRNA expression and AP-1 activity in rat synovial cell strain RSC-364 induced by IL-17 and TNF-α. To investigate the mechanism about total saponin from RDN inhibition of angiogenesis. Methods Medicated serum of total saponins from RDN and tripterygium (positive control) were prepared. Rat synovial cells RSC-364 were divided into four groups: the blank control,IL-17+TNF-α model,tripterygium medicated serum,and total saponins medicated serum groups. After one hour of incubation,all groups except for the blank control were incubated with both IL-17(10 μg·L-1 ) and TNF-α(10 μg·L-1 ) for 24 hours. VEGF mRNA expression in RSC-364 was detected by PrimeScriptTM real-time quantitative PCR (RT-PCR) detection kit,and the AP-1 DNA-binding activity was detected by electrophoretic mobility shift assay (EMSA). Results Compared with the control blank group,both of the VEGF mRNA expression and AP-1 activity in rat synovial cell strain RSC-364 induced by IL-17 and TNF-α increased remarkably (P<0. 05,P<0.01). The VEGF mRNA expression and AP-1 activity in tripterygium medicated serum group and total saponins medicated serum group were remarkably lower than those of the model control group (P<0.05). There was no significant difference between the two medicated serum groups. Conclusion Serum medicated with total saponins from RDN can remarkably decrease VEGF mRNA expression and AP-1 activity,indicating that the total saponins from RDN could influence VEGF secretion by inhibiting the AP-1 signal transduction pathway,VEGF is the key factor of angiogenesis,thereby to restrain angiogenesis.

Forty three medical graduates from Hainan Medical University participating in the standardized general practice residency training in 2015 and 2016 were randomly divided into study group (n=22) and control group (n=21). The study group received a mid-term assessment and formative assessment, and the control group received the final assessment only. At the end of the six months of training, the scores of the mid-term assessment in study group were significantly higher than those in the control group [(82.9±8.4) vs. (75.5±10.2), t=12.706, P<0.01]. A questionnaire survey was conducted among the participants in study group, 86.4% of them recognized and supported the formative assessments. Formative assessment can improve the teaching quality of general practice residency training. The trainees have a positive attitude towards this assessment mode.

AIM: To study effects and adverse drug reactions of mtrisone in the treatment of patients with severe acute respiratory syndrome. METHODS: The information of the medications in 680 patients with severe acute respiratory syndrome (SARS) in Xiaotangshan Hospital was collected by HIS system and the effects and ADRs of metrisone were staiated. RESULTS: The kinds of drugs of SARS patients who had been cured by metrisone were more than those which were not cured by metrisone. Condition of SARS patients who had been cured by metrisone was more serious than those which were not cured by metrisone. The ADRs rate, blood glucose and leukocyte of SARS patients who had been cured by metrisone are higher than those which were not cured by metrisone while blood K+ is lower. CONCLUSION: The utilization of metrison to SRAS patient should be more cautious to balance the effects and ADRs of metrisone.

Objective:To understand the pathogen distributions of community-acquired pneumonia (CAP) in children, and to provide evidence for clinical diagnosis and treatment.Methods:The hospitalized children with CAP in Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine from January to December 2022 were selected as the research subjects. They were divided into infant group (28 d to less than one year), toddler group (one year to less than three years), preschool age group (three years to less than six years), and school age group (not less than six years) by age. According to the onset season, they were divided into spring group (February to April), summer group (May to July), autumn group (August to October), and winter group (January, November to December). Deep airway sputum samples were collected from all patients for bacterial culture identification. Respiratory viruses (influenza A virus (IVA), influenza B virus (IVB), respiratory syncytial virus (RSV), adenovirus, parainfluenza virus type 1 (PIV1), parainfluenza virus type 2 (PIV2), parainfluenza virus type 3 (PIV3)) were detected using direct immunofluorescence assay. Mycoplasma pneumoniae (MP) DNA was detected using fluorescent quantitative polymerase chain reaction, and particle agglutination was used to detect serum MP antibodies. Statistical analysis was performed using the chi-square test. Results:Among the 397 cases of CAP in children, pathogens were detected in 269 cases, with a positivity rate of 67.8%. A total of 309 pathogens were identified, including 204 strains of MP (66.0%), 60 strains of bacteria (19.4%), 42 strains of viruses (13.6%), and three strains of fungi (1.0%). Staphylococcus aureus (19 strains), Haemophilus influenzae (15 strains) and Streptococcus pneumoniae (five strains) were the predominant bacteria, while RSV (19 strains) and PIV3 (nine strains) were the main viruses. The distribution rates of MP, bacteria, and viruses showed statistically significant differences among different age groups ( χ2=99.82, 24.71 and 17.40, respectively, all P<0.05). MP infection was mainly observed in the preschool age group and school age group, and bacterial infection predominantly occurred in the infant group, and viral infection was most common in the toddler group. Among virus infected patients, RSV was detected in the toddler group and the preschool age group, while three cases of PIV3 cases were found in children over five years old. The distribution differences of MP, bacterial and viral infections between different seasons were statistically significant ( χ2=141.65, 20.44 and 31.87, respectively, all P<0.001), with a higher prevalence in winter. RSV infections demonstrated a clear seasonal trend, with 16 cases of RSV infections occurring in winter and spring. Conclusions:MP is the most frequently detected pathogen in children with CAP. Bacterial infection is the most common pathogen in infants with CAP. RSV is the most common viral pathogen, with infections concentrated in the toddler group and the preschool age group, and prevalence in winter and spring. Attention should be paid to PIV3 pneumonia in children over five years old. Rational drug use should be based on the pathogen spectrum characteristics of different seasons and age groups before selecting empirical treatment combinations.