OBJECTIVE To survey the varieties of microorganism on nurse hands and probe into its controlling measure in general hospital.METHODS We sampled microorganism of nurse hands during intravenous fluids infusion in the Respiratory Department,the Cardiovascular Department,the Department of Digestion,Gynecology and Obstetrics Department,the Department of Thoracic Surgery and the Department of Organ Transplantation in our hospital.All samples carried out co-cultures of fungi and bacteria.RESULTS The varieties of microorganism included not only opportunistic pathogens such as Acinetobacter,Corynebacterium,Pantoea agglomerans(Enterobacter agglomerans) former,and Escherichia coli,but also strong pathogenic microorganisms such as Staphylococcus aureus,and it is so common that finding meticillin-resistant coagulase-negative staphylococci.CONCLUSIONS Nursing staff's hands contamination is serious in the process of manipulating operation in general hospital,emphasis should be placed on prophylaxis and control for nosocomial infection.

Objective To study the effects of BCG-PSN on the expression of the receptor of selectins——one of the important cell adhesion molecules, and the characteristics of cytoskeleton structure in lung cancer cells. Methods The effects of BCG-PSN on the expression of sialyl Lewis X (slex) and the cytoskeleton structure of highly metastatic human pulmonary giant cell carcinoma (PG) cells and lowly metastatic human pulmonary adenocarcinoma (PAa) cells were observed by flow cytometry and transmission electron microscopy. Results Flow cytometric results showed that the expression of slex on the surface of PAa cells (66.8%) was higher than that on PG cells (5.72%). After treatment with BCG-PSN, the expression of slex on PAa cells decreased in a dose-dependent manner. Transmission electron microscopy showed that the microtubules and microfilaments were sparse in the PAa cells and diminished in PG cells. After treatment with BCG-PSN, the microfilaments were more abundant than before in PG cells and showed a branch-like appearance, but still remained sparse in PAa cells. Conclusion Changes in the components of the cytoskeleton structure are associated with the ability of the migration and movement of the tumor cells. The inhibitory effect of BCG-PSN on the adhesiveness of lung cancer cells may not be the cytoskeleton-mediated enhancement of adhesion, but the start-up process resulted from the down-regulation of cell adhesion molecules on the surface of lung cancer cells.

In order to improve the Interns’ synthetic medical quality of respiratory medicine, based on the teaching practice of respiratory medicine in our hospital, the analysis of admission introduction and requests for high quality medical ability are reviewed in the present article.

Objective To evaluate the efficacy and safety of donepezil in the treatment of cognitive dysfunction caused by radiation-induced encephalopathy.Methods A total of fifty-five patients with radiation-induced cognitive impairment were divided into treatment group with extra donepezil 5-10 mg/d combined with conventional therapy and control group with conventional treatment for 16 weeks.The cognitive function was assessed according to Montreal cognitive assessment (MoCA) and mini-mental state examination (MMSE) before and 16 weeks after treatment.Results After 16 weeks of treatment,the patients in treatment group displayed significantly greater improvement in cognitive function.In treatment group,the scores of patients after donepezil therapy in MoCA and MMSE were obviously higher than the control group (t =5.40,3.88,P ＜ 0.01).The scores in the visual space and executive function,naming,attention,abstract thinking,delayed memories also had improved,which suggested the statistically significant difference(t=-3.55,-3.08,-3.21,-2.58,-3.65,P＜0.05).The scores of control group unchanged accordingly.Conclusions Donepezil combined with conventional treatment was signally effective in the therapy of cognitive dysfunction caused by radiation-induced encephalopathy.

Background:Malnutrition is common in inflammatory bowel disease,especially in Crohn' s disease (CD).Combined partial enteral and parenteral nutrition is effective for nutritional support in patients with severe CD.Aims:To investigate the effect of combined enteral and parenteral nutritional support on body composition and disease activity in severe active CD patients.Methods:A total of 72 patients with severe active CD admitted from July 2015 to August 2016 at Shanghai Tenth People' s Hospital were enrolled.In addition to conventional antibacterial and remission induction therapy,a combined partial enteral and parenteral nutritional support was given after admission.The nutritional status,body composition parameters and disease activity were evaluated and compared on admission and week 1,week 2 and week 3 of hospitalization.Results:The malnutrition rate was 100％ on admission,of which 90.3％ were severe malnutrition.After a 3-week combined enteral and parenteral nutritional support,the proportion of severe malnutrition decreased from 90.3％ to 34.7％ (P ＜0.05).Meanwhile,the body weight,body mass index,muscle mass,fat mass,protein content,and basal metabolic rate gradually increased and the disease activity index gradually decreased (P all ＜ 0.05).Conclusions:Combined enteral and parenteral nutritional support can improve the nutritional status and body composition parameters,reduce disease activity and induce remission effectively in severe active CD patients.

OBJECTIVE: To determine the effect of ulinastatin on plasma thromboxane B(2) and deep vein thrombosis(DVT) in elderly patients after hip joint replacement. METHODS: Eighty ASAI-IIpatients aged 65-81 years undergoing hip joint replacement were randomly divided into 4 groups (n=20): Group U1 (ulinastatin 5 000 U/kg);Group U2 (ulinastatin 10 000 U/kg); Group U3 (ulinastatin 20 000 U/kg); and Group C (the same volume of saline as control).The blood samples were collected at 5 time points: preoperation (T(1)), immediately after the operation (T(2)), 1 d (T(3)), 2 d (T(4)) and 3 d after the operation (T(5)), respectively. Thromboxane B(2) was detected, and DVT was also examined through color Doppler ultrasonography 3 d after the operation. RESULTS: Compared with T(1), the level of thromboxane B(2) significantly increased in Group C at T(2)-5, in Group U1 at T(2-4), in Group U2 and U3 at T(2) (P<0.01). Compared with Group C, the concentration of thromboxane B(2) decreased in Group U1 at T(2-3), in Group U2 and U3 at T(2-4) (P<0.01). Compared with Group U1, thromboxane B(2) significantly decreased in Group U2 and U3 at T(2-4) (P<0.01).The incidence rate of DVT was 40% in Group C, 10% in Group U1. There was no incidence of DVT in the Group U2 and U3 (P>0.05). CONCLUSION Ulinastatin can inhibit blood thromboxane B(2) level in dose dependent manner and prevent DVT in elderly patients after hip joint replacement.
Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip ; adverse effects ; Female ; Glycoproteins ; therapeutic use ; Hip Fractures ; surgery ; Humans ; Male ; Thromboxane B2 ; blood ; Trypsin Inhibitors ; therapeutic use ; Ultrasonography ; Venous Thrombosis ; diagnostic imaging ; etiology ; prevention & control

This study was aimed to reveal characteristics of functions, main indications and applications of Chinese patent medicines in order to provide references for development of new Chinese patent medicines for antitussive ef-fect. Chinese patent medicines recorded in the Pharmacopoeia of the People's Republic of China and the New Na-tional Chinese Patent Medicines were taken as research subjects. Chinese patent medicines classified in the function and indication with key words of cough-relieving, cough-suppressing, cough and chronic cough were col-lected. Analysis was made on the prescription characteristics, such as functions, main indications and applications. The results showed that there were 684 Chinese patent medicines and 462 terms, which were used for a total of 1533 times. The frequently-used terms are antitussive effect with expectorant, antitussive effect, expectorant, heat-clearing and exterior-releasing, antiasthmatic, wind-expelling and antipyretic, antitussive effect with antiasthmatic, purging lung heat, relieving exterior syndrome and moistening the lungs. All 684 Chinese patent medicines were used 48 ma-jor treatments for a total of 1107 times. The main indications include acute and chronic trachitis / bronchitis, exoge-nous wind-heat type of common cold, exogenous wind-cold type of common cold, cough with abundance of phlegm due to phlegm-heat obstructing the lung, acute upper respiratory tract infection, asthma, acute and chronic pharyngi-tis, lung heat cough, and etc. All 684 Chinese patent medicines used a total of 537 kinds of herbs and chemical medicines, including 441 kinds of herbal medicine, 36 kinds of animal medicine, 25 kinds of mineral medicine and 35 kinds of chemical medicine. The top ten herbs in terms of using frequency are Glycyrrhizae radix et rhizoma, Platycodonis radix, Armeniacae semen amarum, Menthae haplocalycis herba, Citri reticulatae pericarpium, Ephedrae herba, Scutellariae radix, Perilla frutescens (L.) Britt, Pinelliae rhizoma, Fritillariae cirrhosae bulbus. Among them, 1/4 of Chinese patent medicines used extract. Five kinds of food or fruits were also used, which were orange, fresh gin-ger, pear, watermelon and dried mushroom. It was concluded that Chinese patent medicines for antitussive effect can be adopted in the treatment of various kinds of diseases, especially for the treatment of cough(heat cough in partic-ular), abundance of phlegm, asthma, pharyngitis, laryngitis, and etc. The treatment methods of clearing heat, dis-pelling wind and relieving exterior syndrome played an important role in the realization of antitussive effect. However, the expression of functions and main indications is far from standardized and clear. Drugs commonly used are herbal medicine plus animal medicine, mineral medicine and chemical medicine as well as food and fruit. The discovery of preparations with certain clinical curative effect from ethnomedicine and the using of their extracts as a major ingre-dient are one important way to develop new Chinese patent medicines with antitussive effect.

Objective To investigate the changes of short chain fatty acids (SCFA) induced by tacrolimus (FK506) in rats and evaluate its effect on blood glucose levels. Methods Ten SD rats were divided into the FK506 group and control group (n=5 in each group). In the FK506 group, the rats were received a subcutaneous injection of FK506 (3 mg/kg) +sunflower oil solution containing 10% ethanol daily for consecutive 4 weeks. In the control group, the rats were received a subcutaneous injection of an equivalent amount of sunflower oil solution containing 10% ethanol for consecutive 4 weeks. During the drug injection period, the body mass of rats was measured every week in two groups. After the drug injection period, blood glucose level, SCFA content in the blood and feces samples were measured in two groups. Results Compared with the control group, the relative body mass of rats in the FK506 group was significantly lower at the 2nd, 3rd and 4thweeks (all P<0.01). Compared with the control group, the blood glucose levels of rats in the FK506 group were significantly increased at 0, 30, and 60 min after giving glucose (P<0.01-0.05). Compared with the control group, the contents of acetic acid, propionic acid, isobutyric acid, butyric acid, isovaleric acid and valeric acid in the feces sample were significantly lower in the FK506 group (P<0.01-0.05). Conclusions FK506 can upregulate the blood glucose level in rats, which is probably induced by the decrease of SCFA content in rat feces.

Objective:To explore the application of 16-words formula " resection surrounding the proximal part of seminal colliculus, lateral tunnel, plane extending and bladder neck preservation" in transurethral enucleation resection of prostate with plasma rod electrode (TUERP).Methods:The clinical data of 88 patients with benign prostatic hyperplasia (BPH) admitted to our department from May 2018 to July 2019 were retrospectively analyzed. The age of patients was (67.0±8.6)years, and the volume of prostate was (51.0±27.3)ml. All patients were treated with TUERP using transurethral plasma rod electrodes according to the above 16-words formula. The perioperative clinical data and follow-up results at the 3rd month postoperation were statistically analyzed.Results:All operations were successfully completed. The operation time was (49.7±17.7)min, including gland enucleation time (16.8±6.7)min, tissue resection time (33.0±12.3)min, enucleated tissue weight (45.5±24.4)g, intraoperative blood loss (10.2±2.9)ml, postoperative continuous bladder irrigation time (1.9±0.8)d, postoperative hospital stay (4.1±0.7)d. There were no significant changes in hemoglobin and sodium concentration at 2 hours after operation ( P>0.05). The International Prostate Symptom Score (IPSS), quality of life score (QOL), maximum urinary flow rate (MFR) and residual bladder urine were significantly improved at 3 months after operation ( P<0.05). The patients were followed up for 3 to 14 months (average 6.8 months). There were 6 cases of Clavien grade Ⅰ complications, 1 case of Clavien Ⅱ complications, 1 case of Clavien Ⅲ complications, and no Clavien Ⅳ-Ⅴ complications occurred. Conclusions:The TUERP with plasma rod electrode according to the 16-words formula is an ideal choice for BPH treatment, which has the advantages of simple operating, high efficiency of enucleation, less blood loss, fast recovery and satisfied improvement of urination symptom.

Objective To investigate the safety and efficacy of conversion from calcineurin inhibitors (CNI) to mammalian target of rapamycin (mTORi) in liver transplant recipients.Methods Such databases as MEDLINE (PUBMED),EMBASE,Cochrane Library and clinical trial registries (ClinicalTrials.gov,WHO International Trial Registry Network,Australian & New Zealand Clinical Trials Registry) were searched from the inception of each resource up to April 2015 for collecting the randomized controlled trials (RCTs) about liver transplant recipients after conversion from CNIs to mTORi,and the references of those trials were also searched by hand.After study selection,assessment and data extraction conducted by two reviewers independently,meta-analyses were performed by using the RevMan5.3 software.The quality of those trials was assessed by using the Jadad Score.Then,the safety and efficacy of conversion from CNI to mTORi were systematically assessed as a strategy for eliminating CNI exposure in liver transplant recipients.Results Ten RCTs (1917 patients) were included in this meta-analysis.The follow-up duration post-randomization was 6 to 36 months.The mean mTORi conversion time after transplantation was ≤6 months in 4 trials,and ＞6 months in 6.The meta-analysis revealed that the estimated glomerular filtration rate was significantly increased,and the incidence of renal failure and hyperglycemia was significantly reduced in mTORi conversion group as compared with those in CNI treatment group (P＜0.05 for all).The incidence of acute rejection in mRORi conversion group and CNI treatment group was 11.3％ and 6.3％ respectively (P＜0.01),and that confirmed by biopsy was 14.0％ and 8.4％ respectively (P＜0.01).The percentage of recipients discontinuing the medication in mRORi conversion group and CNI treatment group was 41.6％ and 21.5％ respectively (P＜0.01).The main reasons for drug withdrawal were drug-related adverse events (Aes),including acute rejection,bone marrow depression,anemia,leucopenia,thrombocytopenia,mouth sores/stomatitis,hyperlipidemia,hypercholesterolemia,rash,edema,and pyrexia.There was no significant difference between the two groups with regard to death,graft loss,loss to follow-up,infection,gastrointestinal symptoms,malignancy,and hypertension.Conclusion Conversion from CNI to mTORi therapy results in a significant improvement in renal function.However,this conversion strategy may lead to the high discontinuation rate due to mTORi-associated Aes,indicating that conversion may only be a treatment option in selected patients.