Nosocomial infection is a serious problem in the diagnosis, treatment and management of neonatal disease. Neonatal intensive care unit (NICU) is high risk place for nosocomial infections whose clinical features vary with age, nation and region. The improvemnts in hand hygiene measures and antibiotic stewardship and control of the risk are recommended to effectively prevent nosocomial infections in NICU and to improve the healthcare service in neonates.

Objective To study the diagnostic value of high-sensitivity C-reactive protein (hs-CRP) and C-reactive protein (CRP) in patients with SARS.Methods The level of hs-CRP and CRP in patients with SARS,general bacterial pneumonia and the control are quantitatively detceted by automatically partielc enhanced immunoturbidimetric assay.Results The quantification level of -hs-CRP and CRP are 0 69?0 62mg/L and 4 4?0 9 mg/L in healthy control respectively,10 79?1 36 mg/L and 98 0?28 9 mg/L in bacterial pneumonia,3 16?3 72 mg/L and 11 0?9 6 mg/L in SARS.Conclusion The serum level of hs-CRP and CRP rese in patients with both SARS and bacterial pneumonia,especially in the latter,which is 2 4 and 7 9 times more than the former.This suggests that hs-CRP and CRP may be goog indicators to differentiate SARS with general bacterial pneumonia.

Objective To study the clinical features of alveolar soft part sarcoma (ASPS) and assess its prognostic factors.Methods The clinical data of 28 ASPS patients from January 2006 to January 2009 were analyzed retropectively,and were followed up to get their prognosis.The survival analysis and risk factors were analyzed and compared.Results Two cases with soft tissue primary ASPS got recurrence after the first resection,the recurrence rate was 8.0％ (2/25).After re-resection,no postoperative recurrence occurred.Three cases with bone primary ASPS did not have postoperative local tumor recurrence,but 2 cases appeared tumor progression and got pulmonary metastasis.All the patients had poor overall prognosis,11 cases survived without tumor,8 cases survived with tumor,9 cases died.The median survival time was 38.5 months,5-year survival rate was 46.4％ (13/28),5-yeax survival rate of male patients was 50.0％ (5/10),female patients was 44.4％(8/18),5-year survival rate between male and female patients had no statistical significance (P =0.260).The 5-year survival rate of patients without distant metastasis was 81.8％ (9/11),while the rate of patients with distant metastasis (pulmonary,brain or bone metastasis) was only 23.5％(4/17),and the rates had significant difference (P =0.036).Age,gender had no significant relation with the prognosis,while tumor size,location and distant metastasis were the important factors affecting the prognosis.Conclusions ASPS commonly occurs in young persons.The hips and thighs are the most common sites ofsofte tissue primary ASPS.Prognosis has relation with distant metastasis,tumor size and part or thorough resection.The risk of recurrency and metastasis can be decreased through assessing disease condition as soon as possible,developing a reasonable treatment plan and wide resection of the primary tumor.

Objective To explore the value of neutrophils gelatinases related lipid a carrier protein (NGAL),renal injury molecule-1 (KIM-1) and serum creatinine (SCr) for early diagnosis in adult cardiac surgery after acute renal injury (AKI).Methods Blood and urine samples of 65 cardiac surgery patients before and 24,48,72 h after surgery were collected,SCr,urine NGAL and KIM-1 levels was detected,among whom AKI occurred in 34 cases(AKI group),did not occur in 31 cases (non AKI group),and they were compared with 20 cases of healthy physical examination (control group).Logistic regression model was used to judge the value of early diagnosis of SCr,urine NGAL and KIM-1.Results The incidence of AKI after cardiac surgery was 52.31％ (34/65).The SCr,urine NGAL and KIM-1 levels in AKI group and non AKI group before and 24,48,72 h after surgery were significantly higher than those in control group [SCr:(62.44 ±22.26),(77.38 ±24.38),(98.24 ±25.02),(98.14 ±45.26)μmol/L and (56.67 ±21.68),(59.25 ± 15.58),(55.40 ±22.91),(40.10 ±23.45)μmol/L vs.(16.43 ±5.01)μmol/L;urine NGAL:(4.81 ±0.65),(9.48 ±3.29),(11.87 ±3.93),(7.66 ± 1.52) μg/L and (4.67 ±0.53),(8.89 ± 2.64),(11.46 ± 3.60),(7.47 ± 1.63)μg/L vs.(2.87 ± 0.48) μg/L; KIM-1:(47.93 ± 5.54),(61.89 ± 12.44),(100.21 ± 27.32),(67.69 ± 8.72) μ g/L and (47.12 ± 4.08),(56.38 ± 9.27),(90.14 ± 27.26),(69.40 ±8.90) μ g/L vs.(32.21 ± 12.54)μ g/L] (P ＜ 0.01).Urine NGAL and KIM-1 levels in AKI group and non AKI group 24,48,72 h after surgery were significantly higher than those before surgery (P＜ 0.01).SCr,urine NGAL and KIM-1 levels in AKI group 24 h after surgery were significantly higher than those in non AKI group (P＜ 0.01).Twenty-four hours after surgery,the sensitivity and specificity of urine NGAL,KIM-1 in the diagnosis of AKI,compared with that of SCr had no statistical significance (P ＞ 0.05).Conclusions The adults who accept extracorporeal circulation cardiac surgery appear high incidence of AKI.Twenty-four hours after surgery,early biological markers-urine AKI,KIM-1,has similar sensitivity and specificity with traditional diagnostic gold standard of SCr.

Based on the global burden of disease classification, to explore the scope of chronic diseases. Methods:Searching relevant literature and books to screen and remove the acute non-communicable diseases among the non-communicable diseases which is the second category of global burden of disease ( GBD) classification. Results: Acute non-communicable diseases mainly concentrated on the acute inflammatory diseases, it also existed in other acute diseases which are not caused by infection. Conclusion: To screen and remove the acute non-communicable diseases in the non-communicable diseases could define the scope of non-communicable chronic diseases on certain extent, which has certain significance for the workers who study all chronic diseases.

Objective To explore the relationship between the incisure changes in the intracranial vertebral artery (VA) segments on transcranial Doppler (TCD) and their diseased regions. Methods Incisure changes in VA intraeranial segments on TCD in 24 cases were found. Digital subtract angiography (DSA), computed tomography angiography (CTA)or coler Doppler flow imaging (CDFI)of carotid arteries were performed to confirm their diseased regions. Results (1)The group with end-systolic and pre-diatolic wide incisures was found in 9 cases: DSA or CTA showed 5 cases with severe stenosis, 2 cases with occlusion and 2 cases with congenital tenuity of the affected vertebral artery proximal part(VA-Pr). Within the above 8 cases, ipsilateral subclavian artery (SubA) was normal, 1 case was complicated with moderate stenosis of ipsilateral SubA,and 1 case was complicated with occlusion of contralateral SubA. Haemodynamics test showed (1)negative; (2)The group with systolic incisures was in 12 cases, and 12 patients were divided into two groups based on the haemodynamics test : ① positive group was in 6 cases. DSA showed that VA-Pr was normal but SubA had impaired with different degrees; ② negative group was in 6 cases. DSA showed VA-Pr was with occlusion in 4 cases and 2 cases was with congenital tenuity; The above 2 cases were complicated with stenosis of ipsilateral SubA and in 4 cases ipsilateral SubA were normal; (3) The group with small vibrated sharp waves on Doppler was in 3 cases, and DSA showed VA-Pr occlusion in 3 cases. In the 3 cases,one case was complicated with occlusion of ipsilateral SubA. Blood stealing was present in cervical muscular branches but not present between vertebral arteries . Ipsilateral SubA were normal in 2 cases. Haemodynamic tests showed negative. Conclusions VA incisures were not only present in the early subclavian steal syndrome (SSS) but also were found in the patients with impaired SubA . However, blood steal pathway is imperfect, and would be found in affected VA-Pr or congenital tenuity. Haemodynamic tests can help identify the above situation. The TCD screening method can be used in the routine diagnosis for SubA and VA from proximal to intracranial segments involvement, but there are limitations to some extent. It needs to combine with DSA and CDFI for diagnosis.

Objective To analyze the impacts of early enteral nutrition (EN) and parenteral nutrition (PN) on the prognosis of acute pancreatitis.Method By searching relevant literature between January 1996 and August 2013 in Chinese and English databases including Wanfang,VIP,CNKI,PubMed,the Cochrane Library,CBM,and EMABSE,we compared the prognosis of acute pancreatitis after EN or PN in terms of casefatality rate,infections,multiple organ failure,and other complications.Result Compared with PN,early EN significantly reduced the case-fatality rate [OR =0.37,95％ CI (0.23,0.58),P ＜ 0.000 1],decreased the infection rate [OR =0.24,95％ CI (0.15,0.39),P ＜0.000 01],shortened hospital stay [MD =-9.87,95％ CI (-10.84,-8.89),P ＜ 0.000 01],and reduced complications [OR =0.26,95％ CI (0.12,0.58),P =0.001 0] in patients with acute pancreatitis,although the incident of multi-organ failure showed no significant difference [OR =0.35,95％ CI (0.10,1.19),P =0.09].Conclusions For patients with acute pancreatitis,early EN is superior than PN in terms of case-fatality rate,infection rate,hospital stay,and complications.Therefore,it should be applied in such patients whenever condition allows.

Objective To investigate the application value of virtual touch tissue quantification (VTQ) technique in staging of chronic kidney disease (CKD). Methods VTQ examination was performed on a random sample of 96 CKD patients at different clinical stages and 45 healthy volunteers (control group). Shear wave velocity (SWV) of renal parenchyma was measured and compared. Correlation between SWV and clinical stage and glomeru-lar filtration rate (GFR) of CKD patients was analyzed. Results The SWV value of renal parenchyma decreased gradually, along with the progression of CKD disease and impairment of renal function. There was no significant difference(P>0.05)between the control group and the CKD1 group ( P=0.061), the CKD2 group and the CKD3 group (P = 0.238), and the CKD4 group and the CKD5 group (P = 0.624). The difference of SWV between the remaining groups was statistically significant(P < 0.05). SWV of renal parenchyma was negatively correlated with CKD stage (r =-0.65, P < 0.001), which means the higher the stage of CKD was associated with the lower the SWV. SWV was positively correlated with GFR (r = 0.73, P < 0.001), which means the lower the GFR was related to the lower the SWV. Conclusion VTQ technique can noninvasively reflect the changes of renal parenchyma elas-ticity and evaluate the impairment of renal function in CKD patients. It can provide a new quantitative evaluation index for the clinical staging of CKD.

Objective: Accumulating evidence shows that hypertension is a chronic low-grade inflammatory disease,and inflammatory reaction is involved in the formation and progress of target-organ damage in hypertension.The authors aimed to explore the changes in the serum levels of interleukin-6(IL-6),soluble CD40 ligand(sCD40L),metalloproteinase-9(MMP-9),tissue inhibitor of metalloproteinase-1(TIMP-1),lipid profile and left ventricular structure in patients with essential hypertension.Methods: The serum levels of IL-6,sCD40L,MMP-9 and TIMP-1,along with blood lipids were determined and echocardiography was performed to evaluate the cardiac structure and function of 158 hypertension patients and 22 age-and sex-matched controls.Results: The hypertension patients exhibited higher levels of IL-6(P

Objective To construct a recombinant adenovirus vector containing the gene of major histocompatibility complex(MHC)class Ⅱ transactivator(C Ⅱ TA).Methods The restriction fragment of CIITA was inserted into pUC57 vector with EeoR Ⅰ and Xho Ⅰ.Then,recombinant plasmid pShutde-GFP-CMV CⅡTA was constructed with EcoR Ⅰ and Sal Ⅰ,and was confirmed by restriction enzyme digestion and sequeneing.After the treatment with Ⅰ-Ceu Ⅰ and Ⅰ-See Ⅰ,the fragment C Ⅱ TA from recombinant plasmid DShuttle-GFP-CMV.CⅡTA Was inserted into vector pAdxsi.And the pAdxsi-GFP-C Ⅱ TA wag packed into liposome,and was transfected to 293 cens.Results Recombinant plasmid pShuttle-GFP-CMV-C Ⅱ TA Was constructed successfully. After packed into vector pAdxsi, and transfected to 293 cells, significant virus Dlaques were observed,which showed the successful homologous recombination.The titer of the purified AdC Ⅱ TA was 2.0×10~(11) PFU/ml.Conclusions Recombinant adenovirus AdC Ⅱ TA containing gene of MHC class Ⅱ transactivator was established successfully.