OBJECTIVE To study the distribution and drug resistance of nosocomial infection(NI) pathogens.METHODS The NI pathogens collected between Jan 2002 and Dec 2008 were completely surveyed and analyzed.RESULTS Totally,9518 samples were cultured to find NI pathogens,in which 6703 NI pathogens were isolated.In the pathogens,G-pathogens occupied 59.5%,G+ cocci 25.0%,and fungi 15.5%.The rate of ESBLs in E.coli was reached to 47.8%,and that in K.pneumoniae was 29.4%;The first two predominant G+ pathogens were Staphylococcus aureus(11.7%) and Enterococcus(5.7%).The rate of MRSA in S.aureus was 78.2%,and that of VRE in Enterococcus was 2.3%,The pathogens of fungus were mainly Candida albicans(10.2%).CONCLUSIONS The G-NI pathogens are markedly increased year by year and become the first important instead of G+ cocci,meanwhile the multiple drug resistance and ESBLs pathogens are also markedly increased.

Objective:To understand the basic situation of pharmacy staff in the hospitals in Beijing Xicheng district. Methods:Totally 12 hospitals in Xicheng district were investigated by a questionnaire( including the age,educational degree and professional title of phama-cists) , and the obtained information was classified, gathered and counted, and the evaluation and recommendation were also performed after the combination with regulations and actual work. Results:There were 385 persons working in the pharmacies of the 12 hospitals, which accounted for 7. 56 % of the total health professionals. Among them, 67. 02% were under the age of 40, 83. 11%were undergraduates or specialists, 84. 93% had primary or intermediate titles, 3. 38% had finished standardized training, and 4. 68%were clinical pharmacists. Conclusion:The composition of pharmacy staff can not match the national requirements. It is necessary to optimize the structure of pharmacy staff, improve the level of education, and strengthen the standardized training and clinical pharma-cist training in order to promote the career competence of pharmacists.

Objective To study CT and MRI findings of the eclamptic encephalopathy in plateau.Methods CT and MRI findings in 28 patients in plateau with eclamptic encephalopathy were retrospectively analyzed.Results CT and MRI appearances of eclamptism were as follow:normal in brain in 3 cases;cerebral edema in 18 cases,including slight encephaledema in 2 cases,focal encephaledema in 11 cases and diffuse encephaledema in 5 cases;cerebral hemorrhage in 6 cases and sinovenous thrombosis in 1 case.Conclusion CT and MRI scan are of significant value in diagnosis and treatment of eclamptic encephalopathy in plateau.

Objective To preliminarily evaluate the efficacy and safety of chemotherapy on hemophagocytic lymphohistiocytosis(HLH) with hepatic dysfunction in children.Methods The children diagnosed as non-malignancy-associated HLH from Mar.2004 to Apr.2008 were selected,and the therapeutic effect was evaluated according to the HLH-04 protocol at the 8th week of chemotherapy,and the level of serum alanine aminotransferase(ALT),serum albumin(Alb) and plasma fibrinogen(Fib) were detected at pretherapy,2 weeks and 8 weeks of post-treatment.Results Altogether 60 HLH children complicated with hepatic dysfunction before chemotherapy,47 children had increased ALT,58 children had decreased Alb,and 38 children had decreased Fib.Forty-two cases(70%) were virus-associated HLH,1 case(1.7%) was fungi-associated HLH,and 17 cases(28.3%) had unknown origin.Among the 60 children,55 cases showed improvement in the 4 weeks of inductive treatment,15 cases gave up therapy,45 cases completed the 8 weeks of inductive treatment according to the protocol(among these children,42 cases had no active disease,3 cases had active disease),and these 45 children had obviously improved ALT,Alb and Fib at 2 weeks and 8 weeks of post-treatment,compared with pretherapy,the differences had statistical significance(Pa

Objective To investigate the clinical features and characteristic of auxiliary examination of neuralgic amyotrophy(NA).Methods8 patients with idiopathic neuralgic amyotrophy were analyzed retrospectively with literature review.Results and ConclusionAntecedent events were found before attack in 5 patients.Serious pain,which was followed by paresis and atrophy,as initial symptom,was found in 7 patients.Damage in the upper and middle trunk distribution occurred most frequently.Elevated liver enzymes were found during the early phase of their attacks in 2 patients.CSF analysis was performed in 5 patients,and mildly elevated protein was found in two.5 patients had been misdiagnosed as cervical spondylosis.After medical and/or physical therapy(6 patients with corticosteroid and physical therapy,2 only with physical therapy),all the patients had been followed up for 2～13 months.Muscle power was recovered in 67% of all the patients,partially recovered in 33%.

Objective To evaluate short-term curative effect of endovascular abdominal aortic aneurysm repair. Methods Twelve cases of infra-renal abdominal aortic aneurysms were checked. Results The av-erage bleeding in the operation was 245 millimeter, the avenage hospitalization time was 8.6 days, and the average abrosia time was 1.5 days. White blood cell, hemoglobin, thrombocyte, hepatic function, and renal function were in the normal limits. Prothrombin time and activated partial thromboplastin time were post-poned after operation, and recovered normally within one week. Complications of operations were as follows:1 case of pulmonary infection, 2 cases of abdominal distention, and 1 case of intraoperafive endoleak. The former two kinds of complications alleviated after conventional treatment, and the latter disappeared naturally after 3 months. Conclusion Endovascular abdominal aortic aneurysm repair is safe, mini-invasive, and has little disturbance for body internal environment.

Objective To investigate clinical effect of combined laparoscopic and endoscopic submucosal resection for the gastric antrum-body tumors originated from the muscularis propria.Methods A total of 8 patients with gastric antrum-body tumors originated from the muscularis propria were treated by combined laparoscopic and endoscopic submucosal resection from Jan 2013 to Apr 2014.All patients were diagnosed as having gastric antrum-body tumors originated from the muscularis propria by preoperative endoscopic ultrasonography.Endoscopy showed that the surface mucosa of tumors were normal in all patients.Tumors were found in the gastric antrum-body front wall in 4 cases,and in the back wall in 2 cases,and in the lesser omental bursa in 1 case,and in the greater omental bursa in 1 case.The tumors size was from 1.5 to 3.5 cm,averaging (2.4 ± 0.7) cm.The therapeutic procedure included three phases.The lesion was first exposed with laparoscopy.Then,the fluid was injected into the submucosa in the part of tumor by endoscopy.Finally the tumor was resected by laparoscopy.These patients were followed up and analyzed retrospectively.Results Combined laparoscopic and endoscopic submucosal resection was successfully performed in all patients.All tumors were resected completely.Sever bleeding,infection or death were not found in any patients.Postoperative pathology and immunohistochemistry staining confirmed 6 stromal tumors and 2 neurofibroma.All patients were followed up for 6 months,and there was no recurrent case.Gastric mucosa and function were normal in all patients.Conclusion Combined laparoscopic and endoscopic submucosal resection is a simple,safe and effective method for gastric antrum-body tumors originated from the muscularis propria,and leads to little complication.

OBJECTIVETo observe the expression of Ginkgo biloba Tablet (GbT) on scavenger receptor A (SRA) of the aortic wall and changes of serum inflammatory factors in atherosclerotic rats, and to explore its new mechanism for fighting against atherosclerosis (AS).

METHODSTotally 45 male Wistar rats were randomly divided into the control group, the model group, the GbT group, 15 rats in each group. Levels of blood glucose, blood lipids, blood calcium, serum C-reactive protein (CRP), soluble intercellular adhesion molecule-1 (slCAM-1), and soluble vascular cell adhesion molecule-1 (sVCAM-1) were measured in all rats. The expression of SRA in the aortic wall of atherosclerotic rats was observed by immunohistochemical assay. The correlation between the expression of SRA and levels of in-flammatory factors was also observed.

RESULTSCompared with the control group, blood glucose and blood calcium obviously increased (P < 0.05); levels of TG, TC, and LDL-C were significantly elevated (P < 0.01); neointimal areas were significantly thickened, increased intima percentage was significantly enlarged, narrowed lumen index was significantly reduced; levels of CRP, sICAM-1, and sVCAM-1 were significantly elevated in the model group (all P < 0.01). Compared with the model group, blood glucose and blood calcium obviously decreased (P < 0.05); levels of TG, TC, and LDL-C significantly decreased (P < 0.01) in the GbT group. Aortic lumens were obviously narrower in the model group than in the GbT group (P < 0.05). SRA expressed at the aortic wall. The aforesaid 3 indices were significantly improved in the GbT group than in the model group (P < 0.01). Serum levels of CRP, sICAM-1, and sVCAM-1 were significantly decreased in the GbT group than in the model group (P < 0.01). Serum levels of CRP, sICAM-1, and sVCAM-1 were positively correlated with the percentage of SRA positive expression area (r = 0.701, 0.604, 0.581, all P < 0.01).

CONCLUSIONSSerum levels of inflammatory factors in atherosclerotic rats were elevated, and the expression of SRA in the aortic wall was enhanced. The expression of SRA was closely correlated with serum levels of inflammatory factors. GbT could decrease serum levels of inflammatory factors and inhibit the expression of SRA.

Animals ; Aorta ; drug effects ; metabolism ; Atherosclerosis ; drug therapy ; Blood Glucose ; analysis ; C-Reactive Protein ; analysis ; Calcium ; blood ; Drugs, Chinese Herbal ; pharmacology ; Ginkgo biloba ; chemistry ; Intercellular Adhesion Molecule-1 ; blood ; Lipids ; blood ; Male ; Random Allocation ; Rats ; Rats, Wistar ; Scavenger Receptors, Class A ; metabolism ; Tablets ; Vascular Cell Adhesion Molecule-1 ; blood

Objective To assess the diagnostic predictive value of Wells score and modified Geneva score for acute pulmonary embolism by prospective case series and to explore a more suitable scoring system for Chinese population.Methods All the patients suspected of pulmonary embolism (PE) and received CT pulmonary angiography (CTPA) were enrolled consecutively in Fuxing Hospital,Capital Medical University,China,from June 2009 to August 2011.Before CTPA test or on condition that test results were unknown,clinical scoring was assessed prospectively by the Wells score and the modified Geneva score.The probability of PE in each patient was assessed and the patients were divided into low,moderate and high probability groups according to the clinical scores.The result of CTPA was used as the diagnostic gold standard for PE.Diagnostic accuracy in each group was analyzed.The predictive accuracy of both scores was compared by AUCROC curve.Results A total of 139 patients met our enrollment criteria and 117 eligible patients entered our study at last.PE was diagnosed in 47 patients by CTPA with an overall prevalence of 40.2％.Prevalence of PE in the low,moderate and high pretest probability groups assessed by the Wells score and by the simplified modified Geneva score were 7.1％ (3/42),42.9％ (21/49),88.5％ (23/26)and 10.0％ (3/30),48.1％ (37/77),7/10,respectively.AUCROC curves for the Wells score and the simplified modified Geneva score were 0.872 ( 95％ CI 0.810-0.933 ) and 0.734 ( 95％ CI 0.643-0.825 )respectively,with a significant difference ( P =0.005 ).Conclusion The Wells score is more accurate for clinical predicting acute PE than the modified Geneva score.

Objective To clone and express the alkaline protease AprA , one important virulence factor secreted by Pseudomonas aeruginosa(PAE)in Escherichia coli, to clone and express the inhibitor of AprA (AprI) and its substrate flagellin , and to detect the function of AprA and the inhibitory function of AprI .Methods The genes encoding AprA ,AprI and flagellin gene were amplified respectively by PCR using PAE PAO 1 genome DNA as the template .The expression vec-tors (pET-28a-AprA, pET-28a-AprI and pET-28a-Flagellin) were constructed and transformed into E.coli BL21(DE3) respectively.The recombinant AprA protein was expressed by IPTG induction and purified via denaturing and renaturation. The recombinant AprI and flagellin were expressed and purified by Ni 2+affinity chromatography .The cleavage activities of AprA on flagellin were detected by SDS-PAGE.Results Recombinant AprA , AprI and flagellin protein were expressed and purified .It was demonstrated that AprA cleaved flagellin , which was blocked by AprI .Conclusion Recombinant AprA could cleave its substrates as an alkaline protease , and its inhibitor AprI inhibits the activities of AprA .This study will contribute to further investigations on the role of AprA in the pathogenesis of PAE .