Objective To observe the effect of adjusting high dietary profein intake on nutritional status of peritoneal dialysis (PD) patients. Method Thirty three PD patients whose daily protein intake (DPI) was over 1.2g/(kg? d) were included in study from July, 2005 to November, 2006. A recipe was given by a professional dietitian for every patient to reduce DPI meanwhile maintaining sufficient daily energy intake (DEI). DPI, DEI, serum albumin (ALB), lean body mass(LBM) and subjective global assessment(SGA) and the prevalence of hyperphosphatemia, hyperkalemia and metabolic acidosis were evaluated before and after 3 and 6 mo adjustment. Results At the end of observation, 28 patients were enrolled in the study. Their mean age was 61.37?12.25 yrs, 11 males and 17 females with dialysis period 8.8 mon (1～66 mo). DPI and DEI were significantly decreased during 6 mo (P=0.000). Nobody complained about gastrointestinal symptoms, and the quality and satisfaction of life during the study were not significantly different. Serum Alb at 3 rd month was higher than the start of study (36.22?2.79g/L vs 37.34?3.32 g/L,P

Abstract: Objective　This study aims to investigate the drug resistance, resistance mechanisms, and serotype epidemiological features of clinically isolated Streptococcus pneumoniae (SP) in Shanxi Province. Methods　SP strains were isolated between January 2021 and July 2023 from Shanxi Provincial People's Hospital. An automatic microbiological identification and drug sensitivity analysis system was used to identify strains and conduct antibiotic susceptibility assay. The species identification was also carried out using a MALDI-TOF mass spectrometer, optochin assay, and amplification of the CPSA gene. Finally, the polymerase chain reaction (PCR) technique was implemented for drug-resistant and virulence gene detection and serotyping. Results　A total of 117 strains were isolated including 115 strains (98.3%) being erythromycin-resistant Streptococcus pneumoniae (ERSP). The ERSP was composed of 114 macrolide-lincosamide-streptogramin B (MLSB) resistant strains, carrying the ermB (114/114) and mefA (42/114) gene, and one M-resistant strain absent of ermB and tetM. The most common pneumococcal six serotypes in ERSP strains were 19F, 3, 34, 19A, 6A/6B, and 23F, respectively, totaling 71 strains (61.7%). Compared with pediatric and adult, serotype 19F in geriatric patients was the dominant type with a significant difference (χ2=6.315, P=0.043). Compared with adult patients, the strains isolated from pediatric and elderly patients showed a higher rate of insensitivity (resistance and intermediate) to oral penicillin (χ2=7.277, P=0.026). Serotype 19F strains showed high insensitivity to oral penicillin (81.0%), compound sulfamethoxazole (100.0%), tetracycline (94.7%), and ceftriaxone (9.5%). The serotypes 19A and 23F strains also showed high insensitivity to penicillin (>70%), tetracycline (100%) and compound sulfamethoxazole (>85%). However, serotype 3 strains had low insensitivity to oral penicillin (8.3%), ceftriaxone (0%), and compound sulfamethoxazole (27.3%). There were 42 strains positive for ermB+mefA, of which serogroup 19 was the main type, accounting for 64.3% (27/42). Of these strains, 88.1% (37/42) carried ply, lytA, and HylA genes simultaneously. Conclusion　Drug resistance to ERSP still to be a serious problem for human health. There are differences in serotype distribution in terms of age, resistance genes, and drug resistance. Therefore, the vaccination of pneumococcal conjugate vaccine 13 (PCV13) is an essential and effective measure to prevent SP infection in this region.

Objective To investigate the protective effects of erythropoietin (EPO) on myocardium injury after sepsis in rats in order to clarify the mechanisms.Methods The rat models of sepsis were produced by cecal ligation and perforation method (CLP).Ninty-six healthy SD rats were randomly (random number) divided into 3 groups:the sham operation group (Sham group,n =32),the sepsis group (CLP group,n =32),and the EPO treatment group (EPO group,n =32) treated with EPO 1000 IU/kg intraperitoneal injection after the CLP.The observation intervals were set at 3 h,6 h,12 h and 24 h after the surgery.The cardiac hemodynamics of the CLP group were measured.Plasma levels of inflammatory factors and myocardial enzyme indicators were determined by enzyme-linked immunosorbent assay (ELISA) ; Membrane potential levels of chondriosome of myocardial cells,cell apoptosis rates and expressions of nuclear factor-κB p65 of myocardium tissue were detected by flow cytometer; Then the pathological change of myocardium with HE staining was observed under light microscopy.Results (1) Compared with the CLP group,left ventricle systolic pressure (LVSP),left ventricle diastolic end pressure (LVEDP),the maximum rate of left ventricle rise and fall (+ dp/dtmax and-dp/dtmax) in the EPO group improved (P ＜0.05,P＜0.01); (2) Compared with the Sham operation group,plasma levels of tumor necrosis factoralpha (TNF-α),interleukin-6 (IL-6),C-reactive protein (CRP),cardiac troponin-I (cTNI),creatine kinase (CK),lactate dehydrogenase (LDH) and glutamine-oxaloacetic transaminase (GOT) in the CLP group increased at each interval (P ＜ 0.05),and those biomarkers in the EPO group were lower than those in the CLP group (P ＜ 0.05) ; On the contrary,plasma level of anti-inflammatory factor IL-10 in EPO group was higher than that in the CLP group (P ＜ 0.01) ; (3) Compared with the Sham operation group,the cell apoptosis rates in the CLP group increased significantly (P ＜ 0.01),and it decreased obviously in the EPO group (P ＜ 0.01); (4) Compared with the Sham group,membrane potential levels of chondriosome of myocardial cell in the CLP group decreased (P ＜0.01),while it increased in the EPO group in comparison with the CLP group (P ＜ 0.01) ; (5) Pathological changes of myocardium after the CLP could be lessened by the EPO treatment.Conclusions EPO may increase membrane potential levels of chondriosome and decrease the apoptosis rates of myocardial cell in rats after sepsis,and it may reduced the production of inflammatory factors to protect the myocardial cell by down-regulating NF-κB p65.Both increased membrane potential level of chonriosome and decreased inflammatory factor may implicate in myocardium protection thereby improving cardiac function after sepsis.

Objective Current study used quantitative research methods to reveal the regional medical information research in hotspots, and summarize the mainstream knowledge base to provide the reference for researchers in the field.Methods A systematic search was conducted to find publications in CNKI, Wanfang Database and PubMed.Bibliometrics method, social network analysis, coword analysis, principal component analysis and multidimensional scaling analysis were used in this study.Results ① total 11,482 articles published from 1984 to 2013 were screened out.The development of research publications showed an increasing trend, and the papers were distributed in 1233 types of journals.The number of authors who located in Beijing, Guangdong, Jiangsu, Shanghai,Shandong ranked top five.② The top 59 high frequency key words were identified that representing the hot contents in regional health information technology research field, and was used to build knowledge network map.Among them, HIS, electronic medical records, hospital information technology,information technology were at the core of this research area.③ We summarized research and development in the field of nine major mainstream knowledge base include: research on electronic medical records, medical personnel, information systems, information security, information networks, information sharing, information integration, information technology, and information management, resident' s health record related studies;qualitative analysis and problem-oriented research;HIS and telemedicine-related research;community related research, two-way referral related research, health care reform and cloud computing-related research, telemedicine related research and V43 related research.Conclusions The development of regional medical information research has good momentum and closely follow the international trend, but the research contents and methods are still distance from international standard..Research mostly focused on hospital information system construction, regional research and applied research are weak and need to be further improved.

BACKGROUND: Pancreatic stem cells can be differentiated into endocrine functioning cells under a suitable cultivation condition, suggesting that pancreatic stem cells can be used as a new source of islet in treating diabetes mellitus.OBJECTIVE: To discuss the expression of stem cell in different purities of pancreatic islets.DESING: A controlled observation based on cells.SETTING: Third People's Hospital of Mianyang City.MATERIALS: The experiment was conducted in the Center Laboratory (Key Laboratory of Chongqing City), the First Affiliated Hospital of Chongqing Medical University from March 2005 to March 2006. Thirty healthy male SD rats, of clean grade, aged 50 days were used in this study. During the experiment, the disposal of animals corresponded to Animal Ethical Standard. Cytokeratin (CK)-19 and β-actin were designed by Shanghai Invitrogen Biological Co., Ltd.Brdu reagent, mouse anti-rat Brdu monoclonal antibody, rabbit anti-mouse (RAM) CK-19 polyclonal antibody and Brdu immunohistochemical kit were from Boster Co., Ltd. (Wuhan); HistostainTM -DS double immunohistochemical staining kit was purchased from Beijing Zhongshan Company.METHODS: Rats were intraperitoneally injected with Brdu for labeling, and subjected to perfusion with Ⅴ-type collagenase via pancreatic ducts, with pancreas being excised, ripped, beaten up, digested and centrifuged to obtain pancreatic islet sediments. After being precipitated, the sediments were divided into 3 groups. Group A: The isolated sediments of islets were not purified; Group B: The sediments were added slowly with 25% Ficoll-400 and Hanks solution for purification; Group C: The sediments were slowly added with 25% Ficoll-400, 11% Ficoll-400 for purification in order.MAIN OUTCOME MEASURES: Expressions of Brdu and CK-19-positive cells in the islet samples were detected by immunohistochemical method, and mRNA expression of CK-19 in the different purities of islets was detected by reverse transcription-polymerase chain reaction.RESULTS: ① The purity of islets in the group A was the lowest. The purity of islets obtained by different purification techniques showed significances among the three groups (F =89.42, P ＜ 0.05). ②Positive expressions of Brdu and CK-19 in the group A were significantly higher than those in the group B and group C (F =18.64, 22.12, 38.61. P ＜0.01). ③Expression of CK-19 mRNA in the group A was significantly higher than that in other groups, with group C showing the lowest.CONCLUSION: Expressions of Brdu and CK-19-positive cells exist in different purities of islets, suggesting the existence of more stem cells in the low purify of islets.

By means of literature review,the paper made a comparative study of key development projects of healthcare information in China over the last decade,in terms of their project characteristics,economic environment,development entity,investment and compensation practice,development strategy,coverage,experience and promotional values.Setbacks identified include the following:discrepancy in regional development stages of healthcare information; successful pilots are limited to scientific research samples; lack of regional models; systems separation; poor continuity and coordination; waste and insufficiency of resources in the investment and construction among others.The authors recommend a better exchange of experiences in building the regional healthcare information service platforms,greater investment,better compensation mechanism,better top-tier design,and maximized coverage within reach of supervision and technology.

Objective To observe the efficacy and toxicity of low dose thalidomide combined with VAD regimen contained one-week dexamethasone in treatment on patients with multiple myeloma (MM). Methods 42 patients with MM were diagnosed in our hospital.The VAD regimen contained one-week dexamethasone was vincristine 0.4 mg/d, adramycin 10 mg/d and dexamethasone 40 mg/d for 4 days. At the same time, thalidomide is given 150-200 mg/d. Results The overall response rate (ORR) is 80.95%. Before and after treatment, all the detection indicators in MM patients were statistically different (P＜0.001). There is small adverse reactions. Conclusion Low dose thalidomide combined with VAD regimen contained one-week dexamethasone in treatment of MM has more merits such as less side effects, good tolerance, convenient administration and significant curative effects, so it should be recommended in clinical works.

Objective To investigate the expression of scaffold protein palladin in pancreatic ductal adenocarcinoma (PDAC) tissues and to discuss its clinicopathological significance.Methods 56 samples of PDAC and corresponding adjacent normal pancreas (NP) tissues were collected.Another 10 samples of chronic pancreatitis (CP) tissues were collected.Western blot analysis and immunohistochemistry assay were performed to detect the expression of protein palladin.The correlation of palladin expression with clinicopathological factors of PDAC was analyzed.Results Western blot analysis revealed that the expression of palladin in PDAC,CP and NP tissues were respectively 0.93±0.07,0.41±0.07 and 0.20±0.06,and the expression of palladin was significantly increased in PDAC tissues compared with NP and CP tissues (P ＜ 0.05),and its expression was significantly increased in CP tissues compared with NP tissues (P ＜ 0.05).Immunohistochemical staining showed that palladin was mainly expressed in activated myofibroblasts in PDAC tissues.The rate of palladin expression was 79 ％ (44/56),which was higher than that in NP tissues (2/10) and CP tissues (4/10),and its expression was found to be correlated with the degree of tumor differentiation,lymph node metastasis and clinical TNM classification (P ＜ 0.05),and it had no correlation with patient' s sex,age,tumor location and distant metastasis (P ＞ 0.05).Conclusions Scaffold protein palladin is highly expressed in PDAC tissues,and it is expressed in the activated myofibroblasts within tumor microenvironment.Scaffold protein palladin may be involved in the invasion and metastasis of PDAC.

Objective To reveal the status quo and emerging issues of co-authorship in regional health informatization research community in China.Methods The terms or keywords describing and covering regional health informatization were used to search the most relevant literatures about the subject in CNKI,Wanfang database and PubMed.Software tools were used to extract bibliographic,Social network analysis (SNA);co-authorship,and co-word analysis were used in this study.Results ①11,482 articles with 16,449 authors in the period of 1984-2013 were found.Each publication has an average of 1.43 authors,and each author has 0.70 publications.The number of coauthored literature was 7741 (67.42 ％).Both production and collaboration have been growing steadily.② Coauthored knowledge network was build which composed by 150 high-yielding Authors.The largest component comprises 43 authors(28％,43/156).The intermediate centrality of 57 authors were above 0.③ 230 2-plexes were found,and 65 2-plexes scale was 4 and over;and there was overlap among them.There were extensive cooperation between the military institutions,a large number of regional health information technology research talent were found in army research institutes..Cohesive subgroups density showed an E-I index=-0.901,which indicated that factionalism was comparatively weaker in this field,and the relationship tended to occur among subgroups.④ Cooperative network was established between the provinces and municipalities.Beijing,Guangdong,Jiangsu,Hubei were the core area.⑤ The average distance between the author=3.155,and it consistent with the small-world characteristics.⑥ The largest component of the network research can be summarized into three categories:HIS-related research,electronic medical records related research,and regional health informatization related research.Conclusions Although such collaboration is growing steadily,the collaboration behavior about regional health informatization study needs to be enhanced.Policy makers and researchers can refer to the relevant information and promote cooperation,improve the capacity of regional health information research and construction.

Objective To compare the clinical efficacy of postoperative analgesia between intercostal nerve freezing and con‐trolled intravenous analgesia in patients of thoracic surgery .Methods 80 patients of thoracic surgery from January 2012 to June 2013 were randomly divided into two groups :Intercostal nerve cryotherapy group (frozen group n=40) and intravenous analgesia group(control group n=40) .Frozen group :the intercostal incision and down each one intercostal and chest tube placement of inter‐costal nerve roots were frozen before sternal closure ;control group :intravenous analgesia pump were used postoperative .According to VAS method to evaluate pain level and observe adverse reactions ,complications and analgesic drug usage of postoperative pa‐tients .Results The analgesic effect of frozen group was better than that of control group within five days after thoracotomy .Com‐pared with the control group ,the incidence of adverse reactions ,postoperative complications ,and analgesic drug usage was signifi‐cantly reduced in frozen group ,there was a significant difference between the two groups (P<0 .05) .Postoperative follow‐up dis‐play :intercostal nerve area in some patients may appear numbness ,dysesthesia ,etc .,but the above situation can return to normal gradually .Conclusion The analgesic effect of intercostal nerve cryotherapy for thoracotomy patients is excellent ,and with few side effects and good safety ,and it is worthy of promotion .