OBJECTIVE To analyze multi-drug resistant Acinetobacter baumannii(ABA) outbreak of nosocomial infection in the respiratory intensive care unit(RICU),to explore effective measures for prevention and control.METHODS In RICU on April 3 to 30 2009,patients under mechanical ventilation in the respiratory tract with MDRABA were conductd epidemiological surveys.RESULTS On 27 consecutive days,six cases occurred in mechanical ventilation in patients with lower respiratory tract MDRABA infection,of which 5 patients were cured;6 cases of lower respiratory tract of patients in sputum specimens isolated the same resistance spectrum MDRABA.CONCLUSIONS Medical personnel lack the consciousness of washing their hands.Indoor environment,air disinfection machine lack of supervision in mechanical ventilation patients with lower respiratory tract MDRABA,were the main reasons of infection outbreak.Strict isolation of patients should be strengthened,full implementation of hand-washing compliance,education,conventional screening,early intervention to prevent outbreak of hospital infection.

To assess the concentration-responses relationships of propofol, 16 adult patient,ASA grade Ⅰ-Ⅱ,scheduled for upper abdominal operation, were randomly allocated to undergoing epidural block (group Ⅰ, n = 8)or combined anesthesia (group Ⅱ, n = 8) respectively. After a bolus injection of propofol 2.5mg ?kg, blood pressure (BP), heart rate (HR) and tidal volume (TV) were recorded, and drowsiness,amnesia,cooperation and orientation were evaluated by scorring scales in both groups. The venous samples were taken before and after the administration to measure the propofol plasma concentration by spectrofluorophotometric detector. The results revealed that there were no significant differences in pharmacokinetic parameters between two groups;the plasma concentration of propofol at 2. 5rag. L~(-1) was required for adequate anesthesia,and 1.5 to 1.9rag. L~(-1) for hypnosis,the patients were fully awake at 0.94?0.3mg. L~(-1); BP,HR and TV were significantly depressed at more than 2.0rag. L~(-1), and recovered to baseline at less than 1.5mg. L~(-1). It is suggested that there are good relationships between propofol plasma concentrations and its pharmacodynamic responses.

Objective: To evaluate the clinical application of MBT straight wire. Methods: 41 cases, 11 males and 30 famales aged 12-42 years old, with malocclusion were treated by MBT straight wire appliance in orthodontic clinics, follow-up was carried out. Results: Satisfactory effects were obtained in 11 completely treated cases, preliminary improvement of occlusion was observed in the other 30 cases being still in the treatment. Conclusion: MBT straight wire appliances may be used in the treatment of various malocclusion, but special consideration should be taken according to the type of occlusion in each case.

Objective To analysis the related influencing factors and explore the approach of improving the effect of platelet transfusion through compared the posttransfusion effect of matched-type with random platelet transfusion.Methods Analysis the results of platelet antibody screening test and matched-type test in our hospital′s inpatients during July 2013 to June 2014,who applied for platelet transfusion.The influence of sex,blood transfusion history,pregnant history on the antibody were analyzed.The factors of sex,times of blood transfusion,pregnant times,platelet component sorts,storage time,combined with other components,platelet antibody (positive or negative) and transfusion matched-type platelet on the effect of platelet transfusion were analyzed.Application in our clinical blood transfusion intelligent management and evaluation system to evaluate the effect of platelet transfusion.Results Totally 812 patients′ platelet antibody were screened.Then we randomly selected 87 antibody positive inpatients were selected and 1 247 U plateletswere transfused,which including matched-type platelet transfusion for antibody screening positive patients,random platelet transfusion for antibody screening positive patients,random platelet transfusion for antibody screening negative patients,there were statistical difference (P<0.05).With Logistics regresion analysis,the history of blood transfusion was an independent risk factor for platelet antibody production (P<0.05,OR=13.104,95%CI:7.784-22.061).Sex (P<0.05,OR=1.629,95%CI:1.236-2.148),transfusion times,different platelet component sorts (leukocyte-reduced platelets aphaeresis and irradiation leukocyte-reduced platelets aphaeresis),different storage time,transfusion combined with other components (RBC)(P<0.05,OR=2.464,95%CI:1.053-5.765),transfusion matched-type platelet(P<0.05,OR=0.576,95%CI:0.389-0.854) were the risk factors for platelet transfusion.Conclusion Matched-type test should be done to improve efficiency when the platelet antibody screening were positive.Sex,times of blood transfusion,platelet component sorts,storage time,combine with other components,transfusion matched-type platelet couldinfluence the effect of platelet transfusion.

Objective To evaluate the effect of age factor on the analgesic efficacy of morphine during recovery from remifentanil-based anesthesia in pediatric patients undergoing minor surgery.Methods Fifty pediatric patients of both sexes,aged 3-10 yr,with body mass index ≤ 30 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective tonsillectomy,were divided into preschool group (3-5 yr,n=30) and school-age group (6-10 yr,n =20) according to age.Anesthesia was induced by inhaling 8％ sevoflurane and Ⅳ morphine 0.1 mg/kg.Pediatric patients were mechanically ventilated after tracheal intubation,and end-tidal pressure of carbon dioxide was maintained between 35-45 mmHg.Anesthesia was maintained by inhalation of 2％-3％ sevoflurane and Ⅳ infusion of remifentanil 0.2 μg · kg-1 · man-1.Pain was evaluated using Faces Pain Scale (FPS) and Face Legs Activity Cry Consolability (FLACC) scale during the recovery period in the postanesthesia care unit.When FPS or FLACC scores ≥ 4.morphine 0.05 mg/kg was intravenously injected.When pain was still unrelieved after morphine was given for 2 times (time interval 5 min),fentanyl 1 μg/kg was intravenously injected until FPS and FLACC scores ＜4.The requirement for analgesics and consumption of analgesics (fentanyl consunption was converted into morphine consumption) were recorded.The development of nausea and vomiting,pruritus and respiratory depression was also recorded.Results Compared with preschool group,the requirement for analgesics and consunption of analgesics were significantly decreased during recovery from anesthesia (P＜0.05),and no significant change was found in the incidence of nausea and vomiting in school-age group (P＞0.05).No pruritus or respiratory depression was found in two groups.Conclusion The analgesic efficacy of morphine is affected by age factors during recovery from remifentanil-based anesthesia in pediatric patients undergoing minor surgery,and morphine produces better analgesic efficacy in school-age pediatric patients than in preschool pediatric patients.

Liver fibrosis is the response of the body to wound repair, and it is the only way for various chronic liver diseases to develop into liver cirrhosis. At present, there is still no chemical or biological drugs for blocking or reversing liver fibrosis. Liver fibrosis has a complex pathogenesis, which involves the TGF-β/Smad, Notch, Wnt, and Hedgehog signaling pathways. However, how to use simple methods to solve this complex issue remains a key scientific problem in the treatment field. As a critical determinant for cell fate, Numb is involved in the regulation of various signaling pathways such as Notch, Wnt, and Hedgehog, but its role in anti-fibrosis has not been taken seriously. This article reviews the potential value of Numb in anti-fibrosis.

Fifty-four simulated tooth roots made of polymethacrylate (PMMA) were divided into six groups according to the root canal convergence angles of 0 degrees, 3.93 degrees, 5.71 degrees, 7.48 degrees, 11.31 degrees, 14.71 degrees. Cast post and cores were manufactured and cemented with Zinc phosphate cement (ZP). The retention capacities of the posts were tested. The bonding strength of ZP at different convergence angles were tested with some casted wafers, and linear regression was made. So the effect of interlocking and the proportion could be calculated. With these results, we made some curvilinear regressions. The results showed that the retention of cast post declined and the bonding strength of ZP fell with the increase of convergence angles. There were significant differences in the bonding strength and retention among groups, P<0.05. The experiment indicates that the dentists should reduce the convergence angles of posts as much as possible to obtain greater retention.
Cementation ; Crowns ; Dental Prosthesis Retention ; Dental Stress Analysis ; Post and Core Technique ; Tensile Strength

Objective　To study the clinicopathologic features of hepatic angiomyolipoma (AML) and to investigate the feasibility of a new antibody-A103 as a diagnostic aid for AML. Methods　Ten cases of AML were retrieved from hospital records and analyzed morphologically. Immunohistochemistry was performed on paraffin-embedded tissues with a panel of antibodies, including antibody-A103. Results　There were eight women and two men, with ages ranging from 38-58 years (median 45.7). Clinically, nine cases were asymptomatic and found by imaging techniques. None of the patients had associated tuberous sclerosis. All tumors were sharply demarcated from the surrounding liver parenchyma. Histologically they were composed of a heterogeneous mixture of three components: thick-walled blood vessels, spindle or epithelioid smooth muscle cells and adipose tissue. All tumors showed a strong immunoreactivity to A103, HMB-45 and smooth muscle actins. Follow-up information on all 10 cases showed a benign course with no signs of recurrence. Conclusions　Hepatic AML is a rare mesenchymal tumor of the liver. A103 is a promising marker for a pathologic diagnosis of hepatic AML.

Objective: To investigate HPV vaccine hesitation and associated factors among female college students in Weifang, and to provide a suggestions for improving the coverage rate of HPV vaccine among female college students. Methods: The questionnaire of HPV vaccine hesitancy of female college students was designed. By adopting the stratified sampling method, the survey was conducted among female students at one medical university and three nonmedical universities in Weifang. Chi-square test and Logistic regression were used to analyze the influencing factors of vaccine hesitation. Results: Female college students who had high risk perception toward vaccine (OR=4.15, 95%CI=1.55-11.10) and those who were angry about the sideeffects of the vaccine (OR=3.63, 95%CI=1.95-6.75) were hesitate to vaccinate against HPV. Female college students who believed long protection period of HPV vaccine (OR=0.08, 95%CI=0.04-0.17), that women had a high probability of cervical cancer (OR=0.44, 95%CI=0.21-0.90) and that the knowledge of HPV vaccine scored >6 (OR=0.31, 95%CI=0.15-0.67) were more likely to receive HPV vaccine. Conclusion High risk perception of vaccines and anger at vaccine adverse reactions are important factors affecting HPV vaccines for female college students. Our findings call for strategic role of the state, school-based health education as well as medical professional guidance in lowering HPV vaccination hesitation among fenale college sutdents.

Objective: To explore the clinical efficacy of thymalfasin on the immune function and inflammatory response in the treatment of patients with severe pneumonia. Methods: From June 2015 to June 2018, 86 patients with severe pneumonia in the Hospital of Zhejiang Provincial General Team of Armed Police were enrolled in the study.According to different treatment methods, they were divided into control group and treatment group, with 43 cases in each group.The control group was treated with cefoperazone/sulbactam sodium on the basis of conventional treatment.The treatment group was treated with thymalfasin on the basis of the treatment of the control group.The expression of monocyte human leukocyte antigen-DR (mHLA-DR), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) levels were measured before and after treatment.At the same time, CD₄⁺, CD₈⁺, CD₄⁺/CD₈⁺ before and after treatment were examined in the two groups.The efficacy and bacterial clearance rate of the two groups were evaluated.The adverse reactions were recorded. Results: After treatment, the levels of IL-6 and TNF-α in the two groups were significantly lower than those before treatment [treatment group: (44.9±11.8)ng/L, (42.9±13.1)ng/L vs. (86.5±27.9)ng/L, (79.6±28.6)ng/L, control group: (71.5±14.2)ng/L, (65.9±22.6)ng/L vs. (87.1±28.6)ng/L, (78.8±29.1)ng/L, t=9.005, 7.650, 3.203, 2.295, all P<0.05]. The expression level of mHLA-DR in the treatment group after treatment [(44.8±5.7)%] was significantly higher than that before treatment [(27.1±3.4)%, t=17.487, P=0.000]. The changes of the indicators in the treatment group were significantly better than those in the control group (t=9.447, 5.773, 8.725, all P<0.05). After treatment, the CD₄⁺ level of the two groups were higher than those before treatment, and the CD₈⁺ levels of the two groups were significantly lower than those before treatment, the differences were statistically significant(t=3.050, 3.429, 6.965, 13.327, all P<0.05), and the CD₄⁺/CD₈⁺ of the two groups were significantly increased (t=0.370, 3.314, all P<0.05). The indicators of the treatment group were improved more significantly than the control group (t=4.416, 12.355, 3.089, all P<0.05). The bacterial clearance rate of the treatment group was 88.89% (32/36), which was significantly higher than that of the control group [67.65% (23/34), χ²=4.686, P=0.030]. The clinical efficacy of the treatment group was 93.02%(40/43), which was significantly higher than 76.74%(33/43) of the control group (χ²=6.095, P=0.047). The incidence of adverse reactions between the two groups had no statistically significant difference (χ²=0.212, P=0.645). Conclusion Thymalfasin in the treatment of patients with severe pneumonia can improve the immune function, reduce the inflammatory response, improve the bacterial clearance rate and clinical efficacy, and will not increase the adverse reactions, so it is worthy of promoting.