Objective To summarize the nursing experience on nosocomial infection in elderly patients with intra-aortic balloon pump (IABP) after coronary artery bypass grafting. Methods The clinical data of elderly patients who underwent coronary artery bypass grafting with application of IABP from April 2006 to February 2009 were retrospectively collected and analyzed. Results 29 patients suffered nosocomial infection in all 111 cases. The hospital mortality was much higher among patients with nosocomial infection than in patients without nosocomial infection (19 cases vs 11 cases). 87 positive strains were separated from 29 patients with nosocomial infection, which included 47 strains of gram-negative bacterial, 23 strains of gram-positive bacterial and 17 strains of fungi. Conclusions The nosocomial infection was one of the risk factors for hospital mortality in elderly patients with intra-aortic balloon pump after coronary artery bypass grafting. It is important to take effective nursing strategies to prevent the postoperative nosocomial infection in this population.

Objective:To observe neurotransmitter changes of post cerebral infarction depression (PCID) before and after being treated with amitriptyline or acupuncture of Baihui,in order to explore a good way with a less toxicity and good effect of treatment on PCID.Methods:The 60 patients were divided into treatment group and control group.Besides the basic treatment,the treatment group was given acupuncture of Baihui (DV20) and point injection therapy,the control group was given amitriptyline. Both before and after treatment,compared the two groups with HAMD score,neurologic impairment score,plasma 5-HT and NE,and observed the adverse events and side effects.Results:The results of two groups in monoamine neurotransmitter 5-HT(5-HT),norepinephrine (NE) and the HAMD scale were significantly improved.Conclusion:Acupunture of Baihui and point injection of Herba Erigerontis had equal effect to the amitriptyline on PCID.Furthermore,it had fewer venenosus side effects.It provided a new way for the use of the traditional Chinese medicine in treating PICD.

Objective To study the significance of plasma brain natriuretic peptide(BNP)in differentiating patients with chronic cor pulmonale from those with hypertensive heart failure.Methods Thirty cases of cor pulmonale and 30 of hypertensive heart disease were recruited for the study.Heart rate and arterial partial oxygen pressure(PaO2)were measured for them,as well as plasma level of BNP Was measured by rapid immunofluorescence quantitative analysis.with 30 normal healthy persons as controls.ResultsAs compared with the control group.plasma level of BNP increased significantly in patients with chronic cor pulmonale and hypertensive heart failure(P＜0.05),and that in those with hypertensive heart failure[(597±68)ng/L]Was significantly higher than that in those with cot pulmonale[(179±34)ng/L,P＜0.05].Conclusion Plasma level of BNP can be used as an indicator to differentiate cor pulmonale from hypertensive heart failure both with dyspnea.

Objective To upgrade No.1 Military Medical Project from single operation to Oracle RAC to eliminate single failure of the operation system, protect medical data and lay a foundation for the following upgrade and deployment.Methods RAC software and hardware environment was constructed for database upgrade and deployment of Data Guard.Results The database was gifted with high availability and high performances, and database maintenance and upgrade could be carried out with the operation system less ceased than before.Conclusion The database is upgraded from a single-mode rigid architecture to a multi-mode elastic one, with the performances, safety and extendibility enhanced greatly.

Objective To investigate the effect on bioeffects such as sonoporation and cell killing that induced by domestic ultrasound contrast agent(perfluoropropane-albumin microsphere)and diagnostic ultrasound by microbubble concentration.Methods Suspensions of hepatocyte with microbubbules in different concentrations were exposed to diagnostic ultrasound.The study included blank contrast group(no microbubble,no ultrasound),exposed group(no microbubble,exposed to ultrasound)and 6 microbubble groups in different concentration(with different microbubbule/cell ratios for 1,5,10,50,100 and 200,exposed to ultrasound for 10min).The uptake of fluorescein isothiocyanatedextran(FD500)by hepatocyte was observed and the percentages of sonoporation cells were counted,the cell viability was determined by trypan blue stain immediately after exposure,and apoptosis of ceils were detected by flow cytometry,with double staining of fluorescein isothiocyanate(FITC)-labeled Annexin V/propidium iodide(PI).Results Fluorescence stain results:compared with blank contrast group or exposed group,the sonoporatin of groups with microbubble/cell ratio of 5 to 200 increased significantly(P＜0.05).Cell killing effects:compared with the blank contrast group,only the cell death percentages of microbubble groups with microbubble/cell ratio of 50,100 and 200 increased significantly(P＜0.05).Compared with the exposed group,only that of groups with microbubble/cell ratio of 100 and 200 increased significantly(P＜0.05).There was no significant different between blank contrast group and exposed group for all these results.Conclusions Sonoporation and cell killing effect can be induced by diagnostic ultrasound in HL-7702 with domestic ultrasound contrast agent(perfluoropropane-albumin microsphere).For diagnosis,the ratio of microbubbule/cell should better be under 10.While for gene transfection,the ratio should better be 50 and could be 100 if it is necessary.

Objective To investigate the feasibility of using low Kv,low iodine contrast Agent concentration (dual low)CT scan techniques in Coronary CTA (CCTA).Methods Seventy-six patients undergoing CCTA were divided into Group A and Group B , randomly.Group A (38 patients)was the dual-low group,which was scanned with tube voltage of 100 kVp,and injected with iso-osmolarity contrast agent visipaque 270 (270 mg I/mL),with iterative reconstruction technique (ASIR 40%).Group B (38 pa-tients)was scanned with 120 kVp,and low osmolarity contrast agent omnipaque 350 (350 mg I/mL)and FBP reconstruction,The images are assessed double-blindly by two experienced radiologists.Five ROIs were placed onto the ascending root of aorta (AO), left main artery(LM),left anterior descending (LAD),left circumflex artery(LCX),right coronary artery (RCA),and the image qualities are evaluated objectively using CT values,noise,signal noise ratio (SNR),contrast noise ratio (CNR),and compared sta-tistically using Paired t-test.The radiation dosages,such as CTDIvol,DLP and ED were also recorded and compared with Paired t-test.Results CTDIvol,DLP and ED of Group A (dual low)decreased 35.7%,38.6% and 38.6% respectively compared with Group B,the iodine intake decreased 22.9%.While the image qualities of the two groups were not significantly different,all images are good enough for diagnosis,with Group A slightly better than Group B in radiologists’scores.Conclusion Voltage 100 kVp, combined with low contrast agent concentration of 270 mg I/mL can fully satisfy the diagnostics need in CCTA,and significantly lower both the radiation dosage and iodine intake.

Objective To study the CBCT image registration of PTV enlarging distance and IMRT planning(CT-1) for patients with lung cancer,and evaluate their characters.Methods Ten patients with lung cancer were included in the study.Two sets image,before and after radiotherapy,were acquired every week.Then delineated the targeted volume and made the planning (CT-2) according the enlarging distance data.To comparize the parameters of DVH for lung and spinal cord,volumes and dose of PTV and NTCP with CT-1 and CT-2.The difference of two plan was analyzed by covariance analysis or Wilcoxson's z-test.Results The max,min and mean dose of PTV,the lung V5,V10,V20,V30,V50 were similar in both plans (P =0.242-0.663).There was superiority in CT-2 of PTV and lung's mean dose(P =0.049,0,035).The NTCP had the decent tendency followed by the increasing of lung Vs,V10,V20(P =0.146,0.053,0.000).Conclusions CBCT based image registration can reduce PTV,the mean dose of lung,NTCP,and increase PTV dose.This provides a tool for exploring acurate radiotherapy strategies.

BACKGROUND: Traditional glass ion sealant has a poor abradability and a low rupture strength. The sealant on the occlusal surfaces easily fell off, and is difficult to replace resin sealant. OBJECTIVE: To observe the effects of traditional resin sealant and atraumatic restorative treatment (ART) glass ionomer-based pit and fissure sealant for the young children. METHODS: Randomized comparison method was used to compare ART glass ionomer-based pit on molars of one side with resin sealant on the opposite side in 89 3-year-old children. RESULTS AND CONCLUSION: The retention rates of ART glass ionomer sealant after 6 and 18 months were significantly lower than those of resin sealant (P < 0.05). The caducous position of ART gliass ionomer sealant was the second deciduous molar of the lower mandible, but the caducous position of resin sealant was the second deciduous molar of the upper mandible. The secondary caries rate of ART glass ionomer sealant was significantly lower than that of resin sealant at 6 months. No significant difference was determined between groups at 18 months. These suggest that ART glass ionomer pit and fissure sealant has lower drop-out rate, simple operation and low cost with excellent caries-preventing effect. Since it is economically superior to resin sealant, the method is worth popularizing in caries-preventing projects.

BACKGROUND: It has been reported that glass ionomer sealants have a poor wear resistance and low rupture strength that are easy to fall off on the occlusal surfaces. OBJECTIVE: To observe the effects of high-strength glass ionomer via the atraumatic restorative treatment (ART) on the pit and fissure of deciduous teeth in the young children. METHODS: A self-controlled method was used to compare ART glass ionomer-based pit and fissure seal on unilateral molars with resin sealant on the contralateral side in 89 children aged 3 years. RESULTS AND CONCLUSION: The retention rates of ART glass ionomer sealant after 6 and 18 months were 94.15% and 77.72%, respectively. At 6 months after treatment, ART gliass ionomer sealant was more caducous in mandibular second deciduous molars > mandibular first deciduous molars > maxillary second deciduous molars > maxillary first deciduous molars; at 18 months after treatment, the rank was mandibular second deciduous molars > maxillary second deciduous molars > mandibular first deciduous molars > maxillary first deciduous molars. The second deciduous molar of the lower mandible, but the caducous position of resin sealant was the second deciduous molar of the upper mandible. The caries prevalence rate of the deciduous teeth treated with ART glass ionomer sealant was significantly lower than that without sealant at 6 and 18 months (P < 0.01). These findings indicate that ART glass ionomer pit and fissure sealant is of a lower drop-out rate, easy to operate and of low cost with excellent caries-preventing effect.

The study aims to establish a method for simultaneous determination of repaglinide and pravastatin sodium in rat plasma by LC-MS/MS and to study its pharmacokinetic interactions. Eighteen male SD rats were divided into repaglinide group, pravastatin sodium group and co-administration group. Blood samples were collected at different times after oral administration. Repaglinide and pravastatin sodium in rat plasma were separated by Agilent HC-C18 with the mobile phase consisting of methanol-0.1% formic acid (80 : 20). Detection and quantification were performed by using ESI-MS. The detector was operated in selected Reaction-monitoring mode at m/z 453.3-->230.1 for repaglinide, m/z 447.2-->327.4 for pravastatin sodium and m/z 285.1-->192.9 for diazepam as the internal standard. The calibration curve obtained was linear (R2>0.99) over the concentration range of 9.77-10,000 ng.mL-1 for repaglinide and 4.88-625 ng.mL-1 for pravastatin sodium. Compared with the single administration group, Cmax and AUC0-6h of repaglinide increased significantly (P<0.05) and tmax of pravastatin sodium prolonged (P<0.05) in co-administration group. The method is found to be simple, sensitive and accurate for determining the concentration of repaglinide and pravastatin sodium in rat plasma. There exists pharmacokinetic interactions in the co-administration of repaglinide and pravastatin sodium.