Objective To study role of color Doppler ultrasonography in predicting the benignity and malignancy of the peripheral hypoechoic lesion of the prostate.Methods Seventy-seven patients who had peripheral hypoechoic lesions were detected with transrectal color Doppler ultrasonography.The black and white color ratio (BCR) in peripheral hypoechoic was calculated by color histogram and compared with prostate BCR.The amount of flow signal was considered increasing if BCR in the lesions was higher than 5% in their prostate.Results Transrectal ultrasound-guilded biopsy of the hypoechoic lesions revealed prostate cancer in 51 patients and benign prostate hypertrophy in 26 patients.The increase of flow signal was in 50 patients,41 of them were prostate cancer.For an increased flow signal within a peripheral hypoechoic lesion as a signal of prostate cancer,color Doppler ultrasonography has a sensitivity of 80.4% ,a specificity of 65.4% ,and a positive predictive value of 82.0% .Conclusions Color Doppler ultrasonography through rectum on blood flow in peri-prostate hypoechoic nodules with BCR account for their rich degree in malignancy and benignity differentiation.

OBJECTIVE To investigate the affinity of 20 Klebsiella pneumoniae(KPN)strains.METHODS Twenty nine genes were detected from 20 KPN strains.They were sixteen kinds of beta-lactamase genes,six kinds of aminoglycosides modification enzyme genes,chlorhexidine-sulphanilamide drug resistance genes,TMP drug resistance genes;three kinds of integrase genes and Tn21/Tn501 transposon genetic mark were detected.And they were used as molecule marker for the sample clustering analysis and assay of the detected results.RESULTS The beta-lactamase genes,aminoglycosides modification enzyme genes,chlorhexidine-sulphanilamide drug resistance gene,TMP drug resistance gene,integrase genes and Tn21/Tn501 transposon genetic mark were all detectable.Clone transmission was shown through the sample clustering analysis.CONCLUSIONS The resistance to the beta-lactam and aminoglycoside antibiotics of the 20 KPN strains is intimately correlated to the generation of beta-lactamases and amino glycosides modification enzymes,which could be clone transmitted.

BACKGROUND: Most studies believed that lesion sites are decisive to the attack and types of aphasia, which is also in disputation.OBJECTIVE: To classify and evaluate aphasia with CT and MRI examinations, so as to reveal the association between aphasia types and lesion sites.DESIGN: A cross-sectional study.SETTING: Department of Neurology, Beijing Tiantan Hospital affiliated to Capital University of Medical Sciences.PARTICIPANTS: The lesion sites were selected from 1 198 patients with cerebral infarction, who were hospitalized in the stroke unit of the Department of Neurology, Beijing Tiantan Hospital affiliated to Capital University of Medical Sciences between February 2002 and February 2005, the diagnosis accorded with the diagnostic standard of cerebral infarctionset by National Meeting for Cerebrovascular Disease, and the patients with cerebral infarction were caused by lesions of left cerebral hemisphere ry school and above, the intellect was normal before attack, and there was score of Western battery aphasia was ＞ 93.8. Totally 221 males and 104 females were enrolled, and the average age was (68.72±4.56) years.and received MRI examination within 1 week after admission. The data collection and treatment were finished with the Siemens Trio 2003T magaphasia of the patients was classified and evaluated with the Western battery aphasia by professional language therapist within 2 weeks after adtic aphasia examination severity grading standard by the same language therapist on the same day of Western battery aphasia. There were 6 grades, grade 0 was taken as meaningless language or auditory understanding ability, and grade 5 as extremely few differentiable language disorders, the patients could feel some difficulties subjectively, but the hearer was uncertain to obviously detect.MAIN OUTCOME MEASURES: Association between aphasia types and lesion sites; Grading of aphasia severity. Aphasia not caused by the involvement of language centers: Of the 1 198 patients with cerebral infarction, the Broca area in 5 cases and Wernicke area in 4 cases were involved, and did not cause aphasia syndrome in the Western battery aphasia showed that 83 cases had Broca aphasia, 48 cases Wernicke aphasia, 58 cases complete aphasia, 12 cases conduction aphasia, 36 cases transcortical motor aphasia, 17 cases transcortical sensory aphasia, 19 cases transcortical mixed aphasia and 52 cases nominal aphasia. The lesions located at typical language center in 240 cases and at nonaphasia examination severity grading standard: It was grade 0 in 84 cases, grade 1 in 79 cases, grade 2 in 77 cases, grade 3 in 63 cases and grade 4 in 22 cases, and the typical language centers were involved in most of the patients of grade 0 and grade 1.CONCLUSION: The association between types and lesion sites of most aphasia are in accordance with the typical aphasia mode, but it was not completely accordant in a few aphasias, the lesion of non-language centers can also cause aphasia, and the aphasia is greatly severe in the patients with the lesion site of language centers.

Objective To compare contrast-enhanced ultrasonography (CEUS) features of clear cell renal cell carcinoma (CCRCC) and angiomyolipoma (AML), and to explore the value of CEUS for differential diagnosis. Methods CEUS appearance of 106 CCRCCs and 25 AMLs confirmed pathologically were analyzed retrospectively. For each lesion, the enhancement degree, the homogeneity of enhancement, the presence of perilesional enhancement, the washing-in and washing-out pattern and the process of enhancement (i.e. diffuse, centrifugal or centripetal enhancement) were evaluated. The results were compared with the pathologic findings. Results There was no statistically significance in the degree of enhancement and the washing-in and washing-out pattern between CCRCC and AML (P>0.05). However, significantly different was found in the homogeneity of enhancement, the presence of perilesional enhancement and the process of enhancement between CCRCC and AML (P<0.01). Heterogeneous enhancement, perilesional enhancement and diffuse enhancement were mainly seen in CCRCC, and the positive predictive value for CCRCC was 97.26%, 100% and 94.74%, respectively. When all the three CEUS findings combined were used as criterion for differentiating CCRCC from AML, the positive and negative predictive values was 100% and 95.00%, respectively. Conclusion CEUS characteristics of CCRCC is different from that of AML. CEUS is useful for the differential diagnosis of CCRCC and AML.

Objective To investigate the feasibility of contrast-enhanced ultrasonography (CEUS) combined with Bosniak classification in diagnosis of cystic renal cell carcinoma (CRCC). Methods Routine and contrast-enhanced ultrasonic manifestations of 24 patients (24 lesions) of CRCC confirmed with operation and pathology were retrospectively analyzed. The number of septa, thickness of wall and septa, with or without solid nodules and blood supply were evaluated. Each tumor was categorized on CEUS images using the Bosniak classification system, and the diagnostic coincidence rate was calculated. Results On routine ultrasonographic images, there were 2 lesions without septa, 8 with a few septa and 14 with multiple septa, 5 lesions with septa and (or) wall thickness ≤1 mm and 19 lesions thickness ＞1 mm; solid nodules were shown in 7 lesions and the color flow was shown in 11 lesions. On CEUS images, there were 8 lesions with a few septa and 16 with multiple septa, 1 lesion with septa and (or) wall thickness ≤1 mm and 23 lesions thickness ＞1 mm; solid nodules were shown in 9 lesions, and the enhancement could be demonstrated in all the lesions. According to Bosniak classification system, CEUS demonstrated 15 grade Ⅲ and 9 grade Ⅳ lesions. The diagnostic coincidence rate of CEUS combined with Bosniak classification was 100%. Conclusion The blood supply and sophisticated internal structures of CRCC can be shown better with CEUS than routine ultrasonography. CEUS combined with Bosniak classification can be used for the diagnosis of CRCC.

Objective To analyze risk factors and antimicrobial use for hospital-acquired pneumonia (HAP)due to multidrug-resistant organisms (MDROs)in an intensive care unit(ICU),so as to perform risk assessment and guide antimicrobial use.Methods From January 2012 to December 2013,HAP patients were conducted retrospective co-hort study,risk factors for MDRO-HAP and rationality of antimicrobial use were analyzed.Results A total of 110 cases of HAP occurred in ICU,63 cases (57.27%)were MDR-HAP.Logistic regression analysis revealed that re-cent hospital stay ≥5 days (OR=19.94),transference from other hospitals (OR =19.33),infection type of late-onset HAP (OR=7.98),and antimicrobial use in recent 90 days (OR =3.42)were independent risk factors for MDR-HAP.Initial empirical anti-infective treatment revealed that there were no significant difference in timing of antimicrobial administration within 24 hours after clinical diagnosis was confirmed,and rationality of antimicrobial selection between MDR-HAP group and non-MDR-HAP group (both P >0.05);The isolation rate of pathogens in MDR-HAP group was lower than non-MDR-HAP group (73.02% vs 91 .49% P <0.05 ).Targeted antimicrobial therapy revealed that there were no significant difference in selection,dosage,and frequency of antimicrobial use be-tween two groups(all P >0.05 );the rationality rate of therapy course in MDR-HAP group was higher than no-MDR-HAP group,but rationality rate of combination use of antimicrobial agents was slightly lower than the latter (both P < 0.05 ).Conclusion Patients in ICU should be conducted risk factor assessment,and according prevention and control measures should be formulated,so as to reduce the occurrence of MDR-HAP,health care workers should standardized the initial empirical anti-infective treatment.

Objective To evaluate the effect of plan-do-check-act (PDCA)cycle method in improving disinfection efficacy of object surface in intensive care unit (ICU).Methods On the basis of management of healthcare-associat-ed infection (HAI)and prevention of multidrug-resistant organisms,disinfection efficacy of object surface in an ICU was intervened,data about surface object specimens taken before,during,and after intervention,HAI in patients, as well as detection of MDROs were collected.Results The total qualified rate of specimens taken before,during, and after intervention was 58.24%,76.74%,and 88.71 %,respectively,there was an increased tendency,the difference was significant (χ2 =17.41 ,P =0.009);the incidence of HAI was 3.72%,2.42%,and 1 .78%,respec-tively,there was a decreased tendency(χ2 =6.03,P =0.039),case infection rate was 4.36%,2.75%,and 2.37%respectively,there was a decreased tendency (χ2 = 7.24,P = 0.046 );detection rate of MDROs was 34.03%, 27.45%,and 14.05%,respectively,there was a decreased tendency (χ2 =33.84,P =0.007),the percentage of pa-tients who were detected MDROs and HAI caused by MDROs showed a decreased tendency(χ2 =6.14,6.02,both P<0.05).Conclusion The implementation of PDCA cycle can effectively improve disinfectant efficacy of ICU object surface,and reduce the incidence of MDRO HAI.

Abstract: This study is to elucidate the metabolic pathway of 1,2-[bis (1,2-benzisoselenazolone-3 (2H)-ketone)]-ethane (BBSKE) in rats. Rats were administrated with a single dose of BBSKE 200 mg x kg(-1). The metabolites in rat urine, feces, bile and plasma were identified by LC-MSn analysis. The characterization of fragment ions from LC-MSn chromatography and mass spectrometry was applied to the investigation of structures of metabolites. Three phase I metabolites were detected in rat urine and feces. Two of them were also found in plasma and one existed in bile. These products were derived from oxidized, methylated and S-methylated BBSKE, separately. One phase II glucuronide of BBSKE was also found in bile. Therefore, it is possible that BBSKE was metabolized by oxidization, methylation and glucuronidation.

Objective:To investigate of AIDET communication model in caring for type 2 diabetes mellitus of hospitalized patients.Methods:A total of 113 patients with type 2 diabetes mellitus treated in our department from January 2018 to November 2019 were enrolled, and divided into the control group(receiving a conventional communication mode)and the observation group(receiving an AIDET communication mode)according to a time order in the selecting of the research patients.The changes of self-care behavior and glucose metabolism index were evaluated and analyzed between the two groups.Results:On admission, the fasting blood glucose, 2-h postprandial blood glucose and glycosylated hemoglobin were(9.1±1.7)mmol/L, (13.8±2.9)mmol/L and(8.4±3.5)% in the observation group, and(9.4±2.1)mmol/L, (14.1±3.2)mmol/L and(8.1±2.9)% in the control group, respectively, with no statistically significances( P>0.05). At discharge, the observation group versus the control group showed a statistically significantly improved levels in FPG of(5.9±1.5)mmol/L vs.(7.8±1.9)mmol/L, in 2h-PBG of(10.1±3.7)mmol/L vs.(12.8±3.9)mmol/L and in glycosylated hemoglobin of(6.3±1.2)% vs.(7.5±0.9)%, respectively( P<0.05). The scores of management of poor blood glucose, foot care, blood glucose monitoring, medication compliance, regular exercise and diet control were higher in the observation group than in the control group at discharge( P<0.05). Conclusions:The application of AIDET communication mode can effectively enhance the self-care behavior of patients and help improve the glucose metabolism in hospitalized patients with type 2 diabetes mellitus.It has very positive effects on controlling the development of type 2 diabetes mellitus and improving the quality of life.

Funds management,which has a direct effect on the development of scientific research projects,is an important part of the scientific research management in hospitals.By investigating the present situation of the scientific research funds management in a local hospital in Shanghai,this paper analyzes the problems commonly found in the scientific research funds management.Based on the findings of the analysis,this paper proposes some corresponding recommendations and countermeasures to improve the management.