OBJECTIVE To explore the status of nosocomial infection,infection sites of patients and susceptible factors of infection in neuro-intensive care unit(NICU) in order to correspondently prevent and control the occurrence of nosocomial infection.METHODS The clinical data of 471 patients admitted to NICU from Mar 2005 to Feb 2006 were investigated retrospectively.RESULTS Out of 471 cases in one year,a total of 90 cases of nosocomial infection were found.The rate of nosocomial infection was 19.11%.Among the nosocomial infection sites,the respiratory tract was the most frequent one(46.67%).The second was urinary tract(44.17%).The patients aged of more than 60 years,or with urethral catheter,mechanical ventilation,vein intubations,or with long medical intubation suffered infection more susceptibly than other patients.The infection rate of nosocomial infection was significantly different from hospitalization group.Sex was not evidently related to nosocomial infection.CONCLUSIONS The rate of nosocomial infection in NICU is largely higher than the total rate of infection.The susceptible factors are age,long-term hospitalization,invasive operations and long medical intubation.

OBJECTIVE:To study the improving effects of argatroban on the brain damage of model rats with cerebral hemor-rhage. METHODS:50 SD rats were randomly divided into normal control group(equivalent normal saline),model group(equiva-lent normal saline),argatroban high,medium and low dose groups (0.75,1.5,3 mg/kg). All groups,except for normal control group,were reproduced models with cerebral hemorrhage,and the rats in each group were treated by corresponding drugs after 30 min,ip,once a day. The rats were executed after continuous administration for 3 days. The data was detected,including the con-tents of tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),activity of cysteine-containing aspartic protease 3(Caspase-3), expressions of Bcl-2,Bax,matrix metalloproteinase-2(MMP-2)and MMP-9,and the phosphorylations of nuclear factor κB(NF-κB) p65 and IκBα. RESULTS:Compared with the normal control group,the contents of TNF-α and IL-1β,the activity of Cas-pase-3,the expressions of MMP-2,MMP-9 and Bax proteins were increased;the expression of Bcl-2 was decreased;and phos-phorylations of NF- κB p65 and IκBα in model group were increased,with significant differences(P<0.01). Compared with the model group,the contents of TNF-α and IL-1β,the activity of Caspase-3,the expressions of MMP-2,MMP-9 and Bax were de-creased;the expression of Bcl-2 was increased;and phosphorylations of NF-κB p65 and IκBα in argatroban low,medium and high dose groups were decreased,with significant differences (P<0.01 or P<0.05). And it was positively correlated with the dose. CONCLUSIONS:Argatroban has dose-dependent inhibition effects on the inflammatory cytokine secretion and apoptosis of brain tissue of model rats with brain hemorrhage,and the mechanism may be related to NF-κB signaling pathway.

Objective To compare the reproducibility and reliability of facial soft tissue landmarks using a direct and an indirect placement methods in facial three-dimensional (3D) soft tissue assessment.Methods 3D coordinates of 37 soft tissue landmarks were obtained respectively in 35 normal healthy volunteers from 3D optical capture system and Materialise's interactive medical image control system (Mimics).Landmarks were affixed on the cutaneous surface (direct method) and marked on the 3D reconstructed craniofacial model (indirect method).Intra-class correlation coefficients (ICCs) and paired t-tests were used to compare the reliability and reproducibility of facial landmarks between two placement methods.Results For the direct placement method,86.5 ％ landmarks had an ICC higher than 0.75.For the indirect placement method,75.7％ landmarks had an ICC higher than 0.75.The inter-observer variability using the direct placement method was (1.259±0.566) mm,which was significantly smaller (P＜0.05) than (1.420±0.638) mm obtained by the indirect placement method.Conclusions Compared with indirect method,direct method has higher reliability and reproducibility in evaluating facial soft tissue.

AIM: To establish the quality standard of Agui Yangxue Tablets (Radix Angelicae sinensis, Radix Codonopsis, Rhizoma Atractylodis macrocephalae, etc.) METHODS: Radix Astragali, Radix et Rhizoma Glycyrrhizae and Radix Rehmanniae praeparata were identified by TLC. The content of ferulic acid and paeoniflorin was determined by HPLC. The HPLC condition of ferulic acid was as follows: column was Diamonsil~ TM C_ 18 (4.6 mm?200 mm,5 ?m), the mobile phase consisted of acetonitrile -0.085% phosphoric acid (22 ∶ 78), the UV detection wavelength was at 322 nm, the flow rate was 1.0 mL/min with column temperature at 35 ?C . The HPLC condition of paeoniflorin was as follows: column was Diamonsil~ TM C_ 18 (4.6 mm?200 mm,5 ?m), the mobile phase consisted of acetonitrile -0.1% phosphoric acid (15 ∶ 85), the UV detection wavelength was at 229 nm, the flow rate was 1.0 mL/min with column temperature at 25 ?C . RESULTS: The developed TLC spots were quite clear. The calibration curve of ferulic acid was linear with 0.012 9-0.154 8 ?g(r=0.999 7). The average recovery was 99.32% with RSD of 1.74% (n=9). The calibration curve of paeoniflorin was linear with 0.106 8-1.602 0 ?g(r= 0.999 9). The average recovery was 98.68% with RSD of 0.98 (n=9). CONCLUSION: The established TLC and HPLC methods are exclusive, reproducible and suitable for the quality control of Agui Yangxue Tables.

Objective To explore the effect of action research based on group learning in hospice care module for nursing students. Methods 82 students were divided into cooperative learning group (40) and conventional teaching group (42). The cognition and attitude of good death questionnaire was used to evaluate teaching effect before and after teaching of hospice care. After teaching, self-feedback and self-feedback questionnaire were made to evaluate the effect of cooperative learning group. SPSS 17 was used to make comparison of data between groups and within groups, and t test, chi square test or Fisher exact probability 2 were also used . Results There were no difference between two groups of nurses before teaching. The students' cognitive level and attitude in cooperative learning group increased significantly, especially their cognitive level of physiological needs (t=5.398, P=0.001), cognition and attitude of death education in intervention group was higher than control group (t=2.992, P=0.004; t=3.661, P=0.001). Although 95% of the nursing students of the cooperative learning group thought group cooperative studying could improve their interests and cultivated their comprehensive abilities, only 50% could accept this kind of studying methods . Conclusions Action research based on group cooperative studying can improve students' cognitive level and attitude of good death, and it is also good for cultivating their ability of au-tonomous learning, innovation, cooperation, and meanwhile, educational action research is a good way to improve both teaching effect and research ability of teacher staffs, but in practice, students' acceptance of group learning needs to be improved.

Objective To describe an intelligent three-dimensional technique for automatic visualization of the fetal cranial mid-sagittal view to allow for the differential diagnosis of fetal midline anomalies.Methods Two hundred and twenty pregnant women with singleton pregnancies were imaged to display the mid-sagittal view of fetal head using a new 3D program (Smart MSP) developed by our team.Results The mid-sagittal view of the fetal head was successfully visualized in 190 normal cases (95％) and 18 abnormal cases (90％) by Smart MSP program.The total successful rate was 94.5％ (208/220).Conclusions Smart MSP is a novel and feasible method for the automatic visualization of fetal cranial midsagittal plane and may become a potential tool for routinely screening the fetal midline anomalies.

Objective To study the relationship between the medial artery calcification and expression of core-binding factor alpha 1 (Cbf α-1) and collagen Ⅱ (Col Ⅱ) in chronic kidney disease (CKD) stage 5 patients.Methods Pieces of radial arteries were taken from 40 patients with CKD stage 5 during internal arteriovenous fistula operation.Ten patients with subtotal gastrectomy and normal renal function were chosen as control.The vessels were examined for calcification by von Kossa stain and for the presence of Cbfα-1 and Col Ⅱ by immunohistochemistry.According to von Kossa stain,CKD stage 5 patients were divided into no calcification group,mild-moderate calcification group and severe calcification group.Other related factors including serum calcium,phosphate,intact parathyroid hormone (iPTH),C-reactive protein (CRP),triglyceride(TG),cholesterol(TC) and lowdensity lipoproteins(LDL) were also detected.Results Seventeen (42.5％) of CKD Stage 5 patients showed vascular calcification,while calcification was not found in controls.Most calcification occurred in medial layer.Positive immunohistochemical staining of core-binding factor and Col Ⅱ was found in the smooth muscular cell plasma of medial layer in the vessels with calcification.However,above positive staining was also observed in 78.3％ of no calcification group.But there was little staining in control group.Positive staining score of Cbfα-1 and Col Ⅱ in severe calcification group was significantly higher than that in no calcification group.Same findings were obtained in mild-moderate calcification group,but the difference between them was not statistically significant.CRP and Ca × P were positively correlated with staining score of Cbfα-1 and Col Ⅱ.Serum phosphate was positively correlated with Cbfα-1 (r=0.786,P＜0.01) and Col Ⅱ (r=0.785,P＜0.01) respectively.Conclusions 42.5％ of CKD stage 5 patients in our group shows vascular calcification,which occurrs mainly in medial layer.High expression of Cbfα-1 and Col Ⅱ can be observed in vascular calcification of radial arteries,which is earlier than vascular histological changes.Cbfα-1 and Col Ⅱ may be involved in the development of vascular calcification.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Combined Modality Therapy ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Melanosis ; drug therapy ; therapy ; Middle Aged ; Young Adult

Objective To evaluate the effect of dexmedetomidine and small dose of ketamine on the expression of P2X4 receptor (P2X4 R) mRNA and P2X7 receptor (P2X7R) mRNA in the dorsal root ganglion of rats with neuropathic pain.Methods Ninety male Sprague-Dawley rats,aged 6-9 weeks,weighing 180-220 g,were randomly divided into 5 groups (n =18 each):sham group (group S),chronic constrictive injury group (group CCI),dexmedetomidine group (group D),ketamine group (group K) and dexmedetomidine + ketamine group (group DK).The animals were anesthetized with intraperitoneal 10％ chloral hydrate 400 mg/kg.Neuropathic pain was induced by CCI in CCI,D,K and DK groups.The sciatic nerve was exposed and 4 loose ligatures were placed on the sciatic nerve at 1mmintervals with 4-0 silk thread.In group S,the sciatic nerves were only exposed but not ligated.In D,K and DK groups,dexmedetomidine 50μg/kg,ketamine 10 mg/kg and dexmedetomidine 25μg/kg + ketamine 5 mg/kg were injected intraperitoneally,respectively,while the equal volume of normal saline was injected in S and CCI groups,once a day for 14 consecutive days after CCI.Mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured at 1 day before CCI,and 3,7 and 14 days after CCI.Six animals were sacrificed after measurement of pain threshold at 3,7 and 14 days after CCI and the lumbar segments (L4-6) of the dorsal root ganglion were removed for determination of P2X4 R mRNA and P2X7 R mRNA expression by RT-PCR.Results Compared with group S,MWT and TWL were significantly decreased at 3,7 and 14 days after CCI in groups CCI,D,K and DK,the expression of P2X4R mRNA and P2X7R mRNA was up-regulated at 3,7 and 14 days after CCI in groups CCI,D and K,and the expression of P2X4 R mRNA and P2X7 R mRNA was up-regulated at 3 and 7 days after CCI in group DK (P ＜ 0.05).Compared with group CCI,TWL and MWT were significantly increased and the expression of P2X4 R mRNA and P2X7 R mRNA was down-regulated at 3,7 and 14 days after CCI in groups D,K and DK (P ＜ 0.05).Compared with D and K groups,TWL and MWT were significantly increased and the expression of P2X4 R mRNA and P2X7 R mRNA was down-regulated at 3,7 and 14 days after CCI in group DK (P ＜ 0.05).Conclusion The mechanism by which the combination of dexmedetomidine and small dose of ketamine produces a synergistic antinociception in rats with neuropathic pain may be related to down-regulation of the expression of P2X4 R mRNA and P2X7 R mRNA.

Objective To explore the feasibility of the double venipuncture instead of central venous catheter as a temporary vascular access in hemodialysis.Methods The upper arm below the 1/3 was tied a tourniquet,and fistula needle directly punctured the vein in the middle of the elbow.After the success of the puncture,elastic bandage was replaced by a tourniquet,and the ball movement was done by imitating the blood donation member for blood donation at hand gripping a ball or elements as the artery blood lead.Another elbow vein or lower limb saphenous vein was punctured.Thirty patients using double venipuncture dialysis or central venous catheter dialysis 2 weeks or more were randomly selected into each group,and biochemical and renal function was measured before dialysis.Results All of 1 282 patients who were newly into the blood dialysis,mature arteriovenous fistula was in 8 patients (0.6％,8/1 282),deep venipuncture to insert the central venous catheter was in 542 patients(42.3％,542/1 282),using the double venipuncture was in 732 patients (57.1％,732/1 282).The flow of blood was 180-200 ml/min,the avalible time was 1-2 months.The serum creatinine,blood urea nitrogen,calcium,phosphorus and carbon dioxide combining power had no significant difference between two groups (P ＞ 0.05).Conclusions The majority of patients with double venipuncture blood flow can satisfy the need of dialysis.Because the operation is simple,no recycling and may reduce the deep venipuncture,it is an ideal temporary vascular access.