Objective To investigate the distribution and drug resistance of pathogens of ventilator-associated pneumonia(VAP) in general intensive care unit(ICU).Methods Statistical methods were used to analyze retrospectively the data of pathogens and drug resistance of VAP in general ICU from 2004 to 2006.Results Totally 347 pathogens were isolated from deep-part secretion of lower respiratory tracts of 302 VAP in general ICU.The main pathogens included Pseudomonas aeruginosa(32.3%),Acinetobacter baumanii(31.1%),Staphylococcus aurous(16.7%),Klebsiella(7.5%) and Coagulase-negative Staphylococci(6.1%).Gram-negative bacillus showed a high resistance to piperacillin and Cefotaxime but high susceptibility to carbapenems and the enzyme inhibitor antibiotics.Gram-positive coccobacteria showed a high resistance to Penicillin,Clindamycin and Erythromycin but high susceptibility to Vancomycin and Quinolone.Conclusion Gram-negative bacillus was the main pathogen of VAP in general ICU,multidrug resistance was serious.The rate of methicillin-resistant staphylococcus aurous(MRSA) and methicillin-resistant coagulase-negative staphylococci(MRCNS) was high,with serious drug resistance.According to the data of the bacteria pathogen and antibiotics susceptibity,we can select antibiotics reasonably to control the infection and delay the emergency of new drug-resistant bacteria.

Objective To investigate and discuss the limb salvage strategies of malignant bone tumors in region S2 of shoulder girdle.Methods The data of 17 patients(13 males and 4 females)were retrospectivelv analyzed.All of them had malignant scapular tumor at least in region S2,and underwent limb salvage between January 2005 and January 2009.They aged from 14 to 55 years old(mean,32.6 years).The histologic types of them were chondrosarcoma in 6 patients,osteosarcoma in 4,fibrosareoma in 1,myeloma in 1,Ewing's sarcoma in 1,rhabdomyosarcoma in 1,non-Hodgkin lymphoma in 1,malignant giant cell tumor of bone in 1 and recurrent chondrosarcoma in 1.The tumors were staged according to Enneking surgical staging system:IB in 4 and IIB in 13.According to the MSTS classification system,the region S2 and lateral 1/3 of region S1 were effected in 11 cases,the region S2 and large part of region S1 were effected in 6 cases.The rotator cuff was involved to some extent in all patients,and the articular capsule were involved in 8 cases.Neo-adjuvant chemotherapy was given to 14 patients.The surgical strategies were depended on the range of tumor and preservation of articular capsule.The scapular prosthetic replacement was done in 8 cases with a relatively large range of tumor or resection of articular capsule,otherwise the scapular allograft replacement was done.Among the 11 cases with region S2 and lateral 1/3 of region S1 effected,the scapular allograft replacement was done in 9 cases with articular capsule preserved and the prosthetic replacement was done in 2 cases with articular capsule resected.And the prosthetic replacement was done in the other 6 cases.The articular capsule and partial rotator cuff were preserved and reconstructed preferentially.Results All patients were followed up 16-62 months (mean,35.1 months).Postoperative complications were noted in 9 patients, including mild allograft rejection and mild allograft resorption in 1 patient,allograft rejection in 1,prosthetic acromion exposure in 3,allograft resorption in 4.Local recurrence were noted in 1 patients.Three patients were dead because of extensive metastasis.The average function scores were 74.1%(range,53.3%-93.3%).Conclusion During the limb salvage surgery.it's very important to guarantee the en bloc resection of the tumor.In the meanwhile,the en bloc resection and functional reconstruction should be well balanced.

Objective To explore the predictive value of combined ABCD2 scores and tracheal constriction resulted from internal carotid atherosclerosis (ICAS) in cerebral infarction within 7 d of onset of a transient ischemic attack (TIA). Methods The clinical data of 171 patients with TIA,admitted to our hospital from September 2008 to March 2011, were retrospectively analyzed. All patients were evaluated with ABCD2 scale and degrees of tracheal constriction resulted from ICAS were examined by Color Doppler ultrasound.And 7-d follow-up of patients was performed to select those patients appearing cerebral infarction; and then, the relationships between risk of post-TIA cerebral infarction and both ABCD2 scores and degrees of tracheal constriction were analyzed using chi-square test. Results Among 171 TIA patients,39 (22.8％) suffered cerebral infarction within 7 d of onset of TIA.Significant difference of risk of post-TIA cerebral infarction was noted in patients with different ABCD2 scores and degree of tracheal constriction (P＜0.05): the higher the ABCD2 scores/ the degrees of tracheal constriction, the higher incidence of cerebral infarction in TIA patients. Conclusion A rather high accuracy may be achieved with ABCD2 scale in the prediction of short-term risk of cerebral infarction after onset of TIA,and a higher accuracy may be expected by combination of ABCD2 scale with carotid atherosclerosis findings.

A rapid, sensitive and simple liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was developed and validated for the simultaneous determination of clevidipine butyrate and its primary metabolite clevidipine acid in dog blood. After one-step protein precipitation with methanol, the chromatographic separation was carried out on an Ecosil C18 column (150 mm x 4.6 mm, 5 µm) with a gradient mobile phase consisting of methanol and 5 mmol · L(-1) ammonium formate. A chromatographic total run time of 13.0 min was achieved. The quantitation analysis was performed using multiple reaction monitoring (MRM) at the specific ion transitions of m/z 454.1 [M-H]- --> m/z 234.1 for clevidipine butyrate, m/z 354.0 [M-H]- --> m/z 208.0 for clevidipine acid and m/z 256.1 [M-H]- --> m/z 227.1 for elofesalamide (internal standard, IS) in the negative ion mode with electrospray ionization (ESI) source. The linear calibration curves for clevidipine butyrate and clevidipine acid were obtained in the concentration ranges of 0.5-100 ng · mL and 1-200 ng · mL(-1), separately. The lower limit of quantification of clevidipine butyrate and clevidipine acid were 0.5 ng · mL(-1) and 1 ng · mL(-1). The intra and inter-assay precisions were all below 12.9%, the accuracies were all in standard ranges. Stability testing indicated that clevidipine butyrate and clevidipine acid in dog blood with the addition of denaturant methanol was stable under various processing and/or handling conditions. The validated method has been successfully applied to a pharmacokinetic study of clevidipine butyrate injection to 8 healthy Beagle dogs following intravenous infusion at a flow rate of 5 mg · h(-1) for 0.5 h.
Animals ; Butyrates ; blood ; pharmacokinetics ; Calibration ; Chromatography, Liquid ; Dogs ; Infusions, Intravenous ; Pyridines ; blood ; pharmacokinetics ; Tandem Mass Spectrometry

The study was aimed to investigate the clinical significance of serum lactate dehydrogenase (LDH), β2-microglobulin (β2-MG) and vascular endothelial growth factor (VEGF) detection in non-Hodgkin's lymphoma (NHL) patients. 58 newly diagnosed NHL patients from January 2010 to December 2011 in our hospital were selected as the study group (NHL group) and 58 healthy individuals were selected at the same time as a control group. Serum LDH level was determined by a biochemical method, while β2-MG and VEGF levels were determined by enzyme-linked immunosorbent assay. The results showed that as compared with control group, the LDH, β2-MG and VEGF levels in NHL group were significantly higher (P < 0.05). In NHL group, the LDH and VEGF levels at different pathological types and clinical stages changed remarkably. Compared with low grade patients, the LDH and VEGF levels of intermediate grade and high grade patients were significantly higher (P < 0.05). As compared with patients at stage I, the LDH and VEGF levels of patients at stage II, III and IV increased significantly (P < 0.05). Out from 58 cases in NHL group, 30 cases (51.72%) showed LDH-positive, 39 cases (67.24%) showed β2-MG positive and 29 cases (50.00%) showed VEGF-positive. It is concluded that some significant changes of serum LDH, β2-MG and VEGF appears in NHL patients, detection of these 3 tumor marker levels may be help to clinically grading patients with NHL.
Adult ; Aged ; Case-Control Studies ; Female ; Humans ; L-Lactate Dehydrogenase ; blood ; Lymphoma, Non-Hodgkin ; blood ; Male ; Middle Aged ; Neoplasm Grading ; Vascular Endothelial Growth Factor A ; blood ; Young Adult ; beta 2-Microglobulin ; blood

Aged ; Female ; Humans ; Male ; Middle Aged ; Multiple Myeloma ; diagnosis ; immunology ; Prognosis ; T-Lymphocyte Subsets ; immunology

This study was aimed to investigate the effects of As2O3 on proliferation of B lymphoma Raji cell and to study the expression changes of VEGF mRNA. The modified MTT was adopted to evaluate the effect of As2O3 on proliferation of Raji cells. Semi-quantitative RT-PCR was used to detect the expression of VEGF121 and VEGF165 mRNA in Raji cells exposed to As2O3. The results showed that the As2O3 significantly inhibited the proliferation of Raji cells, the relationship between the inhibition rate and the concentrations of As2O3 was dose- and time-dependent. The VEGF121 and VEGF165 mRNA expressions were found in Raji cells, and both were well-matched in expression levels. After treatment of As2O3 at 1 micromol/L for 48 hours, the expression levels of VEGF121 and VEGF165 mRNA were significantly down-regulated and demonstrated negative correlation with the time of exposure to As2O3. Otherwise some difference were observed in effects of As2O3 on VEGF121 and VEGF165, the expression of VEGF165 mRNA was down-regulated earlier and longer than that of VEGF121, while no similar correlation was found in selected concentration groups. It is concluded that As2O3 can significantly inhibit the growth of Raji cells and may exerted its anti-angiogenesis effects by down-regulating the VEGF mRNA expression even in a low concentration for a long term.
Antineoplastic Agents ; pharmacology ; Arsenicals ; pharmacology ; Cell Proliferation ; drug effects ; Down-Regulation ; Humans ; Lymphoma, B-Cell ; metabolism ; pathology ; Oxides ; pharmacology ; RNA, Messenger ; biosynthesis ; genetics ; Vascular Endothelial Growth Factor A ; biosynthesis ; genetics

OBJECTIVETo study the effects of phytoestrogen alpha-zearalanol (alpha-ZAL) on normal human breast.

METHODSTen specimens of normal human breast tissues were subcutaneously implanted into 30 athymic nude mice aged 9-10 weeks, one for 3 mice. These mice were then randomly divided into three groups: control group (without hormone treatment, n = 10), 1 mg/kg alpha-ZAL group (n = 10), and 5 mg/kg alpha-ZAL group (n = 10). All breast tissues were taken out 6 weeks later. Immunohistochemistry was used to determine the protein expressions of proliferating cell nuclear antigen (PCNA), inhibiting apoptosis gene Bcl-2, estrogen receptor (ER), and progesterone receptor (PR). Reverse transcription polymerase chain reaction (RT-PCR) was used to measure the expression levels of estrogen sulfotransferase (EST) mRNA and bridging integrator protein-1 (BIN1) mRNA. Morphological features of grafts before and after treatment were also observed.

RESULTSAlpha-ZAL had no significant effects on Bcl-2, PCNA, ER, and PR expression of mammary epithelial cells in graft specimens. Alpha-ZAL upregulated BIN1 mRNA expression in grafts, but had no significant effect on ESTmRNA expression.

CONCLUSIONSAlpha-ZAL does not affect the morphology, proliferating, and apoptosis of epithelial cells in normal human breast tissues implanted into nude mice, but it may increase the gene expression of tumor-inhibiting BIN1, suggesting that alpha-ZAL may have potential proteotive effect on normal human breast.

Adult ; Animals ; Breast ; chemistry ; drug effects ; Estrogens, Non-Steroidal ; pharmacology ; Female ; Humans ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Phytoestrogens ; pharmacology ; Proliferating Cell Nuclear Antigen ; analysis ; Random Allocation ; Receptors, Estrogen ; analysis ; Receptors, Progesterone ; analysis ; Zeranol ; pharmacology

Because of different display parameters and other factors, digital medical images present different display states in different section offices of a hospital. Based on CPI integration profile of IHE, this paper implements the consistent presentation of medical images, and it is helpful for doctors to carry out medical treatments of teamwork.
Computer Simulation ; Diagnostic Imaging ; Integrated Advanced Information Management Systems ; Medical Informatics Computing ; standards