OBJECTIVE To investigate the respiratory tract infection rate,pathogenic organism and drug resistance for the patients with tracheotomy and endotracheal incubation in ICU,and to provide first-hand information for diseases prevention and clinical treatment.METHODS Fifty eight patients admitted in our hospital ICU from Dec 2006 to May 2007 were analyzed for their pathogenic organisms of lower respiratory tract infection,drug resistance,underlying diseases and age.RESULTS Pathogenic organisms from sputum culture for 58 patients with tracheotomy and endotracheal incubation were all positive.A total of 139 strains of pathogenic organisms have been found.Among them 106 were Gram-negative bacteria,accounted for 76.3%,and 26 were Gram-positive bacteria,accounted for 18.7% and 7 were fungi,accounted for 5%.From sputum culture of 29 patients Burkholderia cepacia was positive,which was the No.1 bacterial infection,accounted for 20.7% of total.Drug sensitive test for most Gram-negative bacteria showed resistance.CONCLUSIONS Bacteria infection of respiratory tract of the patients with mechanic ventilation in ICU is mostly Gram-negative.Clinical doctors should emphasize the inspection of pathogenic infection regularly and its drug resistance evaluation,to administer appropriate antibiotics.

Animals ; Gene Expression Regulation ; drug effects ; Gene Targeting ; methods ; Humans ; Oligonucleotides, Antisense ; genetics ; pharmacology ; RNA Interference ; RNA, Small Interfering ; genetics ; Transfection

ObjectiveTo investigate the high risk factors,etiology,diagnosis,treatment and precaution of venous thromboembolism (VTE) in pregnancy and puerperium. MethodsData of 16 cases of VTE admitted in Department of Obstetrics and Gynecology,Peking Union Medical College Hospital from January 1992 to April 2011 were analyzed retrospectively.The differences of blood routine test and coagulation function between VTE patients (study group) and normal pregnant women (control group) were compared by paired t test in this case-control study.Results All patients were diagnosed by color Doppler ultrasound or CT pulmonary artery angiography.Five cases (31.2 ％) occurred before delivery and 11 (68.8 ％) occurred during postpartum.Two cases (12.5 ％)complicated by pulmonary thromboembolism,and one of them died.Six cases (37.5％) were older than or equal to 35 years old,and 12 cases (75.0％) had gestational complications.The hematocrit in study group were lower than that in control group (0.29±0.06 vs 0.39±0.02,t=4.56,P=0.01).There was no statistical difference between the coagulation function of the two groups.After anticoagulant therapy or surgery,15 cases recovered.One pulmonary thromboembolism patients complicated with rheumatic cardiac disease remained shock after anti-coagulants was administered,then died of hemorrhage of respiratory tract after inferior vena cava filter placement. Conclusions VTE is likcly to happen in puerperium than in pregnancy.There are no good screening indicators for thromboembolism during pregnancy and puerperium.Anticoagulation is recommended to be the first line therapy.For women with high risk of thromboembolism,it is suggested to prevent actively and treat early to decrease the complications and long-term sequelea.

Objective To observe the effects of hepatocyte-like cells differentiated from human umbilical cord mesenchymal stem cells (HuMSCs) on the liver function of the rats with liver cirrhosis.Methods Carbon tetrachloride was used to prepare rat model of liver cirrhosis.Then the rats in the experimental group received portal vein injection of 1 ml differentiated hepatocyte-like cells (1 × 107) ; the mesenchymal stem cell (MSC) group was injected with the same volume and number of MSCs; the model group was injected with the same volume of saline (NS) ; the normal rats were treated as control group.After transplantation,the rat angular vein blood and liver tissue were obtained for testing.Results One week after transplantation,compared with the model group,levels of serum alanine aminotransferase (ALT),aspartate aminotransferase (AST) and total bilirubin (TBil) in the experimental group significantly decreased (P ＜0.05),while the albumin (Alb) level increased significantly (P ＜0.05).Compared with the MSC group,the level of Alb in the experimental group also significantly increased (P ＜ 0.05),but there were no differences between the two groups of ALT,AST and TBil.4 weeks after transplantation,compared with the model group,levels of serum ALT,AST and TBil in the experimental group also significantly decreased (P ＜ 0.05),while Alb level increased significantly (P ＜ 0.05).Compared with the MSC group,the differences of the levels of Alb,ALT,AST and TBil were all statistically significant (P ＜ 0.05).Real-time PCR test results showed that the expressions of four liver-related genes of the MSC group and experimental group significantly increased comparing with the model group (P ＜ 0.05).And the experimental group showed higher expression level comparing with the MSC group (P ＜ 0.05).Conclusion The differentiated hepatocyte-like cells could improve hepatic function of patients with liver cirrhosis to a certain degree and showed greater advantage than MSC.

In order to study on the properconcentrations for patch test(PT),and the availability of PT w ith the suspected cosm etic products used by the patients,PT ofvarious cosm etic products w as per- form ed on 35 healthy subjects and 38 patients w ith non-contactderm atitis and non-eczem a by using dif- ferent concentrations of cosm etic products and their vehicles in cosm etic products.In 62 patients w ith cosm etic derm atitis PT w as done using their ow n suspected causative cosm etic products.The results show ed thatm ost products could be tested “w ith originalproducts”,w ithout dilution,such as skin care products(cream ),lipsticks,hair care products(hair cream ,hair oil,m ousse),others had to be diluted, such as hair dyes,hotoiland soap,to 2% solution,sham poos to 5% solution,perm anent-w ave solutions and perfum es to 5% or 10% in distilled w ater,nailvarnish to 5% or 10% in acetone.The totalpositive rate of PT by using suspected cosm etics w as 95.16% .Our results indicate that PT concentrations and vehicles vary w ith different products in suspected cosm etics,PT of the suspected causative cosm etic products is an im portant m eans for the diagnosis of cosm etic derm atitis.Our study provides necessary data for the further study ofChinese standard cosm etic screening series allergens for PT.

Adolescent ; Adult ; Cholecystitis ; complications ; drug therapy ; surgery ; Cholecystolithiasis ; complications ; drug therapy ; surgery ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Pancreatitis ; drug therapy ; etiology ; surgery ; Phytotherapy ; Postoperative Period ; Sphincterotomy, Endoscopic

Objective To evaluate the effectiveness of hospital environmental cleaning practice by fluorescence labeling method.Methods From January to February 2015,312 ward rooms in 7 hospitals were chosen,high touch object surface were labeled with fluorescence,after object surface being cleaned by cleaners,clearance rates of fluorescence labeling were calculated (as baseline survey data),training and on-site guidance for cleaners were performed(intervention measures),fluorescence labeling clearance effect before and after intervention was compared.Results A total of 110 ward rooms were performed baseline survey,the fluorescence labeling clearance rate of 2 856 touched clean surface was only 50.81％,the quantitative evaluation value was 45.70;after intervention,202 rooms were surveyed,fluorescence labeling clearance rate of 3 992 touched clean surface enhanced to 79.23 ％,the quantitative evaluation value was 76.30;there was significant difference in fluorescence labeling clearance rate between before and after intervention (x2 =612.14,P＜0.05).In the baseline survey,the clearance rates of fluorescence labeling on touched surface of medical instruments,hospital beds,and toilets were 46.07％,37.80％,and 25.20％ respectively;after intervention,the clearance rates were 80.59％,75.90％,and 51.70％,respectively.After intervention,fluorescence labeling clearance rates of beepers,toilet seat covers,toilet electrical switches,and chairs were low,the clearance rates of these touched surface in baseline survey were＜ 30％,after intervention were 47.03 ％-68.32％;the clearance rates of other high touch surface were all＞75 ％.Conclusion Fluorescence labeling method can directly reflect the operation quality of cleaners,and improve the cleanliness of ward environment,it is a simple,inexpensive and objective globally popular method for evaluating hospital environment cleanliness.

Objective To investigate the clinical characteristics, diagnosis and treatment of placenta increta.Methods A retrospective analysis was carried out on 13 admitted cases of placenta increta from 1989～2006. Results Among the 13 cases analysed, 5 cases with a history of Caesarian section had a 0% success rate of treatment with conservative care (0/5), 100% less than that of cases with no history of Caesarian section (8/8), P＜0.05; the success rate of treatment of partial placenta increta with methotrexate with Jia Wei Sheng Hua Tang was 100%. Conclusion Caesarian section is a risk factor of placenta increta, and its prognosis is poor; however, Jia Wei Sheng Hua Tang has proven satisfactory as a supplementary treatment for placenta inereta.

Remarkable progress has been achieved in the transplantation of mesenchymal stem cells (MSCs)for the treatment of liver injury and hepatic failure.However,there are obstacles such as low engraftment capacity,tumorigenesis,and a fibrogenic potential that all hamper the use of MSCs in clinical trials.Therefore,it is worthwhile to talk about the alternatives that will increase the safety and efficacy of MSCs therapy.To date,applications of MSCs-derived hepatocytes,genetically modified MSCs,or MSC-conditioned medium for promoting liver regeneration have shown encouraging results.This review summarizes the current applications of MSCs in the study of hepatic regeneration.

Primary hepatocellular carcinoma progresses from liver fibrosis and cirrhosis to eventually result in liver failure and distant metastasis.Surgical resection is the preferred method of treatment for liver cancer while interventional treatment and liver transplantation are the choices to treat end-stage liver cancer.Unfortunately,partial hepatectomy and interventional treatment are not ideal due to the resulting consequence of hepatocyte dysfunction.Extensive clinical application of liver transplants is limited by the lack of available donors and high costs.Over the past decade,researches on bone marrow mesenchymal stem cells (BMSCs)have made remarkable achievements in the medical field.In this review,we summarize the recent progress of BMSCs in the treatment of liver diseases.