OBJECTIVE To investigate the associated risk factors for the infected patients in respiratory intensive care unit(RICU) and to study the resistance of isolates.METHODS To study the bacterial spectrum and drug resistance test of all the patients with hospital acquired infection from Jan to Dec 2005.Identification and antimicrobial susceptibility were determined with the methods of API and K-B,respectively.RESULTS A total of 265 strains were isolated from 117 patients,the rate of isolation of Gram-negatives was the highest(74.3%),the species were predominated by Pseudomonas aeruginosa,Acinetobacter baumannii and Klebsiella pneumoniae,the rates of isolates were 28.68%,23.02% and 5.66%,respectively.The predominated species of Gram-positives was Staphylococcus aureus.Gram-negative bacilli were susceptible to imipenem and meropenem,there were not vancomycin-resistant strains.CONCLUSIONS It is important to realize the associated risk factors of infected patients in RICU and to promote the rational use of antimicrobial agents.

The ancient documents and modern literature in recent 15 years have been retrieved and reviewed on acupuncture treatment of migraine.This article has analyzed syndrome and disease differentiation,acupoint-selection and combination as well as therapies and manipulations,and further provided clinical application thoughts based on therapeutic evaluation of the above aspects.

Objective To study the percutaneous permeability through mouse skin of lidocaine hydrochloride-loaded destran-based niosomes(LID-HLD-BNs)in vitro and in vivo. Methods HPLC was employed to exam lidocaine hydrochlo?ride. Lidocaine hydro-chloride-loaded conventional liposomes (LID-CLs) and lidocaine hydrochloride injection (LID-IJ) were used as control. Isolated mouse skin was added into Franz diffusion cell to evaluate the permeability of LID-HLD-BNs in vitro. Confocal Laser Scanning Microscopy(CLSM)was used to observe the permeation depth of mouse skin in vivo. Re?sults The permeation rate and cumulative permeation amount were significantly higher in LID-HLD-BNs group than those of LID-CLs and LID-IJ groups (P<0.05). CLSM studies also confirmed that HLD-BNs reached deeper layers of the skin. Conclusion LID-HLD-BNs has good transdermal ability.

AIM To evaluate the integration method for analysis of voltage-dependent Ca2+-independent transient outward K+ currents (Ito) in pharmacology. METHODSThe inactivation phases of Ito were best fitted by the sum of two or three exponentials equations. The area under the raw current curves (AUC) was obtained by the integration of exponential equations. The AUC normalized to the cell capacitance represented the net K+ charge flow during any depolarized duration and was as the index for comparison. Calcineurin overexpression transgenic (TG) mice showed downregulation of Ito. These data were tested by the integration method. RESULTS AUC obtained from three or two exponentials fittings was calculated as: AUC=A1τ1+A2τ2+A3τ3+A0t-A1τ1e-t/τ1-A2τ2e-t/τ2-A3τ3e-t/τ3 or AUC=A1τ1+A2τ2+A0t-A1τ1e-t/τ1-A2τ2e-t/τ2. The 50% and 90% action potential duration (APD50, APD90) in ventricular myocytes of mice are about 10 ms and 30 ms, respectively. AUC at 10 ms (AUC50, AUC of 50% APD) and 30 ms (AUC90, AUC of 90% APD) in left ventricle cardiomyocytes of wild type (WT) and TG mice were normalized to the cell capacitance. The normalized AUC50 and AUC90 of WT group were significantly more than those of TG group, which was consistent to the prolongation of APD in TG mice and the previous published results(downregulation of components of Ito in TG mice). CONCLUSION The integration method was an ideal way for analysis of transient outward K+ currents in pharmacology.

Objective To retrospectively analyze the cardiac systolic synchrony and cardiac function in patients with chronic heart failure (CHF） by gated SPECT myocardial perfusion imaging (GSMPI). Methods (1) From January 2010 to February 2015, 123 cases including 82 CHF patients (57 males, 25 females, age (59.5±11.0) years) and 41 healthy people (control group; 27 males, 14 females, age (33.8±5.2) years) were enrolled in this retrospective study. According to the New York Heart Association (NYHA) classification, the CHF patients were classified into grade Ⅰ-Ⅳ groups. The systolic synchrony and cardiac functional parameters including PHB, PSD, LVEF, EDV, summed rest scores (SRS) were acquired by Emory Cardiac Toolbox software. Differences of PHB, PSD and LVEF were compared between the CHF group and the control group using two-sample t test. The difference among the four CHF groups was compared by one-way analysis of variance. The difference of some clinical factors was compared between the two groups with and without damage of systolic synchrony. The relationship between the cardiac synchrony and myocardial perfusion was analyzed by Pearson correlation analysis. Results There was no obvious difference of PHB and PSD between the grade Ⅰ CHF patients and the control group (t=-1.502 and -0.448, both P>0.05), while LVEF was significant different (t=10.419, P<0.05). Significant difference of PHB, PSD and LVEF existed between the grade Ⅱ-Ⅳ CHF patients and the control group (t values: from -27.250 to 32.723, all P<0.05). There were significant differences of PHB, PSD and LVEF among the 4 CHF groups (F=118.05, 4.13 and 154.37; all P<0.05). The differences of LVEF, EDV and SRS were significant between the patients with and without damage of systolic synchrony (t=9.57, 10.85, 18.87, all P<0.05). The ratios of damage in systolic synchrony in grade Ⅰ-Ⅳ CHF patients were 8.7% (2/23), 60.0%（12/20）, 15/18 and100% (21/21), respectively. PHB and PSD were both positively correlated with SRS (r=0.808 and 0.773, both P<0.05). Conclusions The damage of systolic synchrony are getting severer from patients with NYHA grade Ⅱ to patients with NYHA grade Ⅳ. The damage could be accompanied by the heart failure progression. Diabetes mellitus, LVEF, EDV, ESV, and SRS are related to the damage. The myocardial perfusion damage is positively correlated with the damage of cardiac systolic synchrony. GSMPI is useful to early diagnosis and treatment of heart failure.

Objective To detect levels of C?X?C chemokine receptor type 5 (CXCR5) and inducible costimulator(ICOS)in blister fluid of patients with bullous pemphigoid(BP), and to explore their significance in the pathogenesis of BP. Methods Blister fluid samples were collected from 15 patients with BP(experimental group)and 15 patients with second?degree burns(control group). Enzyme?linked immunosorbent assay(ELISA)was performed to detect the levels of CXCR5 and ICOS in the 2 groups. Results The level of CXCR5 was significantly higher in the experimental group than in the control group(219 ± 145.31 vs. 147 ± 23.83 ng/L, t=4.577, P<0.05), while no significant difference in the ICOS level was observed between the 2 groups (30.18 ± 14.86 vs. 21.43 ± 5.32 ng/L, t = 1.628, P > 0.05). Conclusion The expression of CXCR5 may be associated with the occurrence of BP, but further researches are needed to determine the relationship between ICOS and the occurrence of BP.

Objective To investigate the treatment and prevention strategies of hematomas in operation area after anterior approach surgery for cervical spondylosis.Methods A retrospective review was conducted on 12 with hematoma compression in operation area out of 785 patients managed by anterior cervical surgery from January 2007 to July 2013,including 10 males and 2 females at age ranging from 40-71 years (mean 56.8 years).Surgery method was anterior cervical corpectomy and interbody fusion using titanium mesh cage plus plate and intraoperative blood loss was 300-1 200 ml.Primary clinical manifestations were neurological dysfunction in 5 patients,dyspnea in 6,and both neurological dysfunction and dyspnea in 1.There were 10 patients with the presence of symptoms at postoperative 0.5-22 hours,1 at postoperative 73 hours,and 1 at postoperative 74 hours.All the 12 patients underwent a second anterior cervical exploration.Results There were 5 patients with epidural hematoma,6 with subcutaneous hematoma,and 1 with both hematomas.After surgical interventions,the patients presented improvement in respiratory and neurological function,with inapparent respiratory abnormality and improved neurological function at discharge.One patient was died of cardiovascular-associated disease after being discharged from hospital.The left 11 patients were followed up for mean 19.8 months (range,6-43 months),with improved Japanese Orthopedic Association (JOA) score at final follow-up.Conclusions Hematoma took place frequently in the early period,especially within 24 hours in operation area after anterior approach to cervical disorders and close attention should be paid to respiratory and limb sensation and motion functions.Early detection and early surgical interventions are the key countermeasures to avoiding the severe results.

Objective To investigate the methods and effects of posterior fixation and fusion in treatment of complete thoracolumbar fracture and dislocation.Methods The study enrolled 8 cases of complete thoracolumbar fracture and dislocation treated by posterior fixation and fusion with pedicle screwrod system between January 2006 and December 2012.There were 7 males and 1 female,at mean age of 31.9 years (range,19-49 years).Mean time interval between injury and surgery was 8.1 days (range,4-12 days).Fracture-dislocation classification was AO type C,Denis three-column injury,and Meyerding grade V.According to American Spinal Injury Association (ASIA),there 5 cases at grades A,1 at grade B,1 at grade C 1 at grade E.Fracture-dislocation segments included T5-T6 in 1 case,T12-L1 in 3,L1-L2 in 2,L3-L4 in 1 and L4-L5 in 1.Results Mean duration of surgery was 220.6 minutes (range,135-335 minutes) and mean intraoperative blood loss was 1 150 ml (range,500-2 400 ml).Seven cases sustained dural laceration during the operation,which were sutured or covered with autologous fat grafts,but 3 of them were subjected to cerebrospinal fluid leakage and healed after conservative therapy.Anatomic reduction was achieved in 6 cases,partial reduction in 1 and non-reduction in 1.Mean Cobb angle improved from 29.3 ° (range,8 °-51 °) preoperatively to 1.9 ° (range,-5°-10 °) postoperatively.After a mean follow-up of 39.3 months (range,2-76 months),2 cases were recovered from preoperative ASIA grade A and B to C respectively and 6 cases (4 A,1 C,1 E) revealed no significant improvement.There was no implant loosening or breakage.One case was died of lung-related complications at postoperative 4 years.One case sustained lumbar deep infection at postoperative 3 weeks and managed by debridement,irrigation,drainage and implant retention.Conclusion Posterior fixation and fusion is the general treatment principle for complete thoracolumbar fracture and dislocation,but the degree of reduction depends on severity of the injured spinal cord.

Objective To investigate the expression level of immunoglobulin G (IgG)4 cells in patients previously diagnosed as unexplained liver injuries,and to analyze whether these patients could be diagnosed as immunoglobulin G4-related disease (IgG4-RD).The clinical characteristics of patients with IgG4 positive cells infiltration in liver tissues who did not met IgG4-RD diagnosis criteria were also analyzed.Methods From August 2010 to July 2016,33 patients with unexplained liver injuries even after liver biopsy were enrolled.Immunostaining of IgG and IgG4 in liver tissue slices was performed.Whether the patients met the IgG4-RD diagnosis criteria was analyzed.Also,the relation between IgG4 positive cell infiltration in liver tissues and serum parameters (alanine aminotransferase (ALT),aspartate transaminase (AST),alkaline phosphatase (ALP),γ-glutamyl transpeptadase (GGT),IgG),the classification of liver inflammation and stage of liver fibrosis were analyzed.Chi-square,Fisher exact probability method,t test and Wilcoxon rank and inspection were used for statistical analysis.Results Among 33 patients with unexplained liver injuries,average age of onset of the disease was (50.48 ± 14.52) years old.Ten patients (30.3 ％) presented with different degree of IgG4 positive cells infiltration in liver.In one patient,the IgG4 positive cell number in liver tissue was over 10/high-powered field (HPF),IgG4+ / IgG+ ratio was over 40％,the serum IgG4 increased and low density nodules in the left hepatic lobe level,which met the diagnostic criteria of IgG4-RD.Serum parameters of liver function of this patient were as follows:ALT 948 U/L,AST 658 U/L,ALP 176 U/L,GGT 197 U/L,TBil 21.5 μmol/L,DBil 10.0 μmol/L.According to whether there were IgG4 positive cells infiltration in liver tissues,33 patients were divided into IgG4 positive cells infiltration group (IgG4 positive group,10 cases) and no IgG4 positive cells infiltration group (IgG4 negative group,23 cases).The medium levels of ALT,AST,ALP and GGT in the IgG4 positive group and the IgG4 negative group were 26.0 U/L vs 31.0 U/L,28.5 U/L vs 32.0 U/L,114.0 U/L vs 77.0 U/L,65.0 U/L vs 36.0 U/L,respectively and there were no statistically significant differences (Z=-0.098,-0.216,-0.862,-0.705;all P＞0.05).The serum IgG level of the IgG4 positive group was higher than that of the IgG4 negative group (17.15 g/L vs 13.65 g/L),and the difference was statistically significant (Z=-1.776,P =0.035).Conclusions IgG4-RD may be the reason of liver injury.There are no significant differences in clinical charateristics,serum parameters and inflammation degree in liver tissue between patients with or without IgG4 positive cells infiltration.

To find antibacterial candidate compounds, eighteen novel sulfonamide derivatives containing a fused-ring were designed and synthesized on the basis of previous studies, with structures confirmed by ¹H NMR, ¹³C NMR and MS. Antibacterial activities of the products were evaluated by the agar dilution method. The results show that these derivatives have different degrees of inhibitory activity on the tested bacteria, with the compounds IIi and IIr the most potent. The MIC of IIi for S. aureus, E. coli and MRSA was 8, 32 and 16 μg·mL^-1, respectively, and the MIC of the IIr was 8, 64 and 32 μg·mL^-1, respectively. The anti-MRSA activities of the two compounds is significant and is worthy of further structural optimization and study.