Objective To explore the effective disinfection and management measures of standby aspirators. Methods Randomly sampled 17 standby aspirators in our hospital and examined whether their liquid storage bottles and covers were contaminated by pathogens.According to the situation,we developed appropriate measures to intervene.4 months after intervention,we sampled 17 standby aspirators which were tested again. Results 82.4% liquid storage bottles and 88.2% covers were contaminated. While the contamination rate after intervention was zero.The pathogens found were mainly Pseudomonas Aeruginosa, Klebsiella pneumoniae and other opportunistic pathogens.Conclusions To strengthen the disinfection management of standby aspirators can control the contamination of standby aspirators.

Objective To observe the effect of tongue-drawing at lateral position in nasogastric intubation for senile patients with conscious disorders. Methods One hundred senile patients with conscious disorders were randomly divided into observation group and control group with 50 cases in each group. The patients in the control group were given routine nasogastric intubation while those in the observation group were given nasogastric intubation by tongue drawing at the lateral position. The two groups were compared in terms of success rate of intubation, the rate of adverse reactions and intubation effects. Result Compared with the control group, the observation group showed significantly higher in one-time intubation success rate , comfort rate and lower rate of adverse reaction (all P<0.01). Conclusions The nasogastric intubation by tongue-drawing at lateral position is superior to the routine intubation. It can improve the success rate of one-time intubation, decrease the rate of adverse reactions and relieve the pains of patients.

AIM:Activin A,a member of transforming growth factor superfamily,is the negative regulator factor in liver regeneration. In this study,the effects of extract of Ginkgo Biloba on hepatic fibrosis and the expression of Activin A in rats with cirrhosis were investigated. METHODS:The experiment was performed at in the Central Laboratory of Wuhan First Hospital from September 2005 to December 2006. ①Thirty-six male SD rats of(160?20) g were randomized into 3 groups:control group,model group and treatment group. ② Except the rats in the control group,others were intraperitoneally injected with 500 mL/L CCl4 for 8 weeks to establish models of hepatic fibrosis. Meanwhile,the extract treatment group was infused with the extract of Ginkgo Biloba(Chinese drugs preparation laboratory of Wuhan First Hospital,detected by Hubeu Wushi Medicine Industry Co.,Ltd. No. 02-391) daily for 8 weeks. ③After administration,all anesthetized rats were sacrificed. Blood samples were collected for the determination of liver function biochemical indexes. Liver tissue samples were used for histopathological examinations. The expression of Activin A was determined by immunohistochemistry and RT-PCR. RESULTS:All 36 rats were involved in the final analysis. ①The liver function in extract treatment group was significantly improved compared with that in model group. ②The grade of fibrosis in extract treatment group were remarkably lower than that in model group under light microscope. ③The positive staining of Activin A in treatment group was significantly reduced compared with model group. ④The expression of Activin A mRNA in extract treatment group was significantly reduced compared with model group. CONCLUSION:Extract of Ginkgo Biloba can effectively decrease the expression of Activin A in rats with hepatic fibrosis caused by CCl4,and lessen the degree of hepatic fibrosis.

Objective To investigate the optimal b value of diffusion-weighted imaging (DWI)in predicting the grade of cerebral gliomas.Methods 38 patients with pathologically-proved brain gliomas (24 high-grade gliomas and 14 low-grade ones)were studied retrospectively.All patients received conventional MRI and DWI examination with three different b values (1 000 s/mm2 ,2 000 s/mm2 and 3 000 s /mm2 ).The signal features of the tumor on DWI with three different b values were evaluated and compared.The minimum ADC values of the tumors were calculated and compared between each other.Through drawing the ROC curve of different b values, the best diagnostic threshold was found.The sensitivity and specificity in predicting the grade of brain gliomas were assessed using Chi-square test.Results On DWI with b value of 3 000 s/mm2 ,91.6% (22/24)of high-grade tumors showed hyper-intensity, while 85.7%(12/14)of low-grade tumors presented hypo-intensity signals.Regarding hyper-intensity signals as diagnostic criterion for high-grade tumors,the sensitivity and specificity were 91.6% and 100% respectively.When the b value was similar,the minimum ADC value of high-grade glioma was significantly lower than that of low-grade glioma,and statistically significant differences in differentiating high-grade glioma from low-grade glioma existed among three b values (P <0.05).When the ADC 3 000 value<0.74×10 -3 mm2/s was regarded as a standard for the identification of high-grade and low-grade glioma,the sensitivity and specificity were 100% and 87.3%respectively.Conclusion DWI with high b value is more useful than standard moderate b value in preoperative grading the gliomas.When DWI with b value of 3 000 s/mm2 is used,the minimum ADC value will provide quantitative indicators in preoperatively precisely predicting grading glioma.

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 investigate the detection of respiratory tract virus from throat swabs of patients with lower respiratory tract infection(LRTI)in a hospital,so as to provide reference for clinical diagnosis and treatment. Methods Throat swabs of hospitalized children with LRTI between May 2103 and April 2014 were detected by di-rect immunofluorescence assay,infection/carriage of respiratory syncytial virus(RSV),adenovirus(ADV),influen-za virus A(IV-A),IV-B,parainfluenza virus 1(PIV-1),PIV-2,and PIV-3 in children were surveyed.Results Of 8 425 throat swab specimens of hospitalized patients,1 879 were detected virus,the total detection rate was 22.30%,detection rate of RSV was the highest (11 .31 %),followed by PIV-3(4.37%).There was no significant difference in the total detection rate of respiratory tract virus between children of different genders (P =0.051).Of all age groups,detection rate of RSV in infants and young children was the highest,the detection rates of 7 kinds of virus from preschool children were approximate,detection rate of ADV from primary school children was the high-est (37.50%).In spring and winter,children mainly infected with RSA,accounting for 62.82% and 69.88% re-spectively;in summer,PIV-3 was the predominant virus,accounting for 41 .47%,in autumn,there was little difference in the percentage of each virus.Conclusion The detection rate of 7 kinds of virus isolated from throat swabs of hospitalized children with LRTI is related to age and season;the detection rate of 7 kinds of virus from in-fants and young children is high,RSA is the main virus.

ObjectiveToinvestigatetherolesofbrain-derivedneurotrophicfactor(BDNF)and tyrosine receptor kinase B (TrkB) in ischemic postconditioning. Methods Wistar rats w ere randomly assigned to three groups:a sham operation (9 rats), an ischemic postconditioning, and an ischemia-reperfusion group. According to the reperfusion time, the latter 2 groups w ere redivided into 6, 12, 24, 48, and 72 h subgroups (9 rats in each subgroups). A middle cerebral artery occluded by suture method for a cerebral ischemia-reperfusion model. Triphenyl tetrazolium staining w as used to detect infarct volume (P=4). Immunohisto-chemical staining w as used to detect the expression levels of BDNF and TrkB proteins (P=5). Results The infarct volumes in the ischemic postconditioning group w ere reduced significantly compared w ith those in the ischemia-reperfusion group (6 h:143.3 ±8.7 mm3 vs.166.8 ±7.5 mm3, t=4.104, P=0.006;12 h:151.7 ±7.8 mm3 vs.171.6 ±9.1 mm3, t=3.314, P=0.016; 24 h: 159.2 ±9.3 mm3 vs.177.1 ± 7.6 mm3, t=3.000, P=0.024;48 h:166.9 ±9.6 mm3 vs.184.9 ±9.0 mm3, t=2.732, P=0.034;72 h:172.0 ±9.1 mm3 vs.198.1 ±8.2 mm3, t=2.640, P=0.039), and the positive cel numbers of BDNF (6 h:23.98 ±4.07 vs.18.63 ±2.5, t=2.479, P=0.038;12 h:27.64 ±3.18 vs.22.01 ±3.14, t=2.817, P=0.023;24 h:34.82 ±4.17 vs.28.46 ±4.05, t=2.446, P=0.040; 48 h:34.30 ±3.27 vs.26.29 ± 3.26, t=3.872, P=0.005;72 h:28.77 ±3.53 vs.23.64 ±3.54, t=2.297, P=0.051) and TrkB (6 h:33.83 ±3.90 vs.21.51 ±3.86, t=5.012, P<0.001; 12 h:38.59 ±4.84 vs.23.41 ±3.67, t=5.586, P<0.001;24 h:46.07 ±3.06 vs.28.78 ±3.61, t=8.169, P<0.001; 48 h:47.90 ±3.30 vs.29.51 ± 3.81, t=8.160, P<0.001; 72 h:42.78 ±4.07 vs.27.46 ±3.19, t=6.623, P<0.001) per high-pow er field at each time point in the ischemic postconditioning group w ere significantly more than those in the ischemia-reperfusion group. Conclusions Ischemic postconditioning upregulates the expressions levels of BDNF and TrkB proteins after ischemia-reperfusion and reduces cerebral infarct volumes. BDNF/TrkB may play an important neuroprotective effect in ischemic postconditioning.

ObjectiveTo evaluate clinical significance of serum free light chains (sFLC) in diagnosis and response to the therapies of patients with multiple myeloma (MM).MethodssFLC (κ,λ and κ / λ ratio)were examed by immumoassay from 62 patients with MM at different stage. The results were analyzed associated with clinical data,and 35 cases of chronic renal failure(CRF)patients and 62 cases of healthy donors were taken as controls.ResultsMedium sFLC of normal κ value was (13.25±6.46) mg/L,λ value was (18.39±11.42) mg/L; and κ / λ ratio was (0.97±0.64) mg/L (range 0.33-1.61).sFLC κ and λ of CRF patients were (200.01±299.87) mg/L,(191.02±245.98) mg/L,significantly higher than that of the normal control group (t =-17.804,-16.894,both P ＜ 0.001),but the κ/λ ratio was at normal range (1.11±0.29).κ value range was at 16.20- 35 250 mg/L in newly diagnosed intact immunoglobulin MM patients with IgGκ,IgAκ and IgDκ type.The range of λ values was 15.70-4885 mg/L in IgGλ,IgAλ,IgDλ type,and κ/λ ratio was abnormal in 96.5 ％ (55/57) patients (＜0.5 or ＞1.5).The κ,λ value and κ/λ ratio were close to that of the normal after remmision.ConclusionsFLC ( κ,λ,and κ / λ ratio) are very good monitoring markers for MM.

Objective To evaluate the effects of dexmedetomidine on the activity of cAMP response element binding protein (CREB) and c-fos in the spinal dorsal horn in a rat model of neuropathic pain.Methods Fifty-four adult male Wistar rats,aged 6-8 weeks,weighing 180-220 g,were randomly divided into 3 groups (n =18 each):sham operation group (group S),chronic neuropathic pain group (group C) and dexmedetomidine group (group D).The animals were anesthetized with intraperitoneal 10％ chloral hydrate 350 mg/kg.The sciatic nerve was exposed and 4 ligatures were placed on the right sciatic nerve at 1 mm intervals with 4-0 silk thread in C and D groups.In group D,dexmedetomidine 50 μg/kg was injected intraperitoneally once a day starting from the end of operation until 1 day before the animals were sacrificed,while the equal volme of normal saline was injected instead of dexmedetomidine in S and C groups.Paw withdrawal threshold to mechanical stimulation with yon Frey filament (MWT) and paw withdrawal latency to thermal stimulation (TWL) were measured on 1 day before operation and 3,7 and 14 days after operation.The animals were sacrificed after measurement of MWT and TWL.Their lumbar segments (L4-6) of the spinal cord were removed for measurement of the expression of phosphorylated CREB (pCREB) and c-fos by immunohistochemistry.Results Compared with group S,MWT was significantly decreased,TWL was shortened,and the expression of pCREB and c-fos was up-regulated on 3,7 and 14 days after operation in C and D groups (P ＜ 0.05).Compared with group C,MWT was significantly increased,TWL was prolonged,and the expression of pCREB and c-fos was down-regulated on 3,7 and 14 days after operation in group D (P ＜ 0.05).MWT was significantly lower,and TWL was shorter on 3,7 and 14 days after operation than on 1 day before operation in C and D groups (P ＜ 0.05).MWT was significantly lower,TWL was shorter,and the expression of pCREB and c-fos was higher on 7 and 14 days after operation than on 3 days after operation in C and D groups (P ＜ 0.05).MWT was significantly higher,TWL was longer,and the expression of pCREB and c-fos was lower on 14 days after operation than on 7 days after operation in C and D groups (P ＜ 0.05).Conclusion The mechanism by which dexmedetomidine reduces neuropathic pain is related to inhibition of the activity of CREB and c-fos in the spinal dorsal horn of rats.

Objective To investigate the effect of cerebral ischemic preconditioning (IP) on the expressions of angiopoietin-1 (Ang-1) and its receptor Tie-2 mRNA in cerebral ischemia in rats.Methods Ninety-nine Wistar rats were randomly assigned to three groups:sham operation (n =9),non-ischemic preconditioning (NIP) (n =45),and IP (n =45).The latter two groups were redivided into 5 subgroups:ischemia-reperfusion 1,3,7,14,and 21 days (n =9 in each group).A model of transient middle cerebral artery occlusion (MCAO) was induced by the intraluminal suture method for focal IP (ischemia for 10 minutes and restoring perfusion).Infarct volume was determined by 2,3,5-triphenyltetrazolium staining.The expression levels of Ang-1/Tie-2 mRNA were detected by in situ hybridization.Results The infarct volumes in the 1 -,3-,and 7-day subgroups of the IP group were significantly smaller than those in the relative subgroups of the NIP group (all P＜ 0.05).The expression of Ang-1 mRNA in the 3- and 7-day subgroups of the IP group and the expression of Tie-2 mRNA in the 1-,3-,and 7-day subgroups of the NIP group were upregulated significantly (all P ＜ 0.05).The infarct volume in the 3-day subgroup of the IP group was reduced most significantly (P ＜ 0.05).The expression of Ang-1 mRNA in the 7-day subgroup was upregulated significantly,and the peak expression of its receptor Tie-2 mRNA appeared at day 3 after IP and continued to day 7.Pearson correlation analysis showed that the expression levels of Ang-1/Tie-2 mRNA were significantly negatively correlated with infarct volume (P ＜0.01).Conclusions The expression of Ang-1/Tie-2 mRNA in the IP group was upregulated within the time window of ischemic tolerance (1 - 7 days after preconditioning),in which Ang-1 may mainly act on the later stage of the cerebral ischemic tolerance.