1.Conclusion ABR can evaluate the function of brainstem of patients with severe traumatic brain injury in PVS and provide evidence for prognosis.

Objective: To evaluate the hemodynamics and oxygen consumption following induction of anesthesia with etomidate or midazolam in patients with coronary heart disease(CAD). Method: Thirty patients were divided into E (etomidate,n=15)and M(midazolam,n=15)groups,receiving a infusion of etomidate or midazolam until their eyelash reflex was lost. After pipeuronium(0.15mg/kg) and fentanyl were administered according to the mean blood pressure,the intubetion was achieved. Hemodynsmic and oxygen data were measured before induction, during induction and 1 min after intubation. Result: Induction caused a significant fall in HR,MAP,SVRI,PVRI and VO_2I in both groups (P

Objective A rapid and highly sensitive method, based on the high performance thin-layer chromatography, was described for the qualitative and semiquantitative determination of 7-aminon-itramepam, the main metabolites of nitramepam, in human urine. Method 7-aminonitramepam was extracted by diethyl ether under pH9 condition. Fluorecsamine was used as a reagent to produce fluorescent product to show analyte on plate. Results The limit of detection for 7-aminonitramepam in urine was 5ng/ ml and the limit of quantitation was 15ng/ml. Conclusion The method can be successfully used for determining 7-aminonitramepam in urine samples excreted over 48h period after receiving 10mg nitramepam o-rally and could be applied to drug examination for the cases of drug-facilitated rob.

Objective To analyze the distribution of aminoglycoside acetyltransferases (aac) gene in Acinetobacter baumannii, and to establish a molecular biology method to detect the drug-resistance of the bacteria. Methods The aac genes of 42 isolated Acinetobacter baumannii were analyzed by drug susceptibility and multiplex PCR assay. Results The isolated bacteria were more resistant to Gentamicin (57%) and less resistant to Amikacin (29%). As to the bacteria resistant to at least one of the following aminoglycosides, Gentamicin, Tobramycin, Amikacin, aminoglycoside resistant genes were detected in all of pathogens except 2 special. Among them 6 strains with aac(6′)-Ih, 20 strains with aac(3)-Ia, 14 strains with aac(6′)-Ib and 14 strains were found to have both aac(6′)-Ib and aac(3)-Ia. Conclusion Acinetobacter baumannii isolated in this district are easily resistant to Gentamicin, and it is most caused by the enzyme encoded by aac(3)-Ia and aac(6′)-Ib.

OBJECTIVE: To analyze the basic data of adverse drug reactions(ADR) and assess the quality of ADR reports submitted in 2006 in Shenzhen,and to provide bases for ADR monitoring.METHOD: The electronic forms of ADR cases reported in 2006 by different units in Shenzhen that had been subjected to the evaluation of Guangdong provincial center were downloaded,and the related data were subjected to frequency analysis.The three time points(duration of medication,onset time of ADR,turnover time) were used to evaluate the integrity of ADR process recording,and the relevance was evaluated by means of contrast.RESULTS: 19 drug categories and total 465 kinds of medicines were involved in 3 303 ADR cases.The categories of antimicrobials and Chinese herbal preparations and ADR cases induced by these drugs ranked at the first and second among all the drugs.The lesions of ADR involved primarily skin and its accessories,followed by gastrointestinal system.Most ADR cases were caused thorough intravenous route of administration.The majority ADR cases had a favorable turnover.New and severe ADR reports were few.The qualities of most reports were poor.CONCLUSION: The training program for ADR reporters should be strengthened;ADR reporters' reporting awareness and responsibility should be strengthened to enhance ADR reporting quality,and physicians' prescribing behavior should be intervened properly so as to reduce the incidence of ADR.

Objective To evaluate the effects of acitretin combined with clarithromycin on tumor growth in human oral epidermoid carcinoma xenografts in nude mice,and to investigate their antitumor mechanisms.Methods A cell line of human oral epidermoid carcinoma was subcutaneously inoculated into 31 Balb/c nude mice to establish a xenograft model of human skin tumor.Then,the nude mice were randomly classified into 6 groups according to a double blind protocol:control group (n =6) remaining untreated,placebo group (n =5) treated with wheat flour,acitretin group (n =5) treated with acitretin 7.2 mg/kg per day,clarithromycin group (n =5) treated with clarithromycin 100 mg/kg per day,acitretin + placebo group (n =5) treated with both acitretin (7.2 mg/kg per day) and wheat flour,and acitretin + clarithromycin group (n =5) treated with acitretin (7.2 mg/kg per day) and clarithromycin 100 mg/kg per day.All the drugs were intragastrically administrated once daily.After three weeks of treatment,mice were sacrificed and xenografts were removed.Then,the size and weight of xenografts were measured,and pathological analysis was conducted.Real time-PCR was performed to quantify the mRNA expressions of vascular endothelial growth factor (VEGF) and nuclear factor (NF)-κB,and immunohistochemistry was carried out to observe the expression of VEGF as well as to determine microvessel density (MVD) and Ki-67 proliferation index.By using the software SPSS 19.0,analysis of variance was performed for comparison of measurement data,and least significant difference (LSD) test for paired comparisons.Results Both the size and weight of xenografts in the acitretin + clarithromycin group were significantly lower than those in the other groups (all P ＜ 0.05).Real-time fluorescence-based PCR revealed weaker mRNA expressions of VEGF and NF-κB in the acitretin + clarithromycin group compared with the control group,clarithromycin group and acitretin group (all P ＜ 0.05).As immunohistochemistry showed,the acitretin + clarithromycin group displayed a decrease in the expression rate (all P ＜ 0.01) and staining intensity of VEGF,MVD (all P ＜ 0.01) with a sparse distribution of microvessels,Ki-67 proliferation index (all P ＜ 0.05) and proliferative activity of tumor cells compared with the control group,clarithromycin group and acitretin group.Conclusion Acitretin combined with clarithromycin can synergistically inhibit the growth of human oral epidermoid carcinoma xenografts in nude mice,downregulate VEGF expression,and suppress angiogenesis and tumor proliferation.

Objective To evaluate the effect of transitional care on the quality of life in patients with maintenance hemodialysis (MHD).Methods 101 MHD patients with symptoms of kidney ＜ 80 points were assigned into the interventional group (47 of 51 cases completed the study) and the control group (45 of 50 cases completed the study) by random number table method.The patients in the interventional group received transitional care for 6 months,while control group received routine care.The effects on function index,satisfaction index and clinical index were evaluated at the 3rd month and 6th month after intervention.Results 6 months after intervention,the scores of physical composite,mental composite,burden of kidney disease,symptoms/problems list,effects of kidney disease in the interventional group were 51.78±5.91,55.32±5.36,29.79±17.64,79.39±6.73,68.02±11.38,while the scores of the control group were 38.22±9.46,42.03±8.32,19.58±17.25,69.49±10.10,52.09±16.78,and the difference between the two groups was statistically significant (t=5.308-9.063,Z=-3.07,P ＜ 0.01).The scores of self-management behavior,health locus of control in the interventional group were 71.30-±5.42,25.74±2.42,while the scores of the control group were 65.0±8.74,22.47±3.97 (t=4.132,4.759,P ＜ 0.01).The nursing satisfaction in the interventional group scored 91.06±7.29,which was significantly higher than the control group scored 86.22±10.72 (Z=-2.45,P＜ 0.05).The level of serum phosphorus (PO4),Ca × PO4 products,parathormone (PTH) in the interventional group were (1.76±0.35) mmol/L,(51.02±10.04) mg2/dl2,464.56 ng/L,which were significanlty lower than (2.01±0.54) mmol/L,(57.41±17.38) mg2/dl2,625.78 ng/L in the control group (t=-2.691,-2.167,-2.000 in tum,P ＜ 0.01 or 0.05).Conclusions Transitional care achieves good effectiveness on the quality of life in patients with MHD.

Objective To investigate the prevalence of multidrug resistant genes in Klebsiella pncumoniae.MethodsTwenty strains of multidrug resistant Klebsiella pneumoniae were isolated from burn patients.Susceptibility of these strains to 14 antibiotics was detected by KB method.PCR was used to detect oqxA,smrKpn,qacE,tehA,mdfA and qacEΔl-sul1 genes.ResultsThe antibiotic sensitivity rates of 20 multidrug resistant Klebsiella pneumoniae isolates to antibiotics tested were ＜ 30％ except that to imipenam.The positive rates of efflux pump genes mdfA,qacEΔl-sull and oqxA were 65％,100％ and 100％,respectively; while those ofsmrKpn,qacE and tehA were 0％,0％ and 15％.ConclusionoqxA gene has been detected in multidrug resistant Klebsiella pneumoniae from burn patients with high positive rate.

Objective To investigate the regulation of protein kinase C(PKC) to the expression of β-1,4-galactusyhransferase- Ⅰ ( β-1,4-GalT- Ⅰ ) and the influence on cytoskeleton and adherence ability of human umbilical vein endothelial cells(HUVECs) when stimulated by lipopolysaccharide (LPS). Methods Cultured HUVECs were pretreated by various PKC inhibitors or phorbol 12-myristate 13-acctate( PMA), an excitomotor of PKC respectively for 30 min, then stimulated by LPS for 4 h. β-1,4-GalT-Ⅰ expression were detected by RT-PCR and Western blot, expression of β-1,4-galactosylated carbohydrate chains and cytoskeleton were assayed by immumofluorescence, and adherence ability of HUVECs was observed by endothelialmonocyte cell adherence test. Results Up-regulated expression of β-1,4-GalT- Ⅰ and β-1,4-galactosylated carbohydrate chains in HUVECs stimulated by LPS were suppressed by PKC inhibitors and increased by PMA. F-actin and β-1,4-GalT- Ⅰ were partly co-localized in HUVECs. PKC inhibitor inhibited the effect of LPS on the distribution of F-actin and β-1,4-GalT- Ⅰ. Adherence ability of HUVECs enhanced by LPS was significantly suppressed by PKC inhibitor. Conclusion PKC signal transduction pathway may participate in regulating β-1,4-GalT-Ⅰ expression in endothelial cells stimulated by LPS. Furthermore, polytypes of PKC may participate in this regulating process; PKC might regulate cytoskeleton reorganization and adherence ability of EC through β-1,4-GalT-Ⅰ during inflammation.

Objective Through conducting the project of quality improvement for intrahospital transport of critically ill patients from ward to ICU,to establish graded management under early warning to improve transport efficiency and quality.Methods Through setting up project team,setting goals of quality improvement,measuring and analyzing transport status,the graded management under early warning was established from three aspects:condition,equipment and transport personnel.The graded management under early warning was applied to clinical nursing practice to evaluate the effects.Results There was no statistical difference before and after the implementation of graded management under early warning in gender,age and condition of critical ill patients between two groups,but the time of transport was significantly reduced after the implementation,while there was no equipment failure,and the incidence of adverse events associated with devices decreased effectively.Conclusion The establishment and application of graded management under early warning has effectively reduced the risks of transport,improved efficiency and quality of transport.