OBJECTIVE To explore the risk factors in aged patients with ventilator-associated pneumonia(VAP) and to provide the corresponding clinical prevention strategies. METHODS The ages,underlying diseases,mechanical ventilation method,use of antibiotics,and pathogenic bacteria of the VAP patients were investigated and analyzed. RESULTS Totally 155 VAP of elderly patients had serious underlying diseases,and treated with broad-spectrum antibiotics,tracheal intubation or trachea incision.Most pathogenic bacteria were mutiple-resistant. CONCLUSIONS The prevention of VAP was in priority for control of VAP patients.In order to control the occurrence and spread of VAP,clinicians should cut the time of ventilator,pay more attention to sterilization and isolation,and strengthen the tend of the patients.

Objective To observe the action of lowering blood fat of Agaricus blazei Murill ?-6 polyunsaturated fatty acid(?-6APFA) on hyperlipemia rats and mice.Methods Sixty rats were randomly divided into control group,model group,natural soybean phospholipids capsule(NSPC)0.70 g?kg~(-1) group,?-6APFA 0.28,(0.14,)0.07 g?kg~(-1) groups(n=10).The other groups except control group were given high-fat diets for 14 d,on the fourteenth day the rats were administered orally,the control group and model group were administered distilled water 10 mL?kg~(-1) at the same volume,14 days after continuous administration,rats were anesthetized,the blood were extracted from abdominal artery,T-CHO,TG,HDL-C,LDL-C in sera were determined. At the same time,the activity of SOD in liver and the content of MDA were determined,the fat accumulated coefficient was calculated.72 male mice were randomly divided into control group,model group,NSPC 1.0 g?kg~(-1) group,(?-6APFA)0.4,0.2,0.1 g?kg~(-1) groups(n=12).Mice were administered continuously,16 h before the last administration,except control group,the mice in the other groups were injected 75% yolk physiological salt solution 0.5 mL through the abdominal cavity,and began to starve,1 h after the last administration,blood was extracted from eyeball,serum T-CHO and TG were determined.Results Compared with model group,T-CHO and TG in rats treated with NSPC 0.70 g?kg~(-1) and ?-6APFA 0.28 g?kg~(-1) all reduced and HDL-C raised obviously(P0.01).)Compared with model mice,T-CHO and TG in acute hyperlipemia mice treated with NSPC 1.0 g?kg~(-1) and ?-6APFA0.4,0.2 g?kg~(-1) reduced obviously(P

OBJECTIVE To study drug resistance status of infected bacteria in abdominal surgical wound for their countermeasures. METHODS The abdominal surgical infection of a hospital was investigated from Jan 2000 to Dec 2004.Bacterial isolation and identification were carried out complying with National Operation Procedure of The Clinical Laboratory.Drug sensitivity test was performed with KB method. RESULTS The infection rate was 4.1%.The species were predominated by Gram-negative bacilli(71.1%),especially Escherichia coli(17.2%),Pseudomonas aeruginosa(16.7%) and Klebsiella pneumoniae(12.7%),and they all beared high antibiotics resistance. CONCLUSIONS Special attention should be paid to abdominal surgical wound infection.

Objective To make clear the knowledge level of emergency treatment during the disasters among emergency nurses,and then make out the countermeasures.Methods Using the self-designed questionary to investigate the knowledge level of emergency treatment during the disasters among emergency nurses.The contents of survey included: general condition,related experiences about emergency treatment,the anxiety and the pattern of how to obtain the related knowledge.Results The level of knowledge of emergency treatment was different in the different nurses according to their different working time.Most of the emergency nurses had not accepted the normal training about the emergency treatment of disasters.Conclusion The nursing administers should put out certain measures to strengthen the training about emergency treatment,and then improve the nurses ability to deal with disaster.

BACKGROUND: Previous results of our study show that oyster extract has some protective effects on apoptosis of the neuroepithelium in neural tube defects induced by hyperthermia in vivo.It remains unclear whether the extraet also protects in vitro cultured neural stem cells.OBJECTIVE: To investigate the protective effect of oyster extract on apoptosis of cerebral neural stem cells induced by hyperthermia.METHODS: The cerebral neural stem cells of embryonic mice of 13 days were cultured in vitro.Nestin expression was detected by immunofluorescence method to identify neural stem cells.The neural stem cells of passage 3 were divided randomly into 4groups: hyperthermia control group and oyster treated Ⅰ,Ⅱ,Ⅲ groups(mass concentration 2.5,5,10 g/L oyster extract solution).In addition,culture solution control group(no cells),and culture solution+oyster extract control group(no cells)were designed.All oyster extract groups and control groups were treated by hyperthermia over 39 ℃.The survival rate and the vitality of neural stem cells were detected by trypan blue staining and MTT assay.Western-blotting was employed to explore the expression of p53 in cerebral neural stem cells of each group.RESULTS AND CONCLUSION: The survival rate and the value of MTT assay in oyster treated groups Ⅱ and Ⅲ were significantly greater than hyperthermia control group(P < 0.05),but the expression of p53 in oyster treated groups Ⅱ and Ⅲ were weaker than hyperthermia control group.Oyster extract plays an important protective role in the apoptosis of neural stem cells induced by hyperthermia.

Objective:To investigate the difference of CD3+CD4+and CD3+CD8+T cells between patients with advanced small cell lung cancer and with non-small cell lung cancer, and provide available reference for treatment.Methods: Peripheral blood was taken from 65 patients with advanced lung cancer which was included 14 cases of small cell lung cancer and 51 cases of non-small cell lung cancer, 20 cases normal controls.The expression of CD3+CD4+ and CD3+CD8+ on lymphocytes was analyzed with flow cytometry.Results:We found that the percentage of CD3+CD4+T cells in small cell and non-small cell lung cancer patients were both much less than that of normal controls.There was no significant variation in the percentage of CD3+CD8+T cells between advanced lung cancer patients and normal controls.CD4+/CD8+in patients with advanced small cell lung cancer were a lot less than those in normal controls.Conclusion:Both of the percentage of CD3+CD4+T cells in small cell and non-small cell advanced lung cancer patients were significantly decreased than that in normal controls.Patients who attacked with advanced lung cancer were severely injured in cellular immunity.

Objective To investigate the prevalence of psoriatic arthritis (PsA) in patients with psoriasis and its clinical features.Methods A cross-sectional study was conducted among patients diagnosed with psoriasis from January 2014 to January 2015.Through a questionnaire survey,the diagnosis of PsA was confirmed according to the Classification Criteria for Psoriatic Arthritis (CASPAR) in patients with suspected PsA.Clinical data were collected from patients with newly and previously diagnosed PsA.Statistical analysis was carried out by t test for two-group comparisons,one-way analysis of variance (ANOVA) for multi-group comparisons,and chi-square test for comparisons of rates.All the statistical tests were two-sided.Results Totally,1 062 outpatients with psoriasis were enrolled into this study,and 125 were suspected to have PsA.According to the CASPAR,70 (6.59％) patients were finally diagnosed with PsA,with the ratio of male to female being 2.1 ∶ 1,and 45 of them (64.29％) were newly diagnosed.Psoriasis vulgaris lesions were observed in 50 (71.43％) patients with PsA,and were the most common type of skin lesions in patients with PsA.There were 5 clinical types of PsA in these patients,including asymmetrical oligoarthritis (23 cases,32.86％),symmetric polyarthritis (19 cases,27.14％),distal interphalangeal predominant arthritis (10 cases,14.29％),vertebral or sacroiliac arthropathy (7 cases,10.00％),and arthritis mutilans (11 cases,15.71％),with some overlap among these clinical types.As relatively distinctive manifestations of PsA,dactylitis and enthesitis were observed in 14 (20.00％) and 8 cases (11.43％) respectively.In addition,43 (61.43％) cases had nail involvements.Conclusion To master clinical features of PsA and to diagnose it early are of great significance for long-term prognosis of PsA patients.

Objective The aim of this study is to investigate the expression of Survivin in laryngeal car-cinoma and to elucidate the relationship between cell proliferation and the expression of Survivin .Methods The expression and DNA quantification of Survivin in 63 cases of laryngeal carcinoma and 15 cases of normal laryngeal tissues were detected by immunohistochemical staining ( SP) and flow cytometry .Results Forty-five sections of laryngeal carcinoma were positive for survivin as determined by immunohistochemical staining ,but Survivin was undetected in normal laryngeal tissues .The intensity of Survivin expression was significantly increased with tumor differentiation and lymph node metastasis (P<0.05),and was negatively correlated with age ,gender and clinical stage of patients(P>0.05).High DNA index(DI)and proliferation index(PI)were detected in laryngeal carcino-ma(P<0.05),and PI was positively correlated with expression of Survivin (P<0.05).Conclusion Survivin overexpression triggers laryngeal carcinoma cell hyperproliferation ,especially in development of laryngeal carcino-ma.These data identify Survivin as an important target in laryngeal carcinoma and provide a translational pathway for developing new therapies against this target .

Objectives To optimize the curriculum for better education quality. Methods By literature review, the curriculum of the bio-medical English program of Peking University was summa-rized. Interviews were conducted on 8 sophomores of the program based on convenience sampling for their concerns over the curriculum and a questionnalre was designed based on such concerns. Ques-tionnalre survey was used for the remarks and suggestions of the 129 graduates of year 2002, 2003 and 2004 on the curriculum, with 79 valid questionnalres collected and the data analyzed by Microsoft Excel. Results Respectively 64 (81.02%), 52 (65.82%), 53 (67.09%) respondents believe the se-quence, duration and connection of the English courses are appropriate and 65 (82.27%), 46 (58.22%), 50 (63.29%) respondents believe the sequence, duration and connection of the medical courses are appropriate. 63 (81.77%) respondents hoped that they could do experiments in the medical courses, but 18 of them (23.08%) worried that the experiments would make the curriculum more tense. 71 (89.97%) respondents thought that the internship at hospital in the curriculum was conducive to better understanding of medical course contents . Suggestions on the improvement of the curriculum were also made by respondents. Conclusions The curriculum could be further optimized, especially on the connection between different courses, although most of the respondents by and large believe that the curriculum of the program is rational and hold positive attitude towards the internship in hospital and experiments in the curriculum.

Objective:To evaluate the efficacy of Epstein-Barr nuclear antigen 1/immunoglobulin A (EBNA1/IgA), BamH1 Z transactivator/IgA (Zta/IgA), capsid antigen/IgA (VCA/IgA), and Epstein-Barr virus deoxyribonucleic acid (EBV-DNA) in detecting different stages of na-sopharyngeal carcinoma (NPC). The relationship between the EBV markers and stages of NPC was also analyzed. Methods:Blood sam-ples of 152 untreated patients with NPC and 675 healthy subjects were collected.ELISA was used to detect the serum levels of EBNA1/IgA, Zta/IgA, and VCA/IgA. Fluorescence quantitative PCR (FQ-PCR) was used to detect the plasma levels of EBV-DNA. ROC and correla-tion analyses were employed to assess the detection assays for NPC diagnosis. The positive rates of EBV markers in NPC patients in dif-ferent stages were analyzed statistically. Results: The positive rates of EBNA1/IgA, Zta/IgA, VCA/IgA, and EBV-DNA in NPC patients were higher than those in the healthy individuals. The expression of EBNA1/IgA was relatively high in early NPC. The sensitivity of EB-NA1/IgA was 77.8%. In advanced NPC, the level of EBV-DNA was high, and the sensitivity of EBV-DNA was 88.8%. The specificity of EBV-DNA and EBNA1/IgA could reach more than 96%. The combination of EBV-DNA and EBNA1/IgA showed the best diagnostic value, with a sensitivity of 92.1%(early stage 82.5%, advanced stage 98.9%) and a specificity of 96.9%. The positive rates of EBV-DNA were positively associated with the NPC clinic stage and N stage. The positives rates of Zta/IgA were positively associated with the NPC N stage. Conclusion:The best single index for NPC screening in an asymptomatic population is EBNA1/IgA. EBV–DNA is an ideal index for auxiliary diagnostics of advanced NPC. The combination of EBV-DNA and EBNA1/IgA shows the best diagnostic value. EBV-DNA is an important index in the stage and illness monitoring of NPC. Zta/IgA can indirectly reflect the character of lymph node metastasis, and it may be useful in assessment of NPC surveillance.