Objective To evaluate the effect of selective oral decontamination (SOD)on reducing incidence of ventilator-associated pneumonia (VAP).Methods Sixty patients hospitalized in an intensive care unit (ICU)for >72 hours and with mechanical ventilation for >48 hours from January to June 2102 were selected for study,patients were ran-domly divided into trial group(n =30)and control group(n=30).All patients received cefotaxime intravenous drip for 4 days,then trial group received oropharyngeal application of tobramycin during the whole process of mechanical ventila-tion,control group topically received saline solution,the incidence and onset time of VAP ,duration of mechanical ventila-tion,length of stay in ICU,and mortality of two groups were compared.Sputum in the trachea was taken periodically for bacterial culture.Results The incidence of VAP in trial group was lower than control group (30.00% vs 63.33%);the onset time of VAP was later than control group ([9.37±6.62]d vs [5.17 ±4.72]d);Overall duration of me-chanical ventilation was less than control group ([7.63 ±6.91 ]d vs [12.26 ±9.36]d);length of stay in ICU was shorter than control group([13.56±7.22]d vs [16.79±11 .16]d)(all P <0.05).There were no significant differ-ence in mortality between two groups(P >0.05).Conclusion SOD is effective for preventing and treating VAP,it can reduce the incidence of VAP,delay onset time of VAP,shorten mechanical ventilation,and reduce length of stay in ICU.

300 ?m ) damage when the islets are rewarmed to 37 ℃ . These novel findings may help to understand the pathophysiology of early loss of islet tissue after transplantation,and may provide a new strategy to improve graft function in the clinical setting of islet transplantation.

Objective To study the pathway of IFN-?-iNOS-NO on T lymphocytic cells in the rats with experimental autoimmune myasthenia gravis (EAMG).Methods Lewis rats were divided randomly into groups EAMG , normal control(NC) and completed Freund's adjuvant control(CFA-C) . The rats were immunized in foot pad, abdomen and back subcutaneouly with the AChR protein extracted from electric organ of Narcine timilei and CFA in the EAMG group, or only with CFA in the CFA-C group. The above-mentioned emulsions were injected again after 4 weeks . At the 7th week after first immunization, T lymphocytic cells in every rat were separated from the spleen. After cultured in vitro for 48 h, the content of IFN-? in the supernatant of cultured T lymphocytic cells was detected by enzyme-linked immunoadsordent assay (ELISA), and the level of NO was examined with Griess reagent method. Results The contents of IFN-? were (81.68?10.23 ) pg/ml in EAMG group,(29.20?5.41) pg/ml in NC group,(31.54?6.12) pg/ml in CFA-Cgroup.The levels of NO were (23.68?7.13 )?mol/L in EAMG group ,(9.05?2.11) ?mol/L in NC group,(10.21?2.67 )?mol/L in CFA-C group.The contents of IFN-? and NO in EAMG group were increased markedly than groups NC and CFA-C(allP

Objective To compare the cerebral vessels stenosis in acute cerebral infarction patients with or without diabetes mellitus.Methods Using case-control study,51 acute cerebral infarction patients with diabetes mellitus and 64 patients without diabetes mellitus were checked by digital subtraction angiography(DSA).The condition of stenosis and obstruct of vessels in intracranial and extracranial were compared.Results Stenosis of intracranial arteries was frequent in both two groups.The main involved arteries included M1 and M2 segments of middle cerebral artery and external cranial segment of internal carotid artery.The rate of cerebrolvascular abnormality in the patients with diabetes mellitus(84.31%) was higher than that in the patients without diabetes mellitus(70.31%).Stenosis of multiple arteries(52.94%),arteriostenosis combined with ulcer or plaque(39.21%) and collateral circulation development(11.63%) were found in diabetic patients,while the rates were 18.75%,17.19% and 31.11%,repectively,in non-diabetic patients.These differences between two groups were statistical significances(all P

Objective To evaluate the diagnostic value of TSSC1 in glioma patients and its influence on cell biologi-cal behavior of glioma U87 cells. Methods RT-PCR and Western blot were used to examine the expression of TSSC1 in glioma samples, including 80 normal paraneoplastic tissues and 80 primary tumors. MTT and transwell were used to analyze the effect of TSSC1 knockout on proliferation, migration, and invasion in U87 cells. Results TSSC1 is down-regulated in glioma compared to its paraneoplastic counterparts and negatively related to higher grade. Furthermore, knockdown of TSSC1 expression results in increased proliferation, migration and invasion in U87 cells in vitro. Conclusion Our results may worked as a marker for early diagnosis and prognosis of glioma.

ObjectiveTo review the etiology and classification of cholangiectasia. MethodThe clinical data of 1098 patients with cholangiectasia treated from January 2000 to December 2009 were retrospectively analyzed. Results For the 1098 patients, 69 patients (6.3％) had congenital choledochal cyst, and 1029 patients (93.7％) had secondary cholangiectasia which were secondary to 22 diseases, The top 5 of the etiological diseases were bile duct stones (366 patients, 33.3 ％), pancreatic head carcinoma (137 patients, 12.5％), peri-ampullary carcinoma (122 patients, 11.1％), cholangiocarcinoma (68 patients,6.2％),and chronic pancreatitis or pancreatic head cyst (62 patients,5.6 ％). ConclusionsCholangiectasia can be divided into two major categories (congenital and secondary). Congenital choledochal cyst accounted for 6.0％, secondary cholangiectasia accounted for 94 ％.The most common etiologies were bile duct stones, pancreatic head carcinoma and peri-ampullar carcinoma.

Objective To investigate the radiation dose to the lens of patients in temporal bone CT scanning with different protocols. Methods With the same values of kV and effective mAs, the tranaxial and coronal scans of exsomatize cadaveric head was performed with conventional sequential scan mode,routine multi-slice helical scan and modified multi-slice helical scan, respectively. The values of CT volume dose index (CTDIvol) and dose length product (DLP) at various scanning mode were anylyzed, and effective doses of subject were calculated. Organ doses of the lens were measured with thermoluminescence dosimetry (TLD). Results When sequential scan mode was selected, gross effective dose was 1.21 mSv,while organ doses to lens were 50.96 and 1.73 mGy separately in axial and coronal slice scan,respectively. Effective dose was 0. 803mSv at helical scanning, while dose to lens was 40. 17 mGy. With modified helical scan mode, the effective dose was similar to routine helical scan, but dose to lens was 10.33 mGy which was significant lower than that of routine helical scan (40.17 mGy). Conclusions With the same values of kV and effective mAs, the effective doses and lens dose obtained in sequential axial and coronal scan were 1.51 times and 1.31 times higher than helical scan, respectively. With modified helical scan mode thinner slice images could be used to reformat axial, coronal and sagittal plane images, and lens dose was reduced by 74.3%. The modified helical CT scan mode of temporal bone could be selected in the clinical application.

Objective To study the effects of dendritic cells (DC) modified with transforming growth factor ?1 (TGF-?1) gene on experimental autoimmune myasthenia gravis (EAMG) in Lewis rats. Methods 30 female Lewis rats were divided randomly into 6 groups: normal group, EAMG group, DCs treatment group, pcDNA_3-TGF-?1-DCs treatment group, pcDNA_3-DCs treatment group and normal saline group. The rats were immunized with the acetylcholine receptor (AChR) protein extracted from electric organ of Narcine timilei and completed Freund’s adjuvant (CFA) in the experiment groups except normal group. 2?106 pcDNA_3-TGF-?1-DCs/rat were injected subcutaneously into the backs of the rats that had been immunized 5 days earlier with AChR+CFA. The rats in DCs treatment group, pcDNA_3-DCs treatment group and normal saline group were injected in parallel with untreated DCs, pcDNA_3-DCs and normal saline respectively. Then the clinical manifestations were observed everyday. And 7 weeks after the first immunization, repetitive nerve stimulation, detection of acetylcholine receptor antibody (AChRab) and ultrastructural study of neuromuscular junction (NMJ) were performed. Results (1) The mild symptoms were observed on 1 or 2 rats in the experiment groups except normal group after a week, which lasted for 2 to 5 days. After about 5 weeks, the rats in EAMG group, DCs treatment group, pcDNA_3-DCs treatment group and normal saline group presented some symptoms at different degree like myasthenia gravis, and only one of the rats in pcDNA_3-TGF-?1-DCs treatment group presented mildly decreased activity. (2) The significant decrement of repetitive nerve stimulation were found in EAMG group, DCs treatment group, pcDNA_3-DCs treatment group and normal saline group(16.75?6.13, 17.75?7.81, 18.25?8.22 and 16.50?7.14, respectively), but there was no attenuation in pcDNA_3-TGF-?1-DCs treatment group and normal group(3.20?3.70 and 5.60?2.70, respectively). The percentage of decrement in pcDNA_3-TGF-?1-DCs treatment group was lower than that in EAMG group(5.60?2.70 and 16.75?6.13, respectively,P0.05). (4) The combined AChRs in NMJ of the rats in pcDNA_3-TGF-?1-DCs group were higher than that in EAMG group, and the structure changes of the synapse were relieved.Conclusion It suggests that DCs, transfected with pcDNA_3-TGF-?1, when injected subcutaneously into Lewis rats with incipient EAMG, could inhibit the production of AChR-Ab, relieve the pathologic changes in NMJ and ameliorate the development of EAMG.

Objective To explore the effect of TGF-β microbubble targeting on the treatment of skeletal muscle injury in rats.MethodsEighty SD rats of 2 months old were randomly divided into experimental group(including TGF-β microbubble),pure drug group,microbubble group(exclusive drug) and control group,20 SD rats in each group.Four groups accepted ultrasonic transmission with consistent time and frequency.The contraction stress and stress relaxation of injured gastrocnemius muscle were measured,the changes of injured gastrocnemius muscle were observed by light microscope and electron microscope.Results There was no statistically significant difference in contraction stress of gastrocnemius muscle among all groups at 1,5,9 days after injury(P>0.05).And at 14 days,the contraction stress of gastrocnemius muscle of the experimental group and the pure drug group were obviously higher than those of the rest two groups,the differences were significant(P<0.05).The difference of gastrocnemius muscle contraction stress was statistically significant between the experimental group and the pure drug group(P<0.05).For the stress relaxation of gastrocnemius muscle,the experimental group was lower than the other three groups at 1 day after injury,the differences were significant(P<0.05).Light microscopy showed the number of muscle fiber in the experimental group increased obviously at 9 days after injury.There was no scarring at 14 days after injury.Electron microscope showed mitochondria and sarcoplasmic reticulum increased in the experimental group,and the new muscle cells and satellite cells were significantly more than those of the rest three groups.Conclusion TGF-β cell targeted therapy can obviously improve the shrinkage stress of skeletal muscle in rats after injury and recover the stress decay,which can obviously promote the injury repair and regeneration of skeletal muscle,and reduce scar formation at the same time.

Objective To emphasize the correlation and concordance of electronic medical record through analysis of frequently asked problems on handwritten medical record.Methods The problems of electronic medical record were classified and found the typical cases to analyze.Results In order to improve the quality of medical record,the quality control of electronic medical record must be strengthened and the phenomenon that some doctors pay attention to hand-written med-ical record more than electronic medical record must be overcame.Conclusion The normative management of electronics medical is strengthened that is fundamental guarantee for paper-based medical records.