Objective To analyze the relations between obstructive sleep apnea and bradyarrhythmia.Methods From 1999 to 2005,203 patients who came from Bering Tongren Hospital and Fuwai Hospital were found to have sleep apnea in an ambulatory study. A Hoher electrecardiogram was recorded for 24 hours within 2 weeks after patients were diagnosed as obstructive sleep apnem Results Nocturnal episodes of bradyarrhythmia were identified in 12(5.9%)of 203 patients.Body mass index and respiratory disturbance index in patients with bradyarrhythmia(n=12)were higher than those in patientswithour bradyarrhymia(n=191)(34±5 735.24±6 and 63±15 vs.25±5,respectively,both P<0.01).There was a significant difference in end-apneic oxygen saturation in apnea/hypopnea episodes with and without bradyarrhythmia(63%±15% vs.75%±11%,P<0.05).A linear relation between end-apneic oxygen saturation and number of sinus arrests and heart blocks was not found.Conclusions Patients with apnea-associated bradyarrhythmia have higher body mflgB index and higher respiratory disturbance index than patients without bradyarrhythmi&Bradyarrhythmia occurres independently from decrease in oxygen saturation.

Twenty-six strains of Aeromonas hydrophila isolated in cultured fish and soft-shelled turtles were collected from various areas of China. Their susceptibilities to 21 antibacterial agents were studied by disc diffusion method. It was showed that all strains tcsted were resistant to pcnieillin and cephalosporins. Most of the strains were sensitive to norfloxacin, chloramphenicol and furazolidone, but up to 73.1%, 70. 1% and 50. 0% of strains tested showed resistance to sulfonamides, aminogylcosides and tetracyclines respectively. Meanwhile, their susceptibilities were examined by micro-dilution procedure against 8 commonly used antibacterials including ampicillin, furazolidone, teltracycline, oxytetracyeline ,steptomycin, chloramphenicol, sulfonamides and ciprofloxacin. Only two of 26 strains of A. hydrophila were sensitive to all drugs tested except ampicillin. The remaining 24 strains were resistant to various combinations of 8 drugs. Majority of the strains carried a marker of resistance to 2～3 drugs and highly sensitive to ciprofloxacin and chloramphenicol. The results indicated that A. hydrophila was highly resistant to most of common antibioties in China and more new antibacterials should be introduced into aquaculture to control ever-increasing fish diseases. The criterion for drug resistant bacteria was also discussed in this paper.

Twenty six strains of Aeromonas hydrophila isolated in cultured fish and soft shelled turtles were collected from various areas of China. Their susceptibilities to 21 antibacterial agents were studied by disc diffusion method. It was showed that all strains tcsted were resistant to pcnieillin and cephalosporins. Most of the strains were sensitive to norfloxacin, chloramphenicol and furazolidone, but up to 73.1%, 70.1% and 50.0% of strains tested showed resistance to sulfonamides, aminogylcosides and tetracyclines respectively. Meanwhile, their susceptibilities were examined by micro dilution procedure against 8 commonly used antibacterials including ampicillin, furazolidone, teltracycline, oxytetracyeline ,steptomycin, chloramphenicol, sulfonamides and ciprofloxacin. Only two of 26 strains of A. hydrophila were sensitive to all drugs tested except ampicillin. The remaining 24 strains were resistant to various combinations of 8 drugs. Majority of the strains carried a marker of resistance to 2～3 drugs and highly sensitive to ciprofloxacin and chloramphenicol. The results indicated that A. hydrophila was highly resistant to most of common antibioties in China and more new antibacterials should be introduced into aquaculture to control ever increasing fish diseases. The criterion for drug resistant bacteria was also discussed in this paper.

Objective To learn the impacts of major diagnosis, other diagnoses, major surgery and other surgeries on the grouping of DRGs, and to optimize the DRGs data grouping quality by analyzing the main influencing factors of DRGs.Methods Based on regrouping results of the 1 940 questionable cases which have been corrected, using SPSS 13.0 to study the impacts of the questions found on the grouping of DRGs.Results 438 Patient records affecting DRGs grouping were regrouped according to major diagnosis, other diagnoses, major surgery and other surgeries.Influences of the above four groups on the grouping vary in general For comparison between two groups, P＞0.007 1 between main surgery and other surgeries;while P＜0.007 1 for comparison between other groups.Conclusion The highest influence of grouping was found in questionable major diagnosis, much higher than such other factors as other diagnoses, major surgery and other surgeries.This conclusion conforms to the steps of basic DRGs grouping logic-sorting the eases according to major diagnosis first of all Correct naming of surgery influences DRGs grouping, but the influence extent of major surgery and other surgeries is close.

Objective To establish a mouse model of lung adenocarcinoma brain metastasis with human luc+-PC?9 cells stably expressing luciferase and to compare the evaluation values of bioluminescence imaging and18 F?FDG ( 18 F?flu?orodeoxyglucose) SPECT/CT in these models. Methods Suspension of luc+?PC?9 cells was injected into the left ventri?cle of BALB/c nude mice to establish a mouse model of brain metastasis from lung cancer. Bioluminescence imaging and18 F?FDG SPECT/CT were used to evaluate the metastasis of tumors as compared with HE?staining pathology as a golden standard. Results The success rate of brain metastases was 85% through injecting luc+?PC?9 cells into the left ventricle. The number of tumor cells was positively related to the intensity of light, with a linear correlation (R2 =0. 96). Fluores?cence was observed in the brain, spine and femur by bioluminescence imaging, and the metastases were confirmed by H&E pathological examination. 18 F?FDG SPECT/CT observed abnormal density collective foci in the spine or femur but not in the brain. Conclusions Injection of tumor cell suspension into the mouse left ventricle is a good method to establish a brain metastasis of lung cancer. Bioluminescence has a higher sensitivity and specificity in detecting brain metastasis and bone metastasis, with advantages of real?time, dynamical and non?invasive detection of tumor metastasis growth. 18 F?FDG SPECT/CT does not have superiority in detection of brain metastases but is suitable for detecting bone metastasis.

OBJECTIVETo investigate the expression of Toll-like receptor 4 (TLR4) in the liver tissue of rats with bile duct ligation (BDL)-induced hepatic fibrosis and evaluate the inhibitory effects of perindopril and losartan on TLR4 expression.

METHODSMale Wistar Rats were randomly divided into sham-operated group (n=6), BDL group, perindopril treatment group (2 mg/kg) and losartan treatment group (50 mg/kg) (n=12). Perindopril and losartan groups were further divided into two subgroups for corresponding treatments by gastric lavage once daily for 14 and 30 days. The protein level of TLR4 in the liver tissue was examined by Western blotting.

RESULTSIn 14-day BDL group, the protein level of TLR4 significantly increased to 6.53∓1.11 folds of that in the sham group (P<0.05), and was lowered significantly to 1.71∓0.41 folds and 0.95∓0.38 folds following perindopril and losartan treatments for 14 days. TLR4 expression significantly increased to 6.51∓0.87 folds and 5.64∓0.87 folds of that of the sham group in perindopril and losartan groups after the 30-day treatments (P<0.05).

CONCLUSIONTLR4 expression is up-regulated in the liver of rats with BDL-induced hepatic fibrosis, and can be lowered by perindopril and losartan treatmemts for 14 days.

Animals ; Bile Ducts ; surgery ; Down-Regulation ; drug effects ; Ligation ; Liver Cirrhosis, Experimental ; metabolism ; pathology ; Losartan ; pharmacology ; Male ; Perindopril ; pharmacology ; Rats ; Rats, Wistar ; Toll-Like Receptor 4 ; genetics ; metabolism

Objective To translate The Pressure Ulcer Risk Primary or Secondary Evaluation Tool (PURPOSE-T) into Chinese,and assess its reliability and validity in Chinese hospitalized patients. Methods The original PURPOSE-T was translated into Chinese and back translated and modified for cultural adaptation according to guidelines.The reliability and validity of the Chinese version of PURPOSE-T were tested in 230 hospitalized patients. Results The Chinese version of PURPOSE-T consists of three parts and contains 25 entries. The inter-rater consistency Kappa coefficient was 0.798, the weighted Kappa coefficient was 0.843. The evaluation results were compared with binary variables with a Kappa coefficient of 0.745. The test-retest reliability Kappa coefficient and the weighted Kappa coefficient were 0.863 and 0.892. Two classified assessment Kappa coefficient was 0.857. The item content validity index ranged from 0.83 to 1.00, and the scale content validity index was 0.98. The phi correlation coefficient of PURPOSE-T and Braden scale was 0.781; the phi correlation coefficient of Waterlow Scale evaluation result was 0.777. The correlation coefficient between Chinese PURPOSE-T items and Braden scale items ranged from 0.605 to 0.877 (P<0.01), and the Waterlow Scale items ranged from 0.599 to 0.887 (P<0.01). Conclusions The Chinese version of PURPOSE-T appears to possess adequate validity, test-retest reliability and internal consistency. The newly translated Chinese version of PURPOSE-T may be used to assess the risk of pressure injury in inpatients in China.

Objective:To analyze the 99 Tcm-methylene diphosphonate single photon emission computed tomography/spiral computed tomography (SPECT/CT)fusion imaging of bone metastases in patients with lung cancer and to evaluate the value of SPECT/CT in differentiating metastases from benign bone lesions.Methods:A total of 113 patients with bone metastases from lung cancer confirmed by pathology underwent bone scintigraphy and SPECT/CT imaging.Metastatic bone sites,quantity,up-take of radiotracer,and CT manifestations of each lesion were analyzed via bone scintigraphy imaging and SPECT/CT fusion imaging.Results:A total of 482 lesions from 113 patients were analyzed in this study.Among them,429 lesions were metasta-ses.Metastatic sites included spine(50.6%),thorax (29.1% ),pelvis (17.0%),extremities (2.1%),and skull(2.1%).CT manifestations were osteoblastic (41.0%),osteolytic (50.3%),mixed (4.0%),and normal (4.7%).Among these lesions, the proportion of hot spots displayed on SPECT/CT pictures was 90.7%(389/429),and the proportion of lesions with normal uptake of radiotracer was 9.3%(40/429).There were 53 benign lesions in 23 patients with bone metastasis.Conclusions:The most frequent metastatic sites in patients with lung cancer are spine and thorax.Bone metastasis from squamous carcinoma is more com-mon than from other types of lung cancer.The common CT manifestations are osteoblastic.The sensitivity and specificity of SPECT/CT fusion images for the diagnosis of bone metastatic lesions of lung cancer are high.

OBJECTIVETo analysis the pathological demography in Chinese patients undergoing renal biopsy from our nephrology center.

METHODSBetween January 1979 and October 2000 in Jinling Hospital, Nanjing, China, 10,002 attempts of percutaneous renal were performed in patients with renal disease from 33 provinces of China. The pathological classifications were made according to the WHO criteria of 1982 for renal pathology or the modified WHO criteria of 1995 by a panel of pathologists and nephrologists during routine clinical-pathological rounds. The pathological demography between those specimens collected from 1979 - 1989 and those from 1990 - 1999 was compared.

RESULTSThe mean age of the 10,002 subjects undergoing renal biopsy was 31.4 +/- 13.0 years (ranging from 1 to 78 years), with a male to female ratio of 1.3:1; for the 592 renal transplant recipients, the mean age was 37.5 +/- 9.1 years (ranging from 16 to 66 years), with a male to female ratio of 2.36:1. Primary glomerular diseases (PGD) accounted for 71% of the total patients undergoing renal biopsies, secondary glomerular nephritis (SGN) 23%, tubular-interstitial diseases 3.2%, unclassified renal diseases 1.3%, hereditary and congenital renal diseases 1.0%, end stage renal diseases 0.96%, and recently realized or rare renal diseases 0.15%. IgA nephropathy (IgAN) was the most frequent pathological pattern (40%) of PGD, followed by mesangial proliferative lesion (MsPL) (30%), membranous nephropathy (MN) (10%), and focal segmental glomerulosclerosis (FSGS) (6%). Lupus nephritis (LN) was the most pathology common seen (74%) in SGN. During the 22 years of the study period, there was a steady increase in patients with SGN discovered during pathological evaluation of renal disorders. A rise in prevalence was found in IgA nephropathy, MN (both P < 0.001), crescentic glomerulonephritis (P < 0.0001), anti-GBM disease, and hemolytic-uremic syndrome/thrombotic thrombocytopenic purpura related renal damages (both P < 0.001). There was a decrease in endocapillary proliferative glomerulonephritis (P < 0.001) and IgM nephropathy (IgMN) (P < 0.01) from 1990 - 1999 as compared to 1979 - 1989. Infrequent renal pathological entities were also diagnosed in this group, including Niemann Pick disease, Fabry's disease, POEMS syndrome, and lipoprotein glomerulonephropathy.

CONCLUSIONSThis is the largest series of renal biopsy data in China, and therefore may reflect the demographic picture of renal diseases in this country. Changes in prevalence of renal pathological entities were reflected in this group of patients over the last 22 years. In primary glomerular diseases, IgA nephropathy is still the most frequently observed pathological pattern. In SGN, LN appeared the most often. Increased prevalence was found in anti-GBM nephritis and HUS/TTP.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Japan ; epidemiology ; Kidney Diseases ; epidemiology ; pathology ; Male ; Middle Aged ; Prevalence

Objective:To explore the application effect of breakthrough series (BTS) quality improvement model in the prevention of catheter-related bloodstream infection in hospitalized patients with indwelling non-cuffed catheter (NCC).Methods:Using a non synchronous pre and post control study method, convenience sampling was used to select NCC patients from four hospitals in Tianjin from January to September 2022 who received conventional nursing plans as the control group, and NCC patients from February to October 2023 who received nursing plans based on the BTS quality improvement model as the observation group. Compared the incidence of NCC related bloodstream infections between two groups of patients, the implementation of key preventive measures for NCC related bloodstream infections by nursing staff, and patient satisfaction.Results:Among the 984 patients included in the control group, there were 687 males and 297 females, aged (62.43 ± 13.77) years old; among the 959 patients included in the observation group, there were 651 males and 308 females, aged (61.96 ± 13.89) years old. After applying the improved model, the incidence of NCC related bloodstream infections in the observation group was 0.12‰ (1/8 676), lower than the control group′s 0.71‰ (7/9 827), and the difference was statistically significant ( χ 2=4.37, P<0.05) ;the implementation rate of key measures for preventing NCC related bloodstream infections in the observation group was 90.00% (54/60) for catheter outlet care and 91.67% (55/60) for maximizing sterile barrier, both higher than 70.37% (38/54) and 75.93% (41/54) in the control group, with statistical significance ( χ2=7.03, 5.30, both P<0.05); the total satisfaction rate of patients in the observation group was 92.91% (891/959), which was higher than 58.64% (577/984) in the control group, and the difference was statistically significant ( χ2=15.28, P<0.05). Conclusions:The implementation of BTS quality improvement model is helpful to improve the nursing quality of patients with indwelling NCC dialysis and improve the patient outcomes.