Objective To explore the causes of nosocomial infections in ICU as to provide scientific evidence for the corresponding intervention measures.Methods The retrospective survey was used to investigate and analyze the incidence of nosocomial infections in ICU from 2013 to 2014.Results The total of 1225 patients investigated,182 patients suffered from nosocomial infections and the nosocomial infections rate was 14.86％.The etiology of ICU specimen was 95.22％.Gram negative bacilli,Gram positive bacteria and fungi,which accounted for 69.16％,18.22％ and 12.62％ respectively.The main infection site were respiratory tract,blood and urinary tract,which accounted for 70.43％,11.30％ and 4.78％ respectively.Conclusion The hospital infection rate of ICU in our hospital is kept the same level of the hospital in the same area.Etiology specimens rate comply with national standards.Main pathogens are gram negative bacilli,and the main site of infection is respiratory.

Objective To evaluate the application of nutritional risk screening in children hospitalized in general surgery department,in order to provide the basis for selecting the screening tool.Methods Nutritional risk screening was performed on 123 children hospitalized in the general surgical department by using the Assessment of Malnutrition in Paediatrics (STAMP) and Paediatric Yorkhill Malnutrition Score (PYMS).The malnutrition prevalence based on the World Health Organization (WHO) child growth standards(WHO standards) was evaluated.The data of hospital stay and total hospital expenses were recorded and analyzed.Results By using the STAMP and PYMS,76.4％ (94/123 cases) and 85.4％ (105/123 cases) of the patients had low-moderate nutritional risk,23.6％ (29/123 cases) of the patients and 14.6％ (18/123 cases) had high nutritional risk,respectively.The malnutrition prevalence was 17.9％ (22/123 cases) based on WHO standards.Children with high nutritional risk screened by STAMP,PYMS and malnutrition evaluated by WHO standards had significantly longer hospital stay(days) and higher total hospital expenses(yuan) compared with those in low-moderate nutritional risk or non-malnutrition patients,and the differences were statictically significant (hospital stay:STAMP:M =8.50 ＞ 7.00,Z =-2.608,P =0.008;PYMS:M =8.00 ＞6.25,Z =-2.761,P =0.006;WHO standards:M =8.25 ＞6.75,Z =-2.812,P =0.005.Total hospital expenses:STAMP:M =4 970.46 ＞ 2 939.07,Z =-2.913,P =0.004;PYMS:M =5 486.57 ＞ 3 294.96,Z =-3.024,P =0.002;WHO standards:M =5 515.87 ＞ 3 170.04,Z =-3.098,P =0.002).According to WHO standards,the sensitivity,specificity,Youden index,positive predictive value and negative predictive value of STAMP and PYMS were 68.2％ vs.77.3％,86.1％ vs.99.0％,54.3％ vs.76.3％,51.7％ vs.94.4％,92.6％ vs.95.2％ respectively.Conclusion Both STAMP and PYMS can be used for nutritional risk screening in hospitalized children in general surgery department,while sensitivity and specificity of PYMS are better than those of STAMP.

Aim To investigate the effects of total gin-senosides ( TG) on microvascular regeneration and car-diac function in rat after acute myocardial infarction ( AMI ) . Methods The acute myocardial infarction model was created with left coronary artery ligated in male Sprague Dawley rats. The model rats were ran-domly divided into sham, model, TG low and high dose groups. TG groups were injected into abdominal cavity with TG(20 mg·kg-1·d-1, 40 mg·kg-1· d-1 ) . Sham and model groups were injected with e-qual-volume normal saline. On the 35th day post-opera-tion, heart function was examined by color doppler ul-trasoundination. HE, Masson and immunohistochemis-trical staining were used to observe the histopathologi-cal changes of myocardium and micro vessel density. The level of vascular endothelial growth factor( VEGF) and basic fibroblast growth factor( bFGF) mRNA were detected by real-time PCR. Results Compared with the model group, high and low dose TG obviously de-creased the left ventricular end diastolic dimension, the left ventricular end-systolic dimension, the left ventric-ular end-diastolic volume and the left ventricular end-systolic volume(P<0. 05 and P<0. 01), and signifi-cantly increased the ejection fraction and the fractional shortening ( P <0. 01 ) . The histopathological changes of myocardium on myocardial infarction and fibrosis were dramatically reduced by TG. But ventricular wall was thicker. Two dose TG remarkably increased the expressions of VEGF and bFGF mRNA and micro ves-sel density of compositive CD31 + cells in ischemic myocardial tissue and around of infarct area(P<0. 01, P <0 . 0 5 ) . Conclusions TG could improve the car-diac function of acute myocardial infarction rat. The mechanism may be related to the upregulation of VEGF and bFGF gene expression, the promotion angiogene-sis, then the improvement of blood supply in myocardi-al infarction area.

Objective To investigate the status of nutritional risk and clinical outcome in children hospitalized in the general surgical department, which can provide basis for clinical nutritional support and selecting the screening tool. Methods Nutritional risk screening was performed on 506 children hospitalized in the general surgical department by using the Paediatric Yorkhill Malnutrition Score (PYMS). The data on incidence of complications, parenteral nutritional support during hospitalization, length of hospital stay and total hospital expenses were recorded. Results Of the 506 cases, 64.6%(327/506) had low nutritional risk, 27.1%(137/506) had moderate nutritional risk, and 8.3%(42/506) had high nutritional risk. Hepatic and gall diseases were the most common types of moderate nutritional risk (55.2%, 16/29), intestinal obstruction were the most common types of high nutritional risk (23.1%, 6/26). The incidence of complications, parenteral nutritional support during hospitalization, length of hospital stay and total hospital expenses were 10.2%(14/137), 21.9%(30/137), (9.54±4.95) d, (6 899.13±3 281.18) yuan RMB and 21.4%(9/42), 35.7%(15/42), (10.60±7.25) d, (7 521.64±6 026.23) yuan RMB in moderate or high nutritional risk children, and 0.9%(3/327), 3.1%(10/327), (17.17 ± 4.17) d, (4 691.96 ± 3 114.43) yuan RMB in low nutritional risk children, and there were significant differences (χ2/F=18.665-64.554, P<0.05). Conclusions Moderate or high nutritional risk is seen in children hospitalized in the surgical department. High nutritional risk score is correlated with adverse clinical outcome. PYMS can be used for nutritional risk screening in hospitalized children.

AIM To provide toxicokinetics data for toxicity studies of repeated doses of sodium 9-[2-(phosphonomethoxy) ethyl] adenine (PMEA-Na). METHODS The concentrations of PMEA-Na in plasma and urine were determined by HPLC/MS/MS method after single and multiple iv administrations in dogs. Data were executed by the statistical moment method to acquire the toxicokinetics parameters. Serum biochemical tests and histopathological examination were performed. RESULTS The system exposure of PMEA-Na in dogs was dose-dependent over the dose range of 1.0-6.0 mg·kg-1. The areas under the plasma concentration-time curve of PMEA-Na after single and multiple iv administrations at 1.0, 3.0 and 6.0 mg·kg-1 dosage were (2.3±0.5), (8.4±1.6), (17.5±3.7) and (5.0±0.4), (15.9±3.2), (30.3±4.7)mg·L-1·h, respectively. The urinary excretion of PMEA-Na in 72 h after iv administration was (87.0±4.8)% at the dose of 3.0 mg·kg-1. In 6.0 mg·kg-1 dose group, liver enzyme activity of glutamic-pyruvic transaminase and serum levels of total bilirubin, blood urea nitrogen, creatinine and triglycerides were all significantly elevated; glucose level significantly decreased comparing with the control group. Histopathological observation showed distinct pathological changes in liver and kidney tissues of 6.0 mg·kg-1 dose group. CONCLUSION There was evidence of toxicity after repeated-dose (14 d) of PMEA-Na in dogs and the major toxicity target organs were the kidney and liver.

ObjectiveTo explore the effect of Yinaotongluo capsule on preventing the microcirculation dysfunction in rats.Methods40 SD rats were randomly divided into the thrombosis model group, three Yinaotongluo capsule groups (low, moderate and high dosages) and control group with 8 rats in each group. Photosensitizer was injected through vessel. Endothelium damage, cell adhesion and thrombosis were induced by photochemistry. The change of microcirculation was recorded and analyzed by microphotography technique.ResultsYinaotongluo capsule groups could prolong the time to thrombosis induced by photochemistry compared with control group (P<0.05). However, the area of thrombus to vessel significantly decreased in all Yinaotongluo capsule groups compared with control group (P<0.01). The effect of moderate dosage group of Yinaotongluo capsule was superior to Buchangnaoxintong group.ConclusionYinaotongluo capsule can improve the microcirculation of mesentery of rats, in part it can improve the systematic microcirculation of rats.

10.3969/j.issn.2095-4344.2013.23.010

In order to investigate the relationship between the expression of cyclin A and drug resistance in adult patients with acute leukemia (AL), the mRNA expression of cyclin A, mdr1, Top II alpha, bcl-2 was detected in 64 adult patients with AL and 20 normal controls by semi-reverse transcription polymerase chain reaction (semi-RT-PCR). It was found that the cyclin A and Top II alpha mRNA expression levels in drug resistant group were significantly lower than in sensitive group (P < 0.01). Under the same experimental condition no cyclin A mRNA expression was detectable in all normal controls. The mdr1 and bcl-2 mRNA expression levels in resistant group were significantly higher than in sensitive group (P < 0.01), cyclin A and Top II alpha gene expression levels were closely correlated (rs = +0.794, P = 0.000, n = 64) in all AL patients, but cyclin A was not correlated with mdr1 and bcl-2 gene expression levels. In drug resistant group there was a negative correlation between the gene expression levels of cyclin A and mdr1 (rs = -0.337, P = 0.029). The 10 AL patients with positive lower expression of both cyclin A and Top II alpha were all resistant to drugs. Logistic regression of Binary analysis showed the correlation between the lower expression of cyclin A and drug resistance. It was concluded that lower expression of cyclin A gene might be an unfavorable prognostic factor for patients with AL, and detection of both cyclin A and Top II alpha gene expression would predict drug resistance in AL patients.
ATP-Binding Cassette, Sub-Family B, Member 1 ; genetics ; Adolescent ; Adult ; Aged ; Cyclin A ; biosynthesis ; genetics ; Drug Resistance, Multiple ; genetics ; Drug Resistance, Neoplasm ; genetics ; Female ; Genes, MDR ; genetics ; Humans ; Leukemia, Myeloid, Acute ; genetics ; Leukemia, Promyelocytic, Acute ; genetics ; Male ; Middle Aged ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; genetics ; RNA, Messenger ; biosynthesis ; genetics

Multiple myeloma(MM) as one of the most common tumors of hmatologic system, is characterized by malignant proliferation of plasma cells, and the chemotherapy is the main therapeutic method. MM is an incurable disease because of drug-resistance of MM cells. Although the pathogenesis of MM remains unknown, the chromosome abnormalities exit in half of the patients, particularly the highly expressed gene C-MYC. Furthermore, plenty of clinical researches indicated a high expression level of C-MYC implied worse progression and/or poor prognosis of MM. Recently, the work exploiting the compounds targeting MYC has made substantial progress, even in the MM therapy. In this article, briefly the recent advances of the research on C-MYC proto-oncogene in multiple myeloma are reviewed.
Chromosome Aberrations ; Genes, myc ; Humans ; Multiple Myeloma ; Plasma Cells ; Proto-Oncogene Proteins c-myc