Objective To review the prevalence of nosocomial infection and the change of drug resistance in a comprehensive intensive care unit (ICU) and to provide theoretical basis for clinical prevention and treatment.Methods The strains of bacteria and fungi were isolated from ICU and their drug resistance was retrospectively analyzed from Jan.1st,2010 to Dec.31th,2011.Results The main pathogen of nosocomial infection were Gram-negative bacteria ( 73.3％ ),Gram-positive bacteria ( 17.9％ ) and fungi ( 8.7％ ).In bacterial infection,Gram-negative and G-positive bacteria accounted for 80.3％ and 19.7％ respectively.In Gram-negative bacteria,pseudomonas aeruginosa was the major type (21.7％).In Gram-positive bacteria,staphylococcus aureus (31.4％) was most prominent.Drug resistance of bacteria was severe,while that of fungi was mild.Conclusion Bacteria has severe drug resistance and exhibits multi-drug resistance for commonly used antibiotics.The principle of antibiotics application should be mastered and antibiotics should be chosen according to drug-sensitivity tests.

Objective: To investigate the immune regulation mechanism and anti-inflammatory effect of ω-3 fatty acids on sepsis patients.Methods: Totle 18 patients were divided into two groups,therapy group and control group. The control group was given routine therapy while the theray group was given routine therapy and fish oil.The expression of HLA-DR on peripheral monocytes was measured by flow cytometry at the beginning and 5 d during therapy, in parallel with serum c-reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),and severity of the disease(APACHE Ⅱ score),serum and oxygenation index(PaO2/FiO2)Results: Compared with conventional group,serum concentration of CRP, IL-6 and TNF-α in patients of therapy group were significantly reduced,and oxygenation index improved. There was no difference in the expression of HLA-DR and APACHE Ⅱscore between two groups.Conclusion:Fish oil can decrease the elevated mediators of inflammation on sepsis patients,and can't regulation the expression of HLA-DR on peripheral monocytes.

Objective: To evaluate the protective effect and possible mechanism of ω-3 PUFA supplementation in the early stage of experimental acute bacterial pneumonia in mice.Methods: Mice of Pseudomonas aeruginosa (PA)-induced lung injury were randomly divided into three groups: fish oil supplementation treatment group (n = 8),soybean oil treatment group (n = 8) and normal sodium treatment group (n = 8).Evaluation criteria were inflammatory response 24 h after the injury assessed with TNF-α、IL-1β,IL-10 levels in bronchoalveolar lavage and lung injury evaluation by H-E staining.Results: Compared with the other two groups,the levels of IL-1β,IL-10 in fish oil supplementation treatment group were reduced.No difference was found in the TNF-α level and histological scoring among the groups.Conclusion: The ω-3 PUFA can decrease the elevated mediators of inflammation in bacterial pneumonia,but can't affect the pneumonia progress within 24 hours.

Objective:To investigate the immune regulation mechanism and anti-inflammatory effect of ?-3 fatty acids on sepsis patients.Methods: Totle 18 patients were divided into two groups,therapy group and control group.The control group was given routine therapy while the theray group was given routine therapy and fish oil.The expression of HLA-DR on peripheral monocytes was measured by flow cytometry at the beginning and 5 d during therapy,in parallel with serum c-reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor-?(TNF-?),and severity of the disease(APACHE Ⅱ score),serum and oxygenation index(PaO2/FiO2) Results: Compared with conventional group,serum concentration of CRP,IL-6 and TNF-? in patients of therapy group were significantly reduced,and oxygenation index improved.There was no difference in the expression of HLA-DR and APACHE Ⅱscore between two groups.Conclusion:Fish oil can decrease the elevated mediators of inflammation on sepsis patients,and can't regulation the expression of HLA-DR on peripheral monocytes.

Objective: To evaluate the protective effect and possible mechanism of ?-3 PUFA supplementation in the early stage of experimental acute bacterial pneumonia in mice.Methods: Mice of Pseudomonas aeruginosa(PA)-induced lung injury were randomly divided into three groups: fish oil supplementation treatment group(n = 8),soybean oil treatment group(n = 8) and normal sodium treatment group(n = 8).Evaluation criteria were inflammatory response 24 h after the injury assessed with TNF-?、IL-1?,IL-10 levels in bronchoalveolar lavage and lung injury evaluation by H-E staining.Results: Compared with the other two groups,the levels of IL-1?,IL-10 in fish oil supplementation treatment group were reduced.No difference was found in the TNF-? level and histological scoring among the groups.Conclusion: The ?-3 PUFA can decrease the elevated mediators of inflammation in bacterial pneumonia,but can't affect the pneumonia progress within 24 hours.

Objective: To investigate the effect of UGT2B7 A268G and UGT2B7 G211T genetic polymorphism on serum drug concentration of valproic acid (VPA).
Methods:Genetic polymorphisms of UGT2B7 A268G and UGT2B7 G211T were tested in 248 epileptic patients by polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP). Data including basic information, epilepsy type, times and doses of drug, treatment response and liver and kidney functions were collected. Statistical analysis was performed by SPSS 13.0 through multivariate linear regression, one-way ANOVA,χ2 test, and paired T-test.
Results:Based on multivariate linear regression, there was no significant difference between gender, age, or body mass index and VPA, but concentration-to-dose ratios (CDRs) were positively correlated with VPA. hTe genetic polymorphisms of UGT2B7 A268G and UGT2B7 G211T were consistent with Hardy-Weinberg equilibrium. UGT2B7-268A>G allele frequency distribution A was 30.05%, and G was 69.95%. Variance analysis showed that serum drug concentration was significantly different in the genotype of AA, AG, or GG (F=5.477, P=0.005). Further analysis of paired T test showed that AA type was significantly different from GG type (P=0.048), and that serum concentration of AA type was much higher than that of GG type, while no signiifcant difference between AA type and AG type, GG type and AG type. UGT2B7 G211T allele frequency distribution G was 77.24%, and T was 22.58%. hTere was no signiifcant difference in standardized serum concentration among genotypes of GG, GT, and TT.
Conclusion:hTis study reveals UGT2B7 A268G genetic polymorphism distribution in Chinese epilepsy population. UGT2B7 A268G plays an important role in VPA’s metabolism, and has certain effect on VPA’s serum concentration. Epilepsy patient with this genotype should be adjusted the dose of VPA to make a therapeutic effect.

Objective To observe the effectiveness of early enteral nutrition (EEN) in managing ICU mechanically ventilated patients.Methods Totally 47 patients who had been ventilated for more than one week were randomly divided into EEN group and control group.The EEN group was supplied with enteral nutrition (EN) 12-24 hours after ICU admission,whereas the control group received EN 72 hours-5 days later.The function of intestinal mucosal barrier was evaluated by the reabsorb concentration of disaccharides lactulose/mannitol (L/M).In addition,the body mass index (BMI),body temperature,urine L/M ratio,serum albumin,pre-albumin,and ventilation days were recorded or calculated.Results On the seventh day,the L/M ratio was (0.036 ±0.004) in the EEN group,which was significantly lower than that (0.108 ±0.020) in the control group (t =2.746,P ＜0.01) ; the average body temperature was significantly lower in the EEN group than in the control group [(38.25 ± 1.20) ℃ vs (38.92 ± 1.40) ℃ ; t =2.683,P ＜ 0.05)] ; the incidences of adverse reactions such as constipation and diarrhea were significantly lower in the EEN group [16.7％ (4/23) vs 27.3％ (6/22),P＜0.05].The weaning rate within 2 weeks also favoured the EEN group [90％ (18/20) vs 80％ (16/20),P ＜ 0.05].Compared with the control group,the nutritional status of serum albumin and pre-albumin also showed a favourbale trends in the EEN group.Conclusions EEN can improve intestinal mucosal barrier and increase the weaning possibility in patients with mechanical ventilation.

Objective To compare the effect of transplant islets between the subcutaneous inguinal white adipose tissues and renal capsule in the treatment of type 1 diabetes mellitus in mouse models. Methods The mice with type 1 diabetes mellitus undergoing islet transplantation were divided into the white adipose group (n=10) and renal capsule group (n=10). The islets were isolated, purified and transplanted to the subcutaneous white adipose tissues of inguinal region and renal capsule. The random blood glucose level and glucose tolerance function of the recipient mice in two groups were continuously monitored after operation. Islet grafts of the surviving recipient mice were harvested at postoperative 100 d for histopathological examination. Results In the white adipose group, the blood glucose levels of 6 recipient mice were restored to normal at 1 month after transplantation, whereas the blood glucose levels of the other 4 recipient mice were high, which died before the end of monitoring. In the renal capsule group, the blood glucose levels of 10 recipient mice returned to normal within 10 d after transplantation. Islet grafts of the recipient mice in two groups could lower the blood glucose levels, whereas the islet grafts in the white adipose group required a longer time to exert the effect. The glucose tolerance function of the mice in the renal capsule group was significantly better than that of those in white adipose group (P < 0.05). Histopathological examination demonstrated that the insulin of the islet grafts was normally expressed in two groups. Conclusions The islets transplanted into the subcutaneous white adipose tissues of inguinal region can play an effective role in regulating the changes of blood glucose level. Although the blood glucose-lowering function is slightly weaker than that of the islets graft in the renal capsule, it has multiple advantages resembling the ideal islet transplantation sites, which is a promising replacement site for islet transplantation.

To establish a platform to monitor the immune rejection after abdominal aortic patch suture in a xenotransplantation model.Methods The carotid was excised from wild-type Bama pigs,cut into 2.5 cmx 1.0 cm pieces in shuttle shape and subsequently sutured to the abdominal aorta of cynomolgus monkeys.No immunosuppressive agent was administered.General conditions of the recipient monkeys were observed.The morphological changes of the graft artery were assessed by pathological examination at postoperative 1 year.Before and 7,14,28 and 49 d after surgery,the blood samples were collected from the recipient monkeys.The serum levels of IgM and IgG antibodies were quantitatively measured by the red blood cell and peripheral blood mononuclear cell (PBMC) from Bama pigs.The quantity of lymphocytes in the recipient monkeys was detected by routine blood test and flow cytometry.Results All 3 monkeys undergoing transplantation survived well.At postoperative 1 year,the lateral tissues of the vascular wall at the artery graft were seen in dark red color.Hematoxylin-eosin (HE) staining revealed a large quantity of red blood cell and platelet deposition,accompanied with lymphocyte infiltration.Using porcine red blood cell and PBMC as target cells,the serum levels of anti-pig IgM and IgG antibodies peaked at postoperative 28 d,and slightly declined at postoperative 49 d.The quantity of lymphocytes and T cell subset also peaked at postoperative 28 d and began to decrease at postoperative 49 d.Conclusions Artery patch suture is a simple and reliable xenotransplantation model.The recipients can maintain normal physiological state without the use of immunosuppressive agents.The grafts can effectively activate the immune system of the recipients,induce the production of anti-pig antibodies and provoke cellular immune rejection.Therefore,this model can be utilized to monitor the immune rejection throughout the xenotransplantation process.

Objective To investigate the clinical efficacies of Milrinone on cardiac function and blood-gas analytic indices in elderly patients with chronic heart failure.Methods During January 2013 to December 2016,50 elderly patients with chronic congestive heart failure admitted into the First People's Hospital of Qingdao Economic and Technological Development Zone were randomly selected and divided into the observation group (n=25) and the control group (n=25).The control group was given conventional treatment including diuretics,ACEI/ARBs,vasodilators,β-adrenergic receptor inhibitors and digitalis drugs,as well as anti-infection,fluid intake treatment and inhibiting the excessive activation of nerve-endocrine system.And Milrinone was taken as add-on to the therapy of control group in observation group.The changes in cardiac function,blood-gas analysis indices and adverse reactions were compared between the two groups.Results The total improvement rate of cardiac function was significantly higher in the observation group than in control group (92.0％ vs.76.0 ％,x2 =5.446,P＜ 0.05).The cardiac function indices,blood-gas analysis index and the level of CRP were significantly improved after treatment versus before treatment in both groups (all P＜0.05).And these improvements were significantly more superior in observation group than in control group (P＜0.05).Conclusions Milrinone can significantly improve the clinical efficacies in elderly patients with chronic heart failure.It can also improve the blood-gas indices and alleviate clinical symptoms,which seems to deserve more clinical application and promotion.