OBJECTIVE To investigate the status of hospital infection of elderly in internal medicine,in order to prevent and control hospital infection of them.METHODS A restrospective survey on 157 cases of hospital(infection) of elderly from Aug 2003 to Apr 2005 was conducted in internal medicine.(RESULTS)The results showed that the high risk wards were in geriatrics,neurology,endocrinology and(cardiovascular) departments.The high risk season was in winter.Respiratory tract was the most common(infective) site.Fungi were the main pathogens.CONCLUSIONS The hospital infection of elderly should be(controlled) better,geriatrics department is the key(control) unit.Winter is the key control season.The diagnostic level of clinician about the hospital(infection) of(edlerly) should be enhanced and the antibiotic must be used reasonably.

Objective To investigate the relationship between neurokinin B (NKB), endothelin-1 (ET-1) and the pathogenesis of hypertensive disorder complicating pregnancy (HDCP). Methods 22 HDCP, who received antenatal examination in the Department of Obstetrics and Gynecology of Union Hospital of Tongji Medical College in Huazhong University of Science and Technology from March to July in 2005, were selected for the study, including 12 gestational hypertension (gestational hypertension group) and 10 preeclampsia (preeclamptic group); 22 normal pregnant women in the same period were served as control. At different gestational weeks, maternal plasma levels of NKB and ET-1 in three groups were detected by enzyme-linked immunoassay technique, the expression and location of NKB in placenta were examined by immunohistochemical SP, and mRNA expressions of NKB and ET-1 in placenta were measured with RT-PCR method. Results (1) At 10 - 14, 20 - 24, and 30 - 34 gestational weeks, the plasma levels of NKB and ET-1 in preeclamptic group were ( 35. 6±5.2), ( 17. 9±4. 3), (39. 5±4. 3 ), (22. 7± 3.6), (47. 1±3. 3) and (27.5±3.5) μg/L, respectively; in the control group they were (22. 9±3. 3), (10.7±5.3), (30.2±3.4), (13.2±4.1), (34.6±4.3) and (16.6±4.8) μg/L, respectively. There was a significant difference between preeclamptic group and control group ( P < 0. 05), while there was no significant difference between gestational hypertension group and control group (P>0.05).(2) Immunohistochemical staining for NKB protein was observed in all groups and was located in the villous syncytintrophoblast and villous vascular endothelial cells as well as cytoplasm of stromal cells, mostly located in villous syncytiotrophoblast. The expressions of NKB in placenta of preeclamptic group (0.244±0.020) was significantly higher than that in control group (0. 160±0. 012), with a significant difference between the two groups (P<0.05 ). However, there was no significant difference between gestational hypertension group (0.162±0.019) and control group (P>0.05). (3) The transcription levels of the NKB mRNA (0. 97±0. 36) and ET-1 mRNA (0. 90±0. 36) in preeclamptic placentas were both significantly higher than those in control groups (0. 78±0. 54, 0. 65±0. 47, respectively ), with a significant difference between the two groups( P <0. 05 ). But there was no significant difference between gestational hypertension group (0. 80±0. 40, 0. 70±0. 32, respectively) and control group (P >0. 05). (4) There was an evident positive correlation between plasma NKB and ET-1 levels in preeclampsia ( r =0. 79, P < 0. 05 ). Conclusions The significantly increased maternal plasma levels of NKB and ET-1 of patients with preeclampsia occur at early pregnancy (10 -14 gestational weeks) before the onset of clinical symptoms. The change of maternal plasma levels of NKB and ET-1 is closely related to pathogenesis of HDCP.

Objective To explore skeletal‐related events (SREs) clinical factors and analysis prognosis factors on patients with non‐small cell lung cancer(NSCLC) with bone metastases .Methods We collected clinical data of pathology confirmed 383 patients with non‐small cell lung cancer between April 2007 and January 2007 in the third affiliated hospital of the third military medical uni‐versity .It was used to screening for Emission Computed Tomography (ECT ) for bone metastases .And then it was need to con‐firmed for CT ,MRI or PET‐CT or pathology .Statistics in patients between clinical features and the SREs prediction factor with Univariate and Multivariate .And Kaplan‐Meier method analysis of survival in the non‐small cell lung cancer patients with bone me‐tastases .Results Out of 383 patients with bone metastases ,178 patients with SREs .The incidence was 46 .5% .Univariate analysis showed that women ,adenocarcinoma ,never smoking history ,single bone metastases ,bisphosphonate therapy ,targeted therapy in patients with bone metastases are less likely to have SREs ,it was considered statistically significant (P<0 .05) .Multivariate analy‐sis showed multiple bone metastases and no bisphosphonate therapy is independent risk factors for SREs .Median survival time was 14 .5 months in non‐small cell lung cancer patients with bone metastases ,1 year survival rate was 46 .5% ,2 years survival rate was 15 .9% .The survival analysis shows that more bisphosphonate treatment and bisphosphonate with EGFR‐TKI therapy on the prog‐nosis of patients with statistically significance (P<0 .05) .Conclusion It was likely to occur SREs in NSCLC patients with bone metastases .No bisphosphonate and multiple bone metastases are independent risk factors for SREs .Bisphosphonate treatment may prevent or reduce occur SREs for NSCLC patients with bone metastases ,and it may prolong survival ,it speculated that bisphospho‐nate may have resistant NSCLC cell activity .

Objective:To investigate the effects of Daidzein on behavior of chronic stress depression rats and the expression of hippocampal brain-derived neurotrophic factor ( BDNF ) , neuropeptide Y ( NPY ) and non-specific immune regulation.Methods: 40 healthy adult male SD rats with body weight(210±19)g,clean grade,were chosen and fed with 1%sucrose solution for 4 d to change drinking habits.On the fifth day rats were subjected to water deprivation for 24 h without fasting.On the sixth day rats were fed with 1%surcrose solution.4 h later, preference of 1% surcrose solution was examined.According to the 1% sucrose solution preference and weight rats were randomly divided into 4 groups,normal control group(CG),model control group,(MG),fluoxetine group(FG,10.0 mg/kg),daidzein group(DG,80.0 mg/kg).At the same time of establishing model,rats were administered orally once a day for 32 d.The depression model was established by chronic unpredictable mild stress model and separation.The behavioral changes of the rats were observed, and expression of BNDF in hippocampus and NPY was measured by Western blot technology and immunohistochemistry.It was observed the proliferation function of lymphocytes,spleen index,the number of peripheral blood leukocytes and antibody-secreting cell function.Results: Compared with the normal control group(CG),the weight of rats with chronic stress protocol was lower, 1%sucrose consumption decreased,scores of rats in the open field test dropped significantly,the immobility time in the forced swimming test prolonged,the level of expression of BNDF and NPY decreased,all the differences above were statistically sig-nificant(P<0.01).Compared with model group,weight of rats in fluoxetine treatment group(FG) and daidzein treatment group(DG)in-creased,sugar consumption,scores in the open field test and the levels of expression of BNDF and NPY significantly increased,the differences were statistically significant( P<0.05 or P<0.01 ).The number of peripheral blood leukocytes and antibody-secreting cell function and proliferation of lymphocytes force in daidzein treatment group was significantly higher than the model group,daidzein dose spleen index was significantly higher than the model group(P<0.01).Conclusion: The daidzein can antagonize depressive symptoms in chronic stress mice,daidzein may increased content of BDNF in hippocampus and NPY protein, and enhanced the role of humoral immune response and lymphocyte proliferation in rats with chronic stress model.The mechanisms of antidepressant effects of daidzein might be related to the increase of content of BDNF in hippocampus and NPY protein and non -specific immune regulation.

Objective To observe the therapeutically effect of kangnao liquid on Pi3k mRNA and Aktm RNA ex-pressions in rats with focal cerebral ischemia-reperfusion (I/R) injury. Methods 180 male SD rats were randomly divided into 6 groups:sham operated group, model group, three kangnao liquid groups (high-dose, medium-dose and low-dose) and nimodipine group. Rats in kangnao liquid groups were administrated with kangnao liquid of 24 g/(kg · d), 12 g/(kg · d) and 6 g/(kg · d), orally once a day. Rats in nimodipine group were given nimodipine 1 mg/(kg · d). Rats in model group and sham group were treated with the same volume of distilled water for 7 days. The animal model of middle cerebral artery occlusion (MCAO) was established by a monofilament method from right internal carotid artery. The neurological evaluation was per-formed 24 h after reperfusion. The in situ hybridization was used to investigate the expression levels of Pi3k mRNA and Akt mRNA in rats on 12 h, 24 h, 48 h, 72 h and 168 h after ischemia for 2 h. Results Compared with model group, neurological functions were improved significantly in kangnao liquid groups. The expression levels of Pi3k mRNA and Akt mRNA were al-so significantly higher in kangnao liquid groups than those of model group. The expression levels of Pi3k mRNA and Akt mRNA were significantly higher in nimodipine group than those of model group, but which were lower compared with those of high-dose and medium-dose kangnao liquid groups. Conclusion Kangnao liquid can protect nerve cells by enhancing the expressions of Pi3k mRNA and Akt mRNA in rats with cerebral ischemia-reprefusion injury.

Objective To analyse the pathological features in 12 patients demonstrated with demyelination lesions of peripheral nerves Methods Twelve abnormaly cases were screened with EMG from 60 cases of multiple sclerosis (MS) Sural nerve biopsy was done in 12 patients and specimens were analyzed by HE and Loyez,and by electronic microscopy Results Myelinated fibers was reduced in sural nerve biopsy in 8 cases and most striking demyelination seen in 11 cases In electronic microscopy,11 cases specimens were shown myelinated losses,regeneration of myelinated fibers,vacuoate,hyperplasia of Schwann cell and typical onion bulb formation 8 cases of the large thickened fibers showed increased members of myelin lamellae Conclusion MS is charaterized by inflammatory demyelinating disorder limited to the CNS And some patients' peripheral neves are also shown sectionally demyelinated injury.

Objective To investigate the clinical and renal pathological features in the new rat model induced by anti-human podocyte-protein antibody. Methods The rat model was induced by once intravenous injection of rabbit anti-human podocyte-protein antiserum which was prepared at first. Male Sprague-Dawley rats (n=36) were randomly divided into six groups (6rats in each group): control group (CG), the time points of day 7 group (D7), day 14 group (D14),day 21 group (D21) and day 28 (D28) group after antiserum injection, and day 28 group after the normal rabbit serum injection (NRG). The level of 24 hour proteinuria, the clearance of creatinine,albumin, blood urea nitrogen, triglyceride, cholesterol and serum creatinine were measured. The renal morphology was detected under the light microscope, immunofluorescence microscope, and electron microscope. Results 24-hour proteinuria (mg) was gradually increased, and the level of proteinuria in D28 (48.56±13.80) was significantly higher than that in CG (5.34±2.77, P＜0.01)and NRG (11.32±4.90, P＜0.01). The clearance of creatinine (ml/min) and serum creatinine (μmol/L) in D28 (0.90±0.47, 33.48±9.94) were significantly different from CG (1.68±0.54, P＜0.05;26.03±2.67, P＜0.05), but showed no difference with NRG (1.34±0.87, P＞0.05; 27.40±4.73, P＞0.05). The level of albumin (g/L) was lower in D7, D14, D21, D28 (28.20±0.87, 27.80±1.97,27.42±1.66, 27.77±1.95) than CG (29.98±0.76, P＜0.05). But there was no difference in the level of albumin among the groups after antiserum injection and NRG (28.68±1.18, P＞0.05). The level of blood urea nitrogen, triglyceride, cholesterol showed no difference among the groups (P＞0.05). The renal morphology showed no obvious changes between CG and NRG. Among the groups after antiserum injection, the renal pathological changes under the light microscope were some spikes formation in D28. Immunostained for rabbit IgG in rat glomeruli progressively decreased over the 28 days, while rat IgG progressively increased. The renal section deposition for rat complement 3 reached a maximum at day 21 then decreased afterward. Under the electron microscope, there were immune complexes and foot process fusion at day 14. Conclusions The new rat model induced by anti-human podocyte-protein antibody showing typically clinical and pathological changes of the membranous nephropathy is successfully established.

ObjectiveTo investigate the number of γδT cells in the peripheral blood from patients with systemic lupus erythematosus(SLE) and their correlation to disease activity.MethodsγδT cells were detected in the peripheral blood from 42 SLE patients and 20 normal controls by flow cytometry.Anniex-V/Pl double-staining flow cytometry was employed to observe the proportion of the apoptotic γδ and CD3+ T cells in 6 SLE patients with active disease and 6 normal controls,respectively.The levels of plasma anti-nuclear antibody and anti-dsDNA antibody were determined by using enzyme-linked immunosorbent assay.Data were analyzed with t test and Pearson's correlation test.ResultsThe percentages of γδT cells were remarkably down-regulated in SLE patients [(3.0±1.8)％ ] with active disease compared with that of those patients with inactive[(5.3±3.0)％] disease and normal controls [(6.8±2.8)％](t=-3.071 and -5.913 respectively,both P＜0.01 ).The absolute number of γδT cells decreased significantly in SLE patients with active disease[ ( 1.7± 1.6)× 107/L ] than those with inactive SLE [ (5.3±3.6)× 107/L ] (t=-3.292,P＜0.01 ),and both were lower than the normal controls [ (10.1±5.0)×l 07/L] (t=-7.247 and -2.905 respectively,both P＜0.01 ).There was a negative correlation between systemic lupus erythematosus disease activity index (SLEDAI) andT cell counts in 30 SLE patients with active disease (r=-0.365,P=0.047).γδT cell percentage (r=-0.336,P=0.030) and counts (r=-0.410,P=0.007) were both inversely correlated with the erythrocyte sedimentation rate,but positive correlation were found between hemoglobulln and γδT cell counts (r=0.409,P=0.007).The apoptosis ofγδT cells in SLE patients was more common than in normal controls(t=2.886,P＜0.05 ).The number of apoptotic γδT cells was higher than that of CD3+ T cells in SLE patients (t=2.952,P＜0.05 ).Conclusion γδT cells of the peripheral blood of SLE patients are down-regulated partially due to excessive apoptosis,which may correlate with the disease activity.

Objective To assess the treatment of splenic artery aneurysms (SAA) and prognosis.Methods Clinical data of 18 SAA patients treated in our hospital from 1999 to 2011 were retrospectively analyzed. Results There were 18 patients diagnosed as SAA,including 7 males and 11 females.The average age was 53.8 ± 7.3 years.8 patients were asymptomatic found by routine physical examination,7 patients complained upper left abdominal pain,3 cases suffered from aneurysm rupture. Diagnosis was established by three-dimensional computed tomography angiography (3DCTA) in 14,Digital subtraction angiography (DSA) in 3 and magnetic resonance angiography (MRA) in 1 patient.Three patients with ruptured splenic artery aneurysm underwent emergent operations,11 patients underwent elective surgery or interventional therapy.Surgical procedures included aneurysmectomy and splenectomy in 4 patients,distal pancreatectomy in 5 cases; aneurysmectomy and splenic artery ligation in one patient; and aneurysmectomy with splenectomy and colon resection in 1 case.Interventional embolization by coils of the splenic aneurysm in 3 patients.The remaining 4 being asymptomatic and with tumor diameter less than 2 cm were put on a close follow-up.There was no perioperative mortality.Two were lost to follow-up.16 cases were followed-up for averaging 3.2 years. 1 patient died of cerebral hemorrhage after four years. Conclusions Splenic artery aneurysms was a rare disease and with usually occult symptoms,but rupture can leads to abdominal apoplexy.Open surgery and minimally invasive endovascular treatment is effective and offers a good prognosis.

Objective To investigate the expression of FcγRⅡb on peripheral B cells and its clinical significance in primary Sj(o)gren's syndrome (pSS).Methods FcγRⅡb expression on peripheral B cells from 19 pSS patients and 15 healthy controls was examined by flow cytometry.The levels of serum anti-SSA and SSB antibodies were determined using enzyme-linked immunosorbent assay (ELISA).Data were analyzed with t test,one-way ANOVA,SNK-q test and Pearson's correlation test.Results The percentage of memory CD19+CD27+ B cell subpopulation was significantly lower in pSS patients [ (20.8±2.7)％] when compared to normal controls [(37.8±2.2)％ ](t=-4.002,P＜0.01).The level of expression of FcγRⅡb in active pSS memory CD19+CD27+ B cells [ MFI(74±8)] was significantly reduced when compared to inactive [ MFI( 132±11)] and normal controls [ MFI (139±12)] (F=10.699,P＜0.01).The level of expression of FcγRⅡb on memory CD19+CD27+ B cells from pSS patients was inversely correlated with Sj(o)gren's syndrome disease activity index (SSDAI) (r=-0.744,P=0.0003 ).pSS patients with the serum anti-SSA/SSB antibodies positive group [ MFI(75+3),(48±7)] displayed a lower expression of FcγRⅡb on memory CD19+CD27+ B cell than in patients with the serum anti-SSA/SSB antibodies negative group [MFI( 122±11),(108±9)] (t=-4.336 and -3.776 respectively,the P value of both tests were less than 0.01).The level of expression of FcγRⅡb in the memory CD19+CD27+ B cells of patients with active pSS was inversely correlated with anti-SSA antibody titers (r=-0.685,P=0.014).Conclusion The expression of FcγRⅡb on peripheral memory B cells from active pSS patients is inversely correlated with SSDAI and is also inversely associated with anti-SSA antibody levels.Decreased expression of FcγRⅡb might play an important role in the pathogenesis of pSS.