OBJECTIVE To study characteristics of hospital infection,risk factors and bacterial resistance in our Intensive Care Unit(ICU) to draw up effective interfering measure and supply the scientific basis.METHODS The data of 1115 inpatients in our ICU in 2008 were analysed prospectively and retrospectively.RESULTS The hospital Infection rate was 12.10%,the case-time infection rate 12.47%,the lower respiratory tract infection rate 56.12%,the G-infection rate 57.30%,the G+ infection rate 25.84%,and the fungus infection rate was 16.85%,These pathogens were resistant to antibiotics in various degree.CONCLUSIONS The ICU infection rate is obvious higher than that in all clinical departments.The resistance to most of the antibiotics are increasing which need enhancing bacterial supervi.

OBJECTIVE To investigate and analyze the pathogenic bacteria of burn infection and their drug resistance in recent 5 years from 2001.METHODS The patients were divided into two groups.The group 1 included patients from Jun 1996 to May 2001 and the group 2 was from Jun 2001 to Jun 2006.Burn wound bacteria were cultured,and identified and their drug sensitivity was analyzed.RESULTS In burn wound culture,in group 2 Pseudomonas aeruginosa with the rate of 30% was still in the 1st place.Staphylococcus aureus was in the 2nd place with the rate of 28.2%.The G-bacilli comprised 58.2% and the G+ cocci 40.3 %.Proteus mirabilis,Acinetobacter baumannii,Enterococcus faecalis and Candida albicans increased remarkably.The drug resistant percentage of P.aeruginosa,Enterobacter cloacae and Escherichia coli to third generation cephalosporin increased greatly.CONCLUSIONS The changes of pathogenic bacteria of burn infection and bacteria drug resistance have certain relations with the wide usage of broad spectum antibiotics such as cephalosporin and imipenem.

Objective To explore a new way of physiological signal wireless measurement to popularize the physiological signal wireless measurement. Methods We added a UART-Wi-Fi module between the signal detecting module and the PC, the physiological signal measurement system transmitted the signal data collected by the single chip computer to the UART-Wi-Fi module through the serial interface RS-232C. Then the UART-Wi-Fi module sent the signal data out to the Wi-Fi wireless network. The PC received the signal data from the Wi-Fi wireless network and processed the signal data, then output the results. Result Through the UART-Wi-Fi module, the communication between PC and the signal detecting module was converted from wired communication into wireless communication successfully. Conclusion As a result of any computer can be used as a physiological signal receiving and processing terminal equipment, the use of the UART-Wi-Fi module can help achieve popularization of physiological signal wireless measurement.

Objective To observe whether treatment with cannabidiol (CBD) affect nonalcoholic steatohepatitis (NASH) induced by methionine choline-deficient diet (MCD) in rats and investigate the underlying molecular mechanism. Methods Sixty-three adult male SD rats were randomly divided in to three groups as follows: Control group (rats fed with normal diet), MCD group (rats fed with MCD and MCD+CBD group [rats fed with MCD and treated with cannabidiol, 2mg/(kg.d), i.p.]. Ten weeks later, steatohepatitis and fibrosis were evaluated by hematoxylin-eosin and Masson staining, respectively. Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels were measured by using an automatic biochemical analyzer and hepatic levels of cholesterol and triacylglycerol were determined with kits. Autophagic flux in livers was evaluated by Western blotting. Results Treatment with cannabidiol reduced ratio of liver/body weightratio (4.2%±0.6% versus 3.1%±0.6%, P<0.05), histological scores (4.7±1.1 versus 2.2±0.5, P<0.05) and fibrosis (1.4%±0.4% versus 0.8%±0.3%, P<0.05) in rat livers, lowered levels of ALT (214.5±54.1U/L versus 92.1±36.0U/L, P<0.05) and AST (175.9±55.2U/L versus 70.8±24.9U/L, P<0.05) in serum, attenuated hepatic fat accumulation (cholesterol, 182.4±42.7mmol/mg protein versus 101.0±33.8mmol/mg protein, P<0.05; triglyceride, 71.4±12.5mmol/mg protein versus 38.7±11.1mmol/mg protein, P<0.05), and down-regulated mRNA expression of Col1A1 (2.9±0.4 versus 1.6±0.3, P<0.05) in livers of rats fed with MCD. Furthermore, cannabidiol led to the LC3 turnover (LC3-Ⅱ/LC3-I, 37.1±10.8 versus 71.2±17.1, P<0.05) and p62 decrease (202.4±40.9 versus 125.8±32.7, P<0.05) in the livers of MCD-fed rats. Conclusion Treatment with cannabidiol could relieve MCD-induced NASH in rats, at least in part, by autophagic flux promotion.

Objective To investigate the mechanisms of astrocytes modulating neurons in rat supraoptic nucleus induced by hypotonic stimulation and the effect of 6-aminomethyl-3-methyl-4H-1,2,4-benzothiadiazine-1,1dioxide HCl(TAG,a antagonist for taurine) or carbenoxolone(CBX,a gap junction blocker)on the responses of astrocytes and neurons in SON.Methods Adult male Sprague-Dawley rats were divided into four groups: the control group was injected with 5.5ml/kg 0.9% NaCl solution into the caudal vein;the hypotonic group was injected with 5.5 ml/kg hypo-saline(0.83% glucose plus 0.3% NaCl);TAG + hypotonic and CBX + hypotonic groups were injected with TAG(100?mol/L) or CBX(10g/L) into the lateral ventricle respectively,and were injected 2 hours later with hypotonic saline into the caudal vein.With anti-Fos,anti-vasopressin(VP),anti-glycine receptor(GlyR),anti-glial fibrillary acidic protein(GFAP) and anti-connexin43(Cx43) immunofluorescent staining methods,the responses of neurons and astrocytes in SON were studied.Results In control rats,Fos-,VP-,and GlyR-expression in the neurons and GFAP-or Cx43-expression in the astrocytes were lower.In hypotonic rats,GFAP-,Cx43-and GlyR signals were more than those in control rats,while Fos-and VP-signals were less.Compared with those in hypotonic rats in TAG + hypotonic or CBX + hypotonic rats,GFAP-and Cx43-signals in the astrocytes were the same,GlyR-signals in the neurons decreased,and Fos-and VP-signals increased.Conclusion Hypotonic stimulation activates SON astrocytes,which then release taurine through gap junction signaling to the neurons and inhibit the release of VP from the neurons.

Objective To evaluate the therapeutic effects of liver transplantation (LT) for cholangiocarcinoma(CC)and analyze the prognostic factors.Methods From December 2001 to December 2006,234 patients receiving LT for hepatic carcinoma in our institute were enrolled as a basis of comparative study for 6 CC patients undergoing LT during the same period.Results These 6 patients were followed-up from 1 to 56 months.Five patients died and one recurred.The 0.5-,1-and 2-year patient cumulative survival rates were 4/6,3/6 and 1/6,respectively.The 0.5-,1-and 2-year tumor-free survival rates were 3/6,2/6 and 1/6,respectively.The average patient or tumor-free survival time were both(14±4) months.Conclusion The prognosis of cholangioearcinoma patients after LT iS poor.

Objective To investigate the surgical options for the management of portal vein thrombosis (PVT) during liver transplantation and its impact on the outcome of patients. Methods 773 cases of liver transplantation were analyzed retrospectively. PVT occurred in 107 patients, inclu-ding 59 of grade Ⅰ ,33 of grade Ⅱ, 12 of grade Ⅲ and 3 of grade Ⅳ. Simple thrombectomy or thrombus-extraction was performed in grade Ⅰ and Ⅱ. 12 patients with grade Ⅲ received thrombus-extraction or using the donor iliac vein to act as a bridge between the donor portal vein and host superior mesenteric vein. Two cases of grade Ⅳ received a modified cavo-portal hemitransposition and one case received portal-vena coronaria varication anastomosis. Results Liver function had a good recover and the perio-perative mortality is 4. 3% in grade Ⅰ and Ⅱ. In grade Ⅲ , 5 cases received thrombus-extraction had a normal liver function after transplantation and had no died. 2 cases among the other 7 cases using por-tal vein reconstruction had bad liver function and died. The liver function recovered well after trans-plantation and there was no died in grade Ⅳ. Conclusions PVT is not a contraindication for liver transplantation. Good results can be obtained by applying reasonable operative procedures individually.

Objective:To investigate the effects of posterior internal fixation combined with transpedicular bone grafting in elderly patients with osteoporotic thoracolumbar fractures.Methods:Clinical data of 92 elderly patients with osteoporotic thoracolumbar fractures were retrospectively analyzed.According to the operation method, patients were divided into the control group(n=38)and the observation group(n=54). The control group received the conventional posterior approach and short-segment transpedicular fixation, and the observation group underwent transpedicular fusion in addition to the treatment the control group received.Surgery quality metrics, clinical effects and postoperative recovery were compared between the two groups.Results:The operation time and bleeding volume were higher in the observation group than in the control group( P<0.05). The bone fusion rate was higher and the failure rate of internal fixation was lower in the observation group than in the control group(96.3% vs.78.9%, 3.7% vs.15.8%, χ2=6.929 and 4.103, all P<0.05). The Japanese Orthopaedic Association score(JOA score)increased in both groups after operation( Ftime=47.628, P<0.05). The increase of the JOA score( Finteraction=4.477, P<0.05)and the overall JOA score( Fgroup=5.638, P<0.05)were greater in the observation group than in the control group.The Oswestry Disability Index(ODI)index in both groups decreased with time( Ftime=72.581, P<0.05). The decrease of the ODI index( Finteraction=7.421, P<0.05)and the overall ODI( Fgroup=9.276, P<0.05)were higher in the observation group than in the control group.The visual analogue scale(VAS)score in both groups decreased with time( Ftime=93.157, P<0.05). The decreases of the VAS score( Finteraction=9.473, P<0.05)and the overall VAS( Fgroup=13.272, P<0.05)score were greater in the observation group than in the control group.The Frankel nerve function grade was better in the observation group than in the control group 12 months after operation( z=2.123, P<0.05). Conclusions:Posterior internal fixation combined with transpedicular bone grafting can help improve nerve function, reduce postoperative pain, and has a high bone fusion rate and a low failure rate of internal fixation.

BACKGROUNDTo summarize the clinical results of bronchoplastic procedures and pulmonary artery reconstruction or combined with other resection and plasty of heart, great vessels in the treatment of 304 patients with locally advanced lung cancer.

METHODSFrom February, 1983 to December, 2001, double sleeve resection and reconstruction of bronchus and pulmonary artery, or combined with other resection of heart, great vessels were carried out in 304 patients with locally advanced lung cancer. The operations included double sleeve left upper lobectomy in 199 cases; double sleeve right upper lobectomy in 21 cases; double sleeve right upper middle lobectomy in 14 cases; double sleeve left upper lobectomy combined with resection of left atrium in 8 cases; double sleeve right upper lobectomy combined with superior vena cava (SVC) resection and reconstruction with Gortex graft in 29 cases; double sleeve right upper middle lobectomy combined with SVC resection and reconstruction in 21 cases; double sleeve right upper middle lobectomy, carinal and SVC resection and reconstruction in 11 cases; left pneumonectomy combined right main pulmonary artery and pulmonary artery trunk resection and reconstruction with Gortex graft in 1 case.

RESULTSThere were 3 operative deaths. The operative mortality was 1% in this series. Sixty four patients had operative complications. The operative complication rate was 21.05% (64/304). The 1-, 3-, 5- and 10 year survival rates were 81.75%, 60.14%, 37.21% and 24.39% respectively.

CONCLUSIONSDouble sleeve lobectomy or comblined with other resection and reconstruction of heart, great vessels can significantly improve the prognosis and increase the curative rate and long term survival in patients with locally advanced lung cancer.

Objective:To evaluate the efficacy and safety of microemulsified cyclosporine(Neoral)and tacrolimus(FK506) for immunodepression after Iiver transplantation.Methods:According to the including criteria,fifteen randomized controlled trials were enrolled in this analysis.The data of trial design,characteristics of the subjects,and findings of the studies were reviewed and analyzed by RevMan 4.2.8 software.Results:The patient survival rate,graft survival rate,incidence of nephrotoxicity,and incidence of infection were not significantly different between Neoral and FK506 groups,with the relative risk and(95% CI,P)being 0.99(0.96-1.02,0.37),0.97(0.92-1.03,0.30),0.99(0.87-1.13,0.86)and 1.08(0.97-1.20, 0.16),respectively.The incidences of hypertension(1.34[1.15-1.55,0.000 1])and acute rejection(1.15[1.06-1.25,0.001]) were significantly lower in the FK506 group,with no significant difference found in the degree of acute rejection(1.00[0.92- 1.22],0.98).Interestingly,the incidence of diabetes was significantly higher in the FK506 group within 1 year after the operation,but was similar to that of the Neoral group thereafter,with relative risk(95%CI,P)being 0.72(0.62-0.83,