Objective To analyze the bacterial distribution and resistance of clinical isolates from exacerbation of COPD patients in C and D classification in our emergency department.Methods The sputums were taken to culture and antimicrobial susceptibility test.VITEK-2 compact automicrobe system was used to identify bacteria.Disc diffusion test was used to determine the antimicrobial resistance.Results Of 222 clinical isolates,27.0％ were Gram positive bacteria,73.0％ were Gram negative bacteria.The Gram positive bacteria mainly was Staphylococcus aureus and Streptococcus pneumoniae.The detection rates of methicillin-resistant Staphylococcus aureus (MRSA) were 50.00％.The MRSA were more resistant than methicillin-sensitive Staphylococcus aureus (MSSA),and they were all sensitive to vancomycin,linezolid or tigecycline.The Gram negative bacteria mainly was Pseudomonas aeruginosa,Escherichia coli,Klebsiella spp and Acinetobacter baumannii.Pseudomonas aeruginosa and Acinetobacter baumannii had high resistant rates.The extended spectrum β-lactamases (ESBLs) producing strains in Escherichia coli were higher than in Klebsiella spp,which had multiple drug resistance.Conclusions The bacterial resistance situation is very severely in exacerbation of COPD patients in C and D classification in our emergency department.The first isolating rate was Pseudomonas aeruginosa.Surveillance of bacterial resistance is very important and effective control measures to reduce resistance is very necessary.

ObjectiveTo study the characteristic of apoptosis and the expression of inducible nitric oxide synthase(iNOS),as well as relation between them after spinal cord injury (SCI) in rats.Methods84 adult SD rats were randomly divided into three groups,and made into mild,moderate and severe acute SCI models.The rats were killed at 4h,8h,1d,3d,7d,14d and 21d after surgery.The histopathology changes in spinal cord tissue were observed with HE staining microscopic examination.The expression of iNOS was determined by immunohistochemistry and the apoptosis was labeled by terminal deoxynucleotidyl transferase mediated dUTP nick end labeling(TUNEL).ResultsThe histopathology changes in spinal cord tissue deteriorated with increasing in injury degree.A little iNOS immunoreactivity (iNOS-IR) was detected in nerve cells,gliocytes,ependymocytes and blood vessel endotheliocytes of normal and vertebra shelf operated controls,increasing at 8 h, and in flood tide in 7 d. The expression of Bax and the rates of TUNEL positive cells were similar with that of iNOS after SCI. There was positive correlation between expression of iNOS and degree of primary SCI ,apoptosis index(r=0.414,P<0.01;r=0.854,P<0.01).Conclusions Expression of iNOS and Bax increase and a large number of TUNEL positive cells present after SCI in rats. There is positive correlation between expression of iNOS and degree of primary SCI,apoptosis index.

Wheat bran, as the testa of wheat, has a long history of medication. Modern studies have discovered that wheat bran contains dietary fiber, phenolic compounds, proteins, vitamins, minerals and many other compounds, and boasts wide pharmacological activities such as blood glucose reduction, hypertension reduction, lipid reduction, anti-oxidation, anti-bacteria, anti-inflammatory, antivirus, prevention of colon cancer and mutations, immunomodulation and adsorption of heavy metals. With great development and utilization values, wheat bran has long attracted wide attention from Chinese and foreign scholars. The paper summarizes the latest advance in domestic and foreign studies on effective components in wheat bran and their pharmacological effect, and gives a brief introduction of the limiting factors in the comprehensive development and utilization of wheat bran, in order to provide new preference for the development and utilization of abundant wheat bran resources in China.
Animals ; Dietary Fiber ; analysis ; pharmacology ; Humans

Objective:To investigate the effectiveness of immunoFISH technology in detecting tumor cells in cerebrospinal fluid (CSF) for adjuvant diagnosis of meningeal metastasis from lung cancer. Methods:Circulating tumor cells (CTCs) were detected by im-munoFISH technology in CSF samples from 16 patients with meningeal metastasis from lung cancer and 8 patients with non-tumorous brain diseases. Meningeal metastasis from lung cancer was diagnosed on the basis of neurological symptoms and confirmed by en-hanced magnetic resonance imaging and CSF cytological examination. Results:The number of CTCs was significantly greater in pa-tients with meningeal metastasis from lung cancer than in those with non-tumorous brain diseases (P<0.01). The critical point of the maximum correct diagnosis index (Youden index) was regarded as the judging criterion for the positive tumor cells in CSF based on the receiver operating characteristic curve. When one tumor cell existed in 7.5 mL of CSF, the area under the curve was 0.875, and the 95%confidence interval ranged from 0.705 to 1.000. The diagnostic sensitivity, specificity, effectiveness, positive predictive values, and neg-ative predictive values were 75.0%, 100.0%, 83.3%, 100.0%, and 66.7%, respectively. Conclusion:ImmunoFISH technology provides great significance in detecting CTCs in CSF to diagnose meningeal metastasis from lung cancer.

Objective To evaluate the safety of coronary intervention using iodixanol in patients with diabetic renal insufficiency.Methods Clinical data of 97 patients with diabetic renal insufficiency undergoing coronary intervention during June 2004 to June 2006 were retrospectively analyzed,50 of them with iodixanol,an iso-osmolar contrast medium (iodixanol group),and 47 with iopromide,a hypotanic contrast medium (iopromide group).Judkin's coronary angiography showed 167 diseased vessels in the patients,65 in anterior descending branches,44 in circumflex branches,and 58 in right coronary arteries. Levels of serum creatinine and blood urea nitrogen were determined before percutaneous coronary intervention (PCI),on the day of the procedure,the 3rd and 7th days after PCI,respectively,as well as radiocontrast media-induced nephropathy (CIN) was observed.Results Totally,192 drug-eluting stents were successfully implanted in 167 diseased vessels,and all patients' angina pectoris symptom disappeared soon after the procedure,with a full success.No acute or subacute stent thrombosis and major adverse cardiac events (MACE) occurred.Two patients (4%) in iodixanol group and 10 (21%) in iopromide group got CIN,with a statistical significance (P

OBJECTIVETo explore the recording method of the electrophysiological signals in corticospinal tract (CST) of adult rats by plugging microelectrodes and analyze the characteristics of these signals. These could provide some valuable and basic neural electrophysiological information for further research of recovering and refunctioning after spinal cord injury.

METHODSThe microelectrodes were plugged into the corticospinal tract at the T8 spinal section of Sprague-Dawley rats and the neuro-electrical signals were identified and recorded from CST by means of the Cerebus System. The characteristics of the recorded signals were described with the help of the Offline sorter and Neuroexplorer softwares, including the wavelength, amplitude, discharging frequency, the synchrony among the multi-discharging units from the same electrode and two different electrodes, analysis of interspike interval (ISI), etc.

RESULTSThe continuous and steady spontaneous electrophysiological signals were recorded from CST. Three or four types of discharging signals originated from different discharging units were collected with each electrode. The waveform of the signals appeared bidirectional. The wavelengths were 0.6 - 1.3 ms with wave amplitudes at a grade of hundred microvoltage and high signal-noise ratios. The LFB staining proved that the electrodes were accurately plugged into the corticospinal tract.

CONCLUSIONThe neuro-electrical signals at a grade of hundred microvoltage could be recorded stably from the corticospinal tract of rats by the Cerebus System with the microelectrodes, which provided valuable and basic neural electrophysiological information for further research on recovering and refunctioning after spinal cord injury (SCI) by analyzing the characteristics of electrophysiological signals.

Animals ; Electrodes, Implanted ; Electrophysiological Phenomena ; physiology ; Evoked Potentials, Motor ; physiology ; Male ; Microelectrodes ; Pyramidal Tracts ; physiology ; Rats ; Rats, Sprague-Dawley ; Spinal Cord ; physiology ; Spinal Cord Injuries ; physiopathology

Objective To investigate the ability of different standards on the evaluation of vascular invasion of pancreatic carcinoma. Methods The MSCT imagings of 56 cases of pancreatic carcinoma confirmed by surgery were analyzed retrospectively. The vascular invasion degrees of 5 large vessels around the pancreas were evaluated according to Loyer classification standard, Lu classification standard and the Changhai standard, the surgical result was used as the gold standard. The accuracy of different standards was evaluated, and the Kappa coefficient were calculated. Results The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of Loyer classification standard were 86.79%, 86.27%, 86.90%, 59.46% and 96.60%, respectively, and the Kappa coefficient was 0.623. The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of Lu classification standard were 93.21%, 84.31%, 95.20%, 79.63% and 96.46%, respectively, and the Kappa coefficient was 0.777. The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of Changhai standard were 95.36%, 84.31%, 97.82%, 89.58% and 96.55%, respectively. The Kappa coefficient was 0.841. Conclusions The Changhai standard was feasible to evaluate the vascular invasion of pancreatic carcinoma.

Objective To study the feasibility of using heat and moisture exchangers (HME)as an alternative to heated humidifiers (HH) in patients undergoing mechanical ventilation. Methods 266 pa-tients with mechanical ventilation admitted to our ICU over the recent 3 years were allocated to the experi-mental group (humidification with a heat and moisture exchanger) and the control group (with heated hu-midifier), and the effect of humidification, the reserved time of artificial airway, the time on mechanical yen-tilation, the time of stay in ICU, the ineidenee of ventilator-associated pneumonia (VAP) and the mor-tality rate were comparatively studied and analyzed. Results Significant differences were found between the experimental and the control group in effect of humidification, insufficiency of humidification or excessive hu-midification, airway spasm and time on mechanical ventilation and time of stay in ICU. The incidence of VAP in the control group was significantly higher than that in the experimental group. There were no significant dif-ference between the two groups in the reserved time of artificial airway and the mortality rate. There were no accident of humidification occurred in the experimental group while there were one case complicated with air-way burn and 11 eases complicated with choking with water in the control group. Conclusions We conclude that HH can be replaced by HME on mechanical ventilation while disease evolution and effect of humidification should be monitored closely and keep HME unobstructed.

Objective To evaluate the feasibility and safety of endoscopic intraluminal closure of small colon perforation with metal clips in porcine model.Methods A 2 cm full-thickness colon perforation was made in 4 bama mini-pigs.One did not receive local closure as a control, while 3 others underwent closure with bi-and tri-arm clips, one of which received additional fibrin glue injection after closure.Necropsy was done on day 14 after the procedure, and dye leak test, peritoneal fluid bacteria culture and histological examination were performed.During the 2 week observation period, the body temperature and blood leukocytes count were recorded and compared.Results Endoscopic closure of the colon perforation was technically successful in all 3 pigs.The body temperature and blood leukocyte count of these pigs were both lower than those of the control.Necropsy showed that the perforation in control pig was not completely closed and with multiple adhesions around.Perforation complete closure and pathological healing without adhesion were observed in 2 pigs with clip closure only, while adhesion and incomplete pathological healing was detected in the other one with clip closure plus fibrinogen injection (P＜0.05).Conclusion Endoscopic intraluminal closure of a 2 cm colon perforation with metal clips is feasible and safe, while further study is needed to evaluate the effect of combined local fibrinogen injection.

Objective To evaluate preventive effect of semireclining and alternately lateral recumbent position on ventilator associated pneumonia.Method Fifty-fiv patients requiring mechanical ventilation for more than 48 hours were randomly divided into two groups 28 in semireclining with ahemately lateral recumbent position group and 27 in only semireclining group.Chest physiotherapy was carried out simultaneously in two groups.The secretion in lower respiratory tract was regularly cullected for quantitative cultures of microbiology.Results There were no significant differences between groups on gender,age,Acute Physiology and Chronic Health EvaluationⅡscore,risk factors for VAP.VAP occurred in 6 of 28 patients in the semireclining and alternately lateral recumbent position group and in 11 of 27 in the semireclining group (P0.05).Conclusions Semi-reclining with alternately lateral recumbent position can reduce aspiration and postural drainage that can decrease VAP rate and shorten duration of mechanical ventilation and ICU stay.