Ventilator-associated pneumonia (VAP) is a common hospital acquired infection in neonatal intensive care unit with high incidence in China. There is no diagnostic gold standard of VAP. The risk factors include premature birth, low birth weight, dura-tion of mechanical ventilation, episodes of intubation, blood stream infections. The recommended precautions include rising head of bed, closed tracheal suction, sucralfate, selective decontamination in digestive tract, improvement of mechanical ventilation, oral and skin care, hand hygiene. However, it is controversial that sucralfate, selective decontamination in digestive tract, passive humidifiers, oral and skin care can reduce the incidence of VAP.

Autophagy is an important pathway in the body to remove damaged cell organelles and dysfunctional proteins to maintain protein equilibrium and intracellular homeostasis by the lysosomal system .As a degenerative disease of central nervous system , the main feature of Alzheimer ’ s disease is abnormal protein aggregation .However , the role of autophagy in the pathogenesis of Alzheimer ’ s disease is not fully clear yet .The aim of this paper is to take β-amyloid peptide as a starting point to explore the relationship between autophagy and β-amyloid peptide in the pathogenesis of Alzheimer’s disease.

Objective To investigate the clinical significance of the expression of CD_(21) on peripheral blood B lymphocytes in different age periods.Methods All the cases was divided into newborn group,infant group and children group.The expression of CD_(21) on B lymphocytes were analyzed by the flow cytometry.Results 1.The number of CD_(21) on B lymphocytes of newborn group were obviously lo-(wer) than those in other two groups;and with growth of a child,the numer tended to grow up.2.Mean fluorescence intension(MFI),the expression of CD_(21) on B lymphocyte,also had the characteristic of increase with the age.Conclusions With the growing up of a child,the expression of CD_(21) on B lymphocyte has the tendency of up-regulation;which conforms to the feature of immune system development in childhood.Because of the higher expression of CD_(21) on B lymphocyte in certain age,it has the sensitivity to Epstein-Barr virus infection for children.

Objective To explore post-operative treatment and intensive care of infants with congenital heart disease(CHD).Methods Clinical data of post-operative treatment and intensive care in 264 infants with CHD were analyzed retrospectively from May.1998 to Apr.2006.Among them,256 cases underwent radical operation,and 8 cases with palliative operation.Results Sixteen cases died early.Among them,after operation,there were 8 cases with Fallot′s syndrome,2 cases with complete atrioventricular canal anomalous,3 cases with ventricular septal defect(VSD)and pulmonary hypoplasia(PH),1 case with tricuspid atresia,1 case with single ventricle,and 1 case with persistent truncus arteriosus.Causes of death include low cardiac output,acute renal failure,degree of Ⅲ atrioventricular block(AVB),lung infection,respiratory failure and arrhythmia.One case with complete pulmonary vein ectopia was discharged due to post-opertative refractory hypercapnia;1 case with atrial septal defect(ASD)and patent ductus arteriosus(PDA) died of refractory heart failure due to high pulmonary arterial pressure 1 year after operation;1 case with tetralogy of Fallot died of lung hemorrhage after radical correct operation followed by palliative outflow tract deo-ppilant operation.Of them 245 cases alive,there were 233 cases with heart function grade Ⅰ,12 cases with grade Ⅱ.Conclusion Correct management of respiratory system,systemic electrocardial care,handling with arrhthymia on time,low cardiac output and nutritional support are the important measures in improving survival rate of infants with CHD.

Objective To investigate the influence of discontinuance of methimazole (MMI) and propylthiouracil (PTU) on 24 h radioactive iodine uptake(RAIU) in normal rats.Methods A total of 66 female SD rats were randomly divided into 3 groups by simple random sampling method.MMI group (30 rats) received MMI with a dose of 0.6 mg·ml-1·d-1 orally for 2 weeks, PTU group (30 rats) received PTU with a dose of 6 mg·ml-1·d-1 orally for 2 weeks.At 1, 3, 5, 7 and 9 d after MMI or PTU was discontinued, 6 rats were sacrificed to measure 24 h RAIU respectively.The control group (6 rats) received normal saline with a dose of 1 ml/d orally for 2 weeks, and then they were sacrificed to measure 24 h RAIU too.Data were analyzed with two-sample t test or t′ test.Results Thyroid 24 h RAIU in normal rats was (14.6±4.3)%.The 24 h RAIU on 1, 3, 5, 7 and 9 d was (4.6±0.7)%, (24.2±7.2)%, (13.1±2.9)%, (14.1±2.6)%, (16.1±3.7)% respectively after MMI withdrawal.The 24 h RAIU was significantly lower than that in control group at day 1 (t′=5.55, P<0.01), higher at day 3 (t=-2.83, P<0.05), and returned to the normal level at day 5, 7, 9 (t=0.68, 0.24,-0.67, all P>0.05).The 24 h RAIU on 1, 3, 5, 7 and 9 d was (1.9±0.8)%, (3.3±1.2)%, (7.7±2.4)%, (29.0±4.0)%, (17.1±4.8)% respectively after PTU withdrawal.It was lower than that in control group (t=7.01, 6.10, 3.40, all P<0.05) at day 1, 3, 5, and higher at day 7 (t=-5.97, P<0.01).The 24 h RAIU of 9 d showed no difference when compared with that in control group (t=-0.95, P>0.05).Conclusions MMI and PTU can inhibit the iodine uptake of thyroid, the 24 h RAIU returns to normal level at day 5 after withdrawal of MMI and at day 9 after withdrawal of PTU in euthyroid rats.

Objective To learn the current obstetric beds allocation,obstetric service delivery and access in midwifery institutions at various levels in the localities and nationwide as well as the trends,and assess the equity of obstetric beds allocation,for the purpose of recommending on a reasonable adjustment of obstetric beds allocation in these institutions.Methods Random sampling made in 44 cities in China for questionnaire survey on obstetric beds allocation,service delivery and utilization in 2008～2010 at all midwifery institutions in these cities.Interview of health administrators and medical workers at obstetric of midwifery institutions in 6 counties.Results Every thousand square kilometers in China average 5.9 midwifery institutions,and every thousand people average 0.24 obstetric beds.During 2008 ～ 2010,the number of beds and midwifery service delivery kept a growing trend while in townships obstetric service deliveries maintain a falling trend.The fairness index of maternity beds layout nationwide is 0.021283.Obstetric beds supply and demand ratio in different regions ranges among 0.97～ 1.41.The number of deliveries made in county level hospitals is 54.1％,but the beds in such hospitals account for but 48.1％.Conclusion The equity of obstetric beds allocation is good in terms of population layout.The quantity of obstetric beds meets the current needs nationwide,while the allocation of obstetric beds is less than reasonable among obstetric institutions of various levels in the country.The authors recommend a better control and adjustment of midwifery institutions layout,especially more such hospitals at the township level to meet the need of women delivery in hospital in remote areas.

To analyze the data of 284 smoking patients visiting the clinic during January 2009 to December 2011.There were 273 males and 11 females with a mean age of 49 years and an average length of 26 years of smoking 24 cigarettes per day.The average volume fraction of exhaled carbon monoxide was 16 × 10-6.The average score of Fagerstrom test of nicotine dependence (FTND) was 5.The importance,confidence and preparation of quitting smoking were graded at an average of 8.5,6.7 and 7.6 respectively.Abstinence rate was 66.1％ at 1 month and 50.9％ at 3 months.A particular focus was placed upon those smokers with more serious nicotine dependence and longer smoking years.They knew much about the importance of smoking cessation,but there was a lack of confidence.Smoking cessation improves abstinence rate via behavioral counseling,psychotherapy and medication.We should strengthen publicity of smoking cessation and smoking cessation clinic to attract more patients with heightened confidence through treatment.

Objective To investigate the effects of C-terminal fragment of parathyroid hormonerelated protein (PTHrP107-139) on bone mineral density (BMD), bone histomorphometry and biomechanical properties in ovariectomized (OVX) rats and its effect on bone metabolism is also explored. Methods Forty 4-month old female Wistar rats in which 30 were ovariectomized and then divided into 3 groups: the placebo, the PTHrPC and the CT groups, the other 10 rats were Sham-operated as the control group (Sham). Five weeks later, the rats of PTHrPC and CT groups were subcutaneously injected with PTHrP107-139 (40 μg/kg) and Salmon Calcitonin (15 U/kg) respectively once every other day. The rats of the placebo and sham groups were injected with 0.2 ml saline once every other day. After treatment of 12 weeks, all rats were sacrificed and all samples were collected and analyzed. Results ① Compared with the placebo, the BMD and bone strength of PTHrPC and CT groups were significantly increased (P<0.05). ② Histomorphometry revealed that the tetracycline labeled bone surfaces, osteoid surfaces, mineral apposition rate and bone resorption rate were remarkably decreased in PTHrPC, and CT groups comparing with those of the placebo group. Conclusion Cter-minal PTHrP107-139 is effective in increasing the BMD, bone strength and quality when administered intermittently to ovariectomy-induced osteoporotic rats. Its increasing in bone quality may relate to reducing bone turnover and inhibiting resorption.

Cells, Cultured ; Comet Assay ; DNA Damage ; drug effects ; Dose-Response Relationship, Drug ; Humans ; Lymphocytes ; drug effects ; Styrene ; adverse effects