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Objective To explore the distribution and antibiotic resistance of the pathogens in the patients with central venous catheter-related blood stream infection in neurosurgical intensive care unit (NSICU).Methods A total of 452 patients with central venous catheter were identified in NSICU from January 2014 to January 2017.Medical records were reviewed retrospectively to examine the incidence of central venous catheter-related blood stream infections,and the pathogen distribution and antibiotic resistance profile.Results The incidence of central venous catheter-related blood stream infection was 4.6％ (21/452).The incidence of such infection was significantly higher for the catheter in femoral vein (10.5％) than in internal jugular vein (4.0％) and subclavian vein (2.6％) (x2=9.755,P=0.008).Twenty-six strains of pathogen were isolated from the 21 patients,including 13 (50.0％) grampositive bacteria,11 (42.3％) gram-negative bacteria and 2 (7.7％) fungal strains (Candida albicans and Candida parapsilosis each).The most common gram-positive bacteria were Staphylococcus epidermidis(5) and Staphylococcus aureus(3).The most common gram-negative bacteria were Klebsiella pneumoniae(4) and Serratia marcescens(3).The most frequently isolated pathogen of central venous catheter-related blood stream infections was S.epidermidis (19.2％) and K.pneumoniae (15.4％).The antimicrobial susceptibility testing showed that gram-positive bacteria were highly resistant to penicillin,erythromycin,oxacillin and clindamycin.Gram-negative bacteria were highly resistant to cefazolin and piperacillin.The two fungal strain were highly sensitive to fluconazole,voriconazole,itraconazole and amphotericin B.Conclusions The predominant pathogens of central venous catheter-related blood stream infections in NSICU patients are gram-positive bacteria.S.epidermidis and K.pneumoniae are the major pathogens with high level of antibiotic resistance.Aseptic procedures and rational antibiotic therapy according to antimicrobial susceptibility test should be emphasized to control the resistant strains.
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Objective To explore the effect of low-carbohydrate/high-monounsaturated fatty acids (LC/HMD) nutrition program for patients with diabetes mellitus and stroke. Methods Thirty-seven patients with diabetes mellitus and stroke after percutaneous endoscopic gastrostomy (PEG) were enrolled in this study, and these patients were treated with liquid food nutritional support. All patients were given high-carbohydrate (HCD) nutritional support at the first and second day and then changed to LC/HMD nutrition program. The blood glucose fluctuations were monitored by continuous glucose monitoring(CGM) system. Meanwhile the daily dose of insulin injections, glycosylated hemoglobin (HbA1c) and biochemical indicators were detected. for just admission and just give LC after/HMD nutrition program and three months later on HbA1c and blood biochemical indexes were detected. Results 3 months after LC/HMD nutrition program treatment, the levels of mean amplitude of plasma glucose excursions (MAGE), ratio of hyperglycemia to time, ratio of glycopenia to time, HbA1c, daily dose of insulin injections were significantly improved compared with those at the 2nd of LC/HMD nutrition program treatment and with HCD nutritional support (P < 0.05). Three months after LC/HMD nutrition program treatment, the levels of blood biochemistry index had no significant change (P > 0.05). Three months after LC/HMD nutrition program treatment, the blood glucose fluctuations significantly reduced in all patients. Conclusions For patients with diabetes mellitus and stroke and receiving liquid food treament, LC/HMD nutrition program can significantly improve glycemic index, reduce dependence on insulin, and lower blood sugar fluctuations.
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Objective To explore the effect of low-carbohydrate/high-monounsaturated fatty acids (LC/HMD) nutrition program for patients with diabetes mellitus and stroke. Methods Thirty-seven patients with diabetes mellitus and stroke after percutaneous endoscopic gastrostomy (PEG) were enrolled in this study, and these patients were treated with liquid food nutritional support. All patients were given high-carbohydrate (HCD) nutritional support at the first and second day and then changed to LC/HMD nutrition program. The blood glucose fluctuations were monitored by continuous glucose monitoring(CGM) system. Meanwhile the daily dose of insulin injections, glycosylated hemoglobin (HbA1c) and biochemical indicators were detected. for just admission and just give LC after/HMD nutrition program and three months later on HbA1c and blood biochemical indexes were detected. Results 3 months after LC/HMD nutrition program treatment, the levels of mean amplitude of plasma glucose excursions (MAGE), ratio of hyperglycemia to time, ratio of glycopenia to time, HbA1c, daily dose of insulin injections were significantly improved compared with those at the 2nd of LC/HMD nutrition program treatment and with HCD nutritional support (P < 0.05). Three months after LC/HMD nutrition program treatment, the levels of blood biochemistry index had no significant change (P > 0.05). Three months after LC/HMD nutrition program treatment, the blood glucose fluctuations significantly reduced in all patients. Conclusions For patients with diabetes mellitus and stroke and receiving liquid food treament, LC/HMD nutrition program can significantly improve glycemic index, reduce dependence on insulin, and lower blood sugar fluctuations.
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Objective To observe the effects of bone marrow mesenchymal stem cells (BMSC) transplantation on the expression of nerve growth factor(NGF) and brain derived neurotrophic factor(BDNF) in the rat spinal cord with spina bifida,and to investigate the change in cell apoptosis after BMSC transplantation.Methods Spina bifida aperta was induced with a single intragastric injection of all-trans retinoic acid,then the BMSC was microinjected into spina cord of rat embryos on embryo 16 d(E16),BDNF and NGF were tested by immunofluorescence staining,and TUNEL assay were used for investigating cell apoptosis.Results Transplantation of BMSC enhanced the expression of NGF and BDNF,and reduced cell apoptosis in the defective site of spinal cord.Conclusion The transplantation of BMSC may improve the microenvironment of spinal cord and repair the neurological defects by enhancing the expression of neurotrophic factor and reducing the cell apoptosis.
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BACKGROUND: Ethanol chemical damage method can be used to establish thin endometrium rat model. Expression of proliferation-related proteins is decreased in thin endometrium animal model, which contributes to the study of thin endometrium-related mechanism and provides guidance for clinical treatment. OBJECTIVE:To explore the changes in vimentin and vascular endothelial growth factor expression in rat modelsof high concentrations of ethanol-induced thin endometrium. METHODS: 0.3 mL 95% ethanol was slowly injected in the right uterus of female Sprague-Dawley rats to establish rat models of thin endometrium. An equal volume of physiological saline was injected into the left uterus as control sides. RESULTS AND CONCLUSION:The thickness of endometrium in the injured uterus was significantly thinner than the control ones. Number of glands reduced, structure became disorder, and vimentin and vascular endothelial growth factor expression markedly diminished. These results suggest that 95% ethanol injury can effectively establish rat models of thin endometrium. Proliferation-related protein expression altered in the thin endometrium.
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Objective:To compare the immediate therapeutic effect and safety between esmolol and lanatoside in con-trolling ventricular rate for patients with rapid atrial fibrillation.Methods:A total of 72 patients with rapid atrial fi-brillation (ventricular rate ≥120 beats/min)were randomly and equally divided into esmolol group and lanatoside group.Esmolol group received first dosage of 0.5 mg/kg intravenously for 1 min,then were observed for 5 min,if ventricular rate still >100 beats/min or decreased 100 beats/min or decreased0.05)between two groups.Conclusion:Intravenous using esmolol is efficient and safe,and it can be regarded as pre-ferred therapy to control ventricular rate in patients with rapid atrial fibrillation.
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Objective To investigate the difference among neonatal rat models of hypoxia-ischemia induced white matter injury of brain by three different methods and to provide theory basis on choosing the proper animal model for deep study on white matter injury of premature infants.Methods Three different hypoxia-ischemia methods were applied to induce brain white matter injury model of Wistar rats of postnatal 3rd day which were left carotid artery ligation followed by 6％ oxygen for 30 minutes and for 4 hours respectively,and bilateral carotid artery ligation followed by 8％ oxygen for 30 minutes.Compared brain pathological results of rats in different groups,changes in white matter of brain by glial fibrillary acidic protein (GFAP) and myelin basic protein (MBP) immunostaining,and changes in time of opening eyes and eyes appearance.Results Left carotid artery ligation followed by 6％ oxygen for 30 minutes resulted in sparse and vague periventricular white matter without necrotic lesions,and the degree of GFAP intensity [(5 021.63 ± 358.92) OD] increase and MBP intensity [(18 488.63 ± 1 822.62) OD] decrease were lowest (P ＜ 0.000 1),as well as the delay of opening time of the left eye.Left carotid artery ligation followed by 6％ oxygen for 4 hours resulted in necrotic lesions of periventricular white matter,with the degree of GFAP intensity [(6 069.13 ± 458.61) OD] and MBP intensity [(15 003.38 ± 1 559.11) OD],and also the delay of opening time of the left eye.Bilateral carotid artery ligation followed by 8％ oxygen for 30 minutes caused cystic necrosis of bilateral periventricular white matters,and the degree of GFAP intensity [(6 194.50 ±432.69) OD] increase and MBP intensity [(10 119.35 ± 735.16) OD] decrease of the left side were highest(P ＜ 0.000 1),as well as the delay of opening time and cataract in both eyes.Conclusion Left carotid artery ligation followed by 6％ oxygen for 30 minutes is more suitable for investigating mild brain white matter injury.Left carotid artery ligation followed by 6％ oxygen for 4 hours and bilateral carotid artery ligation followed by 8％ oxygen for 30 minutes are more proper for the investigation of severe periventricular leukemacia cases.
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Objective To investigate the application of education of nursing safety in nursing technique teaching.Methods 60 cases of new entry nursing personnel in our hospital from December 2009to June 2010 were divided into the observation group and the control group,the control group was given traditional teaching methods of training and evaluation,the observation group was given nursing safety education on the basis of the control group.The evaluation of teaching methods,the testing score 1 year later and incidence rate of adverse events between two groups were compared.Results The observation group believed that their ability in the discovery,analysis,solving of the problems of nursing safety was enhanced by teaching.Theoretical examination results between two groups had no significant difference.But technique assessment score in the observation group was significantly higher than that in the control group,the incidence of adverse nursing events was significantly lower than that in the control group.Conclusions The nursing safety education helps to improve the foresight ability in nursing safety,improve the occupational quality and ensure patients' safety.
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Objective To explore the value of evaluating rat liver fibrosis using contrast enhanced sonography.Methods Carbon tetrachloride was used to induce liver fibrosis.Under the mode of pulse-inversion harmonic imaging,ultrasound contrast agent was bolus iniected through tail vein,hepatic artery arrival time(HAAT),portal vein arrival time(PVAT),hepatic vein arrival time(HVAT)was recorded,and their relationship with immunohistochemical results were analyzed.Results There was no statistical difference of HAAT,PVAT between two groups among S0-S4 stage.HVAT was shorter in S3 and S4 stage than in S0-S2 stage(P＜0.05).HVAT was negative correlated with the percentage of immunohistochemical positive area of C-Ⅳ,LN,the correlation coefficients were-0.680 and -0.639 respectively.Conclusions Contrast enhanced sonography is useful for the diagnosing liver fibrosis.
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Aim To illustrate the role of Tanshinone IIA(TanIIA)extracted from dan-shen root in atherosclerosis and its different targets by investigating the effect on the expression of NF-?B、I?B-? and the mRNA of ICAM-1 and VCAM-1 in human umbilical vascular endothelial cell 304(ECV304).Mehods The TNF-?-induced cultured ECV-304 cell injury model was established to analyze the expression of NF-?B、I?B-? by cell ELISA method and the mRNA of ICAM-1 and VCAM-1 by RT-PCR method of the cells cultured with different denses of TanIIA.Results The results of ELISA method showed that the expression of the NF-?B was reduced significantly and the expression of the I?B-? was enhanced significantly in ECV304 which were cultured with higher denses of TanIIA.The results of RT-PCR method showed that the mRNA of ICAM-1 and VCAM-1 induced by TNF-? was significantly refrained.Conclusions TanIIA has a significant effect on inhibiting the mRNA of ICAM-1 and VCAM-1 induced by the NF-?B activation,so it can play an impotant role in resisting atherosclerosis.
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Objective To evaluate the efficacy and safety of small dose Urapidil in the treatment of patients with congestive heart failure. Methods 60 patients with congestive heart failure (NYHA class Ⅲ～Ⅳ) were randomly assigned to treatment with Urapidil (n=30) and Nitroglycerin (n=30). Intravenous Urapidil (100?g/min) or Nitroglycerin (10～20?g/min) was administered for 5～7 days in addition to ordinary treatment. Heart rate, blood pressure were measured and echocardiography was performed before and after the treatment. And side effects were recorded. Results The total effective rate was 86 7% in the Urapidil group, and 90% in Nitroglycerin group. No significant differences of heart rate and blood pressure were found after treatment between two groups. The ejection fraction measured by echocardiography increased significantly in two groups after the treatment, but more significantly in the Urapidil group. Conclusions It is efficacious, safe and well tolerated for intravaneus small dose Urapidil to treat congestive heart failure.