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Objective To understand the epidemiological characteristics and hospitalization death disease composition of elderly hospitalized patients aged 65 years and over in Dongguan city, and provide scientific basis for the health prevention and health care work of relevant departments. Methods Through the "Guangdong province medical institutions medical records statistics management system" selected in 2015 in Dongguan city, 65 years old and over hospitalized patients with death of 959 cases, investigated the hospitalization death disease composition, analysis of its age distribution, gender distribution, the distribution of the season of death and so on. Results The top five hospitalization death disease composition were Malignant neoplasms, Ischaemic heart diseases, Cerebrovascular diseases, Pneumonia and Injury, accounting for 65. 17% of the deaths. There were significant differences in mortality among different gender groups(P<0. 05). There were significant differences in mortality among different age groups(P<0. 05). The distribution of death season is the highest in spring and summer. Conclusion To master the hospitalization death disease composition of elderly hospitalized patients, strengthen health education, reduce mortality and improve the quality of life of the elderly.
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Objective To explore the value of 18F-FDG PET/CT in diagnosis of retroperitoneal fibrosis (RPF).Methods Totally 12 RPF patients underwent 18 F-FDG PET/CT scanning,and the characteristics of metabolic activity,distribution of retroperitoneal lesions and maximum standardized uptake value (SUVmax) were analyzed retrospectively.Results Among 12 patients,7 were initial evaluation patients,5 were post-treatment patients.Of 7 initial evaluation patients,there were 4 patients with secondary RPF,including prostate carcinoma,breast cancer and IgG4-related disease.Retroperitoneal mass isodense with muscle surrounding the abdominal aorta or the iliac arteries were found in 12 patients,and ureteral involvement were found in 11 paients (11/12,91.67%).SUVmax in initial evaluation patients (4.21±1.76) was higher than that in patients after treatment (1.46±0.25,P<0.05).According to PET/CT,3 idiopathic RPF patients as initial evaluation with high metabolic activity lesions received immunosuppressive therapy including corticosteroids and tamoxifen,and 4 secondary RPF patients with high metabolic activity lesions received treatment based on causes.Among 5 post-treatment patients,3 continued to accept current corticosteroids maintenance dose,while 2 did not receive any other treatment.Conclusion PET/CT may be used to evaluate the activity and extension of lesions in patients with RPF.
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Objective To investigate the clinical value of 18 F?FDG PET/CT in staging multiple myeloma ( MM) and evaluating the glucose metabolic activity of MM. Methods A total of 25 MM patients ( 13 males, 12 females, age:39-67 years) from May 2010 to April 2015 were enrolled in this retrospective study. The SUVmax of each patient was recorded. D?S plus staging according to 18 F?FDG PET/CT was com?pared with the traditional D?S staging. The SUVmax and the percentage of plasmacytes of bone marrow of phase Ⅲ and non?phase Ⅲ ( phaseⅠand Ⅱ) according to D?S plus staging were compared. Two?sample t test and Wilcoxon rank sum test were used to analyze the data. Results In 25 MM patients, the range of SUVmax of lesions was 1.8-12?0 and the mean value was 5.15±2.74. According to D?S staging, the numbers of patients with phase Ⅰ,Ⅱ andⅢwere 7, 4 and 14, respectively. While the numbers were 3, 1 and 21 by D?S plus staging. Based on the D?S plus staging system, stages of 7 patients ( 28%, 7/25 ) were changed. According to the D?S plus staging system, the SUVmax between phaseⅢand non?phaseⅢpatients was significantly different (5.75±2.54 vs 3.00±0?70; t=2.12, P0.05). Conclusion 18F?FDG PET/CT is of clinical importance for MM staging and metabolic activity assessment of MM.
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OBJECTIVE:To evaluate the effect of the implementation of comprehensive reform with“zero drug profit”and the like in Jingjiang City People’s Hospital. METHODS:Comparative analysis was made to the data for the adjustment of medical ser-vices and medicine specifications,control of medical expenses,general condition of hospital operation and hospital compensation mechanism before (2012) and after (2013) comprehensive reform in this hospital. RESULTS & CONCLUSIONS:After the com-prehensive reform,the number of medical services provided by this hospital increased from 1 408 to 1 426 (with increase rate of 1.28%),in which the prices of 949 services raised (accounting for 66.55%);the number of medicine specifications decreased from 1 875 to 1 670 (with decrease rate of 10.93%),but the number of essential medicine specifications increased from 261 to 377 (with increase rate of 44.44%);total medical expense and total medical expense per capita respectively increased from 477 565.0 thousand yuan and 633.21 yuan to 524 865.9 thousand yuan and 686.91 yuan(with increase rate of 9.90% and 8.48%), but total medicine expense and total medicine expense per capita respectively decreased from 207 656.8 thousand yuan and 275.33 yuan to 199 052.7 thousand yuan and 260.51 yuan(with decrease rate of 4.14% and 5.38%),the proportion of medicine revenue in total hospital revenue also decreased from 43.48%to 37.92%(with decrease rate of 5.56%);total medical revenue and expendi-ture respectively increased from 453 825.5 thousand yuan and 217 516.3 thousand yuan to 524 865.9 thousand yuan and 263 733.3 thousand yuan (with increase rate of 15.65% and 21.25%),but total drug revenue and expenditure respectively changed from 208 380.8 thousand yuan and 176 054.1 thousand yuan into 199 052.7 thousand yuan and 196 407.5 thousand yuan(with increase rate of -4.48% and 11.56%);although the compensation reached 26 596.0 thousand yuan after raising the prices of hospital ser-vices,the subsidies(including the subsidy for basic construction and equipment procurement,fund for public health services,fund for the retirement conforming to requirements and subsidy for the balance found after checking revenue and expenditure) which should be granted by the government has not become available. It is an urgent issue that government departments and the hospital further improve relevant management policies to promote sound development of medical and healthcare program.
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Objective To analyze and compare the pathological changes of lung tissue in mice infected with the novel H7N9 influenza virus and 2009 pandemic H1N1 influenza virus, respectively, and to preliminarily study the mecha-nisms of acute lung injury induced by those virus infection .Methods SPF 6-week old BALB/c mice ( body weight 18-20 g, male∶female=1∶1) (n=3 in each subgroup) were intranasally infected with H7N9 virus and H1N1 virus, respec-tively.The behavior and survival time of mice after virus infection were observed and the survival rates were analyzed .The heart, liver, spleen, lung, kidney, intestines, and brain were collected at indicated time points for histopathological exami-nation using H&E staining .The distribution of virus antigen was detected by immunohistochemistry .The neutrophil infiltra-tion was also observed .The correlation of lung injury with virus replication and host immune responses was analyzed .Re-sults The lung and spleen injury of mice infected with H 7N9 virus was slighter and their survival rate (100%) was high-er than those of mice infected with H1N1 virus.The damages of the lung and spleen in H1N1virus-infected mice were more severe than that in H7N9 virus-infected mice, and all the 10 mice in this group died within 9 days after virus inoculation . The distributions of both the virus antigens were mainly in the bronchial epithelial cells , a few stromal cells and alveolar ep-ithelial cells .The levels of virus replication in the two groups were not significantly different .There were more intense neu-trophil infiltration in the lung and inflammatory response in the H 1N1 virus-infected mice than those in the H7N9 virus-in-fected mice .Conclusions There are some differences of the pathological characteristics and extent of lung injury in the mice infected with H7N9 virus and H1N1 virus, respectively.The virus replication is a precipitating factor but not the deci-sive factor of the lung injury , and there is a close relationship between the host immune responses and acute lung injury .
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Objective To investigate the awareness of AIDS knowledge among medical staffs and their preventive behaviors among hospitals of traditional Chinese Medicine in Liangshan and to analyze the influential factors so as to provide the scientific basis for the staffs' training as well as for the prevention and control about AIDS. Methods Medical staffs from 7 hospitals of traditional Chinese medicine in Liangshan were surveyed using self-designed questionnaires,among which 276 were valid. Results The total score of the medical staffs' knowledge on AIDS was 34.14 ±6.92 points. Those with the highest score accounted for 16.73%, others with intermediate score accounted for 56.13%and still others with the low score accounted for 27.14%. The total score of the medical staffs' preventive behaviors on AIDS was 35.20 ±9.48 points, with the highest score being 12.64%, the intermediate score being 30.86%and the low score being 56.51%. The major factors to influence the medial staffs' knowledge about AIDS related to his/her educational level, specialty, education background of education, trainings on AIDS and contacts with HIV/AIDS patients and so on (<0.05) . The hospital's level, the specialty, whether or not being trained with AIDS knowledge concerned the level of occupational protection ( <0.05), whereas their ages, titles of a technical post, working years of working were irrelevant. Conclusion The overall level of these medical staffs’knowledge and preventive behaviors has not been satisfactory. Therefore, the various training programs will be necessary to improve the technical level of the medical staffs.
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Objective To investigate the effects of mild pefioperative hypothermia on cellular immune function in patients undergoing surgery for rectal cancer.Methods Fifty ASA Ⅰ or Ⅱ patients aged 30-64 yr undergoing surgery for rectal cancer were randomly divided into 2 groups ( n =25 each):mild hypothermia group and normal body temperature group.Anesthesia was induced with midazolam,fentanyl,etomidate and vecuronium and maintained with propofol,remifentanil and vecuronium.The patients were mechanically ventilated after tracheal intubation.PET CO2 was maintained at 35-45 mm Hg.The venous blood samples were taken from peripheral vein at 1 h before anesthesia (T1 ),at the end of operation (T2),at 24 h after operation (T3),and on 7th day after operation (T4) to measure the serum Th1 and Th2 cytokines levels and Th1/Th2 cytokines balance was observed.Results Compared with the baseline value at T1,the serum Th2 cytokines level was significantly decreased and Th1/Th2 ratio was significantly increased at T4 in normal body temperature group,and the serum Th1 cytokines level and Th1/Th2 ratio were significantly decreased and the serum Th2 cytokines level was significantly increased at T2.3 in mild hypothermia group ( P < 0.05).Compared with normal body temperature group,the serum Th1 cytokines level and Th1/Th2 ratio were significantly decreased and the serum Th2 cytokines level was significantly increased at T2-4 in mild hypothermia group ( P < 0.05).Conclusion Mild perioperative hypothermia can depress cellular immune function in patients undergoing surgery for rectal cancer.
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Objective To explore the practicability of the pressure sore management forms and its effect on improving the nurses' reported compliance rates on high-risk pressure sores and external pressure sores and the passing rate of nursing records. Methods With aided designs as forms, icons and notes,making a comparative analysis on high-risk pressure sores and external pressure sore between 433 cases in 2010(the observation group) and 205 cases in 2009(the control group). Designing and applying the pressure sore management forms, including four kinds of forms: the high-risk assessment form, high-risk pressure sores declaration sheet, the external pressure sore report form, pressure sore prevention and care record sheet, then applied them in the observation group. Results Compared with the control group, all aspects like the compliance rates of nurses' reports on high-risk pressure sores and external pressure sore, the passing rate of nursing records, the healing and improvement rates were obviously increased, the occurrence rate of high-risk pressure sores decreased. Conclusions The pressure sore management forms can help nurses for accurate assessing high-risk pressure sores and external pressure sores, also can help to increase the healing and improvement rate and to enhance the quality of nursing records.
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Objective To evaluate and compare the normal value of glomerular filtration rate (GFR) in different modalities of single photon emission computed tomography (SPECT). Methods Fifty normal volunteers were divided into 4 groups (aged 20-29, n=14;30-39, n=10;40-49, n=14;50-, n=12). All of the volunteers underwent renal dynamic imaging with MPR SPECT, and single renal GFR value as well as total GFR value was calculated, respectively. The data were compared with GFR values obtained from Starcom 400AC/T SPECT (aged 20-29, n=6;30-39, n=11;40-49, n=7;50-, n=9). Single t test was used to testify the difference of the mean value between the two modalities of SPECT. Results The mean value of single renal GFR in each group of MPR SPECT was (51.03±11.12) ml, (48.44±11.13) ml, (47.79±7.71) ml and (46.54±12.28) ml,while of Starcom 400AC/T SPECT was (57.92±9.03) ml, (57.34±10.33) ml, (55.30±8.51) ml and (44.12±7.94) ml, respectively, and the total renal GFR in each group of MPR SPECT was (102.13±18.33) ml, (96.62±19.90) ml, (95.54±13.04) ml and (92.85±22.83) ml, of Starcom 400AC/T SPECT (115.86±16.51) ml, (113.14±17.71) ml, (110.54±11.13) ml and (88.12±14.41) ml, respectively (all P<0.05). The mean value of single renal GFR was (48.51±10.50) ml and (52.92±10.61) ml, respectively, while the mean value of total renal GFR was (97.04±18.16) ml and (105.63±18.72) ml, respectively (all P<0.05). Conclusion GFR standard value obtained from different SPECT renal dynamic imaging is varied. It is necessory to establish GFR standard value for each type of SPECT.
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Objective To investigate the effects of exogenous nitric oxide (NO) on gaseous transmitter molecule of the hippocampus in rats with global cerebral ischemic-reperfusion(I-R) injury.Methods Twenty-four Wistar male rates were randomly divided into 4 groups of sham operation (group S),I-R control(group I-R),I-R plus sodium nitroproside(SNP) 2 mg/kg(LSNP) or plus SNP 4 mg/kg(group HSNP) with 6 rats each.Global cerebral I-R model was established by 4-vessel occlusion.SNP was injected at 30 min before clamping the bilateral carotid arteries in groups of LSNP and HSNP.The carotid arteries were clasped for 20 min.The rats were killed after cerebral reperfusion for 6 h.The concentrations of hydrogen sulfide(H_2S),NO and CO,the activity of cystathionine beta synthase(CBS),HO and inducible nitric oxide synthase(iNOS),as well as the expression levels of CBS mRNA,iNOS mRNA and hemeoxygenase-1 (HO-1) mRNA in the hippocampus were measured.Results Compared to group S,the concentrations of H_2S,NO and CO,the activities of CBS,HO and iNOS and the expressions of CBS mRNA,iNOS mRNA and HO-1 mRNA in group I-R were increased(P<0.05 or P<0.01) ,which were all higher in groups of LSNP and HSNP than those in group I-R(P<0.05 or P<0.01).Conclusion Exogenous NO can induce the expressions of CBS mRNA and HO-1 mRNA,activate CBS and HO in rats with global cerebral I-R injury,indicating that NO has a modulation effect on the CBS/ H_2S and iNOS/NO systemes.
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Abstract: To express human-mouse chimeric IgA antibody directed against H5N1 virus, an anti-H5N1 chimeric IgA antibody gene was constructed by joining the light and heavy chain variable region genes and the corresponding signal peptide coding sequences of the anti-H5N1 mouse monoclonal antibody H5N1-HA with the coding sequences of the constant region of the human IgA2 heavy chain and Kappa chain respectively. Then the full-length chimeric light and heavy chain expressing plasmids pEF-IGHA9 and pEF-IGK9 were constructed and transfected into the CHO/dhfr cells. The chimeric IgA antibody expression was confirmed by ELISA, SDS-PAGE and Western blotting. The successful expression of this anti-H5N1 chimeric IgA may help to provide a stand for developing passive immunological agents for H5N1 virus infection prophylaxis.
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Animais , Cricetinae , Humanos , Camundongos , Anticorpos Monoclonais , Anticorpos Antivirais , Genética , Células CHO , Quimerismo , Cricetulus , Imunoglobulina A , Genética , Alergia e Imunologia , Virus da Influenza A Subtipo H5N1 , Genética , Alergia e Imunologia , Proteínas Recombinantes de Fusão , Genética , Alergia e ImunologiaRESUMO
OBJECTIVE:To analyze the drug resistance of Klebsiella pneumoniae and drug use in patients infected with Klebsiella pneumoniae to promote rational drug use.METHODS:The Klebsiella pneumoniae separated during 2006 in our hospital was subjected to drug susceptibility tests and the results were given a statistical analysis.Meanwhile,the drug use in patients infected with Klebsiella pneumoniae was analyzed.RESULTS:The antibiotic resistance rates of 75% of the antibiotics were above 50%.On average,2.56 kinds of antibiotics were preventively or empirically used per in-patient.CONCLUSION:The drug resistance of Klebsiella pneumoniae is very serious.Clinical treatments should choose antibiotics rationally according to susceptibility tests.
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Objective To obtain Chinese hamster ovary (CHO) cell lines that stably express a targeting complement inhibitor CR2-CD59.Methods The recombinant plasmid PEE14.1-CR2-CD59 was constru-cted by cloning the DNA fragment CR2-CD59 into plasmid PEE14.1,and the obtained plasmid was transfected into CHO cells by FuGENE 6.The clones with stable high expression of target fragment were selected by methionine sulfoximine (MSX),the expression of CR2-CD59 was analyzed by ELISA,SDS-PAGE and Western blotting analysis.Results Several stable expression clones were obtained,and CR2-CD59 was highly expressed in the secret form in CHO cells.SDS-PAGE analysis showed that the molecular weight of the recombined protein CR2-CD59 was consistent with the predicted one.ELISA and Western blotting results revealed that the CR2-CD59 could react with both anti-human CR2 and anti-human CD59 polyclonal antibodies.Compared with serum-containing medium,the protein was highly expressed in serum-free medium (P
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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.
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Objective To explore the organic and biological contamination in water body of Jin River of Tianjin. Methods Three sections were set up in the upper reaches, middle reaches and lower reaches of Jin River respectively. 6 sampling points were set up in each section of the river. The levels of BOD_5~(20), total count of bacteria, fecal coliform count of the river water were determined. The obtained data were assessed based on GB3838-2002 the National Criterion for Environmental Quality of Surface Water. Results The levels of BOD_5~(20) of river water samples collected from each section of Jin River exceeded the standard ruled by GB3838-2002 Grade V. The levels of fecal coliform count of water samples were between the national standards of Grade Ⅲ and Ⅴ of GB3838-2002. The water samples collected from different sections of Jin River water showed no significant differences in the levels of BOD_5~(20) and fecal coliform count, and significant difference in total count of bacteria. Significantly higher levels of total count of bacteria were observed in water samples collected from upper reaches of Jin River compared with those collected from lower reaches (P
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The purpose of this paper was to find a safe and effective concentration of lido- caine in intravenous combining anesthesia.33 cases had been maintained with the intravenous instillation of 0.5% lidocaine and 0.1% scotine the lidocaine concentrations at the period of after introduction,30',60',90',120'and recovery were measured respectively.The safty and effective range of this drug would be 2.1—5?g/ml. Also,in this paper,the relationship between the rate of instilation and the concentration of Lidocaine was studied.There was a positive correlation between the drope per minute amd the concentration during the period of the first 60 minutes. After 90 minutes from the beginning,there was no linear correlation.If we want to maintain the safty and effective blood concentration(2.1—5?g/ml), the necessary rate of instillation is 46?10 drops/minute during the first 60 minutes and 27.8?5 drops/minute after 90 minutes.This result shows that lidocaine is easy to accumulate obviously in the body.If we want the patient to recover at the time of the operation just performed,we must stop this drug 50 miuutes before the operation is finished.