OBJECTIVE To investigate the distribution and resistance rate of clinical isolates from neonatal sepsis in Hubei hospitals.METHODS The antimicrobial susceptibility of clinical isolates from(neonates) blood culture derived from sixteen hospitals in Hubei from 2000 to 2004,was retrospectively analyzed and tested by KirbyBauer(method).RESULTS A total of 1 019 strains were isolated from blood specimens,Gram-positive and Gram(-negative)(bacteria) accounted for 93% and 7% of these isolates,respectively.The main isolates were coagulase(-negative) staphylococci(CNS,79.8%),Enterococcus spp(7.0%),Staphylococcus aureus(SAU4.5%),Klebsiella spp(1.7%),Stenotrophomonas maltophilia(1.2%),and Escherichia coli(0.9%).71.3% CNS and 19.6% SAU were meticillin resistant,46.5% enterococci resistant to ampicillin and almost strains were susceptible to(vancomycin)(except E.gallinarum).ESBLs were detected in isolates of 56% E.coli and 35% K.pneumoniae.S.maltophilia was susceptible to trimethoprim(-sulfamethoxazole) and levofloxacin with resistance rate of 8.3% and 0%.In strains of other Gram-negative rods,resistance rate to imipenem,amikacin and fluoroquinolones were detected between 0% to 15%,and to cephalosporins Ⅰ-Ⅳ were between 20% to 70%.CONCLUSIONS Gram-positive cocci are important pathogens in neonatal sepsis,antimicrobials should be used on the result of(antimicrobial) susceptibility test.It is more important to reduce health care-associated(nosocomial) infections.

Objective To compare the application of debridement combined with vacuum sealing drainage (VSD) versus debridement combined with conventional dressing change in patients with subscalp infection following surgical treatment of traumatic brain injury (TBI) and investigate the effect of VSD in treatment of wound infection associated with surgery for TBI.Methods A retrospective review was conducted on clinical data of 60 TBI patients with combined wound infection after decompressive craniotomy between August 2005 and January 2012.According to the treatment modalities after admission,the patients were divided into debridement combined with VSD group (Group A) and debridement combined with conventional dressing change group (Group B),with 30 patients per group.Then wound healing,infection relapse rate and length of hospital stay were compared between the two groups.Results All 60 patients were followed up for 12-36 months (mean 21.6 months).The wound infection did not recur after surgery in Group A and sutures were removed in time.Seven patients (23％) in Group B presented with recurrent wound infection after the removal of wound drainage tube,which was healed after an additional debridement and drainage as well as the delay of suture removal.Wound healing time (13 d vs 22 d),dressing change frequency (3 times vs 8 times),length of hospital stay (17 d vs 26 d),antibiotic use duration (7 d vs 14 d),and time to drop the body temperature to normal after operation (2 d vs 4 d) in Group A and B respectively showed significant difference (P ＜ 0.05).Conclusion In treatment of wound infection associated with decompressive craniotomy for TBI,VSD is beneficial for rapid healing of the infected wound and is worthy of wide clinical use.

Objective:To efficiently amplify NK cells and determine their cytotoxic activity against a variety of tumor cell lines in vitro,thereby providing evidence for potential clinical application.Methods: PBMCs were isolated from adult peripheral blood and co-cultured with K562 cells that were genetically modified to express 4-1BBL,IL-15 and IL-21 on the surface for 15 days to effectively amplify NK cells.The total cell number and Purity of CD3-CD56+ cells were measured.Granzyme B and perforin expression of the amplified NK cells were detected by flow cytometry and real-time PCR.The anti-tumor effect on different cancer cells was evaluated.Results: This method obtained a more than 1.1×1010 CD3-CD56+ NK cells with 95% purity over a 15 day amplification procedure.The expanded NK cells could efficiently release granzyme B and Perforin.The cytotoxicity against different tumor cells was followed the order from strong to weak:gastric,pancreatic,cervical,ovarian and renal cancer cells,with the highest activity against gastric cancer cell line A549 (90% at E∶T=10∶1) (P<0.05).A time-dependent killing effect of activated NK cells on cervical,liver and pancreatic cancer cells was observed.Conclusion: This amplification procedure can consistently generate large amounts of pure NK cells with effective cytotoxic function against a variety of tumor cells.

Objective:To study the validity of MMPI in police recruitment.Methods:9096 police applicants had been tested with MMPI from 1989 to 2004.Results:1694 male applicants were not accepted, they got higher MMPI(Chinese version) T-scores on scale Hs(61.9?10.0/45.4?6.6,t=8.76), Pa (61.6?12.7/46.6?8.1,t=5.85), Pt (58.7?10.1/43.3?7.6,t=6.45), Sc (65.4?7.8/44.6?6.6,t=11.46), and Ma, so did the female ones on scale Pt (60.9?3.7/42.2?8.2 ,t=3.79), Sc (68.9?3.0/45.2?8.2,t=4.96), and Ma (63.5?4.1/50.1?9.2, t=2.48). After a 16-year follow up, the results showed that in the group enrolled, none had suffered mental illness. 43 out of 70 applicants who were not accepted during 1989 to 1990 were investigated. Two of them had been sent to psychiatric hospital for schizophrenia.Conclusion:Result of MMPI is valuable in police recruitment.

Objective To determine the validation of measuring blood flow velocity intravascularly using a new Doppler microprobe. Methods Catheterization and signal recording were investigated using a new 0.3 mm diameter microprobe in 40 patients during routine cerebral angiography (45 vessels). Blood flow velocity was determined using this technique (intravascualar Doppler sonography, IVDS) in another 14 patients with femoral-popliteal stenosis before and after percutaneous transluminal angioplasty (PTA). Results IVDS was successful in 95.6% healthy vessels (43/45) and recorded the same typical flow-pulse curve as seen in transcutaneous measurement. Measurement of blood flow velocity was successful in 12 out of 14 patients (86%) with femoral-popliteal stenosis before and after PTA. IVDS could verify that blood flow velocity increased significantly after successful PTA (t= 4.01, P

ObjectiveTo observe the effect of the doctor-led telephone interview on the state of anxiety for outpatients with epilepsy.Methods100 outpatients with epilepsy and state of anxiety were divided into two groups: intervention group (doctor-led telephone interview) and control group (outpatient face-to-face visit in the epileptic clinic), 50 cases in each group. Doctor-let semi-structured telephone interview was performed in the intervention group, while routine face-to-face interview in outpatient was performed in the control group for 6 months. Self-rating Anxiety Scale (SAS) was used to assess the anxiety state before and 6 months after intervention. The state of anxiety and the patients' contents in the two groups were analyzed.ResultsThe scores of SAS in two group decreased 6 months after intervention and the intervention group was better than the control group.ConclusionThe doctor-led telephone interview can improve the state of anxiety for the patients with epilepsy.

Objective To evaluate 3D CT features of normal anatomy,anatomic variations and fractures of occipital squama.Methods The 3D CT features on MIP,VR images were analyzed retrospectively in 589 pediatric cases.The normal anatomy,anatomic variations and fractures of occipital squama were observed respectively,and the differential diagnostic features including the individual location,appearance and extension were analyzed.Results Four hundred and thirty-three patients (75.2％) showed normal anatomy,including 154 patients with adult occipital anatomical features,279 patients with posterior intraoccipital synchondrosis,and 37 patients with Kerckring-supraoccipital synchondrosis.When cases with recent trauma history were excluded,113 patients (19.1％) showed anatomic variants,including unpenetrating sutures and penetrating sutures.The former could be subdivided to Mendosal sutures in 23 cases,superior median fissures in 19 cases,and midline supraoccipital fissures in 4 cases,while the latter could be subdivided to the interparietal bone variations in 54 cases,wormian bones in 23 cases,and accessory bones in 7 cases.Two or more variations coexisted in 33 cases.The occipital squama fractures were shown in 34 cases (5.6％),including linear fractures in 27 cases,comminuted fractures in 3 cases,with depression fracture in one case,separation of cranial sutures in 3 cases,and other fractures associated with variants in 3 cases.The fractures were sharp,or jagged,without limitation of the occification.Conclusion There are different 3D CT features of normal anatomy,anatomic variations and fractures of occipital squama in children,which are important for making the accurate diagnosis.

Objective To study the clinical and pathologic features of chromphobe renal cell carcinoma (ChRCC) and to evaluate the conventional pathologic prognostic parameters in prognosis.Methods Seventy-five cases (42 males and 33 females) with pathological confirmed ChRCC (36 on the left and 39 on the right kidney) after nephrectomy during 1998 to 2009 were retrospectively analyzed. Patient's age ranged from 25 to 74 years, with a mean age of 56 years. Evaluation of conventional prognostic parameters was carried out. Kaplan-Meier survival curve was used to study the survival relationship. Results The mean tumor diameter was 7.3 cm. The majority of tumor macroscopic surface color was gray and yellow or gray and red. The majority of tumor cells were big polygon chromphobe cell or small round eosinophils. The TNM stages of these ChRCC were as follows: 30 cases in T1N0M0, 1 in T1N0M1, 26 in T2N0M0, 1 in T2N0M1, 11 in T3N0M0, 3 in T3N0M1, 1 in T3 N1 M0, 1 in T4 N0 M1 and 1 in T4 N1 M1. The pathologic grade of ChRCC was G1 in 3 cases, G2 in 24cases, G3 in 46 cases and G4 in 2 cases. All the 75 cases were followed up for 9 to 93 months (mean 44months), 7 patients died and others were alive without recurrence and metastasis. 3-year and 5-year survival rates were 93.3% and 90. 7%, respectively. The univariable analysis showed that tumor size (P=0. 028), TNM stage (P＜0. 001) were associated with tumor progression. The multivariable Cox regression model revealed that TNM stage was an independent predictor of aggressive ChRCC. Conclusions The ChRCC tumors are generally larger than other types of RCC and with a favorable prognosis. Fuhrman nuclear grade is not suitable for ChRCC. TNM stage is an independent predictor of aggressive ChRCC.

ObjectiveTo compare the clinical effect of posterior circumferential fusion with versus without intertransverse process fusion on lumbar instability in aged patients. MethodsThe elderly with lumbar instability were treated with the posterior instrumented circumferential fusion technique in 80 cases. Among 58 patients followed up for at least 2 years, 28 cases (group A)underwent posterior circumferential fusion with intertransverse process, while 30 cases (group B)without intertransverse process. X-ray examination was used before and 1, 3, 6, 12 and 24 months after operation to evaluate the fusion condition of the bone graft, and visul analogue scale (VAS) and Oswestry disability index (ODI) questionnaire were applied to assess the pain of center back and leg,and the conventional activity.ResultsThe operation time and blood loss were more in group A[(185.3±56.6) min and (376.3±92.9) m1] than in group B [(146.4±46.3) min and (234.3±64.5)ml (t=12.37, 37.49, P＜0.01)]. All the 58 cases were followed for at least 2 years. The 27 cases (96.4％) of group A and 28 cases (93.3％) of group B got bone fusion (x2 =0.004, P＞0.05).There were marked differences in the VAS of center back at 1 and 3 months after operation between the 2 groups (t=3.178, 2.158, both P＜0.05), while no difference at the other 3 time point. VAS about the leg pain and the ODI showed no differences between group A and B after operation (all P＞0.05). ConclusionsFor the lumbar instability in the elderly, the posterior circumferential fusion with or without intertransverse process fusion can achieve a similar high rate of fusion and satisfactory clinical results,andtheposteriorcircumferentialfusionwithoutintertranaverseprocess is recommended for less trauma.

AIM: To evaluate the clinical efficacy and safety of Qili Qiangxin Capsule(Radix Astragali,Radix Aconiti lateralis praeparata,Radix et Rhizoma Salviae miltiorrhizae,Radix et Rhizoma Ginseng,Semen Lepidii,Semen Descurainiae,Flos Carthami,Pericarpium Citri reticulatae,Rhizoma Alismatis,Cortex Periplocae,Rhizoma Polygonati odorati,Ramulus Cinnamomi) with chronic heart failure(CHF).METHODS: Seven randomized controlled trials were reviewed.RESULTS: The meta-analysis indicated that the treatment group of Qili Qiangxin Capsule could decrease the cardiac functional grading of NYHA with 1.21 of the relative risk,and 95% confidence interval(CI) from 1.08 to 1.36;increase 6 minute walking distance with the weighted mean difference(WMD) was 37.39,and 95% confidence interval was from 22.58 to 52.20;raise left ventricular ejection fraction(WMD = 3.97[2.09,5.85]),decrease the left ventricular end-diastolic diameter(WMD = 2.81[1.41,4.22]),lower the level of B-type natriuretic peptide(WMD = 118.00[4.44,231.56]) and N-terminal pro-brain natriuretic peptide(WMD = 476.90[371.26,582.54]) in blood plasma and drop the score of Minnesota living with heart failure questionnaire(WMD =8.00[3.48,12.52]),but Qili Qiangxin Capsule for reduction in left ventricular end-diastolic volume,left ventricular end-systolic volume,heart rate and blood pressure also need to be confirmed.Besides,individual ca-ses occurred adverse reactions like dry cough,epigastric discomfort,gastric distention.However,It could be tolerated and hadn't significant statistical difference with comparison to control group.CONCLUSION: Qili Qiangxin Capsule is effective and safe for the patients of chronic heart failure in improving the heart function and living quality.