OBJECTIVE With surveillance of the distribution and antibiotic resistance of Escherichia coli during the last six years in our hospital,the basis for the reasonable clinical use of antibiotic is provided to doctor.METHODS A total of 1 907 strains of E.coli isolated during the last six years were analyzed by Kirby-Bauer disk or VITEK-2 system.RESULTS Among 1 907 strains of E.coli,1 114 strains were isolated from urine,accounted for 58.4%;215 from pus or secret,accounted for 11.3%;165 from sputum,accounted for 8.7%;and 159 from blood,accounted for 8.3%.ESBLs production rate of E.coli increased steadily from 5.11%,10.34%,14.56%,15.14%,33.79% to 29.96%,separately during the six years.The resistance of E.coli with ESBLs to most antibiotics was much higher than those without ESBLs.And E.coli demonstrated much higher resistant rate to ciprofloxacin,penicillins,and first or second generation cephalosporins,and much lower to amikacin and cefoperazone/sulbactam.No strains were found to be resistant to imipenem.CONCLUSIONS E.coli is the major pathogen,causing nosocomial infection with multi-resistant mechanism, since ESBLs-producing strain is increasing as years gone,reasonable choice of antibiotic should be in term of result of antibiotic resistant test and patient symptom to cure the E.coli infection induced.

OBJECTIVE To study clinical distribution of Serratia and learn the antimicrobial susceptibility to S.marcescens in vitro in order to offer the reference to optimally selecting antibiotic.METHODS It was analyzed that the 222 Serratia strains were distributed in and the was deteted 164 S.marcescens strains were isolated from our hospital from 2001 to 2006.Their VITEK-2 of French Bio-M?rieux Company was adopted to proceed the identification of bacteria and antimicrobial susceptibility test.Data were analyzed by WHONET 5.4.RESULTS Serratia were mainly isolated from sputum,urine,blood,secretion,bile,cerebrospinal fluid,abdominal fluid,et al.Infection of both in-and out-patients could be caused by Serratia and most were in surgery ward.S.marcescens had higher drug resistance rates to piperacillin,cefazolin,cefuroxime,gentamicin and tobramycin which were all above 60%.They were all susceptible to imipenem(minimum inhibitory concentration only 1 ?g/ml) and their susceptible rates to piperacillin/tazobactam,ceftazidime,cefepime,and levofloxacin were all higher than 80%.CONCLUSIONS Serratia are less isolated from clinics,but have much higher antimicrobial resistance to the 1st and 2nd generation cephalosporin and show diversely drug resistance to 3rd cephalosporin,so physicians should pay attention to the infection caused by them.

Objective To study the optimum extration process of polysaccharides from Meretrix meretrix Linnaeus.A spectrophotometry method for content determination of polysaccharides from Meretrix meretrix Linnaeus was established with Phenol-sulfuric acid coloration.Methods The samples were extracted by ultrasonic wave,dissolved in 50mL,4mol?L~(-1) HCl and heated to hydrolyze by acid.The contents of polysaccharides from Meretrix meretrix Linnaeus were determined by spectrophotometry at 490nm.Results Extracted for thirty minutes by ultrasonic wave,two times,and acidic hydrolysis were the optimum technology.The calibration curve was linear over the range of 4.848～24.242mg?L~(-1).The regression equation was C=28.69A+0.229(r=0.9992).The average recovery rate was 100.67% and RSD was 2.83%(n=6).Conclusion The method was proved to be simple,accurate and reliable,and could be used to extract and determine the polysaccharides from Meretrix meretrix Linnaeus.

Objective To compare tbe efficacy of conventional therapy,psychotherapy,serotonin reuptake in- hibitor,and psychotherapy combined with serotonin reuptake inhibitor in rehabilitating nerve function in the treatment of post-stroke depression.Methods One hundred and twenty patients with post-stroke depression were divided into a control group(A),a group treated with serotonin reuptake inhibitor (B),a psychotherapy group (C) and a group in which psychotherapy was combined with serotonin rcuptake inhibitor(D).These groups were graded with the SDS for the degree of their depression and with the MESSS for their muscle strength before andafter treatment.Results The anti-depression therapies showed significantly different effects in improving depression.After eight weeks,group D showed significantly less depression than the others.However,muscle strength did not show statistically significant differences until twelve weeks,when group D again showed better progress than the others.Conclusion Psychothera- py combined with serotonin reuptake inhibitor can promote the rehabilitation of nervous function-after stroke.

Objective To investigate the application of prenatal ultrasonograpy in diagnosis of fetal heart disease during the medium-term and terminal pregnancy,and to avoid misdiagnosis.Methods The prenatal ultrasonographic screening was conducted in 7020 pregnant women with medium-term and terminal pregnancy.All confirmed and suspicious cases of fetal heart disease were observed by echocardiography once 4 weeks until postnatal sixth month to 1 year while normal cases was traced at the intervals of 8 weeks.All the cases were confirmed by autopsy or surgery while part of them were confirmed by postnatal angiocardiography before surgery.The reasons of misdiagnosis were analyzed.Results In fifty-three cases of fetal cardiovascular abnormality,43 cases were found,2 cases were misdiagnosis while 8 cases were missed diagnosis.2 cases of misdiagnosis included 1 case of pulmonary valve stenosis and 1 case of tetralogy of Fallot.8 cases of miss diagnosis included 2 cases of inferior vena cava in ectopic drainage and 6 cases of ventricular septal defect (defect diameter ＜ 5 mm).The accuracy rate of diagnosis of fetal heart disease was 81.1 ％ by echocardiography.Conclusions Using high frequency probe,image zoom,enhancing the detection of vein-atrium connection and the structure of right ventricular outflow with pulmonary artery are important factors to avoid missed diagnosis and incomplete diagnosis.

Objective:To explore the reason why the CT manifestation of the patients with chronic nasosinusitis is negative.Method:To analyze the clinical and CT manifestation of the patients with chronic sinusitis having a negative CT manifestation.Result:Pathological changes were found in all 8 patients during the course of endoscopic sinus surgery, such as pus storing in the sinus cavity, mucous swelling polypoidly, small polyps formation and so on. Conclusion:The reasons that the patients with chronic sinusitis having a negative CT manifestation are, ①CT scan can only give a static one-off image, ② partial volume effect,③ maybe result from the location of CT scan and the resolving power of tomograph,④ maybe attribute to the pathological classify of chronic sinusitis.

Objective The aim of the study is to study the effect of manual massage on relapse rate and quality of life of grand mal epilepsy patients.Methods Using prospective research method,clinical data of patients with epileptic seizures and without attack up to 3 years and undergoing withdrawal of drugs for one year were collected.The grand mal epilepsy patients were randomly divided into the experimental group and the control group (76 cases in each group).The experimental group was given manual massage.The control group was not given manual massage.Both groups were given follow-up for 1 year.The relapse rate and quality of life were compared between two groups.Results The relapse rate of the ex perimental group was 17％,and that of the control group was 33％,the difference was significant.The score of life quality in the experimental group was significantly better than that of the control group.Conclusions Manual massage can reduce relapse rate and improve quality of life for patients with epileptic seizures after withdrawal of drugs,which is worthy of wide application.

Objective To investigate the effect of nicorandil pretreatment on myocardial mitochondria in a rabbit model of myocardial ischemia-reperfusion (I/R). Methods Tirty-two healthy male New Zealand white rabbits weighing 2.0-2.5 kg aged 4 months were randomly allocated into 4 groups ( n = 8 each): Ⅰ group sham operation (group S); Ⅱ group I/R; Ⅲ group nicorandil pretreatment (group N) and Ⅳ group nicorandil + 5 hydroxydecanoic acid (group N + 5-HD). Myocardial I/R was induced by 30 min occlusion of left circumflex coronary artery followed by 120 min reperfusion. In group N and N + 5-HD a bolus of nicorandil 100 μg/kg was given iv at 10 min before myocardial ischemia followed by continuous infusion at 10 μg· kg-1 · min-1 until the beginning of myocardial ischemia. In group Ⅳ a bolus of 5-HD 5 mg/kg was injected iv at 20 min before myocardial ischemia.The animals were sacrificed at the end of 120 min reperfusion. The mitochondrial membrane potential was measured by flow cytometry using JC-1 fluorescence probe as indicator. Bcl-2, Bax and cytochrome c protein expression was determined by immuno-histochemistry. Myocardial ultrastructure was examined with transmission electron microscope. Results Red fluovescence intensity indicating normal live cells was significantly higher, the green fluorescence intensity indicating apoptotic cells was lower and red/green fluorescence intensity ratio was higher; the Bcl-2/Bax ratio was significantly higher and cytochrome c protein expression lower in group N than in group I/R.5-HD administration negated the protective effect of nicorandil pretreatment against myocardial I/R injury. Conclusion Nicorandil stabilizes mitochondrial membrane potential, decreases cytochrome c protein releasing, and suppresses mitochondrial apoptotic signal transduction by opening the mito-KATP channels.

Objective To establish nude mouse model with human brain glioma SHG-44 and understand its growing characteristics in vivo.Methods The 4-week-old male mice were randomly divided into high density cell suspension inoculation group(n=10),low density cell suspension group(n=10),the tumor tissue mass vaccination group(n=10)and the blank control group with normal saline injection(n=10).The SHG-44 human brain glioma cell suspension was injected into the subcutaneous of the nude mice' s armpit.The tumor tissue was cut into 1 mm3 after tumor tissue growth and formation,and re-inoculated into the subcutaneous of the new nude mice' s armpits.Apart from daily observation,the long and short diameters of tumor were recorded every 5 days after graft.All the mice were sacrificed at 60 days and the tumor tissues were harvested for pathological examination.Results With a longer incubation period and slower growth rate,the tumor formation rate in high density cell suspension inoculation group and low density cell suspension group was lower compared with that in the tumor tissue mass vaccination group.Around day 20,grafted tumor appeared remarkably big((41.51 ±6.42)mm3) with good morphology.On day 50,the tumor derived from group the tumor tissue mass vaccination group((565.69± 123.36)mm3) showed a bigger size in comparison with that from high density cell suspension inoculation group((203.85±104.63) mm3) and low density cell suspension group ((153.02± 31.76) mm3,all P＜0.05).The tumors in three groups were well defined with a rich vascularity and no apparent invasion was observed.The positive expression of GFAP and S-100 in a large body of tumor cells was observed under optical microscope.Conclusion With a shorter incubation period and faster growth,the mouse tumor models established with tissue pieces from the tumor-bearing mice are much better compared to those with cell suspension.

OBJECTIVE To offer the clinical physician the basis of optimal application of antibiotic,we have investigated the variation of antibiotic resistance and the bacterial spectra in the blood culture.METHODS Blood was cultured in BACTEC9120 of BD.The clinical isolates were identified by API and VITEK-2 of Bio-Merieux of France.Antibiotic susceptive test was done by Kirby-Bauer method and the result which was analyzed by WHONET5.3 and SPSS11.5 software was determined by the NCCLS standard of 2005′s edition.RESULTS Organisms were isolated from the blood specimen of 1468 patients,and there were 743 strains of Gram-positive cocci accounted for 50.7%,565 strains of Gram-negative bacilli accounted for 38.5%.Ninety three strains of fungi accounted for 6.3%.We analyzed the drug-susceptive result of Staphylococcus,Escherichia coli,and Klebsiella pneumoniae during five years,and found that all the antibacterial drug lost efficacy in some degree,except that the sensitivity of the staphylococci to vancomycin was 100%.CONCLUSIONS Gram-positive cocci are the main bacteria in blood culture,the species from which are diversified,and the rate of the drug resistance of some bacteria is high.It indicated that doctors should take more blood culture and monitor the bacteria drug resistant for the data of etiology,so that they can utilize antibiotic more reasonably.