Objective To survey the antimicrobial resistance of nosocomial Klebsiella Pneumoniae (Kpn) isolates. Methods All the 68 Kpn strains were isolated and collected from nosocomial infections during April 2002 to March 2003. The susceptivity of bacteria and the production of extended spectrum ?-lactamases (ESBLs) were determined by Kirby-Bauer disc diffusion test and phenotypic confirmatory testing, respectively. Results All 68 Kpn strains were 100% susceptible to Menopenem and Imipenem but resistant to 14 other antimicrobials to different degrees. The first five drugs of high resistant rate were ampicillin (100%), amoxycillin/clavulanic acid (79.4%), sulphamethoxazole/trimothoprim (67.6%), cefotaxime (58.8%), gentamycin (47.0%). There were 28 isolates producing ESBLs (41.2%), which showed much higher resistance to ?-lactam, aminoglycosides, quinolones and sulphamethoxazole/trimothoprim than the non-ESBLs-producing strains. Conclusion Nosocomial Kpn isolates were most multidrug resistant, of which ESBLs-producing strains showed a higher resistance and which may involve other resistant mechanisms.

OBJECTIVE:To study the difference between the hydrophilic and hydrophobic fluoroquinolones(FQNLs)in?ducing resistant Klebsiella pneumoniae(Kpn)in vitro.METHODS:Hydrophilic ciprofloxacin(CIP)and hydrophobic sparfloxacin(SPFX)were used to induce FQNLs resistant mutants from a clinical susceptible isolate Kpn909with stepwise selection method,respectively,The susceptivity of bacteria to was determined by the standard method of two fold agar dilu?tion.RESULTS:The resistance of Kpn909to FQNLs was raised up gradually as FQNLs'concentration increased;Minimum inhibitory concentrations(MICs)of Kpn9098Selected by CIP at2?MIC(0.5mg/L)were16～32times higher than that of Kpn909,and showed resistant to ofloxacin(OFX),lomefloxacin(LMFX)and enofloxacin(ENX)with a MIC of8mg/L,16mg/L and8mg/L.Otherwise,SPFX-selected Kpn with a similar resistant level occurred at the concentration of8?MIC(1mg/L).The maximal selecting concentration of CIP and SPFX were128mg/L and64mg/L,and MIC of5FQNLs to the resistant mutants obtained at which were≥256mg/L and32～128mg/L,respectively.CONCLUSION:Both hydrophilic CIP and hydrophobic SPFX could induce Kpn the cross resistance to others FQNLs,but hydrophobic FQNLs may be superior to hydrophilic FQNLs to delay the resistance occurrence in Kpn.

Objective To investigate costimulatory molecules CD80 and CD86 expression in acute myelogenous leukemic cells and clinical implication.MethodsThe expression of CD80 and CD86 in the patients with acute myelogenous leukemia and HL-60 cells,U937 cells,NB4 cells,K567 cells was confirmed by Flow Cytometer.ResultsCD80 was very low or no expression in patients with acute myelogenous leukemia.CD86 expressed in acute myelogenous leukemia (27.86±19.65)%,which was much higher than that in control group[(1.21±0.13)%,t＝3.55,P＜0.01].No significant changes were observed in the expression of CD86 in M4 cells(48.65±21.92)%,M5 cells(39.25±18.67)% and control group(50.20±20.31)%(P＞0.05).After the cells were cultured for 24 h and 48 h,the expression of CD86 was (30.62±5.35)% and (29.43±4.67)% in HL-60 cells ,(24.12±5.23)% and (26.56±6.54)% in U937 cells,and,(21.25±3.78)% and (23.21±6.98)% in NB4 cells (all P＞0.05).The expression of CD80 and CD86 was very low in K562 cells.ConclusionsCostimulatory molecules CD86 expressed in acute myelogenous leukemic cells in the patients with acute myelogenous leukemia and HL-60 cells,U937 cells,NB4 cells.

Objective To investigate gene mutations of the epidermal growth factor receptor of tumor tissue and peripheral blood in non-small-cell lung cancer, and to compare the consistency of EGFR mutations in tumor tissue and peripheral blood, fluorescence quantitive polymerase chain reaction (FQ-PCR) was performed according to standard procedure. Methods 112 peripheral blood and 87 tumor tissue of NSCLC were detected by FQ-PCR, among which 45 cases were analyzed using peripheral blood-tumor tissue matched samples. The relationship between clinical efficacy and EGFR mutations Was analyzed. Results Our results showed that there is 32 mutations in EGFR in 112(28.6%)of the patients'peripheral blood samples and 27 mutations in EGFR in 87(31.O%)tumor tissue. EGFR mutations were mainly found in adenocarcinoma and non-smokers in NSCLC (P<0.05). The consistency of EGFR mutation between tumor tissue and peripheal blood reached 71.4%. The clinical outcome of mutations Was significantly effective(P

Objective To investigate the mental health status of students with foreign nursing spe-cialty and analyze its relationship with stress, coping style and perceived social support. Method The cluster sampling was conducted between students with foreign nursing specialty. The Perceived Social Support Scale (PSSS), Symptom Check List-90 (SCL-90), and self-designed demographic questionnaires including demographic information questionnaire, College Students Stress Scale and Coping Style Questionnaire were employed. Results Students with foreign nursing specialty obtained significantly higher scores in all factors of SCL-90 when compared to the national youth norm,and obtained significantly higher scores in factors of somatization, obsession, anxiety, fear and psychotic diseases when compared to the norm of college students. The multifactor analysis of mental health status in students with foreign nursing specialty showed that soma-tization factors contained personal stress, seeking help, family supports and other supports;obsession factors contained personal stress, negative life events, academic stress and solving problem;interpersonal sensitivity factors contained personal stress, academic stress, solving problem, self-blame, fantasy and retreat; depres-sion factors contained personal stress, academic stress, solving problem, self-blame and other supports;anxiety factors contained personal stress, academic stress, fantasy, self-blame, family supports and other supports; hostility factors contained personal stress, seeking help, retreat, fantasy and other supports; fear factors contained personal stress, academic stress, seeking help, retreat and fantasy; crankiness factors con-tained personal stress, academic stress, solving problem, retreat, self-blame, family supports and friend sup-ports; factors of psychotic diseases contained personal stress, academic stress, solving problem, self-blame and friend supports;and factors of other symptoms contained personal stress, negative life events, academic stress, retreat, self-blame, family supports, friend supports and other supports. Conclusion The mental health status of students with foreign nursing specialty was inferior to the norms of national youths and col-lege students. It was negatively correlated with stress, active coping style, friend supports and other supports;while positively correlated with passive coping style (except escape) and family supports. Therefore, mental health education toward students with foreign nursing specialty should be strengthened in order to reduce their stress, improve their coping style, enhance their social supports, and finally promote their mental and physical development.

Objective To evaluate the image quality,diagnosis accuracy and dose reduction of split-bolus CT urography (CTU) with low voltage scan and sinogram affirmed iterative reconstruction (SAFIRE).Methods A total of 80 cases of consecutive patients with confirmed or suspected urinary system disease needed CTU examination were divided into two groups (control group and test group) by using random number table.In control group,convention scan (120 kV) with one time injection was used.But low voltage scan (80 kV) with SAFIRE algorithm and split-bolus injection (SBI) was used in experiment group.The radiation dose,image quality and diagnosis accuracy were compared.Results A total of 77 cases completed CTU examination successfully in the two groups,including 39 cases in control group and 38 cases in test group.The effective dose reduced from (26.68 ± 4.07) in control group to (3.93 ± 0.85) mSv in test group (t =-33.78,P ＜ 0.05).Subjective image quality score was (4.49 ± 0.79) in control group and (4.39 ± 1.53) in test group,with no significantly statistical difference (Z =2.71,P ＞ 0.05).Signal-to-noise ratio (SNR) of objective image quality in test group was higher than that in control group (127.3±15.9 vs.109.6 ± 13.2,t =4.49,P＜0.05).But there was no significantly statistical difference in contrast-to-noise ratio (CNR) between control group(100.8 ± 12.9)and test group (109.0 ± 14.4,P ＞ 0.05).For diagnosis accuracy,no statistical difference were found between two groups(84.62％ and 81.58％,P ＞ 0.05).Conclusions The combination of low voltage scan with SAFIRE algorithm and split-bolus injection CTU could reduce the radiation dose significantly,but the objective image quality,CNR (except SNR) of subjective image quality and diagnosis accuracy were all unaffected obviously.

Objective To evaluate the effect of psychological interventions for patients with urnary cancer on pain and quality of life.Methods One hundred and twenty patients were randomized into research and control group.Each group contained 60 cases. The study group received regular analgesic treatment and psychological interventions.The control group received the same scheme but for psychological interventions.As LQ-C30 was applied to evaluate patients' pain intensity and quality of life respectively.Result The pain relief rate of study group acquired is different significantly from control group, as well as in a higher score in global quality of life, role function, emotional function (P<0.05).Conclusions High-quality psychological care service can improve the quality of life of patients and release cancer pain.

Objective To investigate the influence of tissue-specific growth hormone receptor (GHR)deficiency in type 1 diabetes in the mice at the gene level using pancreaticβcells combined with streptozotocin (STZ)-induced type 1 diabetes model.Methods The experiment was divided into four groups:knockout mice group (LLc knockout group), using the homozygotes (LLc:LL+Cre) producted by pancreaticβ cell-specific expressed recombinant enzyme mice (RIP-Cre)and Cre-LoxP system modified GHR mice (Floxed,LL);LL control group, containing Floxed GHR allele homozygous mice (LL);LLc STZ group and LL STZ group (STZ was used for inducing type 1 diabetes model mice). The mice with feeding glucose≥25 mmol · L-1 were considered to be successful models.The Glucose Tolerance Test (GTT),pancreas tissue HE staining and immunohistochemistry were performed in the mice.Results The blood glucose of the mice in LL STZ group and LLc STZ group and LLc STZ group were increased after inj ection of STZ and the models achieved the diagnostic criteria for diabetes 1 6 d later.The results of GTT showed that compared with LLc control group and LLc knockout group, the blood glucose levels of the mice in LL STZ and LLc STZ groups were increased (P<0.05).There was no significant change of morphology and structure of islets between LL control group and LLc knockout group detected by HE staining. The immunohistochemistry results showed that the insulin level of the mice in LL STZ group was significantly reduced compared with LL control group;the insulin level of the mice in LLc STZ group was reduced compared with LLc control group.Conclusion Pancreaticβcell GHR gene knockout has no effect on the blood glucose and the function ofβcells in the mice with STZ-induced type 1 diabetes.

Objective To explore the computed tomography (CT)manifestations of adrenocortical oncocytoma (ACO)for better understanding the disease and improving its diagnosis accuracy.Methods The CT manifestations of 9 cases with adrenocortical onco-cytomas confirmed by surgery were retrospectively reviewed and compared with pathological results.Results Five of cases were lo-cated in left side while 4 cases were in right side.Well defined and round or oval border could be found in all the cases.Of all the ca-ses,3 cases were solid lesions with equal density,< 3 cm in diameter,and mild consistent intensification after enhancement.Cystic lesion was detectd in 6 cases with > 3 cm in diameter.The mixed cystic and solid components with polycystic changes could be found on CT image,and remarkable intensification on solid lesion while no intensification on cystic lesion after the enhancement. Moreover,patchy or cotton-like shape could be found on solid lesion in 4 cases and 1 case with island like intensification;reticular pattern could be found in the central of lesion in 3 cases and 1 case with stellate shape.Pathological observation showed that the on-cotytomas were comprised of cells with abundant eosinophilic cytoplasm and necrotic and fibrous capsule without pathological mitosis could be found in some of lesion.Conclusion The characteristic CT features of adrenocortical oncotytoma has a worse specificity,its diagnosis was dependent on pathologic examination.

Objective To explore the value of the laparoscopic ultrasonography (LUS) in laparoscopic common bile duct explora-tion(LCBDE) .Methods 47 cases with cholecystolithiasis combined with bile duct dilatation or abnormal liver function were tested by conventional ultrasound ,magnetic resonance cholangiopancreatgraphy (MRCP) CT and LUS after LCBDE .All results were com-pared with the surgical findings and the intraoperative biliary endoscopy results .Results The diagnosis coincidence rate of conven-tional ultrasonography ,CT ,MRCP and LUS in 47 cases were 85 .1% ,72 .3% ,95 .7% ,100 .0% respectively .6 cases completed the surgery under the guidance of LUS ,1 case was converted to open surgery .Conclusion LUS is an examination method to avoid bile duct injury effectively and reduce postoperative residual stone in LCBDE .