OBJECTIVE To investigate the resistance of Pseudomonas aeruginosa isolated from two hospitals and its chlorhexidine-sulfadiazine-resistant genes(qacE△1-sul1). METHODS Microdilution tests were performed to detect the susceptibility of 66 strains of P.aeruginosa to 6 kinds of antimicrobial agents.The qacE△1-sul1 gene was analyzed by PCR. RESULTS The resistant rates to other antimicrobial agents were between 12.5-87.5%.qacE△1-sul1 gene was 50.0%. CONCLUSIONS The 66 strains are multiple-drug-resistant.There are very high positive percentages of qacE△1-sul1 gene in P.aeruginosa isolated from two hospitals.

Objective To study the effect of berberine on extracellular release of high mobility group box 1 (HMGB1) and its mechanism. Methods After LPS was activated by different concentration of berberine, the release of HMGB 1 and TNF-a, and expression of HMGB 1 mRNA in cultured mouse peritoneal macrophages was investigated. Results Berberine markedly suppressed the release of HMGB 1 and expression of HMGB 1 mRNA from LPS-stimulated macrophages (P<0.05). While the release ofTNF-a was't significantly affected. Conclusion Berberine suppressed extracellular release of HMGB 1 by decreasing expression of HMGB 1 mRNA.

Objective To investigate the feasibility of fast-track surgery in colorectal surgery.Methods Eighty consecutive patients with colorectal cancer admitted for colorectal surgery were divided into two groups by random digits table with 40 cases each. Group A was treated with the new concept of fasttrack surgery and group B was treated with the traditional methods of operation. The time of postoperative bowel venting and defecation,hospital stay time, the rate of complication, the rate of readmission and the total cost during hospitalization were compared. Results The time of postoperative bowel venting and defecation,hospital stay time were shorter in group A [(2.7 ± 0.9), (2.9 ± 0.1 ), (5.8 ± 1.0) d,respectively]than those in group B [( 3.9 ± 0.5 ), (4.2 ± 0.3 ), ( 8.3 ± 1.2) d, respectively] and the rate of complication and the total cost during hospitalization in group A [7.5%(3/40), ( 1.83 ± 0.22) ten thousand yuan] were lower than those in group B[27.5%(11/40), (2.35 ± 0.36) ten thousand yuan](P＜ 0.05). Conclusion The new concept of fast-track surgery can accelerate recovery after colorectal resection,reduce the rate of overall complications and total cost during hospitalization.

ObjectiveTo discuss the clinical characteristic and perioperative management of colonic obstruction caused by colonic carcinoma in elderly.MethodsThe clinical characteristic and perioperative management of 30 patients with colonic obstruction caused by colonic carcinoma from January 2000 to November 2010 were collected and analyzed retrospectively.Among 30 cases,11 cases were accepted emergency operation,19 cases were accepted limited operation.Resection and anastomosis at stage Ⅰ was in 26 cases (86.7％),shortcut surgery and simple fistulation was in 4 cases ( 13.5％ ).ResultsThe length of stay was 22-56 days.Postoperative complication including wound infection in 5 cases,wound liquescence in 3 cases,wound dehisce in 2 cases,anastomotic fistula in 2 cases,pulmonary infection in 3 cases.Two cases died during perioperative period.Conclusions Besides diagnosis as early as possible,appropriate perioperative management should be taken to the elderly patients,including reasonable operative time and surgical approaches and these are the keys to improve clinical curative effect.

Objective To discuss the clinical value of laparoscopic cholecystectomy (LC) combined with endoscopic retrograde cholangiopancreatography (ERCP)/endoscopic Oddi sphincterotomy (EST) on treating choledocholithiasis with cholecystolithiasis. Method The clinical data of 48 patients with choledocholithiasis complicated by cholecystolithiasis treated with LC combined with ERCP/EST from January 2005 to August 2010 was collected and analyzed retrospectively. Results Forty-six patients achieyed success by ERCP,and 45 patients finished LC,all patients underwent LC combined with ERCP/EST were recovered more rapidly,with shorter hospital stays. No severe complications or residual stone and refluent cholangitis in the follow-up of 3-12 months of 46 patients. Conclusions Combining the advantages of LC with ERCP/EST treating patients with choledocholithiasis complicated by cholecystolithiasis,according to the theoretics of minimally invasive surgery, with less invasive and the advantages of shorter hospital stays and rapid recovery. It is the comparatively ideal choice for the treatment of choledocholithiasis complicated by cholecystolithiasis at present.

OBJECTIVE:To make an investigation on the quality of decoctions of traditional Chinese medicine prepared by decocting device and fire heating decocting method.METHODS:To compare the chemical compositions in decoctions of Salvia miltiorrhiza Bunge prepared by above-mentioned two methods and to take the contents of danshensu and protocatechualdehyde as indices,both of which were determined by HPLC.RESULTS:There were no evident difference between the two methods in extracting chemical compositions.In addition,the contents of danshensu and protocatechualdehyde prepared by decocting device were as2.97times and5.6times as those prepared by fire heating decocting method respectively.CONCLUSION:The prepa?ration of decoction of Saliva miltiorrhiza Bunge by decocting device can double the effective constituents.This provides scien?tific basis for making rational use of herbs.

Objective To investigate the significance of determination for binding ratio of L-PHA(leukoagglutinating phytohemagglutinin) with serum alkaline phosphatase in the diagnosis of primary hepatic cancer.Methods The binding ratios of L-PHA with serum alkaline phosphatase in 50 healthy individuals,103 cases of primary hepatic cancer,22 cases of hepatocirrhosis,36 cases of chronic hepatitis,18 cases of acute hepatitis and 13 cases of digestive tract tumor were determined by lectin affinity chromatography.Results The binding ratio of L-PHA with serum alkaline phosphatase in primary hepatic cancer(16.01% 5.42%) were significantly increased as compared with the healthy control(7.50% 2.53%)(P 0.01).The binding ratios were positively correlated with the tumor size and AFP level.Conclusion The binding ratio of L-PHA with serum alkaline phosphatase is a potential parameter for the laboratory diagnosis of primary hepatic cancer.

OBJECTIVE To investigate the resistance of Enterobacter cloacae and its gene of chlorhexidine-sulfadiazine-resistance(qacE△1-sul1) isolated from two hospitals. METHODS Microdilute tests were performed to detect the susceptibility of 20 kinds of antimicrobial agents in 74 strains of E.cloacae.The qacE△1-sul1gene was detected by PCR. RESULTS There was no strain resistant to imipenem and meropenem.The resistant rates to other antimicrobial agents were between 44.6% and 94.6%.The positive rate of qacE△1-sul1gene was 74.3%. CONCLUSIONS The 74 strains were multiple-drug-resistant.There was a high positive rate of qacE△1-sul1gene in E.cloacae isolated from two hospitals.

OBJECTIVE To investigate the prevalence of three kinds of antimicrobial-resistant genes in Enterobacter cloacae. METHODS Antimicrobial susceptibility test was performed by microdiluted method and antimicrobial - resistant genes were detected by PCR methods in 20 clinical strains of E. cloacae. RESULTS Twenty strains of E. cloacae showed multiple-drug resistance.Among 20 strains, the positive rates of ACT-1, DHA and TEM genes were 70.0%, 45.0% and 55.0%, respectively. The positive rates of aac(6′) -Ⅰ , ant(3″)-Ⅰ, ant(2″)-Ⅰ, aac(6′)-Ⅱ, and aac(3)-Ⅱgenes were 50.0%, 15.0%, 10.0%, 5.0% and 5.0%, respectively . The positive rates of sul Ⅰand dfrA1 genes were 50.0%, and 5.0%, respectively. But other genes were not found. CONCLUSIONS This study shows that there are multiple-drug resistance and high positive rate of three kinds of antimicrobial- resistant genes in E. cloacae isolated from our hospital.

Objective:To explore influence of nasal continuous positive airway pressure (nCPAP)on maximal oxygen uptake (V · O2 max )etc.in patients with chronic congestive heart failure (CHF)complicated moderate-to-severe ob-structive sleep apnea-hypopnea syndrome (OSAHS)and explore its significance.Methods:A total of 83 CHF com-plicated moderate-to-severe OSAHS patients were selected and randomly divided into routine treatment group (n=40)and nCPAP group (n = 43).Both groups were treated for six months.Left ventricular ejection fraction (LVEF),apnea hyponea index (AHI)and V · O2 max were measured and compared between two groups before and af-ter treatment.Results:Compared with routine treatment group after six-month treatment,there was significant re-duction in AHI [(27.5±6.2)vs.(6.8±1.2)],and significant rise in LVEF [(0.45±0.07)vs.(0.48±0.05)]and · V O2 max [(16.5±3.5)ml·kg-1 ·min-1 vs.(19.2±3.4)ml·kg-1 ·min-1 ]in nCPAP group,P <0.05 all.Con-· clusion:The nCPAP can improve ventilation function,heart function and V O2 max in patients with CHF complicated moderate-to-severe OSAHS,who have received basic medication.