OBJECTIVE By using the VITEK32 and Microscan AS-4 microbiology identification system to identify the external quality control(QC) strains of microbes,to find out the difference and the coincidence degree with quality assessment result of the two systems. METHODS Thirty nine various strains of QC bacteria were isolated and cultured according to operation rule,and were identified by VITEK-32 and Microscan AS-4 and compared within them. RESULTS The coincidence rate of VITEK-32 and Microscan AS-4 to identify directly their species was 76.9% and 69.5% for 39 strains of QC bacteria,It was 89.7% and 76.9% after the serum or further tests,and the coincidence rate was 90.9% and 81.8% in 22 strains of Gram negatives,and 88.2% and 58.8% in 17 strains of Gram positives. CONCLUSIONS The detectable rate and coincidence rate of VITEK-32 are superior to those of Microscan AS-4,especially in the identification of Enterococcus and Streptococcus,the accuracy of Gram negatives is good,and of Gram positives is short,both them could not identify Salmonella and Shigella to their species.

Objective To evaluate the usefulness of cytologic examinations in the diagnosis of pancreatic neoplasms using nasopancreatic drainage and pancreatic duct brushing during ERCP.Methods In 47 patients with pancreatic diseases,cytologic examinations of pancreatic duct brushing and nasopancreatic drainage during ERCP were performed.Results The rate of accuracy,sensitivity,and specificity of brush cytologic examination were 70\^4%,65\^2% and 100%,respectively,and that of pancreatic juice cytologic examinations was 45%,8\^3% and 100%,respectively.Conclusion Our results confirm the value,safety,and utility of obtaining cytologic specimens at the time of ERCP for the early diagnosis of pancreatic neoplasms.

Objective To evaluate the usefulness of cytologic examinations of pancreatic duct brushing obstained during ERCP in diagnosis of pancreatic neoplasms. Methods In 27 patients with suspected manlignancy, cytologic examinations of pancreatic duct brushing during ERCP were performed. Results The positive rate of brush cytology was 55.6%.The results were affected by the location of lesion, correct cytodiagnoses of cancer were 69.2% in cancer at the head of the pancreas and 60% in cancer of the body. The accuracy rate of ERCP was 77.8%.However, by combining these 2 methods, the accuracy rate rose to 100%. Conclusion Our results confirm the significance,safety,and usefulness of the cytologic specimens obtained at the time of ERCP for the diagnosis of pancreatic neoplasms.

Objective: To assess the surgical techniques and surgical outcomes of temporoparietooccipital and parietooccipital disconnection. Methods: The authors conducted a retrospective review of clinical, neuropsychological, EEG, imaging data in 16 patients with intractable epilepsy who underwent temporoparietooccipital and parietooccipital disconnection between April 2008 and October 2011. Of the 16 cases, 12 were males and 4 were females. The age of seizure onset was from 0.1 to 27 years (average 6.6) and disease duration of 0.1 to 18 years (average 7.5). The surgery was performed between the age of 3 and 37 years (average 14.1). Nine patients underwent temporoparietooccipital disconnection, 5 patients parietooccipital disconnection and 2 patient parietooccipital disconnection and temporal lobotomy. Results: After a mean follow-up of 1.6 years (range 0.5–3.9 years), 13 patients (81%) were seizure free, 1 patient had Engel Class II seizure outcome and 2 patient had Engel class III outcome. Two patients exhibited severe brain swelling and one patients had second resective operation with good recovery. None of the patients developed new motor defi cits postoperatively and there was no mortality. Conclusion: Temporoparietooccipital and parietooccipital is a safety and effective epilepsy surgery procedure for patients with epileptic zone localization to the posterior quadrant on one side. The results of surgical disconnection for posterior quadrantic epilepsy have yielded excellent seizure outcomes in 81% of the patients, with no mortality or major morbidity.

Objective To investigate rectal visceral perception、 anorectal manometry and colonic transit time in functional constipation and constipation-predominant irritable bowel syndrome (IBS) and to assess their variety of manometric abnormalities. Methods The cases with functional constipation and constipation-predominant IBS were studied in a colonic transit test by radiopaque markers. Rectal visceral perception thresholds, rectal compliance and anorectal manometry were examined in patients with functional constipation or constipation-predominant IBS by electric barastat. Results The colonic transit time in both groups of constipation patients was abnormal. A lot of radiopaque markers remined in right colon when patients with constipation-predominant IBS were examined, as the patients with functional constipation in anorectum. The anorectal resting pressure, squeeze pressure and relaxation pressure were similar in both groups. Rectal compliance and defecation thresholds were much higher than normal, and the rectal visceral perception of functional constipation was also abnormal. Conclusion The motility abnormalities between functional constipation and constipation-predominant IBS occure in the different colonic segments. The results suggested that colonic transit test and anorectal manometry might provide a method in differentiatial diagnosis.

Objective To explore the possible role of vitamin D in the pathogenesis of IgA nephropathy (IgAN). Me-thods After the IgAN model was successfully induced at 12 weeks, the BALB/C mice were randomly divided into IgAN group (n=15) and IgAN+VitD group (n=15). The nephrosis mice were administrated with 100 μl/d propylene glycol or propyl-ene glycol+1,25(OH)2D, 3 ng/(100g?d), for 6 weeks. The control group was setted (n=15). The level of 24 hour urine protein was determined at week 0, 12 and 18. At week 18, the levels of serum 25(OH)D, ifbroblast growth factor 23 (FGF23) and galactose-deifcient IgA1 (Gd-IgA1) were detected. The mRNA and protein expressions of interleukin-21 (IL-21) in Peyer’s patches (PPs) were detected by lfuorescent quantitative reverse transcription-polymerase chain reaction and western blot respectively. The protein expression of Bcl-6 was detected by western blot. The percentages of Tfh cells/T lymphocytes, B220+IgM+/B lympho-cytes, B220+IgA+/B lymphocytes, B220-IgA+/B lymphocytes in PPs were determined by lfow cytometry. Results Compared with control group, the levels of 24 hour urine protein, FGF23 and Gd-IgA1 were increased, serum 25(OH)D was decreased, the mRNA and protein expressions of IL-21 and the protein level of Bcl-6 were increased, the percentages of Tfh cells/T lym-phocytes, B220+IgM+/B lymphocytes, B220+IgA+/B lymphocytes, B220-IgA+/B lymphocytes were elevated in IgAN group (P<0.05). These indicators were improved in IgAN+VitD group. Compared with the IgAN group, the differences were statisti-cally signiifcant (P<0.05), however compared with control group, some indicators showed no signiifcant differences (P>0.05). Conclusions 1,25(OH)2D may protect the microenvironment of PPs in IgAN through inhibiting the differentiation of Tfh cells and B cells and the generation of Gd-IgA1.

Objective To establish the quality standard of Yifukang Capsule. Methods The identification of Radix Puerariae, Radix Salviae miltiorrhizae, Radix Ginseng was carried out by TLC. The content of puerarin was determined by HPLC. Results Radix Puerariae, Radix Salviae miltiorrhizae, Radix Ginseng could be identified by TLC. A good linearity of puerarin was in the range of 0.2～ 1.6 ? g(r=0.9999) and the average recovery of puerarin was 102.6 % , RSD was 1.70 % . Conclusion This method is simple, sensitive, accurate and with good reproducibility and can be used for the quality control of Yifukang Capsule. 

OBJECTIVE To explore the factors and effective preventive method of nosocomial lower respiratory(infection) after general anesthesia through trachea intubation.METHODS Using bacterial culture and identification technique to detect the samples collected from pipe and the sides of anesthetic machine,from disposable virus/(bacteri)a respiratory filter and buccal and bronchial secretion of patients with general anesthesia through trachea(intubation.) RESULTS Eight of 15 anesthetic machines without disinfection were with positive bacterial culture.All sides of virus/bacteria respiratory filter,and buccal and bronchial secretion of patients during operation had same(bacteria.) No bacteria growth was found in anesthetic machine and disposable virus/bacteria respiratory filter used after operation.The same bacteria as from buccal secretion were isolated from anesthetic machine in patients(without) using virus/bacteris respiratory filter.CONCLUSIONS The(results) showed the anesthetic machine is more easy to be contaminated by patients,and the reuse of anesthetic machine is an important factor for nosocomial(lower) respiratory infection after general anesthesia through trachea intubation.Intensifying periodic disinfection of(anesthetic) machine and using virus/bacteria respiratory filter can prevent contamination between anesthetic(machine) and patients and decrease nosocomial lower respiratory(infection) after operation.

Objective To observe the treatment effect of nicardipine for the presence of hypertension responses during thyroidectomy under cervical plexus nerve block.Methods Patient without hypertension before the operation was brought into if he received thyroidectomy under cervical plexus nerve block,and with the presence of hypertension responses during the operation,and without effect after injected innovar one dose or dolantin 50mg by vein when the blood pressure was over 160/90mmHg.20 patients according to the criterion mention above were dripped nicardipine 20?g/kg by vein.The SBP,DBP,MAP,HR,SpO_2 and ECG were recorded at 3min,5min,15min,30min,45min after injection and the side effects were also recorded.Results The SBP,DBP,MAP of all patients were fallen distinctly at 3min after injection,and reached lowest at 5min.The blood pressures were steady at other points.There was significantly difference between the point before and after injection(P

Objective To observe the therapeutic effect of tramadol combined with fentanyl in patient controlled intravenous analgesia after nucleotomy of intervertebral disc.Methods 60 patients under general anesthesia,scheduled for nucleotomy of intervertebral disc,were randomly divided into three group(n=20):group tramadol(group T),group fentanyl(group F) and group tramadol+fentanyl(group TF).All patients were received patient controlled intravenous analgesia by loading dose+background dose+PCA bolus dose.The BP,HR,RR,VAS at 6,12,24,48h of postoperation were observed.The sedation score in 24h,average effective-press times and drug dose in 48h of postoperation were recorded.The incidence of nausea and vomiting during 24h of postoperation were observed.Results It had no significantly difference of BP,HR,RR,VAS among three groups.The average effective-press times of group TF (8?2) were significantly less than those of group T (14?3) and group F (12?3).The drug dose of 48h was tramadol (17.9?1.5)mg/kg(group T),fentanyl (16.8?1.5)?g/kg(group F) and tramadol (11.5?0.7)mg/kg+fentanyl (9.1?0.7)?g/kg(group TF).The drug dose of group TF showed significant difference compared with others.The sedation score in group F was the highest,it had significant difference compared with the other two group.The frequency of nausea and vomiting in group T was significantly more than that in others.Conclusion Tramadol or fentanyl gived alone can afford the same satisfied analgesic effect on nucleotomy of intervertebral disc.But there is high nausea-vomiting frequency in tramadol and strong sedation frequency in fentanyl.Tramadol combined with a little opioid fentanyl can afford more satisfying analgesic effect,and is provided with advantage in less drug and side-effect.