Objective To analyze the clinical characteristics and drug resistance of gram -negative bacillus in Department of Respiratory Medicine.Methods 100 patients in Department of Respiratory Medicine were selected, analyzed the clinical characteristic and drug resistance of 125 strains of gram -negative bacillus that was separated. Results 125 strains of pathogenic gram negative bacilli were isolated out of 100 patients,among which 34 strains were pneumonia klebsiella bacteria,24 strains were acinetobacter baumannii,18 strains were pseudomonas aeruginosa, 10 strains were enterobacter cloacae,18 strains were escherichia coli and 21 strains were other bacteria.Results The drug resistance rates were 79.4%,76.5%,76.5% and 76.5% respectively in klebsiella pneumoniae to amikacin, cefotaxime,ampicillin and imipenem,was more sensitive to meropenem and cefoperazone,the drug resistance rate was 100.0% in acinetobacter baumannii to ampicillin and cefazolin,and was 91.7% to ceftriaxone,and the resistance rate for other drugs are higher generally.The drug resistance rate was 100.0% in pseudomonas aeruginosa to ampicillin and ceftriaxone,and was 94.4% to cefotaxime and levofloxacin,the drug resistance rate was 90.0% in enterobacter cloacae to ampicillin,and was 60.0% to ceftriaxone,cefazolin and cefoxitin,the drug resistance rate on the other drug was relatively low.Conclusion Klebsiella pneumoniae,acinetobacter baumanni and pseudomonas aeruginosa were the main gram negative bacillis the cause hospitalized patients with drug resistance.

Objective To evaluate the methods of standard patient (SP)combined with case-based learning (CBL ) in humanistic quality cultivation for interns in the department of thoracic surgery. Methods Medical interns in the department of thoracic surgery were divided randomly into experimental(n=30)and control group(n=30)respectively. In experimental group,SP combined with CBL was used while in control group traditional teaching was used. At the end of the study,teaching effect was assessed by the final examination and questionnaires and the data were processed by t test andX2 test. P<0.05 signifies statistical differences. Results There was no significant difference in test scores between the two groups (P>0.05). Scores of history-taking,medical check-up,paper writing quality in the final examination in experimental group were significantly higher than those in control group(P<0.01). Satisfaction degrees of doctor-patient communication,responsibility and service attitude in experimental group were better than those of control group(X2=16.484,10.335,20.376,32.851,P<0.01). Conclusions SP combined with CBL teaching method can stimulate the students' interests in thoracic surgery practice,improve the doctor-patient relationship and strengthen the ability of human-istic concern. It is a better clinical thoracic practice teaching method and it is beneficial to cultivating medical students with humanistic concern.

BACKGROUND: The authors have studied the porosity, pore size, mechanical strength, in vitro biological activity,ectopic osteogenic activity of porous biphasic calcium phosphate enhanced by recombinant bone morphogenetic protein-2/silk fibroin sustained-release microsphere (BCP/rBMP-2/SF). However, further investigation on the osteogenic ability of the composite bone graft material is warranted based on a reliable animal model, which will provide experimental data for the clinical application of the composite material in the spinal fusion.OBJECTIVE: To investigate the osteogenic efficacy of BCP/rBMP-2/SF in a sheep lumbar interbody fusion model.METHODS: Sixteen healthy adult sheep were divided into two groups randomly. All sheep were operated on the left extraperitoneal approach and intervertebral discs of L1/2, L3/4, and L5/6 were exposed respectively. Three of the following four materials were randomly implanted into the L1/2, L3/4, and L5/6 of each animal: autologous iliac, BCP/rhBMP-2/SF,BCP/rhBMP-2 or BCP/SF.RESULTS AND CONCLUSION: The group of BCP/SF/rhBMP-2 achieved a similar fusion rate compared with the group of autologous iliac at 12 and 24 weeks after operation, and they were significantly better than the other two groups. These findings indicate that the novel new artificial bone, BCP/rhBMP-2/SF, can obtain similar lumbar fusion results compared with the autologous iliac. It is expected to be applied to clinical practice in the future by further improving its properties.

Objective To evaluate the relationship between the CCNE1 or RIP2, identified at a single nucleotide poly?morphism, and the risk, clinic stage and pathological grade of bladder cancer. Methods Peripheral venous blood samples were obtained from 176 patients with bladder cancer and 210 controls without cancer. DNA was extracted. Polymerase chain reaction (PCR) method was used to detect CCNE1 (rs8102137) and RIP2 (rs42490) polymorphism. According to the postoper?ative pathological results, patients with bladder cancer were determined the grading and staging. The genotype differences of medium gene and the distribution gene were analyzed and compared in bladder cancer group and control group. The relation?ship of CCNE1 (rs8102137) and RIP2 (rs42490) genotypes and clinical data of patients with bladder cancer was analyzed, and the relationship of them with the genetic susceptibility to bladder cancer was also analyzed. Results The genotype dis?tribution was with good group representative in control group. The frequency of CCNE1(rs8102137) variant allele was signifi?cantly higher in bladder cancer group (40.91%) than that of control group (30.95%,OR=1.54,95%CI:1.02-2.45, P<0.05). The frequency of RIP2 (rs42490) variant allele was significantly higher in bladder cancer group (72.73%) than that of control group (62.38%, OR=1.61, 95%CI:1.04-2.48, P<0.05). There were no significant differences in gene polymorphisms of CC?NE1(rs8102137) and RIP2 (rs42490) between different pathological grades and different clinical stages of bladder cancer. Conclusion The CCNE1 (rs8102137) and RIP2 (rs42490) polymorphism have interaction in occurrence of bladder cancer process. There is higher risk of bladder cancer in individuals carrying mutant alleles than that of individuals carrying wild type.

Objective To explore the correlation and role of E2F3 gene,miR-17-5p and miR-20a in the cell lines of transitional cell carcinoma of bladder. Methods The plasmids of pcDNA3.1-HA-E2F3 and pAAV-siRNA-E2F3 were used to overexpress and knockdown E2F3.The mimics of miR-17-5p,miR-20a and their anti-miRNA oligonucleotides were used to overexpress and screen miR-17-5p and miR-20a.The expression levels of E2F3 gene,miR-17-5p and miR-20a were detected by quantitative real-time PCR,and E2F3 protein were detected by Western blot. Results When E2F3 was overexpressed,the 2- △△Ct of miR-17-5p and miR-20a were 2.26 ± 0.30 and 4.04 ± 0.51,it was statistically significant to compared with control (P ＜ 0.05) ; when E2F3 was knockdown,the 2 △△Ct of miR-17-5p and miR-20a were 0.49 ± 0.02and 0.65 ± 0.04 (P ＜ 0.05) ; when miR-17-5p and miR-20a were overexpressed simultaneously,the level of E2F3 mRNA was significantly decreased,the average E2F3 protein gray scale was 55.31 ± 7.89,the control was 103.67 ± 13.61 (P ＜ 0.05 ) ; when miR-17-5p and miR-20a were knockdown simultaneously,the E2F3 mRNA was significantly increased,the E2F3 protein gray scale was 295.68 ± 19.25,the control was 103.67 ± 13.61 ( P ＜ 0.05 ). Conclusions miR-17-5p and miR-20a could be up-regulated by E2F3 gene,and the E2F3 gene could be down-regulated by miR-17-5p and miR-20a.The regulatory feedback loop of E2F3 gene,miR-17-5p and miR-20a exists in transitional cell carcinoma of bladder. The loop maybe plays a key role in the development of bladder cancer.

ObjectiveTo explore the best time for replacing the long-term indwelling catheter in patients with silicone catheter.MethodsDomestic literature were retrieved and analyzed using Cochrane systematic review,and the meta-analysis of randomized controlled trials was conducted in accordance with inclusion criteria and exclusion criteria so as to look into the most suitable time for replacing the indwelling catheter for patients with silicone catheter at clinical trials.The replacement frequency for the catheters of different size together with the relevant infections in urinary tract infection and relative risk(RR)were used as values for effectiveness of interventions.ResultsA total of 11 literature were retrieved. Meta-analysis results suggested that the RR values of urinary tract infections when the catheters were replaced once every two weeks vs. every four weeks,and once every three weeks vs. every four weeks were 0.51[95% CI(0.40,0.66),P <0.001],0.79[95% CI(0.58,1.08),P = 0.14],respectively.The urinary infection rate of replacing a silicone cathether every 2 weeks was higher than that of every 4 weeks,but there was no difference between that of every 3 weeks and 4 weeks.Conclusion According to the nature of silicone catheter material as well as the clinical indexes, it is most reliable to replace a silicone catheter every four weeks to reach a best clinical outcome.

An efficient and sensitive analytical method for the simultaneous content determination of 18 amino acids in compound amino acid injection was developed using high performance liquid chromatography (HPLC) with pre-column derivatization. Phenyl isothiocyanate (PITC) was used as derivatization reagent. The target compounds were separated on a Unitary-C18 column (250 mm í 4.6 mm, 5 μm) in gradient elution mode using sodium acetate and the mixture of acetonitrile, methanol and water as mobile phases. The detection wavelength was 254 nm. The derivatization reagent dosage, derivatization time, salt concentration, the pH and the column temperature of mobile phase were investigated. Finally, 18 amino acids were separated within 40 minutes. The method showed that the good linearity (r2 ≥ 0.997 7) was at a range from 9 μg·mL-1 to 1 021 μg·mL-1. The recoveries ranged from 92.6% to 110.7%. And the relative standard deviations (RSD) ranged from 0.01% to 5.68%. The limits of quantification (LOQ, S/N = 10) ranged from 0.02 μg·mL-1 to 13.41 μg·mL-1. This method, which was simple, sensitive and accurate, can be applied for the content determination of amino acids in compound amino acid injections.

Objective To detect mechanism of action mode of Jiuxieling Granules in spleen and kidney yang deficiency ulcerative colitis. Methods The perfusion of Rhei Radix et Rhizoma Decoction plus intramuscular injection of hydrocortisone and combined with TNBS and ethanol enema were employed to establish UC animal model. Ninety rats were randomly divided into blank group, model group, SASP group and Jiuxieling Granules 7 days, 14 days and 21 days groups. All treatment groups received relevant medicine intervention. The levels of IL-1, IL-6, TNF-α, and IFN-γin serum and colon tissue were detected by ELISA. Results Compared with the blank group, the levels of IL-1, IL-6, TNF-α, and IFN-γ in serum and colon tissues of rats in model group increased (P<0.05);compared with the model group, the levels of IL-1, IL-6, TNF-α, and IFN-γin serum and colon tissues of rats in treatment groups were reduced greatly (P<0.05), among which Jiuxieling Granules 21 days group showed the most obvious effects (P<0.05). Conclusion Jiuxieling Granules can regulate the normal secretion of the levels of IL-1, IL-6, TNF-α, and IFN-γin serum and colon tissue of model rats, and inhibit inflammation and protect colonic mucosa.

Objective To sum up the surgical characteristics,indications and curative effects of burst fracture by anterior decompression,bone grafting and internal fixation.Methods Since Sep 2004,6 cases with the average age of 32 who were with thoracolumbar spine burst fracture and spinal cord injury of 12-day mean time,were treated with anterior decompression,bone grafting and Z-plate steel plate internal fixation.Before the operation,pateients were classified according to the ASIA classification: 4 cases of grade C,2 cases of grade D;Kyphotic angle(Cobb)15~40?;and vertebral canal 50%~60%.Results The follow-up lasted from 6 to 16 months(average 11 months) and it was found that incision recovered better,no infection of thoracic,abdomen,no grafting loosing or braking occurred.According to the ASIA classification,the functional recovery of spinal cord was 1~2 grade.The Denis assessment showed 5 cases was light back pain,1 case needed medication from time to time but didn't affect the life and work and spine was in order.Conclusion Surgical treatment of thoracolumbar fracture by anterior decompression,bone grafting,internal fixation can provide sufficient decompression,high rate of fusion of the implanted bone,stability in the spine and vertebral body,better recovery of neurological function and satisfied curative effects.It is the best choice for thoracolumbar burst facture and spinal cord injury.

Objective To study the effect of electrical stimulation of vagus nerve on inflammatory response in septic shock rats. Methods SD rats were randomly divided into 5 groups: Group Ⅰ was the sham group, group Ⅱ with the cecal ligation and puncture (CLP) and the vagus nerve were isolated but not transected, group Ⅲ with bilateral cervical vagotomy following CLP, group Ⅳ with bilateral cervical vagotomy after CLP and the left vagus nerve trunks were stimulated with bipolar electrodes, group Ⅴ with bilateral cervical vagotomy after CLP and the right vagus nerve trunks were stimulated. The common carotid artery pressure was monitored, and the plasma tumor necrosis factor α (TNF-α), nitric oxide synthases (NOS) and nitric oxide (NO) were measured 2 h after stimulation. Results The mean arterial blood pressure (MAP) gradually decreased and the concentration of plasma TNF-α, NOS and NO significantly increased after CLP. Electrical stimulation of the left and right vagus nerve significantly increased the MAP and decreased the plasma TNF-α, NOS and NO levels. Conclusion Direct electrical stimulation of the left and right vagus nerve can significantly improve the blood pressure and reduced plasma TNF-α, NOS and NO levels during septic shock, which may play a role in anti-shock in rats.