Objective To explore the clinical characteristics and drug sensitivity of newborn pneumonia of klebsiella pneumoniae,and investigate the positive rate of extended-spectrum ? lactamases(ESBLs)in klebsiella pneumoniae.Method Sixty-seven cases of sputum samples newborn pneumonia of klebsiella pneumoniae from Jan.2003 to Dec.2005 were collected.Bacteria identification and drug sensitivity test were performed.At the same time,ESBLs were detected.Results The clinical characteristics of newborn pneumonia of klebsiella pneumoniae were non special,and the positive rate of ESBLs in klebsiella pneumoniae was 17.91%.The klebsiella pneumoniae was 100%sensitivie to carbopenems,but resistant to commonly used ?-antibiotics such as penicillin and cephalosporin.ESBLs negative strains had higher drug sensitivity than ESBLs strains.Conclusions Partial klebsiella pneumoniae are ESBLs strains and insensitive to commonly used antibiotics.In order to decrease ESBLs strains,the antibiotics treatment shall be used appropriately and the selection of antibiotics shall be guided by the results of drug sensitivity tests.

Objective To explore the diagnosis value of ultrasound real-time elastography in thyroid diffuse diseases.Methods Eleven elastic quantitative parameters of 123 patients with thyroid diffuse diseases and 42 healthy volunteers obtained from the ultrasound real-time elastography were analyzed with principal components analysis to attain a comprehensive evaluation value which was named stiffness index(SI),reflecting the organization elastic information of different thyroid diffuse diseases.SI among each group was compared by ANOVA.Results Chronic lymphocytic thyroiditis SI was 86.37±20.45,subacute thyroiditis SI was 86.14±19.95,primary hyperthyroidism SI was 54.68±21.69,normal control group SI was 41.34±15.59,respectively.The SI between chronic lymphocytic thyroiditis,subacute thyroiditis,primary hyperthyroidism and normal controls had significant statistical differences (P<0.05),the SI between primary hyperthyroidism and chronic lymphocytic thyroiditis,subacute thyroiditis had significant statistical differences (P<0.05),the SI between chronic lymphocytic thyroiditis and subacute thyroiditis had no significant statistical difference (P>0.05).Conclusions Ultrasound real-time elastography could indirectly reflect the stiffness information of thyroid lension tissue and have a certain degree of diagnosis value in thyroid diffuse disease.

ObjectiveTo deter mine the sustained attention function of the patients with mild Alzheimer's disease(AD) and mild cognitive impairment(MCI).Methods10 patients with MCI, 10 with mild AD and other 10 healthy elderly controls were tested with Continuous Performance Task(CPT) aimed to assess sustained attention. ResultsCompared with the normal controls, the mild AD patients reacted very more slowly(P<0.001), missed more targets(P<0.05), while that the MCI patients did was as well as the control group. ConclusionThe mild AD patients shows impairment in sustained attention function, but the MCI patients shows a preserved ability of sustained attention function.

Academic Dissertations as Topic ; Diagnostic Imaging ; Humans

ObjectiveTo investigate the effect of controlled low perfusion pressure on expression of phosphor-Akt (p-Akt) and phosphor-ERK1/2 (p-ERK1/2) following spinal ischemia-reperfusion (1/R) in rabbits.MethodsThirty-six Japanese long-ear white rabbits aged 3 months weighing 2.0-2.5 kg were randomly divided into 3 groups ( n ＝ 12 each):group sham operation (group S) ; group spinal I/R (group I/R) and group controlled low perfusion pressure (group LP).Auricular artery and femoral artery were carnulated for proximal and distal BP monitoring.A 4F catheter with a balloon at the tip was inserted into abdominal aorta.The tip was positioned 1 cm below left renal artery.Spinal ischemia was induced by inflating the balloon until the distal MAP < 20 mm Hg,and maintained for 25 min.During the first 10 min of reperfusion the distal MAP was increased to 45-55 mm Hg by partially deflating the balloon.Then the balloon was fully deflated to allow complete reperfusion.The function of lower limbs was assessed with Tarlov score (0 ＝ no detectable movement,4 ＝ normal function) at 1,3,7,28 d of reperfusion.Au the animals were sacrificed at 1 d of reperfusion in each group.The lumbar segment L3-5 of the spinal cord was removed for microscopic examination and determination of expression of p-Akt and p-ERK1/2 by immuno-histochemistry) and detection of neuronal apoptosis in dorsal horn (by TUNEL).ResultsSpinal I/R significantly decreased Tarlov scores,and increased the number of apoptotic cells and expression of p-Akt and pERK1/2 in group I/R as compared with group S.Low perfusion pressure during the 10 min at the beginning of reperfusion significantly increased Tarlov scores,decreased apoptotic index and further increased p-Akt and pERK1/2 expression in group LP compared with group I/R.The histopathological damage in the spinal cord was attenuated in group LP.ConclusionControlled low pcrfusion pressure can reduce the spinal cord I/R injury by activating Akt and ERK1/2 and decreasing neuronal apoptosis.

Adult ; Aged ; Aged, 80 and over ; Anthracosis ; complications ; Diagnostic Imaging ; Humans ; Lung Neoplasms ; epidemiology ; etiology ; Middle Aged ; Retrospective Studies

Objective To investigate the risk factors for postoperative cognitive dysfunction (POCD)induced by patient-controlled intravenous analgesia(PCIA)in elderly patients. Methods 95 patients with POCD and 97 cognitive normal controls were included in the study. The cases and controls were matched for gender, type of operation and PCIA volume dose. Cognitive function was assessed by Mini-Mental-State test and the relationship between POCD and various factors was analyzed by univariate and multivariate analysis. Results Univariate analysis revealed that the education level and visual analog scale (VAS) score had significant differences between the two groups. Multivariate analysis showed that the VAS score and education level were significantly related to POCD induced by PCIA, with the odds ratios of 2. 379 (95%CI:1.205～4.698) and 0. 292 (95%CI:0.157～0.543), respectively. Conclusions Lower VAS score is an independent risk factor and higher education level seems to be a protective factor for POCD induced by PCIA.

Objective To explore the diagnostic value of ultrasonic elastography and fine flow imaging in differential diagnosis of cervical lymph nodes.Methods Totally 87 lymph nodes were examined with ultrasonic elastography,fine flow and conventional ultrasonography.The results were confirmed with postoperative pathology or fine-needle biopsy as well as follow-up.Using consistency check of Kappa and ROC curve to analyse the accuracy of three types of ultrasonic examination.Results Taking the results of postoperative pathology or fine-needle biopsy as well as follow-up as golden standards,the Kappa value of conventional ultrasonography was poor (Kappa =0.153,P =0.078),fine flow was moderate (Kappa =0.526,P ＜0.01) and ultrasonic elastography was better (Kappa =0.741,P ＜0.01).The area under ROC of ultrasonic elastography,fine flow and conventional ultrasonography was 0.899 (P ＜0.01),0.787 (P ＜0.01) and 0.568 (P =0.241),respectively.Conclusions Ultrasonic elastography is more valuable to differentiate malignant from benign lymph nodes.

Objective To evaluate sound velocity tissue quantification ( SVQ ) for the quantitative assessment of liver fibrosis stage in chronic hepatitis B ,and to evaluate the correlation between diagnostic performance of sound velocity tissue quantification and blood parameters . Methods From the May of 2013 to May of 2014 ,collect ninety‐nine patients with chronic hepatitis B who was diagnosed by clinic and / or liver biopsy as experiment group ,and thirty healthy volunteers as control group at the same time . The experiment group and control group were evaluated with to measurement the zone speed index ( ZSI) ,and blood cell count . The AST/PLT ratio index ( APRI) was calculated according the following formula , APRI=AST(ULN)/PLT(109/L) . The liver biopsy was performed in the same day with SVQ and all blood parameters .ZSI and APRI were compared by correlation with liver fibrosis stage in chronic hepatitis B . Referring to the histologic fibrosis stage on liver biopsy ,all the ZSI and the APRI value were assessed by using ROC curve analysis . The corresponding cut‐off value ,sensitivity and specificity were also calculated andcompared.Results 1)ThemeanvaluesofAPRIwere(15.9±5.7)m/sforpatientswithS0,(28.1± 2 .8)m/s for patients with S1 ,(35 .8 ± 1 .2)m/s for patients with S2 ,(42 .6 ± 0 .8)m/s for patients with S3 , and (46 .3 ± 1 .3)m/s for patients with S4 .2)Accordingly ,the areas under the ROC curve for ZSI and APRI were 0 .875 and 0 .762 for S≥S1 ,0 .832 and 0 .597 for S≥S2 ,0 .913 and 0 .675 for S≥S3 ,0 .891 and 0 .709 for S≥S4 ,respectively . Conclusions The ZSI and APRI all could be used to evaluate the stage of liver fibrosis ,but the ZSI index is superior to APRI in assessing the stage of liver fibrosis . SVQ could provide object and accurate image ,the quantitative analysis of tissue could timely and accurately evaluate the severity of liver fibrosis .

Objective To evaluate the effects of dexmedetomidine with different-dose on the hemodynamics during anesthesia induction in patients undergoing off-pump coronary artery bypass grafting. Methods Sixty patients undergoing off-pump coronary artery bypass grafting were selected, with ASA grade Ⅱ - Ⅲ, NYHA cardiac functional grading Ⅱ - Ⅲ, and left ventricles ejection fraction >45%. The patients were divided into D1 group, D2 group and control group by table of random digit method with 20 cases each. In D1 group, intravenous infusion dexmedetomidine 0.3μg/kg was given for 20 min before anesthesia induction;in D2 group, intravenous infusion dexmedetomidine 0.6μg/kg was given for 20 min before anesthesia induction;in control group, intravenous infusion the same volume of 0.9% sodium chloride was given before anesthesia induction. The mean arterial pressure (MAP), heart rate, cardiac output and stroke volume variation (SVV) were recorded before infusion dexmedetomidine (T0), before anesthesia induction (T1), 3 min after anesthesia induction (T2), trachea cannula (T3) and 5 min after trachea cannula (T4). The adverse cardiovascular events and drug intervention were recorded during anesthesia induction. Results There were no statistical differences in MAP, heart rate, cardiac output and SVV at T0 among 3 groups (P>0.05). Compared with that in control group, the heart rate at T1, T2, T3 and T4 in D1 group were decreased, the MAP, heart rate, cardiac output and SVV at T1, T2, T3 and T4 in D2 group were decreased, and there were statistical differences (P<0.05). Compared with that at T0, the heart rate at T1, T2, T3 and T4 in D1 group were decreased, the MAP, heart rate, cardiac output and SVV at T3 in control group were increased, the MAP, heart rate, cardiac output and SVV at T1, T2, T3, T4 in D2 group were decreased, and there were statistical differences (P<0.05). Compared with that in D1 group, the MAP, heart rate, cardiac output and SVV at T2, T3 and T4 in D2 group were decreased, and there were statistical differences (P<0.05). The rates of adverse cardiovascular events in D1 group and D2 group were significantly lower than those in control group:35%(7/20) and 40%(8/20) vs. 95%(19/20), the rate of drug intervention in D1 group was significantly lower than that in control group and D2 group:10% (2/20) vs. 45% (9/20) and 35% (7/20), and there were statistical differences (P<0.05). Conclusions Dexmedetomidine (0.3 μg/kg) is beneficial for the stability of hemodynamics before anesthesia induction in patient undergoing off-pump coronary artery bypass grafting.