OBJECTIVE:To observe therapeutic efficacy of ulinastatin in the treatment of acute pancreatitis. METHODS:A to-tal of 80 acute pancreatitis patients were randomly divided into control group and observation group,with 40 cases in each group. Control group was given conventional treatment as gastrointestinal decompression,analgesia and spasmolysis,anti-infective treat-ment,fluid replacement,electrolyte disturbances balance,in vivo microcirculation improvement;observation group was additional given ulinastatin 100 000 U added into 5% Glucose injection 250 ml,ivgtt,bid,on the basis of control group,and then given medicine qd after improving symptoms;finally,stopped taking medicine immediately the symptom disappeared. Both groups was given 8d of treatment. Serum levels of IL-6 and TNF-α were observed in 2 groups before and after treatment,and clinical symp-tom,the time of sign and lab index improvement were also observed. Clinical efficacy was evaluated. RESULTS:After treatment, serum levels of IL-6 and TNF-α in observation group was significantly lower than in control group;the time of clinical symptom and sign,lab indicator improvement were significantly shorter than in control group,with statistical significance(P<0.01). The ef-fective rate (95.00%) of observation group was significantly higher than that (70.00%) of control group,with statistical signifi-cance(P<0.05). CONCLUSIONS:Ulinastatin can significantly reduce acute pancreatitis significantly,improve clinical symptom, promote disease recovery and clinical efficacy.

The artifacts in magnetic resonance imagines(MRI) seriously degrade the imagine quality and affect the exact diagnosis. The reasons that may cause artifacts in magnetic resonance imaging and the suppressing methods are presented in this paper. One of the intractability appeared in researches is how to restrain all kinds of artifacts quickly and efficiently. It is important to search for new methods to solve this problem. It may provide reliable basis for medical observation and clinical diagnosis.

ObjectiveTo evaluate the discriminative stimulus effects of nicotine on the basis of a rat model of heroin discrimination.MethodsMale Sprague-Dawley rats were trained to discriminate 0.3 mg/kg heroin from saline under a fixed-ratio (FR10) schedule of food reinforcement.After training,different doses of heroin and nicotine were used to substitute for training dose of heroin,the dose-response curve for heroin and the discriminative stimulus effects of nicotine were identified in rats.ResultsAll rats reliably discriminated 0.3 mg/kg heroin from saline.Different doses of heroin ( 0.03,0.1,0.3,0.56 mg/kg ) produced ( 33.9 ± 15.0 ) ％,( 43.3 ± 13.3 ) ％,(98.7 ± 0.5 ) ％,(99.4 ± 0.2 ) ％ total responding on heroin associated lever,heroin at the doses of lower than 0.3 mg/kg produced the dose-dependent relationship in heroin-appropriate responding.In heroin-trained rats,nicotine at the dose of 0.03,0.1 mg/kg produced(1.9 ±1.1)％,(13.7 ±5.6)％ total responding on heroin associated lever,there were extremely significant differences with 0.3 mg/kg heroin control (P＜0.01).However,nicotine at the dose of 0.3,0.5 mg/kg produced ( 60.4 ± 16.1 ) ％,(65.9 ± 16.4) ％ total responding on heroin associated lever,there were no significant differences with 0.3 mg/kg heroin control (P＞ 0.05 ).ConclusionNicotine at the dose of 0.3,0.5 mg/kg can partially produce heroin-like discriminative stimulus effects.

OBJECTIVE To analyze the sequence of IMP-4 metallo-?-lactamases(MBLs) encoding gene from clinical isolates of multiple-drug-resistant Klebsiella oxytoca strains and attempt to know the integrons composing the drug resistance gene box.METHODS The antibiotic sensitivity test of multi-resistant K.oxytoca strains was done according to Kirby-Bauer method of CLSI 2005,and the double disk synergy test and Etest were for detecting their MBLs.The Class 1 integrons were detected by PCR.The purified amplicons of Class l integrons were sequenced.The type and order of gene cassettes in integrons were analyzed by searching GenBank.RESULTS The K.oxytoca was resistant to carbapenems,the third-generation cephalosporins,cefoxitin,quinolones,cefoperazone/sulbactam,sulfamethoxazole/trimethoprim,amoxicillin/clavulanate,ticacillin/clavulanate,piperacillin,cefepime,rifampicin and piperacillin/tazobatam,only susceptible to amikacin and polymyxin B.The IMP-4 metallo-?-lactamases,aadA1,AmpC,CTX-M-14,qacE△1-sull and intI1 were positive.CONCLUSIONS Integrons are important molecular mechanism in the development of multidrug resistance.There are resistance gene boxes in them.

Objective To investigate the expression and significance of aromatase P450,COX-2,ER and PR in the patients with adenomysis.Methods The immunohistochemistry staining was used to detect the expression of aromatase P450,COX-2,ER and PR in ectopic endometrium and eutopic endometrium of 30 patients with adenomyosis and 30 cases in control group.Results The expression of aromatase P450,COX-2 in ectopic endometrium were significantly higher than those in eutopic endometrium (all P ＜ 0.05) ; The expression of ER,PR in ectopic endometrium were significantly lower than those in eutopic endometrium (all P ＜ 0.05),excepted the expression of PR in eutopic endometrium,the expressions of both ER and PR lose their periodical cycle.There was positive correlation between the expression of aromatase P450 and COX-2 in adenomysis group(P ＜ 0.05).In adenomyosis,the expression of aromatase P450,COX-2,ER and PR in dysmenorrhea subgroup were significantly higher than those in non-dys menorrhea subgroup(all P ＜ 0.05).Conclusion Aromatase P450,COX-2 and ER play important roles in the genesis and development of adenomyosis and dysmenorrheal,PR is not the main pathogenic factors of adenomyosis.The expressions of aromatase P450,COX-2 and ER in adenomyosis have nothing to do with endometrial cyclical change and are not subject to the regulation of ovarian hormones.

Objective To investigate the effect of double lumen tube applied in the simple negative pressure drainage.Methods Forty cases were divided into two groups by a random table method,with 20 cases in each group. The double lumen tube was used in observation group while the normal gastric tube was used in control group,then the indexes on the drainage effect and wound healing were quantized and analyzed.Results In the observation group,one case suffered obstruction at 2 -4 days,1 case after 4 days of treatment,the obstruction rate was 10%.In the control group,two cases suffered obstruction at 2 -4 days,and 2 cases after 4 days of treatment,the obstruction rate was 25%.There was significant difference between two groups(χ2 =9.212,5.021,P =0.027,0.032).There were two cases of delayed healing and 17 cases with effective in the observation group,but 8 cases delayed healing and 11 cases with effective in the control group,there was statistically significant difference (χ2 =5.833,4.800,P =0.016, 0.028).Conclusion Double lumen tube can delay the occurrence time and reduce the occurrence rate of obstruction in simple negative pressure drainage,which promotes wound healing,and it is worth popularizing and using clinically.

Objective To evaluate the performance and clinical utility of Verigene gram-negative blood culture ( BC-GN ) assay for a rapid identification of gram-negative bacteria and resistance genes . Methods Non-repetitive blood culture samples containing gram-negative bacteria were collected from inpa-tients in the Second Affiliated Hospital of Zhejiang University School of Medicine from June to October , 2013 .BC-GN assay was performed to identify the species and genetic resistance determinants of gram -nega-tive bacteria directly from the positive blood culture bottles .VITEK MS and the VITEK 2 Compact were used for species identification and antimicrobial susceptibility test , the results of which were considered as gold standards.The resistance genes were further validated by PCR amplification and sequencing analysis .A comparison of the results and time between the BC-GN assay and routine methods was conducted . Results The detection range of BC-GN assay almost covered all of the common gram-negative bacteria .BC-GN assay showed an advantage of high accuracy in the identification of Escherichia coli (13/13), Klebsiella pneumoniae (19/24), Klebsiella oxytoca (9/9), Pseudomonas aeruginosa (39/39), Serratia marcescens (4/5), Enterobacter spp.(6/8), Citrobacter spp.(11/11), Proteus spp.(6/6) and Acinetobacter spp. (24/24) with an overall accuracy of 94.24%for the identification of mono-microbial blood culture samples . Moreover , BC-GN assay accurately identified all of the bacteria and resistance genes from the two multi -mi-crobial samples .Species identification and resistance profiles could be 42 hours earlier available by using BC-GN assay than those by using routine methods .Conclusion BC-GN assay could simultaneously and ac-curately identify bacteria and resistance determinants from blood cultures within 2 hours.More time for clini-cally effective therapy could be achieved by using BC-GN assay for the reduction of mortality associated with bloodstream infection .

Aim Toinvestigatetheeffectofhigh,me-dium and low doses of Mahuang decoction on the re-lease amount of rat hippocampal neural transmitter (Glu,Gly,Asp,GABA),then compare Mahuang de-contion with ephedra alkaloids and ephedra.Methods Ratswererandomlydividedinto6groupsandgiven orally with Mahuang decoction of high dose (calculated by ephedra 4 g·kg-1 ),medium dose (calculated by ephedra 2 g·kg-1 ),low dose (calculated by ephedra 1 g · kg-1 ),ephedra (calculated by ephedra 2 g · kg-1 ),ephedra alkaloids (ephedrine 7 mg · kg-1 , pseudoephedrine 2. 4 mg · kg-1 , methylephedrine 1. 12 mg · kg-1 )and blank control group.Samples were obtained from the hippocampus of conscious rat by microdialysis sampling technique.The content of ami-no acid neurotransmitters in dialysates was detected u-sing the established HPLC-ECD with OPA pre-column derivationmethod.Results Fouraminoacidneuro-transmitters could be well separated in 28 min.High, medium and low doses of Mahuang decoction,ephedra and ephedra alkaloids significantly increased the con-tent of these four amino acid neurotransmitters,com-pared with blank control group (P<0. 05 ).Ephedra alkaloids significantly reduced the levels of inhibitoryamino acid neurotransmitters GABA and Gly in 90 min,compared with the medium dose of Mahuang de-coction.Excitatory neurotransmitters of ASP and Glu in hippocampus showed the trend of increase first and then decrease after oral administration of Mahuang de-coction and ephedra. The levels of Glu and Asp reached peaks from 90 min to 120 min after treatment with Mahuang decoction,and also increased along with dose increase of Mahuang decoction.In comparison with the medium dose of Mahuang decoction group,the level of Glu reached peak at 90 min and 150 min in ephedra alkaloids group and ephedra group respective-ly,and the content of Glu significantly increased at peaktime.Conclusions Increasedcontentofexcita-tory amino acid neurotransmitters (Asp and Glu ) shows positive correlation with the dose of Mahuang de-coction.Other components in Mahuang decoction in-hibits the up-regulation effect of ephedra and ephedra alkaloids on Glu,and promotes the up-regulation effect of ephedra alkaloids on GABA and Gly.

Objective To investigate clinical effect and safety of in vitro maturation(IVM)of human immature oocytes in infertile women with polycystic ovary syndrome by comparing with conventional in vitro fertilization(IVF)and intracytoplasmic sperm injection(ICSI).Methods From Jan.2003 to Dec.2009,157 infertile women with PCOS underwent 162 cycles IVM in Center for Reproductive Medicine,the First Affiliated Hospital of Anhui Medical University.In the mean time,109 patients with PCOS underwent 114 IVF/ICSI cycles as control group 1 and 106 patients with other factors underwent 106 IVF/ICSI cycles as control group 2.Treatment and outcome of pregnancy and infant were compared among those 3 groups.Results No statistically significant difference were found in terms of the positive rate of hCG in urine[35.7％(56/157),42.2％(46/109),44.3％(47/106)],the rate of clinical pregnancy[29.3％ (46/157),37.6％(41/109),41.5％(44/106)],the rate of entopic pregnancy[1.9％(3/157),1.8％ (2/109),0.9％(1/106)],the rate of miscarriage[18.6％(8/43),12.8％(5/39),20.9％(9/43)]and the rate of live-birth[22.3％(35/157),31.2％(34/109),32.1％(34/106)]among three grbups(IVM group,control group 1,control group 2,P ＞ 0.05).The rate of preterm labor,low weight newborn,mean birth weight,ratio of male to female did not show significantly difference among 3 groups(P ＞ 0.05).The average control ovarian stimulation was 6 days,the median dose of gonadotropin(Gn)was 675 IU,and the total hospital cost was(8392 ± 1328)RMB in IVM group,which were statistically lower than those in the other two control groups(P ＜ 0.01).The rate of multiple pregnancy was 4.7％(2/43)and ovarian hyperstimulation syndrome(OHSS)0 in IVM group,which were significantly lower than those in the other control group(P ＜0.01).Conclusion In vitro maturation is an effective treatment in infertile women with PCOS,it could obtain the similar pregnancy outcome and reduce total cost,the dosage of gonadotropinreleasing hormone and rate of OHSS compared with conventional IVF/ICSI.

Objective To evaluate the contribution of gyrA and parE detection in Ureaplasma genotyping.Methods Sixty Ureaplasma isolates were selected with the Mycoplasma IST kit.The gyrA and parE were amplified by PCR.The DNA was sequenced and compared with the corresponding sequences in GenBank.Results The nucleotide sequence of gyrA had 100% identity in serovar 1,3,6,14 and 100%identity in serovar 2,4,5,7～13,too.But the sequence had 91%identity between the two groups.The nucleotide sequence of parE had 98%～99% identity in serovar 1,3,6,14.And it had 100% identity in erovar 2,5,7,8,11 and 100% identity in serovar4,12,13.But it had only 90% identity between the two groups.Ureaplasma parvum(Up),Ureaplasma urealyticum(Uu)and Up+Uu infection were found 68.3%(41/60),21.7%(13/60)and 10%(6/60) of clinical specimens,respectively.In Up isolates,serovar 3 was 48.8%(20/41).Conclusion Ureaplasma can be divided into two genotypes(Up and Uu)by gyrA analysis.And Up can be divided into four subtypes which correspond to serovar 1,3,6,14,respectively.Serovar 3 is the main isolate in our research.