This paper is to report a clinical analysis of 90 cases of acute myocar-dial infarction (AMI) admitted in the past 9 years. High incidence of AMI was found between the ages of 50 to 69 years. Infarction frequently occurred on the anterior interventricular septal part, lower part, and anterior ventricular part of the cardiac wall. AMI was complicated with cardiac arrhythmia in 84.4% of cases, with cardiac failure in 25.6%, and cardiogenic shock in 18.9%. UDT hemorrhage, ventricular aneurysm and interventricular septum rupture were also seen. 13 cases died in the acute phase due to pumping failure, 6 due to sudden cardiac standstill, 5 due to interventricular septum rupture, and 1 due to extra-cardiac cause. 77 cases were discharged after clinical recovery.63 cases were followed up from 5 months to 8 years. Among them, 4 cases died 1 to 2 years after the onset of AMI, and 1 case 4 years after. 58 cases are living up to present. Long term prognosis is not closely related to the location and extent of the infarction.

OBJECTIVE To investigate the incidence rate of Pseudomonas aeruginosa whose ceftazidime resistance was induced by imipenem and the relationship of excretion pump with sensibility of imipenem and ceftazidime.METHODS The sensibility to 15 antibacterials and ceftazidime resistance induced by imipenem were detected by slip diffusion method,detect these bacteriumas′s MIC to Imipenem and Ceftazidime before and after excretion pump inhibitor hydroxide radical cyanogen chlorine phenylhydrazone(CCCP) were added by agar dilution,detect Ceftazidime′s MIC value which were added different concentration imipenem by agar dilution.RESULTS From 325 strains 116 strains(35.7%) were imipenem induced ceftazidime-resistant drug fast,from them 80.2% were imipenem-resistant and ceftazidime-sensitive,19.8% were imipenem and ceftazidime both sensitive.Sensibility to imipenem and ceftazidime was no marked change before and after CCCP added,MIC value of ceftazidime was step up 4-12 times by imipenem.CONCLUSIONS The incidence rate of ceftazidime-resistant P.aeruginosa induced by imipenem is high,clinical microbiological laboratory should evolve D-test to guide clinician use antibacterials more reasonable.

BACKGROUND:Previous studies have confirmed that healing of in vivo tendon is the outcome of interaction between endogenous healing and exogenous healing. Exogenous healing is a main reason for tendon adhesion, and affects the recovery of tendon function.OBJECTIVE: To explore application of tissue engineering technique and its materials in prevention and treatment of tendon adhesion induced by movement injury.METHODS: Using the key words of "movement injury, biomaterial, tissue engineering, tendon adhesion", we retrieved randomized animal controlled studies and clinical application literatures addressing tendon biomechanics function, adsorbable biomaterial polyglycolic acid, tendon cells-constructed tissue engineered tendon in vitro, biomembrane, chitosan, adsorbable antistick membrane, sodium hyaluronate, bioprotein gel and so on in prevention of tendon adhesion in Chinese Journal Full-text Database published from January 1990 to December 2000. By aggregate analysis of literature data, follow-up and function evaluation, this article summarized clinical application of tissue engineered techniques and materials in prevention of tendon adhesion.RESULTS AND CONCLUSION: A total of 61 literatures were primarily obtained. Following reading titles and abstracts, 31 literatures of irrelevant objectives and contents, and 9 literatures of repetitive contents were excluded. Totally 21 literatures were included for analysis. Tendon adhesion refers to hyperplasia and invasion of surrounding tissues during repair of tendon damage. With the deep understanding of tendon repair healing, application of tissue engineering to preventing tendon adhesion became more and more. Tendon healing is an interaction between endogenous healing and exogenous healing, and mainly endogenous healing, which was simultaneously associated with tendon sheath, vincula tendinum and synovial fluid. Tendon adhesion is mainly induced by excessive action of exogenous healing and damage to surrounding tissues. Tissue engineering is a novel technique. Novel biomaterials are widely used in tissue engineering performance to solve problems such as tendon injury andchondronecrosis. Presently, it Is important to reconstruct tissues, which can reach clinical outcomes of preventing adhesion.

Twenty cases of clinically diagnosed dilatation cardiomyopathy (DCM) were examined with the Model XJY-6 ultrasound instrument to determine the anatomical changes of their hearts and the changes of their left ventricular diastolic function (LVDF) . Twenty healthy individuals were also examined as control. The following results were observed.Most patients exhibited dilatation of all the chambers and the increase of the left ventricular weight, however, dilatation was the main manifestation. Cardiac dilatation and hypertrophy present the similar pictures on radiograph or ECG, differentiation of the two conditions can hardly be made with either of the above methods, but must depend on ultrasound especially in cases complicated with left atrial dilatation and fibrillation.The changes of LVDF of DCM patients revealed by ultrasoundfwere the abnormalities of the amplitude and rate of the posterior wall movement and of the dias-tolic filling volume and filling rate of the left ventricle. It was found that the PWE, DPWV, RFF, RER/ESV of the patients were much lower than those of the control (P

Objective:To analyse the behavioral problems of children with chronic tic disorders(CTD).Methods:Children with CTD only and with comorbid attention deficit hyperactivity disorder(ADHD)as well as ADHD and normal controls were assessed by Child Behavior Checklist(CBCL).The rates and scores of behavioral problems between groups were compared.Results:The rate of behavioral problems,total score and most subscales scores in CTD comorbid ADHD group and ADHD group were significantly higher than those of CTD only and control group.There were no significant differences between CTD only and control group except obsessive compulsive problem,hyperactivity behavior,aggressive behavior and total score.Conclusion:The present study suggests that comorbid ADHD was associated with more behavioral problems.

Objective To evaluate the accuracy of air column width difference (ACWD) between inflation and deflation of the cuff of the endotracheal tube (ETT) in predicting post-extubation stridor (PES).Methods A total of 102 intubated patients of both sexes and all ages,who were mechanically ventilated for ≥24 h in the intensive care unit,of American Society of Anesthesiologists physical status Ⅲ or Ⅳ,were enrolled in the study.After the patients were in a stable condition and recovered consciousness and myodynamia,they were weaned from the ventilator,and ultrasound examination of the larynx was performed to determine ACWD between ETT cuff inflation and deflation.PES was assessed using blinding nethod after extubation,and the patients were divided into 2 groups depending on whether or not the patients developed PES:PES group (group P) and non-PES group (group N).Results There were 94 patients in group N and 8 patients in group P.Compared with group N,ACWD was significantly decreased in group P (P＜ 0.05).The cut-off value of ACWD determined by the receiver operating characteristic curve was 1.65 mm,the sensitivity and specificity of ACWD were 0.830 and 0.750,respectively,and the area under the receiver operating characteristic curve was 0.801.Conclusion For the intubated patients who are mechanically ventilated for ≥24 h in an intensive care unit,ACWD between ETT cuff inflation and deflation＜ 1.65 mm can effectively predict PES.

Objective To investigate the effects of early tracheotomy on the prognosis of patients with severe brain lesions .Methods The clinical data of 68 patients with severe brain lesions were retrospectively analyzed . According to the time of tracheotomy ,we assigned 68 patients to receive either early tracheotomy or late tracheotomy . 34 patients who were given tracheotomy within 72 hours in Intensive Care Unit were selected as the early tracheotomy group (ET group).34 patients who were given tracheotomy after 14 days in Intensive Care Unit were selected as the late tracheotomy group(LT group).The time of mechanical ventilation,length of hospital stay,and the incidence of ventilator associated pneumonia ( VAP ) , sedative drug use time , antibiotic use time , in-hospital mortality were compared between the two groups.Results In ET group,the hospitalization time,mechanical ventilation time, incidence of VAP,sedative drug use time,antibiotic use time were (4.2 ±2.4)d,(3.5 ±0.6)d,(14.5 ±3.2)%, (1.5 ±0.5)d,(3.3 ±0.3)d,those in LT group were (12.5 ±4.8)d,(8.5 ±5.6)d,(28.6 ±8.6)%,(6.3 ±1.2)d, (13.2 ±1.1) d respectively,the differences between the two groups were statistically significant ( t =3.14,2.96, 3.28,3.46,2.57,all P<0.05).The hospitalization mortality rates of ET group ,LT group were (23.8 ±4.38)%, (24.5 ±4.16)%,respectively no significant difference between the two groups ( t=1.49,P<0.05).Conclusion The use of early tracheotomy can reduce the hospitalization time ,shorten the time of mechanical ventilation ,reduce the incidence of ventilator associated pneumonia ,and reduce the time of using sedative drugs and antibiotics ,but the mor-tality has no significant effect in the severe craniocerebral injury patients .

Objective To explore the expression of heme oxygenase-1 (HO-1) in gastric mucosa of patient with portal hypertensive gastropathy (PHG),and its role in the pathogenesis of PHG.Methods The specimens were obtained from the gastric mucosa of 22 healthy subjects,20 portal hypertension (PHT) without PHG,and 22 PHG patients.Histological changes of the gastric mucosa were detected,and portal venous flow (PVF) was measured.The expression of HO-1 protein in gastric mucosal specimens was assessed by immunohistochemistry and Western blot analysis,respectively.The relationship between HO-1 expression and PHG severity score,HO-1 expression and PVF,PHG severity score and clinical parameters were investigated.Results HO-1 protein expression in gastric mucosa of PHG and PHT was significantly higher than that of the control (P ＜ 0.05),while there was no significant difference in this variable between PHG and PHT (P ＞ 0.05).The positive correlation was detected between HO-1 expression and PHG severity score in PHG patients (r =0.459,P ＜0.05),however,PHG severity score was irrelevant to severity of esophageal varice (r =0.059,P ＞ 0.05) or to Child-Pugh classification (r =-0.001,P ＞ 0.05).Of all the patients with PHT and PHG,no significant correlation was found between HO-1 expression and PVF (r =0.071,P ＞ 0.05).Conclusion HO-1 protein is up-regulated in gastric mucosa of PHG patients,which may contribute to gastric circulation disorder of PHG.

Objective To study the effects of constant and intermittent high glucose on the apoptosis of cultured bovine retinal capillary pericytes (BRPs), and to investigate the role of mitochondrial apoptotic pathway in the apoptosis of BRPs. Methods After being cultured under glucose with different concentrations tot 6 days, the change of uhrastructure of BRPs was observed under electronmieroscope, the apoptosis of pericytes was detected by TUNEL method, the mitochondrial inner transmembrane potential (△Ψm) was detected by laser scanning confocal microscopy, the change of cytochrome c (cyt-c) was assayed by spectrophotometer and the expression of apoptotic genes was detected by immunohistochemical method and RT-PCR. Results (1) BRPs showed typical changes of apoptosis in constant and intermittent high glucose concentrations. The apoptosis induced by constant high glucose concentration was more obvious than that by intermittent high glucose. (2) Constant and intermittent high glucose concentrations obviously decreased △Ψm compared with control group. The △Ψm of BRPs was correlated negatively with the apoptotie rate of BRPs (r = - 0.89, P < 0.01) ; (3) Constant and intermittent high glucose concentrations increased the release of cyt-c from mitochondria to cytoplasm, and the concentration of cyt-c in the cytoplasm was correlated positively with the apoptotic rate of BRPs (P < 0.01) ; (4) Constant and intermittent high glucose concentrations increased the expression of proapoptotie gene Bax and decreased the expression of prosurvival gene Bcl-2, resulting in increased Bax/Bcl-2 ratio. Bax/Bcl-2 ratio was negative correlatied with the △Ψm of BRPs, and positively eorrclaticd with the concentration of cyt-c in cytoplasm and apoptotic rate (both P < 0.01).Conclusion Constant and intermittent high glucose concentrations could decrease △Ψm, increase the release of cyt-c and induce the apoptosis of BRPs, the effects being stronger with constant high glucose concentration. The mitochondrial apoptotic pathway plays an important role in the apoptosis of BRPs, in which Bax and Bcl-2 are involved.

Objective To investigate the effect and mechanism of murine bone marrow mesenchymal stem cells(BM-MSCs)transplantation on B-cell activating factor(BAFF)expression and B cell activation of MRL/Ipr mice.Methods Eighteen female MRL/Ipr mice were divided into the treatment group and the control group.Five female BAL B/C mice were used as negative controls.At the age of 18 weeks,the treatment group was transplanted with 1×10~6 murine BM-MSCs through vena caudalis,the control group was treated with 0.5ml sodium chloride.Enzyme linked immunoserbent assay(ELISA)was used to measure the level of the BAFF,IFN-γ,IL-2 and IL-10 in the serum.The percentage and numbers of Marginal zone,T1 and T2 B cells in spleen were detected by flow cytometry.Results①Eight weeks after transplantation,the level of BAFF [(32±14)ng/ml]in serum of the treatment group decreased significantly than the control group[(47±13)ng/ml](P＜0.05)as well as the level of serum IL- 10,IFN-γ and IL-2 levels[(19±7)vs(40±13)pg/ml](P＜0.01)[(25±20)pg/ml vs(38±25)pg/ml][(73±10)pg/ml vs(80±15)pg/ml].② Eight weeks after trans-plantation,the mice in the treatment group had lower percentages of marginal zone B cells[(15±4)% vs (21±5)%],and the numbers of marginal zone B cells were significantly decreased in the treatment group as compared with the control group[(9±6)×10~6 vs(19±10)×10~6,P＜0.05].③ Eight weeks after transplantation,the mice in the treatment group had lower percentages of T1 and T2 B cells[(3.4±2.1)% vs(7.3±4.0)%][(2.6+1.4)%vs(4.8±2.7)%],and the numbers of T1[(2.7±1.7)×10~6 vs(5.1±2.0)×10~6,P＜0.05]and T2 B cells[(2.0±1.2)×10~6 vs(3.7±1.7)×10~6,P＜0.05]were both significantly decreased in the treatment group as compared with the control group.Conclusion BM-MSCs transplantation decreases the expression of BAFF in association with the diminished production of the pathogenic cytokines IFN-γ and IL-10.Inhibition of BAFF also results in decreased numbers of T1 and T2 B cells and MZ B cells.