Objective To analyze the distribution and drug resistance of the isolated strains of K lebsiella pneumonia .Methods The strains of K lebsiella pneumonia were isolated from specimens from clinical departments ,and the drug resistance was tested . The results were analyzed .Results There were 415 strains of K lebsiella pneumonia were isolated .The isolated strains distributed mainly in Department of Neurosurgery (36 .1% ) ,Department of Respiratory Medicine (27 .7% ) ,and ICU (16 .9% ) .74 .7% of the strains were isolated from sputum specimens .30 .0% of the isolated strains were ESBLs positive .The drug resistance rates of K leb‐siella pneumonia to meropenem and imipenem were both low to 0 .5% .Conclusion Monitoring the drug resistance of K lebsiella pneumonia is very important to guide the treatment .

Objective:To investigate the expression of multidrug resistance (MDR1) gene and multidrug resistance-associated pro-tein (MRP) gene in patients with non-small-cell lung cancer (NSCLC) and its relation to histopathological type. Methods:The MDRi and MRP genes were determined by reverse transcription-polymerase chain reaction (RT-PCR) in 48 NSCLCspecimens. Results:The positive rates of the MDR1 and MRP gene expression were 62.5％ and 66.7％ respectively in the48 patients. Twenty-one of the 48 NSCLCs (43.8％) expressed both MDR1 and MRP genes. The positive rates of the MRPgene expression in squamous cell carcinoma was significantly higher than those in adenocarcinoma (P＜0.01), and therewas no significant difference in MDR1 gene expression between the two groups (P＞0.05). Conclusion: The MDR1 andMRP gene expressions were both or respectively in the NSCLCs. The incidence of the MRP gene expression in squamous cellcarcinoma was higher than that in adenocarcinoma.

Objective: To study the clinical effect of nursing after laparoscopic myomectomy after nursing intervention. Methods: Retrospective analysis of our hospital from 2009 May to 2012 October in our department, laparoscopic myomectomy in the treatment of 148 cases of uterine fibroids patients clinical data, were randomly divided into 2 groups, 74 cases in each group, the control group routine nursing care to patients, nursing intervention on the patients with study group, The quality of life of patients with depression and anxiety scores were compared between the two groups before and after the rate and nursing of exhaust and ambulation time, hospitalization time, complications. Results: Research group of exhaust, ambulation, time of hospitalization, the incidence of complications compared with the control group, showed significant difference; the study group before operation and nursing of patients with anxiety and depression and quality of life scores compared with the control group, there was no significant difference, nursing intervention, there were significant differences. Conclusion: Laparoscopic myomectomy nursing intervention, can promote the rehabilitation, and improve the living condition, patients with significant effect, should be popularized.

Objective To establish a new method to identify and analyze Qingdai Powder and its composition.Methods X-ray Diffraction with Fourier pattern was used.Results The standard X-ray diffraction with Fourier pattern and characteristic diffraction peaks of Qingdai Powder and its composition drugs were obtained.Conclusion The powder X-ray diffraction method can be used as a simple and convenient method for the identification of Qingdai Powder and its composition drugs.

Objective:To study the influence of the DCs from mononuclear cells in axillary draining lymph nodes of patients with breast cancer to the cytotoxicity of the antigenic specific CTLs stimulated by freeze-thrawing antigen from breast cancer cells in vitro.Methods:The mononuclear cells were isolated from axillary draining lymph nodes,and were cultured with cytokines to induce DCs and tumor draining lymph node cells(TDLNCs) respectively.DCs stimulated by the auto-breast cancer freeze-thrawing antigen(DCs-Ag).TDLNCs were co-cultured with DCs-Ag to derive tumor antigenic specific CTLs(DC-Ag-TDLNC).Then the cytotoxicty of specific CTLs to auto-breast cancer cells and MCF-7 cells was detected.Results:The cytotoxicity of DC-Ag-TDLNC,DC-TDLNC and TDLNC to the auto-breast cancer cells was 67.64%、31.25% and 26.36% respectively,P0.05.Conclusion:Typical DCs can be induced from the mononuclear cells from axillary draining lymph nodes after stimulated with cytokines(rhGM-CSF,rhIL-4 and TNF-?).The DCs possess stronger antigen presentation and can obviously increase the killing activity of tumor antigen specific CTLs to auto-breast cancer cells.

[Objective]To investigate the effect and complications of treating radial neck fractures in children with elastic stable intramedullary nail(ESIN).[Method]A retrospective study was applied in 35 children(5~13 years) with displaced radial neck fractures,that were corrected with ESIN in our hospital from 2005 to 2008.[Result]All cases were successfully followed up,with an average time of 7.5 months.Ninteen cases were evaluated as excellent,6 cases were good,the excellent and good rate was 68%.Avascular necrosis was found in 9 cases,including 4 cases of radial head bulk formation,1 case showed ossification and delayed union was proved in 2 cases.[Conclusion]Treating the radial neck fracture with ESIN is a simple and minimally invasive method,the overall effect is good while the complications are limited.

[Objective]To evaluate the role of Southwick angle and Klein line in the diagnosis of slipped capital femoral epiphysis (SCFE). [Methods]Forty-two cases of SCFE were treated by Russell traction and screw or pins fixation in situ from 1995 to 2006. The hip anteroposterior and frog-lateral radiographs were reviewed to measure the occurrence of metaphyseal change,the Southwick angle and the Klein line.[Results]The metaphyseal changes occurred in all cases. The Southwick angles were reduced with the severity of SCFE. The positive ratio of Klein line was higher in the lateral radiographs,but lower in the anteroposterior radiographys.[Conclusion]The Southwick angle and Klein line play an important role in the diagnosis of SCFE. The lateral radiography should be emphasized in the diagnosis of SCFE.

ObjectivesTo evaluate the therapeutic result of various management for severe radiation injury of the bowels.MethodsThe clinical presentation, diagnostic approach, managements and therapeutic effects were analysed retrospectively in 28 severe radiation therapy caused enteric injury patients. In all intestinal stricture cases, partial ileal resection was performed in 14 patients, right hemicolectomy in 1 patient, rectosigmoid resection in 3 patients. Instestinal fistulae was treated by diseased segment resection and reanastomosis in 7 patients, sigmoidostomy was undertaken in 2 patients.ResultsThere was no inhospital mortality. One case suffered from low colonic fistula,4 died of recurrence of the primary tumor.Postoperative bowel function and nutrition status significantly improved in all patients.ConclusionSurgical management combined with nutrition support is safe and effective for the treatment of severe radiation caused enteric injury.

Objective To study the early diagnosis of cutaneous T-cell lymphoma(CTCL).Methods DNA from39formalin-fixed,paraffin-embedded tissues of24cases of CTCL,2cases of dubious lymphoma,and4cases with non-specific erythroderma,was amplified by polymerase chain reaction(PCR),with special primers of TCR V?1-8,V?9,and J?1/?2to analyze T-Cell receptor?gene clonal rearrangement(TCR-GR clonal).The specimens from30patients with non-specific dermatitis were taken as negative control.Results Clonal of TCR V?1-8was demonstrated in38of39paraffin-embedded specimens.V?9-GR was shown in37of39specimens TCR?-GR was shown especially in13patients with MF of early stage,2patients with dubious CTCL,and4patients with non-specific erythroderma,as well as in6of30patients with histiologically nonspecific dermatitis which suggested that these6cases were"clonal dermatitis".Conclusion Clonal TCR?-GR may be detected in patients with early CTCL,even when the histologic findings are not unequivocally diagnostic.

Objective: To evaluate the relationship between the change of left ventricular mass and arterial stiffness in the aged patients with diabetes mellitus. Methods: The pulse wave velocity (PWV) and left ventricular mass index(LVMI)were used to estimate the left ventricular mass and arterial stiffness. The relationship between LVMI and PWV and other influencing factors were evaluated with univariate analysis and stepwise regressive analysis in 105 patients with diabetes mellitus. The value of PWV was compared in the subjects of the left ventricular hypertrophy and the non- left ventricular hypertrophy groups. Results: LVMI was positively correlated with PWV, systolic blood pressure, pulse pressure,medical history and body mass index (the values of r were 0.821, 0.792, 0.799, 0.664 and 0.241 respectively,P ＜ 0.01 or P ＜ 0.05). A stepwise regression analysis was used to assess the combined influence of variables on left ventricular hypertrophy. The model included the following variables: PWV, systolic blood pressure and diabetes mellitus medical history. PWV value was significantly higher in patients with left ventricular hypertrophy than that of the patients without left ventricular hypertrophy(t = 9.109,P < 0.01). Conclusion: The increased arterial stiffness is one of the important factors which lead to the increased left ventricular mass index in aged patients with diabetes mellitus.