Objective We aimed to study the optimal method for local compression following removal of needle after intravenous injection and protect patients' vein to the highest degree. Methods 620 patients were divided into the observation group and the control group with 310 cases in each group randomly. Comparison study was carried out by adopting interchange compression (routine method) and noninterchange compression (direct pressing with hypothenar). Results The incidence of pain, bleeding and subcutaneous stasis after removal of needle in the observation group was lower than those in the control group (P<0.01). Conclusions Local compression following removal of needle with hypothenar was superior to routine compression method and it was worth applying in clinics widely.

Objective To evaluate segmental resection of involved portal vein (PV) in the surgical treatment of advanced pancreatic carcinoma (PC). MethodsIn our 22 advanced PC patients involving PV and/or superior mesenteric vein (SMV) extended pancreaticoduodenectomy or distal pancreatectomy plus extensive regional lymph node clearance were performed and cancer involved PV and/or SMV segment were resected enbloc. Results Among 22 cases, 6 underwent wedge resection and repairment of PV or SMV. Eight underwent segmental resection of PV or SMV followed by end-to-end anastomosis in 5,autotransplantation of great saphenous vein in 2, mesocaval shunt in one. The mean operation time was 7 5?h, the average blood transfusion was 600?ml, and there was no mortality in all cases. All 22 patients were followed up with a postoperative survival of 6 mos in one, 12 mos in 3, 18 mos in 6 cases, 24 mos in 8 and 36 mos in 4 cases. ConclusionsIt is rationale to resect the advanced PC en bloc with the cancer involved segment of PV and/or SMV in terms of low morbidity and long postoperative survival.

Objective To examine the distribution and antibiotic resistance of the Acinetobacter baumannii strains isolated from Department of Neurology.Methods A retrospective review was conducted for the 269 strains of A.baumannii isolated during the period from January 2009 to March 2014.VITEK 2 Compact system was used for bacteria identification and antimicrobial susceptibility testing.The data were analyzed with WHONET 5.6 software and compared by Chi-square test.Results The prevalence of A.baumannii was higher in Department of Neurology than in Department of Neurosurgery or Neurology ICU. Majority (97.4%)of the A.baumannii strains were isolated from sputum.About 54.3% of the A.baumannii isolates were resistant to imipenem.Relatively lower percentage of the A.baumannii isolates were resistant to amikacin (20.7%),but as high as 54.3% and 55.0% of the strains were resistant to imipenem and piperacillin-tazobactam.More imipenem-non-resistant A.baumannii strains (89.4%)were resistant to trimethoprim-sulfamethoxazole than imipenem-resistant A.baumannii (72.6%)(P < 0.05). However,to the other antimicrobial agents tested,imipenem-resistant A.baumannii strains showed significantly higher resistance rate than imipenem-non-resistant A.baumannii strains (P< 0.05).Conclusions The prevalence of A.baumannii and imipenem-resistant A.baumannii is high in Department of Neurology.Further monitoring of antibiotic resistance and rational use of antimicrobial agents are helpful to effectively control the epidemic of multidrug-resistant A.baumannii.

ObjectiveTo investigate the effect of intrathecal (IT) Ro25-6981 (a selective NR2B receptor antagonist) on focal cerebral ischemia-reperfusion (I/R) injury in rats.MethodsSixty healthy male SD rats weighing 280-320 g in which IT catheter was successfully implanted without complication were randomly divided into 4 groups ( n ＝ 15 each):group sham operation (group S) ; group focal cerebral I/R(group I/R) ; group I/R + Ro25-6981 (group Ro) and group I/R+ normal saline (group NS).The right middle cerebral artery was occluded for 2 h with a nylon thread with rounded tip which was inserted into right internal carotid artery and advanced cranially until resistance was met in groups I/R,Ro and NS.In group Ro Ro25-6981 100 μg/10 μl was injected IT at 0,2,23 h of reperfusion,while in group NS NS was injected IT instead of Ro25-6981.Neurological dificit was assessed and scored (0 ＝ no deficit,3 ＝ severe deficit) at 24 h of reperfusion.The infarct size was determined by 2,3,5-triphenyl tetrazolium chloride staining.ResultsIT administration of Ro25-6981 significantly reduced cerebral I/R-induced infarct sized and neurological deficit score in group Ro as compared with groups I/R and NS.ConclusionRo25-6981 injected IT can protect the brain against local cerebral I/R injury.

Objective To evaluate the distribution of neuropeptide Y and its receptors in the cardinal ligament and uterosaeral ligaments in women with and without pelvic organ prolapse(POP).Methods Sixteen patients with pelvic organ prolapse entered the study.All patients were evaluated by pelvic organ prolapse quantitation(POP-Q).Group A consisted of six patients with grade Ⅰ,Ⅱ POP,and group B comprised ten patients with grade Ⅲ,Ⅳ POP.Eight nonfunctional ovarian tumor patients without POP were recruited as control subjects.Biopsies of cardinal ligament and uterosacral ligament were obtained from each woman during surgery.Immunohistochemical study with polyclonal antibody against a general nerve marker S-100 and neuropeptide Y was performed on paraffin-embedded sections of all the samples.In addition,mRNA levels of the human NPY-Y1 and NPY-Y2 receptors were assessed in both patients and controls.Results (1)NPY immunoreactivities were identified in both cardinal ligament and uterosacral ligament. NPY immunoreactive nerve fibers were insignificantly lower in POP patients(P＞0.05).The distribution pattern of NPY was similar in cardinal ligament and uterosacral ligament ( P＞0. 05 ). (2)mRNAs encoding the NPY-Y1 and NPY-Y2 receptors were detected in the pelvic supporting tissues. Besides the expected NPY-Y1 PCR products, an additional 97 bp long amplicon originating from an alternative splicing event was found in most tissues studied. (3)In cardinal ligaments, mRNA encoding NPY-Y1 receptor had a significant difference between group A(3.9±1.0)and B (6. 0±1.5), and between control (3.4±0.9) and group B (P = 0. 019,P = 0. 004), while there was no significant difference between group A and controls(P =0. 082). In uteresacral ligaments, mRNA encoding NPY-Y1 receptor had no significant difference between Group A(6. 0±1.1) and B (6. 3±0. 7), or between group A and controls(4. 8±0. 7;P = 0. 151 ,P = 0. 690);while there was a significant difference between group B and controls (P = 0. 016).(4) mRNA encoding NPY-Y2 receptor had no significant difference between controls (0. 49±0. 34, 0. 61±0. 15 ), group A (0. 56±0. 21,0. 67±0. 13) and group B (0. 85±0. 43, 0. 69±0. 21 ) patients in cardinal ligament and uterosacral ligaments ( P＞0. 05 ). (5) mRNA encoding NPY-Y1 ( P = 0. 084 ) and NPY-Y2 (P=0.470) receptors had no significant difference between cardinal ligament and uterosacral ligament.Conclusions There are NPY and NPY receptors in cardinal and uterosacral ligaments. The increased expression of NPY Y1 receptor may be related to local blood flow reduction and structural changes of pelvic supporting tissue.

AIM:ToinvestigatetheroleofMALAT1incolorectalcancermetastasis.METHODS:ThemRNA expression levels of MALAT1 and Rac1b in the tumor and adjacent normal tissues were examined by real-time PCR. MALAT1 was knocked down by siRNA in colorectal cancer cell lines .The expression of Rac1b and the epithelial-mesen-chymal transition markers was examined by Western blot .Cell proliferation was determined by EdU analysis .The effects of MALAT1 on the cell migration and invasion were examined by Transwell assay .RESULTS: The expression of MALAT1 was down-regulated in colorectal cancer .Down-regulation of MALAT1 induced Rac1b overexpression, which in turn in-creased the expression levels of E-cadherin and β-catenin.Furthermore, down-regulation of MALAT1 promoted the cell proliferation, invasion and migration.CONCLUSION:MALAT1 is associated with metastasis of colorectal cancer through regulating the expression of Rac1b and the downstream factors.

Objective To investigate the drug resistance of patients samples in terms of pathogenic bacteria in order to provide the basis for clinical diagnosis,treatment of blood infection.Methods Six hundred and seventy-one bacteria strains out of 5042 blood samples of hospitalized patients were used to analyze its characters and drug resistance from January 2009 to December 2012 in the people's hospital of inner mongolia autonomous region.BacT AIERT 3D automatic rapid microbial detection system was applied to perform blood culture.The bacteria identification and drug sensitivity test (MIC method) were detected by using VITEK 2Compact automatic bacteria identification instrument.Results Bacteria positive rate was 13.3％ (671/5042),of which the gram negative bacilli accounted for 49.9％ (335/671),and gram positive for 40.8％ (274/671).The top 5 bacteria strains of blood samples were escherichia coli,staphylococcus,staphylococcus aureus,klebsiella pneumoniae and staphylococcus aureus.The pathogenic bacteria rates of blood samples were 30.5％(29/95),44.4％ (55/124) and 52.5％ (94/179) respectively during 2009-2012.The main source of blood bacteria renal were department of internal medicine ward (12.1％,81/671),department of general surgery (11.6％,78/671),and ICU ward (10.6％,71/671).The detected bacteria rate in department of general surgery separation rate increased to the first in 2012 from fifth in 2009.However the detected bacteria rate in department of internal medicine was down to the tenth in 2012 from the third in 2009.The drug resistance rate of imipenem,piperacillin/tazobactam,cefotaxime,ceftazidime resistant cefotetan on escherichia coli and klebsiella pneumoniae were all less than 9.7％,and the rate of linezolid,vancomycin,teicoplanin,quinupristin/dafoe leptin and nitrofurantoin resistance of staphylococcus aureus,staphylococcus bacteria and gold staphylococcus aureus were all less than 2.3％.Conclusion The distribution,sources and drug resistance of pathogenic bacteria had been changed recently.Therefore the laboratory shall strengthen the monitoring of drug resistance of bacteria in the bloodstream infection in order to guide clinical rational application of antibiotics.

Objective:To establish the quality standard for Tongduhuoxue Tablets.Methods: Radix Salvia miltiorrhiza and Rhizoma Corydalis in this prescription were identified by TLC. Tanshinone Ⅱ A was determined by HPLC and astragaloside was determined by dual wavelength TLC Scanning.Results:Radix Salvia miltiorrhiza and Rhizoma Corydalis could be detected by TLC. Determination method of tanshinone Ⅱ A and astragaloside was linear at the range of 0.04 ～ 0.8 ?g( r= 0.99998 ,n=7 ) and 0.3 ～ 6.0 ?g( r= 0.9991 ,n=7 ),average recovery was 98.6% ( RSD= 1.1% ,n=5 ) and 97.7% ( RSD= 1.8% ,n=5 ),respectively. Conclusions: The established method is accurate and reproducible. This study provides a method for the quality control of Tongduhuoxue Tablets.

Objective To explore the value of multislice spiral computed tomography ( MSCT ) in predicting the resectability of pancreatic cancer ( PC) .Methods The MSCT images of 102 PC patients ( 62 men, mean age, 61 ±9 years;40 women, mean age, 60 ±9 years) confirmed by postoperative pathology were analyzed retrospectively .The images were analyzed and evaluated by 2 senior radiologists who were double blinded.The relationship between tumor and vessels was investigated based on consensus statement on the radiological diagnosis of PC of the Society of Abdominal Radiology and the American Pancreatic Association in 2014 .The diagnostic criterion on the resectability of PC was based on the 2015 NCCN Clinical Practice Guidelines on PC . Image analysis included the lesion location , size and density , the characteristics of pancreatic and bile ducts , relationship of tumor and adjacent vessels , the extrapancreatic findings as well as T staging and resectability.Results The locations of PC were found in the pancreatic head (n=71,69.6%), body (n=23, 22.5%) and tail (n=8, 7.8%).The long-and short-axis diameter were (28.9 ±8.8)mm and (23.8 ±8.0)mm in head, and respectively, (31.2 ±11.0)mm and (23.8 ±6.3)mm in body and tail, respectively.The imaging findings included hypo-(n=98, 96.1%) and iso-density masses (n=4, 3.9%) on pancreatic phase, intra-and extrahepatic bile duct dilation (n=63, 61.8%), main pancreatic duct cut-off with dilation (n=46, 45.1%), the pseudocyst (n=4), acute pancreatitis (n=1) and chronic pancreatitis (n=2).T staging evaluation by MSCT observed T1 (n=3), T2 (n=7), T3 (n=78) and T4 (n=14), respectively.MSCT assessment for T staging was correct in 98 (96.1%), but wrong in 4 (3.9%), which was quite consistent with pathological T staging (K=0.88, P<0.05).MSCT assessment for the resectability was correct in 98 (96.1%), but wrong in 4 (3.9%).Sensitivity, specificity, positive and negative predictive values, and area under curve of MSCT in the assessment of the resectability were 96.8%, 87.5%, 98.9%, 70.0%and 92.2%, respectively.Conclusions MSCT could improve the diagnostic accuracy for T Staging and resectability of PC .

Objective To sum up the measures for nursing the patients with laparoscopic gastrectomy-induced anastomotic leakage treated by open center vacuum aspiration. Method We retrospectively reviewed the histories of 22 patients with laparoscopic gastrectomy-induced anastomotic leakage to look into the nursing measures to look into the management of open vacuum aspiration , observation of the drainage, leakage care, mental care. Results The time for open center vacuum aspiration was between 10 to 17 days, averaged (15.63 ± 3.22)d. The hospital stay was between 13 to 23 days, averaged (17.21 ± 5.47)d. No complications were observed. Conclusions The nursing measures for managing the anastomotic leakage can be effective in improving the effect of peritoneal irrigation. The mental care can be effective for the reduction of patients′pains so as to promote the heal of the leakages.