Camptothecin/*pharmacology ; Liver Neoplasms, Experimental/*immunology ; Neoplasm Transplantation ; Sarcoma, Experimental/*immunology ; Transplantation, Isogeneic

OBJECTIVE To analyze the drug-resistance of Escherichia coli isolated from clinic in the past two years. METHODS The drug-resistance to 19 kinds of antimicrobial agents of 435 E. coli strains was detected by K-B method. 3-D test was performed to detect AmpC ?-lactamase and Extended-spectrum ?-lactamases(ESBLs). RESULTS It showed that the strains from cervical secretions, urine, throat swab and lochia specimens had the highest positive rate. Sensitivity test results showed that the resistance rate to ampicillin, aztreonam, sulfamethoxazole/trimethoprims and quinolones was high (49.23-84.10%), and resistance rate to the third, and fourth-generation cephalosporins was high too(31.35-46.80%). Strains that resistant to imipenem and meropenem were not detected out and they had a high sensitivity rate (93.38%), to cefoperazone/sulbactam. Detection rate of ESBLs and AmpC was 32.67% and 5.52%, respectively. Nineteen srtains produced both of them and 6 srtains produced AmpC only. CONCLUSIONS The detection rate and drug resistance are increasingly severe. Clinic and laboratory should make efforts to reduce hospital infection and dissemination of drug-resistant strains.

Objective:To explore diagnostic value of 6min walking test (6MWT) for coronary heart disease (CHD) . Methods :A total of 192 patients suspected of CHD ,including 123 men and 69 women ,who were treated in our hos‐pital ,were selected .After hospitalization ,all patients received 6MWT and coronary angiography (CAG) examina‐tion .With CAG results as the gold standard for diagnosing CHD ,sensitivity ,specificity ,accuracy ,positive predic‐tive value and negative predictive value of 6MWT diagnosing CHD were calculated ,and they were compared be‐tween men and women .Detections of 6WMT among groups of different diseased number of vessels were compared . Results :With CAG results as the standard ,accuracy ,specificity ,sensitivity ,positive predictive value and negative predictive value of 6MWT diagnosing CHD were 71.35% ,80.58% ,60.67% ,72.97% and 70.34% respectively . Compared with female patients ,there were significant rise in accuracy (57.97% vs .77.24% ) ,sensitivity (39.29%vs .70.49% ) ,specificity (70.73% vs .83.87% ) and positive predictive value (47.83% vs .81.13% ) , P<0.05 or<0.01 ,and significant reductions in false positive rate (29.27% vs .16.13% ) and false negative rate (60.71% vs . 29.51% ) in male patients (P<0.05 or <0.01) ,there was no significant difference in negative predictive value be‐tween two groups (P>0.05) .Compared with single - and double -vessel coronary disease ,there was significant rise in true positive rate (43.75% ,54.05% vs .100% ) of triple - or multi -vessel coronary disease diagnosed by 6MWT , P< 0.01 both . Conclusion:The 6min walking test possesses high specificity and sensitivity diagnosing CHD ,and its diagnostic value is higher for male patients and patients with serious condition .Its procedures are sim‐ple with low cost and no damage to patients ,which can be used as adjunctive examination for CHD diagnosis and ex‐tended in clinic .

Objective To evaluate the feasibility and the safety of thulium laser vaporization enucleation of prostate(TVEP) combined with traditional transurethral resection of prostate (TURP) for therapy benign prostate hyperplasia (BPH) with its volume larger than 80 millilitres.Methods Twenty-five BPH patients (volume larger than 80 millilitres) underwent TVEP combined with TURP.The operation time,intraoperative blood loss,enucleation time,cutting time,bladder irrigating time,catheterization time,perioperative and 6 months' follow-up data such as the international prostate symptom score,quality of life score,the maximum urinary flow rate,the residual urine volume and so on were observed.Results The operation time was (66 ± 26) min.The enucleation time was (25 ± 9) min.The cutting time was (32 ± 8) min.The intraoperative blood loss was (140 ± 25) ml.The bladder irrigation time was (3.0 ± 1.0) d.The catheterization time was (5.7 ± 1.0) d.After 6 months,the maximum urinary flow rate,residual urine volume,international prostate symptom score and quality of life score were improved:(18.7 ± 1.7) ml/s vs.(6.8 ± 1.7) ml/s,(18.9 ± 1.8) ml vs.(65.7 ±8.1) m1,(8.7 ± 1.6) scores vs.(25.7 ±4.3) scores,(1.7 ± 1.2) scores vs.(4.7 ± 1.1) scores,and there were significant differences (P ＜ 0.05).Urethral stricture developed in 2 patients and epididymitis happened in 3 patients.No blood transfusion events and transurethral electric cutting syndrome occurred.Conclusion TVEP combined with TURP for therapy BPH larger than 80 millilitres is safe,and the incidence of complications is low.

OBJECTIVE To understand the pathogen distribution of infant infectious bacterial conjunctivitis and keratitis,and drug resistance to provide guidence on clinical treatment.METHODS The routine bacterial culture of eye secretions in the 331 cases was identified with K-B to determine the resistance of pathogenic bacteria.RESULTS A total of 124 strains were isolated with positive rate of 37.46%,there were Haemophilus parainfluenzae,Staphylococcus aureus,H.influenzae,S.epidermidis,fungi,etc.The resistance of S.aureus,S.epidermidis and S.pneumoniae to penicillin were 86.36%,88.89% and 0,respectively.The resistance rate of H.parainfluenzae,H.influenzae,Escherichia coli,Klebsiella pneumoniae and Pseudomonas aeruginosa to ampicillin were 12.50%,27.78%,87.50%,100.00% and 100.00%;that to cefazolin were 16.67%,16.67%,62.50%,14.29% and 100.00%;and to cotrimoxazole were 50.00%,27.78%,12.50%,14.29% and 100.00%.CONCLUSIONS The H.parainfluenzae,S.aureus,H.influenzaeand S.epidermidis are isolated from the newborn eye secretions;they were lower resistant to ofloxacin and ciprofloxacin.

OBJECTIVE To understand the clinical distribution and drug resistance of Enterococcus to provide evidence for the rational use of antibiotics. METHODS The Enterococcus isolated form clinic from Jan 2006 to Dec 2007 and the sensitivity to 13 kinds of antibiotics were tested by K-B method. RESULTS All of 122 strains of Enterococcus were isolated which included 76 strains of E.faecalis(62.3%),29 strains of E.faecium(23.8%) and 17 strains of other enterococcus(13.9%).Most enterococcus were detected from vaginal secretion,urine,drainage fluid,cervical secretion and throat swab.Drug sensitivity test showed that the sensitivity to vancomycin and teicoplanin was high while the resistance to rifampicin,erythromycin,tetracycline and ciprofloxacin was the highest,and the total resistance rate of E.faecium was higher than E.faecalis. CONCLUSIONS The detection rate and resistance rate of Enterococcus present a rising trend,which should be paid for more attention by clinic.Bateria cultivation is necessary for suspected enterococcus infection and the drugs selected according to sensitivity result to improve the curative effect.

Objective To observe the clinical efficacy of Tiaoxinyin treatment for diabetic cardiac autonomic neuropathy (DCAN);To evaluate its efficacy and safety.Methods One hundred patients of DCAN were randomly divided into experimental group (51 cases) and control group (49 cases). Both groups were given basic treatment of diet control and Metformin hydrochloride tablets orally taking. Patients in the experimental group were given Tiaoxinyin, while patients in the control group were treated with Mecobalamin tablets for 8 weeks. Changes and untoward effects in blood glucose, blood fat and heart rate variability were observed before and after treatment so as to compare the efficacy of two groups.Results The total effective rate of the experimental group was 82.35% (42/51) and the control group was 63.27% (31/49), with statistical significance between the two groups (P<0.01). The TCM scores of the two groups decreased after treatment, with statistical significance compared with those before treatment (P<0.01). The difference in TCM scores between the two groups was significance (P<0.05). The level of FBG and 2 h PG in the two groups declined (P<0.05). Heart rate variability had statistical significance compared with that before treatment (P<0.05), with statistical significance between the two groups (P<0.05). No obvious adverse reaction was found.Conclusion Tiaoxinyin is effective and safe in treating DCAN and can improve the heart rate variability indicators in patients.

BACKGROUND:Previously, serious thoracolumbar burst fractures with spinal cord injury were mainly treated by anterior surgery. The superiority of conventional posterior repair lies in strong reduction and fixation effects. However, it is difficult to fuly decompression. The anterior and central cylinders of the injured vertebra cannot receive good reconstruction. Loss of correction and internal fixation failure always appear. It remains controversial which repair method is more ideal. OBJECTIVE:To comparatively analyze the effect of posterior and anterior approaches with subtotal vertebrectomy, decompression, reconstruction of spine, and internal fixation for patients with thoracolumbar burst fractures. METHODS: The data of 42 patients with thoracolumbar burst fracture treated by anterior and posterior approaches with subtotal vertebrectomy, decompression, and reconstruction of spine from May 2006 to December 2012 was retrospectively analyzed. They were divided into two groups according to the surgical procedures: anterior approach group (n=23) and posterior approach group (n=19). They were folowed up for at least 24 months. Repair results and imaging results were compared in patients of both groups. RESULTS AND CONCLUSION:None patients in the two groups affected fixator loosing or breakage, and obtained good bone fusion. The intraoperative blood loss was more and operative time was longer in the anterior approach group than in the posterior approach group, showing significant difference (P < 0.05). The pulmonary function was significantly better in the posterior approach group than in the anterior approach group (P < 0.05). Visual Analog Scale score, Japanese Orthopaedic Association score for back pain and Frankel classification were significantly improved during final folow-up compared with pre-treatment in both groups, but no significant difference was found between groups (P > 0.05). No significant difference in the anterior vertebral height and kyphosis Cobb angle was detected before treatment, at 1 week after treatment and during final folow-up (P > 0.05). The incidence of postoperative complications was significantly higher in the anterior approach group than in the posterior approach group (P < 0.05). These findings confirm that subtotal vertebrectomy through anterior approach and posterior approach can effectively repair thoracolumbar burst fractures. However, the complications of posterior approach are less, and posterior approach has few impacts on the pulmonary function, is safe, and has good biocompatibility with the host.

Objective To evaluate the procedure of surgical treatment of intrahepatic biliary calculi with blood vessel variation in hepatic hilus. Method The clinical data of 57 patients with intrahepatic biliary calculi and blood vessel variation in hepatic hilus treated by biliary operation were retrospectively analyzed.Results The simply biliary operation was performed on 13 cases ; variant blood vessels were cut off and ligated in 14 cases;The bile duct and blood vessel across conversion operation were performed on 22 cases;and the intrahepatic cholangiojejunostomy was carried out in 8 cases. There were no severe postoperative complications and perioperative mortality.51 patients(89.6%) were followed up for 4 to 15 years with the exellent results in 43(84.3%)cases. There were residual stones in 7 cases,of them,5 patients had intermittent abdominal pain in the right upper quadrant; reoperation was performed on another 2 cases because of recurrent cholangitis. One died of variceal bleeding 1.5 years after operation. Conclusions In order to accomplish the complex operations of biliary tract and avoid ischemic damage of liver, proper operation should be chosen for patients with intrahepatic biliary calculi with blood vessel variation in hepatic hilus.

Objective The aims of this study were to assess the efficacy of video-assisted thoracoscopic extended thymectomy(VATET) as a treatment for non-thymomatous myasthenia gravis (NTMG) and to identify prognostic factors for thymectomy.Methods Retrospectively analyzed clinical datas of 112 patients received VATET for the treatment of NTMG.Clinical efficacy and variables influencing outcome were evaluated by Kaplan-Meier method and Cox proportional hazards regression analysis.Results At 3.2 years averaged (1.5-6.2 years) of follow-up,none of these patients were lost to follow up.According to the MGFA post-intervention status,54 patients(48.2％) obtained complete stable remission during follow-up,21 patients(18.8％) obtained pharmacologic remission,10 patients (8.9％) obtained minimal manifestations,7 patients (6.3％) improved,20 patients(17.8％) unchanged,and none of these patients were worse or died of MG.By multivariate analysis,the chance of complete stable remission was significantly increased when age ＜ 40 years (P ＜ 0.01,OR =3.468),symptom duration ＜ 12 months(P ＜ 0.01,OR =3.203) and the presence of thymic hyperplasia (P ＜ 0.01,OR =3.064).Conclusion Video-assisted thoracoscopic extended thymectomy achieved satisfactory long-term results in patients with nonthymomatous myasthenia gravis,while age,symptom duration,the presence of thymic hyperplasia correlated with response to operation.