Objective To investigate the influence of age on the perioperative characteristics of posterior lumbar interbody fusion (PLIF). Methods 129 patients (25~91 years old) with spondylolisthesis, lumbar stenosis and/or disc degeneration/herniation with instability,or unsuccessful results after a failed previous PLIF. They were divided into control group (<65 years old, n=85) and experimental group (<65 years old, n=44). The American Society of Anesthesiologists (ASA) score, the number of fusion segments, estimated blood loss and hospital stay were observed. Results The ASA score was higher in the experimental group than in the control group (P<0.001). There was no significant difference in complications, estimated blood loss and operative time (P>0.05) between 2 groups. Conclusion Age can not increase the rate of perioperative complications of PLIF, and the advanced age should not be surgical contraindication.

Objective To provide evidence for the rational use of antibiotics.Methods Analyze on the results of pathogen detec-tion and antibiotic susceptibility tests for the patients in the hospital from January 2013 to December 2013.Results There were 2 111 strains of pathogenic bacteria detected in 2013,among which the Gram-negative bacteria accounted for 75.5%(1 594/2 111). The main species were Klebsiella pneumonia,Escherichia coli,Acinetobacter baumannii,Enterobacter cloacae,Pseudomonas aerugi-nosa,Klebsiella oxytoca.Gram-positive bacteria accounted for for 20.3%(428/2 111),the main species of which were Streptococcus pneumonia,Staphylococcus aureus,Staphylococcus aureus and Enterococcus faecalis.There were 89 strains of fungi,which accoun-ted for 4.2%(89/2 111).The antibiotic susceptibility tests showed that Klebsiella pneumoniae′s drug resistance to 13 kinds of anti-biotics were all less than 25.00%.Escherichia coli,Acinetobacter baumannii,Pseudomonas aeruginosa displayed highly resistance to cephalosporin antibiotics while sensitive to Cefperazone-Sulbactam.The antibiotic resistance of Gram-positive bacteria to macrolide were greater than 70% while that to Vancomycin was 0.0%.Staphylococcus aureus and Staphylococcus epidermidis were highly re-sistant to penicillin.Conclusion The monitoring of bacterial resistance in hospital contributes to the rational use of antibiotics and avoiding the formation and spread of drug-resistant strains.

Objective To observe the therapeutic effect on thymus radiotherapy in the patients with myasthenia gravis (MG).Methods The clinical data of 68 patients with MG treated by thymus radiotherapy (X ray radiotherapy in the deep for 22 cases, 60 Co treatment for 46 cases)in our hospital from 1957 to 1999 were analysed retrospectively.The patients were followed up long term.Results Total remission rate of patients with MG treated by radiotherapy was 90%.Clinical results were significant,the life quality of patients with MG improved greatly.The side effect with the skin injury for 10 cases and the alimentary canal symptom for 9 cases were found mostly.Conclusion The following patients can obtain obvious therapeutic effect with radiotherapy,they are those with poor efficiency to drugs,those with invasive thymoma during the operation,those with instable symptoms after the operation.

Objective To study the relationship among depression associated type 2 deabetes mellitus (T2DM) and personality and quality of life.Methods A total of 246 cases of hospitalized T2DM patients were investigated by schedule tables:self-rating depression scale (SDS),Eysenck personality questionaire (EPQ) and adjusted diabetes-specific quality of life scale (A-DQOL).According to the results of SDS,patients were divided into depression group (171 cases) and non-depression group (75 cases).Correlation analysis and regression analysis were carried out for the collected data.Results There were differences in satisfaction,influence,anxiety Ⅰ,anxiety Ⅱ,neuroticism and extraversion between the two groups(P ＜ 0.05 or P ＜ 0.01).Depression extents was related to the quality of life,neuroticism,extraversion and course(r =-0.243-0.392,P ＜ 0.05 or P ＜ 0.01).Anxiety Ⅱ,satisfaction and course enter the regression equation of depression (β =-0.205-0.322,P ＜ 0.05 or P ＜ 0.01).Conclsion Anxiety Ⅱ,satisfaction and course are key factors inducing depression in T2DM.Neuroticism and extroversion may be the predisposing personality characteristics in T2DM patients with depression.In clinical work,it is helpful for treatment by changing personality and mood of patients.

Objective To realize hand hygiene status and effect of hand-drying measures on hand-washing of health care workers(HCWs)in an intensive care unit(ICU).Methods From February to April 2013,210 HCWs in an ICU were selected and randomly divided into three groups,group A dried hands with paper towel,group B with hand drier,and group C with personal towel,specimens from hands before hand-washing,after hand-washing,and after hand-drying were taken and performed detection.Results Hand microorganism count in group A,B and C before washing hands after contacting patients was (29.10±15.08)CFU/cm2 ,(31.42±14.76)CFU/cm2 and (30.36±15.52) CFU/cm2 respectively,the difference was not statistically different(F=0.048,P >0.05);After six-step hand-washing, hand microorganism count before hand drying in group A,B and C was (3.26 ±0.61 )CFU/cm2 ,(2.98 ±0.59) CFU/cm2 and (3.87±0.67)CFU/cm2 respectively,compared with hand microorganism count before hand-washing, the difference was statistically different(all P <0.01 ).After adopting different hand-drying methods,microorgan-ism count in three groups was statistically different(F =1 .892,P <0.05),group A ([1 .29±0.58]CFU/cm2 )was significantly lower than group B and C,group B ([9.51 ±0.73 ]CFU/cm2 )was significantly lower than group C ([22.76±4.11]CFU/cm2 );the qualified rate in group A (90.00%)was significantly higher than group B and C, group B (68.57%)was significantly higher than group C (47.14%).The top 5 pathogens isolated from HCWs’ hands were Pseudomonas aeruginosa ,Acinetobacter baumannii ,Klebsiella pneumoniae ,Escherichia coli ,and Coag-ulase negative Staphylococcus ,these strains were highly consistent with the top 5 multidrug-resistant organisms (MDROs)isolated from ICU patients in this hospital in 2013.Conclusion HCWs’hands are seriously contamina-ted after all kinds of medical performance;if hands are improperly dried,secondary contamination may occur;patho-gens isolated from HCWs’hands are highly consistent with MOROs from patients,timely and correct hand-washing and hand-drying is the key link to ensure the quality of hand hygiene,and is of great significance to reduce the occur-rence of MDROs infection in ICU patients.

Objective To isolate and identify leukemia stem cells from acute myeloid leukemia patients for further research. Methods By Ficoll density gradient centrifugation, mononuclear cells were firstly separated from bone marrow of patients. According to specific surface markers, CD+34 CD+123 of leukemic stem cells were sorted by flow cytometer. Their ability of self-renewal and differentiation were evaluated by colony formation and cobblestone forming ability. At the same time, the purity and cell morphology of CD+34 CD+123 cells was analysed. Results Comparared with total mononuclear cells, the proportion of the CD+34 CD+123 cells after sorting was 10.7 %, and these cells showed the ability of colony forming and cobblestone forming, and the purity proportion of CD+34 CD+123 cells was 62.1%. Conclusion The leukemia stem cells were isolated successfully and could be used in further study.

Objective To investigate the gene expressions of IL-1 and TNF-? in bronchoalveolar lavage fluid(BALF) and lung tissues in mice with pulmonary fibrosis(PF) at various periods and to study the effects of cytokines on pulmonary fibrosis.Methods Forty male mice were randomly divided into two groups:experimental group(n=30) and control group(n=10),and poured respectively by bleomycin solutions and saline and killed on the 3rd,7th,14th,28th and 56th day.RT-PCR method was used to analyse the mRNA expressions of IL-1 and TNF-?.Results ① The expressions of IL-1 mRNA and TNF-? mRNA in BALF in experimental group were higher than those in control group(P

The status of current clinical probation teaching is not satisfactory,so it is essential to establish and perfect clinical teaching mode based on laws and guide students to properly handle the relationship among the internship,employment and preparation for the examination for postgraduates,reform the clinical teaching system,strengthen the training and education of medical ethics and quality,integrate the clinical teaching resources and make full use of clinical cases,as well as strengthen the internship management so as to ensure the quality of teaching of clinical internship.

AIM: To explore whether inhibition of NF-?B by antioxidant pvrrolidine dithiocarbamate (PDTC) sensitizes leukemia cells to cytotoxic drugs and its mechanism. METHODS: The indirect immunofluorescence method and electrophoretic mobility shift assay (EMSA) were used to measure the activation of NF-?B. The apoptotic cells were evaluated by flow cytometry (FCM) and the in vitro growth inhibitory effect was performed using a MTT assay. RESULTS: EMSA showed that NF-?B was activated by daunorubicin (DNR), VP-16 and then was inhibited by PDTC in a dose-dependent manner. NF-?B activation was further verified because of subunit RelA of NF-?B locating in the nuclei. FCM analysis showed that apoptotic index of HL-60 cells was up to (8.97?0.81)%, (16.01?1.06)%, (22.96?1.33)% from (5.34?0.62)%, (10.16?0.42)%, (17.32?1.15)% after exposure of HL-60 cells to 2.5-10 mg/L VP-16 combined with PDTC. VP-16 added with PDTC produced greater growth inhibitory effect to HL-60 cells than did VP-16 or DNR only (P

Objective To explore the value of endothelial dysfunction assessment in predicating major adverse cardiac and cerebrovascular events (MACCE) in peritoneal dialysis (PD) patients.Methods A prospective cohort study included 136 end stage renal disease (ESRD) patients from Jan 1,2009 to Dec 31,2011 was conducted.Endothelial function was assessed by flowmediated dilation (FMD) of brachial artery.Kaplan-Meier method was used to estimate survival rate.The survival difference between the two groups was compared by the log-rank test.Multivariate Cox proportional hazards regression was used to determine the independent risk factors of MACCE.Results In the follow-up period,18 patients in low FMD (FMD≤2.7％) group occurred MACCE,and 13 patients in high FMD (FMD ＞ 2.7％) group occurred MACCE.Compared with high FMD group,MACCE-free survival rate in the low FMD group had a significantly decreased (x2=4.190,P=0.041).Multivariate Cox proportional hazards regression analysis showed that higher level of total cholesterol,lower FMD,longer PD time and higher levels of hs-CRP were all independent predictors of MACCE.Conclusion Reduced brachial artery FMD is an independent risk factor of MACCE,and the application of FMD contributes to the risk stratification of cardiac and cerebrovascular disease in PD patients.