Objective To establish the rational antibiotic treatment by accurate screening of high level aminoglycoside (HLA) resistant enterococci in clinical laboratory. Methods A single HLA genta micin 500 ?g/ml and streptomycin 200 ?g/ml for agar dilution method, and gentamicin 120 ?g/disk and streptomycin 300 ?g/disk for disk diffusion method were used as parallel screening tests to detect high level aminoglycoside resistance in 172 enterococci strains. Antibiotic time kill test was performed to verify the accuracy and reliability of both methods.Results The resistant rates of the two methods for HLA gentamicin were 60.0% and 59.3%,respectively. While for HLA streptomycin, both were 61.1%. In disk diffusion tests of 172 enterococci strains, the resistant rates for penicillin, ampicillin and vancomycin were 16.9%, 14.0%, and 1.7%, respectively. ? lactamase from 80 strains enterococci were all negative. Conclusion High concentration aminoglycoside disk diffusion method is a simple, reliable method for screening the HLA resistant enterococci in clinical laboratory. The results can provide a rational base for physicians to treat enterococcal infections.

Osteoporosis complicated with fracture is a common and severe condition. This paper summarizes present advances and new concepts in its treatment. Since the secondary osteoporosis will likely develop after fracture treatment with immobilization, more and more bone mass will get lost in addition to primary osteoporosis. A vicious cycle will be established and influence the fracture healing. Therefore, the key to the treatment is to block the vicious cycle to stop or decrease the bone loss. As a routine measure, to do exercises and weight- bearing activities as early as possible is as important as to take medicines for osteoporosis treatment. Stable internal fixation and prosthetic replacement should be firstly chosen for treatment of most fractures. In drug treatment, calcitonin, bisphosphonate (alendronate), HRT (Livial), vitamins D2 and D3, and calcium are indicated.

Three-dimensional virtual surgery experiment is the application of virtual reality technology in the medical field.Doctors use the information in the virtual environment to develop surgical planning,surgical drills.surgical teaching,surgical skills training,to lead the surgical technique and postoperative rehabilitation,and the information is available for surgery every sur-gical member to share.Virtual Surgery experiments combined with the real operation together constitute complete experimental teaching system,making telemedicine experimental teaching methods and teaching content rich and varied.

Objective To establish the rational antibiotic treatment by accurate screening of highlevel aminoglycoside (HLA) resistant enterococci in clinical laboratory. Methods A single HLA gentamicin 500 μg/ml and streptomycin 200 μg/ml for agar dilution method, and gentamicin 120 μg/disk and streptomycin 300 μg/disk for disk diffusion method were used as parallel screening tests to detect high-level aminoglycoside resistance in 172 enterococci strains. Antibiotic time-kill test was performed to verify the accuracy and reliability of both methods. Results The resistant rates of the two methods for HLA gentamicin were 60.0％ and 59.3％, respectively. While for HLA streptomycin, both were 61.1%. In disk diffusion tests of 172 enterococci strains, the resistant rates for penicillin, ampicillin and vancomycin were 16.9 %,14.0%, and 1.7%, respectively. β-lactamase from 80 strains enterococci were all negative. Conclusion High-concentration aminoglycoside disk diffusion method is a simple, reliable method for screening the HLA resistant enterococci in clinical laboratory. The results can provide a rational base for physicians to treat enterococcal infections.

Objective To study the value of color Doppler ultrasonography in assessing the severity of deep venous insufficiency of the lower extremities.Methods Forty-five patients (46 lower extremities) in patient group confirmed as venous insufficiency by descending phlebography and 20 volunteers (40 lower extremities) in control group were assessed by color Doppler ultrasonography. The results of 45 patients were compared with those of 20 volunteers.Results The diameters of superficial femoral vein measured by color Doppler ultrasonography were correlated with the severity of venous reflux showed in phlebography(r=(0.771),P(0.05)).Conclusions The reflux distance in superficial femoral vein is a useful parameter in assessing the degree of venous insufficiency.

The regulations of unregistered herbal medicine had important changes in the UK after the EU Directive 2004/24/EC promulgation. British Drugs Act was amended to allow the sale of unregistered herbal medicine by registered practitioners, however, the regulations about the register of parishioners has not been issued yet. At the same time, the unregistered herbal medicine can be sold during the transitional period. But as problems about unregistered herbal medicine security appeared frequently, MHRA decided that the deadline for transitional period was April 30, 2014 through the consulting from all sectors of society. Therefore, the TCM practitioners in the UK cannot sell, and even have no right to sell unregistered herbal medicine after this date, which will bring a huge obstacle on the TCM development in the UK.

Objective To study the facial nerve canal (FNC) abnormalities of the congenital external auditory canal (EAC) atresia by MSCT curved planar reformation (CPR).Methods 15 cases(17 ears) of congenital EAC atresia were scanned by MSCT. Post-processing images were completed by Philips Mx8000 workstation.Results In 17 ears, there were 2 ears with stenosis of EAC, 2 ears with membranous atresia of EAC and 13 ears with bony atresia of EAC.There were 1 ear with congenital cholesteatoma, 3 ears with malformation of tympanum, 7 ears with malformation of the ossicular chain and 1ear with malformation of inner ear. In 17 ears with abnormalities of FNC, included 11 ears with the shortness of FNC general length, 5 ears with the anomalous course of FNC, 9 ears with the displacement of FNC, 1 ear with the narrowing of FNC and 1 ear with the branch of FNC.Conclusion MSCT CPR of FNC, combined with HRCT axial scan, can clearly show the FNC abnormalities of the congenital EAC atresia and provide valuable information for surgery.

Objective Using curved planar reformation(CPR)to delineate the ossicular chain(OC)in one image and evaluate its clinical application. Methods HRCT of temporal bone was performed in 122 cases(165 ears).The CPR of OC was then performed.The main parameters were as follow:collimation 0.5mm,pitch 0.875,reformation interval 0.2～0.3mm,reformation matrix 1024?1024.Results (1)CPR of normal OC were performed on 80 ears,the three ossicles and its joints could be showed on one image clearly.(2)Clincal application(72cases):in 39 cases of temporal bone trauma,OCs were normal in 21 cases and abnormal in 18 cases.Subluxation or dislocation of malleoincudal joint(MIJ)(5,5) and incudostapedial joint(ISJ)(5,6),dislocation of MIJ and ISJ with rotation of incus(1 case),fracture of manubrium of malleus(1 case) were found respectively.In 16 cases of external auditory canal dysplasia(EACD),the most commonly associated type of OC deformity was absence of manubrium of malleus(10 cases)。Absence of OC associated with coarctation of middle ear cavity(3 cases) and fusion of the malleus and incus associated with absence of long process of incus represented in 1 case.Congenital ossicular anomalies without associated EACD were found in 2 cases.The long processes of the incus of both side were absent in 1 case.Incudostapedial disconnection was demonstrated in 1 case due to improper development of the long process of the incus.In 15 cases of chronic otitis media(COM),6 cases were complicated cholesteatoma.Destruction of OC was demonstrated in 6 cases.Conclusion CPR of OC with multislice spiral CT is an effective method in the diagnosis of conductive hearing loss.

Objective Adverse reactions to Gd-DTPA contrast media should be noticed enough.Methods Three cases of adverse reactions to Gd-DTPA contrast media were studied, and literatures were reviewed.Results The rate of adverse reactions to Gd-DTPA contrast media in our hospital was 0.206%.Conclusion Although the rate of adverse reactions to Gd-DTPA contrast media is very low, this problem must be noticed enough with the medical quality’s developement.

Objective To analyze the relationships between body mass index (BMI), blood pressure and the cerebral vascular function in middle-aged population that underwent health checkup. Methods Participants from health management centers of Renmin Hospital of Hubei province, the Second Hospital Affiliated to Nanhua University, Hospital of Shandong Electric Power and Chinese People's Liberation Army No. 180 Hospital aged 45 to 64 years were selected from health checkup population by cluster sampling. Levels of height, weight and blood pressure as well as the cerebral hemodynamics were checked. Subjects were grouped according to age, BMI, systolic and diastolic blood pressure. The differences and distribution of cerebrovascular function scores (CVFS) between groups were compared and described. Moreover, the risk of stroke in the population was evaluated. Results Of the 17 258 individuals who met inclusion criteria, the abnormal rate (the score below 75 points) of CVFS was 20.9 percent. The CVFS in normal, overweight and obese groups were 91.0±15.4, 83.3±21.3, 70.3±26.5 and differences in all age groups were statistically significant (P<0.01). The CVFS in systolic blood pressure<120,120-139, 140-159,≥160 mmHg (1 mmHg=0.133 kPa) groups were 93.9±12.9, 86.5±18.9, 72.1±23.5, 56.2±25.7 and differences in all age groups were statistically significant (P<0.01). CVFS in normal diastolic pressure<80, 80-89, 90-99,≥100 mmHg groups were 91.0±16.1, 85.5±20.2, 75.4±23.6, 62.7±25.0 and the differences among all age groups were statistically significant (P<0.01). Conclusions The abnormal rate of cerebrovascular function integral and high risk stroke individuals in middle-aged health checkup people was approximately 21 percent. The overweight, obese and the high level of systolic and diastolic pressure may induce the injury of cerebrovascular function and the severity will increase with the level of BMI and blood pressure.