Nine strains of Serratia rnarcescens were isolated from clinical samples. In the identification, 20 items of biochemical reactions and 124 items of substrate utilization tests have been used. Two strains, which have not been appointed to a biotype of the species, can utilize 3-hydroxybenzoate, 4-hydroxybenzoate or protoeatechuate as sole carbon source for growth. The growth in protocatechuate medium was more rapid as compared with 3 or 4-hydroxybenzoate medium. So, we here suggest that protocatechuate should be included in the substrate utilization for the genus. The other seven strains have been identified as Grimont' s A_2 subphenon of S. marcescens. Pencillin and other wall-acting antibiotics are all resisted by these strains; aminoglycoside antibiotics are almost all effective. Co-trimoxazole and sulfadiazine, though couldn't inhibite the growth of the strains, do inhibite their pigment production.

Objective To study the pathological foundations of enhanced MRI with superaramagnetic iron oxide(SPIO) and its diagnostic value in liver diseases.Methods 52 SD rats were divided into 2 groups in random,group A(n=40) bred with 2 ‰ diethylnitrosamine(DEN) to induce hepatocellular carcinoma(HCC),group B(n=12) as control group bred with water.6 rats and 2 rats in group A and group B were killed 6,8,11,14,17,20 week later,respectively,before that every SD rats underwent conventional plain and SPIO enhanced MRI examinations.All specimens were examined by HE staining and immunohistochemistry to test CD 68 with SP.Results The successful ratio of induced HCC was 90% and the mortality was 15%.The rats in group A could be divided into 4 stages,including hepatic fibrosis(HF),liver cirrhosis(LC),hyperplastic nodules and hepatocellular carcinoma(HCC).CD 68 positive cell in the normal control tissue(22.83?4.61/HP) was significantly more than that in LC(11.67?4.64/HP)(P

Objective To investigate a kind of inflammatory pathogen of infectious skin lesion and its position of the bacteria classification. Methods Based on the phenotypic properties of morphology,physiology and biochemical et al.The identification of bacteria was made almost thoroughly and systemically.Results A unique kind of gram-positive bacteria were separated from the lesion of the disease.Which featured by a bacilli to cocci circulation,obligate acrobes,inactive of biochemical reaction and resistance to conventional antibiotics.Conclusion The bacteria are classified into a rare kind of opportunistic pathogen.Few references both at home and abroad has seen so far according to its phenotypic properties,the bacteria is Brevibacterium epidermids which had never been reported at domestic.

Objective To analyse the features of vertebral hemangioma and inaging diagnostic value of vertebral hemangioma.Methods There were 14 cases with hemangioma proved by clinic and pathology.X-ray plain was performed in all cases,of which 9 cases were performed by CT scan and,only 6 cases were taken MR,and 2 cases had both CT and MR scan.Results The tumors were located in thoracic spine in 10 cases,in lumbar spine in 3 cases and in cervical spine in 1 case.8 cases showed typically fence-like or nest-like;the verterea were irregularly destroyed in 5 cases,of which 2 cases were associated with vertebrea collapsing.According to the features in plain film and CT scan,there were 2 cases misdiagnosed,but 6 cases were all made a correct diagnosis on the base of MR before surgry.Conclusion Typical vertebral hemangima can be diagnosed correctely according to plain film or CT while MR plays an important role in atypical cases.

Objective To carry out a taxonomic identification of a strain of claviform bacteria iso-lated from prostatic fluid of a patient who suffered from chronic prostatitis, and to approach its phylogenic and biologic position. Methods We undertaked an initial identification by phenotypic characters such as morphologecal, physiological and biochemical characteristics to ascertain its phylogeny by chemical composi-tion analysis of cell wall and 16S rRNA gene sequencing and alignment. Results A club-shaped gram posi-tive rod bacillus was isolated in pure culture state. Its biochemical reactions were not active. The diamino-acid of cell wall was meso-diaminopimelic acid (meso-DAP) and it had wall chemotype Ⅳ ( contained arabi-nose, galactose and maltose ). Sequence searches of the GenBank database revealed that this strain had a highest level of 16S rDNA sequence similarity (99.4%) to C. tuberculostearicurn strain ATCC35692 with only 8 nucleotides difference. Conclusion On the basis of phenotypic and phylngenetie analysis, it is rea-sonable to assign this strain to the species C. tuberculostearicum, and this is the first isolation of C. tubercu-lostearicum from prostatic fluid home and abroad.

ObjectiveTo observe the in-hospital and long-term results in patients with drugeluting stenting age≥70 years with unprotected left main (UML) coronary artery disease.MethodsIn this retrospective study, 100 patients with UML disease were enrolled. Death, myocardial infarction, repeated revascularization and composite end points during follow-up were compared between groups aged ≥70 years and control aged ＜70 years.ResultsThere was no remarkable distinction between the two groups in cardiovascular risk factors, anatomic findings of coronary artery disease and stent variables. No significant differences were found between the two groups in procedure success rate[96.2％ (50 cases) vs. 97.9％ (47 cases) ,x2 = 1.75, P＞0.05] and in-hospital mortality [3.8％ (2 cases) vs. 2.1％ ( 1 case), x2 = 0.27, P ＞0.05]. Patients were clinically followed for an average time of 22.0 months in the elderly group and 23.0 months in the control group (t= -0.78, P＞0.05). There were no significant differences in death[3.9％(2 cases) vs. 2.1％(1 case) ,x2 =2.51,P＞0.05], myocardial infarction[7.7 ％ (4 cases) vs. 4.2 ％ (2 cases), x2 = 0.55, P＞0.05], repeated revascularization [13.5％ (7 cases) vs. 12.5％(6 cases) ,x2 =0.02, P＞0.05]and composite endpoints of death, myocardial infarction and repeated revascularization[30.7％ (16 cases)vs. 18.8％ (9 cases),x2 = 1.92, P＞0.05] between the elderly group and the control group.ConclusionsThe procedure success rate and in-hospital mortality of drug-eluting stent implantation in elderly patients aged≥70 years old with unprotected left main coronary artery are comparable to group aged＜70 years. The main endpoints including death, myocardial infarction and repeated revascularization are favorable at about 2 years clinical follow up. It is safe and efficacious to implant drug-eluting stent in patients aged ≥70 years old with unprotected left main coronary artery.

Objective To investigate the clinical characteristics and prognosis of acute myocardial infarction(AMI) patients with gastrointestinal bleeding (GIB) in the elderly.Methods Total 325 elderly patients with AMI were divided into AMI control group (n=304,patients without gastrointestinal bleeding around the period of AMI),GIB-post-AMI (n=14,patients developing gastrointestinal bleeding after AMI) group and AMI-post-GIB (n=7,patients with gastrointestinal bleeding subsequently suffered an AMI) group.The clinical characteristics and combined end points of cardiovascular death and hospitalization for recurrent angina pectoris,non-lethal AMI,heart failure and stroke were analysed.Results (1) Estimated glomerular filtration rate (eGFR) became lower in the patients with GIB-post-MI (61.9+27.3) ml · min-1 · 1.73 m2 compared with AMI control patients (77.3+27.9) ml · min-1 · 1.73 m2,P＜0.05.Multivariate regression analysis revealed that the relative risk from a decreased eGFR for developing gastrointestinal bleeding after AMI in elderly patients was 0.980 (95％CI:0.960-0.999,P＜0.05).(2) There were significantly less patients adopting anti-platelet and anti-coagulant medications in AMI-post-GIB group and less patients applying aspirin in GIB-post-AMI group as compared with AMI control group,respectively (P＜0.05).AMIpost-GIB patients had significantly lower hemoglobin (74 + 14) g/L than GIB-post-AMI patients (111±25) g/L,P＜0.01.More MI-post-GIB patients (6 cases,85.7％) versus GIB-post-AMI patients (4 cases,28.6％)underwent blood transfusion( P＜0.05).There were significantly less patients adopting PCI and thrombolytic therapy in AMI-post-GIB group as compared to AMI control patients (P＜0.01).(3) The combined end points of cardiovascular death and hospitalization for recurrent angina pectoris,non-lethal MI,heart failure and stroke in GIB-post-MI group were significantly higher than in AMI control group[42.9％ (6/14) vs.17.8％ (54/304),P＜0.05].Conclusions Reduced eGFR is an important predictor for elderly AMI patients developing gastrointestinal bleeding which makes it difficult to take anti-platelet and anti-coagulant medication and to receive revascularization treatment,usually with worse prognosis.

Objective: To study the prognostic impact of chronic total occlusion (CTO) on non-infarct-related artery (non-IRA) in patients of acute ST-elevation myocardial infarction (STEMI) with emergent primary percutaneous coronary intervention (PCI).
Methods: In this prospective study, a total of 185 consecutive acute STEMI patients received early stage primary PCI in our hospital from 2010-01to 2011-06 were enrolled. The patients were divided into 2 groups:non-CTO group, n=160 and CTO group, n=25. The patients were followed-up for 1 year and the primary endpoint events included the hospitalization for angina, re-MI, heart failure or revascularization and cardiac death.
Results: ①There were more patients with diabetes and three vessel disease in CTO group than those in non-CTO group (40.0%vs 20.0%, P=0.049) and (68.0%vs 36.3%, P=0.003);LVEF in CTO group was lower than non-CTO group (40.0 ± 20.1%vs 51.3 ± 15.3%, P<0.05).②The cardiac mortalities at 6-month and 1-year followed-up period were higher in CTO group than those in non-CTO group (26.3%vs 6.1%, P=0.013) and (31.6%vs 8.4%, P=0.010);1-year primary endpoint events were higher in CTO group (52.6%vs 16.8%, P=0.001). ③Multivariate regression analysis revealed that non-IRA combining CTO (HR=3.889, 95%CI 1.239-4.206, P=0.020), cardiac shock (HR=3.229, 95%CI 2.760-3.725, P=0.012) and three vessel disease (HR=2.008, 95%CI 1.549-3.372, P=0.040) were the independent predictors for 1-year mortality in patients of acute STEMI with primary PCI.
Conclusion: Non-IRA combining CTO in STEMI patients with primary PCI are usually having poor prognosis.

Objective:To evaluate the diagnostic value of coronary angiography-based fractional flow reserve(caFFR)versus a wire-based fractional flow reserve(FFR)in elderly patients with stable ischemic heart disease.Methods:A total of 168 patients(186 vessels)who underwent a pressure wire(PW)-based FFR measurement from Jan.2015 to Dec.2019 in Beijing hospital were enrolled and analyzed retrospectively.Coronary angiography images and matched steady-state aortic pressure of patients were sent to the core laboratory for caFFR measurement under the blind method.All patients were divided into the non-elderly group(<65 years, n=93)and the elderly group(≥65 years, n=75). The diagnostic value of caFFR was evaluated by using the wire-based FFR cut-off value of ≤0.80 as the reference standard.The correlation and consistency of caFFR and wire-based FFR were analyzed, and compared between the non-elderly and elderly groups.Results:The caFFR had a good correlation and consistency with wire-based FFR in the elderly group( r=0.796, P<0.01). In non-aged versus elderly groups, diagnostic accuracy of caFFR was 91.9% versus 93.1%, diagnostic sensitivity of caFFR was 91.8% vs.93.2%, diagnostic specificity of caFFR was 92.3% vs.93.0%, all P>0.05.The area under the receiver-operating characteristic curve of caFFR had no significant difference between the non-elderly and elderly patients(0.964 vs.0.972, Z=0.00823, 95% CI: -0.037-0.052, P>0.05). Conclusions:The caFFR has a good diagnostic correlation and consistency with wire-based FFR in the elderly group, and caFFR's diagnostic performance in the elderly is similar to that in the non-elderly patients.

Objective To evaluate the clinical impact of percutaneous coronary intervention (PCI)on prognosis in elderly patients(≥70 years old)with coronary artery chronic total occlusion (CTO). Methods A total of 445 consecutive patients with a angiography-confirmed CTO lesions registered from January 2011 to December 2013 were divided into the elderly group(≥70 years)and the non-elderly group(< 70 years).The primary endpoints measured were defined as the composite outcomes of hospitalization due to angina,re-infarction,heart failure,repeat re-vascularization,and cardiac death at 36 months follow-up. Results The elderly group included 200 patients(44.9%) and the non-elderly group included 245 patients(55.1%).During the follow-up,the proportions of coronary lesion were significantly higher in the elderly group with left main(LM)disease(45, 22.5%),three-vessel disease(166,83.0%)and J-CTO score≥2(64,32.0%)than in the non-elderly group with diseases of LM,three-vessel,and J-CTO score ≥ 2〔(34,13.9%);(180,73.5%);(57, 23.3%),respectively〕(χ2 =5.607,5.782,4.243;P=0.018,0.016,0.039).T he ratio of the patients undergoing PCI-reperfusion therapy of CTO was higher in non-elderly group(109/275,39.6%)than in elderly group(53/222,23.9%)(χ2 =13.891,P<0.001),while CTO PCI success rate was similar between the two groups(38 patients,71.7% vs.90 patients,82.6%,χ2 = 2.541,P= 0.111).The elderly group versus non-elderly group showed that the 3-year cardiac mortality rate was 12.5%(25 patients)versus 3.3%(8 patients)(χ2 =13.677,P<0.011),and the incidence rate of 3-year primary endpoint was 31.5%(63 patients)versus 22.9%(56 patients)(χ2 =4.199,P=0.040).Among the elderly group,patients without CTOs re-vascularized by PCI had a greater tendency toward higher risk of hospitalization due to angina,re-infarction,heart failure,or repeat re-vascularization than patients with CTOs re-vascularized by PCI(34/149,22.8% vs.3/33,9.1%,χ2 =3.143,P=0.076),while they had comparable incidence of 3-year cardiac death(19/149,12.8% vs.5/33,15.2%,χ2 = 0.007,P=0.933).Multivariate analysis revealed that after adjusting for baseline and procedure differences,LM combined with three vessel disease(OR= 3.804,95% CI:1.274 to 11.356,P= 0.017)remained an independent predictor for 3-year cardiac mortality in elderly patients with CTOs. Conclusions Elderly patients with CTO have mostly a serious coronary artery disease and a poor prognosis.Although CTO is re-vascularized by PCI,long-term clinical outcome seems not more to be improved in elderly patients with CTOs.LM combined with three-vessel disease might be an independent predictor for 3-year cardiac mortality in elderly CTO patients.