0.5).The resistance rates of MRCNS to PEN,GEN,SXT,CIP,TET,ALL and ERY,are all above 50%.The resistant rates of MSCNS to other antibiotics are below about 50% except for PEN(80.4%)and ERY(57.1%).MRS are more than 70% and no VAN resistant in CNS.Conclusion:All the 5 methods are suitable for clinical detection of MRCNS ,and latex agglutination is the most convenient and rapid.MRCNS had a serious cross-resistance in aminoglycosides,guinolones,tetracycline,macrolides,sulfanilamide and,so the best choice for therapy is VAN.GEN,SXT,CIP,TET and CLI could be used for MSCNS,except VAN.

Objective:To investigate whether the combination of the advantages of deep learining in image processing and radiotherapy will make the radiotherapy process more intelligent.Methods:The generative adversarial network (GAN) is a generation model using neural network. High-quality dose distribution images can be generated by inputting relevant features. Firstly, random unconditional GAN was utilized to verify the ideal data, then conditional GAN (cGAN) was employed to train DICOMRT data of tumor patients, and the target contour information was used to directly generate dose distribution images.Results:For the verification of ideal data, the generation of ideal distribution yielded good effect. By extracting target contour and real dose slice data and using cGAN training, the dose distribution maps of planning target volume (PTV) and organs at risk (OAR) of tumor patients could be obtained. The absolute error evaluation of the maximum and average values between the predicted value and the real dose was shown as[3.57%, 3.37%](PTV), [2.63%, 2.87%](brain), [1.50%, 2.70%](CTV), [3.87%, 1.79%](GTV), [3.60%, 3.23%](OAR1) and[4.40%, 3.13%](OAR2), respectively.Conclusions:GAN model can be used to generate ideal dose distribution data, and cGAN model with prior knowledge can be employed to establish the relationship between target information and dose distribution. Directly generating the corresponding dose distribution image by inputting the target contour information is an effective attempt for dose prediction.

0.9 mm(n = 26).Twenty-five healthy individuals served as a control group.Clinical data including age,sex,BMI,ABI,HbA1c,fasting glucose and insulin were collected.Insulin resistance index in Homa model was calculated following the equation:Homa IR = FINS ? FPG) /22.5.Serum adiponectin level was measured by ELISA.Results The serum adiponectin level was significantly lower in atherosclerosis group than in non-atherosclerosis and control groups(P

Objective To observe the risks of hypoxemia after uvulopalatopharyngoplasty (UPPP) in patients with obstructive sleep apnea syndrome (OSAS).Methods Forty-six ASA Ⅱ or Ⅲ male patients with OSAS,aged 30-50 yr,with body mass index 27-33 kg/m2,Mallampati Ⅰ-Ⅳ,underwent UPPP under general anesthesia with propofol and remifentanil.O2 was inhaled for 24 h via a nasal catheter starting from the end of surgery.SpO2 was monitored within 24 h after surgery.Oxygen desaturation index (ODI,hourly average number of desaturation episodes in which the decrease in SpO2 ≥4% and duration ≥ 10 s) and the cumulative time percentage with SpO2 ＜ 90% (CT90) from oximetry were recorded.Results Compared with the baseline value before surgery,ODI and CT90 were significantly decreased at 2 and 2-4 h after extubation and on 1 st night after surgery (11:00 pm-6:00 am) (P ＜ 0.05).ODI and CT90 were significantly lower on 1st night after surgery than at 2 and 2-4 h after extubation (P ＜ 0.05).The rate of ODI abnormalities was 100%,48% and 50% before surgery and at 2 and 2-4 h after extubation,respectively.Compared with the baseline value before surgery,the rate of ODI abnormalities was significantly decreased at 2 and 2-4 h after extubation,while increased on 1 st night after surgery (P ＜ 0.05).There was no significant difference in the rate of ODI abnormalities between that on 1 st night after surgery and that before surgery (P ＞ 0.05).Conclusion Although UPPP can significantly improve airway obstruction in patients with OSAS,hypoxemic episodes still occur after surgery,suggesting that UPPP should not be treated as an ambulatory surgery.

10.3969/j.issn.2095-4344.2013.26.019

Objective To investigate the inhibitory effect of Berberine hydrochloride alone or combined with antibiotics on the formation of Staphylococcus epidermidis biofilm and the expressions of relative genes in order to explore a new way to treat the infection induced by the bacteria.Methods Biofilm of Staphylococcus epidermidis was constructed in vitro first,and then Berberine hydrochloride alone or combined with norvancomycin,ciprofloxacin or erythromycin was used to affect the biofilm formation.Then the inhibition was detected by CRA,and the expressions of icaA and agr by the way of fluorescent quantitation RT-PCR.Results The effectiveness of Berberine hydrochloride on the expressions of icaA and agr in Staphylococcus epidermidis was not as better as the other antibiotics.When different-dosed berberine hydrochloride was combined with norvancomycin,ciprofloxacin or erythromycin to affect the biofilm,the inhibition on the expressions of icaA and agr showed a negatively dose-dependent fashion.Conclusion Berberine hydrochloride can inhibit the formation of the biofilm of Staphylococcus epidermidisthrough suppressing the relative genes,though not as good as the antibiotics,such as norvancomycin,ciprofloxacin and erythromycin.It should not be combined with these antibiotics because the effectiveness is antagonism.

Objective To determine the value of ERCP and EST after Billroth gastroenterostomy. Methods ERCP was used in 31 patients after Billroth- Ⅰ gastroenterostomy, 12 of whom received EST. It was in 137 patients after Billroth-Ⅱ gastroenterostomy, of the 34 received EST and 4 EPBD.Results Billroth- Ⅰ gastroenterostomy ERCP was successfully performed in 28 out of the 31 patients and EST in 11 out of the 12 patients. Billroth- Ⅱ gastroenterostomy ERCP was successfully performed in 109 out of the 137 patients and EST in 31 out of the 38 patients. There were no serious complications in patients receiving endoscopic treatments. Concluasion The success rates of ERCP and EST are high in patients with bile duct lithiasis after Billroth-gastroenterostomy. Endoscopic treatment or cholangioduodenostomy has good therapeutic effects.

The effect of acupuncture cooperated with low-frequency repetitive transcranial magnetic stimulation (rTMS) on chronic insomnia was explored.Seventy-eight patients with chronic insomnia were randomly allocated into two groups:treatment group and control group.In the treatment group,the patients received acupuncture combined with rTMS treatment,and those in the control group were given acupuncture cooperated with sham rTMS treatment,3 days per week for 4 weeks.Before and after treatment,the primary outcomes including the scores on Insomnia Severity Index (ISI) and Pittsburgh Sleep Quality Index (PSQI) and the secondary outcomes including total sleep time (TST),sleep onset latency (SOL),wake after sleep onset (WASO),sleep efficiency (SE％) recorded by sleeping diary and actigraphy were observed in both groups.Seventy-five participants finished the study (38 in treatment group and 37 in control group respectively).After treatment,the scores in the two groups were improved significantly,more significantly in the treatment group than in the control group.It can be inferred that acupuncture cooperated with rTMS can effectively improve sleep quality,enhance the quality of life of patients and has less side effects.

Objective To explore the relationship among social support, postpartum depression and quality of life of puerperal women. Methods A total of 348 puerperal women were investigated with Postnatal Social Support Questionnaire,Edinburgh Postnatal Depression Scale (EPDS) and WHO Quality of Life-BREF (WHOQOL-BREF). Results Pearson correlation analysis showed that there was a significant positive correlation between social support and the quality of life (r=0.483, P < 0.01), and a significant negative correlation to postpartum depression (r=-0.243, P < 0.01),and a significant negative correlation between postpartum depression and quality of life (r=-0.408, P<0.01). Intermediary effect of postpartum depression was tested. Conclusions A good social support system is benefit to improve depression scores for EPDS, and promote the life quality in puerperal women.

Objective To assess the dynamic changes of bacteria culture of patients with chronic suppurative otitis media (CSOM ) preoperative ,intraoperative ,and postoperative the mastoidectomy .Methods Secretions or tissues in 86 CSOM patients were collected for bacterial culture and drug sensitivity tests ,and analyzed the rusults between cholesteatoma group and nonchol-esteatoma group .Results Hospitalized CSOM patients with positive culture rates preoperatively ,intraoperatively and postopera-tively were 75 .6% ,41 .9% and 1 .2% respectively ;Before the mastoidectomy ,positive bacteria ,positive fungus and no pathogenic bacteria were found correspondingly 49 .1% ,25 .0% and 28 .6% of positive bacteria during the surgery .Culture positive rates be-tween the cholesteatoma group and noncholesteatoma group were significantly different intraoperatively (P<0 .05);while during in-traoperative samples ,no significant differences of positive rates were found between pyogenic fluids and tissues ,as well as tissues of mastoid tympanic antrum area and tympanic antrum entrance area (P>0 .05) .Different bacteria showed different drug sensitivity results .Conclusion Intraoperative bacteriological results shows the different bacteria and drug sensitivity from the preoperative bacteriological results ;CSOM patients with cholesteatoma are more likely to develop bacteria ;it is necessary to carry out dynamic detection on bacterial culture and drug sensitivity tests before ,during and after the surgery .