Objective To investigate the influence of patients suffered from acute lower wall cardiac infarct appeared Ⅲ atrio-ventricular block tneatment with thrombolytic recanalization for the early recovery of sinus rhythm.Methods From October 01 till October 06, a total of 25 hospitalized patients in our hospital with acute lower cardiac infarct, chest pain persist over thirty minutes, but less than one hour, immediately treatment with urokinase thrombolytic therapy after hospitalization, among them 17 cases reinfusion therapy success ful and 8 cases failed. Divided into reinfusion therapy success group and failed group, observate thromholytic therapy 6 hours recanalization success and fail group the situation of sinus rhythm recovore. Results Among 17 cases recanalization success patients and 14 cases recover sinus rhythm within 6 hours ,and 8 case fail in recanalization 2 cases recover sinus rhythm in 6 hours(25%)compared these two groups statistical are meaningful ( P＜0. 01 ). Conclusion Acute lower cardiac infarct patients with Ⅲ atrio-ventricular block must use thrombolytic therapy as soon as possible in order to let oclusive coronary artery recanalize, help to recover sinus rhythm as soon as possible and decrease mortality rate.

Objective To investigate the clinical distribution and drug resistance of stenotrophomonas maltophilia and to provide reference for the clinical application of drugs and to control the nosocomial infection. Methods MicroScan autoSCAN4 and Kirby -Bauer (K -B)method were used to assess the bacteria and test the drug sensitivity.The data were analyzed with software WHONET5.6.Results The isolation rate was the highest in respiratory specimens.There was a highest isolation rate of 90.2%.Drug sensitive test showed that stenotrophomonas maltophilia was most sensitive to minocyline,and the resistance rate was 3.6%.The resistance rates of trimethoprim -sulfamethoxazole,levofloxacin and cefoperazone -sulbactam were12.2%,13.4% and 26.8%.Conclusion Drug resistance monitoring of stenotrophomonas maltophilia should be enhanced.Treatment based on drug susceptibility test should be adapted as soon as possible.

Objective To investigate the mechanism of radioulnar dissociation, an uncommon special injury, and its clinical diagnosis and treatment. Methods From 1990 to 1998, 4 patients with concurrent injuries of the proximal and distal radio ulnar joints were treated in my department. Of the 3 cases diagnosed early, 2 were treated with open reduction and internal fixation and 1 with closed reduction. The remaining one patient, whose radio ulnar dissociation was diagnosed 2 months later, had to be treated by secondary operation. Results The 4 patients were followed up for 16 months to 8 years (averaging 46 months). All had excellent results. Conclusion The early accurate diagnosis and early treatment of concurrent injuries of the elbow and the distal radio ulnar joint produce satisfactory results.

Objective To investigate the effect of parental presence on the anxiety of children during induction of anesthesia with sevoflurane. Methods One hundred and twenty children (ASA Ⅰ or Ⅱ ) aged 2-12 yr weighing 12-32 kg were assigned to one of 2 groups using a random number table ( n = 60 each): control group (group C) and parental presence group (group P). Preoperatiave visit was made the day before surgery in both groups. In group P a parent played with toys with the children for 15 min before induction of anesthesia, while in group C a nurse played with them. Anesthesia was induced with 8% sevoflurane in O2 delivered at 6 L/min through a scented face mask held by the parent or anesthesiologist talking with them in soft words. Modified Yale preoperative anxiety scale (mYPAS) was used to measure anxiety of the children during preoperative visit, before and during induction of anesthesia. Induction compliance checklist (ICC) was used to measure behavioral compliance during induction. ICC score ＞ 5 implied failure of induction of anesthesia with sevoflurane. Adverse events were recorded. Results The mYPAS scores were significantly lower before and during induction of anesthesia in group P than in group C (P ＜ 0.05), but there was no significant difference in ICC scores between the 2 groups ( P ＞0.05). There was no failure of induction in group P while in group C there were 3 failures. Cough occurred in 2 patients in group P but in 3 patients in group C. One patient vomited during induction of anesthesia in group C.Conclusion Parental presence is effective in reducing anxiety of children during induction of anesthesia.

[Objective] To observe the cure effect of photodynamic therapy(PDT) combined with TCM on verruca acuminata. [Method] Select 80 cases of verruca acuminata, divide them into control group and treatment group, n=40 for each; the control one only took LE D-IB PDT therapeutic apparatus, the treatment one added with TCM on the base of control one; Observe their cure effects and side effects. [Result] The effective rate was 97.5% for treatment group, and 88.5% for control one, the treatment one was better than other one; there ’re 2 cases in each group respectively who had slight red and swol en skin of the il umination part, without side effects of erosion, ulcer, infection or scar;the recurrence rates were respectively 2.5% and 12.5% for both groups, the difference had statistical meaning. [Conclusion] PDT combined with TCM treating verruca acuminata had high cure rate, low recurrence rate, little side effects and high safety, without influencing patients ’life quality, with good compliance, worth clinical broad popularization.

Objective To investigate the possibility and accuracy of idenfication of the sentinel lymph node(SLN) in breast cancer(BC) by using methylene blue intra operatively.Methods 4～6ml methylene blue dye was injected around the breast mass intra operatively. 5～10 minutes after injection,the operation for BC was performed. All blue stained lymph nodes found during operation were considered as SLN, and removed for pathological examination. All patients had axillary lymphadenectomy(ALDN),and the acquired nonsentinel lymph nodes(NSLN)from them were also examined. Results The SLN were identified in 45 of 50 patients(90.0%).There were all 117 SLNs in this series. Of 117 SLNs,111 were located in stage I lymph nodes in axilla(95.0%),and 6 SLNs in stage II(5.0%). Of the 5 cases of the unidentified SLN,the primary tumor was located in the inferior quadrant in 4 cases,and in the uper quadrant in 1 case (P0.05). Histologic status of the SLNs accurately predicted axillary nodes status with an accuracy rate of 91.0%. 4 cases or SLN examination were negative while their NSLN were positive with false negative rate 8.9%. Conclusions This technique can identify SLN accurately;the histology of SLN can predict axillary status correctly. Sentinel lymph node has correlation with the location of the primary tumor but has no correlation with the size of the tumor or breast operation before.

Objective To discuss the relationships between expression levels of CD147 and vascular endothelial growth factor C (VEGF-C) in lung squamous cell carcinoma and adenocarcinoma and the clinicopathological features.Methods The expression of CD147 and VEGF-C in 57 lung cancer tissues was detected by immunohistochemical method.Results The positive expression rates of CD147 and VEGF-C in 57 lung cancer tissues were 63.16 ％ (36/57),66.67 ％ (38/57) respectively.The expression of CD147 and VEGF-C in lung squamous cell carcinoma and adenocarcinoma had no statistical difference (both P ＞ 0.05).The expression of CD147 and VEGF-C in lung squarnous cell carcinoma and adenocarcinoma had relationship with lymph node metastasis and tumor TNM stage (all P ＜ 0.05),however they had not correlation with the patient' s age,sex,smoking and tumor cell differentiation extent irrelevant (all P ＞ 0.05).The expression of CD147 was related positively with VEGF-C (P ＜ 0.01).Conclusions CD147 and VEGF-C play important roles in the progression and metastasis of lung squamous cell carcinoma and adenocarcinoma,which may have a synergistic effect.The joint detection of CD147 and VEGF-C can be used as a useful prognostic indicator in patients with lung cancer.

Objective To Study the clinical characteristics of the :sick sinus syndrome,(SSS) in elderly patients.Methods The disease onset age and causes, natural course and symptoms,dynamic electrocardiography(DCG) and cardiac pacing occasion were reviewed and analyzed. in 50 elderly patients had the diagnosis of SSS.Results The morbidity of SSS had increased significantly in elderly men over 70 years. The ordinary causes were coronary heart disease (CHD),specific SSS and the hypertensive heart disease,cardiomyopathy; and degenerative valvular heart disease etc.The mean natural course were about 10 years.The course of DCG type III was the longest one and the type IV was the shortest. The early symptoms were palpitation, dizzy and weakness,and the late symptoms were transient amaurosis, syncope and the worse cardiac angina and heart failure .The cardiac pacing was predicated by the clinical symptom's severity, which was determinated by both of the severity of bradycardia or sinus arrest and the patient's ability of compensation and adaptation.DCG was the commonly used diagnostic method for SSS in elderly patients.Conclusions The SSS has high incidence in elderly men over 70 and is caused by kinds of deasese,such as CHD and specific SSS,etc.The course is frequently intermittent,hide and very long the disease course. The early symptoms and DCG are atypical. The late symptoms commonly are transient amaurosis and syncope .and the late DCG has four types.The cardiac pacing was predicated by the clinical symptom's severity and DCG was the commonly used to diagnose SSS in elderly patients.

Objective To detect the expression of HSPA2 mRNA and protein in pancreatic cancer and corresponding adjacent nontumorous tissues, and investigate the expression of HSPA2 protein in pancreatic cancer and its association with clinicopathological characteristics.Methods Western blot and qPCR (real-time quantitative PCR) was used to evaluate HSPA2 expression in pancreatic cancer and corresponding adjacent nontumorous tissues.Immunohistochemistry was used to investigate the HSPA2 expression in pancreatic cancer and its association with clinicopathological characteristics.Results Both the mRNA and protein levels of HSPA2 were significant higher in pancreatic cancer tissues than those in their paired adjacent nontumorous tissues.High HSPA2 expression was detected in 68.8% (55/80) of pancreatic cancer tissues.HSPA2 protein expression was significantly associated with tumor differentiation, vascular invasion, and status of metastasis (P=0.011,0.005,0.012).Conclusion HSPA2 expression is elevated in pancreatic cancer, and positively correlated the process of invasion, metastasis and progression of pancreatic cancer.

From the course setting and method of using case-study teaching in the medical microbiology,the article discussed its advantages and disadvantages,finding that carrying out such method can improve students' learning interest,their thinking and discriminating abilities and the humanism,thus giving some new opinions about the reform of the course system in the future.