Stenotrophomonas maltophilia.At the same time 136 strains of fungi were isolated.Candida albicans was the most predominant accounted for 60.3%.50.7% Strains of K.pneumoniae and 75.7% strains of E.coli produced ESBLs.The resistance rates of all K.pneumoniae and E.coli to ?lactams were above 50%.All isolates of Enterobacteriaceae were sensitive to imipenem or meropenem.The activity of antibacterial agents against P.aeruginosa was coming down. CONCLUSIONS K.pneumoniae and E.coli are the major pathogens in senile patients with lower respiratory tract infection.Increasing of nonfermenters and fungi as an infection should bring great concern.

OBJECTIVE To study the isolation rate,distribution characteristics and antimicrobial resistance of Acinetobacter baumannii infection.METHODS Surveillance data of A.baumannii infection,distribution and resistance rates to 12 kinds of antibiotics in our hospital for 3 years were analyzed.RESULTS During the 3-year infection surveillance,194 strains of A.baumannii were isolated in our hospital.The isolation rate was 7.8% in 2006,though 2.4% in 2004.Eighty strains(41.2%) of A.baumannii were from intensive care unit;95 strains were from over 60-year-old sufferers;compared with 2004 and 2005,the resistance rates of A.baumannii in 2006 to 12 kinds of antibiotics were increasing at different degree.The antibacterial susceptibility to imipenem/meropenem was the highest.CONCLUSIONS The isolation rate of A.baumannii and antimicrobial resistance rate are increasing year by year.The A.baumannii strains shows obvious multiple antibacterial resistance.We must keep monitoring of A.baumannii infection and drug-resistant changes in order to prevent nosocomial infections.

OBJECTIVE To explore the pathogenesis of Ureaplasma urealyticum(Uu)and Mycoplasma hominis(Mh)in urogenital tract infection and their susceptibility to antibiotics.METHODS Mycoplasma culture was carried out with the samples of 336 cases and then the susceptibility to 9 kinds of antibiotics was detected on positive samples.RESULTS From 336 cases 177 were infected with mycoplasma,the total positive rate was 52.7%,the positive rates of Uu,Mh and their mixed infection were 40.5%,2.4% and 9.8%,respectively.The positive rate of female was higher than of male(P

OBJECTIVE To study the clinical species distribution and drug resistance of Enterococcus.METHODS We had collected 201 isolates of Enterococcus by cultured in normal methods in our hospital from July 2005 to June 2008,and analyzed the characteristics of species distribution,drugsensitive test,drug resistance of high concentration aminoglycoside antibiotics and measured the ?-lactamase.RESULTS There are 106 E.faecalis strains(52.7%),76 E.faecium strains(37.8%) and 19 the other Enterococcus strains(9.5%).There were 102 Enerococcus strains separated from urine and 46 separated from sputamentum.The drug resistance rate of Enterococcus faecalis to erythromycin,tetracycline,rifampin and ciprofloxacin were more than 75.0% and the resistance rate of E.faecium to penicillin,ampicillin,erythromycin,rifampin,ciprofloxacin and nitrofurantoin were more than 93.0%;the total resistance rate of Enterococcus to vancomycin and teicoplanin were 14.4% and 10.4%,respectively.The number of the isolates resistant to high concentration aminoglycoside antibiotics was 151(75.1%);Enterococcus with positive ?-lactamase were 74(36.8%).CONCLUSIONS The infection in urinary system and respiratory system were mainly caused by E.faecalis and E.faeciumwith multidrug resistance.

OBJECTIVE To investigate the correlations on hepatitis B virus(HBV)preS1-antigen(preS1-Ag)and HBV-DNA,HBV markers in patients with hepatitis B.METHODS The markers,preS1-Ag and HBV-DNA were determined by ELISA and PCR in 406 patients with hepatitis B and 80 healthy persons.RESULTS The positive rates of preS1-Ag in 160 patients with HBsAg(+)and HBeAg(+)were 84.4%.The positive rates of preS1-Ag in 246 patients with HBsAg(+)and HBeAg(-)were 42.3%;the difference between them was significant(?2=70.9,P

Objective To study the microbial strains,risk factors and resistance profiles of lower respiratory tract fungal infection in hospital of Zhoushan archipelago area.Methods A total of 204 patients who were hospitalized for lower respiratory tract infection were retrospectively analyzed from May 2008 to April 2011 in Zhoushan archipelago area,and collected 204 fungal strains isolated from confirmed lower respiratory tract fungal infection cases.Chi-square test and Logistic regression analysis were performed.Results Among the 204 fungal strains isolated from lower respiratory tract specimens,110 (53.8％) strains of Candidaalbicans,32 (15.7％) strains of Candida tropicalis,24 (11.8％) strains of Candida glabrata,12 (5.9％) strains of Candida krusei,14 (6.9％) strains of other Candida,and 12 (5.9％) strains of Aspergillus were detected.Logistic regression analysis showed that chronic obstructive pulmonary disease,bacterial pneumonia,long-term use of broadspectrum antibiotics and corticosteroids,endotracheal intubation or incision,old age,exposure in intensive care unit (ICU),and hospitalization ≥7 days were major risk factors (P=0.000,0.001,0.000,0.000,0.012,0.000,0.000,0.000).The resistance rates of isolated Candida against amphotericin B,5-flucytosine,voriconazole,itraconazole and fluconazole were 0,2.1％,4.2％,14.8％ and 22.9％,respectively.Conclusions Candida albicans is the major pathogen of lower respiratory tract fungal infection in hospital of Zhoushan archipelago area,and Candida is sensitive to amphotericin B,5-flucytosine and voriconazole.

Objective To study the effect of early enteral nutrition(EN) and total parenteral nutrition(TPN) in patients with severe acute pancreatitis by a mata analysis.Methods Randomized controlled trials of TPN and early EN in patients with severe acute pancreatitis were searched in Medline,Pubmed and Embase from Jan 1970 to June 2009,and Cochrane Library(Issue 2,2009).Seven studies were enrolled into the analysis.The detail about the trial design,characters of the subjects and results of the studies were reviewed by two independent authors and analysed by using Revman 5.0.18 software.Results Compared with TPN,early EN was associated with a significantly lower incidence of pancreatic infections(OR =0.38,95% CI :0.18～0.82,P =0.01),organ failure(OR =0.43,95% CI :0.23～0.79,P =0.007),fewer surgical interventions(OR =0.34,95% CI :0.18～0.63,P =0.0006) and mortaily(OR =0.41,95% CI :0.19～0.88,P =0.02).However,there was no significant difference in total infections [ OR =0.43,95% CI(0.17,1.10),P =0.08]between patients with TPN and early EN.Conclusions Early EN could be the preferred nutrition feeding method for patients with severe acute pancreatitis.

BACKGROUND:Central pancreatectomy is a surgical treatment for tumors at the neck or the middle part of the pancreas, which can reserve more normal pancreas, not cut adjacent organs, and reduce the incidence of postoperative internal and external pancreatic secretion deficiency with respect to the expanded proximal and distal pancreatectomy. OBJECTIVE: To systematicaly evaluate the clinical efficacy of the central pancreatectomy and distal pancreatectomy. METHODS: A computer-based search of Chinese and English databases was performed, and then 15 controled clinical trials were included and systematicaly evaluated using RevMa5.2 software. RESULTS AND CONCLUSION: Totaly 1 079 cases were included in this study, which consisted of 436 central pancreatectomy cases and 643 distal pancreatectomy cases. Meta-analysis showed that compared with the distal pancreatectomy group, the incidences of postoperative pancreatic fistula and complications were significantly higher, the risk of postoperative endocrine and exocrine insufficiency were significantly lower, while the surgical time (SMD: 59.23, 95%CI: 22.41-96.05, P < 0.01) and hospital stays (SMD: 7.01, 95%CI: 1.94-12.09,P< 0.01) were longer in the central pancreatectomy group. These findings indicate that although the central pancreatectomy has a high postoperative complication incidence, it can be accepted clinicaly, which may be a reasonable operation method to preserve pancreatic exocrine and endocrine function.

OBJECTIVE: To investigate the expression of HPA, CK2beta and HIF-1alpha gene in nasopharyngeal carcinoma (NPC) tissues, and the correlation between their expression with the clinical characteristics of NPC and the relativity of HPA, CK2beta and HIF-1alpha gene in NPC tissues. METHOD: HPA, CK2beta and HIF-1alpha were detected with Super-Vision immunohistochemical method using antibody in 49 NPC specimens and 30 specimens with chronic nasopharyngitis tissue (CNT). RESULT: The expression of HPA, CK2beta and HIF-1alpha in NPC tissue were significantly higher than those in CNT tissue (P<0.05, separately). The expression of HPA, CK2beta and HIF-1alpha were significantly related to the TNM stage and whether recurrence or metastasis occur after treatment (P<0.05, separate ly), but there was no obvious correlation between its expression and the sex of NPC patient (P>0.05). The expression of HIF-1alpha was significantly related to the age of NPC patient (P<0.05), while HPA, CK2beta were not. The expression of HPA, CK2beta and HIF-1alpha in NPC tissue was positively correlated with each other (P<0.05, separately). CONCLUSION HPA, CK2beta and HIF-1alpha play synergetic role in development of NPC, which plays an important role in invasiveness,recurrence and metastasis of NPC. There could be a positive cooperation among HPA, CK2beta and HIF-1alpha in the carcinogenesis and development of NPC.
Carcinoma ; Casein Kinase II ; metabolism ; Female ; Heparin Lyase ; metabolism ; Humans ; Hypoxia-Inducible Factor 1, alpha Subunit ; metabolism ; Male ; Middle Aged ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; metabolism ; pathology ; Neoplasm Staging

Objective To systematically review the clinical efficacy of transanastomotic pancreatic ductal stents placement after pancreaticoduodenectomy.Methods According to the Cochrane reviewers handbook (version 5.0 ),literatures were retrived from PubMed,Embase,Cochrane,VIP database,China Biology Medicine disc and CNKI database,and then the quality of the literatures was analyzed.Meta analysis was carried out using the RevMan software ( version 5.0.18 ).A random effects model was adopted,and the results of the meta analysis were presented with odds ratio (OR) and 95％ confidence interval (95％ CI).Results Four randomized controlled trials including 557 patients were retrieved.External stents were used in 160 patients and internal stents in 115 patients.The results of meta analysis showed no significant difference in the rate of fistula,overall postoperative morbidity and mortality between patients who did or did not receive pancreatic stents placement (OR =0.66,0.70,0.63,P ＞ 0.05 ).There were significant differences in the rate of pancreatic fistula and overall postoperative morbidity between patients who received external pancreatic stents placement and those did not receive pancreatic stents placement ( OR =0.48,0.55,P ＜ 0.05 ).There was no significant difference in the mortality rate between patients who received external pancreatic stents placement and those did not receive pancreatic stents placement (OR =0.71,P ＞ 0.05 ).There were no significant difference in the incidence of pancreatic fistula,overall postoperative morbility and mortality between patients who received internal pancreatic stents placement and those did not receive pancreatic stents placement ( x2 =0,0.75,2.11,P ＞ 0.05 ).Conclusions External pancreatic stents placement after pancreaticoduodenectomy can reduce the incidence of postoperative complications.The effects of internal pancreatic stents placement need to be proved by further highquality prospective randomized trials.