Objective To investigate the status of urogenital Ureaplasma urealyticum (Uu) infection and their drug tolerance in our area,so as to guide rational administration for the clinic.Methods Mycoplasma culture and drug susceptibility test were performed for 771 patients with urogenital infaction. The culture,identification and drug resistance of mycoplasma were carried out with one complex mycoplasma kit.Results The positive rate of Uu was 49.9%. The proportional percentage of males was 12.5% and the Uu positive rate was 22.3%,for females,the proportional percentage and Uu positive rate was 87.5% and 60.6% respectively. The population aged 21-40 was susceptible to Uu infection. The most sensitive antibioties to Uu was clindamycin (95.12%),followed by doxycycline (87.57%) and roxithromycin (86.24%).Conclusion The difference of Uu drug sensitivty was significant in different areas. So it is necessary to select antibioties by drug sensitivity. Clindamycin,doxycycline and roxithromycin may are used as preferred antibioties in treating Uu infection in our area. The drug-resistance status of spectinomycin and lincomycin was serious.

Objective:To investigate if there is difference about the parameters of acoustic analysis with the different vowe |a|、|i|、| | and decide which vowels is best fitted to the acoustic analysis. Method:40 normal and 130 pathologic voice patients accepted acoustic analysis. Each acoustic parameters such as jitter,shimmer、NNE、 SDF0、SNR were compared with different vowels. Result:Jitter、shimmer、NNE with |i| were much lower than that with |a| and | | in normal cases and light hoarseness group. While the acoustic parameters with |i| were much higher than that with |a| and | | in moderate and heavy hoarseness group. Conclusion: |a| and | | were the preferred vowels for normal and light hoarseness group,while the |i| could supply some useful suggestion for the moderate and heavy hoarse patients.

Objective To detect whether there is neurotropism following end-to-side neurorrhaphy by means of the neuron retrograde tracing technique. Methods Forty female Sprague-Dawley rats were randomly divided into 4 groups: tracing main branch of musculcutaneous nerve(MC) of end-to-side group, tracing MC main branch of normal group, tracing MC motor branch of end-to-side group and tracing MC motor branch of normal group.In two end-to-side groups, the MC was transeeted, then an 1 mm epineukral window was created on the ulnar nerve. Distal end of MC nerve was sutured to the windowed ulnar nerve by means of end-to-side neurorrhaphy.In two normal control groups, MC and ulnar nerves were just exposed. Five months post operation, by means of retrograde Fluoro-Gold neuron tracing technique,the number of C5～ T1 anterior horn motoneurons and dorsal root ganglion sensory neurons of all groups were counted. Results In two tracing MC main branch groups: the motor neuron counts in end-to-side group was 245.2 ± 93.8, the motor neuron counts in normal group was 846.7 ± 264.8, and counts of end-to-side group was 30.0% of the normal control group (P＜ 0.01). The sensory neuron counts in end-to-side was 434.7 ± 160.4, the sensory neuron counts in normal group was 1545.2 ± 287.4, and counts of end-to-side group was 28.1% of the normal control group (P ＜ 0.01). The per-centage of motor neuron in end-to-side group was 0.36 ± 0.09, there was no difference between end-to-side group and normal control group(P＞ 0.05). In two tracing MC motor branch groups: the motor neuron counts in end-to-side group was 72.3 ± 35.3, the motor neuron counts in normal group was 189.7 ± 57.0, and counts of end-to-side group was 38.1% of the normal control group (P ＜ 0.01). The sensory neuron counts in end-to-side was 110.8 ± 52.5, the sensory neuron counts in normal group was 157.9 ± 50.0, and counts of end-to-side group was 70.2% of the normal control group (P ＞ 0.05). The percentage of motor neuron in end-to-side group was 0.40 ± 0.14, the difference between end-to-side group and normal control group was signifieant(P ＜ 0.01 ). Conclusion Neurotropism in collateral spouting after end-to-side neurorrhaphy is not significant.

Objective To analyse the effective rate and adverse effect of only levetiracetam (LEV) versus LEV plus other drugs in the treatment of middle and old aged patients with partial seizures (PS) and secondary generalized tonic-clonic seizure (SGTCS).Methods The self-control study was used and 59 elderly patients with PS and SGTCS were treated with LEV single or plus drug (therapeutic dose was 1000-2000 mg/d,bid).The effective rate and the side effects of LEV were observed and compared between LEV single and plus drug or between the patients with only epilepsy versus epilepsy plus other diseases,respectively.Results The effective ratios at the end of 3,6,9and 12 months after LEV treatment were 76.2％,70.6％,64.3％ and 66.7％,respectively and there were no significant difference among above time points (x2=1.911,P＞0.05).A chi-square test showed that the differences in effective ratios were not statistically significant (P＞ 0.05) between single and combination of drugs (x2 =1.437) and between two groups of patients at the end of 12 months.Clinical effect of LEV showed no remarkable difference between different types of epilepsy at the end of 6 months (x2 =1.315,P＞0.05)and 12 months(x2 =2.700,P＞0.05).The control ratio of epileptic attack was higher in single LEV than in combination drugs (x2 =10.83,P＜0.05).The total side effects were 13.6％,including somnolence,weakness,anorexia,headache,irritability and forgetfulness.Conclusions The curative effects of levetiracetam single or in combination are definite,stable and continuous for PS and SGTCS,especially in combination with other diseases.

Objective To investigate the molecular mechanism of Klebsiella pneumoniae resistant to imipenem.Methods Anti-microbial susceptibility was evaluated by disk diffusion test,Seven imipenem-resistant strains of Klebsiella pneumoniae were select-ed.And PCR was used to amplify so as to detect eighteen resistant genes.Results Seven imipenem-resistant strains of Klebsiella pneumoniae were more sensitive to aminoglycosides and sulfamethoxazole/trimethoprim.The positive rates of KPC,ant(3′′)-Ⅰ, SHV,CTX-Mand ant(2′′)-Ⅰin these imipenem-resistant strains were high.Conclusion Carbapenem-resistant Klebsiella pneumon-iae isolated from our hospital carries several kinds of resistant genes.Carrying KPC may be the main resistant mechanism of Kleb-siella pneumoniae resistant to carbapenem,but other mechanisms also exist at the same time.

Objective To discuss the characteristics and management of pregnancy on cesarean section scar. Methods Five women with pregnancy on cesarean section scar were reviewed from Apr. 2000 to Mar. 2003. Results All of the five patients had cesarean section before and suffered from painless,irregular vaginal bleeding after 6～8 weeks of amenorrhea. The pregnancy could be misdiagnosed as invasive mole or cervical pregnancy. All had better outcome by uterine suction under ultrasound monitoring without massive bleeding or hysterectomy. Conclusions Women who had cesarean section before are in the risk of pregnancy on the old scar. Clear diagnosis should be made before any treatment. Ultrasound monitoring,local MTX injection and packing can be utilized to prevent perforation during suction. Patients should be monitored continuously after operation with serum hCG level and ultrasound. The principle prevention of pregnancy on cesarean section scar is to reduce the cesarean section rate and effective contraception.

Objective To explore the operational indications, preoperative evaluation,operative essentials and clinical prospect of endovascular repair(EVR) for aortic dissection.Methods Twenty-six patients underwent EVR for aortic dissection and all cases were Stanford B dissection.Four patients had two or more tear entries in different sites.Computed tomography angiography(CTA) or digital subtraction angiography(DSA) were used as preoperative evaluation methods.Results The grafts were installed successfully in 26 patients(100%).The patients were followed up for 1 to 18 months after treatment,and there was no endoleaks and organ or limb ischemia in all the patients.Conclusion Endovascular repair was simple,safe and effective in treating aortic dissection and dissecting aneurysm.

Objective To investigate the clinical value of serum soluble intercellular adhesion molecule-1 (sICAM-1 )in patients with primary biliary cirrhosis (PBC)and autoimmune hepatitis (AIH).Methods Sixty-one PBC patients and 59 AIH patients,who were hos-pitalized or visited the outpatient department from June 2012 to September 2013,as well as 50 healthy controls,were included in the study. The PBC patients included 29 incipient cases,21 cases in remission,and 11 recurrent cases;the AIH patients included 26 incipient cases, 20 cases in remission,and 13 recurrent cases.Serum sICAM-1 level was measured by double-antibody sandwich enzyme-linked immu-nosorbent assay,and serum levels of alanine aminotransferase (ALT)and total bilirubin (TBil)were determined by biochemical enzyme as-say.Comparison between groups was made by analysis of variance;Pearson correlation analysis was performed.Results Among PBC pa-tients,the incipient group and recurrent group had significantly higher serum sICAM-1 levels than the remission group and control group (P=0.000 for all);there was no significant difference in serum sICAM-1 level between the incipient group and recurrent group (P=0.484);the remission group had a significantly higher serum sICAM-1 level than the control group (P=0.000).Among AIH patients, the incipient group and recurrent group had significantly higher serum sICAM-1 levels than the remission group and control group (P=0.000 for all);there was no significant difference in serum sICAM-1 level between the incipient group and recurrent group (P=0.802);no significant difference in serum sICAM-1 level was seen between the remission group and control group (P=0.281).For patients with PBC and AIH,serum sICAM-1 level was positively correlated with serum levels of ALT (r=0.664,P=0.000;r=0.784,P=0.000) and TBil (r=0.715,P=0.000;r=0.580,P=0.000).Conclusion Serum sICAM-1 may be involved in the immunologic injury in PBC and AIH.In patients with PBC and AIH,the elevation of serum sICAM-1 level is closely correlated with the severity of liver damage. Clinical monitoring of serum sICAM-1 level may play an important role in severity assessment,prognostic evaluation,and therapy guidance among patients with autoimmune liver diseases.

Humans ; Hypereosinophilic Syndrome ; complications ; Male ; Middle Aged ; Thrombosis ; complications

Objective To analyze the feasibility, safety, and technique of laparoscopic myomectomy in patients with large hysteromyoma. Methods A total of 82 hysteromyoma patients with the uterus larger than 14-week gestational size were treated by laparoscopic myomectomy. The outcome of the operation were compared with that in 182 hysteromyoma cases with the uterus smaller than 14-week gestational size. Results In the 82 patients with the uterus larger than 14-week gestational size, 77 were treated successfully by laparoscopy, in which pneumoperitoneum was used in 68 cases and gasless laparoscopy in the other 9. One of the cases converted to open surgery, and small abdominal incision was made in 4 patients. Compared with the patients with the uterus smaller than 14-week gestational size, the 77 patients who had been successfully by laparoscopy had longer operation time [(157.6?89.7) min vs (35.3?26.2) min, t=16.926, P=0.000] and more blood loss [(218.0?108.2)ml vs (108.5?67.5)ml,t=9.904,P=0.000]. Conclusions Myomectomy can be performed under a laparoscope for patients with the uterus larger than 14-week gestational size. Highly skilled technique is important for the surgery.!Gasless laparoscopy is applicable to myomectomy for patients with the uterus smaller than 16-week gestational size.