OBJECTIVE To study 39 kinds of resistant-related genes in a pan-resistant Burkholderia cenocepacia(BCE) strain,in the sputum from a severe hepatitis B patient.METHODS To detect the susceptibility to antimicrobial agents by MIC,16S rRNA,39 resistant-related genes including 29 ?-lactamases genes,6 aminoglycoside-modifying enzymes(AMEs) genes,chlorhexidine/sulfadiazine resistant gene(qacE△1-sul1),integron(intⅠ1,2,3),et al,of 1 strain of BCE in the sputum from a severe hepatitis B patient,were measured by PCR,and verified by DNA sequencing.RESULTS The strain was BCE conformed by 16S rRNA-PCR-DNA sequencing.It was susceptible to ceftazidime,cefepime,ciprofloxacin,levofloxacin,and trimethoprim/sulfamethoxazole,but resistant to piperacillin,aztreonam,cefotaxime,cefoxitin,meropenem,imipenem,nitrofurantoin,gentamicin and amikacin.There were positive of 6 kinds of resistant-related genes(blaTEM-116,aac(6′)-Ⅰb,aac(3)-Ⅰ,ant(2″)-Ⅰ,ant(3″)-Ⅰ,and intⅠ1),28 kinds of ?-lactamases genes,2 kinds of AMEs genes(aac(6′)-Ⅱ and aac(3)-Ⅱ),2 kinds genes of intⅠ(intⅠ2 and intⅠ3) were negative.CONCLUSIONS The multi-resistant BCE is with its multiple resistant mechanisms,and mainly relates to 6 kinds of resistant-related genes(blaTEM-116,aac(6′)-Ⅰb,aac(3)-Ⅰ,ant(2″)-Ⅰ,ant(3″)-Ⅰ and intⅠ1.

OBJECTIVE To study 39 kinds of resistant-related genes in a pan-resistant Alcaligenes xylosoxidans subsp xylosoxidans(AXXxx) in the sputum isolated from a severe hepatitis B patient.METHODS The susceptibility to antimicrobial agents were detected by MIC.16S rRNA and 39 resistant-related genes including 29 ?-lactamases genes,6 aminoglycoside-modifying enzymes(AMEs)genes,1 chlorhexidine-sulfadiazine resistant gene(qacE△1-sul1)and 3 intergron genes separated(intⅠ1,2,3) an AXXxx strain in the sputum of a severe hepatitis B patient were measured by PCR,and verified by DNA sequencing.RESULTS Among the strains,7 kinds of resistant-related genes(blaTEM-116,blaCARB-8,aac(6′)-Ⅱ,aac(3)-Ⅱ,ant(3″)-Ⅰ,qacE△1-sul1,and intI1)detected out.But other 27 kinds of ?-lactamases genes,3 kinds of AMEs(aac(6′)-Ⅰb,aac(3)-Ⅰ,ant(2″)-Ⅰ) genes,and 2 kinds of intⅠ(intⅠ2 and intⅠ3) genes were negative.CONCLUSIONS The pan-resistant A.xylosoxidans,mainly relates to 7 kinds of resistant-related genes(blaTEM-116,blaCARB-8,aac(6′)-Ⅱ,aac(3)-Ⅱ,ant(3″)-Ⅰ,qacE△1-sul1,and intⅠ1).

Objective To explore the cause, clinical feature, rescue measures and prognosis of tracheo-innominate artery fistula (TIF). Methods From January1995 to January 2015, there were 621 patients who were performed tubotomy, and 8 patients had TIF. The diagnosis of TIF were established by surgery exploration or autopsy. Results The interval between tracheostomy and TIF was 8- 78 d. Before TIF, hemoptysis occurred in 4 patients. When TIF occurred, bedside aid was performed and 4 patients quickly died of asphyxia because of massive blood in the trachea. The others lived long enough to reach the operating room. The family of 1 patient refused surgical therapy and he eventually died. Three patients accepted median sternotomy. One patient underwent vascular repair and died after surgery because of infection in repaired area. The other patients accepted ligation of the innominate artery without suction drains in the mediastinum and died after surgery because of re-bleeding due to mediastinal infection. The last one patient underwent ligation of the innominate artery with suction drains in the mediastinum, and was still alive without long-time neurological complications and re-bleeding after a follow-up of 14 months. Conclusion A prompt diagnosis and surgical intervention can save the life of TIF patient. Prevention is very vital because of the high mortality of this disease.

This article summarizes the effects of intense exercise on the structure and function of the kidney,the possible mechanism of the changes of the structure and function of the kidney and the research state of the improvement of the function of the kidney by the medicine.The research suggests the intense exercise will lead to the damage of the renal tubules and the glomerulus,the increase of the LPO of the kidney tissue,the decrease of the activity of SOD,the appearance of the exercise-induced albuminuria,exercise-induced hematuria.Vitamine E,Vitamine C,GSH have some protective effect on the structure and function of the kidney.

Objective To explore the clinical and pathological characteristics of singularity uterine leiomyoma.Methods The cause of disease and the clinical features in 15 patients with singularity uterine leiomyoma were analyzed.The patients were examined by pathology and immunohistochemistry.Results The main clinical manifestations were irregular vaginal bleeding,pelvic tumor and anemia.3 patients combined with pregnancy,4 patients had the treatment history of exogenous progesterone.The tumor appeared grayish red,and with complete envelope by macroscopic examination;The multi-and mono-nucleated giant cells were seen under surgical microscopy,the mitosis count was 0～3/10HPF.The tumors showed weak positive staining for Ki-67 and p53,negative staining for ER in 8 cases and positive staining for PR in all cases.Conclusions Singularity uterine leiomyoma belongs to benign tumor,its clinical features and treatments are similar to common leiomyoma;It has certain relation with exogenous and endogenous progesterone.The differentiation of leiomyoma with leiomyosarcoma is basically depended on HE staining observation;The immunohistochemistry of leiomyoma has certain feature.

Objective To explore the histopathological features, immunohistochemical characteristics and clinical manifestation of lymph nodes in patients with cat-scratch disease (CSD). Methods Nineteen cases of lymph nodes of CSD were analyzed by histopathological and immunohistochemical techniques. Results All patients with CSD had a clear history of close contact with cats. The local lymph nodes were punctured swelling. The histopathological characteristics were granulomatous small abscess, lymphocytes and immunoblastic cells growing. CEA (-), EMA (-), CD_ 45 (+), CD_ 20 (+), CD_ 45 RO (+) and CD_ 68 (++) were observed in immunohistochemistry. Conclusion CSD is a self-limited infectious disease caused by cat scratching and biting, its pathogen is bartonella henselae. Its histopathological characteristics, immunohistochemical expressions and clinical history have very important meaning for the diagnosis and differential diagnosis of CSD.

Literatures of study on acupoint functional effect of encephalic region with functional magnetic resonance imaging (fMRI) are collected from the database of China National Knowledge Information (CNKI) and Wan fang database. Analysis and comments are made respectively from the status quo of studies on combination of single acupoint, two acupoints and multiple acupoints under both physiological and pathological conditions. The results show that the corresponding encephalic regions can be specifically activated by acupuncture. And different regions can be activated by different acupoints. However, studies on single acupoint, two acupoints and three acupoints are the major researches carried out at present. It is still lack of observation on effect of commonly-used combinations in clinic. Moreover, the reliability of the research results are also affected by disunity of operations protocol, reinforcing or reducing manipulations, intensity or depth of stimulation and duration of needling retention. Therefore, it is necessary to establish a unified and standard operation protocol to strictly control the bias factors which may affect the result of research in the future, and take patients as the study target as much as possible, so as to further explore the central effect mechanism.
Acupuncture Points ; Acupuncture Therapy ; Brain ; diagnostic imaging ; physiology ; Humans ; Magnetic Resonance Imaging ; Radiography

11?-hydroxylase deficiency is one of the main causes of congenital adrenal hyperplasia (CAH),which is caused by the mutation of CYP11B1 gene that encodes the enzyme.Researches have shown that mutations of CYP11B1 gene would result in decreased activity or inactivation of the enzyme in classical 11?- hydroxylase deficiency,and their relationship between genotype and phenotype of 11?-hydroxylase deficiency is not clear.

Arthroplasty, Replacement ; Fracture Fixation, Internal ; methods ; Humans ; Shoulder Fractures ; therapy ; Shoulder Joint ; surgery