Objective To understand whether it had differences in bile culture and drug susceptibility test between patients with community-acquired acute cholecystitis and patients with community-acquired acute cholangitis at present.Methods 169 patients with community-acquired acute cholecystitis and the 97 patients with community-acquired acute cholangitis in our department were selected prospectively,in which 16 patients suffered from both community-acquired acute cholecystitis and community-acquired acute cholangitis.Bile sample was extracted in operations and delivered to perform aerobic culture and drug sensitivity test.The bile samples coming from cholecyst were divided into group A,while the bile samples coming from bile duct were divided into group B.Results The positive rates of bile culture in group A and group B were separately 24.9% and 64.9%(P<0.05).The result of the sample coming from cholecyst and the result of the sample coming from bile duct were not the same in 4 patients of the 16 patients who suffered from both community-acquired acute cholecystitis and community-acquired acute cholangitis simultaneously.The main bacteria of acute cholecystitis included Escherichia coli(28.0%),Klebsiella pneumonia(24.0%)and Enterococcus faecium(16.0%).The main bacteria of acute cholangitis included Escherichia coli(39.7%),Klebsiella pneumonia(19.2%)and Enterobacter cloacae(12.3%).The antibiotics which were lowly resistant to gram negative bacteria in the two groups(A and B) included amikacin(0%/0%),ertapenem(0%/0%),imipenem(0%/7.0%)and piperacillin/tazobactam(0%/7.0%).The antibiotics which had lower resistant rates to gram positive bacteria in the two groups included tigecycline(0%/0%)and linezolid(0%/0%).The proportions of the multidrug-resistant strains in the two groups were separately 24.0% and 35.6%(P>0.05).Conclusion Some difference exist in the results of bile culture between patients with community-acquired acutecholecystitis and patients with community-acquired acute cholangitis,but the main bacteria of the both two types of biliary tract infection are Escherichia coli and Klebsiella pneumonia.The drug resistance is serious in the both infections,and the most sensitive antibiotics to gram negative bacteria include amikacin,ertapenem,imipenem,piperacillin/tazobactam,and the most sensitive antibiotics to gram positive bacteria include tigecycline,linezolid in the both infections.

Objective To verify the safety and efficacy of percutaneous coronary intervention of Type Ⅳ bifurcation lesion of left main by using a left main bifurcation strategy and crush stenting technique with domestic drug-eluting stents(DES).Methods The study population consisted of patients with isolated unprotected ostial stenosis of the left anterior descending(LAD)or circumflex(LCX)artery.Sequential steps of crush stent deployment and post-dilation were undertaken followed by a modified crush stenting technique with domestic DES.Clinical and angiographic follow up was obtained to assess the primary endpoint of death,non-fatal myocardial infarction(MI)or target lesion revascularization(TLR).Results Twenty-nine patients(21 males,8 females)with a mean age of 62.57?14.21 years were evaluated.All patients were successfully treated using crush stenting technique with which final kissing balloon inflations were performed.The radial approach was utilized in 44.8% of the procedures.The mean procedural time was 36.2?9.4 minutes while the mean fluoroscopic time was 18.3?3.5 minutes.LAD ostial lesion was found in 58.6% of the patients.Predilatation with balloon angioplasty was performed in 44.8% of the patients.Partner stents and Excel stents were used in 79.3% and 20.7% of the patients respectively.The average stent diameter was 3.76 mm and the average stent length was 18.19 mm of main branch.GP IIb/IIIa inhibitors were used in 6(20.7%)patients.Angiographic results from Quantitative coronary angiographic(QCA)data showed mean target lesion length was of 13.20?4.71 mm and the baseline ostial stenosis was 78.4%.Follow-up angiography at a mean interval of 11.5?2.7 months revealed late lumen loss of 0.06?0.10 mm and 0.21?0.12 mm in the main branch and in the side branch,respectively.Binary restenosis did not occur within the main branch and side branch stents.Clinical follow up was available in all patients with mean duration of 14.2?5.2 months.No cardiac death,non-fatal MI occurred and no TLR needed during the followup of all patients.Conclusion The application of modified crush stenting technique and final kissing balloon inflations with domestic DES may be a reasonable option for the treatment of Type Ⅳ bifurcation lesion of left main.

Objective To explore the clinical manifestation of a patient with hypoparathyroidsmsensorineural deafness-renal dysplasia (HDR) syndrome and to sequence the related GATA3 gene of the patient.Methods A 22 year old person with HDR syndrome was reported in regard to clinical manifestation,laboratory examination,and genetic mutation.Some related literatures were reviewed.Results The patient showed tetany,deafness,and positive Chvosteks' and Trousseau' s signs.The initial laboratory studies showed that serum concentration of calcium was lowed and the iPTH level were lower than normal.Binaural pure tone audiometry showed Binaural sensorineural deafness.Colour doppler ultrasound revealed that his right kidney was not observed and the level of creatinine was increased,indicating renal insufficiency.GATA3 mutations on DNA sequence analysis indicated that the 6 exon IVS6-1G-A (G/A heterozygosis splicing),showed the mutation of G to A is in the upstream of the first base in the six exon.After treating with calcium carbonate and vitamin D,the symptoms and signs were improved.Conclusion HDR syndrome is a rare endocrine disease,that should receive more attention in order to avoid missing diagnosis;The IVS6-1G-A as a novel mutation of GATA3 gene,has not been reported so far.

Objective To evaluate the curative effect and safety of dibutyl phthalate on demodicidosis. Methods A single blinded and controlled study of human demodicidosis treated with dibutyl phthalate was conducted. One hundred and forty three patients with demodicidosis, including 81 acne and 62 rosacea, randomly divided into trial and control groups. The trial group was treated with dibutyl phthalate and control group with "new fumanling" cream twice a day in the early morning and evening respectively for six weeks consecutively. Results The rates of excellent, good, and fair efficacy and total effective rate in the trial group with acne were 53\^7%, 41\^5%, 4\^9% and 100% respectively, with a significant difference to the control group (P0\^05). No complaint of side effects in the trial group was recorded. Conclusion Dibutyl phthalate is highly effective to demodicidosis without prominent adverse reactions.

Objective To investigate the prevalence of hyperglycemia in patients with primary aldosteronism.Methods Thirty two patients diagnosed as primary aldosteronism(PA) in our hospital from 2010 to 2013 (PA group),and 40 patients as essential hypertension (EH group).Two groups were measured and compared,including blood pressure,plasma aldosterone,urine aldosterone,and plasma potassium.Oral glucose tolerance test (OGTT) was performed and homeostasis model assessment-insulin resistance index(HO-MA-IR) were calculated.Results The prevalence of hyperglycemia was 43.75％ in PA group,including 25％ patients of glucose intolerance and 18.75％ patients of diabetes mellitus,which was significantly higher than those of EH group (25％,12.5％,and 12.5％,respectively).PA group's fasting and 2-hour postprandial insulin levels and insulin resistance index were higher than that of EH group.Conclusions The present study indicated that patients with PA had a significantly high prevalence of glucose metabolism disturbance and insulin resistance.Screening test should be performed and avoid missed diagnosis.

Objective To explore the effect of quality control circle(QCC)on reducing adverse event incidence of the instrument management.Methods QCC group of 7 nurses in the central sterile supply department was set up for QCC training and then analyze the causes of adverse events in the instrument management and finally make countermeasures to apply continuous quality improvement.Result The adverse incidents were significantly decreased from 69 before QCC to 24 after QCC.(χ2=33.694;P<0.01).Conclusion QCC is effective in the reduction of the adverse events in instrument management and improvement of surgical safety.

We studied the status of parasite pollution in fish and shrimps in Fujian Province,and provided basis for prevention and control of parasite pollution and food safety in aquatic products.Stratified random sampling method was used,and Fujian Province was divide into Eastern,Southern,Western,Northern and Central five regions of Fujian province.Based on the data collected from the five regions between 2012 and 2016,digestion and compression methods were conducted to detect the levels of parasite metacercariae and larvae in both freshwater and marine products.Results showed that the total parasitoid infection rate was 5.15％ (130/2 524).The infection rate of trematode metacercariae and nematode larvae were 3.72％ (94/2524) and 1.43％ (36/2 524),respectively.Twenty-eight marine aquatic species were investigated and the infection rate was 17.25 ％ (88/510),in the form of Anisakis infection.The parasite infection rates in the five regions were 10.38％ (27/260) in Mindong,5.84％ (27/462) inMinnan,4.63％ (30/648) in Minxi,4.64％ (29/625) in Minbei and 9.91％ (103/1 039) in Minzhong.The freshwater products in Fujian Province have been polluted by parasites and are area-depended.The infection rate of marine aquatic products is kept in a high level.Fujian Province should strengthen the food safety and health publicity,take effective prevention and control strategies,and use early warning mechanisms to insure the food safety in province.

Objective To investigate the correlation between XRCC1 R280H,XRCCl TSS+29C/T genetic polymorphisma and susceptibility to non-Hodgkin lymphoma (NHL). Methods The MassARRAY method was applied to detect the DNA repair gene XRCC1 genetic polymorphisms in 73 cases of NHL and 540 cases of normal healthy controls. Chi-square test was performed to calculate the adjusted odds ratios (OR) and 95% confidence intervals (CI). Results For XRCCl R280H genotypes, there was a significant difference between frequencies of the G and A among patients and controls (P=0.001). However, XRCCl TSS+29C/T genotypes had no statistical difference as for the T and C frequencies between patients and controls (P = 0.383). The frequency of XRCCI R280H with at least one A genotype was lower in the NHL cases than in controls, indicating a decreased risk for NHL development (OR=0.309, 95 % CI =0.168-0.567), comparing with GG genotype. In XRCC1 TSS+29C/T genotypes, the frequeney of TC and CC genotype was higher in NHL cases than in controls and associated with an increased risk of NHL development (P=0.472, OR =1.262, 95 % CI =0.669-2.379). Conclusion DNA repair XRCCl gene possesses significant correlation with NHL.

Objective To evaluate the efficacy of parecoxib sodium combined with epidural morphine for multi-mode analgesia after gynecologic operation in a randomized,double-blind,placebo-controlled,multicenter,prospective study.Methods Two hundred and forty ASA Ⅰ or Ⅱ female patients,aged 18-64 yr,scheduled for elective gynecologic operation under combined spinal-epidural anesthesia,were randomly divided into 2 groups:control group (group C) and parecoxib sodium group (group P).Normal saline 2 ml or parecoxib sodium 40 mg was injected intravenously 30 min before the start of operation and was injected again 12,24 and 36 h later.Patient-controlled epidural analgesia with morphine was used for postoperative analgesia in both groups.VAS score was maintained ≤ 3 after operation.When VAS score ＞ 4,tramadol was injected as rescue analgesic.The number of attempts,the number of successfully delivered doses,the amount of morphine used,requirement for the rescue analgesic within 48 h after operation and patient' s satisfaction at 48 h after operation were recorded.Blood samples were taken at 48 h after operation for determination of serum creatinine (Cr),blood urea nitrogen (BUN),alanine aminotransferase (ALT),aspartate transaminase (AST),total bilirubin levels and coagulation function.The abnormality in the parameters was recorded.The adverse effects (nausea,vomiting,pruritus) and recovery of gastrointestinal function were recorded within 48 h after operation.Results Of the 225 patients who completed the study,there was 112 cases in group P and 113 cases in group C.Compared with group C,the number of attempts,the number of successfully delivered doses,amount of morphine used and requirement for the rescue analgesic were significantly decreased,the satisfaction score was increased and the incidence of postoperative vomiting was decreased in group P (P ＜ 0.05 or 0.01).There was no significant difference in the incidence of nausea and pruritus,recovery of gastrointestinal function,and abnormality in the parameters of liver and kidney functions and coagulation function between the two groups (P ＞ 0.05).Conclusion Parecoxib sodium combined with epidural morphine can be safely and effectively used for multi-mode analgesia after gynecologic operation and reduce the requirement for morphine and side effects of morphine.

Objective To investigate the efficacy of jet endotracheal tube (JET) designed by Wei (WEI JET) for tracheal intubation.Methods One hundred and two ASA Ⅰ-Ⅲ and Cormack & Lehane grade Ⅰ-Ⅳ patients of both sexes,aged 15-50 yr,weighing 40-99 kg,requiring tracheal intubation under general anesthesia,were randomly allocated into 2 groups (n =51 each):conventional tracheal tube group (group C) and WEI JET group (group WJ).Groups C and WJ were further divided into 2 subgroups according to Cormack & Lehane grade:difficult airway subgroup (n =16) and non-difficult airway subgroup (n =35).The patients were tracheal intubated with the common Kendall endotracheal tube in group C.Jet ventilation (driving pressure 100 kPa,frequency of ventilation 15 bpm,I∶ E =1∶2) was performed and the patients were simultaneously tracheal intubated with WEI JET of the same internal diameter in group WJ.PETCO2 was recorded immediately after mechanical ventilation.The success rate of tracheal intubation at first attempt and time spent were recorded.The complications were also recorded within 24 h after extubation.Results Compared with group C,the intubation time was significantly prolonged,and the success rate of tracheal intubation at first attempt was increased in patients with a difficult airway than that in the patients without difficult airways in group WJ (P ＜ 0.01).There was no significant difference in PETCO2 recorded immediately after mechanical ventilation,intubation time and the success rate of tracheal intubation at first attempt between the patients with a difficult airway and the ones without difficult airways in group WJ (P ＞ 0.05).PET CO2 recorded immediately after mechanical ventilation was significantly higher and the success rate of tracheal intubation at first attempt was lower in the patients with a difficult airway than in the patients without difficult airways in group C (P ＜ 0.01).No severe barotrauma such as pneumothorax,mediastinal emphysema and subcutaneous emphysema occurred in group WJ.There was no significant difference in the incidences of laryngospasm,sore throat,and flatulence between the two groups (P ＞ 0.05).Conclusion WEI JET can not only provide adequate ventilation safely and effectively in patients requiring tracheal intubation under general anesthesia,but also increase the probability of successful tracheal intubation in patients with a difficult airway.