OBJECTIVE To investigate the distribution and drug resistance of pathogenic bacteria from lower respiratory tract infection in elderly patients.METHODS A total of 1739 strains of bacteria isolated from sputum and lower respiration secretion culture of the elderly patients were identified and their drug resistance was tested by K-B method.RESULTS From 1739 strains of pathogens isolated,Gram-negative bacilli accounted for 63.8%.The main Gram-negative bacilli were Escherichia coli and Pseudomonas aeruginosa,Acinetobacter baumannii,Enterobacter cloacae and Klebsiella pneumoniae.Gram-positive cocci accounted for 22.9% and Candida albicans accounted for 13.3%,respectively.The resistance rates of Gram-negative bailli to imipenem,cefoperazone/sulbactam and amikacine were relatively low.And all Gram-positive cocci were sensitive to vancomycin.CONCLUSIONS The antimicrobial resistance of pathogens in elderly patients with lower respiratory tract infection is serious.It is important to mornitor the antimicrobial resistance.

OBJECTIVE To compare the three methods on relatedness analysis of Acinetobacter baumannii strains in hospital infection.METHODS Twenty-seven A.baumannii strains caused hospital infection were analyzed by pulsed field gel electrophoresis(PFGE),amplified fragment length polymorphism(AFLP) and multiple gene cluster analysis.RESULTS PFGE analysis showed 19 strains isolated from clinic were with identical clone;AFLP analysis showed 19 strains isolated from clinic were with identical clone;but multiple gene cluster analysis showed 3 clones including 11 strains carried with 8 positive genes(TEM,OXA-23group,ADC,aac(3)-Ⅰ,aac(6′)-Ⅰ,ant(3″)-Ⅰ,qacE△1-sul1 and intⅠ1),6 strains with 7 positive genes(TEM,ADC,aac(3)-Ⅰ,aac(6′)-Ⅰ,ant(3″)-Ⅰ,qacE△1-sul1 and intⅠ1) and 4 strains with 6 positive genes(TEM,ADC,aac(3)-Ⅰ,ant(3″)-Ⅰ,qacE△1-sul1 and intⅠ1).CONCLUSIONS The resolving ability of multiple gene cluster analysis is higher than that of PFGE and AFLP in relatedness analysis of A.baumannii strains from hospital infection.

OBJECTIVE To analyze the relationship of Acinetobacter baumannii in Ningbo No.2 Hospital by pulsed field gel electrophoresis(PFGE) and amplified fragment length polymorphism(AFLP).METHODS The sensitivity of 13 kinds antibacterials were analyzed according to American National Committee for Clinical Labotatory 2004′s Standard.The genotypes were analyzed by PFGE and AFLP.The relationship was analyzed with cluster analysis methods.RESULTS Twenty seven strains of A.baumannii were divided into two groups by AFLP method or into four groups by PFGE method.Cluster analysis showed the concordance.CONCLUSIONS Amplified fragment length polymorphism has more clinical practice.

OBJECTIVE To analyze the existence state of drug-resistant gene,integron and Tn21/Tn501 transposon and the relationship of Acinetobacter baumannii in Ningbo No.2 Hospital by genetic mark.METHODS Twenty seven strains of A.baumannii were clinically isolated.Drug-resistant gene,integron,and Tn21/Tn501 transposon were analyzed using polymerase chain reaction(PCR).The relationship was analyzed with cluster analysis methods.RESULTS The positive rates of blaTEM,blaOXA-23 cluster,blaADC,aac(3)-Ⅰ,aac(6′)-Ⅰ,ant(3″)-Ⅰ,qacE△1-sulⅠ,and intⅠ1 were 81.5%,44.4%,85.2%,85.2%,66.7%,81.5%,85.2%,and 85.2%,respectively.The others were negative.The result of multi-gene cluster analysis showed that the clone transmission existed.CONCLUSIONS The clone transmission of A.baumannii exists in Ningbo No.2 Hospital.The outbreak of A.baumannii may be possible because there are more than 3 clone transmission strains.

According to request of the socialism outlook for honor and shame to university students,this article elaborated the principles,connotation and implementation of honesty evaluation system so as to make a beneficial exploration for the honesty education of university students.

Objective: Our aims were to measure DNA content in primary lung cancer and to study the relationship between the DNA content and TNM stage, histological differentiation of tumor cell, cellular proliferation, and apoptosis. Methods: The DNA content and cellular proliferation were analyzed using flow cytometry. Tumor cell apoptosis was detected by using TUNEL method. Results: (1) The DNA index (DI) distribution ranged from 0.829 to 2.514. There were 41 cases (77.4%) of DNA aneuploid. The distribution of DI and DNA aneuploid was independent of histological subtypes（P>0.05）.(2) With the increase of TNM stage, the DI and the rate of DNA aneuploid increased（P<0.05）.(3) There was relationship between DI and histological differentiation of tumor cell. The DI was higher in tumors of poor differentiation than those in tumors of moderate and good differentiation（P<0.05 and P<0.01）. (4) The cellular proliferation index of aneuploid tumors was significantly higher than that of diploid tumors(P<0.01), while apoptosis index of aneuploid tumors was significantly lower than that of diploid tumors (P<0.01). Conclusion: Correlations exist between DNA content and TNM stage, hiological differentiation, cellular proliferation, and apoptosis.

A retrospective analysis was carried out in 36 patients with blunt diaphragmatic rupture during March 1991 and March 2006. Twenty-two diagnoses were confirmed preoperatively, and the rest 14were confirmed perioperatively. Three patients underwent surgical treatment after no response to conservative therapy. Thoracotomy was performed in 21 patients, laparotomy in 9, thoracotomy plus laparotomy in 5 and combined thoraco-laparotomy in 1. Most diaphragmatic rupture may be caused by blunt collision and could lead to thoracoabdominal injury. In spite of high mortality rate, the condition is usually under diagnosed. Definite diagnosis and timely operation are important to increase survival rate and reduce mortality.

BACKGROUND:Non-heart beating donors have become the most promising source of donor in recent years. Tofurther improve donor preservation solution, on the basis of conventional storage solution hypertonic citrate adenine solution, artificial cordyceps was added to prepare artificial cordyceps compound solution. It is hoped to reduce donor injury and to elevate donor quality by antioxidation. OBJECTIVE: To investigate the preservation effect of artificial cordyceps compound solution on isolated renal from non-heart-beating rats. METHODS: Medulas of 39 Sprague-Dawley rats were injured. Withoutin vitro respiratory and circulatory supports, non-heart-beating models were established and randomly divided into three groups: artificial cordyceps compound group (n=15), hypertonic citrate adenine solution group (n=15) and physiological saline group (n=9). The kidneys of rats in different groups were stored in artificial cordyceps compound solution, hypertonic citrate adenine solution and physiological saline at 4℃. RESULTS AND CONCLUSION: Compared with the hypertonic citrate adenine solution group, after 6 and 12 hours of preservation, morphological injury was mild, apoptotic index, malondialdehyde, Bax and Caspase-3 expression levels decreased, superoxide dismutase activity and Bcl-2 expression increased; after 24 hours, the degree of injury was similar, malondialdehyde content decreased, and superoxide dismutase activity increased in the artificial cordyceps compound group. These findings indicated that the preservation effect of artificial cordyceps compound on antioxidation and inhibition of apoptosis was better than that of hypertonic citrate adenine solution in non-hearting beating rats.

OBJECTIVETo investigate the application and effects of external fixator under the guidance of damage control therapy in limb open fracture.

METHODSFrom May 2008 to January 2013,72 cases with severe limb open fractures (Unincor- porated shock) were divided into control group and observation group (36 cases in each group). In observation group, 36 patients (including 22 males and 14 females) were treated by external fixator at stage I, as soon as possible after waiting for patients physiology conditions being stable,the stage II fracture operation was performed. In control group, 36 patients (24 males and 12 females) were treated by the first stage open reduction. The hospital admission time, open fracture severity score (OFSS),operation duration,operative blood loss,X-ray expose times, callus appear time, fracture healing time, postoperative infection rate, complications and Johner-Wruhs accceccment were recorded and evaluated.

RESULTSAll patients were followed up for 8 to 12 months (10.4 in averaged). The mean operation duration, operative blood loss, callus appear time, fracture healing time the mean operation duration reespectively were (56.79±8.87) min, (216.16±18.21) ml, (5.32±0.71) weeks, (12.79±2.52) weeks in observation group,and (104.53±9.28) min, (439.93±14.65) ml, (4.97±1.26) weeks, (14.81±2.63) weeks in control group. According to Johner-Wruhs acccecement,there were were 33 cases in excellent,2 in good,and 1 in poor in observation group,non-union of fracture in 1 case,local infection occurred in 1 cases; in control group 25 cases in excellent,6 in good, and 5 in poor, non-union of fracture in 1 case,local infection occurred in 8 cases. There were significant differences in operation duration, operative blood loss, callus appear time, fracture healing time, postoperative infection rate, complications (P<0.05). There were no significant differences in hospital admission time, open fracture severity score and X-ray expose times (P>0.05).

CONCLUSIONUnder the guidance of damage control therapy,using external fixator measures to treat patients with open fractures of limbs is worth popularizing in clinical application because it can shorten the operation time, less blood loss, reduce the infection rate and complications, improve the success rate of surgery and recovery rate.

Adult ; Aged ; External Fixators ; Extremities ; injuries ; surgery ; Female ; Fracture Healing ; Fractures, Open ; surgery ; Humans ; Male ; Middle Aged ; Operative Time ; Postoperative Complications ; epidemiology

Hip fracture patients preoperative and postoperative exist hidden blood loss which often affect patients' wound healing, increase the probability of infection, prolong rehabilitation exercise, influence postoperative effect. At the same time, the body's blood loss increase the activation of the blood clotting mechanism, promote the incidence of deep vein thrombosis, bleeding and deep vein thrombosis has become the main causes of high risk in hip operation. It is very important to stop bleeding, anticoagulation should not be ignored, so how to effectively deal with the prominent contradiction between the postoperative anticoagulation and bleeding or looking for a best balance has become a intractable problems in hip fracture treatment.
Anticoagulants ; therapeutic use ; Blood Loss, Surgical ; prevention & control ; Hip Fractures ; complications ; surgery ; Humans ; Intraoperative Complications ; drug therapy ; etiology ; prevention & control