Objective The distribution and drug resistance of Klebsiella pneumonia isolated from clinical department were ana‐lyzed in this article .It will provide evidence for the clinical rational medication and the control of nosocomial infections .Methods In this hospital ,892 strains of Klebsiella pneumonia isolated from January 2011 to December 2013 were performed a statistical analy‐sis .Results Among all the samples ,the extended spectrumβ‐lactamases(ESBLs) positive Klebsiella pneumoniae accounted for 40 . 92% .The highest detection rate in the all the clinical department is the ICU with a value of 46 .46% .The highest detection rate in the sample is the sputum with a value of 43 .51% .In addition ,the ESBLs positive strains had a trend of multiple drug resistance . The Klebsiella pneumonia was the most sensitive bacteria to imipenem ,meropenem ,piperacillin/tazobactam and cefoperazone/sul‐bactam ,no matter whether they produced ESBLs or not .Conclusion The resistant rate of ESBLs positive strains is higher than that of ESBLs negative strains .It was recommended to the rational use of antibiotics based on the duration of disease and the products with or without ESBLs .Furthermore ,it will be of great importance to reduce the incidence of multiple drug resistance ,and to con‐trol the hospital infection effectively .

Objective To investigate the correlation between PaCO2 and cerebral blood flow (CBF), cerebral metabolism of oxygen (CMRO2), glucose (CMRglu) and lactate (CMRlact) and intracranial pressure during intracranial surgery. Methods Twenty ASA Ⅰ - Ⅱ patients (6 male, 6 female), aged between 26-54yr, weighing (65 ? 11) kg scheduled for elective intracranial surgery were studied. The patients were unpremedicated. Before general anesthesia radial artery was cannulated and a catheter was inserted into internal jugular vein and advanced cranially until jugular bulb. Lumber puncture was performed at L3-4 and a catheter was inserted into subarachnoid space for 3 cm, for pressure monitoring and CSF sampling. Anesthesia was induced with diazepam 10mg, fentanyl 3-4?g?kg-1, propofol 2mg?kg-1 and vecuronium 0.08mg?kg-1 iv. The patients were mechanically ventilated with a mixture of oxygen and argon (O2 : argon = 3 : 1) after tracheal intubation. Anesthesia was maintained with sevoflurane and intermittent iv boluses of vecuronium. Arterial and cerebral venous blood gases, glucose and lactate levels, CBF, ICP and CSF level of lactate were determined before anesthesia when patients were awake(Ⅰ) and during anesthesia when PETCO2 = 40, 30, 20 mm Hg (Ⅱ,Ⅲ,Ⅳ). CBF was measured by modified Kety-Schmidt inert gas saturation technique with argon. CMRO2 and CMRglu were calculated based on the difference in their arterial -cerebral venous blood levels. Results At PETCO2 20mm Hg (Ⅳ) CBF decreased by 57.75% and CMRO2 by 58.70% as compared with the baseline; CMRglu decreased by 46.93% as compared with the baseline. There was no significant change in lactate level, jugular venous blood O2 saturation and pH. ICP decreased from (22.14 ? 7.88)mm Hg( Ⅰ) to (17.57?5.03)mm Hg( Ⅱ ),(13.43?4.89)mm Hg(Ⅲ) and (10.00? 2.31)mm Hg(Ⅳ) and the differences were significant. All measurements were done when MAP and HR were stable. PET CO2 was (10? 2) mm Hg lower than PaCO2 . Conclusions Cerebral blood flow, cerebral oxygen and glucose metabolism and intracranial pressure change with changes in PET CO2 . Cerebral vascular reactivity to CO2 is not impaired by 1.3 MAC sevoflurane. Mild hypocapnia is necessary during neurosurgery.

After a description of the basic situation of medical literature retrieval course for foreign undergraduates studying in Sun Yat-sen University, the problems in their teaching contents and teaching methods were pointed out with measures proposed for improving the teaching of their medical literature retrieval course.

Objective To investigate the change in intracranial pressure (ICP) during induction of anesthesia with fentanyl, propofol and succinylcholine in neurosurgical patients by measuring cerebral spinal fluid (CSF) pressure at the level of lumbar spine.Methods Twenty ASA Ⅰ or Ⅱ patients (9 males, 11 females) aged 24-54 yrs scheduled for elective craniotomy for intracranial tumor were included in this study. Lumbar puncture was performed at L2,3 or L3,4 interspace with an epidural needle through which an epidural catheter was placed in the subarachnoid space to allow measurement of lumbar CSF pressure. Anesthesia was induced with fentanyl 2-3 ?g?kg-1 followed by propofol 2 mg?kg-1 and succinylcholine 1.5 mg?kg-1. CSF pressure was recorded before induction of anesthesia (baseline value), at 5 min after intravenous fentanyl injection, 1, 2, and 3 min after propofol injection, during fasciculation of muscle and immediately after intubation.Results CSF pressure was significantly decreased at 1, 2 and 3 min after i.v. propofol and during muscle fasciculation. The CSF pressure was lowest at 3 min after propofol injection. Tracheal intubation did not result in significant increase in CSF pressure as compared with the baseline value before induction. Conclusion Intracranial pressure is decreased during induction of anesthesia with fentanyl, propofol and succinylcholine in neurosurgical patients and the adverse effect of tracheal intubation on ICP is effectively blunted.

Objective Intestinal subepithelial myofibroblasts(ISEMFs) exist throughout the gastrointestinal tract. Due to their ability to secrete cytokines, prostaglandins, growth factors, and extracellular matrix proteins, they are thought to play critical roles in inflammation, repair, fibrosis and neoplasia. The goal of this study was to investigate the relationship between ISEMFs and ulcerative colitis by establishing the method of ISEMFs detection from the biopsy specimens. Methods ISEMFs in colon biopsy specimens (15 from active ulcerative colitis patients and 20 from controls) were detected by immunohistochemistry with smooth muscle actin monoclonal antibody. Results ISEMFs existed in a subepithelial location of colon, were located in the basement of epithelial, and were oval or scaphoid in appearance. ISEMFs in active ulcerative colitis (71.3?9.1) were more than those in controls (56.3?6.9) per field of high power ( P

Objective To investigate the feasibility of L-[1- 13 C]phenylalanine breath test to assess liver function and determine the effective parameters of the test for quantitative assessment of liver function in adult. Methods Twelve healthy volunteers served as control group, and 26 liver cirrhotic patients with hepatitis B were divided into three groups, 10 patients in Child-Pugh classification A, 8 in B and 8 in C, An oral dose of 100 mg of nonradiative tracer L-[1- 13 C]phenylalanine were administered to all the subjects. Breath samples were taken before and different intervals within 360 min after administration. 13 CO_2 enrichment was measured by isotope ratio mass spectrometer. Results After the oral administration of L-[1- 13 C] phenylalanine, 13 C excretion reached a peak within 10-30 min. The parameters of 13 CO_2 excretion rate at 30 min ( 13 CO_2ER_ 30 ) , 13 C cumulative excretion of 60 min ( 13 C_ cum60 ), 75 min( 13 C_ cum75 ), 90 min( 13 C_ cum90 ) and 13 CO_2 half excretion time ( t _ 1/2 ) were shown sensitive, which could differentiate significantly the groups( P

Objective　To explore the development of endogenous CO and its mechanisms in asthma.Methods　50 guinea pigs were equally separated 5 groups.After the models of asthmatic guinea pigs were established in 4 groups,3 groups of them were treated with dexamethasone,the specific stimulator(hemin)and inhibitor(Sn-PP)of HO-1 respectively.The rest of groups were asthmatic one and normal control one(NCG).From all tested animals,the COHb in blood and lung HO-1 activity were examined,the lung tissues were pathologically observed and immunohistochemically stained.Results　In asthmatic and hemin stimulated groups,the levels of COHb with enhanced expression of lung HO-1 and their activity were significantly increased compared with NCG(t=4.43～9.97,P＜0.01).For example,the lung HO-1 activities in asthmatic group were (881±361)pmol/(mg*pro*h),COHb (4.94±2.15)% respectively.In dexamethason prevented and Sn-PP inhibited groups,however,all determined levels were markedly reduced compared with asthmatic group(P＜0.01).Conclusion　The increased HO-1 had resulted in the growth of endogenous CO in asthma.

Objective To study the effect of bcl-2 antisense oligodexynucleotides on the apoptosis in human small-cell lung cancer cell line NCI-H69. Methods Cultured cells were divided into 4 groups: antisense oligodexynucleotides(ASODN), sense oligodexynucleotides (SODN), nonsense oligodexynucleotides (NSODN) and control.The different bcl-2 oligodexynucleotides was transfected into corresponding cells using oligofectamine.The expression of bcl-2 was examined by Western blot.The apoptosis rates were measured by flow cytometry (FCM).Results The bcl-2 expression in ASODN group was significantly inhibited compared to the control group, SODN and NSODN groups, but it was not obviously inhibited in SODN and NSODN groups.The apoptosis rate of ASODN group in different concentration was (9.97±1.54) %, (15.28±1.73) % and (21.41±1.85) % respectively, it was significantly higher than that of the control group (F = 7.19-15.48,q = 5.21-7.98, P ＜0.01). Conclusion The bcl-2 ASODN could enhance cell apoptosis rate in small-cell lung cancer by blocking bcl-2 gene effectively.

Objective To investigate the expression of heat shock protein(HSP)70 and HSP90 in patients with atrophic gastritis(AG)or gastric cancer(GC)and its significance.Methods One hundred and forty-one patients including 35 with superficial gastritis(CSG),66 with AG(miner in 21,medium in 30 and severe in 15)and 40 with GC were enrolled with mean age of 47.8,56.1 or 59.4 years,respectively.H.pylori positive patients were 12 with CSG and 28 with AG.The quantity analysis of HSP90 and HSP70 were detected by immunohistochemistry,whereas their mRNA and protein expressions were measured by Western bolt and real-time PCR,respectively.Results The mRNA expression of HSP70 was significantly higher in CSG(1.31±0.80)and AG(1.41±0.80)than that in GC(1.18±0.70,P＜0.05),but was significantly lower in miner(1.32±0.70)and medium(1.34±0.60)AG than that in severe AG(2.20±0.80,P＜0.05).The mRNA expression of HSP90 was kept on increasing in order of CSG(1.27±0.60),AG(1.53±0.80)and GC(1.84±0.70); or in order of miner(1.33±0.60),medium(1.47±0.90)and severe(2.75±0.70)(P＜0.05).The patients infected with H.pylori had higher expression of HSP90 compared with those without H. pylori infection (P＜0.05). Conclusion The synchronous increase of HSP90 and HSP70 indicates the aggravation of AG. When HSP90 is up-regulated and HSP70 is down-regulatied, it may predict the occurrence of cancer.

Objective To investigate the clinical value of the combined detection of Golgi protein 73 (GP73),alpha-fetoprotein variant-L3 (AFP-L3)and transforming growth factorβ1(TGFβ1)in the early diagnosis of hepatocellular carcinoma (HCC).Meth-ods 48 cases of healthy control,42 cases of hepatitis B,50 cases of posthepatitic cirrhosis and 58 cases of HCC were selected and detected GP73,AFP-L3 and TGFβ1.The detection results were compared among 4 groups.Results (1)The levels of GP73,AFP-L3 and TGFβ1 had statistical differences among 4 groups(P <0.05 );(2 )The positive rate of the 3-marker combined detection reached 96.55%,which was higher than that of the 2-marker combined detection and the single marker detection.Conclusion (1) GP73,AFP-L3 and TGFβ1 may be used as the serum indicators for the early diagnosis of HCC;(2)Compared with the traditional HCC marker AFP,AFP-L3 has relatively high sensitivity and specificity and has the important role in the differential diagnosis of benign and malignant diseases of the liver,which is considered as a better serum marker in the HCC diagnosis;(3)The 3-indicator combined detection can significantly improve the positive detection rate of HCC and has better application value.