Objective To analyze the change trend of drug resistance in clinical strains of Escherichia coli,and to provide the basis for rational use of antibiotics in clinic,and to increase the level of drug resistance.Methods The drug resistance of Escherichia coli isolated from various clinical specimens in hospital from January 2012 to November 2016 were analyzed retrospectively.Results From all kinds of clinical specimens 3 458 strains of Escherichia coli were isolated,extended spectrum beta-lactamases producing rate of which was 57.92％.The drug resistance rates of Escherichia coli to Quinolones,Penicillins,Cephalosporins,Aminoglycosides,Sulfonamides were more than 50.00％;The resistance rate of Imipenem,Meropenem,Piperacillin/Tazobactam,Cefoperazone/Sulbactam and Cefoxitin were less than 10.00％ of the antibacterial drugs,the resistance to some third,forth generation Cephalosporins were significantly increased.The Wilcoxon test showed that drug resistance rate of Escherichia coli isolated from sputum was significantly higher than that of blood,urine,secretions,the difference was statistically significant(P<0.05).Conclusion Clinicians should attach great importance to which the drug resistance of Escherichia coli in a hospital increased year by year.

AIM: To investigate the anti-apoptotic effect of hepatocyte growth factor(HGF) on actinomycin D(ActD)-induced apoptosis in hepatocytes and the possible pathway.METHODS: Hepatocytes were exposed to ActD and HGF.The cytotoxic effects of ActD were tested by MTT.Apoptotic cells were identified by Hoechst 33342 staining,flow cytometry and detection of DNA fragmentation with agarose gel.Akt and phospho-Akt were detected by Western blotting analysis.RESULTS: The results showed that ActD induced apoptosis in hepatocytes 5 h after treatment.Phosphatidylinositol-3 kinase(PI-3K) specific inhibitor wortmannin enhanced the apoptotic effect of ActD.Furthermore, HGF significantly reduced the apoptosis in hepatocytes induced by ActD in a concentration-dependent manner.In the presence of wortmannin,HGF did not overcome apoptosis.CONCLUSION: Wortmannin enhances the apoptotic effect of ActD.HGF protects hepatocytes from apoptosis induced by ActD through a PI3K/Akt pathway.

Objective To discuss the clinical manifestations and the morphological features of intracranial arteriovenous malformation (AVM) in childhood. Methods During the period from Jan. 2012 to June 2013, a total of 14 AVM patients under the age of 14 years were admitted to authors’ hospital. Of the 14 patients, 11 had a history of spontaneous intracerebral hemorrhage (78.6%), 7 complained of headache (50.5% ), 5 showed signs of unilateral limb weakness (35.7% ), and 2 was accompanied with epileptic attacks (14.3% ). The clinical characteristics, the preoperative imaging features and DSA findings were retrospectively analyzed. Results DSA showed that terminal feeding branches were visualized in 9 cases and blood supply from perforating branches was seen in the remaining 5 cases. In seven cases the feeding artery was single, while in the remaining 7 cases the feeding artery was multiple, and in four of them combination blood supply from both anterior and posterior circulation was found. The lesions were situated at the lateral or convex surface of cerebral hemisphere (n = 5), lateral ventricle (n = 4), cerebral bottom (n = 3) or medial surface of cerebral hemisphere (n = 2). The lesion’s diameter was < 30 mm in 10 cases and (30 -60) mm in 4 cases. According to Spetzler- Martin grading, grade Ⅰ was seen in 4 cases, grade Ⅱ in 2 cases, grade Ⅲ in 5 cases and grade Ⅳ in 3 cases. Conclusion Although in childhood AVM lesion is small in size and lower in grading, its onset is early and the lesion is prone to bleeding. DSA findings indicate that most AVMs in childhood take the form of immature type. Nevertheless, its natural course needs to be further studied.

Objective To evlauate the effect of pulmicort respule combined with solution salbutamoI aerosol on the treatment of bronehiolitis.Methods 65 cases of bronchioiltis were randomly divided into two groups.solution saltutamol inhalation group or pulmicort respule combined with solution salbutamoI group,the time of easing asthma symtpoms was assessed.Results Therapeutic group cure rate is higher than the control group(87.9%/62.5%,P＜0.01),there is significant difference.Observation group duration of symptoms was significantly shorter than the oontrol group(P＜0.01),the difference is significant.Condmlon Pulmicort respule combined with solution salbutamol has significant therapeutic effect on the treatment of bronchiolitks,there are obvious advantages.

ObjectiveTo discuss neonatal hypoxic-ischemie eneephalopathy points,and the vesting of the re- lationship between the prognosis and current treatment methods. MethodsFrom January 2004 to April 2008, pedi-atric hospital treated 88 cases of HIE were assessed, inspected, grading and treated. Results8 cases in the 88 easesantomatically discharged, 51 patients (63.8 %) were recovered and 28 patients (35.0 %) improved, and 1 patient(1.3 %) died. HIE clinical severity has close relationship with prognosis. Mild and moderate cases were 78.4 % (29/37) ,53.7% (22/41) were recovered and no deaths, and severe 1 case, 1 death. ConchtsionHIE clinical severityand prognosis have close relationship, the time of birth asphyxia situation on the vesting of infants discharged andwas no significant impact.

Laser has been used in the treatment of glaucoma for more than twenty years.Its main applications include laser peripheral iridoplasty,laser trabeculoplasty,laser sclerostomy,and laser cyclophotocoagulation. Other applications such as C02 laser filtering surgery and photodynamic therapy(PDT)have just started.In this paper,a review is provided on the present applications of lasers in the treatment of glaucoma including choice of laser,indications,surgery approach and efficacy.The prospect of the future application is also discussed.

Objective　To study the characteristics of serious central nervous system(CNS) involvement in childhood systemic lupus erythematosus.Methods　We made a comparison on the level of ANA、dsDNA and positive rate of Sm、C3 between primary and secondary CNS involvement and analysed the clinical manifestations between two groups.Results　The level of ANA、dsDNA and ositive rate of Sm、C3 were not related with SLE encephalopathy;EEG was useful to the diagnosis of SLE.Conclusion　The differiential diagnosis between primary and secondary CNSD in volvement of SLE must be analysed according to clinical manifestations and other laboratory findings.

Objective:To improve the determination method for compound sodium acetate injection. Methods:Atomic absorption spectrophotometry ( AAS) was used to determine sodium chloride, calcium chloride and potassium chloride in compound sodium acetate injection. Results:The linear range of calcium ion, potassium ion and sodium ion was 9.124 ×10 -7-1.369 ×10 -5 g·ml-1(r =0.999 5),1.501 ×10 -7 ~4.504 ×10 -6 g·ml-1(r=0.999 2) and 7.500 ×10 -8-2.251 ×10 -6 g·ml-1(r=0.999 5), and the av-erage recovery was 100. 4%(RSD=1. 4%,n=9),102. 4%(RSD=1. 6%,n=9) and 100. 3% (RSD=1. 1%,n=9), respectively. Conclusion:The method is simple, accurate and reproducible, and can be used to control the quality of compound sodium acetate in-jection.

Objective To compare the clinical effects of different labor induction methods in the termination of intermediate pathological pregnancy. Methods From January 2015 to December 2016,ninety?two cases of intermediate ( 11-16 weeks ) pathological pregnancy were treated in Huangyan Hospital of Wenzhou Medical University. The patients were treated with different intermediate labor induction program to terminate their pregnancy. Among them,29 cases were treated with mifepristone combined with water bag abortion ( group A) ,47 patients with mifepristone and misoprostol induction( group B) ,16 cases with single rivanol ( group C) . The successful rate of labor induction and the labor induction related indexes ( the onset time of contraction,the total duration of labor,the total amount of bleeding in the hospital,the volume of bleeding in the perioperative period) , the rate of postpartum re?curettage and the adverse events after birth of the two groups were compared. Results The successful rates of labor induction in the three groups were 93. 10% (27/29),100%(47/47) and 87. 50% (14/16) respectively,the difference among the groups was statistically significant (χ2=8. 502,P<0. 05). The onset time in group A was (4. 61±2. 15) h,in group B it was (3. 68±2. 10) h,in group C it was (5. 85±2. 30) h,the difference among the 3 groups was statistically significant (F=6. 05,P =0. 025). The total duration of labor in group A was (10. 45±3. 21) h,in group B was (7. 50±3. 40) h,in group C was (14. 60±4. 89) h,the difference among the 3 groups was statistically significant (F=7. 48,P =0. 013). The total hospitalization time in group A was (4. 70 + 2. 33) d,in group B was (2. 80±1. 7) d,in group C was (6. 05±2. 50) d,the difference among the 3 groups was statistically significant (F=10. 23,P =0. 011). The perioperative bleeding volume in group A,B,C were (64. 88±20. 50) ml,(40. 10±15. 26) ml,(91. 50±31. 73) ml,respectively,the difference was statistically significant (F=8. 70,P=0. 020). The rate of postpartum re?curettage in group A was 7 cases (24. 10%),in group B was 6 cases (12. 80%),in the group C was 9 cases ( 56. 30%) ,the difference was statistically significant (χ2=20. 40,P=0. 003) . The incidence of adverse events in group A and group B were all 0,and in the group C,it was 3 cases ( 18. 75%) ,the difference was statistically significant (χ^2= 40. 00, P<0. 001 ) . Conclusion The pathological pregnancy should be terminated by induction of mifepristone combined with misoprostol, the operation is simple, safe and effective, and the implementation is feasible in the outpatient operation room of obstetrics and gynecology department.