OBJECTIVE To investigate the distribution and resistance of pathogens in lower-respiratory tract infection in our area,and help doctors to use antibiotic reasonably.METHODS According to National Guide to Clinical Laboratory Procedures,API identification system or K-B method,the pathogens of 1326 cases sputum specimens were isolated,identified and tested in drug sensitive test.RESULTS A total of 982 strains of pathogens that included 540(20.0%) G-bacilli,196(20.0%) G+ cocci and 246(25.1%) fungi were isolated from 1326 sputum specimens and the detection rate was 74.1%.From them 176 cases which occupied 13.3% were with mixed infection.The drug resistance of G-bacilli to imipenem was the lowest,then was to cefoperazone and amikacin,but the resistance of ampicillin was the highest.From 234 strains of Klebsiella had 89 strains of ESBLs-positive;in 50 strains of Escherichia coli,the strains of ESBLs-positive were 20(40.0%).The resistance rate of Staphylococcus aureus and S.epidermidis to penicillin was 97.5% and 97.2%,respectively,both of them were sensitive to vancomycin,and less sensitive to ciprofloxacin.Fifty seven strains of MRSA were detected from 90 strains of S.aureus(63.3%);and 42 strains of MRSE were detected(56.0%).CONCLUSIONS G-bacilli are the main pathogens in lower respiratory tract infection and the infection caused by fungi is more than that caused by G+ cocci,so we must pay attention also to mixed infection which occupies certain ratio.

BACKGROUND: Distal humerus fracture is often comminuted, and is difficult to receive reduction and fixation due to its special anatomical structure. Choosing which surgical approach is still a controversy.OBJECTIVE: To compare and analyze the curative efficacy of the perpendicular double-locking plating system for the internal fixation of type C distal humerus fractures through two kinds of postcubital approaches.METHODS: Thirty-two cases of type C distal humerus fractures were enrolled and divided into groups A (osteotomy of olecranon approach) and B (tricep anconeus flap approach). There was no significant difference in the baseline data between two groups. The operation time, intraoperative blood loss, hospital stay, healing time,postoperative follow-up and complications were recorded and analyzed. The patients were followed up at 2 weeks, 1, 3,6, 12, and 18 months. The healing time and complications were recorded according to radiographs and physical examinations. The Mayo Elbow Performance Score was used to determine the elbow function at 1 year postoperatively.RESULTS AND CONCLUSION: (1) The group A had a longer operation time and more intraoperative blood loss than those in the group B (P < 0.05), but showed a better elbow flexion and extension degrees, and higher Mayo Elbow Performance Score at 1 year postoperatively (P < 0.05). (2) There was no significant difference in the healing time between two groups (P > 0.05). (3) These results suggest that the articular surface of the distal humerus fracture is displayed well through two approaches, and the perpendicular double-locking plating system for the internal fixation of type C distal humerus fractures is rational. Noticeably, the tricep anconeus flap approach dose little damage to the muscle, while the osteotomy of olecranon approach obtains better elbow function and less complications.

0.05). The durations between the start of infusion to the onset of SZ, DYS and ASYS were longer in group C than in group A(P

Objective To study surgical techniques and curative effects of laparoscopic vaginoplasty with transferring vascularized ileal flap.Methods Clinical data of 62 cases of laparoscopic vaginoplasty using vascularized ileal flap from March 2004 to March 2006 in this hospital were retrospectively analyzed.There were 16 cases of total laparoscopic surgery and 46 cases of laparoscope assisted surgery.Results The operation was successfully completed in all the 62 cases.The intraoperative blood loss was 30~50 ml(40.0?0.6 ml) and the operating time was 90~313 min(165.0?5.6 min).Intestinal obstruction occurred 1 month after total laparoscopic surgery in 1 case,requiring a re-operation of ileectomy with end-to-end anastomosis.Vaginal stenosis occurred in 3 cases because of incorrect use of the vaginal mold.The remaining 58 cases had satisfactory vaginal dilatation outcomes. Conclusions Laparoscopic vaginoplasty with vascularized ileal flap is micro-invasive and accordant to normal physiological conditions,being an ideal method for vaginoplasty.

Objective To explore the diagnostic value of CT for the vegetable stone disease in the stomach,esophagus and small intestine.Methods The clinical data and CT findings of 27 cases confirmed by endoscopy or surgery were analyzed retrospectively. Among 27 cases,6 cases performed contrast-enhanced scan.Results Among 27 cases,18 cases were the gastrolithiasis,6 cases were the intestinal stone disease,1 case was the esophagus stone disease,and 2 cases were the multiple stones of stomach and small intestine.CT missed 7 cases and misdiagnosed 1 case with the rate of missed diagnosis was 25.93%.The lesions were cylindrical or oval shape with mixed density in 27 cases,distinct boundary in 26 cases,sclerotic margin in 22 cases,ethmoid or honeycomb bub-bles in the lesion in 25 cases,no enhancement in 6 cases,and complicated small bowel obstruction in 8 cases on CT images.Conclu-sion The phytobezoars in the stomach,esophagus and small intestine have typical CT findings.Careful analyses can improve its di-agnostic accuracy.

Objective To evaluate the effects of prostaglandin E1 (PGE1 ) infused in the pulmonary artery of the ventilated lung on hemodynamics and pulmonary gas exchange during one-lung ventilation (OLV).Methods Experiments were performed on 12 healthy pigs of both sexes (6 males , 6 females) aged 3 months, weighing 14-17 kg. The animals were anesthetized with intramuscular ketamine 15-20 mg?kg-1 , diazepam 1.5-2.0 mg?kg-1 and atropine. The animals were mechanically ventilated after tracheal intubation (FiO2 = 0.7, VT = 12-15 ml?kg-1, RR=15bpm, I:E=l:2). PaCO2 was maintained at 35-45 mm Hg. Swan-Ganz catheter was positioned in the right pulmonary artery via the left femoral vein. The right femoral artery was cannulated for BP monitoring and blood sampling. Anesthesia was maintained with a mixture of ketamine 100 mg and succinylcholine 100 mg in 2% procaine 100 ml infused i.v. at a rate of 2-3 ml?kg-1?h-1. The animals were placed in right lateral position. The left chest was opened and OLV was established by clamping the left main bronchus. During OLV RR was increased from 15 to 20 bpm but the minute ventilation remained unchanged. The animals were randomly divided into 2 groups of six : group A and B. Group A received PGE1 infusion in the right pulmonary artery with an initial dose of 0.01 ?g?kg-1?min-1 which was gradually increased to 0.02, 0.04, 0.06, 0.08 and 0.1 ?g?kg-1?min-1 . Theinfusion of each dose was maintained for 20 min. In group B normal saline was infused instead of PGE1. MAP, HR, CVP, PCWP, CO, PaO2 PvO2 were recorded at each dose and at 20, 40, 60 min after PGE1 infusion was terminated. Qs/Qt, PVR and SVR were calculated.Results MPAP, PVR, SVR, peak inspiratory pressure (PIP) and Qs / Qt significantly increased while CO, Cdyn and PaO2 significantly decreased (P 0.05) and a significant decrease of MPAP and PVR ( P

Objective To study clinical effect of transplantation with vascularized ilium bone and free fibulae, and internal fixation of titanium plate on reconstruction of maxillary defect. Methods Nine cases of maxillary defect were repaired by 7 iliac muscle flaps with deep circumflex iliac artery and vein, 2 cases of fibulae muscle flap with peroneal artery and vein, meanwhile, fixed internally by titanium plate. The vessels were anastomosed with arteria and vena maxillaries externa. Results Nine patients were confirmed by 99m TcMDP 2-4 weeks after operation that the supply of blood was well and the graft bones were survival. By follow-up from 6 months to 3 years after operation, the fixations of graft bones were good. Conclusion Vascularized bone graft and internal fixation of titanium plate is one of the best ways for reconstruction of maxillary defect.

Objective To construct lentivirus vectors carrying alphastatin gene, test its secretion expression in human umbilical vein endothelia cells (HUVECs) and observe its effects on growth, migration and tube formation of HUVECs. Methods We constructed recombinant lentivirus vectors of NT4-alphastatin fusion gene containing neurotrophin-4 signal peptide, pro-region sequences and alphastatin, then transfected the recombinant lentivirus vectors into HUVECs to obtain secretory protein alphastatin and test its anti-angiogenic activities in vitro. Results Our data showed that recombinant self-inactivating lentivirus vectors of NT4-alphastatin were successfully constructed, and stable NT4-alphastatin transduced HUVECs were capable of sustainably secreting alphastatin which significantly suppressed HUVECs migration and differentiation but not VEGF-induced proliferation. Conclusion This report represents the first time on the use of lentivirus-based vectors to deliver alphastatin, the endogenous angiogenesis inhibitor, and reveals the potential utility of anti-angiogenic gene therapy with lentivirus vectors for treating cancer.

Global Campaign Against Epilepsy conducted the Demonstration Project to improve epilepsy care in rural China from 2000 to 2004. The project involved 5 provinces and 2,455 patients with convulsive epilepsy using phenobarbital monotherapy. Forty percent of the patients were seizure free in one year and another 30% had their seizures decreased by over half. With the support of the central government, the project has currently been extended to cover 12 provinces with 11,000 patients. The long-term plan is to integrate epilepsy management into the existing primary health delivery system of China.

Objective To investigate the protective effects of morphine preconditioning on the lungs against ischemia-reperfusion (I/R) injury and the possible mechanisms.Methods Twenty-four Japanese long-ear white rabbits weighting 2.5-3.0 kg were used in this study. The animals were anesthetized with intramuscular atropine 0.5 mg and intravenous 3 % pentobarbital 30 mg ?kg-1, tracheostomized and mechanically ventilated ( VT 10 ml?kg-1, RR 30 bpm, FiO2 100% , PEEP 1 cm H2O) . Right carotid artery was cannulated for BP monitoring and blood sampling. An elastic band was placed around the hilum of left lung via thoracotomy to perform lung ischemia. Body temperature was maintained at 36-38℃( rectal) . The animals were randomly allocated to one of 3 groups (n = 8 each) : (1) Sham group; (2) I/R group was subjected to 2 h in situ left hilar occlusion followed by 2 h reperfusion and (3) morphine preconditioning group received morphine 4 mg?kg-1 via pulmonary artery 30 min before I/R. Mean pulmonary artery pressure (MPAP) and peak inspiratory pressure (PIP) were monitored and recorded. Arterial blood samples were taken before occlusion of lung hilum (baseline) and at 5, 30, 60, 90 and 120 min of reperfusion for blood gas analysis, and determination of plasma endothelin-1 concentration. The animals were killed at the end of 120 min reperfusion. The lungs were removed for determination of lung water content (W/ D ratio), percentage of neutrophils in the broncho-alveolar lavage fluid ( BALF) and microscopic examination.Results MPAP and PIP were significantly lower while PaO2 was significantly higher at 30, 60, 90 and 120 min of reperfusion in morphine preconditioning group than in I/R group. Plasma endothelin-1 concentration was significantly lower at 60 and 120 min of reperfusion in morphine preconditioning group than in I/R group ( P