Objective To explore the distribution and drug resistance of pathogenic bacteria causing postoperative infections in gastrointestinal surgical inpatients during 2011-2015 in order provide the basis for clinical rational use of antibacterial drugs .Meth‐ods The bacterial species identification and drug susceptibility test were performed by adopting the BacT/ALERT3D automatic culture system and VITEK‐2 system .The analysis was performed by using the WHONET5 .6 statistical software .Results Among 1 140 specimens ,753 strains of pathogenic bacteria were detected .The specimens sources were mainly blood ,sputum ,abdominal drainage fluid ,pus and urine (77 .7% ) .In pathogenic bacteria ,537 strains (71 .3% ) were Gram‐negative bacteria(G-) ,198 strains (26 .3% ) were Gram positive bacteria(G+ ) and 18 strains (2 .4% ) were fungi .The top five detected pathogenic bacteria were E . coli (32 .3% ) ,klebsiella pneumoniae (11 .4% ) ,pseudomonas aeruginosa (10 .0% ) ,staphylococcus aureus (8 .1% ) and acinetobact‐er baumannii (5 .8% ) .E .coli ,klebsiella pneumoniae and pseudomonas aeruginosa had higher resistance to second and third genera‐tion cephalosporin antibacterials ,but had lower resistance to piperacillin/tazobactam and imipenen ,acinetobacter baumannii had higher resistance to multiple antimicrobial agents (> 50% ) ,no vancomycin‐resistant positive staphylococcus strain was found;Gram‐positive staphylococcus aureus had higher resistance to quinolones (>40% ) and traditional antibiotics of penicillin and eryth‐romycin(>50% );enterococcus faecalis and enterococcus faecium were highly sensitive to vancomycin and linezolid .Conclusion Strengthening the bacterial drug resistance surveillance and reducing the generation and spread of drug‐resistant bacteria is of great significance to improve the effect of gastrointestinal surgical infection treatment .

Denonvilliers fascia locating between the front of the rectum and urogenital organs is an important barrier separating the urogenital organs and the rectum.It has great significance in the clinical treatment of rectal tumors and genitourinary system tumors.However,controversial on the embryological origins and anatomic characteristics of the Denonvilliers fascias still exist.In this article,the embryonic origin,anatomical structure,adjacent structures and clinical applications of the Denonvilliers fascias were introduced.

Objective To evaluate the efficacy and safety of ultrasonography-guided percutaneous nephrolithotomy(PCNL).Methods Between May 2006 and June 2008,110 patients underwent PCNL by a single urological team at our hospital.The clinical data of the patients were retrospectively reviewed.Of the cases,supracostal access(the 11th intercostal space) was made in 62 patients(supracostal group),and subcostal access was obtained in 48 patients(subcostal group).Forty-five patients in the supracostal group(45/62) and 36 of the subcostal group(36/48) received CT three dimensional reconstruction.Results The stone free rate of the supracostal group was 72.6%(45/62),while that of the subcostal group was 60.4%(29/48;?2=1.818,P=0.178).The mean operation time of the supracostal group was(78.6?5.1) min,while that of the subcostal group was(102.4?7.1) min(t=-20.454,P=0.000).There was one patient in each group received blood transfusion.One patient in the supracostal group had pneumothorax and recovered uneventfully by conservative treatments.Conclusion Ultrasonography-guided PCNL via the supracostal approach is effective and safe with short operation time.

Objective To evaluate the clinical effects of sinus tarsi approach and eight-shape approach in the treatment of calcaneal fractures.Methods Analyzed the outcomes of 23 patients(21 males and 2 females)with calcaneal fractures(25 feet)treated with plate via sinus tarsi approach and eight-shape approach.The mean age of patients was 38 years old(ranged from 24 to 55 years).According to Sanders classification:16 feet in type Ⅱ,9 feet in type Ⅲ.Results The average operation time was 85 min(ranged from 70 min to 100 min),and no wound compli-cations occurred.X-ray review showed that bony healing,and healing time was 3-6 months.The average duration of follow-up was 13 months(ranged from 12 to 18 months).The result was excellent in sixthteen cases,good in six cases and fair in one case according to Maryland score.The satisfactory rate was 95 .6%.Conclusion Open reduction and internal fixation via the sinus tarsi approach and eight -shape approach provides not only reliable fixation,but also less complications.

Objective To observe the ultrastructural characteristics of human retinal progenitor cells cultured in vitro. Methods Six 5-month-old human fetuses(12 eyes)without eye diseases were selected. Retinal progenitor cells from the retina of one eye of each fetus were cultured in vitro,and observed by transmission electronic microscopy(TEM); while those from the other eye were directly observed by TEM. Results Abundant heterochromatin were found in the karyon of 5-month embryonic retinal neuroepithelial cells,and the figure of the karyons was irregular.A few scattered initial cells were seen in retinal neuroepithelial layer with large karyon,smooth surface,abundant euchromatin,and distinct nucleolus.The human retinal progenitor cells cultured in vitro had the same ultrastructural characteristics as the initial cells:with huge karyon which almost occupied the whole cell,little cytoplasm,distint nucleolus,abundant euchromatin,and little heterochromatin.The cells clung to each other in the neural globoid cell mass.The size of the outer cells was large,and karyokinesis could be found. Conclusion The cultured human retinal progenitor cells are provided with the same ultrastructure characteristics as the initial cells.

Objective To evaluate the diagnostic accuracy of the combination of endorectal ultrasonography and serum CEA in preoperative diagnosis of rectal wall invasion (T staging) and nodal involvement (N staging) of rectal carcinoma.Methods We retrospectively analyzed clinical records of 310 patients with rectal carcinoma who underwent endorectal ultrasonography and serum CEA evaluation in Shanxi Province Tumor hospital from January 2007 to January 2010.The positive standard of CEA is more than 5 μg/L.The endorectal ultrasonography staging with postoperative pathological staging,and calculated the overall accuracy of T staging and N staging based on TRUS alone or on TRUS combined with serum CEA level were compared.Results The difference in serum CEA level was statistically significant from T1 to T4 (P ＜ 0.05).The accuracy rate of preoperative T staging of rectal carcinoma by TRUS alone was 71％ (219/310) and was 82 ％ (254/310) with TRUS combined with serum CEA level,showing significant statistical difference (x2 =10.92,P ＜ 0.01).The accuracy rate of preoperative N staging of rectal carcinoma was 69 ％ (211/308)with TRUS alone and was 77 ％ (238/308) with TRUS combined with serum CEA level,the difference of which was statistically significant (x2 =5.00,P ＜ 0.05).Conclusion Serum CEA level increases with an increasing pathological stage of rectal cancer.The combination of TRUS and serum CEA improves the accuracy of preoperative staging of rectal cancer.

Objective To evaluate the validity and reliability of multi-slice spiral CT (MSCT) in preoperative TNM staging judgment of rectal carcinoma. Methods Three hundred and one patients with rectal carcinoma were diagnosed and treated consecutively in Colorectal and Anal Surgery Department of Shanxi Province Tumor Hospital from January 2009 to December 2009. The clinical data of these patients were analyzed retrospectively. The diagnosis results were compared between the preoperative MSCT staging and the postoperative pathological staging,the ROC curve and the diagnostic concordance test were analyzed by software Medcalc 11.2. Results The sensitivity, specificity, Kappa value, area under the curve of TNM staging were 64.7% ,96. 8% ,0. 667,0. 808 for T2 staging tumors; 93.8% ,75.0% ,0.709,0.844 for T3 staging tumors;87. 8% ,98. 1% ,0. 859,0. 929 for T4 staging tumors; 72. 0% ,91.2% ,0. 619,0. 816 for N staging tumors;92. 7%, 99. 7%, 0. 925,0. 963 for M staging tumors respectively. Conclusion The diagnostic value of independent use of MSCT in estimating the infiltration degree and lymph node metastasis of rectal cancer is very poor and cannot be used in preoperative staging judgment.

Objective To explore the role of microRNA-206 (miR-206) in peripheral blood mononuclear cells (PBMCs) in infantile bronchiolitis caused by respiratory syncytial virus (RSV).Methods Thirty-five cases of infantile bronchiolitis and 25 cases of healthy controls were enrolled into the current study.PBMCs were isolated from the peripheral blood of both healthy subjects and those with infantile bronchiolitis in the acute and the convalescent stages.Total RNAs were extracted from PBMCs which were stimulated by phorbol-12-myristate-13-acetate (PMA) and Ionomycin, and then the RNA was transcribed reversely into cDNA.The expressions of miR-206 and Kruppel-like transcription factor 4 (KLF4) were detected by real-time quantitative polymerase chain reaction (qRT-PCR) method.Plasma interleukin-17 (IL-17) was determined by enzyme linked immunosorbent assay (ELISA).Results There was a significant difference in miR-206 levels of children with RSV bronchiolitis in the acute stage(0.055 ±0.018) and the convalescent stage(0.187 ±0.069) as well as the healthy controls(0.204 ± 0.075).Through pairwise comparison, the miR-206 levels in the children in the acute stage were significantly lower than those in the convalescent stage and healthy control group (P ＜ 0.01), but no statistical significance was found between the convalescent stage group and healthy control group(P ＞ 0.05).The levels of KLF4 mRNA of children in the acute stage,convalescent stage as well as the healthy subjects were 0.588 ± 0.161,0.086±0.024,0.075 ±0.019, respectively,which was significantly difference (P ＜ 0.01).The levels of IL-17 were (58.26 ±25.88) ng/L, (9.87 ± 3.01) ng/L, (7.65 ± 2.16) ng/L, respectively (P ＜ 0.01).Compared to the convalescent and the normal control group,both the KLF4 mRNA and IL-17 levels were markedly higher in the acute stage (P ＜ 0.01), but there were no significant differences between children with RSV bronchiolitis in convalescent stage and in the healthy controls (P ＞ 0.05).Furthermore, the result of this study showed a negative correlation between the expression of miR-206 and KLF4(r =-0.624 ,P ＜0.01)and IL-17 (r =-0.609 ,P ＜0.01) in children in the acute stage and a positive correlation between KLF4 mRNA and IL-17 in children in the acute stage (r =0.662, P ＜ 0.01).Conclusion The levels of miR-206 may play a role in the onset of RSV associated post-bronchiolitis (PB) and the low expression of miR-206 in children infected with RSV may increase the susceptibility to PB.

OBJECTIVE To investigate the in vitro antimicrobial susceptibility of Streptococcus pneumoniae and guide the rational use of drug clinically. METHODS We performed statistical analysis of the susceptibility of 62 strains of S.pneumoniae isolated in our hospital from May 2007 to Aug 2008. RESULTS S.pneumonia e could be isolated from various specimens,most of them were isolated from sputum(84.0%).S.pneumoniae could be detected from many hospital wards,but more strains isolated from pediatric(67.8%) and respiratory(11.4%) departments.A total of 67.7% of S.pneumoniae isolates were penicillin non-susceptible,the resistance prevalence to tetracycline was 87.1%,to erythromycin 79.0% and to trimethoprim/sulfamethoxazole 49%,while they were highly susceptible to ofloxacin(90.3%),vancomycin(91.9%),levofloxacin(95.2%),moxifloxacin(96.8%) and rifampicin(98.4%),and more strains showed multi-resistance from penicillin non-susceptible isolates. CONCLUSIONS The resistance to penicillin of S.pneumoniae is serious in our hospital.The tetracycline and erythromycin are not the best ckoice in treating S.pneumoniae infection,and the new fluroquinolones show strong activity against S.pneumoniae.

Objective To investigate the distribution and characteristics of drug resistance of pathogens in premature infants with ventilator‐associated pneumonia(VAP) ,and explore the therapeutic measures for premature infants with VAP ,so as to provide references for clinically reasonable administration of antibacterial agents .Methods A total of 54 cases of premature infants diag‐nosed with VAP in the First Affiliated Hospital of Xiamen University from January 2013 to June 2014 were enrolled in this study . Specimens of respiratory tract secretion were collected ,and species identification of pathogens and drug sensitivity test were per‐formed by VITEK 2 Compact system .Results A total of 69 strains were isolated .Gram negative bacteria was accounted for 94 .20% ,and gram positive bacteria was accounted for 5 .80% .Four of the most common pathogenic bacteria were Klebsiella pneu‐monia (29 strains ,42 .03% ) ,Enterobacter aerogenes (12 strains ,17 .39% ) ,Pseudomonas aeruginosa (10 strains ,14 .49% ) and Stenotrophomonas maltophilia(7 strains ,10 .14% ) .The results of antibiotics‐sensitivity tests showed that these strains were multi‐drug resistant to most commonly used antibiotics ,but sensitive to only a few antibiotics .Conclusion Gram‐negative bacteria are the major pathogens for premature infants with VAP in this hospital .Mixed infection and multidrug resistance are common .Therefore , the rational use of antibiotics according to drug sensitivity tests′results is critical in treating VAP .