OBJECTIVE To investigate drug-resistance status and changing tendency of Escherichia coli in traditional Chinese medicine hospital to provide the evidence for reasonable use of antibiotics.METHODS Pathogenic bacteria were isolated and identified according to the National Clinical Laboratory Operation Rules.Drug resistance profile was analyzed by K-B methods.RESULTS In the four years,the resistance to seventeen commonly used antibiotics in E.coli was on the rise.The resistance rate to ampicillin was the most highest(90.8-94.2%).No strain was resistant to imipenem and meropenem.the detection rate of extended spectrum ?-lactamases(ESBLs) producing E.coli was increasing from 13.2% to 32.0%.CONCLUSIONS Drug-resistance status of E.coli in traditional Chinese medicine hospital is very serious.We should strengthen the management of antibiotic use and control the spread and prevalence of the drug-resistant bacteria.

Objective To investigate the effect of matrix metalloproteinase-9 (MMP-9) on the prognosis of transient ischemic attack(TIA). Methods Sixty-four patients with first-onset TIA(TIA group)and 64 age and sex matched cases without any cerebrovascular disease (control group) were involved in this study. The level of MMP-9 was measured by ELISA method,and the subsequent vascular events and death rate were determined in both groups over 4 years. Results The level of MMP-9 in TIA group was significantly higher than that in control group [(5.25 ± 0.51 ) μg/L vs. (3.25 ± 0.39 ) μg/L, t = 7.830, P <0.05]. Furthermore, in TIA group, the level of MMP-9 was significantly higher in patients with primary endpoint events than that in the patients without primary endpoint events [(5.78 ± 0.48) μg/L vs. (3.15 ±0.29) μg/L, t = 3.250, P < 0.05]. Compared with the patients with lower MMP-9 level ( < 2.5 μg/L), the relative risk of primary endpoint events in higher MMP-9 level patients ( > 4.5 μg/L) was 2.612 (95% CI 1.557-5.463 ,P < 0.01 ) in TIA group. This increased relative risk for primary endpoint events in TIA group persisted after the adjustment for age, sex, body mass index, blood fat level and other cardiovascular risk factors such as hypertension, diabetes and smoking (OR =2.346,95% CI 1.418-5.216,P =0.006).Conclusions The level of MMP-9 in TIA patients has relationship with prognosis and inflammation may play an important role in TIA. MMP-9 may be a marker in predicting prognosis.

Antibody bridging keratinocyte/mononuclear leucocyte adhesion(ABKMA), an experimental model in vitro for psoriasis, has been used in the investigation of cytokine network changes. ABKMA was formed by using normal human epidermal cells incubated with IgG of patients with psoriasis, and then mononuclear leucocytes(ML) of patients with psoriasis were added. Interleukin 2 and interleukin 6 in culture supernate were estimated by ABC amplified ELISA. The results indicated that the synthesis and secretion of interleukin 2 and interleukin 6 were higher than normal IgG and serum free medium controls. Immunohistochemistry staining was used to demonstrate the cell surface interleukin 2 receptor ? chain (IL2R?). The expression of IL2R? +ML/ML and IL2R? +ML/adhesion ML was 4.6% and 40.4% respectively. Both these data were higher than corresponding controls.

Objective To investigate the assessment value of multimodal CT examination for collateral circulation after cerebral ischemia. Methods Within 3 days of admission,39 patients with ischemic stroke received multimodal CT examinations,including CT scan,CT perfusion (CTP)imaging,and CT angiography (CTA). The postprocessing software of the German SIEMENS 64-slice spiral CT system was used to evaluate the state of brain tissue perfusion and the conditions of head blood vessels of the subjects. The cerebral blood flow(CBF),cerebral blood volume(CBV),mean transit time(MTT),time to peak(TTP) and the score of the modified Rankin scale (mRS)in the 90 d after discharge were compared between the patients with good collateral circulation and poor collateral circulation. Results Among 39 patients, multimodal CT examination revealed that 2 patients were negative,one of them was followed up by head MR and was clinically proven as transient ischemic attack,and the other was lacunar infarction. Thirty-seven patients were positive. Multimodal CT examination found 24 patients had offending vessels occlusion and/or stenosis on the lesion sides,the collateral circulation formation in 11 of them was observed on the lesion sides;another 13 patients had poor collateral circulation on the lesion sides. The comparison of lesion sides and contralateral sides,the patients with good collateral circulation showed the CBF decreased (t= -5. 92),the MTT and TTP prolonged (t=4. 27 and 3. 17 respectively). There were significant differences (all P<0. 01). The CBV and CBF in patients with poor collateral circulation were decreased significantly (t= -14.27 and-14.82 respectively),MTT and TTP prolonged (t=7. 26 and 7. 54 respectively). There were significant differences (all P <0. 01). There were significant differences in CBF,CBV,and TTP on the lesion sides between the two groups of patients (t=3. 24,4. 11,and -2. 34,respectively;all P<0. 05). The 90 d mRS scores for patients with good collateral circulation and poor collateral circulation were 1. 3 ± 0.6 and 4. 0 ± 0. 9 respectively. There was significant difference (t = -8. 29,P <0. 01). The patients of having collateral circulation formation had good prognosis. Conclusion Multimodal CT examination has certain clinical significance for evaluation of cerebral perfusion state,understanding the establishment or patency of cerebral collateral circulation,and determining the clinical prognosis.

Objective To discuss the role of matrix metalloproteinase-8(MMP-8) mRNA in apical granuloma and periapical cyst by detecting the its expressions in the periapical granuloma and periapical cyst.Methods Reverse transcription polymerase chain reaction(RT-PCR) technique was used to measure the expressions of MMP-8 mRNA in 22 cases of periapical granuloma,11 cases of periapical cyst and 10 cases of normal periapical tissues.Results The positive rates and the levels of MMP-8 mRNA expression in apical granulomas and periapical cysts were significantly higher than those in normal tissues(P0.05).Conclusion The expression of MMP-8 may play an important role in the pathogenesy of apical granuloma and periapical cyst,and it may be involved in the process of bone destruction.

5453 patients with cervical cancer in stageⅠ～Ⅳ had been treated in our hospital from January 1971 to December 1989. Of them,862 cases developed recurrence. The recurrence rate was 15.81% patients with more advanced cancers had higher recurrence rate (P

Objective To evaluate T2WI sequence and liver acquisition with volume acceleration (LAVA) technique in the diagnosis of early endometrial carcinoma on 3.0 T MR scanner. Methods Twenty-seven patients with endometrial carcinoma confirmed by pathology were retrospectively analyzed. MRI sequences included axial T1WI and sagittal T2WI with fat saturation, axial and sagittal LAVA scanning including four phases: early arterial phase, late arteral phase, parenchymal phase and delayed phase. The tumor location, signal features, and myometrial infiltration by tumor were recorded and preoperative staging was compared with pathologic results. The sensitivity, specificity, accuracy of T2WI and LAVA in diagnosing endometrial carcinoma was assessed. The accuracy of the evaluation of the deep myometrium infiltration was compared between the two sequences using Fisher's exact test. Results According to Federation International of Gynecologie and Obstetrigue (FIGO) standard, 27 patients with endometrial carcinoma were classified as: stage Ⅰ in 22 cases, stage Ⅱ in 5 cases. The sensitivity, specificity, positive and negative predictive values in assessing deep myometrium infiltration were 70.0% (7/10), 94. 1% (16/17), 87. 5% (7/8), 84. 2% (16/19) respectively for T2WI sequence. Its accuracy in assessing myometrium invasion was 85.2% (23/27). The sensitivity, specificity, positive and negative predictive values were 80. 0% (8/10), 94. 1% ( 16/17 ), 88. 9% (8/9), 88. 9% ( 16/18 ) respectively for LAVA sequence, and the accuracy was 88.9% (24/27). There was no statistical difference of accuracy between two techniques( P = 1.00). Conclusion 3.0 T MR T2WI sequence has important role in diagnosing early endometrial carcinoma, and LAVA technique is highly valued in preoperative diagnosis and staging in early endometrial carcinoma for myometrium infiltration.

Objective To determine the relationship between acceptance of disability and posttraumatic stress response in patients with brachial plexus injury. Methods Total 160 patients with brachial plexus injury were recruited and investigated with the Impact of Event Scale-Revised (IES-R) and the Acceptance of Disability Scale (ADS). Results The total score of ADS was (79.07±11.99) which showed medium level of acceptance of disability. The total score of IES-R was 4-66 (33.51±14.41), which showed that most of the patients suffered from posttranmatic stress response. Significantly negative correlation was found between acceptance of disability and posttraumatie stress response(r=-0.480, P<0.001). Conclusions Nurses should pay more attention to the acceptance of disability and posttranmatic stress response in patients with brachial plexus injury, and provide appropriate health education and effective psychological intervention to improve the patients' mental health and quality of llfe.

Objective To compare the effect of different body position and length of bed time after lumbar puncture on the postoperative headache.Methods Literatures were searched at home and abroad through the database,and provided comprehensive quantitative analysis to compare the effect of different body position and length of bed time after lumbar puncture on the postoperative headache by the Cochrane collaboration Meta-analysis.Results A total of 20 studies (3 514 patients) were included for Meta-analysis.Mter lumbar puncture for the low supine pillow and the pillow recumbent position,headache incidence rate had no significant difference between the two positions,combined odds ratio (OR) and 95％ confidence intervals were 0.87 (0.41-1.87)(P＞ 0.05);After lumbar puncture to stay in bed for a long time to rest (≥ 4 h) and short time in bed rest (＜1 h),headache incidence rate had no significant difference between the two different time,the combined odds ratio (OR) and 95％ confidence intervals were 0.77 (0.58-1.02)(P ＞ 0.05).Conclusions After lumbar puncture,the occurrence rate of headache is not increased after taking a low pillow lying position or a short time in bed rest (＜1 h).

Objective To compare the effect of laminar flow bed in the prevention of hospital infections in patients with leukemia after chemotherapy. Method The Meta-analyses were done on Meta RevMan5.0 by retrieving the domestic databases from January 1999 to January 2014 to look into and compare the hospital infections in leukemic patients using laminar flow beds and common beds, including of the rate of hospital infection, duration of fever, days for antibiotic use, hospital stay. Results A total of 16 papers were included. The Meta analyses showed that the rate of hospital infection in the wards with laminar flow beds was significantly lower than that in the wards with common beds (RR=0.54,95%CI (0.47, 0.62), P<0.01). The fever duration, time for antibiotics use and hospital stay in patients in the wards with laminar flow beds were all significantly shorter than those in the patients in the wards with common beds [WMD=-3.64, 95%CI (-4.83,-2.46);WMD=-4.13, 95%CI (-5.95,-2.32)];WMD=-5.36, 95%CI (-7.52,-3.20);P<0.01,respectively)]. Conclusion Laminar flow beds are effective in preventing hospital infections among acute leukemic patients having undergone chemotherapy.