Objective To investigate the distribution and antibiotic resistance of clinical pathogen isolated from patients of intra-abdominal infection associated sepsis in surgical intensive care unit (SICU ) during recent 5 years ,then instruct clinical application of antibiotics reasonably .Methods Abdominal drainage of 65 patients of intra-abdominal infection associated sepsis were collected from January 2008 to December 2012 .All the specimens were analyzed for pathogen distribution and drug susceptibility .Results A total of 151 strains of pathogenic bacteria was isolated ,in which Gram-negative bacteria were the most popular pathogen (104 strains ,68 .9% ) ,whereas Gram-positive bacteria and fungi accounted for 19 .2% (29 strains) and 11 .9% (18 strains) ,respectively . The five most common pathogens were Escherichia coli(23 .2% ) ,acinetobacter baumannii(15 .2% ) ,enterococcus faecium(13 .2% ) , pseudomonas aeruginosa(8 .6% ) ,andklebsiella pneumonia(7 .9% ) .The rate of the ESBL-producing strains of escherichia coli and pneumonia pneumonia were 80 .0% and 33 .3% .Both of them showed low resistance to carbapenem antibiotics .The proportion of multidrug resistantstrains and extensive drug resistant strains of acinetobacter baumannii was 56 .5% and 30 .4% ,respectively .Con-clusion The resistance of the pathogen isolated from the patients of intra-abdominal infection associated sepsis in SICU is seriously high .Early and rational using of antibiotics is of great importance to control the production and transmission of drug resistance .

Teaching is very important for anesthesiology developmemt,so residents should be cultivated the teaching capacity as soon as possible.This article discussed how to cultivate the teaching capacity of residents in anesthesiology department.

Objective To observe the stability and the change pattern of VEGF expression in myocardium in varied postmortem periods,and to evaluate its usefulness in diagnosis of early myocardial ischemia after death.Methods An animal model of early myocardial ischemia was established by ligating coronary artery of rabbit,immunohistochemistry(SP protocol),image analysis technique and statistical analysis system are applied to detect and compare the area and intensity of expression of VEGF in cardiocytes,and its stability in different postmortem perieds.ResultsIn ischemic myocardium,VEGF shows foci or sheets of intense positive staining in cardiocytes,with negative or weak staining in some cells.There was weak staining in vascular endothelial cells and smooth muscle cells,but no staining in interstitium.When ischemic myocardium stored at 4℃,the staining of VEGF became weaker with time delay,but there was weak staining in a fraction of cardiocytes even 10d after death.There was significant difference in the intensity of VEGF staining between ischemic and normal postmortem myocardium from 1 to 10d.Conclusion VEGF can withstand a certain degree of autolysis or putrefaction,and the immunohistochemical staining of it is valuable in the diagnosis of early myocardial ischemia in corpses stored at 4℃ for 1~10d after death.

Objective To study the feasibility of TCI etomidate for total intravenous anesthesia (TIVA). Methods Forty patients scheduled for abdominal operation were divided into two groups with 20 cases each. Anesthesia in group E was induced and maintained with TCI etomidate 1-2 μg/ml and remifentanil 6 ng/ml,which in group P with TCI propofol 2-4 μg/ml and remifentanil 6 ng/ml to keep BIS 40-60. The perioperative changes of plasma glucose, cortisol, aldosterone and ACTH were Observed. Recovery from anethesia was recorded as well Results Both groups had the stabilized hemodynamics and glucose concentration. The plasma cortisol and ACTH concentrations in group E were decreased at the end of operation(P<0.05), but returned to preoperative level on the next day, which were not significantly changed perioperatively in group P. The time of eye opening was longer in group E than that in group P. Conclusion Etomidate has an inhibition on the function of the adrenal cortex temporally and can be used safely togather with remifentanil for TIVA in patients without hypoadrenocorticism.

Objective:To investigate the effect of ulinastatin(UTI) on the changes of IL-6,TNF-?,IL-10 and IL-4 expression during perioperative period of surgical correction of adolescent idiopathic scoliosis(AIS).Methods: Twenty patients with AISⅠ-Ⅱ scheduled to receive surgical correction of spinal deformities were equally randomized into 2 groups-UTI group and control group.Patients in UTI group received intravenous infusion of 10 000 U/kg UTI with 250 ml normal saline just before operation and every 4 h thereafter if necessary;patients in control group received same amount of normal saline.ECG,CVP,SpO_(2)and P_(ET)CO_(2) were continously monitored during operation in both group.Mean arteral pressure(MAP) was maintained at(60?5) mmHg(1 mmHg=0.133 kPa).Venous blood samples were collected immediately before induction of anaesthesia(T_(1)),10 min after induction(T_(2)),1 h after UTI administration(T_(3)),30 min after extubation(T_(4)) and 24 h postoperatively(T_(5)).The plasma levels of IL-6,TNF-?,IL-10 and IL-4 were measured by enzyme-linked immunosorbent assay(ELISA),and their mRNA expression was assayed by real-time quantitative reverse transcription polymerase chain reaction.Results: At T_(3),T_(4) and T_(5),plasma levels of IL-6 and TNF-? and their mRNA copies in control group were significantly higher than that at T_1(P

Objective To investigate the feasibility of repairing spinal tracts with peripheral nerve graft combing neurotrophic factors in rats following complete spinal cord transection.Methods One hundred and twenty-one male Wistar Rats were transection at T9 level of spinal cord, and randomly divided into five groups. Group A with spinal cord transection was underwent acidic fibroblast growth factor (aFGF) treatment and peripheral nerve grafts (n=25); Group B: spinal cord transection was underwent aFGF treatment only (n=25); Group C: spinal cord transection was underwent peripheral nerve grafts only (n=25); Group D: spinal cord transaction only (n=25); and Group E: sham control (laminectomy only, n=21). The locomotor behavior of all rats was analyzed by the BBB open field locomotor test over the six months of survival time. Motor evoked potentials (MEP) were used to evaluate axon growth across the damage site. Biotinylated Dextran Amine (BDA) and retrograde tracing with fluorogold were used to evaluate the presence of axons through the damage site after treatment. Results The presence of anterograde BDA labeling of corticospinal tract axons at the graft site and fluorogold retrograde labeling of neuron populations was found in motor cortex and in red nucleus, reticulospinal nuclei, raphe nuclei, and vestibular nuclei in Group A. The average latency and amplitude of MEP were improved significantly in Group C. The mean of BBB scores showed significant improvement in Group A. Statistical analysis indicated that Group A had significant improvement compared to Group BC and D at 6 months post-surgery (P

Objective:To investigate the influence of gender difference on the activation of platelets in septic rats.Methods: Totally 20 female and 20 male SD rats were randomly divided into four groups: male sham-operated group,female sham-operated group,female septic group,and male septic group,with each group containing 10 rats.Sepsis model in the last two groups was produced by cecal ligation and puncture(CLP);rats in the sham-operated group received no CLP.The rats were sacrificed 24 hours after surgery;the blood samples were collected for blood routine test;and the serum ?-TG levels were detected by ELISA assay.Serum estrogen(E2) levels were detected by radioimmunoassay.Results: The blood platelet counts were decreased in both septic rats of both genders;the count in female rats was significantly higher than in the male rats(P

0.05);the onset time periods of the 3 groups were(1.9?1.1) min,(3.6?2.1) min,and(3.3?1.5) min,respectively,with that of group A significantly shorter than those of B and C groups(P0.05).The glottis exposure degree in group A was significantly better than that of B and C groups(P0.05).Conclusion:Rocuronium is superior to cisatracurium in induction intubating for general anesthesia in terms of clinical effect time and glottis exposure degree,and it can provide better intubating conditions.

12 cases of COPD with cor pulmonale and 5 health volunteers were observed while load dose of aminophylline (6mg/kg) was infused intraveneously.LVEF,LVER were measured by 113In-nuclide before and after administration,and FEV1.0,FVC,and arterial blood gas were determined.Serum concentration of theophylline was measured simultaneously.The results showed:(I) In COPD and cor pulmonale patients 10/12 (85%) showed abnormal LVEF,LVER without evidence of coronary heart disease.The results suggested that left ventricular performance were impaired.(2)After load dose of ami-nophylline infusion the left ventricular performance and pulmonary ventilation were improved synchronously.It suggested that aminophylline may be a drug of choice in the stable state of these patients.

Objective: To determine the effects of intravenous anesthetics (fentanyl,midazolam and propofol )on inflammatory responses. Method: We employed carrageenan-sensitized endotoxemic rabbit model. Thirty-two New Zealand rabbits were randomly assigned to one of four groups,control group(no anesthetic was used), fentanyl group, midazolam group and propofol group. Different anesthetics were used intravenously for anesthesia induction and maintenance according to the group classification. Meanwhile, all animals were mechanically ventilated, then, 2?g?kg~(-1) lipopolysaccharide(LPS) were injected for endotoxin challenge. Result:In all groups, serum tumor necrosis factor (TNF)activity began to increase at 30 min,reached its maximal level at 60 min,and tended to decrease at 120 min after (LPS) challenge,and the significant increase of TNF activity was associated with development of hypotension. Meanwhile,serum phospholipase A_2(PLA_2)activity began to increase at 60 min and persisted in going up within 2h. Those animals,with continuous infusion of these three different anesthetics and mechanical ventilation,had much lower peak level of TNF and higher mean arterial pressure (MAP)than control levels, but their changes of serum PLA_2 activity had no significant difference from control level. Conclusion: With mechanical ventilation, intravenous infusion of these anesthetics can reduce LPS induced injury in the acute phase of endotoxemia, probably by the inhibition of TNF production.