OBJECTIVE To investigate the resistance and the resistant mechanism of the imipenem-resistant Acinetobacter baumannii(IRAb) strains isolated from inpatients to guide for the clinical treatment and prevention.METHODS VITEK2-compact system was used to identify 77 IRAb strains,and to detect their susceptibility to antibiotics.K-B susceptibility testing was used to detect their susceptibility to amikacin and minocycline.PCR was carried out to detect their related genes.RESULTS The 77 isolated strains were multidrug-resistant.The rate of resistance to cephalosporins and quinolones was respectively higher than to amikacin whose sensitivity came to 90%;PCR confirmed OXA-23 was 100% related with IRAbs,OXA-51 was the same.CONCLUSIONS Most of IRAb were MDRAb.The mechanism of A.baumannii(ABA) to imipenem is closely related with OXA-23,K-B susceptibility test is more accurate and minocycline could be used for IRAbs.

Small cell lung cancer, most malignant and highly aggressive has a high relapse rate due to drug resistance. Potential strategies as high dose chemotherapy with autologous bone marrow transplantation and analysis on genes of metastases are focused on. In spite of great improvement, methods and clinic significances of bone marrow micrometastases are still to be determinated. Bone micrometastases may be a resort to clarify the mechanism of metastases.

Objective To investigate the resistance and infection case for the Multidrug-Resistant Acinetobacter baumanii (MDRAb) strains.Methods Retrospective study.Thirty-eight MDRAb strains were collected in Beijing Friendship Hospital from February to August 2008.VITEK2-compact system was used to detect the MDRAb.PCR was carried out to detect their resistance related genes and look up the medical records those who were infected by MDRAb.Results The resistance rate of the MDRAb is the highest in ICU.PCR confirmed that OXA-23 and OXA-51 were 100％ related with the MDRAb.Combination drug therapy such as sulbactam combined with β-lactam antibiotics was more effective than β-lactam antibiotics only to treat the infection with MDRAb.Cases analysis showed that a number of patients infected by MDRAb were the aged with basic diseases,low immunity,received a variety of antibiotic therapy even traumatic operation,and they had a poor prognosis finally.Conclusions The resistance rate of the MDRAb is the highest in ICU,OXA-23 is closely related to multidrug-resistance.Combination drug therapy is necessary and sulbactam can play a great role in curing the inpatients infected with MDRAb.

Pseudomonas aeruginosa,a ubiquitous organism,shows a remarkable resistance to antibiotics because of its low permeability of the outer-membrane,over-expression of efflux pumps,inactivation of antibotics,or mutations in targets.These mechanisms are often present simultaneously,and increase the burden on clinical therapy.

OBJECTIVE To investigate the resistance and the homology of the Acinetobacter baumannii(ABA) strains isolated from inpatients to offer basis for clinical treatment and preservation.METHODS VITEK2-compact system was used to identify 110 ABA strains,and detect their susceptibility to antibiotics.REP-PCR was carried out to detect their homology.RESULTS The 110 isolated strains were multidrug resistant.Rate of sensitivity to amikacin was 91.3%,Rates of resistance to ceftazadime,ciprofloxacin and imipenem were 100.00%,97.83% and 91.30%,respectively.REP-PCR was confirmed part of them was from the same clone.CONCLUSIONS Most of the isolated strains are multidrug-resistant.The same clone of MDR-ABA probably leads to transmission among patients.

Objective To investigate the laparoscopic anatomy of the spleen vessels and its clinical application. Methods The data of 47 cases of total laparoscopic splenectomy (TLS) were analyzed. Among the patients, 21 had cirrhotic portal hypertension, 19 had thalassemia, 2 idiopathic thrombocytopenic purpura, 2 hereditary spherocytosis, 1 angioma of the spleen, 1 splenic cyst, and 1 primary hypersplenism. The color of the spleen was observed after the splenic artery near the pancreatic tail was ligated. And then the splenic artery was categorized according to the color. Results Among the 47 cases, 34 (72.3%) were categorized as typeⅠ, 9 were type Ⅱ (19.1%), and 2 were type Ⅲ (4.3%). The arterial anatomy was unclear under a laparoscope in 2 cases (4.3%). The TLS was completed in 46 cases with a success rate of 97.9% (46/47). Among the cases, 14 received extensive esophagogastric devascularization simultaneously,and 3 patients who had thalassemia underwent cholecystecotomy after the TLS because of gallbladder stones. One case was converted to an open surgery because of extensive bleeding owning to coagulation disorder. The spleen artery was ligated in 43 cases, and the hilar vessels were resected by dissecting and ligating in 45 cases. The Operation time averaged at (110?35) min (range 50-240 min), and the mean intraoperative blood loss was (160?87) ml (range, 20-1500 ml). Conclusions In spite of the prominent type Ⅱ of the spleen vessels, the spleen artery can be dissected and ligated at the level of the superior edge of the pancreatic tail to stop the blood supply to the spleen. The hilar vessels can be resected by dissecting and ligating. The spleen artery ligation and hilar vessels resection by dissecting and ligating are effective in controlling intraoperative bleeding and avoiding pancreas injury.

Objective To discuss the efficacy of photoselective vaporization of the prostate(PVP) for patients with benign prostatic hyperplasia(BPH).Methods From July 2006 to August 2007,110 patients with BPH received PVP in our hospital.The safety of the procedure,Pre- and postoperative Qmax,and IPSS of the cases were recorded and analyzed.Results The mean operation time was(51.2?36.3) minutes(ranged from 15 to 180).In the patients,23 cases had a prostate weighed ≥100 g,9 of them received TURP during the procedure.89 patients underwent bladder irrigation for 15 to 48 hours(mean,36 hours).After the operation,urinary catheter was left indwelling in all the patients except for 6(

Objective To evaluate the clinical outcomes of emergency intracoronary stenting for senile patients with acute myocardial infarction (AMI). Methods Eighty-four senile patients with AMI underwent emergency intracoronary stenting were compared with eighty-eight non-senile patients with AMI. Results Eighty-six stents were implanted in eighty-four infarction related arteries (IRA), two patients died during hospitalization,the procedural success rate was 97.6% in senile group. Eighty-eight stents were implanted in eighty-eight IRA, one patient died during hospitalization, the success rate was 98.9% in non-senile group. There was no significant difference in characteristic of stents, bleeding complication and LVEF between the senile group and the non-senile group.Conclusion Emergercy intracoronary stenting was an effective and safe therapeutic maneuver for the senile patients with AMI.

Objective To evaluate the clinical value of carbon nanoparticles suspension in gallbladder carcinoma lymphadenectomy.Methods 21 cases of gallbladder carcinoma who received radical resection from January 2008 to August 2013 were randomly divided into experimental group (11 cases received carbon nanoparticles injection into the subserosa around the tumor before operation) and control group (10 cases did not receive any tracer).The number of dissected lymph nodes,black-stained lymph nodes and positive lymph nodes were analyzed.Results A total of 138 lymph nodes were resected in experiment group,average 12.546±5.047 lymph nodes per patient,which was significantly more than that in control group in which there were overall 87 lymph nodes,average 8.700±2.497 lymph nodes per patient (t =2.176,P =0.042).The blacken rate of lymph nodes in experimental group was 56.522 ％ (78/138).There were 46 metastasis lymph nodes out of 79 blacken lymph nodes,and the positive rate was significantly higher than that of non-blacken lymph nodes [58.228 ％ (46/79) vs 38.983 ％ (23/59),P=0.039].There was no local or systemic adverse reaction occurred in experimental group.Conclusions Carbon nanoparticles suspension maybe helpful for lymphadenectomy during radical gallbladder carcinoma dissection to reduce operating damage and be safe.