Objective To discuss the drug resistance and the vicissitude of Pseudomonas aerugi-nosa in Intensive Care Unit (ICU), in order to provide basis for rational use of antibiotics in clinic. Methods Identification of bacteria was performed by applying ATB Expression Identification System produced by BioMerieux Company; drug susceptibility tesr was done by using K-B method. The drug resistance of Pseudomonas aeruginosa was compared between ICU and general wards; and then the difference of drug resistance was investigated between 2006 and 2007. Resnlts The more sensitive an-tibiotics to Pseudomonas aeruginosa in ICU of our hospital were as follows, amikacin (resistance rate 6.7%-9.4%), eiprofloxacin (resistance rate 7.7%-24.7%), cefoperazone/sulbactam (resistance rate 11.5%-34%), ceftazidime (resistance rate 11.5%-37.7%), aztreonam (resistance rate 20.2%-40.6%). The drug resistance rate of ICU was higher than that of the general wards, and the drug re-sistance rates to ciprofloxacin, ceftazidime, cefoperazone/sutbaetam,meropenem, imipenem and aztreo-nam in 2007 were significantly higher than those in 2006 (P<0.01). Conclusion The drug resistance rate of Pseudomonas aeruginosa in ICU of our hospital was very high,and it is rising year by year. So it is important to retrospect the results of the drug resistance periodically and provide the up-to-the-mi-nute data of epidemiology and vicissitude of drug resistance.

Objective Better drying methods of Forsythia suspense leaves was studied to provide some basis for the development and utilization of Forsythia suspense leaves. Methods A RP-HPLC method was used on XTerraTMRP8 (3.9 mm?150 mm, 5 ?m) column with acetonitrile-0.1% acetic acid solution (12 : 88) as mobile phase for forsythoside. The detection wavelength of forsythoside was at 328 nm and detection temperature was 30 ℃. Results The contents of forsythoside was higher when dry, microwave drying, absorbent paper drying, steaming 2～10 min, cooking 2～10 min was used to deal with Forsythia suspense leaves. The contents of forsythoside was lower when dried, drying, infrared drying, vacuum drying was used to deal with Forsythia suspense leaves. Conclusion Steaming 2～10 min, cooking 2～ 10 min is more appropriate for drying of Forsythia suspense leaves, when factors of the contents of forsythoside, the cost and ease of operation were considerd.

Objective Chromatography fingerprint of Radix Codonopsis of different age from Shanxi province was studied to provide the reference for the science appraisal of intrinsic quality of Radix codonopsis. Method A RP-HPLC method was applied on GraceSmart-RP18 (250 mm?4.6 mm, 5 ?m) column with acetonitrile-0.1% acetic acid gradient elution as mobile phase, and the flow-rate was 0.6 mL/min. The detection wavelength was at 268 nm and the column temperature was at 30 ℃. Result Chromatography fingerprint of Radix Codonopsis can demonstrate obviously the difference and the similarity of Radix Codonopsis of different age. The RSD were lower than 3% in the precision, stability and the repetitiveness trial, and the codonopsis pilosula alkyne glucoside can be used as the reference to identify the active composition of Radix Codonopsis. Conclusion The method was simple, reproducible and reliable. The integrity of fingerprint can be used to supply the reference for the quality control of Radix Codonopsis from Shanxi provice.

OBJECTIVEWe used functional magnetic resonance imaging (fMRI) to explore the effects of noxious coldness and non-noxious warmth on the magnitude of cerebral cortex activation during intraoral stimulation with water.

METHODSSix male and female subjects were subjected to whole-brain fMRI during the phasic delivery of non-noxious hot (23 °C) and no- xious cold (4 °C) water intraoral stimulation. A block-design blood oxygenation level-dependent fMRI scan covering the entire brain was also carried out.

RESULTSThe activated cortical areas were as follows: left pre-/post-central gyrus, insula/operculum, anterior cingulate cortex (ACC), orbital frontal cortex (OFC), midbrain red nucleus, and thalamus. The activated cortical areas under cold condition were as follows: left occipital lobe, premotor cortex/Brodmann area (BA) 6, right motor language area BA44, lingual gyrus, parietal lobule (BA7, 40), and primary somatosensory cortex S I. Comparisons of the regional cerebral blood flow response magnitude were made among stereotactically concordant brain regions that showed significant responses under the two conditions of this study. Compared with non-noxious warmth, more regions were activated in noxious coldness, and the magnitude of activation in areas produced after non-noxious warm stimulation significantly increased. However, ACC only significantly increased the magnitude of activation under noxious coldness stimulation.

CONCLUSIONResults suggested that a similar network of regions was activated common to the perception of pain and no-pain produced by either non-noxious warmth or noxious coldness stimulation. Non-noxious warmth also activated more brain regions and significantly increased the response magnitude of cerebral-cortex activation compared with noxious coldness. Noxious coldness stimulation further significantly increased the magnitude of activation in ACC areas compared with noxious warmth.

Objective To evaluate the efficacy and safety of the damage-controlling surgery for the elderly patients with obstructive biliary diseases. Methods 278 elderly patients with obstructive biliary diseases were divided into the damage-controlling surgery group and definite surgery group.The obstructive biliary diseases were divided into the benign obstructive group and the malignant obstructive group. The complication rate and mortality between the 2 groups were analyzed and compared. Results One hundred and eighteen elderly patients were treated by damage-contolling surgery, its complication rate was 9.32 % and the mortality was 0 %. One hundred and sixty elderly patients,were treated by definite surgery, its complication rate was 24.38%, the mortality was 6.88%. There were significant differences in complication rate and mortality between the damage-controlling surgery group and the definite surgery group (all P＜0.01). The complication rate of the benign obstructive diseases group treated by damage-controlling surgery was 17.3%, the mortality was 0%. The complication rate of the benign obstructive diseases group treated by definite surgery was 16.3%, the mortality was 4.34%. There was no significant difference in the complication rate and mortality between the 2 groups (all P＞0.05). The complication rate and mortality of the malignant obstructive biliary diseases group treated by damage-controlling surgery were 4.45% and 0% respectively, and were 35.29% and 10.29% by definite surgery, there were significant differences in the complication rate and mortality between the 2 groups (P＜0.01 and P＜0.05). Conclusions Damage-controlling surgery may decrease the complication rate and mortality of the elderly patients with obstructive biliary diseases, and improve the operation safety of the elderly patients.

Objective To observe the changes of high mobility group box 1(HMGB1) and nuclear factorκB(NF‐κB) expres‐sion in the hippocampus of rats after cardiopulmonary resuscitation so as to unravel the role of HMGB 1 and NF‐κB in neuroin flam‐mation .Methods Totally 40 Sprague‐Dawley rats were randomly divided into shame‐operated group and recover group [including 2 ,6 ,12 ,24 and 48 h of 5sub‐groups after restoration of spontaneous circulation (ROSC)] .The animals were sacrificed and hippo‐campus were removed at the indicated time .Pathological changes were observed at each time point .The expression of HMGB1 and NF‐κB were determined using RT‐PCR and Western blot respectively .Results There were no histopathological in the hippocampus of rats in shame‐operated group ,brain tissue appeared change of ischemia pathology in recover group ,it was the most severest at ROSC 24 h and still obviously at ROSC 48 h time point .HMGB1 mRNA and NF‐κB mRNA expression in the hippocampus of rats of recover group increased obviously along with the prolongation of time following ROSC and reached its peak at ROSC 24 h(P<0 . 01) ,much higher than that of shame‐operated group ;the HMGB1 level in the hippocampus of rats after recover significantly de‐clined at 2 h after ROSC and increased obviously at 6 ,12 h and reached peak 24 h later ,then decreased 48 h later(P<0 .01) ,there was positive correlation between the expression of HMGB1 and NF‐κB protein .Conclusion HMGB1/NF‐κB signaling pathway may play an important role in the early stages of brain injury after cardiopulmonary resuscitation .Targeted therapies of this path way would be possible to open a new avenue for preventing neuroinflammation after recover .

Objective_To investigate the role of HMGB1 involved in the activation of P38MAPK signal pathway in the hippocampus of rats after cardiopulmonary resuscitation.Methods_Rats were randomly divided into two groups as shame-operated group, CPR group including 2, 6, 12, 24 and 48 h after restoration of spontaneous circulation ( ROSC) (5sub-groups) .The animals were sacrificed and hippocampus were removed at the indicated time.Patholog-ical changes were examined at each time point.Calculated the brain water content by day/wet ration.The HMGB1 mRNA expression was detected by RT-PCR technique.The expressions of HMGB1 and P38MAPK activity were deter-mined using Western blot.Results_There were no histopathological change in the hippocampus of rats in shame-op-erated group, brain tissue appeared change of ischemia pathology in CPR group, it was the most severest at ROSC 24 h.The brain water content, HMGB1 mRNA in rats of CPR group increased obviously along with the prolongation of time following ROSC and reached its peak at ROSC 24 h(P<0.01),much higher than that of shame-operated group, the HMGB1 level in the hippocampus of rats after CPR significantly declined at 2 h after ROSC(P<0.01)and increased obviously at 6, 12 h and reached peak 24 h later(P<0.01), the P38MAPK activity in the hippo-campus of rats after CPR, significantly increased at 2 h after ROSC and reached peak 6 h later(P<0.01), then declined slowly later, much higher than that of shame-operated group.Conclusions_HMGB1 involved in the acti-vation of P38 MAPK signal pathway may play an important role in the early stages of brain injury after CPR.

Objective To investigate the correlation between Kruppel-like transcription factor 6 (KLF6) and gastric cancer.Methods By using immunohistochemistry (IHC) and reverse transcription PCR,the expression of KLF6 protein and mRNA in human gastric carcinoma specimens and adjacent tissues from 73 patients were examined.Results The KLF6 protein expression rates were 39.7 ％ (29/73) and 90.41％(66/73) in 73 cases of gastric cancer and adjacent tissues,The KLF6 protein expression was significantly lower in human gastric carcinomas than the adjacent tissues by chi-square test (P ＜ 0.01).The KLF6 expression rates were 25.0 ％ (10/40),57.6 ％ (19/33) in poorly and well differentiated cancer.The difference between the two groups was significant (P ＜ 0.01).The optical density ratio of KLF6 mRNA were 0.1586±0.1071 and 0.8899±0.0638 in the gastric cancer and cancer adjacent tissue respectively,the difference between the two groups was significant (P ＜ 0.01).Conclusion KLF6 expression is low in gastric carcinoma,and moreover,KLF6 expression is significantly lower in poorly differentiated cancers than the well differentiated gastric cancers,there are negative correlation between KLF6 and gastric cancer,therefore KLF6 could be a useful marker for gastric cancer.

Objective To evaluate the intraoperative advantage and postoperative outcomes of threedimensional laparoscopic common bile duct (CBD) choledochoscopic exploration by micro-incision made at the cystic duct-CBD junction (LCBDEM) for gall stones and choledocholithiasis.Methods From January 2014 to December 2015,31 patients were operated under 3D LCBDEM (study group) and 37 patients under 2D LCBDEM (control group).The outcomes of patients in two groups were compared,including total procedure time (TPT),modified procedure time(MPT),suturing time(ST) and the wrong grasping per 100grasps(WG)of the LCBDEM.8 surgeons experienced in 3D LCBDEM were asked to fill in a subjective questionnaire.Results In control group,the TPT,MPT,ST and WG were (148 ± 47) min,(108 ± 42)min,(20 ±3)min and (19 ±4)per 100 grasps,respectively.In study group,the TPT,MPT,ST and WG were (148 ± 46) min,(9 1 ± 25) min,(1 8 ± 3) min and (8 ± 2) per 100 grasps,respectively.There were significant differences in MPT (t =-2.026,P ＜ 0.05),ST (t =-2.239,P ＜ 0.05) and WG (Z=-7.062,P ＜ 0.001).In subjective questionnaire survey,3D laparoscopy has advantages over 2D laparoscopy in visual and operation experience.But 3D laparoscopy made eyes more easily tired and dizzy.31 aparoscopy was inferior to 2D laparoscopy in spinning the camera around to get optimal field of vision.Conclusions 3D LCBDEM shortens procedure time and suturing time,increases operating accuracy and safety by providing high definition stereovision.

Objective To investigate bile leakage prevention in laparoscopic common bile duct (CBD) choledochoscopic exploration through micro-incision approach at the cystic duct-CBD junction.Methods From August 2007 to February 2015,a total of 147 cases undergoing laparoscopic CBD choledochoscopic exploration through micro-incision approach at the cystic duct-CBD junction were included in this study.From August 2007 to November 2012,57 patients were treated with laparoseopic CBD exploration (control group).From November 2012 to February 2015,90 patients were with optimized suture method of CBD (study group).The outcomes of patients in two groups were compared,including procedure time (PT),postoperative hospitalization time (PHT),and postoperative complications.Results In control group,the bile leakage rate was 5.3％,compared to 1.1％ in study group.There were significant differences in postoperative hospitalization time(t =1.98,P =0.0007) and hile leakage rate (x2 =139.5,P =0.04)between the two groups.Conclusions The prophylaxis measurements during operation are important to prevent bile leakage in laparoscopic CBD choledochoscopic exploration through micro-incision approach,including strict indications for micro-incision operation,proper expertise for laparoscopic cholecystectomy and laparoscopic suturing,choledochoscopic exploration,and suturing the whole layer of CBD wall,and carefully checking the suturing spot in case of bile leakage.T-tube placement is recommended while bile leakage is suspected.