OBJECTIVE To investigate the distribution and resistantce of three commonly encountered Gram-negative bacilli in our hospital,and provide doctors with the laboratory evidence of guiding antibiotic therapy.METHODS Bacterial identification and antibiotic susceptibility tests of isolates between Jan 2005 and Dec 2006 were performed by MicroScan WalkAway-40.RESULTS Totally 2024 common Gram-negative bacilli strains were isolated,807 of which were Escherichia coli,737 were Klebsiella pneumoniae,480 were Pseudomonas aeruginosa.The antimicrobial resistant rate of E.coli and K.pneumoniae to imipenem(2.2%) was lower than to the other antibiotics(2.7%).While 14.0% of P.aeruginosa isolates were resistant to imipenem.The antimicrobial resistant rate of all the isolated bacteria to piperacillin/tazobactam and amikacin was low,accounted less than 15%.CONCLUSIONS The resistant rate of three commonly encounted Gram-negative bacilli is increasing year by year.Therefore,monitoring bacterial drug resistance is very important for the rational use of antibiotics and the containment of multi-drug bacteria.

Objective To investigate the application of “top-down” method in assessment of measurement uncertainty of bio-chemical detection indicators .Methods The assessment data of internal quality control and external quality and “top-down”method were used to assess the precision and accuracy of 26 biochemical indicators ,and the two variables above were combined to calculate the measurement uncertainty .Results Uncertainty of 18 biochemical indicators was compatible with the target uncertainty ,ac-counting for approximately 69 .2% of all assessment projects .Five indicators ,such as TBIL ,albumin ,CK ,calcium and magnesium , was not compatible with the target uncertainty ,accounting for approximately 19 .2% of all assessment projects .Conclusion The“top-down” method is effective and feasible for assessment of measurement uncertainty of biochemical detection indicators .

Objective To assess the CT perfusion characteristics of breast diseases. Methods Twenty-two patients with fibroadenoma accompanied with cyst (n=1), other benign diseases (n=5), and carcinomas (n=16) underwent breast CT scan. CT perfusion was performed for breast with cine mode (0.5 s per rotation ) on a multislice CT scanner ,120 kV, 60 mA, 4?5 mm collimation. Contrast injection was done by using 50 ml nonionic contrast agent ( 300 mg I/ml ), at a flow rate of 4 ml/s with a power injector, 5 seconds delay, and data acquisition lasted for 50 seconds. These data were processed on a GE AW 4.1 workstation using perfusion 3 software package, and the mean BF, BV, MTT and PS were measured and statistically analyzed. Results The mean BF, BV, MTT and PS in carcinoma were (33.55? 28.40) ml?min -1 ? 100 g -1 , (5.60?3.08) ml/100 g, (15.37?6.41) s, (18.71?10.42) ml?min -1 ?100 g -1 . The mean BF, BV, MTT and PS in contralateral normal breast of carcinoma were (10.36?9.44) ml?min -1 ? 100 g -1 , (0.70?0.22) ml/100 g, (13.55?7.27) s, (1.54?1.74) ml?min -1 ?100 g -1 . The mean BF, BV, and PS between carcinoma and normal breast were statistically significant (P0.05). The mean BF, BV, MTT and PS in fibroadenoma were (62.57?19.62) ml?min -1 ?100 g -1 , (7.37?1.30) ml/100 g, (11.24?3.34) s, (27.63?3.87) ml?min -1 ?100 g -1 . The mean PS between carcinoma and fibroadenoma was statistically significant (P0.05). The mean BF, BV, MTT and PS in benign lesion were (7.65?10.24) ml?min -1 ?100 g -1 , (1.23?0.97) ml/100 g, (14.94?10.68) s, (1.81?1.72) ml?min -1 ?100 g -1 . The mean BF, BV, and PS between carcinoma and benign lesion were statistically significant (P0.05). Conclusion MSCT perfusion may reflect the features of breast diseases, and provide valuable hemodynamic message. These parameters have a value in diagnosis of breast diseases and are helpful for differential diagnosis.

Objective:To explore the effects of body mass index (BMI) and gender on primary lung cancer 18F-FDG uptake param-eters, standardized uptake value (SUV), and standard uptake value of lean body mass (SUL). Methods:Data of 50 patients with prima-ry lung cancer confirmed by 18F-FDG positron emission tomography (PET)/computed tomography (CT) were retrospectively analyzed. AW4.6 workstation was employed to measure the SUVmean and SUVmax. Meanwhile, PETVCAR (PET Volume Computed Assisted Reading, GE Healthcare) software was used to automatically measure the SULmean, SULmax, and SULpeak. The SUVmean, SUV-max, SULmean, and SULmax of the liver (central region of the right lobe) were also measured automatically by PETVCAR. Afterward, T/N ratios (lesion SUVmax/liver SUVmean, lesion SULmax/liver SULmean, and lesion SULpeak/liver SULmean) of the lung cancer lesions were calculated. Correlations of the 18F-FDG metabolic parameters with BMI and gender of the patients were analyzed. Results:Liver SUVmean and SUVmax demonstrated significant positive correlations with BMI in all the patients (γ=0.38 and 0.36, P<0.05), and the SUVmean and SUVmax were positively correlated with BMI in male and female groups (γ=0.47 and 0.44, P<0.05), respective-ly. By contrast, no correlation existed between the liver SULmean and SULmax and BMI (P>0.05). No significant correlation was not-ed between the SUVmean, SUVmax, SULmean, SULmax, and SULpeak of the lung cancer lesions and BMI (P>0.05). The correlation trend is the same as that in different gender groups. Only the SUVmax T/N ratio of the lung cancer lesions showed a significant nega-tive correlation with BMI (γ=?0.29, P<0.05). The T/N ratios did not correlate with BMI in the different gender groups (P>0.05). Con-clusion:Patient BMI and gender mainly affect SUV values, particularly SUVmax, by contrast, patient BMI and gender did not signifi-cantly influence SUL and T/N ratio (SUL). Hence, SUL can be more suitable to quantitatively analyze and assess treatment response ob-jectively. This result will be helpful to the clinical application and promotion of PERCIST, which evaluates treatment response mainly by SUL.

Objective To investigate the inhibitory effects and mechanisms of a nature product derivate oridonin on in?vasion of human lung cancer. Methods Human lung cancer A549 and PC-9 cell lines were treated with oridonin. MTS as?say was used to determine cell proliferation. Transwell assay was used to determine the cell invasion, and adhesion assay to determine the cell adhesion. Flow cytometry was used to determine cell cycle. Western blotting and realtime-PCR were used to detect expression levels of CDK1, mTOR, p53, p21, E-cadherin, CD44,β-catenin, uPA, MMP-2/9, p-AKT and p-Src. The luciferase reporter assay was used to detect the NF-κB promoter activity. Results In vitro proliferation, invasion and adhesion of A549 and PC-9 cells were significantly inhibited by oridonin. The cell cycle was halted by G2/M phase, and ex?pressions of E-cadherin, p53 and p21 were promoted, while expressions of CDK1, mTOR, CD44,β-catenin, uPA, MMP-2/9, p-AKT and p-Src and promoter activity of NF-κB were down-regulated. Conclusion Oridonin is able to inhibit the in vitro invasion of human lung cancer A549 and PC-9 cell lines, which might be correlated with its abilities to regulate the ty?rosine kinase activity.

Objective: To evaluate and compare the safety and efficiency of the combined therapy of 89Sr plus zoledronic acid and those of 89Sr-chloride alone, in patients with painful bone metastases. Methods: A total of 87 patients with osseous metastasis were ran-domly divided into treatment groups of 89Sr-chloride alone (group A, 53 patients) and 89Sr plus zoledronic acid (group B, 34 patients). A total of 17 patients in group B received zoledronic acid 2-14 days after 89Sr therapy, and 13 other patients in the group received 89Sr 4-7 days after zoledronic-acid therapy. Pain response and KPS score were evaluated after the different treatments. Results: No obvious bone marrow suppression and liver damage were found in all cases. All patients who received both 89Sr-chloride and 89Sr plus zoledronic acid showed reduced bone pain and total discomfort, as well as improved KPS score, but the response was more pronounced in group B (P=0.047; P=0.036). No statistical differences in pain score and KPS scores were observed between the groups treated with zoledronic acid first and 89Sr therapy first (P=1.000; P=0.667). Comparison of bone pain relief and changes in the KPS score of different primary tumors after treatment with 89Sr-chloride or 89Sr plus zoledronic acid showed no statistical significance. Conclusion: Compared with 89Sr-chloride, treatment with 89Sr plus zoledronic acid was more effective in patients with painful bone metastases. The safety of these two treatments are similar.

Objective To explore the value of 18 F-fluorodeoxyglucose (i8 F-FDG) PET/CT examination in the differential diagnosis of the gastric cancer and primary gastric lymphoma (PGL).Methods The clinical data of 80 patients with gastric cancer (60 with non-mucinous adenocarcinoma and 20 with mucinous adenocarcinoma) and 47 patients with PGL [22 with mucosa-associated lymphoid tissue (MALT) and 25 with diffuse large B-cell lymphoma (DLBCL)] who were admitted to the Tianjin Medical University Cancer Institute and Hospital from June 2006 to May 2014 were retrospectively analyzed.Spiral CT scan was first done and then followed by PET.The CT value of the lesions,maximum standardized uptake value (SUVmax) of patients and maximal gastrointestinal wall thickness (THKmax) were analyzed by the ANOVA test.The SUVmax comparison between groups was evaluated with the Student-Newman-Keuls.The lesions type was analyzed by the chi-square test.The THKmax and SUVmax among groups were analyzed by the Pearson correlation analysis.Results 18 F-FDG PET/CT imaging of patients with gastric cancer and PGL showed different types of gastric wall thickening,segmental and limited thickening of gastric wall were the main features of gastric cancer and diffuse and segmental thickening of gastric wall were the main features of PGL.The type Ⅰ,Ⅱ and Ⅲ of lesions were detected in 12,21 and 27 of 60 patients with nonmucinous adenocarcinoma,in 2,7 and 11 of 20 patients with mucinous adenocarcinoma,in 8,8 and 6 of 22 patients with MALT and in 13,7 and 5 of 25 patients with DLBCL respectively.There were significant differences in the 4 pathological types of lesions among all the patients (x2 =14.849,P ＜ 0.05).The lymph nodes beneath the renal hilum and at the retroperitoneum were involved in 16 patients with gastric cancer and in 10 patients with PGL,and 7 patients with gastric cancer and 12 patients with PGL were complicated with splenomegalia,respectively,showing a significant difference in the splenomegalia between patients with PGL and gastric cancer (x2=7.506,P ＜0.05).There was no significant difference in the metastasis of lymph nodes beneath the renal hilum and at the retroperitoneum between patients with PGL and gastric cancer (x2=0.178,P ＞0.05).Among 80 patients with gastric cancer,positive 18F-FDG was detected in 79 patients and negative 18F-FDG in 1 patient with T3 stage of mucinous adenocarcinoma.Among 47 patients with PGL,positive 18 F-FDG was detected in 46 patients and negative 18F-FDG in 1 patient with stage Ⅰ of MALT.The CT value of the lesion,SUVmax and THKmax in patients with non-mucinous adenocarcinoma,mucinous adenocarcinoma,MALT and DLBCL were (40 ± 8)HU,(39±11)HU,(41±11)HU,(38±9)HU and 9.9 ±6.6,5.6±1.9,4.6 ±2.9,18.3±7.6 and (2.1 ± 1.2) cm,(1.9 ± 0.9) cm,(1.3 ± 1.1) cm and (2.6 ± 1.5) cm,respectively,showing significant differences in the SUVmax among all the groups (F =26.920,P ＜ 0.05).In the pairwise comparisons,there were no significant difference between the MALT group and mucinous adenocarcinoma group (P ＞ 0.05),and significant differences among the other groups (P ＜ 0.05).The CT value of the lesions and THKmax among all the patients were compared,with no significant differences (F =0.578,4.510,P ＞ 0.05).There were no significant differences in the SUVmax and THKmax among all the patients (r =0.055,0.346,0.226,0.133,P ＞ 0.05).Conclusions There is an important diagnosis value of PET/CT examination in patients with gastric cancer and PGL.The pathological types of the lesions in patients with gastric cancer and PGL are different.The occurrence of splenomegalia in patients with PGL is easier than that with gastric cancer.SUVmax of patients with DLBCL is higher than those with gastric cancer and MALT.FDG uptake in patients with mucinous adenocarcinoma and MALT are not enough,and these may lead to false negative result of PET/CT examination.

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 .

AIM: To explore the role of cPKCs in the development of cerebral hypoxic preconditioning, the effect of repetitive hypoxia on the level of protein kinases C ?I and ?II (cPKC ?I and ?II ) membrane translocation in the brain of mice was observed. METHODS: The hypoxic preconditioned mouse model was adapted with minor modification from our previous report. The biochemistry techniques of SDS-PAGE and Western blotting were applied to determine the level of cPKC ?I and ?II membrane translocation in cortex and hippocampus of mice. RESULTS: cPKC ?II translocated from the cytosolic fraction to the particulate fraction in response to the repetitive hypoxic exposure (H1-H4) both in hippocampus and cortex of mice, which was regarded as membrane translocation. The significant membrane translocation of cPKC ?II was found in hippocampus of H4 group (173.3%?21.3% vs H0: 100% or H1: 79.5%?10.7%, P0.05, n=8). CONCLUSION: These results suggest that cPKC ?II may play an important role in the development of cerebral hypoxic preconditioning, but the changes of novel and typical PKC isoenzymes are still under investigation.