OBJECTIVE To determine the bacterial distribution and resistance of biliary tract infections in China.METHODS Disc diffusion test,MIC test or E-test were used to detect the antimicrobial sensitivity of bacterial isolates from bile specimens.WHONET software was applied for analysis of the bacterial sensitive data from 84 tertiary Mohnarin member hospitals at different area in China from June 1,2006 to May 31,2007.RESULTS A total of 1441 bacterial strains were collected in the survey period,which included 952 Gram-negative strains(66.1%),of which the top three were Escherichia coli(31.0%),Klebsiella pneumoniae(8.4%) and Pseudomonas aeruginosa(7.8%) and 489 Gram-positive strains(33.9%),the top three were Enterococcus faecalis(11.6%),E.faecium(9.5%) and Staphylococcus(7.4 %).Susceptibility results showed that the resistant rates of E.coli and K.pneumoniae to three generation cephalosporins and quinolones were 25.9-70.0%,17.9-44.8% and 66.9-70.9%,34.6-40.0%,respectively,which were comparable with the results of overall bacteria collection.The resistant rates of P.aeruginosa to imipenem and cefoperazone/sulbactam were 37.5%,13.8%,and the detection rate of meticillin-resistant Staphylococcus aureus(MRSA) from bile samples was higher than the results of overall bacteria collection.Vancomycin-resistant Enterococcus(VRE) were rare.CONCLUSIONS Gram-negative bacilli are still the predominant pathogens in biliary tract infections;the overall bacterial resistance is severe.MRSA is increasing.Prudent application of antibiotics in biliary tract infections needs to be emphasized.

OBJECTIVE:To provide theoretical basis for pharmaceutical enterprises in their choice of suitable e-commerce application modes.METHODS:The options available for pharmaceutical enterprises in regard to e-commerce application modes were introduced and compared,and the influential factors that should be take into consideration in the selection for the pharmaceutical enterprises were studied as well through the method of factor analyses.RESULTS&CONCLUSION:A decision tree has been established for pharmaceutical enterprises in their selection of application modes of e-commerce.

Objective To systematically observe the damage of pancreas and changes of serum amy-lase and lipase in septic rat at different time points after the septic rat model being established. Methods Fifty-four male rats were randomly divided into sham group,sepsis group and normal control group. In the sepsis group,rats were given cecal ligation and puncture so as to produce a model of the rat′s intestinal septic shock. In sham group,after opening the abdominal cavity of the rats,only the cecum was pulled out of the abdominal cavity,then the abdominal cavity was satisfied and stitched. The arterial blood and pancreatic tis-sues of the rats in both sepsis and sham groups were collected for detection of serum amylase and lipase and observation of damage of pancreas by light and electron microscopy at 3 h,6 h,12 h,24 h after the model be-ing established. Results The levels of serum amylase of sepsis group showed a rising trend over time,and peaked at 24 h(2 779. 83 U/L), which showed no difference among 4 time points. There was no significant difference of serum amylase among 3 groups at each time point except for 12 h value. The levels of serum li-pase in both sepsis and sham group were higher than that in normal control group at 3 h(P<0. 05),while de-creased to the level of normal control group at 24 h. By light microscope,pathological changes of pancreas in the sham groups were that lobule was slightly widened; mild interstitial edema,vasodilation and a little in-flammatory cell infiltration were occasionally found;most of the lobular structure was complete. In the sepsis group,pancreatic pathological changes aggravated with time prolonged. Pancreatic lobules gap widened,inter-stitial were infiltrated by the inflammatory cell,flocculus brim structure was fuzzy,focal necrosis was found occasionally,islet structure was complete at 3 h. Pancreatic lobule was significantly wider,more inflammatory cell infiltrated,necrosis enlarged at 6 h,and pancreatic lobule was obvious edema,more inflammatory cell in-filtration and focal necrosis were found at 12 h. Vascular of pancreatic lobule was dilatation and congestion, pancreatic lobule and islet edge blurred,more lobular necrosis at 24 h. The modified Schmidt scoring of sham group and sepsis group at 3 h,6 h,12 h,24 h were 2. 0,3. 6,3. 4,3. 6 and 4. 6,6. 0,6. 8,7. 6,respectively. By transmission electron microscope,the ultrastructure of pancreatic cell in sham group was normal,mitochondri-al and lysosomal swelling were found occasionally. When in the sepsis group,the nucleus was normal,some mitochondria was swelling and cracking, lysosomes was swelling at 3 h, nucleus was complete, a part of swelling mitochondria and lysosomes appeared vacuolated necrosis at 6 h,and karyopyknosis and chromatin condensation were found,more mitochondria and lysosomes were swelling necrosis and vacuolar degenerated, rough endoplasmic reticulum was swelling at 12 h,cell karyopyknosis and chromatin condensation were obvi-ous,a large number of mitochondria and lysosome, endoplasmic reticulum were swelling, dilatation and vacuolar necrosis at 24 h. The modified Schmidt scoring showed no significant correlation with the levels of serum amylase and lipase in sepsis group(r=0. 472,P=0. 199;r=0. 260,P=0. 499). Conclusion The pancreas was damaged in the septic rat. The pathological changes of pancreas were obvious at 6 h after sepsis onset. The characteristics of the pancreas ultrastructure change includes the changes of the mitochondria and lysosome in the early period,clear vacuoles necrosis of mitochondria and lysosome,and destruction of nucleus and the endoplasmic reticulum. There is no significant correlation between pancreatic pathological changes and serum amylase as well as lipase,serum amylase and lipase can′t indicate the extent of pancreas damage in sepsis.

BACKGROUND: With further understanding of deep venous thrombosis(DVT)following total hip replacement,reduction and prevention of DVT has become hot topic in clinical studies.The reports of DVT formation factors remain controversial due to small samples,little statistical significance,confusion of basic experimental and clinical results and lacks of science.OBJECTIVE: To explore the causes and factors for the early DVT following total hip replacement and summarize measures to prevent and treat early DVT to reduce incidence of complications.METHODS: A total of 1780 cases of primary total hip replacement operation were analyzed retrospectively.The statistical indexes included sex,age,body mass,other system disease,previous hip joint operation,anesthesia,operative time,prosthetic fixation,blood transfusion,postoperative functional exercise,antithrombotics,and complication.Standardized database was built and analyzed by SPSS(version 13).Regression analysis was performed using Binary Logistic Regression.RESULTS AND CONCLUSION: Of 1780 cases,136 had DVT.Age,other system diseases,anesthesia,prosthetic fixation,blood transfusion,postoperative functional exercise and antithrombotics were correlated with early DVT(P < 0.05).Old age,hypertension or diabetes,general anesthesia,fixation of bone cement,whole blood transfusion were the risk factors for early DVT following total hip replacement,while postoperative functional exercise and antithrombotics were the protective factors for DVT.The incidence rate of early complications can be reduced by the methods such as dealing with perioperative treatment carefully,effectively controlling the chronic diseases,efficient evaluation before surgery,precise manipulation,and the postoperative prophylactic treatment and nursing.

Objective To study the influence of spinal instability after lamina decompression in symptoms and progno?sis. Methods The 76 patients were followed up for a minimum of 4 more years. The patients were divided into instability group (n=27) and non-instability (n=49) group according to the X-ray result of the final follow-up. The visual analogue scale (VAS) score, JOA score and improvement rate were compared between two groups at preoperation, 3-month after operation and the final follow-up. Results There were no significant differences in gender, age and mean follow-up time between two groups. There were no significant differences in VAS and JOA scores before surgery, 3-month after surgery and final follow-up between two groups. Postoperative VAS score decreased and JOA score increased with the increase in follow-up time (P<0.05). There were no significant differences in improvement rate [(80.0±8.8)%vs (83.6±11.7)%] and improvement ratio [81.48%(22/27) vs 61.22%(30/49)] between two groups (P > 0.05). Conclusion Although some patients show instability even with lumbar spondylolisthesis after lamina decompression on radiograph,which is no correlation with improvement of symptoms. With appropriate indications, lamina decompression is a simple and effective surgical method,which also retains the spinal movement function.

Objective To understand the role of increasing peripheral blood platelet count in the diagnosis and prognosis of patients with active pulmonary tuberculosis.Methods This analysis included 80 inpatients with active pulmonary tuberculosis evidenced by positive sputum smear,43 patients in recovery and 89 healthy controls during the period from January to June in 2012.Peripheral white blood cell,platelet count,and neutrophil percentage were assayed.Erythrocyte sedimentation rate (ESR)and serum C-reactive protein (CRP)were measured and compared.The data were analyzed by using SPSS 13.0 software.Results ESR and CRP values were significantly higher in the patients with active pulmonary tuberculosis than in the patients in recovery (P=0.006 5 and P=0.007 3,respectively).The peripheral blood platelet count exceeded normal range in 41.94% of the patients with active pulmonary tuberculosis,which was significantly higher than that in the patients in recovery (P=0.001 4)and controls (P=0.000 0).Platelet count was positively correlated with CPR (r=0.515,P<0.000 1)and ESR (r=0.398,P<0.001)value.However,peripheral white cell count and neutrophil count were not different from the corresponding values of controls.Conclusions Increasing peripheral platelet count may play a role in assessment of tuberculosis disease activity and the effect of anti-tuberculosis treatment.

Objective To investigate the epidemiology of 10 000 patients with mammary gland disease.Methods 10 000 mammary gland disease cages during 1987～2006 in Yangquan Tumor Institute were collected,all patients had integrity case files and were diagnosed by molybdenum target radiography,near infrared ray,sonography,aspiration-needle biopsy or polyrrhea smear examination.Results In 8919 outpatient treated cases,7493 suffered cyclomastopathy(84%).1081 cases were inpatient cared(11%),the top five mammary gland disease are:breast cancer 342 cases,cyclomastopathy 252 cases,adenofibroma 104 cases,intraductal papilloma 86 cases and ductal ectasia 76 cages.For breast cancer patients,there were 125 cases during 1987～1996,3 were 21～30 years old and 23 were 31～40 years old.The number during 1997～2006 was 217,24 were 21～30 years old and 69 were 31～40 years old.Conclusion In 10000 cases,there are 7745 cyclomastopathy patients(77.45%)which takes the first place.Especially for 342(3.42%)breast cancer cases,the incidence grew up and patients age was much younger.

Aim To investigate the effects of valsartan on activation of signal transducers and activators of transcription 1,3 in glomerular mesangial cells(GMCs) under high concentration of glucose.Methods we used high concentration glucose and valsartan to stimulate the cultured rat GMCs in vitro.The protein expressions of signal transducer and activatior of transcription 1,3(STAT1,STAT3),p-STAT1 and p-STAT3 were observed by Western blot.The protein synthesis of TGF-?_1,fibronectin and type IV collagen in the supernatants of the GMCs were detected by enzyme-linked immunoadsorbent assay(ELISA) and radioimmunoassay.TGF-?_1 mRNA was measured by reverse transcription and polymerase chain reaction(RT-PCR).Results Compared with low glucose control group,the expressions of p-STAT1,p-STAT3 and TGF?_1 mRNA were significantly increased in GMCs under high concentration glucose medium and there observed the high concentration of TGF-?_1,fibronectin and type IV collagen in the supernatants.The expression levels of p-STAT1,p-STAT3 and TGF-?_1 mRNA were significantly lower in the valsartan group than in those the high concentration glucose group.The concentration of TGF-?_1,fibronectin and type IV collagen in the supernatants in the valsartan group were lower than that in the high concentration glucose control group.Conclusion Valsartan can inhibit overproduction of TGF-?_1 and ECM proteins in GMCs under high concentration of glucose,partly by regulating the phosphorylation of STAT1 and STAT3.

Objective To evaluate the diagnostic value of CT in the spondylolysis of lumbar spine and improve the technique of CT scan.Methods The CT appearances of the spondylolysis of lumbar spine were analyzed in 20 cases.Results CT could demonstrate the spondylolysis and its abnormal features that led to compress nerve root.Conclusion CT scan plays an important role in the diagnosis of the spondylolysis of lumbar spine and in selecting treat methods.Technique of CT scan improved can depict the specific feature of spondylolysis truely.

Objective] To observe the alteration of specific IgG4 antibody of schistosomiasis patients before and after treatment. [Methods] ELISA. [Results] The SEA IgG4 and AWA IgG4 positive rates of 27 schistosomiasis cases were 96 3% and 100%, respectively,their average OD values were 1 62 and 0 72. 6 months post treatment 18 cases were followed up, the positive rates were 94 4% and 100%, respectively, their average OD values were 1 06 and 0 56, respectively. 12 months post treatment all cases were followed up, the positive rates of SEA IgG4 and AWA IgG4 were 96 3% and 92 6%, resepectively ,their average OD values were 0 99 and 0 58, respectively. [Conclusion] No obvious changes were found in the SEA IgG4 and AWA IgG4 positive rates of 27 schistosomiasis cases before and after treatment, whereas the antibody level of specific IgG4 was decreased.