BACKGROUND: Nowadays, it is thought that transforming growth factorβ (TGFβ) is closely related with cicatrization. TGFβ that is a key active molecule can affect each phase of cicatrization. Theoretically, to inhibit the biological effect of TGF β can reduce cicatrization.OBJECTIVE: To explore the inhibitive effect of antisense TGF β1 deoxy-oligonucleotide on generation of cicatricle in intention of animal models with hyperplastic scars and observe the effective route of administration of using antisense TGF β1.DESIGN: Own control and animal study.SETTING: Department of Plastic Surgery, Anning Hospital of General Hospital, Lanzhou Military Area Command of Chinese PLAMATERIALS: The experiment was performed at the laboratory of anatomy,Lanzhou Medical College from September 2002 to July 2003. Totally 20flap-eared Japanese rabbits were selected.METHODS: Blood vessels could be seen in ventral surface of each rabbits' ear getting out of the way along long axis to establish two 1.0 cm×2.5 cm oblong full-thickness cutaneous deficiency raw surfaces that interval for 1.5 cm, to the surface of cartilage, totally 80, so asto establish ventral surface of rabbits' ear models with hyperplastic scars. After epithelizatio of raw surfaces of rabbits' ear (20 days, averagely), 5μL(1 g/L) antisense TGF β1 deoxy-oligonucleotide was closely injected into local endepidermis of each raw surface of left ear of each rabbit with microinjector, which was regarded as TGF β1 group. 5 μL saline was injected into each raw surface of right ears, which was regarded as saline control group. After injection for3, 7, 11, 20, 30 days, cicatricial tissues were cut, 4 rabbits in each time phase. Hematoxylin-esoin (HE) staining, Masson staining and TGFβ1 mRNA, type Ⅰ and Ⅲ collagen mRNA in situ hybridization histochemistry staining were applied.MAIN OUTCOME MEASURES: Results of HE staining, Masson staining and in situ hybridization histochemistry staining.RESUTLS: A total of 20 animals were included in the result analysis. ①HE staining showed that inflammatory cell infiltration and significant infiltrative zone of leukocytes occurred in hyperplastic scars of right ears in each group. There was inflammatory cell infiltration, but no infiltrative zone of leukocytes in hyperplastic scars of left ears after intervention with antisense TGF β1. ②Masson staining suggested that collagen fibers with deep blue-stain occurred in hyperplastic scars of right ears from the 3rd week after injury, till the 7th week there still was blue-stain collagen fibers,which was bulky (width of about 8-10 μm) and arranged in a great mess.The blue-stain collagenous fibers also appeared in hyperplastic scars of left ears at the 3rd week after injury by the intervention of antisense TGF β1,but till the 6th and 7th weeks the blue-stain became light and thin (width of about 3-5 μm), arranged in order. ③In situ hybridization revealed that expressive rates of TGF β1 mRNA, type Ⅰ collagen mRNA, type Ⅲ collagen mRNA positive cells decreased obviously.CONCLUSION: Antisense TGF β1 can inhibit the proliferation of hyperplastic scars of rabbits' ears and lighten markedly the fibrosis of cicatricial tissue. The local injection with naked DNA is feasible in the treatment of cicatricle.

Objective To investigate distribution and antimicrobial resistance among nosocomial pathogens from 13 teaching hospitals in China in 2009. Methods Non-repetitive pathogens from nosocomial BSI, HAP and IAI were collected and sent to the central lab for MIC determination by agar dilution method.WHONET5.6 software was used to analyze the data. Results A total of 2 502 clinical isolates were collected. The top three pathogens of BSI were Escherichia coli [27. 1% (285/1 052 )] , coagulase-negutive staphylococcus [12. 6% ( 133/1 052)] and Klebsiella pneumoniae [10. 8% ( 114/1 052)]. The top three pathogens of HAP were Acinetobacter baumannii [28. 8% (226/785)], Pseudomonas aeruginosa [16. 1% (126/785)] and Klebsiella pneumoniae [14.6% (115/785 )] . The top three pathogens of IAI were Escherichia coli[31.0% ( 206/665 )], Klebsiella pneumonia [11.3% ( 75/665 )] and Enterococcus faecium [10. 8% (72/665)]. Against Escherichia coil and Klebsiella spp. , the antimicrobial agents with higher than 80% susceptibility rate included imipenem and meropenem (98. 1%-100% ), tigecycline (95.3%-100% ), piperacillin-tazobactam ( 88.6% -97. 1% ) and amikacin ( 88. 3% -92. 5% ). Against Enterobacter spp. , Citrobacter spp. and Serratia spp. , the susceptibility rates of tigecycline were 93.5% -100% whereas the value of imipenem and meropenem were 92.9% -100%. Other antimicrobial agents with high activity included amikacin ( 85.2% -96. 7% ), pipcracillin-tazobactam ( 82.4% -96.4% ), cefepime ( 79. 6% -96. 7% ) and cefoperazonc-sulbactam (78. 7%-90. 0% ). Polymyxin B showed the highest susceptibility rateagainst Pseudomonas aeruginosa ( 100% ), followed by amikacin ( 81.9% ) and piperacillin-tazobactam (80.1% ). Polymyxin B also showed the highest susceptibility rate against Acinetobacter baumannii (98. 8% ), followed by tigecycline (90. 1% ) and minocycline (72. 0% ). The incidence of carbapenemresistant Acinetobacter baumannii was 60. 1%. The MRSA rate was 60. 2% and the MRSCoN rate was 84. 2%. All Staphylococcus strains were susceptible to tigecycline, vancomycin, teicoplanin and linezolid except for one isolate of Staphylococcus haemolysis with intermediate to teicoplanin. Two Enterococcus faecalis isolates which were intermediate to linezolid and one Enterococcus faecium isolate which was resistant to vancomycin and teicoplanin was found in this surveillance, while the MICs of tigecycline against these three isolates were 0. 032-0. 064 μg/ml. Conclusions Tigecycline, carbapenems, piperacillin-tazobactam,amikacin and cefepime remain relatively high activity against nosocomial Enterobacteriaceae. Pseudomonas aeruginosa exhibite high susceptibility to polymyxin B, while Acinetobacter baumanni shows high susceptibility to polymyxin B and tigecycline. Tigecycline, vancomycin, teicoplanin and linezolid remain high activity against nosocomial gram-positive cocci.

Objective To explore the outcomes and complications of 111 patients with pituitary neoplasms after neuroendoscopic endonasal transsphenoidal surgeries.Methods A retrospective review of clinical and radiographic data of 111 patients (113 procedures),admitted to our hospital from June 2010 to July 2014,was performed.The resection rate,clinical cured rate and complications in pituitary neoplasms of different Knosp classifications were compared.Results Gross total resection (GTR) rate for pituitary neoplasms according to Knosp classification was 97.4％ in grade 0,85.7％ in grade 1,88.7％ in grade 2,51.9％ in grade 3 and 0％ in grade 4,with significant differences (P＜0.05);GTR rate in pituitary neoplasms of grade 3 and 4 was significantly lower than that in pituitary neoplasms of grade 1 and 2 (P＜0.05).Clinical cured rate of the prolactin adenomas of different Knosp grades was significantly different,and that of grade 0 was statistically higher than that of grade 1-4 (P＜0.05).Clinical cured rate of growth hormone adenoma,adeno-corticotrophic stimulating hormone adenoma and mixed-functional adenomas of different grades showed no significant differences (P＞0.05).Chief complaints were improved in 75.0％-91.7％ non-functioning adenomas.Postoperative severe complications included 3 patients (2.7％) with cerebrospinal fluid rhinorrhea,4 (3.5％) intracranial hematoma,1 (0.9％);postoperative mild complications included 3 (2.7％) epistaxis,14 (12.4％) transient diabete insipidus,1 (0.9％) permanent diabetes insipidus and 3 (2.7％) hyponatremia.Mortality was observed in one patient with intracranial hematoma.Conclusions Neurendoscope provides a superior view of the sellar region,and improves the extent of resection of pituitary adenoma especially for those with cavernous sinus invasion;however,blind pursuit of GTR for tumor with Knosp classification greater than grade 3 will increase the risk of severe complications.Safety should always be the priority for a procedure with a long learning curve like neuroendoscopic surgery.Remission of residue tumor can be addressed by subsequent radiotherapy/stereotactic surgery.