OBJECTIVE To investigate the bacterial distribution and antibiotic resistance of main pathogens from urinary tract infection (UTI) in our hospital for the guidance of rational use of antibiotics. METHODS The antibiotic resistance of clinical pathogen isolates from urinary tract infection by routine bacterium culture from Jan 2006 to Dec 2007 were studied retrospectively. The extended spectrum ?-lactamases (ESBLs) were detected out to the Gram-negative bacilli. RESULTS There were 722 strains of pathogens in the whole 2773 urinary samples with the isolating rate 26.0%. Most of the Urinary tract infections of patients were caused by Gram-negative bacilli (69.4%),then by Gram-positive cocci (16.3%) and fungi (14.3%). The most common pathogens in urinary tract infection were Escherichia coli (47.9%),Enterococcus faecais (7.9%),E. faecium (4.0%),Proteus mirabilis (3.9%),and Pseudomonas aeruginosa (3.5%). The Gram-negative bacilli were found to be sensitive to imipenem and meropenem,but highly resistant to the most other antibiotics,while P. mirabilis was susceptive to amikacin and cephalosporins. The Gram-positive cocci were more sensitive to nitrofuvantoin and vancomycin,but highly resistant to penicillin,oxacillin and SMT. CONCLUSIONS E. coli is still the primary urinary pathogen among patients,and highly resistant to a lot of antibiotics,We should carry out cultivation,isolation,and antimicrobial susceptibility testing as soon as possible to guide reasonable clinical drug therapy.

Objective To investigate the morphological changes of the head,body and tail of the hippocampus in patients with Alzheimer's disease (AD).Methods Totally 30 AD (AD group),30 mild cognition impairment (MCI) patients (MCI group) and 30 normal old persons (normal control group) underwent brain MR scan.Based on the MR images,the head,body and tail of the hippocampus were segmented and the volume was measured.The difference of the volume in total,head,body and tail of hippocampus in AD group,MCI group and normal control group were compared.The correlation between hippocampal volume and the scores of neurological assessment scale was analyzed.Results The left total,head,body and tail volume were greater than those of the right side in 3 groups (all P＜0.05).For the comparison of total volume of left and right sides among the 3 groups,AD group was less than normal control group (both P＜0.01) and MCI group (both P＜0.05),MCI group was less than normal control group (both P＜0.05).Compared with the normal control group,the head,body and tail volume of hippocampus of both sides were decreased in AD group (all P＜0.05) and the volume of left head,body and right head of hippocampus in MCI group were decreased (all P＜0.05).Both sides hippocampus's head and body volume of AD group were less than those of MCI group (both P＜0.05).The scores of minimum mental state examination (MMSE) were positively correlated with the total and the head,body,tail volume of bilateral hippocampus.Except volume of left tail,there were negative correlations between the scores of activities of daily living (ADL),clinical dementia rating (CDR) and the volume of total and head,body,tail of bilateral hippocampus,which were positively correlated with Montreal cognitive assessment (MoCA) score.Conclusion The volume of bilateral hippocampus was significantly reduced in AD patients.The head of hippocampal volume was significantly reduced and the body and tail was not obvious.

In order to investigate whether Laribacter hongkongensis could be detected in stool samples of Rattus norvegicus in the wild,Rattus norvegicus were trapped alive in an urban community of Guangzhou,China over a period of one year from June 2015 to May 2016,and their stool samples were examined for the presence of L.hongkongensis strains.Isolates were identified based on phenotypic characteristics and 16S rRNA sequence analysis,and were examined for their susceptibility to 19 antimicrobial agents.Further typing of the isolates was performed using multi-loci sequence typing (MLST) analysis.A total of 191 R.norvegicus were trapped alive.L.hongkongensis was identified and successfully isolated from two samples,representing a prevalence of 1.05 ％.Although the two isolates possessed similar phenotypic characteristics and have no base difference of 16S rRNA gene,they constituted two new distinct sequence types (STs),ST-163 and ST-164.This is the first report that L.hongkongensis can be detected in the intestinal tract of R.norvegicus.Results suggest that R.norvegicus could serve as carriers of L.hongkongensis and therefore could be another potential source of infection.

Objective To evaluate the application effect and value of four kinds of neuroendoscopic operation mode in the treat-ment of hydrocephalus .Methods The four kinds of neuroendoscopic operation mode ,including endoscopic third ventriculostomy , septostomy of the septum pellucidum ,cyst ventriculostomy and ventrideperitoneal cavity ,were selected in 58 cases of hydrocephalus according to the indications .The treatment effects were analyzed and the application value was evaluated .Results Among 58 cases of hydrocephalus ,50 cases were significantly improved after operation ,the total effective rate was 86 .21% ,2 cases appeared some complications .The four kinds of operation mode could better treat hydrocephalus .Conclusion Neuroendoscopy is an ideal method in treating hydrocephalus and has the advantages of the slight trauma and fewer complications ,which is a method deserving to be promoted in clinic .

Objective To control the nosocomial infection and avoid the second pollution of thereclaimed medical apparatus to the washing area of supply room. Methods Count, classification and place of the reclaimed medical apparatus went along at the same self-designed categorizing pedestal of the muhi-function apparatus.No absorbing cloth was needed on the table-board, the dirty water flew into the outfall of the sewer directly and automatically, the discreteness could be unpicked, washed and lis-terized after work. Results It avoided the collision of the apparatuses, shortened the time of counting effectively and reduced the chance of pollution.It also avoided the waste of the manpower, the material resources, the time and the second environmental pollution. The effects of the two table-boards after disinfection had statistical difference (P＜0.01). Conclusions The categorizing pedestal of the mul-ti-function apparatus makes the reclaim and handling of the polluted apparatus more standard and to re-move the pollution more thoroughly.

Objective To observe the efficacy and safety of remifentanil in patients with mechanical ventilation in Intensive Care Unit (ICU) .Methods Totally 90 cases were enrolled ,patients with mechanical ventilation were randomly divided into two groups (remifentanil vs .fentanyl) ,45 cases in each group .We used facial expression score (FPS) to monitoring pain ,richmond se‐dation agitation score (RASS) was the sedation tool for measuring quality and depth of sedation .Propofol wase used for sedation therapy .We recorded the data including FPS and RASS and vital signs during the treatment .The primary outcome was the time to reach the goal of analgesia sedation ,cases of using propofol and doses of propofol .The secondory outcome was mechanical ventila‐tion time ,ICU length of stay and adverse events .Results Fentanyl and remifentanil all could achieve the desired analgesic effect . Compared with fentanyl group ,FPS scores showed significantly decreased after 5 min application of remifentanil (P< 0 .05) ,but FPS scores showed significantly decreased after 10 min application of fentanyl .Analgesia goal time of the remifentanil and fentanyl were(5 .00 ± 1 .37)min and (30 .00 ± 4 .50)min ,respectively .Only 28 .9% of the patients should be combined use of propofol in remifentanil group ,but fentanyl group was 64 .4% (P<0 .01);the dosage of propofol of remifentanil group was lower than those of fentanyl group ;there was no significant difference in central venous pressure (CVP) and heart rate(HR) between the two groups at each time point(P>0 .05) .The mechanical ventilation time ,ICU length of stay in the patients with remifentanil were significantly shorter(P<0 .05) ,and adverse events occur less(all P<0 .05) .Conclusion Remifentanil analgesia in patients mechanical ventilated patients is fast onset of action ,analgesic effect significantly ,with less sedative drug dosage .It also can shorten mechanical ventila‐tion time ,ICU length of stay and has no obvious side effects .

Objective To establish abdominal aortic dissection model in ApoE-/-mice, and to evaluate the ability of 7.0T MR to detect the abdominal aortic artery aneurysms in ApoE-/-mice in vivo. Methods ApoE-/-mice aged 10 months were infused with angiotensin Ⅱ with 14 days Osmotic minipump after 10 weeks of high lipid diet. Two different doses of angiotensin Ⅱ were given to mice, i.e. 1000 ng/(kg·min) and 500 ng/(kg·min), respectively. The contrast group was infused with saline water. The abdominal aortic artery was observed in vivo with MR before and within 14 days infusion. At last, the pathological changes of the abdominal artery were compared with MRI findings. Results After 6 or 7 days higher dose of angiotensin Ⅱ infusion, aortic dissection was seen. MR T2WI showed crescent-shaped high signal in the vessel wall of one side，the pathological study identified the hematoma between media and adventitia. Abdominal aortic dissection aneurysms were also found in the mice 13 or 14 days after lower dose of angiotensin Ⅱ infusion, which were consistent with pathological studies. Besides, the signal of the vessel wall was significantly higher in both T2WI and PDWI sequences. There was excellent agreement between MR and histopathology. 〖WTHZ〗 Conclusion Abdominal aortic dissection aneurysms model can be successfully established with different doses (1000 ng/(kg·min) and 500 ng/(kg·min)) of angiotensin Ⅱ infusion into ApoE-/-mice fed with high lipid diet. High-resolution MR is able to visualize the abdominal aortic dissection aneurysm formation in vivo.

This study was aimed to verify the chemical component cantharidin from Chinese blister beetle by LC-MS/MS. Components were first processed by HPLC to choose the appropriate separation conditions before LC/MS/MS analysis. Through the positive and negative ions pre-scan, positive ions scanning way was selected in the scanning of each separate component. The scanned maps were obtained and the relative molecular mass was deduced. The results showed that 8 types of cantharidin compounds were identified, including three isomers. It was concluded that LC-MS/MS was able to determine the chemical component cantharidin from Chinese blister beetle rapidly and accurately, which was existed in the body by the form of combined amino acid.

Aim To investigate the preventive effect of Polygonum Multiflorum (PM)on the deteriorated mi-cro-structure and biomechanical properties induced by prednisone.Methods Ninety 6-month-old male Sprague-Dawley rats were randomly divided into nine groups,which were control,prednisone,CAL,30%ethanol eluent of the PM(H,M,L),PM(H,M,L). Prednisone was gavaged to rat for 21 weeks as model group of osteoporosis.Meanwhile,tested herbal ab-stract were orally administrated to the modeled rats in-duced by prednisone.At the end of the experiment, the right femur was collected for micro-CT scanning, three-dimensional reconstruction and biomechanical test.Results Compared with the control group,mod-el group showed destruction of bone microarchitecture, BV /TV fell 28.6%(P <0.05),bone biomechanical parameters decreases,and stiffness fell 29.7%(P <0.01 ). Compared with the model group, positive group had significantly improved effect on bone micro-architecture,and biomechanical parameters,BV /TV increased 46.7%(P <0.01 ),and stiffness increased 25.9%(P <0.01 ).30% ethanol eluent of the PM (M,L)dose may improve bone microstructure by in-creasing BV /TV 46.7% (P <0.01 ),40.0% (P <0.05)respectively,PM(H)may improve the biome-chanical parameters by increasing stiffness 24.7%(P<0.05),and 30% ethanol eluent of the PM(H)and PMhigh-dose may improve the biomechanical parame-ters,but not as positive group.Conclusions Predni-sone reduces biomechanical properties of rat femur and deteriorates femoral microstructure.30% ethanol eluent of the PM(M,L)and PM(H)plays a preventive role in the changes of micro-structural and biomechanical properties by prednisone,and increases BMD,whereas other groups have no significant preventive effect.

Objective:To analyze the correlation factors between peripapillary duodenal diverticulum (PDD) and choledochectasia by CT scan.Methods:The clinical data of 220 patients with duodenal diverticulum detected by multi-slice spiral CT scan and confirmed by gastrointestinal angiography or endoscopic retrograde cholangiopancreatography (ERCP) in Dahua Hospital, Xuhui District of Shanghai City were retrospectively analyzed. The correlation of the PDD, the contact of common bile duct (CBD), length of contact and exudation with choledochectasia in patients with PDD were analyzed.Results:A total of 236 duodenal diverticulum were found in 220 patients. Among them, there were 152 PDD, 41 diverticulum located superior to the duodenal papilla, 28 diverticulum located inferior to the duodenal papilla, 3 diverticulum located lateral to the duodenal papilla, and 12 diverticulumlocated in the horizontal portion. The incidence of choledochectasia in patients with PDD contacted with CBD was significantly higher than that in patients with PDD not contacted with CBD: 59.35% (73/123) vs. 37.93% (11/29), and there was statistical difference ( P<0.05); the incidence of choledochectasia in patients with contact length of PDD and CBD ≥1.5 cm was significantly higher than that in patients without contact of PDD and CBD and patients with contact length of PDD and CBD <1.5 cm: 82.43% (61/74) vs. 24.49% (12/49) and 37.93% (11/29), and there was statistical difference ( P<0.05); the incidence of choledochectasia in PDD patients with exudation was significantly higher than that in PDD patients without exudation: 10/11 vs. 52.48% (74/141), and there was statistical difference ( P<0.05). Conclusions:The patients with contact length of PDD and CBD ≥1.5 cm and patients with PDD combined with exudation could be prone to choledochectasia.