Objective:To investigate the relationship between antibiotics use and antimicrobial resistance of Acinetobacter bauman-nii to provide reference for rational antibiotics use. Methods:The DDDs of antibiotics in the inpatients and the drug resistance rate of A. baumannii were analyzed in our hospital from 2010 to 2014. The relationship between the antibiotics use and the antimicrobial re-sistance of A. baumannii was analyzed by SPSS 19. 0. Results:From 2010 to 2014, the total DDDs of antimicrobials in our hospital were decreased year by year in the first three years, while increased significantly in the last two years. The total DDDs of cephalospo-rins always ranked the first and the DDDs of carbapenem were increased year by year. The resistance rate of Acinetobacter baumannii a-gainst multiple antibacterials was increased in varying degrees in the past five years. In addition to levofloxacin, cefoperazone/sulbac-tam and tigecycline, the resistance rate against the other antibacterials was increased up to 50% in 2014. The resistant rate of A. bau-mannii against ciprofloxacin, gentamycin, cefepime, imipenem and tazobactam/piperacillin presented a positive correlation with the DDDs of cephalosporins and quinolones(P<0. 05). The resistance rate of A. baumannii against cefepime, imipenem tazobactam/pip-eracillin and levofloxacin was also positively correlated with the DDDs of carbapenem(P<0. 05). Conclusion: Antibiotics consump-tion is related to drug resistance of A. baumannii,so it is necessary to strengthen the management of clinical antibiotics use to decrease the multidrug-resistant strains.

Objective To report the treatment outcome of nonunion of tibial fractures with local muscle flap transfer and injection of autogenous bone marrow. Methods 15 patients who had suffered from nonunion of tibial fracture 10 to 42 (mean 22) months after the initial injury underwent open reduction, internal fixation with locking intramedullary nail, wound coverage with locally transferred muscle flap and injection of autogenous bone marrow into the fracture site 12 to 15 days after operation. Results The follow-ups revealed bone union in all the cases of this series with a mean healing time of 22 (3 to 11) months. Except for limited necrosis of the skin edge in 2 cases which healed after dressing changes, the wounds healed primarily in all the cases without infection and implant failure. Conclusion Besides stable internal fixation and bone graft, coverage of fracture site with locally transferred muscle flap and injection of autogenous bone marrow can be used to treat nonunion of tibial fractures with satisfactory results.

Objective To observe the effects of stellate ganglion block (SGB) on humoral immunity func-tion in patients who received modified radical mastectory (MRM). Methods Eigty female patients were randomly divided into control group(group Ⅰ ,n =40) and intervention group (group Ⅱ,n =40). Blood samples were taken pre-intervention (T1), after intervention ( T2 ) and 30 rain after operation ( T3 ) for the determination of lgG, IgA, IgM. Results Compared with T1, IgG, IgA, IgM at T2 and T3 in two groups were lowered, IgG [ ( 11.8±2.2 ) g/L vs (9.5 + 1.5) g/L,t = 5. 4630,P =0.0041 ] and IgA [(1.9±0.3)g/L vs (1.7±0.4) g/L,t =2. 5298,P = 0.0134 ] at T3 in group Ⅱ were significantly different as compared with that of group Ⅰ ; IgM at T2 [ (2.5±0.8 ) g/L vs (2.1±0.6)g/L,t =2.8276,P=0.0072] and T3[ (2.1±0.5)g/L vs (1.6±0.5)g/L,t =4.4721,P = 0.0000 ] was significantly different between the two groups. Conclusions Preoperative-SGB can improve the inhibi-tion degree of humoral immunity caused by modified radical mastectory.

Objective To investigate the effects of bone mesenchymal stem cell (BMSC) transplantation on neuronal nuclei (NeuN) and neurogenin 1 (Ngnl) in focal cerebral ischemic rats.Methods A total of 64 healthy adult male Sprague-Dawley rats were randomly divided into normal (N) + phosphate-buffered solution (PBS),middle cerebral occlusion (MCAO)+ PBS,N + BMSC and MCAO + BMSC groups (n =16 in each group).A rat model was induced by the intraluminal suture method.BMSC was cultured in vitro.At 24 h after modeling,brain transplantation was conducted.Magnetic resonance imaging (MRI) was used to detect infarct volume in vivo.NeuN/DAP,Ngnl/DAPIimmunofluorescence double-labeling and Western blot were used to detect the expression of NeuN and Ngnl around ischemic brain tissue.Results On day 14 after transplantation,the T1-and T2-weighted imaging revealed that the cerebral cortex and striatum had abnormal signal areas in the rats of the MCAO group.The infarct volume of the MCAO + BMSC group was significantly less than that of the MCAO + PBS group (32.5％ ± 4.2％ vs.47.9％ ± 7.9％ ; P ＜ 0.01).Immunofluorescence doublelabeling assay showed that the numbers of cells of NeuN+/DAPI+ (976.2 ± 87.5/mm2 vs.1 908.3 ±127.8/mm2; P ＜ 0.01) and Ngn1 +/DAPI + (251.6 ± 23.1/rmm2 vs.285.1 ± 25.2/mm2 ; P ＜ 0.01) of the MCAO + PBS group were significantly less than those of the N + PBS group,but those of NeuN+/DAPI +(1 439.9 ± 101.7/mm2; P ＜ 0.01) and Ngn1 +/DAPI + (356.3 ± 35.6/mm2; P ＜ 0.01) of the MCAO + BMSC group were significantly more than the MCAO + PBS group.Western blot analysis showed that the protein expression levels of NeuN (0.69 ±0.06 vs.0.91 ±0.09; P ＜0.01) and Ngn1 (0.53 ±0.05 vs.0.62 ±0.07;P ＜0.01) of the MCAO +PBS group were significantly lower than those of the N +PBS group,but those of NeuN (0.82 ± 0.07; P ＜ 0.01) and Ngn1 (0.77 ± 0.09; P ＜ 0.01) of the MCAO + BMSC group were significantly higher than the MCAO + PBS group.Conclusions BMSC transplantation may promote the expression of NeuN and Ngn1,and alleviate MCAO caused brain injury.

OBJECTIVE: To search the features and the treatment of vascular compressive syndrome caused by the facial, acoustic nerves. METHOD: Ten cases of vascular compressive syndrome caused by the facial, acoustic nerves were included in the group,which were treated by microvascular decompression(MVD). Besides, the microanatomic relationship between the nerve and their adjacent vessel at the root exit zone (REZ) were observed under microscope or nasoendoscopy in MVD. RESULT: Tinnitus, vertigo and facial spasm disappeared after MVD in 7 cases (70%), improved in 2 cases (20%), and relapse in 1 case (10%). All cases were found out vessels compressing at the root zone of the facial nerve and the auditory nerve. CONCLUSION The Clinical features of vascular compressive syndrome caused by the facial, acoustic nerves are facial spasm, tinnitus, and vertigo, for which microvascular decompression has a positive therapeutic effect as long as the diagnosis is correct.
Adult ; Cochlear Nerve ; Decompression, Surgical ; Facial Nerve ; Female ; Follow-Up Studies ; Humans ; Male ; Microsurgery ; Middle Aged ; Nerve Compression Syndromes ; diagnosis ; physiopathology ; surgery

The anti-idiotypic antibodies Specific for anti-HBs were prepared by Immunizing New Zealand white rabbits with anti-HBs according to the method of Kennedy. The serum was first purified through IgG of normal human-Sepharose 4B affinity Column.The anti-idiotypic Specificity of the antibodies obtained was identified with ELISA or RIA inhibition test.The resultshowed that the anti-idiotypic antibodies were directed at the idiotypic determinants on anti-HBs,and no cross reaction between anti-idiotypic antibodies and normal human IgG.

John Cunningham virus(JCV)is a type of human polyomavirus. It was first isolated from the brain of a patient with progressive multifocal leukoencephalopathy(PML)in 1971 and named after that patient. The seroprevalence of JCV in the general population is 40% to 60% . The mortality rate among patients with AIDS complicated by PML was shown to be 50% . For immunocompromised patients and pa-tients with long-term use of immunosuppressive drugs,JCV would cause fatal polyomavirus associated ne-phropathy(PVAN),viremia and some other related diseases. While the pathogenesis of JCV has well stud-ied,there are no specific prevention and treatment measures for infected individuals. Therefore,reliable, specific and sensitive JCV detection methods in clinical settings are needed. This review describes the pros and cons of different methods for JCV detection with potentials for clinical applications.

Objective To investigate the adjustment effect of microRNA-155 on CD4+CD25+ regulative T cell (Treg) in peripheral blood of sepsis patients,and to elucidate the role of miR-155 in the pathogenesis of sepsis.Methods A retrospective study was corducted.60 sepsis patients (mild n =20,moderate n=20,and severe n =20)from emergency room or intensive care unit (ICU) of the Fourth Hospital of Jiangsu University were enrolled.20 healthy volunteers were enrolled as controls.Real-time fluorescent quantitation polymerase chain reaction (qRT-PCR) was used to detect the levels of miR-155 and Foxp3 mRNA expressions in peripheral blood.CD4+CD25+ Treg cells in peripheral blood were identified by flow cytometry.Peripheral interleukin-10 (IL-10) was measured by enzyme-linked immunosorbent assay (ELISA).Results The expressions of miR-155,Treg,Foxp3 mRNA and the level of IL-10were higher in the patients with sepsis than those in healthy control group [Treg:(2.89 ± 1.13)％ vs.(2.32 ± 0.91)％,t=10.540,P=0.002; miR-155:1.19 ±0.48 vs.0.80 ±0.33,t=8.605,P=0.006; Foxp3 mRNA:0.18 ±0.08 vs.0.13 ±0.03,t=6.862,P=0.008; IL-10 (ng/L):56.89 ± 17.28 vs.33.24 ± 11.93,t=12.742,P=0.001].These variables were elevated gradually with the elevation of acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ)score.The expressions of Treg,miR-155,Foxp3 mRNA and the level of IL-10 were (3.05 ± 1.21)％,1.36 ± 0.79,0.21 ±0.10,(62.82 ±21.38) ng/L in severe sepsis group; they were (2.86 ±0.88)％,1.25 ±0.56,0.17 ±0.08,(56.38 ± 19.65) ng/L in moderate group; they were (2.61 ± 0.87)％,0.94 ± 0.52,0.15 ± 0.05,(45.43 ± 14.40) ng/L in mild group.The values showed significant statistical difference among the mild,moderate and severe sepsis groups (all P＜0.01).Above values were significandy higher in non-survival group than those in survival group [Treg:(3.46 ±1.53)％ vs.(2.85 ± 1.03)％,t=14.250,P=0.005; miR-155:1.41 ±0.85 vs.1.16 ±0.76,t=11.875,P=0.006;Foxp3 mRNA:0.24 ± 0.11 vs.0.17 ± 0.09,t=8.795,P=0.001 ; IL-10 (ng/L):65.47 ± 23.58 vs.51.70 ± 16.86,t=16.313,P=0.001].The expression of miR-155 was positively correlated with the expression of CD4+CD25+ Treg and Foxp3 mRNA (r1=0.635,P1=0.007; r2=0.671,P2=0.005).Conclusion The result of this study suggest that miR-155 is involved in the cell proliferation regulation of CD4 +CD25 + Treg cells,and play some role in the immunological dissonance in sepsis.

Objective To study the impacts of quality of life,stress response and sources of stress on mental health of community residents.Methods A total of 703 questionnaires completed by community residents living in Hangzhou and Cangzhou were prospectively collected.All the subjects were assigned o five age groups:18-25 years old group,26-35 years old group,36-50 years old group,51-64 years old group and ≥65 years old group.Psychological health status was compared between the groups by using analysis of variance.Results Significant difference in mental health was found among 5 age groups.Correlation analysis showed that quality of life,stress response and sources of stress had significant effects on mental health.Conclusion Our data suggest significant impacts of quality of life and stress on mental health of community residents.

Objective To analyze the motion, elastic and derived parameters of normal common carotid artery (CCA) wall in short-axis orientation with velocity vector imaging (VVI) technique. Methods Two-dimensional dynamic images of CCA in 40 healthy volunteers people were obtained in short-axis view with Siemens Acuson Sequoia 512 color Doppler ultrasound. The motion, elastic and derived parameters were analyzed in right CCA including 6 segments: Anterior wall, posterior wall, anterolateral wall, anterior internal wall, posterolateral wall and posterointernal wall. Relationship between these parameters and the influencing factors were analyzed as well. Results There was no statistical difference of the elastic parameters among 6 walls (P>0.05). Some of the motion parameters of the lateral wall and anterior wall were higher than those of the posterior wall and internal wall (P<0.05). Age and intima-media thickness were negatively correlated with some elastic parameters and some motion parameters (P<0.05). Heart rate were positively correlated with some elastic parameters and some motion parameters (P<0.05). Elastic parameters were positively correlated with motion parameters (P<0.05) and positive correlation was found between time to peak of elastic and motion parameters (P<0.05). Conclusion VVI is an effective technique for observing CCA mechanical characteristics of the movement in normal human, and has potential for studying some of related factors of the characteristics.