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 assess the clinical outcome of massive hiatal hernia repair by mesh via laparoscopic approach. Methods A total of 31 patients with massive hiatal hernia who underwent laparoscopic repair from March 2005 to January 2009 were enrolled in the study, among which mesh was used in 20 patients. The clinical outcomes of these patients were compared with other 11 patients without mesh repair procedures. Results Surgical repair, combined with Dor fundoplication, was successful in all 31 cases.Five patients in the mesh group developed post-operative recurrent symptoms, 2 ( 10% ) of whom were confirmed by imaging study. Six patients in non-mesh group had recurrent symptoms after operation and 4 (36. 4% ) were confirmed. Conclusion Laparoscopic repair of massive hiatal hernia is technially demanding with a high post-operative recurrent rate. Administration of intro-operative mesh can reduce the difficulty of the procedure and recurrence as well.

Adult ; Aged ; Dust ; analysis ; Humans ; Middle Aged ; Niacin ; therapeutic use ; Nitric Oxide ; blood ; Nitric Oxide Synthase ; blood ; Occupational Exposure ; analysis ; prevention & control ; Silicon Dioxide ; adverse effects

BACKGROUND: Cell apoptosis is one of the important pathological changes in ischemic-reperfusion (IR) injury. As the key factor involved in cell apoptosis regulation, interleukin (IL)-iβ converting enzyme, when activated, leads to cell apoptosis via protein degradation.OBJECTIVE: To investigate the relationship between the expression of IL-1β converting enzyme and cell apoptosis in cerebral IR injury and explore the role of this enzyme in post-ischemia cell apoptosis.DESIGN: Randomized controlled experiment.MATERIALS: The experiment was performed at the Center of Neuroscience of the Third Military Medical University between March 1996 and December 2000. Totally 64 adult healthy Wistar rats were randomized into two groups, namely IR group (n=56) and sham operation group (n=8). In IR group, the rats were subjected to four vessel occlusion to mimic whole brain IR injury, and reperfusion was carried out after 30 minutes of ischemia for 3, 6, 12, 24, 48, 72 hours and 7 days, respectively (8 rats at each time point). Only separation but not occlusion of the bilateral common carotid artery was performed in sham operation group.METHODS: Four rats were randomly selected from IR group at each time point and 4 from the sham operation group for immunohistochemical study and in situ hybridization, with the other 4 rats for in situ end-labeling assay.MAIN OUTCOME MEASURES: Protein and mRNA expression of ILlβ converting enzyme and neural cell apoptosis in the brain.RESULTS: Totally 64 rats were used in this study and all data were statistically analyzed. In the sham operation group, IL-1β converting enzyme protein and mRNA were expressed in small amount in most of the normal brain tissues, and their expressions were also detected in the neurons and small glial cells in IR group localized mainly in the cerebral cortex, cerebellum Purkinje's cells, hippocampal and subcortical white matters. The expression of IL-lβ converting enzyme began to increase at IR 12 hours, reaching the peak level at 48-72 hours followed by declination since 7 days after the operation. Cell apoptosis occurred 12 hours after IR (49.4±6.8) /section and peaked at 72 hours (228.6±29.8)/section, showing significant correlation with the temporal expression of IL-1β converting enzyme protein and mRNA (r=0.89, 0.68, P ＜ 0.05).CONCLUSIONS: Expressions of IL-1β converting enzyme protein and mRNA increased after IR in close correlation with post-ischemia cell apoptosis, and their temporal expression pattern supports the presumption that IL-1β converting enzyme is an important factor in cell apoptosis.Apoptosis is mostly likely to occur in the cerebral cortex, hippocampus and basal ganglion in IR injury, where IL-1β converting enzyme is highly expressed, further demonstrating that post-ischemia expression of IL-1β converting enzyme might be involved in cell apoptosis regulation.

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 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

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.