OBJECTIVE To explore the drug resistance of the infection caused by meticillin-resistant Staphylococcus aureus(MRSA) in ICU and the effect of linezolid in the treatment on MRSA.METHODS The collection of sputum,blood,urine,cerebrospinal fluid,the top and local drainage of central venous needle in 3 years(2006 to 2009) in ICU was carried out,and the bacteriological culture and drug susceptibility testing were executed.Fifteen cases of MRSA infection patients were treated with linezolid.RESULTS There were 72 cases of MRSA infection in 3 years in ICU,most of them were drug-resistant.The sensitivity for MRSA infection was high to 100% by used with vancomycin,teicoplanin and linezolid.The trend of MRSA infection in ICU had increased in the past 3 years.The efficiency and recovery rates of linezolid group(73.3% and 33.3%,respectively) were higher than the vancomycin group(66.7% and 28.6%,respectively)(P

Objective To study the clinical efficacy of theophylline combined with tiotropium dry powder in the treatment of stably chronic obstructive pulmonary disease (COPD).Methods 140 patients with stable COPD were divided into the study group and control group according to the random number table method,70 patients in each group.The control group was treated with theophylline,while the study group was treated with theophylline combined with tiotropium dry powder.The quality of life was evaluated by quality of life scale(QLC),the exercise tolerance was estimated by 6min walk distance(6MWD),and the forced expiratory volume in one second(FEV1 ),FEV1 /forced vital capacity(FVC),matrix metalloproteinase enzyme -9(MMP -9)and interleukin -8(IL -8)were detected in two groups before and after treatment.The adverse reactions of two groups were compared.Results After treatment, FEV1 ,FEV1 /FVC of the two groups were (1.49 ±0.04)L,(3.21 ±56.02)% and (1.89 ±0.21 )L,(59.98 ± 2.09)% respectively,which were significantly better than before treatment(t =7.98,9.03,8.03,8.32,all P <0.05),and which of the study group after treatment were significantly better than the control group(t =7.21,8.23,all P <0.05).6MWD and QLC after treatment of the two groups were (301.19 ±18.08)m,(67.19 ±2.31)points and (342.89 ±8.07)m,(75.21 ±5.25)points,which were significantly better than before treatment(t =7.98,8.03, 7.28,7.43,all P <0.05),and which of the study group after treatment were significantly better than the control group (t =8.03,8.47,all P <0.05).MMP -9 and IL -8 levels of two groups after treatment were (524.58 ±7.02)ng/mL, (7.23 ±1.04)ng/mL and (419.26 ±6.39)ng/mL,(6.09 ±0.06)ng/mL,which were significantly better than before treatment(t =7.52,8.13,7.23,7.41,all P <0.05 ),and which of the study group after treatment were significantly better than the control group(t =8.45,8.91,all P <0.05).The difference of adverse reactions of two groups was not statistically significant(χ2 =2.13,P >0.05).Conclusion Theophylline combined with tiotropium dry powder has an exact efficacy in the treatment of stable COPD,which can improve the lung function and the quality of life of patients.

Twenty-four cases of carcinoma of biliary duct, 6 of carcinoma of gallbladder and 19 of carcinoma of Vater's ampulla are reported. All of those 49 cases were con- firmed by operation and/or pathology.The diagnostic accuracy by endoscopic retragra-de cholangiopancreatography(ERCP)was 85.7%.The radiological appearances of carcinoma of biliary tract under ERCP were described and classified into 3 types, namely obstruction,stricture and polypoid types. The stricture type was further divided into 3 subtypes of occlusive,annular and diffuse stenosis.The obstruction type and occlusive stenosis type were more common. Carcinoma of gallbladder manifested as a constant filling defect with a wide base in the gallbladder, while carcinoma of ampulla as an irregularly bordered space occupying lesion in it, which could obstruct the biliary duct and/or pancreatic duct. The soft rattan-form change in intrahepatic biliary ducts was the characteristic manifestation of malignant tumor of biliary tract.

Spleen cells of BALB/C mice immunized with medical urokinase were fused with FO and NS-1 myeloma cells three times, and six hybridoma cell lines(I-UB5, I-UD2, 3-UA2, 3-UD12,3-UG2 and 3-UH7)secreting monoclonal antibodies against urokinase were obtained after screening.Of them, I-UB5 and I-UD2 v/ere cloned, frozen, stored, resuscitated and analysed chromosomally.It was found that I-UB5 and I-UD2 were clones obtained by fussing spleen cells of BALB/C mice with FO myeloma cells.Their subclasses are IgG1 and IgG2a respectively determined by immunodifussion and enzyme-linked immunosorbent assay(ELISA).The titers dctc-termined by ELISA were in the range of 10-2-10-3 in culture supernatants, and 10-6-10-7 in ascitic fluid.The I-UB5 and I-UD2 were proved to be monoclonal antibodies against high molecular weight subunit of urokinase, since they did not react with the purified low molecular weight subunit of, but reacted with mixed subunit of urokinase

The common description of the accessory meningeal artery in the textbooks of ana-tomy is either too brief or inaccurate, and some current misconceptions and contradic-tions have not yet been cleared up. Our investigation is based on the results of 57 dissections of 33 cadavers with thefollowing conclusions: 1. Frequency of occurrence: The accessory meningeal artery is found in 50 sidesof 32 cadavers, i.e. in 87.7% of the dissections and 97.0% of the cadavers. 2. The accessory meningeal artery often originates from the middle meningeal artery(the 2nd class 70% and the 4th class 8%), and less frequently originates from themaxillary artery (the 1st class 16%) or from both of them (the 3rd class 6%). 3. The accessory meningeal artery often passes medial (type P 50%) or lateral(type S 28%) to the posterior division of the mandibular nerve (or the inferior dentalnerve and the lingual nerve). Usually the artery courses forwards and upwards intothe pterygospinous foramen. 4. In most cases, the main trunk of the accessory meningeal artery does not passthrough the foramen ovale. 5. The accessory meningeal artery distributes principally to the lateral and medialpterygoid muscle, tensor veli palatini muscle, parts of the sphenoid bone, and the man-dibular nerve. In addition, its small ramus passes through the accessory foraminum ornotch of the foramen ovale into the middle cranial fossa, and supplies the dura materanterior to the foramen ovale. Some possible racial differences between the Chinese and American materials arediscussed.

[Objective]Two high-risk complications following artificial joint replacement were investigated in an attempt to improve medical quality and ensure medical safety.[Method]By searching relative reference database,the author investigated the incidence of two high risk complications following artificial hip or knee joint replacement in China during the past 3 years.Preventive measures were discussed.[Result]A total of 840 cases of artificial hip or knee joint replacement were reported in 6 key orthopedic periodicals from 2005 to 2007.One hundred cases of deep vein thrombosis(DVT) were found with an incidence of 11.9%.in all 6 periodicals,the lowest incidence was 8.06% and the highest one was 20%.Six cases of pulmonary embolism(PE) were reported by 3 periodicals,of which 3 had a successful emergency rescue and 3 died.In the same period,10 orthopedic periodicals reported 171 cases(172 joints) of prosthesis infection after artificial hip or knee joint replacement.[Conclusion]With rapid development of urban/rural construction and transportation,and the increase of elderly people,severe osteoarticular injury cases have increased relatively.Artificial joint replacement has been wider performed in the clinical practice.Although the success rate has been greatly improved benefited from the upgrades of prosthesis technique and surgical instrument,the complications such as PVT,PE and infection are still risk factors.Relevant preventive measures should be taken to keep safety and advance of artificial replacement technique.

Abandon of treatment and euthanasia is a hot topic on the medical ethics.The issue includes the ethical significance,the definition of criteria,the ethical disputes,the legislation,the basic procedure and so on.The paper comprehensive analyzes these issues in different respects and make the necessary explanation.

OBJECTIVE: To establish the quality standard of Jieyin effervescence tablet. METHODS: Dictamnus dasycarpus, Sophora flavescens, Phellodendron chinense,Cnidium monnieri, Zanthoxylum bungeanum were identified by TLC. The content of berberine was determined by HPLC. RESULTS: The TLC was specific for the identification of D. dasycarpus, S. flavescens, P. chinense,C. monnieri, Z. bungeanum. The linear range of berberine was 0.208～1.04 ?g(r=0.997 8)with an average recovery of 101.38% (RSD=1.39%,n=6). CONCLUSION: Established quality standard is applicable for the quality control of Jieyin effervescence tablet.

Objective To explore the effect of glutamine on changes in the expression of intercellular adhesion molecule-1(ICAM-1)and E-selectin and the characteristics of pulmonary vascular endothelial cells(VECs)in sepsis rats.Method Totally 56 Sprague-Dawley rats were randomly divided into three groups:a control group,a sepsis group and a treatment group.All experiments were performed at the animal research center at Sun Yat-sen University in Guangzhou.Sepsis was induced by injecting 4 mg/kg lipopolysaccharide(LPS).The treatment group was injected with 4 mg/kg LPS and 0.3 g/kg glutamine.The control group was not injected with either LPS or glutamine.The rats were killed at 6,12 or 24 h after treatment and pulmonary tissue samples were obtained.The expression of ICAM-1 and E-selectin in VECs was detected by reverse transcription-polymerase chain reaction and immunohistochemistry.Apoptosis of VECs lung tissue was analyzed by Hoechest-33258 staining.The ultramicrostructure of VECs was observed under an electron microscope.Data were analyzed using analysis of variance using SPSS 13.0.Results At 6,12 and 24 h,the expression of ICAM-1 and E-selectin was significantly higher in the sepsis group(relative expression;ICAM-1:0.0864 ± 0.0101,0.141 ± 0.0147 and 0.1677 ± 0.0127,respectively;E-selectin:0.1535 ±0.0180,0.0811 ±0.0107 and 0.0505 ± 0.0031,respectively)compared with the control group(ICAM-1:0.021 ±0.0032,0.0228±0.0042 and 0.0204±0.0059,respectively;E-selectin:0.0423 ±0.0108,0.0412 ±0.0066 and 0.0418 ±0.0092,respectively)(all:P＜0.01).Glutamine treatment significantly decreased(P＜0.01)the expression of ICAM-1(0.0646±0.0136,0.1202±0.0143 and 0.1378 ±0.0085,respectively)and E-selectin(0.1071 ±0.0189,0.0628±0.0088 and0.0463±0.0049,respectively)at all time points compared with the sepsis group.However,the expression of ICAM-1 and E-selectin remained significantly higher than that in the control group(all:P＜0.05).There were similar changes in the expression of pulmonary ICAM-1,E-selectin mRNA and the results of VEC apoptosis.Electron microscopy confirmed these findings.Conclusions The expression of ICAM-1 and E-selectin was significantly increased in sepsis rats,leading to necrosis and apoptosis of VECs,and the onset of acute lung injury.Glutamine had a protective effect in VECs against lipopolysaccharide-induced sepsis.

Objective:To observe the changes and significance of pulmonary vascular endothelial cells (VEC),ICAM-1 and E-selectin in sepsis rats.Methods:60 SD rats were randomly divided into 2 groups:the control group and the sepsis group.The sepsis model was prepared by injection of lipopolysaccharide(4 mg/kg).The expression of ICAM-1 and E-selectin in pulmonary VEC of rats was detected by reverse transcription-polymerase chain reaction (RT-PCR) and immunohistochemical method.The VEC apoptosis in lung was analyzed with Hoechest-33258 staining.The ultramicrostructure of pulmonary VEC was observed under electron microscope.Results:Compared with the control group,the expression of ICAM-1 was significantly increased in the sepsis group (P<0.01),the expression of ICAM-1 was increased gradually and achieved the peak value at 24 h.The expression of E-selectin was achieved the peak value at 6 h and decreased gradually during 24 h.The apoptosis and necrosis of pulmonary VEC was increased gradually and achieved the peak value at 24 h (P<0.01).Conclusion:The expression of ICAM-1 and E-selectin in sepsis rats is significantly increased,probably leading to both necrosis and apoptosis of pulmonary VEC,resulting in the occurrence of acute lung injury (ALI) and acute respiratory distress syndrome (ARDS).