Humans ; Hydrocarbons, Brominated ; analysis ; metabolism

Objective To evaluate the effectiveness of prophylactic antibiotic therapy on nosocomial infection in patients with severe viral hepatitis,and inquire into its applied mechanism.Methods 159 cases of severe viral hepatitis were divided into groups according to clinical stage and the applied circumstance of antibiotic medicine;Group A:receiving no prophylactic antibiotics therapy,Group B intravenous injection of the third generation cephalosporins and Group C intravenous injection of the semisymthetic penicillins.All cases had no infection on admission and received no antibiotics for 7 days before entering hospital and had stayed in hospital over 72 hours.Results Nosocomial infection occurred in 76 patients among the 159 selected cases.The incidence of nosocomial infection of Group A,Group B and Group C was 56.16%(41/73),34.0%(17/50) and 50.0% (18/36),respectively.The occurring time of nosocomial infection of Group B in early,middle and late stage patients with severe viral hepatitis was significantly later than Group A.The incidence of nosocomial infection in middle and later stage patients was significantly lower,and the mortality was significantly decreased in middle stage patients.There was significantly difference between group A and B(P0.05).Conclusion Prophylactic usage of antibiotics of third generation cephalosporins can not only delay nosocomial infection but also decrease the incidence of nosocomial infection in middle and late stage patients and mortality in middle stage patients with severe viral hepatitis.

The construction of 64-slice-dual-source computed tomography(DSCT) is introduced.Its imaging principle and clinical application are put forward.DSCT has special advantages in diagnosing coronary stricture.The principles of DSCT and energy subtraction imaging are expatiated in detail.DSCT has great value in clinical research and application.

OBJECTIVE To study the antimicrobial susceptibility and distribution of the ?-lactamases producing Escherichia coli from hepatopathy patients.METHODS Thirty-six ?-lactamases producing E.coli strains from hepatopathy patients were detected with a multi-disk test(synergy test,antagonized test for the inducible AmpC ?-lactamases(IABLs)),AmpC ?-lactamases(ABLs)phenotype test and extended-spectrum ?-lactamases(ESBLs) comfirmation test,and the susceptibility of antimicrobial agents with K-B test.RESULTS Twenty-six strains of 38 strains produced the ?-lactamases(68.4%),13(34.2%)strains produced penicillinases,5(13.2%)strains produced broad-spectrum ?-lactamases or penicillinases and 8(21.1%)strains produced ESBLs alone.All were not detected out to produce ABLs and carbapenem-hydrolyzing ?-lactamases(CHBLs);All nonnproducing ?-lactamases strains were sensitive to 9 kinds of antimicrobial agents;but in the 26 strains producing ?-lactamases,the resistant rate to AMP,KZ,FTX,IMP,AK,CN,CIP,SXT and TET were 100.0%,50.0%,30.8%,0,61.5%,15.4%,73.1%,61.5%,and 69.2%,respectively.CONCLUSIONS The rate of ?-lactamases producing E.coli from hepatopathy patients is high.The main types of ?-lactamases are penicillinases and ESBLs.Most strains producing ?-lactamases are susceptible to imipenem and amikacin.

Objective To investigate the relationship between lipopolysaccharide binding protein(LBP) in serum and degree of hepatic inflammation. Methods The levels of LBP in serum of 99 patients with chronic viral hepatitis (CVH) were detected by ELISA. The levels of LBP in 33 of all patients with chronic severe viral hepatitis were further detected 2～4 weeks after treatment. Results The serum levels of LBP in patients with chronic viral hepatitis were higher than that in normal patients [(79.62?45.52) ng/ml vs (50.22?31.44) ng/ml, P=0.001]. The serum levels of LBP in patients with chronic severe viral hepatitis were significantly higher than that in patients with moderate degree CVH group, severe degree CVH group, and normal group (P

Objective To investigate the significance of the expression of interleukin-10(IL-10),interleukin-13(IL-13)and interleukin-15(IL-15)in serums of patients with hepatitis B.Methods The expression of IL-10,IL-13 and IL-15 in serums of 109 patients was measured by ELISA.Results The serum levels of IL-10,IL-13 in patients with moderate degree chronic hepatitis B(CHB)group were significantly higher than that in patients with chronic severe hepatitis group,severe degree CHB group,acute hepatitis group and normal group.The serum level of IL-15 was increased in patients with acute hepatitis、moderate degree CHB group,severe degree CHB group and chronic severe hepatitis compared with normotensives.The proportion of IL-15/IL-10 and IL-15/IL-13 in patients with chronic severe hepatitis group,severe degree CHB group and acute hepatitis group were higher than that in patients with moderate degree CHB group and normotensives.The serum level of IL-15 and the proportion of IL-15/IL-10 and IL-15/IL-13 in dead group were significantly higher than that in improving group with chronic severe hepatitis.Conclusion There is an abnormal cell-mediated immune response in patients with hepatitis B.Combining detection on the levels of serum IL-10,IL-13 and IL-15,and the proportion of IL-15/IL-10 and IL-15/IL-13 would nicely show the cellular active status and be helpful to the prediction of prognosis and direction of therapy in patients with hepatitis B of different kinds of clinical type.

Objective To study the clinical pathological characters of malignant melanoma.Methods To analyze the clinical pathological materials of 86 cases of malignant melanoma.Results The original sites of 49 of the whole 86 cases locate at limbs,among those 26 cases at sole or heel.49 cases of them have melanotic nevus history,36 cases have trauma history.30 cases were diagnosed as carcinomatous change of ulcer before the surgical operation while 51 cases were diagnosed as other pathological diseases.Only 5 cases were diagnosed as malignant melanoma.The major histological type of the 86 cases is the epitheliod cell type,which made 50%(43 cases) of all the cases.61 cases(70.9%) of them has lymphnodes metastasis when the diagnosis was made.Conclusion Malignant melanoma most commonly located at limbs,especially at sole or heel.It's inclined to misdiagnose the disease and the disease is likely to metastasize before surgical operation.Final diagnosis should be confirmed by pathology examination.

ObjectiveTo investigate the effects of selective splenectomy on modulation of portal vein flow and prevention of small-for-size syndrome (SFSS) in living donor liver transplantation.MethodsTwenty six recipients who received LDLT from September 2007 to March 2008 were reviewed.The data of the portal vein flow of these recipients were collected during the operation.Simultaneous splenectomy was performed in patients with portal blood flow ＞250 ml/(min · 100g).No splenectomy was performed when the portal blood flow was less than 250 ml/(min · 100g).The effect of selective splenectomy on modulation of portal vein flow and whether splenectomy prevented the occurrence of SFSS were analyzed.ResultsThe portal vein flow decreased significantly after splenectomy in 8 patients who received splenectomy (P＜0.01),No SFSS occurred in the patients with or without splenectomy.Actual graft-to-recipient weight ratio (GRWR) of patients with splenectomy was significantly smaller than those with no splenectomy (P=0.044).The portal vein flow of patients with splenectomy was much higher than those with no splenectomy (P＜0.01).ConclusionAccording to the portal blood flow,selective splenectomy in LDLT decreased the portal vein flow and prevented the incidence of SFSS.

ObjectiveTo evaluate the effectiveness of PBL teaching model for medical students in surgery bed side teaching.MethodsThe method of meta-analysis.ResultsFinally,twenty-six documents met the requirement.The resuhs of Meta-analysis showed that,in the aspect of theory improvement for medical students,WMD=6.46,95 ％ CI 为 2.56 ～ 10.36,P＜0.01 ; in the aspect of skill ability improvement,WMD=5.32,95 ％ CI 为 2.47 ～ 8.16,P ＜0.01.ConclusionThe model of PBL teaching could significantly improve the effectiveness in theoretical knowledge and skill ability.

Objective To investigate the proliferation and survival of endogenous new born cells in the hippocampus of post-stroke depression (PSD) rats. Methods Male SD rats were divided into 4 groups (n = 18): control, stroke, depression and PSD group. The animals were subjected to left middle cerebral artery occlusion (MCAO) reaulting in consistent focal cerebral infarcts, followed by an 18-day exposure to chronic mild stress (CMS) and single housing to induce PSD animal model The dynamic expression of brodmodeoxyuridine (BrdU), neuron-specific nuclear protein (NeuN) and glial fibrillary acidic protein (GFAP) in the left dentate gyrus of hippocampus were determined by immunohistochemistry or double-lable immunofluorescence staining. BrdU was a marker of new born cell, NeuN and GFAP marked that new born cell differentiated into neuron and astrocyto respectively. Results Compared with ischemia animals (232.2±8.6,123.7±2.6,136.2±2.6), in the left dentate gyrus, PSD samples had significantly less BrdU-positive cells ( 156.2±2.5, t =28.83, P < 0.01 ) on the 21st day after ischemia, and on day 30 and 45 ( 70.2±2.0, 81.2±1.1, t = 52.27, 62.08, both P < 0.01 ). The ratio of BrdU-positive cells to NeuN had decreased on day 30 (79.3%±2.8% vs 69.0%±3.4%, t =5.871, P < 0.01 )and day 45 (87.7% ±4.6% vs 78.3%±2.4%, t =4.403, P < 0.01) in PSD animals. There was a statistically significant increased proportion of BrdU-positive cells co-stained with GFAP in PSD animals compared with the ischemia ones on day 30 and45 (t =4.226, 8.945, both P < 0.01). Conclusion CMS following ischemia exerts an inhibitory effect on hippocampal survival of new born cells as well as their differentiation into neurons, while promotes new born cells differentiating into astrocytes.