Objective To explore the clinical characteristics and drug sensitivity of newborn pneumonia of klebsiella pneumoniae,and investigate the positive rate of extended-spectrum ? lactamases(ESBLs)in klebsiella pneumoniae.Method Sixty-seven cases of sputum samples newborn pneumonia of klebsiella pneumoniae from Jan.2003 to Dec.2005 were collected.Bacteria identification and drug sensitivity test were performed.At the same time,ESBLs were detected.Results The clinical characteristics of newborn pneumonia of klebsiella pneumoniae were non special,and the positive rate of ESBLs in klebsiella pneumoniae was 17.91%.The klebsiella pneumoniae was 100%sensitivie to carbopenems,but resistant to commonly used ?-antibiotics such as penicillin and cephalosporin.ESBLs negative strains had higher drug sensitivity than ESBLs strains.Conclusions Partial klebsiella pneumoniae are ESBLs strains and insensitive to commonly used antibiotics.In order to decrease ESBLs strains,the antibiotics treatment shall be used appropriately and the selection of antibiotics shall be guided by the results of drug sensitivity tests.

Objective To explore the diagnosis value of ultrasound real-time elastography in thyroid diffuse diseases.Methods Eleven elastic quantitative parameters of 123 patients with thyroid diffuse diseases and 42 healthy volunteers obtained from the ultrasound real-time elastography were analyzed with principal components analysis to attain a comprehensive evaluation value which was named stiffness index(SI),reflecting the organization elastic information of different thyroid diffuse diseases.SI among each group was compared by ANOVA.Results Chronic lymphocytic thyroiditis SI was 86.37±20.45,subacute thyroiditis SI was 86.14±19.95,primary hyperthyroidism SI was 54.68±21.69,normal control group SI was 41.34±15.59,respectively.The SI between chronic lymphocytic thyroiditis,subacute thyroiditis,primary hyperthyroidism and normal controls had significant statistical differences (P<0.05),the SI between primary hyperthyroidism and chronic lymphocytic thyroiditis,subacute thyroiditis had significant statistical differences (P<0.05),the SI between chronic lymphocytic thyroiditis and subacute thyroiditis had no significant statistical difference (P>0.05).Conclusions Ultrasound real-time elastography could indirectly reflect the stiffness information of thyroid lension tissue and have a certain degree of diagnosis value in thyroid diffuse disease.

ObjectiveTo deter mine the sustained attention function of the patients with mild Alzheimer's disease(AD) and mild cognitive impairment(MCI).Methods10 patients with MCI, 10 with mild AD and other 10 healthy elderly controls were tested with Continuous Performance Task(CPT) aimed to assess sustained attention. ResultsCompared with the normal controls, the mild AD patients reacted very more slowly(P<0.001), missed more targets(P<0.05), while that the MCI patients did was as well as the control group. ConclusionThe mild AD patients shows impairment in sustained attention function, but the MCI patients shows a preserved ability of sustained attention function.

Academic Dissertations as Topic ; Diagnostic Imaging ; Humans

Objective To evaluate the enhancement effect of the thrombus-targeted ultrasound contrast agent on acute thrombus in normal canine femoral vein.Methods Acute thrombi were created in both sides of the femoral vein in ten canine models.Targeted ultrasound contrast agent was given in a dose of(0.06) ml/kg in ten canines via intravenous bolus injection from forelimb of canine,the images of the acute thrombus were taken at 0,2,4,8,12,14 minutes after infusion of ultrasound contrast agent and stored in magneto optical disks.The images were assessed qualitatively by two independent observers and quantitatively using acoustic densitometry(AD) to determine the contrast enhancement effect of acute thrombus in normal canine femoral vein.Results After infusion of targeted ultrasound contrast agent,the thrombus was enhanced considerably and easy to be detected.AD analysis demonstrated that peak indencity(PI) and area under curve(AUC) increased with the changes of time,reaching the peak at 8th minutes after infusion of targeted ultrasound contrast agent,then decreased.PI and AUC increased at the 8th minute after infusion of targeted ultrasound contrast agent than before [((333.21)?(38.56))dB vs((168.18)?(28.18))dB,((884.40)?(94.62))dB vs((439.65)?(98.54))dB,respectively,P

Objective To study the screening value of color doppler flow imaging (CDFI) for gastroesophageal reflux(GER).Methods Through the window of left lobe liver, the abdominal esophageal length,the phenomenon of GER and the frequency of GER were detected by CDFI in 55 children with GER and 55 control group.Results Abdominal esophagus was identified by CDFI in every children. The abdominal esophageal length was shorter in refluxers than that in control group. A significant correlation was found between its length and the age of control group.To diagnose GER with CDFI ,its accuracy was 98.18%,and its specificity was 76.36%.Conclusions Visualization and measurements of the abdominal esophagus are readily achieved with CDFI in children.Abdominal esophageal length is shorter in refluxers than that in control group. CDFI is a rapid method of screening GER.

Objective To study whether gastric liquid emptying is delayed in children with gastroesophageal reflux and its clinical significance. Methods At different times after meal, the gastric antral diameters were measured by real - time ultrasonography in 55 children with gastroesophageal reflux and 55 controls. Results At 20 min,60 min after meal , there was a significant difference in gastric emptying rate between case groups and control groups, respectively(P

Objective To explore the diagnostic value of ultrasonic elastography and fine flow imaging in differential diagnosis of cervical lymph nodes.Methods Totally 87 lymph nodes were examined with ultrasonic elastography,fine flow and conventional ultrasonography.The results were confirmed with postoperative pathology or fine-needle biopsy as well as follow-up.Using consistency check of Kappa and ROC curve to analyse the accuracy of three types of ultrasonic examination.Results Taking the results of postoperative pathology or fine-needle biopsy as well as follow-up as golden standards,the Kappa value of conventional ultrasonography was poor (Kappa =0.153,P =0.078),fine flow was moderate (Kappa =0.526,P ＜0.01) and ultrasonic elastography was better (Kappa =0.741,P ＜0.01).The area under ROC of ultrasonic elastography,fine flow and conventional ultrasonography was 0.899 (P ＜0.01),0.787 (P ＜0.01) and 0.568 (P =0.241),respectively.Conclusions Ultrasonic elastography is more valuable to differentiate malignant from benign lymph nodes.

Objective To evaluate sound velocity tissue quantification ( SVQ ) for the quantitative assessment of liver fibrosis stage in chronic hepatitis B ,and to evaluate the correlation between diagnostic performance of sound velocity tissue quantification and blood parameters . Methods From the May of 2013 to May of 2014 ,collect ninety‐nine patients with chronic hepatitis B who was diagnosed by clinic and / or liver biopsy as experiment group ,and thirty healthy volunteers as control group at the same time . The experiment group and control group were evaluated with to measurement the zone speed index ( ZSI) ,and blood cell count . The AST/PLT ratio index ( APRI) was calculated according the following formula , APRI=AST(ULN)/PLT(109/L) . The liver biopsy was performed in the same day with SVQ and all blood parameters .ZSI and APRI were compared by correlation with liver fibrosis stage in chronic hepatitis B . Referring to the histologic fibrosis stage on liver biopsy ,all the ZSI and the APRI value were assessed by using ROC curve analysis . The corresponding cut‐off value ,sensitivity and specificity were also calculated andcompared.Results 1)ThemeanvaluesofAPRIwere(15.9±5.7)m/sforpatientswithS0,(28.1± 2 .8)m/s for patients with S1 ,(35 .8 ± 1 .2)m/s for patients with S2 ,(42 .6 ± 0 .8)m/s for patients with S3 , and (46 .3 ± 1 .3)m/s for patients with S4 .2)Accordingly ,the areas under the ROC curve for ZSI and APRI were 0 .875 and 0 .762 for S≥S1 ,0 .832 and 0 .597 for S≥S2 ,0 .913 and 0 .675 for S≥S3 ,0 .891 and 0 .709 for S≥S4 ,respectively . Conclusions The ZSI and APRI all could be used to evaluate the stage of liver fibrosis ,but the ZSI index is superior to APRI in assessing the stage of liver fibrosis . SVQ could provide object and accurate image ,the quantitative analysis of tissue could timely and accurately evaluate the severity of liver fibrosis .

Objective To evaluate the effects of dexmedetomidine with different-dose on the hemodynamics during anesthesia induction in patients undergoing off-pump coronary artery bypass grafting. Methods Sixty patients undergoing off-pump coronary artery bypass grafting were selected, with ASA grade Ⅱ - Ⅲ, NYHA cardiac functional grading Ⅱ - Ⅲ, and left ventricles ejection fraction >45%. The patients were divided into D1 group, D2 group and control group by table of random digit method with 20 cases each. In D1 group, intravenous infusion dexmedetomidine 0.3μg/kg was given for 20 min before anesthesia induction;in D2 group, intravenous infusion dexmedetomidine 0.6μg/kg was given for 20 min before anesthesia induction;in control group, intravenous infusion the same volume of 0.9% sodium chloride was given before anesthesia induction. The mean arterial pressure (MAP), heart rate, cardiac output and stroke volume variation (SVV) were recorded before infusion dexmedetomidine (T0), before anesthesia induction (T1), 3 min after anesthesia induction (T2), trachea cannula (T3) and 5 min after trachea cannula (T4). The adverse cardiovascular events and drug intervention were recorded during anesthesia induction. Results There were no statistical differences in MAP, heart rate, cardiac output and SVV at T0 among 3 groups (P>0.05). Compared with that in control group, the heart rate at T1, T2, T3 and T4 in D1 group were decreased, the MAP, heart rate, cardiac output and SVV at T1, T2, T3 and T4 in D2 group were decreased, and there were statistical differences (P<0.05). Compared with that at T0, the heart rate at T1, T2, T3 and T4 in D1 group were decreased, the MAP, heart rate, cardiac output and SVV at T3 in control group were increased, the MAP, heart rate, cardiac output and SVV at T1, T2, T3, T4 in D2 group were decreased, and there were statistical differences (P<0.05). Compared with that in D1 group, the MAP, heart rate, cardiac output and SVV at T2, T3 and T4 in D2 group were decreased, and there were statistical differences (P<0.05). The rates of adverse cardiovascular events in D1 group and D2 group were significantly lower than those in control group:35%(7/20) and 40%(8/20) vs. 95%(19/20), the rate of drug intervention in D1 group was significantly lower than that in control group and D2 group:10% (2/20) vs. 45% (9/20) and 35% (7/20), and there were statistical differences (P<0.05). Conclusions Dexmedetomidine (0.3 μg/kg) is beneficial for the stability of hemodynamics before anesthesia induction in patient undergoing off-pump coronary artery bypass grafting.