OBJECTIVE To investigate the distribution and drug resistance of pathogenic bacteria from lower respiratory tract infection in elderly patients.METHODS A total of 1739 strains of bacteria isolated from sputum and lower respiration secretion culture of the elderly patients were identified and their drug resistance was tested by K-B method.RESULTS From 1739 strains of pathogens isolated,Gram-negative bacilli accounted for 63.8%.The main Gram-negative bacilli were Escherichia coli and Pseudomonas aeruginosa,Acinetobacter baumannii,Enterobacter cloacae and Klebsiella pneumoniae.Gram-positive cocci accounted for 22.9% and Candida albicans accounted for 13.3%,respectively.The resistance rates of Gram-negative bailli to imipenem,cefoperazone/sulbactam and amikacine were relatively low.And all Gram-positive cocci were sensitive to vancomycin.CONCLUSIONS The antimicrobial resistance of pathogens in elderly patients with lower respiratory tract infection is serious.It is important to mornitor the antimicrobial resistance.

Objective The study analyse the multi-drug resistance and epidemiological investigation in Acinetobacter baumannii.Methodes Using,multi-drug resistance gene test,three-dimension test,membranes active efflux test studied multi-drug resistance and epidemiological investigation.The genetype were analyzed by Amplified Fragment Length Polymorphism(AFLP).The strains' homology were researched by multi-gene cluster analysis methods.Results Cluster analysis show that the result of drugsensitive test,multi-drug resistance gene test and AFLP are accordant.The study find at least 3 clones by multi-gene cluster analysis methods.AFLP show that all of the multi-drug-resistance of A.baumannii evolutes from a clone.Conclusions The study combined with clinical practice find that ICU in Ningbo No.2 Hospital now is the core of the arises,evolution,transmission of A.baumannii.Strengthening management of ICU is very important to pretect the prevalence of Acinetobacter baumannii in nosocomial infection.

Objective To study the effect of oleic acid on the morphology of cultured human umbilical vein endothelial cell (HUVEC) and on the secretive function of endothelial cell mediated by insulin or leptin. Methods The cell morphological characteristics were studied by phase microscopic observation. The changes of endothelial cell secretive function were studied by detecting the concentrations of nitric oxide (NO) and endothelin (ET-1) after endothelial cell was pretreated with oleic acid of different concentrations. Results With the increased concentration of stimulating insulin, the concentration of NO increased and ET-1 decreased gradually in a dose-dependent fashion. The profile of endothelial cell pretreated with oleic acid became darker than before. As the concentration of pretreatment oleic acid increased, the concentration of NO secreted by endothelial cell which was mediated by insulin and leptin gradually decreased in a dose-dependent fashion, but the concentration of ET-1 secreted by endothelial cell mediated by leptin decreased significantly only in the 50～100 ?mol?L -1 of pretreatment oleic acid. Conclusion Oleic acid damages endothelial cell directly and inhibits endothelial cell mediated by insulin and leptin to secrete NO. Oleic acid and insulin can directly inhibit release of ET-1 by cultured endothelial cell.

OBJECTIVETo investigate the application and effects of external fixator under the guidance of damage control therapy in limb open fracture.

METHODSFrom May 2008 to January 2013,72 cases with severe limb open fractures (Unincor- porated shock) were divided into control group and observation group (36 cases in each group). In observation group, 36 patients (including 22 males and 14 females) were treated by external fixator at stage I, as soon as possible after waiting for patients physiology conditions being stable,the stage II fracture operation was performed. In control group, 36 patients (24 males and 12 females) were treated by the first stage open reduction. The hospital admission time, open fracture severity score (OFSS),operation duration,operative blood loss,X-ray expose times, callus appear time, fracture healing time, postoperative infection rate, complications and Johner-Wruhs accceccment were recorded and evaluated.

RESULTSAll patients were followed up for 8 to 12 months (10.4 in averaged). The mean operation duration, operative blood loss, callus appear time, fracture healing time the mean operation duration reespectively were (56.79±8.87) min, (216.16±18.21) ml, (5.32±0.71) weeks, (12.79±2.52) weeks in observation group,and (104.53±9.28) min, (439.93±14.65) ml, (4.97±1.26) weeks, (14.81±2.63) weeks in control group. According to Johner-Wruhs acccecement,there were were 33 cases in excellent,2 in good,and 1 in poor in observation group,non-union of fracture in 1 case,local infection occurred in 1 cases; in control group 25 cases in excellent,6 in good, and 5 in poor, non-union of fracture in 1 case,local infection occurred in 8 cases. There were significant differences in operation duration, operative blood loss, callus appear time, fracture healing time, postoperative infection rate, complications (P<0.05). There were no significant differences in hospital admission time, open fracture severity score and X-ray expose times (P>0.05).

CONCLUSIONUnder the guidance of damage control therapy,using external fixator measures to treat patients with open fractures of limbs is worth popularizing in clinical application because it can shorten the operation time, less blood loss, reduce the infection rate and complications, improve the success rate of surgery and recovery rate.

Adult ; Aged ; External Fixators ; Extremities ; injuries ; surgery ; Female ; Fracture Healing ; Fractures, Open ; surgery ; Humans ; Male ; Middle Aged ; Operative Time ; Postoperative Complications ; epidemiology

Hip fracture patients preoperative and postoperative exist hidden blood loss which often affect patients' wound healing, increase the probability of infection, prolong rehabilitation exercise, influence postoperative effect. At the same time, the body's blood loss increase the activation of the blood clotting mechanism, promote the incidence of deep vein thrombosis, bleeding and deep vein thrombosis has become the main causes of high risk in hip operation. It is very important to stop bleeding, anticoagulation should not be ignored, so how to effectively deal with the prominent contradiction between the postoperative anticoagulation and bleeding or looking for a best balance has become a intractable problems in hip fracture treatment.
Anticoagulants ; therapeutic use ; Blood Loss, Surgical ; prevention & control ; Hip Fractures ; complications ; surgery ; Humans ; Intraoperative Complications ; drug therapy ; etiology ; prevention & control

A retrospective analysis was carried out in 36 patients with blunt diaphragmatic rupture during March 1991 and March 2006. Twenty-two diagnoses were confirmed preoperatively, and the rest 14were confirmed perioperatively. Three patients underwent surgical treatment after no response to conservative therapy. Thoracotomy was performed in 21 patients, laparotomy in 9, thoracotomy plus laparotomy in 5 and combined thoraco-laparotomy in 1. Most diaphragmatic rupture may be caused by blunt collision and could lead to thoracoabdominal injury. In spite of high mortality rate, the condition is usually under diagnosed. Definite diagnosis and timely operation are important to increase survival rate and reduce mortality.

Objective: Our aims were to measure DNA content in primary lung cancer and to study the relationship between the DNA content and TNM stage, histological differentiation of tumor cell, cellular proliferation, and apoptosis. Methods: The DNA content and cellular proliferation were analyzed using flow cytometry. Tumor cell apoptosis was detected by using TUNEL method. Results: (1) The DNA index (DI) distribution ranged from 0.829 to 2.514. There were 41 cases (77.4%) of DNA aneuploid. The distribution of DI and DNA aneuploid was independent of histological subtypes（P>0.05）.(2) With the increase of TNM stage, the DI and the rate of DNA aneuploid increased（P<0.05）.(3) There was relationship between DI and histological differentiation of tumor cell. The DI was higher in tumors of poor differentiation than those in tumors of moderate and good differentiation（P<0.05 and P<0.01）. (4) The cellular proliferation index of aneuploid tumors was significantly higher than that of diploid tumors(P<0.01), while apoptosis index of aneuploid tumors was significantly lower than that of diploid tumors (P<0.01). Conclusion: Correlations exist between DNA content and TNM stage, hiological differentiation, cellular proliferation, and apoptosis.

Child ; Community-Acquired Infections ; microbiology ; Humans ; Pneumonia, Bacterial ; microbiology

Two regression models, based on panel data over the period of 2000-2011, are built and used to analyze what factors determine China's exports of primary and semi-finished products of traditional Chinese medicine to ASEAN. The results indicate that, China GDP, the ratio of ASEAN to China GDP per capita, average export price, the ratio of state-owned assets to total assets, have a significant positive influence on the export volumes of primary products of Chinese medicine. At the same time, RMB appreciation, the ratio of three kinds of foreign-invested assets to total assets, China-ASEAN Early Harvest Program, ASEAN-China Free Trade Area have a significant negative influence. In respect of the export volumes of semi-finished products of Chinese medicine, the significant influential factors are ASEAN GDP and the ratio of ASEAN to China GDP per capita. The former is positive and the latter is negative. In order to optimize the commodity composition of experts, it is needed to increase export volumes of both primary and semi-finished products of Chinese medicine. According to the analysis above, some proposals are put forward, such as, improving the performance of foreign capital, playing an exemplary and leading role in technological innovation by state-owned enterprises, taking advantage of bargaining power of suppliers, increasing outward foreign direct investment.
China ; Commerce ; Drugs, Chinese Herbal ; chemistry ; economics ; Europe, Eastern ; Medicine, Chinese Traditional ; economics ; standards ; Quality Control

Child, Preschool ; Humans ; Male ; Nevus, Blue ; pathology ; Skin Neoplasms ; pathology