Objective To investigate the bacterial distribution and resistance in orthopedic patients with wound infections in the hospital in 2014 .Methods The bacteria identification and the antimicrobial susceptibility test were conducted by VITEK‐2 compact automatic system .Results A total of 864 pathogenic strains were collected ,with Gram‐positive bacteria 451 strains (52 .2% ) , Gram‐negative bacteria 398 strains(46 .1% ) .The first major pathogens of Gram‐positive bacteria were Staphylococcus aureus(n=233 ,27% );The top three pathogens of Gram‐negative bacteria were Pseudomonas aeruginosa(n=94 ,10 .9% ) ,Enterobacter cloacae (n=63 ,7 .3% ) ,Acinetobacter baumannii(n=58 ,6 .7% ) .All the Staphylococcus aureus isolates were susceptible to vancomycin , tigecycline ,nitrofuratoin ,quinupristin/dalfopristin ,linezolid .The resistant rates of Acinetobacter baumannii were higher than 50%to multiple antibiotics .Conclusion Staphylococcus aureus were predominant pathogens in orthopedic patients with wound infec‐tions in our hospital .Meantime ,Pseudomonas aeruginosa and Enterobacter cloacae were the prime pathogens in the Gram‐negative bacteria .The drug‐resistance situation is still severe ,and more effective measures should be taken to control the dissemination and growth of resistant strains .

Objective To evaluate the potential effects of RS504393, CC chemokine receptor (CCR) 2b and CCR1 antagonist, on LPS-induced acute lung injury (ALI) and to investigate the underlying mechanisms. Method A549 cell line was stimulated with LPS (10 μg/mL) and then treated with RS504393 (10 μg/mL) for 6 hours. ALI model was established with intranasal administration of LPS (5 mg/kg) in C57BL/6J mice. RS504393 (5 mg/kg) was administered 30 min before LPS dripped nasally. IL-8, IL-1β, plasminogen activator inhibitor (PAI)-l,monocyte chemoattractant protein (MCP)-2,and the expressions of CCR1 and CCR2b were studied by using Realtime-RT-PCR, ELISA and cyto-flowmetry. Results In A549 cell line treated with RS504393,the expressions of CCR1, CCR2b and IL-8 were significantly inhibited after LPS stimulation. In rats with LPS-induced ALI, treatment with RS504393 significantly protected mice against lung injury by attenuating influx of leukocytes and protein into bronchoalveolar space and by lessening pathological changes of lung. Treatment with RS504393 down-regulated IL-1β and PAI-1 expressions in bronchoal veolar lavage fluid (BALF) and lungs at mRNA and protein levels along with up-regulation MCP-2 expression compared to rats of vehicle-treated groups. Conclusions CCR2b and CCR1 play pivotal roles in the development of ALl,and RS504393 as a antagonist can halt the development of ALI.

Objective To study clinical value of percutaneous intrabiliary expandable metallic biliary stenting (EMBS) for treatment of malignant obstructive jaundice. Methods One hundred and sixty patients with malignant obstructive jaundice were treated with EMBS ( EMBS group) . Thirty patients underwent only external drainage by PTCD were recruited as control. The patency rate of stent,decline of bilirubin and the complication were analyzed retrospectively. Both groups were followed up for three months. The Kaplan-Meier method (log-rank test) was used to compare the survival period between the two groups. Results Anorexia,skin pruritus and color of urine alleviated at a certain degree in both groups.In the EMBS group,plasma total bilirubin was(218. 78 ±2. 29) μmol/L pre-stent,and decreased to (134. 90 ±2. 34), (83. 18 ±2.40) , (40. 74 ±2. 29) μmol/L at the 7,14,21 days after the stenting, respectively; direct bilirubin was (128.82 ±2.40) μmol/L pre-stent, and decreased to (81.28 ± 2. 34), (51. 29 ±2. 45) and (25. 70 ±2.40)μmol/L at the 7,14,21 days after the stenting ( P =0. 000). In the PTCD group,plasma total bilirubin was (223. 57 ± 2. 58) μmol/L pe-stent, and decreased to ( 145. 68 ± 2. 57 ) ,(87.57 ±2.58) ,(38.65 ±2. 20) μmol/L at the 7,14,21 days after the stenting,respectively;direct bilirubin was (127. 6 ±2. 59)μmol/L pre-stent,and decreased to (79. 78 ±2. 70) ,(58. 36 ±2. 46) and (29.46 ±2. 20)μmol/L at the 7,14,21 days after the stenting,respectively ( P <0.001 ). No significant difference was found between the two groups at any time point ( P > 0. 05). Complications occurred in 34 patients in the EMBS group and the incidence rate was 20. 62% . Two or more complications occurred in 9 patients. In the PTCD group, complications occurred in 60.00% of the patients. In the EMBS group, 14 patients were failed to follow up, and 136 died. The median length was 214 days. In the PTCD group,all patients were followed up and all died,with a median length of survival of 75. 5 days. The survival analysis showed that the EMBS group survived longer than the PTCD group (P =0. 000). Conclusions EMBS placement showed better effect than PTCD. Compared to PTCD, internal drainage of metallic stents lead few complications and faster recover, and can improve the life quality and prolong survival time of patient with malignant obstructive jaundice. The placement of metallic stents is recommended as a preference for palliative therapy of malignant biliary obstruction.

Objective To investigate the activity changes of gelatinase in the formation of ascending aortic aneurysm.Methods Thirty five young Wistar rats were divided into two groups:the control group and the experiment group.The rat models induced by ascending aorta banding were made.The ascending aortas were taken after 3-5 months operation,changes of gelatinase activity was observed by gelatin zymography and film in situ zymography.Results Gelatinase activity of ascending aortic aneurysm was significantly increased compared with that of normal ascending aortic aorta.Conclusion Elevation of gelatinase activity may play a significant role in the formation of ascending aortic aneurysm.

Objective To investigate the expressions and significance of transforming growth factor-beta 1(TGF?1) and its typeⅡ receptor(TGF?RⅡ) in experimental rat ascending aortic aneurysm of rat model.Methods The rat ascending aortic aneurysm models were made by banding ascending aorta of young Wistar rats.The ascending aortas were taken 4 months after operation.Immunohistochemistry staining and Western blotting were used to investigate the expressions of TGF?1 and TGF?RⅡ.Result Immunohistochemistry staining results showed that TGF?1 expressed in all layers of the aortic aneurysm and the control.TGF?RⅡ was extensively located in the hyperplastic intima and tunica media smooth muscle cells in the aortic aneurysm,while there was only a little positive staining in the control group.Western blotting results indicated that the expression levels of TGF?1 and TGF?RⅡ in the aortic aneurysm were stronger than the control,P

Objective:This study aimed to detect the special methylation profile in peripheral blood for hepatocellular carcinoma (HCC). Methods:The methylation status of 12 tumor suppressor genes (TSGs) in the plasma of 55 HCCs and 54 chronic liver diseases (CLDs) was tested by methylation-specific PCR (MSP). Results:In HCC, the methylation frequencies were 78.18%in APC, 63.64%in cyclin D2, 58.18% in TFPI2, 49.09% in DKK3, 49.09% in GSTP1, 47.27% in p16, 40.00% in Sigma 14-3-3, 18.18% in SFRP2, 16.36% in ppENK, 9.09% in DKK2, 7.27% in NPTX2, and 5.45% in LHX1. In CLD, the methylation frequencies were 27.78% in APC, 22.22%in cyclin D2, 7.41%in TFPI2, 3.70%in DKK3, 16.67%in GSTP1, 37.04%in p16, 37.04%in Sigma 14-3-3, 11.11%in SFRP2, 20.37%in ppENK, 7.41%in DKK2, 7.41%in NPTX2, and 9.26%in LHX1. The methylation frequencies of APC, cyclin D2, TFPI2, DKK3, and GSTP1 were higher in HCC than in CLD (P<0.01). The methylation index (MI) of the five-gene methylation profile was statistically higher in HCC (median, 0.6;IQR, 0.4-0.8) than CLD (median, 0.2;IQR, 0-0.2) (P<0.01). In HCC, MI was statistically related to the patient's age. Older patients with HCC had a higher MI. No significant correlation was observed between MI and other clinicopathological data. Moreover, MI was not related to the disease free survival and the overall survival in HCC. Conclusion:This five-gene methylation profile may be a promising biomarker for the assistant diagnosis of HCC.

Objective To evaluate the dose distribution of target volume and normal tissues in forward intensity modulated radiotherapy (fIMRT) and inverse intensity modulated radiotherapy (iIMRT) modes for breast cancer after radical mastectomy.Methods Both fIMRT and iIMRT plans were developed for 10 patients with breast cancer after radical mastectomy.On each patient's CT images the supraclavicular area, chest wall, and internal mammary area were delineated.The prescription dose was 50 Gyin 25fractions.In the fIMRT plan X-ray irradiation at the dose of 6 MV was adopted for the supraclavicular and the chest wall areas and electron irradiation at the dose of 9 - 12 MeV was adopted for the internal mammary area, and the doses of cold and hot spots were adjusted according to the fitting doses of these 3 regions.In the iIMRT plan the supraclavicular area, chest wall, and internal mammary area were taken asa whole target, 6 MV X-rays was used, and inverse optimal design was performed.The dose distribution oftarget volume and normal tissues, conformal index (CI) , and heterogeneous index (HI) , and acceleratormonitor unit (MU) were analyzed using dose-volume histogram (DVH)for the two intensity modulated modes.Results The maximum dose of PTV of the iIMRT plan was significantly lower than that of the fIMRT plan(t = -3.23,P ＜0.05), the minimum dose and V95% of PTV of the iIMRT were significantly higher than those of the fIMRT plan(t = 4.08, -2.69, both P ＜0.05).The CI level of the iIMRT plan was significantly higher than that of the fIMRT plan and the HI level of the iIMRT plan was significantly lower than that of the fIMRT plan (t = -3.13, 2.74, both P ＜0.05).There were not significant differences in V10, V20, V25, V30, and Dmean of the ipsilateral lung between these 2 groups.However, the V15 of ipsilateral lung of the iIMRT group was significantly lower by 4.2% than that of the fIMRT group (t= 3.2, P ＜ 0.05).There were not significant differences in the mean dose (Dmean) and V30 of heart, and Dmean of contralateral lung and contralateral breast between these 2 groups.Conclusions Compared with fIMRT, the iIMRT plan results in more PTV coverage, higher conformity index, and more homogeneous dose distribution, with lower dose upon the lung at the affected side, and better protection of the contralateral lung, heart, and breast.

Monte Carlo method was used for calculation of finite-diameter laser distribution in tissues through convolution operation. Photo-thermal ablation model was set up on the basis of Pennes bioheat equation, and tissue temperature distribution was simulated by using finite element method by ANSYS through the model. The simulation result is helpful for clinical application of laser.
Algorithms ; Finite Element Analysis ; Laser Therapy ; Monte Carlo Method ; Temperature

Objective To study the prevalence of dilated cardiomyopathy and the quasi-latent Keshan disease in villages of non-endemic areas of six Keshan disease endemic provinces in China,and to provide reference values for proposing a elimination standard of keshan disease.Methods County,township and village was selected as the study area by using multi-stage sampling in non-Keshan disease areas of Sichuan,Shanxi,Henan,Shandong and in Keshan disease areas of Chongqing and Yunnan.In each county two townships were selected and in each township one village was chosen.The residents of the villages sampled were surveyed by questionnaire,physical examination,electrocardiogram (ECG) and cardiac echocardiography.Suspected dilated cardiomyopathy patients had chest X-ray.Dilated cardiomyopathy patients were diagnosed according to the criteria proposed by 2006 World Health Organization/International Society and Federation of Cardiology (WHO/ISFC).Results The number of investigated villages was 126 and 54 139 people were surveyed by questionnaire and clinical examination.Ten patients with dilated cardiomyopathy were found,the prevalence was 18.47/100 000(10/54 139),and its 95％ confidence interval was 18.11/100 000-18.84/100 000.A total of 197 patients with quasi-latent Keshan disease were found,the prevalence was 363.88/100 000 (197/54 139),and its 95％ confidence interval was 362.27/100 000-365.49/ 100 000.The prevalence of male quasi-latent Keshan disease was 353.34/100 000(83/23 490) and of female was 372.07/100 000(114/30 639).The number of subjects with normal and abnormal ECG was 45 222 and 8917,respectively,and the rate of abnormal ECG was 16.47％.The highest rate of abnormal ECG was 38.28％ (1585/4141) in Chongqing.The lowest rate of abnormal ECG was 8.10％ (1175/14 507) in Yunnan.The highest detection rate of T wave and ST segment changes was 4.67％ (2528/54 139).In abnormal ECG indices,the detection rate of Henan,Shandong and Chongqing was higher,and all of them were higher than 10.0％.Conclusions We suggest that the reference baselines of dilated cardiomyopathy and quasi-latent Keshan disease in Keshan disease areas of the six provinces in the south of China be 18.47/100 000 and 363.88/100 000,respectively.