Objective:To explore the relationship between carotid atherosclerosis (CAS)detected by ultrasonography and ECG abnormality and correlation between CAS and blood pressure in patients with coronary heart disease (CHD).Methods:A total of 389 CHD patients were divided into CAS group (n=213)and no CAS group (n=176).ECG abnormalities were compared between two groups,and ECG and blood pressure were compared among patients with different degrees of CAS in CAS group.Results:Compared with no CAS group,there were significant rise in constituent ratios of atrial fibrillation,Ⅱ~Ⅲ°atrioventricular block,total lead number of ST segment de-pression,and of abnormal T wave,ST segment deviation complicated abnormal T wave and angina pectoris compli-cated ST segment depression in CAS group (P <0.05~<0.01).Along with CAS grade increased (grade I~ grade IV),there were gradual rise in percentages of atrial fibrillation (8.33% vs.21.33% vs.31.03% vs.45.00%),to-tal lead number of ST segment depression (17.64% vs.27.22% vs.37.07% vs.52.08%),total lead number of ab-normal T wave (5.00% vs.6.56% vs.10.34% vs.22.08%)and ST segment deviation complicated abnormal T wave (26.67% vs.37.33% vs.50.00% vs.60.00%),P <0.05 or <0.01. There were no significant difference in diastolic blood pressure (DBP)between no CAS group and CAS group,but systolic blood pressure (SBP)and pulse pressure (PP)of CAS patients were significantly higher than those of no CAS patients,and they gradually elevated along with CAS severity increased (P <0.05~<0.01).Pearson correlation analysis indicated that CAS was signifi-cant positively correlated with SBP and PP (r =2.064,1.348,P <0.01 both).Conclusion:The incidence rate of abnormal ECG in CHD patients complicated CAS is higher than that of CHD patients without CAS;and CAS is pos-itively correlated with blood pressure.Therefore,carotid ultrasonography can better reflect CHD patients′condition.

Objective To evaluate the clinical outcomes of the reformed microlumbar discectomy preserving partial ligamentum flavum to prevent lumbar spinal instability and .scar tissue oppression and adhesion after operation. Methods A prospective, randomized, controlled clinical study was conducted.The patients with unilateral lumbar disc herniation were randomly divided into two groups. The control group (41 cases) underwent classic mien)lumbar disceetomy,.and the test group (44 cases) underwent the same procedure but with a curved incision on the lumbo-dorsa fascia and with partial preservation of the ligamentum flavum. Visual analog scale (VAS) scores and Oswestry scale scores were used to appraise the outcomes. Results Chnieal parameters were significantly improved after the operation in two groups. In the test group the postoperative VAS scores showed a less intensity of pain after the operation than that in the control group, and this superiority disappeared 1 year after the operation. After the operation, the VAS scores in the test group and contnd group were (1.8±0.6) and (3.8±1.3) scores at 3 days (P <0.05), (1.3±0.6) and (3.5±2.1) scores at 12 weeks (P<0.05), and (1.9±0.6) and (2.8±1.7) scores at 1 year (P>0.05) respectively. After the operation, the Oswestry scale scores in the test group and control group were (18.2±6.6) and (34.4±11.8) scores at 12 weeks (P <0.05), (12.0±9.2) and (22.6±10.0) scores at 1 year (P<0.05) respectively. In both groups, there was no patient who had recurrence of intervertebral disc hernia and reoperation. Conclusions Minimally invasive discectomy has satisfactory clinical outcomes,however, with partial preserved ligamentum flavum shows a less intensity pain and a better lumbar function state. Preserving the ligamentum flavum is helpful to prevent the fibrosis-related complication and to preserve the stabihty of the spine.

Surgical resection remains the cornerstone of therapy for early stage lung cancer. Five-year survival rates are reported as high as 92% for stage Ⅰ non-small cell lung cancer (NSCLC). However, many patients presenting with resectable early stage disease are unable to tolerate pulmonary resection, even sublobular resection, because of compromised cardiopulmonary functions or other comorbidities. Traditionally,patients deemed medically inoperable have been treated by external-beam radiation. But the results were poor with a mean survival of 20 months and a 5-years survival rate of 12%. In this scenario, we need to develop other non-surgical local therapies. One of these was image-guided percutaneous radiofrequency ablation(RFA).Many clinical trials show that RFA for lung tumors is a minimally invasive, feasible and safe technique with minor mortality and morbidity. Moreover, its efficacy seems to be promising, even in the long-term follow-up.Further experiences and comparison with other emerging minimally invasive local treatments are required to determine its rote in the treatment of medically inoperable early stage NSCLC.

Objective To evaluate the therapeutic effects afer radiofrequency ablation(RFA) in 24 patients with pulmonary neoplasms through quantitative iodine-based and water-based material decomposition images with spectral computed tomography(CT) imaging.Methods 30 patients(19 male,11 female;age range,52-85 years;mean age,69 years;26 peripheral lung cancer,4 central lung cancer) underwent lung radiofrequency ablation on a GE Discovery CT750HD scanner from March 2012 to March 2013.We compared the volume,CT value,water-based value and iodine-based value of lung tumor before and after the RFA using spectral imaging mode.Results 22 of 30 tumors was bigger after the RFA,8 had no change.Through water-based material decomposition images,the water content in the tumors were increased from(1 014.76 ±6.83) mg/ml to (1 022.71 ± 10.16)mg/ml after RFA,and the difference was significant (t =-2.329,P ＜ 0.05).The iodine-based value in parenchyma of the tumor was 2.49 ± 0.74 mg/mL before the RFA.The tumor was most or completly necrosis after the RFA,the value of iodine in the area of necrosis was (0.45 ± 0.29) mg/mL,which was obviously reduced than before (t =11.072,P =0.000).Conclusion Through compared with the volume,CT value,water-based value and iodine-based value of the parenchyma of the tumors before and after the RFA with spectral computed tomography(CT) imaging,we can know the morphology and metabolism of the tumors to investigate the short term results.

Objectives To explore the optimal startup time of patient controlled intravenous analgesia (PCIA) in aged patients after thoracotomy for pulmonary lobectomy.Methods The 67 aged patients after thoracotomy for pulmonary lobectomy from January to December 2008 were randomized divided into two groups:PCIA was startup immediately after waking (instantly group) or after removal tracheal intubation (delayed group).The analgesia efficacy,cardiopulmonary function and side effect were evaluated at the awake time,12,24 and 48 hours after surgery respectively.Result Both of VAS scores at 12 hours after surgery and oxygenation index at 48 hours after surgery had significant difference (P<0.05) between the two groups.The analgesia efficacy was better in the instantly group.There was no significant difference on the duration of mechanical ventilation and side-effect rates between the two groups.No patient suffered from respiratory depression.Conclusion The early use of PCIA in aged patients after thoracotomy for pulmonary lobectomy can gain better pain control and oxygenation effect.

Objective To explore the risk factors and clinical features of systemic lupus erythematosus (SLE) patients with venous thromboembolic disorders (VTE). Methods Twenty SLE patients with VTE (VTE group) and 40 SLE cases without VTE (control group) were retrospectively analyzed for clinical and laboratory features. T test, Mann-Whitney U rank sum test, χ2 test, Logistic regression analysis were used for statistical analysis. Results The prevalence of VTE in SLE patients was 1.5%(20/1 326). Renal involvement, increased blood pressure, history of lower extremity deep vein catheter, merging with antiphospholipid antibody syndrome (APS) could be seen more frequently in VTE group than control group ( χ2=5.508, 7.033, 5.208, 7.882, respectively), and the difference were statistically significant (both P<0.05). Hydroxychloroquine dosage used in the VTE group (133±119) mg/d was lower than that of the control group (211±126) mg/d (t=2.156, P=0.034), antiplatelet drug use rate was lower than the control group too, the difference were statistically significant ( χ2=7.080, P=0.008). Logistic regressions showed that renal involvement [OR=5.5, 95%CI (3.6, 12.7), P=0.003], lower C3 level [OR=2.3, 95%CI (1.8, 5.2), P=0.005], SLEDAI activity score [OR=8.13, 95%CI (5.2, 7.3), P=0.001] were independent risk factors for VTE in SLE. Conclusion SLE patients with renal involvement, increased blood pressure, history of lower extremity deep vein catheterization or complicated with APS were risk factors for VTE, while hydroxylchloroquine, antiplatelet drugs may help prevent VTE.

Objective To investigate the species composition and quantitative dynamic state of rodent and parasitic flea in Huairou District of Beijing City,and to carry out serologic monitoring of animal plague.Methods Rodent density was investigated at different habitats in eight villages and towns between 2009 and 2011.Serum samples from captured rodents were detected by indirect hemagglutination test,and genotypes of collected parasitic fleas were identified.Results A total of 709 rodents which belong to eight different kinds were captured with a rodent density of 2.52％ (83/3 300),and Rattus niviventer and Apodemus peninsulae were dominant species,acounted for 46.4％ (329/709) and 18.1％(128/709),respctively.Five hundred and sixty-three serum samples of rodents were tested by plague indirect hemagglutination,and all of them were plague antibody negative.Two hundred fleas were checked with a flea infected rate of 29.63％ (48/162),and a flea index of 1.23; Paraceras crispus and Leptopsylla pavlovskii were dominant flea species,a total of 30 and 27,respectively.Conclusion Some environment conditions are suitable for rodents survival,even though there is no sign of animal plague epidemic.

OBJECTIVE:To clone,prokaryotic express and characterize the TEM-type ?-lactamase produced by Enterobacter cloacae clinical isolate EC002. METHODS: The drug susceptibility of Enterobacter cloacae clinical isolate EC002 was detected by agar double dilution,double disk screening and confirmatory test were employed to detect the ESBLs. The isoelectric point (pI) of enzyme was detected by isoelectric focusing electrophoresis (IEF),the genes were coded by PCR amplification enzyme,and the prokaryotic expression and phenotype of the TEM-type ?-lactamase were detected. RESULTS: Enterobacter cloacae EC002 were resistant to most of the ?-lactamases. Positive results were noted for the phenotype identification and plasmid conjugation test. IEF showed that Enterobacter cloacae EC002 produced two ?-lactamases with pI value at 8.7 and 5.4 respectively,which were confirmed to be CTX-M-22 and a new TEM-subtype ?-lactamase by DNA sequencing,and the phenotype of the expressed enzyme of the cloned strains was non-ESBLs. The TEM-type ?-lactamase was named as TEM-141 by GenBank. CONCLUSION: The TEM-141 produced by Enterobacter cloacae EC002 was a new type of plasmid-mediated broad-spectrum ?-lactamase.

OBJECTIVE To study the molecular mechanism of the drug-resistance of Gram-negative bacilli to the third generation of cephalosporins.METHODS MICs of 13 ?-lactams to the eleven Gram-negative bacilli clinical isolates were detected with the standard agar dilution technique.K-B disc confirmatory method was conducted to determine the ESBLs phenotype of the eleven isolates.The ESBLs encoding genes were analyzed by using PCR.RESULTS The eleven isolates were all resistant to the third generation of cephalosporins(MIC≥64 ?g/ml).Disk confirmatory test showed that 10 isolates produced ESBLs.The hydrolytic activity of the ESBLs from the 10 isolates to cefoperazone and cefamandole was very high.However,the hydrolytic activity of the ESBLs from the 10 isolates to ceftazidime was very low.CONCLUSIONS The enzyme activities and the genes of extended-spectrum ?-lactamases from 10 Gram-negative bacilli clinical isolates are preliminarily analyzed.These results provide the basis for further study on the molecular mechanism of the drug-resistence of Gram-negative bacilli.

OBJECTIVE:To observe the relationship between gyrA gene mutations of the clinical isolates of Pseudomonas aeruginosa and quinolone resistance and to evaluate the feasibility of analyzing gyrA gene mutations using PCR-RFLP-SSCP.METHODS:With gyrA gene order of the clinical isolates of Pseudomonas aeruginosa taken as target sequence,gyrA gene mutations in strain ATCC 27853 and 16 clinical isolates of Pseudomonas aeruginosa were analyzed contrastively using PCR,PCR-RFLP,PCR-SSCP,and DNA sequencing.RESULTS:Of the total 8 ciprofloxacin resistant Pseudomonas aeruginosa,6 strains showed single point ACC→ ATC mutation in the gyrA gene at codon 83,leading to amino acid substitution of Thr83→Ile.SacⅡ digestion fragment of the PCR amplified products in gyrA gene was in line with the sequencing results.SSCP showed that the banding patterns of all strains were different from that of strain ATCC 27853 except 2 strains.CONCLUSION:The molecular mechanism of the quinolone resistant Pseudomonas aeruginosa isolated from clinics was manifested as mutations in the gyrA gene at codon 83.The results showed that PCR-RFLP-SSCP is a rapid and accurate method for the detection of basyl variation in gyrA in quinolone resistant Pseudomonas aeruginosa.