Objective To Screen the carbapenem-resistant acinetobacter baumannii so as to understand the drug resistance,and to analyze the outer membrane protein expression between the carbapenem-resistant Acinetobacter baumannii and the sensitive strains.Methods The twofold agar dilution method was used to screen the carbapenem-resistant acinetobacter baumannii.PCR technique was used to detect the outer membrane protein-encoding gene carO.SDS-PAGE was used to analyze the expression of outer membrane protein.Results 32 strains were carbapenem-resistant acinetobacter baumannii separated from 1 10 strains,which were 100% sensitive to polymyxin B and were resistant to other drugs with different degrees O.They all carried carO gene.There were different protein bands between the carbapenem-resistant strains and the sensitive strains,in which two protein bands of 50× 10 3 and 22×10 3 were recognized as outer membrane proteins through the analysis of SDS-PAGE.Conclusion Drug resistance of acinetobacter baumannii is serious,and the outer membrane protein expression between the carbapenem-resistant strains and the sensitive strains presents discrepancy.

Objective To study the therapeutic effect of sub-hypothermia on 80 patients with diffusing axonal injury (DAI) and its prognosis.Methods All 80 patients with DAI were randomly divided into the sub-hypothermia group(40 cases)and the control group(40 cases). All patients'vital sign,intracranial pressure (ICP) and blood sugar were measured. 40 cases of the patients with DAI were treated by sub-hypothermia, the rectal temperate (RT) reached 32 0℃～35 0℃,sub-hypothermia lasted for 1～7 days; the control group was treated routine. According to Glasgow Outcome Scale (GOS), the prognosis of the patients was evaluated 3 months later.Results In comparison with the control group, increased ICP and raised blood sugar in sub-hypothermia group were significantly decreased (P

Objective To summarize the diagnostic and therapeutic experiences of 18 patients with chronic expanding intracerebral hematoma.Methods Clinical data of 18 patients with chronic expanding intracerebral hematoma was analyzed retrospectively.Results Most of the lesions were misdiagnosed preoperatively as cerebral neoplasms.Among 18 cases, 15 cases were cured, 2 cases had severe disability, and one case died after operation.Conclusions Chronic expanding intracerebral hematoma must be considered when encapsulated mass lesion is present in the brain. The ultimate diagnosis is confirmed at surgery and by histological analysis.

Objective To investigate the new therapy for primary intraventricular hemorrhage (PIH).Methods 31 cases of PIH were treated by rigid neuroendoscopy.The cases were composed of 16 cases of single intraventricular hemorrhage,14 cases of double intraventricular hemorrhage and 1 case the third-fourth intraventricular hemorrhage.24 cases were accompanied with acute obstructive hydrocephalus.Results Duration of operation lasted from 30 minutes to 60 minutes, with an average time of 43.4 minutes.More than 90 percent of hemorrhage in 24 cases with single or double intraventricular hemorrhage were evacuated. 50 percent to 90 percent of hemorrhage were evacuated in other 7 cases. Neurological status was obviously improved and improved in 25 cases, no change in 4 cases and dead in 2 cases.Only one patient developed hydrocephalus.Conclusion Neuroendoscopic neurosurgy for PIH was characterized by visualized manipulation, shorten operative time,minimal invasion, effective hemorrhage evacuation and excellent post-operative outcomes.

Objective To discuss the Clinical character of pulmonary tuberculosis combined malignant lymphoma and its Pathogenesis,and to review the literature.Methods Eighteen cases of pulmonary tuberculosis combined malignant lymphoma from 1996 to 2003 were retrospectively analyzed by its clinical manifestations,X-ray features,diagnosis and treatments.Results 18 cases were all infiltrative pulmonary tuberculosis,13 them were calcification focals,5 were active pulmonary tuberculosis;5 of all were Hodgkin’s lymphomas,13 of all were non-Hodgkin′s lymphomas.16 cases were lymphomas after tuberculosis,2 cases tuberculosis after lymphomas,none were co-existent malignant lymphoma and tuberculosis.Tuberculosis may precede or complicate a lymphomatous process during the development of both diseases,This might is linked to immune deficiency and chronic inflammation;Lymphomas might cause pulmonary tuberculosis,it might cause the immune turbulence of an individual,Pulmonary tuberculosis infection occurring during or after the radiotherapy and chemotherapy of lymphoma.Conclusions It may pulmonary tuberculosis combined malignant lymphoma in the patients in the endemic areas of tuberculosis,Appropriate invasive biopsy procedures are necessary for early diagnosis.

BACKGROUND: Odontogenic infection factor has been given much importance in the study of the etiology of secondary trigeminal neuralgia,and the theory of jaw bone cavities is proposed. OBJECTIVE: To study the relationship of the jaw bone cavities and the etiology of trigeminal neuralgia.DESIGN: A self-controlled trial.SETTING: Department of oral and maxillofacial surgery of a university hospital.PARTICIPANTS: The patients with the trigeminal neuralgia were treated in Department of Oral and Maxillofacial Surgery, Affiliated Hospital of the Medical College of Qingdao University from February 1994 to December 2003, from whom 45 were selected for this study, including 15 males and 30 females with altogether 74 jaw bone cavities.METHODS: Curettage of the jaw bone cavities was performed in these cases, and visual analogue scale(VAS) was adopted for evaluation of the postoperative pain.MAIN OUTCOME MEASURES: ① VAS; ② Pathological examination and bacteria culture of the specimens.RESULTS: Pain relief was achieved in 33 cases(73.3% ) after the first surgery and in 10 cases(22.2% ) after a second or third surgery. In 2 cases (4.5%), the pain was alleviated but medication was still needed for pain control. Pathological examinations in most cases identified predominantly in flammatory and granulation tissues.CONCLUSION: Jaw bone cavities may be one of the major etiologic factors of trigeminal neuragia.

Purpose:To evaluate the significance of NF ?B P65 protein expression in various human cerebral tumors. Methods:The expression of NF ?B P65 protein in 106 cases of cerebral tumors was studied immunohistochemically. 106 cases included 64 cases of astrocytic tumors and 22 cases of medulloblastoma and 20 cases of meningioma. 10 cases of normal brain tissue were employed as a control group.Results:The positive rate of NF ?B P65 protein of 64 astrocytic tumor specimens was 54.7%; the positive rate of NF ?B P65 protein of 22 cases of medulloblastoma was 36.4% and 5.0% for 20 cases of meningioma. In contrast, none of the normal tissues exhibited NF ?B P65 protein staining. Significant difference were observed between astrocytic tumor group and meningioma, as well as between medulloblastoma and meningioma ( P

Objective To investigate the role of N-acetylcysteine as a protective agent in rifampicin-induced hepatic injury of mice. Methods Thirth-two Kunming mice were randomly divided into four groups(n=8 each).The mice in each group were injected intraperitoneally with 0.9% sodium chloride solution (control), N-acetylcysteine (NAC), combination of rifampicin (R), or NAC and R (NAC+R) once every day.After 14 days, the liver index (LI), alanine aminotransferase (ALT) and aspartate aminotransferase ( AST) activity in serum, and the level of malondialdehyde( MDA) ,superoxide dismutase( SOD) activity in liver tissues were measured respectively.Hepatic tissue morphology was observed under light microscope. Results Macroscopic analysis revealed that rifampicin led to severe liver tissue injury,including a wide range of hepatocellular vascular congestion,fatty change and local necrosis, whereas the administrationof NAC produced a significant reduction of rifampicin-induced hepatotoxicity .LI,ALT and AST activities in R or NAC+R group were significantly elevated as compared with the control group(P<0.01) .LI, activities of ALT and AST in serum,and MDA levels in liver tissues in NAC+R group were significantly lower than those in R group ( P<0.01) ,but the SOD activity in NAC+R group was increased significantly in comparison with R group (P<0.01). Conclusion Rifampicin was able to cause severe hepatic injury.Pre-administration of NAC reduced the side-effect induced by the treatment with the rifampicin.

Objective To observe the effects of Roux-en-Y gastrointestinal reconstruction(RYGR) on carbohydrate and lipid metabolism in non-obese patients with type 2 diabetes and gastric carcinoma.Methods Fifty seven gastric cancer cases who underwent radical distal gastrectomy were studied and among them 35 patients had Roux-en-Y gastrointestinal reconstruction (RYGR group) and 22 had Billroth-Ⅰ gastrointestinal reconstruction (B-I GR group).Both groups were subjected to the measuring of preoperative and postoperative third,sixth months values of body mass index (BMI),glycosylated hemoglobin (GHbA1c),fasting glucose (FPG),fasting insulin (Flns) and C-peptide (FC-P),oral glucose tolerance (OGTT) including 2 hour insulin (2hIns) and C-peptide (2hC-P),plasma levels of total cholesterol (TC),triglycerides (TG),high density lipoprutein (HDL-c) and low density lipoprotein (LDL-c).Result There was no significant difference between the two groups in preoperative values (P＞0.05).There was no statistically significant difference in BMI values measured postoperatively (P ＞ 0.05).In RYGR group,preoperative FPG and that of third and sixth month postoperatively was (9.3±0.9) mmol/L vs.(7.2±2.1) mmol/L vs.(7.1±0.8) mmol/L,P=0.000,GHbAlc was (9.2±1.2)% vs.(7.3±1.2)% vs.(7.2±1.1)%,P=0.000,TG was (3.21±0.88) mmol/L vs.(2.12±0.97) mmol/L vs.(2.02±0.09) mmol/L,P =0.000,TC was (6.4±1.9) mmol/L vs.(4.3±1.0) mmol/L vs.(4.1±1.0) mmol/L,P =0.000 and LDL-c was (3.61±1.05) mmol/L vs.(2.77±0.68) mmol/L vs.(2.71±0.18)mmool/L,P=0.000,2 hour glucose after OGTT(2hPG) was (17.6±2.5) mmol/L vs.(12.1±1.9) mmol/L vs.(11.6±2.3) mmol/L,P = 0.000.Levels of FIns was (98±11) pmol/L vs.(120±9)pmol/L vs.(122±8) pmol/L,P =0.000,FC-P was (0.21±0.08) mmol/L vs.(0.30±0.01) mmol/L vs.(0.30±0.01) mmol/L,P=0.000,HDL-c was (1.08±0.10) mmol/L vs.(1.61±0.34) mmol/L vs.(1.62±0.09) mmol/L,P = 0.000,2 h Ins was (410±19) pmol/L vs.(446±19) pmol/L vs.(459±18) pmol/L,P = 0.000 and 2 h C-P was (0.87±0.17) mmol/L vs.(1.22±0.14) mmol/L vs.(1.19±0.15) mmol/L,P =0.000.In B-I GR group,preoperative and third and sixth postoperative month values of GHbA1c were (9.2±1.2)% vs.(8.4±1.6)% vs.(8.3±1.1)%,P =0.046.Conclusion Roux-en-Y gastric bypass can significantly improve the metabolism of carbohydrate and lipid in non-obese patients with type 2 diabetes and gastric carcinoma,and the effects are not related with postoperative weight loss.

Objective To summarize our experience in the modified total cystectomy and neobladder in patients with invasive bladder cancer.Methods Twenty one male patients with invasive bladder cancer were treated with modified total cystectomy and neobladder.Reconstruction of the lower urinary tract using modifiled ileal neobladder(in 17 patients)and sigmoid neobladder(in 4 patients)were performed.The median age of the patients was 62 years.The patients were followed up for 1-4 years.Clinical outcomes of these patients was evaluated,including the function of the neobladder,urinary function,renal function,serum electrolytes and QOL.Results There was no surgical mortality.The operating time was 3.5-6.5 h(mean,4.5 h).Blood transfusion was required in 4 cases.Fifteen patients(97 ％ had voluntary control of urination at daytime and 6 at night.They were functional to control urination 3-6 months after operation.Hydronephrosis to certain extent occurred in 5 patients,but was recovered after 6-8 months.There were one case of intestinal obstruction and one case of metabolic acidosis.Residual urinary volume was 30 ml in 1 cases and 40 ml in another.Conclusions Modified total cystectomy and neobladder is an ideal technique to treat invasive bladder cancer with good clinical outcomes of tumor control,high life quality,few severe complications and good urination control.