Objective:To investigate the relationship between antibiotics use and antimicrobial resistance of Acinetobacter bauman-nii to provide reference for rational antibiotics use. Methods:The DDDs of antibiotics in the inpatients and the drug resistance rate of A. baumannii were analyzed in our hospital from 2010 to 2014. The relationship between the antibiotics use and the antimicrobial re-sistance of A. baumannii was analyzed by SPSS 19. 0. Results:From 2010 to 2014, the total DDDs of antimicrobials in our hospital were decreased year by year in the first three years, while increased significantly in the last two years. The total DDDs of cephalospo-rins always ranked the first and the DDDs of carbapenem were increased year by year. The resistance rate of Acinetobacter baumannii a-gainst multiple antibacterials was increased in varying degrees in the past five years. In addition to levofloxacin, cefoperazone/sulbac-tam and tigecycline, the resistance rate against the other antibacterials was increased up to 50% in 2014. The resistant rate of A. bau-mannii against ciprofloxacin, gentamycin, cefepime, imipenem and tazobactam/piperacillin presented a positive correlation with the DDDs of cephalosporins and quinolones(P<0. 05). The resistance rate of A. baumannii against cefepime, imipenem tazobactam/pip-eracillin and levofloxacin was also positively correlated with the DDDs of carbapenem(P<0. 05). Conclusion: Antibiotics consump-tion is related to drug resistance of A. baumannii,so it is necessary to strengthen the management of clinical antibiotics use to decrease the multidrug-resistant strains.

Objective To report the treatment outcome of nonunion of tibial fractures with local muscle flap transfer and injection of autogenous bone marrow. Methods 15 patients who had suffered from nonunion of tibial fracture 10 to 42 (mean 22) months after the initial injury underwent open reduction, internal fixation with locking intramedullary nail, wound coverage with locally transferred muscle flap and injection of autogenous bone marrow into the fracture site 12 to 15 days after operation. Results The follow-ups revealed bone union in all the cases of this series with a mean healing time of 22 (3 to 11) months. Except for limited necrosis of the skin edge in 2 cases which healed after dressing changes, the wounds healed primarily in all the cases without infection and implant failure. Conclusion Besides stable internal fixation and bone graft, coverage of fracture site with locally transferred muscle flap and injection of autogenous bone marrow can be used to treat nonunion of tibial fractures with satisfactory results.

Objective To investigate the effects of bone mesenchymal stem cell (BMSC) transplantation on neuronal nuclei (NeuN) and neurogenin 1 (Ngnl) in focal cerebral ischemic rats.Methods A total of 64 healthy adult male Sprague-Dawley rats were randomly divided into normal (N) + phosphate-buffered solution (PBS),middle cerebral occlusion (MCAO)+ PBS,N + BMSC and MCAO + BMSC groups (n =16 in each group).A rat model was induced by the intraluminal suture method.BMSC was cultured in vitro.At 24 h after modeling,brain transplantation was conducted.Magnetic resonance imaging (MRI) was used to detect infarct volume in vivo.NeuN/DAP,Ngnl/DAPIimmunofluorescence double-labeling and Western blot were used to detect the expression of NeuN and Ngnl around ischemic brain tissue.Results On day 14 after transplantation,the T1-and T2-weighted imaging revealed that the cerebral cortex and striatum had abnormal signal areas in the rats of the MCAO group.The infarct volume of the MCAO + BMSC group was significantly less than that of the MCAO + PBS group (32.5％ ± 4.2％ vs.47.9％ ± 7.9％ ; P ＜ 0.01).Immunofluorescence doublelabeling assay showed that the numbers of cells of NeuN+/DAPI+ (976.2 ± 87.5/mm2 vs.1 908.3 ±127.8/mm2; P ＜ 0.01) and Ngn1 +/DAPI + (251.6 ± 23.1/rmm2 vs.285.1 ± 25.2/mm2 ; P ＜ 0.01) of the MCAO + PBS group were significantly less than those of the N + PBS group,but those of NeuN+/DAPI +(1 439.9 ± 101.7/mm2; P ＜ 0.01) and Ngn1 +/DAPI + (356.3 ± 35.6/mm2; P ＜ 0.01) of the MCAO + BMSC group were significantly more than the MCAO + PBS group.Western blot analysis showed that the protein expression levels of NeuN (0.69 ±0.06 vs.0.91 ±0.09; P ＜0.01) and Ngn1 (0.53 ±0.05 vs.0.62 ±0.07;P ＜0.01) of the MCAO +PBS group were significantly lower than those of the N +PBS group,but those of NeuN (0.82 ± 0.07; P ＜ 0.01) and Ngn1 (0.77 ± 0.09; P ＜ 0.01) of the MCAO + BMSC group were significantly higher than the MCAO + PBS group.Conclusions BMSC transplantation may promote the expression of NeuN and Ngn1,and alleviate MCAO caused brain injury.

Objective To observe the effects of stellate ganglion block (SGB) on humoral immunity func-tion in patients who received modified radical mastectory (MRM). Methods Eigty female patients were randomly divided into control group(group Ⅰ ,n =40) and intervention group (group Ⅱ,n =40). Blood samples were taken pre-intervention (T1), after intervention ( T2 ) and 30 rain after operation ( T3 ) for the determination of lgG, IgA, IgM. Results Compared with T1, IgG, IgA, IgM at T2 and T3 in two groups were lowered, IgG [ ( 11.8±2.2 ) g/L vs (9.5 + 1.5) g/L,t = 5. 4630,P =0.0041 ] and IgA [(1.9±0.3)g/L vs (1.7±0.4) g/L,t =2. 5298,P = 0.0134 ] at T3 in group Ⅱ were significantly different as compared with that of group Ⅰ ; IgM at T2 [ (2.5±0.8 ) g/L vs (2.1±0.6)g/L,t =2.8276,P=0.0072] and T3[ (2.1±0.5)g/L vs (1.6±0.5)g/L,t =4.4721,P = 0.0000 ] was significantly different between the two groups. Conclusions Preoperative-SGB can improve the inhibi-tion degree of humoral immunity caused by modified radical mastectory.

Adult ; Aged ; Dust ; analysis ; Humans ; Middle Aged ; Niacin ; therapeutic use ; Nitric Oxide ; blood ; Nitric Oxide Synthase ; blood ; Occupational Exposure ; analysis ; prevention & control ; Silicon Dioxide ; adverse effects

Objective To study the impacts of quality of life,stress response and sources of stress on mental health of community residents.Methods A total of 703 questionnaires completed by community residents living in Hangzhou and Cangzhou were prospectively collected.All the subjects were assigned o five age groups:18-25 years old group,26-35 years old group,36-50 years old group,51-64 years old group and ≥65 years old group.Psychological health status was compared between the groups by using analysis of variance.Results Significant difference in mental health was found among 5 age groups.Correlation analysis showed that quality of life,stress response and sources of stress had significant effects on mental health.Conclusion Our data suggest significant impacts of quality of life and stress on mental health of community residents.

Objective To assess the clinical outcome of massive hiatal hernia repair by mesh via laparoscopic approach. Methods A total of 31 patients with massive hiatal hernia who underwent laparoscopic repair from March 2005 to January 2009 were enrolled in the study, among which mesh was used in 20 patients. The clinical outcomes of these patients were compared with other 11 patients without mesh repair procedures. Results Surgical repair, combined with Dor fundoplication, was successful in all 31 cases.Five patients in the mesh group developed post-operative recurrent symptoms, 2 ( 10% ) of whom were confirmed by imaging study. Six patients in non-mesh group had recurrent symptoms after operation and 4 (36. 4% ) were confirmed. Conclusion Laparoscopic repair of massive hiatal hernia is technially demanding with a high post-operative recurrent rate. Administration of intro-operative mesh can reduce the difficulty of the procedure and recurrence as well.

To obtain recombinant human β2-microglobulin (rhβ2M) with properties of good solubility and high purity from E. coli, prokaryotic expression conditions were optimized and protein purification was performed in this study. After testing the effect of different IPTG concentrations, temperatures and induction times on the production of rhβ2M, the optimum expression conditions were determined, i. e. joining IPTG to final concentration being 0.8 mmol/L and inducing time 6 h and at temperature of 25 degrees C. Under the optimum induction conditions, the ratio of soluble rhβ2M to soluble bacterial protein was 63.7%. After purified by Ni Sepharose 6 Fast Flow, the purity of rhβ2M achieved a greater value of 95%. Western blot analysis revealed that rhβ2M possessed the antigen property that specifically interacted with anti-β2M antibody.
Blotting, Western ; Escherichia coli ; metabolism ; Humans ; Recombinant Proteins ; biosynthesis ; Solubility ; beta 2-Microglobulin ; biosynthesis

Objective To measure the mandibular thickness relative to the osteotomy line of mandibular angle plasty so that to provide the anatomical basis for operation.Methods 37 youth women patients mandible were scanned by spiral CT,then the three-dimensional reconstruction was done,the thickness of the mandible around osteotomy line were measured on the planes corresponding to the posterior margin of mandibukar ramus,the middle part of the mandibular ramus,the posterior line of the third molar,the line between the second and third molar,the line between the second and first molar and the line between the first molar and the second premolar.The data were analyzed by Spss 11.5.Results The thichest bone around the osteotomy line was under the second and third molar,then the bone thickness became thinner forward and backward.The thinnest bony was on the middle part of the mandibular ramus.Conclusion The result of this study is of significant for guiding operation and reducing the complications.

Skull bore device has an important role in neurosurgery.This review is a summary of the development,current research status and advances of skull bore.The electrical operation power device is the emphasis in the review.It is important to develop newly operation power devices for human health.