OBJECTIVE:To analyze the distribution characteristics and drug resistance of pathogens in Shandong Dong’e and to provide reference for local physicians to choose antimicrobial agents. METHODS:Detected pathogens in Dong’e coun-ty of Shandong province during Jan. 2014-Dec. 2015 were analyzed statistically in respects of type,distribution and drug re-sistance. RESULTS:A total of 25 562 specimens were collected from Dong’e county of Shandong province during 2014-2015,and there were 6 302 positive samples with positive rate of 24.65%. The samples with high positive rate included respiratory samples(positive rate of 34.52%)and secretion,pus(positive rate of 33.79%). A total of 6 350 pathogens were detected,among which there were 3 707 strains of Gram-positive bacterias (58.38%),mainly including Escherichia coli, Pseudomonas aeruginosa and Klebsiella pneumonia;2 042 strains of Gram-negative bacterias (32.16%),mainly including Staphylococcus aureus and Streptococcus pneumonia;601 strains of fungus. E. coli,S. aureus,P. aeruginosa,K. pneumonia, Acinetobacter baumannii and Proteus mirabilis mainly distributed in ICU,and S. pneumonia and Hemophilus influenza mainly distributed in pediatric department. Sensitive rates of E. coli and K. pneumonia to piperacillin sodium and tazobactam sodium, imipenem,amikacin and tigecycline were higher than 90%;the strain resistant to or intermediate to tigecycline was not found. Sensitive rate of P. aeruginosa to aminoside antimicrobial agents was higher than 90%. Resistant rates of A. baumannii to vari-ous antimicrobial agents were higher than 70%,and resistant rate of it to minocycline was 96.67%. S. aureus was sensitive to vancomycin,quinupristin/dalfopristin and tigecycline,and S. pneumonia was sensitive to rifarnpin,linezolid and vancomycin, with sensitive rate of 100%. A total of 264 strains of MRSA were detected,and detection rate was 39.28%;a total of 200 strains of penicillin-resistant S. pneumonia were detected,and detection rate was 35.13%. CONCLUSIONS:The samples from Dong’e county of Shandong province during 2014-2015 were mainly respiratory samples,detected pathogens were mainly Gram-negative bacterias and resistant rate of them were lower than related domestic reports. The distribution characteristics and drug resistance of pathogens should be considered before using antimicrobial agents to improve the rationality and perti-nence of drug use.

Objective To study the establishment methods of virtual three-dimensional cerebral aneurysm models by using three-dimensional moulding software.Methods The virtual model including the cerebral arteries and the aneurysms were established by using the three-dimensional moulding software of 3D Studio MAX R3 in 20 cases of normal cerebral DSA image and 216 cases of cerebral aneurysms DSA image as the original.Results ①In comparison with DSA image,the virtual cerebral arteries possessed similarity in appearance,and had a benefit for understanding the vascular three-dimensional spatial relation in visual sense.The virtual cerebral arteries could display the virtual guide wire and catheter in semitransparent.The several models of different variant anatomy could be established easily based on the copy files of the virtual cerebral arteries model;②In comparison with DSA image,virtual cerebral aneurysm could display the location of development,direction of growth and feature of appearance correctly.The several aneurysms models of different location,direction of growth and appearance could be established easily based on the copy files of the virtual cerebral aneurysms model.Conclusion The virtual three-dimensional cerebral aneurysm models that were established by the software method can display the three-dimensional spatial relation of the cerebral arterial system and aneurysmal shape distinctly,and would be useful in assisting morphology study and guiding clinical work.

Objective To analyse gene mutation in members of a Chinese family with Hailey-Hailey disease(HHD)and study the relationship between the genotype and clinical features of the disease.Meth-ods Genomic DNA of leucocytes were obtained from members of the Chinese family with HHD including4patients and6normal persons.Ten exons of ATP2C1gene were amplified by polymerase chain reaction(PCR)and the products were analysed by single-strand conformation polymorphism(SSCP)and direct DNA sequencing.Results A novel mutation was identified in this family.The sequence of"TGTAGCCAT"(2068→2076)was substituded by"AGATGGAACA",which caused a frame shift of open reading frame and premature termination codon(PTC)in gene ATP2C1.There was no relationship between the genotypes and the phenotypes.Conclusion Gene mutation of ATP2C1gene at exon21is the cause for HHD in this fami-ly.

Objective To observe the effects of secreted protein,acidic and rich in cysteine (SPARC) on the expression of TGF-β1 and collagen type Ⅰ in cultured human keloid fibroblasts by real-time fluorescence quantitative RT-PCR.Methods In vitro keloid fibroblasts were stimulated by different concentrations of recombinant human SPARC,and with the control group for comparison,real-time fluorescence quantitative RT-PCR to detect expression of TGFβ1 and collagen type Ⅰ.Results Compared with the control group,the expression of TGF-β1 and collagen type Ⅰ was significantly increased in the experimental group.Conclusions SPARC could enhance the expression of TGF-β1 and collagen type Ⅰ in keloid fibroblasts significantly.

BACKGROUND: With the development of neural interventional therapy, the application of covered stents in neural intervention is becoming a topic of general interest.OBJECTIVE: To introduce the structure of stent-graft, and to summary the application of covered stents in clinical treatment of the neural interventional therapy and the shortage of covered stents.RETRIEVAL STRATEGY:The relevant articled were searched for in Pubmed database by researcher of this article with the key words of "stent graft, covered stents, cerebrovascular disease" in English, and with the key words of "covered stent, cerebrovascular disease" in Chinese in VIP database. 223 English and 196 Chinese articles were selected and reviewed primarily. Inclusive criteria: Articles having a close relation with the application of covered stents in neural intervention, especially in cerebrovascular disease, and the latest articles or articles published in authority journals in the same field were chosen. Exclusive criteria: articles with repetitive studies were excluded.LITERATURE EVALUATION: 223 English and 196 Chinese articles were primarily checked by reading titles and abstracts. Among the 31 collected articles, 4 are reviews, 3 are experimental studies and others are clinical studies.DATA SYNTHESIS: Covered stents show special advantages in neural interventional therapy and become a hot spot in present study. There are individual case reports or small group case reports on the application of covered stents in hemorrhagic cerebrovascular disease. It is reported that the covered stent effectively occludes aneurysm, dissecting aneurysm and arteriovenous fistula, keeps patency of the parent artery. The covered stent isolates ulcerated plaque via physical barriers, avoids the abscission of embolus, which can further reduce the development of embolism in percutaneous carotid artery stenting. After releasing covered stents, polytetrafluoroethylene makes the disepiment smooth. Its good biocompatibility reduces thrombosis, and then decreases the incidence of restenosis. Covered stents in vessel for cerebrovascular disease have achieved good effects, but there are some problems in clinic as follows. ①The main shortage of covered stents is to occlude small branch vessels. ②Thrombosis and restenosis occur after covered stenting. ③Covered stents increase the volume of the stent, reduce the compliance and flexibility of the stents, and increase the pushing difficulty and vascular injury. ④Covered stents cannot be used in vessels of less than 4 mm.CONCLUSION: Covered stents for intracranial ischemic and hemorrhagic diseases shows significant outcomes, but there are disadvantages. With the clarification of the related theories and the improvement of new material technology, there will be a brighter future of the application of covered stents for treatment of cerebrovascular diseases.

Objective To explore the methods and clinical application of percutaneous pediculoplasty in the treatment of vertebral pedicular osteolytic metastases.Methods Percutaneous pediculoplasty was performed in 18 patients with (23 Vertebral pedicles ) osteolytic metastases,3 cases localized in thoracic vertebral pedicles and 15 cases in lumbar vertebral pedicles,and two vertebral pedicles involved in 5 cases . Under Multislice helical CT guidance ,2.5～5ml of polymethylmethacrylate ( PMMA ) mixture (ratio of polymer,moner,ultrafluid iodinated oil was 20g:10ml:3ml) was injected into pathologic pedicles in step by step after successful puncture using 11-13G needles. All cases had been followed for 1～18 months.Results All cases were successful punctured. Pain relieved in all cases after percutaneous pediculoplasty.7 cases had cement leakage,among them,cement leaked into tumor tissue in 5 cases(2 cases with leakage into intervertebral foremen),nerve radicular pain occurred in one case,the pain disappeared 3 days later after intravenous mannitol and lower dose dexamethasone drips;the cement leaked into vertebral canal a little without clinical symptom in one case.Conclusion CT-guided percutaneous pediculoplasty is a minimally effective and safe method for osteolytic vertebral pedicular metastases in treatment of pain and enhancement of spinal stability.

Objective To compare optimal protein extraction method of velvet antler ( VA ) and explore the repairmen activity of velvet antler proteins ( VAPs ) on 1-methyl-4-phenylpyridinium ( MPP +) damaged nerve cell.Methods VAPs was obtained from fresh velvet antler by homogenization and micronization method respectively.The protein content of VAPs was measured by Bradford and the molecular weight was identified by SDS-PAGE.Scanning electron microscope (SEM) was perfomed to observe the ultrastructure of VAPs.Neuroblastoma cell line (SH-SY5Y) damage was induced by MPP +, and activity of each compound was compared by the proliferation of damaged cell detected by MTT method.Results The yield of micronization method of VAPs was higher than homogenization method and with better characters both in SDS-PAGE and SEM.Activity detection indicated that VAPs at the concentration of 125 μg/mL by homogenate method could significantly increase the proliferation rate of damaged SH-SY5Y cells.By contrast, VAPs by micronization method had more effective effect at 62.5μg/mL, and proliferation rate could reach 25.45% .Conclusion Micronization method does not only acquire more protein but also has cell proliferation activity, is a relatively ideal way of protein extraction of velvet antler.

Objective To investigate the of 5-fluorouracil effects on the expression of Smad7,TGF-β receptorⅠ,Bcl-2 and Bax in keloid fibroblasts.Methods After primary culture of keloid fibroblasts,4-6 passages of cells were inoculated in 5 different concentrations of 5-fluorouracil(10,20,40,80,160μmol/L)for 24,48 and 72 hours.Proliferative ability of keloid fibroblasts was detected by MTT assay.Expression of Smad 7,TGF-βreceptorⅠ,Bcl-2 and Bax in keloid fibroblasts was measured by Western blot.Results During MTT,5-fluorouracil did not affect cell viability at 24 hour at the concentration of 10 and 20 μmol/L.Compared with the control group,no significant difference was detected(P＞0.05).At other concentrations,fibroblast death was visible in each group(P＜0.01).Western blot analysis showed that the expression of Smad7 significantly decreased and the expression of TGF-β receptor Ⅰ significantly increased in the TGF-β1 group compared with the blank control group(P＜0.0 1).5-fluorouracil could significantly enhance the expression of Smad7(P＜0.01).There was a remarkable decrease of the Bcl-2 expression and marked increase of the Bax expression in different concentrations of 5-fluorouracil compared with the control group(P＜0.05).But,5-fluorouracil did not show any effect on the synthesis of TGF-β receptor Ⅰ.Conclusion 5-fluorouracil could inhibit proliferation and induce apoptosis on human keloid fibroblasts in vitro.

Objective To study the feasibility of endometrial sampling device as a sampling tool during the follow-up visit for endometrial cancer patients undergone conservative treatment.Methods Before the hysteroscopy examination,endometrial sampling device was used to take the endometrium specimens 43times in 19 patients who had been diagnosed as endometrial cancer or atypical hyperplasia,and were undergone conservative treatment during May 2012 to Mar.2013.All cases accepted vaginal ultrasound screening before every sampling by endometrial sampling device.The histological results were compared with those done by hysteroscopy.Results The average age of those patients was (30 ± 6) years old.The mean thickness of the endometrium during the treatment was (0.81 ± 0.65) cm.The qualified rate for the sampling was 95％ (41/43).Compared with the specimens undergone by hysteroscopy direct sampling,32samples got by the endometrial sampling device with thicker endometrium (0.93 ± 0.70) cm had the same histological results,while the other 9 patients with thinner endometrium (0.40 ± 0.14) cm were not (P =0.031).Conclusion The endometrial sampling device could be used during the follow-up visit for the conservative treatment patients with endometrial cancer or atypical hyperplasia,the vaginal ultrasound screening should be used together to figure out those with thinner endometrium.

Objective To investigate the clinical efficacy,indications and complications of transcatheter arterial embolization for the treatment of traumatic hemorrhage of liver.Methods Retrospectively analyzed 33 cases of traumatic hemorrhage of liver admitted to West China Hospital from May 1996 to May 2006.Twenty-four cases underwent hepatic arterial angiography and were diagnosed as hepatic arterial pseudoaneurysms and followed by superselective embolization of the feeding vessel with gelatin sponge and/or spring coils.Results Embolization was succeeded technically in 28 pseudoaneurysms of 24 cases.Rebleeding occurred in 2 cases and a second embolization was performed with one recovered uneventfully.The other died of rebleeding and severe abdominal infection one week after the second embolization.Fever unrelated to embolization occurred in 9 cases.Conclusion Transcatheter arterial embolization is safe,prompt and effective for the treatment of hemorrhage due to hepatic injury.(J Intervent Radiol,2007,16:226-228)