Objective To investigate the clinical value of endoscopic ultrasonography (EUS)on minute gas-tric stromal tumor (MGST).Methods 90 patients diagnosed with MGST were randomly divided into two groups. 45 patients in A group were given conventional endoscopic diagnosis,45 cases in B group were treated with endoscopic ultrasound diagnosis.After the two groups of patients with endoscopic treatment,the coincidence rate of preoperative diagnosis and pathological inspection test results was recorded,clinical features in MGST under EUS diagnosis were analyzed.Results All patients were diagnosed in the case of endoscopic surgery,endoscopic submucosal dissection (ESD)accounted for 94.44%,which was significantly higher than the use of endoscopic full -thickness resection (EFR)percentage of 5.56%,and the difference was statistically significant (χ2 =14.22,P <0.05);The two groups of patients after endoscopic treatment,were diagnosed as pathological inspection MGST.Preoperative diagnosis showed that EUS MGST suspected cases of 40 patients,conventional endoscopy MGST suspected cases of 31 cases.The diag-nosis coincidence rate of B group (88.89%)was significantly higher than that in A group (68.88%),the difference was statistically significant (χ2 =5.40,P <0.05);MGST of EUS images could be clearly observed in patients with tumor morphology,size,location,growth pattern,internal parenchyma,echo pattern,strengthening methods,the compo-sition ratio in line with the results of endoscopic treatment,diagnosis results in line with the pathological diagnosis. Conclusion EUS has significant value for the diagnosis of MGST,it has advantages in the clinical guidance and treatment.

OBJECTIVE:To study the difference between the hydrophilic and hydrophobic fluoroquinolones(FQNLs)in?ducing resistant Klebsiella pneumoniae(Kpn)in vitro.METHODS:Hydrophilic ciprofloxacin(CIP)and hydrophobic sparfloxacin(SPFX)were used to induce FQNLs resistant mutants from a clinical susceptible isolate Kpn909with stepwise selection method,respectively,The susceptivity of bacteria to was determined by the standard method of two fold agar dilu?tion.RESULTS:The resistance of Kpn909to FQNLs was raised up gradually as FQNLs'concentration increased;Minimum inhibitory concentrations(MICs)of Kpn9098Selected by CIP at2?MIC(0.5mg/L)were16～32times higher than that of Kpn909,and showed resistant to ofloxacin(OFX),lomefloxacin(LMFX)and enofloxacin(ENX)with a MIC of8mg/L,16mg/L and8mg/L.Otherwise,SPFX-selected Kpn with a similar resistant level occurred at the concentration of8?MIC(1mg/L).The maximal selecting concentration of CIP and SPFX were128mg/L and64mg/L,and MIC of5FQNLs to the resistant mutants obtained at which were≥256mg/L and32～128mg/L,respectively.CONCLUSION:Both hydrophilic CIP and hydrophobic SPFX could induce Kpn the cross resistance to others FQNLs,but hydrophobic FQNLs may be superior to hydrophilic FQNLs to delay the resistance occurrence in Kpn.

objective To explore the effect of application of cluster-based strategies on preventing the complication of fibrosclerosis of patients with systemic scleroderma.Methods A total of 59 patients with systemic scleroderma were randomly assigned to the experimental group (34 cases) and the control group (25 cases) during the period of hospitalization in our department.The experimental group took the cluster-based strategies after admission,including a gymnastics,two kinds of respiratory breathing,three kinds of habits,four kinds of protection to prevent the complication of fibrosclerosis.The control group received the conventional care procedures of dermatology.The skin stiffness,joint function,Raynaud's phenomenon and swallowing function were evaluated when patients were admitted and before discharge in two groups.The length of stay between the two groups was also compared.Results The skin stiffness,joint function,Raynaud's phenomenon and swallowing function scored (14.74±1.33),(7.06±0.69),(0.88±0.33),(0.54±0.21) in the experimental group,significantly better than those of the control group,(24.08±1.12),(13.48±0.77),(1.24±0.60),(0.96±0.34),P ＜ 0.01.The length of stay in the experimental group and the control group was (23.65±5.45),(32.00±6.56) days,t=-5.340,P ＜ 0.01.Conclusions Application of cluster-based strategies can be effective against the fibrosclerosis damage of patients with systemic scleroderma and reduce the occurrence of complications.

Objective To make an epidemiological investigation on TORCH infection in children in Pu′er city of Yunnan prov‐ince ,in order to provide references for the prevention and treatment of TORCH infection in children .Methods A total of 1 194 children treated at this hospital from January to December 2014 were selected and divided into five age groups .Serum TORCH spe‐cific IgM and IgG antibodies were detected by using enzyme‐linked immunosorbent assay(ELISA) and the positive rate of TORCH specific antibody and TORCH infection rate were comparatively analysed .Results The positive rate of TORCH specific IgM anti‐body was significantly lower than that of IgG .The range of positive rate of IgM was 0 .00% -3 .10% ,and that of IgG was 10 .13% -82 .24% .The total infection rate of TORCH was 96 .98% .There were no significant differences in the infection rate of single item of TORCH or the total TORCH infection rate among the five different age groups(P>0 .05) .The distribution of infec‐tion rate of single item of TORCH among the five age groups was statistically significantly different(P<0 .05) .There was no sig‐nificant difference in the infection rate of TORCH or the distribution of infection rate of single item of TORCH among different sea‐sons(P>0 .05) .Conclusion Children with TORCH infection in this area mainly are infected by CMV ,followed with RV and HSV infections ,while TOX infection is uncommon .There are no obvious differences in different seasons and children in different age groups .

Objective To analyze the results of children′s respiratory tract infection pathogens IgM antibody nine‐combined de‐tection in Pu′er and grasp the epidemiological characteristics of respiratory tract infection of local children for providing reference for clinical diagnosis and treatment .Methods 1 327 cases of children′s blood sample with respiratory tract infection were randomly sampled from in Pu′er People′s Hospital in 2014 .All the samples were tested with nine respiratory tract infection pathogens IgM antibody detection reagent kit(indirect immunofluorescence) ,and the test results were adopted for statistical analysis .Results There were 446 cases positive for IgM antibody in 1 327 cases of respiratory tract infection children ,the total positive rate was 33 .6% .The Positive rate of mycoplasma pneumonia(MP) was the highest ,for 23 .6% .The second was influenza B virus(INFB) , for 18 .5% .The eosinophilic lung legionella type 1(LP) ,adenovirus(ADV) ,respiratory syncytial virus(RSV) ,influenza A(INFA) and parainfluenza virus(HPIVs) were all much lower :respectively for 0 .4% ,1 .1% ,1 .0% ,1 .1% and 1 .0% .It was showed that no positive results were found in Q fever rickettsia(CB) and chlamydia pneumonia(CP) .There was significant difference of the positive rate among 9 kinds of pathogens(P<0 .05) .There was significant difference of the monthly positive rate among the main six patho‐gens(P<0 .05) .There was significant difference of the positive rate in the different age groups(P<0 .05) .Conclusion The respir‐atory tract infection pathogens of children in Pu′er are mainly mycoplasma pneumoniae and influenza B virus .The epidemiological distribution of the pathogens is related to the age and season ,the clinician should reasonably diagnose and treat according to the test results for children .

Objective To survey the antimicrobial resistance of nosocomial Klebsiella Pneumoniae (Kpn) isolates. Methods All the 68 Kpn strains were isolated and collected from nosocomial infections during April 2002 to March 2003. The susceptivity of bacteria and the production of extended spectrum ?-lactamases (ESBLs) were determined by Kirby-Bauer disc diffusion test and phenotypic confirmatory testing, respectively. Results All 68 Kpn strains were 100% susceptible to Menopenem and Imipenem but resistant to 14 other antimicrobials to different degrees. The first five drugs of high resistant rate were ampicillin (100%), amoxycillin/clavulanic acid (79.4%), sulphamethoxazole/trimothoprim (67.6%), cefotaxime (58.8%), gentamycin (47.0%). There were 28 isolates producing ESBLs (41.2%), which showed much higher resistance to ?-lactam, aminoglycosides, quinolones and sulphamethoxazole/trimothoprim than the non-ESBLs-producing strains. Conclusion Nosocomial Kpn isolates were most multidrug resistant, of which ESBLs-producing strains showed a higher resistance and which may involve other resistant mechanisms.

Objective To explore the value of the laparoscopic ultrasonography (LUS) in laparoscopic common bile duct explora-tion(LCBDE) .Methods 47 cases with cholecystolithiasis combined with bile duct dilatation or abnormal liver function were tested by conventional ultrasound ,magnetic resonance cholangiopancreatgraphy (MRCP) CT and LUS after LCBDE .All results were com-pared with the surgical findings and the intraoperative biliary endoscopy results .Results The diagnosis coincidence rate of conven-tional ultrasonography ,CT ,MRCP and LUS in 47 cases were 85 .1% ,72 .3% ,95 .7% ,100 .0% respectively .6 cases completed the surgery under the guidance of LUS ,1 case was converted to open surgery .Conclusion LUS is an examination method to avoid bile duct injury effectively and reduce postoperative residual stone in LCBDE .

Objective To evaluate the role of intra-aortic balloon pumping(IABP) in high risk patients with acute myocardial(AMI).Methods The clinical data of all patients with acute myocardial infarction treated with IABP admitted into the first affiliated hospital to PLA General Hospital from January 2004 to May 2008 was collected.The efficacy of the IABP was evaluated. Results A total number of 23 patients with acute myocardial infarction were treated with IABP.17patients received revascularization therapy. Death rate was 30.4%.Conclusion IABP is safe in high risk patients with AMI who represented poor hemodynamic status or cardiogenic shock,and it can sufficiently stablieze the hemodynamic status,improve cardiac function and can decrease in-hospital mortality.

BACKGROUND:Ultrasonography as a noninvasive means has been widely recognized in the examination of the skeletal muscle system. OBJECTIVE: To investigate the clinical significance of ultrasonography for the elderly with degenerative knee cartilage. METHODS:Totaly 102 patients (204 knees) who were≥ 60 years old and successively admitted for knee disease were selected and according to clinical diagnostic criteria of degenerative knee disease, divided into two groups: osteoarthritis group (167 knees) and non-osteoarthritis group (37 knees). Al the knees were subjected to ultrasonography for observing the effusion depth of the suprapatelar bursa, medial bursa and lateral bursa, as wel as the synovium, pannus and cartilage. RESULTS AND CONCLUSION: Of the 204 knee joints, degenerative changes of the knee occurred in 167 knees, primary knee arthritis in 91 knees, secondary knee arthritis in 76 knees, and the degeneration rate was 82%. The volume of effusion in the suprapatelar bursa, medial bursa and lateral bursa was significantly higher in the osteoarthritis group than the non-osteoarthritis group. In the osteoarthritis group, synovial hyperplasia was in 59 knees, pannus formation in 23 knees, rough cartilage surface in 167 knees, and the knee cartilage thinning or loss in 117 knees. In the non-osteoarthritis group, synovial hyperplasia was in 5 knees, rough cartilage surface in 27 knees, and the knee cartilage thinning or loss in 4 knees. These findings indicate that ultrasonography is of certain clinical significance in evaluation of degenerative knee cartilage in the elderly.

Objective To evaluate the electrocardiographic(ECG)-gated 4-dimensional computed tomographic angiography (4D-CTA) in the determination of pulsation of unruptured cerebral aneurysms (URCAs).Methods This study included 48 patients with 62 URCAs.Examinations of ECG gated 4D-CTA of dual-source CT were performed.Twenty sets of image data with the time intervals of 5％ in a cardiac cycle were obtained after postprocessing on the workstation.The convex was defined as the point of pulsation if small bubble or small pointed convex could be found in continuous three or more images at the same location.The 62 URCAs were divided into two groups based on whether having a point of pulsation.All the URCAs were scanned at the follow-up by 3D-CTA or ECG gated 4D-CTA more than 120 days later.The diameters of aneurysms and aspect ratio between the two groups were compared with independent t test,while neck of aneurysms and follow-up time were compared with two-independent samples Mann-Whitney U test.The other variables including history of hypertension,type 2 diabetes,smoking et al between the two groups were analyzed by x2 test.The sensitivity and specificity of aspect ratio for diagnosis of pulsation were analyzed by receiver operating characteristic (ROC) curve.Results Pulsation was observed in 28 of the 62 URCAs.Aspect ratios in whose pulsation was or was not detected were 1.5±0.3 and 1.1±0.3,respectivelyThe difference between the two groups was statistically significant (t=-2.274,P＜0.001).The sensitivity and specificity of the aspect ratio were 75.0％ and 70.6％.After follow-up more than 3 months,of the 28 URCAs in which pulsation was observed,11 showed a change in shape,while in 34 URCAs without visible pulsation,5 showed a change in shape.The aneurysms with detectable pulsation were more likely to show a change in shape (x2=4.891,P=0.027),with an odds ratio of 3.753.Conclusions URCAs with a large aspect ratio are easily to show the pulsation by ECG gated 4D-CTA.Besides,the aneurysms with visible pulsation are more likely to show a change in shape after follow-up,which suggests a higher risk of rupture.