Objective To explore the clinical features of acute myocardial infarction (AMI) complicated by cerebral infarction.Methods 857 AMI cases were divided into the groups with cerebral infarction and without cerebral infarction.The data were analyzed.Results The mean creatine kinase (CK) peak value,heart tip infarction,cardiogenic shock and arrhythmia were higher in the group with cerebral infarction than that in group without cerebral infarction (P

Objective To establish the optimal section planes for observing ventricular septal defect(VSD) by real-time three dimensional echocardiography(RT-3DE).Methods In 6 pig hearts with different types of VSD, after high pressural perfusion with coupling reagent, two dimensional, dual plane and RT-3DE were performed with different section planes, estimating with half quantificational visional grade:4 marks,very clear;3 marks,clear;2 marks,not clear enough; 1 marks,not clear. Results Observation by RT-3DE, en-face view of atrial-ventricular(S2a) and en-face view of left ventricular septum(L1a) provided relatively ideal section planes in sub-arterial ventricular septal defect, S2a and en-face view of right ventricular septum(L2a) provided relatively ideal section planes in perimembranous and muscular VSD. Conclusions S2a reflects relatively ideal section plane in sub-arterial, perimembranous and muscular VSD.

To translate the Kolcaba brief general comfort questionnaire (GCQ) to Chinese and measure the applicability under the Chinese culture background. Methods This study was composed by two phases, the first phase was to measure the content validity of brief GCQ by 5 nursing specialist after GCQ was translated into Chinese. The second phase was to testing the reliability of the brief GCQ by investigating patients when they had undergone chest surgery operation before 48 hours. Results The overall CVI of brief GCQ was 0.86, the Cronbach's a was 0.92, the subscale ? was from 0.53 to 0.85. The total GCQ score about patients with chest surgery was 91.27?8.63. The lowest mean score was physical subscale: 2. 50?0. 47, the highest mean score was psychological sub-scale: 3.26?0.35. Conclusion The Kolcaba brief GCQ fit to use in China, but its content validity and the internal consistency should be tested in future study.

OBJECTIVE To study the distribution and characteristic about drug resistance of extended-spectrum ?-lactamases(ESBLs) producing Klebsiella pneumoniae and Escherichia coli for guiding the clinical drug using. METHODS Using K-B agar diffusion method and confirmed test to detect the drug resistance and distributions of ESBLs-producing K.pneumoniae and E.coli. RESULTS Among 582 K.pneumoniae and E.coli isolates,128(22%) were ESBLs-producing strains.For E.coli,the ratio was 17.5%,while K.pneumoniae was 28.3%.The sensitive rate of K.pneumoniae to imipenem was 100%. CONCLUSIONS ESBLs-producing K.pneumoniae and E.coli are the most common species causing infections,and imipenem is the best choice.

OBJECTIVE To investigate the drug resistance of Gram-positive organisms infection in our hospital and offer scientific basis for reasonable usage of antibiotics.METHODS The 318 strain organisms were isolated from the specimens of Aikang Hospital since Jan 2001 to Dec 2005.Gram-positive organisms were isolated from the specimens by the routine methods.The drug susceptivity was tested by K-B method.We got the results by 1999 standard of NCCLS.RESULTS Among the 318 strains,Staphylococcus aureus were 128 strains,40.3% of the total organisms;coagulase-negative S.aureus were 69 strains,21.7% of the total organisms;Enterococcus faecalis were 67 strains,21.1% of the total organisms;meticillin-resistant S.aureus(MRSA) were 32.8%;Meticillin-resistant coagulase-negative S.aureus(MRCNS) were 29.0%.The results of drug sensitivity test showed the drug resistant rate of Gram-positive strains for commonly used antibacterials was lower than in Shenzhen,Beijing,Shanghai,Wuhan,Guangzhou and other cities.CONCLUSIONS We should attach in our city importance to supervise the drug-resistance of Gram-positive organism,and preclude dissemination and epidemic of drug resistant strains.

BACKGROUND: Measuring the slope of proximal tibiofibular joint may elucidate the anatomical structure and type of proximal tibiofibular joint, and evaluate the stability of proximal tibiofibular joint. OBJECTIVE: To investigate the measurement methods and clinical significance of the joint slope by comparing the slope measurement of bilateral proximal tibiofibular joint surface on X-ray and 64-row spiral CT reconstruction.METHODS: One hundred normal adult volunteers, including 50 males and 50 females, aged 18-90 years, were photographed in double knees via internal rotation to 30°, 45° and 60°, respectively and scanned with 64-row spiral CT, tibiofibular bone (including knee joints) was reconstructed. The included angle between proximal tibiofibular articular surface and the longitudinal axis of the fibula shaft, between the proximal tibiofibular articular surface and the horizontal line, were measured using an angle square.RESULTS AND CONCLUSION: There were great variations of the data in the same proximal tibiofibular joint measured by X-ray and spiral CT. X-ray results are affected by the site of photograph position, and the slope of articular surface is estimated, so the 64-row spiral CT is an accurate and convenient method to reconstitute the slope of proximal tibiofibular joints. Spiral CT could be used to distinguish the dislocation and instability of the proximal tibiofibular joint, accordingly reduce the clinical misdiagnosis.

A 50?year?old woman presented with intermittent dull pain in the forehead and mild dizziness occasionally after her forehead was subjected to a mild bump accidentally 20 days prior to the presentation, and was diagnosed with angioneurotic headache in a local hospital. After the treatment with oral sibelium tablets, the condition wasn′t relieved obviously. Computed tomography (CT) scan showed multiple localized bone destruction and low?density area in the frontal and bilateral parietal bones with adjacent soft tissue swelling. Magnetic resonance imaging(MRI)revealed equal T1 signals and slightly long T2 signals for multiple nodules in the frontal and bilateral parietal bones, high signals on diffusion?weighted imaging (DWI), obvious enhancement on contrast?enhanced MRI, and linear enhancement in adjacent meninges. Whole?body bone scintigraphy showed multiple increased radionuclide uptake in the skull. Laboratory examination demonstrated that specific antibodies to Treponema pallidum (Tp) were positive, and the serum rapid plasma reagin(RPR)titer was 1∶128. Cerebrospinal fluid(CSF)examination showed normal CSF pressure, nucleated cell counts(8 × 106/L)and glucose level(4.0 mmol/L), slightly high chloride flux(129.1 mmol/L), high protein level(0.9 g/L), high CSF?RPR titer of 1∶16 and presence of specific antibodies to Tp. Histopathological examination revealed hyperemia of adjacent tissues in the cranial osteolytic area, hyperplasia of interstitial fibrous tissue, endothelial cell swelling, and infiltration of inflammatory cells mainly containing plasma cells. The treatment regimen for neurosyphilis was given, and headache was relieved after 1 week of treatment, basically disappeared after 2 weeks, and completely disappeared after 4 weeks, and no similar headache occurred thereafter. Finally, the patient was diagnosed with acquired syphilitic skull osteomyelitis complicated by syphilitic meningitis.

Objective To investigate the curative effects of dexamethasone in the prevention of delayed encephalopathy after acute carbon monoxide poisoning in the rats.Methods Eighty healthy male Wistar rats were randomly(random number)divided into hyperbaric group(H),dexamethasone group (D),combined treatment group(C)and model control group(M)after carbon monoxide poisoning,twenty rats in each group.Twelve air-modeling rats were selected as normal control group(N).Using eight-arm maze training and testing,the rat's function of cognitive and memory was detected.The serum MBP levels were detected by enzyme-linked immunosorbent assays(ELISA).Magnetic resonance imaging was used for observing the demyelination of the head and the morbidity of delayed encephalopathy.Measured data was analyzed with single factor analysis of variance(one-way ANOVA).Results The result of eight-arm maze showed that there were 6,7,1,1 rats with delayed encephalopathy in groups M,H,C,D,respectively.At 3 days after poisoning,except N group,the serum MBP levels of every groups increased significantly.At 10 days after poisoning,serum MBP levels in groups C and D were significantly decreased,then returned to normal levels at day 18.The serum MBP in groups M and H was higher than normal levels at all the time.Head MRI showed except D group,the rest groups were abnormal signals,which appeared 7 in M group,6in H group and 1 in C group.Conclusions Dexamethasone administrated as soon as possibly after acute carbon monoxide poisoning may reduce the serum MBP levels,prevent demyelination occurs,decrease the pathological damage,eventually play a preventive role in DE.

Objective To explore the guiding role of serum procalcitonin (PCT) in antibiotic therapy during acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods Totally 72 patients with AECOPD were randomly divided into PCT group (n=40) and conventional therapy group(n=32).For patients in PCT group,the use of antibiotics was based on PCT serum levels,antibiotics were stopped when PCT＜0.25 μg/L,while in conventional treatment group,the use of antibiotics was based on clinical symptoms of patients.The main observation indexes included ratio of antibiotic usage,time of antibiotics use,hospital stay,clinical efficacy,aggravating cases and death cases. Results There were no significant difference in clinical efficacy between the two groups(82.5％ vs.75.8％,x2 =0.217,P=0.641),however,the ratio of antibiotics usage in PCT patients was significantly lower than conventional therapy group (47.5％ vs.71.9％,x2 =4.346,P=0.037),average time of antibiotics use and days of hospital stay were shorter in PCT treatment group than conventional therapy group [(6.84±3.27) d vs.(10.22±3.67)d,x2 =3.116,P=0.003; (11.7±5.2) d vs.(20.3±8.7) d,x2 =5.202,P=0.000].There were no difference in double infection incidence (2.5％ vs.18.8％,x2 =3.657,P=0.056),aggravating cases (3 cases vs.4 cases,x2 =0.097,P=0.756) and mortality (2.5％ vs.6.3％,x2 =0.039,P=0.843) between the two groups.Conclusions Serum PCT level may be an appropriate indicator to guide antibiotic therapy in patients with AECOPD in view of its effective decreases of excessive use of antibiotics,double infection opportunities and hospitalization time.

Objective To detect eight kinds of clinical common pathogenic bacteria by DNA microarray.Methods Eight kinds of common pathogenic bacteria,including Staphylococcus aureus,Pseudomonas aeruginosa,Klebsiella pneumoniae,Escherichia coli,Proteus mirabilis,Enterobacter aerogenes,Pseudomonas fluorescens,Shigella sonnei were collected.Universal primers were designed to amplify 16S rRNA gene fragment from the genomic DNA of the eight bacteria,and probes were designed in the highly variable regions.DNA microarray detection system was established and used for detection of colleted bacteria.A total of 50 samples were collected from the Zhongnan Hospital of Wuhan University,including 6 blood samples,32 sputum samples,9 feces samples and 3 bronchoscope lavage samples.DNA were extracted and detected by the established DNA microarray system.Results The desired fragments were well amplified by the self-designed universal primers.The selected probes had good detection results according to repeated detection.Of the 50 samples detected,pathgenic bacteria were accurately detected in 47 samples.Other three samples were not detected as those bacteria were not included in the chip.By optimizing the detection process,the results could be reported within 8 hours.Observation of probe signal attenuation indicated that even attenuated after 60 days,but the attenuation did not affect the results.Conclusion A microarray system was established for detection of clinical common bacteria accurately and quickly,which provided foundation for its clinical application.