The susceptibility to 9 kinds of antibiotics of 393 animal pathogenic E. coli isolated from clinical samples was determined from 2000 to 2003. The resistance to TC, GM, CMP, AMP, RA, KM, FT, SM and CIP were 93.89%, 57.76%,78.63%, 77.86%, 92.11% ,47.33%, 46.82%, 76.84% and 74.81%, respectively. The isolates could be classified into eight classes according to the number of drugs to which srains were resistant. The resistance spectrum of the isolates varied from 2to 9 kinds of the above drugs. The strains that were resistant to seven kinds of drugs were more than 80 percent. The resistance rates of swine origin strains to GM,AMP and KM were higher than those of poultry origin strains, while the resistance rates of poultry origin strains to TC, CMP, SM and CIP were higher remarkably than those of swine origins. The frequency of resistance increased from 2000 to 2003,which was from 67.33% to 90.58% for CMP, 71.29% to 84.81% for AMP, 73.76%to 80.10% for SM and 61.88% to 88.48% for CIP. At the same time, the resistance rate of GM decreased from 61.39% to 53.92%. Thirty-seven strains (95 %) could make all the Kunming mice die within 72 h injected intraperitoneally with the culmice three times in vivo. The pathogenicity of wild strains with drug resistance acquired naturaly to mice did not decline.

Objective To assess the cost-utility and medical economics of surgjcal treatment for SAP.Methods A retrospective study of SAP patients admitted from January to December 2003 to Ruijin Hospital was carried out.The cost of treatment was obtained from financial department and patients questionnaire;health-related quality of life was assessed by using the SF-36 brief questionnaire and the results were compared with normal population and were converted into rQALY,then utility scores were obtained so as to conduct CUA (cost-utility analysis)and related factors were analyzed.Results 98 patients with SAP were discharged,85 were discharged healthy;of them,59 patients had complete records were followed up,2 died during follow up,with a mortality of 3.4%,one patients could not finish the questionnaire and 6 did not respond,finally 50 finished the questionnaire;the total cost in hospital was 9899095 yuan,per capita 101011 yuan;the corrected post-discharge cost was 681737 yuan;the total cost was 10580832 yuan.The cost of medication was the highest,which accounted for 56%of all the cost.The means and deviations for each of eight scales(PF,RP,RE,BP,VT,MH,SF,GH)scores of SF-36 in SAP patients were 83.00±14.64,61.5.0±42.32,68.67±36.52,79.98±14.90,68.80±18.94,72.40±14.75,75.00±17.53,64.70±18.28.compared with normal population,gained 1929.05 QALYs;the cost-utility analysis was 5485 yuan per QALY.The patient's age,length of stay,chronic co-morbidity was associated with the cost of treatment.Conclusions SAP treatment in surgery department was justified in medical economics.Medication contributed to the most part of total costs.The related factors of cost included age,length of stay and chronic co-morbidity.

Objective To discuss the effects of acupuncture therapy on resting state functional magnetic resonance imaging (fMRI) in patients with ischemic stroke; To explore the central mechanism of acupuncture therapy.Methods Ten is chemic stroke patients with hemiplegia limbs and ten matched control subjects were included. Treatment group was given anti-platelet aggregation, anticoagulation, and nutrition brain cell therapy. At the same time, acupuncture therapy was given, taking Jianyu, Quchi, Shousanli, Waiguan, Hegu, Zusanli, Fenglong, Yanglingquan, Sanyinjiao, and Taichong, with even reinforcing-reducing method, and retaining the needle 30 min, manipulating needle every 10 min, once a day, 5 times a week, needle stopping for 2 d, for continuous 30 d. The health group did not undergo any treatment. BOLD-fMRI imaging technique was used, and based on RSET1.8 software, the parameters of brain activity before and after treatment were observed by amplitude of low frequency fluctuation (ALFF) method. The Results were compared with healthy group. Results Before treatment, the ALFF value of left caudate nucleus, putamen and globus pallidus in the treatment group was lower than that in the health group, and the ALFF value of bilateral precentral and postcentral gyrus, left grus frontalis superior, gyrus frontalis medius, gyrus temporalis medius and precuneus was higher than the health group (P<0.05). After treatment, the ALFF value in left caudate nucleus, putamen and globus pallidus in the treatment group was higher than that before treatment, and the ALFF value in left gyrus frontalis superior, gyrus frontalis medius and precuneus decreased than before group (P<0.05).Conclusion In the resting state of the ischemic stroke patients with hemiplegia limbs, the principal injured brain regions are caudate nucleus, putamen and globus pallidus. Acupuncture has a regulatory role for these brain areas, presumably may be the central mechanism of efficacy.

Purpose To assess the feasibility of applying dual-energy dual-source CT virtual non-contrast (VNC) imaging in the diagnosis of colorectal diseases. Materials and Methods Eighty-ifve patients with clinically suspected colorectal lesions underwent abdominal CT scan as well as arterial and venous phase dual-energy enhanced scan, VCN images of arterial and venous phase were obtained using the dual-energy software, the differences of image quality, radiation dose and diagnostic coincidence rate between the true non-contrast scan and VNC images were compared. Results The radiation dose of two-phase dual-energy scan was 34.8%lower when compared with the conventional three-phase scans. The CT values of the intestinal lesions, metastasis lymph nodes and intestinal fat in VNC were lower than the true unenhanced scan (P<0.05 or P<0.01), whereas were higher than the real scan in liver and liver metastases (P<0.01), there was no signiifcant difference of VNC between the arterial and venous phase. Differences of intestinal wall thickness, metastasis lymph node size, peripheral invasion and liver metastases observed from real non-contrast scan and VNC were not statistically significant (P>0.05), and neither was the diagnostic coincidence rate for intestinal diseases (P>0.05). The noise level of images obtained from VNC was lower than that of the real non-contrast scan (P<0.05), with higher SNR and CNR, there was no signiifcant difference of image scoring among the three groups (P>0.05). Conclusion For colorectal lesions, the virtual non-contrast images from the dual-energy dual-source CT scan can be used to reduce the radiation dose without effecting image quality and diagnosis accuracy.

Objective: To provide some experience and help for the pharmaceutical care for drug-induced acute kidney injury through analysis and pharmaceutical care performed by clinical pharmacist for two cases of drug-induced acute kidney injury. Meth-ods:Clinical pharmacist analyzed the mechanism of drug-induced acute kidney injury, provided some suggestions for the medication, helped doctors select hormone drugs reasonably and performed medical education in the patients. Results:The kidney function of the two patients was recovered during the hospitalization after the reasonable treatment and care by doctors and pharmacists. Conclusion:The drug-induced acute kidney injury should be paid high attention, and the medical education should be strengthened in the patients.

Objective To investigate the accuracy of low-dose dual-source computed tomography (DSCT) coronary angiography in the step-and-shoot (SAS) mode for the diagnosis of coronary artery stenosis in comparison with conventional coronary angingraphy (CCA).Methods Prospective multiple-center study, 46 patients[mean age(58±9) years;bedy mass index(BMI) (25±3) kg/m2]underwent both DSCT in the SAS mode and CCA within 14 days.The inclusion criteria for contrast-enhanced CT: (1) heart rate less than 65 times/rain (bpm).(2) regular sinus rhythm, heart rate fluctuations within the range of 6 bpm. (3) holding breath well, breath-hold time is about 12-15 s.The exclusion criteria:(1) allergy to iodinecontaining contrast medium, nephropathy (serum creatinine level 120 μmol/L), heart failure and serious arrhythmias.(2) patients with coronary stents or bypass grafts.(3) heart rate can not be controlled very well (4)the patient could not take nitroglycerin.(5)BMI 30 kg/m2.(6) other heart disease: carcliomyopathy, valvular disease etc.Sensitivity, specificity, negative (NPV) and positive predictive value (PPV) were determined with CCA as standard of reference.The Kappa value between the two modalities and the two observers was calculated.Radiation dose values were measured.Results Mean heart rate during scanning was (61±6)bpm.99.19% (614/619) coronary segments were depicted with a diagnostic image quality. The vessel-based sensitivity, specificity, PPV, and NPV for the diagnosis of coronary artery stenosis were 96.2% (75/78), 88.2% (60/68), 90.4% (75/83), and 95.2% (60/63), respectively.The Kappa value between the two modalities was 0.848 (P=0.000).The mean effective dose of the SAS-CTCA was (2.95± 0.96) rosy(1.26-4.32 mSy).Conclusion In selected patients, DSCT coronary angiography in the SAS mode have good image quality, which allows for the accurate diagnosis of coronary stenosis at a low radiation dose.

This study is to evaluate the therapeutic effect of fibroblast growth factor 21 (FGF21) on NAFLD in MSG-IR mice and to provide mechanism insights into its therapeutic effect. The MSG-IR mice with insulin resistance were treated with high dose (0.1 micromol.kg-1d-1) and low dose (0.025 micromol.kg-1d-1) of FGF21 once a day for 5 weeks. Body weight was measured weekly. At the end of the experiment, serum lipids, insulin and aminotransferases were measured. Hepatic steatosis was observed. The expression of key genes regulating energy metabolism were detected by real-time PCR. The results showed that after 5 weeks treatment, both doses of FGF21 reduced body weight (P<0.01), corrected dyslipidemia (P<0.01), reversed steatosis and restored the liver morphology in the MSG model mice and significantly ameliorated insulin resistance. Additionally, real-time PCR showed that FGF21 significantly reduced transcription levels of fat synthetic genes, decreased fat synthesis and promoted lipolysis and energy metabolism by up-regulating key genes of lipolysis, thereby liver fat accumulation was reduced and liver function was restored to normal levels. In conclusion, FGF21 significantly reduces body weight of the MSG-IR mice, ameliorates insulin resistance, reverses hepatic steatosis. These findings provide a theoretical support for clinical application of FGF21 as a novel therapeutics for treatment of NAFLD.

Objective The abnormal ankle-brachial index ( ABI) is associated with the incidence of cardiocerebral vascular diseases, but little is known about its relationship with cerebral microbleeds (CMB).This study aimed to investigate the correlation be-tween ABI≤0.9 and different distribution patterns of CMB . Methods We enrolled 187 patients with acute lacunar infarction , inclu-ding 115 non-CMB cases and 72 CMB cases (20 strictly lobar, 24 strictly deep, and 28 lobar and deep).We analyzed the differences between the two groups and the association of abnormal ABI with the occurrence and distribution of CMB by logistic regression analysis . Results ABI≤0.9 was found in 57 (30.5%) of the patients, with a significantly higher incidence rate in the CMB group than in the non-CMB group (43.1%vs 22.6%, P=0.003).The level of ABI was negatively correlated with the number of CMBs (r=-0.211, P=0.006).Multivariate logistic regression analysis after adjusted for confounders indicated that ABI ≤0.9 was significantly associated with the presence of CMB (OR=2.363;95%CI:1.181-4.729), deep CMB (OR=3.434;95%CI:1.283-9.187), and lobar and deep CMB ( OR=2.837;95%CI:1.098-7.333) in patients with ischemic cerebrovascular disease . Conclusion Decreased ABI is a risk factor of CMB, particularly deep CMB, in patients with ischemic stroke.

Objective To investigate the risk factors for reduced renal function in patients with ischemic stroke.Methods The medical records of patients with ischemic stroke were analyzed retrospectively.They were divided into normal renal function group and reduced renalfunction group.Reduced renal function was defined as estimated glomerular filtration rate (eGFR) ＜60 ml/(min·1.73 m2).Multivariate logistic regression analysis was used to identify the risk factors for reduced renal function in patients with ischemic stroke.Results A total of 805 patients with ischemic stroke were enrolled in the study.8.8％ of patients had a reduced renal function.There was no significant differences in the proportion of patients with mild and moderate neurological deficit between the reduced renal function group and the normal renal function group (all P ＞ 0.05),however,the proportion of patients with severe neurological deficit was significantly higher than that in the normal renal function group (8.4％vs.2.6％,x2 =5.573,P =0.017).The proportion of small artery occlusion in the reduced renal function group was sigaificantly higher than that in the normal renal function group (66.2％ vs.46.5％,x2 =9.962,P =0.002),and the proportion of large artery atherosclerosis was significantly lower than that in the normal renal function group (19.7％ vs.43.5％,x2 =15.045,P =0.000).Multivariate logistic regression analysis indicated that old age (odds ratio [ OR] 3.301,95％ confidence interval [ CI],1.575 to 6.918; P=0.002) was the most important independent risk factor for reduced renal function,then was female (OR,2.291,95％ CI 1.355to 3.872; P=0.002) and hyperlipidemia (OR,2.527,95％ CI 1.095 to 5.831; P=0.030).Conclusions Reduced renal function in patients with ischemic stroke is strongly associated with old age,female,and hyperlipidemia.

OBJECTIVETo observe the effect of Tanshinone II A on the expression of epidermal growth facter (EGF) and epidermal growth facter recepter (EGFR) in human hepatocellular carcinoma cell line SMMC-7721.

METHODSThe human hepatocellular carcinoma SMMC-7721 cells cultured in vitro was treated with different concentrations of Tanshinone II A. The proliferation of the cells was measured by MTT assay, and the apoptosis of the cells was investigated by flow cytometry and cytochemical staining with Hoechst 33342. The expression of EGF and EGFR was detected by immunocytochemistry method. The levels of EGF in medium were measured by radioimmunoassay.

RESULTTanshinone II A inhibited the growth of SMMC-7721 cells remarkably in a dose-dependent manner. The inhibitory rate reached the peak (72.5%) after 0.5 microg/ml Tanshinone II A was used for 48 h, which was significantly higher than that in the controls (P<0.05). FCM analysis showed that when SMMC-7721 cells were treated with 0.5 microg/ml Tanshinone II A, the apoptosis rates for 24 h, 48 h and 72 h were (4.06+/-0.27)%, (7.58+/-0.56)% and (5.23+/-0.13)%, respectively which were markedly higher than those in the controls (all P<0.01). SMMC-7721 cell apoptosis with cell shrinkage, nuclear chromatin concentration and fragmentation as well as the formation of apoptotic bodies were observed by cytochemical staining when treated with Tanshinone II A. The immunocytochemistry showed that the expressions of EGF and EGFR were down regulated while the concentration of Tanshinone II A was increasing. The high expression rates for EGF and EGFR were 10%, 20%, respectively, and the gray scale was 181.52+/-1.63, 179.37+/-1.59, which were markedly higher than those in the controls (all P<0.05). The levels of EGF in medium measured by radioimmunoassay were decreased significantly after Tanshinone II A treatment.

CONCLUSIONTanshinone II A can inhibit cell proliferation and induce apoptosis in hepatocellular carcinoma cell line SMMC-7721, which may be related to the down-regulation of EGF and EGFR protein expression.

Antineoplastic Agents, Phytogenic ; pharmacology ; Apoptosis ; drug effects ; Carcinoma, Hepatocellular ; metabolism ; pathology ; Cell Line, Tumor ; Cell Proliferation ; Diterpenes, Abietane ; Down-Regulation ; drug effects ; Epidermal Growth Factor ; genetics ; metabolism ; Humans ; Liver Neoplasms ; metabolism ; pathology ; Phenanthrenes ; pharmacology ; Receptor, Epidermal Growth Factor ; genetics ; metabolism