OBJECTIVE To approach the effect of empirically applying ?-lactam antibiotics for treatment of hospital-acquired pneumonia on distribution and antibiotic-resistance of pathogenic bacteria.METHODS To investigate 141 patients with hospital-acqired pneumonia in intensive care unit during Jan 2001-Oct 2005,and divide into 3 groups:third generation cephalosporin group;lactamase inhibitor group;and other lactam antibiotics group according to different initial antibacterial strategy,then analyze difference in distribution and antibiotic-resistance of pathogens among each group.RESULTS We acquired 164 strains of pathogens.Comparing with other two groups,the proportion of Gram-positive cocci in lactamase inhibitor group was higher significantly(P

Objective To establish the animal model of periventricular leukomalacia (PVL) caused by lipopolysaccharide (LPS) and investigate the immune mechanisms in the pathogenesis of cerebral palsy due to intrauterine infection. Methods Twenty-six mature pregnant Wistar rats were divided into experiment(n= 15)and control groups(n =11). LPS(0. 3 mg/kg) and distilled water were injected on 15 days of gestation to two groups respectively intraperitoneally. One hundred and twenty-eight neonatal rats of experiment group and 105 in the control group were obtained till the gestation day of 21. The level of IL-2, TNF-? and histology changes in neonatal rats' brain were observed by HE staining and RIA, water content in brain tissues were compared. Results IL-2[(3. 56?0. 450) ng/g] and TNF-? concentrations [(8. 23?0. 47)ng/g] in neonatal rats' brain of the experiment group were significantly higher than those in the control group [(0. 78?0. 2)ng/g and (5. 23?0. 32)ng/g, P

Objective:To investigate the necessity and measures about quality assurance (QA) and quality control (QC) in bedside photography based on digital radiography (DR). Methods: To do retrospective analysis on bedside photography in the same month of different years (2013.9 and 2014.9) by image storage and PACS system. Each has 200 cases. They were evaluated and analyzed of its causes in order to explore the QA improvement measures.Results:The application of DR and its quality control in bedside photography can improve image quality obviously, shorten the examination time greatly, reduce radiation dose, put an end to waste film.Conclusion: DR has obvious advantages in the bedside photography, can provide better image with more information for clinic work.

Objective To study the diagnostic value of MRCP in cholangiocarcinoma.Methods MRCP in 39 patients with cholangiocarcinoma comfirmed by surgery and pathology were performed on a GE 1.5T superconductive MR imaging unit before operations.Results MRCP imagings with diagnostic value were obtained in 39 cases,MRCP accurately showed the obstructive positions confirmed by surgery and pathology in all cases (100%).The qualitative rate of cholangiocarcinoma was 97%(38/39).Conclusion MRCP can not only accurately show the position of cholangiocarcinoma but also make accuracy diagnosis.

Objective To summary MRI findings and its diagnostic value of Balo's concentric sclerosis .Methods Brain MRI images of 4 cases with Balo's concentric sclerosis were studied with review of the literature in 13 cases.Results MRI showed multiple ring-like lesions within brains in 16 patients and single lesion only in 1.The deep white matters of cerebrum were involved in all patients.The cerebellum and brain stem were invaded in 2 and 4 respectively. Typical concentric sclerosis lesions demonstrated alternate middle and low signal rings on T1WI, middle and high on T2WI. The ring-like lesions were best seen on T1WI. The middle signal rings were enhanced on post-contrast images.The typical multiple sclerosis lesions were seen in 7 patients. Conclusion Balo's concentric sclerosis has characteristic findings on MRI.MRI is a very reliable diagnostic methed for this disease.

Objective To observe the clinical efficacy of electroacupuncture plus nasal irrigation in treating upper airway cough syndrome (UACS).Method A total of 114 UACS patients were randomized into 3 groups, 38 cases in each group. Group A was treated with acupuncture plus electrical stimulation with sparse-dense wave, group B was intervened by nasal irrigation with Shuang Huang Lian, and group C was treated with the two methods together. The clinical efficacies of the three groups were compared.Result The total effective rates were respectively 84.2%, 73.7% and 94.7% in group A, group B and group C. The total effective rate of group C was significantly different from that of group A and group B (P<0.05).Conclusion Electroacupuncture plus nasal irrigation can produce a more significant therapeutic efficacy compared to electroacupuncture or nasal irrigation alone.

Objective To investigate the value of dynamic contrast?enhanced MRI (DCE?MRI) in the differential diagnosis of glioblastoma and brain metastases. Methods Twenty patients with high grade gliomas and 20 cases patients with brain metastases proved by surgery and pathology were collected, and patients were examined with conventional MRI and DCE?MRI preoperatively. The ROIs were manually placed in solid parts of the tumors and their surrounding tissues to calculate Ktrans, Kep and Ve values. The Ktrans, Kep and Ve values differences for the solid part and surrounding tissues of the two brain tumors were compared by two independent sample t test. The correlation between Ktrans of the solid parts of the two brain tumors and Ktrans, Kep and Ve values of their surrounding tissues were studied by Pearson correlation analysis. Results The Ktrans, Kep and Ve values of glioblastoma were(0.258 ± 0.063)min-1,(0.398 ± 0.082)min-1, 0.632±0.084, the Ktrans, Kep and Ve values of brain metastases were(0.233±0.053)min-1,(0.357±0.042)min-1, 0.672±0.113. There were no significant differences between the glioblastoma and brain metastases for Ktrans, Kep and Ve values(t=-1.354,-1.982, 1.276, all P>0.05). The Ktrans, Kep and Ve values of surrounding tissues of glioblastoma were(0.093±0.032)min-1,(0.411±0.089)min-1, 0.107±0.021, the Ktrans, Kep and Ve values of surrounding tissues of brain metastases were(0.033±0.010)min-1,(0.204±0.045)min-1, 0.069±0.017. The Ktrans, Kep and Ve values of surrounding tissues between glioblastoma and brain metastases had significant difference (t=-7.978,-9.303,-6.203, all P<0.05). The Ktrans of glioblastoma were correlated with Ktrans, Kep and Ve values of their surrounding tissues (r=0.759, 0.464, 0.651, all P<0.05); The Ktrans values of brain metastases had no relationship with Ktrans, Kep and Ve values of their surrounding tissues (P>0.05). Conclusion The DCE?MRI can quantitatively display the microvascular permeability and accurately evaluate the damage of blood?brain barrier of glioblastoma and brain metastases, which has an important value in studying biological characteristics and differential diagnosis of the two brain tumors.

Objective: To observe the clinical effect on treatment of Tourette's syndrome with combination of acupuncture and Chinese herbs. Method: Sixty cases were randomly divided into acupuncture-Chinese group and western drug group, which have been treated with acupuncture plus modified Tranquilizing Liver-wind Decoction and orally taken holoperidol respectively.Result: Therapeutic effect comparison between the two groups showed a significant difference (P＜0.05).Conclusion: Combination of scalp acupuncture and Chinese herbs has good effect in treating Tourette's syndrome, with better result than western drug.

Objective To examine the effectiveness of HGF in blocking TGF-β1 induced α-SMA and extracellular matrix production in fibroblasts of the flexor tendon sheath. Methods Seven adult male New Zealand white rabbits (3.75-4.00 kg) were used for this study. Both of their front feet were sterilised and the middle digit flexor digitorum profundus tendon equivalents were identified and isolated. These specimens were used to establish primary cell cultures. Sheath fibroblasts were obtained from rabbit flexor tendons. After the cells reached confluence, cells were detached with trypsin/ethylenediamine tetra-acetic acid. All experiments were performed using the cells at the third passage. At 70% confluence the medium was supplemented with 5 ng/ml of TGF-β1 along with increasing doses of HGF (10-40 ng/ml). After 72 hours incubation, the productions of α-SMA were assayed by Western-Blot. The productions of collagen Ⅰ and fibronectin in supernatants culture were examined using ELISA. Results Evaluation of protein expression revealed that TGF-β1 markedly induced α-SMA expression in cultured rabbit flexor tendon sheath fibroblasts. TGF-β1 treated fibroblasts expressed 1.8-fold more protein compared to non-treated fibroblasts (P ＜ 0.05). However, simultaneous incubation of HGF significantly abrogated TGF-β1 induced α-SMA expression in a dose-dependent manner (P＜ 0.05). Treatment with TGF-β1 significantly stimulated collagen Ⅰ and fibronectin production in flexor tendon sheath fibroblasts (P ＜ 0.01). Remarkably, the addition of HGF reduced productions of all components induced by TGF-β1 in a dose-dependent manner (P ＜ 0.05). Conclusion HGF antagonizes TGF-β1 induced α-SMA, collagen Ⅰ, and fibronectin production in flexor tendon sheath fibroblasts. The findings provide a cellular and molecular basis for HGF's acting as a therapeutic agent for adhesions in flexor tendons.

Objective:To summarize the main issues, analyze the causes and offer a strategy for AIDS preven-tion and control for all types of healthcare facilities in the health care system. Methods:184 leaders and experts of tertiary-level healthcare facilities ( provinces, cities and counties) from 30 provinces who had been engaged in AIDS prevention and control for more than five years were studied through a questionnaire including the issues and causes in AIDS prevention and control. Results: According to the results of the respondents and experts’ demonstration, the main issues were identified, including a lack of human resources in the system of disease control facilities, a lack of relevant agencies involved in AIDS response, the difficulty for AIDS patients to receive surgery and follow-up, poor detection of HIV, shortcomings in medical insurance, and so on. Conclusion: Based on the analysis of issues and causes, the paper offers strategic solutions: Clearly define the responsibilities of various health institutions in AIDS prevention and control;promote the participation of primary health institutions in AIDS prevention and control; im-prove the medical service system for AIDS patients;improve AIDS medical security policies;reform the management system of antiretroviral therapy drugs;and strengthen technical support from disease control facilities.