OBJECTIVE To investigate the resistance in clinical isolates of Stenotrophomonas maltophilia to antimicrobial agents. METHODS Susceptibility of 48 S. maltophilia isolates were tested by agar dilution or K-B method. RESULTS The lowest resistance rate of isolates to the antimicrobial agents was to ticarcillin/clavulanic acid (12.5%),then to minocycline (25.0%) and trimethoprim/sulfamethoxazole (31.3%). The resistance rate to ceftazidime,ceftazidime/sulbactam,levofloxacin,and chloramphenicol was 62.5%,52.1%,52.1%,and 50.0%,respectively. CONCLUSIONS Most of S. maltophilia isolates are susceptible to ticarcillin/clavulanic acid,minocycline,trimethoprim/sulfamethoxazole and resistant to other antimicrobial agents. More mornitoring should be enhanced.

BACKGROUND: Orphanin, which was found in recent years, is an important bioactive polypeptide. Its extensive distribution in the central nervous system and peripheral tissue suggests a function of adjusting global behaviors.OBJECTIVE: To explore the correlation of plasm orphanin level and monoamine neurotransmitters in patients with postpartum depression by determining the levels of orphanin and monoamine neurotransmitters such as 5-hydroxytryptamine (5-HT) and dopamine(DA) in patients.DESIGN: Case-control experiment taking diagnosis as evidence.SETTING: Departments of Obstetrics and Gynecology, Changzheng Hospital and Changhai Hospital, Second Military Medical University of Chinese PLA.PARTICIPANTS: Twenty-five healthy women and seventeen women patients with postpartum depression after delivery who came in the Department of Obstetrics and Gynecology, Changzheng Hospital and Changhai Hospital, Second Military Medical University of Chinese PLA for further consultation during February 2002 to October 2004 were enrolled in this study, and served as control group and postpartum depression group, respectively. All the enrolled women, aged 21 to 43 years, with fair education levels, and voluntarily participated in this study. Women patients of 15 to 25 days after delivery suffered from the incipient postpartum depression with total scores of Edingburgh Postnatal Depression Scale (EPDS) above 13. Informed consents were obtained from all the subjects.METHODS: The levels of orphanin and monoamine neurotransmitters in venous blood from 25 healthy women and 17 women patients with postpartum depression were determined. ① Sample collecting: Blood was taken from women in the postpartum depression group 2 weeks after onset, while from control group 35 days after delivery. ② Assay method:The level of orphanin was determined with radioimmunoassay (RIA). The reagent kit was provided by phoenix company (USA) and the procedure was strictly performed according to the instructions on the reagent kit. The levels of 5-HT and DA were measured with high-performance liquid chromatography or electrochemical detection method.MAIN OUTCOME MEASURES: ① Changes in the levels of orphanin as well as 5-HT and DA in postpartum depression group and control group. ② Correlation of the total scores of EPDS and the levels of orphanin in postpartum depression group.RESULTS: Twenty-five healthy women and seventeen women patients with postpartum depression after delivery all participated in the result analysis. ① The level of orphanin in the postpartum depression group[(27.39±6.04) ng/L] was significantly higher than that in the control group [(10.37±3.65) ng/L](P ＜ 0.01),the levels of 5-HT in the postpartum depression group [(0.93±0.21) μmol/L] was remarkably lower than that in the control group[(1.43±0.36) μmol/L](P ＜0.05) ,and the levels of DA in postpartum depression group[(2.15±0.41) μmol/L] was obviously lower than that in the control group [(3.64±0.72) μmol/L]( P ＜ 0.01). ②The level of orphanin was negatively correlated with those of 5-HT and DA in postpartum depression group(r = -0.601 , -0.593,P ＜ 0.05). ③ The total scores of EPDS were significantly positively correlated with the level of orphanin (r = 0.512, P ＜ 0.05), and negatively correlated with the levels of 5-HT and DA (r = -0.571,-0.526, P＜ 0.05).CONCLUSION: The level of orphanin in patients with postpartum depression is increased and is negatively correlated with the levels of 5-HT and DA, but positively correlated with the total scores of EPDS.

OBJECTIVETo evaluate the clinical therapeutic effect of electroacupuncture for treatment of catatonic schizophrenia.

METHODSEighty cases were randomly divided into an observation group and a control group, 40 cases in each group. The observation group was treated with electroacupuncture, Baihui (GV 20) and Taiyang (EXHN 5) were selected, once daily; the control group was treated with modified electric convulsive therapy (MECT), the treatment was given once every 2 days or 3 days, 14 to 21 days constituted one course in the two groups.

RESULTSThe markedly effective rate and total effective rate were 72.5% and 92.5% in the observation group, 77.5% and 97.5% in the control group, respectively, there was no significant difference between the two groups (both P>0.05).

CONCLUSIONThe therapeutic effect of electroacupuncture is similar to that of MECT.

Acupuncture Points ; Adolescent ; Adult ; Combined Modality Therapy ; Electroacupuncture ; Electroconvulsive Therapy ; Female ; Humans ; Male ; Middle Aged ; Schizophrenia, Catatonic ; therapy ; Treatment Outcome ; Young Adult

OBJECTIVETo investigate prospectively the effectiveness of kyphoplasty with SKY bone expander system in treatment of compression fracture of thoracic/lumbar vertebrae and correction of the deformity.

METHODSTwenty-five patients with thoracic/ lumbar vertebral osteoporotic compression fracture were admitted to our hospital between March 2007 and March 2008, and treated by kyphoplasty with SKY bone expander system. Patient's pain status was rated with Visual Analogue Scale (VAS) score system 1 day before and 1 hour, 48 hours, 6 months, 12 months after surgery. In addition, Rolland-Morris and Oswestry disability questionnaires (RDQ and ODI) were used for survey 1 day before and 1, 6, 12 months after surgery. Pre- and post-operative vertebral heights and Cobb's angles were measured based on the X-ray films and statistically analyzed.

RESULTSThere were 27 fractured vertebrae in these 25 patients. After SKY kyphoplasty, the Cobb's angles (9.8 degree ± 9.76 degree) were significantly reduced compared with preoperative angles (17.18 degree ± 9.35 degree P < 0.05), and the average improvement rate was 39%. Patients'pain VAS scores were also greatly improved after operation (P < 0.05). Moreover, postoperative RDQ and ODI scores were significantly smaller than preoperative values (P < 0.05).

CONCLUSIONSKyphoplasty with SKY bone expander system provides an effective method for treating thoracic/ lumbar vertebral osteoporotic compression fracture, with the advantages of small surgical wound and short duration. It can effectively recover the anterior and medial heights of fractured vertebrae (33% and 50%, respectively), reduce the Cobb's angle, quickly alleviate pain and improve patients'quality of life in a relatively short time period.

Aged ; Aged, 80 and over ; Female ; Fractures, Compression ; surgery ; Humans ; Kyphoplasty ; methods ; Lumbar Vertebrae ; injuries ; Male ; Osteoporotic Fractures ; surgery ; Thoracic Vertebrae ; injuries ; Tissue Expansion Devices

OBJECTIVESTo study the diagnosis and treatment for the injury of cervical disc and longitudinal ligament.

METHODSFrom 2001 to 2005, the clinical data of sixty-three patients with cervical disc and longitudinal ligament injury were studied. Early treatment was done based on spinal cord injuries and spinal stabilities by X rays and MRI. Early operation was done in fifty-four cases and early non-operation in nine cases.

RESULTSThe follow-up time was six to forty-one months in all patients. The neurological recovery was found in two of eight complete SCI post-operation, thirty-one in thirty-nine incomplete SCI. Cervical collar or plaster orthotic were used in nine cases with four to six weeks. Evidence of instability was noted in four patients, who were operated with anterior decompression fusion. Neck chronic pain was found in two patients, anterior decompression and fusion was done in one with cervical spinal cord compression.

CONCLUSIONSMRI examination is the most value measure for the diagnosis of cervical disc and longitudinal ligament injury. Early anterior decompression and fusion was an important approach for cervical disc and longitudinal ligament injury.

Adolescent ; Adult ; Aged ; Cervical Vertebrae ; injuries ; surgery ; Decompression, Surgical ; Female ; Humans ; Intervertebral Disc ; injuries ; surgery ; Longitudinal Ligaments ; injuries ; surgery ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Retrospective Studies ; Spinal Fusion ; methods ; Spinal Injuries ; diagnosis ; therapy

Objective: To investigate the long-term outcome of anterior decompression and bone graft fusion for cervical spondylotic myelopathy(CSM) and factors affecting the outcome. Methods: Two hundred and forty-five patients with CSM were treated with anterior cervical decompression and auto iliac bone graft fusion, of whom 31 had a second operation between 4 months and 2 years after operation. Follow-up studies were carried out within 5 to 15 years after operation, averaging 6.8 years. Results: Function evaluation: excellent in 118 cases (48.16%), good in 71 (28.98%), passable in 35 (14.29%) and poor in 21 (8.57%). According to the 40 points score method, there was an average of 8 point increase in all cases, of which 101 were between 36 to 40 points, 54 between 31 to 35 points. Conclusion: The long-term outcome of surgical treatment for CSM is definite. Significant factors affecting the outcome include timing of operation, degree of pathology and technique of surgery.

Objective To investigate the effects of dominant-negative truncation mutant?NTCF4, lacking the N-terminal form of TCF4 gene,on biological characteristics of renal cancer cell line GRC-I and explore the molecular mechanisms.Methods GRC-I cell was transfected with pCDNA3-?NTCF4 eukary- otie expression plasmid,pCDNA3 empty vector to construct the stable cell line GRC-I/?NTCF4 and GRC-I/ Mock respectively.The morphological changes of stable cells were observed and the cells growth curve was detected through light microscope.The cellular proliferation activities were determined using the MTT assay. The protein expression of Wnt pathway downstream target gene C-Myc and Cox-2 was evaluated by immuno- cytoehemieal method and Western Blot analysis.Results After the dominant-negative?NTCF4 gene was permanently expressed,the GRC-I/?NTCF4 stable cells morphologically showed that appearance changed from circular to long-spindle shape,growth rate decreased with less karyosehisis found,malignant pheno- types reversed to normal renal tubular cells.MTT assay revealed that the proliferation activities of GRC-1/?NTCF4 cells were inhibited by 11.2%-35.5% compared with GRC-I cells (P＜0.05),while the GRC- I/Mock cells have no difference with the control cells.Immunocytochemical analysis and Western Blot showed that the C-Myc and Cox-2 protein expression level of GRC-I/?ANTCF4 cells were significantly sup- pressed in comparison with that of GRC-I/Mock and GRC-I cells.Conclusions The dominant-negative truncation mutant?NTCF4 could partially inhibit the growth of renal cancer cells and down-regulate the pro- tein expression of Wnt pathway target gene C-Myc and Cox-2.These findings provide a experimental founda- tion for applying cell signal therapy to renal cell cancer by blocking the Wnt signaling pathway.

Objective To compare the clinical efficacy between Clamshell incision and bilateral posterolateral incision in the sequential double lung transplantation for end-stage lung disease. Methods Clinical data of 120 recipients undergoing double lung transplantation were retrospectively analyzed. All recipients were divided into bilateral posterolateral incision group (n=108) and Clamshell incision group (n=12) according to different surgical methods. Intraoperative parameters were collected and statistically compared between two groups, including operation time, amount of blood loss, amount of blood transfusion, use of extracorporeal membrane oxygenation (ECMO) or not, cold ischemia time on the first side, and cold ischemia time on the second side. Postoperative parameters were also compared between two groups, including the length of hospital stay, length of intensive care unit (ICU) stay, tracheal intubation duration, ECMO duration, forced vital capacity (FVC), forced expiratory volume in one second (FEV1), incidence of anastomotic stenosis, incidence of bronchopleural fistula, perioperative fatality, and 6-minute walk test for the first time after operation. Results In the Clamshell incision group, the amount of blood loss and blood transfusion was significantly higher than those in the bilateral posterolateral incision group (both P < 0.05). The proportion of ECMO and cold ischemia time on the second side in the Clamshell incision group were significantly lower or shorter than those in the bilateral posterolateral incision group (both P < 0.05). In the Clamshell incision group, the tracheal intubation duration and ECMO duration were significantly shorter compared with those in bilateral posterolateral incision group (both P < 0.05). Conclusions Both Clamshell incision and bilateral posterolateral incision are safe and effective in sequential double lung transplantation. Bilateral posterolateral incision approach can significantly reduce the amount of blood loss and blood transfusion of the recipients without significantly prolonging the operation time. Compared with bilateral posterolateral incision approach, the cold ischemia time of lung graft, tracheal intubation duration and ECMO duration are significantly shortened via the Clamshell incision.

Objective:To investigate the expression of RNF38 in lung cancer,and its correlationship with clinicopathologic feature and prognosis.Methods:Tissue microarray was used to detect the level of RNF38 in 208 lung cancer patients,then its correlationship with clinicopathologic feature and prognosis was analyzed.Results:RNF38 expression was higher in lung cancer tissues compared with the corresponding adjacent normal lung tissues.High level of RNF38 was related significantly to tumor size (P= 0.0002),tumor stage (P= 0.011),lymph node metastasis (P= 0.00004)and histological type (P= 0.030 ).High level of RNF38 indicates low overall survival rate.Single factor analysis showed that RNF38 expression was related to lung cancer patients'prognosis.Conclusions:The high level of RNF38 could be a new marker in predicting the prognosis of lung cancer.

OBJECTIVETo study the clinical problems about posterior atlanto-axial internal-fixation and fusion for atlanto-axial instability or dislocation.

METHODSSurgical treatments of 138 cases with atlanto-axial instability or dislocation were reviewed. There were 62 cases of odentoid malformation, 54 cases of odentoid fracture or rupture of transverse ligament, 22 cases of subluxation and rotation. All cases were treated using Gallie's technique. Six cases were also fixed with transarticular screws, and protected with Philadelphia collar. Other patients were fixed with plaster paris brackets. The followed-up period was 1 to 12 years with an average of 3 year and 5 months.

RESULTSAccording to Sumi's criteria, excellent 70 cases (50.7%), good 40 cases (29.0%), fair 15 cases (10.9%), poor 13 cases (9.4%). 9 cases with bone graft postponed fusion were cured by enhance external-fixation. 2 cases with nonunion were treated with revision surgery. Complication of cord injury happened in 1 case.

CONCLUSIONGallie's fusion technique is an effective method to manage the atlanto-axial instability or dislocation. Skull distraction before operation and reliable external-fixation post operative are important assistant measures. Key points for successful operation are careful wiring or cable traversing, decortication of posterior arc of C1, and maintaining the physiological height between C1 and C2 posterior arc. Indications and objectives should be conformed before revision surgery for failure cases.

Adolescent ; Adult ; Atlanto-Axial Joint ; surgery ; Bone Transplantation ; Child ; Female ; Humans ; Joint Dislocations ; surgery ; Joint Instability ; surgery ; Male ; Middle Aged ; Retrospective Studies ; Spinal Fusion ; adverse effects ; methods ; Transplantation, Autologous