Objective To study the pathogenic bacteria species and drug resistance rate in the intensive care unit(ICU)in county hospital to guide clinical rational use of antibiotics. Methods 263 various specimens were chosen from January 2013 to December 2013 in the ICU of Zigui County People's Hospital in Hubei Province,these were applied to perform the bacterial culture and identification,and disc AGAR diffusion method was used to test the in vitro drug susceptibility and observe the specimens distribution,pathogenic distribution and the rate of drug resistance. Results In the 263 specimens,the top three isolated were 131 sputum(49.8%),49 blood(18.6%) and 38 ascites specimens(14.4%)respectively,and the pleural effusion was the least isolated with 5(1.9%). A total of 125 strains bacteria were isolated with positive detection rate of 47.5%(125/263). In the 125 strains,80(64.0%) were Gram-negative(G-)bacilli at the pioneer position,and the top four were:Klebsiella pneumonia 23(18.4%), Acinetobacter Baumanni 19(15.2%),Escherichia coli 18(14.4%)and Pseudomonas aeruginosa 12 strains(9.6%). There were 33 strains(26.4%)of Gram positive(G+)cocci including mainly Staphylococcus aureus 25 strains(20.0%);fungi strains were 12,the least(9.6%). The drug resistance rates of the top four G- bacillus were as follows:the rate of Klebsiella pneumoniae to ampicillin sodium was the highest(100%),while its rate to imipenem,meropenem and ciprofloxacin was 0;the rates of Acinetobacter baumannii to tobramycin and ceftriaxone were very high(100%, 92.3%),while to imipenem,meropennem were much lower respectively(26.3%,15.4%);the rates of Escherichia coli to ampicillin sodium and piperacillin were relatively high(88.9%,83.3%),while the rates to amikacin,imipenem, meropennem respectively were 0;the rates of Pseudomonas aeruginosa to ceftriaxone,cefotaxime sodium were very high(both 100%),while the resistant rate to levofloxacin was 0. The G+ cocci had no drug-resistance to linezolid, teicoplanin and vancomycin;the rates of Staphylococcus aureus to azithromycin,clindamycin,erythromycin and penicillin were higher than 80%,and those of Excrement enterococcus to erythromycin,gentamycin,levofloxacin were also higher than 80%. Conclusions The ICU infection of our hospital is primarily respiratory tract infection, the pathogenic bacteria are mainly G- bacilli and the antibacterial drug resistance is very serious. Therefore it is necessary to monitor the trend of bacterial resistance closely,and according to the results of bacteria identification and drug susceptibility,the antimicrobial agents are reasonably chosen to effectively reduce and control the ICU hospital infection.

Objective To study the changes of detrusor microvessel density and apoptosis related factor PCNA and Bax in different phase of partial bladder outlet obstruction. Methods Forty Wistar rats were divided into control(n =10), sham-operation(n =10) , two-week obstruction( n = 10) and five-week obstruction group(n = 10). The expression of detrusor microvessel density and apoptosis related factors PCNA and Bax were evaluated with immunohistochemistry method. Results The average weight of bladder was (125.5?10. 1) ,(128.5?8.9) ,(380.0?12.4) ,(400.0?12.5) mg in control, sham-operation, two-week obstruction and five-week obstruction group, respectively. The difference between control, sham-operation group and obstruction group was significant (P 0. 05 ) . The expression of microvessel density was 2. 1?1.3,13.3?2.3,36.4?4. 1 and 37.3?5.6 in control, sham-operation, two-week obstruction and five-week obstruction group, respectively. The difference between control, sham-operation group and obstruction group was significant ( P 0. 05 ). The expression of PCNA was (38. 2?17. 2)% , (39. 4?11.4)% , (64. 1?11. 5)% and (46. 2?9. 6)% in control, sham-operation, two-week obstruction and five-week obstruction group, respectively. The difference between control, sham-operation group and obstruction group was significant (P

Objective The study was aimed to detect the correlation of B cell activating factor (BAFF) promotor polymorphism-871 C/T and systemic lupus erythematosus (SLE).Methods BAFF promotor polymorphism-871 C/T was detected by the means of allele specific polymerase chain reaction (ASPCR) and agarose gel electrophoresis in 76 cases of SLE and 80 nonthrombosis normal individuals.The data of genotypic frequency and allele genotypic frequency were analyzed statistically with x2 test between the two groups.Results Fifty-one point two percent of normal individuals exhibited C/C.Thirty-five percent were heterozygous for C/T,and 13.8％ were homozygous for T/T.SLE group exhibited a different distribution pattern (30.3％ C/C,43.4％C/T,26.3％T/T).The allele frequency of T in SLE and normal individuals was 48.0％ and 31.2％ respectively.There was significant difference in the BAFF-871 C/T genotypic frequency between the SLE and nonthrombosis normal individuals (P＜0.05).Conclusion The polymorphism-871 C/T of BAFF promoter is correlated with the pathogenesis of SLE.The gene may be a major susceptible gene for SLE in Chinses Han people.Further investigations may be needed.

Objective To explore the reasonable radiotherapy range by analyzing the patterns and characteristics of intra-thoracic lymph node metastasis in small cell lung cancer (SCLC).Methods One hundred and fifty patients with limited-stage SCLC who received radical resection of primary tumor and systemic intra-thoracic lymph node dissection were included in the study.All the lymph nodes in each area were recorded and examined pathologically to analyze the patterns and characteristics of intra-thoracic lymph node metastasis.Results A total of 2372 lymph nodes were found in 631 areas,and a total of 413 positive lymph nodes (17.4％) were found in 188 lymph node areas (29.8％ ).Intra-thoracic lymph node metastasis were found in 88 patients,with a positive rate of 58.7％.The frequencies of metastasis in the area 11,10,7,5,4 were much higher than those in the other areas,and central located lesions and the higher T-stage lung tumors were more likely to develop intra-thoracic lymph node metastasis (x2 =15.32,39.72;P =0.000,0.000,respectively).Tumors located in the right upper lobe and right middle/lower lobe had a higher tendency of metastasis to the areas 4,7,10 and 4,7,10,11,respectively.Tumors located in the left upper lobe and left lower lobe had a higher tendency of metastasis to the areas 4,5,6,10 and 4,7,9,10,11,respectively.Mediastinal lymph node metastasis (N2 ) were found in 72 patients,among whom 29 patients (40.3％ ) had skipping N2 metastasis without hilar metastasis.Tumors located in the upper lobe had a tendency of skipping metastasis to the upper mediastinum,while tumors located in the middle/lower lobe had a tendency of skipping metastasis to the upper and lower mediastinum.Conclusions The lymph node metastases in SCLC follow the lymphatic drainage routes,that is,from intrapulmonary to the hilar and then to the mediastinum,but with some skipping metastases.Tumors located in different lobes have different high risk lymph node areas for metastasis,and elective irradiation to these lymph node areas maybe increase radiotherapy gain ratio in SCLC.

Objective To estimate the application of ultrasound measurement of detrusor wall thickness (DWT) in the assessment of curative effect after operation. Methods Detrusor thickness was measured by linear ultrasound (7. 5 MHz) either at a filling volume of 50% of cystometric capacity or at 250 ml filling in 86 patients, who were diagnosed equivocal BOO, during a pressure-flow study. All patients accepted transurethral resection of the prostate. At 3 months post-surgery, the patients were divided into two groups according to curative effect after operation. The volume of the prostate, age and DWT were compared between the two groups. Results There was no difference in either age or volume of the prostate between the two groups. DWT was significantly higher (P＜0.01) in the more curative effect group (37 cases, DWT 2. 5±0.3 mm) compared to the less curative effect group (49 cases, 2.2±0. 3 mm). As a predictor of curative effect, DWT of 2. 8 mm or greater had a positive predictive value of 100%, a negative predictive value of 62%, specificity of 100% and sensitivity of 19%. Receiver operating characteristic analysis (ROC) revealed that DWT had a high predictive value for curative effect post-surgery with an AUC of 0. 84±0. 04. Conclusions In patients with equivocal BOO, ultrasonographically assessed detrusor thickness may have a predictive value for curative effect post-surgery. However, this cutoff value needs to be validated in a larger study population.

Objective: To evaluate the function of collagen in osteointegration and bone remodeling. Methods: Sirius-red stainning and polarized microscope were employed to investigate the collagen type I and III around titanium-implants, natural teeth and extraction sockets of rhesus mulatta. Results: More type I collagen was observed in the bone-implant interface around the middle and tip parts of implants than that of normal teeth or sockets after tooth extraction (P

Objective To determine the serum level of pepsinogenⅠ,Ⅱ(PGⅠ,PGⅡ) and PGⅠ/Ⅱin the residents from Zhuanghe county,a high risk area of gastric cancer in North China,and to explore their distribution as well as related factors.Methods Serum PGⅠand PGⅡlevels were detec- ted with ELISA method in 6990 subjects.Gastric diseases were diagnosed by endoscopy and histopatho- logic examination.Serum H.pylori-IgG antibody was determined by ELISA method.Results The me- dian values for PGⅠ,PGⅡ,PGⅠ/Ⅱwere 86.9/?g/L,10.6/zg/L and 8.1 respectively.Serum PGⅠand PGⅡin male(95.2?g/L,12.1?g/L) were significantly higher than those in female(79.7?g/L, 9.4?g/L;P=0.000),PGⅠ/Ⅱratio(7.9) was significantly lower in male (8.3,P=0.000).There were significantly decrease in PGⅠ/Ⅱratio along with age increase.PGⅠ/Ⅱratio decreased signifi- cantly following with progression of gastric mucosa from normal (10.4) to non-atrophic lesions(8.8) and to atrophic lesions (6.6).Serum PGⅠand PGⅡin H. pylori positive subjects (88.7?g/L,11.4?g/L) were significantly higher than those in H.pylori negative subjects (81.4?g/L,8.4?g/L;P= 0.000),PGⅠ/Ⅱratio(7.7) was significantly lower in H.pylori positive subjects (9.6,P=0.000). For patients with atrophic lesions,the area under the PGⅠ/ⅡROC curve was 0.622.The best cut-off point for PGⅠ/Ⅱwas 6.9,with sensitivity of 53.2%,and specificity of 67.5%.Factors linked to PGⅠ/Ⅱwere identified using multinomial logistic regression:male (OR:1.151,95% CI:1.042—1.272, P=0.006),age=61(OR:1.358,95% CI:1.188—1.553,P=0.000),atrophic lesion(OR:2.075,95% CI:1.870—2.302,P=0.000),and H.pylori infection (OR:1.546,95% CI:1.368—1.748,P= 0.000).Conclusions The serum PG levels are significantly skewed from normal distrubition in the residents of Zhuanghe county,and affected by age and gender,as well as associated with gastric diseases and H.pylori in- fection.Compared with PGⅠand PGⅡalone,PGⅠ/Ⅱis more suitable for screening gastric cancer.

Objective To identify whether the branches of cervical nerve roots joined into the accessory nerve trunk or not.Methods In 10 adult cadavers (7 males and 3 females, including 20 laterals of brachial plexus nerves), we observe source of cervical plexus branches to the accessory nerve anatomically.In 10 clinical cases of males with brachial plexus nerve injures, in the supraclavicular approach of brachial plexus exploration, the part of the supraclavicular cutaneous nerve for histological specimen were cut off;in the posterior approach, electrical stimulation of the trunk and branches of cervical plexus were performed to observed istaltrapezius muscle contraction.After accessory nerve transfer, the residual terminal accessory nerve and branch of cervical plexus were taked for histological specimens;and observed and judged of each nerve sample by acetylcholinesterase (AchE) immunohistochemical staining.Results In 10 of 20 lateral cases, cervical plexus communicating branches were derived from the fourth cervical nerve root.The intraoperative electrical stimulation of the accessory nerve trunk, 10 cases of distal trapezius muscle were significantly shrink;electrical stimulation of the cervical plexus branch, 2 cases after stimulation of the mild distal trapezius contraction, the remaining 8 cases without trapezius muscle contraction.10 cases of supraclavicular nerve staining for AchE were negative, 10 cases of accessory nerve terminal branches of AchE staining were mixed,10 cases of branch AchE cervical plexus to the accessory nerve staining were negative.Conclusion The branches of the fourth cervical nerve root constantly joins into the accessory nerve, participating in the trapezius muscle inner vation, the fibers of the branches are sensorial fibers.

Objective To investigate the expression and significance of E-cadherin and β-catenin in type Ⅰ endometrial carcinoma.Methods The expression of E-cadherin and β-catenin were detected by immunohistochemistry in 60 patients with type Ⅰ endometrial carcinoma and 10 normal endometrial tissues.The patients were followed-up postoperatively for the survival rate.Results Expression of E-cadherin and β-catenin in 10 normal endometrial tissues was all high expression,while those of both abnormal expression in type Ⅰ endometrial carcinoma with expression rates with 60.0 ％ (36/60) and 55.0 ％ (33/60),respectively,which were difference compared with both in normal endometrial tissues (P ＜ 0.05).The expression rates were markedly decreased in carcinoma with lymph node metastasis than those without lymph node metastasis.The proportions of abnormal expressions of E-cadherin and β-catenin were positively correlated with tumor grade and myometrial invasion in type Ⅰ endometrial carcinoma (P ＜ 0.05).The postoperative two-year survival rate in the patients with abnormal expression of E-cadherin and β-catenin were much lower than those with normal expression (P ＜ 0.05).Conclusions Abnormal high expression of E-cadherin and β-catenin may play important roles on generation and metastasis in type Ⅰ endometrial carcinoma.Both of them may be promising method for predicting invasion and metastasis and can be prognostic predictors in type Ⅰ endometrial carcinoma.

Objective To study the current management strategy for colorectal injuries. Methods The clinical data of 86 consecutively admitted patients with penetrating colorectal injuries were retrospectively reviewed. Results Most injuries were of closed type. Iatrogenic colon injury accounted for 14%. There were 61 patients (71%) associated with other abdominal organ injuries. Operations were performed in all patients. Seventy six patients were treated with primary repair or resection and anastomosis, and 10 with diverting colostomy. In recent 10 years mortality rate dwindled from 10% to 4%(2/46). Mortality was most often caused by hemorrhagic shock, associated organ injuries or severe secondary infection. Conclusions Most colorectal traumas are blunt closed type in China. Primary repair or resection and anastomosis at the time of initial exploration is most often used for colorectal injuries. Indications for diverting colostomy are severe shock, heavy intra abdominal contamination, poor condition, and rectal injury. Fecal peritonitis should be effectively prevented and treated.