Objective Analysis isolated from ICU patients with severe types of different samples of Acinetobacter baumannii re‐sistance difference ,for effective prevention and control of Acinetobacter baumannii infection in ICU .Methods Retrospective analy‐sis of the college from January 2010 to December 2014 568 strains isolated from hospitalized ICU patients samples Acinetobacter baumannii clinical data .Results Isolated from ICU patients infected with Acinetobacter baumannii main source of sputum (60 .0% );drug sensitive test showed that Acinetobacter baumannii resistance to commonly used antimicrobial agents were generally multiple drug resistance ,the most sensitive to tigecycline ,cefoperazone/sulbactam ,resistance rate of less than 40 .0% ;isolated from sputum and sterile body fluid in Acinetobacter baumannii was generally higher than that of blood and urine to imipenem ,meropen‐em ,cefoperazone/sulbactam ,piperacillin/tazobactam ,ciprofloxacin ,levofloxacin ,amikacin resistance rate ,the difference was statis‐tically significant (P<0 .05) .Conclusion Acinetobacter baumannii multidrug resistant to commonly used antibiotics .In ICU differ‐ent specimen type drug resistance existence difference ,clinicians should strengthen the monitoring of drug resistance ,the treatment of the infection when the first choice of tigecycline ,Cefoperazone/sulbactam .

Objective To analysis of the causes and drug resistance characteristics in ICU patients with Citrobacter freundii hos‐pital infections ,for the future of clinical treatment and prevention of Citrobacter freundii infection provides the basis .Methods Col‐lected our hospitals from December 2011 to November 2014 clinical samples of ICU patients ,conventional isolation and culture of bacteria ,K‐B disk diffusion susceptibility test ,using Whonet5 .6 software analysis processing tentative data .Results Isolated from Critically ill patients Citrobacter freundii lower respiratory tract ,accounted for 64 .4% ;ESBLs producing high ,accounted for 35 .6% ;susceptibility testing showed the bacteria to imipenem ,meropenem ,nitrofurantoin ,kanamycin ,amikacin ,cefoperazone/sul‐bactam and piperacillin/tazobactam were more sensitive ,drug resistance rates were 3 .8% ,4 .5% ,8 .3% ,9 .1% ,17 .4% ,18 .1% and 22 .7% ,the rest of antimicrobial drug resistance rates more than 25 .0% .Conclusion Citrobacter freundii caused critically ill pa‐tients hospital infection have become increasingly serious ,lower respiratory tract was the main site of infection ,the bacteria used in the clinic for cephalosporin ,quinolones ,aminoglycosides and a variety of internal β‐lactam antibiotics were highly resistant ,clinicians should strengthen monitoring of drug resistance ,to reduce the resistant strains produced and spread within the hospital .

Objective To explore the expression of the nuclear factor -κB (NF-κB) regulating monocyte ehemoactracttive peptide -1 ( MCP-1) in asthma patients, and investigate the effect of seretide, budesonide and vento-lin. Methods 81 asthma patients were randomly divided into seretide therapy group and budesonide and ventolin therapy group. The NF-κB activation in PBMC and the plasma concentrations of MCP-1 were measured by ELISA. ventolin therapy group (1.70±0.39) ng/L of asthma patients were significantly higher than that control group (0.89±0.34) ng/L ( P<0.001 ) ; The plasma MCP-1 level in seretide therapy group ( 66.89±5.62 ) ng/L and in budesonide and ventolin therapy group (73.35±7.52 ) ng/L of asthma patients were also significantly higher than level of seretide therapy group in asthma patients were significantly lower than budesonide and ventolin therapy group (P <0.001 ). Conclusion NF-κB gene and its regulating protein MCP-1 may be involved in asthma. Glucocotios-teroid and beta2 agonists combination may prolong the process of asthma.

Objective To explore the clinical effect of reconstruction of coracoclavicular and acromioclavicular ligaments with multi - bundle - polystyrene - suture for treatment of Ⅲ degree acromioclavicular dislocation. Methods 30 patients with Ⅲ degree acromio-clavicular dislocation were randomly divided into two groups. Multi - bundle - polystyrene - suture was used to reconstruct coracoclavicular and acromioclavicular ligaments in treatment group; Cross - Kirschner and tension bands or clavicular hook plates were used to reconstruct coracoclavicular ligaments in control group. Then the clinical effects of the two methods were analyzed and assessed clinically. Results The clinical effects of treated group was significantly better than those of the control group on the volume of blood loss, surgical time and shoulder function. Conclusion It is a simple, minimally invasive, inexpensive and effective method. We need not to remove the internal fixation to reconstruct coracoclavicular and acromioclavicular ligaments with multi - bundle - polystyrene - suture for treatment of Ⅲ degree acromioclavicular dislocation.

Objective To evaluate the feasibility and safety of trans-umbilical NOTES to perform abdominal adhesion lysis using a flexible endoscope.Methods A 42-year-old female was admitted to our hospital with a complain of abdominal pain due to abdominal adhesion after hysterectomy.A gastroscope (GIF-2TQ260M,Olympus)was inserted into the peritoneal cavity through an incision(1.5 cm)of the umbilical opening.Pneumoperitoneum was established by the endoscopic air supply system using CO2 instead of air.Abdominal exploration showed that omentum and bowel were stuck to the scar of the low central peritoneum incision.Separation of the abdominal wall adhesions was performed with an IT knife and a hook knife respectively.After most of the adhesions were separated,bleeding was found from the isolated adhesion wound of the omentum and bowel.Hemorrhaged blood vessel was difficult to be found with the flexible gastroscope.Then a 5 mm Trocar was placed at the left lower abdomen and laparoscopic assistance was adopted to search the bleeding point.However,no bleeding site was found and the hemorrhage was stopped automatically.Residual adhesion lysis was conducted with laparoscopic assist.After the procedure,the umbilical incision was closed with absorbable suture,but lower left abdominal incision was left without suturing.Results The operation time was 40 minutes.The patient suffered from minus pain from the umbilical incision without need of treatment.She had normal diet and got out of bed after reconsious.She was discharged 2 days after the procedure without any complaints.Conclusion Trans-umbilical NOTES using a flexible endoscope for peritoneal adhesion lysis is safe and feasible,but the effectiveness remains to be further confirmed.

This study explored the molecular mechanisms underlying the time-dependent autophagy and apoptosis induced by nutrient depletion in human multiple myeloma cell line RPMI8226 cells. RT-PCR and qRT-PCR were used to evaluate the transcriptional levels of Deptor, JNK1, JNK2, JNK3, Raf-1, p53, p21 and NFκB1 at 0, 6, 12, 18, 24 and 48 h after nutrient depletion in RPMI8226 cells. We found that transcriptional levels of Deptor were increased time-dependently at 0, 6, 12 and 18 h, and then decreased. Its alternation was consistent with autophagy. Transcriptional levels of Raf-1, JNK1, JNK2, p53 and p21 were increased time-dependently at 0, 6, 12, 18, 24 and 48 h accompanying with the increase of apoptosis. Transcriptional levels of NFκB1 at 6, 12, 18, 24 and 48 h were decreased as compared with 0 h. It was suggested that all the studied signaling molecules were involved in cellular response to nutrient depletion in RPMI8226 cells. Deptor contributed to autophagy in this process. Raf-1/JNK /p53/p21 pathway may be involved in apoptosis, and NFκB1 may play a possible role in inhibiting apoptosis. It remained to be studied whether Deptor was involved in both autophagy and apoptosis.

Objective To explore the effect of proprioceptive neuromuscular facilitation (PNF) on balance function of stroke patients in community. Methods 204 stroke patients in community were divided into control group (n=98) and observation group (n=106). The control group accepted routine rehabilitation and the observation group received PNF additionally. Fugl-Meyer Assessment of lower extremities (FMA), Berg Balance Scale (BBS) and static balance locator were used to evaluate the motor and balance function before and 3 months after treatment. Results The scores of FMA and BBS were higher after treatment than before (P<0.05) in both groups, and were higher in observation group than in control group (P<0.05). The length of path (L), covered area (A) and L/A were less in observation than in control group (P<0.05) both in the eye-open and eye-closed modes. Conclusion PNF can improve the lower extremities motor and balance function of stroke patients in community.

ObjectiveTo examine the effects of proprioceptive neuromuscular facilitation(PNF) techniques on lower limb motor function of strokes and its mechanism.MethodsWe used simple random sampling and cross-section survey design. PNF Contract Relax Agonist Contract(PNF-CRAC) techniques were applied to 44 stroke patients. Surface electromyography values(sEMG) was recorded from rectus femoris and hamstring of stroke patients with both low limbs. ResultsPNF-CRAC techniques not only caused the irradiation of muscles activities in the contralateral extremity during unilateral exercise, but also increased agonist EMG activities and the motor control of knee joint in strokes.ConclusionPNF-CRAC techniques can improve the knee stability and enhance the recovery of motor function in paretic lower limb.

Objective To study the chemincal theraputic effect and value of pancreatic carcinoma by regional arterial infusion and catheter mantained.Methods The catheterization using Selolinger by transfemoral artery puncture were performed in fifteen patients.The ends of catheters were inserted into coeliac trunk.The segments of catheters out of body were circled and fixed above inguinal ligment.After operation,the chemotherapy transcatheters were performed with ADF projects.Results Of 15 cases,jaundice was disappeared in 8 cases,slight ened in 4 cases,the total effective rate was 80%(12/15).Abdominal pain was disappeared in 9 cases and slight ened in 6 cases Appetite and weight of patients were improved and increased in 12 cases.The 1,2 and 3 year survival rates were 60%(9/15),33.3%(5/15),20%(3/15).Conclusion The chemotherapy by the regional arterial infusion is superior to traditonal venous chemotherapy for pancreatic carcinoma.

Objective Toinvestigatetheclinicalvalueofhumanneutrophillipocalin(HNL)detectioninthedifferentialdiagnosis of bacterial and viral infections of elderly patients with acute respiratory infection .Methods 142 elderly patients with respiratory infection were divided the bacteria group (96 cases) and the virus group (46 cases) according to their infections ,42 healthy people in the corresponding period were enrolled as the control group .Enzyme-linked immunosorbent assay and highly sensitive dry chemi-cal particles enhanced immune turbidity assay were employed to detect their blood HNL and C-reactive protein(CRP) ,respectively , and virus-specific antibodies detection were performed simultaneously .Results Compared the blood HNL ,CRP levels and their positive rates of patients in bacteria group with those in the virus group ,control group ,respectively ,differences showed statistically significant(P<0 .01) ,while the differences of indicators listed above between the virus group and control group had no statistically significant(P>0 .05) .Antibiotic treatment before and 24 ,48 and 72 hours after ,the concentrations of HNL were (216 .8 ± 64 .1) , (192 .0 ± 41 .2) ,(158 .0 ± 54 .5) and (87 .0 ± 12 .4)μg/L ,respectively ,while those of CRP were (50 .9 ± 40 .9) ,(46 .2 ± 18 .3) , (39 .6 ± 9 .6) and (12 .6 ± 9 .8) mg/L ,respectively .Sensitivity ,specificity ,positive predictive value and negative predictive value of HNL detection were 90 .6% ,90 .9% ,91 .5% and 89 .9% ,respectively ,which were higher than those of CRP (88 .5% ,85 .2% , 86 .7% and 87 .2% ,respectively) ,with statistically significant difference(P<0 .05) .Conclusion NHL detection possesses impor-tant significance in differential diagnosis between bacterial and viral infections of elderly patients with acute respiratory infection .