Objective To understand the drug-resistance of MRSA patients in neurosurgery intensive care unit,raise the prevention of MRSA and provide doctors the basis for controlling it. Methods The 5 year(20012005) MRSA patients were tested by Kirby-Bauer in neurosurgery intensive care unit of a third-tier general hospital in Shanghai. Statistic and analysis the drug-resistance of the patients. Results The rates of 121 MRSA drug-resistance to penicillin G,erythromycin, ciprofloxacin, amikacin and the cephalosporins are 92.3 % to 100 %, totally senaitire to teicoplanin and vancomycin and lower drug-resistance to rifampin,netilmicin and fosfomycin, but it rapidly raised from 10.0 % (2001 ) to 95.2 % (2005) to sulfamethoxazole. Conclusion It is time to take care of the drug-resistance of MRSA. Prevention and use antibiotics properly are the important ways to decrease the hospital infection and to improve the quality of recovered.

Background and purpose:Hepatocellular carcinoma (HCC) is a common malignant tumor of the digestive system in our country, with high fatality, development of HCC and the machine system research and treatment is a primary issue in current study of HCC. To explore the expression ofβ-catenin at different stages in the process of hepatocellular carcinoma carcinogenisis for SD rats induced by chemicals. Methods: The experimental group included 48 male SD rats mice with primary liver cancer induced by diethylnirtosamine/carbon tetrachloride/Ethanol, while 48 normal male SD rats mice were used as the control group. The rats were killed every 3 weeks to collect the specimens and observe the pathological changes by HE staining. The changes ofβ-catenin protein expressions were detected by immunohistochemistry and Western blot respectively. Results:SD rats liver cancer was conifrmed by HE staining after 21 weeks DEN/CCl4/Ethanol induction. Immunohistochemistry showed thatβ-catenin expression level was obviously higher in the experimental group(0.27±0.01) than that of the control group(0.21±0.02) after 3 weeks induction(P<0.05). As time progresses, the expression levels ofβ-catenin kept on rising, and at the 18th(0.30±0.02) and 21th weeks(0.32±0.02), it was significantly higher than that of the earlier liver tissues of the experimental group(P<0.05), Western blot consistent with immunohistochemical results. Conclusion:β-catenin protein expression is different in the normal liver tissue, cirrhosis, liver cancer,β-catenin and the occurrence of liver carcinoma development had close relationship.β-catenin protein in the cell with further accumulation, may active a series of target gene, leading to the formation of liver cancer..

Objective To evaluate common carotid arterial intima-media thickness (IMT) and elasticity using ultrasound radio-frequency data (RF-data) technology, the normal values of the related parameters were determined in healthy adults for their potential clinical applications.Methods One hundred and sixty healthy adults were included and divided into 4 age groups with 20 males and 20 females in each group.The quantitative parameters of common carotid arterial IMT, common carotid arterial distensibility (CD),local pulse wave velocity(PWVβ) and stiffness(β) were calculated automatically.The correlations that the IMT, PWVβ and β were correlated positively with aging and CD was correlated negatively with between IMT and PWVβ or β, while no correlation between IMT and CD.The positive correlation was found correlation between IMT and age ( P＜0.05) ;In 30～39 and 40～49 years old groups,PWVβ increased and CD decreased with aging;In 50～59 years old group,PWVβ and β increased with aging;But in 60～69 years these parameters changed with aging in subjects＜60 years old.Conclusions RF-data technology could quantitativly evaluate common carotid arterial IMT and elasticity, the normal values of the related parameters were determined with aging,it may be a promising modality to assess the arterial condition.

Objective To master the rehabilitation in patients with traumatic brain injury in Eastern China, and provide evidence for clinicians to rehabilitate early,correctly and effectively.Methods All sampling of the TBI patients from 80 hospitals in Eastern China were clustered and were analyzed using SPSS 13.0.Results The rate of in -patients in Eastern China with early rehabilitative intervention was 4.68%,and the rate of male was higher than female(male to female ratio was 3.80:1),mean age was (40.10 ±16.33)years old,but there was no difference in gender(χ2 =3.23,P =0.072)and age(t =-0.819,P =0.413)for the early rehabilitative intervention.Local resi-dent patients in early rehabilitative intervention was lower(χ2 =8.28,P <0.05).The average length of stay for the early rehabilitative intervention patients was(39.57 ±34.22)d(t =-17.74,P <0.05),the average cost of hospitali-zation was(42 741.50 ±43 186.69)yuan(t =-18.96,P <0.05).The rate of average length of stay and average cost of hospitalization of the rehabilitative intervention patients were higher and more expensive than the patients who did not obtain early rehabilitative intervention,but did have higher unfavourable prognosis rate(χ2 =85.45,P <0.05). Conclusion We advocate correct and early rehabilitative intervention for traumatic brain injury in patients with different degree,and promote not only the physical and functional rehabilitation,but also comprehensive rehabilitation such as the psychological treatment,family treatment and social regression.

ObjectiveTo explore the diagnostic value of Tei index of right ventricle and serum level of NT-proBNP in patients with high-altitude heart disease (HAHD).MethodsRight ventricle Tei index and serum NT-proBN level were calculated and tested in 32 local healthy volunteers and 34 cases of HAHD patients hospitalized in our hospital in Golmud city (2808 meters above sea level) from 2008 to 2010,and a correlation study was conducted thereafter.ResultsThe pulmonary arterial systolic pressure and right ventricle Tei index,elevated significantly in HAHD patients compared with the control group [(86.61 vs 9.72)mm Hg(1 mm Hg=0.133 kPa) and(0.90 vs 0.33)respectively,P＜0.05].Patients diagnosed as mild pulmonary hypertension without alteration in cardiac structure showed higher pulmonary arterial systolic pressure and the Tei index compared with the control group [( 57.1 vs 9.72 )mm Hg and (0.78 vs 0.33 ) respectively,P ＜ 0.05 ].In addition,the level of serum NT-proBNP was significantly higher in HAHD group than that of control group [( 1246.8 ± 512.6) ng/L and (98.6 ± 21.7 ) ng/L respectively,P ＜ O.05 ].ConclusionRight ventricle Tei index and serum NT-proBNP level are sensitive indicators for right ventricular function and thus of favorable clinical significance for the diagnosis of HAHD.

Objective To analyze of related factors in affecting condylar buttress plate (CBP) surgical treatment of distal femoral fractures.Methods One hundred patients with distal femoral fractures were grouped according to eight related factors (gender,age,fracture type,fracture classification,surgical time,reset quality,whether bone graft and plaster braking),respectively.Operative efficacy was scored by the Neer knee functional score table,and score ≥ 72 was excellent,while ＜ 72 was good.Eight related factors were carried out single factor analysis with x2 test to compare the operative efficacy of each group,then the related factors with single factor analysis result of P＜0.05 were put in Logistic multifactor regression analysis,in order to clarify the independent risk factors for CBP treatment of distal femoral fractures.Results There was no significant difference (P＞0.05) in the operative efficacy between male and female group,open fracture and closed fracture group.The difference between youth,middle-aged and elderly group,type A and type C fracture group was statistically significant (P＜0.05).The operative efficacy of patients got surgery within 7 d was obviously better than those who got surgery 7 d later (P＜0.05).The operative efficacy of patients who had no intraoperative bone graft was better than those who had bone graft (P＜0.05).The operative efficacy of satisfactory reset group and none plaster braking group was better than that of unsatisfied reset group and plaster braking group (P＜0.05),respectively.Conclusions Age,fracture type and reset quality are CBP therapy independent risk factors for the efficacy of operation for patients with distal femoral fractures,which will provide some reference for improving the operative efficacy of CBP operation in treatment of distal femoral fractures.

Background:Tripterygium glycosides(TG)is effective for treatment of ulcerative colitis(UC)in clinical practice, however,the underlying mechanism has not been clarified yet. Aims:To investigate the therapeutic effect of TG on dextran sulfate sodium(DSS)-induced experimental colitis in mice and its possible mechanisms. Methods:Sixty healthy male BALB/ c mice were randomly divided into six groups:model control group,low,medium and high-dose TG group,blank control group and normal control group. Mice in the first four groups drank 5% DSS freely for 7 days to induce experimental colitis;simultaneously,distilled water,9. 01,27. 03 or 81. 09 mg/(kg·d)TG were given intragastrically for 21 days in these four groups,respectively. Histopathological changes of colonic mucosal tissues were observed;expressions of TLR4 mRNA and protein were determined by RT-PCR and Western blotting;expression of NF-κB p65 was detected by immunohistochemistry;concentrations of IL-1α,TNF-α and IL-13 were measured by ELISA. Results:Tissue damage and inflammation in varying degrees were observed in colonic mucosal tissues in TG groups with different dosage,but all were less severe than those in model control group. Expressions of TLR4 mRNA,TLR4 protein,and NF-κB p65 in colonic mucosal tissues,as well as concentrations of IL-1α and TNF-α in supernatant of colonic homogenate were significantly lower in TG groups than those in model control group(P < 0. 01). These parameters in medium and high-dose TG groups were significantly lower than those in low-dose TG group(P < 0. 05),but higher than those in blank control group and normal control group(P < 0. 05). Except for TNF-α,no significant differences were seen between medium and high-dose TG groups(P > 0. 05). Conclusions:TG exerts a protective effect on DSS-induced experimental colitis in mice. The underlying mechanism of its anti-inflammatory effect might be related with the inhibition of TLR4 / NF-κB signaling pathway activation and subsequently suppressing downstream proinflammatory cytokines expression and secretion.

Objective To assess the diagnostic value of ultrasonographic elastography for identifying suspected malignant thyroid nodules. Methods Fifty-one patients with small single solid thyroid nodule underwent two-dimensional and color power Doppler ultrasonography. The size, shape, boundary, internal echo and halo, calcification of thyroid nodule were observed with two-dimensional ultrasound. Then color Doppler ultrasonography was used to detect blood signal and distribution in the nodules. Longitudinal scanning of elastography was performed, and the findings on elastography were classified into Ⅰ-Ⅴ grades. The ultrasonographic results were compared with pathologic findings. Results Six patients were found with grade Ⅰ and Ⅱ benign lesions;9 with grade Ⅲ ( 6 benign and 3 malignant), 36 with Ⅳ and Ⅴ (2 benign and 34 malignant) lesions on ultrasonographic elastography. Taking the elasticity grade Ⅳ or Ⅴ as malignant standard, the diagnostic sensitivity was 91.89%, specificity was 85.71%, accuracy was 90.20%, while the positive and negative predictive value was 94.44% and 80.00%, respectively. Conclusion Real-time ultrasound elastography is a promising imaging technique that can assist in the differential diagnosis of malignant thyroid small single solid nodule.

Objective To analyze the emergercy epidemiological characteristics of coeualties with head in-jury in Shanghai. Method By a prospective study,the data of 18 076 casualties with head injury during the whole year 2004 collected from 12 joint hospitals in Shanghai were documented well in the unified survey tables with wide-range items failed in by the attending physician, who got the firsthand information from patients and witness.The data were analyzed by using SPPS version 11.5 software. Results Of 18 076 casualties with head injury,the ratio of male to female was 2.11: 1.The mean age of female was older than that of male (t=10.575, P<0.01).The highest incidence of casualties occurred in people of twenties (24.7 % ). The local residents of Shanghai ac-counted for 34.2% of casualties. More casualties often occurred in December,January,Mareh and August than in he rest. Of 5.1% casualties with head injury were assochted with labour work.The leading cause of injury was dif-ferent in patient cohorts of different ages. Fall was the most main cause of trauma in children cohort (aged<14)and the senile patients cohort (aged > 60). The violert assault and traffic accident caused the most head injuries in the adolescent people cohort ( aged 15～34 years old) and the young people cohort ( aged 35～59 year old). The majority of casualties (85.5%) received CT scan.The scalp laceration (40.2% of patients) was seen more often than other types of injury . The mortality of easualties with traumatic brain injury was 0. 5 % . Conclusions The kmowledge of epidemiologieal aend of emergency deparhnent visitors with head injury is amportant guidance to physicians arranging emergency medical resources rationally and formulating a comprehesive prevention stategy of castahies with head injury.

Objective To dynamically monitor the blood glucose in traumatic brain injury (TBI) patients within three days after admission, and to assess the impact of hyperglycemia on prognosis. Method Between 2007 and 2008, 62 TBI patients, who were admitted within 6 hours after the ineidence of injury without diahetes or severe combined injuries, were involved in this study. Blood glucose was monitored at 4 time points (instantly, 24 hours, 48 hours, and 72 hours after admission). Patients were classified into the mild, the moderate, or the se-vere TBI group according to GCS (Glasgow Coma Scale) scores, being classified into the survival or the dead group according to prognosis, or into the mile or severe hyperglycemia group depending on whether the blood glucose ex-ceeds 11.1mmol/L on admission. T tests and χ2 tests were applied to analyze the relationship among blood glucose levels, the degrees of injury, and the prognosis of studied patients. Results Patients with mild, moderate, or se-vere TBI showed hyperglycemia with different levels, and the blood glucose levels was consistent with the degree of the injury. The blood glucose of the patients in the dead group were significantly higher at all checked time points than those of the survival group, particularly instantly after admission (8.51±2.01 mmol/L vs. 11.54±2.45 mmol/L, P=0.0001, t=4.988). The mortality of patients with severe hyperglycemia was 64.71%, signifl-candy higher than that of the mild hyperglycemia group 13.95% (P=0.0002, χ2=15.46). The Intensive Care Unit Length of Stay (ICULOS) of the above two groups was 22.6 and 10.2 days,respectively (P=0.021, t= 3.216), but their hospital length of stay (HLOS) showed no statistical difference (P=0.052). Conclusions Hyperglycemia, as an early stress response to TBI, may reflect the degree of the injury. Blood glucose levels that exceed 11.1 mmol/L on admission may imply high mortality of TBI patients, so this could be used as a simple indi-cator to predict prognosis.