Objective To study the drug resistance and production status of highly producing AmpC enzymes, extended-spectrum β-lactamases (ESBLs) and drug resistance in Acinetobacter bau-mannii. Methods Drug sensitivity test was performed with Kirby-Bauer method. ESBLs were detected with phenotype confirmatory test (double-disk synergy test), and highly producing AmpC enzymes were measured with phenotype screening method. Results 93 strains of Acinetobacter baumannii were mainly obtained from respiratory department and neurosurgery, and isolated from sputum/pharyngeal stab, raw surface/wound secretion and urine samples. 15 strains (16.1%) of highly producing AmpCenzyme-producing Acinetobacter baumannii were detected, so were 10 strains (10. 8%) of ESBLs-pro-ducing isolates. All enzymes-producing strains displayed multi-resistant, and their resistant rates to the third cephalosporin, penicillins and aztreonam were much higher than enzymes non-producing ones. None was detected resistant to imipenem. Conclusion Occurrence of highly producing AmpC en-zymes and extended-spectrum β-lactamases (ESBLs) is one of causes for Acinetobacter baumannii multi-resistance. It suggests that detection of ESBLs-producing isolates should be strengthened so as to prevent their outbreak and spread.

Objective To explore a novel operative management for irreducible atlantoaxial dislocation. Methods Fifty-four patients, which as 32 males and 22 females aged from 7 to 63 years old with a mean of 32 years, were diagnosed with irreducible atlantoaxial dislocation, including 18 patients with os odontoideum, 22 occipitalization, 5 malunion of odontoid fracture and 9 relaxation of transverse ligament of atlas. Forty patients presented signs and symptoms of myelopathy or spinal cord injury. All of the patients underwent the operation of open reduction and release by transoral approach. The longus collies muscles, longus capitis muscles, anterior longitudinal ligament, atlantoaxial articular capsules, the apical odontoid ligament and alar odontoid ligaments may be included, were transected, followed by arthrodesis via posterior approach in one stage. Different methods of posterior arthrodesis were conducted as followed: C1,2 transarticular screw fixation in 5 cases, occipitocervical fixation using pedicle screws of axis and occipitocervical plate in 37 cases, and C1,2 joint fixation with plates and screws in the lateral masses of the atlas and axis in 12 cases. Results A complete reduction was achieved in 41 cases, and the other 13 patients obtained partial reduction. Forty-eight patients were followed up from 4 to 40 months, 15.7 months at the average. All of them achieved solid arthrodesis. According to Odom's scoring system, among the 38 patients with preoperative upper cervical myelopathy, 15 patients were assessed as excellent, 14 good, 8 fair and 1 poor. During the operation, cerebral spinal fluid leakage occurred in 1 case, and pedicle screwing failed in 1 case. After the operation, respiratory failure was found in 1 case, nasal sound in 3 cases, dysphagia in 1 case. One patient became quadriplegia due to myelitis caused by septicemia at two weeks after the operation. The internal fixation loosened in 1 case at 2 months postoperatively. Conclusion Transorally surgical release for reduction and posterior arthrodeses could achieve satisfactory outcomes in patients with irreducible atlantoaxial dislocation.

Objective To investigate the usefulness of percentage of free prostate specific antigen(FPSA/TPSA)/PSA density[(F/T)/PSAD]in the diagnosis of prostate cancer of PSA level in 4~10ng/ml. Methods 88 patients of PSA level in 4~10ng/ml were carried out transrectal ultrasound guided prostate biopsy. Among them,21 patients were proved to be suffering from prostate cancer,and other 67 patients were identified as benign prostate hypertrophy. The effect of F/T ratio,PSAD and(F/T)/PSAD in the diagnosis of prostate cancer were investigated. Results The mean value of(F/T)/PSAD of prostate cancer were significantly lower than benign prostate hypertrophy for patients with PSA levels in 4.0-10ng/ml, This difference has arrived statistical significance(P

Objective Comprehensive geriatric assessment is the core technology,this paper describes the concept of comprehensive geriatric assessment,objects,content,assessment methods,interventions and research pro-gress,provide experience to carry out comprehensive geriatric assessment in Tibet,the Tibet region to explore for com-prehensive geriatric assessment mode.

Objective To analyze the effect of cigarette smoking on replantation of amputed digit, investigate the pathologic mechanism of vascular crisis(VC) caused by smoking. Methods 1)The replantation risk factor such as smoking to VC and blood insufficiency of replanted digit was reviewed in 1 685 cases of digit replantation. 2)The complications after digit replantation in short and long terms among patients smoking were compared with those not smoking after operation. The results of management and time of appearance VC was assayed. 3)The possible pathologic mechanism of VC caused by smoking was analyzed. Results 1)A significant correlation between the ratio of VC, blood insufficiency of replanted digit and smoking index(SI, the number of cigarette in a day multiplies the years of smoking) was found. 2)The rate of VC, wound infection and unhealing in short term and the feeling of pain, numbness and cool in the long term in patients smoking after operation (92.6%,55.6%,48.1% and 71.6%) was obviously more than that in non smoking patients(17.8%,9.3%,2.0% and 3.0%,P

Objective To evaluate the relationship between hypertriglyceridemia and acute pancreatitis.Methods Data was analyzed from 41 patients with acute pancreatits from Apr.1998 to Oct.2000 in our hospital.Of the 13 patients(GroupⅠ) with plasma TG level being higher than 11.3 mmol/L, 8 accompanied with gallstone(61.5%)and 5 without gallstone(38.5%)of the 28 patients (GroupⅡ) with plasma TG level being lower than 11.3 mmol/L,19 accompanied with gallstone(47.3%)and 9 without gallstone(52.7%)RANSON score,morbidity of complications and the level of ALT and AST were compared between two groaps.The correlation between TG and RANSON score was analysed.Results There were significant difference between the two groups on RANSON score,morbidity of complications and level of ALT and AST(P0.05).Conclusion There is an close relationship between hypertriglyceridemia and acute pancreatitis,the high level of plasma TG plags a key a role in acute pancreatitis,patients with acute pancreatitis with hypertriglyceridemia are more likely to have higher morbidity of complications and liver function aggravating.

OBJECTIVE To investigate the effect of NF-κB on cardiomyopathy induced by doxorubicin(Dox) in rats and the effect of melatonin(MT). METHODS Thirty male Sprague-Dawley rats were randomly divided into 3 groups: normal control group; Dox model group; Dox+MT group. The content of nitric oxide (NO) and the activity of inducible nitric oxide synthase (iNOS) in cardiac tissues were examined by spectrophotography method; the activity of NF-κB in myocardial cell was observed by immunohistochemistry method; the apoptosis information of myocardial cell was detected by TUNEL method. RESULTS There was significant difference in activity of NF-κB between normal control and the Dox model group. MT could inhibit the activation of NF-κB(P＜0.05). There was significant difference in the content of NO and the activity of iNOS between normal control and Dox model group, MT could decrease content of NO and the activity of iNOS(P＜0.05); apoptotic rate in Dox model group was significantly increased compared with that in normal control group, MT could significantly decrease myocardial cell apoptosis (P＜0.05). CONCLUSION The activation of NF-κB plays an important role in cardiomyopathy induced by Dox, NF-κB seems to increase the activity of iNOS, and then significantly increase the content of NO in cardiac muscle; NF-κB possibly enhances myocardial cell apoptosis in cardiomyopathy induced by Dox. MT may inhibit the activation of NF-κB, and prevent excessive oxidative stress and suppress myocardial cell apoptosis, MT has protective effect against cardiomyopathy induced by Dox.

Objective To analyze the multi-slices spiral CT (MSCT) findings of hepatic alveolar echinococcosis(HAE), and to evaluate the value of MSCT for diagnosis of HAE. Methods Twenty-six cases with HAE were scanning by MSCT. The raw data were transmitted to advanced workstation for reconstruction imaging. Correlated studies were made between the CT features and pathology or other imaging results. Results Altogether 28 lesions were detected. They all revealed as heterogeneous hypodense mass with ill-defined boundary in plain CT but were easily being distinguished from surrounding parenchyma after contrast medium injection.Characteristics of the lesions include different amount of calcification (26/26), liquefied necrosis in center area (20/26), peripheral lacunae or alveolar signs (15/26), compensatory hypertrophy of healthy hepatic part (18/26) and the retraction in the involved hepatic lobe or segment (12/26). The lesions that located at or extended to hepatic hilum caused dilatation of intra-hepatic biliary ducts(9/26), splenomegaly (12/26), and ascites (1/26). MSCT angiography (CTA) depicted signs of abnormalities of hepatic vessels such as compression, displacement, encasement and occlusion. Compared with findings of operation, the sensitivity, specificity and positive prediction value of CTA for evaluating the hepatic artery system disorders were 88%, 96% and 93%, respectively; and for portal venous system were 95%, 100% and 95%, respectively; while for hepatic venous system were 96%, 86% and 96%, respectively. Conclusion MSCT is able to comprehensive display the CT features and vessels complication of HAE. It provides reliable imaging for both accuracy diagnosis and proper treatment of the disease.

Objective To investigate the role of glutaredoxin1(Grx1)on high glucose-induced apoptosis in cultured umbilical vein endothelial cells.Methods Human umbilical vein endothelial cells was cultured and induced with different dose of glucose and Grx1.We divided the cells into three groups:cell control group,damage group(high glucose group),pretreatment with Grx1 group(Grx1+ high glucose group).The morphological changes of the cells were observed by light microscope.The proliferation of cell was measured by MTT assay.The morphon of cell nucleolus of endothelial cell was observed in a fluorescence microscope by Hoechst 33258 stain and the influences of Grx1 on the apoptosis were determined by the immunofluorescent of Annexin V-FITC/PI with flow cytometer.Results Under the light microscope Grx1 ameliorated cells condition and restore the structure of organelle compared with damage group.Grx1 prevented the inhibitory effect on cell viability induced by high glucose;Hoechst33258 stains suggested Grx1 protect the cells nucleolus against high glucose-induced apoptosis.The analysis of Grx1 can restrain apoptosis rate of endothelial cell significantly.Conclusion Grx1 can obviously protect human umbilicus vein endothelial cells from apoptosis damages induced by high glucose.

Objective To investigate the clinical value of the combined detection of Golgi protein 73 (GP73),alpha-fetoprotein variant-L3 (AFP-L3)and transforming growth factorβ1(TGFβ1)in the early diagnosis of hepatocellular carcinoma (HCC).Meth-ods 48 cases of healthy control,42 cases of hepatitis B,50 cases of posthepatitic cirrhosis and 58 cases of HCC were selected and detected GP73,AFP-L3 and TGFβ1.The detection results were compared among 4 groups.Results (1)The levels of GP73,AFP-L3 and TGFβ1 had statistical differences among 4 groups(P <0.05 );(2 )The positive rate of the 3-marker combined detection reached 96.55%,which was higher than that of the 2-marker combined detection and the single marker detection.Conclusion (1) GP73,AFP-L3 and TGFβ1 may be used as the serum indicators for the early diagnosis of HCC;(2)Compared with the traditional HCC marker AFP,AFP-L3 has relatively high sensitivity and specificity and has the important role in the differential diagnosis of benign and malignant diseases of the liver,which is considered as a better serum marker in the HCC diagnosis;(3)The 3-indicator combined detection can significantly improve the positive detection rate of HCC and has better application value.