Objective To investigate the infection situation of Pseudomonas aeruginosa (PA) in patients with the lower respira‐tory tract infection in the department of respiratory intensive care units (RICU ) in recent five years ,and to analyze the changing trend of antibacterial resistence ,in order to guide rational selection of antimicrobial agents .Methods Strains of bacteria were isola‐ted and identified from sputum specimen of patients in the department of RICU and common ward from Jul .2008 to Jul .2013 .The situations of PA infection and antibacterial resistence were analyzed ,and differences of infection rates of PA and antibacterial resis‐tence were compared between RICU and common ward .Results 517 strains of bacteria were detected from sputum specimens of patients in the department of RICU from 2008 to 2013 ,including 141 strains of PA (accounted for 27 .3% ) ,and ticarcilli/clavulanic acid(61 .0% ) was with the highest rate of resistance among 14 drugs and colistin B(9 .2% ) was with the lowest rate of resistance . 378 strains of bacterias were detected from sputum specimens of patients in common wards ,including 125 strians of PA(accounted for 33 .1% ) ,and ticarcilli/clavulanic acid(28 .0% ) was with the highest rates of resistance and colistin B (4 .0% ) was with the low‐est rate of resistance .Conclusion In recent 5 years ,PA might be one of the main pathogenic bacterias of respiratory tract infections in the depatment of RICU in this hospital ,and antibiotic resistance may increse gradually .The antibiotic resistance in the depatment of RICU may be higher than that in cionmon wards .Clinical effective measures should be taken to prevent nosocomial infection ,and rational use of antibiotics should be taken to reduce the emergence of resistant strains .

AIM:To assess changes of tear film function in patients after pterygium excision combined with amniotic membrane transplantation.
METHODS:Totally 126 patients with pterygium excision with amniotic membrane transplantation from January 2011 to November 2013 were entered in the study. The tear breakup time ( BUT) , the Schirmer I test ( SⅠt) and tear ferning test ( TFT ) were elevated in the patients before and after pterygium excision combined with amniotic membrane transplantation. The examnation times were 1d before surgey, 1wk, 1, 2mo after surgery. Operation eyes were studied group, while opposite healthy eyes as control group.
RESULTS: Compared with the control group, BUT and TFT were significantly different in the eyes with pterygium (P<0. 05); However, no obvious difference was detected in the results of SⅠt (P>0. 05). The results of BUT and TFT at 1mo after surgery in study group were significantly better than 1wk (P<0. 05), while no significant difference compared with 2mo (P>0. 05); The tear film stability in the study group at 1wk after surgery was still inferior to the control group (P<0. 05) and there was no significant difference at 1, 2mo after surgery (P all>0. 05). SⅠt results did not differ between the different examination times(P>0. 05).
CONCLUSION:Tear film stability was broken in the eyes with pterygium. Pterygium excision combined with amniotic membrane transplantation can obviously restore the tear film function into normal state, and the tear film function could reach steady-state 1mo after surgery.

AIM: To determine the association between subfoveal choroidal thickness before therapy and therapeutic activity in diabetic macular edema.
METHODS: The current study was a retrospective study, which included 32 patients ( 32 eyes ) diagnosed with diabetic retinopathy and macular edema. All the patients were firstly treated with intravitreal injections of ranibizumab. Main outcome measures were included the subfoveal choroidal thickness, central macular thickness and best-corrected visual acuity ( BCVA) at preoperation and postoperative visit at 3mo.
RESULTS: After 3 monthly intravitreal injections of ranibizumab, the BCVA was significantly higher than that before therapy and accompanied with significantly reduced thickness of subfoveal choroid and central fovea of macula. Spearman analysis was revealed that a greater baseline subfoveal choroidal thickness was associated with a better BCVA (rs=0. 544, P=0. 036).
CONCLUSION:In the therapy of intravitreal injections of ranibizumab on diabetic macular edema, there seems to be a better BCVA in the patients with a greater baseline subfoveal choroidal thickness. Therefore, baseline subfoveal choroidal thickness may be a useful predictor for the therapy of diabetic macular edema.

Objective To analyze the clinical value of ultrasound and ultrasound-guided core needle biopsy ( UNB) in the evaluation of axillary lymph node metastasis for breast cancer.Methods A total of 454 cases of breast cancer treated between June 2008 and August 2014 at our hospital were retrospectively analyzed.UNB was performed on patients with abnormal ultrasonic diagnosis of axillary lymph nodes.Among them, 354 cases underwent neoadjuvant chemotherapy or endocrine therapy while 100 cases underwent surgery after UNB.The sensitivity, specificity, accuracy, positive predictive value, negative predictive value and false negative rate of ultrasound and UNB were evaluated.Results Among the 454 patients with abnormal axillary lymph nodes of ultrasound imaging, the metastasis rate with UNB was 70.9%,while the negative rate was 29.1%.Among the 100 cases who underwent surgery after UNB, the metastasis rate was 25% while the ultrasound imaging lymph node longitudinal and transversal ( L/T)≤1.5,the lymph node size>1 cm,and the metastasis rate was 92.3%(12/13).UNB showed that sensitivity was 64.1%, specificity 100%, accuracy 86%, positive predictive value 100%, negative predictive value 81.3%,and false negative rate was 18.7%.The results of UNB seemed consistent with those of postoperative pathological diagnosis, the Kappa value being 0.685.Based on 2 and 3 needles, the above mentioned 6 indices were 50% and 77.8%, 100% and 100%, 77.8% and 92.5%, 100% and 100%, 71.4% and 89.7%,and 28.6%and 10.3%, respectively.The Kappa value of UNB based on 3 needles was higher than on 2 needles (0.822 vs 0.526 ) .Conclusion Ultrasound is a valuable tool for detecting axillary lymph node metastasis in breast cancer.UNB can accurately determine the axillary lymph node metastasis status.UNB based on 3 needles shows a higher accuracy than on 2 needles.

Objective To explore the prenatal genetic diagnosis for classic phenylketonuria (PKU) families.Methods Probands and their family members from three classic PKU families were analyzed by combining linkage analysis through short tandem repeats (STR) polymorphism and PCR-sequencing for the exons within mutation hot spot of phenylalanine hydroxylase gene.Results Linkage analysis found uninformative for Family 1,while 100 % confirmative information was obtained from Family 2 and 3.Sequencing showed compound heterozygous mutations of phenylalanine hydroxylase gene for all of the three probands.Five mutations were detected,namely Y166X,R243Q,R413P,EX6-96A ＞ G and IVS11-1G＞ C,and IVS11-1G ＞ C was a novel identified muntation.Information from linkage analysis and mutation screening showed clearly that the fetus of Family 1 and 2 were affected,while normal for Family 3.Conclusions For those PKU families,reliable service of prenatal genetic diagnosis could be provided by combining linkage analysis with mutation screening of phenylalanine hydroxylase gene.

In recent years (2007 to 2011),although the overall number of rabies cases in China has decreased,there is evidence of emerging or re-emerging cases in regions without previous rabies cases or with low incidence of rabies.To investigate the origin and the factors affecting the spread of rabies in China,specimens were collected from 2007 to 2011 from provinces with emerging and re-emerging cases and tested for the presence of the rabies virus.Positive specimens were combined with sequences from GenBank to perform comparisons of homology and functional sites,and to carry out phylogenetic analyses.Out of these regions,five provinces had 9positive specimens from canine and cattle,and 34 canine or human specimens were obtained from previously high-incidence provinces.Complete sequences of G gene were obtained for these samples.Homology of the sequences of these 43 specimens was 87％-100％ at the nucleotide level and 93.7％ -100％ at the amino acid level.These G gene sequences were combined with reference sequence from GenBank and used to construct a phylogenetic tree.The results showed that 43 specimens were all assigned to China clade I and clade Ⅱ,with all specimens from emerging and re-emerging areas placed within clade I.Specimens isolated from Shanxi and Inner Mongolia in 2011 were distinct from previously-isolated local strains and had closer homology to strains from Hebei,Beijing and Tianjin whereas new isolates from Shanghai were tightly clustered with strains isolated in the 1990s.Finally,Shaanxi isolates were clustered with strains from adjacent Sichuan.Our results suggest that the rabies cases in emerging and re-emerging areas in China in the last 5 years are a consequence of the epidemic spreading from of neighboring provinces and regions experiencing a serious epidemic of rabies.

Objective To detect the expression and function of cysteinyl leukotriene receptors (CysLTRs)in keratinocytes.Methods Human keratinocytes were isolated from the tissue of foreskin by digestion with dispase Ⅱ and trypsin,and subjected to primary culture.By using confocal laser scanning microscopy and reverse transcriptase PCR,the localization and expression of CysLTRs were studied in kemtinocytes.respectively.Some primarily cultured keratinocytes were pretreated with leukotriene D4 (30 nmoi/L),MK571(300 nmol/L),and BAYu9773 for 5 minutes followed by the detection of intmcellular calcium level using the Ca2+ indicator dye Fura-2/AM as well as cell proliferation bv MTT assay.Results The expressions of CysLTR1 and CysLTR2 were observed in cultured keratinocytes,and they were mainly located on cell membrane,partly in cytoplasm and nuclei.Compared with non.stimulated cells,a significant increase Was noted in the expression of CysLTRs,especially in the nuclei of keratinocytes stimulated by LTD4(P＜0.05),together with an elevation in intracellular calcium level(42.27±3.00 mmol/L,P＜0.01)and acceleration in cell proliferation (P＜0.01).However,both MK571 and BAYu9773 could completely block the effect of LTD4 on intmcellular calcium level and cell proliferation.and there was no significant difference in the blocking effect between MK571 and BAYu9773.Conclusions Functional CysLTRs are expressed in human keratinocytes.and they carl increase the intracellular calcium level in,and cell proliferation of,keratinocytes.

? AlM: To evaluate the clinical application of simply performing phacoemulsification or combining intravitreal Ranibizumab injection in the treatment of cataract combined with diabetic retinopathy.
?METHODS:Forty-six patients (46 eyes) were recruited in this study. All of the patients were non-proliferative diabetic retinopathy without significant macular edema. They were randomly divided into two groups, the control group simply performed phacoemulsification, while the study group performed intravitreal Ranibizumab injection and phacoemulsification. Observation of indicators included the condition of best corrected visual acuity (BCVA), intraocular pressure, macular retinal thickness and complication at preoperative and postoperative 1, 6mo.
? RESULTS: BCVA and macular retinal thickness of patients in two groups had no differences in the preoperative and postoperative 1mo. At postoperative 6mo, the BCVA of the study group was better than that in the control group, while its macular retinal thickness was thinner than that in the control group (P<0. 05). The ratio of macular edema ( central macular thickness was >60μm than that in control group) was 13. 0% eyes in the study group which was significantly lower than the control group (47. 8%;P = 0. 033). The complications was no significant differences in two groups and neither occurred severe complications.
?CONCLUSlON: lntravitreal Ranibizumab injection can reduce the development of macular edema and improve the BCVA after phacoemulsification.

Objective To determine the changes of interleukin-12(IL-12) and IL-12 mRNA in gastric mucosa of children with helicobacer pylori (Hp) infection,and to study the effects of Hp infection on the expression levels of IL-12 and IL-12 mRNA,and to evaluate its possible roles in the pathogenesis of gastric mucosal inflammation in Hp related gastroduodenal diseases.Methods Biopsy specimens were taken from the antral mucosa on endoscopy in patients with or without Hp infection, which were diagnosed by urease test and Giemsa staining. The expression levels of IL-12 and IL-12 mRNA in gastric mucosa were determined by ELISA and RT-PCR.Results Inflammation of gastric antral mucosa was more severe in Hp-positive mucosa .The expression levels of IL-12 and IL-12 mRNA in Hp-positive mucosa were (66.42?15.15) ng/g and (59.21?15.03)%,which were more than those in (Hp-negative )(22.22?8.79) ng/g and (17.94?7.39)%(P

Objective To investigate the clinical value of axillary ultrasound (AUS)in the identification of axillary nodal metastasis (ALNM).Methods Two hundred and eighty-two consecutive patients with stage Tis-T2 breast cancer were prospectively enrolled between December 2013 and September 2015.All the patients underwent AUS performed by two specified senior ultrasound doctors.Sonographic features of their axillary lymph nodes (longitudinal and transverse diameters,cortical and hilar thickness,blood flow form)were collected.These patients were divided into metastatic, suspicious and non-metastatic groups based on the ultrasound features by ultrasound doctors.The diagnostic accuracy of AUS was compared with results of pathology.Univariate and multivariate Logistic regression analyses were used to evaluate the relationship between sonographic features and ALNM.The area under the ROC curve was used to assess the accuracy of the multivariate Logistic regression model.Results The sensitivity,specificity,positive and negative predictive value and accuracy of AUS were respectively 85.6%,87.1%,86.4%,86.3%,and 86.3% in the metastatic and non-metastatic groups.The Kappa value was 0.727(P <0.001).The ALNM burden in the non-metastatic group was significantly lower than in the metastatic group (1.2 vs 6.9,P <0.001).The false-negative results were found only in 16 cases,fourteen of whom had only 1,and two had 2 and 3 ALNM,respectively.Univariate Logistic regression analysis showed that maximum cortical thickness was the most significant predictive factor of ALNM(the area under the ROC curve was 0.872).Multivariate Logistic regression analysis suggested that cortical thickness and the ratio of hilar thickness to cortical thickness were predictive factors of ALNM(P <0.05).The area under the ROC curve of the multivariate Logistic regression model was 0.879 and its sensitivity and specificity were 77.0% and 85.1%,respectively.Conclusion AUS is a valuable tool for detecting ALNM.Patients with false-negative results of AUS have a lower axillary metastatic burden.Maximum cortical thickness is the most significant predictive factor of ALNM.AUS may be a potential alternative method for sentinel lymph node biopsy as axillary lymph node staging in early-stage breast cancer patients.