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 .

Animals ; Ear, Inner ; growth & development ; Mice ; MicroRNAs

Objective To investigate the effect of terlipressin on hepatic and renal function in cirrhotic patients undergoing hepatectomy.Methods Aanlyze the clinical data of 57 patients following irregular hepatectomy for hepatocellular carcinoma with cirrhosis,according to whether use terlipressin or not after operation,which were divided into terlipressin group (A group,n =27) and control group (B group,n =30).Liver function parameters (ALT,AST,TB),ascites,urine volume and renal function parameters (Cr,BUN) preoperatively and on postoperative day(POD) 1,3,5 and 7 were compared between the two gruops.Results Compared with those of POD 1,the levels of ALT,AST and ascites on POD 3,5,7 were significantly lower in two groups (P ＜ 0.05),urine volume was significantly increased (P ＜ 0.05),Cr of POD 7 was significantly lower (P ＜0.05),but it is more remarkable in group A than group B.The levels of ALT in terlipressin group on POD 5,7 were (144.9 ±76.3) U/L,(100.5 ±61.5) U/L,which were lower than those of (267.2±91.2) U/L,(199.3 ±70.5) U/L in control group.On POD 3,5,7,the levels of AST,BUN,Cr and peritoneal fluid in terlipressin group,which were respectively(211.1 ±99.8) U/L,(80.4 ±54.6) U/L,(50.6 ±46.5) U/L,(6.6 ± 1.9) mmol/L,(6.5 ± 1.7) mmol/L,(6.3 ± 2.1) mmol/L,(74.3 ± 10.9) μmol/L,(71.5 ± 8.9) μmol/L,(58.7 ±4.1) μmol/L,(247.6±60.3) ml,(58.8±54.3) ml,(40.2±31.8) ml,were significantly lower than those in control group which were (298.7 ±131.2) U/L,(201.1 ±93.4) U/L,(114.7 ±70.3) U/L,(7.3 ± 1.9) mmol/L,(7.2±1.8) mmol/L,(7.1±1.7) mmol/L,(79.5±15.1) μmol/L,(76.9±16.2) μmol/L,(69.4±11.4) μmol/L,(275.2±88.1) ml,(191.7±71.6) ml,(93.2±50.2) ml.while urine volume of (2232.3±409.8) ml,(2270.5 ±395.8) ml,(2179.0±301.4) ml was much more than that of (1921 ± 510.4) ml,(2019.1 ±411.2) ml,(1978.7±323.7) ml in the control group,the differences in the two groups were statistically significant (P ＜ 0.05).There were 11 (36.7％) patients with hepatic and renal dysfunction and hepatorenal syndrome after operation in group B,while only 2 (7.4％) patients in group A.Conclusions The use of terlipressin after partial liver resection has a protective effect on hepatic and renal function in patients with cirrhosis,and can reduce postoperative ascites and prevent hepatorenal syndrome.

Objective To study the clinicopathological characteristics and the prognostic factors in metastatic pancreatic tumor.Methods The clinical data of 32 patients with metastatic pancreatic tumors were retrospectively analyzed.The survival of the patients were evaluated with the KaplanMeier method.Univariate analysis was done by log-rank test.Results The primary foei of these32 patients included:9 lung cancer,6 renal cell carcinoma,5 gastric cancer,12 others.The median survival was 15.5 months in the radical surgery group (n 8),18 months in the cryosurgery group(n=3),8 months in the group with palliative bypass operation (n=9),6 months in the group with local radiotherapy (n=3),and 5 months in the group without treatment (n=9).Univariable analysis revealed the type of primary tumor,treatment of the primary tumor,interval between diagnosis of primary tumor and pancreatic metastases,localized pancreatic metastasis,and treatment of the metastatic pancreatic tumor were associated with prognosis.Conclusions Metastatic pancreatic tumors are rare.Long term survival can be achieved with pancreatic resection in a highly selected subset of patients according to the type of primary tumor.Therapeutic cryosurgery as a new minimally invasive,targeted and immunologic method needs to be further evaluated.

Objective To study the clinicopathological characteristics,diagnosis and treatment of patients with mucinous cystic neoplasms (MCNs) of the pancreas.Methods The clinical data of 42 patients with mucinous cystic neoplasms of pancreas were retrospectively analyzed.Chi-square test and independent sample t-test were used for statistical analysis.Results The mean age of the patients was 53.1 yeas (ranged from 29 to 78 y).There were 32 female (76.2％).The patients were divided into two groups according to symptoms (the symptomatic group and the asymptomatic group).There were significant differences in tumor size,tumor location,operation type,operation time and adhesions with the surrounding tissues between the 2 groups of patients.The patients were then divided into three groups according to pathological type.There were significant differences in age,tumor marker,tumor location,operation type,operation time,adhesions with the surrounding tissues,operative blood loss,and postoperative hospital stay among the 3 groups of patients.There was no tumour recurrence in the patients with cystadenoma.Patients with cystadenocarcinoma developed tumor recurrence at a mean of 16.4 months (range,0-50) and died of tumor recurrence even after radical surgery at a mean of 22.9 months (range,3-58).Conclusion MCNs were seen most commonly in middleaged women.The presence of symptoms was a sign of malignancy.Resection of the tumor in the early stage is the key in dealing with MCNs.

Objective The aim of this study was to investigate the effect of ultrasonically activated hematoporphyrin on ultrastructure of ehrlich ascites tumor(EAT) cells and to evaluate the potential mechanism of action inducing this cytotoxicity. Methods EAT cells in vitro were exposed to ultrasound at 2^0?MHz and 1^5?W/cm+2 for 3?min in the presence or absence of hematoporphyrin.The changes of ultrastructure of sample preparation for different time were observed by transmission electron microscope. Results The degree of destruction of treated EAT cells was enhanced with the increasing of time for the sample preparation.The sites destroyed mainly involved cell membrane,mitochondrion,endoplasmic reticulum and cell nuclei.Furthermore,morphoiogical characters of ultrasound-activated hematoporphyrin induced apoptosis were observed on EAT cells.Conclusion The killing of tumor cells was ascribed mainly to the damage of ultrastructure induced by ultrasound in combined with hematoporphyrin,apoptosis was also induced during ultrasound and hematoporphyrin killing process.;

Objective To investigate the role and mechanism of SDF-1/CXCR4 in the development of chronic rejection (CR) in rat models.Methods CR rat models were established using Fisher 344 to Lewis rats.In the blank control group (n=10),Lewis rats getting isotransplantation were treated with Cyclosporine A.CR rat models were established in positive group (n=10) and the rats were treated with Cyclosporine A.CR rat models were also established in CXCR4 antagonism group (n=10) and the rats were treated with both Cyclosporine A and AMD3100 (1 mg/kg).The serum creatinine levels were monitored every week.Kidney grafts were harvested 12 weeks after transplantation for histological analysis.We evaluated graft injuries using chronic allograft damage index (CADI) scores.Q-PCR and Western blotting were used to measure CXCR4,TGF-β1/Smad3 signaling pathway and α-smooth muscle actin (α-SMA) expression in renal allograft tissues.Results The serum creatinine levels in blank control group and CXCR4 antagonism group were significantly lower than those in positive control group (P<0.05).The blank control group and CXCR4 antagonism group presented milder pathological manifestations of CR.The CADI score in CXCR4 antagonism group was 3.54,which was lower than that of positive control group (P<0.05).The expression of biological markers in TGF-β1/Smad3 signaling pathway and SDF-1/CXCR4 signaling pathway was significantly lower in blank control group and CXCR4 antagonism group than in positive control group (P<0.05).Conclusion SDF-1/CXCR4 signaling pathway may play a crucial role in the development of CR.The usage of SDF-1/CXCR4 antagonist can protect renal allograft by inhibiting the TGF-β1/Smad3 pathway.Therefore,antagonism of CXCR4 may provide a novel way to prevent the development of CR.

Adolescent ; Child ; Child, Preschool ; Combined Modality Therapy ; External Fixators ; Female ; Humans ; Male ; Manipulation, Orthopedic ; methods ; Radiography ; Radius Fractures ; diagnostic imaging ; therapy ; Splints ; Ulna Fractures ; diagnostic imaging ; therapy

Objective To investigate the reliability and practicality of Chinese version the hearing handicap in-ventory for the elderly -screening version(HHIE -S) scale for elderly hearing screening in China .Methods We compared the HHIE -S scores with results of pure -tone audiometry test .A total of 840 Chinese individuals older than 60 years filled in the scale all by themselves first ,then refilled it according to explanations of each question translated by researchers .All participants finished pure -tone audiometry test with frequencies of 0 .25 ,0 .5 ,1 .0 , 2 .0 ,and 4 .0 kHz .Sensitivity ,specificity ,positive predictive value (PPV ) ,false-negative rate and false -positive rate were compared with HHIE -S cut -off points of >8 or >10 and pure-tone averages (PTAs) greater than 25 ,40 and 60 dB HL .Analysis the area under the curve (AUC) values of receiver operating characteristic (ROC) curves for each three PTA levels .Results Cronbach's α of the scale was 0 .85 .HHIE -S scale pre -explanatory score was 7 .6 ± 10 .6 ,and post-explanatory score was 10 .8 ± 16 .7(P<0 .01) .HHIE -S> 8 points higher than H HIE-S> 10 points in the sensitivity ,positive predictive value increase ,specificity ,false-positive rate ,false negative rate decreased ,paired samples t - test sensitivity and false -negative rate (P< 0 .05) .After the guide meanwhile HHIE-S cut-off points of > 8 when grouping with PTA> 25 dB HL ,PTA> 40 dB HL and PTA>60 dB HL ,conducted ROC curve analysis ,the AUC value was 0 .70 ± 0 .03 ,0 .84 ± 0 .01 and 0 .88 ± 0 .02 .Conclusion The score of HHIE-S scale>8 points can be used when PTA> 40 dB HL as goal for hearing loss of old people , it can be more accurate after explanations ,so HHIE-S scale can be used as a preliminary hearing screening method for Chinese elderly people .

OBJECTIVE: To investigate the effect of mycophenolate mofetil(MMF) on early inflammatory reaction of renal lesion in streptozotocin(STZ)-induced diabetic rats. METHODS: Thirty-six male Sprague-Dawley rats were randomly divided into 3 groups after uninephrectomy: normal control group, diabetic model group, and MMF-treated group. Six rats in each group were sacrificed at the 4th week and 14th week after STZ injection. Twenty-four hour urinary protein (24 h Upro) count was measured before death. The expressions of regulated on activation of normal T expressed and secreted (RANTES),ectodermal dysplasia (ED-1)and Col-IV protein in the renal tissue were detected by immunohistochemistry. The expression of RANTES mRNA in the renal tissue was detected by RT-PCR. RESULTS: MMF prevented the increasing of 24h Upro in diabetic rats,and the expressions of RANTES,ED-1,Col-IV protein and RANTES mRNA in the kidney of MMF-treated rats were significantly decreased. CONCLUSION MMF plays an early renal protective role in diabetic nephropathy, possibly through inhibition of early inflammatory reaction.
Animals ; Chemokine CCL5 ; biosynthesis ; genetics ; Diabetes Mellitus, Experimental ; drug therapy ; metabolism ; Diabetic Nephropathies ; metabolism ; prevention & control ; Ectodysplasins ; biosynthesis ; genetics ; Inflammation ; metabolism ; Kidney ; metabolism ; Male ; Mycophenolic Acid ; analogs & derivatives ; therapeutic use ; RNA, Messenger ; biosynthesis ; genetics ; Random Allocation ; Rats ; Rats, Sprague-Dawley