OBJECTIVE To evaluate distribution and resistance of pathogens in patients with pulmonary infection after abdominal operation by stages,and provide reference to select antibiotics in clinics.METHODS Forty five patients with pulmonary infection after abdominal operation were included from Jan 2004 to Sep 2007.Their course was divided into 3 stages: onset stage,middle stage and last stage,at every stage to identify pathogens and to test drug sensitivity and the sputa and broncho-alveolar lavage fluid(BALF) were sampled.RESULTS A total of 189 strains of pathogens were isolated,from them 110(58.2%)were Gram-negative bacilli including Pseudomonas aeruginosa,Escherichia coli and Klebsiella pneumoniae;and 59(31.2%)were Gram-positive cocci including Staphylococcus aureus and Enterococcus;and 20(10.6%)were fungi,Candida albicans was the main fungus.At onset stage the most pathogens were Gram-negative bacilli;at middle stage the Gram-positive cocci increased distinctly;and the fungi were detected at middle and last stages.The mixed infection rate was high.The result of drug sensitive test showed that there were high rates of multidrug resistance in P.aeruginosa.The resistance rates of all isolates of Enterobacteriaceae to imipenem or meropenem were 0.The resistance rates of all Gram-positive cocci to linezolid or vancomycin were 0.CONCLUSIONS Distribution of pathogens in patients with pulmonary infection after abdominal operation is different at each stage.The most are multidrug resistant,and rationl use of antibacterial drug in clinics must be based on the distribution and drug-resistance of pathogens.

Objective To evaluate whether therapeutic ultrasound, applied alone or with urokinase, may have a thrombolytic effect on blood clots in vitro, and the other factors influencing the urokinase-mediated thrombolysis. Methods Experiments were carried out in an in vitro blood clot model.The blood clots were divided into four groups as physiological solution group(NS), urokinase group(UK),physiological solution plus ultrasound group(NS + US), urokinase group plus ultrasound group(UK + US).After intervention of one hour in static 37 ℃ water bath, each group of blood clots was weighed. After that,the weight loss and thrombolysis rate of the blood clots in each group were calculated. To observe the impact of the age of the blood clots on urokinase-mediated thrombolysis rate, the thrombolysis rate of eight time points 3, 4, 5, 6, 7, 8, 9, 10 hours was tested. The time was determined from the blood drawn from the body to the initiation of thrombolysis test. Results In terms of thrombolysis rate, there was significant difference between UK group and UK + US group(LSD-t 12. 1, P ＜ 0.01), with a thrombolysis rate 29. 3% ±8. 2% and 37. 5% ±7. 9%, respectively. However, the difference of thrombolysis rate between NS group and NS + US group with a thrombolysis rate 13. 4% ±4. 4% and 14. 5% ± 5.4%, respectively,was not statistically significant with a P value of 0. 08(LSD-t 1.8). The age of the blood clots had a negative correlation to the thrombolysis rate to some extent. Conclusion Therapeutic ultrasound has a significant effect on thrombolysis in combination with urokinase rather than used alone. To a certain extent,the thrombolysis rate decreases with the age of blood clot.

Objective To analyze the stroke subtypes and influencing factors in four largest economic regions of China.Methods We analyzed the investigation data of QUEST(Quality Evaluation of Stroke Care and Treatment)study conducted in 2006 which included 62 hospitals in a national scale.According to the concept of four economic regions designed by the Development Research Center of the State Council,we performed the univariate and multivariate analysis for the stroke subtypes and its related risk factors in the different economic regions.Results There were 3362(73.5％)ischemic stroke patients and 1214(26.5％)hemorrhagic stroke patients among the total 4576 first-ever stroke patients.Comparison of stroke subtypes in the four different economic regions was statistically significant(P ＜ 0.001),with a percentage of 80.8％ ischemic stroke patients in the northeastern region,78.9％ in the eastern region,68.3％ in the central region and 67.0％ in the western region.The comparisons of risk factors such as history of hypertension,diabetes,hyperlipidaemia,coronary artery event,atrial fibrillation,and overweight in the four different economic regions were also statistically significant(P ＜0.05).Conclusions The subtypes of first-ever stroke vary in the four largest economic regions with a highest proportion of ischemic stroke in the northeastern region and relatively high proportion of hemorrhagic stroke in the central and western economic regions.There are also discrepancies of stroke risk factors in the different economic regions.

Objective Beta platelet-derived growth factor receptor ( PDGFR-β)-mediated signaling plays a key role in mor-phine tolerance , but its molecular mechanisms are not yet completely understood .The present study aims to investigate whether the ex-tracellular signal-regulated kinase ( ERK) and cyclic AMP response element binding protein ( REB) signaling pathways are involved in the development of PDGFR-βactivation-induced morphine tolerance in rats . Methods Thirty-six adult male SD rats were randomly divided into six groups of equal number:normal saline (20μL), morphine (15μg), morphine +imatinib (morphine 15μg +ima-tinib 10μg), morphine +PDGF-BB (morphine 15μg +PDGF-BB 10 ng), imatinib (10μg), and PDGF-BB (10 ng), all treated intrathecally at 20μL once daily for 7 consecutive days .Paw withdrawal latency ( PWL ) was measured 1 d before and 30 min after medication at 1, 3, 5, and 7 days, respectively, followed by calculation of the maximal possible effect of analgesia (MPE).On the 8th day, PWL was again obtained from all the rats at 30 min after intrathecal injection of morphine (15μg).Then, all the animals were sacrificed and the L4-5 segment of the spinal cord was isolated for determination of the expressions of ERK , phosphorylated ERK ( p-ERK) , CREB, and phosphorylated CREB ( p-CREB) by Western blot. Results At 5 and 7 days after medication, MPE was significant decreased in the morphine group ([52.90 ±8.20] and [15.12 ±3.80] %) and the morphine +PDGF-BB group ([43.51 ±5.42] and [14.81 ±3.60] %) as compared with (100.00 ± 0.00) %in both groups at 1 day (P<0.05), but had no significant changes in the morphine +imatinib group at 1, 3, 5, and 7 days.After intrathecal injection of morphine on the 8th day, MPE was (16.22 ±2.51) %in the morphine group, (15.22 ±3.50) %in the morphine +PDGF-BB group, and (35.21 ±4.51) %in the PDGF-BB group, all remarkably lower than (100.00 ±0.00) %in the control group (P<0.05).There were no significant differences in the expression levels of ERK and CREB among the six groups.The expressions of spinal p-ERK and p-CREB were markedly increased in the morphine , morphine +PDGF-BB, and PDGF-BB groups as compared with the control group (P<0.05), but significantly decreased in the morphine +imatinib group in compari-son with the morphine group, (P<0.05). Conclusion The PDGFR-βsignaling pathway plays an important role in the develop-ment of tolerance to morphine-induced analgesia and its underlying mechanisms may be associated with the activation of the ERK and CREB pathways .

Underwater treadmill training (UWTT) is a new hydrotherapy technique, with features of immersion bath, under water walking and body-weight support treadmill training. UWTT can reduce the load on legs, release spasm, improve gait, muscle atrophy and remain muscle strengthen for SCI patients. It also reduces the risk for cardiovascular disease, and incidence of postural hypotension. The present studies on UWTT are insufficient. More researches should further explore the therapeutic effects on SCI.

Objective To estimate the prevalence and related risk factors of post-stroke depression (PSD) in ischemic stroke survivors from community-based medical centers in urban areas of Beijing.Methods Five community-based medical centers in urban areas of Beijing were selected.Patients with first-ever or recurrent ischemic stroke were evaluated from January 2003 to December 2006. The prevalence of PSD was evaluated by Self-Rating Depression Scale (SDS), and the information on the onset of stroke, vascular risk factors and living style was also collected.Results Totally 1089 stroke patients were registered, 1074 cases among which had complete information and met inclusion criteria. The mean age of the patients was (65.0 ± 8.9) years with a median stroke course of 13.0 months. The overall prevalence of PSD was 49.9% (536/1074), and the proportions of mild, moderate and major PSD were 52.2%, 36.0% and 11.8%, respectively. There were no significant differences in prevalence of PSD among different stages of stroke and the prevalence of PSD was 51.3% within 6 months after stroke onset, 47. 1% during 6-18 months and 53.2% after 18months. Low education, activities of Daily Living (ADL) dependence, cognition impairment and recurrence of stroke were independent risk factors for PSD.Conclusions The prevalence of PSD among ischemic stroke patients is higher in community-based medical centers, but most of PSD patients are mild or moderate. More effective early intervention should be adopted to decrease PSD,promote the recovery of neural function and improve their quality of life.

Objective To observe the effects of nAChR antagonistα-conotoxin Eb1.6 on ther-mal pain threshold and spinal IL-1βexpression levels and astrocytes activation in rats using L5 spinal nerve transaction (SNT)model.Methods Fifty male Sprague-Dawley rats were randomly assigned into 5 groups with each group 10 rats:sham group,different doses of α-CTX Eb1.6 (0.1 5,1.5 and 1 5 nmol/kg)groups and the saline group after SNT.Saline solution or different doses of Eb1.6 were intraperitoneally injected seven days after the surgery when the model was stable and the treatment continued for seven days.Measured the TWLs of all groups of the rats 1,2,4,7,12 hours after the in-jection on 7 d and 13 d.The rats were sacrificed and L5 spinal cord tissues were collected immediately after the behavioral tests on 13 d.The expression of GFAP and IL-1βwere assessed by Western blot assay and enzyme linked immunosorbent assay (ELISA)separately.Results Groups E1,E2,E3 and C had shorter TWL before the injection on 7 d and 13 d than group N(P <0.05).The TWLs of the rats in groups E1,E2 and E3 of 1 h,2 h and 4 h after the injection on 7 d were significantly higher than that before the injection(P <0.05)with 2 h after the injection showed the most obvious change.The TWL of 1 h,2 h,4 h and 7 h after the injection of the rats in group E1,E2 and E3 and those of 12 h after the injection of the rats in group E2 and E3 on 13 d were significantly higher than that before the injection(P <0.05 )and also higher than TWL of the respective time points on 7 d(P < 0.05 ),also with 2 h after the injection showed the most obvious change.The TWLs of 2 h after the injection a-mong group E1,E2 and E3 showed significant differences both on 7 d and 13 d (P <0.05).Rats spi-nal IL-1βand GFAP expression levels of group E1,E2,E3 and C were significantly higher than those of group N(P <0.05).Rats spinal IL-1β and GFAP expression levels of groups E1,E2,E3 signifi-cantly decreased compared with group C(P <0.05).There were significant differences among the spi-nal IL-1βand GFAP expression levels of group E1,E2 and E3(P <0.05).Conclusion Eb1.6 dose-de-pendently reduced the thermal hyperalgesia induced by L5 spinal nerve transection.Repeated treat-ment of Eb1.6 could produce better analgesic effect,which might be partly attribute to the inhibition of spinal IL-βlevels and astrocytes activation.

Objective To observe the distribution and possible mechanism of P2X7R in periaq-ueductal gray matter (PAG)in a rat model with chronic neuropathic pain in vivo.Methods The in-trathecal catheterization and sciatic nerve injury (SNI)were performed.All animals were randomly assigned into 3 groups with 26 rats in each,which was group Sham,control group (group C)and brilliant blue G (BBG)group (group BBG),respectively.Normal saline or BBG 10 μl were intrathe-cally injected after SNI and repeated for seven days.Paw-withdrawal mechanical thresholds (PWT) were measured on day 0,day 7,day 14,and day 21 after SNI.The rats were sacrificed and PAG tis-sues were collected on day 14 and day 21,separately.The distributions of P2X7R were observed by immunofluorescence.The protein contents of P2X7R and GFAP were assessed by Western blot assays.Results The P2X7R was expressed in PAG in rats.The PWTs of the control group showed a significant decrease during the 21-day period compared with the sham group.The P2X7R signals were predominantly expressed in astrocytes in PAG after SNI.Both P2X7R and GFAP expression remark-ably increased.Administration of BBG increased the PWTs,and inhibited the P2X7R and GFAP ex-pressions compared with those atthe same point of time of the control group.Conclusion These results indicated that P2X7R in PAG might participate in nociception modulation in the midbrain in chronic neuropathic pain.

Objective To explore the diagnostic value of radial ultrasound (EBUS) combined with virtual navigation (VBN) in peripheral pulmonary nodules.Methods Two hundreds and forty cases of peripheral pulmonary nodules(0.8 cm≤diameter≤3 cm) in the respiratory department of our hospital from July 2014 to July 2015 were included and according to the different guide de vices,which were divided into the radial ultrasound combined with virtual navigation group (EBUS+ VBN group),radial ultrasound group (EBUS group),virtual navigation group (VBN group) and control group.The diagnostic rates were compared among the four groups and among different sizes of lesion.The time of lesion location and operating time were also compared between the EBUS+ VBN group and EBUS group.Results Among 240 cases,the diagnostic rate in the EBUS+VBN group was highest(81.67％),and the diagnostic rates had statistically significant difference among the four groups (x2=19.344,P=0.00);the diagnostic rates of lesions less than 2 cm in diameter were lower than that of lesions ＞2 cm in the EBUS+-VBN group and EBUS group,but without statistically significant difference (x2 =2.04,3.40,P =0.15,0.07);the locating lesions time and operating times in the EBUS+ VBN group were shorter than those in the EBUS group,but the difference between them was not statistically significant (P=0.03,0.04).Conclusion EBUS combined with VBN could improve the diagnostic rate of peripheral pulmonary nodules and shorten the time of lesion location and operating time.

Objective To identify differences in the anal sphincter surface electromyography (sEMG)variables in spinal cord injury (SCI) subjects with different severities. Methods One hundred and ten SCI patients' impairments were classified as ASIA A,B,C or D using the International Standards for the Neurological Classification of Spinal Cord Injury.The evaluation was pedormed using sEMG equipment with an inserted anal sensor electrode and the Glazer pelvic floor muscle sEMG protocol.The sEMG variables were recorded and compared. Results There was no significant difference in sEMG variables between groups A and B,but the mean and maximum sEMG values of groups C and D in flick contractions ( 1 s),tonic contractions ( 10 s),and endurance contractions (60 s) were significantly higher than those of group A.Compared with group C,the mean and maximum sEMG values of group D were all significantly higher. Conclusions The sEMG data from the anal sphincter during contractions decreases significantly after SCI.Glazer's pelvic floor muscle sEMG protocol is a noninvasive and convenient real-time assessment.It is a useful complementary tool for quantitative assessment of the pelvic floor muscles of SCI patients.