OBJECTIVE To analyze pathogenic bacterium distribution and antibiotic resistance of our hospital,and provide scientific basis for clinical rational using of antibiotics.METHODS The patients′ clean catch(midstream)(urine) was collected from Jan 2004 to Dec 2005 and cultivated.Antibiotic sensitivity test and adopted by Kirby-Bauer method.RESULTS The pathogenic bacteria mainly consisted of Gram-negatives,among which Escherichia coli was the most frequent,the others in turn were Pseudomonas aeruginosa,Enterobacter cloacae and(Proteus) mirabilis;Enterococcus were the most common among Gram-positives;fungal infection obviously(increased).The bacteria showed different antibiotic resistance rate and multi-drug resistance.CONCLUSIONS It′s very important for making the clinical use of antibiotic more reasonable and controlling drug resistant strains(transmission).

Objective: To evaluate the pharmacodynamic of clematis. Methods: 1) The relaxation of isolated ileum muscle of guinea pig by clematic was tested. The antagonism of clematis on histamine or Ach induced ileum muscle contraction was tested also. 2) By using the model of turning of trunk, the pain releasing effect of clematis was evaluated. 3) The experiments about anti-inflammation action of clematis were carried out in two models. Results: Clematis relaxed the ileum muscle. It also antagonized the contraction of the muscle caused by histamine and Ach. A single intrapeditional administration of clematis to Kun-Ming mice significantly prolonged the latency and reduced the writhe number at the turning of trunk model; clematis dose-dependently inhibited the mouse ear swelling caused by xylol. It also had anti-inflammation effect at the other model. The results demonstrated that clematis could release the pain, suppress the inflammation and smooth muscle contraction.

OBJECTIVE To investigate the distribution and the drug resistance changes of the pathogenic bacteria isolated from the blood culture specimens collected during the period of 2006-2008.METHODS Blood culture of patients in our hospital was performed by BacT/Alert 240 and the isolated bacteria were identified by API and Microscan and tested for drug resistance against antimicrobial agent by K-B method.A retrospective analysis was made to the blood culture results during the period of 2006-2008 with WHONET 5.4 software.RESULTS Gram-negative rods were the predominant bacteria which caused sepsicemia.The isolated rates of Escherichia coli took the first place during the period of 2006-2008.Klebsiella pneumoniae,Pseudomonas aeruginosa and Staphylococcus aureus(SAU) were also the most important pathogens which caused blood infection.The infection rate of coagulase negative staphylococcus(CNS) and P.aeruginosa had increasing tendency.Imipenem and meropenem were the most effective antibiotics(100%) to E.coli and K.pneumoniae.Then amikacin and cefoxitin also had high susceptibility to E.coli and K.pneumoniae.Furthermore,drug susceptibility in 2008 was higher than that of two years before.All antibacterials had low drug susceptibility to P.aeruginosa,and its drug resistance rate rised obviously.The drug resistance situation of Acinetobacter baumannii was serious.Except imipenem and meropenem had relatively higher susceptibility(20-69.2%),the susceptibility to other antibacterials was lower than 41.7%.Vancomycin,teicoplanin and quinupristin/dalfopristin were the most effective antibiotics to(SAU).CONCLUSIONS The species and drug resistance of the bacteria isolated from blood specimens have changed.More attention should be paid to the detection and surveillance of bacterial resistance in blood culture to promote the rational use of antibiotics.

Objective To discuss the clinical application of individualized strategy of endoscopic retrograde cholangiopancreatography (ERCP) in the treatment of bile duct stenosis after liver transplantation (LT).Methods Fifty-two patients,including 40 men and 12 women,aged 54.3 ± 9.1 years old,who suffered from bile duct stenosis and accepted 88 times of ERCP from June 2014 to May 2016 in our department were investigated.The procedures,clinical features and biochemical criteria were analyzed retrospectively.Results According to the treating occasions and clinical symptoms,single plastic stent,dilatation combined with single plastic stent,and dilatation combined with multiple plastic stents were chosen to use.ERCP in 8 patients out of 52 patients failed technically,and the therapeutic efficacy was 82.7％.The treatment duration was 8.2 ± 2.9 months.The recurrence rate was 4.7％ (2 cases) during the follow-up period.The most common complications were postERCP pancreatitis (2.3％) and cholangitis (3.4％),which would be cured by conservative treatment in most cases.Conclusion ERCP,as an effective and safe method,could be used as the first choice or bridge treatment for bile duct stricture after LT.We recommend individualization strategy,including step by step mode and different combinations of PTC or endoscopic procedures,in order to improve clinical efficacy of all kinds of stricture.

Objective The aim of this study was to analyse characteristics of CRC in a cohort under the age of 40 .Methods Using single center retrospective cohort study ,we reviewed the prospectively collected database of 2 897 colorectal cancer patients who had undergone curative CRC resections in Chongqing Medical University between 2010 and 2014 .175 patients (5 .8% ) were under 40 ,in which six patients for various reasons (including recurrent colorectal cancer hospital ,incomplete information ,etc .) were excluded .A group of 180 consecutive patients over the age of 40 undergoing surgery for colorectal cancer in the same centre was used as control .Results There had no difference in tumor classification and tumor location between the younger group (<40) and the older group(>40) ,but the lymph node positive rate in younger group was higher ,unable to accurately grasp the preopera‐tive lymph node status ,lead to lack of preoperative staging ,and that made it difficult to preoperative treatment options .Conclusion Therefore ,to young people in colorectal preoperative neoadjuvant chemoradiation indications and the assurance of intraoperative re‐section range ,we need to do more consideration.

Objective To assess the safety and efficacy of the local nerve block anesthesia procedure in daysurgery inguinal herniorrhaphy practice.Methods Fifty-eight inguinal herniorrhaphy were performed under the local nerve block anesthesia in the form of day surgery between April 2014 and April 2015 other 58 inguinal hemiorrhaphy were performed under general anesthesia.Time of operation,hospitalization stay,complications and costs were evaluated.Results The average operating time of the day-surgery group was (47 ± 12) min.All operations were completed successfully.Fifty-six patients were discharged in 24 hours and 2 patients were discharged in 48 hours after the surgery.The average costs were 8437 yuan.The rate of postoperative complications was approximately 6.6％ (4/58),including hematoma(3 cases),urinary relention(1 case),and chronic pain (1 case).The VAS scores of 6 hours after the operation were (2.4 ± 0.8).Conclusions It suggests that preperitoneal hemiorrhaphy under the local nerve block anesthesia in the form of day-surgery was safe and effective.Also,it could significantly shorten the time of hospitalization and reduce medical costs.

Objective To investigate the correlation between helicobacter pylori infection and pathological characteristics of gastric mucosal in the elderly.Methods Retrospective analysis was conducted in 278 patients with benign upper gastrointestinal disease from January 2014 to June 2014.The patients were examined by endoscopy and 13C-UBT,and divided into elderly group (aged 60 years and over,n=111) and non-elderly group (aged＜60 years,n=167).The relationships between Hp infection and pathological changes in gastric mucosal tissue (severe chronic inflammation,neutrophil infiltration,lymph follicles,gastric gland atrophy,intestinal metaplasia) were analyzed.Results There was no significant difference in helicobacter pylori infection rate between the elderly group and non-elderly group [27.0％ (30/111) vs.36.5％ (61/167),P＞0.05].The rate of gastric gland atrophy was higher in elderly group than in non-elderly group [13.5％ (15/111) vs.6.0％ (10/167),P=0.028].The rates of severe chronic inflammation,neutrophil infiltration,lymph follicles,gland atrophy and intestinal metaplasia were 73.6％,70.3％,14.3％,18.7％,29.7％ in patients with helicobacter pylori infection,which were higher than those in patients without helicobacter pylori infection (19.8％,3.2％,0.5％,4.3％,8.6％,respectively,all P=0.000).Removing the factor of Hp infection,the rates of glands atrophy and intestinal metaplasia were higher in elderly group than in non-elderly group (8.6％ vs.0.9％,43.3％ vs.23.0％,P=0.013 and 0.045).Conclusions Helicobacter pylori infection correlates with severe chronic gastric mucosal inflammation,neutrophil infiltration,lymph follicles formation.Gland atrophy and intestinal metaplasia are related to the Hp infection,and age is also their influencing factor.

objective To discuss the possible reasons responsible for the symptomrecurrence after operation for choledochocele, prevention and treatment. Methods By analyzing the symptom recurrent cases among 76cases of choledochocele who were treated in our hospital during the period from March 1966 to September 1997, we discuss the possible reasons responsible for the symptom recurrence after operation for choledochocele and its prevention and treatment. Result The possibility of symptom recurrence has no relationship with the age, sex and the type of the cyst. But it is closely related to the opportunity and method of operation (p

Objective: To study the reasons and prevention of residual stones after choledo- choscopic treatment of cholelithiasis. Methods:The clinical data of 219 patients who had under- gone choledochoscopic treatment were analyzed retrospectively. Results: 21 cases were found with residual stones in the bile duct after the operations. Residual stone rate was to 9.58% . Bile duct stones of 8 patients could not be removed completely during operations. 13 patients were proved that stones still remain in their bile ducts by T-tube cholangiography and choledochoscope after opera- tions. There were 5 patients with acute obstructive suppurative cholangitis accompanying septic shock, 5 patients with stenosis in intrahepatic bile ducts, 4 patients with stones of in trahepatic bile duct and variation of bile duct, 2 patients with stones in sphincter of duodenal papilla,2 patients withstones and stenosis at the inferior segment of choledochus,3 patients were founded residual stones in bile duct obviously after the operations. Conclusions: B-type ultrasonic scanning and T-tube cholangiog- raphy are useful to reduce the rate of residual stones.

Objective:To observe the expression of chemokine receptor CCR7 and CXCR4 in human colorectal carcinoma and its significance,so as to assess their expression with the metastasis and prognosis of colorectal carcinoma. Methods:Immunohistochemistry was used to detect the expression of chemokine receptor CCR7 and CXCR4 in 110 patients with colon cancer.The relationship between the CCR7 and CXCR4 expression and the clinic pathological characters was statistically analyzed. Results:CCR7 and CXCR4 expression were positively expressed in 59.1% and 45.5%of the patients. The high expression rate of CCR7 and CXCR4 in lymph node metastasis positive cases was 81. 5% and 60.0% respectively,but the without lymph node metastasis positive cases were 26.7% and 24.4% respectively. The positive expression was significantely higher in the patients with lymph node metastasis than those non-lymph node metastasis(P