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 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 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 compare the effect of midazolam pretreatment on propofol sedation using closed-loop target-controlled infusion (TCI) between two age groups - the adult and the aged. Methods Forty-eight ASA Ⅰ-Ⅱ patients of both sexes weighing 45-81 kg undergoing elective lower abdominal or lower extremity operation under epidural anesthesia were divided into two age groups : (A) the adult group (18-39 yrs) and (B) the aged group (66-79 yrs). The two groups were further divided randomly into 2 subgroups : midazolam subgroup ( n=12) received midazolam 0.04 mg?kg-1 10 min before propofol TCI and placebo subgroup ( n = 12) received normal saline instead of midazolam 10 min before propofol TCI. The patients were unpremedicated. An intravenous line was established before operation, which was connected to a TCI system comprising a Graseby 3500 infusion pump and a closed-loop TCI automatic control system. BP, HR, SpO2 and BIS were continuously monitored during operation. During epidural anesthesia the patients were sedated with propofol administered by TCI. The initial target blood concentration of propofol was set at 1.5?g?ml-1 . The level of sedation was assessed by OAA/S scale (5 = alert,0 = no response to prodding). The target blood propofol concentration was then increased or decreased in 0.5?g?ml-1 increment to maintain OAA/S score at 3. The BIS value at this level of sedation (OAA/S=3) was used as feedback in controlling TCI of propofol. The induction dose and the total dose of propofol, induction time and emergence time (OAA/S=5) were recorded. Results Midazolam premeditation significantly reduced the induction dose and total dose of propofol, shorten the induction time and prolonged the emergence time compared with placebo in both groups, especially in the aged group (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

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 identify the miR-122 which regulateing GATA4 expression during the induction of rat bone marrow mesenchymal stem cells (bMSCs) differentiating into cardiomyocyte-like cells. Methods BMSCs were isolat-ed from bone marrow and induced to differentiate into cardiomyocyte-like cells using 5-azacytidine. The miR-122 which may regulate expression of GATA4 were predicted using miRanda and TargetScan softwares and identified by dual luciferase report system. The expressions of miR-122 and GATA4 were determined using q-PCR during the differentiation of bMSCs into cardiomyocyte-like cells. Results The induced cells were completely in contacted with adjoining cells and uniform in shape and aligned parallelly. Cardiac troponin I (cTnI) expression was detected by immunofluorescence cytochemistry. Using dual luciferase reporter system in vitro, miR-122 were proved to be able to effectively inhibit GATA4 expression by binding the 3′UTR of GATA4 mRNA. q-PCR results showed that the expression of miR-122 is negatively correlated with that of GATA4 mRNA transcription. Conclusion These results indicated that miR-122 regulate the expression of GATA4 during the induction of cardiomyocyte-like cells.

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.