OBJECTIVE To study the 16 genotypes of ?-lactamase in multidrug-resistant Acinetobacter baumannii isolated from inpatients,to know the state of multidrug resistance of A.baumannii in Urumqi.METHODS Bacterial strains were identified by system of API,and antibiotic susceptibility test was detected by K-B and microdilution according CLSI.PCR was used to determine the genotypes of ?-lactamase and compare with that in GenBank.RESULTS The antibiotic resistance rates to cefataxime and tetracycline of the isolates were the highest,(100%).Resistance rate to cefoperazone/sulbactam was the lowest(5 TEM(25%)strains and 10 OXA-23 strains(50%)from 20 strains multidrug resistant A.baumannii).CONCLUSIONS There is a high percentage of multidrug resistance production of A.baumannii in Urumqi.The ?-lactamase is focused on TEM and OXA-23;it is deserved to make further augmentation of epidemiology surveillance on ?-lactamase.

Objective To evaluate effects of neoadjuvant chemotherapy on axillary lymph node status in patients with breast cancer.Methods A total of 45 patients with stage Ⅱ or Ⅲ breast cancer treated with neoadjuvant chemotherapy followed by surgery(Combination Group) were compared with 79 patients with breast cancer treated with initial surgery only(Surgery Group) in respect of axillary lymph node status,including the total number of the lymph nodes and the number of positive and negative lymph nodes,according to findings of physical examination,B-ultrasonography,and molybdenum target radiography.Results The total number of the lymph nodes and the number of positive lymph nodes were significantly less in the Combination Group(16.9?5.9 and 2.5?2.2) than in the Surgery Group(20.8?8.0 and 3.9?3.0)(t=-2.856,P=0.005;t=2.790,P=0.006),whereas the number of negative lymph nodes were 14.4?5.4 and 16.7?7.0 in the Combination Group and the Surgery Group,respectively,without statistical significance(t=-1.904,P=0.055).Four patients were found loco-regional relapse in each group during follow-up checkups for 6~19 months(mean,10 months) in 40 patients in the Combination Group and 7~21 months(mean,12 months) in 67 patients in the Surgery Group.Conclusions Total and positive axillary lymph nodes retrieved after axillary lymph node dissection decrease in number after neoadjuvant chemotherapy.

Objective To investigate the morphological features of choroidal neovascularization (CNV) in central exudative chorioretinopathy (CEC) using optical coherence tomography (OCT). Methods OCT and fundus fluorescein angiography (FFA) were performed in 41 cases (43 eyes) of CEC,and the course of CEC disease was from 1 week to 10 months. Twenty seven of 43 eyes were also examined by indocyanine green angiography (ICGA). Results OCT images revealed 5 kinds of morphological features of CEC: well defined CNV(41.86 %),poorly defined CNV(30.23 %),hemorrhagic pigment epithelium detachment (PED)(16.28 %), CNV companied with serous (6.98 %) or hemorrhagic neurosensory retina detachment (4.65 %). CNV mainly showed well defined and poorly defined CNV (72.09 %).In those eyes that could clear define the CNV boundary,there were 12 eyes on FFA examination and 20 eyes on ICGA examination which defined the boundary from retinal horizontal plane, while there were 23 eyes on OCT examination which defined the boundary from retinal vertical section. Classic CNV on FFA consistently presented with well defined boundaries on OCT ,whereas non classic CNV had a variable cross sectional appearance. Conclusions The OCT morphological features of CNV in CEC is mainly well defined CNV and poorly defined CNV; OCT examination can precisely observe the retinal and choriocapillaries pathological anatomy of CEC from retinal vertical section, in making the CEC diagnosis as an important complementary examination of FFA and ICGA which observe the focus from retinal horizontal plane.

OBJECTIVE To investigate the coding genes of ?-lactamases,aminoglycoside modifying enzymes and the drug-resistant to chlorhexidine-sulfanilamide genes on 20 Acinetobacter baumannii isolates in Xinjiang.METHODS Twenty strains of A.baumannii were isolated from hospitalized patients,and 9 kinds of ?-lactamases genes,3 kinds of aminoglycoside modifying enzymes genes and drug-resistant to chlorhexidine-sulfanilamide genes were detected.The drug-resistant to chlorhexidine-sulfanilamide genes were labeled and cluster analysis was performed to analyze the affinity of strain.RESULTS The detection rates of ?-lactamases coding genes of TEM,ADC and SHV groups were 65%,60% and 5%,respectively.The others were not found in all 20 isolates tested.The detection rates of aminoglycoside modifying enzymes coding genes of aac(3)-Ⅰ,aac(6′)-Ⅰ and aac(3″)-Ⅰwere 60%,65%and 70%,respectively.And the detection rates of qacE△1-stull genes were 70%.There were 9 strains showed clone transmission according to cluster analysis.CONCLUSIONS Drug-resistance of the 20 strains to ?-lactam and aminoglycosides is connected with ?-lactamases and aminoglycoside modifying enzymes,and there exists clone transmission.

Cysts ; congenital ; diagnosis ; surgery ; Female ; Humans ; Infant, Newborn ; Male ; Tongue Diseases ; congenital ; diagnosis ; surgery

Objective To study the prediction value of C-reactive protein (CRP) level to ankylosing spondylitis disease activity score (ASDAS),the most widely used activity score in ankylosing spondylitis (AS).Methods A total of 386 patients with AS were enrolled and divided into 2 groups by CRP≥3.5 mg/L (n =266) and CRP ＜ 3.5 mg/L(n =120).ASDAS-CRP was evaluated in patients with CRP below the normal range (3.5 mg/L) in different subgroups.Three methods were used to test the consistency between ASDAS-CRP and ASDAS-erythrocyte sedimentation rate (ESR).Results The ASDAS-CRP showed a good correlation with the ASDAS-ESR when CRP level was ≥ 3.5 mg/L (r =0.899,P =0.000).In the group of CRP ＜ 3.5 mg/L,ASDAS-ESR showed better consistency with ASDAS-CRP when CRP level was below 1.5 mg/L(intra-class correlation coefficient 0.902;kappa coefficient 0.70).By the evaluation of variant gradient matrix,CRP 1.5 mg/L coincided with disease activity states.Conclusion There is good consistency between ASDAS-CRP and ASDAS-ESR.When CRP level is below the normal range,1.5 mg/L could be a cut-off value to calculate the optimal ASDAS-CRP score.

Objective To analyze antimalarial assosiated retinopathy detected by different methods with of modern ocular fundus examination, and explore screening strategy and the diagnosis of hydroxych-loroquine assosiatedretinopathy according to clinical experience and international guidelines. Methods Full fundus examination was performed in two patients with antimalarial retinopathy. The related literature were reviewed. Results Two patients had bull's eyes maculopathy and abnormal visual fields. Conclusion Clin-icians' alertness to hydroxychloroquine related retinopathy may improve early diagnosis of hydroxychloroquine toxicity. New objective tests are more sensitive than visual fields examination. Visible bull's-eye maculopathy is a late change, and the goal of screening is to recognize toxicity at early stage.

Capital Medical University Pediatrics Online Course which has been set since June 2013 provides students with more personalized and efficient learning platform in line with modern educational concepts.The paper has introduced the application platform,basic framework and usage of the Online Course,analyzing the characteristics of excellent teaching resources,bilingual teaching,students' participation and students' learning more in line with manifestations habits,and finally reflected on the subsequent development of Pediatrics Online Course in the future.

OBJECTIVE To study the antibiotic resistance gene of qacE△1-sul1 in Acinetobacter baumannii isolated from inpatients in Urumqi and the distribution and difference of qacE△1-sul1 genotype in Xinjiang. METHODS Bacterial strains were identified by system of API and antibiotic susceptibility test was detected by K-B and microdilution methods according CLSI.PCR was used to determine the gene of qacE△1-sul1 and compared with the sequences in GenBank. RESULTS Antibiotic resistance phenotypes showed the resistance rate to cefataxime and tetracycline was the highest(100.0%),but that to cefoperazone/sulbactam was the lowest.The positive rate of qacE△1-sul1 gene in A.baumannii was 52.2%. CONCLUSIONS High resistance in A.baumannii is found in Xinjiang.The positive rate of qacE△1-sul1 is high.Strengthening epidemiology surveillance of resistance carried by integron-carrying gene is important.

Objective To investigate the expression of MMP-9 genes in primary hepatocellular carcinoma(HCC).Methods RT-PCR was used to detect MMP-9 mRNA in surgically extracted specimens from 28 patients with HCC.Results The expression of MMP-9 mRNA was significantly higher in tumor than in corresponding nontumoral tissue(P0.05).Meanwhile,the expression of MMP-9 mRNA in HCC was significantly correlated to the existence of portal vein tumor thrombus(P