OBJECTIVE To analyze the resistance of Enterobacter cloacae AmpC ?-lactamase with/without being induced by imipenem(IMP),cefepime(FEP),ceftriaxone(CRO) and aztreonam(ATM).The ampD genes of mutant strains were sequenced. METHODS Five wild type strains and 5 hyper-inducible type strains of E.cloacae were selected and induced by the tested antibiotics in vitro.At the same time,antibiotic susceptibility tests,3-D test,isoelectric focusing(IEF) and inhibit experiment were detected to identify hyper-producing AmpC ?-lactamase.ampD Gene sequencing was preformed in part of mutant strains. RESULTS There wasn′t obvious alteration in MIC with IMP,FEP,CRO and ATM for wild type strains whether they were induced or not.But,for the hyper-inducible type,there was apparent increasing in MIC after antibiotics inducing,especially CRO and ATM,up to 10.7-128 times.The DNA sequences analysis in the mutation strains showed there existed the replacement of the single base in multiple sites,and a few sites of amino acid were altered. CONCLUSIONS Mutant sites in ampD gene sequences are identical even though antibiotics as inducer are different.

Objective To observe the impact of alone or combined use of ezetimibe and simvastatin on transient outward potassium current (Ito) in ventricular myocytes of rat model of ischemia and reperfusion (IR). Methods Seventy-five male SD rats were randomly divided into five groups, control group (CON), control-IR group (CIR), ezetimibe treatment group (EIR), simvastatin treatment group (SIR) and combined ezetimibe and simvastatin treatment group (ESIR). After two weeks of treat?ment with intragastic normal saline or drugs (ezetimibe or simvastatin), myocytes were isolated from right ventricular with colla?genaseⅡ, and Ito was recorded by whole-cell patch clamp technique. Results (1) The Ito current density at+60 mV was sig?nificantly decreased in CIR group than that of CON group (P<0.05). There was no significant difference in Ito current density between SIR group and ESIR group (P>0.05). The Ito current densities were higher in SIR group and ESIR group compared to those of CIR group. There was no significant difference in Ito current density between SIR group and ESIR group (P>0.05). (2) There was a significant increase in the half-inactivation (V1/2) in CIR group than that of CON group, but no significant differ?ence between EIR group and CIR group (P >0.05). There was a significant difference in the half-inactivation (V1/2) in SIR group and ESIR group compared to that of CIR group (P<0.05), but no significant difference between SIR group and ESIR group (P>0.05). There was no significant difference in the slope factor (K) between five groups (P>0.05). (3) The time-con?stant (τ) of Ito recovery curves from inactivation was significantly higher in CIR group than that of CON group (P<0.05), which was no significant difference between EIR group and CIR group (P>0.05). There was a significant difference in the time-con?stant (τ) of Ito recovery curves from inactivation in SIR group and ESIR group compared to that of CIR group (P<0.05), but no significant difference between SIR group and ESIR group (P>0.05). Conclusion Simvastatin pre-treatment or ezetimibe+simvastatin pre-treatment can reverse the effect of IR on Ito of ventricular myocytes, but ezetimibe shows no such effects.

Objective To evaluate the diagnostic value of 64 multidetector-row CT angiography for internal carotid artery(ICA)stenosis and the application in the follow-up of carotid endarterectomy and percutaneous transluminal stenting.Methods Forty transient ischemie attack(TIA)patients with interpretable CTA and DSA of the cervical carotid arteries were selected from May 2005 to December 2005. This yielded a total of 80 vessels.The CTA curved planar reformations(CPR)and DSA images referenced to the distal cervical internal carotid were graded by two senior neuroradiologists blindly,according to the North American Symptomatic Carotid Endarterectomy Trial(NASCET)guidelines.The paired-t test was used to verify the statistical significant difference between pre-operating and post-operating of carotid endarterectomy or percutaneous transluminal stenting in measuring the vascular diameter and area of cross section using CTA.Results When the 70% stenosis was used as the cut-off value,the seasitivity,specificity,negative predictive value,and the positive predicting value were 97%,95%,95%,and 98%,respectively.There was statistically significant difference in measuring the vascular diameter(P

Objective To investigate the correlation between specific features on contrast-enhanced CT and its clinical findings of adrenal tuberculosis so as to improve the diagnostic accuracy of the disease. Methods Contrast-enhanced CT features in 30 patients with documented adrenal tuberculosis were retrospectively evaluated blindly for the features of location,size,morphology,attenuation and enhancement patterns on CT images,and compared with clinical and pathological materials.Results The common CT manifestations were as follows:enlargement of the adrenal glands in all 30 cases(bilateral 90%,mfilateral 10%)including mass-like enlargement in 13 cases and enlargement but the contours preserved in 17 cases, heterogeneity(28 cases,93.3%),calcification(17 cases,56.7%),and low attenuation in the center with peripheral enhancement(16 cases,53.3%)of the lesions.After antituberculosis chemotherapy, 5 cases of enlarged adrenal glands decreased in size or returned to normal size and configuration,with disappearance of the central low attenuation and new appearance of dot-like calcification in 2 cases.Cochran Armitage trend test showed there was an increasing tendency of calcification rate with clinical duration(X~2= 7.47,P

OBJECTIVETo observe the effect of Weichang'an (WCA, a Chinese preparation) in preventing post-operative metastasis of progressive stage of gastric cancer.

METHODSA prospective randomized, controlled study was conducted by dividing the 148 patients of progressive staged gastric cancer after radical operation into the WCA group, the chemotherapy (CT) group and the WCA + CT group, to observe the survival rate, metastasis rate, quality of life (QOF) and tumor-bearing survival time after relapse (TST) in patients.

RESULTSThe 1-, 2- and 3-year survival rate after operation in the WCA + CT group was 89.51%, 69.77% and 55.76% respectively, which was significantly higher than that in the CT group (83.86%, 59.33% and 49.43%) respectively (P < 0.05), but showed insignificant difference as compared with that in the WCA group (93.23%, 79.34% and 71.78%). Only 1-year metastasis in the WCA group was 15.25%, and in the WCA + CT group was 15.52%, the two were significantly lower than that in the CT group (35.48%, P < 0.05). But the comparison of 2-year metastasis rate among the 3 groups (28.81%, 41.38% and 45.16%) and 3-year metastasis rate among them (33.90%, 46.55% and 51.61%) were insignificantly different. The QOF and TST were markedly better in the WCA group than those in the CT group.

CONCLUSIONWCA has preventive effect on relapse and metastasis in post-operational gastric cancer patients.

Adult ; Antineoplastic Combined Chemotherapy Protocols ; administration & dosage ; therapeutic use ; Doxorubicin ; administration & dosage ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Fluorouracil ; administration & dosage ; Humans ; Male ; Middle Aged ; Mitomycin ; administration & dosage ; Neoplasm Metastasis ; Phytotherapy ; Postoperative Period ; Prospective Studies ; Stomach Neoplasms ; drug therapy ; pathology ; surgery

OBJECTIVETo evaluate therapeutic effects of Rigidfix cross pins combined with Intrafix pins for the reconstruction of anterior or posterior cruciate ligament under arthroscopy.

METHODSFrom January 2009 to June 2010,34 patients with anterior or posterior cruciate ligament injuries were divided into two groups : group A and group B. There were 24 patients in group A, including 19 males and 5 females,with an average age of (31.83±9.57) years old. The patients in group A were treated with anterior cruciate ligament reconstruction under arthroscopy; Rigidfix cross pins and Intrafix pins were used to fix femoral and tibial side respectively. Among the 10 patients in group B, 8 patients were male and 2 patients were female, with an average age of (27.20+7.59) years old. The patients in group B were treated with posterior cruciate ligament reconstruction under arthroscope; Intrafix pins and Rigidifix cross pins were used to fix femoral and tibial side sepectively. The drawer test and Lachaman test were used to evaluate postoperative knee stability. All the patients were followed up at least 18 months. Lysholm and Tegner knee scores were used to evaluate the clinical therapeutic effects.

RESULTSAll the 34 patients were followed up, and the duration ranged from 18 to 26 months,with an average of (20.79±2.39) months. All the patients obtained good pain relief and knee stability. In group A,Lysholm scores significantly increased from 43.04±7.57 preoperatively to 85.41±4.68, 92.50±3.05, and 93.45±2.57 at 6,12, and 18 months postoperatively; Tegner scores significantly increased from 2.62±0.92 preoperatively to 7.45±1.14, 8.58±0.77, and 8.95±0.55 at 6, 12, and 18 months postoperatively. In group B,Lysholm scores significantly increased from 46.20±8.27 preoperatively to 86.40±5.14,90.40±2.67,and 92.00±3.85 at 6,12,and 18 months postoperatively ;Tegner scores significantly increased from 2.00±0.66 preoperatively to 7.10±0.99, 8.60±0.84, and 8.80±0.42 at 6,12, and 18 months postoperatively. There were no differences in Lysholm and Tegner scores between group A and B at different times during follow-up. Lysholm scores of all patients significantly increased from 43.97±7.79 preoperatively to 85.70±4.76,91.88±3.06,and 93.02±3.01 at 6,12,and 18 months postoperatively. Tegner scores of all patients significantly increased from 2.44±0.89 preoperatively to 7.35±1.09, 8.58±0.78, and 8.91±0.51 at 6,12,and 18 months postoperatively. During the follow-up period,there were no serious immunological rejection and complications.

CONCLUSIONReconstruction of anterior or posterior cruciate ligament under arthroscopy with Rigidfix cross pins and Intrafix pins fixation is feasible therapy for anterior or posterior cruciate ligament injuries, and the fixation is rigid. The therapy restores knee stability and provides a satisfactory short-term results.

Adolescent ; Adult ; Anterior Cruciate Ligament ; surgery ; Arthroscopy ; methods ; Bone Nails ; Case-Control Studies ; Female ; Humans ; Male ; Middle Aged ; Posterior Cruciate Ligament ; surgery ; Reconstructive Surgical Procedures ; instrumentation ; methods

Objective To study the relationship between cyclooxygenase 2 (COX-2) polymor phisms and the susceptibility of bladder cancer.Methods Polymerase chain reaction restricted frag ments length polymorphism (PCR-RFLP) and the primer introduced restriction analysis (PIRA-PCR)assay were used to genotype the COX-2-765G/C, 1195G/A and 8473T/C polymorphisms in a case control study of 180 bladder cancer cases and 180 cancer free controls in a Chinese population.Re stilts The distribution of the genotype frequencies of 765G/C and 1195G/A were not statisticallydifferent between the cases and controls (P=0.582 for-765G/C and P=0.270 for-1195G/A).Poly morphisms of COX 2-8473T/C were associated with the susceptibility to bladder cancer.The individ uals with the 8473C allele had a decreased risk of bladder cancer (OR=0.56,95% CI=0.35 0.88).Conclusions Polymorphisms of COX-2-765G/C and-1195G/A are not associated with the suscepti bility to bladder cancer.However,COX-2-8473T/C can reduce the risk of bladder cancer.

Objective To investigate the relationships between genetic polymorphism of CYP2A6 alone or in combination with smoking and hereditary susceptibility to bladder cancer.Methods Based on case-control study,CYP2A6*4 was determined by the nested polymerase chianreaction(nPCR)in 186 patients with bladder cancer and 192 nontumorous controls.The relations between the genetypes of CYP2A6*4 alone or combinated with smoking and bladder cancer was estimated with the X2 test and logistic regression model.Results In the case subjects,the number of the wil/wil genetype was 168,the number of the wil/del genetype was 13,and the number of the del/del genetype was 5.In the control subjects,the number of the wil/wil genetype was 150,the number of the wil/del genetype was 32,and the number of the del/del genetype was 10.The frequency of CYP2A6 del allele was significantly lower in the case Subjects(9.68%)than the controls(21.88%,P＜0.05,OR:0.383).When eombinated with smoking,the risk of bladder cancer in smokers was significantly higher than nonsmoker(P＜0.05,OR=2.322).In smokers,the frequency of CYP2A6 del allele was significantly lower in cases(7.88%)than controls(28.00%,P＜0.05,OR=0.221).In smoking people,the one with CYP2A6 del genotype had a lower risk of bladder cancer than the one with CYP2A6 wild genotype(OR=0.221,95%CI:0.092,0.534).Conclusions Genetic polymorphisms of CYP2A6 are associated with the susceptibility to bladder cancer and have interaction with smoking in carcinogenesis of bladder cancer.Deficient CYP2A6 activity to genetic polymorphism mayreduee bladder cancer risk in smokers.

Objective To study the feasibility of percutaneous pedicle screw fixation in treatment of thoraco-lumbar fractures.Methods Twenty-two patients with thoraeo-lumbar fractures were treated with the posterior percutaneous or open pedicle screw fixation respectively.Operation time,the bleeding volume,the height of the anterior border,the cobb angles of seoliosis,the late loss of correction,and complications were compared.Results All patients were followed up for mean 19 months(13 to 22 months).In percutaneous group,the mean time of operation was 102 minutes,the anterior height of compressed vertebral bodies was restored from 52% to 95% of the normal height,and the Cobb angle was corrected from 16?to 6.3?,the mean late loss of correction was 13% in percutaneous group,and there were no significant differences between the two groups(P＞0.05).The mean bleeding volume in the percutaneous group and open group was 102 ml and 290 ml respectively,which showed significant difference(P＜0.05).Conclusion Posterior percutaneous pedicle screw fixation in treatment of thoracolumar fractures,which didn't need vertebral canal decompression,was a perfect and effective method.Compared with open method,it had such strongpoints as quicker recovery and less invasive.

Objective To evaluate the value of echocardiography in diagnosing infective endocarditis (IE) in children. Methods The shape, size, echogenicity, distribution of vegetations and valvular function of the heart were observed by transthoracic echocardiography (TTE) in 30 patients with suspected IE. We correlated TTE ifndings with the results of hemoculture and serologic test. Results Vegetations were observed in all patients by echocardiography:seven patients with tricuspid valve vegetations, two with mitral valve vegetations, three with pulmonary valve vegetations, three with main pulmonary artery vegetations, three with aortic valve vegetations, two with aortic valve abscess, and two with vegetations in right atrium. After anti-infection therapy, the size of vegetations in iffteen patients became smaller and the less echogenic than before. Vegetations disappeared in two patients. Vegetation was recurrent repeatedly in one case. Ten patients recovered after operation. Two severe cases died. Five patients underwent TTE again one week after the previous negative TTE. Of them, echocardiography demonstrated vegetations in three cases. However, no vegetations were found in rest two cases because antibiotics had been used at early stage. In addition, echocardiography demonstrated one patient with mitral valve vegetation. But the lesion was ifnally conifrmed to be operating suture. The sensitivity and specificity of TTE in detecting vegetations were 88.0% and 80.0%, respectively. Blood cultures were positive in twenty-seven cases and were negative in three cases. Conclusions The early diagnosis of IE is important to improve patient′s prognosis. It takes a long time in organism cultivation before achieving the clinical diagnosis. TTE can help obtain an early diagnosis stage of IE, and provide the assessment of size and location of vegetation. It plays an important role in treatment and prognosis prediction.