Objective To analyze the distribution and drug resistance of the isolated strains of K lebsiella pneumonia .Methods The strains of K lebsiella pneumonia were isolated from specimens from clinical departments ,and the drug resistance was tested . The results were analyzed .Results There were 415 strains of K lebsiella pneumonia were isolated .The isolated strains distributed mainly in Department of Neurosurgery (36 .1% ) ,Department of Respiratory Medicine (27 .7% ) ,and ICU (16 .9% ) .74 .7% of the strains were isolated from sputum specimens .30 .0% of the isolated strains were ESBLs positive .The drug resistance rates of K leb‐siella pneumonia to meropenem and imipenem were both low to 0 .5% .Conclusion Monitoring the drug resistance of K lebsiella pneumonia is very important to guide the treatment .

Objective To analyze the expressions and clinical significance of human epidermal growth factor receptor-2 (C-erbB-2) protein in sinonasal squamous cell cancer cells.Method Immunohistochemical and RT-PCR methods were used to detect the expression of C-erbB-2 in 62 cases of sinonasal squamous carcinoma tissues,30 cases of nasal polyps and 25 cases with normal nasal mucosa.The relationships between the expression of C-erbB-2 in sinonasal squamous carcinoma tissues and clinical pathological characteristics were analyzed.Results There was significant difference in the expression of C-erbB-2 in sinonasal squamous carcinoma tissues, nasal polyps and normal nasal mucosa tissues(P <0.05).The expression of C-erbB-2 was positively correlated with the clinicopathologic stage, tumor classification and lymph node involvement(P<0.05).Conclusion The expression of C-erbB-2 is correlated with tumorigenesis,invasion and metastasis of sinonasal squamous cell carcinoma.It can be used as an auxiliary diagnostic and prediction maker as well as a new therapeutic target of sinonasal squamous cell cancer.

Information has become the soul of military affairs,campaign,combat support,and other various elements in the battlefield.In the particular war of 5.12 Wenchuan earthquake,in the face of sudden major geological disasters,sensitive information is the premise to effectively run the emergency response mechanism.The information collection,processing and determination permeate throughout the course of earthquake resistance & disaster relief and serve as the core in the effective commanding and coordination.

Objective To investigate the effect of propofol on myocardial injury induced by hepatic ischemia/reperfusion (I/R) in rats and the role of PI3K/Akt signaling pathway. MethodsOne hundred and two male SD rats weighing 250-280 g were randomly divided into 5 groups:Ⅰ sham operation group (group S, n =6), ⅡI/R group ( n = 30), Ⅲ propofol group (group P, n = 30), Ⅳ propofol + LY294002 group (group P+ LY, n =18), and Ⅴ propofol + dimethylsulfoxide group (group P+ DMSO, n = 18). Hepatic I/R was produced by occlusion of hepatic pedicle for 30 min followed by reperfusion in group Ⅱ - Ⅴ. Propofol 12 mg/kg, propofol 12mg/kg + LY294002 (a specific PI3K inhibitor) 1.5 mg/kg, and propofol 12 mg/kg + DMSO 0.5 ml were injected I.v.via femoral vein at 10 min before ischemia in group Ⅲ -Ⅴ respectively, and then propofol was infused I.v. At a rate of 30 mg· kg- 1 · h - 1 and the administration was stopped before the rats were sacrificed in group Ⅲ - Ⅴ . At 0,30, 60, 120, and 240 min of reperfusion (T1-5) in group Ⅱ and Ⅲ , and at T3.5 in group Ⅳ and Ⅴ , six rata were sacrificed and myocardial tissues were taken for determination of the total Akt (t-Akt) and phosphorylated Akt (p-Akt) expression and Bcl-2 expression and apoptosis were detected at T3. The hepatic tissues were taken for microscopic examination. The rats were sacrificed at T1 and the parameters mentioned above were detected in group Ⅰ . ResultsCompared with group Ⅰ , p-Akt expression and apoptosis rate were significantly increased in the other4 groups, and Bcl-2 expression was up-regulated in group Ⅱ , Ⅲ and Ⅴ (P ＜ 0.05). Compared with group Ⅱ , p-Akt and Bcl-2 expression was up-regulated, and the apoptosis rate was significantly decreased in group Ⅲand Ⅴ ( P ＜ 0.05). Compared with group Ⅲ , p-Akt and Bcl-2 expression was down-regulated, and the apoptosis rate was significantly increased in group Ⅳ ( P ＜ 0.05). The microscopic examination showed that the injury to the hepatic tissues was less severer in group Ⅲ and Ⅴ than in group Ⅱ and Ⅳ. ConclusionPropofol can attenuate myocardial injury induced by hepatic I/R in rats by activation of PI3K/Akt signaling pathway.

Clinical data of one patient diagnosed as IgG4-related retroperitoneal fibrosis was analyzed.IgG4 and retroperitoneal fibrosis were used as the key words to search literatures from PubMed and Wanfang Database.Clinical data of 27 cases with IgG4 retroperitoneal fibrosis,including clinical manifestation,diagnostic basis,therapeutic method and prognosis,which were retrieved through literatures,were analyzed.A 82-year-old male patient presented with urinary tract obstruction and renal insufficiency.Imaging examination revealed a retroperitoneal irregular lump shadow,and showed chronic inflammation of soft tissues in posterior peritoneum with fibrosis by biopsy pathology.The IgG4-positive plasmocyte infiltration was found by immunohistochemical method.The serum level of IgG4 was significantly increased,which was in accord with IgG4-related retroperitoneal fibrosis.After treatment with methylprednisolone,retroperitoneal lump shadow was obviously dissipated.The serum level of IgG4 became normal.27 cases with IgG4-related retroperitoneal fibrosis were searched through literature retrieval,with 19 confirmed cases,3 suspected cases,and 5 suspicious cases.Male accounted for 92.6％ (25/27),and the average age was 67.6 years old.The cases with the involvement of extraperitoneal organs accounted for 37.0％ (10/27).The misdiagnosis rate was 55.6％ (15/27).23 cases took effective therapy with glucocorticoids.IgG4-related retroperitoneal fibrosis is an orphan disease,which can be misdiagnosed easily.The diagnosis is made with histopathological examination and determination on the serum level of IgG4.The therapy with glucocorticoids is effective.

To investigate the relationship between the expression of early growth response gene 1 (EGR-1) and p38MAPK pathway in the paclitaxel resistance of ovarian carcinoma cells, the effect of p38MAPK inhibitor SB203580 on cell apoptosis was examined by using Hoechst 33258 staining. The intracellular Rh123 (Rhodamine 123) accumulation was detected by the flow cytometry (FCM). The 50% inhibition concentration (IC50) of paclitaxel for A2780/Taxol cells was determined by MTT method. Electrophoretic motility shift assay (EMSA) was employed to examine the EGR-1DNA binding activity. MDR1 and EGR-1 mRNA were assessed by RT-PCR. The expressed of p-gp, phosphorylated p53 and p38 were detected by Western blotting. SB203580 could remarkably promote the apoptosis of A2780/Taxol cells, and the cell apoptosis was in a time-dependent manner. Cellular Rh123 accumulation was increased, and the IC50 of paclitaxel for A2780/Taxol cells was decreased significantly. A2780/Taxol cell line after SB203580 treatment was shown to have a significantly higher level of EGR-1 DNA binding activity. SB203580 down-regulated the activity of p38MAPK pathway, but up-regulated EGR-1 expression. SB203580 significantly increased the level of cellular phosphorylated p53 protein, but decreased the p-gp protein level and MDR1 mRNA level in A2780/Taxol cells. There existed a close relationship between p38MAPK pathway and the paclitaxel resistance of ovarian carcinoma cells. The expression of EGR-1 mediated by p38MAPK pathway plays a critical role in paclitaxel resistance of ovarian carcinoma cells.

Objective To observe the effect of light emitting diode (LED) red light irradiation on serum lipid in experimental hyperlipidemia rats. Methods 36 healthy male Sprague-Dawley rats were randomly divided into normal control group (n=12) and hyperlipidemic model group (n=24). The normal group was fed with normal diet while the hyperlipidemic model group with fat-rich forage for 6 weeks. The hyperlipidemic model group rats were randomly divided into the hyperlipidemic control group (n=12) and LED treatment group (n=12), and the latter accepted LED red light irradiation for 28 d. The levels of serum lipid including total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL-C), high-density lipoprotein (HDL-C), and the activities of lipoproteinesterase (LPL) and hepatic lipase (HL) were detected with biochemical assay. The expression of 3-hydroxy-3-methylglutaryl coenzyme A reducase (HMG-CR) of hepatic tissue were measured with immunohistochemical staining. Results Compared with the hyperlipidemic control group, the levels of serum TC, TG and LDL-C decreased while the serum HDL-C increased significantly in the LED treatment group (P<0.01) after treated with LED. The levels of LPL and HL in serum increased (P<0.01) while the activity of HMG-CR decreased (P<0.05). Conclusion LED red light irradiation might play a regulating effect on serum lipid by enhancing the activities of LPL and HL and inhibiting the expression of HMG-CR to interfere the metabolism of TC, TG, LDL-C and HDL-C.

Objective To introduce our experiences of reconstruct the first web space using flaps.Methods One hundred and twelve patients sustained contracture of the first, summarized the indications of different flaps in coverage of the first webspace and their prognosis of these flaps were retrospectively reviewed.Results The local flaps, such as double Z-plasty or Z-plasty, were suitable to cover minor contracture of the first webspace; the dorsal flap arising from the index finger was suitable for the coverage of the medium contracture, and the posterior interosseous artery flap or the reverse antebrachial island flap based on the dorsal branch of the anterior interosseous artery suitable for the severe cases. Conclusion The usage of flaps is important to resume the cosmetic shape and function of the first webspace after release of the contracture of the first webspace.

The Delphi method was called into play to determine the level-1 indicator,level-2 indicator and plus-minus indicator for evaluating clinicians of various academic titles,while the ranking method was used to determine the weight of these indicators.The Chi-square test found P＞0.05,proving this indicators system as consistent for clinicians at all levels; the t test found the majority as P＞0.05,indicating the weight of level-2 indicators for dimciam of different titles as different with partial consistence.This system is proved to be scientific,comprehensive,objective and authentic in evaluating clinicians of various levels Targeted evaluation and appraisal system guarantees quality of care and medical safety,which functions as an efficient meansfor better hospital management and better quality of care,paving the wayfor reforms in income distribution system and personnel system in the hospital.

Objective To observe the influences of modified constraint-induced movement therapy (mCIMT)on lower-extremity walking ability and femoral artery blood flow among elderly patients with stroke. Methods Totally 67 patients with stroke were randomly divided into mCIMT group(n =35) aged ( 73.2 ± 5.2 ) years and neurodevelopmental treatment (NDT) group ( n =32) as control aged(76.4 ± 3.8) years.Patients in control group exercised by NDT 2 h/time,2 times/d,5 d/week for 6 weeks. Patients in mCIMT group exercised including: up and down exercise,100-120 times/d; movement flatbed exercise for 16-20 min/d; upstairs and downstairs exercise,balance training,standing in a single leg exercise,mandatory exercise time of lower-extremity about 4 h/d,5 d/week for 6 weeks.The patients were assessed for lower-extremities motor function using maximum walking speed (MWS),Berg balance scale (BBS),timed up to go test (TUGT) and Fugl-Meyer(FMA-L) at pre-treatment and post-treatment.The change of femoral artery blood flow velocity and lumen diameter on the affected lower limb were observed by color Doppler. Results There were no differences in the above scores,lumen diameter and blood flow velocity before treatment between the two groups (P＞ 0.05).After treatment,the scores of MWS (56.68 ± 6.57vs.45.61 ± 5.34),BBS(46.84 ± 4.05vs.29.84 ± 4.05),TUGT ( 14.55 ± 8.25vs.25.35 ± 8.70)were higher in mCIMT group than in NDT control group (t=15.09,17.38,15.25,all P=0.001)while no difference in FMA-L score between the two groups was found (35.24 ± 7.62 vs.31.32 ±3.28,t=19.99,P＞0.05).Lumen diameter of femoral artery [(9.05±1.15) mm vs.(8.05±0.68)mm,t=6.72,P=0.001] and blood flow velocity[(92.55±18.25)cm/s vs.(69.35 8.7)cm/s,t=6.83,P=0.001] were increased in mCIMT group as compared with NDT group. Conclusions The mCIMT therapy is better in improving the lower-extremity walking function and blood flow velocity of femoral artery.