Objective To investigate the resistance of multi-drug resistant Acinetobacter baumannii against aminoglycosides and its resistance genes.Methods The minimal inhibitory concentrations (MICs) of seven antimicrobials (gentamicin, amikacin, tobramycine, netilmicin, neomycin, streptomycin and kanamycin) against 20 strains of multi-drug resistant Acinetobacter baumannii were detected by agar dilution method. Meanwhile, two resistance genes of aminoglycoside nucleotidyltransferase were amplified by PCR and vertified by DNA sequencer.Results It was found that MIC50 and MIC90 of gentamicin, amikacin, streptomycin and kanamycin in 20 strains of Acinetobacter baumannii were all above 1 024 mg/L, and their resistant rates were 95%, 95%, 100% and 90% respectively, while the resistant rates of tobramycin, netilmicin and neomycin were 85%, 90% and 40% respectively. Two aminoglycoside-modification genes ant(2″)-Ⅰ and ant(3″)-Ⅰ were detected in 20 strains, with 55% and 80% of positive rate respectively. The double positive rate of two resistance genes was 50%.Conclusion The resistance of multi-drug resistant Acinetobacter baumannii against aminoglycosides was closely associated with ant(2″)-Ⅰ and ant(3″)-Ⅰ genes.

ObjectiveTo observe the clinical efficacy of acupoint application plusXiao Pi Jianin treating hyperplasia of mammary glands.MethodTotally 103 patients with hyperplasia of mammary glands were randomized into a treatment group of 52 cases and a control group of 51 cases. The treatment group was intervened by acupoint application plus oral administration ofXiao Pi Jian, while the control group was by oral administrationofXiao Pi Jianalone. The criteria for diagnosis and therapeutic evaluation of hyperplasia of mammary glands were adopted in the study.ResultThe total effective rate was 94.2% in the treatment group, significantly higher than 82.4% in the control group(P<0.05).ConclusionAcupoint application plusXiao Pi Jiancan produce a significant efficacy in treating hyperplasia of mammary glands.

OBJECTIVETo observe the efficacy difference in the treatment of breast hyperplasia between the combined therapy of auricular point sticking and Xiaopijian and the simple application of Xiaopijian.

METHODSNinety-one patients were randomized into an observation group (46 cases) and a control group (45 cases). In the observation group, the sticking therapy on the auricular points was applied in combination with the oral medication of Chinese herbal medicine, Xiaopijian. Auricular points included Ruxian, Neifenmi (CO18), Luanchan, Shenmen (TF4), Gan (CO2), Pi (CO13). The auricular point sticking therapy was applied once a week on the auricular points of one side alternatively. Xiaopijian was the self-prepared decoction. The main ingredients are radix bupleuri Bupleurum chinense, spica prunellae prunella vulgaris and radix peoniae alba Paeonia lactiflora, 30 mL each time, three times a day. In the control group, Xiaopijian was simply prescribed for oral administration, 30 mL each time, 3 times a day. The treatment was discontinued during menstruation in the two groups. The menstrual cycle of one month made one session of treatment. The treatments for 3 sessions were observed. The scores of symptoms and physical signs, including the degree of breast pain, hardness and size of breast masses as well as the scores of general and supplementary symptoms were compared before and after treatment in the patients of the two groups. The clinical efficacy was compared between the two groups.

RESULTSAfter treatment, the scores of symptoms and physical signs were reduced apparently as compared with those before treatment in the patients of the two groups (both P<0. 05). The score reduction in the observation group was much more than that in the control group (11.02±1. 78 vs 9.82±1. 53, P<0. 05). The total effective rate was 95.7% (44/46) in the observation group, higher apparently than 80. 0% (36/45, P<0. 05).

CONCLUSIONThe combined therapy of auricular point sticking and Xiaopijian achieves the superior efficacy on breast hyperplasia as compared with the simple application of Xiaopijian.

Acupuncture Points ; Acupuncture, Ear ; Adult ; Breast ; pathology ; Breast Diseases ; drug therapy ; pathology ; therapy ; Combined Modality Therapy ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Hyperplasia ; drug therapy ; pathology ; therapy ; Middle Aged ; Young Adult

Objective To observe the antitumor effect of 153Sm-DTPA-c (CGRRAGGSC) on MHCC97-H human liver cancer using a nude mice model.Methods 153Sm-DTPA-c(CGRRAGGSC) was indirectly synthesized by the reaction of 153SmC13 with DTPA-c(CGRRAGGSC).Western blot was used to detect the expression changes of IL-11 receptor of eight different cell lines.20 MHCC97-H tumor-bearing nude mice were randomly divided into four groups by random number table method with five mice in each group,administered with different activities of 153 Sm-DTPA-c (CGRRAGGSC) by tail vein injection (5.5,11.0,22.0 MBq/0.2 ml and physiological saline/0.2 ml in turn).All nude mice were terminated after 16 d then the tumor tissue was observed and analyzed with microscopy,electron microscopy and immunohistochemistry for Ki-67,Bc1-2 and IL-11 receptor.Western blot was used to evaluate the expression changes on IL-11 receptor of tumor tissue at different doses.Results After administration with 153 Sm-DTPA-c(CGRRAGGSC),the central region in the early stage of tumor became dry,necrosis,and crusting.In the late stage,tumor continually grew surrounding necrosis tissue.The inhibition rates in the low,middle and higher dose group were (22.72 ±2.76)％,(34.65 ±2.36)％ and (85.13 ±5.78)％,respectively(F =89.32,P ＜ 0.05).The morphologic results showed that tumor structures were severely damaged along with radiation dose.The results of immunohistochemistry showed that the IL-11 receptor-positive cells in the control group and 5.5 MBq group was (84.13 ± 5.71) ％ and (61.57 ± 5.98) ％ (t =13.62,P ＜0.05),respectively.The Ki-67 and Bcl-2 positive cells were decreased in the injection group (t =20.91,6.68,P ＜0.05).Western blot analysis showed that the expression of IL-11 receptor protein decreased with antitumor-effect of radiation.Conclusions 153Sm-DTPA-c (CGRRAGGSC) effectively depresses the growth of MHCC97-H human liver cancer and suppresses the expression of IL-11 receptor,and hence could be a promoting agent for the treatment of MHCC97-H human liver cancer.

Objective To evaluate the clinic effect of a hybrid technique of laser and foam sclerosant in treating varicose vein of the lower extremity.Methods From April 2009 to April 2013,hybird operation of endovenous laser combined with foam sclerosant was carrird out in 126 patients with lower extremity varicosities.A total 175 diseased legs were treated.Catheter guidewire techniques was performed first in placing optical fiber below saphenous vein flap,which was followed by laser ablation for the great saphenous vein,then foam sclerotherapy were used for greater saphenous vein trunk 4 cm below tibial tubercle and the superficial varicose veins with diameter less than 6 mm.All patients were followed up for 3-24 months.The operation time,average hospitalization days,patients quality of life score,curative effect and complications were analyzed.CT angiography in the evaluation of occlusion of varicose vein of lower limbs trunk and recurrence were performed at the time of discharge and three months later respectively.Results Hybrid operation of endovenous laser treatment and foam sclerosant was successfully performed in all cases.The procedure time for a single leg was (32 ± 7) minutes; the quality of life score and the hospitalization after procedure was (4.2 ± 1.8) days and (40 ± 7) score respectively.CT angiography at discharge and 3 months later revealed that 97 (55.42％) and 111 (63.42％) limbs varicose veins disappeared respectively,78 (44.57％),64 (36.57％) lower limb varicose veins was reduced respectively,143 (81.71％),158 (90.28％) great saphenous vein trunk were in emphraxis respectively and 32 (18.28％),17 (9.71％) great saphenous vein lumen were narrowed.No vascular recanalization was found.The complications included saphenous nerve injury in 5 cases,soft tissue infection in 5 cases,calf skin burn in 11 cases,local funicular patches nodules in 32 cases,edema in 16 cases,subcutaneous hematoma in 10 cases.No complications such as pulmonary embolism,and deep venous thrombosis happened.Conclusions For the treatment of lower extremity varicosities,hybrid operation of laser and foam sclerosant ablation have high limb cure rate,less operation time and complications.

Objective To analyze the changes and characteristics of cancer incidence and mortality among Jiaxing residents in the past 6 years,and to provide evidence for the prevention and control of cancer incidence and mortality.Methods Registered malignant tumor data from the Zhejiang Chronic Disease Information Monitoring and Management System were collected and analyzed based on the International Statistical Classification of Diseases (ICD-10).The statistical indexes used for analyses included crude incidence,standardized incidence,crude ortality,standardized mortality,potential years of life lost (PYLL),average years of life lost (AYLL),rate of potential years of life (PYLL‰) and so on.Results From 2010 to 2015,the crude incidence,the standardized incidence,the crude mortality,and the standardized mortality were 342.52/105,240.89/105,194.71/105 and 126.27/105,respectively.The crude incidence and mortality for males were both higher than those for females(378.44/105 vs.307.49/105,x2=763.06,P＜0.01;255.31/105vs.135.62/105,x2-3 814.11,P＜0.01).The PYLL,AYLL and PYLL‰ of residents in Jiaxing were 248,307 years,6.16 years and 12.00‰,respectively.The PYLL‰for males was significantly higher than that for females(x2=37073.85,P＜0.01).The AYLL for females was 6.50 years,higher than that for males(5.98 years)(t =125.15,P＜0.01).The incidence of malignant tumors increased with age,especially in the older than 40 age group,with the older than 80 age group showing the highest rate at 1 779.01/105 (x2 =38 840 907,P ＜ 0.01).Rates for Lung cancer (70.59/105),colorectal cancer (39.86/105),liver cancer (29.14/105),breast cancer(26.73/105) and stomach cancer (26.00/105) were the most common malignant tumors in Jiaxing.Conclusions The morbidity and mortality of malignant tumors are showing signs of rising and the incidences of lung cancer and gastrointestinal cancer are particularly pronounced in Jiaxing.In consequence,measures for the prevention and control of malignant tumors should be developed with clearly defined objectives and research on the pathogenesis of malignant tumors should be stepped upto reduce the incidence and mortality of malignant tumors.

Objective To study the effect of laparoscopic cholecystectomy(LC) in the treatment of patients with schistosomiasis hepatic cirrhosis(SHC) complicated with symptomatic gallstone. Methods The clinical data of 256 cases of SHC with symptomatic gallstone underwent cholecystectomy in recent 4 years in our hospital were reviewed retrospectively. Of them, 74 underwent LC , which was compared with the cases who underwent open cholecystectomy(OC) in operation time, operative heamorrage,operative complications, and hospital stay.Results The operation time in LC group and OC group was 63 min and 54 min respectively; the operative bleeding of LC group was 15.6ml, OC group 85 ml;and hospital stay was 1.2days in LC group,8.9 days in OC group。Six cases of LC group was converted to OC.None had postoperative complications in LC group; but 1 case in OC group had bile leakage. Conclusions With strict the operative indications and proper operative method,LC in the treatment of SHC patients with gallstone is safe and feasible.

OBJECTIVE: To observe the effects of Jianpi Huoxue Decoction, a compound Chinese herbal medicine, on Kupffer cell signal pathway activation in rats with liver injury induced by Lieber-Decarli liquid diet and lipopolysaccharide (LPS). METHODS: SD rats were divided into normal, control liquid diet, ethanol liquid diet and ethanol liquid diet plus Jianpi Huoxue Decoction group. Rats were administrated with Jianpi Huoxue Decoction or distilled water via gastrogavage for 4 weeks after administration with ethanol or control liquid diet for 2 weeks respectively. After that, rats in each group were stimulated with LPS via gastrogavage for 3.5 h and harvested. Alanine aminotransferase (ALT) in serum and triglyceride (TG) in liver were analyzed. Pathological changes in liver tissues were observed in HE staining section. Tumor necrosis factor-alpha(TNF-alpha) in portal vein plasma was assayed by ELISA. The protein expressions of CD68, Toll-like receptor 4 (TLR4), phosphorylation-I kappa B (P-I kappa B) and TNF-alpha in liver were evaluated with Western-blotting. RESULTS: After the treatment with Jianpi Huoxue Decoction, the pathologic changes in liver tissue were lightened, levels of ALT in serum, TG in liver and TNF-alpha in portal vein plasma were decreased, and the protein expressions of CD68, TLR4, P-IkappaB and TNF-alpha in liver were reduced. CONCLUSION: Jianpi Huoxue Decoction can inhibit Kupffer cell signal pathway activation in rats with liver injury induced by Lieber-Decarli liquid diet and LPS.

Objective To study the expression of signaling lymphocytic activation molecule (SLAM)CD150 in peripheral blood mononuclear cells(PBMCs)isolated from adult non-responders to recombined yeast gene hepatitis B vaccine.Methods A total of 202 cases were recruited.All these subjects had been immunized with recombined yeast gene hepatitis B vaccine for more than one standard scheme in two years(from Sep 2007 to Dec 2009)and remained negative for hepatitis B markers(HBsAg,anti-HBs,HBeAg,anti-HBe and anti-HBc).After recruitment,all 202 subjects received another standard scheme(0,1 and 6 month)revaccination.The blood samples were collected 7 months later after the first injection of revaccination to detect anti-HBs titer.The PBMCs were isolated from 18 adult non-responders(anti-HBs titer<10 mIU/mL)and 18 adult responders(antiHBs titer≥100 mIU/mL).CD150 expression on cell surface was analyzed by flow cytometry.SAS package was used for t test and spearman rank correlation analysis.Results After rHBsAg stimulation,the percentage of PBMCs expressed CD150 was significantly higher in non-responders (39.20%±10.66%)than responders(23.73%±12.41%)(t=2.1947,P<0.05).The same trend was also observed in rHBsAg stimulated C133+CD4+T cells,but the difference was not statistically significant(49.64%±11.94%vs 37.73%±11.02%)(t=1. 7175,P>0.05).After phytohaemagglutinin (PHA)stimulation,the percentage of CD150-positive PBMCs was also significantly higher in non-responders (39.21%±7.37%)than responders(23.18%±12.68%)(t=2.2835,P<0.05).CD150 expressions in both PBMCs and CD3+CD4+T cells were negatively correlated with anti-HBs titer after rHBsAg stimulation (r=-0.726,P<0.05).Conclusion Activation of CD150 may contribute to the non-response to hepatitis B vaccine.

Objective To explore the relationship between K-ras gene and cholangiocarcinoma by detecting the K-ras gene mutation of bile duct tissues.Method We studied all the patients who presented to our hospital from June 2010 to June 2012 with stenosis of the bile duct.There were 17 cases of cholangiocarcinoma and 17 cases of benign stenosis.From the DNA extracted from the paraffin tissues,we used the HRM assay for K-ras gene mutation.Result We found that the HRM method and the DNA typing had exactly the same result for the DNA content which confirmed the effectiveness of the HRM assay.Of note,the K-ras mutation rate was found to be significantly higher in the cholangiocarcinoma cases (11/17) when compared with the benign cases (3/17).Conclusion The mutation of the K-ras gene was closely related to cholangiocarcinoma.Our results suggest a new way to diagnosis cholangiocarcinoma.