Objective To investigate the common pathogenic bacteria distribution and drug resistance in children with lower respiratory tract infection,which guide how to use antibiotics and decrease the progress of drug resistance.Methods Nine hundred and ninety-seven cases of lower respiartory tract infection were analyzed retrospectively in the Department of Pediatrics of the First Hospital of Lanzhou University from Jan.2008to Dec.2010.The sputum samples were collected for routine bacterial cultivation.The antibiotic sentivity test were used for pathgen.Results The phelm cultivition amount is 997,bred and separated 498 bacteria of 425samples,the check rate is 42.73％.There were 151 Gram Positive Bacteria,which had a rate of 30.32％,and 321 Gram Negative Bacteria,which had a rate of 64.46％,and 26 fungi whose rate is 5.62％.The main bacteria was changed during the three years.There were significant differences in detection rate of pseudomonas aeruginosa(PA) and haemophilus parainfluenzae(HPI) during the three years.PA was declining while HPI was rising.There were no significant differences in detection rate of streptococcus pneumoniae( SP),staphylococcus aureus ( SA),escherichia coli( E.coli ),klebsiella pneumoniae ( K.pn ),haemophilus influenzae ( HI ) and fungi.There were no significant differences in detection rate of PA between different age groups.With the increasing of age,the detection rate of SP,HI and HPI trended to rise,whereas the detection rate of SA,E.coli and K.pn trended todecline.The resistance phenotype of SA,E.coli and HPI in detection rate had significant difference in each year.SP and SA were most sensitive to linezolid and vancomycin.Ecoli and K.pn were most sensitive to carbapenems.HI and HPI were relatively sensitive to common antibiotics.Conclution In the past three years,the main pathogen in children with lower respiartory tract infection were Gram Negative Bacteria.Among the bacteria,SP and Ecoli was the most,followed by SA,HI,K.pn,and HPI.These bacteria had signifeicant difference in dectection rate between different age groups.SP and SA were most sensitive to vancomnycin and linezolid.E.coli and K.pn were most sensitive to carbapenems.HI and HPI were relatively sensitive to common antibiotics.So clinical doctors should use antibiotics based on the microorganism cultivation and sensitivity test m order to decrease the drugresistance strain.

The carotid plaque (CP) detachment can induce thrombosis, which may lead to cerebral vascular disease. In recent years,research of CP is mainly focused on qualitative and quantitative analysis of vulnerable plaque. Therefore, it is important to choose therapeutic method and opportunity according to the structure and stability of the plaque. This article reviews the progress in the diagnosis of plaque from the aspects of common ultrasound, contrast enhanced ultrasound, ultrasound real-time tissue elastography, intravascular unltrasound, digital subtraction angiography (DSA), comuted tomography angiography (CTA), magnetic resonance imaging (MRI) and optical coherence tomography (OCT). Common and all kinds of new ultrasonic technology can be used to evaluate the vulnerability of CP from different aspects.

Objective To explore the preoperative misdiagnosis in the breast cancer and the methods to improve the diagnostic accordance rate. Methods The preoperative diagnosis and results of 358 cases with breast cancer has been analysized retrospectively in the recent ten years. Results Total Cases with present diagnostic technique diagnosed befor operation was 176 only;the accordance rate was less than 50%.With aspiration biopsy and molybdenum palladium roentgenograph,the rate was 25%(79 cases).The actual preoperative accordance rate was less than 10%(32 cases).It is said approximately 90% cases were postoperatively diagnosed. Conclusion The present excision biopsy not only has made many patients lost the chance of chemotherapy preoperation, but also interferenced the application of new therapic methods in the clinical practice.Infrared spectroscopy and ultrasonography have been commonly used in the clinical practice.With the low diagnostic accordance rate,they were applied only for screening.With simplity and high diagnostic accor dance rate,aspiration biopsy and molybdenum pall adium roentgenograph should be enrolled extensively in the clinical practice. The puncture and specimen fixing technique also should be improved.

Objective To find an effective operational approach that can mostly reduce heat and other injury to Calot's triangle when separating and anatomizing it at LC operation.Method We abandoned traditional hot separating method by electric coagulation hook which can cause hot injury easily and cold separating method simply by elastic separating plier which can cause errhysis and illegibility of operational field.We applied sucting and scraping cold separating method mainly by suction apparatus which can keep operational field clear and avoid hot injury.Result 52 cases with different cholecyst disease (including cholecystolithiasis,cholecyst polyp,acute cholecystitis with edema and acute cholecystitis with partly gangrene) were adopted by this method and achieved satisfacted effect.Conclusion Sucting and scraping cold separating method are easily operated and can mostly keep separated tube skeletonized.It can avoid hot and other injury in operation,keep operational field clear by less errhysis.To acute cholecystitis with edema it has more advantage and are worth to adopting.

Objective To investigate and compare the clinical efficacy of mifepristone alone and combined with Gongliuxiao capsule in the treatment of uterine fibroids.Methods 106 patients with uterine fibroids in Harrison International Peace Hospital from December 2012 to December 2013 were selected.The patients were randomly divided into control group and experimental group(n=53).The former were treated with mifepristone alone while the later were treated with the combination of mifepristone and Gongliuxiao capsule.All the patients were given 2 courses of treatment with 12 weeks for a course.The menstrual phase,volume of menstruation,uterus and the volorne of uterine fibroids before and after the treatment,and the clinical efficacy of both groups were evaluated.All the results were recorded and compared. Results The menstrual phase,volume of menstruation,uterus and uterine fibroids of both groups after the treatment were significantly less than those before treatment (P <0.05 ).And the total effective rate of experimental group was 92.45%,which was significantly higher than 73.58% of control group.Both groups had some mild adverse reactions,which didn’t affect the treatment.Conclusion The combination of mifepristone and Gongliuxiao capsule has a great efficacy in the treatment of uterine fibroids.Compared with the use of mifepristone alone,the combination treatment is much more effective.

[Objective]To establish a HPLC method or the determination of ginsenside Rg1 in Danqi tablet.[Method]HPLC conditions were as fellows:DiamonsiLTM C18 colum,a mobile phase of MeOH:H2O(48:52),and the wavelength at 280nm.[Results] There was a good linearity within the rang of 4.8ug～24.0ug of ginsenside Rg1.The average recover was 99.80%and RSD was 1.46%.[Conclusion]This method can be used for the quality control of Danqi tablet.

AIM: To investigate the infection factors,diagnosis and treatment of endophthalmitis after intraocular foreign body injury.METHODS: Totally 256 cases with intraocular foreign bodies including the occurrence of endophthalmitis in 42 cases were analyzed retrospectively.RESULTS: The incidence of endophthalmitis after intraocular foreign body injury was 16.4%.Posterior segment foreign bodies and combined with traumatic cataract were the risk factors of endophthalmitis after intraocular foreign body injury (all P<0.05).Intravitreal injection of vancomycin hydrochloride and ceftazidime in the treatment of intraocular foreign body injury reduced the incidence of endophthalmitis (P<0.05).Types and sizes of intraocular foreign bodies,the time of extraction and the condition of wound had no significant effect on the incidence of endophthalmitis (all P>0.05).Vitrectomy was the main treatment of endophthalmitis.CONCLUSION: Posterior segment foreign bodies and combined with traumatic cataract were the risk factors of endophthalmitis after intraocular foreign body injury.It should be kept the integrity of the posterior capsule of lens in traumatic cataract surgery.Intravitreal injection of vancomycin and ceftazidime is recommended in emergency surgery.Vitrectomy should be performed as soon as possible when confirmed endophthalmitis.

OBJECTIVE: To screen reaction system of the anticoagulation effect and establish reaction system of bioactivity assay of Hirudo in vitro and control the quality of Hirudo.

Objective To investigate the evolution of nonspecific manifestations of pulmonary function in elderly people.Methods Retrospective analysis of the data of nonspecific pulmonary function(NSPF) on the initial PF testing in elderly people from the same PFT apparatus in Beijing Hospital were collected from January 2004 to December 2012.All the patients with complete clinical data and reexamination at least one time were enrolled into this analysis.NSPF was defined as normal FEV1/FVC and TLC combined with a decreased FEV1 or FVC or both.All the patients with complete clinical data were divided into blocking group,restricted group,NFSP group and normal group according to their PF.The comparison was performed among these groups.Kaplan-Meier was used for analysis of the turnover and outcome of elderly NSPF patients,log-rank test was used for comparing the difference of turnover and outcome and COX regression was used for analyzing single and multiple factors of different turnover and outcome.Results Overall 59 patients were diagnosed as NSPF,with male:female ratio of 52:7,the average age of(71.8 ± 8.8)years and at a median follow-up of 4 years.The statistically significant differences in age,sex,body mass index(BMI),smoking status,both the clinical manifestations and chest CT performance at first visit and during the following-up were not found among the groups(all P ＞0.05).The pulmonary functions of NSPF patients were transformed into an obstructive pattern(19.6 ％),into a restrictive pattern(7.6 ％)and into a normal pattern(8.8 ％) in 4 years cumulative incidence rate,with statistically significant in differences(x2 =7.411,P =0.024).An invariant pulmonary function in NSPF patients accounted for 64.0％ in the most,and the second was obstructive ventilation function disability.Monomial and multinomial Cox regression analysis showed that emphysema and bulla in the initial CT scan was the predictor of the change to the obstructive pattern from NSPF during follow-up(HR=4.325,P=0.045),age was the predictor of the change to the restrictive pattern(HR=1.143,P=0.020).And pleural thickening and disappearing of pleural effusion were the predictor of change to the normal pattern (HR =8.889,P =0.018) respectively.Conclusions Most NSPF in elderly people could exist consistently.Obstructive pattern is the maximal likelihood of NSPF changing to the other pattern.Emphysema and bulla in the initial CT scan is the predictor of the obstructive pattern.The change is related with emphysema and bulla in the initial CT scan.

Objective:To investigate the chemical constituents in the roots of Angelica dahurica var.formosana.Methods: The dried rhizomes of Angelica dahurica var.formosana were chopped and extracted with 80% EtOH for 3 times under reflux.The EtOH extract was isolated by chromatography on silica gel using a gradient solvent system(PE:EtOAc & CHCl_3MeOH) and Sephadex LH-20.The structures of the contents were elucidated by nuclear magnetic resonance and MS spectral analysis.Results: Seventeen compounds were identified,namely,isoimperatorin(1),imperatorin(2),bergapten(3),alloimperatorin(4),xanthotoxol(5),cnidilin(6),byakangelicin(7),bergaptol(8),byakangelicol(9),pabulenol(10),oxypeucedanin hydrate(11),desmodimine(12),palmitic acid(13),stiamasterol(14),?-sitosterol(15),?-daucosterin(16),and sucrose(17).Conclusion: Compounds 8 and 12 have been isolated from Angelica dahurica var.formosana for the first time.Compound 12 has been firstly isolated from Umbelifera plants.All the courmarin compounds belong to linear 6,7-furanocourmarins.