OBJECTIVE To investigate antimicrobial resistance of Enterobacter cloacae in our hospital,for guiding the treatment of these infections in clinical practice.METHODS Bacterial susceptibility testing was done by Kirby-Bauer method and bacteria were identified by VITEK-32.Retrospective analysis of the drug resistance was done to the E.cloacae isolated from our hospital in the recent 3 years.RESULTS A total of 364 E.cloacae strains were isolated,which mainly isolated from sputum.They were resistant to 13 types of antibacterial agents but the resistance rate to imipenem was 3.30%.The resistant rate to third and fourth generation cepholosporins(excepting cefoperazone/sulbactam) and quinolones was more than 30% and to ampicillin and cefazolin was more than 94.00%.CONCLUSIONS E.cloacae is severely resistant to cepholosporins and quinolones.More attention should be paid to the surveillance of such strains.Imipenem may be considered for use in critical patients.

The angiotensinogen(AGT) expression and angiotensin Ⅱ (AngⅡ ) secretion levels in cultured SD rat mesangial cells were determined. High glucose up-regulated AGT mRNA(0. 29±0.07 vs 0. 20±0. 05,P< 0.05)and protein(0.66±0.23 vs 0.37±0. 15,P<0.05) expression and Ang Ⅱ secretion [(9.85±2.08 vs 7.50± 1. 51) pg/ml,P<0. 05]levels, which were down-regulated by pyrrolidine dithiocarbamate( PDTC) treatment via inhibiting NF-κB activity.

Objective To investigate the clinical value of Fluorine-18-fluorodeoxyglucose (18 F-FDG) PET/CT examination to predict the prognosis of patients after colorectal cancer operation.Methods The retrospective cross-sectional study was adopted.The clinicopathological data of 80 patients with colorectal cancer who were admitted to the First Hospital of Nanjing Medical University from March 2007 to October 2015 were collected.Eighty patients received first preoperative 18 F-FDG PET/CT examination and underwent operations under decisions of patients and their families,and then adjuvant chemotherapy were performed according to the patients' condition.Observation indicators included:(1) preoperative imaging examination,(2) situations of treatment and follow-up,(3) analysis of prognostic factors.The patients were followed up by outpatient examination and telephone interview once every 3 months within postoperative 1 year,once every half a year within postoperative 2 years and then once a year up to May 2016.The follow-up included tumor recurrence or progression and survival of patients.Tumor-free survival time was from postoperative day 1 to tumor recurrence or progression and death or end of follow-up.Overall survival time was from postoperative day 1 to death or end of follow-up.Measurement data with skewed distribution were represented as M (Qn) and M (range).The optimal cutoff point of tumor-free survival of maximum standardized uptake value (SUVmax),mean standardized uptake value (SUV),metabolism of volume (MTV) and total lesion of glycolysis (TLG) were investigated using the ROC curve analysis,and calculating area under the curve (AUC).The median was used as a cutoff point if there was smaller AUC.The Kaplan-Meier method and Log-rank test were respectively used for survival analysis and univariate analysis,and COX proportional hazards model for multivariate analysis.Results (1) Results of preoperative imaging examination:results of PET/CT in patients with colorectal cancer showed there were circumscribed thickening of bowel wall,intestinal cavity strictures,fuzzy fat space around the some lesions,enlarged lymph node and 18 F-FDG uptake increased abnormally.The SUV SUV MTV and TLG of 80 patients were 11.83(4.26,35.42),7.06(2.38,20.92),20.47 cm3 (1.29 cm3,161.50 cm3) and 138.58 (14.17,857.89),respectively.ROC curve showed that the AUC of SUV SUV MTV and TLG were 0.453,0.448,0.815 and 0.749 [95％ confidence interval (CI):0.307-0.600,P ＞0.05;0.303-0.594,P ＞ 0.05;0.717-0.913,P ＜ 0.05;0.635-0.863,P ＜ 0.05],respectively.The median SUVmax (11.83) and SUV (7.06) were used as the cutoff points due to smaller AUC of SUVmax and SUV.The cutoff point of MTV was 18.79 cm3 (sensitivity =86.2％ and specificity =68.3％),and the cutoff point of TLG was 142.05 (sensitivity =75.9％ and specificity =70.7％).(2) Situations of treatment and follow-up:among 80 patients,13 underwent the radical resection of colorectal cancer and resection of liver metastasis and 67 underwent radical resection of colorectal cancer.Sixty-two patients received postoperative chemotherapy,including 45 with chemotherapy regimens of capecitabine and 17 with fluorouracil.Eighty patients were followed up for 41.8 months (range,6.5-109.1 months).During the follow-up,29 patients had tumor recurrence or progression,and 19 patients were dead.The median tumor-free survival time,1-,3-and 5-year tumor-free survival rates in 80 patients were 19.5 months (range,2.0-109.1 months),73.7％,36.3％ and 18.8％,respectively.The median overall survival time,1-,3-and 5-year overall survival rates were 31.8 months (range,3.3-109.1 months),76.3％,37.5％ and 20.0％,respectively.(3) Analysis of prognostic factors:results of univariate analysis showed that tumor location,N staging,M staging,clinical staging,postoperative chemotherapy,MTV and TLG were relative factors affecting postoperative tumor-free survival rate (HR =3.469,5.325,5.295,8.605,2.630,7.388,5.155,95％ CI:1.522-7.906,2.256-12.568,2.405-11.657,2.969-24.937,1.063-6.504,2.550-21.403,2.178-12.204,P ＜ 0.05).The tumor location,tumor differentiation,N staging,M staging,clinical staging,MTV and TLG were relative factors affecting postoperative overall survival rate (HR =2.697,2.814,3.083,2.916,4.193,5.450,4.876,95％ CI:1.011-7.197,1.121-7.062,1.166-8.149,1.140-7.454,1.386-12.678,1.581-18.786,1.727-13.766,P ＜ 0.05).In multivariate analysis,stage Ⅲ-Ⅳ of clinical staging and TLG≥ 142.05 were independent risk factors affecting postoperative tumor-free survival rate (HR =9.879,3.569,95％ CI:1.854-22.836,1.127-11.306,P＜0.05).The stage M1,stage Ⅲ-Ⅳ of clinical staging and TLG≥ 142.05 were independent risk factors affecting postoperative overall survival rate (HR =4.522,9.315,10.120,95％ CI:1.223-16.717,1.338-24.864,2.385-12.947,P＜0.05).Conclusion TLG through 18 F-FDG PET/CT examination is an independent prognostic factor affecting postoperative tumor-free survival rate and overall survival rate in patients with colorectal cancer after curative resection,and it has certainly reference value for prognosis.

This investigation was made on 30 adult female rats weighing approximately 150～200g. during estrus as judged from vaginal smear examination. Ovaries which investigated with electron microscope, were fixed in 3％ glutaraldehyde. Other ovaries were embeded in paraffin and examined under light microscope.Theca folliculi of large antral follicles were examined with electron microscope. Three kinds of theca cells were distinguished. They were secretory cell, fibroblast and smooth muscle cell. The secretory cell showed the characterastics of the steroidproducing cell, having smooth endoplasmic reticulum, mitochondria and lipid droplets. The fibroblast contained rough endoplasmic reticulum, free ribosomes and mitochondria in the cytoplasm. The smooth muscle cell was located in the outer layer of theca folliculi, and its structural features were typical according to the criteria of Somlyo and Somlyo: (1) pinocytotic vesicles of the cytoplasmic membranes; (2) myofilaments in the cytoplasm; (3) dense bodies intimately related to the myofilaments; and (4) location of mitochondria and endoplasmic reticulum at the nuclear poles.The ultrastructure of smooth muscle cell, its differentiation and other problems were discussed.

0.05).The effective rate on relieving traditional Chinese medical syndrome was 95.0% in the treatment group and 73.3% in the control group,the difference being significant(P0.05).After treatment,the parameters of 24-h dynamic blood pressure were improved in both groups(P

Child, Preschool ; Female ; Hand, Foot and Mouth Disease ; complications ; diagnosis ; therapy ; Humans ; Infant ; Male ; Pulmonary Edema ; etiology ; Radiography, Thoracic

Anti-Arrhythmia Agents ; therapeutic use ; Cardiomyopathies ; drug therapy ; etiology ; Child, Preschool ; Female ; Humans ; Moricizine ; therapeutic use ; Tachycardia ; complications ; drug therapy ; Treatment Outcome

Objective To investigate the difference of standard tangential field and multiple fileld radiotherapy in axillary lymph node after conserving surgery,to provide a reference for clinical treatment.Methods 20 cases of left breast cancer patients were selected,all patients underwent breast -conserving surgery,postoperative radiothera-py.All patients used standard radiotherapy wild tangent based and reverse -intensity modulated radiation therapy optimization.Armpit I,Ⅱ lymph nodes were used to calculate the extent of coverage of the original plan,target dose uniformity HI,dose conformal CI,dosimetric parameters were calculated.Results Under standard tangential field irradiation,I stand mean dose was (33.95 ±8.24)Gy,which was significantly higher than Ⅱ station (22.13 ± 6.67)Gy,and V50,V45,V40 were (22.45 ±6.32)%,(39.83 ±7.54)%,(49.65 ±8.31)%,which were higher than Ⅱ stand,I stand irradiation was significantly more,the differences were statistically significant (t =5.632,P =0.009;t =7.214,P =0.000;t =8.954,P =0.000;t =6.121,P =0.002).The whole breast irradiation armpit IMRT plan,19 patients (95.00%)reached 95% by volume APTV≥50Gy,coverage was better;but HI,CI were (1.11 ± 0.03),(1.36 ±0.07)respectively,which were significantly worse than the standard wild tangent,the differences were statistically significant (t =6.584,P =0.001;t =9.144,P =0.000).Under Hatano IMRT irradiation ipsilateral lung,heart suffered an average dose of (1 694.58 ±102.31)cGy,(645.54 ±74.44)cGy,which were significantly more than the standard tangential field irradiation,the differences were statistically significant (t =7.654,P =0.000;t =6.654,P =0.001).Conclusion Standard tangential field irradiation has poor coverage in Ⅱ axillary lymph node station,irradiation intensity modulated radiation has better coverage,but significantly increased the dose to normal tissues.

Adolescent ; Adult ; China ; Counseling ; Dangerous Behavior ; Female ; HIV Infections ; prevention & control ; Humans ; Middle Aged ; Patient Acceptance of Health Care ; Young Adult

objective To evaluate the clinical application value of ileum to the S-type of suture pro- duced orthotopic neobladder.Methods Radical cystectomy and ileal neobladder with"S"shape were per- formed in 3patients with transitional cell carcinoma.Ureter implant into neobladder with embedding nipple techniques,bottom of neobladder coincide with urethra stump.Results The average operative time to form a neobladder was 5 hours,average bleeding volume was 366 ml during operation,3 cases can control urine dur- ing daytime,nycturia 1-3 times every night.Neobladder has a large capacity,low pressure,and electrolytes of blood was normal.Conclusion The construction of an ileal neobladder using a smaller part of ileum that has been completely detubularized and fashioned by S shape is easy and agreeable to perform.This mode of oper- ation has low complication rates,achieves adequate capacity at low pressure,and provides satisfactory conti- nence rates.It is a fine scheme to treat invasion and multiple carcinoma of bladder.