Objective To investigate the clinical characteristics, risk factors and prevention measures of carbapenem-resistant Klebsiella pneumoniae (CRKP) infection. Methods Thirty-nine cases whose CRKP isolation and culture were positive and who were confirmed with nosocomial infection in 2nd affiliated hospital medical school of Zhcjiang University between July 2006 and July 2008 were retrospectively investigated. Results There were 22 (56.4%) sputum specimens among CRKP samples. The average age of the patients was 64.0 years old and the average length of staying in hospital was 80.8 days. There wcre 36 patients who had been in intensive care unit (ICU) within 2 weeks and 26 were conscious disturbance,38 received urethral catheterization, 34 inserted with central venous catheter, 32 received tracheal intubation and 30 assisted with mechanical ventilation. There were 27 (69. 2 % ) patients who were co-infected with other bacteria and 8 were co-infccted with fungi. The mortality was 46. 2% in patients with CRKP infection. Before CRKP-positive culture, 27 (69.2%)experienced ＞4 kinds of antibiotics with the majority of β-lactams/β-lactamase inhibitors and carbapenems.Conclusions CRKP infection frequently occurrs in elder and patients who prolonged stay in hospital,especially patients in ICU. Invasive procedures could increase the infection opportunities.

Objective To analyze the stress distribution of calcaneus and talus with posterior facet after compression fracture during gait by finite element method. Methods A wedge was resected to simulate the malunion calcaneus with compression fracture of posterior facet. The Bo?hler’s angle was reduced from 35? to 10?. The calcaneus and talus malunion were used to simulate for three phases of the stance during the gait (heel strike, midstance, push off). A finite element solver to calculate. The results were compared with normal condition. Results The stress distribution within the bone in condition of malunion was obtained, and sites of enhanced stresses for three phases were located. The results were significantly different from that of normal condition. Conclusion The results revealed the importance of reconstruction of calcaneal structure and helped us understand the cause of sequela of calcaneal fractures

Objective:To investigate the stiffness characteristic of triple-negative human breast cancer at different size in a implantation nude female mice model using shear wave elastography(SWE) and to compare the clinical pathologic features of tumors with elasticity variables.Methods:Human breast cancer MDA-MB-231 cells were injected into 30 nude female mice and 27 transplanted tumors were successfully found in nude female mice. Ultrasound and SWE were longitudinally performed on maximum diameter plane of 21 tumours in 21 nude mice. The elastic parameters of maximal elasticity(Emax), mean elasticity (Emean) and standard deviation of elasticity(Esd) were recorded. The mice were divided into 3 groups according to the tumor size. They were group A with tumor size less than or equal to 5 mm, group B with tumor size greater than 5 mm and less than or equal to 10 mm, group C with tumor size larger than 10 mm and smaller than or equal to 15 mm. Compared with pathology, the relationships between Ki67 of transplanted tumor and elastic parameters were analyzed.Results:As the transplanted tumors increased, the values of Emax, Esd, Ki67 all increased. The lesions maximal size, Emax, Esd, Ki67 were significant higher in group B ( P<0.001, P=0.006, P=0.002, P=0.026) and group C ( P<0.001, P<0.001, P<0.001, P=0.028) than group A. The other parameters were not significantly different among the groups(all P>0.05). The size of transplanted tumors was significantly and positively correlated with Emax ( rs=0.673, P=0.001), Esd ( rs=0.661, P=0.001), and Ki67 ( rs=0.509, P=0.018). Conclusions:SWE Emax and Esd can reflect the tumor tissue stiffness change and biological activity during the tumor growth.

Objective To evaluate one-stage arthroscopic reconstruction of anterior crueiate ligament (ACL)and posterior cruciate ligament(PCL)using Achilles tendon-bone allografts. Methods From July 2000 to February 2005.we treated 15 patients(11 males and 4 females)whose ACL and PCL were ruptured at one knee but the eontralateral knee was intact.Their associated meniscus injuries were treated arthroscopically according to established procedures prior to ligament reconstruction.Thirty Achilles tendon-bone allografts were used to reconstruct torn ACL and PCL in 15 knees at one stage.Reconstruction of both ligaments was performed at subacute or chronic phase(>3 to 8 weeks)in 12 casses,and at acute phase in 3 cases(<3 weeks).All knees were graded pre-and postoperatively using the International Knee Documentation Committee(IKDC)and Lysholm scoring systems.At follow-up,functions were evaluated for all patients and compared with those of the contralateral healthy knee. Results All patients were followed up for a minimum of 3 years(mean,38 months).Preoperatively,the IKDC ratings showed all the injured knees were severely abnormal.At final postoperative f0Uow-up,9 knees received a normal rating,5 a nearly normal one and 1 an abnormal one.The differences in Lysholm score were statistically significant (t=15.660,P<0.05)between pre-and postoperative analyses.The most noticeable postoperative complication was a short localized fever coupled with arthroedema in 1 case. Conclusions Achilles tendon-bone allograft offers an alternative for simultaneous arthroseopic reconstruction of ACL and PCL.However,problems inherent in allograft tissues entail further investigation to ensure future application.

Aim To assay the mutagenicity of Enphorbia lunulata(EL) decoction and to modify the Ames test for evaluation the mutagenicity of herbal medicine samples.Method The mutagenicity of EL decoction was assayed by standard Ames test; the teratogenicity was done by mammalian bone marrow chromosomal aberration test. In modified Ames test system,the influence of histidine EL decoction was excluded by additional negative control, in which the test media was supplied with histidine (histidine amount equaled to the histidine in different concentration of EL decoction).Result The mutagenicity of EL decoction was positive in the standard Ames test. The teratogenicity of EL decoction was negative in mammalian bone marrow chromosomal aberration test. By the modified Ames tests,the mutagenicity of EL decoction was negative.Conclusion The standard Ames test is not suitable for evaluating the mutagenicity of EL decoction, but the modified Ames test is. The mutagenicity in vitro and the teratogenicity in vivo of EL decoction are all negative.

Objective To study curative efficacy of dezocine in treatment of receiving laparoscopic appendectomy and its effects on white blood cell count and c reactive protein.Methods 90 patients of laparoscopic appendectomy who received therapy from January 2015 to October 2016 in our hospital were selected as research objects,according to random number table,those patients were divided into the observation group and the control group,45 cases in each group.The control group was treated with sufentanil, while the observation group was treated with dezocine.Then operation index, T0 (preoperative),T1(extubation),T2(after extubation) mean arterial pressure(MAP),heart rate(HR), respiration rate(RR),isual analogue scale/score ( VAS) , ramsay score ( RSS) , white blood cell count and c reactive protein of two groups after treatment were compared .Results After treatment, MAP,HR in the observation group were significantly lower than control group [(78.30 ±6.20)mmHg vs.(86.08 ±6.09)mmHg,(76.45 ±5.90)mmHg vs.(80.48 ±5.80)mmHg,(90.82 ±9.50)time/min vs.(96.73 ±9.83)time /min,(87.21 ±8.15)time /min vs.(93.59 ±9.90)time /min](P<0.05); VAS, RSS score were significantly lower than the control group[(2.60 ±0.70)score vs.(5.29 ±0.83)score,(3.53 ±0.92)score vs.(6.38 ± 1.21)score](P<0.05); White blood cell count, c reactive protein were significantly lower than the control group[(7.92 ±2.01) ×109/L vs.(14.98 ±2.11) ×109/L,(7.90 ±2.30)mg/L vs(12.46 ±3.10)mg/L](P<0.05).Conclusion Dezocine is well for receiving laparoscopic appendectomy, obvious analgesic effect, can significantly reduce the white blood cell count and c reactive protein.

Remaining organic and functional damage of ischemia cardio-cerebrovascular disease is always a main trouble puzzling the clinicians. After the discovery of endothelial progenitor cells (EPCs), researchers realize that postnatal angiogenesis is an important biological process, which play a key role to repair the ischemia tissue and improve the function. So a new concept which names therapeutic angiogenesis supply a new treament way for the ischemia cardio-cerebrovascular disease. Traditional Chinese medicine (TCM) has accumulated rich experience on treating the ischemia disease, studies found that many Chinese medicine prescriptions and effective ingredients can increase the therapeutic angiogenesis, howerer the mechanisms were not the same, they mainly manifest in regular the secretion of angiogenic factors, increase the proliferation and differentiation etc. In this paper, we review recent studies, summary the Chinese medicine prescriptions and effective ingredients which can increase the therapeutic angiogenesis, and analyze the differernt pathway. We view to provide reference for the later researchers.
Angiogenesis Inducing Agents ; administration & dosage ; Animals ; Brain Ischemia ; drug therapy ; physiopathology ; prevention & control ; Cerebrovascular Disorders ; drug therapy ; physiopathology ; prevention & control ; Drugs, Chinese Herbal ; administration & dosage ; Humans

OBJECTIVE:To investigate in vitro antibacterial effect of extracts from Miao medicine Rubus multibracteatus leaves. METHODS:The aqueous extract and 80% ethanol extracts from R. multibracteatus leaves were used to prepare solution with mass concentration of 200 mg/mL. Using ampicillin and fluconazol as positive control (50 mg/mL),cup plate method was used to determine antibacterial effects of the extracts from R. multibracteatus leaves to Staphylococcus aureus,Staphylococcus epi-dermidis,Escherichia coli,Shigella dysenteriae,Proteus vulgaris,Candida albicans and Cryptococcus neoformans. The petroleum ether,acetic ether and n-butyl alcohol were used to extract 80% ethanol extracts in turns. After obtaining relevant extracts (50 mg/mL),cup plate method was used to investigate antibacterial effects of them to above 7 bacterial strains. The parts with antibacte-rial effects and bacterial strains sensitive to drug were screened. Micro-broth dilution method and agar culture medium plate method were used to determine minimum inhibitory concentration(MIC)and minimum bactericidal concentration(MBC). RESULTS:The aqueous extract of R. multibracteatus leaves almost had no inhibitory effect while 80% ethanol extract showed different degrees of antibacterial effect to tested bacterial strains,and it also had higher activity against 5 bacterial stains than 2 fungus. The ethyl ace-tate and n-butyl alcohol fractions of 80% ethanol extracts showed good effect while the petroleum ether and water layer fractions had no antibacterial effect,and all the fractions of 80% ethanol extracts showed no inhibitory effect on fungus. To 5 bacterial stains,MIC and MBC of 80% ethanol extract were 6.25-12.5,12.5-25 mg/mL,those of ethyl acetate fractions were 3.13,6.25 mg/mL and those of n-butyl alcohol fraction were 3.13-6.25,6.25-12.5 mg/mL,respectively. CONCLUSIONS:80% ethanol ex-tract of Miao medicine R. multibracteatus leaves and its ethyl acetate and n-butyl alcohol fractions have obvious in vitro antibacteri-al effect to bacteria.

Objective To investigate serum DJ-1 expression and its significance in ovarian cancer. Methods The expression levels of DJ-1 protein were detected by double antibody sandwich method in 52 cases of ovarian tumors (9 cases of benign ovarian tumors, 5 cases of borderline ovarian tumors and 38 cases of ovarian cancer,ovarian tumor group and 20 non-ovarian tumors (control group). Results The expression of DJ-1 protein was lower in the control group than that in ovarian tumor group (P<0.05). The expression of serum DJ-1 protein was higher in ovarian cancer than that in borderline ovarian tumors and in benign ovarian tumors. The expression of serum DJ-1 protein was higher in borderline ovarian tumors than that in benign ovarian tumors (P<0.05).The expression of serum DJ-1 protein was higher in poorly differentiated and moderately differentiated ovarian cancer than that in high-grade differentiated ovarian cancer (P<0.05). No significant dif-ference was found in the expression serum of DJ-1 protein between different pathological and different histological types of ovarian cancer (P>0.05). Conclusion DJ-1 might be used as a serum marker in the diagnosis of ovarian cancer. It might be involved in the pathogenesis of ovarian cancer,and could predit the development and prognosis of ovarian cancer.

Objective To explore the diagnostic value of detecting serum DJ-1 protein combined with CA125 for epi?thelial ovarian tumors. Methods Double antibody sandwich method and electrochemiluminescence immunoassay were used to determine the serum levels of DJ-1 protein and CA125 in 82 cases of epithelial ovarian tumors and 80 non-ovarian tumor cases (control group). The clinical significance of detecting serum DJ-1 protein combined with CA125 was analyzed. Results The expression levels of DJ-1 and CA125 were significantly higher in ovarian tumor group than those in the con?trol group (P<0.05). The critical value of serum DJ-1 was 6.800μg/L and 6.965μg/L in ovarian cancer group compared with the control group and non-ovarian tumor group. The sensitivity of combined detection of DJ-1 and CA125 was higher than that of any marker alone. Conclusion The detecting serum levels of DJ-1 combined with CA125 are helpful to the diagnosis of ovarian cancer, which can be a good marker of ovarian cancer and may improve the early diagnosis rate of ovarian cancer.