Objective To investigate the antimicrobial resistance of Gram-positive cocci isolated from 17 hospitals located at different areas in China. Methods All the Gram-positive cocci isolated from 17 hospitals from October 1 st, 2004 to September 30th, 2005 were collected for susceptibility test using standard agar dilution method issued by The Clinical and Laboratory Standards Institute (CLSI,2004). The minimal inhibitory concentration (MIC)50 and MIC90 were detected for antibacterial activity in vitro of 35 antimicrobial agents. The rates of resistance, intermediate and susceptiblity of bacteria to the agents were calculated. Results Totally, 925 Gram-positive cocci strains were collected during the period, which included Staphylococcus 536, Enterococcus 249, Streptococcus 137 and other Gram-positive cocci 3; the rates of oxacillin resistant Staphylococcus aureus (ORSA) and oxacillin resistant Staphylococcus epidermidis (ORSE) were 62.9% and 82.9%, respectively. The penicillinnonsusceptible Streptococcus pneumoniae (PNSP) was 40.7 % including 10.5 % resistant and 30.2intermediate. All strains of Enterococcus were susceptible to teicoplanin. No Enterococcus was resistant to vancomycin. Five strains of Enterococcus were found intermediate to vancomycin, which were 1 E.faecalis, 2 E. faecium, 1 E. gallinarum and 1 E. avium. No glycopeptides resistant Gram-positive coccus was detected. Conclusions The antimicrobial resistance of Gram-positive cocci is increasing with higher isolate rate of penicillin-resistant Streptococcus pneurnoniae (PRSP) and methicillinresistant Staphylococcus aureus (MRSA). All the investigated Gram-positive cocci are highly resistant to macrolides. No glycopeptide resistant strains are detected during the surveillance.

Objective To evaluate the value of 64-slice spiral CT angiography in diagnosing diabetic leg arteriosclerosis obliterans(DLASO).Methods 64-slice spiral CT angiography was done in 90 patients with diabete and suspected vascular disorders of lower limb.Images were analyzed on the basis of the transverse CT source data including the maximum intensity projection(MIP),volume rendering(VR),multiplanar reconstruction(MPR) and curved planar reconstruction(CPR).Results 64-slice spiral CT angiography could exactly show the space relationship and anatomical detail of aortoiliac and lower extremity arteries.Arteriosclerostic obliterans was found in variant degree in 67 cases(67/90),of them,49(56.3%) were slight to medium arteriostenosis,18(20.7%) were obvious arteriostenosis and 7 were complete obstructed with collateral circulation.Conclusion 64-slice spiral CT angiography is of significant value in the assessment of arteriosclerosis obliterans of lower extremity arteries in the patients with diabetes.

?Pterygium is one of the most common ocular surface diseases. Its exact etiology and pathogenesis are not completely understood. At present, it is considered that its occurrence and development is the result of many factors. Current studies have indicated that the occurrence of pterygium is closely related to the environmental factors. Long time exposure to sunlight, dust, pollen and other long - term chronic stimulation are the main incentive factors. Various factors have caused limbal barrier dysfunction, induced the level of a variety of growth factors and inflammatory factors increased, so that the conjunctival tissue degenerate and proliferate to the cornea in the formation of pterygium. In this paper, the research progress of the pathogenesis of pterygium is reviewed.

Objective To assess the efficacy of dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) of the breast in the detection of residual lesions of early stage breast carcinoma after lumpectomy. Methods 53 patients with breast masses confirmed to be malignant tumors by pathology after lumpectomy underwent the dynamic contrast-enhanced breast MR imaging and then further surgical treatment by lumpectomy. The DCE MRI-based diagnoses were compared to the results of pathological analyses after the second lumpectomy. Results 17 (32%) cases were detected with abnormal enhancement. 8 cases presented mass-like enhancements , and 6 of them showed tumorous residuals (P < 0.01). 6 presented focal enhancements, taking up 35% and one of them was confirmed pathologically to have tumorous residuals (P < 0.01). 3 cases presented mass-like enhancement, taking up 18% and 2 of them were confirmed with cancerous residuals . MR dynamic enhancement showed 68% of the them presented no abnormal enhancements in the breast and 33 of themhad no residual cancer , taking up 92%. 3 of them were confirmed with tumorous residuals , taking up 8%. The The positive predictive value and negative predictive value of DCE MR imaging for diagnosing residual malignant lesion were 52% and 92%, respectively . Conclusion The dynamic contrast-enhanced MRI of breast is helpful for evaluating residual malignant lesion after lumpectomy and affects positively subsequent treatment.

With the development of medical education,the traditional cell biology teaching modes and methods need constant adjustment to adapt to the current teaching.In view of the present high-speed development of cell biology,we seriously picked some representative themes to carry out thematic teaching.Students were encouraged to read some references about the corresponding content and thought primarily before the class.After the lesson,the teacher guided students to discuss and find the answers to the questions they asked before.Participation in class discussion and homework completion accounted for 10％ of the final assessment results.The thematic teaching helped to optimize classical teaching contents and frontier progress.This teaching mode not only stimulated learning interest but also fully exercised learning ability.

Objective To evaluate efficacy in detecting lung nodules at low-dose CT(LDCT) by nodule enhanced viewing(NEV).Methods One hundred and twenty seven patients who were referred to undergo low-dose CT (LDCT) for the evaluation of pulmonary metastasis or screening lung cancer were selected randomly.Two radiologists with at least 10 years experience read the images with normal clinical reading speed to find actionable nodules ≤ 2.0 cm in maximum diameter,and their consensus result was referred as Standard.NEV was adopted to detect the pulmonary nodules.Two residents with experience of less than three years read first detected suspicious nodules and recorded reading time,first consensus and mean time were recorded.Then,they made second decisions on the images with the help of NEV and the results and the reading time were recorded and analyzed by using wilcoxon test.The sensitivity and accuracy of NEV,residents and residents with NEV were analyzed.Results Standard,resident,NEV and resident with NEV detected 570,404,768 and 593 lung nodules ≤2.0 cm in maximum diameter,respectively.More than 60％ nodules were less than 0.5 cm in maximum diameter.The performance of NEV in detecting nodules ≤2.0 cm as well as nodules ＜ 0.5 cm in maximum diameter was significantly higher than that of the resident(Z =-6.887,P ＜0.01 and Z =-7.235,P ＜0.01),and the performance of resident with NEV indetecting nodules ≤2.0 cm as well as nodules ＜ 0.5 cm in maximum diameter was significantly higher than that of resident without NEV (Z =-6.606,P ＜ 0.01 and Z =-6.657,P ＜ 0.01).The resident,NEV and the resident with NEV detected nodules ＜ 20 mm in maximum diameter with sensitivities of 61.4％,86.3％ and 95.3％,and with accuracy of 56.1％,58.1％ and 87.6％,respectively.The resident achieved sensitivities of 51.4％,88.1％ and 94.8％,and accuracy of 47.0％,56.9％ and 87.5％ for nodules ＜5 mm in maximum diameter,respectively.The resident,NEV and resident with NEV spent 120-444 s,85-262 s and 131-1512 s per case to read the CT scans,respectively.The reading time of resident with NEV in was significantly higher than that of resident without NEV(Z =-9.781,P ＜ 0.01).The resident spent 23 s per NEV mark.Conclusion NEV considerable improves the resident's performance in lung nodule detection,especially in maximum diameter ＜ 0.5 cm nodule detection.

AIM　The relation between lung collagen,lung elastin and anti-oxidative capacity was investigated in the experiment, and the aging model of mice was induced by D-galactose. METHOD　The aging mice treated with cistanche desertica polysacchrides (50,100 mg*kg-1*d-1) and determinate the modification of SOD、GSH-Px、Vit E、MDA in blood and lung. RESULTS　Cistanche desertica polysacchrides (CDP), which was isolated from Cistanche desertica cultivated in Xinjiang could enhance lung anti-oxidative capacity and inhibit the modification of lung elatic constitution induced by D-galactose. CONCLUSION　Cistanche desertica polysacchrides have anti-oxidative injury and anti-aging effects on lung.

To state the importance of scientific research capability and general practitioners training for the poor scientific innovation conditions of general practitioner standardization training by the analysis of several ways to improve the scientific research capacity and the probe of the impact on strengthening the consciousness of scientific research to help general practitioner to better work in the areas of primary care and public health.

Objective To investigate the clinical efficacy and safety of radiofrequency ablation (RFA)combined with low frequency ultrasound radiation with microbubble for the treatment of malignant liver neoplasms.Methods The clinical data of 25 patients with malignant liver neoplasms who received RFA combined with low frequency ultrasound radiation with microbubble at the Kunming General Hospital from January 2010 to June 2011 were retrospectively analyzed.RFA was firstly performed with ultrasonic guidance,and then low frequency ultrasound radiation with microbubble was performed according to the results of ultrasound contrast examination 1 week after RFA.Ultrasound contrast examination was performed and the hepatic function and serum alpha fetoprotein (AFP) were assayed before operation,3 and 6 months after operation,respectively.All data were analyzed using the t test or chi-square test.Results The gross tumor volumes of 16 patients reduced by 30％ at 3 months after operation when compared with that before operation.The gross tumor volumes of 17 patients reduced by 50％ at 6 months after operation when compared with that before operation.The gross tumor volume of 7 patients reduced,but tissues surrounding tumors showed the signal of bloodstream.The gross tumor volume of 1 patient did not reduce.The levels of aspartate aminotransferase (AST),total bilirubin (TBil) and alpha fetoprotein (AFP) at 3 months after operation were significantly lower than those before operation (t =23.51,13.79,257.07,P ＜0.05).The levels of alanine aminotransferase (ALT),AST,TBil and AFP at 6 months after operation were significantly lower than those before operation (t =5.67,27.19,21.02,333.46,P ＜ 0.05).No local recurrence was detected during a follow-up of 6 months.The scores of quality of life (QOL) were very good in 21 (84.0％) patients,good in 2 (8.0％) patients,fair in 1 (4.0％) patient and poor in 1 (4.0％) patient.The scores of Karnofsky (KPS)were improved in 19 (76.0％) patients,stable in 5 (20.0％) patients and aggravated in 1 (4.0％) patient.There were significant differences in QOL and KPS between pre-and postoperation (x2=41.600,18.960,P ＜0.05).Conclusion RFA combined with low frequency ultrasound radiation with microbubble is effective in reducing the tumor size and protect the hepatic function for patients with malignant liver neoplasms.

AIM:To study the correlation of serum uric acid ( UA) level with carotid plaques and arterial stiff-ness in the patients with essential hypertension ( EH) , and to explore the predictive value of serum UA for evaluating EH preclinically .METHODS:A total of 92 patients with EH and 30 healthy individuals were enrolled .The value of UA and other indicators were detected .B-mode ultrasound examination was performed to measure the common carotid artery intima -media thickness ( IMT) and the sites of plaque in the internal carotid-artery, external carotid artery and carotid bifurca-tions.Carotid-femoral arterial pulse wave velocity ( CFPWV) was assessed by Complior?atherosclerosis measurement in-strument.RESULTS:The serum level of UA in the patients with EH was higher than that in control group [(361.51 ± 83.81) μmol/L vs (317.03 ±62.22) μmol/L, P<0.05].The mean value and abnormal rate of IMT between hyperten-sion group and control group were significant difference [(0.69 ±0.14) mm vs (0.60 ±0.12) mm, 42.39%vs 10.00%, P<0.05].In 92 EH patients, 45 cases had carotid plaques .These 45 cases were divided into 3 groups according to the plaque severity, among which the serum UA level had statistically significant differences [(285.25 ±78.41) μmol/L, (341.19 ±63.99) μmol/L and (401.33 ±88.49) μmol/L, P<0.05].Compared with rigid plaque group ( n=34), the serum UA level in soft plaque group (n=11) was significantly higher [(389.00 ±69.45) μmol/L vs (323.03 ± 72.71) μmol/L, P<0.05].A stepwise multiple linear regression analysis demonstrated that age ( r=0.414), systolic blood pressure (r=0.224), pulse pressure (r=0.270) and uric acid (r=0.219) were predisposed factors for higher CFP-WV (P<0.05).CONCLUSION:UA is one of the risk factors causing hypertension .Serum UA level may reflect the sever-ity and stability of carotid plaques .The increased arterial stiffness is closely related to the increased serum UA level in EH .