OBJECTIVE To evaluate the in vitro inhibitory effects of antibacterials in combination carbapenem against multiresistant Pseudomonas aeruginosa.METHODS The protocol was designed by checkboard method and the MIC of the two antibiotics in combination was determined by broth dilution method.FIC was calculated according to MIC results.RESULTS The MIC50 and MIC90 of eight kinds of antibiotics were lower to 1-16 times and 1-64 times,respectively.The synergistic and additive antibacterial activity was seen in ceftazidime with amikacin,piperacillin with tobramycin and azlocillin with sulbactam.The lomefloxacine with ampicillin and lomefloxacine with ceftriaxone were not correlated.CONCLUSIONS Antibacterial activity of ceftazidime combined with amikacin against carbapenem-multiresistant P.aeruginosa is the best.

Objective To study the intelligence and memory impairment of patients with craniocerebral injury during traffic accident and its correlated factors. Method Data of psychological tests, eletroencepa-lograph (EEG) and brain image information of 652 subjects with brain injury who survived from traffic accident in Chengdu from Jan. 1,1999 to Dec. 31,2001 were collected and analysed. Results The average intelligence quotient (IQ) of patients in patients group was 77.85?15.97. 27.9 % patients's IQ was lower than 70. 51.9% patients's memory quotient (MQ) was lower than 51. The intelligence impairment was correlated with education level, left temporal lobe injury, three or more lobes of the brain injuried and EEG abnormality. Memory impairment was correlated with education level, interval between injury and e-valuation, brain stem injury, left temporal lobe injury, and EEG abnormality. Conclusion Impairment of intelligence and memory in different degrees were observed in most patients with traumatic brain injury during traffic accident. Intelligence and memory impairment were correlated with left temporal lobe injury, EEG abnormality, brain stem injury and education level.

OBJECTIVE To analyze the resistance and gene existing in 7 extended-spectrum beta-lactamases(ESBLs)producing Klebsiella pneumoniae strains from patients after cerebral surgical operation.METHODS Susceptibility test,ESBLs screening and nucleotide sequencing for PCR products of ?-lactamase BLA such as CTX-M,TEM,OXA,SHV,GES,PER and VEB were taken.RESULTS seven isolates of K.pneumoniae may have closed relation with CTX-M positive.CONCLUSIONS The little outbreak might be caused by these 7 homologous strains in the same.

Objective To evaluate the clinical effects of the artificial humeral head prosthesis in the treatment of proximal humerus bone tumors. Methods Fifteen patients with proximal humerus bone tumor had excision of bone tumor and application of artificial humeral head prosthesis were analyzed retrospectively. Among them,8 patients had osteosarcoma,4 patients had giant cell tumor of bone,2 patients had chondrosarcoma, 1 patient had fibrosarcoma. Results All cases were followed up for average (39 ± 5 ) months after the surgery.The duration time of operation were( 110 ± 10) minutes in average. The bleeding volume during operation were (600 ± 41 ) ml in average. One patient with osteosarcoma died of recurrence and metastasis 20 months after the surgery. The functions of the other 14 patients were assessed by Enneking system and the average score was 23.3 ± 3.7. The overall rate of excellent or good results was 84.6% ( 11/15 ). Conclusion Limb salvage surgery with the artificial humeral head prosthesis is an efficacious treatment for proximal humerus bone tumors,which can improve short-term clinical outcome.

Objective To explore the diagnesticvalue of the inhalant allergens in patients with allergic disea-ses. Methods The intradermal tests(IT) of 20 types of the inhalant allergens which were supplied by Diagnosis Rea-gent Factory of Beijing Union Hospital were made on 1434 cases with allergic diseases. The samples were divided into two age groups:4～18 year-old(children group,n=318) and 19-80 year-old( adults group,n=1116). Distribution of the inhalant allergens of the two groups was investigated. Results A total of 1434 cases (male :702, female:732) were diagnosed with allergic diseases. There were 8 kinds of allergic diseases. The number of allergic rhinitis was the first place( 1130 cases,78.80% ). The first 9 positive allergens separately were: polyvalent pollen Ⅰ (51.05%),house dust(48.81% ) ,mixed inhalant allergens( 48.61% ), artemisia pollen( 46.86% ), dust mite( 45.19% ) , poly-valent insects(36.82% ) ,spring poLlen Ⅰ(33.99% ) ,ragweed pollen(31.24% ) ,spring pollen Ⅱ (30.68% ). There were 1289 cases(89.89% ) at ]east one type positively on allergens. The 19～40 aged patients were the most in dif-ferent age groups. The difference of positive detection rate of allergens was significant in different quarters ( P<0.01 ). Conclusion The youth and middle aged is easoer to suffer loom allergic diseases. Allergic rhinitis was the most common disease,and polyvalent pollen Ⅰ ,house dust,artemisia pollen,dust mite,ragweed pollen were the main allergens.

Purpose To investigate the role of SOCS3 on diabetic renal injury. Methods Male CD-1 mice were randomly divided into four groups:control group, diabetic group, empty plasmid vector transfection group and SOCS3 plasmid transfection group. The diabet-ic mice were induced by intraperitoneal injection of STZ at a dose of 150 mg/kg body weight. The mice of transfection group were re-ceived an injection of SOCS3 plasmid or empty vector at every 7 days thereafter. Specimens were collected at 12 week after STZ injec-tion. The morphological changes of tubular epithelial cells were observed by transmission electron microscope. RT-PCR and immuno-histochemistry were used to determine the mRNA and protein expression of CK18 and α-SMA. Western blotting analysis was used to determine the protein expression of SOCS3, p-STAT3, CK18 and α-SMA. Results SOCS3 overexpression in kidney down-regulated the levels of p-STAT3 andα-SMA but up-regulated the expression of CK18. Conclusion Overexpression of SOCS3 can ameliorate the tubular epithelial-mesenchymal transdifferentiation of diabetic mice via inhibiting the phosphorylation of STAT3.

Objective To reduce the screening positive rate (SPR) and improve clinical efficiency of maternal serum screening for Down's syndrome.Methods Nine thousand and thirty-three cases of second trimester maternal serum screening for Down's syndrome were included from Apr.2013 to Apr.2014 in the present study.The screening results,all basic data and equation curves were analyzed retrospectively.Based on the data from the authors' laboratory,the important adjustment parameters were simulated.Combined with postnatal follow-up results,the quality and clinical performance of second trimester serum screening for Down's syndrome were evaluated.Results The SPR of second trimester serum screening for Down's syndrome was 6.69％(604/9033),the detection rate (DR) was 75％(3/4),and FPR was 6.65％(601/9033).The median multiple of median (MOM) of alpha-fetoprotein (AFP) was low and SPR was high,and MOM of free human chorionic gonadotropin β subunit (free hCGβ) were high and SPR was high,while MOM of unconjugated estriol (uE3) were a little bit low,and SPR was slightly high.Considering these three factors,it is believed that the screening positive rate is high.By the simulation adjustments of MOM value equations (AFP and free hCGβ) and weight correction equation,the SPR reduced to 4.11％(371/9033) after recalculating the risk,FPR declined to 4.07％(368/9033),and no more Down's syndrome fetus were missed compared with postnatal follow-up results.Conclusion Based on a localized setting depending on the local laboratory data,we suggest that the MOM value distributions(AFP,free hCGβ and uE3) and maternal weight should be regularly adjusted since it is a useful way to reduce the false-positive rate and improve clinical efficiency of maternal serum screening for Down's syndrome.

Objective To study the effect of thorium and rare earth mixed dust on chromosome aberrations in the lymphocytes of occupational exposed worker8.Methods Analyses of unstable chromosome aberrations on 53 occupational exposed worker8 and 58 control workers were carried out by the conventional Giemsa staining method.Fluorescence in situ hybridization method Wills performed to analyze the chromosome stable aberrations on 10 occupational exposed workers and 10 control workers.Results The frequencies of chromosomal aberration cells,dicentfics plus rings,total aberrations in exposed workers were significantly higher than those in controls.No significant difference was found in the frequency of acentric aberrations between exposed and non-exposed workers.No significant difference was found in the frequency of translocations between exposed and non-exposed workers.Conclusions Chronically occupational exposure to thorium and rare earthmixed dust can increase the induction of unstable chromosome aberration,but the increase of stable chromosome aberrations(translocation)can not be observed.

Objective To investigate the expression of nuclear factor-κB (NF-κB) and p53 up-regulated modulator of apoptosis (PUMA) in acute lung injury (ALI) induced by severe acute pancreatitis (SAP), and the therapeutic role of proline dithiocarbamate (PDTC). Method SD rats weighed 200～ 250 g were randomly(random number) divided into sham operation group (A group, n = 18), ALI group (B group, n = 18) and PDTC treatment group (C group, n = 18). The model of SAP was eastablished by injecting 1 mL/kg of sodium tauarocholate into the pancreatic capsule of the rats in B group and C group. The model rats in C group were treated with PDTC one hour after modeling. Six rats of each group were sacrificed 6 h,12 h, and 24 hours after modeling. The histopathological changes in lung and pancreas were observed. The levels of NF-κB p65 and PUMA in lung were detected by using Western blotting, and the expressions of bcl-2, bax and caspase-3 mRNA in the lung were detected by using RT-PCR. The lung tissue was taken for examination under transmission electron microscope. TUNEL was used for detection of apoptotic alveolar epithelial cells. Results Six to 24 hours after modeling, the pathological scores in lung of ALI group were significantly higher than those of control group and PDTC group after sodium taurocholate injection ( P ＜ 0.05). The levels of NF-κB p65 and PUMA, and the expressions of bax and caspase3 mRNA in ALI group at different intervals were higher than those in control group and PDTC group ( P ＜ 0.05),whereas the expression of bcl-2 mRNA in ALI group was lower than that in control group and PDTC group ( P ＜0.05). The NF-κB p65 was correlated closely and positively with PUMA ( r= 0.987, P ＜ 0.01). Higher activity of caspase-3 acrtive units was seen in ALI group than that in control group and PDTC group ( P ＜ 0.05). The microvilli disappeared in ALI group 24 hours later. The apoptosis index in ALI group was higher than that in control group and PDTC group ( P ＜ 0.05). Conclusions The apoptosis of alveolar epithelial cells of rats in ALI group is caused by PUMA activated by NF-κB. PDTC treatment can inhibit apoptosis of alveolar epithelial cells of rats in ALI group by inhibiting the activation of NF-κB.

Objective · To investigate the clinical characteristics and multidisciplinary treatment of children with clear cell sarcoma of kidney (CCSK). Methods · Data of seven children with CCSK treated at Xinhua Hospital, Shanghai Jiao Tong University School of Medicine between Jan 2011 and Jan 2016 were collected. The retrospective analysis of clinical manifestations, features of imaging and pathology, treatment, and follow-up was performed. Results · Of 7 children with CCSK, 6 were male and 1 was female with the median age of 28 months (4-59 months), and 3 were at stageⅠ, 2 at stage Ⅲ, and 2 at stage Ⅳ. All cases were discussed and evaluated by multidisciplinary teams, including pediatric hematology/oncology, pediatric surgery, pathology, radiology and radiotherapy. CCCG-WT-2009 protocol was adopted to treat these patients. The median follow-up period was 22 months (8-56 months). Six children survived and one died. Conclusion · The multidisciplinary treatment mode can effectively improve the prognosis of CCSK. CCCG-WT-2009 protocol has good therapeutic effect and high cure rate for children with early stage CCSK, but the treatment of advanced stage CCSK needs to be further explored and perfected.