Bone Marrow Cells ; pathology ; Bone Marrow Neoplasms ; pathology ; physiopathology ; Humans ; Neoplasm Metastasis ; pathology ; physiopathology ; Tumor Cells, Cultured

OBJECTIVE To realize the present resistance characteristics of enterococci to common antimicrobial agents,and to provide reference for clinical therapy. METHODS A total of 79 isolates of enterococci were collected from samples during the period of 2000-2003.The broth microdilution test and ?-lactamase determination were performed for each of the strains.The laboratory data were analyzed. RESULTS The rates of Enterococcus faecalis and E.faecium were 73.4%,and 26.6% of all enterococci isolates.The most common sites of infection were urinary tract(35.4%),surgical secretion(24.1%),and sputum(15.2%).The rate of E.faecium approached 50% of enterococci in urinary tract.The antibiotic resistance of E.faecium was more than E.faecalis to ampicillin,penicillin,and rifampin.The ratio of HLAR enterococci and VRE to total enterococci isolates were 61.9% and 0;?-lactamase producing rate was 6.3%. CONCLUSIONS Urinary infection caused by enterococci is most frequent.E.faecium is found more easily in urinary tract than in the others and very resistant to antibiotics.Vancomycin shows fairly high activity against enterococci.The different regimens should be adopted for different enterococci.

OBJECTIVE:To improve the quality standard of Shuangshen capsule. METHODS:TLC was conducted for the qual-itative identification of Curcumnae radix and Rehmannia glutinosa in the preparation. HPLC was used for the content determination of salvianolic acid B in the preparation:the column was Diamonsil C18(2)with mobile phase of acetonitrile-0.1% H3PO4(22:78, V/V) at a flow rate of 0.5 ml/min,detection wavelength was 286 nm,column temperature was 30 ℃,and the injection volume was 2 μl. RESULTS:The TLC spots of C. radix and R. glutinosa were clear and well separated;the linear range of salvianolic ac-id B was 0.0792-0.792 μg(r=0.9999);RSDs of precision,stability and reproducibility tests were lower than 1%;recovery was 100.71%-101.82%(RSD=0.50%,n=6). CONCLUSIONS:The established standard can be used for the quality control of Shuang-shen capsule.

Objective To explore the efficacy and safety of terminating biochemical pregnancy (the stage in which intrauterine or ectopic pregnancy cannot be confirmed) with mifepristone and misoprostol. Methods Mifepristone (150 mg) combined with misoprostol (600 ?g) 3 days later were given to 500 biochemical pregnancies (G_1),500 early clinical pregnancies (G_2) and 500 clinical pregnancies (G_3) which were classified according to amenorrhea days,serum human chorionic gonadotropin-beta subunit (?- hCG) and vaginal B-ultrasonic examinations.All were observed for 6 hours after taking misoprostol and returned for assessment per week.Results Expulsion of conceptus was G_1 123 (24.6%,123/500),G_2 438 (87.6%,438/500) and G_3 467 (93.4%,467/500).Failure rate was G_1 6 (1.2%,6/500),G_2 24 (4.8%,24/500) and G_3 79 (15.8%,79/500) for ongoing pregnancies,hospitalizations for suspected ectopic pregnancies and surgical intervention for heavy or long-time bleeding.Bleeding cases during the administration of mifepristone were G_1 272 (54.4%,272/500),G_2 141 (28.2%,141/500) and G_3 87 (17.4%,87/500);the mean bleeding days were G_1 (5.8?1.5),G_2 (9.0?2.9) and G_3 (14.3?5.9) days.Other side effects including abdominal pain,nausea,vomiting and diarrhea were low and light in each group,increasing with advancing gestational age.Menses recovery was 486 (97.2%,486/500),452 (90.4%,452/500) and 433 (86.6%,433/500) for each group on scheduled time.Satisfaction was 499 (99.8%,499/500),485 (97.0%,485/500) and 369 (73.8%,369/500) respectively.Conclusion Mifepristone and misoprostol in combination is as safe,and effective for termination of biochemical pregnancies as ordinary medical abortion.It does not need to wait till ectopie pregnancy is excluded.

Communicable Diseases, Emerging ; genetics ; Genomics ; Humans

OBJECTIVE:To observe clinical effects and safety of sequential therapy of Ginkgo biloba extract preparation for elderly acute cerebral infarction,and to evaluate its pharmacoeconomics. METHODS:Totally 98 patients with acute cerebral infarc-tion selected from neurology department of our hospital during Aug. 2014-Aug. 2015 were divided into control group and test group according to random number table,with 49 cases in each group. Both groups received routine therapy of antiplatelet aggregation, microcirculation improvement. Control group was additionally given Shuxuening injection 10 mL,ivgtt,qd,for consecutive 21 d. Test group was additionally given Shuxuening injection 10 mL,ivgtt,qd,for 7-10 d;and then given G. biloba tablet instead,1 tablet,po ,tid,for 21 d in total. Clinical efficacies of 2 groups were compared as well as ESS score,ADL score,blood flow in-dexes and blood lipid indexes before and after treatment,and adverse drug reaction. Cost-minimization analysis was used for phar-macoeconomic evaluation. RESULTS:After treatment,total response rate of control group and test groups were 87.23% and 83.33%,without statistical significance (P>0.05). Before treatment,there was no statistical significance in ESS score,ADL score,blood flow indexes and blood lipid indexes between 2 groups (P>0.05). After treatment,ESS score and ADL score of 2 groups were increased significantly,and whole blood viscosity,plasma viscosity,hematocrit,fibrinogen content,TC and TG were decreased significantly;there was statistical significance with before treatment(P<0.05);there was no statistical significance be-tween 2 groups(P>0.05). There was no statistical significance in the incidence of ADR between 2 groups(P>0.05). The average cost of control group and test group were (7060.9 ± 234.8) yuan and (5800.7 ± 149.5) yuan,with statistical significance (P<0.01). CONCLUSIONS:The sequential therapy of G. biloba extract preparation is similar to intravenous dirpping in the treatment of elderly acute cerebral infarction in therapeutic efficacy and safety. The sequential therapy is better in economics field.

Clinical competence was estimated for grades 2011-2013 general practitioners (GPs)trained by the DxR Clinician software.Clinical cases were solved on computer.And the abilities of diagnosis,thinking and handling were assessed.The average score of all GPs was 61.68 ± 10.69.The average score of diagnostic ability was the highest at 71.82 ± 15.47 (weighted score of 25.1).The average score of thinking ability was 62.36 ± 10.40 (weighted score of 28.1).And the average score of handling ability was the least at 42.27 ± 18.22 (weighted score of 8.5).Significant differences in average scores existed between grades 2011 and 2013 (P ＜ 0.05).Significant differences in score of clinical thinking ability existed between grades 2011,2012 and 2013 (P ＜ 0.01) respectively.None of them passed the part of handling.The longer period of training,the higher scores the residents obtained.Since the ability of clinical handling fared the worst,targeted training should be strengthened.

Objective To investigate the diagnostic value of the split-hand sign in amyotrophic lateral sclerosis ( ALS).Methods Ninety ALS patients, 41 patients with other neuromuscular disorders and 71 normal controls were recruited for conventional nerve conduction study.Compound muscle action potential ( CMAP) amplitude recorded from abductor pollicis brevis ( APB) , abductor digiti minimi ( ADM) and first dorsal interosseous (FDI), CMAP amplitude ratios, CMAP amplitude differences and split-hand index ( SI) were analyzed.Results The APB/ADM CMAP amplitude ratio was significantly lower in the ALS patients (0.44(0.44)) than that in the patients with other neuromuscular disorders (1.31(0.87);z=6.967, P<0.01) and the normal controls (0.99(0.42);z=7.687, P<0.01).The FDI/ADM CMAP amplitude ratio was significantly decreased in the ALS patients ( 0.79 ( 0.46 ) ) compared with that in the normal controls ( 1.23 ( 0.39 ); z =5.899, P <0.01 ).The FDI/ADM CMAP amplitude ratio was comparable between the ALS patients and the patients with other neuromuscular disorders ( 0.93 ( 0.62 );z=1.737,P=0.081).SI was significantly lower in the ALS patients (2.42 (3.14)) than that in the patients with other neuromuscular disorders (10.10(6.54);q=7.947, P<0.05) and the normal controls (17.93(8.32);q=10.827, P<0.05).SI <5.2 can help differentiate ALS from mimic disorders, with a sensitivity of 83.33% and specificity of 96.43%.Conclusions The split-hand sign appears to be a specific feature of ALS.SI robustly differentiates ALS from mimic disorders and potentially facilitates an earlier diagnosis of ALS.

Objective To explore the correlation between extratemporal hypometabolism on preoperative 18F-FDG PET imaging and the outcome after temporal lobectomy in temporal lobe epilepsy (TLE)patients.Methods A total of 96 patients with intractable TLE who underwent temporal lobectomy were recruited.The outcome was evaluated according to International League Against Epilepsy (ILAE) 2001 outcome classification (OC) criteria:OC 1-3 was considered as good outcome and OC4-6 as poor outcome.The follow-up period was more than 2 years.The 18F-FDG PET brain images were retrospectively analyzed.The preoperative extratemporal cortical hypometabolism and extratemporal subcortical hypometabolism occurred in basal ganglia and thalamus were taken as independent exposure factors of poor outcome and the odds ratios (OR) were calculated respectively.Results Thirteen of 96 cases had poor outcome.Extratemporal cortical hypometabolism was found in 12 of 83(14.5％) cases with good outcome and in 11 of 13 cases with poor outcome.Extratemporal subcortical hypometabolism was found in 25 of 83 (30.1％) cases with good outcome and in 10 of 13 cases with poor outcome.The occurrence of extratemporal hypometabolism was significantly higher in poor outcome group than that in good surgical outcome group (cortical:x2 =26.63 ;subcortical:x2 =8.70; both P＜0.05).The OR of extratemporal cortical hypometabolism was 32.54,with 95％ CI of 6.40-165.44,and that of extratemporal subcortical hypometabolism was 7.73,with 95％ CI of 1.96-30.52.Conclusion Extratemporal cortical hypometabolism and subcortical hypometabolism in TLE patients are associated with poor outcome of temporal lobectomy in TLE patients.

Objective To investigate the clinical efficacy of laparoscopic radical gastrectomy in elderly patients with advanced gastric cancer.Methods The clinical data of 85 elderly patients with advanced gastric cancer who were admitted to the Ningbo First Hospital from January 2012 to June 2014 were retrospectively analyzed.Laparoscopic radical gastrectomy was performed on 46 patients (LRG group) and open radical gastrectomy on 39 patients (ORG group).All the patients underwent primary tumor resection for gastric cancer + D2 lymph node dissection,and the postoperative recovery plans were done according to enhanced recovery program.The volume of blood loss,number of lymph node dissected,operation time,intraoperative arterial partial pressure of carbon dioxid (PaCO2),time to anal exsufflation,indwelling time of gastric tube,time for out-off-bed activity,time for fluid diet intake,postoperative hemoglobin,duration of hospital stay and occurrence of complications in the 2 groups were analyzed.The follow-up by outpatient examination and telephone interview was carried out on patients up to August 2014.The count data were analyzed by the chi-square test and Fisher exact probability.The measurement data with normal distribution were presented as x ± s and analyzed using the t test.The t' test was used if the data were deficient.Results Surgical procedures in the 2 groups were successfully carried out and no perioperative death occurred.There was no conversion to open surgery in the LRG group.The resection margins in all the patients were negative.The operation time and number of lymph node dissection in the LRG group were (239 ±68)minutes and 27 ± 10,compared with (227 ±50)minutes and 26 ± 10 in the ORG group,with significant differences (t =0.919,0.179,P ＞ O.05).PaCO2 in the LRG group was (41 ± 5) mmHg (1 mmHg =0.133 kPa),which was significantly higher than(36 ± 5) mmHg in the ORG group (t =4.745,P ＜ 0.05).The volume of blood loss was (102 ± 44)mL in the LRG group,which was significantly less than (200 ± 120) mL in the OPG group (t' =-4.807,P ＜ 0.05).The postoperative level of hemoglobin in the LRG was (110 ± 15) g/L,which was significantly higher than (98 ± 27)g/L in the ORG group (t' =2.471,P ＜ 0.05).The time to anal exsufflation,indwelling time of gastric tube,time for out-off-bed activity,time for fluid diet intake,duration of hospital stay in the LRG group were (2.6 ± 0.7) days,(2.1 ± 0.7) days,(1.1 ± 0.3) days,(4.1 ± 0.7) days and (11 ± 4) days,which were significantly different from (4.8 ± 1.5) days,(4.0 ± 1.8) days,(4.5 ± 0.6) days,(5.9 ± 1.8) days and (18 ± 3) days in the OR G group (t' =-8.415,-6.206,-33.831,-5.879,t =9.632,P＜0.05).Eight patients in the LRG group and 15 patients in the ORG group had complications,with the incidence of complications of 17.4％ (8/46) and 38.5％ (15/39),respectively,showing a significant difference (x2 =4.748,P ＜ 0.05).Forty-four patients in the LRG group and 36 patients in the ORG gorup were followed up for 2-25 months,1 patient in the LRG group and 2 patients in the ORG group died and others had full recovery.Conclusions Laparoscopic radical gastrectomy could provide a safe and complete tumor resection for elderly patients with advanced gastric cancer compared with open radical gastrectomy,meanwhile,it can improve postoperative recovery and reduce postoperative complications in elderly patients with advanced gastric cancer.