Objective To explore cephalosporinase from nosocomial Klebsiella pneumoniae infection and their drug-resistant characteristics among the ICU patients so as to provide an instruction for rational clinical medication.Methods 67 samples were identified with VITEK-60 automated system.The strains producing AmpC β-lactamases were screened with cefoxitin disk diffusion method recommended by the CLSI,and confirmed by cefoxitin three-dimensional test.AmpC β-lactamase genotype was differentiated by PCR-sequencing and susceptibility tests which were done with the Kirby-Bauer method recommended by the CLSI.Results In the 67 isolates of Klebsiella pneumoniae,11 strains(16.4％) were found to produce AmpC β-lactamases.The drug-resistant genotype for all the 11 AmpC-positive strains was DHA-1.AmpC-producing strains developed multi-drug resistance,especially for broadspectrum β-lactam antibiotics and enzyme inhibitors.β-lactamases-producing strains were more resistant than non-producing ones.Conclusion Klebsiella pneumoniae in ICU patients has a higher proportion of producing AmpC β-lactamase strains,which are all of DHA-1 genotype and have multi-drug resistance.

As antigen-presenting cells, DCs are the most potent and unique,they can stimulate the primitive T cells. They play a major role in initiating the immune response. Tumor infiltrating dendritic cells (TIDCs) can reflect the antitumor immune capability of the host. The density of TIDC perhaps is associated with the prognosis in some cancers. The disablement of TIDCS is partly due to the phenotype they have. Perhaps it is the immunosuppressive factors secreted by tumor cells that have changed their phenotype.The studies about TIDCs provide the basis for DC-mediated antitumor immune therapy,and suggest the use of DC to treat tumors through different approaches.

Adenocarcinoma ; etiology ; metabolism ; pathology ; Barrett Esophagus ; complications ; epidemiology ; etiology ; metabolism ; pathology ; Biomarkers, Tumor ; metabolism ; Biopsy ; CDX2 Transcription Factor ; Esophagogastric Junction ; pathology ; Esophagus ; pathology ; Homeodomain Proteins ; metabolism ; Humans ; Intercellular Signaling Peptides and Proteins ; metabolism ; Keratin-20 ; metabolism ; Keratin-7 ; metabolism ; Mucous Membrane ; pathology ; Precancerous Conditions ; metabolism ; pathology

Objective To observe pain and ADL change in patients with osteoporotic vertebral fracture trea- ted by percutaneous kyphoplasty.Methods Percutaneous kyphoplasty were performed in 14 patients with thoracic and lumbar vertebral compression fracture resulted from osteoporosis.All patients were evaluated with regard to pain index and Barthel index before and after operation.Results All the patients'pain were significantly relieved,their score with Barthel index was markedly improved.Conclusion Percutaneous kyphoplasty is a kind of good tech- nique to treat patient with thoracic and lumbar compression fractures resulted from osteoporosis.

Objective To investigate the therapeudc effect of treating lung mbereulosis with integrated traditional Chinese and western medicine. Methods 152 patients with lung tuberculosis aging from 25 to 35 years were randomly recruited into 2 groups. Western medicine and integrated traditional Chinese and western medicine were applied to each group respectively. Observe the therapeutic effects after the treatment. Results The group treated with integrated traditional Chinese and western medicine was significantly better than the group treated with western medicine in terms of therapeutic effect speaking, with P＜0.05. Conclusion The therapy of integrated traditional Chinese and western medicine has good effect in treating lung tuberculosis.

Vasovagal syncope (VVS)is the most common clinical unexplained syncope,and its pathogenesis has not been fully understood yet.The contradictory reflection of cardiac autonomic nervous system caused by riggerring Bezold-Jarisch reflex,which could cause dilated blood vessels,blood pressure and cardiac output decreased,insufficient blood supply to the brain relate with syncope occurrence.Currently,most people consider it mainly relatel to the age and gender of patients,history of syncope,family history,mental and psychological factors,dietary habits and other factors,but the exact risk factors of VVS remains further study of multi-center and a large sample of data.

Adult ; Air Pollutants, Occupational ; analysis ; poisoning ; Arsenic Poisoning ; complications ; Causality ; Female ; Humans ; Male ; Maximum Allowable Concentration ; Purpura, Thrombotic Thrombocytopenic ; epidemiology ; Young Adult

Objective To study the clinical application of laparoscopy in the treatment of closed abdominal trauma. Methods Emergent laparoscopic exploration and treatment was conducted in 21 patients with closed abdominal trauma, who had stable hemodynamic parameters,from July 2000 to December 2003. Results Diagnosis was clarified laparoscopically in all the 21 patients. There were 4 cases of open liver repair, 2 cases of laparoscopic liver repair, 5 cases of open splenectomy, 3 cases of hand-assisted laparoscopic splenectomy, 2 cases of video-assisted small incisional intestinal repair, 4 cases of partial intestinal resection and 1 case of laparoscopic greater omentum hemostasis. Conclusions Laparoscopy in the diagnosis and treatment of closed abdominal trauma is accurate, safe and effective.

Objective To investigate the clinical significance of gamete intrafallopian transfer (GIFT) under laparoscope. Methods The gonadotropin was adopted to induce superovulation and the spermatic fluid was managed with the swim-up method. After oviums were dislodged by puncture under laparoscope, gametes were transplanted by intubating the fallopian tube. Results Among a total of 19 patients, 4 were pregnant, the pregnancy rate being 21.1% (4/19). Three women had a delivery at term and 1 had an abortion. No serious complications were seen. Of the 15 unfertilized patients, normal pregnancy was observed within 6 months after surgery in 5 patients, the circle pregnancy rate being 5.6% (5/89). Conclusions GIFT under laparoscope is a practical assisted reproductive technique (ART) that may achieve a relatively high pregnancy rate. Some other pelvic diseases resulting in infertility can be treated simultaneously, which contributes to natural fertilization in the future.

The design and efficacy of surgery for horizontal idiopathic nystagmus (HIN) with abnormal head posture and strabismus were investigated. Different surgical procedures were selected according to the angle of head turn in 44 cases of HIN with abnormal head posture and strabismus. For patients with a head turn of 15° or less, the Anderson procedure was used; the yoke muscles were recessed upon slow-phase. For patients with a head turn between 15° and 25°, the surgery was designed as a Kestenbaum 5-4-4-5 procedure. For patients with a head turn of 25° or more, the surgery was designed as a Parks 5-8-6-7 procedure. The surgery to correct the abnormal head posture was performed on the fixating eye while that to correct the deviation was then performed on the non-fixating eye at the same time. The amount of surgery of the horizontal rectus muscles on the non-fixating eye was sum of the angle of head turn and the degree of deviation, which was calculated as follows: recession/resection amount of medial and lateral rectis/2×5=angle of head turn±degree of deviation. The results showed as follows: (1) Visual acuity: the visual acuity in the primary ocular position increased two lines or more in 35 patients, accounting for 79.55%. Nine patients had no or only one-line improvement, accounting for 20.45% of the entire study population; (2) The degree of deviation in the primary ocular position: 37 cases had a normal primary ocular position or the degree of deviation ≤8(δ) after surgery, accounting for 84.09%. Six patients had a residual degree of deviation of 8(δ)-15(δ), accounting for 13.64%. One patient had a residual degree of deviation >20(δ), accounting for 2.27% of the patients examined; (3) Abnormal head posture: 34 patients had a normal head posture or a head turn of less than 5°, accounting for 72.27%. Eight patients had a residual head turn of 5°-15°, accounting for 18.18%. Two patients had a head turn of 15°-25°, accounting for 4.55%. It was concluded that different surgical procedures based on the angle of head turn and the relationship between deviation and null zone can eliminate anomalous head posture, correct deviation, and improve vision acuity in the primary ocular position.