Objective To investigate?the?distribution?and?antibiotic?resistance?profile?of?clinical?isolates?in?2015?for?improving?antimicrobial treatment in Chuzhou First Hospital. Methods Bacterial identification and antimicrobial susceptibility testing were?performed?with?MicroScan?WalkAway?96?PLUS?bacterial?identification?system.?All?the?data?were?analyzed?by?WHONET5.6?software. Results A total of 1499 clinical isolates were collected during 2015, of which gram positive organisms and gram negative organisms accounted for 24.7% and 75.3%, respectively. Prevalence of MRSA among S. aureus was 37.0% and MRCNS among CNS 86.3%. All (100%) Staphylococcus and E. faecalis isolates were susceptible to vancomycin, daptomycin and linezolid. About 2.8% of the E. faecium isolates were resistant to vancomycin. All the Streptococcus pneumoniae isolates were penicillin-susceptible, mainly isolated from children. The prevalence of extended-spectrum beta-lactamases (ESBLs) positive strains was 52.9% in E. coli, 30.8% in Klebsiella spp. (K. pneumoniae and K. oxytoca) and 25.0% in P. mirabilis. The ESBLs-positive strains showed higher resistance rate than ESBLs-negative strains to most antibiotics. The percentage of the P. aeruginosa isolates resistant to meropenem and imipenem was all 29.4%. The percentage of the Acinetobacter spp. (A. baumannii accounted for 85.5%) strains resistant to imipenem and meropenem was 63.0% and 64.5%, respectively. Conclusions Antibiotic resistance is still serious in Chuzhou First Hospital in 2015, especially the emerging carbapenem-resistant Enterobacteriaceae, which is of great concern.

Objective To investigate the current prevalence of depressive disorder and the associated factors in pa?tients with essential hypertensive from cardiovascular divisions of tertiary general hospitals. Methods A Chinese version of Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) Axis I Disor?ders was conducted by five mental health professionals on 876 essential hypertensive outpatients at cardiovascular divi?sions of tertiary general hospital. Data on the socio-demographic and clinical characteristics of these hypertensive pa?tients were also collected. Results The current prevalence of depressive disorders among essential hypertensive outpa?tients of tertiary hospitals was 16.6%(145/876). Risk factors for depressive disorders in hypertensive patients included fe?male gender (OR=2.817, 95%CI:1.161~6.885), being 65-year-old and older (OR=1.747, 95%CI:1.118~2.688), non-marital status (OR=2.023, 95%CI:1.203~3.398), gradeⅢhypertension (OR=1.776, 95%CI:1.226~2.333) and car?diovascular diseases (OR=2.018, 95%CI:1.427~2.587). Conclusion Essential hypertensive outpatients, who receive med?ical services at cardiovascular divisions of tertiary general hospital, have high prevalence of depressive disorders. Clini?cians should pay more attention to the mental health of outpatients with essential hypertension.

Acupuncture Therapy ; Adult ; Female ; Humans ; Laryngitis ; therapy

Obiective To discuss the diagnosis value, limitations and mutual complement of MRI and TDUI in the fetus. Methods, TDUI and MRI was performed in 24 cases pregnant women that suspected fetus congenital malformation by Ultrasound examination, the examination results were compared by MR1 and TDUI with the clinical results.Results The 9 cases congenital malformation of 24 cases pregnant women were found by MRI. The 9 cases were confirmed and 3 cases were more sufficient by MRI. The one case examined by MRI was normal other than Ultrasound examination. Conclusion MRI is superior to Ultrasound in diagnosing malformation of nervous system. The Ultrasound and the TDUI in particular is better in finding the surface malformation than MRI. In clinical application, MRI and Ultrasound must be connected to make up the limitation and have a definite diagnosis.

Adult ; Diagnostic Errors ; Humans ; Leprosy, Lepromatous ; diagnosis ; Male ; Sinusitis ; diagnosis

Objective:To study the CT and PET/CT features of pleural mesothelioma and the value of CT and PET/CT imaging in the diagnosis of the disease.Methods:We retrospectively analyzed the spiral CT images of 23 patients and PET/CT images of 7 patients with pleural mesothelioma,all histologically confirmed.Results:Of the 23 cases detected by spiral CT,7 were benign and 16 malignant;local nodular pleural thickening was found in 9 cases,7 benign and 2 malignant;diffuse pleural thickening was observed in 14 cases,all malignant.Of the 7 cases diagnosed by PET/CT,5 were excluded from surgery.Conclusion:CT imaging helps determine the location,shape,extent of the pleural lesion and its relation to the surrounding tissues,while PET/CT is better in the differentiation of pleural mesothelioma and staging of malignancy,and therefore plays an important guiding role in the treatment of the disease.

Objective: To discuss the imaging features of esophageal fistula and the value of intervention.Methods: We retrospectively analyzed the complete clinical data of 12 cases of esophageal fistula treated from June 2000 to May 2008,of whom,2 developed esophago-thoracis fistula and esophago-mediastinum fistula respectively after conservative radiotherapy,and 10 developed esophageal fistula after surgery for esophageal cancer.All the patients received iodine-based oral contrast,spiral CT scanning and intraperitoneal stent implantation for fistula closure.Results: Iodine-based oral contrast showed that the contrast agent overflowed into the chest in 8 cases,into the airway in 3 and into the mediastinum in 1.Spiral CT scanning revealed 8 cases of pleural fistula and 2 cases of remnant stomach-airway fistula,but failed to display the other 2 because of the small size.Intraperitoneal stent implantation was successfully accomplished in all the cases,which helped to close the fistula,take in food,stop bucking,control lung,mediastinum and other infections,and improve the patients' quality of life.Conclusion: Esophageal fistula can be effectively diagnosed based on the findings of iodine-based oral contrast and spiral CT scanning.As a novel technique,intraperitoneal stent implantation for fistula closure,simple,safe and with obvious immediate effect,is well worth promoting.

Objective:Percutaneous fluoroscopic gastrostomy(PFG) is an alterative method for the patients who were not suitable for percutaneous endoscopic gastrostomy(PEG) and stent.This is a study to report the clinical experience of PFG in 25 patients. Methods:Twenty-five patients could not have oral intake due to obstruction of the oesophagus and depended on long-term parenteral nutrition.They contraindicated for percutaneous endoscopic gastrostomy.Results:The procedures all were successful completed without complication.The patients could use home enteral nutrition and get rid of parenteral nutrition.The patients' quality of life was improved significantly.Conclusion:PFG is a useful,convenient and less complication method for patients who are contraindication for PEG.

BACKGROUND:Intertrochanteric fractures can be generaly treated by surgical treatment. Along with deep research on the biomechanics of the proximal femur, proximal femoral locking compression plate appears recently. The locking plate fixation is not strong, can reduce the local stress shielding, and maintain optimal system stability, but fracture fixation failure often occurs due to the inappropriate choice of nail plate. OBJECTIVE:To evaluate the value of digital orthopedics technology in preoperative planning in locking plate fixation for intertrochanteric fracture. METHODS: Forty intertrochanteric fracture patients receiving CT tomography femur upper segment were selected and divided into two groups. In the conventional group, after reading X-ray films and CT images, patients received locking plate fixation. In the computer planning group, before repair, fracture model was established using Mimics software to segment fracture fragments, simulate operation reset and 3-matic software was used to reconstruct locking plate and screws. Locking plate was assembled with Mimics to obtain the best plate position, best screw angle and screw length. Proximal femoral locking compression plate fixation was performed. Fluoroscopy times, operation time, blood loss and fracture healing time were compared in both groups. RESULTS AND CONCLUSION: Three-dimensional models of proximal femur were reconstructed, and a series of data were obtained. The optimal position of each plate was obtained from each patient. The screw length was predicted, so preoperative operation planning was realized. Al patients were folowed up for 6-20 months. Fluoroscopy times, operation time, and blood loss were significantly less in the computer planning group than in the conventional group (P < 0.05). No significant difference in fracture healing time was detected between the two groups (P > 0.05). These findings suggest that digital orthopedics technology used in intertrochanteric fracture can simulate the locking plate position, determine the screw placement angle and length of the screw in advance, and reduce fluoroscopy times, operation time, blood loss and screw position misalignment.

AIM: To investigate the effect of high and low shear stress on endothelial permeability and tight junctions(TJs). METHODS: Rabbit abdominal aortas in normal and high fat diet groups were stenosed to 60.7%?7.0% of original cross areas, they were sacrificed after 7 days, and the arteries were stained with Evans blue and Sudan Ⅳ. TJs were investigated with freeze fracture. RESULTS: The non-stenosis aortas were negative, there are 1 mm-wide constant and circular positive areas proximal and distal to the stenosis and scattered, dotted and patched positive areas within 8 mm distal to stenosis. Freeze fracture reveals that in the hyperpermeable regions, the percentages of zonular type of TJs and the numbers of strands of TJs of zonular and macular types in the distal regions are significantly lower than those in the proximal regions (P