OBJECTIVE: To probe into the drug resistance of gram negative bacilli in patients with lower respiratory infection and to analyze the application of antibacterials in the department of respiratory disease.METHODS: Routine drug susceptibility test was conducted by K-B disk agar diffusion method,and the DDDs and consumption sum of the antibacterials were analyzed as well.RESULTS: Pseudomonas aeruginosa which was susceptible to Meropenem took the lead with 22.1% among all the gram negative bacilli in patients with lower respiratory infection,followed by E.coli(20.7%) and Klebsiella(15.1%).Quinolone and third generation cephalosporins took the lead on the DDDs list in the treatment of gram negative bacilli in patients with lower respiratory infection.CONCLUSION: Hospital should intensify the monitoring of gram negative bacilli in patients with lower respiratory infection and analyzing of the application of antibacterials so as to guide clinicians for a rational use of antibacterials.

Objective To observe the clinical curative effect of Xiaoer Chiqiao Qingre granule in the treatment of infantile upper respiratory tract infections.Methods 100 children with upper respiratory tract infection were selected,and they were randomly divided into observation group and control group,50 cases in each group.The observation group was treated with Xiaoer Chiqiao Qingre granule,the control group was given ribavirin effervescent granules.The effects of the two groups were observed.Results The total effective rate of the observation group was 96％,which was significantly higher than 78％ of the control group (x2 =9.500 6,P ＜ 0.05).The fever,symptoms and signs of improvement time in the observation group were better than those in the control group.Conclusion Xiaoer Chiqiao Qingre granule in the treatment of infantile upper respiratory tract infection can defervesce quickly,and has quick curative effect,so it is worthy of promotion.

ObjectiveTo cultivate students innovative spirit and the ability of studying all their lives independently in the course of clinical transfusion laboratory medicine.MethodsBeginning with examination reform,we adopted the teaching mode,problem situation setting up-guidance to research and cooperation-evaluation of the students' learning effect by use of formative assessment.ResultsNew teaching mode acquired satisfactory results with development of students' activity and creativity.

Based on the Miller Pyramid for assessing clinical competence, this article analyzed the existing problems in the practice of teaching physical examination and provided suggestions for possible reforms.

0.05). Serum levels of CT in acute per iod of patients who suffered from MAP and SAP were significantly higher than tho se in control group (P0 05). ②Between serum levels of CT in acut e period of patients who suffered from SAP and serum calcium existed a linear neg ative correlation (r=-0.453, P

ObjectiveTo investigate the influence of recombinant thioredoxin (TRX)on apoptosis of myocardium cell in viral myocarditis of mice.MethodsTwenty-four Balb/c mice,weighting 12 - 14 g,were randomly divided into 3 groups:the control group,the virus group and the protective group,8 mice in each group.The virus group and the protective group were injected with 0.1 ml 100TCID50 Coxackie virus B3 (CVB3)intraperitoneally,and the control group was injected equal volume of saline.Therewithal the protective group was injected with TRX(2 mg/kg) by tail vein,and the virus group was injected saline the same way.After 14 days all mice were killed and hearts were taken.Changes of myocardial histopathology was observed with optical microscope,cell apoptosis was checked by TUNEL technique,and the expression of apoptosis-related proteins (Bcl-2,caspase-3)in infiltrated cell of myocardium was determined by immunohistochemistry.Results(①)Lymphocyte infiltration and necrosis were observed in survivals of the virus group,sporadic coagulation necrosis and ballooning degeneration of cells were observed in the protective group,however no myocardial lesion was found in the control group.(②)TUNEL technique showed that the positive ratio of apoptosis in the virus group and the protective group[(90.23 ± 3.63)％,(20.02 ± 2.41)％] was significantly higher than that of the control group(0.00 ± 0.00,all P ＜ 0.05),the positive ratio of apoptosis in the protective group was significantly lower than that of the virus group (P ＜ 0.05 ).(③)Immunohistochemistry showed that the expression of protein Bcl-2(+,++,+++) in the virus group and the protective group was significantly higher than that of the control group (all P ＜ 0.05).The expression of protein Bcl-2 in the protective group was significantly higher than that of the virus group(P ＜ 0.05).The expression of caspase-3 (+,++) was significantly higher in the virus group and the protective group than the control group (all P ＜ 0.05).Compared with the virus group,the expression of caspase-3 in the protective group was significantly lower(P ＜ 0.05).ConclusionTRX could inhibit cardiomyocyte apoptosis in viral myocarditis mice and the inhibition is related to regulation of apoptosis-related protein expression.

Heuristic teaching is propitious to cultivating students' ideation. We have used different heuristic modes for example problems, stories, contrast, associationin and so on to cultivate medical students' ideation in pathobiology and immunology teaching and acquired good effect.

Low frequency sensorineural deafness is a common subtype of idiopathic sudden deafness. Certain patients suffered recurrent attacks without vertigo, much alike Meniere's disease. Few of them developed into definite Meniere's disease during long-term follow-up in many clinical studies. Although the pathophysiology of recurrent low frequency deafness is yet unknown, the desease is considered associated with early state of endolymphatic hydrops or migraine. Otologists shall be aware of its clinical course and careful explanation is necessary at time of initial informed consent.
Endolymphatic Hydrops ; complications ; Hearing Loss, Sensorineural ; complications ; diagnosis ; Hearing Loss, Sudden ; Humans ; Meniere Disease ; complications ; Vertigo

Objective To analyze the clinical and epidemiological characteristics of human avian influenza A (H7N9 ) epidemic in Jiaxing City,and to provide scientific basis for the control and prevention of the disease.Methods The epidemiological and clinical information of 15 cases of human infection with avian influenza A (H7N9)reported from April, 2013 to May,2015 were collected.Sample of patients and external environmental samples of suspected exposure were collected and detected by real-time PCR.The epidemic distribution and clinical characteristics were analyzed.Results Fifteen cases of human infection with H7N9 were confirmed from April,2013 to May,2015,including 11 cases of death (77.33%).The confirmed cases mostly reported in winter and spring,and 9 confirmed cases were over 60 years,and male case proportion was higher than women (1.5∶1 ).Most of cases (66.67%)were sporadic and occurred in rural areas,but no epidemiological association was observed among the cases.Fever (100%),cough (66.67%),and wheezing and tightness in chest (33.33%)were common initial symptoms.The chest imaging examination of patients showed ground glass opacity and patchy consolidation,and 7 cases had simple pleural effusion.Twelve of confirmed cases had other chronic diseases.Eleven cases of death had appeared multiple medical comorbidities,such as respiratory failure (6/1 1 ),pulmonary embolism (4/1 1 ),multiple systemic organ failure (3/1 1 ),and heart cerebrovascular embolization (2/11).Twelve cases had been exposed to the live poultry markets where the positive rate of novel influenza A (H7N9) virus in environmental specimens was 7.69%(25/325).One of the 252 close contacts to confirmed cases appeared mild flu-like symptoms.No positive result related to novel influenza A (H7N9)virus nucleic acid was detected from each close contact's throat swabs.Conclusion Human infections with avian influenza A (H7N9)virus showed obvious seasonal distribution in Jiaxing.Elderly men,especially those with chronic diseases were the high risk people of human infection with H7N9 avian influenza.The infection might be associated with the exposure to live birds.Standard management of live poultry markets is the key measure in preventing and controlling H7N9 virus infection among population.

OBJECTIVETo evaluate the changes of cerebral blood flow (CBF) with real-time contrast-enhanced ultrasound (CEU) in a canine model of acute cerebral ischemia.

METHODSCerebral perfusion was assessed in 6 dogs subjected to craniotomy with CEU at the time of 0, 30, 60, 90 and 120 min after occlusion of the left common carotid artery (LCCA). The microvascular volume (A) and blood flow velocity (beta) in the brain were measured from the time-versus-acoustic intensity plots, and the value of Axbeta were calculated. 99mTc-ECD brain single photon emission computed tomography (SPECT) was performed on the day before the experiment and at 120 min after LCCA occlusion. The radioactive counts on both sides of the cerebral cortex were calculated.

RESULTSA significant correlation was found between Axbeta from CEU and volume of the blood flow of the CCA from Doppler flowmetry. A, beta and Axbeta values varied significantly between the different time points (P>0.001). The ipsilateral hemisphere showed a low-perfusion state while the contralateral hemisphere showed a high-perfusion state immediately after the occlusion.

CONCLUSIONSThe changes of beta is the main regulation mechanism during acute cerebral ischemia in dogs.

Animals ; Blood Flow Velocity ; Brain ; blood supply ; Brain Ischemia ; diagnostic imaging ; Cerebrovascular Circulation ; Dogs ; Male ; Regional Blood Flow ; Ultrasonography