Objective To analyse the pathway of infection,risk factors,clinical characteristics and pathogenic bacteria distribution of neonatal sepsis.Methods Eighty-eight neonatal with sepsis were enrooled from January 2006 to December 2011 in the First Affiliated Hospital of Lanzhou University.According to disease stage,they were divided into early-onset sepsis group and late-onset sepsis groups.Results Respiratory infections in two groups was the majority (44.7％ vs.46.0％),and there was no significant difference (P =0.906).That premature birth,low birth weight infant,amniotic fluid pollution and asphyxia were risk factors for early-onset sepsis.The most common clinical characteristics in early-onset sepsis were eating less milk(57.9％,22/38) and had fever of the late-onset sepsis(42.0％,21/50).Forty-one cases were with positive blood culture and the rate was 46.6％ (41/88),the blood culture specimens were mainly Gram-positive bacteria in two group (75.0％ (15/20),90.4％ (19/21)).The most common pathogenic bacteria were Staphylococcus aureus and Coagulase-negative staphylococci.Conclusion Premature birth,low birth weight,meconium,asphyxia are risk factors of early onset neonatal sepsis.Early-onset sepsis often shows poor feeding,and late-onset sepsis in children prone to be fever.The common pathogenic germ of early-onset and late-onset sepsis are Grampositivebacteria,Staphylococcus aureus and coagulase-negative staphylococci common.As for neonate with highrisk factors,clinical features of early pathologic examination should be performed in order to further clarify the diagnosis and taking clinical therapy.

Objective]To explore the basic connotation of “fire stagnation requiring dissipation”and analyse ancient physicians' discussion about the fever, in order to expand its application in the clinical treatment.[Method] Using the method of conceptual thinking to explain the etiology and pathology of“fire stagnation”,the specific connotation of“fire stagnation requiring dissipation”,collecting ancient physicians' exposition on“fire stagnation requiring dissipation”,and listing the relevant prescriptions in order to deepen the thinking.[Result] Fire stagnation produces nothing more than exogenous ,internal injuries,the mechanism is in the human body, the anger's ascending-descending and coming in-going out is out of balance by some factors ,the anger stagnates and can't get out. Neijing first recorded“fire stagnation requiring dissipation”,that is treating the fire stagnation disease needs making the gas opening,lifting,entry becomes coordinate,finally the body goes back to health. In the Shang Han Lun, Zhang Zhongjing expounded the meanings and mechanism of“fire stagnation requiring dissipation”perfectly. Since Jin and Yuan Dynasties, ancient physicians have come up with several prescriptions and have promoted the development of the doctrine.[Conclusion] Since the Neijing proposed the theory of“fire stagnation requiring dissipation”,physicians' understanding of fire stagnation syndrome has been gradually deepening,and provided a broader ideas for clinical treatment.In recent years,the theory of“fire stagnation requiring dissipation”is widely used in various kinds of diseases,its academic value is worth summarizing,inheritance,extension.

In order to meet the needs of training targets of medical higher occupational education.the construction and management of labs was explored.The lab construction developed rapidly,and lab management was further standardized to become more scientific.The whole benefits of labs were improved.These offered powerful support of quality to practical teaching and culture of skilled talents.

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.

Objectives To evaluate the clinical efficacy of treatment uterine leiomyoma using radiofrequency ablation. Methods From September 2004 to March 2005, 30 patients of uterine leiomyoma were treated using radiofrequency ablation under B ultrasonic scouting; the diameter of uterine leiomyoma was 1.5～4.8cm. Results The 30 patients were callback after the operation 3～6 months; the curative effect rate was 100%, including cure rate 50%, obvious effect rate 33.3%, and efficient effect rate 16.7%. Conclusion The radiofrequency ablation is a simple, safe, effective and economic technique with tiny hurt and remains the functions of uterine on the therapy of uterine leiomyoma.

Objective To investigate the role of microsatellite instability(MSI) in the carcinogenesis and development of gastric cancer (GC). Methods MSI was examined in 36 gastric cancer specimens obtained endoscopically and during surgery and in 30 intestinal metaplasia specimens using PCR SSCP methods. Results MSI was detected in 15 of 36 GC and 9 of 30 intestinal metaplasia specimens at one or more loci. MSI was positive in all three cases of early GC. The incidence of MSI in well differenciated GC was significantly higher than that in poorly differentiated GC (66.7% vs 26.3%, P

8 mg/L). The rdxA gene fragment (886 bp) of H. pylori was amplified by PCR and then sequenced. Finally polymorphism analysis was performed in the rdxA gene sequence from those strains resistant or susceptible to Mtz and standard strains H.pylori 26695. Results A total of 47 H.pylori strains were isolated from 51 patients positive for rapid urease test. Mtz resistance rate was 34% by E-test method and 31.9% by breakpoint susceptibility testing. Among them 15 strains were resistant to Mtz by the two tests. The rdxA genes of both 15 strains resistant to Mtz and 8 strains susceptible to Mtz were sequenced. Compared with that of strain H.pylori 26695, the sequence of rdxA gene nucleotide in 15 H.pyloristrains resistant to Mtz showed similarity ranging from 90% to 95% and being 92.5% on average, and the sequence of rdxA gene nucleotide in susceptible strains showed similarity ranging from 94% to 95% and being 94.5% on average. In most resistant strains, the rdxA genes occurred point mutation, single nucleotide insertion or deletion, however, the insertion or deletion of large nucleotide fragment were rare, and mutational site were variable. Conclusions The rdxA gene mutation in H.pylori strains resistant to Mtz may result from point mutations in several bases or insertional mutations or deletional mutations in one base, without insertion or deletion of large neuclectide fragment, and mutational position being variable.

Objective To observe the clinical efficacy and influence of atorvastatin and Urinary Kallidinoge-nase on rheology,endothelin and inflammatory mediators in the treatment of elderly patients with acute cerebral infarc-tion,and to guide clinical treatment.Methods 86 patients with acute cerebral infarction were randomly divided into 43 cases of the observation group and 43 cases of the control group.Both groups were given conventional therapy,then the control group were given atorvastatin(20mg/d,qd),the observation group were given atorvastatin(20mg/d,qd) and Urinary Kallidinogenase(0.15PNA /time).2 weeks were set for a course of treatment,NIHSS score and ADL score were calculated before and after treatment.Then endothelin,CRP,IL -1 and hemorheology were measured by phlebotomized when limosis to evaluated the efficacy.Results The high shear whole blood viscosity,erythrocyte ag-gregation index,hematocrit,fibrinogen,erythrocyte sedimentation rate,endothelin,CRP,IL -1 and NHISS of the ob-servation group and control group after treatment were respectively (3.45 ±0.21)mpa/s vs.(4.89 ±0.31)mpa/s, (4.05 ±0.56)vs.(6.43 ±0.63),(33.4 ±3.4)% vs.(39.8 ±3.7)%,(2.43 ±0.72)g/mL vs.(3.18 ±0.64)g/mL,(20.5 ±7.5)mm/h vs.(27.3 ±7.3)mm/h,(58.8 ±5.7)pg/L vs.(70.7 ±7.5)pg/L,(6.68 ±2.96)mg/L vs.(16.78 ±8.97)mg/L,(3.64 ±1.56)ng/L vs.(6.53 ±2.64)ng/L,(8.2 ±3.3)point vs.(15.5 ±6.3)point. Data of both groups were significantly lower than before treatment,(t =5.234 vs.4.267,4.627 vs.3.532,4.872vs.3.726,5.021 vs.3.429,6.046 vs.3.848,10.477 vs.6.818,11.557 vs.6.686,9.267 vs.6.421,12.712 vs. 5.044,all P <0.05).The ADL score were (28.7 ±11.2)point vs.(22.5 ±10.1)point,and the data of both groups were significantly higher than before treatment (t =8.396 vs.5.336,all P <0.05).The high shear whole blood vis-cosity,erythrocyte aggregation index,hematocrit,fibrinogen,erythrocyte sedimentation rate,endothelin,CRP,IL -1 and NHISS of the observation group were significantly lower than the control group(t =3.207,3.388,3.667,3.761, 3.959,3.929,3.884,3.304,3.778,all P <0.05).The ADL score of the observation group were significantly higher than the control group(t =3,447,P <0.05);The total effective rate of the observation group and control group were 95.35% (41 /43 )vs 69.77% (30 /43 ),the difference was statistically significant (χ2 =10.904,P <0.05 ). Conclusion The method contained atorvastatin and urinary kallidinogenase have exact clinical efficacy,can improve neurological deficit assessment and the ability of daily life.Its mechanism may be that it can reduce endothelin levels of inflammatory mediators and improve blood circulation,which is worthy of clinical use.

Objective To investigate the application v al ue of stereotactic vacuum-assisted core needle breast biopsy (Mammotome biopsy) for breast masses and the surgical treatment for atypical ductal hyperplasia (AD H) detected by the Mammotome biopsy. Methods Ultrasound guide d Mammotome biopsies and corresponding surgical management were carried out in 3 2 patients (39 lesions) in this hospital between March 2003 and January 2004. Results Of the 32 patients (39 lesions), fibroadenosis was diag nosed in 24 patients (31 lesions), plasma cell mastitis in 1 patient, atypical d uctal hyperplasia in 4 patients, and breast cancer, 3 patients. Of the 4 patient s with atypical hyperplasia, a re-operation was conducted and a confirmative dia gnosis of atypical hyperplasia was made in 2 patients, while the oral administra tion of Tamoxifen was given in 1 patient with mild atypical hyperplasia and in 1 patient with moderate to severe hyperplasia. Conclusions For patients with severe ADH detected by the Mammotome biopsy, a re-operation is req uired. For patients with mild to moderate ADH: if the breast mass is palpable pr eoperatively, a surgical excision is recommended; if the patient has non-palpabl e masses with negative family history, in condition that the lesion has been ent irely removed, the surgery is not necessary and the oral administration of Tamox ifen with regular follow-up is indicated.

With well understanding of the ethical problems in ophthalmic clinical treatment, strategies were developed to help establish a credible relationship with children and then to avoid causing psychological harm to them. The informed consent given prior to treatment can effectively minimize potential medical risks.