Objective:The drug resistance of E.coli to fluoroquinolones is getting stronger in the recent years.This study aimed at the drug resistance of E.coli induced by fluoroquinolones in vitro,so as to provide a guidance for the rational use of antibiotics and effective control of nosocomial infections.Methods: Drug resistance was induced in vitro by a multi-step method in 10 strains of E.coli from clinical isolates with Ciprofloxacin,Levofloxacin and Gatifloxacin.The minimal inhibition concentration(MIC) of the E.coli was determined by the agar dilution method before and after the induction.Results: After in vitro induction,the E.coli acquired a high resistance(MIC ≥ 128 ?g/ml).And one drug could induce different degrees of resistance to the other two.Conclusion: The MIC of the E.coli induced by fluoroquinolones in vitro was increased by 8 to 8 205 folds compared with that before induction,which demonstrated a gradually developed resistance of E.coli strains to fluoroquinolones.

Objective To explore clinical results of posterior spinal approach microendoscopic disectomy(MED) for the treatment of lumbar disc herniation in adolescents.Methods A total of 25 consecutive patients treated by MED from February 2000 to August 2004 in this hospital were analyzed retrospectively.Clinical results were assessed with the modified Macnab criterion.Pre-and post-operative symptoms and functional states were evaluated by the Chinese version Oswestry Disability Index(ODI).Results A conversion to open procedure was required in 1 patient.The operating time was 35～65 minutes(mean,44.8?9.0 minutes);the estimated blood loss during operation was 30～80 ml(mean,51.3?14.6 ml);the postoperative hospital stay was 6～10 days(mean,7.5?1.0 days).All incisions healed by first intention.There were no dural tears,nerve root injuries,intervertebral space infections,or great vessel injuries.Twentg-two patients were followed for 7～57 months(mean,33.4?17.8 months).There were significant differences between preoperative ODI(46.2%?8.5%) and postoperative ODI(1.8%?3.0%).The improvement rate of ODI was 44.4%?9.2%(t=21.61,P=0.00).Clinical results assessment by the modified Macnab criterion revealed "excellent" in 19 patients and "good" in 3 patients,the rate of excellent or good results being 100%. Conclusions Microendoscopic disectomy can be performed safely and effectively for lumbar disc herniation in adolescents,resulting in little trauma,fast recovery,and excellent clinical results.

Objective To compare the intensity of cognitive impairment and the level of pathological lesion in hippocampus induced by ischemia or chronic stress for a more valuable guidance in the treatment of post-stroke cognitive impairment(PSCI).Methods Forty male adult SD rats were divided medially into 4 groups:control,stress,ischemia and ischemia plus stress.Animals in 3 treatment groups were subjected respectively to an operation of modified selective middle cerebral artery occlusion or a procedure of continuous 3-week chronic unpredictable mild stress or a combined program of the two treatments.Morris water maze was employed to assess hippocampus-dependent learning and memory function and the brain-derived neurotrophic factor(BDNF)expression was detected by immunohistochemical staining in CA3 area and the mRNA amplification through semi-quantitative reverse transcription polymerase chain reaction(RT-PCR).Results Both chronic stressors and ischemia could significantly decrease the learning and memory function in rats like the escape latency in the performance of the Morris water maze test compared with the controL The stress group was related preferentially to a more severe deterioration in the learning function but not statistically in the memory loss as compared to ischemia group.The cognitive function decreased more markedly in rats when suffered the chronic unpredictable mild stresses plus ischemia,In comparison to control,ischemia significantly increased BDNF+ cells in hippocampal CA3 area (27.0 ±2.5 vs 20.1 ±2.1),while stress markedly reduced the expression of BDNF(15.2 ± 1.8 vs 20.1 ±2.1).Their combined effects still statistically led to a reduction in BDNF expression(8.2 ± 1.5,F =52.87,P ＜0.05).The same tendency was found in BDNF mRNA expression.Conclusions Stress may preferentially and powerfully influence hippocampus-dependent cognitive function compared with ischemia and the combination of focal ischemia and stress leads to the most impairments in cognition and hippocampal BDNF expression.Data suggest that more attention should be given to the strategies to increase the resistance to psychosocial stressors and decrease the depressed symptoms for a full PSCI recovery.

Objective To investigate the influence of fast track surgery on stress and inflammatory re-sponse in breast cancer patients treated with modified radical mastectomy .Methods Ninety nine patients with breast cancer undergoing modified radical mastectomy were allocated randomly to fast track surgery group (46cases)and general group(53cases).The concentrations of serum PRA,Ang-Ⅱ,ALD,cortisol,IL-6,IL-8,TNF-αof each group were measured before operation ,12 hour,24hour and 48hour after operation by radioim-munoassay method.Operation time,operative blood loss and hospitalization days were analyzed between the two groups,simultaneously ,the incidence of subcutaneous hydrops ,flap necrosis and upper limb edema were also de-tected.Results The concentration of serum PRA ,Ang-Ⅱ,ALD,cortisol,IL-6,IL-8 and TNF-αwere no significantly differences in two groups before operation and at 48 hours after surgery(P>0.05).The concentra-tions of serum PRA,Ang-Ⅱ,ALD,cortisol,IL-6,IL-8 and TNF-αof FTS group were significantly different between the preoperative and different time points (P<0.05).The concentration of serum PRA,Ang-Ⅱ,ALD, cortisol,IL-6,IL-8 and TNF-αof FTS group were lower than that of control group at the same time point ( P<0.05).The operative time was(158.32 ±22.47)mins in FTS group and(161.32 ±22.37)mins in control group,respectively,and there were no significant statistical differences (P>0.05).The intraoperative blood loss in the FTS group(156.98 ±17.09)ml was not significantly less than that in the control group (158.57 ±16.92) ml(P=0.644).Hospitalization days were 8.37 ±1.89 and 10.37 ±2.05 in the FTS and the control group re-spectively ,with significant difference .The incidence of upper limb edema ,subcutaneous hydrops ,flap necrosis in FTS group were not less than control group .Conclusion Fast track surgery could attenuate stress and inflamma-tory response during ,and it is safe and effective in modified radical mastectomy .

OBJECTIVETo investigate the effects of closed reduction and ulna intramedullary nail fixation for the treatment of fresh Monteggia fractures of Bado type I and II in children.

METHODSTwenty-three children patients with Monteggia fracture during July 2010 to September 2013 were treated by closed reduction and ulna intramedullary nail fixaion including 18 boys and 5 girls with an average age of 9.3 years old ranging from 6 to 13 years old. Among them,15 cases were Bado type I and 8 cases were Bado type II. There were 9 cases with radial nerve injury. The operation time,the recovery of nerve injury, the fracture healing and the function of elbow were observed and recorded.

RESULTSAll patients were followed up for 6 to 24 months (12 months on average). All patients were obtained bone healing. According to Anderson standard, at the final follow-up, 20 cases got excellent result, 2 cases got good result, and one case got fair result.

CONCLUSIONTreatment of the fresh Monteggia fractures in children by closed reduction and ulna intramedullary nail fixation has advantages of simple operation, less trauma and good results.

Adolescent ; Child ; Female ; Fracture Fixation, Intramedullary ; methods ; Fracture Healing ; Humans ; Male ; Monteggia's Fracture ; surgery ; Ulna ; surgery

[Objective]To explore improved operation treatment of fractures of olecranon and internal or external malleolus by fixing them internally with needle wire amend tension band.[Method]A total of 89 cases of olecranon fracture and 63 cases of internal and external malleolus fracture were treated by the amended traditional tension belt using needle wire nails.[Result]Sixty-eight and 55 of these cases(80.9%) had been followed-up respectively for 2.5 years in average,the longest follow-up period was 5 years and the shortest was 6 months.It shows through evaluation with Wolfgang post curative standard that 65 and 53 cases were excellent in curative effect(95.9%),3 and 2 cases had moderate result(4.1%),and there was no worse case.The average fracture cure time was 1.5 months.[Conclusion]The improvement of traditional tension belt in olecranon and internal or external malleolus fracture operation by using needle wire nails has the following advantages:(1)Simplifying operation procedures;(2)Reducing number of steel nails;(3)Keeping the biomechanical principle of the tension band and internal AO fixing advantage;(4)Reducing the phenomena of "tension loss" caused by expanded steel wire holes as a result of osteonecrosis,and avoiding internal loose complication.The disadvantage of this method is that the fixation has to be taken out through operation.

Purpose: To report the treatment result for lung cancer with brain metastasis. Materials and Methods: 117 patients with brain metastases from lung cancers were treated by radiotherapy alone or surgery followed by radiotherapy from January, 1987 to December, 1993. Radiotherapy were given with the dose of 23～40Gy (whole brain irradiation) then followed with 15～24Gy booster. Results: The median survival period and one year survival rate were 9.5 months and 62.5% in surgery plus radiotherapy group and 5.7 months and 14.2% in radiotherapy alone group(P

Objective To introduce the techniques and specification of complete-block radical gastrectomy, and to compare with traditional radical gastrectomy in the operative time, surgical costs and postoperative complications. Methods Thirty gastric cancer patients meet the criteria were randomly divided into 2 groups. Group A: complete-block radical gastrectomy;group B: radical gastrectomy. Analysis and comparison were made on tumor site, time consuming of block, the proportion of gastrointestinal reconstruction, operative time, cost of block, pathological TNM stage, length of stay, postoperative complications and postoperative chemotherapy. Results Group A has longer operative time than group B (P<0.05). However, there was no significant statistical difference in the other indicators between these 2 groups. Conclusions Complete-block technology can separate cancer more completely during operation with the advantage of simplicity, low-cost, little effect on the subsequent operation. The incidence of postoperative complications and length of stay with the traditional surgery there was no significant difference.

Objective To systematically evaluate the association between IL-6 gene rs1800796 polymorphism and febrile seizures(FS)susceptibility.Methods The related literatures on IL-6 gene rs1800796 polymorphism and febrile seizures(FS)susceptibility were retrieved from PubMed,Web of Science Embase,Cochrane Library,CNKI,WanFang,VIP and CBM Databases by computer.OR and its 95％CI were taken as the pooled effects.The RevMan 5.2 software was adopted to conduct the statistical analysis.The publication bias analysis was performed by using the STATA12.0 software.Results Seven independent case-control studies were included according to the inclusion and exclusion standard,involving 516 accumulated cases and 528 controls.The results showed that IL-6 gene rs1800796 polymorphism had a significant association with FS susceptibility in Chinese population(GG+CG vs.CC:OR=2.22,P=0.05;G vs.C:OR=2.44,P<0.01;GG vs.CC:OR=3.69,P=0.03;GG vs.CG+CC:OR=3.43,P<0.01).The subgroup analysis was conducted according to possible important confounding factors,and the results showed that this gene polymorphism had a significant association with FS susceptibility in Chinese population(GG+CG vs.CC:OR=3.32,P<0.01;G vs.C:OR=3.23,P<0.01;GG vs.CC:OR=7.27,P<0.01;GG vs.CG+CC:OR=5.17,P<0.01:CG vs.CC:OR=2.56,P=0.02).But in other populations,except recessive model(GG vs.CG+CC:OR=2.40,P<0.01),all other genetic models did not display obvious correlation.The subgroup analysis was conducted by FS diagnostic standard,and the results showed that this gene polymorphism had a significant correlation with infantile FS onset in diagnosing FS by the Chinese standard(GG+CG vs.CC:OR=4.57,P<0.01;G vs.C:OR=4.36,P<0.01;GG vs.CC:OR=12.75,P<0.01;GG vs.CG+CC:OR=8.60,P<0.01:CG vs.CC:OR=3.40,P<0.01).Conclusion IL-6 gene rs1800796 polymorphism may be associated with infantile FS susceptibility and allele G may be a risk factor for FS onset.

Objective　To probe the curative effect of thiotepa and mitomycin C for the prevention of the relapse of pterygium after its operation.Methods　One hundred and eighty-two cases with pterygium were randomly divided into two groups:one group of thiotepa(158 cases with 169 eyes)and the other group of mitomycin C (24 cases with 24 eyes) and a comparative study was conducted.Thiotepa was used through dropping on the third day after the operation(1∶2 000),while MMC was used in the same way during the operation and on the third day after the operation respectively(0.2g*L-1).Results　In the group of thiotepa,the wounded skin on the cornea was repaired significantly more rapidly than that in the group of mitomycin C,and the rate of the relapse of pterygium was lower in the former group than that in the latter one.Conclusion　Applying thiotepa by dropping after the excision of pterygium is a safe,simple and effective supplementary measure for the prevention of pterygium relapse and also effective for recurring cases.