Objective To assess the value of ultrasound in evaluating clinical effect of treatment of hysteromyoma uterine by selective uterine artery embolization ( UAE ) .Methods 42 hysteromyoma uterine in 30 cases were examed by color doppler ultrasound befort and after uterine artery embolization with one year monthly.The size , morphology,internal echotexture and doppler signal of the uterus and myoma were observed , and the doppler signal of uterine artery , peripheral and interal vascular in myoma were measured . Results There was significant difference of the average colume of the uterus and its myoma between preoperation and postoperation ( 491.37 cm3 vs 236.75 cm3,102.33 cm3 vs 48.87 cm3 respectively,?

目的探讨药物注射配合强化训练对颅脑损伤患者运动功能的影响。方法将60例住院颅脑损伤患者随机分为治疗组(30例)和对照组(30例)。治疗组在常规综合康复治疗基础上加用针对性药物注射治疗及强化训练,而对照组单纯采用康复治疗。两个疗程(20天/疗程)后,采用Fugl- Meyer运动功能量表评定两组的治疗效果。结果两组患者的运动功能均有改善 ,但治疗组的改善程度明显优于对照组(P<0.01)。结论药物注射配合强化训练能够明显改善颅脑损伤患者的运动功能。

Objective To investigate the different compatibility of tripterygium wilfordii on its attenuation and synergistic effects through applying Leigongteng decoction and its demolition decoctions on nephrosis rats,and to select the optimizing decoction to treat nephrotic syndrome.Methods 110 Wister rats were divided into 11 groups randomly,which were 9 groups of nephrosis model groups (including Leigongteng group,Leihe group,Leigui group,Leiqi group,Leigongteng ecoction group,Leijin group,Leigan group,prednisone group and nephrosis model group) and 2 blank groups (normal control group and normal Leigongteng group),10 rats in each group.The normal control group and normal Leigongteng group was intravenous injected with 0.65 ml sodium chloride in caudal vein; 9 groups of nephrosis model groups were injected with 0.65 ml adriamycin.The prednisone group was selected for positive control,24h urine protein,total protein,albumin,urea nitrogen,and creatinine were tested with automatic biochemistric meter.Results ALB (27.58±2.62)g/L,Leigan group Compared with(92.60± 18.12) mg in Leigongteng group,the urine protein in Leigongteng diction group(48.60± 11.75) mg,Leiqi group (53.20± 13.21) mg,and Leigan group (56.40 ±16.52) mg were reduced.Compared with the Leigongteng group TPR(58.98±4.84) g/L,ALB (20.98 ± 3.49) g/L,the Leigongteng decoction group [TPR (68.47 ± 5.25) g/L,ALB (28.97± 3.01) g/L],TPR and ALB in Lei-Qi group TPR(68.21 ±4.19) g/L,TPR(67.51 ± 5.42) g/L,ALB (26.56± 1.89) g/L were all elevated.Compared with Leigongteng group chol (1.48 ± 0.65) mmol/L TG (1.70 ± 1.58) mmol/L,chol and TG in the Leigongteng decoction group chol(0.78±0.13)mmol/L,TG(0.56±0.14)mmol/L,Lei-Qi group chol (0.70±0.13) mmol/L,TG (0.65±0.12) mmol/L,and Leigan group chol (0.97±0.33) mmol/L,TG(0.66±0.18) mmol/L were lowered; compared with Leigongteng group,UN (14.20 ± 2.12) mmol/L,Cr (78.10 ± 6.14) μmol/L,UN and Cr in the Leigongteng decoction group UN(7.59±0.78) mmol/L,Cr(39.60±8.33) μmol/L,Leigan group UN (9.48 ± 0.82) mmol/L,Cr(38.30±7.89)μmol/L,and Leijin group UN(9.71±1.33) mmol/L,Cr(41.40±6.45) μmol/L,Leigui group UN(8.30±1.12) mmol/L,Cr(36.90±6.15) μmol/L were all reduced with significant differences (all P＜0.05).The changes of Kidney morphology and ultrastructure pathology in Leigongteng different combination groups were lighter than the control groups.Conclusion Leigongteng decoction group,Leiqi group,Leigan group had synergistic actions,while Leigongteng decoction group,Leigan group,Leijin group,and Leigui group had kidney toxicity-reducing actions.

OBJECTIVE To investigate the profile of pathogen of infection in emergency intensive care unit(EICU). METHODS Pathogen of infection in EICU of our hospital from Jan to Apr 2005 were retrospectively investigated. RESULTS A total of 25 species from 119 pathogen strains were isolated from 45 cases. Among them, nonfermenters Gram-negative bacilli had great advantage, about 42.9% (51/119). Pseudomonas aerugionosa was the most one , counted for 16.8%. 65.9% of isolates were from sputum, 9.2%from blood. 81.4%(35/43) of cases were caused by multi-bacterial infection. CONCLUSIONS The pathogen of infection in EICU is mainly P. aeruginosa. The isolates are multi-resistant to biotics.

Objective To evaluate normal maturation of the fetal brain with half-Fourier rapid acquisition with relaxation enhancement(RARE) MRI.Methods The normal brains of 25 fetuses of 12-38 weeks gestational age were examined in utero with half-Fourier RARE imaging.Gyrus maturation,gray and white matter differentiation,ventricle-to-brain diameter ratio,and subarachnoid space size were evaluated with respect to gestational age.Results At 12-23 weeks,the brain had a smooth surface,and two or three layers were differentiated in the cerebral cortex.At 24-26 weeks,only a few shallow grooves were seen in the central sulcus,and three layers,including the immature cortex,intermediate zone,and germinal matrix,were differentiated in all fetuses.At 27-29 weeks,sulcus formation was observed in various regions of the brain parenchyma,and the germinal matrix became invisible.Sulcation was seen in the whole cerebral cortex from 30 weeks on.However,the cortex did not undergo infolding,and opercular formation was not seen before 33 weeks.At 23 weeks and earlier,the cerebral ventricles were large;thereafter,they gradually became smaller.The subarachnoid space overlying the cortical convexities was slightly dilated at all gestational ages,most markedly at 21-26 weeks.Conclusion Changes in brain maturation proceed through stages in an orderly and predictable fashion and can be evaluated reliably with half-Fourier RARE MRI.

OBJECTIVE To investigate the prevalence of PER-1 type ESBLs-producing Enterobacteriaceae and their antimicrobial-resistance profile. METHODS Totally 167 strains of Escherichia coli, 154 strains of Klebsiella pneumoniae and 67 strains of Enterobacter cloacae were tested. All of them were isolated from all kinds of clinical specimens in four hospitals of Nanchang city from Aug 2003 to Jun 2004. Antimicrobial susceptibility test(AST) was determined by K-B disk diffusion test. double-disk test(CTX, CTX/CA and CAZ, CAZ/CA)and three- dimension extract test were used to determine ESBLs. PER-1 genes were amplified by PCR. The products of PCR were sequenced to identify its ?-lactamase encoding gene. RESULTS Sixteen isolates were PER-1 gene positive. The PER-1 gene positive rates of E. coli, K. pneumoniae and E. cloacae were 3.6%, 3.2% and 9.0% , respectively . The antimicrobial-resistant rates of isolates harboring blaPER-1 to cefotaxime, ceftaxidime, amikacin , cefoxitin , cefepime and imipenem were 100%,100%, 56%, 94%, 31% and 0%, respectively. CONCLUSIONS blaPER-1 is detected in E. coli, K. pneumoniae and E. cloacace, and has diffused in Enterobacteriaceae . Imipenem and amikacin may be used to treat the infection caused by bacteria harboring blaPER -1.

Objective To explore the value of application of choledochofiberscopy in the diagnosis and treatment of the extrahepatic bile duct disease, and the effect on reducing the incidence of the postoperative residual stone in biliary ducts. Methods According to the case history and ultrasonography,if the common bile duct(CBD) diseases suspected,the CBD was explored by intraoperative choledochofiberscope(IOCF). During the procedure,a biliary passage mirror inducer apparatus and biliary tract probe which were manufactured by ourselves were used. Results During LC,IOCF was performed on 385 cases of the 10 396 LC cases,and possitive findings were dicovered in 102 cases(26.49%). Among those positive patients, 67 cases belonged to stricture of the lower biliary tract; 5 cases were Mirizzi syndrome; 2 cases were carcinoma of the periampulla; 1 case was primarily carcinoma of the bile duct; 1case was ascarisis of the biliary system. Conclusions IOCF is a good inspect technique with high success rate and clear image of bile duct, it can discover the common duct diseases which are difficult to be diagnosed through the routine examination.At the same time, it can provide the locative and qualitive diagnosis, determine reasonable methods of operation,and effectively provent postoperative complications.

Objective To investigate the chemical constituents of Wedelia trilobata.Methods The chemical constituents were separated by chromatography and their structures were determined by physico-chemical constants and spectral analyses.Results Eleven compounds were isolated and identified as grandiflorenic acid(1),1?-acetoxy-6?,9?-dihydroxy-4,10?-dimethyl-5?H,7?H,8?H-endesm-3-en-8,12-olide(2),1?-acetoxy-4?-hydroxy-6?-isobutyryloxy-9?-isovaleryloxyprostatolide(3),16?-hydroxy-ent-kauran-19-oic acid(4),(3R,4R,6R)-3,4-dihydroxy-1-menthene(5),trilobolide-6-O-isobutyrate(6),1?-acetoxy-4?,9?-dihydroxy-6?-isobutyroxyprostatolide(7),16?,17-dihydroxy-ent-kauran-19-oic acid(8),daucosterol(9),protocatechualdehyde(10),and caffeic acid(11).Conclusion All the compounds are isolated from W.trilobata for the first time except compounds 6 and 7.Compounds 2 and 3 are new sesquiterpene lactones,named as trilobolide A and 1?-acetoxy-4?-hydroxy-6?-isobutyryloxy-9?-isovaleryloxyprostatolide,respectively.

Objective To investigate the prevalence of aac(6')-Ib-cr in clinical isolates of Klebsiella pneumoniae.Methods A total of 337 isolates of Klebsiella pneumoniae were isolated from clinical specimens in our hospital from Jan,2006 to Sep,2007.Gentamycin,amikacin or tobramicin was used to screen the isolated with aac(6')-Ib-cr.aac(6')-Ib and class 1 interase gene(intl1)was determined by PcR All PCR products of aac(6')-Ib were sequenced for determination of aac(6')-Ib-cr. MICs of antibiotics were determined by agar dilution method.The ESBLs-producing isolates were determined by the CLSI-recommended confirmatory tests.Conjugation test was used to detect the transfer of plasmid.Results Of the 337 clinical isolates of Klebsiella pneumoniae,64(19.0%),28(8.3%)and 55(16.3%)isolates were resistant to gentamycin,amikacin and tobramycin,respectively.Among 64 gentamycin-resistant isolates,24(37.5%)were positive for aac(6')-Ib-cr,including 13 ciprofloxacin-resistant isolates and 11 ciprofloxacinsusceptible isolates.The prevalence of aac(6')-Ib-cr in ciprofloxacin-resistant and-susceptible isolates were 54.2%(13/24)and 27.5%(11/40).The positive rates of ESBLs and intl1 in the 24 isolates carrying aac(6')-Ib-cr were 79.2%(19/24)and 91.7%(22/24).Plasmids carrying aac(6')-Ib-cr of 13 isolates were successfully transferred to E.coli J53.Plasmids of all transconjugants were positive for aac(6')-Ib-cr and intl1.All transconjugants were ESBL producing strains.Conclusions aac(6')-Ib-cr exists widely in clinical isolates of Klebsiella pneumoniae.aac(6')-Ib-cr and ESBL gene usually coexist in a selftransmissible conjugative plasmid by class 1 integron.

Objective To explore the prevalence of self reposed mania/hypomania symptoms of depressive disorders and the difference between the two self-rating symptoms questionnaires in setting of psychiatric clinic of a general hospital.Methods 102 outpatients who were diagnosed with depressive disorders by ICD-10 in department of psychiatry of Tongji Hospital of Tongji University were continuously investigated and fulfilled the Chinese Version mood disorder questionnaire(CV-MDQ)and the Chinese Version 32 items hypomania check list(CVHCL-32).The positive mania symptoms were elevated with at least seven positive mania items reported by the CVMDQ.The positive hypomania symptoms were elevated with at least fourteen positive hypomania items reported by the CV-HCL-32.Results The internal consistency(Cronbach alpha)of the CV-MDQ was 0.808(95% CI=0.767～0.845,P<0.01).The internal consistency(Cmnbach alpha) of the CV-HCL-32 was 0.916(95% CI=0.898～0.930,P<0.01).11 patients(10.8%) reported positive mania symptoms by the CV-MDQ.14 patients (13.7%)had been reported positive hypomania symptoms through the CV-HCL-32.The ability of discriminating mania or hypomania between the two scales was significantly different(Kappa=0.227,P<0.05).Compared to the patients who were reported negative hypomania symptoms by the CV-HCL-32.the 11 patients with positive hypomania symptoms by the CV-HCL-32 had much earlier age in first episode(35.0 vs 50.5,z=-2.065,P<0.05),much longer months in total disease course(60.0 vs 22.0,z=-2.102,P<0.05)and present episode (12.0 vs 6.0,z=-2.180,P<0.05),and much higher frequency of relapse(2.5 vs 1.0,z=-2.168,P<0.05),but no significant differences at age,gender and education.No significant differences appeared between CV-MDQ positive and negative group.Conclusion Mania or hypomania symptoms may be screened by CV-MDQ and CV-HCL-32 from the outpatients with depressive disorders who are diagnosed by ICD-10 in general hospital.whether CV-HCL-32 is superior to CV-MDQ when screening bipolar Ⅱ disorder is worthly further study.