OBJECTIVE To monitor and analyze the distribution and antibiotic resistance of common bacteria isolated from urine-tract infection patients in our hospital in recent two years and to provide new evidence for clinicians to choose the antibiotics. METHODS We used VITEK system to identify the bacteria,performed the drug-resistant test by K-B and analyzed the distribution and drug resistance of the isolated bacteria by WHONET 5.3 software. RESULTS A tatal of 1379 strains of bacteria were isolated from 2991 urine samples,most of which were Gram-negative bacteria.among which Escherichia coli was the most common.Enterococcus were the most common pathogen of gram-positive bacteria,especially for E.faecalis and E.faecium and fungi infection also increased.The resistance to antibiotics was quite different,manifesting multi-resistance.The detection rates of ESBLs-producing E.Coli,Klebsiella penumoniae and Proteus were 72.1%,69.9% and 34.2%,respectively. CONCLUSIONS It′s of great significance to summarize and analyze the distribution and biotic resistance of isolated bacteria in urine-tract infection to control resistant strains and indicate the choice of antibiotics in clinic.

SUMMARY Delayed postoperative spinal epidural hematoma(DPSEH) is a rare and potentially devastating complication of laminoplasty, and cervical nerve root palsy occurs more frequently than DPSEH, especially with C5 nerve root palsy. The authors describe a case of DPSEH with C5 nerve root palsy that developed in a patient 3 days after he underwent laminoplasty. In this case, a 78-year-old man with a history that having taken Aspirin without the doctor’s instruction for 5-6 years,he underwent cervical laminoplasty for mild myelopathy. On the 3rd postoperative day, he complained of weakness of his left upper extremity and could not raise his left arm. The symptom aggravated in the next few days. On the 9th postoperative day, there was an obvious motor deficit of both upper and lower extremities. Magnetic resonance imaging demonstrated abnormal signal characteristics consistent with a hematoma at levels C3-C4, compressing spinal cord. The clot was evacuated during emergency revision surgery, and the postoperative course after the operation was uneventful and the muscle strength was improved five days later. Therefore, the symptoms of DPSEH are not so typical that its possibility should be kept in mind. Sometimes a differential diagnosis should be made with C5 nerve root palsy which may only represent weakness of upper extremities. The authors recommend that magnetic resonance imaging is helpful for the diagnosis of DPSEH and a revision surgery should be taken as soon as possible once the hematoma causing the neurologic deterioration was confirmed.

Objective To investigate the therapeutic mechanism of Chinese medicine of Yi Xin Le oral liquid (YXL) on insomnia. Methods Mice spontaneous activities,mice sleep time induced by sodium pentobarbital in the threshold dose and under the threshold dose and mice convulsion induced by strychnine nitrate were observed to evaluate the sedative, hypnotic and anticonvulsive actions of YXL. Results YXL could restrain the spontaneous movement in mice,had a synergistic action with sodium pentobarbital on mice sleep,and could counteract the convulsive attack induced by strychnine nitrate in a dose-dependent manner. Conclusion YXL has obvious sedative, hypnotic and anticonvulsive actions and this will supply evidence for its clinical usage.

[Objective] To observe the effect of Jiedu Lifei Oral Liquid (JLOL, mainly composed of Flos Lonicerae,Fructus Forsythiae, Radix Scutellariae, Bulbus Frityllariae, etc. ) on the immune function in mice with viral pniumonia.[Methods] Sixty mice were randomized into 5 groups: normal group (A), model group (B), virazole group (C), small-dose JLOL group (D) and large-dose JLOL group (E). Mouse models of viral pheumonia were induced by infection ofinfluenza virus FM1. Effects of JLOL on serum levels of interleukin-1 (IL-1), interleukin-2 (IL-2), tumor necrosisfactor ? (TNF-?) and interferon ? (IFN-?) were observed. [Results] Compared with normal group, serum levels of IL-1 and (IFN-? were decreased and TNF-? increased (P 0.05 ) in model group.After treatment wth JLOL, serum levels of IL-2 and IFN-? were increased , TNF-? decreased (P 0.05). [ Conclusion] JLOL can increase the immune function by increasing the serumlevels of IL2 and IFN-? and can reduce the immune impairment by inhibiting the over production of TNF-?.

The continuing education system at the Peking University Health Science Center for vis-iting scholars (Research program for young and middle-aged doctors) is a relatively advanced and compre-hensive medical continuing education system in China, among which, the tutorial system is a good method to guide the visiting scholars of continuing education. On this basis we conducted scholars learning effect questionnaire survey and combined with the feedback results, discussed the advantages and disadvantages of the current educational system of visiting scholars in China, and put forward some concrete suggestions on the development of the continuing education in China.

Objective To assess metabolic state in patients with Roux-y sigmoid neobladder.Methods The study comprised 33 patients(21 men and 12 women) with Roux-y sigmoid neobladder after oneological sur-gery.All enrolled patients were treated by the same protocol.Before and after withdrawing the catheter , serum e-lectrolytes, ereatinine and urea were analysed and used to assess the effect.Results All 33 patients were evalu-able.Before and after withdrawing the catheter , serum electrolytes, creatinine and urea were normal values and there was no signifcant difference(P >0.05).Three patients developed mild metabolic acidosis.Conclusions The Roux-y sigmoid neobladder is a feasible , safe and effective method for continent urinary diversion.This surgi-cal technique had no signifcant effect on metabolic state.

Objective:To investigate the effect of propofol on proliferation, invasion and migration of human melanoma cell line A375 via miR-137/fibroblast growth factor 9 (FGF9) pathway.Methods:A375 cells were cultured in vitro. The half inhibitory concentration and half inhibitory time of propofol on A375 cells were determined by methyl thiazolyl tetrazolium (MTT) method. miR-137 mimics and miR-137 inhibitors were transfected into A375 cells by lipofectamine method. A375 cells were divided into control group, propofol group, miR-137 mimics group, propofol+ miR-137 mimics group, miR-137 inhibitors group and propofol+ miR-137 inhibitors group. After treated with the optimal time and concentration, the mRNA expression of miR-137 and FGF9 was detected by real time fluorescence quantitative reverse transcription polymerase chain reaction (qRT-PCR), and the invasion and migration ability of cells in vitro was detected by transwell method. Results:With the increase of propofol concentration, the proliferation rate of A375 cells was gradually decreased, and 80 μmol/L was selected as the half inhibition concentration. With the increase of propofol action time, the proliferation rate of A375 cells was gradually decreased, and 48 hours was selected as the half inhibition time. Compared with the control group, propofol could promote the expression of miR-137 mRNA, inhibit the expression of FGF9 mRNA, and inhibit the invasion and migration of A375 cells ( P<0.05). miR-137 mimics could promote the expression of miR-137 mRNA, inhibit the expression of FGF9 mRNA, and inhibit the invasion and migration of A375 cells. At the same time, after propofol intervention, the effect of promoting the expression of miR-137 mRNA, inhibiting the expression of FGF9 mRNA and inhibiting the invasion and migration of A375 cells was more significant ( P<0.05); miR-137 inhibitors could inhibit the expression of miR-137 mRNA, promote the expression of FGF9 mRNA, and promote the invasion and migration of A375 cells ( P<0.05). At the same time, after propofol intervention, the effects of inhibiting the expression of miR-137 mRNA, promoting the expression of FGF9 mRNA and promoting the invasion and migration of A375 cells were inhibited ( P<0.05). Conclusions:Propofol can inhibit the proliferation, invasion and migration of human melanoma cell line A375. The mechanism may be related to the inhibition of miR-137/FGF9 pathway activation by propofol.

Objective To summarize the experiences of diagnosis and treatment for blunt tracheobronchial injuries ( BTI) . Methods From January 1993 to December 2013, 15 patients were diagnosed with BTI and underwent surgical treatment at our hospital.Mean age of the 15 patients (11 men and 4 women) was 26.4 ±4.5 years.All the patients had a history of trauma, which included crushing injury in 8 cases, deceleration injury in 4, fall injury in 2, and traction-type injury in 1.BTI loca-tion: right main bronchus in eight cases, left main bronchus in four cases, upper trachea in one case, lower trachea with the right main bronchus in one case, and cervico-thoracic trachea with left main bronchus in one case .Thoracic computerized tomo-graphy was performed in 15 patients, which showed pneumothorax, subcutaneous emphysema, pneumomediastinum or falling lung sign of Kumpe.Preoperative fiberoptic bronchoscopy examination was performed in 15 cases, which included bronchial atresia in 9 cases, bronchial transection in 3 cases, laceration of trachea in 2 cases, and tracheal transection in 1 case.An e-lective surgical procedure after BTI was performed in 10 cases, and emergency surgery was performed in 5 cases.Tracheo-bron-chial laceration repair were performed in 2 cases, tracheal end-to-end reanastomosis in 1 case, and bronchial end-to-end re-anastomosis in 12 cases.Results There was no operative death, and one case was complicated with anastomotic stenosis.The average operation time was 205.7 ±41.3 minutes, and the average blood loss was 268.4 ±109 ml.The postoperative hospi-tal stay was 11.6 ±3.7 days on average.Follow-up was completed in 15 patients (mean, 29.3 months), and 15 patients were all symptomatic improvement .Conclusion The most common site of BTI was the right main bronchus near Carina parts .Al-though the diagnosis and treatment are often delayed , our findings indicate that chest CT and endoscopic findings could be used for the diagnosis of BTI.Surgical resection and reconstruction are effective methods to repair BTI successfully even many months after they occur.Often they do not require the resection of pulmonary parenchyma .

Objective To investigate the effect of exogenous hydrogen sulfide (H2S) on intestinal mucosal barrier after cardiopulmonary resuscitation (CPR) in cardiac arrest (CA) rabbits. Methods Forty-four male New Zealand rabbits were divided into sham operation group (Sham group, n = 12), post-cardiac arrest syndrome (PCAS) group (n = 16) and H2S intervention group (PCAS+NaHS, n = 16) according to random number table method. The rabbit model of PCAS was established by tracheal clamping and suffocation, and CPR was started at 5 minutes after CA. However, Sham group did not clamp the tracheal intubation after anesthesia, and the other operations were the same as those in PCAS group. In the PCAS+NaHS group, a bolus of NaHS (0.5 mg/kg), a H2S donor, was injected via era vein 1 minute before the start of CPR, followed by a continuous injection of NaHS (1.5 mg·kg-1·h-1) for 3 hours, while the rabbits in other group were intravenously injected with the same volume of normal saline (NaCl 0.9%). Intestinal and portal vein blood samples were collected 24 hours after return of spontaneous circulation (ROSC). The level of serum fluorescein isothiocyanate-dextran (FD-4) was detected by fluorescein isothiocyanate (FITC) labeling method to reflect intestinal mucosal permeability. After hematoxylin-eosin (HE) staining of small intestine tissues, the morphological changes of mucosa were observed under light microscope, and the intestinal mucosa injury score was calculated. The expression of tight junction protein ZO-1 in intestinal mucosa was detected by immunohistochemistry. The content of malondialdehyde (MDA) in small intestinal tissue was determined by thiobarbituric acid chromogenic method, the activity of superoxide dismutase (SOD) was determined by xanthine oxidation method, and the level of myeloperoxidase (MPO) was determined by double antibody sandwich enzyme linked immunosorbent assay (ELISA) to reflect the oxidative stress and inflammatory reaction in small intestinal tissue. The expression of apoptosis protein (caspase-3) and autophagy related protein (Beclin-1, LC3) in small intestine tissue was detected by Western Blot. Results 12, 13 and 14 animals were successfully resuscitated in Sham group, PCAS group and PCAS+NaHS group respectively, while 12 animals in each group survived to the end of experiment. Compared with Sham group, the level of FD-4 in portal vein serum was significantly increased in PCAS group (mg/L: 11.95±0.59 vs. 1.43±0.48, P < 0.05), the pathological injury and inflammation infiltration were obviously aggravated under light microscope, the score of small intestine injury was significantly increased (4.21±0.37 vs. 0.36±0.18, P < 0.05), the expression of tight junction protein ZO-1 in the intestine was visibly down-regulated detected by immunohistochemistry, MDA content and MPO activity were significantly increased [MDA (nmol/mg): 3.65±0.32 vs. 1.54±0.24, MPO (U/g): 362±35 vs. 134±18, both P < 0.05], while SOD activity was significantly decreased (U/mg:78.84±7.49 vs. 115.48±8.48, P < 0.05), the expression levels of cleaved capase-3, Beclin-1 and LC3 proteins in the intestine were significantly increased (caspase-3/β-actin: 1.11±0.08 vs. 0.21±0.02, Beclin-1/β-actin: 2.08±0.11 vs. 0.42±0.03, LC3/β-actin: 1.05±0.07 vs. 0.37±0.05, LC3-Ⅱ/ LC3-Ⅰ: 1.28±0.14 vs. 0.17±0.02, all P < 0.05). Compared with PCAS group, the portal vein serum FD-4 level in PCAS+NAHS group was significantly decreased (mg/L:5.59±0.48 vs. 11.95±0.59, P < 0.05), the intestinal mucosal pathological injury and inflammatory cell infiltration were significantly decreased, the score of small intestine injury was significantly decreased (2.18±0.47 vs. 4.21±0.37, P <0.05), the expression of ZO-1 in intestine was significantly increased, MDA content and MPO activity in intestine were significantly decreased [MDA (nmol/mg): 2.65±0.31 vs. 3.65±0.32, MPO (U/g): 251±21 vs. 362±35, both P < 0.05], while SOD activity was significantly increased (U/mg: 96.86±7.52 vs. 78.84±7.49, P < 0.05), while the expression of activated caspase-3, Beclin-1 and LC3 proteins was significantly decreased (caspase-3/β-actin: 0.72±0.06 vs. 1.11±0.08, Beclin-1/β-actin: 0.96±0.08 vs. 2.08±0.11, LC3/β-actin: 0.72±0.06 vs. 1.05±0.07, LC3-Ⅱ/ LC3-Ⅰ:0.83±0.09 vs. 1.28±0.14, all P < 0.05). Conclusion H2S has a protective effect on intestinal mucosal injury induced by CA/CPR, which may be related to tight junction protein ZO-1 up-regulation, oxidative stress alleviation, inflammation reduction, apoptosis and autophagy inhibition.