Objective To detect the situation of metallo-beta-lactamase(MBL) producing of strains resistant to imipenem in pseudomonas aeruginosa(PA) isolated from hospital patients from April to July in 2005.Methods PA strains were isolated and antimicrobial resistances were done by the VITEK auto-microbic system.MBL producing strains were detected by Kirby-bauer method.Results 103 strains of PA were isolated. There were 47 strains resistant to imipenem and 16 strains resistant to ceftazidime. 8 strains were found MBL producing. Accounted for 17.0% of resistance strains to imipenem. One of 8 strains was sensitive to levofloxacin,others were resistant to such antibiotics as carbenicillin, amikacin, ticarcillin/clavulanic acid, cefoperazone, ceftazidime, cefepime, netilmicin, trimethoprim/sulfamethoxazole, piperacillin/tazobactam, ciprofloxacin. Non-MBL producing strains were found resistant to almost all antibiotics, except that 2 strains were sensitive to carbenicillin and one was sensitive to amikacin.Conclusion Among the PA strains isolated from clinic, both MBL producing strains and non-MBL ones were multiple antimicrobial resistance.It was one of the antimicrobial merchanisms that MBL producing led to PA resistant to cephalosporins and carbapenems. Antimicrobial agents should be chosen reasonably under the help of laboratory detecting this type correctly so as to reduce the antimicrobial resistance.

Objective To investigate the predisposing factors of urinary tract infection(UTI) with extendedspectrum beta-lactaraase(ESBLs) producing Escherichia Coli(E. coli) and its resistance to antimicrobial agents.Methods 26 cases of UTI patients with ESBLs producing E. coli from 2003 to 2005 in our hospital were analyzed retrospectively and compared with the ESBLs non-producing strains. Results 88.5 % of the patients with UTI in ESBLs producing E. coli had received broad-spectrum antimierobial therapy before the diagnosis, 69.2 % of the patients were complicate UTIS, 42.3 % of the patients experienced invasive operations in urinary tract; the incidence of drug resistance of ESBLs producing bacteria to the second, third-generation cephalosporins and quinolone was significantly higher than that of ESBLs non-producing bacteria, but it was highly sensitive to imipenem. Conclusion The drug resistance of ESBLs producing E. coli is severe gradually. So much attention should be paid to the ESBLs producing bacteria detection in UTIs. Antimicrobial therapy should be initiated under the guidance of drug sensitivity test,it is necessary to rid the predisposing factors of UITs as much as possible in order to decrease ESBLs-producing bacteria infection.

A total of 203 hypertensive patients with established health files received standard disease management for 1 year. We found that the patients who underwent grade 2 or 3 management showed statistically significant difference in exercise, salt and oil restriction, body mass index (BMI), waist to hip ratio, blood pressure, and blood-lipid from baseline (all P < 0.05). Hypertension awareness, behavior improvement, and disease control had statistically significant difference from baseline in all the patients (P < 0.05 or P < 0.001). After one year's intervention, the patient number in each grade was largely changed. Our study suggests that hierarchical hypertension management might be practical and effective in communities.

Objective To summarize the expression of CK19, HBME-land 34βE12 in papillary carcinoma of the thyroid (PCT) and their differential diagnostic value. Methods Clinical data of papillary carcinoma of the thyroid,nodular goiter and paraeareinoma were reviewed. All HE slides were reexamined and immunostains for CK19, HBME-land 34βEI2 were performed in selected case. Staining results were evaluated. Results Those cases typically showed complex papillary structures and interstitial fibrosis, while nuclear features included ground class appearance, grooves and nuclear pseudoinelusion. The positive rates for CKI9, HBME-1 and 34βE12 in PCT were 100.0 %, 89.4 % and 42.6 % respectively, the differences were statistically significant(P <0.01). Conclusion PCT occurs preferentially in the group of middle-aged women. The diagnosis of PCT should be distinguished from other plesiomorphous benign papillary lesions. Combined detection of CK19, HBME-1, 34βE12 can be most helpful for diagnosis for of PCT.

Objective To analyze the clinical characteristics and resistance of group B hemolytic streptococcus septicemia in neonates,and to provide the evidence for clinical treatment.Methods 7 neonates with group B hemolytic streptococcus septicemia hospitalized from Jan.2001 to Aug.2011 were enrolled in this study.The clinical data and laboratory results of antimicrobial sensitivity were analyzed retrospectively.Results There were 4 cases of early-onset infection and 3 cases of late-onset infection,6 cases with leukopenia,6 cases with c-reactive protein elevated,4 cases with suppurative meningitis,3 cases with septic shock and 2 cases with disseminated intravascular coagulation.All strains were sensitive to penicillin, vancomycin and linezolid.Conclusion Attention should be paid to neonatal group B hemolytic streptococcus septicemia.Penicillin and vancomycin are first choice for this type of infection.

Objective To evaluate the diagnostic value of dynamic contrast-enhanced MR angiography(DCE MRA)of the renal arteries.Methods 18 patients suspected with renal arterial diseases underwent DCE MR Angiography examinations.After 20 ml(0.15～0.20 mmol/kg)Gd-DTPA being injected quickly via cubital vein,a scaning and data acquisition with coronal three-demensional fast spoiled gradient(FSPGR)sequence was performed in a breath-hold time,the source images were introduced into work station for post processing,including maximum intensity projection(MIP)and multiplanner reconstruction(MPR),finally 3D DCE MRA images were obtained.Results A comparative study on renal artery stenosis and its degree between DCE MR angiography and DSA was done in 25 arteial segments of 12 cases.In 12 normal renal arteries shown by DSA,DCE MRA found 11 normal and one mild stenosis;Four moderate and one severe stenosis was shown by DCE MRA in five renal arteries with moderate stenosis identified by DSA;DCE MRA found five severe stenosis and three occlusion of renal anteries,which had accordance with DSA findings.Conclusion Dynamic contrast-enhanced MR angiography can accurately assess renal arterial diseases,the accuracy was especially higher in patients with severe arterial stenosis and occlusion.

Objective To identify the relationship between impaired glucose regulation of neuronal apoptosis in hip-pocampus and the ability of learning/memory in rats.Methods The model rats were made by high fat and sugar diet;The morris water maze was used to detect the learning and memory function;The TUNEL method was used to detect neuronal apoptosis in hippocampus .Expression of Bcl-2/Bax and Bcl-2 mRNA/Bax mRNA factor in hippo-campus neurons was detected with immunohistochemistry and in situ hybridization .Results Compared with NGT group, in IGR group the learning and memory ability were meaningfully decreased (P<0.05);the number of neuro-nal apoptosis in hippocampus was increased significantly ( P<0.05 ); the expression of Bcl-2 and Bcl-2 mRNA in hippocampus decreased significantly ( P<0.05);the expression of Bax and Bax mRNA in hippocampus increased sig-nificantly ( P<0.05 );The ability of learning and memory was positively correlated with expression of Bcl -2 ( P<0.05) and negatively correlated to the expression of Bax (P<0.05).Conclusions There is a relationship between impaired glucose regulation and the ability of learning and memory in rats , its mechanism may be potentially related to hippocampal neuronal apoptosis .

Objective To study the expression feature and clinical significance of plasma Protein C(PC) in pre‐PICC placement and post‐PICC placement in patients with cancer .Methods The levels in plasma of PC was tested by ELISA in patients with cancer in one day before PICC placement ,in one day ,30 day ,and 90 day after PICC placement ,the change of feature and clinical signifi‐cance was analyzed .Results The levels of PC in one day after PICC placement were 3 .74 ± 1 .99 μg/L ,the levels was lower than the levels of in one day before ,and in 30 ,90 day after PICC placement ,which were 5 .00 ± 2 .40 ,4 .78 ± 2 .41 and 5 .35 ± 2 .71 μg/L (q=3 .74 ,2 .85 and 4 .58 respectively ,P<0 .05);There were no statistical significance both in D‐D levels and PLT count among pre‐PICC and post‐PICC placement(P>0 .05);There were no correlation both PC levels and D‐D levels ,and both PC levels and PLT count(r= -0 .024 1 and 0 .111 0 ,all P>0 .05) .Conclusion The PC levels in one day after PICC placement were lower ,but there were no correlation both PC and D‐D ,and PLT .PICC catheter were safety .

Objective To investigate the effect of CT perfusion (CTP) imaging guidance in the treatment of acute cere?bral infarction. Methods Patients (n=200) with acute cerebral infarction who visited our clinic within 6 hours underwent CTP examination and were divided into two groups:penumbra group and non-penumbra group according to their CTP imag?ing (presence of penumbra or not). Recombinant tissue plasminogen activator (rt- PA) was administrated for intravenous thrombolysis in both groups. NIHSS (The NIH Stroke Scale), BI (Barthel Index), mRS (modified Rankin Scores) and hemor?rhagic transformation events of two groups were determined before and after thrombolysis to evaluate its effect and prognosis in these two group. Results Compared with non penumbra group, NIHSS was reduced in penumbra group from 7 days after rt-PA (6.67±3.46 vs 4.76±2.04), and this decrease became obvious at 4 weeks after rt-PA (6.67±3.46 vs 3.68±1.93). Effi?ciency rate at 4 week (60.3%) and good prognosis rate at 3 months(71.7%)were both significantly improved in penumbra group than those in non penumbra group(34.7%,56.8%). Conclusion rt-PA under CTP guidance is effective and safe in the treatment of acute cerebral infarction. The thrombolytic therapy window can be enlarged according to the presence of pen?umbra or not and the bleeding conversion rate remains at low level.

Angiography ; Female ; Hepatic Artery ; abnormalities ; diagnostic imaging ; Humans ; Middle Aged ; Tomography, X-Ray Computed ; Ultrasonography