OBJECTIVE To explore the clinical distributed features and drug-resistant conditions of pathogenic bacteria in nosocomial infection in the last three years for the reference to clinical drug administration. METHODS Retrospective analysis was performed about drug-resistant conditions of pathogenic bacteria in nosocomial infection in the last three years from 2004 to 2006. RESULTS Totally 488 pathogenic strains, including 289 strains of Gram-negative bacteria (59.22%);95 strains of Gram-positive bacteria (19.47%) and 104 strains of fungi (21.31%),were isolated from patients in the last three years, the isolation rate of fungi,Acinetobacter baumannii and Enterobacter cloacae tended to increase year by year. They resisted to commonly used antibiotics at different degree, the rate of multiple-resistance was 80.33%. CONCLUSIONS Most pathogens isolated from patients with nosocomial infection are Gram-negative bacteria, which always display multi-resistant tendency to routine antimicrobial agents. The culture of pathogenic bacteria and rational use of antimicrobial agents should be emphasized to decrease the incidence of nosocomial infection, the factors which easily caused nosocomial infection should be reduced as well.

Objective:To evaluate the value of color Doppler ultrasound combined with ultrasonic elastography for curative effect of neoadjuvant chemotherapy (NAC) for breast cancer.Methods: 100 patients with breast cancer who has received NAC were divided intoobservation group (50 cases, underwent examination of color Doppler ultrasound scanner combined with ultrasonic elastography) and control group (50 cases, only underwent examination of color Doppler ultrasound scanner) according to the different examination methods. The accuracy, sensitivity and specificity of differential diagnosis methods for curative effect of NAC between the two groups were compared as above data.Results: The accuracy, sensitivity and specificity of differential diagnosis for curative effect of NAC in observation group were 88.00％, 90.00％ and 86.00％, respectively. While them of control group were 78.00％, 80.00％ and 76.00％, respectively. And the differences of these indicators between the two groups were statistically significant (x2=2.01,x2=3.24,x2=3.45, P<0.05).Conclusions: Color Doppler ultrasound combined with ultrasound elastography can diagnose the curative effect of NAC for patients with breast cancer from two aspects which includes tissue hardness and blood supply, and it can achieve more diagnostic accuracy compared with only using simple color Doppler ultrasound.

Diabetic neuropathy is the most common neuropathy. Pathology and electrophysiology are important for early diagnosis of diabetic neuropathy. This article would review the newest progress of the pathology and electrophysiology of diabetic neuropathy.

Objective To study the methods of the Chinese New Year (CNY) Factor's Adjustment based on the ARIMA models. Methods First, a common regressor for CNY was created. Then, the re-gressor was included in the seasonal ARIMA regressive model(regARIMA or TRAMO) ,AIC or BIC was used for model selection,and the generalized least squares method or maximum likelihood method was used for the earl-mation of model parameter. The estimated regressive coefficient was used for analyzing the degree of the CNY factor. A case was analyzed with the adjustment methods. Results The analysis on the case showed that the methods of the CNY factor's adjustment could remove the effects of the CNY factor on the time series, and the degree of the effects could be esti-mated in quantity. Conclusion The regressor for CNY is applicable,and the methods of the CNY factor's adjustment based on the ARIMA models can be used in seasonal adjustment on the time series. It's a new approach to analyze the effects of the CNY factor.

[Objective]To introduce the safety of the spinal wedge osteotomy by a single posterior approach and to discuss the selection of fusion and fixation. [Method]Sixteen patients with severe post-adolescent congenital spinal deformities were treated by spinal wedge osteotomy by a single posterior approach from February 2000 and July 2006.There were 10 males and 6 females with an average age of 21.4 years(range 16 to 29 years).There were 11 patients with hemivertebre and 5 with fused ribs or bone bridge.Two patients had previous surgery history.The average Cobb's angles of scoliosis and kyphosis before operation were 84.7 ?and 52.6?.The average trunk shift was 15.4 mm.Bony septum in the canal was found in 2 patients on the preoperative CT or MRI.[Result]The follow-up ranged from 2 to 4 years with an average of 2 years and six months.The average fused vertebrae were 10.6 segments(range 8 to 14 segments).The postoperative average Cobb's angles of scoliosis and kyphosis were 38.5 and 27.7.The average correction rates of scoliosis and kyphosis were 54.5% and 47.4%.The average trunk shift was improved to 4.6 mm.There was no significant correction loss of the scoliosis,kyphosis and trunk shift at final follow-up evaluation.No patient developed severe complications except that two had pedicle fracture,one had L1 nerve root injury,one had superior mesenteric artery syndrome and one had exudates of incision.[Conclusion]Spinal wedge osteotomy by the single posterior approach is a reliable and safe surgical technique for correcting severe post-adolescent congenital spinal deformities.

Objective To evaluate the operative technique and the short-term clinical results of ce-mentless total hip arthroplasty (THA) for developmental dysplasia of the hip (DDH) in adults with high level dislocation. Methods Nine patients (11 hips) with DDH of Hartofilakidis type Ⅲ, who underwent cement-less THA between 1997 and 2002, were analyzed. Of 9 patients, 8 were females, and 1 male with an average age of 29.4 years (range, 17 to 56 years). There were unilateral DDH in 7, and bilateral in 2. The patients had no previous surgery. The preoperative average length difference between the two legs was 4.1 cm (range, 0 to 7 cm). The femoral head was dislocated upward from the normal position by 4.8 cm on average (range, 3.2 to 7.0 cm). The Zweym?ller cup was placed on the original acetabulum in all patients with more than 80% bony coverage on the cup, and no bone graft needed. In 4 hips with more than 5 cm of displacement, the reduction of prosthesis was achieved by shortening osteotomy below lesser trochanter. The preoperative average Harris score was 40.2. Results All of 9 patients were obtained follow-up of X-ray films and clinical evaluation. The follow-up ranged from 6 to 32 months with a mean of 18.2 months, the osteotomy of 4 hips were bony healed at 3 months postoperatively showed by X-ray films. The postoperative average difference of the two leg length reduced to an average 1.1 cm (range, 0 to 3 cm), and the postoperative average Harris score increased to 90. Femoral nerve impairment occurred in 1 case, and recovered 4 months later. There were no loosening, dislocation and infection at follow-up. Conclusion Based on the short-term results of the cementless total hip arthroplasty for the developmental dislocation of the hip in adults with high level dislocation, it is proven to be a good technique, and the satisfied clinical results would be obtained.

Objective To explore the effect of amifostine combined with low-dose cyclosporine in treatment of refractory immune thrombocytopenia effect and related mechanisms.Methods 60 cases of refractory immune thrombocytopenia patients using parallel randomized controlled groups, divided into three groups, 20 cases in each group, amifostine group were treated with amifostine, cyclosporine group were treated with cyclosporine, amifostine+CSA group received amifostine+cyclosporine A treatment.The platelet count, platelet membrane glycoprotein antibody, lymphocyte subsets and bone marrow megakaryocyte count were observed and compared.Results After different treatment of three, six months, the level of platelet count of patients in three groups were compared with the group before treatment were significantly increased, and the treatment of platelet count level of amifostine group and cyclosporine group were significantly lower than that of amifostine +CSA group, the difference was statistically significant (P<0.05), there was no significant difference between amifostine group and cyclosporine group.The total efficacy of amifostine+CSA group was significantly higher than the other two groups, the difference was statistically significant ( P<0.05 ) , there was no significant difference between amifostine group and cyclosporine group.After the treatment, the platelet membrane glycoprotein GPIIb/IIIa antibody levels in three groups were significantly increased, and ring the detection level of amifostine+CSA group after treatment was significantly higher than the other two groups, the difference was statistically significant (P<0.05), there was no significant difference between amifostine group and cyclosporine group.After treatment, the three groups of CD4 +, CD4 +/CD25 +and CD4 +/CD8 +levels were significantly increased, CD8 +decreased significantly, the difference was statistically significant (P<0.05).And the level of change after treatment with amifostine +cyclosporine group was significantly higher than that of the other two groups, the difference was statistically significant (P<0.05), there was no significant difference between amifostine group and cyclosporine group.After treatment, the number of bone marrow megakaryocytes in the three groups was significantly lower than that before treatment , the level of count after treatment with amifostine +cyclosporine was significantly lower than that of the other two groups, the difference was statistically significant (P<0.05).there was no significant difference between amifostine group and cyclosporine group.The adverse reactions of amifostine group and amifostine+CSA group were significantly lower than that in cyclosporine group, the difference was statistically significant (P<0.05).there was no significant difference between amifostine group and amifostine+CSA group.Conclusion Amifostine combined with low dose of cyclosporine in treatment of refractory immune thrombocytopenia can play a synergistic effect, improve the therapeutic effect, and effectively reduce the dosage and adverse reactions.

Objective To analyze the prevalence rate and risk factors for aspiration pneumonia in elderly inpatients,and to identify a high-risk population for aspiration pneumonia.Methods Totally 398 inpatients aged ≥ 60 years in Beijing Hospital from April 2014 to April 2015 were selected.A questionnaire survey was performed for aspiration risk factors,including gender,age,smoking and drinking history,swallowing function,basal diseases,medication history,activities of daily living(ADL),occurrence of aspiration pneumonia over the past year.The patients were divided into aspiration pneumonia group and non-aspiration pneumonia group,and the prevalence rate and risk factors for aspiration pneumonia were studied.Results 364 cases with complete data were collected,and 14.3％ (52/364)were identified definitively as aspiration pneumonia over the past year.The ADL score was (77.0± 33.9) scales in aspiration pneumonia group,and (88.0 ± 22.2) scales in non-aspiration pneumonia group,with statistically significant difference (P＜ 0.05).The incidence rate of aspiration pneumonia was increased along with the increase of the age of patients.Risk factors for aspiration pneumonia were different in different age group.The proportion of patients aged 60-69,70-79 and over 80 years were 23.1％ (12 cases),36.5％ (19 cases),40.4％ (23 cases)in the aspiration pneumonia group,respectively.Under the condition of a propensity score-matched case-control pair design on 104 subjects with versus without aspiration pneumonia,the logistic regression analysis showed that smoking history,coronary heart disease,Parkinson's disease,dementia,chronic obstructive pulmonary disease(COPD),gastro-esophageal reflux disease(GERD),long-term uses of theophylline,calcium antagonists,nitrates,diazepam,antidepressants,anti-Parkinson drugs were the risk factors for aspiration pneumonia in elderly(all P＜0.05).Conclusions Smoking history,basal diseases and medication history are associated with the incidence rate of aspiration pneumonia in elderly.Assessment of these risk factors for aspiration pneumonia should be emphasized,and preventive measures should be considered conscientiously to lower the incidence rate of aspiration pneumonia in elderly.

Transcatheter arterial chemoembolization (TACE) was the preferred method of non-operation treatment for hepatocellular carcinoma (HCC).Radical resection of HCC remains difficult,extrahepatic metastasis was not easy to deal with,and repeated treatment aggravated the liver injury,so the long-term efficacy was poor.Sorafenib could control tumor angiogenesis and block the proliferation of tumor cells.A male patient with primary HCC and in the stage Ⅱb according to the Chinese clinical liver cancer staging system was treated by TACE combined with sorafenib and antiviral treatment in Henan Cancer Hospital.After the treatment,the intrahepatic lesions were inactive,and the pulmonary metastasis was partially relieved.The patient was followed up till May 2012,and the survival time was 39 months.The hepatic function was normal,and the hepatitis B virus (HBV) replication was negative.No intervention treatmentrelated complications were detected,and the KPS score was 100.

Through a series of chemical reactions, a kind of quaternary ammonium salt derivative of nanodiamond, ND-CO-NH-CH2-CH2-N ( CH3 ) 3+· I-( QAS-ND ) , was obtained , which was confirmed by FTIR, element analysis experiment and the electrochemistry measurements. Mixed myoglobin ( Mb) and QAS-ND solution was dropped on the surface of the glassy carbon ( GC ) electrode to prepare QAS-ND/Mb/GC modified electrode. In 0. 1 mol/L phosphate buffer solution (PBS) (pH 7. 0), Mb in the membrane exhibited direct electrochemical properties and showed good stability. The electrocatalytic property of the modified electrode toward H2 O2 was investigated, the results showed that the modified electrode could be used as the H2O2 biosensor to achieve fast, accurate detection of H2O2, with a detection limit of 3. 5 mmol/L (S/N=3).