Objective To investigate the distribution characteristic and drug resistance of respiratory tract pathogens in ICU eld‐erly patients to provide the basis for clinical medication and control of nosocomial infection .Methods The isolation situation and drug resistance of pathogens in ICU elderly patients with respiratory tract infection from January 2012 to December 2014 were ret‐rospectively analyzed .Results Among 501 cases of respiratory tract infection ,350 cases were Gram‐negative bacilli infection ,which were mainly P .aeruginosa and A .baumannii;50 cases were Gram‐positive coccus infection ,which was mainly S .aureus ;101 cases were complicating fungal infection ,which was mainly C .albicans .The resistance of P .aeruginosa to imipenem showed upward trend (P<0 .05) ,A .baumannii had higher resistance to commonly used antimicrobial drugs ,but the drug resistance trend had no obvious change(P>0 .05) .Imipenem‐resistant A .bauman(IRAB) ,ESBLs‐producing E .coli and methicillin‐resistant S .aureus (MRSA) in the elderly patients with respiratory tract infection all exceeded 50% of each constitution ratio .Conclusion Multi‐drug resistant bacteria are usually isolated from ICU elderly patients ,their drug resistance rates maintain a higher level .Therefore clinicians should rationally select antibacterial drugs by combining with the laboratory reports ,increase the prevention and management of multi‐drug resistant bacteria and reduce the nosocomial infection occurrence .

Abstract?AIM: To observe the clinical efficacy of intravitreal Lucentis injection combined with panretinal photocoagulation ( PPR ) and compound trabeculectomy for neovascular glaucoma ( NVG) .?METHODS:A total of 14 cases (14 eyes) with NVG were collected from January to November 2015.All cases were treated with intravitreal lucentis injection, PPR and compound trabeculectomy by turns.Intraocular pressure ( IOP) , visual acuity and the complications at pre-or post-surgery were recorded, respectively.?RESULTS: Followed up for 3-6mo, the average IOP preoperatively was significantly decreased than that detected at post-operation ( 18.00 ±6.70 vs 41.65 ± 4.07mmHg, t=11.288, P<0.05).IOP less than 21mmHg with or without the usage of anti-intraocular pressure drugs was defined as the sign of successful or effective surgery, respectively.At the ultimate follow-up, 11 cases were successful, 2 cases were effective, and the success rate was 79%, effective rate was 14%.Only 1 case was applied cyclocryotherapy due to the uncontrolled IOP. Moreover, the results of visual acuity detection demonstrated that 6 eyes got a better visual acuity, 7 eyes remained the same condition and 1 case got no light perception. Meanwhile, 13 cases showed none iris neovascularization during the follow-up; 1 case got a reappearance of iris neovascularization on the third month, which was then dissolved subjected to the intravitreal lucentis injection in combination with PPR. One case developed post -operative hyphema and absorbed after 1wk. No shallow anterior chamber and eyeball atrophy happened.?CONCLUSION:Intravitreal lucentis injection combined with PPR and compound trabeculectomy is an effective and safe therapeutic strategy for the treatment of NVG.

Objective To evaluate the effects of different levels of neuromuscular blockade(NMB)on transcranial electric motor-evoked potentials(TCeMEPs)during idiopathic scoliosis.Methods Thirty American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients of both sexes,aged 11-23 yr,weighing 31-62 kg,scheduled for elective idiopathic scoliosis under general anesthesia,were enrolled in the study.NMB was monitored with train of four(TOF)-Watch SX.The levels of partial NMB were classified into 5 states according to TOF ratio(TOFR)and TOF counts:1 or 2 TOF counts(TOF1),3 TOF counts and TOFR≤15%(TOF2),TOFR 16%-25%(TOF3),TOFR 26%-50%(TOF4),TOFR 51%-75%(TOF5) and TOFR>75%(no NMB).Each state was maintained for 10 min.Failure and false-positive findings in TCeMEP monitoring,development of unexpected body movement and satisfaction with NMB were recorded.Results Compared with no NMB,the failure and false-positive rates of TCeMEP monitoring were significantly increased,the incidence of unexpected body movement was decreased,and the rate of satisfactory NMB was increased at TOF1,TOF2 and TOF3(P<0.05),no significant change was found in failure or false-positive rates of TCeMEP monitoring at TOF4 and TOF5(P>0.05),and the incidence of unexpected body movement was decreased and the rate of satisfactory NMB was increased at TOF4,the rate of satisfactory NMB was increased at TOF5(P<0.05),and no significant change was found in the incidence of unexpected body movement at TOF5(P>0.05).Compared with those at TOF4,no significant change was found in the failure or false-positive rates of TCeMEP monitoring(P>0.05),the incidence of unexpected body movement was significantly increased,and the rate of satisfactory NMB was decreased at TOF5(P<0.05).Conclusion Maintaining TOFR at 26%-50% the partial NMB during surgery does not affect TCeMEP monitoring during idiopathic scoliosis and meets the intra-operative NMB requirements simultaneously,and it is the optimum NMB for this type of surgery.

0. 05). Conclu-sion The THT and THC have bioequivalence.

Objective:To observe the effect of acupuncture in the treatment of accommodative myopia in children.Methods:A total of 76 children with accommodative myopia who met the inclusion criteria were divided into a control group or a test group according to the random number table method,with 38 cases in each group.The control group was given education on eye hygiene,and the test group was treated with acupuncture twice a week for 2 months in addition to the intervention used in the control group.The patient's uncorrected visual acuity(UCVA),refraction,and axial length(AL)were measured before treatment and 1 month and 2 months after treatment.Results:After 1 month of treatment,there was no significant difference in the UCVA between the two groups(P＞0.05);after 2 months of treatment,the UCVA of the test group was better than that of the control group(P＜0.05).After 1 and 2 months of treatment,the refraction of the two groups was significantly different from that before treatment(P＜0.01),but there was no significant difference between the two groups(P＞0.05).After 1 and 2 months of treatment,the AL in the control group was increased compared with that before treatment(P＜0.05),while there was no significant change in the test group(P＞0.05),and there was no significant difference between the two groups(P＞0.05).Conclusion:Acupuncture treatment can improve UCVA in children with accommodative myopia.

Objective To observe the protection and distribution of bone marrow mesenchymal stem cells (MSCs) by distinct intravenous infusion time on renal ischemia reperfusion injury (IRI) in rats.Methods We used unilateral nephrectomy and contralateral vascular occlusion method to establish renal IRI model in rats.The experimental groups which received 2 × 106 MSCs infusion through the tail vein,were subsequently divided into 3 subgroups:2 h pre-reperfusion (PreOp,n =16),immediately after reperfusion (Op,n =16),6 h post-reperfusion (PostOp,n - 16).The control groups included sham operation group (n =16) and ischemia group (n =16).Chemotaxis of DAPI-labeled MSCs was detected 6 h after administration in the IR kidney.Renal function was detected at 6,24,and 48 h respectively after operation. Forty eight h after operation,the renal tissues were harvested to observe the pathological changes by HE staining and the tubular epithelial cell apoptosis via TUNEL assay.Results MSCs were found in the experimental groups after IR in the kidney,most in PostOp group.Twenty-four and 48 h after reperfusion,there was no significant difference in Cr and BUN between the experimental groups and sham operation group (P＞0.05),but the levels of Cr and BUN in the experimental groups were significantly lower than in the IR group (P＜ 0.05). As compared with IR group,the renal pathological injury was alleviated,the number of apoptotic cells was decreased in the experimental group,most significantly in PostOp group (P＜0.05).Conclusion MSCs can reduce the inflammatory response and inhibit renal tubular cell apoptosis in rat renal IRI.Post-reperfusion administration of MSCs leads to the best chemotaxis efficiency and protection.

OBJECTIVETo probe the recovery mechanism of Zhenggu powder (ZGP) on acute soft tissue injury in cell levels.

METHODSForty rabbits which established animal model of acute soft tissue injury with hammer hitting,were divided randomly into normal group (A), model group (B), vaseline group (C)and ZGP group (D). Injured part was applied external drug daily after model was made. All animals were killed after using drug for 4 days. The local tissue of injured part was taken pathologic study, and was measured the content of IL-1beta, IL-6, TNFalpha by ELISA method and TXB2, 6-keto-PGF1alpha by RIA method.

RESULTSMuscular tissue of group A was normal. But that of group B and C was aberrant,such as swelling and broken of muscular fiber or infiltration of inflammatory cell. Such histological change of group D was lightly and hyperplasia of blood vessel was found. The contents of IL-1beta, TNFalpha, TXB2 and TXB2/6-keto-PGF1alpha in group D were lower than that of group B and group C. On the contrary, the contents of 6-keto-PGF1alpha in the group D were higher than that of group B and group C. The difference of content of IL-6 between groups was not obvious.

CONCLUSIONZGP could promote not only the dilution and the transportation of inflammatory cell factors,but also the repair and the regeneration of the injured tissue structures. The therapeutic effect of ZGP was not relative to IL-6.

Animals ; Cytokines ; immunology ; Drugs, Chinese Herbal ; pharmacology ; Female ; Humans ; Inflammation Mediators ; immunology ; Male ; Rabbits ; Random Allocation ; Soft Tissue Injuries ; drug therapy ; immunology ; pathology

Objective To evaluate enteral nutrition treatment on nutritional status of patients with esophageal cancer during radiotherapy in Chinese population. Methods We searched domestic and foreign relevant databases (PubMed, Medline, Cochrane Library, Wanfang Data, Chinese Journal Database, VMIS) by key words (esophageal cancer, chemoradiotherapy, enteral nutrition) , meeting the conditions of the clinical randomized controlled trials, and evaluated the quality of each document. We used meta-analysis method to analysis the published literatures about clinical randomized controlled trials, which were enteral nutrition treatment on nutritional status of patients with esophageal cancer during radiotherapy in Chinese population.RevMan5.1 statistical analysis software were used. Results Seven separate clinical randomized controlled trials including 503 cases were included into the meta-analysis. The following five indexes of nutritional status in enteral nutrition treatment (ENT) group were superior to routine treatment (RT) group (P<0.05): body weight, Body Mass Index (BMI), hemoglobin, serum albumin, serum prealbumin. The MD Values and 95％CI (confidence interval) were 5.54 (3.61-7.46), 2.20 (2.02-2.39), 12.46 (5.86-19.05), 4.04 (2.48-5.61), 49.53 (20.93-78.13) .The funnel plot showed no significant publication bias in each indexes. Conclusion Enteral nutrition treatment can improve the nutritional status of patients with esophageal cancer during radiotherapy compare only with routine treatment.

OBJECTIVE The purpose of the present study was to investigate the impact of fluvas-tatin formulation on the pharmacokinetics-genetic polymorphis relationship. METHODS We compared the difference between the pharmacokinetics of fluvastatin as an extended-release (ER) 80 mg tablet and an immediate-release(IR)40 mg capsule in terms of drug metabolism enzyme and transporter ge-netic polymorphisms. In this open-label, randomized, two-period, two-treatment, crossover study, ef-fects of BCRP, SLCO1B1, MDR1, CYP2C9, and CYP3A5 polymorphisms on the pharmacokinetics of fluvastatin were analyzed in 24 healthy individuals.Each treatment duration was 7 days with a washout period of 7 days between the crossover.Serum concentration of fluvastatin was evaluated using high-performance liquid chromatography-tandem mass spectrometry. RESULTS The SLCO1B1 T521C genotype had no statistically significant effect on IR 40 mg capsule of fluvastatinafter single or repeated doses.However,for the ER 80 mg tablet,the SLCO1B1 T521C genotype correlated with the AUC0-24of repeat doses (P=0.01). The CYP2C9*3 genotype correlated with the AUC0- 24after the first dose IR 40 mg capsule (P<0.05); however, the difference between CYP2C9*1/*1 and CYP2C9*1/*3 was not statistically significant after repeated doses. CONCLUSION The effect of SLCO1B1 T521C on fluvas-tatin exposure was observed and was more profound in ER and repeated dose administration than in IR and single dose administration.We recommend that formulation should be incorporated into future pharmacogenomics studies and clinical implication guidelines.

OBJECTIVETo search the forming cause and the correlation between the clinical phenotype and chromosome band by the cytogenetic analysis on a case of ring chromosome 21 syndrome.

METHODSIdentification and location of 21 ring chromosome were performed with the G-banding, C-banding, N-banding, high-resolution banding and fluorescence in situ hybridization (FISH) techniques.

RESULTSIt was found that the karyotypes of the patient's parents are normal. The patient's karyotype is 46,XY, r(21)[91]/46,XY,r(21;21)(p11q22.3;p11q22.3) [5]/45,XY,-21[4].

CONCLUSIONThe clinical phenotype of ring chromosome 21 syndrome is related to the deletion of distal segment of 21q, and the abnormal sexual development of male is related with the deletion of 21q22.3.

Child, Preschool ; Chromosome Aberrations ; Chromosome Disorders ; genetics ; pathology ; Chromosomes, Human, Pair 21 ; genetics ; Cytogenetic Analysis ; methods ; Humans ; In Situ Hybridization, Fluorescence ; Karyotyping ; Male ; Phenotype ; Ring Chromosomes ; Syndrome