OBJECTIVE To explore the relationship between multidrug resistance of Acinetobacter baumannii(ABA) and its class Ⅰ integron.METHODS In this study,39 multidrug resistant strains and 41 non-multidrug resistant strains of ABA were collected.The improved Kirby-Bauer was employed to check the collected strains′ drug-resistant phenotype;PCR was administrated to detect the distribution of class Ⅰ integron.and their relationship was also analyzed.RESULTS Results showed that ABA′s drug-resistance rate to the most antibiotics was high.imipenem,cefoperazone-sulbactam,ABA was sensitive to ciprofloxacin,amikacin and Piperacillin-tazobactam,however,ABA′s drug resistance rates to other antibiotics were all over 40%.It revealed that ABA′s drug-resistance rate was high.The study indicated that the positive rate of Class Ⅰ integron in multidrug resistant ABA was as hight as 82.1%(32/39).The positive rate of non-multidrug resistant strains was 26.8%(11/41),and the differences were statistically significant(?2=24.6,P

Objective To evaluate the selective external carotid arterial embolization of uncontrollable epistaxis. Methods 27 procedures of super-selective external carotid arterial embolization were performed with absorbable gelfoam by using Seldinger's method in 26 cases with uncontrollable epistaxis. Results 27 procedures of super-selective intraaterial embolization of uncontrollable epistaxis were all successful without any serious complication. Conclusions Selective external carotid arterial embolization is safe, effective and successful in the treatment of severe epistaxis.

BACKGROUND: Chinese medicines have better effects on preventing and treating diabetic nephropathy at early period, and the effects are caused by the diversity of the effective components of Chinese medicines which acts on the different targets of diabetic nephropathy.OBJECTIVE: To observe the effect of Xiaokening on the proliferation of mesangial cells under high glucose, and investigate the possible mechanism. DESIGN: A controlled observation.SETTING: Department of Endocrinology, the First Affiliated Hospital of Nanjing Medical University.MATERIALS: The experiments were completed in the Research Room of Cell Culture, Research Center of Endocrine Metabolism, the First Affiliated Hospital of Nanjing Medical University from July 2003 to May 2004. The rat mesangial cell lines HBZY-1 were bought from Chinese Center for Typical Culture Collection.METHODS: The mesangial cells were passaged and cultured according to the instructions. ① Grouping according to different concentration of stimulation: In the high glucose+Xiaokening group, Xiaokening of 6 concentrations were used, I.e., 20.0, 40.0, 60.0, 80.0, 120.0, 200.0 g/L. Meanwhile,normal glucose control group and high glucose control group were also set,the glucose concentration in the medium was 5.6 and 30 mmol/L respectively. The proliferations were observed after 72 hours. Grouping according to different time points of stimulation: There were normal glucose control group, high glucose control group and high glucose+Xiaokening group, the glucose concentration in the medium was 5.6, 30 and 30 mmol/L respectively, and the Xiaokening concentration was 60 g/L. The proliferations were observed at 24, 48 and 72 hours respectively in the three groups.② The dispensed cell suspension was placed into the 96-well plate, and 200 μL suspension for each well. The culture plate was placed in the inoculation box containing CO2 (0.05 in volume fraction) at 37 ℃ for 24 hours, then the supernatant was deserted, cell solutions containing different drugs of different concentrations were added in each group, 200 μL for each well. The 96-well plate was then placed in the culture box containing CO2 (0.05 in volume fraction) and 100% humidity at 37 ℃ for inoculation.In the groups of different concentrations, 20 μL MTT (5 g/L) was added into the wells after 72 hours. In the groups of different time points, 20 μL MTT (5 g/L) was added into the wells at 24, 48 and 72 hours. Then the plates were inoculated at 37 ℃ for 4 hours. Under microscope, it was observed that MTT get into the cells, the supernatant was sucked away, then 150 μL dimathyl sulfoxide was added to dissolve methyl alcohol, and shaken to even with plate rocking bed for 30 s, and the absorbance (A) values were recorded with the microplate reader at the wavelength of 492 nm.MAIN OUTCOME MEASURES: The proliferations of mesangial cells (A value) were observed at different time points and in Xiaokening of different concentrations.RESULTS: ①Proliferation of mesangial cells at different time points: The A values in the high glucose control group at 24, 48 and 72 hours (0.685 ±0.010, 0.750±0.087, 0.659±0.018) were higher than those in the normal glucose control group (0.586±0.054, 0.598±0.040, 0.527±0.047, P ＜ 0.05). In both the high and normal glucose control groups, the A value at 48 hours was higher than that at 24 hours (P ＜ 0.05), but the A value at 72 hours was lower than that at 48 hours (P ＜ 0.05). The A value in the high glucose+Xiaokening group at 72 hours was 0.538±0.023, and it was lower than that in the high glucose control group (P ＜ 0.05). ② Proliferation of mesangial cells in Xiaokening of different concentrations: Xiaokening high er than 60.0 g/L could obviously restrain the excessive stimulation of high glucose to the mesangial cells, and the effect was in a concentration-de pendent manner, but too high concentration (120.0 g/L) would result in the abscission and death of cells, whereas no survived cells could be observed in extremely high concentration (200.0 g/L). CONCLUSION: Xiaokening could inhibit the proliferation of mesan gial cells stimulated by high glucose after 72 hours in a concentration dependent manner, but too high concentration would cause strong cytotoxicity.

OBJECTIVE To investigate the genotypes of aminoglycoside-modifying enzymes(AMEs)genes of Acinetobacter baumannii.METHODS Clinical isolates of A.baumannii were collected from 2003 to 2006,and their resistance to gentamicin,amikacin and tobramycin were tested by K-B method.Twenty-three isolates were chosen because of their resistance to aminoglycoside antibiotics(at least resistant to one kind of the drugs).Nine types of the AMEs were detected by PCR.RESULTS Drug resistant rates of 23 isolates of A.baumannii to gentamicin,amikacin and tobramycin,were 86.96%,56.5% and 69.56%,respectively.The detection rates of the 9 AMEs,including ant(3')-Ⅰ,aac(3)-Ⅰ、aac(6')-Ⅰ,aph(3')-Ⅵ,aac(3)-Ⅱ,aac(6')-Ⅱ and ant(2″)-Ⅰ were 69.56%,60.87%,56.52%,47.82%,30.4%,26.09% and 21.73%,respectively.CONCLUSIONS The resistance to aminoglycoside antibiotics of A.baumannii is mainly caused by AMEs.

Objective:To study the relationship between hepatic tissue insulin receptor substrate 2(IRS2) gene and type 2 diabetes,and the regulation of acupuncture on IRS2 gene expression of hepatic tissue in type 2 diabetes mellitus(T2DM) rats.Methods:Obese rats due to diet were injected in abdomen with small dose streptozotocin(STZ) to induce T2DM.Then these T2DM rats were stochastically divided into acupuncture group,Glibenclamide group and model group.After 4 weeks treatment,fasting blood sugar(FBS) was examined with active blood sugar meter,fasting insulin(FINS) was examined by radioimmunoassav,hepatic tissue IRS2mRNA was evaluated in real-time RT PCR,and normal rats were in control.Results:Serum levels of FBS(15.79?1.87) and FINS(37.20?3.92) in model group were higher than those in normal group(5.16?0.13,23.57?1.63),serum levels of FBS(5.46?0.20) and FINS(20.87?1.80) in acupuncture group were obviously lower than those in model group,which were similar to normal group.FBS(5.26?0.13) reduced obviously and serum FINS(28.10?1.86) reduced in some degree in Glibenclamide group compared with model.Relative contents of IRS2mRNA in model group were 2.19 folds compared with that in normal group.And in Glyburide group it was 4.59 folds compared with that in normal group.In acupuncture group it was 4.04% of that in the normal group.Conclusion:Abnormal hepatic tissue IRS2 mRNA expression may be one of pathogenesis of T2DM.Acupuncture can obviously depress hepatic tissue IRS2 mRNA expression,but Glibenclamide can not.

Objective To investigate the clinical effects and complications of uterine artery embolization (UAE) therapy using different embolic agents in treating uterine adenomyosis. Methods During 2004—2011, a total of 45 female patients with uterine adenomyosis were admmitted to authors’ hospital to receive uterine artery embolization therapy. The embolic agents used in the procedures included domestic iodized oil, sodium alginate microspheres and Embosphere microspheres. The patients were randomly divided into group A (n=15, using domestic iodized oil as embolic agent), Group B (n=13, using sodium alginate microspheres as embolic agent) and group C (n = 17, using Embosphere microspheres as embolic agent). After the treatment, all the patients were followed up for over 2 years, focusing on the observation of the clinical symptoms such dysmenorrheal, changes of MRI signs and severe complications. The results were analyzed and compared among the three groups. Results After UAE, the clinical symptoms such as the degree of dysmenorrhea, menstrual quantity, etc. were improved in all patients. Six months after UAE, the obvious remission rate of dysmenorrheal in group A, B and C was 33.3% (5/15), 30.8% (4/13) and 41.1%(7/17) respectively. Twelve months after UAE, MRI scanning showed that the uterine sizes in group A, B and C were reduced to 49.19%, 48.25% and 50.05% respectively. Follow-up examination at 24 months after UAE showed that recurrence of dysmenorrheal in group A, B and C was seen in 2, 4 and 2 cases respectively, and amenorrhea was seen in 2 cases of group A and one case in group C. Conclusion The use of domestic iodized oil, sodium alginate microspheres or Embosphere microspheres as embolic agents in performing super-selective uterine artery embolization for adenomyosis can effectively relieve the degree of dysmenorrheal, decrease the uterine size. In addition to ovarian dysfunction, the uterine cavity adhesion may be also a possible cause of amenorrhea occurring after UAE may. In order to ensure a similar clinical efficacy, the use of granular solid embolic agent is preferred as its safety is possibly higher than the liquid embolic agents.

Purpose To evaluate the clinical and pathological features of extramammary Paget’ s disease ( EMPD) and to investigate the related prognostic factors. Methods The clinical and pathological data of 30 patients with EMPD were reviewed retrospectively. The HE slides in the file were rechecked. Immunohistochemical stains were performed on archival paraffin-embedded sections with En-Vision method in 20 cases. Follow-up data were recorded. The relationship between the clinicopathological parameters and prognosis was statistically analyzed. Results Among the 30 patients, there were 26 males and 4 females, aged from 53 to 88 years with median age 70. Macroscopically, typical presentations of EMPD were eczematoid lesions. Microscopically, Paget’s cells were distributed sin-gly or in groups ( as glandular or nests patterns) within the epidermis. Immunohistochemical stains showed that Paget’ s cells were pos-itive for CK7, and negative for CK5/6 and p63. Follow-up data were available in 23 cases, 8 cases recurred resection, among them, 6 patients had positive resected margin and 4 died. The recurrent rate and mortality between the groups of dermal invasion and no der-mal invasion (P<0. 01 and P<0. 05), the groups of lymphatic metastasis and no lymphatic metastasis (P<0. 01), and the groups of positive and negative resected margin (P<0. 01 and P<0. 05) were statistically different. There were no statistically different with age and extent of lesion (P>0. 05). Conclusions CK7 is a sensitive and specific marker of Paget’s cells. Dermal invasion, lymphatic metastasis and positive resected margin are poor prognostic factors in EMPD.

Objective To study the relationships among leptin, leptin receptor (OB-R) gene in arcuate nucleus and type 2 diabetes mellitus, and the effect of acupuncture on them. Methods Obese rats due to diet were injected in abdomen with small dosage streptozotocin to induce type 2 diabetes mellitus model, and were divided into acupuncture, glibenclamide and model group. Normal rats were in control. After treatment for 4 weeks, fasting blood sugar (FBS), fasting insulin (FINS), leptin, OB-R mRNA expression in arcuate nucleus were evaluated. Height, weight were measured and Lee's index were calculated before and after treatment. Results The FBS and FINS were higher in model group ［(15.79±1.87) mmol/L, (37.20±3.92) mIU/L］ than in control ［(5.16±0.13) mmol/L, (23.57±1.63) mIU/L］, but decreased in acupuncture group ［(5.46±0.20) mmol/L, (20.87±1.80) mIU/L］ and glibenclamide group ［(5.26±0.13) mmol/L, (28.10±1.86) mIU/L］. Leptin was lower in model ［(0.95±0.15) ng/ml］ than in control ［(1.32±0.15) ng/ml］, but was higher in glibenclamide group ［(1.83±0.23) ng/ml］ than in control. Weight and Lee's index decreased in model, acupuncture and glibenclamide groups after treatment. OB-R mRNA expression in arcuate nucleus in model wasn't different from control, acupuncture or glibenclamide group, nor between acupuncture and control, but was lower in glibenclamide group than in control. Conclusion Leptin decreased in type 2 diabetes mellitus rats when they became thin. Leptin resistance appears when treated with glibenclamide. Acupuncture may improve the OB-R mRNA expression in arcuate nucleus to some extent.

Objectives:To study the clinicopathological features of extraovarian peritoneal serous papillary carcinoma.Methods:The clinical pictures and pathological characteristics of 6 cases extraovarian peritoneal serous papillary carcinoma admitted to our hospital from 1992 to 1999 were studies retrospectively.H & E staining,histochemical staining and immunohistochemical staining were used.Results:The ages of the 6 patients were between 32～62(43.7) years old.The bilateral ovaries and fallopian tubes were almost normal.Tumors were examined histomorphologically by microscope and electron microscope,periodic acid-Schiff (PAS) stain was used in the histochemical study and carcinoembryonic antigen (CEA),CA125,p53,AE1 and AE3 monoclonal antibody assays were detected immunohistochemically.The results revealed no difference between extraovarian peritoneal serous papillary carcinoma and ovarian serous papillary carcinoma.Conclusions:Extraovarian peritoneal serous papillary carcinoma is considered arising from the secondary Müllerian system.Histologically,extraovarian peritoneal serous papillary carcinoma was identical to that of the similar epithelial carcinomas arising from the ovaries.The diagnosis was made only when the ovaries were not involved and without any evidence of similar epithelial carcinoma obtained in the ovaries.Histochemical staining and immunohistochemical staining are helpful as accessory criteria for the differential diagnosis between primary carcinoma of the peritoneum and malignant mesothelioma.The prognosis is poor.