OBJECTIVE To understand the distribution of common pathogens and their drug resistance trend and to provide the basis of the correct selection of antibiotics for clinic.METHODS Retrospective analysis was taken for blood culture specimens during 2 years in our hospital.And statistical analysis was done.All of 4028 cases of blood culture specimens were detected on automatic BacT/Alert3D rapid blood culture system,strains isolated were taken to VITEK-2 automatic microbiological analysis/sensitivity system for identification and drug susceptibility testing.Drug susceptibility results were analyzed using WHONET 5.3 software.RESULTS Totally 435 pathogen were isolated from 4028 cases of blood culture sample and the positive rate was 10.8%.195 Gram-negative bacteria strains accounted for 44.8%,mainly Escherichia coli,Klebsiella pneumoniae,Burkholderia cepacia,Acinetobacter baumannii,and Pseudomonas aeruginosa.Gram-positive bacteria accounted for 49.9%;mainly Staphylococcus epidermidis,S.haemolyticus and S.aureus dominated.Fungi were 23 strains(5.3%),mainly Candida albicans.Among them,extended-spectrum ?-lactamases(ESBLs) produced by E.coli and K.pneumoniae strains were 43.9% and 48.8%,respectively.Meticillin-resistant S.aureus and coagulase-negative staphylococci were 35.3% and 72.9%,respectively.But vancomycin-resistant S.aureus was not found.CONCLUSIONS The bacteria identification detected in blood culture class is quite complicated,and the drug resistance is high.Laboratories should increase the detection rate of bacterial culture and provide drug monitoring results for the clinics on time based on CLSI norms.Clinicians should use the antibiotics reasonably based on the drug susceptibility results in order to reduce nosocomial infections and the emergency of multiple drug-resistant strains.

Objective To compare the effects of remifentanil infused at different rates on median effective target plasma concentration (EC50) of propofol inhibiting responses to laryngeal mask airway (LMA) insertion and determine the optimum infusion rate of remifentanil when used for fiberoptic bronchoscopy in pediatric patients.Methods Eighty-four ASA Ⅰ or Ⅱ pediatric patients,aged 7 months-3 years,scheduled for elective fiberoptic bronchoscopy,were randomly assigned into 3 groups (n =28 each):normal saline group (group C),remifentanil infused at 3 ng· kg-1 ·min-1 group (group R1) and remifentanil infused at 5 ng· kg-1 · min-1 group (group R2).Responses to LMA insertion were defined as body movement and/or bucking during insertion.The initial target plasma concentrations of propofol were 5.2,4.8 and 4.4 μg/ml in groups C,R1 and R2,respectively.The target plasma concentration of propofol was determined by up-and-down sequential allocation.Each time the target plasma concentration increased/decreased by 0.2μg/ml.EC50 and 95 ％ confidence interval of propofol blunting responses to LMA insertion were determined by probit method.Results EC50 (95 ％ confidence interval) of propofol was 5.03 (4.92-5.12) μg/ml,4.71 (4.58-4.84) μg/rnl and 4.46 (4.20-4.94) μg/ml in groups C,R1 and R2,respectively.There was no significant difference in EC50 of propofol between groups R1 and C (P ＞ 0.05).EC50 of propofol was significantly lower in group R2 than in groups C and R1 (P ＜ 0.05).Conclusion The infusion rate of remifentanil should not be lower than 5 ng· kg-1· min-1 when combined with propofol in pediatric patients undergoing fiberoptic bronchoscopy.

Objective: To investigate the osteointegration and osteoinduction of nano hydroxyapatite/bioglass ( nHA/BG ) gradient nanofilm on the surface of titanium ( Ti) prepared by hypotherm sintering and plastic deformation. Methods:Hypotherm sintering was used to produce nHA/BG gradient coating followed by soaking in the simulated body fluid. Ti implants with gradient coatings were planted in femoral condyles at one side of 12 New Zealand rabbits and the untreated Ti implants were planted at the other side as the controls. 1, 3 and 6 months after implantation, the animals were sacrificed after X-ray examination and the tissues around the implants from the 3 month group were used for the preparation of hard tissue section and ground section. New bone formation was observed by tetracycline fluorescence staining. Von Gieson staining was used to observe the osteointegration at the interface between bone and im-plant. Results:The gradient coatings were porous and composed of irregular rod-like nano-HA crystals. Animal study showed well es-tablished osteointegration between the gradient coating and more novel bone was found around the implants with gradient coatings. Conclusion:Osteointegration and ostioinduction of Ti implant can be enhanced by nanostructured surface with gradient coatings of nHA/BG.

Objective To evaluate the effects of hyperbaric oxygen on the expressions of hypoxia-inducible factor 1α (HIF-1α) and insulin-like growth factor-1 receptor (IGF-1R) in the formation of hyperplastic scar in rabbit ears.Methods The ears of 20 New Zealand rabbits were used to construct an animal model for hyperplastic scar by operation.After the establishment of scar models,the rabbits were randomly divided into 4 experimental groups and one control group with 4 mice (48 wound surfaces) in each group.The mice in the 4 experimental groups were treated with hyperbaric oxygen for 7,14,21 and 28 days,respectively,and those in the control group remained in normoxic environment after operation.Scar tissues were resected from all the rabbit ears on day 29 after operation.Hematoxylin and eosin (HE) staining was conducted for the observation of morphological changes and calculation of scar elevation index,and immunohistochemistry to measure the expressions of HIF-1α and IGF-1R.Statistical analysis was carried out by one-way analysis of variance followed by least significant difference t-test.Results HE staining showed that both the number of fibroblasts and amount of collagen fibers were significantly reduced in the experimental groups compared with the control group.Scar elevation index was 4.28 ± 0.22 in the control group,3.64 ± 0.29,3.46 ± 0.21,3.29 ± 0.21,3.16 ± 0.15 in the 7-,14-,21-and 28-day experimental groups respectively,with significant differences among these groups (F =77.70,P ＜ 0.05).The expressions of HIF-1α and IGF-1R were significantly lower in these experimental groups than in the control group (all P ＜ 0.01),lower in the 14-day group than in the 7-day group (P ＜ 0.05),and lower in the 21-day group than in the 14-day group (P ＜ 0.05),with no significant differences between the 28-day group and 21-day group (both P ＞ 0.05).Conclusion Hyperbaric oxygen can effectively down-regulate the expressions of HIF-1α and IGF-1R in scar tissue,and significantly inhibit the formation of hyperplastic scar in rabbit ears.

Heart Neoplasms ; pathology ; Heart Ventricles ; pathology ; Humans ; Infant, Newborn ; Male ; Rhabdomyoma ; pathology

Objective To explore the significance of 1.5-Tesla MRI in the early diagnosis of prostate cancer,and analyze the imaging features in T2WI which are helpful for the diagnosis on early prostate cancer.Methods The clinical data of patients with PSA ＜ 20 μg/L who received prostate biopsy between Feb.2006 and Jan.2011 were reviewed including pelvic MRI and biopsy results.We retrospectively analyzed T2WI image features and evaluated the signal of peripheral zone,seminal vesicles,prostate capsule and the relationship with their surrounding tissues.The results of the reading were analyzed with reference to histopathologic evaluation of prostate biopies.Results Among 359 patients,137 patients were diagnosed prostate cancer and 332 cases were found with low signal lesions on peripheral zone of T2WI.Univariate logistic regression analysis showed that age and PSA are closely related to the diagnosis of prostate cancer (P ＜ 0.05).Low signal lesions on peripheral zone of T2WI are more helpful for the diagnosis of prostate cancer on the image.Number,shape,margin of lesions,the contour of the prostatic capsule,the boundary of peripheral zone and transitional zone are significantly associated with the diagnosis of prostate cancer.Through multivariate logistic regression analysis,it was found that age (P ＜ 0.05),PSA (P ＜ 0.05),prostate volume (P ＜ 0.05),lesion shape (flaky vs nodular,P ＜ 0.05 ; diffuse vs nodular,P ＜ 0.05) and the contour of the prostatic capsule (disappearing vs completely clear,P ＜ 0.05) are risk factors of prostate cancer.The areas under receiver operating characteristic curve are 0.833 (P ＜ 0.05).Conclusions In T2WI,lesion shape and the contour of the prostatic capsule are risk factors of prostate cancer.Age,PSA,prostate volume are also significantly associated with the diagnosis of prostate cancer.

Objective To study the role of using PSA in prostate cancer screening in the male physical examination population over 50yrs in Beijing.Methods From January 2010 to December 2010,in Physical Examination Center of Beijing Hospital and Beijing MeiZhao Health Screening Center,men over 50years with PSA records in the past three years (from 2007 to 2009) were selected.The exclusion criteria included history of prostate cancer,severe diseases of the heart,brain,lung,liver and kidney,and mental or neurological disorders.People who couldn't cooperate with the investigation due to any reasons were excluded as well.The number of recruited cases was 2862.Among the cases,males with PSA over 4 μμg/L received prostate biopsy after singing the informed consent form.The average age was 67.2 ± 9.3 years.Results In the 2862 males,2621 cases (91.5％) had normal PSA levels and 241 cases (8.5％) had abnormal PSA levels.With the age increasing from 50 to 89 years,the proportion of abnormal PSA levels increased significantly from 2.7％ to 10.9％,P ＜ O.001.86 patients (33.2％) received prostate biopsy in the group of abnormal PSA levels; The positive prostate biopsy rate was 41.4％ (39/86).In PSA ＜4 μg/Lgroup,the positive rate was 25.0％ ; in 4 μg/L≤PSA ＜ 10 μg/L group,the positive rate was 29.8％ ; in PSA ≥ 10 μg/L group,the positive rate was 68.9％,P ＜ 0.001.With the PSA level increasing,the proportion of the localized cancer decreased from 100％ to 70％,and the ratio of locally advanced and distant metastatic tumor increased from 0 to 30％ ; the proportion of Gleason≤6 fell from 100％ to 30％,the proportion of Gleason ≥ 8 increased from 0 to 50％.The differences above did not show statistical significance.Conclusions Use of PSA in prostate cancer screening for men over 50 years could increase the detection rate of prostate cancer.

Objective To evaluate the efficacy and safety of doxazosin gastrointestinal therapeutic system (DOX GITS) in the treatment of lower urinary tract symptoms (LUTS) in patients with benign prostatic hyperplasia (BPH).Methods A total of 4063 BPH patients aged ≥60 years from 16 regions and 86 hospitals were enrolled in this study.Patients were divided into 4 groups according to the previous medication:group 1 (treated with α1 receptor blocker but non-doxazosin),group 2 (treated with drugs without α1 receptor blocker),group 3 (without treatment),group 4 (treated with α1 receptor blocker but non-doxazosin and other drugs for BPH).Patients received DOX GITS with a flexible-dosage for 4 weeks.International prostate symptom score (IPSS),quality of life (QOL),maximum urine flow rate (Qmax) and adverse effects were assessed.Results After 4 weeks of the treatment,lower urinary tract symptoms were significantly improved in the 4 group.IPSS in the 4 groups were decreased to (12.3±4.6) scores,(12.2±4.6) scores,(10.9±4.5) scores and (9.9±4.4) scores successively.QOL in the 4 groups were improved to (2.8±0.9) scores,(2.8 ±1.0) scores,(2.5±0.9) scores and (2.4±0.9) scores successively.Qma x in the 4 groups were increased to (16.4±4.5) ml/s,(15.0±4.7) ml/s,(15.3±4.8) ml/s and (16.7±5.7) ml/s qsuccessively.There were significant differences in IPSS,QOL and Qmax of the 4 groups between before and after the treatment (P＜0.001).Adverse events were reported in 64％ of patients.The most common adverse events were dizziness of 43 cases (1.06％),postural hypotension of 10 cases (0.25％) and hypotension of 8 cases (0.20％).Conclusions DOX GITS can significantly improveLUTS and quality of life in BPH patients with a good tolerance and compliance.

Objective To explore the clinical value of image gradings of T2 weighted imaging (T2WI) and diffusion weighted imaging (DWI) for prostate cancer diagnosis in patients with prostate specific antigen (PSA) less than 20 μg/L.Methods A total of 133 patients with PSA＜20 μg/L who received prostate biopsies in our hospital from December 2011 to January 2013 were recruited.The prostate was divided into six regions in MRI images.T2WI and DWI image gradings on each region in peripheral zone were evaluated with reference to histopathological evaluation of prostate biopsies.The significance of grading system for the diagnosis of prostate cancer in the two scanning methods alone or in combination were compared.Results 60 patients were diagnosed as prostate cancer.The positive biopsy rates were 2.8％,13.5％,20.4％,34.6％,52.6％ and 88.9％,respectively in grade 0-5 based on T2WI imaging grading.The positive biopsy rates were 11.1％,16.1％,48.5％,71.0％ and 86.1％,respectively in grade 1-5 based on T2WI+ DWI imaging grading.The positive biopsy rate was significantly increased with the increments of pre-established T2WI and T2WI+DWI image gradings (Z=-9.8552,-13.4148,both P＜0.0001).Receiver operating characteristic analysis showed that the diagnostic capability was better in T2WI combined with DWI than in T2W1 alone in prostate cancer detection (AUC:0.743 vs.0.715,P=0.0072).Conclusions T2WI image grading can predict the risk of prostate cancer in patients with PSA＜20 μg/L,and DWI can enhance the ability to predict prostate cancer.

Objective To study serum level of prostate specific antigen (PSA) by age and its relationship with positive prostatic biopsy.Methods A total of 8818 adults who underwent PSA scanning at Health Chek-up Center of Beijing Hospital during July 2009 and July 2010 were retrospectively studied,40 of whom performed prostatic biopsy.Linear regression was used to assess the relation of PSA with age,while Chi-square test was used to compare positive prostatic biopsy in different PSA groups.Results Serum PSA of more than 4 μg/L was more commonly seen in the elderly group (40 ～ year-old group 1.4％,50 ～ yearold group 1.9％,60 ～ year-old group 9.2％,70 ～ year-old group 15.5％,80 year-old group 17％ ; P ＜0.001 ; RR =0.196).In those whose PSA was ＞ 20 μg/L,6 (83.3 ％) were found to have positive prostatic biopsy; and the figure was 10 (50.0％) or 24 (24.0％) when PSA was ＜4 μg/L or 4-10 μg/L group (P =0.048).Conclusions Age was positively correlated with PSA,although no linear correlation was confirmed.Higher serum PSA level (＞ 4 μg/L) may be more common in elderly people and those with a positive prostatic biopsy.