Objective To observe the clinical effect of alprostadil combined with Yiqi Huoxue Huatan Tongluo Decoction in treating arteriosclerosis obliterans.Methods 60 cases of lower extremity arteriosclerosis occlusion disease outpatient and hospitalized patients were randomly divided into treatment group and control group according to the random number table method, each group were 30, the oral administration of enteric coated aspirin experimental group is set to control group intravenous injection of alprostadil treatment for 4 weeks, the treatment group was treated with Huatan Tongluo Decoction on the basis of the control group.The clinical symptoms, blood vessel function (ABI),low density lipoprotein-cholesterol (LDL-C), total cholesterol( TC) were observed in the two groups of patients, and blood rheology indexes included whole blood viscosity, fibrinogen, liver and kidney function and adverse reactions.ResuIts Total effective rate of the treatment group was 93.33% than control group 73.33% (P<0.05), the treatment group of ankle brachial index ( ABI) was better than the control group, the treatment group TC, LDL-C, high shear whole blood viscosity, low shear whole blood viscosity, fibrinogen protein improve were better than those of the control group (P<0.05).ConcIusion Disease curative effect is better than pure alprostadil in the treatment of occlusion Huoxue Huatan Tongluo Decoction combined with alprostadil in the treatment of lower limb arteriosclerosis.

Objective To investigate the dynamic changes and drug resistance of fungal infection in our hospital during 2010 -2012 for guiding the clinical reasonable use of anti-fungal drugs .Methods The related clinical data and the drug sensitivity tests re-sults of fungal infection in the hospitalized patients from 2010 to 2012 were retrospectively analyzed by the WHONET 5 .6 soft-ware .Results Candida albicans was the major pathogen causing candida infection for these 3 years .The isolated specimens were mainly sputum and blood .In the departments of internal medicine ,general surgery and integrated Chinese and Western medicine ,the number of detected candida were more than that of the other departments .Five kinds of candida showed high sensitivity to ampho-tericin B and high resistance to itraconazole .Conclusion The distribution of pathogens causing nosocomial fungal infection has changed and the drug resistance rate is continuously rising .Therefore the dynamic monitoring and the study of fungal infection should be strengthened for reducing the occurrence of fungal infection in the patients with tumor .

ObjectiveTo investigate the flora distribution and drug resistance status of nosocomial fungal infection in cancer hospitals for providing the scientific basis for clinical prevention and control.Methods The related clinical data and results of drug sensitivity tests of fungal infection in hospitalized patients from April 2006 to November 2010 were analyzed retrospectively.ResultsA total of 1011 strains of candida were isolated in five years, in which, Candida albicans (41.6％ on average) were the highest detection rate strains.The proportion of Candida albicans declined from 53.8％ in 2006 to 31.7％ in 2010, while the other non-Candida albicans increased from 46.2％ in 2006 to 68.3％ in 2010.In the General surgery, the Internal medicine,the Hepatobiliary surgery, and the Chinese and Western medicine, the number of candida were more than the other departments.The specimens were mainly isolated from sputum and swab, followed by blood specimens.In vitro susceptibility test results showed that: voriconazole, amphotericin B and 5-fluorocytosine showed high sensitivity and itraconazole, fluconazole showed high drug resistance to albicans.Conclusion Distribution of pathogens causing nosocomial fungal infection has changed, and the rates of fungal resistance were rising,so this situation should arouse the clinician's attention.

Objective To evaluate the efficacy and toxicity of docetaxel combined with Cisplatin(DDP) and 5-fluorouracil(5-Fu) in the treatment of advanced gastric cancer. Methods 35 patients with advanced gastric cancer,which were confirmed by pathological diagnosis,were treated with docetaxel + DDP +5-Fu regimen:docetaxel 70 mg/m2 iv infusion for 4 hours on day 1, DDP 20 mg/m2 iv infusion on day 1 to 5,5-Fu 750 mg/m2 iv infusion for 6 hours on day 1 to 5 every 3 ～ 4weeks. Patients responsing to the chemotherapy finished at least 4 ～ 6 cycles or proceeded the therapy until progression of the disease (PD). Results 32 cases (91.4% ) were available for response evaluation with CR0;PR 15;SD7;PD 10. The rate of total remission( CR + PR) was 46.9% (15/32) ,and rates of CR and SD were 0 and 21.9% respectively. Leucopenia was seen in 40% patients,in which 13.6% cases were in grade III -IV. One patient had fever with neutropenia and improved after active treatment. There was no systemic infection or therapy-related death in all patients. Conclusion Docetaxel + DDP +5-Fu regimen has an assured response for advanced gastric cancer with tolerable toxicity and could be an effective candidate in clinical treatment.

OBJECTIVE To study the incidence of ?-lactamases,mainly the extended-spectrum beta-lactamases(ESBLs) and metallo-beta-lactamases(MBLs) of Chryseobacterium indologenes and Ch.gleum.METHODS Agar dilution method was applied to detect minimal inhibitory concentrations(MIC) to 12 different antibiotics used frequently.Three-dimensional test was used to detect ESBLs and metallo-?-lactamases.The genes of ?-lactamases were amplified with 3 pairs of primers special for Ch.indologenes and Ch.gleum.RESULTS Among the 25 strains of Ch.indologenes and 10 strains of Ch.gleum,68%(17/25) isolates of Ch.indologenes and 90%(9/10)isolates of Ch.gleum were considered as MBLs positive strains,but no isolates were detected for the production of ESBLs.CONCLUSIONS MBLs are the important mechanism of multi-drug resistance for Ch.indologenes and Ch.gleum.

Objective To investigate the feasibility and safety of minimally invasive pereutaneous nephro-lithotomy(MPCNL) in treating impacted upper ureteral calculi. Methods 50 cases with impacted upper ureteral cal-culi treted with MPCNL were analyzed retrospectively. Results All cases were rendered stone free at one session, clearance rate was 100%, 1 case required transfusion,no other major complications was observed. Conclusion MPC-NL was safe and effective in treating impacted upper ureteral calculi with a high clearance rate.

OBJECTIVE:To investigate clinical efficacy and safety of recombinant human tissue type plasminogen activator (rt-PA) intravenous thrombolytic in the treatment of elderly patients (over 75 years old) with acute cerebral infarction (ACI). METHODS:78 elderly ACI patients,on the basis of routine treatment,were divided into thrombolysis group (40 cases) and non-thrombolysis group (38 cases) according to the will of patients or family members. Non-thrombolysis group received aspirin 200 mg,qd;thrombolysis group was given rt-PA 0.9 mg/kg(maximum dose of 90 mg)by intravenous push of 10% dose within 1 min,and intravenous dripping of residue dose within 60 min;receiving aspirin 200 mg,qd,24 h after thrombolytic therapy with-out contraindications. Both groups were treated for 14 days. The effective rate,NIHSS score before treatment and 24 h,7 d and 14 d after treatment,prognosis after 90 d were compared between 2 groups,and the occurrence of ADR was observed in 2 groups. RE-SULTS:The total effective rate was 67.50% in thrombolysis group and 52.63% in non-thrombolysis group,with statistical signifi-cance(P<0.05);there was significant difference in NIHSS score between 2 groups 24 h,7 d,14 d after treatment(P<0.05);90 d prognosis of thrombolysis group was superior to that of non-thrombolysis group,there was statistically significance (P<0.05);there was no statistical significance in the incidence of ADR between 2 groups (P>0.05). CONCLUSIONS:4.5 h time window rt-PA intravenous thrombolytic therapy is safe and effective for elderly patients with ACI,and can reduce disability and fatality,im-prove prognosis.

Objective To investigate the value of neuronavigation system in resection of pituitary adenoma through the endonasal transsphenoidal approach. Methods Twenty-one patients with pituitary adenomas underwent magnetic resonance imaging (MRI) or CT scans studies. The image datasets were transported into the neuronavigation system. The anatomic information of approach was reconstructed for three-dimensional visualization and the best approach was designed. The midline structure and internal carotid artery were displayed in real-time intraoperatively, the anterior-wall of sphenoidal sinus and the floor of sella were accurately opened and the tumor was resected guiding by neuronavigation system. Results All the operations were smoothly and accurately performed under the neuronavigation by transsphenoidal approach. No injury occurred in the internal carotid artery and cavernous sinus. After surgery, 13 patients got better vision and visual field. Postoperative transient diabetes insipidus was found in 11 cases, and CSF leak in 1 and serious hyponatremia in 2 cases. Total tumor removal was achieved in 17 patients and subtotal removal in 2 cases during operations, which were confirmed by postoperative MRI. Three-month follow-up data showed only one recurrence case (subtotal tumor removal), the recurrence rate was 4.8%. Conclusion Neuronavigation system provided real-time localization with three-dimensional anatomic information of the endonasal transsphenoidal approach during pituitary adenomas surgery. As a result, the approach proceeds more smoothly and accurately, the tumor can be resected more completely, the surgical injury and complications can also be reduced.

Objective To investigate the effects of probucol and losartan on cell proliferation after balloon angioplasty in hypercholesterolaemic rabbits.Methods Forty male New Zealand rabbits were randomly divided into high cholesterol diet group,probucol group,losartan group and combined drugs group.The iliac arteries of the rabbits were balloon-injured and the insulin-like growth factor-I receptor(IGF-IR),vascular endothelial growth factor(VEGF),and proliferating cell nuclear antigen(PCNA) were detected by using immunohistochemical method.Results Compared with high cholesterol diet group,the lumen areas were enlarged and the intimal areas were decreased in the probucol group,losartan group and combined drugs group(all P

Objective To investigate the expression of ER,PR,HER-2,PCNA and P53 in breast cancer patients in Shanghai and the relevant clinical significance.Methods Expressions of ER,PR,HER-2,PCNA and P53 in the breast cancer tissues of 544 patients in Shanghai were detected by immunohistochemistry methods.Statistical analysis was applied to analyze the relationship of these immunohistochemical indices with the clinicopathological features of breast cancer.Results The positive rates of ER,PR,HER-2,PCNA and P53 in the breast cancer tissues of 544 patients were 62.2%,57.2%,15.1%,82.6% and 58.5%,respectively.The expressions of ER,PCNA and P53 were correlated with the tumor size(P