Objective To investigate the clinical distribution and drug resistance of stenotrophomonas maltophilia and to provide reference for the clinical application of drugs and to control the nosocomial infection. Methods MicroScan autoSCAN4 and Kirby -Bauer (K -B)method were used to assess the bacteria and test the drug sensitivity.The data were analyzed with software WHONET5.6.Results The isolation rate was the highest in respiratory specimens.There was a highest isolation rate of 90.2%.Drug sensitive test showed that stenotrophomonas maltophilia was most sensitive to minocyline,and the resistance rate was 3.6%.The resistance rates of trimethoprim -sulfamethoxazole,levofloxacin and cefoperazone -sulbactam were12.2%,13.4% and 26.8%.Conclusion Drug resistance monitoring of stenotrophomonas maltophilia should be enhanced.Treatment based on drug susceptibility test should be adapted as soon as possible.

Objective To investigate the mechanism of radioulnar dissociation, an uncommon special injury, and its clinical diagnosis and treatment. Methods From 1990 to 1998, 4 patients with concurrent injuries of the proximal and distal radio ulnar joints were treated in my department. Of the 3 cases diagnosed early, 2 were treated with open reduction and internal fixation and 1 with closed reduction. The remaining one patient, whose radio ulnar dissociation was diagnosed 2 months later, had to be treated by secondary operation. Results The 4 patients were followed up for 16 months to 8 years (averaging 46 months). All had excellent results. Conclusion The early accurate diagnosis and early treatment of concurrent injuries of the elbow and the distal radio ulnar joint produce satisfactory results.

Objective To investigate the influence of patients suffered from acute lower wall cardiac infarct appeared Ⅲ atrio-ventricular block tneatment with thrombolytic recanalization for the early recovery of sinus rhythm.Methods From October 01 till October 06, a total of 25 hospitalized patients in our hospital with acute lower cardiac infarct, chest pain persist over thirty minutes, but less than one hour, immediately treatment with urokinase thrombolytic therapy after hospitalization, among them 17 cases reinfusion therapy success ful and 8 cases failed. Divided into reinfusion therapy success group and failed group, observate thromholytic therapy 6 hours recanalization success and fail group the situation of sinus rhythm recovore. Results Among 17 cases recanalization success patients and 14 cases recover sinus rhythm within 6 hours ,and 8 case fail in recanalization 2 cases recover sinus rhythm in 6 hours(25%)compared these two groups statistical are meaningful ( P＜0. 01 ). Conclusion Acute lower cardiac infarct patients with Ⅲ atrio-ventricular block must use thrombolytic therapy as soon as possible in order to let oclusive coronary artery recanalize, help to recover sinus rhythm as soon as possible and decrease mortality rate.

Tumor suppressor CYLD is a deubiquitination enzyme that could regulate NF-?B and JNK signal pathways by deubiquitinating TRAFs,NEMO,Bcl-3 and p53,and in turn regulating the cell cycle and apoptosis.Loss or deficiency of CYLD would lead to the development of skin tumor,including multiple familial trichoepithelioma(MFT),familial cylindromatosis(FC),Brooke-Spiegler syndrome(BSS).Cancers like uterine cervix,kidney,and colon and hepatocellular carcinoma are related to the down-regulation of CYLD.

The biodistribution and the radio activity in blood clearance of 99m Tc AMLCA were determined in 5 normal dogs by whole body imaging and measuring the radio activity in blood samples at 2,4,8 and 24h after 99m Tc AMLCA injection. The feasibility of imaging of the site of myocardial infarct was determined in 2 of the experimental MI dogs by demonstration of the left ventricle blood pool imaging (LVBPI) with 99m Tc AMLCA and by subsequent imaging of the excised heart. The results showed that the plasma concentration of 99m Tc AMLCA decreased rapidly from 51 5%?5 2% at 2nd hr to 27 3%?3 1% at 4th, 12 3%?1 8% at 8 hr and 5 6%?0 6% at 24th after the injection. The LVBPI in one MI dog showed that the region of the radionuclide concentration of 99m Tc AMLCA corresponded to region of absence of 99m Tc MIBI. The scintigraphy in another MI dog heart slices showed that the region of the radionuclide concentrate of 99m Tc AMLCA corresponded to the region of triphenyltetrazolium chloride (TTC) staining. The measurement of double radionuclides in the double interesting region in the MI dog heart slices indicated that the infarct myocardium uptook 99m Tc AMLCA specifically. These findings suggested that 99m Tc AMLCA scintigraphy might be a new approach for detecting and localizing MI

From the course setting and method of using case-study teaching in the medical microbiology,the article discussed its advantages and disadvantages,finding that carrying out such method can improve students' learning interest,their thinking and discriminating abilities and the humanism,thus giving some new opinions about the reform of the course system in the future.

Objective To investigate the rural medical orientation undergraduate student's professional commitment,time management disposition and learning burnout and the relationship between them. Methods Use the college students' learning Burnout scale,adolescence time management disposition Questionnaire and College Students'professional commitment scale,survey of Xinxiang Medical University grade 2010 ~2012,739 valid ques?tionnaires,the questionnaire has 92. 61% efficiency. Results Three scores were normally distribution. Learning burnout was the medium level,the average score of each entry was 2.88±0.45,and moderate and above level learn?ing burnout ratio was 45.06%. The average score of time management disposition was 3.45±0.43. Professional com?mitment level was higher,the average score was 3.82±0.43 for each item. Affective commitment,ideal commitment, the sense of time efficacy and the sense of time control have entered on the learning burnout of the stepwise regres?sion equation,and four variables together explained 44.0% of the variance in the dependent variable. Time manage?ment disposition,the professional commitment and learning burnout were negatively correlated, but between time management disposition and professional commitment is positively related, professional commitment, the variance explained by variables of learning burnout was 30.12%. Conclusion The rural medical orientation of undergradu?ate students time management disposition are important factors of learning burnout,which has the forecast function to the learning burnout. Professional commitment is part of the intermediary variables.

Purpose：To determine the treatments and prognostic predictors of malignant melanoma of the head and neck. Methods：Surgical treatment and outcome was analyzed for 28 patients with malignant melanoma of the head and neck at department of the head and neck of our hospital (1984-1994). Results：23 patients underwent local excised as the first treatment, and local recurrence was demonstrated in 8 (34.8%). Margin of resection of primary melanoma was divided into narrow excision (≤2 cm) and wide excision (＞2 cm), and 5-year survival was 58% and 40%(P＜0.01). According to surgical methods, 5-year survival of WE, WE/END and WE/TLND were 80%, 80% and 39%. Conclusions：An excision with 2 cm margin is safe procedure for primary tumor of malignant melanoma of the head and neck. Neck dissection may not be practiced until neck lymph node is positive. Neck dissections differ from the positions of the primary tumors, and the flaps must be raised preferably superficial to the platysma.

Objective:To research expression and function of c-myc gene in hyperacute r ejection of xenotransplantation. 　　Method:Through the model of hyperacute rejection of xenotransplantation wit h isolated rat heart perfused with human plasma,we detected c-myc mRNA expressi on and cell localization with in situ hybridization in hyperacute rejection. 　　Result:c-myc mRNA increased expression in the endothelium cell of heart.Th e value of signal is 450.09±409.99.The value of signal of group of control is 1 74.40±51.50(p＜0.05)。 　　Conclusion:From these study findings,it would appear that hyperacute rejecti on is associated with the elevation of c-myc mRNA expression.

Objective To investigate the effect of parental presence on the anxiety of children during induction of anesthesia with sevoflurane. Methods One hundred and twenty children (ASA Ⅰ or Ⅱ ) aged 2-12 yr weighing 12-32 kg were assigned to one of 2 groups using a random number table ( n = 60 each): control group (group C) and parental presence group (group P). Preoperatiave visit was made the day before surgery in both groups. In group P a parent played with toys with the children for 15 min before induction of anesthesia, while in group C a nurse played with them. Anesthesia was induced with 8% sevoflurane in O2 delivered at 6 L/min through a scented face mask held by the parent or anesthesiologist talking with them in soft words. Modified Yale preoperative anxiety scale (mYPAS) was used to measure anxiety of the children during preoperative visit, before and during induction of anesthesia. Induction compliance checklist (ICC) was used to measure behavioral compliance during induction. ICC score ＞ 5 implied failure of induction of anesthesia with sevoflurane. Adverse events were recorded. Results The mYPAS scores were significantly lower before and during induction of anesthesia in group P than in group C (P ＜ 0.05), but there was no significant difference in ICC scores between the 2 groups ( P ＞0.05). There was no failure of induction in group P while in group C there were 3 failures. Cough occurred in 2 patients in group P but in 3 patients in group C. One patient vomited during induction of anesthesia in group C.Conclusion Parental presence is effective in reducing anxiety of children during induction of anesthesia.