Objective To learn about the antibiotic resistance status of methicillin resistant coagulase negative staphylococcus(MRCNS),and to investigate the distribution and resistant feature of different staphylococcal chromosomal cassette mec(SCCmec) genotypes of children in Anhui,so as to guide clinical medication.Methods Resistance phenotype screening was conducted in coagulase negative staphylococcus,which were isolated from clinical strains in children in Anhui from 2010 to 2014 each year in September.MecA gene was detected by using PCR method in order to collect MRCNS.Minimal inhibitory concentrations (MIC) of 16 antibiotics were determined by adopting agar dilution method.Vacomycin-resistant strains were identified with population analysis and the Brain Heart Infusion vancomycin screen agar dilution method recommended by Clinical and Laboratory Standards Institute in 2013.Van gene and SCCmec types were detected by using PCR method.Results A total of 148 MRCNS strains were detected through the resistance phenotype screening and the detection of mecA gene.There were methicillin resistant staphylococcus epidermidis,methicillin resistant staphylococcus haemolyticus,methicillin resistant staphylococcus hominis,and other kinds of MRCNS,and the proportions of them were 44.59％ (66/148 cases),25.68％ (38/148 cases),19.59％ (29/148 cases) and 10.14％ (15/148 cases),respectively.The analysis of antibiotic resistance showed the antimicrobial resistant rates of MRCNS to Penicillin,Cefoperazone,Cefotaxime,Ceftriaxone,lmipenem and Meropenem were all 100％,to Erythromycin and Azithromycin,Ciprofloxacin,Clindamycin,Gentamicin,Lewofloxacin,Rifampincin,Chloramphenicol,Teicoplanin and Vancomycin were 92.57％,97.98％,83.78％,79.05％,43.24％,35.81％,24.32％,8.78％,2.03％ and 0.68％,respectively.There was 1 heterogeneous Vancomycin-resistant strain,which was resistant to both Vancomycin and Teicoplanin (with MIC 32.00 mg/L and 64.00 mg/L).No vanA,vanB,vanC1 or vanC2/3 gene was detected from heterogeneous Vancomycin-resistant strain by PCR.Ⅰ to Ⅴ SCCmec genotypes were detected from 148 MRCNS strains,and the major SCCmec type was SCCmec type Ⅲ,which was followed by hybrid type.Three subtypes of SCCmec type Ⅳ were identified,including Ⅳa,Ⅳc and Ⅳd.There were 148 MRCNS strains that showed different resistant phenotypes to various antibiotics.Conclusions The MRCNS strains of children in Anhui province showed multiple resistance to antibiotics.It should be on alert when heterogeneous Vaneomycin-resistant strain appeared.There were several different SCCmec types among several kinds of MRCNS,and SCCmec Ⅲ genotype was the major epidemic isolate.There was no significant correlation between the different resistance rates of non-β-lactamase antibiotics and SCCmec genotypes in MRCNS.

Objective:To study the application of direct immunofluorescence in detecting RSV antigen in children respiratory syncytial virus(RSV)pneumonia.Methods:Multi-center,block randomization,parallel control clinic tests were adopted.To use Qingkailing Injection and Ertongqingfei Oral Liquid as test group and ribavirin injection and Compound Guaiacol Potassium Sulfonale Oral Solution as control group for treating accumulation of phlegm-heat in lung syndrome in children RSV pneumonia.Direct immuno uorescence was used to detect RSV turning to negative in different period in treatment time.Results:The time of turning to negative of test group was earlier than the control group's.In the case of 208 include 108 in the test group and 98 in the control group,it had statistic significance(P0.05).Conclusion:Detection of RSV antigen by direct immuno uorescence is simple,stable,sensitive and special.It is better in choosing clinical case and tracing clinical effect and should be widely applied in clinic.

Objective To evaluate the value of 16-slice spiral computed tomography(SCT)in diagnosing acute aortic syndrome.Methods Thirty-four cases with acute aortic syndrome underwent 16-slice SCT,performed with unenhanced,contrast-enhanced scanning of bolus tracking and three-dimensional reconstruction.The CT findings of these cases were analysed.Results Twenty-three of them were confirmed Aortic Dessection(AD),the true and false lumen,intimal flap,extent involved and complications of which were all revealed.Six cases were confirmed intramural aortic hematoma(IMH),with features of ring or crescent-shaped non-enhanced thickening wall around the aorta.Five cases were confirmed penetrating atherosclerotic ulcer(PAU),with features of niche sign outstanding the lumen of the aorta.Conclusion Acute aortic syndrome can he diagnosed exactly and completely by 16-slice SCT,which can provide valuable information to select therapeutic methods.

Objective To study the efficacy,late complications and prognostic factors of postopera-tive radiotherapy for bladder cancer: Methods Between July 1995 and January 21307,109 patients with primary bladder cancer who had received adjuvant pelvic radiation therapy were retrospectively analyzed. The age ranged from 41 to 94 (median 68) years. There were 29 patients with T1 disease,60 with T2,17 with T3, 3 with T4, and 7 with positive lymph node. Three-dimensional radiotherapy was given with a median total dose of 49.2 Gy(39.3 -62.2 Gy) in conventional fractionation after surgery. Field-in-field intensity modu-lated radiotherapy was given to 57 patients. Results The total follow-up rate was 98% ,with a median fol-low up time of 36(2-144) months. The 1-,3- and 5-year local control rate was 63% ,47% and 42% ,respec-tively. The 1-,3- and 5-year overall survival rate was 80% ,48% and 37% ,respectively. Among the 109 pa-tients,33 died of tumor progression or metastasis,42 showed local recurrence,and 22 had lymph node metas-tasis. According to the RTOG criteria,grade 1,2,3 and 4 radiation related early urological side effects were 22% ,59% ,12% and 1% ,respectively;The corresponding late urological side effects were 29% ,28% ,2% and 1%, respectively. Two patients underwent whole bladder cystectomy due to the radiation related side effects. Conclusions Postoperative three-dimensional radiotherapy, achieving high response rate with tol-erable side effects, can be offered as an alternative option to the radical cystectomy in the bladder conserving treatment.

Objective To analyze factors contributing to the quality of life of earthquake victims with nonunion fracture in limbs after medical rehabilitation and to provide a clinical reference for future disasters.Methods Thirty-one wounded who sustained their injuries in the Sichuan earthquake completed the short form-36(SF-36)questionnaire 2 weeks before their amputation,and after 3,6 and 12 months of medical rehabilitation.The SF-36scores were compared with Sichuan population norms.Stepwise multiple linear regression was used to highlight variables which influenced their functional recovery and their physical and mental health.Results The physical and mental health composite scores of the 31 victims were significantly lower than Sichuan population norms before medical rehabilitation,but they had a significant increasing trend after 3,6 and 12 months of treatment.Their scores on all the domains remained significantly lower than Sichuan population norms at a later follow-up.Smoking,external fixations and chronic diseases were related to their recovery of physical function.Age,permanent housing,family income and casualties among family members were related to their mental health recovery.Conclusion The quality of life of patients with nonunion fracture caused by earthquake can be improved significantly through medical rehabilitation.But social factors should be considered in addition to medical rehabilitation after an earthquake.

Objective To investigate factors related to chronic pain in those injured with fractures 27 months after the Sichuan earthquake.The correlation between intensity of pain and quality of life was also analyzed.Methods A total of 705 victims were investigated on site.Their residual pain was categorized using a visual analogue scale (VAS) score as no pain,mild pain,moderate pain or severe pain.The pain-related biological,psychological and social factors were analyzed using the Barthel Index ( BI ),Life Satisfaction Questionaire-11 ( LiSat-11 )and the SF-36 health questionnaire. Rehabilitation and surgical interventions,employment,income and emotional status were also investigated. Results The incidence of chronic pain was 88.5％ in this population,of which mild pain and moderate pain were 35.7％ and 33.3％,respectively.The percentage of the victims who had received fracture surgery was 65.8％ ; the percentage of those who had recovered was 96.9％.BI scores for the victims without pain,with mild,moderate and severe pain were 92.7 + 10.2,92.8 + 8.4,91.2 ± 9.9 and 90.4 + 14.7,respectively ; the differences between these groups were all statistically insignificant.The influence of pain intensity on life satisfaction showed a significant linear trend.The percentages of the victims with restricted occupational ability in the four groups were 38.3％,61.5％,75.7％ and 62.8％ respectively.The median of personal annual income were ￥ 3550,￥ 2500,￥ 2000 and ￥ 2500.The VAS scores were significantly related to abnormal emotions,life satisfaction,employment and annual income.The subjects with different levels of residual pain also showed significant differences in the physical functioning,role-physical,bodily pain,general health,vitality,social functioning,role-emotional and mental health sub-scales of the SF-36.The total SF-36 scores were highest among victims without pain (70.6 + 17.5) and declined significantly in those with mild (61.3 + 14.3 ),moderate (52.7 + 14.3 ) and severe pain (52.3 + 14.7 ).This negative correlation between pain intensity and SF-36 total score was statistically significant. Conclusions Chronic pain remains common among fracture victims 27 months after the earthquake.Its intensity is correlated with psychological and social factors as well as quality of life.

Objective To evaluate 16-SCT in diagnosing aeute appendicitis.Methods The CT findings of 34 cases were retrospectively analyzed.These cases were all proved acute appendicitis by surgical-pathology.Results 30 cases were confirmed by CT,with accuracy 88% (30/34).The diameter of 28 appendix was more than 6mm;2 collapsed with thickening wall.Periappendiceal fat stranding could be seen in 25 cases.Perforated appendicitis happened in 4 cases.Abscess performed in 2 cases.3 cases were missed,1 misdiagnosed.Conclusion 16-SCT could confirm acute appendicitis and its complication timely and accurately.

Objective To improve the diagnosis of cytomegalovirus pneumonia in patients who have undergone kidney transplantation. Methods The CT appearances of 10 cases were retrospectively analyzed. Results Ground glass opacity was seen in all cases, and disseminated several lobes were seen in 7 cases, diffuse distribution was seen in 3 cases. In addition,lung fibrosis happened in 3 cases,nodule in 2 cases,and consolidation in 3 cases.Conclusion Multi-slice CT could provide very valuable information for early diagnosis of cytomegalovirus pneumonia.

Objective To understand the malaria epidemic situation in Hubei Province from 2010 to 2014,so as to provide the evidence for formulating the effective malaria elimination strategies and measures in this province. Methods The data from the Disease Reporting Information System of Chinese Center for Disease Control and Prevention were collected and analyzed with the descriptive epidemiological method for the epidemiological characteristics of malaria in Hubei Province from 2010 to 2014. Results A total of 997 malaria cases were reported in Hubei Province from 2010 to 2014,there were 618 cases of vivax malaria,352 cases of falciparum malaria,18 cases of Plasmodium ovale infection,and 9 cases of Plasmodium malariae infec?tion. Among all the reported cases,479 were local cases and 518 were imported cases. No local malaria cases were reported from Hubei Province since 2013. The overall imported malaria cases showed a gradual increasing trend from 2010 to 2014,the pro?portion of falciparum malaria increased quite significantly from 2010 to 2014. The malaria cases were mainly distributed in Xiangyang,Wuhan,Xiaogan,Yichang,Jingmen and Suizhou cities,reaching 81.85%of the cases of the whole province. There were 810 male cases and 187 female cases,with a sex ratio of 4.33∶1. The local malaria cases were mainly aged from 40 to 69 years,accounted for 78.29%of the total local cases,and 88.22%(457/518)of the whole local cases were concentrated in 20-49 age groups. The local cases were mainly farmers(67.01%). Among the imported malaria cases,the occupation distribution concentrated mainly on the worker,migrant worker,and farmer(63.90%). Conclusions The local malaria epidemic situation has been effectively controlled in Hubei Province,which reflects the initiative achievements of malaria elimination. However, there are still many imported malaria cases from abroad. Therefore,the imported malaria from abroad still remains the key of ma?laria control in Hubei Province.

AIM: To study the possibility and conditions of transplacental infection of coxsackievirus B3(CVB 3) from pregnant mice to their fetuses and newborns. METHODS: Coxsackievirus B 3 strain causing balb/c mice myocardial injury(CVB 3m )was inoculated with 10 5 TCID 50 in dose into the mother mice at 6-7 days (early gestation),9-10 days (middle gestation) and 17-18 days (late gestation) of gestation, in contrast with non pregnant mice. Some placentas and fetuses were removed by caesarean section before mothers partusing; some mothers and their babies were sacrificed after parturition, and virus isolation, serological and pathological tests were performed. RESULTS: Viramiae was observed in mother mice of late gestation inoculated with CVB 3m at a fit amount on the second day after inoculation, while no newtralizing antibody to CVB 3m was detected in blood. The virus was isolated from cardiac muscles of inoculated mother mice in different gestation and the controls. The virus was also isolated from some placentas and fetuses, and both sera and cardiac muscles of infants in the late gestation (virus titer were all 10 -2 -10 -3 ). On d 7 of inoculating virus, pregnant and non pregnant mice titers of neutralizing antibody to CVB 3m in sera were all between 1160 and 1320. Under the electromicroscopy, some cardiac muscle cells of mother or infant mice appeared with morphological changes and little hollow bubbles occured in cytoplasm. The fibers broke off, and the bright and dark belts became indistinct. CONCLUSION: The amimal model, intraplacental passage of CVB 3 from pregnant mother in late gestation to fetus in mice, is a benefitial tool to study enterovirus diseases in human perinatal period.