Objective To investigate the elinicopathologic features, diagnosis and differential diagnosis of oncocytic mucoepidermoid carcinoma of the salivary glands. Methods One case of oncocytic mucoepidermoid carci-noma was observed by clinicopathology and immunohistochemistry, followed by discussion through review of the litera-ture. Results The tumor was consisted of acidophilic cells, mucous cells,epidermoid cells and intermediate cells. The neoplastic cells arranged in a sheet, nest and glandular pattern, that were segregated by fibrous tissue. Some area the tumaor was composed of the same types of acidophilie cells,which had abundant finely granular eosinophilic cytoplasm, showed moderate unclear atypia. Histochemistry staining: the mucous secretory cells and some epidermoid cells were positive for PAS. IHC staining, the tumor cells were positive for CK7 and CK20 ,focal positive reaction to CEA, negative for NSE and CgA. Conclusion Oncocytic mucoepidermoid carcinoma is an extremely rare subtype of mucoepidar-moid carcinoma of the salivary glands. Histological examination plays an important role in diagnosis of this tumor. More attention should be paid on the daily practice in order to differentiate this tumor from oncocytic adenoma, pleomorphic adenoma and mucinous cystadenoma.

There was a 1 1 -year -old school -aged girl complaining of abdomen intumescing and declining physical fitness for 1 6 months,and hydropericardium for 5 months.The child had a intumescent abdomen and strength diminished strength suddenly.After the strenuous exercise she was more tired than before and lost her appetite.The girl was found cardiac enlargement and calcification of pericardium during security check at the airport.The thoracoabdomi-nal computed tomography(CT)suggested hydropericardium,hydrothorax effusion in the right,and seroperitoneum,pel-vic effusion.The girl had no response to pericardiocentesises,anti -inflammation and antituberculosis therapies.The in-flammatory markers and the findings of autoimmunity were normal after her admission.The purified protein derivatives (PPD)test was (++),but the antituberculosis therapy was invalid,so the diagnosis was unclear.The she had peri-cardiectomy.The pericardium visceral and parietale′s pathology showed hyperplasia,hyalinosis and organization of fi-brous connective tissue,congestion of the blood capillaries,infiltration of inflammatory cells.Terminally,she was diag-nosed as constrictive pericarditis.Symptoms disappeared after treatments with cardiotonic,diuretic and potassium sup-ply.The comprehensive analysis is important clinically,the possible causes should be removed gradually,and pathologi-cal examination must be emphasized during the diagnosis of constrictive pericarditis.

Objective To investigate the distribution of carbapenemase-resistant genes carried by multi-drug resistant Acineto-bacter baumannii .Methods 80 strains of multi-drug resistant Acinetobacter baumannii were collected .Polymerase chain reaction (PCR)wasusedtodetectcarbapenemase-resistantgenes,suchasOXA-23,OXA-24,OXA-51,OXA-58,SIM,IMP,VIM ,GIMand SPM ,in multi-drug resistant Acinetobacter baumannii .Results Drug resistant gene OXA-23 [49 (61 .3% )] ,OXA-51 [73 (91 .3% )] ,OXA-58[7(8 .8% )] ,OXA-24[1(1 .3% )] ,IMP[17(21 .3% )] and VIM[2(2 .5% )] were found in 80 strains of multi-drug resistant Acinetobacter baumannii ,while GIM ,SIM and SPM gene were not found .Conclusion IMP ,OXA ,VIM is the main genotypes carried by multi-drug resistant Acinetobacter baumannii .

OBJECTIVE:To establish a simple and rapid preparation technique of Rifampicin eye drops.METHODS:The calculating quantity of hydrochloric acid was used to dissolve Rifampicin,then the equimol quantity of potassium hydroxide was added to neutralize the acid and yield potassium chloride,whose quantity was designed according to the prescrip?tion.RESULTS:Neutralization reaction not only overcame the difficulty of Rifampicin's dissolution in water,but also avoided the irritation to eyes caused by using ethanol as solvent.CONCLUSION:The method is well-versed in design,simple in preparation and controllable in quality.

目的帮助截瘫患者解决便秘的痛苦及促进排便功能的恢复。方法卫生棉条刺激排便和定时排便训练。结果治疗组的有效率为90.49% ,明显高于对照组的33.33%(P<0.01)。结论棉条刺激和定时排便训练能使患者短时间内大量排便并对排便功能的恢复有促进作用。

目的观察水封瓶排除偏瘫患者鼻饲前胃管误入气管的效果。方法将胃管与水封瓶连接,检测胃管前端的压力,通过观察水封瓶内的水柱波动范围来判断胃管的位置,以确定胃管是否误入气管。结果此法经过28例,78次测量,无一次判断失误,及时发现4例患者胃管部分脱出。结论用水封瓶检测判断胃管是否误入气管,是一种客观、可靠、简便的方法。

目的探讨住院偏瘫患者的“偷行”行为与跌倒的关系,以防止患者跌伤。方法自制“偏瘫患者偷行动机与行动问卷”调查表,发给404例住院偏瘫患者填写或由他人协助填写。结果56.93%的被调查患者有偷行动机,5.44%有偷行行为,占有偷行动机人数的9.48%,发生跌倒的占有偷行行为的86.36%,跌倒患者中出现跌伤者占10.52%。结论偏瘫患者中普遍有偷行动机,相当一部分患者有偷行行为,偷行者跌倒率高,容易跌伤,故偷行行为是引起住院偏瘫患者跌伤的主要原因之一 ,应引起医护人员重视,并列为评估患者跌倒因素的内容之一。

ObjectiveTo research a way to verify whether the stomach duct is misplaced into the trachea.MethodsThe air pressure of the stomach duct placed in the stomach or in the trachea were measured using a water bottle.ResultsThe air pressure of the stomach duct was (1±0.45)cmH2O When it was put in the stomach, and was (7±2.03)cmH2O when it was put in the trachea(P<0.01).ConclusionsWhen it is impossible to draw out acerbic substances from the stomach to verify whether the stomach duct is placed in the stomach or misplaced in the trachea, measure the air pressure stomach duct by a water bottle can be used as substitute, which is reliable and convenient.

Objective To clarify the MRI characteristics and outcomes of patients with end stage hypertrophic cardiomyopathy (ES-HCM).Methods Clinical and MRI data of 57 ES-HCM patients were retrospectively analyzed.ES-HCM pa tients were divided into dilated phenotype group (D-ES group,n=39) and restrictive phenotype group (R-ES group,n=18).MRI characteristics and outcomes of patients were compared between both groups.Results The incidence of atrial fi brillation and edema of lower extremity was significantly higher in R-ES than those in D-ES (72.22％ [13/18] vs 30.77％ [12/39];50.00％ [9/18] vs 23.08％ [9/39];both P＜0.05).The left ventricular ejection function,left and right atrial anteroposte rior diameter of D-ES group were significant smaller than those of RRES group (all P＜0.05),while the left ventricular (LV) short axis diameter,LV end diastolic/systolic volume and LV end diastolic/systolic volume index of D-ES were significantly greater than those of R-ES group (all P＜0.05).Log-rank test found no significant difference between both groups in cardiovascular death/ heart transplant events (x2 =1.135,P=0.287).Late gadolinium enhancement (LGE) volume fraction was significantly larger in D-ES ([36.1±14.8]％) than in R-ES ([21.0±9.0]％;P＜0.05).There was a significant correlation between LGE volume fraction and cardiovascular death/heart transplant events (HR:1.054,P＜0.05).Conclusion ES-HCM patients have expanded clinical expression and MRI characteristics,including dilated phenotype and restrictive phenotype.MRI has an important application value in the diagnosis and prognosis evaluation of ES-HCM.

Objective: To evaluate the effectiveness of droplet digital PCR (ddPCR) assay for detection of neuraminidase (NA) H275Y mutations in influenza A H1N1 pdm09 virus. Methods: The primers and dual probes were designed based on the sequence of the H1N1 pdm09 NA gene fragment which contained 275 amino acid sites, and the annealing temperature of ddPCR assay was optimized to establish a method for detection of H275 drug-sensitive genes and H275Y drug-resistant genes in H1N1 pdm09 virus. The sensitivity of ddPCR assay and fluorescent quantitative PCR (qPCR) assay was compared using the detection limit, and the specificity of ddPCR and qPCR assays was compared for detection of 14 respiratory virus samples. In addition, 64 clinical samples and 5 influenza isolates were tested to calculate the abundance of H275Y mutations, and the mutation abundance of 5 influenza isolates was compared with next-generation sequencing results. Results: The optimal annealing temperature was 62.2 ℃. The detection limits of ddPCR assay were 5.28 (95%CI: 4.28-7.45) copies/reaction for H1N1 pdm09 H275 drug-sensitive plasmids and 6.51 (95%CI: 5.25-9.37) copies/reaction for H1N1 pdm09 H275Y drug-resistant plasmids, and the detection limits of qPCR assay were 5.70 (95%CI: 4.83-7.45) copies/reaction for H1N1 pdm09 H275Y drug-sensitive plasmids and 7.06 (95%CI: 5.92-9.40) copies/reaction for H1N1 pdm09 H275Y drug-resistant plasmids. Both ddPCR and qPCR assays detected H275 and H275Y drug-resistant plasmids in H1N1 pdm09 viral samples but did not detect H275 and H275Y drug-resistant plasmids in other 11 respiratory virus samples, and these two assays showed consistent results. Of the 64 clinical samples, ddPCR assay detected H275Y mutation in three pharyngeal swab specimens from a severe pneumonia patients infected with H1N1 pdm09 virus, and the greatest mutation abundance was detected in samples collected on day 4 post-treatment with oseltamivir phosphate (53.37%). ddPCR assay detected 0.63, 88.93%% and 1.27% H275Y mutation abundance in samples collected on days 2, 4 and 5 post-treatment with oseltamivir phosphate, and next-generation sequencing detected 89.46% H275Y mutation abundance in samples collected on day 4 post-treatment with oseltamivir phosphate; however, no H275Y mutation was detected in samples collected on days 2 or 5 post-treatment with oseltamivir phosphate. Conclusions ddPCR presents a higher sensitivity and specificity than qPCR assay for detection of H275Y mutations in H1N1 pdm09 virus, and presents a higher sensitivity than next-generation sequencing for detection of low-frequency mutations, which is effective for quantitative detection of H275Y mutations in the NA fragment of the H1N1 pdm09 virus.