Objective? To?understand?the?distribution?and?antibiotic?resistance?profile?of?clinical?isolates?in?the?Affiliated?Hospital?of Youjiang Medical University during 2015. Methods The pathogenic microorganisms were isolated from inpatients from January to?December,?2015?in?the?Affiliated?Hospital?of?Youjiang?Medical?University.?Antimicrobial?susceptibility?testing?was?carried?out?according?to?a?unified?protocol?using?Kirby-Bauer?method?or?VITEK?2-Compact?systems.?The?results?were?interpreted?according?to CLSL breakpoints released in 2014, and analyzed by WHONET 5.6 software. Results A total of 4004 strains of bacteria were collected, including 1146 (28.6%) strains of gram-positive bacteria, and 2858 (71.4%) strains of gram-negative organisms. The?prevalence?of?MRSA?and?MRCNS?was?25.8?%?and?79.4?%,?respectively.?MRSA?and?MRCNS?strains?were?significantly?more?resistant to most antibiotics than MSSA and MSCNS except trimethoprim-sulfamethoxazole. Most of the S. pneumoniae isolates were from non-meningitis patients, showing high resistance rate to macrolides and tetracycline, but very low resistance rate to quinolones. Enterococcus isolates were mainly E. faecium and E. faecalis. More E. faecium were resistant to high-level gentamicin and high-level streptomycin than E. faecalis. E. faecium isolates were generally more resistant than E. faecalis to most of the antimicrobial agents tested except clindamycin and tetracyclines. But no gram-positive cocci were found resistant to vancomycin, linezolid or tigecycline. ESBLs-producing strains accounted for 53.1% of the E. coli strains and 28.5% of K. pneumoniae isolates. Enterobacteriaceae isolates were still very susceptible to carbapenems. E. coli isolates were more resistant to most of the antimicrobial agents tested than other Enterobacteriaceae except to piperacillin-tazobactam and carbapenems. Enterobacteriaceae showed higher resistance to trimethoprim-sulfamethoxazole than the other antibiotics tested. Majority of P. aeruginosa isolates were susceptible to all the antibiotics tested (<10% resistant). A. baumannii?strains?showed?significantly?higher?resistance rate than P. aeruginosa to all the antibiotics tested. Conclusions Most of the data in this report are consistent with the national?data?in?terms?of?antimicrobial?resistance?profile.?These?data?are?useful?for?rational?use?of?antibiotics.

The reform of performance appraisal and salary system is key to public hospitals reform.This paper introduced practices of the factor performance and salary system reform based on the Balance Scorecard in hospitals.It established a four-dimension performance appraisal structure,a motive salary allocation model covering all members of a hospital.This would help build the performance appraisal and salary allocation system meeting present needs of public hospitals in China.

Objective To evaluate the activities of daily living (ADL) and investigate its influential factor in primary angle-closure glaucoma patients.Methods One hundred primary angle-closure glaucoma patients (acute phase) diagnosed definitely from April to October 2014 were collected.The status of sex,gender,education,income were recorded.Barthel Index (BI),Hospital Anxiety and Depression Scale (HADS) and Glaucoma Quality of Life-15 (GQL-15) were respectively used to assess the ADL,anxiety and depression symptoms and visual quality of life in primary angle-closure glaucoma patients.At the same time the factors affecting ADL of primary angle-closure glaucoma were analyzed.Results There were no dysfunction in 12 patients,46 patients with mild dysfunction,32 patients with moderate dysfunction and 10％ (10/100) patients with severe dysfunction.BI was negatively correlated with anxiety and depression score,GQL-15 results and disease course (r=-0.819-0.395,P ＜ 0.01),and positively correlated with average monthly income (r=0.453,P ＜ 0.01).There were no correlation with gender,sex and education (r=-0.159-0.172,P ＞ 0.05).Conclusions ADL of primary angle-closure glaucoma patients has varying degrees of dysfunction,and disease course,average monthly income,anxiety,depression and visual quality of life are closely related with it.

Actinomycosis ; pathology ; Female ; Humans ; Middle Aged ; Tongue Diseases ; microbiology ; pathology

Objective To discuss the mode of onset,clinical characteristics,treatment and prognosis of children with granulocyte sarcoma (GS),in order to provide guidance for early diagnosis and effective treatment of GS.Methods Six cases of children with GS diagnosed at the Department of Hematology,Children's Hospital Affiliated to Soochow University between June 2009 and June 2014 were analyzed,the data including the mode of onset,clinical manifestation,diagnosis,treatment and outcome.Results There were 2 cases with a painless mass onset (1 case was 2 years old,characterized by right waist mass,about 10 cm × 5 cm;the other case was 6 years old,characterized by axillary lump,about 2 cm × 3 cm),and both of them received surgical removal of the tumor,then the postoperative tumor was examined by pathologic and immunohistochemical method,and at last the primary granulocyte sarcoma was diagnosed.The third case was a 7 years old girl,she was onset characterized by scalp lump,about 2 cm × 3 cm,and was diagnosed by the pathologic and immunohistochemical method,and changes in hematological system appeared a month later and acute myeloid leukemia(AML) was confirmed by bone marrow examination.The onset ages of other 3 cases were in 10 months,1 year and 7 months,13 years and 3 months old respectively,characterized by scalp lump (about 2 cm × 3 cm),spinal canal tumor (about 1.0 cm × 1.5 cm),intracranial tumors (6.0 cm × 4.9 cm),with AML occurring at the same time,which was confirmed by surgical pathology,immunohistochemistry and bone marrow cell morphology,immune classification,chromosome,and fusion gene diagnosis.Four cases were hematopoietic malignancies by pathology,2 cases of then belonging to small round cell tumor.The immune pathology showed 5 cases of myeloperoxidase positive,CD68-positive,3 cases of CD43-positive,CD123-positive.All children CD3,CD20 levels in all children were negative.Four cases underwent surgery combined with chemotherapy,other 2 cases received surgery and then gave up treatment,1 case discontinued follow-up 3 months later,and the other case died of intracranial hemorrhage after 3 months,which induced by thrombocytopenia.The treated 4 cases were followed up 3 to 58 months,and all had disease-free survival.Conclusions Children with GS have low incidence and non-specific diagnostic criteria,its diagnosis depends on immune pathology,and the treatment is mainly in accordance with AML program for high-dose chemotherapy.The systematic chemotherapy helps to prolong overall survival;at the same time,the hematopoietic stem cell transplantation with bone marrow may help to improve the prognosis.

The present paper proposed a central-driven structure of upper limb rehabilitation robot in order to reduce the volume of the robotic arm in the structure, and also to reduce the influence of motor noise, radiation and other adverse factors on upper limb dysfunction patient. The forward and inverse kinematics equations have been obtained with using the Denavit-Hartenberg (D-H) parameter method. The motion simulation has been done to obtain the angle-time curve of each joint and the position-time curve of handle under setting rehabilitation path by using Solid Works software. Experimental results showed that the rationality with the central-driven structure design had been verified by the fact that the handle could move under setting rehabilitation path. The effectiveness of kinematics equations had been proved, and the error was less than 3° by comparing the angle-time curves obtained from calculation with those from motion simulation.
Biomechanical Phenomena ; Humans ; Models, Biological ; Robotics ; Stroke Rehabilitation ; Upper Extremity

Objective To explore the value of interventional therapy in unruptured intracranial aneurysms combined with brain arteriovenous malformations (BAVM).Methods Data of 23 patients with unruptured aneurysms combined with BAVM were retrospectively analyzed.All patients were treated with interventional embolization,and the embolization methods were choosen according to the Redekop classification.The proximal or distal hemodynamic aneurysms were embolized with coils,and the intranidal aneurysms were embolized with Onyx.The outcome was assessed by the Glasgow outcome score (GOS) one week after treatment.DSA scan was used to observe whether there was recurrence during 3-6 months after embolization.Results Totally there were 36 aneurysms in 23 patients,including 8 intranidal aneurysms,16 proximal flow-related aneurysms,11 distal flow-related aneurysms and 1 unrelated aneurysm.Embolizations of 16 proximal hemodynamic aneurysms and l0 distal hemodynamic aneurysms were done with coils.And embolization of 8 intranidal aneurysms were done with Onyx.One distal hemodynamic aneurysm was not embolized due to the difficulty of embolization and the regular shap of aneurysm;and the patient died of cerebral hernia caused by intracranial hemorrhage on the sixth day after embolization.Because it was more suitable for surgical clipping,1 unrelated hemodynamic aneurysm was not embolized.In 23 cases,BAVM were completely embolized in 7 cases and incompletely embolized in 16 cases.A week after operation,the GOS score were 5 in 19 cases and 4 in 3 cases.The GOS score was not evaluated in the dead case.Except for 1 cases of death,the other 22 cases were followed up after embolization.No recurrence and intracranial hemorrhage occurred.Conclusion Interventional treatment of unruptured intracranial aneurysms combined with BAVM is safe and effective.Making treatment plan according to the hemodynamic characteristics of lesions and completely embolizing all lesions to prevent postoperative bleeding is helpful to improve the prognosis of patients.

Objective:To explore the effect of intermittent theta-burst stimulation (iTBS) of the cerebellum on the excitability of the M1 zone in the bilateral motor cortex and the duration of any effect.Methods:Twenty healthy youths were randomly assigned to a left or a right cerebellum iTBS group, each of 10. The resting motor threshold and motor evoked potential (MEP) of the motor cortex were determined before giving 600 pulses of iTBS. Then MEP was measured at the 5th, 10th, 15th, 20th, 25th, 30th, 35th and 40th minute after the intervention ended. Any changes in MEP amplitude were also analyzed.Results:①The average MEP amplitude in the right motor cortex had increased significantly in the left cerebellum iTBS group from the 5th to the 15th minute. The increase lasted at least 10 minutes. Then it had returned to the baseline value at the 35th minute. ②The MEP amplitude in the left motor cortex decreased slightly after iTBS of the left cerebellum began, but there were no significant changes. ③The MEP amplitude in the left motor cortex had a tendency to decrease after iTBS was administered to the right cerebellum, but that change too was not significant. ④The MEP amplitude of the right motor cortex decreased significantly only for the first 30 minutes.Conclusions:iTBS of the cerebellum can increase the excitability of the contralateral motor cortex. The effect can last 25 minutes. It can also decrease the excitability of the ipsilateral motor cortex for 30 minutes.

Objective To evaluate the outcome of the procedure of using the free flap vascularized by the dorsal artery of big toe to treat finger skin defect.Methods From August 2010 to April 2013,21 cases of finger shin defect were treated with the free flap vascularized by the dorsal artery of big toe in which emergency surgeries were conducted in 9 cases and sub emergency surgeries were conducted in 12 cases.The age of the 21 patients was 21 to 48 years old and 15 of them were males and 6 were females.Thumb was involved in 6 patients and index finger was involved in 15 patients.The skin defect occurred at dorsal in 7 patients and palm in 14 patients.The area of the flaps ranged from 2.2 cm × 1.6 cm to 4.0 cm × 3.2 cm.Observed the restoration of the affected fingers' appearance and function,investigated the clinical results and concluded the indication and advantages and disadvantages of this procedure by following up.Results All of the 21 flaps survived at the last office visit.The follow-up period ranged from 3 to 18 months.The shapes and the fingerprints of the flaps were satisfied.The color and texture of the flaps were similar to those of the finger skin.The 2 points discriminations of the flaps was 6-8 mm.No function deficits were found in the donor feet.Conclusion This free flap is satisfied in the shape,easy to harvested and the blood supply was constant in its location,and recommend it in treating the small of middle area skin defect in the finger.

OBJECTIVETo explore the correlation between Chinese medical (CM) syndrome types of chronic atrophic gastritis (CAG) patients and Helicobacter pylori (Hp) infection, polymorphisms of IL-1B, and IL-1β.

METHODSTotally 192 CAG patients and 202 healthy subjects (as the healthy control group) were recruited in this case-control study. The Hp infection was tested by 13C-urea breath test and colloidal gold-labeled assay (GICA). The concentration of peripheral blood IL-1β was measured by ELISA. The polymorphisms of IL-1B gene in the promoter region were analyzed using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP).

RESULTSPi-Wei weakness syndrome (PWWS) was dominant in CAG patients (31.77%, 61/192 cases). The Hp infection ratio in CAG patients was 53.65% (103/192 cases), of which, Pi-Wei damp-heat syndrome(PWDHS, 64.86%, 24/37 cases) and Gan-Wei disharmony syndrome (GWDS, 66.67%, 24/36 cases) were dominant. Compared with the health control group, the plasma concentration of IL-1β was obviously elevated in CAG patients with PWDHS, GWDS, and static blood obstructing collaterals syndrome (SBOCS) (all P < 0.05). Additionally, there was no difference in the distribution of polymorphisms in the promoter region of IL-1 B gene between the CAG patients and the healthy control group (P > 0.05).

CONCLUSIONSThe incidence risk of CAG was not associated with IL-1B polymorphism. But CM syndrome types of CAG patients was associated with Hp infection and peripheral blood IL-1β levels.

Case-Control Studies ; Gastritis ; Gastritis, Atrophic ; genetics ; Helicobacter Infections ; genetics ; metabolism ; Humans ; Incidence ; Interleukin-1beta ; genetics ; Medicine, Chinese Traditional ; Polymorphism, Genetic