Objective To investigate the correlation of Chlamydia trachomatis (Ct) infection with tubal pregnancy by Meta-analysis. Methods Eligible literatures were searched from Chinese websites cnki,wanfangdata and eqvip from 1998 to 2007. Meta-analysis was conducted for the correlation of Ct infection with tubal pregnancy by software RevMan 4.2, and the results were expressed as odds ratio (OR) and 95% confidence intervals (95% CI). Results Thirty-five articles were retrieved, of which 16 were included in the Meta-analysis. The combined ORs of Ct infections in cervix uteri and in uterine tube to tubal pregnancy were7.14 (95% CI: 5.20-9.80) and6.50 (95% CI: 4.52-9.34), respectively. Conclusions There are significant correlation between Chlamydia trachomatis infection and tubal pregnancy.

OBJECTIVE To study the change in drug-resistance to antibiotics in Gram-negative bacteria in Jinhua region in order to guide clinical application of antibiotics reasonably.METHODS The antibiotics resistance of Gram-negative bacteria from clinical samples in four general hospitals in Jinhua region during from Jan 2005 to Dec 2007 was studied retrospectively.RESULTS The detecting rates of extended-spectrum ?-lactamases in Escherichia coli and Klebsiella pneumoniae were rising from 41.0%and 25.3% in 2005 to 56.0%and 53.2% in 2007,respectively.Furthermore,0.8% isolates were resistant to carbapenemase from all E.coli and K.pneumoniae strains.The rate of antimicrobial resistance to carbapenemase was 20.0% in Pseudomonas aeruginosa and was increased from 27.0% in 2005 to 41.0% in 2007 in Acinetobacter baumannii.CONCLUSIONS The drug-resistance rate in Gram-negative bacteria hase increased obviously in past three years in Jinhua region.It suggests that there be an urgent need for surveillance of Gram-negative bacterial resistance in different hospitals and rational antibiotics usage be emphasized during clinical therapy.

OBJECTIVE To establish a method of real-time PCR for detection of mecA gene in meticillin-resistant Staphylococcus aureus(MRSA).METHODS The experiment conditions including Mg2+ concentrations,primers concentrations and probe concentrations were optimized for real-time PCR in the light of factorial design principle.Totally 109 strains of S.aureus were collected and detected respectively in oxacillin disk diffusion method and real-time PCR and MRSA detection rate in the two methods were compared and analyzed.RESULTS Thirty seven MRSA isolates were detected by real-time PCR from the 109 S.aureus strains.The MRSA isolating rate by real-time PCR was conspicuously higher than oxacillin disk diffusion method,by which 27 MRSA isolates were detected.CONCLUSIONS The technology of real-time PCR to rapid identification of MRSA is superior to common PCR and it can make up the deficiency of detecting borderline-resistant strains in oxacillin disk diffusion method.

OBJECTIVE To establish and evaluate detection method of meticillin-resistant Staphylococcus aureus(MRSA) by fluorescence in situ hybridization(FISH) and flow cytometry.METHODS The experiment conditions including bacteria suspension concentrations,probe concentrations,and hybridization temperatures were optimized for FISH test in the light of orthogonal design principle.The fluorescence signals were detected by flow cytometer,and detection results by FISH and flow cytometry were compared with that of real-time PCR.RESULTS The optimal hybridization conditions of FISH detecting MRSA were 40?105 of bacteria suspension concentrations per microliter of hybridization buffer solution,and 4 ng of probe concentrations per microliter of hybridization buffer solution and 50 ℃ of hybridization temperatures.The sensitivity and specificity of detecting MRSA by FISH-FCM were 97.3% and 100.0%,respectively,and detection results between FISHFCM and real-time PCR had not significant deviation.CONCLUSIONS Fluorescence in situ hybridization and flow cytometry,which detect directly mecA gene in MRSA, are a fast and accurate methods for MRSA detection and can apply in clinical laboratory.

Hashimoto’s thyroiditis (HT) is strictly related to a cellular immune response with lymphatic infiltration of the thyroid gland by T and B cells, as well as a humoral immune response leading to specific antibody production. The synchronous appearance of HT and papillary thyroid cancer (PTC) indicates an immunological link between the two entities. In this article, we provide a review of the etiology of HT and the potential immunological mechanism of HT coexistent with PTC, which will provide references for new ideas for clinical diagnosis and treatment of HT coexistent with PTC in the future.

Objective To evaluate the combined detection of serum galactomannan (GM test) and 1,3-β-D-glucan (G test) in diagnosis of invasive pulmonary aspergillosis (IPA).Methods A total of 136 patients suspected for IPA were enrolled in the study from Jinhua Central Hospital in Zhejiang Province from January 2007 to December 2011.GM and G tests were performed.x2 test was used to conpare the sensitivity,specificity,positive predictive value and negative predictive value of individual test and combined test,and the area under the ROC curve (AUC) was used to determine the effectiveness of the tests.Results The sensitivity and specificity of G test were 84.0％ and 80.9％,and those for GM test were 78.0％ and 88.2％,respectively.The combination of two tests (parallel) increased sensitivity to 92.0％ and the serial test increased the specificity to 92.6％.The AUC of the combined test was 0.923(95％ CI:0.867-0.980).Conclusion The combination of GM test and G test can improve the diagnostic effectiveness for IPA.

Objective To investigate the clinical value of penetrating-suture type pancreaticojejunostomy (PPJ) after pancreaticoduodenectomy (PD).Methods The clinical data of 77 patients who received pancreaticoduodenectomy from Taixing People's Hospital from June 2002 to March 2012 were retrospectively analyzed.Of all the patients,34 received PPJ after PD (PPJ group),and the other 43 patients received PJ anastomosis (control group) based on the texture and size of the pancreas,pancreatic duct diameter (duct-to-mucosa pancreaticojejunostomy for pancreatic duct diameter ≥ 4 mm,end-to-end or binding pancreaticojejunostomy for pancreatic duct diameter ≤3 mm).Pancreatic fistula was diagnosed according to the criteria of the International Study Group on Pancreatic Fistula,including grade B or C pancreatic fistula with clinical value.Patients were followed-up through outpatient examination and telephone interview till May 2012.Data were presented by x ± s or median (range) and the t-test and Wilcoxon rank-sum test were used to evaluate quantitative data with or without normal distribution,respectively.Qualitative data were analyzed using Pearson x2 test or Fisher's exact test.Results The mean diameter of the pancreatic duct was 3 mm for both the PPJ group and the control group.The external drainage via the pancreatic duct stent was not used in the PPJ group,compared with 4 cases in the control group,showing a statistically significant difference between the 2 groups (x2=3.632,P ＜ 0.05).The duration of pancreaticojejunostomy was 12 minutes (range,8-25 minutes) in the PPJ group,while no records in the control group.The operation time and intraoperative blood loss in the PPJ group and the control group were (304 ± 60)minutes and (475 ± 75) mL,(304 ± 60) minutes and (500 ± 97) mL,respectively.Twenty-four (70.6％) patients in the PPJ group and 29 (67.4％) patients in the control group received intraoperative blood transfusion,with volume of 400 mL (range,300-800 mL) and 600 mL (range,300-1 200 mL),respectively.The median duration of postoperative hospital stay were 18 days (range,11-32 days) in the PPJ group and 20 days (range,9-44 days) in the control group.None of these comparisons were statistically significant between the 2 groups (t =1.293,0.619,x2=0.088,Z =0.165,0.074,P ＞0.05).The rate of grade B or C pancreatic fistula were 0 for the PPJ group and 27.9％ (12/43) for the control group,and the mortality rate of patients who had pancreatic fistula were 0 and 11.6％ (5/43) for the PPJ group and the control group,with statistical significance (x2=11.232,4.237,P ＜0.05).The overall incidence of bile leakage,peritoneal bleeding and delayed gastric emptying in the PPJ group and the control group were 5.9％ (2/34),2.9％ (1/34),5.9％ (2/34) and 11.6％ (5/43),7.0％ (3/43),14.0％ (6/43),with no significance difference (P ＞0.05).Fifty-six patients were followed up after operation from 9 months to 5 years.Pancreatic duct dilation was detected by imaging examination for 26 patients in the control group.Conclusions PPJ is a simple and feasible approach with better clinical efficacy after PD.

Objective To evaluate the advantages and disadvantages of inserted internal jugular vein cathe-ters and femoral vein catheters in emergency patients outside the operation room.Methods 206 patients received right internal vein catheterization(group J,n=110)and right femoral vein catheterization(group F,n=96).Suc-cessful rates of puncture,operation time,incidence of complications were observed and compared between the two groups.SAS6.04 software was used to analyze the data of the two groups.Results Emergency deep venous catheter-ization was accomplished in all the patients.There were no severe complication in two groups,such as pneumothorax and cardiac arrest.The rate of successful puncture in group J was 88%(97/110),however,100%(96/96)in group F.There was statistical significant difference between two groups(P<0.05).Mean time needed in group J (21.5±8.4)m was more than that in group F(12.5±5.3)min(P<0.05).The cases of puncturing into artery or serious arrhythmia in group F(2 cases)were less than that in group J(7 cases including hematoma in 4 cases)(P<0.05).6 cases were found to have arrhythmia in group J but there was not arrhythmia in group F(P<0.05).Con-chsion Different ways of emergency deep venous catheterization should be selected according to different condi-tions of patients outside the operation room.For critically ill patients,femoral vein puncture is more safe,with high rate of Success and less complication.

Objective To evaluate the advantages and disadvantages of inserted internal jugular vein cathe-ters and femoral vein catheters in emergency patients outside the operation room.Methods 206 patients received right internal vein catheterization(group J,n=110)and right femoral vein catheterization(group F,n=96).Suc-cessful rates of puncture,operation time,incidence of complications were observed and compared between the two groups.SAS6.04 software was used to analyze the data of the two groups.Results Emergency deep venous catheter-ization was accomplished in all the patients.There were no severe complication in two groups,such as pneumothorax and cardiac arrest.The rate of successful puncture in group J was 88%(97/110),however,100%(96/96)in group F.There was statistical significant difference between two groups(P<0.05).Mean time needed in group J (21.5±8.4)m was more than that in group F(12.5±5.3)min(P<0.05).The cases of puncturing into artery or serious arrhythmia in group F(2 cases)were less than that in group J(7 cases including hematoma in 4 cases)(P<0.05).6 cases were found to have arrhythmia in group J but there was not arrhythmia in group F(P<0.05).Con-chsion Different ways of emergency deep venous catheterization should be selected according to different condi-tions of patients outside the operation room.For critically ill patients,femoral vein puncture is more safe,with high rate of Success and less complication.

OBJECTIVE To investigate the current situation of sporadic hepatitis E and analyze its epidemiologic feature among inpatients in our hospital from 2002 to 2004. METHODS The clinical records of inpatients with positive results of HEV-IgM and diagnosed for sporadic hepatitis E during the period of Jan 2002 to Dec 2004 were analyzed with epidemiological method. RESULTS Totally 329 inpatients′ HEV-IgM antibody was positive among(4 641) detected inpatients′ sera.There were 239 male inpatients who accounted for 72.64% and(90 female) inpatients who accounted for 27.36% of the total inpatients whose HEV-IgM antibody was positive.There were 272 inpatients,presenting rate of 82.67%,comed from rural areas and 57 inpatients,presenting rate of 17.33%,comed from urban areas.The case rate of sporadic hepatitis E was respectively 4.92%,6.93% and 9.17% from 2002 to 2004. CONCLUSIONS The incidence of hepatitis E is increasing in recent years,in which male inpatients are higher than females′ and rural inpatients are higher than urban ones.