Objective To investigate the clinical distribution characteristics and trend in antibacterial resistance of Acinetobacter baumannii in Pudong Hospital Affiliated to Fudan University,so as to provide the guidance for clinical rational use of antibacterial agents and infection control.Methods SPSS 1 9.0 statistical software was adopted to retrospectively analyze the specimen source, department distribution and antibacterial resistance change of the 1 678 strains of Acinetobacter baumannii in this hospital from Jan-uary 2010 to October 2014.Results Clinical isolates of Acinetobacter baumannii mainly came from respiratory tract specimens(ac-counted for 79.1%).The intensive care unit(21.1%),department of neurosurgery(1 7.7%)and department of cardiology(1 7.6%) were the top three departments from which the strains were isolated.The isolates of Acinetobacter baumannii were highly resistant to the first and second generation of cephalosporins,cephamycin,ampicillin and nitrofurantoin,and the resistance rates reached a-bove 90%.The resistance rates of these isolates against carbapenems,aztreonam,cefperazone-sulbactam and ampicillin-salbactam showed obviously uptrends,but the resistance rates of these isolates against amikacin and cotrimoxazole showed downtrends.And the resistance rates of these isolates against other antibacterial agents stayed between 30% and 50%.During the five years,the de-tection rates of multi-drug resistant strains steadied around 35.0%.Though the detection rates of pan-drug resistant strains de-clined year by year,the strains were isolated each year.Conclusion The antibacterial resistance of Acinetobacter baumannii is seri-ous in this hospital,with multi-drug and pan-drug resistance persisting.It is necessary to enhance monitoring antibacterial resist-ance,ensure rational use of antibacterial agents,and promote implementation of disinfection and isolation,so as to prevent the spread and popularity of Acinetobacter baumannii resistance in hospital.

Coronary Artery Disease ; Humans

Electrocardiography ; Humans ; Myocardial Infarction ; physiopathology ; Myocardial Perfusion Imaging ; methods

Objective To summarize the characteristics of images and clinical diagnosis of bladdernon-epithelial tumors,and to investigate the relationship between the therapeutic methods and prognosis of thedisease. Methods The clinical data of 25 patients (16 males and 9 females,aged between 2 -71 years)with bladder non-epithelial tumors treated in our hospital were retrospectively analyzed.The clinical manifes-tations included hematuria (6 patients),lower abdominal lump (2),frequent urination (14),dysuria (2)and fainting during voiding (1).Ultrasound and CT examinations suggested space-occupying lesions in thebladder in 22 patients and pelvic tumor involving the bladder wall in the other3 patients.Cystoscopy was per-formed in all patients and 17 patients got biopsy. Results Simple tumor resection or partial cystectomywas carried out in 15 patients with benign tumors;the rest 10 patients with malignant tumors underwent par-tial or radical cystectomy. Adjuvant radiotherapy and chemotherapy were performed in malignant tumor pa-tients.Follow-up time was 3 months to 11years.No recurrence was found in benign tumor patients.Nine pa-tients with malignant tumors died in 3 years after operation (mean survival time of 16 months).A patientwith bladder malignant lymphoma survived for6 years.Three recurrences occurred in another bladder leiomy-osarcoma patient who had tumor resection. Conclusions Bladder non-epithelial tumors are relatively rarein clinical.The pathological types of the tumors are complicated,most of them are malignant and the progno-sis is relatively poor.The clinical perception of these tumors is inadequate and misdiagnosis rate is high.Deep-site biopsy under cystoscope can improve the diagnostic rate.Partial or radical cystectomy is the maintherapy for these tumors,and adjuvant radiotherapy and chemotherapy can be used according to the pathologi-cal features, but the effects are uncertain and the prognosis is quite different.

Objective To investigate the role and possible mechanism of ultrasound-targeted microbubble destruction for accelerating neovascularisation in ischemic skeletal muscle. Methods Unilateral hind limb ischaemia was surgically induced in thirty wister rats. On postoperative day 7 , the rats were randomly divided into three groups: ultrasound-targeted microbubble destruction group (group A), ultrasound group (group B), and control group. After the end of the experiment , parafin sections for the skeletal muscle from one rat in each group were made to observe the changes in microstructure. The remaining rats were sacrificed at 24 h and on day 7. VEGF expression, inflammatory factor E-selectin, and monocyte chemotactic factor-1 (MCP-1) were detected in the rats. Results As compared with the other two goups, expressions of VEGF, neovascularization, E-selectin, and MCP-1 in the skeletal muscle were significantly increased in group A. Conclusions Microvascular rupture caused by ultrasound-targeted microbubble destruction can promote angiogenesis by stimulating secretion of endogenous VEGF in skeletal muscle; meanwhile, an increase in expression level of inflammatory factors may be one of the mechanisms.

Objective To evaluate the risk factors of urethral recurrences following radical cystectomy for transitional cell carcinoma of the bladder and to discuss the treatment options. Methods Clinical data of 278 patients who underwent radical cystectomy for bladder cancer were analyzed retrospectively. Urethral recurrences were observed in 24 patients. Risk factors of recurrence were evaluated by Cox's multifactor regression model. Results None of the 6 patients undergoing selective prophylactic urethrectomy died;10 of the 24 patients with urethral recurrence died of tumor metastasis.Multiple factor analysis suggested that prostate involvement,bladder neck involvement,trigone tumor,multiple tumor and carcinoma in situ were the high risk factors,and their relative risk coefficients were 1.573,1.532,1.360, 1.337 and 1.213,respectively. Conclusions Simultaneous urethrectomy following radical cystectomy should be performed for patients with high risk factors (prostate involvement, bladder neck involvement, trigone tumor,multiple tumor and carcinoma in situ) of urethral recurrence,while patients without risk factors are eligible candidates for reconstruction of the urinary tract after cystectomy by an orthotopic neobladder.

Objective To study the treatment of ureterpelvic junction obstruction in adults. Methods 185 adult patients with hydronephrosis were reviewed for etiology,clinical characteristics and outcome of surgery.Etiological factors included 148 cases of ureteropelvic junction stricture,17 cases of high location of the junction,9 cases of ectopic vessels and 11 cases of fiber chords.Of 195 times surgery procedures,Anderson-Hynes pelvioplasty was conducted for 153 cases,chords brisement for 8,uriteropelvic repositioning for 3,ureteroscopic endopyelotomy for 16,and nephrectomy for 15. Results 170 patients were followed-up for 3 months to 5 years.163 patients had fully recovered,cure rate being 96%.7 patients had to undergo operation again for stricture recurrence,in 3 by Anderson-Hynes pelvioplasty and 4 by ureteroscopic endopyelotomy.All the patients with recurrence have been completely cured. Conclusions Anderson-Hynes pelvioplasty is still the first choice of treatment for ureteropelvic junction stricture,and ureteroscopic endopyelotomy for some special conditions.

Objective To study the cellular immune response to a large-dose of HBsAg vaccine in transgenic (Tg) mice. Method After the Tg mice was immunized with HBsAg vaccine, the number of dentritic cells (DC), the level of proliferation of T-lymphocytes, and the production of IL-2 and IFN-?were determined. Results The percentage of cells positive for common stimulating factors CD80, CD86, and I-E k were significantly higher than that of the control group (P

Aim To investigate the roles of phosphatidylinositol 3 -kinase (PI3K) in the mitogen-activated protein kinase (MAPK) activation by in sulin and epidermal growth factor (EGF). Methods Phosphorylated MAPK, Akt (also termed protein kinase B) and total protein level of MAPK were d etermined by Western blotting using phospho- or non-phospho-state specific an tibodies;the roles of PI3K in these signaling transduction pathways were assess ed by use of PI3K specific inhibitor wortmannin.Results Both in sulin and EGF rapidly stimulated MAPK phosphorylation; wortmannin totally blocke d the MAPK phosphorylation stimulated by insulin, but not by EGF.By contrast, wo rtmannin equally inhibited Akt phosphorylation stimulated by both insulin and EG F. Moreover, wortmannin inhibited insulin-stimulated MAPK phosphorylation in a concentration-dependent manner,and the inability of wortmannin to inhibit EGF -stimulated MAPK phosphorylation was not changed with the use of low concentrat ions of EGF.Conclusion PI3K plays different roles in the MAPK a ctivation induced by insulin and EGF.

Objective To evaluate quantitatively perfusion in coronary microcirculation by transvenous myocardial contrast.echocardiography(MCE).Methods Transvenous MCE was performed before and after LAD stenosis in 12 dogs.Results Peak intensity and area under curve(AUC)in time-intensity curves were significantly decreased after LAD stenois,peak intensity and AUC were strongly related with CBF flow(peakintensity:r=0.9405～0.09666,P=0.0005～0.0001;AUC:r=0.8239～0.9761,P=0.0103～ 0.0056).Conclusion Transvenous MCE could quantitatively assess the perfusion in coronary microcirculation.