Objective To observe the effect of mivacurium,succinylcholine and atracurium in modified electric convulsive therapy (MECT).Methods Sixty ASA Ⅰ or Ⅱ patients with schizo-phrenia aged from 18 to 60 years old were randomly divided into 3 groups :mivacurium group (group A,n=20),succinylcholine group (group B,n=20),atracurium group (group C,n=20).The on-set time of muscle relaxation,the recovery time of spontaneous breathing after MECT,the awake time,as well as the changes of 5 min MAP,HR and SpO2 before and after MECT were observed re-spectively.Results The onset time of muscle relaxation and the recovery time of spontaneous breath-ing in group B were shorter than those in groups A and C (P <0.05).The onset time of muscle re-laxation and the recovery time of spontaneous breathing in group A were shorter than those in group C (P <0.05).Conclusion Mivacurium is a better alternative medicine in MECT in the situation of no succinylcholine or succnylcholine contraindication.

Objective To examine the prevalence of plasmid mediated quinolone resistance (PMQR) genes and their correlation with the genes encoding β-lactamases in E.coli isolates.Methods A total of 200 levofloxacin-and/or ciprofloxacin-resistant E.coli isolates were collected from Fujian Medical University Union Hospital during the period from July to December 2013.PCR method was used to screen these E.coli isolates for the presence of qnrA,qnrB,qnrC,qnrD,qnrS,aac(6')-Ib-cr,qepA,oqxAB genes,and the blaTEM,blasnv and blacTx-M genes in the PMQR positive strains.Agar dilution method was utilized to measure the antimicrobial susceptibility of PMQR-positive strains.Phylogenetic analysis was conducted by triplex PCR.Enterobacterial repetitive intergenic consensus-polymerase chain reaction (ERIC-PCR) was used to evaluate the genetic similarity between the PMQR-positive isolates.Results Of the 200 clinical isolates of E.coli,58 (29.0％)were PMQR-positive.And qnr,aac(6')-Ib-cr,oqxAB,and qepA genes were positive in 11 (5.5％),41 (20.5％),16 (8.0％),1 (0.5％) strains,respectively.The genes encoding CTX-M-1,CTX-M-9 and TEM type enzymes was positive in 32 (55.2％),17 (29.3％),and 1 (1.7％) of the PMQR-positive strains,respectively.The blasHv gene was not identified in any isolate.PMQR-positive strains were multi-drug resistant.Phylogenetic analysis indicated that 21 (36.2％),17 (29.3％),11 (19.0％),and 9 (15.5％) of the PMQR-positive strains belonged to group A,group D,group B2 and group B 1,respectively.ERIC-PCR suggested the PMQR-positive isolates belonged to 50 different types.Only one strain was non-typeable.Conclusions Most of the PMQR-related genes in E.coli are aac(6')-Ib-cr,qnr,and oqxAB in our hospital,which are highly relevant to β-1actamase genes.PMQR-positive strains may spread by way of non-clonal dissemination in our hospital.

Objective To explore the clinical features, diagnosis, and treatment of neonatal necrotizing pneumonia. Methods The clinical data of two cases of neonatal necrotizing pneumonia were retrospectively analyzed. The clinical features, diagnosis, and treatment of neonatal necrotizing pneumonia in literatures were summarized. Results Two cases were diagnosed of community-acquired Staphylococcus aureus necrotizing pneumonia and had the onset with fever. The chest X-ray showed exudative change with cystic shadow. The chest CT showed multiple cavity changes. The sputum and blood cultures were positive for Staphylococcus aureus. Both of them were effectively treated by vancomycin. The imaging was improved during the follow-up. Searching the database, 4 related literatures were being found, and there were totally 7 cases of neonatal necrotizing pneumonia including current 2 cases. The main features were as follows: The pathogenic bacteria in all cases include Staphylococcus aureus. One case was combined with pseudomonas aeruginosa. Six cases were community-acquired infections. All of them were non-immune deficiency newborn. Six cases were primary necrotizing pneumonia. Six cases were unilateral lung involvement. Five cases got fever, 5 cases had septicemia, 3 cases had pleural effusion, 2 cases had aerothorax, one case had bronchial chest and 2 cases had extrapulmonary infection. The C-reactive protein was increased in all cases. Three cases need mechanical ventilation. Six cases had a good prognosis. Conclusions The main pathogenic bacterium in neonatal necrotizing pneumonia was Staphylococcus aureus. The diagnosis was mainly depends on the typical imaging and pathogenic examination. The treatment is mainly the use of antibiotic for gram positive cocci.

Background and objective BIM gene is a member of the BCL-2 family, is involved in cell death. The aim of this study is to explore the relationship between BIM gene polymorphism and therapeutic efficacy in the retreatment advanced non-small cell lung cancer (NSCLC) with tyrosine kinase inhibitor (EGFR-TKI). Methods In the study, there were 123 patients who were diagnosed with advanced NSCLC in Zhejiang Province Cancer Hospital bewteen January 2009 to October 2012, all of who were received gefitinib and erlotinib therapy after failure to chemotherapy. We detected the genotype of peripheral blood leukocytes of patients with BIM gene polymorphism though polymerase chain reaction (PCR). Statistical analysis was performed by SPSS version 13.0. Results On the disease control rates, BIM gene with no polymorphism type was slightly better trend than polymorphism types in disease control rate DCR (75.5% vs 57.1%, χ2=2.931, P=0.087). Univariate analysis the median PFS, women were longer than men (6.9 months vs 4.5 months, χ2 =7.077, P=0.008). Non-smokers were longer than smokers (8.0 months vs 2.5 months, χ2 =15.277, P<0.001). Adenocarcinoma were longer than others pathological type (7.0 months vs 2.0 months, χ2 =14.978, P<0.001). The median PFS in BIM gene with no polymorphism type were longer than with polymorphism type (6.0 months vs 3.5 months, χ2=7.035, P=0.008). Multi-factor analysis showed that smoking, pathological type, the BIM gene polymorphism were the independent prognostic factors for PFS. Conclusion The patients with the BIM gene no polymorphism have longer the median progression-free time than the polymorphism types in retreatment advanced non-small cell lung cancer patients with tyrosine kinase inhibitor.