OBJECTIVE： To find out the change of drug resistance of Shigella shigae in our hospital during recent five years.METHODS： To collect the stool of suspectable cases of clinical bacillary dysentery and to carry out bacterial culture and drug sensitive test.RESULTS： The resistance rates of Shingella shigae to ampicillin and fluoroquinolones raised obviously， but the bacilli were still sensitive to amikacine and cefobid.CONCLUSION： It is important to strictly control the indications in using antibiotics and to prevent the emergence of drug resistance of bacteria.

Objective To investigate the biological features of epidermal growth factor receptor inhibitor AG1478 on cervical carcinoma cell. Methods The proliferation of HeLa cells under AG1478 stimulation was determined by CCK8 assay. The expression of EGFR downstream signaling protein and apoptotic relative protein were examined by Western blot and transcription of apotosis?related genes were measured by RT?qPCR in AG 1478 treated HeLa cells. Nuclear transport of phosphorylated ERK were measured through ICC assay. TUNEL assay was used to determine early stage of apoptosis. Results CCK8 assay showed that AG1478 inhibit the proliferation of HeLa cells and also block phosphorylated level of EGFR ,ERK and AKT. Furthermore ,nuclear transport of phosphorylated ERK upon EGF stimulation were blocked and pro?apoptotic proteins were up?regluated with activat ed cleaved Caspases. Conclusion AG1478 inhibited the proliferation and induced apoptosis in HeLa cells and it could be a potential therapeutic drug for cervical carcinoma.

Objective To investigate the role of AP-1 in the pathogenesis of chronic idiopathic urticaria (CIU). Methods By using immunomagnetic separation technology, peripheral blood basophils were isolated from 10 CIU patients and 10 normal human controls followed by the extraction of nuclear protein from the basophils. TransAMTM AP-1 family kit was used to detect the DNA binding activity changes of AP-1 family transcription factors in basophils, and Western blotting to detect the expression of P-c-jun protein. Results There were some differences in the DNA binding activity of AP-1 family transcription factors in basophils between CIU patients and normal controls. The DNA binding activity of Phospho-c-jun, c-fos, Fos-B, Jun-B and Jun-D factors was increased in CIU patients compared with the controls, and the increase in that of P-c-jun and Jun-D was statistically significant (both P < 0.05). There was an insignificant decrease in the DNA binding activity of Fra-1 factor in the CIU patients compared with the controls (P > 0.05). The P-c-jun (Ser73) protein expression was higher in CIU patients than that in the controls (0.527 ± 0.312 vs. 0.435 ± 0.042, P < 0.05),whereas there was no significant difference in the P-c-jun (Ser63) protein expression level. Conclusion Some changes in DNA binding activity of AP-1 and overexpression of P-c-jun (Ser73) protein in basophils may be involved in the pathogenesis of CIU.

Objective To observe the clinical efficacy of amitriptyline with manipulative therapy for episode tension-type headache (ETTH). Methods 62 patients were randomized into 2 groups: amitriptyline group, amitriptyline with manipulative therapy group. Numbers of days with headache(NDH) and days with medication(NDM), intensity of the headache(IH) between the two weeks before randomisation and 1～2, 3～4 weeks after randomization were recorded by participants in headache diaries. Results In the first 2 weeks after treatment, the NDH in amitriptyline group and amitriptyline with manipulative therapy group were (6.00±2.21) d and (4.19±1.70) d respectively (P<0.05), while in the second 2 weeks, they were (4.00±1.86) d and (2.16±1.21) d respectively (P<0.05). The NDM in amitriptyline group and amitriptyline with manipulative therapy group were (1.77±1.23) d and (1.32±1.22) d respectively in the first 2 weeks after treatment (P<0.05), but there was no significantly difference between the two groups in the second 2 weeks. The IH (with Visual Analog Scale) were(3.32±0.94) and (2.39±1.33)respectively (P<0.05) in the second 2 weeks. Conclusion Amitriptyline with manipulative therapy is better than amitriptyline alone in reducing the symptoms of episode tension type headache.

Objective To assess the diagnostic significance of T cell receptor gamma gene rearrangemerits in mycosis fungoides (MF), so as to develop a sensitive diagnosis tool. Methods A total of 50 specimens were collected, including 33 skin lesion specimens and 2 lymph specimens from 30 patients with MF,15 skin lesion specimens from 15 patients with inflammatory dermatoses. PCR was performed with specific primers targeting TCR V gamma 8, 9, 10, 11 to detect T cell receptor gamma gene rearrangement. Results Monoclonai rearrangements of TCR gene was observed in 88% (29/33) of specimens from patients with MF and 33% (5/15) of samples from patients with inflammatory dermatoses. Conclusions The detection of TCR gene rearrangements, as an ancillary test, is useful in the diagnosis and differential diagnosis of MF.

Objective To detect and analyze the levels of preoperative serum carcino-embryonic antigen (CEA) and CA15-3 in early invasive breast cancer patients and their correlation with pathological parameters. Methods Electrochemical luminescence immunoassay (ECLI) technology was used to detect serum levels of CEA and CA15-3 in 223 cases of early invasive breast cancer patients, 109 patients with benign lesions, and 30 cases of heath control. Immunohistochemical (IHC) and fluorescence in situ hybridization (FISH) were used to detect the estrogen receptors (ER), progesterone recepter (PR), and its HER-2 pathological indicators.Besides, the correlation of serum CA15-3, CEA levels and pathological parameters was analyzed. Results The serum CA15-3 and CEA levels of Breast cancer patients [(22.27±15.11) U/ml, (5.03± 0.49) μg/L] were significantly higher than that of patients in benign lesion group [(14.13±3.04) U/ml, (2.72± 0.11) μg/L] (P< 0.05). CEA level of patients with histological grade Ⅲ was (6.34 ±0.93) μg/L, significantly higher than the level Ⅰ-Ⅱ (4.23±0.50) μg/L (P< 0.05). CA15-3 level was (19.26±15.08) U/ml in T1 tumors, and CA15-3 level was (28.73 ±11.53) U/ml in T2 tumors (P<0.05). The serum levels of CEA and CA15-3 between different histology, pathologic stage, lymph node status, ER, PR, HER-2, pathological characteristics had no significant difference (P>0.05). CEA positive rate of breast cancer group was significantly higher than that of benign lesions(13.5%vs. 3.7%, 26.5%vs. 1.8%, P<0.05). 30 cases of normal control group had no positive one. The joint monitoring sensitivity of CEA and CA15-3 breast cancer group was 9.4 %, the sensitivity was 0 in benign lesion group. There was significant difference (P < 0.05). Conclusion The changes of Serum CA15-3 and CEA levels in breast cancer patients can be considered as the judgment standard for early diagnosis, pathological staging, prognosis and clinical effect monitoring.

Objective To explore the CT characteristics of mucinous cystadenocarcinoma of appendix.Methods The CT findings of 5 patients with mucinous cystadenocarcinoma of appendix proved by surgery and pathology were analyzed retrospectively,and the corresponding literatures were also reviewed.Results All lesions in 5 patients showed cystic changes in the right hypogastrium inclu-ding irregular shape with lobulation in 4 and tubular shape in 1.The maximum traverse diameters ranged from 27 mm to 146 mm. Unclear boundary was showed if the lesion invaded the adjacent gut.The cystic wall was asymmetry and thickened with little nodes and nipple in the inner wall.The thick septa were seen in 3 tumors.Much mucus was seen in tumors with uneven density and average CT value of 1 9.3 HU-34.6 HU.On enhanced CT,obvious enhancement of the cystic wall and septa in 4 and moderate enhance-ment in 1 was showed.The adjacent fatty gap of 3 tumors were clear,however it was vague when accompanied with acute inflamma-tion.Small calcification in 3 and enlarged lymphatic nodes in 3 were also found.Conclusion CT shows some characteristics of mu-cinous cystadenocarcinoma of appendix and plays an important role in the diagnosis of the disease.

Objective To compare the efficacy of different volume of ropivacaine and lidocaine for ultrasound-guided infraclavicular brachial block.Methods Sixty patients scheduled for distal upper limb surgery were divided into group A and group B by random digits table method with 30 cases each.The patients were given ultrasound-guided infraclavicular brachial block,but the patients in group A using 0.3％ ropivacaine mixed with 1％ lidocaine 20 ml,the patients in group B using the same mixture 30 ml.Sensory block was assessed every 5 min after the block.Motor block was evaluated at 30 min after the block.The onset time of anesthesia,surgical success rate,complications and duration of anesthesia were recorded.Results There was no significant difference in the surgical success rate [93.3％(28/30) vs.96.7％(29/30),P＞0.05],onset time of sensory block [10 (5) min vs.5 (5) min,P＞0.05] and degree of motor block between the 2 groups.The duration of anesthesia in group A was shorter than that in group B (P ＜ 0.05).Conclusion The efficacy of ultrasound-guided infraclavicular brachial block with the mixture of 0.3％ ropivacaine and 1％ lidocaine 20 ml and 30 ml is similar in surgical success rate and onset time of anesthesia.

Objective To study and analyze the clinical effect of zoledronic acid in the treatment of bone metastasis in patients with lung cancer.Methods 50 cases of lung cancer patients with bone metastasis from January 2015 to December 2016 in our hospital were selected and randomLy divided into two groups, the control group and the experimental group, with 25 patients in each group.The control group was treated with pamidronate intravenous drug treatment, patients in the experimental group of zoledronic acid monotherapy in the treatment of.After treatment for a period of time, the relative clinical indicators of the experimental group and the control group were compared and analyzed.Results After the corresponding treatment, 3 patients in the experimental group had complications, the proportion was 12%, and 2 cases in the control group had adverse reactions, the incidence was 8%.The incidence of adverse reactions and the effectiveness of pain treatment in the experimental group were not significantly different from those in the control group, and there was no statistical significance.After treatment, the quality of life scores and general status scores of the experimental group and the control group were significantly higher than those before treatment, with statistical difference(P<0.05).There was no significant difference in the quality of life score and general condition score between the experimental group and the control group, and there was no statistical significance.Conclusion Zoledronic acid monotherapy in the treatment of metastasis corresponds largely to pamidronate treatment for lung cancer patients with bone, can improve the treatment effect and quality of life in a large extent, help the patients to relieve pain, with further clinical promotion and application significance.

Objective To analyze the CT manifestation and clinical characteristics of appendiceal mucinous tumor for improving the diagnostic and therapeutic level. Methods The CT and clinical data of 7 patients with appendiceal mucinous tumor verified by histopathology were retrospectively analyzed. Results Among the 7 cases, mucinous cystadenomas was in 6 cases, and mucinous cystadenocarcinoma was in 1 case. One case had no obvious discomfort;3 cases visited because of pain on right hypogastrium and fever;3 cases had the medical history ofchronic appendicitis, among whom 2 cases had the mass on right hypogastrium which had existed for 1 day or 2 years. The unenhanced CT showed that all of 7 cases had the cystic tumors on right hypogastrium near the cecum, and the maximum traverse diameter was 25-208 (67 ± 27) mm. The cyst walls of mucinous cystadenoma in 6 cases were flimsy, symmetrical, 2.3-3.5 mm thickness and smooth. Three cases had cyst walls calcification; the cyst wall of mucinous cystadenocarcinoma was thick and asymmetrical, and the thickness of cyst wall was 3.5-5.7 mm. Small nodes could be found inside the walls. 7 cases had much mucilage, with CT value 14.0-33.5 HU. Four cases had slight septa. The enhanced CT showed that the cyst walls of mucinous cystadenoma in 6 cases were mild to moderate continuous enhancement during venous phase; the cyst wall and nodes mucinous cystadenocarcinoma was obvious and continuous enhancement. Four cases showed clear boundary, while 3 cases accompanied with acute inflammation showed dim edge. The enlargement of lymphatic nodes could be seen near mesentery in 1 case. All the 7 cases were treated by surgical treatment. One patient who survived after 26 months showed the metastasis of peritoneal pseudomyxoma after 20 months. The 6 patients with mucinous cystadenoma were followed up for 18 - 36 months, they did not had metastasis or recurrence by CT review. Conclusions Appendiceal mucinous tumor is often short of characteristic in clinical symptom and physical sign, but has favourable prognosis. CT is a vital tool for its diagnosis and identification.