OBJECTIVE To investigate the positive rate of ?-lactamase,oprD2,aminoglycosides modifying enzyme and qacE△1 gene among clinical isolated strains of multi-resistant Pseudomonas aeruginosa in our hospital.METHODS P.aeruginosa was determined by VITEK,and MIC was determined by agar dilution method.TEM,IMP,VIM,oprD2,aac(3)-Ⅱ,aac(6′)-Ⅰ,aac(6″)-Ⅱ,ant(3″)-Ⅰ,ant(2″)Ⅰ and qacE△1 in strains were detected by polymerase chain reaction(PCR).RESULTS The positive rate of TEM,aac(3)Ⅱ,aac(6′)-Ⅱ,ant(3″)-Ⅰ and ant(2″)-Ⅰ in multi-resistant P.aeruginosa were 51.4%,48.6%,40.0%,54.3%,45.7% and 60.0%,respectively.No IMP and VIM genes were detected.CONCLUSIONS Positive rate of ?-lactamase, aminoglycosides modifying enzyme is high in 35 tested strains,and that should be paid more attention.

Objective To investigate the clinical value and safety of cedilanid, esmolol in the treatment of atrial fibrillation. Methods From August 2014 to August 2016 our Hospital from 117 patients with atrial fibrillation clinical data, according to the random number distribution principle, the patients were divided into observation group 59 cases and control group of 58 cases, all patients were given the treatment of primary disease, the clinical symptoms, the patients in the observation group were given oxygen, has given furosemide, cedilanid, after micro injection pump intravenous nitroglycerin, 5-20 g/min. Start after the injection of nitroglycerin, establish another vein channel, every 30 min to 0.2 mg patients, the treatment group were treated with intravenous injection of small dose esmolol. The clinical efficacy, ventricular rate, systolic blood pressure, diastolic blood pressure and adverse reactions were observed in two groups. Results The early and late effective rates of the two groups were not significantly different. The observation showed that after treatment, the ventricular rate, systolic pressure and diastolic pressure in the observation group were significantly higher than those in the control group (P<0.05), and the incidence of adverse reactions in the two groups was significantly different (P<0.05). Conclusion High dose cedilanid combined with small dose esmolol in treatment of atrial fibrillation, obvious curative effect, high safety, can choose the appropriate application.

Objective To evaluate the value of SPECT/CT in differentiating malignancy from benign spinal disease. Methods Fifty-three patients with foci of abnormally increased uptake in the spine detected by 99Tcm-MDP planar whole body bone scan subsequently underwent bone SPECT/CT. The final diagnosis was determined by pathological examination or clinical follow-up ( ≥6 months), which was applied to calculate the diagnostic efficacy of bone SPECT/CT. Results A total of 25 patients were confirmed to have bone malignancy. The diagnostic sensitivity, specificity, accuracy, false positive rate, false negative rate, positive predictive value and negative predictive value for 99Tcm-MDP bone SPECT/CT were 96.00% (24/25), 96.43% (27/28), 96.23% (51/53), 3.57% ( 1/28), 4.00% ( 1/25), 96.00% (24/25) and 96.43% (27/28), respectively. Conclusion 99Tcm-MDP bone SPECT/CT imaging provides good clinical value for the differential diagnosis of spinal diseases.

Objective To prepare an active anti-tumor component, compound K (C-K), from saponins in leaves of Panax notoginseng (SLPN) using immobilized β-glucanase. Methods Two entrapments, alginate gel-1 (Alg 1) and alginate gel-2 (Alg 2), were evaluated for their ability to immobilize β-glucanase. The amount and purity of C-K obtained from the transformation process were analyzed by HPLC, and the immobilizing parameters were optimized. Results β-Glucanase can be immobilized and reused with either of the entrapment. However, using AIg 1 resulted in higher enzyme activity than Alg 2. The optimal concentration of the immobilized enzyme was 10%; The optimal crosslinking time was 4-6 h; and the optimal concentration of the crosslinking agent was 6%-7%. Conclusion Immobilized β-glucanase shows sustained enzyme activity, good ethanol tolerance, and was reusable for the preparation of C-K from SLPN.

Objective　To study the diagnosis and treatment of perforated gastric cancer(PGC). Methods　The clinical data of 43 patients with PGC proved pathologically were analysed retrospectively; Results　The diagnosis rate preoperatively was 30.2%(13 cases), misdiagonsis rate 69.8% (30 cases, including 2 misdiagonsed intraoperatively); 21 underwent simple suture closure of the perforation, among whom, 4 died (19.1%), 8 had hematemesis and melanorragia (38.1%), 3 reperforation (1.4%) after operation; mean survival period was 5 months. 9 cases had palliative gastrectomy, 1 died, while 1 had hematemesis after operation; mean survival period 18 months. 13 cases had radical gastrectomy, none of them had postoperative complication or death, mean survival period 27 months, 3 surrived for 5 years（23.1%）. 2 delyed diagnosis underwent simple suture closure at first, but had extensive metastasis at reoperation. Conclusions　Comprehensive analysis of clcnical data made before operation and attenton paid to the signs of PGC during operation can enhance the diagnosis rate of PGC. Simple suture closure of the perforation has more complications, and the survival time is shorter . Once PGC gastric cancer is diagnosed , radical or palliative gastrectomy should be performed.

OBJECTIVETo investigate the effect of electro-scalp acupuncture (ESA) on dopamine transporter (DAT) in basal ganglia (BG) of patients with Parkinson's disease (PD) by single photon emission computed tomography (SPECT).

METHODSTen patients with primary PD were divided equally into two groups randomly. Patients in the treated group received ESA at points of MS6, MS4, MS8, MS9 and MS14, for patients with unilateral lesions, ESA was applied on contralateral points, while for those with bilateral lesions, points of both sides were stimulated, the depth of puncturing was made to arrive at the galea aponeurotica. Patients in the control group took medopa orally in the dosage of 125 mg, 3 times per day for mild, 250 mg, 3 times per day for moderate and 250 mg, 4 times per day for severe cases. All the patients were examined with 99mTc-TRODAT- 1 SPECT before and after 6 weeks' treatment to analyze the activity of DAT by ratio of basal ganglia/occipital (BG/OC) using regional of interesting (ROI) technique.

RESULTSThe uptake of 99mTc-TRODAT-1 increased after treatment in both groups. In the treated group, the homolateral (of the affected limbs, the same below) BG/OC ratios before and after treatment were 1.1883 +/- 0.1471 and 1.2416 +/- 0.3146 respectively, and those in the control group 1.1597 +/- 0.0568, 1.2053 +/- 0.1153, showing no significant difference between them (P > 0.05); while the contralateral BG/OC ratios before and after treatment were 0.9019 +/- 0. 1210 and 0.9496 +/- 0.2522 respectively in the treated group, and 1.0436 +/- 0.1393 and 1.2972 +/- 0.2612 respectively in the control group. The difference value of contralateral BG/OC before and after treatment in the control groups was significantly different (P<0.05). But at other cerebral regions, 99mTc-TRODAT-1 SPECT showed no difference between the two groups in changes before and after treatment, therefore, showed no difference in effect of improving DAT between the two groups (P > 0.05).

CONCLUSIONESA could reduce the loss of DAT in basal ganglia and improve its activity in patients with PD to protect the dopamine neuron, so as to delay the progression of PD and alleviate clinical symptoms of patients.

Aged ; Basal Ganglia ; metabolism ; Dopamine Plasma Membrane Transport Proteins ; metabolism ; Electroacupuncture ; Female ; Humans ; Male ; Middle Aged ; Parkinson Disease ; metabolism ; pathology ; therapy ; Scalp ; Tomography, Emission-Computed, Single-Photon ; Treatment Outcome

OBJECTIVETo compare mid-term clinical outcomes between amputation and limb salvage in treating severe open tibial fractures with type Gustilo III B, III C.

METHODSFrom July 2007 to June 2010,68 patients with severe open tibial fractures with type Gustilo III B, III C treated by amputation and limb salvage were retrospectively analyzed. In amputation group, there were 26 males and 12 females with an average age of (44.9±16.3) years old; and 21 cases were type Gustilo (III B, 17 cases were Gustilo III C; amputation were performed in accordance with soft tissue injury degree of shank, fracture types and surgical exploration. In limb salvageg group, there were 21 males and 9 females with an average age of (43.5±14.7) years old; and 23 cases were type Gustilo III B, 7 cases were Gustilo III C; the method of internal fixation and and wound healing were performed in accordance with patients's specific condition. Operative time, blood loss, hospital stay and postoperative infection was compared between two groups; time of loading and rate of return to work was compared; VAS scoring was used to evaluate condition of pain; SF-36 health queationaire was used to assess postoperative life quality.

RESULTSTotally 60 patients were followed up (33 cases in amputation group and 27 cases in limb salvage group) with an average time of 49.1 months. Operative time, blood loss, hospital stay and postoperative infection in amputation and limb salvage group respectively was (109.0±25.7) min, (245.0±58.6) min; (168.0±49.0) ml, (311.0±137.0) ml; (13.8±2.7) d, (28.8±13.1) d; 7.9%, 36.7%. At the final following-up, there was no significance meaning between two groups in VAS scoring and rate of return to work, but time of loading in amputation group was shorter than that of in limb salvage group. Physiological function in amputation group was better than limb salvage group, while body pain was worse; and there was no signicance meaning in psychological health between two groups.

CONCLUSIONAmputation and limb salvage both can treat severe open tibial fractures, and mid-term clinical outcomes between two groups has equivalent efficacy.

Adolescent ; Adult ; Aged ; Amputation ; methods ; Case-Control Studies ; Female ; Humans ; Limb Salvage ; methods ; Male ; Middle Aged ; Tibial Fractures ; surgery

Objective:To compare the cardiovascular risk factors and the characteristics of coronary lesion between Chinese and Australian patients with myocardial infarction(MI). Methods:Five hundred and seventy-eight Chinese and 399 Australian MI patients received selective coronary angiography after hospitalization.The cardiovascular risk factors and coronary angiograms were compared and analyzed.Results:Five hundred and fifty Chinese cases(95.16%)and 376 Australian cases(94.24%)showed angiographically coronary stenosis.The comparing results of MI cases between Chinese and Australians were as follows:the percentage of patients below 40 years old,2.08% vs 6.02%(P0.05);the percentage of patients with three vessel disease and total occlusion,32.87% vs 24.31% and 45.50% vs 32.33%,respectively(P

Objective To report clinical study of diabetic foot with microsurgical treatment.Methods 32 cases basing on physical treatment underwent operation which included reconstruction of vessel under DSA and flap transfer and relaxation of nerves.Results 8 eases were examined with DSA after operation,it showed that the bypass grafts were unobstructed and the distal blood were improved;All flap were lively. Conclusion The ulcer of the patients with diabetic foot was closed early and the blood supply of the limb have been reconstructed by microsurgical treatment,it can not only avoid amputation or lower the limb amputation level,but also improve the life quality of patients and obtain social benefit.

Objective To investigate the correlation between heat-shock protein 70-2 (HSP70-2) gene+1267A/G polymorphism and coronary heart disease (CHD) in Han Chinese population. Methods Using the method of polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) , the polymorphism and genotype and allele distribution of HSP70-2 gene + 1267A/G in 185 CHD patients and 149 controls were analyzed. Results The HSP70-2 gene + 1267A/G polymorphism was found in this study population.The distribution of HSP70-2 genotypes was in Hardy-Weinberg equilibrium. The frequency of G allele in CHD group was significantly higher than that in control (61.89% vs51.68%, P ＜ 0. 01). After multiple logistic regression analysis, HSP70-2 gene (GG + AG) genotype was an independent risk factor of coronary heart disease. Conclusion HSP70-2 gene + 1267A/G polymorphism was associated with CHD risk of Han Chinese population, the G allele might serve as a genetic risk factor of coronary heart disease.