Objective To evaluate the diagnostic value of three-dimensional CT(3DCT)in atlantoaxial lesions.Methods The findings of 3DCT were analyzed and compared with conventional CT and radiography in 124 patients with atlantoaxial disease.Results 124 cases of atlantoaxial lesion included fracture in 42,atlantoaxial rotatory dislocation in 73,hypoplasia of the dens in 4,and congenital atlantoaxial deformity in 5.Among the 124 cases,89 cases were diagnosed by X-ray,109 cases by conventional CT,121 cases by MIP,122 cases by SSD,124 cases by MPR and VR.Conclusion 3DCT can find the slight rotatory dislocation,so it is the most effective means for the diagnosis of atlantoaxial rotatory dislocation.3D and MPR of spiral CT are useful in the diagnosis of atantoaxial fracture.Combining conventional CT and X-ray film with 3DCT can improve the acuracy of the diagnosis.

Objective To investigate the bacteriological features and the epidemiology of methicillin－ resistant Staphylococcus aureus (MRSA) in patients with impetigo, and provide evidence for selection of appropriate agents for treating impetigo and its complications. Methods Two hundred and forty－ six out- patients with impetigo were surveyed. Cultures were obtained from impetiginous lesions. Antibiotic susceptibility tests on 212 S.aureus isolates were performed by standard agar dilution testing (MIC). Results In a total of 246 isolates, 87.0％ yielded S.aureus alone, 2.0％ S.aureus and Group A beta－ hemolytic streptococcus (GABHS), 1.6％ GABHS alone, 4.1％ Staphylococcus epidermidis. Fifteen antimicrobial agents were used in the susceptibility tests. One hundred percent of S. aureus isolates were resistant to penicillin, 87.7％ were resistant to erythromycin, followed by clindamycin (75.5％ ), tetracycline (63.2％ ), chloramphenicol (54.2％ ), ampicillin－ sulbactam (44.8％ ), oxacillin (30.2％ ), ciprofloxacin (12.8％ ), cefotaxime (0.9％ ), fusidic acid (0.9％ ) and gentamicin (0.9％ ). None of the S.aureus isolates was resistant to vancomycin, cefazolin, cefuroxime and mupirocin. Sixty- four MRSA strains were isolated. No vancomycin resistant S.aureus strain was found. Conclusions Penicillin, erythromycin, clindamycin, tetracycline, chloramphenicol and ampicillin－ sulbactam prove to be no longer the appropriate therapeutic agents. Cephalosporin, mupirocin and fusidic acid might be the good choice for treatment of impetigo in our region.

Objective To observe the efficacy and toxicity of 5 -Fluorouracil plus cisplatin (FP)and docetaxel plus cisplatin(DP)in the treatment of patients with metastatic esophageal cancer.Methods A total num-ber of 68 cases of metastatic esophageal cancer confirmed by histopathology and (or)cytological examination was ana-lyzed retrospectively.There were 33 cases in FP group(5 -Fu 500mg/m2 ,d1 -5;DDP 20mg/m2 ,d1 -5,28 days a cycle),and 35 cases were in DP group(DTX 75mg/m2 ,d1,DDP 20mg/m2 ,d1 -3,21 days a cycle).The evaluation of efficacy and toxicity were performed on all patients per 2 cycles.Statistics and analysis of the difference between the two groups was performed.Results For FP group,CR was in 1 case,PR ere in 12 cases,SD ere in 16 cases and PD ere in 4 cases,respectively.The corresponding value was 3,18,11 and 3 for DP group.The objective response rate (ORR)for DP group(68.57%)was significantly higher than FP group(36.39%)(χ2 =5.83,P =0.02),and the disease control rate (DCR)were similar with no significance between the two groups(P =0.71).The Ⅲ -Ⅳ degree myelotoxicity for DP group was higher than for FP group with statistical difference (χ2 =7.07,P =0.01),while the incidence of nausea,vomiting,diarrhea and liver toxicity was similar (P >0.05).Conclusion DP regimen was more effective than FP regimen for the metastatic esophageal cancer,and the patients can tolerate with the slightly higher incidence of myelotoxicity,it was worthy of further study and clinical application.

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Objective To investigate Enterococci resistance to glycopeptides and their genotypes. Methods MICs of antimicrobial agents to Enterococci were determined with agar dilution test and van genes were amplified with PCR. Results 298 E. faecalis and 42 E. faecium clinical isolates were collected from 13 University teaching hospitals around China. The resistant rates of E. faecalis to penicillins were 14.1%～17.8%, which was much lower than those of E.feacium. No glycopeptides resistant Enterococci strain was detected. 8 E. faecalis and 1 E. faecium were intermediate sensitive to vancomycin but sensitive to teicoplanin with MICs of 8～16 and 0.25～2 mg/L, respectively. PCR amplification of van genes gave rise to only vanC2/3 gene positive in E. faecalis B144. Conclusions Glycopeptide resistant Enterococci is not common in China and no vanA or vanB type Enterococci was detected in this study. Penicillins, vancomycin and teicoplanin could be employed in the treatment of Enterococcus faecalis infections. High attention should be paid to future development of vancomycin resistant Enterococcus (VRE) in China.

Objective To obtain better insights into transmission dynamics of macrolide resistance genes between human and animal Enterococcus strains.Methods The antimicrobial susceptibility to 8 anti-bioties of 52 Enterococci isolated from animal and 55 Enterococci isolated from human was determined.PCR was used to detect the macrolide resistance genes ermB and mefA,tetracycline resistance genes tetM,and the integrase gene int of Tnl545 of the total 107 strains.Forty-nine ermB positive strains were chosen to be se-quenced.Filter mating experiments were taken.Results The resistance rate to erythromycin were 89.09% and 80.77%for isolates from human and animal:and resistance rate to tetracycline were 80.00%and 67.3l%for isolates from human and animal.respectively.All isolated Enterococci strains were found sensi-tive to vancomycin ermB was detected in 61.82% human Enterococci and 53.85% porcine ones.Identical er-mB gene sequences were found in animal and human Enterococci.Transfer of the ermB gene from porcine E.faecalis to human E.feacalis was successful.and the transfer frequency is 1.2×10-5.Conclusion En-terococci have a high resistance rate to erythromycin and some other antibio tics,especially in pediatric iso-lates:but still very sensitive to glycopeptide.ermB was the predominant genes for macrolide and tetracy-cline.Identical ermB gene sequences were present in animal and human Enterococci and that transfer of the ermB gene from porcine E.faecalis to human E.faecalis and vice versa is possible.but probably occurs at a low frequency.

Objective: To evaluate the therapeutic effect of gamma knife on patients with intracranial cavernous angioma (CA). Methods: The medical records of 122 patients (134 lesions) who underwent radiosurgery were reviewed retrospectively. Results: hT e average follow-up period was 43 months. No patient died. One patient underwent CA resection. In patients with epilepsy, 83% patients showed alleviation of seizures. About 44% of the lesions shrank in size after treatment with gamma knife radiosurgery (59/134). Seven cases had hemorrhage again after radiosurgery, and the overall annual hemorrhage rate was 1.6%. Edema was found in 11.5% patients (14/122) and all patients showed improvement atf er treatment. Conclusion: Gamma knife is a safe treatment for CA, which could obviously improve the symptoms of epilepsy. Gamma knife radiosurgery is the if rst option for the treatment of cavernous sinus angiomas.

Objective To investigate the role of Ki-67,c-myc,p53 in human in esophageal cancer.Methods 25 specimens of human esophageal cancer as observe group and 25 adjacent normal specimens as control group were selected.Expressions of Ki-67,c-myc,p53 protein were detected by immunohistochemical staining.Results Protein expressions levels of Ki-67,c-myc and p53 in human esophageal cancer were significantly higher than those in control group 5.0,2.0,3.0 vs 1.0,0.5,0.3,respectively (all P ＜ 0.05).The expression level of Ki-67 protein in high differentiation group were significantly lower than that of moderate and low differentiation group (3.0 vs 6.0,P ＜ 0.05).In human esophageal cancer specimens,the expression level of Ki-67 protein was positively correlated with that of c-myc (P ＜ 0.05).Conclusion The expressions of Ki-67,c-myc and p53 are higher in esophageal cancer,which are increased with the higher differentiation.Ki-67,c-myc and p53 proteins may be taken as potential markers in human esophageal cancer.

Objectives To determine the prevalence of Staphylococcus aureus (S. Aureus) colonization and S. aureus-derived exotoxins in lesions of childhood atopic dermatitis (AD) and evaluate the role of S.aureus-derived exotoxins in the pathogenesis of childhood AD. Methods Specimens were taken from the skin lesions of 148 patients, non-lesional skin of 30 patients, and the skin of 250 controls for bacterial cultures. S. aureus-derived exotoxins were detected by reverse passive latex agglutination. Total IgE levels were determined with immunoradiometric assay. Results The prevalence of S. aureus colonization was significantly increased in both the lesional and non-lesional skin of patients with AD in comparison with the controls (P 0.05). However, patients with increased total IgE levels showed significantly high SCORAD indices (P