OBJECTIVE To investigate the pathogen distribution and antimicrobial resistance in ventilator-associated pneumonia(VAP) in intensive care unit(ICU) of our hospital and provide reference for clinical treatment.METHODS Among 135 patients with VAP in ICU of our hospital,pathogens distribution and resistance rate from sputum culture were analyzed retrospectively.RESULTS Among 188 strains of isolated pathogens in 135 patients,the Gram-negative bacteria accounted for 74.5%,the Gram-positive bacteria 14.4% and the fungi were 11.2%.The predominant pathogens were Pseudomonas aeruginosa(19.7%),Stenotrophomonas maltophilia(18.6%),Klebsiella pneumoniae(16.0%),and Acinetobacter baumannii(14.4%),Staphylococcus aureus(10.6%),Candida albicans(9.6%).The percentage of meticillin-resistant S.aureus(MRSA) was 95.0% and no vancomycin-resistant S.aureus isolate was detected out.Sensitive antibiotics were cefoperazone/sulbactam,imipenem/cilastatin,fluconazole etc.CONCLUSIONS The multi-drug resistant Gram-negative bacilli are the main pathogens in VAP in ICU of our hospital.Cefoperazone/sulbactam and imipenem/cilastatin can be used as first empirical antibiotics for patients with VAP in ICU of our hospital.

Objective To investigate the relationship between placental endoglin expression and the pathogenesis of severe preeclampsia (SPE). Methods Forty nine pregnant women with SPE and 40 normal pregnant controls were collected in Peking University First Hospital from January 2006 to January 2008,among which,nine SPE patients complicated with fetal growth restriction (FGR),six with hemolysis,elevated liver enzymes and low platelets syndrome (HELLP syndrome) and 12 with heavy proteinuria. The expression of placental endoglin was detected and semi-quantified by immunohistochemistry.Data were analyzed by independent sample t test. Results Endoglin was presented on cell membranes of placental syncytiotrophoblasts and vascular endothelial cells. The endoglin density of SPE group was higher than that of control group (0.1621± 0.0029 vs 0.1576 ± 0.0038,t=- 6.367,P＜0.05).No significant difference in endoglin density was found between FGR group and non-FGR group (0.1611±0.0026 vs 0.1623±0.0029,t=1.107,P＞0.05) ; neither did the heavy proteinuria group and non-heavy proteinuria group (0.1611±0.0032 vs 0.1624±0.0027,t=1.350,P＞0.05).The endoglin density of HELLP group was lower than that of non-HELLP group (0.1595±0.0032 vs 0.1625±0.0027,t=2.495,P=0.016). Conclusions The elevated placental endoglin expression might contribute to the pathogenesis of SPE.

Objective:To explore a three-dimensional (3D) data fusion and integration method of optical scanning tooth crowns and cone beam CT (CBCT) reconstructing tooth roots for their natural transition in the 3D profile.Methods: One mild dental crowding case was chosen from orthodontics clinics with full denture.The CBCT data were acquired to reconstruct the dental model with tooth roots by Mimics 17.0 medical imaging software, and the optical impression was taken to obtain the dentition mo-del with high precision physiological contour of crowns by Smart Optics dental scanner.The two models were doing 3D registration based on their common part of the crowns'' shape in Geomagic Studio 2012 reverse engineering software.The model coordinate system was established by defining the occlusal plane.crown-gingiva boundary was extracted from optical scanning model manually, then crown-root boundary was generated by offsetting and projecting crown-gingiva boundary to the root model.After trimming the crown and root models, the 3D fusion model with physiological contour crown and nature root was formed by curvature continuity filling algorithm finally.In the study, 10 patients with dentition mild crowded from the oral clinics were followed up with this method to obtain 3D crown and root fusion models, and 10 high qualification doctors were invited to do subjective evaluation of these fusion models.Results: This study based on commercial software platform, preliminarily realized the 3D data fusion and integration method of optical scanning tooth crowns and CBCT tooth roots with a curvature continuous shape transition.The 10 patients'' 3D crown and root fusion models were constructed successfully by the method, and the average score of the doctors'' subjective evaluation for these 10 models was 8.6 points (0-10 points).which meant that all the fusion models could basically meet the need of the oral clinics, and also showed the method in our study was feasible and efficient in orthodontics study and clinics.Conclusion: The method of this study for 3D crown and root data fusion could obtain an integrate tooth or dental model more close to the nature shape.CBCT model calibration may probably improve the precision of the fusion model.The adaptation of this method for severe dentition crowding and micromaxillary deformity needs further research.

Objective To measure the average value of CT lung density at the phase of end inspiration and end expiration in children under 5 years.Methods Sixty patients with normal lungs who underwent chest CT for reasons caused by trauma etc.in our institute from January 2010 to March 2012 were enrolled to the study.All of the patients were divided into end inspiration group and end expiration group through random number table.CT images of the phase of end inspiration and end expiration were taken.Three levels of CT images were chosen to measure the lung density,which were 2 cm above the arch,1 cm below the carina and 2 cm above diaphragm.Lung density was measured at anterior,posterior,lateral,medial and central of the images at each level in each lung.The average lung density of each and entire lung were respectively calculated.The influence of phase,level,location was quantified using analysis of variance methods and LSD method.Results The average lung density at end inspiration was (-766 ±56)HU for the left,right and both lung.At end expiration,the average lung density of the left,right and both lungs was (-625 ± 86),(-647 ± 85) and (-636 ± 86) HU respectively.The average densities at anterior,posterior,lateral,medial and central of the left lung at end inspiration were (-798±63),(-733±68),(-767±64),(-754 ±65),(-775 ±63)HU respectively.The average densities at anterior,posterior,lateral,medial and central of the right lung were (-796 ± 70),(-736 ± 65),(-769 ± 64),(-754 ± 62),(-776-± 59) HU respectively.At end expiration phase,the average densities at anterior,posterior,lateral,medial and central of the left lung were (-692±91),(-555±116),(-639±91),(-598±103),(-640±98) HU respectively.The average densities at anterior,posterior,lateral,medial and central of the right lung were (-712 ± 90),(-575±121),(-657±90),(-619±95),(-670±87) HU respectively.The statistical differences of these five measurement areas were significant at both inspiration and expiration phase (F=12.55,11.29,23.31,25.47,P＜0.01).The posterior lung density was the highest and the anterior was the lowest.As for the other measurement areas,in descending order were medial,lateral,and central.Conclusion The lung density at end inspiration and end expiration in children under 5 years old is described to provide reference for the clinical work.

Objective To assess the efficacy of radiofrequency therapy combined with ozone injection in the treatment of lumbar disc protrusion. Methods A total of 202 patients with lumbar disk protrusion were included and divided into three groups:radiofrequency (RF) group, ozone (Oz) group, and combination (Co) group. The efficacy was evaluated by visual analogue scale (VAS), Macnab curative effect evaluation, and oswestry disability index (ODI) at 1d, 1m and 6m after treat?ment. Results There were no significant differences in gender, age, the course of disease, preoperative VAS scores and ODI scores (P>0.05). All patients were operated successfully. There were no infection of the intervertebral disc, no compli?cations of spinal cord, nerve and no blood vessel injury. There were no significant differences in preoperative VAS and ODI scores between three groups. The VAS and ODI scores were significantly lower at 6 month and 12 month after operation in Co group combined with those of RF group and Oz group. There were no significant differences in these two scores between RF group and Oz group (P>0.05). There were no significant differences in effective rates at 1d, 6 month and 12 month after operation between three groups (P>0.05). But the excellent and good effective rates were higher in Co group than those of RF and Oz groups. There were no significant differences in excellent and good effective rates between RF group and Oz group. Conclusion The therapy of radiofrequency combined with ozone injection is an efficient and mini-invasive tech?nique for the treatment of lumbar disc protrusion and worth promoting.

Objective:To construct human adipose-derived mesenchymal stem cells (hASCs)-biomate-rial mixture 3D bio-printing body and detect its osteogenesis in vivo,and to establish a guideline of osteogenesis in vivo by use of 3D bio-printing technology preliminarily.Methods:P4 hASCs were used as seed cells,whose osteogenic potential in vitro was tested by alkaline phosphatase (ALP)staining and alizarin red staining after 1 4 d of osteogenic induction.The cells were added into 20 g/L sodium alginate and 80 g/L gelatin mixture (cell density was 1 ×1 06/mL),and the cell-sodium alginate-gelatin mixture was printed by Bioplotter 3D bio-printer (Envision company,Germany),in which the cells’survival rate was detected by live-dead cell double fluorescence staining.Next,the printing body was osteogeni-cally induced for 1 week to gain the experimental group;and the sodium alginate-gelatin mixture without cells was also printed to gain the control group.Both the experimental group and the control group were implanted into the back of the nude mice.After 6 weeks of implantation,the samples were collected,HE staining,Masson staining,immunohistochemical staining and Inveon Micro CT test were preformed to analyze their osteogenic capability.Results:The cells’survival rate was 89%±2% after printing.Six weeks after implantation,the samples of the control group were mostly degraded,whose shape was irregu-lar and gel-like;the samples of the experimental group kept their original size and their texture was tough.HE staining and Masson staining showed that the bone-like tissue and vessel in-growth could be observed in the experimental group 6 weeks after implantation,immunohistochemical staining showed that the result of osteocalcin was positive,and Micro CT results showed that samples of the experimental group had a higher density and the new bone volume was 1 8%±1%.Conclusion:hASCs-biomaterial mixture 3D bio-printing body has capability of ectopic bone formation in nude mice,and it is feasible to apply cells-biomaterial mixture 3D bio-printing technology in the area of bone formation in vivo.

Objective To discuss the serum endoglin expression in severe pre-eclampsia and eclampsia women and their relationships. Methods Forty-two severe pre-eclamptic patients and 4 eclamptic patients in Peking University First Hospital from Dec. 2005 to Dec. 2007 were enrolled in the study group, with the mean gestational week of 35 ± 4, the mean age of 29.3 ± 5.7 and the mean BMI (30.1 ± 4.1 ) kg/ m2. This group included 25 cases of early onset pre-eclampsia, 21 cases of late onset pre-eclampsia, 8 cases of fetal growth restriction and 5 cases of HELLP syndrome. The control group included 29 cases of normal pregnant women during the same period, with the mean gestational week of 33±4, the mean age of 30.7± 3.4 and the mean BMI(27.2±2. 2) kg/m2. Peripheral serum endoglin was determined by ELISA in these two groups. Results (1)There is positive correlation between serum soluble endoglin level and the gestational weeks during 27 to 37 gestational weeks in the control group (r=0.79, P<0.05), but there is no distinct relationship in the study group (r=0.31, P>0.05). (2) Serum endoglin level of severe pre-eclampsia group was higher than the normal group [(14.2±5.6)μg/L vs. ( 10.9 ± 4.2 ) μg/L, P<0.05]. (3) Serum endoglin level of early onset group did not differ from late onset group [(14.3±5.7)μg/L vs. (13.6±5.0)μg/L, P >0.05]. (4) No difference of serum endoglin between HELLP group and non-HELLP group was found [(10.1±2.9) μg/L vs. ( 14.4±5.4) μg/L, P>0.05 ]. (5) Serum endoglin level of FGR sub group was higher than non-FGR sub group [(17.3±6.1) μg/L vs. (13.0±4.8) μg/L, P < 0.05] in the stady group. Conclusion The elevated peripheral serum endoglin level may contributes to the pathogenesis of severe pre-eclampsia and FGR, but not the week of the onset of the disease.

Aim To investigate the NIH3T3/STAT3CA cell proliferation ability and the STAT3 transcriptional activity affected by PTPMeg2 . Methods MTT assay and xenograft nude mice model were used to investigate the NIH3 T3/STAT3 CA cell proliferation inhibited by PTPMeg2 in vitro and in vivo. Co-immunoprecipitation assay was used to measure the interaction between PT-PMeg2 and STAT3CA. STAT3 transcriptional activity was measured by dual-luciferase assay. Results The NIH3 T3/STAT3 CA cell proliferation ability was signifi-cantly inhibited by PTPMeg2 in vitro and in vivo com-pared with the control group ( P <0.05 ) . The tran-scriptional activity was increased by PTPMeg2 , but not the PTPMeg2 mutant (PTPMeg2C515S) and the ShPT-PMeg2 . Conclusion PTPMeg2 plays a role in inhibi-ting the proliferation ability of NIH3 T3/STAT3 CA cells through inhibiting the STAT3 transcriptional activity.

Objective To evaluate the effect and clinical value of open surgery combined ultrasound-guided Mammotome in the treatment of multiple breast lumps. Methods Four hundred and forty-four patients in our hospital from Jan. 2006 to Jun. 2008 were divided into 3 groups, who underwent classical open surgery, ultrasound-guided Mammotome operation, or combined therapy respectively and followed by post-operation visits reguarly. The operation effects were compared between the 3 groups. Results Compared with the classical open surgery, combined therapy had no difference in time of procedure and procedural bleeding, but had lower incidence of local skin, better incision condition and higher satisfaction of patients. Compared with ultrasound-guided Mammotome operation, combined therapy took less time in procedure, and in the same time had less procedural bleeding, lower post-operation complication and higher patients satisfaction. Conclusions Combined therapy has high complete removal rate, low post-operation complication as well as cosmetic effect. It has special advantages over the other two kinds of surgery, so it has wide clinical application.

Objective To summarize and explore the clinical value of Mammotome technology in the diagnosis and treatment of breast neoplasms. Methods Nine hundred and eighty-seven breast neoplasms of 710patients were biopsied and excised with the aid of ultrasound-guided Mammotome system. The malignant neoplasms,according to the histological report,were radically removed during the operation without delay. All patients enrolled into the study were followed up closely on the complcations and satisfaction degree. Results All the operations except one were successful and got the sufficient specimen to perform the pathological examination,the biopsy achievement rate was 99. 8% . Both the sensitivity and specificity of the diagnosis were 100% in 16 breast tumors. Complete resection rate was 99%. The incision length was about 3 mm,showing good cosmetic outcome. Complcations were mild,mainly composed of haematoma and ecchymosis. The patients' general satisfactory rate was 93%. Conclusions This technique can help achieve biopsy of breast neplasm and excision of benign lesions at the same time with cosmetic result Further attention should be paid to reduce the lesion residue and hemorrhagic complications.