Adult ; Female ; Hemangioma, Cavernous ; surgery ; Humans ; Nose ; surgery ; Orbit ; surgery ; Orbital Neoplasms ; surgery

Objective To investigate the antimicrobial resistance of Gram-positive cocci isolated from 17 hospitals located at different areas in China. Methods All the Gram-positive cocci isolated from 17 hospitals from October 1 st, 2004 to September 30th, 2005 were collected for susceptibility test using standard agar dilution method issued by The Clinical and Laboratory Standards Institute (CLSI,2004). The minimal inhibitory concentration (MIC)50 and MIC90 were detected for antibacterial activity in vitro of 35 antimicrobial agents. The rates of resistance, intermediate and susceptiblity of bacteria to the agents were calculated. Results Totally, 925 Gram-positive cocci strains were collected during the period, which included Staphylococcus 536, Enterococcus 249, Streptococcus 137 and other Gram-positive cocci 3; the rates of oxacillin resistant Staphylococcus aureus (ORSA) and oxacillin resistant Staphylococcus epidermidis (ORSE) were 62.9% and 82.9%, respectively. The penicillinnonsusceptible Streptococcus pneumoniae (PNSP) was 40.7 % including 10.5 % resistant and 30.2intermediate. All strains of Enterococcus were susceptible to teicoplanin. No Enterococcus was resistant to vancomycin. Five strains of Enterococcus were found intermediate to vancomycin, which were 1 E.faecalis, 2 E. faecium, 1 E. gallinarum and 1 E. avium. No glycopeptides resistant Gram-positive coccus was detected. Conclusions The antimicrobial resistance of Gram-positive cocci is increasing with higher isolate rate of penicillin-resistant Streptococcus pneurnoniae (PRSP) and methicillinresistant Staphylococcus aureus (MRSA). All the investigated Gram-positive cocci are highly resistant to macrolides. No glycopeptide resistant strains are detected during the surveillance.

Objective To establish a national antibacterial resistance surveillance network and explore the epidemiology of bacterial resistance in China. Methods The minimal inhibitory concentration (MIC) was determined by National Committee for Clinical Laboratory Standards (NCCLS) standard agar double dilution method. The susceptibility and resistance rates of drugs were calculated according to the criteria in guidelines of NCCLS (2004). Results According to the previous protocol, a total of 4 075 pathogenic strains isolated from 17 hospitals located at 15 different cities from October 1, 2004 to September 30, 2005 in China were collected and the MICs were detected. Gram-negative bacilli were 3 150 strains ( 77.3%). Enterobacteriaceae Were highly susceptible to Carbapenems. In addition, Moxalactam, Piperacillin/Tazobactam, Cefoperazone/Sulbactam and Cefepime were also exhibited good antibacterial activities against Enterobacteriaceae,the resistance rates of them were less than 10 %. The resistance rates of nonfermentative Gramnegative bacilli, such as Pseudomonas aeruginosa and Acinetobacter baumanii, to Imipenem were 10. 6 % and 10.4 % , respectively. Cefoperazone/Sulbactam, Piperacillin/Tazobactam and Fluoroquinolones also showed good activity against nonfermentative Gram-negative bacilli.Conclusions The drug resistance rates of Escherichia coli and Acinetobacter baumanii increase obviously. Fluoroquinolones and Aminoglycosides are not very effective against Enterobacteriaceae,which should be paid more attention.

Objective To investigate the prevalence of sinusitis in poorly controlled asthma children.Methods Asthmatic children from the Asthma Specialist Department of Hunan Provincial People's Hospital were selected as the study cases,of which 107 children coughing for more than 4 weeks after treatment were allocated to the research group and 105 newly diagnosed asthmatic children were selected as the control group.Results 1.The CT confirmed sinusitis prevalence was 81.3％ (87/107 cases) in research group and 51.4％ (54/105 cases) in the control group,respectively.The 2 groups were significantly different (x2 ＝ 21.242,P ＜ 0.05).2.The patient complained nasal obstruction in sinusitis group was 80.5％ (70/87 cases) compared to 50.0％ (10/20 cases) in non sinusitis group,and the difference between 2 groups was statistically significant (x2 =7.997,P ＜ 0.05).3.In the research group,69.2％ (74/107 cases) suffered from maxillary sinusitis,61.7％ (66/107 cases) ethmoid sinusitis,14.0％ (15/107 cases) frontal sinusitis,and 30.8％ (33/107 cases) sphenoid sinusitis.All the 4 nasosinus involved was 10.3％ (11/107 cases).The frequency of allergic rhinitis symptoms in 4 groups of sinuses had no significant difference (P ＞ 0.05).Conclusions Chronic cough in poorly controlled asthma children is related to sinusitis and upper airway cough syndrome.

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 analyze diagnostic experience of children with anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) and assess its surgical results.Methods Six children with ALCAPA had been diagnosed in our hospital from Mar. 2006 to Oct.2007 aged from 6 months to 10 years old(median 43.5 months).The medical data included common clinical presentations,the findings of electrocardiogram(ECG),the echocardiogram,ECG-gated 64-slice computed tomography,the digital subtraction angiogram (DSA),surgical records and the outcome.Results Diaphoresis,fantod,breathlessness and difficult feeding were commonly presented in 5 cases ALCAPA and the 5 children presented with left ventricular failure in infancy.The predominant ECG findings were Q waves and ST segment changes in the anterolateral chest leads in 4 cases,ST changes in 1 case,and normal ECG in 1 case.Cross-sectional echocardiography showed dilated left ventricles with poor contractility in 4 cases,medium mitral regurgitation in 2 cases and severe mitral regurgitation in 2 cases,aneurysmal dilatation of the right coronary artery(RCA) in 2 cases.CT and DSA examinations showed characteristic changes in these children.The surgical reestablishment of a two-coronary system was performed in 5 cases,direct reimplantation in 2 cases and creation of an autologous extrapulmonary tunnel in 3 cases.Simultaneous mitral annuloplasty was performed in 2 cases.After operation,the symptoms of 5 cases were all improved and none died.Conclusions Understanding the clinical manifestations and lab findings of ALCAPA is helpful to making an early diagnosis of ALCAPA.Early surgical treatment can improve the patients′ outcome.

Background At present,researches about retinitis and acquired immunodeficiency syndrome (AIDS) mainly focus on observation and analysis of the cytomegalovirus (CMV)-induced ocular complication.To screen the effective drugs is very important for the treatment of AIDS-related CMV-induced retinitis.Objective This study was to describe the clinical features,diagnosis and treatment outcome of CMV-induced retinitis with BAY 38-4766 and evaluate the relationship between CMV retinitis and AIDS.Methods This was a case observational study.A total of 154 eyes of 84 patients with CMV retinitis and AIDS were enrolled in this study.Before the definitive diagnosis of CMV retinitis,the AIDS course of these patients were 4-26 months.In the initial examination,the visual acuity ranged from finger counting to 0.4,and the number of CD4+ T-lymphocyte was 0-30 cells/μl.The survival time in the patients ranged from 3 weeks to 18 months.BAY 38-4766 was used in 117 eyes of 62 patients,and 102 eyes of 53 patients showed the srinked of retinal lesion and improvement of vision (0.1-0.7).BAY 38-4766 was used to treat the CMV retinitis in 117 eyes of 62 patients with the initial intravenous dose of 5 mg/kg,twice per day for consecutive 2 weeks and followed by oral dose 1 gram per day.The follow-up duration was 2 weeks to 18 months.The fundus feature,visual acuity and CD4+ T-lymphocyte counts were analyzed.This study proposal was approved by Ethic Committee of the 474th Hospital of PLA,and written informed consent was obtained from each patient prior to entering this study.Results The numbers of CD4+T-lymphocytes increased to 12-402 eells/μl after administration of BAY 38-4766.The CMV retinitis aggravated and the vision decreased in the untreated 22 patients with the CD4+T-lymphocytes 0-30 cells/μl.Conclusions CMV retinitis is the most common intraocular complication in patients with AIDS.Diagnosis of CMV retinitis is based on the characteristics of necrotizing retinitis,which is typically associated with retinal hemorrhage and vasculitis.BAY 38-4766 is an effective drug for the treatment of CMV retinitis.

AIM To evaluate the anti-angiogenesis action of Bevacizumab on corneal neovascularization(CNV) in rats induced by alkali burns.·METHODS: 20 Health Wistar rats, aging from 6 to 8 weeks and weighting from 170g to 190g from 170g to 190g were prepared for CNV animal models. Both corneas of each animal in experimental were cauterized with alkali, then all rats were randomly divided into four groups (each group have 5 rats and 10 corneas), the both corneas of each rats were received subconjunctival Bevacizumab in different dosage (group 2, 0.5rag; group 3, 1.0mg; group 4, 2.0mg)and the group 1 received carrier solution. The occurrence and development ofCNVwereobservedbyslit-lamp microscope, and length and area of CNV were calculated. All rats were followeded up 16 days after alkali burns. The 40 corneas were taken for histopathological examination. Vascular endothelial growth factor (VEGF) were detected in all rat corneas by immunohistochemistry method. ·RESULTS: In the bevacizumabotreated eyes, the vascular area was lower than in the control eyes. The treated group was statistical differences compared with the control group; when vascular area were compared between the treated groups, no statistical differences were observed. The histopathological findings showed that the inflammation cells and the neovascularity in each treated group were significantly fewer than that in the control group. The expression of VEGF markedly increased in CNV control group compared with bevacizumab-injected group. ·CONCLUSION: Subconjunctival application of a certain concentrations Bevacizumab could inhibit angiogenesis in rats corneas induced by alkali burns.

Objective To explore the therapeutic effect of Lingzhu Infusion and Shenqi Capsule sequential therapy in combination with clomiphene citrate(CC)for polycystic ovarian syndrome(PCOS).Methods The 90 PCOS cases in accordance with the enrol- ment standard were randomized into three groups.The treatment groupⅠwas treated with Lingzhu Infusion and Shenqi Capsule se- quential therapy,the treatment groupⅡwas treated with Lingzhu Infusion and Shenqi Capsule sequential therapy and CC,and the control group was treated with CC only.The therapeutic effect was evaluated after two courses of treatment.Results After treat- ment,the changes of TCM syndromes and serum sex hormone indices,ovulation rate and conception rate of the treatment groupⅡwere all superior to those of the treatment groupⅠand the control group.Conclusion The effect of treatment groupⅠis similar to that of control group.The effect of treatment groupⅡis better than that of treatment groupⅠand control group,getting a higher ovulation rate and pregnancy rate.