512?g/mL; MIC of 16 VIE to vancomycin were 16?g/mL; MIC of 8 VIE to vancomycin were 8?g/mL. It is a risk factor for hospital infection that VRE carriage of inpatients in intestinal tract is high. There is 100% agreement be-tween phenotypes and genotypes in 46 vancomycin resistance enterococci. VRE are multiresistant. Part iso-lates have high homology.

Objective To assess the efficacy of laryngeal mask airway (LMA) i-gel used in patients undergoing laparoscopic gynecological surgery. Methods Sixty ASA Ⅰ or Ⅱ patients, aged 21-64 yr, weighing 4590 kg, undergoing elective laparoscopic gynecological surgery, were randomized into 2 groups ( n = 30 each):LMA i-gel group (group Ⅰ) and LMA Supreme group (group S) . Mallampatti test was performed before operation in both groups. Anesthesia was induced with target-controlled infusion of propofol (target plasma concentration 2.5-4.0 μg/ml) and remifentanil (target plasma concentration 3-6 ng/ml) . After the patients lost consciousness, rocuronium 0.6 mg/kg was given to facilitate the LMA insertion. LMA i-gel and LMA Supreme were inserted in I and S groups respectively. A gastric tube was inserted through the drain tube of the LMA. In group S the air was injected into the cuff to make intracuff pressure reach 60 cm H2O after successful LMA insertion. The LMA placement time, the number of attempts of LMA insertion, the number of attempts of gastric tube placement, the airway sealing pressure, the parameters of hemodynamics and ventilation, and complications (sore throat, odynopliagia,hoarseness) were recorded. The fiberoptic laryngoscopy scores were assessed after successful LMA placement. The anesthesia time and recovery time were also recorded. Results There was no significant difference in the anesthesia time, recovery time, LMA placement time, fiberoptic bronchoscopy scores and the parameters of hemodynamics and ventilation between the two group. The success rates of LMA and gastric tube placement were 100% in both groups. The airway sealing pressure was significantly higher, while the incidence of sore throat and odynopliagia was significantly lower in group I than in group S. Conclusion LMA i-gel provides adequate ventilation during operation with fewer complications and can be used effectively for gynecological laparoscopic surgery.

Objective:To study the change of immunological response and cell proliferation in breast tissues augmented by polyacrylamide hydrogel injection(PHI).Methods:The expression of CD68,CD25 and PCNA in 20 breast tissues with indurations,12 without indurations after breast augmentation by PHI,and 10 normal breast tissues was examined by immunohistochemistry P-V6000; analysis was also done by H-E staining.Results:Hyperplasia of fibrous tissue and infiltration of inflammatory cells and macrophages were found in the breast and adjacent tissues 3-8 years after PHI.Positive cells of CD68,CD25 and PCNA hardly existed in the normal tissues,but the breast tissues around the polyacrylamide hydrogel had many positive cells of CD68 and PCNA,especially in cases with indurations;there were significant differences between the 3 groups(P

Objective To evaluate the efficacy of naloxone used in the postoperation of cerebral tumor.Methods Eighty patients were randomly assigned to receive (treated group:40 patients) or not re- ceive (control group:40 patients) naloxone.Both the two groups accepted the conventional therapy.Re- sults After operation,the content of?-EP,ET decreased continuously but the one of the treated groups was more obviously than that of the control groups (P

Adolescent ; Cardiomyopathy, Dilated ; diagnosis ; etiology ; physiopathology ; Diagnosis, Differential ; Female ; Graves Disease ; complications ; diagnosis ; physiopathology ; Humans

OBJECTIVE To identify the antibiotic resistance,homology and the carbapenemases determinants of imipenem-resistant strains of Acinetobacter baumannii isolated from elderly in the Zhejiang Hospital.METHODS All 142 strains of A.baumannii were isolated from Zhejiang Hospital through Jan 2005 to Jan 2007.K-B method was used to screen imipenem-resistant strains.The MICs of imipenem-resistant strains to 14 antimicrobial agents were determined by agar dilution method.The homology of these isolates was analyzed by pulse-field gel electrophoresis(PFGE).The coding genes of carbapenamases and the gene environments were investigated by PCR,clone,and sequencing.RESULTS Ninety-seven strains of imipenem-resistant A.baumannii were isolated from 142 strains.All of the strains of carbapenem resistant A.baumannii belonged to 4 epidemic PFGE-clones.Ninety carbapenem resistant strains contained OXA-23-like carbapenemase gene and 91 isolates were positive for OXA-51-like gene. OXA-23-like gene of 86 strains was just on the down-stream of insert sequence ISAba1.OXA-51-like gene of 6 strains had an ISAba1 sequence just on the up-stream.CONCLUSIONS All imipenem-resistant strains of A.baumannii are pan-resistant isolates.Clone dissemination is the most important style of strains spread.No OXA-24-like,OXA-58like,IMP-like,and VIM-like gene are detected.OXA-23-like and OXA-51-like gene are the most popular carbapenemases coding genes of these strains in the Zhejiang Hospital.ISAba1 has close relationship with OXA type carbapenemases genes in Zhejiang Hospital.

Characteristics and measurement principles of reference methods in clinical biochemistry were described.Implementation of reference systems is one of the most effective approaches to improve the accuracy and comparability of clinical laboratory test results.Reference methods are the key components of reference systems.Reference methods should have measurement uncertainties that meet the requirements of the intended use,and thus should be based on reliable measurement principles.For the well-defined biochemistry analytes,reference methods have been almost all based on instrumental analysis.Isotope dilution mass spectrometry (ID/MS) is considered most reliable and has been the major analytical principle of the reference methods.ID/MS analysis is accurate but expensive.Use of other validated instrumental analyses as reference measurement principles would be justified.

Objective To evaluate three internal fixation methods in treatment of type C3 fractures of distal humerus.Methods From February 2002 to January 2005,73 cases of humeral intercondylar fractures were treated with single plating (Group A,21 cases),Y-shape plating (Group B,33 eases) and dual plating (Group C,19 cases).According to the AO/ASIF classification,73 cases belonged to type C3.The posterior midline incision and the approach of liguliform flap of musculus triceps brachii were used for all the cases.The recorded clinical data were reviewed to analyze effects of internal fixation methods,functions of the elbow and the complications.Results All the cases were followed up.The follow-ups ranged from 12 to 36 months,with an average of 22.3 months.By the end of the twelfth month,according to the Jupiter scoring system,the elhow function was excellent and good in 57.1% of cases in Group A,81.8% in Group B and 89.5% in Group C,the difference between Gronp A and Groups B and C being statistically significant(P＜0.05).Meanwhile,according to Sodergard's criteria for failure of internal fixation system for intercondylar fracture of humerus,the failure rate was 33.3% in Group A,15,2% in Group B and 5.3% in Group C.The loosening or breakage rate in Group C was significantly lower than in Groups A and B (P＜0.05),and that in Group B was obviously lower than in Group A (P＜0.05).No incision necrosis or deep infection occurred.Conclusions The type C3 fractures of distal humerus should not he treated with single plating,because the functional outcome of elbow joint is poor,and the rate of loosening or breakage of internal fixation is higher than other fixation methods.Y-shape plating and dual plating are good for them,but Y-shape plating is not good for severe intercondytar comminnted fractures of the humerus,because its peculiar shape tends to lead to a higher rate of loosening.

Objective To discuss the clinical manifestations and CT findings of eosinophilic cystitis in chidren.Methods Nine cases including Six boys and 3 girls,three to 13 years old,mean age of 8.3- year,have symptoms of hematuria,irritative voiding,dysuria and abdominal pain。The eosinophilic cystitis was pathologically proved in 7 patients and eosinophilic granulomatous cystitis in 2 patients,which based on cystoscopic tissue biopsy or surgery retrospectively.Results Local thickened bladder walls or nodular and sessile masses along the bladder dome showed in four cases with eosinophilic granulomatous cystitis,and the diffusely irregularly thickened bladder walls showed on CT scans in the rest 5 cases with eosinophilic cystitis.Conclusion CT findings are helpful to reveal the site,size and other features of eosinophilic cystitis in children.But biopsy of the lesion is necessary to rule out other bladder tumor and selecting the proper management.

ObjectiveTo investigate the epidemic situation of brucellosis in Datong city, and to provide scientific evidence for making appropriate prevention and control measures. MethodsSurveillance data of human brucellosis in 7 countris and 4 districts in Datong city between 2006 and 2009 were collected, throng the national network straight quote system in an infectious diseases. Excel database was established and all data were statistically analyzed. Incidence of brucellosis in local population was analyzed. The regional distribution, time distribution,occupation, age and sex distribution were analyzed. Epidemic characteristics and trend of brucellosis in Datong city were summarized. Results A total of 5195 cases of brucellosis patients in Datong were found between 2006 and 2009, the average incidence rate was 57.51/10 million. All counties had the disease, and the onset of the disease mainly in the spring and summer. Most cases were young males. Farmer case was 81.67％(4243/5195) of the total patients. ConclusionsFrom 2006 to 2009, epidemic characteristic of Datong human brucellosis ishigh-low-high(incidence). We suggests the Department concerned to strengthen the prevention and control of the disease in some counties, focusing on spreading of disease prevention and control knowledge among farmers and increase their self-protection awareness.