Objective To investigate the distribution and drug resistance of the gram positive bacteria isolates from hospital in Chongqing during 2006-2011 .Methods Non-repetitive gram positive bacterias were collected retrospectively from ten hospitals in Chongqing .Antimicrobial susceptibility testing of all clinical isolates were carried out using Kirby-Bauer(KB) .Results 14 473 strains were isolated .There were 4 840 strains of Staphylococcus aureus (33 .4% ) ,2 566 strains of Staphylococcus epidermidis (17 .7% ) ,1 822 strains of Staphylococcus haemolyticus (12 .6% ) ,1 325 strains of Enterococcus (E .faecalis/E .faecium )(9 .2% ) . Staphylococcus was highly sensitive to nitrofurantoin ,rifampicin ,piperacillin/tazobactam ,linezolid ,teicoplanin and vancomycin ,but their resistance rate to ampicillin/sulbactam ,oxacillin ,penicillin and clarithromycin was high .The resistance rate of E .faecium to the majority of antimicrobial agents was obviously higher than that of E .faecalis ,excluding imipenem ,chloramphenicol and tetracy-cline .Vancomycin and linezolid still remain the strongest antibacterial activity to Enterococcus .Conclusion The distribution and drug resistance of pathogenic bacteria in Chongqing present regional particularity ,and antibiotic resistance is severe .It is significant to strengthen the epidemiology study of pathogenic bacteria and to develop policies to intervene in the use of antimicrobial agents .

Objective To investigate the protective effects of simvastatin on cobalt choride ( CoCl2 ) -induced hypoxia and reoxygenation injury on alveolar type Ⅱ cells and the underlying mechanisms.Methods CoCl2 was used to establish the hypoxia and reoxygenation injury model on AT Ⅱ cells.Blank,control and variant doses simvastatin-treated groups ( 5,10,20,30,50,100 μ mol/L) were designed in the present study.The proliferation of AT Ⅱ cells was evaluated by Cell Counting Kit-8 ( CCK-8 ) assay.The percentage of apoptotic cells was assessed by flow cytometry AV/PI double-staining.The protein levels of surfactant protein-C (SP-C) and proliferating cell nuclear antigen (PCNA) in AT Ⅱ cells was determined by Western blot.Results As compared with the control group,pretreatment with low dose (5 - 20 μmol/L),but not high dose simvastatin (50 - 100 μmol/L) markedly reduced A549 cells apoptosis,and increased their proliferation and the protein levels of SPC and PCNAin vitro.The protective effect could be reversed in vitro by L-mevalonate,a simvastatin competitive inhibitor,which indicated that the inhibition of mevalorate pathway was involved in the simvastatin induced AT Ⅱ cells function restoration.Condusion Low doses simvastatin reversed CoCl2-induced hypoxia and reoxygenation injury of AT Ⅱ cells.The inhibition of mevalonate pathway contributed to simvastatin induced AT Ⅱ cells function restoration.

Objective To explore the value of SOD activity in diagnosis of central nervous system leukemia (CNSL )by detec-ting SOD activity of cerebrospinal fluid of patients with CNSL .Methods The cerebrospinal fluid of 55 patients from department of hematology of Nanfang hospital of southern medical university were collected from January 2008 to January 2009 ,in which 30 pa-tients suffered with central nervous system leukemia (CNSL group) ,the other 25 patients suffered with acute leucemia without im-paired central nervous system(control group) .The SOD activity of cerebrospinal fluid was detected by the xanthine oxidase meth-od ,while the routine test ,biochemistry test and cell smear of cerebrospinal fluid was detected .Results There were statistics differ-ence in the level of white cell and protein in cerebrospinal fluid between CNSL and control group (P<0 .05) ,but with no difference in the level of cerebrospinal fluid pressure ,glucose ,chlorine(P>0 .05) .There was statistics difference in the level of SOD activity between CNSL and control group(P<0 .05) .The white cell quantity and the protein level in cerebrospinal fluid had negative corre-lation with the activity of SOD ,(r=0 .871 ,P=0 .000 ;r=0 .518 ,P=0 .003) .The activity of SOD in the cerebrospinal fluid had sta-tistics difference before and after intrathecal chemotherapy (P<0 .05) .The activity of SOD in the cerebrospinal fluid whose under 45 year-old (755 .64 ± 345 .77) ,which was significant lower than that of the paitents whose equal with or above 45 year-old (1 420 .49 ± 307 .69)(P<0 .05) .Conclusion The changes of the SOD activity in the cerebrospinal fluid had relation with central nervous system leukemia ,and the SOD activity might be a auxiliary diagnosis index used in central nervous system leukemia by revi-sing age factor .

Objective To study the changes of insulin- like growth factor- 1(IGF-1)in blood and cerebrospinal fluid (CSF) in children with viral encephalitis (VE).Methods The IGF-1 levels in blood and CSF were determined before treatment by ELISA in 25 children who admitted with VE, including 15 cases with severe VE and another 10 cases with mild VE, 10 children served as con-trols. Results Before treatment, the blood IGF-1 levels in VE group were significantly lower than those of controls, but the CSF IGF-1 levels were significantly higher than those of controls(P0.05), but the blood IGF-1 levels in serve VE group were significanfly lower than those of mild VE group and controls(P

Objective To investigate clinical significance of computed tomography (CT) scan in diagnosis of bronchial foreign body in children.Methods Twenty-one suspected children with bronchial foreign body were studied with spiral CT cross-section scan and coronal reconstruction and diagnosis was confirmed with bronchoscopy.Results The foreign body was displayed in all of 21 cases. CT scan showed foreign body was located in right main bronchial 12 cases, right middle bronchial 1 case, right inferior lobar bronchial 2 cases and left main bronchial 6 cases. Foreign bodies were extracted with bronchoscopy.Conclusion CT scan can display and locate accurately foreign body in bronchial of children,and has very important diagnostic value in patients having atypical histories, clinical and radiological findings.

Objective To study the influence of electro-acupuncture(EA)at Zusanli points(足三里穴) on the apoptosis of thymocytes in rats with abdominal infection and its mechanism.Methods A total of 40 Sprague-Dawley(SD)rats were randomly divided into four groups,including normal control group,model group,non-acupoint group and Zusanli group.The abdominal infection model of rat was made by cecal ligation and puncture(CLP).After abdominal cavity infection for 36 hours,the apoptosis of thymocytes was observed under electron microscope and light microscope,and the apoptosis ratio of thymocytes was determined by Annexin V-PI method with flow cytometry technique.The content of Bcl-2 protein of thymocytes and concentration of corticosterone in plasma were determined.Results Abdominal infection resulted from CLP could significantly increase the apoptosis of thymocytes and lead to the typical histopathological changes of apoptosis of thymocytes under electron microscope and light microscope.Apoptosis ratios of thyrnocytes in model group[(44.7?3.3)%],non-acupoint group[(42.7?3.0)%]and Zusanli group[(32.6?3.3)%] were significantly higher than the ratio in the control group[(21.2?2.3)%,all P0.05).Abdominal infection resulted from CLP also could reduce the content of Bcl-2 protein of thymocytes.The content of Bcl-2 protein of thymocytes in model group(71.2?5.6),non-acupoint group(73.5?5.9)and Zusanli group(82.4?6.8) were significantly lower than normal control group(95.3?6.3,all P

Objective To assess the various features of Budd-Chiari syndrome(BCS)on three- dimensional contrast-enhanced magnetic resonance angiography(3D CE MRA)and to evaluate the potential value of this new technique.Methods Thirty-three patients with BCS underwent 3D CE MRA examination. In 23 cases,BCS was secondary to hepatocellular carcinoma(21 patients)or right adrenal carcinoma (1 patient)or thrombophlebitis(1 patient).Ten patients had primary BCS.The patency of the hepatic veins,inferior vena cava(IVC)and portal veins were assessed.The presence of intra-and extrahepatic collaterals,liver parenchymal abnormalities and porto-systemic varices were evaluated.The diagnosis on 3D CE MRA was correlated with that on inferior vena cavography and right hepatic venography,which were available in 10 and 2 cases respectively.Results Various features of BCS were displayed on 3D CE MRA. Hepatic venous findings included tumor thrombosis(19 patients),tumor compression(2 patients), nonvisualization(4 patients)and focal stenosis(4 patients)of the hepatic veins.IVC findings were severe stenosis or occlusion(10 cases),tumor direct invasion(2 cases),tumor thrombosis(3 cases), thrombophlebitis(1 case)and web formation(3 cases).Intrahepatic collaterals were demonstrated in 9 patients including 2 with "spider web" sign.Detected extrahepatic collaterals included dilated azygos and hemiazygos veins(13 cases)and left renal-inferior phrenic-pericardiophrenic collaterals(2 cases).The occlusion of the left portal vein and the presence of porto-systemic varices were depicted in 2 and 10 patients respectively.Liver parenchymal abnormalities identified by 3D CE MRA consisted of caudate lobe enlargement(7 cases),heterogenous enhancement(18 cases)and associated tumors(18 cases). Compared with inferior vena cavography and hepatic venography,the accuracy of 3D CE MRA in the diagnosis of IVC obstruction or hepatic venous stenosis was 100%.Conclusion 3D CE MRA can display various features of BCS and has the potential to provide an accurate diagnosis.

Objective To analyze the risk of embolization of brain AVMs,study the angioarchitectural factors affecting the difference of embolization level,and to establish the angioarchitecture grading system for embolization of brain AVMs.Methods The clinical data,angioarchitectural features, embolism complication and embolism level were retrospectively analyzed.Multivariate statistical analysis was performed to determine if any of the variables was predictive of a poor outcome of embolization(death or permanent neurological deficit),and if any of the variables was predictive of the percentage obliteration achieved by embolization.Based on the above results,we established the angioarchitecture grading system.Results Endovascular procedures for embolization were performed 324 times in 189 patients during an 11-year period.Embolization was performed using N-butyl cyanoacrylate.In those patients,3(1.6%) died and 5(2.6%)had a permanent neurological deficit as a result of the embolization.The AVMs were given a score from 0 to 5 based on the size,number of the first grade feeding artery,and number of the second grade feeding artery.The assigned scores were as follows:nidus size(AVF=0,

Objective To investigate the diagnosis and treatment of mucinous cystadenoma and cystadenocarcinoma of the pancreas. Methods The clinical data of 23 patients with pancreatic mucinous cystadenoma or cystadenocarcinoma confirmed by pathology from May 1993 to October 2005 was retrospectively studied. Results Fifteen cases of mucinous cystadenoma, 4 cases of mucinous cystadenocarcinoma, and 4 cases of mucinous cystadenoma with malignancy were included in this data. Ultrasonography, CT, and MRI/MRCP displayed a cystic tumor in 73.7%, 68.8%, and 83.3% of all patients, respectively. The mean diameter of the tumors was 9.4 cm, and the maximum diameter of the tumors was 20 cm. Pancreaticoduodenectomy, distal pancreatectomy and splenectomy, local excision of cystadenoma and other procedures were performed according to the site of tumors. The resectable rate was 82.6%. Twenty-one patients (91.3%) were followed up. All of the 14 patients with mucinous cystadenoma were alive with the follow-up from 4 months to 11 years after operation. Two of the 4 cases of mucinous cystadenoma with malignancy were alive with the follow-up of 5 months and 4 years after operations, while the other 2 died with the survival time of 15 months and 18 months. One patient with mucinous cystadenocacinoma was alive 5 months after operation, while the other 2 died with the survival time of 7 months and 13 months. Conclusion Mucinous cystadenoma has a malignant tendency. As the mucinous cystadenocacinoma is a low malignant potential tumor, the resectable rate is high and prognosis is satisfactory. The excision of total tumor including the surrounding pancreatic tissue is the first choice of the treatment. Pancreaticoduodenectomy, distal pancreatectomy and splenectomy, and other procedures according to the site tumors is feasible.

Objective：To study the clinical and pathologic features of patients with lupus nephritis (LN) whose myeloperoxidase anti-neutrophil cytoplasmic antibody (MPO-ANCA) were positive. Methods：The clinical and pathological features were analyzed in 18 patients with LN whose MPO-ANCA were positive. And the data of patients with different clinical outcomes were compared. Results：（1）The hematological abnormalities, hypertension and serositis in these patients were more common than general ones with LN. （2）Proteinuria and hematuria were common, the morbidities of gross hematuria and renal failure in these patients were higher than general ones with LN.（3）Various autoantibodies were positive in these patients.（4）Segmental necrosis crescentic nephritis accompanied by density of immunocomplex in glomeruli and vasculitis in intestitium were common.（5）The morbidity of ESRF and mortality of these patients were similar to general ones with LN. The morbidity of tubular atrophy in those with poor prognosis was significantly higher than those survived. Conclusion：The patients with LN whose MPO-ANCA are positive have some difference from those with negative MPO-ANCA, but positive MPO-ANCA is not directly related to the prognosis.