Objective To explore the mechanisms of quinolones resistance in Acinetobacter baumannii and homology analysis a-mong the strains .Methods 25 strains of quinolones-resistant Acinetobacter baumannii isolated clinically were collected .Kirby-Bauer(K-B) detection was utilized to detect the sensitivity of conventional drugs ,and polymerase chain reaction (PCR) was em-ployed to detect quinolone resistance-related genes gyrA and parC which were verified by restriction enzyme digestion and sequen-cing ,repetitive extragenic palindrome(REP)-PCR was adopted to analyze the strain homology .Results Multiple resistances to 12 kinds of antibacterial agents were found among the 25 strains of Acinetobacter baumannii which were sensitive only to minocycline and amikacin ,with sensitive rates were 48 .0% and 32 .0% ,respectively ,and were all sensitive to polymyxin B [minimal inhibitory concentration(MIC)≤2 μg/mL] .gyrA and parC genes were found in the all strain .Mutation TCA→TTA(Ser→Leu) at coden 83 in gyrA gene existed in 25 strains ,mutation TCG→TTG(Ser→Leu) at coden 80 in parC gene existed in 23 strains ,mutation GAA→GGA(Glu→Gly) at coden 84 in parC gene existed in 2 strains .REP-PCR showed that the strains had high degree of homology . Conclusion Quinolone-resistant Acinetobacter baumannii has high degree of homology ,existing gyrA and parC gene mutations .

Objective To evaluate the relationship between fatty liver disease and liver metastases from colorectal cancer.Methods Eight hundred and ninety patients with colorectal cancer,who were submitted to hospital from 1993 to 2002 and had complete clinical data,were retrospectively analyzed.Of 890 patients,127 were diagnosed as fatty liver(FL)by ultrasonography,and the other 763 who were without fatty liver were served as controls(NFL).The clinical data including pathology,liver matastasis or mortality after surgery were analyzed.The survival rate and liver matastasis after surgery were followed up and statistically analyzed.Results The liver metastases was lower in FL group than that in NFL group(7 cases vs 102 cases,P=0.012).The tumor size was smaller in FL group than that in NFL group[(4.15±1.80)crn vs(4.77±2.25)cm,P=0.0016].The Dukes B(247/732,33.74%)and C(232/732,31.83%)patients were more common in NFL group,whereas Dukes A(41/121,33.61 %)and B(40/121,32.77%)were more common in FL group with significant difference(P＜0.05).No significant difference was found in 7-year survival rate between two groups who had been followed up(P=0.3024).Conclusion The lower incidence of liver metastases is found in FL group,which indicate that fatty liver disease may inhibit liver metastases from colorectal cancer by underlying mechanisms.

BACKGROUND:Finite element method is widely used in the femoral neck fracture, but the study concerning different fixation methods of femoral neck fracture is not much. OBJECTIVE:To analyze biomechanical properties of different fixation methods for femoral neck fracture using finite element analysis. METHODS:The femur of voluntters was scanned with CT, at thickness 0.6 mm, from the site above the greater trochanter of the femur. Scanning data were saved in .DICOM format. Data of right proximal femur were imported into Mimics software. Osteotomy was performed according to Pauwels I type fracture. Models of two tensile force screws, ful y threaded hol ow screw and proximal femoral locking plate were established. Three-dimensional finite element method was used to analyze stress distribution, stress concentration position, displacement distribution and maximum displacement in different models of femoral neck fracture with different internal fixation methods. RESULTS AND CONCLUSION:(1) The maximum stress value of two lag screws model was biggest. The maximum stress value of ful y threaded hol ow screw model was minimized. The maximum stresses of two lag screws model, ful y threaded hol ow screw model and proximal femoral locking plate model al were concentrated in the fixed end of fractures. (2) The femoral maximum stress of two lag screws model was biggest. The femoral maximum stress value of proximal femoral locking plate model was minimized. The femoral maximum stresses of two lag screws model, ful y threaded hol ow screw model and proximal femoral locking plate model al were concentrated in the medial femoral smal rotor near and medial femoral and fixation contact points. (3) The maximum displacement of two lag screws model was biggest. The maximum displacement of ful y threaded hol ow screw model was minimized. The maximum displacement of two lag screws model, ful y threaded hol ow screw model and proximal femoral locking plate model al was in the femoral head. (4) The maximum displacement value of two lag screws model fixed place was biggest. The maximum displacement value of ful y threaded hol ow screw model fixed place was minimized. The maximum displacement value of two lag screws model was biggest at femoral head. The maximum displacement value of ful y threaded hol ow screw model was minimized at femoral head. (5) Results showed that the treatment effect of ful y threaded hol ow screw on Pauwels I fractures was better than other two fixation methods.

Objective:To explore the diagnostic value of 64‐slice spiral CT for in‐stent restenosis (ISR) after percuta‐neous coronary intervention (PCI) in patients with coronary heart disease (CHD) .Methods :A total of 120 CHD patients after PCI received 64‐slice spiral CT angiography and routine coronary angiography (CAG ) respectively . Then coronary ISR was assessed .Results:With CAG as the gold standard ,sensitivity ,specificity ,positive predictive value and negative predictive value were 87.5% ,95.3% ,80.0% and 97.3% respectively for 64‐slice spiral CT cor‐onary angiography in diagnosis of ISR .Conclusion :The 64‐slice spiral CT coronary angiography possesses high sensitivity and accuracy diagnosing coronary in‐stent restenosis ,which can be used as one of noninvasive measures for postoperative follow‐up after percutaneous coronary intervention .

Objective To observe the effects and feasibility of using walking and breathing exercises to help patients with chronic obstructive pulmonary disease in the community.Methods A hundred and one communitydwelling patients with moderate to severe chronic obstructive pulmonary disease were randomized into an experimental group (51 cases) and a control group (50 cases).The control group was given conventional pharmacotherapy,while the experimental group was given quantified walking (i.e.walking for a pre-set number of steps daily) and breathing exercises (15 minutes,3 sessions daily) to do at home for 48 weeks in addition to the conventional pharmacotherapy,.Both groups were evaluated before and after the 48 weeks of treatment using the 6-minute walk test (6MWT),a clinical COPD questionnaire,Medical Research Council (MRC) dyspnea scoring,a general anxiety/depression questionnaire and a pulmonary function test.In addition,days of hospitalization and incidence of acute exacerbation were also recorded and compared between the 2 groups.Results Among the 101 cases,92 (91.1％) completed the study (45 in the experimental group,47 in the control group,a difference which was not statistically significant).After treatment,the average 6MWT distance in the experimental group was significantly increased and significantly greater than that in the control group.No statistically significant intra-group or inter-group differences were observed with regard to the pulmonary function test or the MRC dyspnea scores.Intra-group comparison and inter-group comparison of the clinical COPD questionnaire scores and anxiety/depression scores did,however,reveal statistically significant differences.There was no significant difference in the average number of acute attacks or in the length of hospital stays.Conclusions Quantified walking and breathing exercises are effective and feasible therapy for patients with chronic obstructive pulmonary disease in the community.

Objective:To investigate the anti-tumor immune responses against renal cell carcinoma induced by dendritic cells(DCs)transfected with survivin gene mediated by recombinant adenovirus.Methods:The DCs derived from human peripheral blood were infected with recombined adenovirus vector carrying the survivin gene.The expression of survivin protein in the infected DCs was examined by Western blotting assay;the surface expression of CD83,MHCⅡ,CD80 and CD86 by flow cytometry(FCM),Interleukin-12(IL-12)in the supernatants of DCs and IFN-? released by the cytotoxic T lymphocytes(CTLs)by ELISA,the ability of DCs in proliferating allo-lymphocytes by mixed lymphocyte reaction(MLR),and specific killing activity of CTLs by MTT assay.Results:The DCs presented mature DCs phenotype after transfection with Ad-svv.The expression of survivin protein in transfected DCs was confirmed by Western blotting analysis.The IL-12 level in the supernatant of DCs transfected with Ad-svv was significantly higher than that transfected with empty vector(Ad-CMV,P

Objective To investigate the relationship between expressions of estrogen receptor (ER), progesterone receptor(PR) and human epidermal growth factor receptor 2 (Her-2) in 311 cases of breast cancer tissue and their clinical feature. Methods The expressions of ER, PR and Her-2 were detected by immunohistochemistry in 311 cases of breast cancer tissue proved pathologically. Results The positive rate of ER, PR and Her-2 were 59.49 %, 62.70 % and 27.97 % respectively in breast cancer tissues. Compared with non-invasive breast cancer, the expressions of ER and PR significant decreased in invasive breast cancer (P<0.05). The expression of ER decreased to follow the elevation of TNM status of breast cancer (P<0.05). Compared with patients who had not metastasis in axiUary lymph node, the expressions of ER significantly decreased and the expressions of Her-2 significantly increased in patients who had metastasis in axillary lymph node (P<0.05). Conclusion These findings indicate that ER, PR and Her-2 are intimate correlation with clinical feature and maybe participate in biological behaviour regulation of breast cancer. The routine detecting of ER, PR and Her-2 may provide the evidence for breast cancer treatment.

Objective To investigate the effect of 4-phenylbutyric acid(4-PBA)on the renal pathogenesis of rats with streptozotocin-induced diabetes and its mechanism. Methods Fifty-four male SD rats were randomly divided into three groups:normal control group(NC group,n=18),diabetic nephropathy group(DN group,n=18),diabetic nephropathy plus 4-PBA treatment group(4-PBA group,n=18).At the end of 4,8 and 12 weeks,index of kidney weight/body weight ratio(KI)were measured and calculated.Serum creatinine (Scr),blood urea nitrogen(BUN),urinary MDA levels,urinary SOD activity,and 24 hour urinary protein excretion ram(UAER)were detected by HITACHI automatically.Morphology of kidney wag examined by special staining of periodic acid-schitt (PAS).The p47phox and nitrotyrosine (NT) expression in kidney were determined by real-time fluorescence PCR and Western blotting. Results Compared with the NC group, the DN group rats showed a significant increase of KI(P＜0.05), UAER(mg/24 h) (4.92±0.70 vs 0.26±0.07, 5.29±0.83 vs 0.28±0.08, 5.54±0.81 vs 0.29±0.04,respectively, P＜0.05]for indicated time, mesangial cells proliferation and mesangial matrix expansion at 12 week. However,4-PBA treatment could significantly inhibit the increase of KI (P＜0.05), decrease UAER (mg/24 h) (3.71±0.37, 3.47±0.36, 3.28±0.40, respectively, P＜0.05]for indicated time, and prevent the glomeruler pathological alteration induced by diabetes. Moreover, the mRNA expression of p47phox in the kidney of DN group was 154.72%, 148.60% and 91.95% more than that of NC group (all P＜0.05) for indicated time. The protein expression of p47phox was 118.00%, 140.10% and 177.82% more than that of NC group (all P＜0.05), and the protein expression of NT was 45.29%,59.13% and 89.28% more than that of NC group (all P＜0.05). In addition, urinary MDA levels in DN group were 2.05-, 2.26- and 2.43- folds of NC group, and urinary SOD activities were decreased by 64.78%, 71.29% and 79.32% of NC group. Compared with the DN group, the mRNA and protein expression of p47phox, and protein expression of NT in 4-PBA group were decreased markedly (all P＜0.05) at the end of 8 and 12 weeks. The urinary MDA level was decreased, and the urinary SOD activity was increased significantly in rats with diabetes after 4-PBA treatment for indicated time (all P＜0.05). Conclusion 4-PBA treatment can significantly inhibit the renal pathogenesis of rats with diabetes through inhibition of oxidative stress.

Objective To assess the value of preoperative MRI in predicting the incidence of cement leakage into adjacent discs during percutaneous vertebral augmentation (PVA) for osteoporotic vertebral compression fracture (OVCF).Methods Clinical and radiological characteristics of 127 patients who were treated with PVA for OVCF were analyzed retrospec tively.The following clinical data of these patients were analyzed,including gender,age,location of treated vertebral body and surgical approach.The image features of endplate injury,fracture line extended to the endplate,adjacent intervertebral dick injury and intravertebral cleft were evaluated on the preoperative MRI.The incidence of cement leakage into the adjacent disc were compared for the above factors with statistical methods.Results Totally 127 patients were enrolled in our study,including 179 treated vertebral bodies,358 endplates and 341 adjacent intervertebral discs.The incidence of intradiscal cement leakage was 57.73％ (56/97) in endplate injury sign,60.98％ (25/41) in fracture line extended to endplate sign,35.91％(51/142) in adjacent discs injury sign and 55.56％(20/36) inintravertebral cleft sign.The differences were statistically significant on preoperative MRI in patients with the above signs compared to those who had not (P＜0.05).The incidence of intradiscal cement leakage in percutaneous kyphoplasty (PKP) and percutaneous vertebroplasty (PVP) were 26.67％(16/60) and 42.86％(51/119),respectively,which was significant different (P=0.035).For bone cement volume ≤ 5 ml vertebral bodies,the incidence of intradiscal cement leakage was 31.19 ％ (34/109),lower than bone cement volume ＞ 5 ml vertebral bodies (47.14％ [33/70],P=0.031).There was no statistically significant association between intradiscal cement leakage and age,gender and location of treated vertebral body (P＞0.05).Conclusion Preoperative MRI can predict the leakage of bone cement into adjacent discs effectively during PVA.The PKP and the lower volume of bone cement injection can reduce the risk of intradiscal cement leakage.

Objective To understand the changes of cardiac systolic and diastolic function in human immunodeficiency virus (HIV)-infected patients without evidence of cardiac disease in China.Methods Forty-two HIV-infected patients who were followed up in the Department of Infectious Diseases at Peking Union Medical College Hospital without cardiac involvement were recruited.All the HIV-infected patients had received highly active antiroviral therapy (HAART) for more than 12 months with viral suppression.And 30 age and sex matched healthy subjects without cardiac disease manifestations were enrolled as controls.Every group members underwent transthoracic echocardiography evaluation.The indexes of cardiac systolic and diastolic function between HIV-infected patients and healthy controls were compared.Results Diastolic abnormality occurred in 20 cases in HIV-infected group and 6 cases in control group, with statistically significant difference (χ2=5.79, P=0.007).The E wave deceleration time (EDT) in HIV-infected patients were significantly decreased than healthy controls ([161.87±21.64] ms vs.[190.34±37.22], t=-3.20, P=0.002).There were no significant differences of E/A ratio ([1.16±0.35] vs.[1.19±0.26]), E/Ea ratio ([5.43±1.99] vs.[5.78±0.91]), isovolumic relaxation time (IVRT), ([93.18±20.34] ms vs.[93.57±18.55]ms), Ea ([10.18±2.80] cm/s vs.[11.45±2.75] cm/s) between HIV-infected patients and controls (t=1.13,1.53,0.67 and 0.29, respectively, all P>0.05).Among cardiac systolic function markers, left ventricular ejection fractions in HIV-infected patients and control group were (66.7±6.4)% and (68.7±4.2)%, respectively.And left ventricular shortening rates were (37.08±4.79)% and (38.17±3.96)%, respectively.Both showed no significant difference between the two groups (t=-1.51 and-1.00, respectively, both P>0.05).Conclusions Compared with control group, subclinical cardiac diastolic dysfunction is more frequently observed in HIV-infected patients.However, there are no significant differences of cardiac systolic function markers between HIV-infected patients and controls.