Objective To analyze the pattern of antibiotic resistance in 1 073 strains of Pseudomonas aeruginosa in People's Hospital of Xinjiang Autonomous Region during 2003-2007. Methods Automated microbe analyzer (VITEK32) was used to analyze antibiotic susceptibility by means of GNS drug sensitivity card and Kirty-Bauer method. Results In recent five years, 1 073 strains of P. aeruginosa were isolated from respiratory specimens, most of which were from ICU, respiratory ICU and surgery ICU (57.8%). Among the 16 antibiotics tested, these strains showed the lowest resistance (17.0%) to cefoperazone-sulbactam, followed by meropenem (18.5%), amikacin (19.6%), imipenem (24.2%), cefepime (25.7%), piperacillin-tazobactam (35.7%) and ceftazidime (36.7%). Although the resistance to cefoperazone-sulbactam and ceftazidime was relatively lower, the prevalence of intermediate strains was relatively higher, 15.2% and 12.5% respectively. Conclusions The antibiotic resistance surveillance Results of five consecutive years indicate that P. aeruginosa was one of the most common pathogens in this hospital associated with serious issue of antibiotic resistance.

Objective To study the impact of obesity on the perioperative outcomes of hand-assisted laparoscopic splenectomy combined with esophagogastric devascularization (LSED).Methods The clinical data of patients who underwent hand-assisted laparoscopic splenectomy combined with esophagogastric devascularization between Jan.2013 and Nov.2015 were retrospectively analyzed.The patients were classified as obese group A (BMI≥28 kg/m2) or non-obese group B (BMI ＜ 28 kg/m2).Group A was further divided into two subgroups:group A1 massive splenomegaly (diameter ＞ 20 cm) and A2 splenomegaly (diameter ≤20 cm).The conversion rates,operative complications,mortality,length of stay,operative time,and blood loss were analyzed and compared.Results One hundred and sixty patients who underwent hand-assisted LSED were included into this study.54 patients were in group A and 106 in group B.A significantly longer operative time was found in group A (291 min vs.261 min,P ＜ 0.05).The conversion rates,blood loss,length of hospital stay,overall morbidity rates,and mortality rates were similar in the two groups (P ＞0.05).The mean operative time was significantly longer in group A1 (336 min vs.270 min;P ＜0.01)although blood loss,conversion rates,and overall morbidity rates were higher in group A1.However,there were no significant differences (P ＞ 0.05).Conclusions Hand-assisted laparoscopic splenectomy combined with esophagogastric devascularization for obese patients was safe and feasible.However,for patients with massive splenomegaly,LSED should be performed with caution.

Acute hepatitis C is an acute infectious disease caused by hepatitis C virus.Accurate diagnosis and proper treatment are very im-portant for preventing the progression of this disease.Recent research advances in acute hepatitis C,including the epidemiological and clini-cal features,diagnosis,and treatment of acute hepatitis C,are reviewed,in order to provide a basis for better understanding of acute hepati-tis C and proper diagnosis and treatment of this disease among clinicians.

Enhanced recovery after surgery (ERAS) has developed continuously in China for 10 years,including optimizing step by step the perioperative analgesia regimens and goal-oriented fluid therapy.The ERAS principle has been accepted and expanded extensively in the surgery field,meanwhile,ERAS for perioperative care have been proved valueble in shortening hospital stay,reducing complications,improving organ function,reducing surgical stress reaction,accelerating recovery and increasing survival rate.ERAS is in the ascendant,and promotes development of multidisciplinary training and education program,supples of high-quality research evidences and translational clinical applications seem to be the direction of ERAS.And therefore,the content that this paper talks about is of great significance to deepen the research and understanding of ERAS.

The essay discussed on how traditional Chinese medicine (TCM) recognizes the mechanism of fatigue stage from three organs of liver, spleen and heart. TCM believes the mechanism of fatigue in sub-health lies in stagnation of liver Qi due to emotional disorder and deficiency both Qi and blood due to overexertion hurting heart and spleen. Stagnation of liver Qi plays an leading role in the occurrence and development of fatigue state, while the strain of heart and spleen is the important manifestation of this state.

Iron is an essential nutrient that not only participates in cell oxidative phosphorylation, DNA synthesis and replication, but also regulates cancer associated genes through hypoxia-inducible factor (HIF).In the process of cancerization, cells change the way of iron metabolism resulting in a high consumption of iron.In this case, pathways of iron acquisition, efflux, storage and regulation are perturbed.Therefore, iron can significantly contribute to tumor growth, cell survival and metastasis.In this paper, we summarize the iron changes in cancer cells and the relationship between the changes and tumorigenesis.We also briefly state the potential problems of current clinical using iron chelating agents in oncotherapy.Targeting iron metabolic pathways may provide new tools for cancer prognosis and therapy.

Hepatitis C virus (HCV) infection is an important public health issue around the world.Direct-acting antiviral agents (DAAs) have become an important method to reduce HCV infection.DAAs can improve the clinical outcome of antiviral therapy,shorten the course of treatment,and reduce complications and have a wide range of application;therefore,they have great advantages over conventional therapies.Accurate clinical diagnosis has increasing importance in the era of DAAs and guarantees the whole management process of chronic hepatitis C patients from the aspects of disease diagnosis,therapeutic regimens,outcome evaluation,and long-term prognosis monitoring.

BACKGROUND:Intracranial aneurysms have a high mortality, and finite element analysis to predict fracture risk has become a hot topic at present. Finite element analysis requires reliable fluid-structure interaction model, blood model of aneurysm is very easy to obtain, but the vascular wal model can not be obtained directly, only by artificial settings, which may have an impact on calculation results.
OBJECTIVE:To investigate the effects of vascular wal thickness on fluid-structure interaction analysis in finite element modeling of complex intracranial aneurysms, and provide a more reliable method of finite element modeling for the numerical simulation study of intracranial aneurysms.
METHODS:A three-dimensional numerical model of tandem left intracranial internal carotid artery aneurysms of a 67-year-old man was obtained by three-dimensional angiography. Four fluid-structure models were got postoperatively by thickening vascular wal , which were artificial y set for 0.3 mm, 0.4 mm, 0.5 mm, 0.6 mm. According to intraoperative measured data, dynamic characteristics of fluid-structure interaction of tandem internal carotid artery aneurysms were simulated by the finite element method, comparing four models to calculate the difference between the results.
RESULTS AND CONCLUSION:Among the four models, there were no difference in blood flow chart, blood pressure drop chart and wal shear stress chart (P>0.05). The deformation of the vascular wal was the most obvious in C 2 segment of the internal carotid artery, and the thicker vessel wal was accompanied by the more apparent deformation (P<0.01). Von Mises stress in the vessel wal of the four models reached a local maximum in the I and J points, the thinner vessel wal was accompanied by the larger local maximum (P<0.01). The settings of vascular wel may affect the fluid-structure interaction analysis of complex intracranial aneurysms and appropriate thickness settings wil obtain accurate calculation.

Background Study confirmed that the active microglia may injure retinal ganglion cells (RGCs) in retinal ischemia reperfusion injury (IRI), and increased cx3cr1 expression is an important factor in microglial activation,and thus blocking the expression of cx3cr1 can inhibit microglial activation, which may be useful in neuronal protection.Objective This study was to analyze the protective effects of cx3cr1 antibody on retinal neuron in rat eyes with IRI.Methods Ninety SD rats were divided into 4 groups according to random number table.IRI models were established by perfusing normal saline solution into the anterior chamber.The cx3cr1 antibody of 1 μl (0.2 μg/μl) was intravitreally injected in the right eyes in the normal rats or model rats as the only cx3cr1 antibody injected group and the model cx3cr1 antibody injected group,respectively,and no any drug was injected in the rats of the normal control group and model control group.Retinal sections were prepared 48 hours after modeling, and apoptosis of retinal neutron was observed under the transmission electron microscope;the morphology of retinas was exmined and the number of survival RGCs was calculated by histopathologic method.The expression of CD68 in activated retinal microglial cells was detected by immunochemistry, and the relative expression levels of cx3cr1 mRNA,tumor necrosis factor-α (TNF-ct) mRNA and interleukin-1 β (IL-1 β) mRNA in the retinas were assayed by real time quantitative PCR.Results The cell nucleus of RGCs showed the round and ellipse in shape and there were abundant organelles in the cells.The mophology of photoreceptors was normal with abundant mitochondrions.Irregular cell shape, disrupture of outer segment membranous disc, proliferative microglial cells in RGC layer were seen in the model group.However,these findings were mild in the model cx3crl antibody group.The mean number of survival RGCs was (38.100 ± 3.929), (37.200 ± 5.266), (26.700 ± 2.584) and (31.700 ± 2.946)/field in the normal control group,only cx3cr1 antibody injected group, model control group and model cx3cr1 antibody injected group,showing significant differences between the model group and the normal control group, only cx3cr1 antibody injected group or model cx3cr1 antibody injected group (t =7.492,6.125,-4.607, all at P＜0.01).The expression levels (absorbance) of CD68 in rat retinas were significantly higher in the model group than those in the normal control group, only cx3cr1 antibody injected group and model cx3cr1 antibody injected group (t =-3.397 ,P =0.008;t =-6.207 ,P =0.000;t =3.494, P =0.007).The relative expression levels of cx3cr1 mRNA, TNF-α mRNA and IL-1 β mRNA in rat retinas were raised in the model group compared with the only cx3er1 antibody injected group and model cx3cr1 antibody injected group (all at P＜0.01).No significant differences were observed in these indicators between the normal control group and the only cx3crl antibody injected group (all at P＜0.05).Conclusions Intravitreal injection of cx3cr1 antibody to neutralize cx3cr1 levels in retinas can effectively inhibit the activation of retinal microglia,decrease the release of inflammatory factors, reduce the apoptosis of RGCs and thereby protect the retinal neutrons against IRI in SD rats.Intravitreal injection of cx3cr1 is safe and feasible.

Objective To investigate the relationship between plasma pro-brain natriuretic peptide (N-pro-BNP) level and heart function, as its well as change before and after interventional therapy. Methods Fifty-eight children with left to right shunt congenital heart diseases were enrolled from July, 2004 to Jan, 2005. Clinical heart function were categorized and plasma N-pro-BNP concentration were detected. The ejection fraction (EF), fractional shortening (FS) and left ventricular and diastolic dimension (LVDd) were measured by two-dimensional echocardiography. The relationship between plasma pro-BNP concentration and the echo parameters, and its change before and after interventional therapy were analyzed. Results The plasma N-pro-BNP concentration, LVDd, EF and FS before and after intervention were 194.7?154.7 ng/L vs 561.0?594.2 ng/L (P