Objective ToanalyzethedistributionanddrugresistancesituationofKlebsiellapneumoniae(KPN)isolatedfromour hospital during 2014 .Methods The drug susceptibility test was carried out by the Siemens fully automatic bacterial identification /drug susceptibility test analyzer .The drug susceptibility test results were judged according to the (CLSI) M100‐S22 document (2012) .Results A total of 291 strains of KPN were detected from 8 486 submitted specimens ,in which 20 strains were multi‐drug resistant Klebsiella pneumoniae(MDR‐KPN)isolates were 213 strains ,48 strains were extended‐spectrum beta‐lactamases producing Klebsiella pneumoniae (ESBLs‐KPN) and 10 strains were carbapenem‐resistant Klebsiella pneumoniae(CR‐KPN) .The KPN detec‐tion rate had statistical difference among different specimens (P= 0 .000) .The constituent ratio of KPN isolation in the sputum specimen was highest(P=0 .000) .The KPN detection rate had statistical difference among different departments (P=0 .000) ,the constituent ratio of KPN isolation in the respiration department was highest (P=0 .000) .The resistance and sensitivity of KPN to different antibacterial drugs had statistical difference(P=0 .000) ,carbapenems had the lowest resistance rate .Conclusion KPN has relatively low resistance rate to commonly used antibacterial drugs ,its multi‐drug resistant strains are in the higher level ,which should arouse clinic and hospital infection management department must to pay attention to and adopt corresponding supervision measures .

Objective To understand the trend of occurrence,diagnosis,and prognosis of breast cancer in the cases treated in Peking Union Medical College Hospital(PUMCH) between 1975 and 2006.Methods A total of 1092 cases of breast cancer treated in the PUMCH from 1975 to 2006 were classified into six groups by time span and reviewed for a comparative study on the parameters of gender,age,menstruation status,tumor size,mumber of positive axillary nodes,pathologic stage,recurrence and metastasis and disease-free survival rate.Results The average age of breast cancer patient has risen from 50.90 to 53.92,while 40-49 year-old group was the largest age group of breast cancer patients,and the percentage of menopause female was the highest.Tumor size has gradually been smaller especially since 2000.The number of positive axillary nodes showed no significant change during the time periods.In all 6 groups,stage-II cases were more frequent,although the percentage of stage-0 and stage-I cases was on the rise,while the percentage of stage-III declined,and that of stage-IV remained stable.In all 6 groups,the 5-year and 10-year disease free survival rate had steadily increased.Conclusions The early diagnostic rate of breast cancer has been improving and subsequently the prognosis has improved as well.

OBJECTIVETo compare clinical effects between percutaneous compressing plating (PCCP) and proximal femoral nail antirotation (PFNA) for the treatment of patients with intertrochanteric fracture with risk external wall.

METHODSFrom September 2007 to June 2010, 43 patients with intertrochanteric fracture with risk external wall were treated by PCCP or PFNA according to different kinds of internal fixations. There were 22 cases in PCCP, including 9 males and 13 females with an average age of 68.4 (ranged, 60 to 86) years old, and 13 cases with type A2.2 and 9 cases with type A2.3; while 21 cases in PFNA, including 7 males and 14 females with an average age of 67.7 (ranged, 57 to 93) years old, and 10 cases with type A2.2 and 11 cases with type A2.3. Blood loss, operation time, hospital stay, fracture healing time, complications and Harris score after 1 years' following-up were observed and compared.

RESULTSAll patients were followed up for 12 to 22 (means 18.4) months, and all patients were obtained fracture healing, and recovered walking ability as before injury. There were no significant differences in blood loss, operation time, hospital stay, fracture healing time, complications and Harris score after 1 years' following-up (P>0.05). One case occurred displacement on the top of greater trochanter, and 1 case injuried weakness of hip abduction. One case occurred screw breakage in PCCP, while 1 case occurred hip joint pain in PFNA.

CONCLUSIONBoth of PCCP and PFNA in treating patients with intertrochanteric fracture with risk external wall can receive good clinical effects, while the effects and therapy strategy for displacement of bone on the top of lateral wall should further study.

Aged ; Aged, 80 and over ; Bone Nails ; Bone Plates ; Case-Control Studies ; Female ; Fracture Fixation, Intramedullary ; Fracture Healing ; Hip Fractures ; physiopathology ; surgery ; Humans ; Male ; Middle Aged

Objective To evaluate the effect of neurotrophin-3 (NT-3) on the expression of serine/threonine protein kinase (Akt) during ropivacaine-induced neurotoxicity to the spinal cord of rats.Methods Healthy adult male Sprague-Dawley rats,aged 1-2 months,weighing 280-320 g,were used in the study.A catheter was inserted at L5,6 interspace into the epidural space of rats.A total of 108 rats,in which intrathecal catheters were successfully implanted,were randomly divided into 3 groups (n =36each):control group (group C),1％ ropivacaine group (group R),and 1％ ropivacaine + NT-3 group (group NT).The equal volume of normal saline was given in group C,1％ ropivacaine 0.12 ml/kg was injected via the intrathecal catheter once every 1.5 h for 8 times in total in R and NT groups.In addition,NT-3 0.1 mg/kg was simultanenously injected via the intrathecal catheter in group NT.On days 1,3,5,7,14 and 28 after the end of administration (T1-6),6 rats were sacrificed in each group.Their lumbar enlargements were removed for determination of neuronal apoptosis (using TUNEL) and Akt expression (by immuno-histochemistry).The apoptotic rate was calculated.Results Compared with group C,the apoptotic rate was significantly increased at T1-4,and Akt expression was significantly up-regulated at T1-3 in group R,and the apoptotic rate were significantly increased,and Akt expression was significantly up-regulated at T1-3 in group NT (P＜0.05).Compared with group R,the apoptotic rate was significantly decreased at T3,4,and Akt expression was significantly down-regulated at T2.3 in group NT (P＜0.05).Conclusion The mechanism by which NT-3 reduces ropivacaine-induced neurotoxicity to the spinal cord may be related to down-regulation of the expression of Akt in rats.

Objective To investigate the clinical effect of the compound flaps of foot with joint transplantation bridging severed segmental damage type finger.Methods Eleven cases with segmental composite tissue damaged fingers,emergency free with plantar metatarsal or metatarsophalangeal,interphalangeal joint of the foot com posite tissue flap transplantation and bridging replanted finger form February,2006 to September,2011 were retrospective reviewed in our study.The therapeutic effect was evaluated according to the assessment standard of Chinese Medical Association of Hand Surgery.Results All patients were followed-up for 6 to 48 months.The composite flap and amputated fingers in the 11 cases were survived after surgery,with satisfactory appearance.Range of motion of interphalangeal joints from 40° to 90°,and metacarpophalangeal joints from 45° to 65°.There was no nonunion or refracture.Two-point discrimination of finger pulp was 5-8 mm.According to the Chinese Medical Society of Hand Surgery Trial upper part of the standard evaluation function assessment,the results were excellent in 3 cases,good in 6 cases,may in 2 case.Conclusion Compound flaps of foot with joint transplantation bridging severed segmental damage type finger could recover the appearance and functions of amputated fingers to satisfy the daily need of patients in a maximum degree.

Objective To investigate the effect of 12-lipoxygenase (12-LO) on the angiotensinⅡtype 1 receptor(ATlR) expression in mesangial cells (MC).Methods p38 MAPK activation and ECM protein expression were determined using AngⅡ-stimulated MC derived from normal and 12-LO knockout mice.AT1R expression was determined using 12-LO product 12(S)- HETE-stimulated MC,MC transfected with 12-LO gene and microdissected glomeruli derived from 12-LO knockout mice.RT-PCR and Western blot were used for evaluating mRNA and protein expression respectively.Results AngⅡstimulation increased p38 MAPK activation and ECM protein expression in normal MC,but not in MC derived from 12-LO knockout mice.Time-dependent and dose-dependent experiment showed that 12 (S)- HETE increased AT1R protein' expression in MC. Similarly,12 (S)-HETE increased AT1R mRNA expression in MC compared with control MC (P＜0.01). Furthermore,AT1R expression was lower in glomeruli derived from 12-LO knockout mice relative to genetic controls (P＜0.01) and MC stably overexpressing 12-LO had greater AT1R protein and mRNA expression relative to control MC (P＜0.01).Conclusion 12-LO activation can upregulate ATIR expression in MC.

Objective:To study the effect of insulin therapy on glucose concentration in saliva in patients with diabetes mellitus(DM), and to study the relationship between blood glucose level and salivary glucose level.Methods: Glucose concentration in blood and in unstimulated mixed saliva was measured with Beckman SYNCHRON CX7 system in 40 DM patients before and after insulin therapy.Results:The average value(mmol/L) of salivary glucose concentration before and after insulin therapy was 2.081?0.287 and 1.571? 0.193 respectively (P

Objective To investigate the imaging findings of the lacerating injury of the lung. Methods Ten patients of lung lacerating injury were examined by X-ray and CT within 1—5 h after injury. X-ray(2—5 times)and CT(3—5 times)examinations were repeated for 7 patients.Results The lung lacerating injury involved 10 sides and 14 lung lobes(21 lesions in total)in the 10 cases,among which 1 case involved the right upper lobe with 1 lesion,2 cases in the right lower lobe with 2 lesions,1 case in the right upper and lower lobes with 2 lesions for each lobe,3 cases in the left lower lobe with 9 lesions,and 3 cases in both the left upper and the lower lobes with 7 lesions.The X-ray findings were cavity-like shadows with smooth margin in 9 lesions(9/21),and patchy shadows of fogging margin in 12 lesions(12/21).The CT imaging findings included 6 pulmonary hematomas(6/21),and 15 cavitary lesions with air-fluid levels (15/21).In the 15 cavitary lesions,CT revealed 14 single cavities and 2 small cavities within a big cavity. On dynamic follow-up observation,the cavity was the biggest in 1—5 h after injury,but the hematoma was the biggest in 2—3 days after injury.Hematomas tended to absorb slower than the cavities.After 16— 32 days,all lesions revolved into small patchy or stripe-like shadows with slightly increased density. Conclusion Cavitary lesion with air-fluid level is the characteristic imaging finding of lung lacerating injury.CT surpasses X-ray plain film in revealing the details of lung lacerating injury.

Objective To investigate the causes of acute renal failure(ARF)after orthtopic liver transplantation(OLT)in patients of acute liver failure(ALF)and the effects of systemic therapy based on continuous renal replacement(CRRT).Methods Clinical data of 412 patients who underwent liver transplantations between January 2001 and June 2006 were analyzed retrospectively (all the cases were followed up to June 2007).According to UNOS grading scale,54 patients were of acute liver failure(UNOS 1 and 2A).Posttransplant ARF developing in 17 cases underwent a systemic therapy based on CRRT as well as anti-rejection,anti-infection and nutrition support.The perioperative courses,complications,causes of death and follow up results were analyzed.Results There were no severe complications during CRRT.Perioperative mortality was 5.4%and 58.8%in patients without ARF and those with ARF respectively.the rate of complications was 35.1%vs 100%.1 year survival rate Was 89.2% vs 41.2%.3 year survival rate was 81.1% vs 41.2%.Condusions The effect of surgery mainly depends on the function of liver and other vital organs.The ALF recipients suffered from a high perioperative mortality,especially those with posttransplant ARL.The systemic therapy based on CRRT benefits patients with postoperative ARF.

OBJECTIVETo study the origin pre-treating and processing integration techniques of Paeonia Radix Alba.

METHODDifferent processing integration techniques were adopted and compared with traditional processing techniques to determine drying rate, aqueous extracts and peoniflori content.

RESULTHalf-dry slices baked at 100 degrees C for 20 min and steamed at 100 degrees C for 10 min had the highest peoniflori contents. Half-dry slices baked at 100 degrees C for 20 min had the highest content of aqueous extracts. Products processed with conventional method and sulfur-fumigation had the lowest content of aqueous extracts.

CONCLUSIONThe origin processing integration techniques of Paeonia Radix Alba lose less active ingredients than conventional processing methods.

China ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Paeonia ; chemistry ; Technology, Pharmaceutical ; methods