Objective To investigate the susceptibility and resistance profile of clinical isolates.Methods Clinical isolates were collected from Children's Hospital of Chongqing Medical University from January 1 to December 31,2015.Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems.Results were analyzed according to CLSI 2015 breakpoints.Results A total of 13 109 clinical isolates were collected from January to December 2015,of which gram negative organisms and gram positive cocci accounted for 65.3 ％ (8 560/13 109) and 34.7 ％ (4 549/13 109),respectively.Methicillin resistant strains in S.aureus (MRSA) and coagulase negative Staphylococcus (MRCNS) accounted for 29.6 ％ and 67.1％,respectively.Most (93.1％) MRSA strains were still susceptible to trimethoprim-sulfamethoxazole,while 80.2 ％ of MRCNS strains were susceptible to rifampin.No staphylococcal strains were found resistant to vancomycin,teicoplanin or linezolid.The resistance rates of E.faecalis strains to most antibiotics tested (except tetracycline) were much lower than those of E.faecium.Some strains of both species were resistant to vancomycin.No E.faecalis or E.faecium strains were found resistant to vancomycin.The prevalence of ESBLs-producing strains was 55.7 ％ in E.coli and 43.5 ％ in Klebsiella (K.pneumoniae and K.oxytoca) and 11.6 ％ in Proteus mirabilis isolates.ESBLs-producing Enterobacteriaceae strains were more resistant than non-ESBLs-producing strains in terms of antibiotic resistance rates.Enterobacteriaceae strains were still highly susceptible to carbapenems.Overall,less than 16.0 ％ of these strains were resistant to carbapenems.About 10.5 ％ and 9.4 ％ of the A.baumannii strains were resistant to imipenem and meropenem,respectively.Compared to the data of year 2014,the prevalence of extensively-drug resistant P.aeruginosa and K.pneumoniae strains increased.Conclusions The antibiotic resistance of clinical bacterial isolates is growing.The emerging and increasing prevalence of multi-drug or pan-drug resistant strains poses a serious threat to clinical practice and implies the importance of strengthening infection control.

Lymph node metastasis represents a common way of distant spread of gynecologic malignancies and an independent risk factor of poor prognosis of patients. The pelvic and paraaortic lymphadenectomy is a critical part of the surgical treatment of gynecologic cancer, which potentially improves the survival outcomes of patients through clarifying the node status to guide the subsequent management and/or removal of positive nodes to reduce the tumor burden. However, when we make a decision about lymphadenectomy, we should balance the related survival benefits and morbidities impacting the long-term quality of life. It is noteworthy that the principles of lymph node management are varied between different types and different stages of tumors characterized with different clinical features. Moreover, the sentinel lymph node biopsy, which has been emerging as a promising alternative to traditional systematic lymph node dissection, provides new options while bringing new issues. Here, based on the latest progress in relevant fields, we attempt to figure out the distinct features and unanswered questions in the management of lymph nodes of patients with cervical cancer, endometrial cancer, and ovarian cancer, which may trigger meaningful thoughts regarding related clinical decision.

Objective To observe the influence of electroacupuncure(EA) at different therapeutic time windows on the effects of inosine on neuronal apoptosis and expression of heat-shock-proteins-70 (HSP70)after focal cerebral ischemic reperfusion injury (CIRI) in rats.Methods The model was established by ligation of the artery for 2 hour.EA was delivered to “baihui” and “dazhui” through acupuncture needles 0.5 hr,2 hr,6 hr and 12 hr respectively following MCAO.The expression level of HSP70 and the number of apoptotic cells were examined by immunohistochemical technique and TUNEL,comparing the average optical density of HSP70 and the number of apoptotic positive cells of cortex penumbra and hippocampus CA1 area in rat brain.Results Compared with the model group,the average optical density of HSP70 in every EA group was increased in apoptotic positive cells of cortex penumbra and hippocampus CA1 area 0.5 h (89.98± 6.55),(128.73 ± 8.03),2 h (90.96±6.38),(132.25±8.78),6 h (93.71±6.12),(132.58±7.04),12 (96.19±7.30),(133.57±6.19)and the number of apoptotic positive cells of cortex penumbra in every EA group was decreased 0.5 h (1.80±0.84),2 h (3.40± 1.14),6 h (5.00± 1.00),12 h (5.00±2.45).The number of apoptotic cells of hippocampus CA1 area was decreased just in the EA group of 0.5 h (1.60± 1.89).Conclusion EA could increase the expression level of HSP70 and at the same time decrease the number of apoptotic cells,EA plays an important part in protecting the neuronal cells of brain after focal cerebral ischemic reperfusion injury.The acupuncture treatment should be taken as far as early.

?AlM: To evaluate the expressions and significances of endoplasmic reticulum stress related protein ( BlP ) , hypoxia-inducible factor-1α ( HlF-1α) and vascular endothelial growth factor ( VEGF) in the retina of diabetic rats.
?METHODS:Seventy-two male Sprague-Dawley ( SD) rats were chosen and divided randomly into 6 groups:normal control 2mo (C2m, n = 12), diabetes mellitus 2mo (D2m, n=12), normal control 4mo (C4m, n=12), diabetes mellitus 4mo (D4m, n = 12), normal control 6mo (C6m, n=12) and diabetes mellitus 6mo (D6m, n=12 ) . The diabetes mellitus mouse were induced by intraperitoneal injection of 0. 1mol/L streptozotocin (STZ, 65mg/kg). The expression of BlP, HlF-1α and VEGF in the retina were detected by enzyme- linked immuno sorbent assay. The location of BlP, HlF-1α and VEGF in epiretinal membranes were investigated by immunohistochemistry staining.
?RESULTS: BlP were significantly increase than control groups in all DM groups with the course of diabetes ( P<0. 01). HlF-1α were detected higher than control groups in all DM groups (P< 0. 05), but there was no statistical significance among treatment groups. VEGF in D4m and D6m groups were higher than control groups (P<0. 05), and there was statistical significance between D4m and D6m groups. BlP can be detected in control groups a little, mainly in the inner limiting membrane and ganglion cell layers. HlF - 1α cannot be detected in control groups, meanwhile it can be detected in all layers in DM. VEGF can be detected in control groups a little, it mainly be detected in inner nuclear layer, outer nuclear layer, around retinal vessel and ganglion cell layers in DM groups.
?CONCLUSlON:The expressions of BlP, HlF-1α and VEGF increase in the retina of diabetic rats than control groups with progressive of diabetes mellitus, both endoplasmic reticulum stress and HlF-1α signal path play important role in the progress of diabetic retinopathy.

Objective:To explore the influence of radiofrequency ablation (RFA)on P-wave dispersion (difference between maximum and minimum P-wave interval)in patients with paroxysmal atrial fibrillation (PAF).Methods:A total of 95 PAF patients underwent circumferential pulmonary vein isolation.The preoperative and postoperative 12-lead ECG were recorded for 24h,maximum P-wave interval (Pmax)and minimum P-wave interval (Pmin)were measured,and P-wave dispersion was calculated.Since three months after operation,patients received outpatient follow up and dynamic ECG every month for six months.The operation was judged for successful or not according to symptoms of atrial fibrillation and dynamic ECG results,and patients were divided into success group (n=70)and recurrence group (n=25).Results:Compared with before operation,there was significant reduction in P-wave dis-persion [(48.84±4.08)ms vs.(42.22±4.02)ms,P <0.01]in all PAF patients after RFA.Compared with be-fore operation,there was significant reduction in P-wave dispersion [(47.63±3.58)ms vs.(40.67±4.82)ms,P<0.01]in success group;and reduction in P-wave dispersion [(49.51±1.64)ms vs.(48.26±3.48)ms]in recur-rence group,but no significant difference (P =0.346).After circumferential pulmonary vein isolation,P-wave dis-persion in success group was significantly lower than that of recurrence group (P <0.01).Conclusion:Circumferen-tial pulmonary vein ablation can improve P-wave dispersion in patients with atrial fibrillation,and it's more signifi-cant for success group.P-wave dispersion can predict the recurrence of atrial fibrillation after circumferential pulmo-nary vein ablation.

Acute kidney injury (AKI) is caused by a variety of causes resulting in rapid decline in renal function and manifestingclinical syndrome, whether mild or severe kidney damage it caused, the permanent loss of renal function will exist; the mortality of patients with septic AKI is as high as over 70%. Renal replacement therapy (RRT) can significantly improve the clinical prognosis of patients with AKI and reduce its mortality. However, the selections of RRT treatment mode, dose and timing of start or stop exist a lot of controversies. In this report, as using RRT to treat critically ill patients with AKI is still a hot topic in academic research, the related literatures of RRT guidelines, score evaluation, renal function indexes and biological marker aspects were reviewed and summarized.

Adenocarcinoma ; pathology ; surgery ; Adult ; Blood Loss, Surgical ; Carcinoma, Squamous Cell ; pathology ; surgery ; Female ; Humans ; Hysterectomy ; adverse effects ; methods ; Middle Aged ; Neoplasm Staging ; Uterine Cervical Neoplasms ; pathology ; surgery

National Natural Science Foundation of China (NSFC) is an important part of national system for innovation, which provides financial assistance mainly for the basic and applied researches of natural sciences, especially for the researchers who work in the learning institutions and the agencies of scientific research with advanced facilities. This paper summarized the applications and approved projects on traditional Chinese medicine in NFSC in 2005. We initially analyzed the growth, quality, characteristics, tendency and problems of these items.

Objective To evaluate the relation of appearance of contrast-enhanced ultrasonography (CEUS) to Ki 67 and C-erbB-2 in breast invasive ductal carcinoma and ductal carcinoma in situ.Methods The appearance of CEUS in 29 patients with breast invasive ductal carcinoma and 12 patients with ductal carcinoma in situ,which was diagnosed by surgery or biopsy,was analysed retrospectively.The Ki-67 and CerbB-2 were measured by immunohistochemical test.The relation of the above two factors to appearance of contrast ultrasonography was analysed.Results The positive rate of Ki-67 was 68.97％ (20/29) in patients with breast invasive ductal carcinoma and 16.67％ (2/12) in patients with ductal carcinoma in situ.The positive rate of C-erbB-2 was 48.2％ (14/29) in patients with breast invasive ductal carcinoma and 42.6％ (5/12) in patients with ductal carcinoma in situ.The masses had a common appearance of high enhance in patients with breast invasive ductal carcinoma and ductal carcinoma in situ,which was not correlated to C-erbB-2.The Ki-67 was significantly higher in patients with ductal carcinoma in situ than that in patients with breast invasive ductal carcinoma,the appearance of CEUS was correlated to Ki 67.Conclusions The features of micro-vessels by CEUS were correlated to Ki-67 in patients with breast invasive ductal carcinoma and ductal carcinoma in situ.

Objective To explore the clinical characteristics,diagnosis and treatment of pancreatic reginal(portal) hypertension(PSPH).Methods The clinical data of 11 cases of PSPH were analysed and(summarized).Results All of the patients in this group underwent surgical operation.Postoperative(complications) occurred in 4 patients,all of whom recovered with conservative treatment.There was no(operative) mortality.Seven cases were followed up after operation;one patient died from cancer of the pancreas three years after operation;in other six cases,no massive digestive tract re-bleeding occurred,and symptoms of hypersplenism disappeared completely.Conclusions PSPH is a special type of portal hypertension,surgical treatment can get excellent results.