Abstract:Objective:To study the expression of hypoxia-inducible factor 1(HIF-1) and vascular endothelial growth factor(VEGF) in myocardium and liver after myocardial ischemia reperfusion injury. Methods:Adult male SD rats were subjected to 30 min myocardial ischemia by ligation of the left anterior descending coronary artery and 6 h (I30minR6h) or 24h (I30minR24h) reperfusion. The protein expression of HIF-1α,HIF-1β and VEGF in myocardium and liver were examined by Western blot,and the mRNA levels of HIF-1α and VEGF were determined by real-time PCR. Results:Compared with sham group,both protein and mRNA levels of HIF-1α and VEGF were increased in the ischemic region of myocardium in I30minR6h,but unaffected in I30minR24h. The level of HIF-1β was not different in myocardium among the three groups. But compared with sham group,there were no differences of the protein expression of HIF-1α,HIF-1β or VEGF in liver after myocardial I30minR6h or I30minR24h. Conclusion:The expression of HIF-1α and VEGF in myocardium were affected in myocardial ischemia reperfusion injury whereas not changed in liver. The affection was associated with the time of reperfusion.

Abstract:Objective: To study the relationship between human herpesvirus(HHV)-6 infection and glioma. Methods:HHV-6, human cytomegalovirus(HCMV) and HHV-7 DNA in glioma samples(n = 40) and control samples(n = 13) were detected by nested PCR. The expression of HHV-6, HCMV and HHV-7 was detected by immunohistochemistry(IHC). Results:HHV-6 DNA was positive in 17/40(42.5%) of glioma samples and 1/13(7.7%) of normal brain samples(P = 0.020), while the positive rates of HCMV and HHV-7 DNA were 20.0% and 5.0% in glioma,respectively. HCMV and HHV-7 DNA hadn’t been found in normal brain samples(P = 0.087 and 0.566 respectively). HHV-6 late antigen p41 was expressed in 11/40(27.5%) of tumors and 0 of the controls(P = 0.030), while HHV-6 early antigen gp116/64/54 was expressed in 13/40(32.5%) of tumors and 0 of the controls(P = 0.014). HCMV pp65 antigen was expressed in 5/40(12.5%) of glioma samples and 0/13 of the normal brain controls(P = 0.229). HHV-7 pp85 antigen hadn’t been found in tumors and normal brain samples. Conclusion:Based on the results of nested PCR and immunohistochemistry,significant difference of HHV-6 infection between glioma and normal brain tissue was confirmed. HHV-6 infection may play a role on the pathagenesis and progression of glioma.

Abstract:Objective:To explore the pathological characteristics of aneurysms of membranous septum (AMS) associated with perimembranous ventricular septal defect by analyzing cell proliferation and survival. Methods:The structure of AMS was analyzed by HE staining. Immunohistochemical staining of Ki67 and phosphorylated Akt (pAkt) was performed to identify cell proliferation and survival in AMS. Results:HE staining showed that the number of cells in false AMS was more than that in true AMS,but the extracellular matrices of false AMS were less compact than those of true AMS. Much more Ki67 positive cells in false AMS suggested a more powerful proliferation than true AMS. pAkt staining was only found in endothelial and subendothelial cells in false AMS. Conclusion:False AMS demonstrates stronger ability of cellular proliferation and survival indicating it’s an active tissue.

Abstract:Objective:To investigate the expression of Notch1,Jagged1 and NF-κB in gastric carcinoma and their correlation with clinicopathological features and Helicobacter pylori(Hp) infection. Methods:The expression of Notch1,Jagged1 and NF-κB was detected by tissue microarray and immunohistochemistry in 60 cases of gastric carcinoma,60 cases of adjacent gastric carcinoma and 20 cases of normal gastric mucosa tissues and Hp infection was tested by Warthin-Starry silver stain. Results:The positive rates of Notch1 and Jagged1 in gastric carcinoma tissue(40.0%,70.0%) were lower than those in adjacent gastric carcinoma tissue (81.7%,96.7%) and normal gastric tissue(85.0%,100.0%),the differences were significantly(P < 0.05). The positive rate of NF-κB in gastric cancer tissue(66.7%) was higher than those in adjacent gastric carcinoma tissue(36.7%) and normal gastric tissue(0.0%),the differences were significantly(P < 0.05). The infection rates of Hp in gastric carcinoma,adjacent gastric carcinoma and normal gastric mucosa tissues were 76.7%,93.3% and 10.0%,respectively,there were significant differences among them(P < 0.05). The expression of Notch1,Jagged1 and Hp infection were not correlated with the clinicopathological features,while the expression of NF-κB was significantly correlated with tumor differentiation status and TNM stage(P < 0.005). The expression of Notch1 was positively correlated with Jagged1(r = 0.460,P < 0.05) and negatively correlated with NF-κB(r = -0.361,P < 0.05). No correlation was shown between Hp infection and expression of Notch1,Jagged1 or NF-κB in gastric carcinoma tissues(r = -0.032,r = 0.155,r = 0.028,P > 0.05). Conclusion:The expression of Notch1,Jagged1 and NF-κB in gastric carcinoma is abnormal but not associated with Hp infection. The low expression of Notch1 and Jagged1 may induce the high expression of NF-κB,which result in the occurrence of gastric carcinoma.

Abstract:Objective:To investigate the expression of MRP1/CD9 as well as their correlations with the metastasis of colorectal carcinoma. Methods:Tissue microarray and immunohistochemistry were used to detect the expression of MRP1/CD9 in 244 cases of colorectal carcinoma. Results:The positive rate of MRP1/CD9 expression was 77.9% in colorectal carcinoma. The expression of MRP1/CD9 had no relationship with the patients’ sex,age,and the depth of infiltration,but it had relationships with the differentiated degree,Dukes stages,and lymphnode metastasis. The expression of MRP1/CD9 was higher in colorectal carcinomas with moderate or high differention than that in the ones with poor differention. The expression of MRP1/CD9 was higher in colorectal carcinomas with Dukes A+B stages than that in the ones with Dukes C+D stages. The expression of MRP1/CD9 was higher in colorectal carcinomas without lymphnode metastasis than that in the ones with lymphnode metastasis. Above all had the significant meaning(P < 0.05). Forward stepwise binary logistic regression reveals:differentiation,which went into the equation first,is the significant factor of MRP1/CD9 expression. The expression of MRP1/CD9 was negatively related to Dukes stages in monofactoral analysis,but disappearing in multifactoral analysis. Conclusion:The loss expression of MRP1/CD9 are closed correlated with the metastasis of colorectal carcinoma,and this marker has hopes to become a new target to evaluate the tumor prognosis.

Abstract:Objective:To investigate the prevalence of the postmenopausal women with osteoporosis in Suzhou urban area and evaluate the relationship between MTHFR gene (677C>T and 1298A>C) polymorphisms and the susceptibility to osteoporosis in postmenopausal Suzhou women. Methods:A population-based case-control study was conducted,including 261 postmenopausal women aged from 45 to 70 years enrolled through randomized cluster sampling in the community of Suzhou city. The research subject registered their basic information such as height,weight,waist circumference,hip circumference. Bone mineral density was measured by radius quantitative ultrasound. The polymorphisms of MTHFR genes were detected using the TaqMan real-time polymerase chain reaction(PCR) method. Results:Compared with the control group(34.02%),the frequency of the MTHFR 677T allele was significantly increased in osteoporosis group (43.48%),P = 0.039. Concerning the incidence of postmenopausal osteoporosis,the TT genotype had more than twice of the risk of the CC and CT genotype (OR=2.37,95%CI=1.15~4.87),especially in women aged≤60 years and central obesity(waist to hip ratio≥0.80). No association was observed between the MTHFR 1298A>C polymorphism and postmenopausal osteoporosis (P = 0.787). Conclusion:The MTHFR 677C>T polymorphism may contribute to the susceptibility of osteoporosis in postmenopausal women in Suzhou city.

Abstract:Objective:To investigate the potential involvement of gene variants of heat shock protein 70-hom(HSP70-hom) in childhood Henoch-Schonlein purpura. Methods:Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to analyze the polymorphisms of HSP70-hom +2437T/C in 131 children with Henoch-Schonlein purpura and 66 health controls. Results:HSP70-hom gene frequencies in children with Henoch-Schonlein purpura were 1.5%(TT),34.4%(TC),64.1%(CC),and 19.7%(TT),19.7%(TC),60.6%(CC) in health controls,the differences between two groups were statistically significant. In addition,the T,C allele frequencies were 18.7%(T),81.3%(C) in Henoch-Schonlein purpura group,and were 29.5%(T),70.5%(C) in control groups,the differences were statistically significant,too. Children carrying at least one +2437C variant allele(TC+CC genotype) had a significantly increased risk for childhood Henoch-Schonlein purpura compared with the wildtype genotype (+2437TT). However,the differences between children without renal involvement in Henoch-Schonlein purpura and children with renal complications did not reach statistical significance. Conclusion:The polymorphisms of HSP70-hom+2437 T/C are genetic predisposing predictors for Henoch-Schonlein purpura in children,but has no relationship with renal complications.

Abstract:Objective:To observe the effect of Irbesartan on inflammatory factors in the brain of ischemia-reperfusion rat. Methods:The male SD rats were randomly assigned to sham operated group,ischemia-reperfusion(I/R) group and Irbsartan pretreatment group. The focal I/R model was made by suture occlusion of right middle cerebral artery(MCAO) for 90 min followed by suture retreat which was defined as the beginning of reperfusion. Irbesartan[30 mg/(kg·d)] was administered for 3 weeks before MCAO. After 24 h or 72 h of reperfusion,the neurologic function impairment was evaluated by Longa standard,NF-κB p65 and IκBα protein levels were examined by Western blot technique. Results:① Compared with I/R group,pretreatment with Irbsartan could significantly improve neurologic function (P < 0.05). ② Compared with the sham group,the NF-κB p65 protein was significantly increased after either 24 h or 72 h of reperfusion in I/R group(P < 0.01). Compared with I/R group,however,the NF-κB p65 protein was significantly decreased in Irbsartan pretreatment group(P < 0.05).③ Compared with the sham group,the IκBα protein was significantly increased after 24 h of reperfusion in I/R group(P < 0.05). Compared with I/R group,the IκBα protein was significantly increased in Irbsartan pretreatment group(P < 0.05). Conclusion:Irbesartan can protect brain and may improve the rat neurologic function through enhancing IκBα protein expression and inhibiting NF-κB protein expression in rat brain with ischemia-reperfusion injury.

Abstract:Objective:To investigate the effects of silymarin (SIL) on the expressions of IL-1β,IL-6,and fractalkine in lung tissue of rat with acute lung injury. Methods:A rat model of acute lung injury (ALI) was induced by lipopolysaccharide (LPS). All rats were randomly divided into SIL group,LPS group and normal saline control group. SIL(200 mg/kg) was dropped into airway of rats in SIL group 6,4,and 2 h before treated with LPS. After LPS was given for 6,12 and 24 h,IL-1β,IL-6,chemotatic factor fractalkine protein levels in lung tissue homogenate were detected by ELISA. Results:At all time point,IL-1β,IL-6,fractalkine protein levels of SIL group were all significantly lower than those in LPS group(P < 0.05). Conclusion:SIL could significantly inhibit the expression of IL-1β,IL-6,fractalkine in lung tissue of rat with acute lung injury.

Abstract:Objective:To explore the changes of ambulatory blood pressure,angiotensin Ⅱ and cortisol levels in the elderly hypertensive patients with depression,and the relationship of angiotensin Ⅱ,cortisol and hypertension,depression. Methods:One hundred and eighty elderly patients selected from Department of Geriatrics,Nanjing Governmental Hospital were divided into two groups:hypertension complicated with depression(HD) group and hypertension(H) group,90 cases in each group,the office blood pressure and the ambulatory blood pressure were measured,and the plasma angiotensin Ⅱ,cortisol levels were detected by radioimmunoassay. Results:According to 24-hour ambulatory blood pressure and office blood pressure,pure systolic hypertension were indicated by the elevation of systolic pressure in both groups. The levels of angiotensin Ⅱ and cortisol were significantly higher in HD group than those in H group(P < 0.01). The levels of angiotensin Ⅱ(r = 0.351,P < 0.01) and cortisol (r = 0.316,P < 0.01) had positive correlation with HAMD score in HD group. Conclusion:Angiotensin Ⅱ,cortisol might be involved in pathophysiology of hypertension complicated with depression in elderly population.

Abstract:Objective:To observe the effect of atorvastatin on renal function and hemodynamics in elderly hypertensive patients. Methods:Fifty-six elderly hypertensive patients with hypertensive nephropathy were randomly divided into atorvastatin group(n = 29) and control group(n = 27), atorvastatin group was treated with atorvastatin for six months. The variation of blood pressure, low density lipoprotein cholesterol(LDL-C), alanine aminotransferase(ALT), creatine kinase(CK), creatinine, estimated glomerular filtration rate (eGFR), 24-hour urinary protein quantitation were examined, and the renal hemodynamics were observed by colour Doppler ultrasound before and after treatment. Results:LDL-C in atorvastatin group decreased significantly after 1 month or 6 months of treatment(P < 0.05). 24-hour urinary protein quantitation was unchanged in one month, and decreased significantly in 6 months in both groups(P < 0.05), which was lower in atorvastatin group than in control group(P < 0.05). Creatinine and eGFR were unchanged in both groups after 1 month of treatment,while in 6 months,creatinine decreased and eGFR increased in both groups, but no significant difference was achieved (P > 0.05), however, the difference was significant between two groups(P < 0.05). No significant difference was found in the peak systolic velocity (PSV) of bilateral renal artery (RA), segmental renal artery(SRA), leaves renal artery (IRA) in two groups before and after treatment. In the atorvastatin group, end-diastolic minimum flow(EDV) increased and resistance index (RI) of RA, SRA and IRA decreased significantly after 6 months of treatment (P < 0.05), significant difference was found between two groups (P < 0.05), especially for the difference of RA(P < 0.01). Conclusion:Atorvastatin have protective effect on renal in patients with hypertensive nephropathy. Reducing renal arteries resistance, improving renal vascular structure may be one of the renal protective mechanisms.

Abstract:Objective:To investigate the changes of pulmonary artery pressure(PAP) and right ventricular function in the infants with acute asthma. Methods: One hundred infants during the acute stage of asthmatic disease as observation group(including 23 severe cases and 77 mild cases) and one hundred healthy infants as control group were chosen in this study from October 2009 to January 2012. PAP,right ventricular ejection fraction(RVEF),pulmonary vascular resistance(PVR),right ventricular ejection time(RVET),acceleration time(AT) and Tei were measured as previously reported using echocardiography,and blood gas was analyzed simultaneously. The infants in observation group were conventionally treated with cardiac diuretics and calcium antagonists in order to reduce pulmonary artery pressure and strengthen the heart function. Results: The incidences of pulmonary hypertension was 34%(34/100) in the observation group,23 cases with severe asthma and 11 cases with mild asthma, and 2%(2/100) in the control group. The difference of the incidences of pulmonary hypertension between two groups was significant(P < 0.05),and the incidence of pulmonary hypertension in severe cases was significantly higher than that in mild cases(P < 0.05). PaO2 and SaO2 in the infants with pulmonary hypertension were lower than those who without pulmonary hypertension (P < 0.05). Compared with the control group,RVET and AT decreased,PAP and PVR increased significantly in the observation group (P < 0.05). Compared with mild cases,RVET and AT decreased,PAP and PVR increased significantly in severe cases(P < 0.05). Conclusion: Pulmonary hypertension and declined right ventricular function emerged in the infants with acute stage of asthmatic disease,and aggravated with the disease progress.

Abstract:Objective:To understand whether human bocavirus (HBoV) is one of the pathogens leading to the children’s respiratory infections in Nanjing. Methods:The patients hospitalized for respiratory tract infections(RTIs) were enrolled in the present study. Nasopharyngeal aspirates(NPAs) were collected from November 2009 to June 2010. HBoV NP1 gene in the samples was determined by polymerase chain reaction (PCR). The amplified positive NP1 fragments were sequenced and alignment with other HBoVs by DNAStar. Phylogenetic trees were drawn with MEGA software. The clinic findings of the children with HBoV infection were collected and analyzed. Results:Of all the 100 NPAs,five positive ones were founded. Among the five positive samples,the sequence homogeneity of the amplified NP1 gene fragment were 99.7%~100.0% at the nucleotide level. As compared with HBoVs from other countries,the homogeneity were 99.4%~100.0%. Among the five patients,the diagnoses were bronchopneumonia,bronchiolitis and bronchitis. Clinic findings included fever,cough,wheezing,etc. The patients were all recovered with conventional therapy. Conclusion:HBoV was one of the pathogens leading to the children’s respiratory tract infection in Nanjing.

Abstract:Objective:To investigate plasma fibrinogen levels in type 2 diabetic patients with periodontal disease,and to explore the correlation between plasma fibrinogen and periodontal diseases in type 2 diabetic patients. Methods:The study included 24 type 2 diabetic patients complicated with severe periodontal diseases,20 type 2 diabetic patients without periodontal diseases and 16 normal controls. The body mass index(BMI) was calculated,and plasma fibrinogen and blood lipids,HbA1c were determined. Results:Compared with normal control and type 2 diabetic subjects without periodontal diseases,plasma fibrinogen levels in type 2 diabetic patients with severe periodontal diseases were significantly increased. Plasma fibrinogen level in type 2 diabetic patients without periodontal diseases was significantly elevated compared with normal controls(P < 0.05). The plasma fibrinogen levels were positively correlated with HOMA-IR-HbA1c. Conclusion:Periodontal diseases may result in higher circulating fibrinogen in type 2 diabetic patients,and aggravate glucose metabolic disorder and insulin resistance.

Abstract:Objective:To explore the clinical value of transient blocking of both pulmonary artery and veins on locally advanced non-small cell lung cancer(LANSCLC). Methods:Thirty cases of patients with LANSCLC using the transient blocking of both pulmonary artery and veins were selected as treatment group. Another 30 cases of patients with blocking of pulmonary artery alone were selected as control group. The operation time,bleeding amount during operation,artery-blocking time and complications after operation between the two groups were compared. Results:The artery-blocking time,operation time in treatment group was obviously shorter than those in control group. The bleeding amount during operation in treatment group was obviously less than that in control group. All of the differences had statistical significant (P < 0.01). The rate of complications after operation in treatment group (6.7%) was obviously lower than that in control group(23.3%). But there was no statistic difference between the two groups(P > 0.05). Conclusion:As a treatment method of LANSCLC,transient blocking of both pulmonary artery and veins can shorten the operation time,reduce the bleeding amount,decrease the complications after operation,and is worth to be popularized in clinical research.

Abstract:Objective:To investigate the safty and feasibility of percutaneous balloon mitral valvuloplasty(PBMV) on women of child-bearing age with severe rheumatic mitral stenosis and the effect of subsequent pregnancy on cardiac function. Methods:PBMV was made in 9 female patients(mean age 24.6 years) admitted in our hospital since January 2000 to December 2011,whose clinical and echo cardiographic evaluation were obtained with a follow-up of 2.5~7.0 years. Results:The procedure was successful in all 9 patients,with no severe complication. There was significant difference in left atrial mean pressure,mitral valve pressure gradient and mitral valve area after the procedure. All patients subsequently got pregnant and had normal vaginal deliveries. The children had normal growth and development with the Apgar score of 9~10. No signifcant change was observed in all echocardiographic parameters and cardiac function before pregnancy and after delivery. Conclusion:In women of child-bearing age with symptomatic mitral stenosis,PBMV is feasible,safe and effective.

Abstract:Objective:To discuss the application value of transesophageal echocardiography(TEE) in double-orifice technique for mitral valve insufficiency in children. Methods:From February 2006 to July 2009,22 patients underwent mitral valve repair using the double-orifice technique. All patients were examined by transthoracic echocardiography (TTE) preoperatively. During the whole procedure,the morphology,function,regurgitation of mitral valve and its affiliated structure were monitored continuously with TEE. The condition of valve was assessed with TEE again postoperatively. Results:In all cases,21 had a successful operation,and one had a second operation for severe regurgitation. All patients showed stable valve function,there were no stenosis of valve,no trans-valve pressure difference and no severe regurgitation. Conclusion:It was of very important clinical value to applicate TEE in double-orifice technique for mitral valve insufficiency in children,which was useful to improve the successful rate and reduce the complications,avoiding once more surgery.

Abstract:Objective:To explore the value of real-time tissue elastography imaging in the diagnosis of solid nodules of thyroid. Methods:The preoperational conventional ultrasound and real-time tissue elastography imaging were carried out in 25 patients (including 35 nodules). The results were compared with pathological results. Results:The sensitivity,specificity,and accuracy of conventional ultrasound in diagnosing the malignant nodules of thyroid were 71.43%(10/14)-95.24%(20/21)-85.71%(30/35),respectively. While the sensitivity,specificity,accuracy of real-time tissue elastography imaging respectively were 64.28%(9/14)-71.43%(15/21)-68.57%(24/35). When both of the two methods were used,the sensitivity,specificity,and accuracy were 85.71%(12/14)-71.43%(15/21)-77.14%(27/35). Conclusion:Real-time tissue elastography imaging is valuable in the differential diagnosis of thyroid nodules. When applied together with conventional ultrasound,it may improve the sensitivity of diagnosing.

Abstract:Objective:To determine the ultrasound imaging features of mammary ductal ectasia(MDE). Methods:The sonographies and clinical characteristics of 52 patients with MDE confirmed by pathology were studied retrospectively. Result:① According to the ultrasound imagines of 52 cases,MDE could be classified into four types: type Ⅰ,duct dilatation(2%); type Ⅱ,cystosolid mass within or around the duct (53.8%);type Ⅲ,hyperechoic or heterogeneous-echoic mass with a hypoechoic rim(19.2%);and type Ⅳ,partly or fully fludified abcess(26.9%). ② The two peaks of incidence were at 30~40 or 50~60 years. Most of the lesions(84.6%) were around the areola(44/52),34.6% of patients with inverted nipple(18/52),and 53.8% with duct dilatation (28/52). ③ The rate of preoperative diagnosis of inflammatory masses was 88.5%(46/52). The diagnostic accordance rate of acute and subacute inflammation was 95%. Conclusion:The appearances of MDE are complicated. It would be misdiagnosed if judged only by sonographic features. Combination with clinical characteristics could improve the accuracy rate of diagnosis. Acute and subacute cases could be diagnosed easily,while chronic cases were harder to be diagnosed.

Abstract:Objective:To analyze the sensitivity and specificity of adenosine stress myocardial perfusion imaging for the diagnosis of coronary artery disease(CAD) and to observe the adverse reaction of adenosine burden test. Methods:A total of 85 inpatients were included in this study. SPECT myocardial imaging acquisition was obtained 1 hour after adenosine infusion. Rest myocardial perfusion imaging would be performed next day regularly. Coronary angiography was performed in 67 patients within one month of myocardial imaging. Results:① Total 85 cases[(66 ± 9) years old,46 men,39 women]were included in this study. In the 52 cases of CAD patients confirmed by coronary angiography,46 patients have positive adenosine 99mTc-MIBI myocardial perfusion SPECT. Of 15 cases without CAD,11 cases have negative adenosine myocardial perfusion tomographic imaging. The sensitivity and specificity of adenosine myocardial perfusion tomographic imaging for the diagnosis of CAD were 88.5% and 73.3%. ② In the 85 patients,8.3% patients had no symptom,91.7% had varied kinds of adverse reaction,consisted of chest complaint(83.3%),skin aestus(23.1%),dizziness(20.5%),palpitation(12.8%),short breath(7.7%),sweating(7.7%) and so on. At the end of 5 minutes of stopping adenosine infusion,all adverse reaction disappeared,heart rate and blood pressure returned to basal level. Conclusion:Adenosine stress myocardial perfusion tomographic imaging is an useful and safty non-interventional method for detecting coronary artery disease.

Abstract:Objective:To evaluate the application of adaptive sequence scanning techniqueology dual-source CT(DSCT) in the low-dose computer tomography coronary angiography (CTCA). Methods:Two hundred and eight-five patients suspected of coronary artery disease with heart rate > 70 bpm and regular rhythm were randomly assigned into experimental study group (145 cases) and control group(140 cases). Study group were checked with adaptive sequence scanning technique,and control group with retrospective ECG-gated spiral scanning. There were 33 cases in study group and 32 cases in control group undergoing conventional coronary angiography(CCA) within 2 weeks. The coronary artery evaluation rate of CTCA between two groups were compared using -字2 test. The imaging quality of coronary artery and radiation dose of two groups were compared using t test,the consistency of coronary artery stenosis in CTCA and in CCA were evaluated with the Kappa test. Results:The evaluation rate of coronary artery in the study and control group were 98.4%(1 787/1 816) and 98.1%(1 717/1 750),respectively. The image quality scores of two groups were(4.42 ± 0.64) and(4.41 ± 0.65) respectively,and there was no statistical difference in scores of imaging quality between the two groups (t = 0.38,P = 0.710). The consistency of CTCA and CCA in diagnosing coronary artery stenosis of two groups were 0.829 and 0.845 by Kappa test,respectively. The average effective radiation doses of study group and control group were (4.60 ± 0.98) and (12.60 ± 1.90) mSv,and there were significant differences between two groups (t = 44.89,P = 0.000). Conclusion:Using DSCT adaptive sequence scanning technique in CT coronary angiography to check the patients with heart rate > 70 bpm and regular rhythm can ensure good image quality and high diagnostic accuracy of coronary artery stenosis,and also significantly reduce the radiation dose.

Abstract:Objective:To determine the pathogen distribution and resistance pattern of the positive clinical specimens in Jiangsu Shengze Hospital in 2011. Methods:A total of 2 224 samples were collected from this hospital in 2011. Bacteria and fungus were identified by API systems,bacterial drug sensitivity was determined by disk diffusion method,WHONET5.5 software was used for data analysis. Results:The positive rate was 29.1%(648/2 224)of 2 224 culture specimens. The majority of the positive specimens were from nerve internal division(26.7%),respiratory division(23.8%),intensive care unit(17.6%) and so on. The percentage of Gram positive bacteria were19.8%(128/648),Gram negative bacteria 66.5%(431/648) and fungus 13.7%(89/648). The most freguent pathogen was Escherichia coli,accounting for 16.4%,the next was Pseudomonas aeruginosa(16.0%) as well as Klebsiella pneumoniae(13.6%). In view of the resistance,extended spectrum β lactamases(ESBLs) were produced in 67.0% of E. coli and 62.5% of Klebsiella pneumoniae. The resistant rates of ESBLs producing strains were higher than those non-ESBLs-producing strains,Enterobacteria were highly sensitive to carbapenem(94.0%~100.0%). The resistant rates of non-fermentative Gram negative strains were higher than Enterobacteriaceae strains. Resistance rates of methicillin resistant strains were higher than methicillin sensitive strains,and no resistant strains to vancomycin and teicoplanin were reported. The resistance rate of Enterococcus and Streptococcus to penicillin and erythromycin were higher(> 65%),no strain was found to resistant to vancomycin and teicoplanin Conclusion:Antimicrobial resistance in clinical bacterial isolates was a very serious problem in our hospital. Surveillance of bacterial resistance was important and valuable for understanding the change of pathogenic bacteria and drug resistance. The reasonable antibiotics should be applied to prevent the occurrence of resistant strains.

Abstract:Objective:There is no clear consensus on the better therapy [radiofrequency ablation (RFA) versus hepatic resection (HR)]for small hepatocellular carcinoma (HCC) eligible for surgical treatments. This study is a meta-analysis of the available evidence. Methods:Systematic review and meta-analysis of trials comparing RFA with HR for small HCC published from January 2000 to December 2009 in PubMed,Medline and CNKI. Pooled odds ratios(OR) with 95% confidence intervals(95% CI) were calculated using either the fixed effects model or random effects model. Results:Six randomized controlled trial,and nine nonrandomized controlled trials studies were included in this analysis. These studies included a total of 2 284 patients:1 213 treated with RFA and 1 071 treated with HR. The difference in overall survival at 1-year was not statistically significant between the RFA and surgery groups(P > 0.05). While the overall survival was significantly higher in patients treated with HR than in those treated with RFA at 3 years.(P < 0.05). And there were no differences in 1-year and 3-year recurrences between the RFA and surgery groups(P > 0.05). Conclusion:HR was superior to RFA in the treatment of patients with small HCC eligible for surgical treatments,particularly for long-term survival rate.