Objective To study Aeromonas hydrophila infection and the clinical status of the major causative factor Aerolysin gene.Methods Clinical isolates of Aeromonas hydrophila was collected from 2012 to 2013 year in People’s Hospital of Shenzhen Longhua Branch.Its identification and antibiotic susceptibility testing was analyzed by VITEK 2 compact.Clinical resistance rates and distribution was analyzed by WHONET5.6 software.Polymerase chain reaction (PCR)was used to de-tect the Aerolysin gene form in chromosomes and plasmids extracted genome.Results The clinical total of 48 isolated Aero-monas hydrophila ,distributed in 16 clinical samples of sputum,blood 11,10 secretions,urine 7 and stool 4.Distribution in ward decentralized,the central tendency was not detected.Drug resistance rates to ampicillin,ampicillin/sulbactam and ce-fazolin reached more than 80%,while amikacin,cefepime,levofloxacin,piperacillin/tazobactam and imipenem was low 10%or less.43.7% strains carried the Aerolysin gene.39.5% of Aerolysin gene was found on chromosome genome.Conclusion Aeromonas hydrophila clinical infection existed in dispersed form,most of which carried Aerolysin gene in chromosome ge-nome.Aeromonas hydrophila had serious resistance to penicillins and first generation cephalosporin,but to broad-spectrum drugs maintaining high sensitivity.Precaution of Aeromonas hydrophila ,as an important condition pathogenic bacteria,is some significant for preventing it’s proliferation of drug-resistant strains.

Objective To compare the clinical effect of application of gene chip microscopy technique for rapid identification of Mycobacterium and classic smear acid-fast staining,and to assess the advantages and disadvantages of the wo methods.Methods From 201 1 to 2014,gene chip microarray and smear acid fast staining were used to identify the mycobacterium tuberculosis in speci-mens suspicious of the infection from all the general hospitals of Shenzhen city.Chi-square test was used to compare the positive rates of the two methods.Results A total of 2 481 specimens were collected from clinic.With smear acid-fast staining technique, the positive specimens of 1 93 cases werefound and the positive rate was 7.8%.Meanwhile,31 7 positive samples were detected by the technology of gene chip microarray,and the positive rate was 12.8%.The positive rate of Gene chip microarray technology was higher than that of the smear acid fast staining,and there was significant difference between them (P < 0.05 ).The 31 7 positive samples identified by Gene chip microarray,included 263 cases of Mycobacterium tuberculosis,27 cases of Mycobacterium absces-sus,18 cases of Mycobacterium intracellulare,3 cases of Mycobacterium gastric uLcer,3 cases of Mycobacterium avium,1 case of Mycobacterium Gordonae,1 case of Mycobacterium marinum and 1 case of Mycobacterium Kansas.Conclusion The gene chip mi-croarray technology is fast,accurate,and its positive rate is higher than that of smear acid-fast staining technique.Classification and identification of Mycobacterium is very helpful for clinical individualized treatment of anti mycobacterium infection.

The ongoing health reform is bringing reforms of public hospitals under spotlight in China, attracting growing attention onto its progress and roadblocks. Probing into the "three steps" of public hospital system reform in Wuxi, this article analyzed such a reform in the city. It described the measures and initial outcomes gained in such fields as the hospital trusteeship reform, the separation of hospital regulation from its administration, and the hospital board system. Citing the case of Wuxi No. 2 People's hospital as an example, the authors introduced the innovative efforts made in hospital internal mechanism, management innovation, medical service model, hospital connotation construction, and talents cultivation.

The authors probed systematically into the delicacy management measures adopted by the hospital in its internal mechanism reform, innovative medical service model, human resource optimization, and its performance appraisal system reform. Discussions in the paper include such topics as flat management for hospitals,intensification,centralization and integration in diagnose and treatment, as well as vertical nursing management, and the outsourced logistic services. The methods and paths to achieve these goals are summarized as “preciseness, accuracy, carefulness, and strictness”.

The reform of performance appraisal and salary system is key to public hospitals reform.This paper introduced practices of the factor performance and salary system reform based on the Balance Scorecard in hospitals.It established a four-dimension performance appraisal structure,a motive salary allocation model covering all members of a hospital.This would help build the performance appraisal and salary allocation system meeting present needs of public hospitals in China.

Objective:To observe the effect of blood glucose lfuctuation and the sustained high blood glucose on renal pathological change and collagen IV (Col IV) expression in diabetic rats.
Methods:hTe 60 male Sprague-Dawley (SD) rats were randomly assigned into a normal control group (NC) and a model group (DM). hTe rats in the normal control group were fed with normal diet, while the rats in the model group were fed with high-sucrose-high-fat diet for 6 weeks. Atfer that,streptozocin (STZ, 30 mg/kg) was injected to induce diabetic model. The model group was then randomly divided into 2 subgroups:a sustained high blood glucose group and a fluctuation blood glucose group (animals in the latter group were subcutaneously injected with insulin twice daily). Rats were sacriifced atfer 3 months and kidney tissues were dissected for HE and PAS staining, Col IV immunohistochemistry and Western blot.
Results:Compared with the normal control group, the renal glomeruli and capillary basal membrane in the diabetic rats was getting larger and thicker, respectively;the capsular space and ground substance was extended and increased, respectively;the volume of renal tubule, kidney hypertrophy index, glomeruler sclerosis index and Col IV content were all increased in the diabetic rats (P<0.01). Compared with the sustained high blood glucose group, the above mentioned pathological changes were more serious in the blood glucose lfuctuation group.
Conclusion:The capillary basal membrane of kidney in diabetic rats is thicker and the ground substance is increased. The degree of glomeruler sclerosis is more serious in the blood glucose lfuctuation group compared with the sustained high blood glucose group, which is conifrmed by the increased level of Col IV.

Aim To investigate changes of eosinophil(EOS) and mast cells(MC) in airway of young asthmatic rats and to evaluate of achyranthes bidentata polysaccharides(ABPS) on it.Methods Fifty Sprague-Dawley(SD) rats were randomly divided into five groups,ten rats per group:asthmatic group(A),control group(C),pretreatment groups with ABPS which was done according to three different schedules:consecutively 3 days at sensitization(T_1),at challenge(T_2) or both of the two periods(T_3).Asthmatic rats were induced by intraperitioneal sensitization and challenged with nebulized ovalbumin(OVA).Lungs were embeded in paraffine and sliced,Hematoxylin and eosin(HE) staind tobuidine blue restained and TUNEL method after animals were executed,then the quantity and degranulation phenomenon of EOS and MC and the apoptosis of EOS in airway were observed.Results ① The number of inflammatory cells and EOS in the airway was significantly increased in asthmatic group but reduced in group T_1 and T_3(P

Objective To explore the correlative factors of sudden death in patients suspected with pulmonary thromboembolism (PTE) in emergency room (ER).Methods A retrospective analysis was conducted.The clinical data of 12 patients with sudden death suspected with PTE (sudden death group) in ER of the Air Force General Hospital from January 2011 to June 2014 were analyzed.The non-sudden death group included 35 patients during the same time period who were diagnosed with PTE based on findings of CT pulmonary arteriography (CTPA) and showed no sudden death in ER.Factors,including sex,age,previous operation,tumor,syncope,dyspnea,bilateral or unilateral edema of lower extremity,heart rate (HR),white blood cell count (WBC),D-dimer,arterial partial pressure of oxygen (PaO2),arterial partial pressure of carbon dioxide (PaCO2) and typical clinical manifestation of electrocardiogram (SⅠTⅢQⅢ),were compared between the two groups.The potential predictors of sudden death of PTE were analyzed by logistic regression analysis.Results Young age (years old:51.3±15.5 vs.62.3±14.4),lower PaO2 [mmHg (1 mmHg =0.133 kPa):49.9± 12.3 vs.62.7± 10.2],higher HR (bpm:122.0± 19.5 vs.89.1 ± 18.5) and higher WBC (× 109/L:13.8 ± 6.9 vs.7.2 ± 2.5) were found in sudden death group as compared with those in non-sudden death group (P ＜ 0.05 or P ＜ 0.01).There was no significant differences in D-dimer level and PaCO2 between sudden death group and non-sudden death group [D-dimer (pg/L):986 (891,3 230) vs.2089 (598,3 397),PaCO2 (mmHg):33.0 (28.6,43.4)vs.36.5 (32.9,41.0),both P ＞ 0.05].The syncope,antineoplaston treatment or tumor metastasis within 6 months,operation in previous 4 months,bilateral asymmetrical edema in sudden death group were more than those of the non-sudden death group,and chest pain was less (P ＜ 0.05 or P ＜ 0.01).Difference in gender,dyspnea and typical SⅠTⅢQⅢ in electrocardiogram were not significant between the two groups (all P ＞ 0.05).It was shown by multiple logistic regression analysis that higher HR [odds ratio (OR) =1.124,95％ confidence interval (95％CI) =1.024-1.235,P =0.014] and higher WBC (OR =1.347,95％CI =1.043-1.738,P =0.022) were identified as independent risk factors of sudden death for PTE.Conclusions Gender,dyspnea,typical S Ⅰ TⅢQⅢ in electrocardiogram,PaCO2 and D-dimer seem unrelated to sudden death of patients with PTE.Young age,chest pain,syncope,bilateral asymmetrical edema,antineoplaston treatment or tumor metastasis within 6 months,operation in previous 4 months and low PaO2 were potential predictors of sudden death according to the univariate analysis.Higher WBC and higher HR are independent risk factors of sudden death for PTE patients.

Objective To evaluate the method and clinical effect of subtalar joint distractor assisted open reduction and internal fixation of comminuted intra-articular calcaneal fracture.Methods Twenty-two patients with fresh closed calcaneal fracture treated with open reduction and internal fixation from May 2011 to July 2013 were included in the study.According to the modes of operation,the patients were randomly divided into two groups (n =11 in each):in group A patients underwent fracture reduction assisted by subtalar joint distractor and in group B patients underwent Steinmann pin traction and poking reduction.All were fixed using the lateral calcaneal plate.Operation time,B(o)hler angle,Gissanes angle,calcaneus height,incision healing time and complications of the two groups were investigated for evaluating the effect of operation.Clinical effect was evaluated using the American Orthopedic Foot & Ankle Society (AOFAS) score before the removal of internal fixation.Results Period of follow-up was (14.3±0.8)months (range,12 to 18 months).Two patients in group B had delayed wound healing,and were treated with regular wound care.At the final follow-up,no infection,nonunion,malunion and internal fixation failure were observed.B(o)hler angle,operation time and calcaneus height observed in group A were superior to those in group B (P ＜0.01).There was no significant difference in Gissanes angle between the two groups (P ＞ 0.05).Compared to the preoperative data,B(o)hler angle,Gissanes angle and calcaneus height were significantly improved in both groups (P ＜0.01).AOFAS score was (83.6 ± 1.4) points in group A and (81.7 ± 1.5) points in group B.Conclusion Subtalar joint distractor assisted open reduction and internal fixation is effective to shorten operation time,improve fracture reduction,reduce wound complications and increase the operative effect for comminuted intraarticular calcaneal fracture.

BACKGROUND:Rehabilitation brace can significantly improve the motor function of patients with post-stroke hemiplegia. OBJECTIVE:To investigate the types and biocompatibility of brace materials for post-stroke hemiplegia. METHODS: A computer-based search of Wanfang, CNKI, PubMed databases was performed for articles related to post-stroke hemiplegia and biocompatibility of brace materials published from 1999 to 2015 using the keywords of cerebral apoplexy, hemiplegia, support, material in Chinese and English, respectively. In the same field, the articles published recently or in authoritative journals were preferred. Finaly, 15 articles were enroled in result analysis. RESULTS AND CONCLUSION: Thermoplastic orthoses are mainly made of polypropylene materials, which are used for foot drop caused by post-stroke hemiplegia. Polypropylene has high strength and good toughness, and it is also safe and non-toxic. Semi-rigid planta pedis can help the lift of the toe in swing phase. Orthoses made of polymer fiber materials are characterized by ease of use, good toughness, high strength, and good air permeability, which cannot impact X-ray examination. Carbon fiber materials have light mass, high specific strength and modulus, good anti-fatigue performance, good safety performance and good designability. Clinical trials have shown that patients wearing ankle foot orthoses made of polypropylene and carbon fiber materials have improvement in walking distance and speed of climbing stairs, and these patients also feel more balanced and secure. Experimental studies on different orthotics materials can get more patient preferences, which have a great help for the design and development of orthotics materials.