Objective To analyze antimicrobial resistance of hospital-associated methicillin-resistant Staphylococ-cusaureus(HA-MRSA)and community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA),and provide reference for clinical treatment and rational antimicrobial use. Methods From May 2013 to June 2014, Staphylococcus aureus in a hospital were collected and analyzed,strains were identified and performed antimicrobial susceptibility testing by using VITEK 2 Compact system,diagnosis of HA-MRSA and CA-MRSA were confirmed in combined with clinical symptoms.Results A total of 84 MRSA isolates were isolated (61 were HA-MRSA strains,23 were CA-MRSA).Resistant rates of HA-MRSA and CA-MRSA to penicillin G and oxacillin were both 100.00% ;to ampicillin/sulbactam was 100.00% and 95.65% respectively;to compound sulfamethoxazole was 39.34% and 34.78% respectively. Antimicrobial resistant rates of HA-MRSA to gentamicin,tetracycline,erythro-mycin,clindamycin,levofloxacin,ciprofloxacin,moxifloxacin,nitrofurantoin,and rifampicin were all higher than CA-MRSA,the difference were significant(all P<0.001).Conclusion Antimicrobial resistance of HA-MRSA and CA-MRSA are all serious,monitor should be intensified,antimicrobial use should be chosen according to antimicro-bial susceptibility testing result.

Objective To investigate the types of staphylococcal cassette chromosome mec (SCCmec)gene and an-timicrobial resistance of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA)isolated from outpatients and inpatients in a hospital.Methods MRSA strains isolated between May 2011 and August 2015 in a hospi-tal and the relevant case data were collected,polymerase chain reaction(PCR)method was used to identify mecA gene of MRSA and SCCmec gene of CA-MRSA,antimicrobial susceptibility testing of CA-MRSA were performed and analyzed. Results A total of 305 MRSA isolates were collected,296 of which were mecA positive,29.73% (88/296)were CA-MR-SA. The genotyping of CA-MRSA showed that 48 strains were SCCmec type Ⅳ,36 were SCCmec type V,the other 4 strains were undefined. Antimicrobial susceptibility testing results showed that susceptibility rates of CA-MRSA to vanco-mycin,linezolid,and tigecycline were all 100% ,resistance rates to penicillin and oxacillin were both 100% ;resistance rates of SCCmec type IV and SCCmec type V CA-MRSA strains to levofloxacin,rifampicin,and ciprofloxacin were all signifi-cantly different (all P<0.05),to ampicillin/sulbactam,furantoin,and erythromycin were all >58% .Conclusion The main SCCmec type of CA-MRSA are type IV and type V in this hospital,antimicrobial resistance rate is high,clinicians should pay high attention,and use antimicrobial agents according to antimicrobial susceptibility testing results.

Non-small cell lung cancer (NSCLC) is currently the leading cause of cancer-related deaths worldwide. Angiogenesis, the formation of new vasculature, is a complex and strictly regulated process that promotes metastasis and disease progression in lung cancer and other malignancies. Anti-angiogenic therapy is an anti-cancer strategy that targets the new vessels. Most anti-cancer agents used in the clinic include cytotoxic drugs, which target all rapidly dividing cells, resulting in severe adverse effects. These effects in-clude immunosuppression, intestinal problems, and hair loss. By contrast, anti-angiogenic agents theoretically exhibit fewer side effects because angiogenesis rarely occurs in healthy adults, except in the uterine endometrium. Various angiogenic factors may contribute to the regulation of angiogenesis in the individual tumor;thus, the proper selection of patients who may benefit from a specific therapy is important, considering the increasing number of clinically tested agents. This study provides an overview of angiogenic molecules cur-rently being investigated as prognostic and predictive biomarkers in NSCLC. Clinical examples are presented to show the rationales for investigating various biomarkers of pre-clinical studies.

Objective:To find out the coefficients of garlic oil by Supercritical Fluid Extraction (SFE). Methods: Cutting, squeezing fermentation and fermentation and ethanol extraction of garlic were respectively as pretreatments and then the use of supercritical carbon dioxide as an extraction and given garlic oil was analysed by means of IR. Result: Garlic oil can be directly extracted by SFE and its best operation condition was under the pressure of 15 MPa and at 40 ?C extractability of garlic oil was up to 44.57% . Conclusion: Fermentation and ethanol extraction method is a best one for garlic oil obtained.

Objective To evaluate clinical the effects and significance of the occurence and development of varies intervention on control of acute lung injury(ALI)in clinical practice.Methods Sixty-nine ALI patients were randomly divided into three groups:traditional ventilation therapy group(n=17),low dose ulinastatin intervention with traditional ventilation therapy group(n=24)and high dose ulinastatin intervention in lung protective ventilation therapy group(n=28).We compared the changes of pneumodynamics,arterial blood gas and hemodynamics among these groups.Resident time in ICU,time course of mechanical ventilation and mortality of these groups were also compared.Results Large dose ulinastatin intervention in lung protective ventilation therapy group had further improved influence on pneumodynamics,arterial blood gas and puhnonary oxygenation than other groups(P＜0.05)and no mechanical ventilation induced lung injury was found in the group.There were no obvious differences in pneumodynamics,arterial blood gas and pulmonary oxygenation between the other two groups(P＞0.05).Lung injuries induced by mechanical ventilation were all observed in these two groups.There were no obvious differences in hemodynamics among the three groups(P＞0.05).Conclusions Large dose ulinastatin intervention in lung protective ventilation can improve pneumodynamics,arterial blood gas and pulmonary oxygenation of ALI patients.It could decrease the incidence of ventilator induced lung injury(VILI).The treatment should been applied prospectively in clinical practice.

Objective To evaluate CT virtual cystoscopy (CTVC) in the diagnosis of bladder tumor. Methods 22 cases of bladder cancer were examined by spiral CTVC with intravenous injection of 60% urografin or omnipaque.The images obtained were compared with that observed on coventional cystoscopy and operation. Results Based on CTVC images and transverse section images of CT,tumors were classified as 3 catogories:(1)superficial papillary tumor.(2)tubercular mass papillary tumor.(3)infiltrated tumor.Of the 22 cases examined with CTVC,18 were papillomas,11 tubercalar mass papillomas and 1 infiltrated tumor.The smallest was 3.0 mm in diameter.CTVC findings have been similar to those observed on conventional cystoscopy and operation. Conclusions CTVC,a new,noninvasive,safe and useful technique,can correctly demonstrate the details of surface of bladder tumor when the latter was greater than 3.0 mm. It could show the normal or abnormal mucosal folds and the relationship of the tumor to the ureteral orifices and the bladder neck.CTVC my be helpful in the choosing of management,in the clinical staging and diagnosis of bladder tumor.

Objective To discuss the value of extra-hepatic artery embolization in the treatment of giant hepatocellular carcinoma (HCC).Methods Thirty-five patients with giant HCC were enrolled in this study.Angiography was performed on celiac artery at the 1st time of transcatheter arterial chemoembolization (TACE),and on superior mesenteric artery and diaphragmatic artery right internal thoracic artery,right intercostal artery,during the 2nd and next TACEs to explore extra-hepatic blood supply of the tumors.Results In all 35 patients,49 extra-hepatic arterial branches were found,and 46 were treated with chemoembolotherapy,3 with super selective chemotherapy.Diaphragmatic artery often served as extra-hepatic arterial blood supply,and then internal thoracic artery,intercostal artery,etc.Conclusion Super selective chemoembolization or chemothrephy of extra-hepatic blood supply arteries can improve the therapeutic effect of TACE for giant HCC.

Objective To evaluate the treatment efficacy and treatment-related toxicity of late course accelerated hyperfractionated radiotherapy (LCAHRT) combined with cisplatin-based chemotherapy (CHT) for locally advanced esophageal squamous cell carcinoma (ESCC).Methods A total of 46 patients with histologically confirmed ESCC,11 in the stage Ⅱa,3 in the stage Ⅱb,and 32 in the stage Ⅲ,underwent conventional fractioned radiation of 40 Gy in 20 fractions on the primary and metastatic lymph nodes,and high-risk lymph node drainage regions,and then the primary and metastatic lymph nodes were irradiated as boost with an additional dose of 19.6 Gy in 14 fractions (1.4 Gy twice a day),and the total prescribed dose was 59.6 Gy in 34 fractions.Two cycles of CHT were administered concurrently during the radiotherapy.The 1-,3-,and 5-year overall survival (OS) rates and local control rates (LCRs) were evaluated by Kaplan-Meier method,and treatment-related toxicity was analyzed based on the RTOG and CTCAE criteria 3.0.Results All patients received the whole course of treatment.The median followup time was 34.4 months (6-67 months).The overall response rate was 91.3％ (42/46).The median OS was 38.5 months (95％ CI 29.6-47.4 months).The 1-,3-,and 5-year OS rates and LCRs were 78.6％,49.4％,and 39.9％,and 84.3％,68.2％,and 61.4％ respectively.The incidence of ≥ G3 radiationinduced esophagitis was 23.9％.Three kinds of serious (≥G3) hematologic toxicities were recorded,including leucopenia (26.1％),thrombocytopenia (13.0％),and anemia (10.9％).Esophagotracheal fistula was recorded in 2 patients (4.3％).Conclusion LCAHRT plus CTH can be favorable for the patients with locally advanced ESCC,however,the treatment-related toxicities may be serious.

Objective Too investigate the application value of procalcitonin(PCT)and high sensitivity C-reactive protein(hs-CRP)in early diagnosis of neonatal septicemia and disease condition assessment.Methods 48 patients with neonatal septicemia treated in the hospital from November 2011 to May 2013 were collected.The data of PCT,hs-CRP and blood culture were recorded and performed the comparative analysis with the serum PCT,hs-CRP detection results in contemporaneous 48 neonates without septicemia.Results The serum PCT and hs-CRP was 93.75% and 10.42% in the neonates with septicemia,which were signifi-cantly higher than 79.17% and 50% in the neonates without septicemia(P <0.05),the positive rate had statistical difference be-tween the two groups.Conclusion PCT and hs-CRP have remarkable change in the early stage of neonatal sepsis,the combination detection of serum PCT and hs-CRP can be used as the indicators for early diagnosis of neonatal sepsis,moreover the sensitivity and specificity of PCT for diagnosing neonatal septicemia are higher the those of hs-CRP,their combined detection can provide fast and accurate diagnostic basis for clinic.