Objective To clarify the clinical distribution and antimicrobial resistance characteris-tic of bacterial biofilm during catheter-associated urinary tract infection,and to simulate biofilm "real state" in vivo. Methods Totally 120 patients with catheter-associated urinary tract infections (UTIs) were enrolled in the study. The urine specimens were collected for screening biofilm strains and the corresponding planktonic strains. The biofilm was detected with semi-quantitative detecting method. Antibiotics susceptibility test were performed on the biofilm bacteria to clarify the difference of drug resistance in common MH medium the between biofilm strains and the corresponding planktonic strains,as well as the difference of drug resistance of positive strains of the biofilm between Poloxamer medium and common MH medium. Results Totally 48 strains (48/120,40%) of biofilm bacteria were detected. The antibiotic susceptibility test of planktonic and biofilm bacteria in Mueller-Hinton agar showed no significant difference (P>0.05), while the antibiotic resistance of biofilm bacteria in Muel-ler-Hinton agar and Poloxamer hydrogel was statistically different (P<0.05),and the former was stronger. Conclusion The biofilm bacteria during the urinary tract infection were mainly Staphylococci and Enterococci. The antimicrobial resistance of planktonic and biofilm bacteria have no significant difference in vitro, h is speculated that Poloxamer media may simulate the real living environment of biofilm bacteria and display their "true" drug resistance.

Objective To investigate the association of esp, gelE, ebpA and QS-fsr system and biofilm formation in Enterococcus faecalis. Methods Totally 24 isolates of Enterococcus faecalis were collected from urine and catheter of clinical urine tract infection patients in Third Xiangya Hospital from Oct. 2007 to Jun. 2008, and were divided into biofilm group and non-biofilm group. The luminance ratios of esp, gelE, ebpA and fsrrB of Enterococcus faecalis in biofilm group and non-biofilm group were detected by RT-PCR. And the expression of esp, gelE, ebpA, fsrrB genes in different groups were detected by real-time PCR and were relatively quantitated through 2-△△Ct method. Moreover, the relevancies between that fourgenes and biofilm formation in Enterococcus faecalis were analyzed respectively. Results The expression of esp and ebpA in biofilm group were 298 times and 59 times more than the non-biofilm group. The expression level ofgelE and fsrB in biofilm group were 1/244 and 1/249 times less than the non-biofilm group, and the luminance ratios of esp, gelE, ebpA and fsrB were not significant between the two groups (rank sum was 92,79, 42 and 34 respectively,all P ＞ 0. 05 ). Conclusions The results showed that the biofilm formation in Enterococcus faecalis was promoted by esp and ebpA, and was inhabited by gelE and fsrB, which suggested that the expression of esp, ebpA and gelE genes was regulated by fsr system.

Surgical site infection (SSI)following spinal surgery is the most common complications, which is devastating for both the patient and the surgeon.There is strong evidence in the literature that opti-mizing specific preoperative,intraoperative,and postoperative variables can significantly lower the risk of developing an SSI.Evidence-based approach will allow surgeons to minimize the risk of SSI and,therefore, significantly improve patient care.Here,we review the current evidence.

Autophagy is a biological process in which cells maintain homeostasis through degradation of cytoplasmic macromolecules and damaged organelles by membrane vesicle structure .Autophagy plays a critical role in maintai-ning survival of intestinal epithelial cells during intestinal mucosal barrier dysfunction .A negative regulator of auto-phagy may lead to intestinal inflammation and tumorigenesis .

Objective To analyze the clinicopathologic characteristics and evaluate the influence factors for the prognosis of rectum carcinoma patients who had undergone surgical resection. Methods A retrospective analysis of data of 272 patients with rectum carcinoma in TNM stage Ⅰ, Ⅱ, Ⅲ was made, all these patients underwent R0 surgical resection from 1998 to 2002 in the General Hospital of PLA. The survival rate was analyzed by Kaplan-Meier method. The clinical characteristics and pathologic features were compared with the aid of monofactorial and multifactorial Cox regression analyses. Results The median survival time was 58.5 months, and the 1-, 3- and 5-year survival rates of rectum carcinoma after surgical resection were 79%, 70% and 62%, respectively. With monofactorial analysis, preoperative CEA level, diameter of tumors, differentiation degree of tumor, depth of tumor invasion, the number of metastatic lymph nodes and TNM staging were found to be significant factors influencing the prognosis. Adjuvant chemotherapy after surgery had influence over the survival rates of stage Ⅱ and Ⅲ rectal carcinoma. Age, gender, histological type and infiltration of canalis haemalis were uncorrelated with prognosis. Preoperative CEA level, depth of tumor infiltration and the number of metastatic lymph nodes were proved independently to be the risk factors influencing prognosis by multifactorial analysis. Conclusions The tumor site was not the prognostic factor of rectal carcinoma after R0 surgical resection. Preoperative CEA level, infiltration and the number of metastatic lymph nodes were independent prognostic factors in predicting the postoperative outcome. Careful preoperative assessment, early radical surgery and adjuvant chemotherapy after operation can improve the survival rate in rectum carcinoma patients.

To evaluate the clinical value of quantitative tissue velocity imaging (QTVI) in estimation of LV regional diastolic function in patients with coronary artery disease (CAD). The moving peak tissue velocity of LV wall in long axis direction during isovolumic relaxation (V IR ), early diastole (V E), atrial contraction (V A), and V E/V A ratio were measured and calculated by QTVI in 30 patients suffering from CAD and 40 healthy individuals. The results of QTVI were also compared with mitral valve peak flow velocities during early diastole (E), atrial contraction (A), and E/A ratio. In patients with CAD, V E was significantly lower than of nomal subjects( P

Objective To evaluate the outcomes and the prognostic factors for advanced squamous cervical cancer after concurrent chemoradiotherapy (CCRT).Methods Totally 172 patients with International Federation of Gynecology and Obstetrics stage Ⅱ b-Ⅳ who were treated in Cancer Hospital,Chinese Academy of Medical Sciences between January 2007 and December 2008 were retrospectively analyzed.Patients were received external radiotherapy,high-dose rate brachytherapy and cisplatin-based chemotherapy concurrently.Results The median follow-up period was 54.5 months.The 2-year and 5-year overall survival (OS) were separately 81.5％ and 68.8％.The 2-year and 5-year progress-free survival (PFS) were separately 69.2％ and 63.1％.Using univariate analysis followed with multivariate analysis,the results showed that these clinicopathological factors including stage (Ⅲ and above versus Ⅱ b; P =0.021,HR =1.95 ; P =0.020,HR =1.86),maximum diameter of local tumor size (＞4 versus ≤4 cm; P =0.009,HR =2.55 ; P =0.033,HR =1.94),squamous cell carcinoma antigen (SCC) level before treatment (＞3 versus ≤3 μg/L; P =0.010,HR =2.47; P =0.013,HR =2.09) and retroperitoneal lymph node status on imaging (para-aortic lymph node positive versus negative,P =0.009,HR =3.00,P=0.010,HR =2.74; pelvic lymph node positive only versus negative,P =0.044,HR =1.98,P =0.033,HR =1.92) had the significant effect on OS and PFS.Patients with no above adverse prognostic factor were assigned to Group A (n =18),those with one factor were assigned to Group B (n =43),and those with no less than two factors were assigned to Group C (n =1 11).Among three groups,the 2-year OS were separately 94.1％,97.7％ and 73.1％,the 5-year OS were separately 81.4％,90.1％ and 58.6％,the 2-year PFS were separately 88.2％,90.4％ and 57.9％,the 5-year PFS were 82.4％,87.9％ and 50.0％.The results showed that group C was significant difference from Group A or B in OS and PFS (all P ＜ 0.05),while Group A had no significant difference from Group B in OS and PFS (P ＞ 0.05).Conclusions Stage Ⅲ or above,maximum diameter of local tumor size ＞ 4 cm,SCC level ＞ 3 μg/L before treatment and positive retroperitoneal lymph nodes on imaging are four independent adverse factors for prognosis of squamous cervical cancer of advanced stage after CCRT.The treatment of patients with no less than two adverse factors should be considered to be improved.

Objective To evaluate the brain invasion in gliomas by diffusion tensor tractography(DTT).Methods Diffusion tensor imaging was preoperatively performed in 35 patients who histologically confirmed gliomas.13 of the 35 tumors were low-grade gliomas and 22 were high-grade gliomas. Then the spatial relationship between the lesions and white matter fiber tracts around tumor was analyzed. displacement, continuity and injured conditions of white matter fiber were observed. Results White matter fiber tract in all lesions could be observed clearly. Three patterns of white matter fibers involvement were identified:displaced,infiltrated and destructed. White matter fiber tracts around low-grade gliomas were primarily displaced ,but were mainly infiltrated and destructed around high-grade gliomas. Conclusion DTT was useful for showing white matter fiber tracts,observing the shape changes stereographically,and evaluating the relationship with gliomas in vivo.

Objectives To investigate the risk factors of acute renal injury (acute kidney injury) in patients with acute left heart failure.Methods Clinical data of 188 patients with acute left heart failure who were admitted to our hospital were retrospectively analyzed.Logistic regression analysis was used to assess the risk factors for AKI.Results Among 188 patients with acute left heart failure,incidence of acute kidney injury was 33.51％.Univariate and Multivariable logistic regression analyses showed that the independent predictors of acute kidney injury were lower baseline eGFR (OR=4.294,P ＜ 0.001) and anemia (OR=3.573,P=0.006).Conclusions The incidence of acute left heart failure complicated with AKI was high.Basic state of renal function and anemia were the independent risk factors for AKI.

Objective To systematically evaluate the relationship between stroke location and post-stroke depression (PSD) in first-ever stroke patients.Methods The studies on the relationship between stroke location and PSD published from January 1980 to March 2016 were retrieved from databases,including Chinese science and technology journal full-text database (VIP),China journal full-text database (CNKI),Wanfan database,PubMed,ISI Web of Science,Ovid database and Elsevier Science Direct.RevMan5.3 software was adopted for data consolidation and analysis.Results A total of 14 studies,including 1 952 cases of patients were included.The meta analysis indicated that no direct relationship was found between stroke location and PSD in first-ever stroke patients [random effects model,95 ％CI(0.89,1.43),P＜0.01].The results of subgroup analysis indicated that the PSD was associated with the right hemisphere lesion when the Hamilton Depression Scale (HAMD) was adopted for assessment [fixed effects model,95 ％ CI(1.21,1.76),P＜0.01],while the relationships were not found in the subgroup analysis of time course after stroke and the aphasia occurrence.Conclusion Stroke location may be not directly associated with PSD,further studies are needed to ascertain the relationship between stroke location and PSD.