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.

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 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.

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 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.

ObjectiveTo assess the differential diagnostic value of serum intestinal fatty acid binding protein (I-FABP)in distinguishing intestinal ischemia patients from acute abdomen patients.MethodsA total of 151 patients with acute abdomen and 17 healthy controls from the PLA General Hospital were enrolled from November,2009 to August,2011. Serum I-FABP levels were measured by ELISA.According to the ROC curve,the cut-off value,sensitivity,specificity,positive likelihood ratio (PLR),negative likelihood ratio ( NLR),positive predietive value (PPV) and negative predictive value (NPV) were calculated. ResultsOf the 151 acute abdomen patients,there were 24 intestinal ischemia patients and 127 without intestinal ischemia.Serum I-FABP level in intestinal ischemia group [( 109.67 ±48.82) μg/L]was significantly higher than those in patients without intestinal ischemia [(36.78 ± 11.25) μg/L]and healthy controls[(8.33 ±6.25) μg/L]( all P values ＜0.01 ).The serum I-FABP cut-off value for the diagnosis of intestinal ischemia was 87.52 μg/L.Serum I-FABP was efficient in terms of sensitivity (0.762),NPV(0.963),PLR(3.05) and NLR (0.24) in the diagnosis of intestinal ischemia.ConclusionI-FABP is potentially useful for discriminating intestinal ischemia from acute abdomen.

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.

Pass an overview about medical social work ethics and analyzed the reasons.Based on China′s na-tional conditions and the basis of the particularity of medical social work in China, puts forward the paths of the lo-calization of medical social work ethics, namely, improve the adaptability of western medical ethics of social work, realizes the Chinese traditional culture and western medical social work ethics, mutual accommodation, with the so-cialist core values at the head of the medical social work ethic construction in our country.

Objective Quadratic regression universal rotary combination design was used to optimize the fluorescence labeling condition of lycium barbarum polysaccharide (LBP).Methods The fluorescence labeling condition of LBP presented, when the covalent coupling of LBP and tyramine was reacted with fluorescein isothiocyanate (FITC). Filter the best labeling condition via using quadratic regression universal rotary combination design experiment on the relationship of labeling efficiency among pH value of buffer solution, reaction time, temperature and the dose of tyramine.Results The regression equation was:Y=0.085 41 - 0.002 82X1 - 0.015 68X2 + 0.008 11X3 + 0.005 01X4 + 0.008 75X1X2 - 0.005 75X1X3 - 0.001 75X1X4 + 0.010 63X2X3 + 0.000 125X2X4 + 0.000 25X3X4 - 0.021 44X12 - 0.008 89X22 - 0.001 984X32 + 0.003 66 X42, and the variables fromX1 toX4 represented pH value, reaction time, temperature and dose of tyramine, respectively. The goodness of fitting of regression equation was statistically significant. The condition of labling LBP was optimized when the temperature was at 50℃, timing of labling at the fourth day and pH value was 8.5.Conclusion The condition of labling LBP was optimized with suitable temperature, pH value and extended timing.