OBJECTIVE With surveillance of the distribution and antibiotic resistance of Escherichia coli during the last six years in our hospital,the basis for the reasonable clinical use of antibiotic is provided to doctor.METHODS A total of 1 907 strains of E.coli isolated during the last six years were analyzed by Kirby-Bauer disk or VITEK-2 system.RESULTS Among 1 907 strains of E.coli,1 114 strains were isolated from urine,accounted for 58.4%;215 from pus or secret,accounted for 11.3%;165 from sputum,accounted for 8.7%;and 159 from blood,accounted for 8.3%.ESBLs production rate of E.coli increased steadily from 5.11%,10.34%,14.56%,15.14%,33.79% to 29.96%,separately during the six years.The resistance of E.coli with ESBLs to most antibiotics was much higher than those without ESBLs.And E.coli demonstrated much higher resistant rate to ciprofloxacin,penicillins,and first or second generation cephalosporins,and much lower to amikacin and cefoperazone/sulbactam.No strains were found to be resistant to imipenem.CONCLUSIONS E.coli is the major pathogen,causing nosocomial infection with multi-resistant mechanism, since ESBLs-producing strain is increasing as years gone,reasonable choice of antibiotic should be in term of result of antibiotic resistant test and patient symptom to cure the E.coli infection induced.

OBJECTIVE To study clinical distribution of Serratia and learn the antimicrobial susceptibility to S.marcescens in vitro in order to offer the reference to optimally selecting antibiotic.METHODS It was analyzed that the 222 Serratia strains were distributed in and the was deteted 164 S.marcescens strains were isolated from our hospital from 2001 to 2006.Their VITEK-2 of French Bio-M?rieux Company was adopted to proceed the identification of bacteria and antimicrobial susceptibility test.Data were analyzed by WHONET 5.4.RESULTS Serratia were mainly isolated from sputum,urine,blood,secretion,bile,cerebrospinal fluid,abdominal fluid,et al.Infection of both in-and out-patients could be caused by Serratia and most were in surgery ward.S.marcescens had higher drug resistance rates to piperacillin,cefazolin,cefuroxime,gentamicin and tobramycin which were all above 60%.They were all susceptible to imipenem(minimum inhibitory concentration only 1 ?g/ml) and their susceptible rates to piperacillin/tazobactam,ceftazidime,cefepime,and levofloxacin were all higher than 80%.CONCLUSIONS Serratia are less isolated from clinics,but have much higher antimicrobial resistance to the 1st and 2nd generation cephalosporin and show diversely drug resistance to 3rd cephalosporin,so physicians should pay attention to the infection caused by them.

Objective To study the optimum extration process of polysaccharides from Meretrix meretrix Linnaeus.A spectrophotometry method for content determination of polysaccharides from Meretrix meretrix Linnaeus was established with Phenol-sulfuric acid coloration.Methods The samples were extracted by ultrasonic wave,dissolved in 50mL,4mol?L~(-1) HCl and heated to hydrolyze by acid.The contents of polysaccharides from Meretrix meretrix Linnaeus were determined by spectrophotometry at 490nm.Results Extracted for thirty minutes by ultrasonic wave,two times,and acidic hydrolysis were the optimum technology.The calibration curve was linear over the range of 4.848～24.242mg?L~(-1).The regression equation was C=28.69A+0.229(r=0.9992).The average recovery rate was 100.67% and RSD was 2.83%(n=6).Conclusion The method was proved to be simple,accurate and reliable,and could be used to extract and determine the polysaccharides from Meretrix meretrix Linnaeus.

Objective To compare tbe efficacy of conventional therapy,psychotherapy,serotonin reuptake in- hibitor,and psychotherapy combined with serotonin reuptake inhibitor in rehabilitating nerve function in the treatment of post-stroke depression.Methods One hundred and twenty patients with post-stroke depression were divided into a control group(A),a group treated with serotonin reuptake inhibitor (B),a psychotherapy group (C) and a group in which psychotherapy was combined with serotonin rcuptake inhibitor(D).These groups were graded with the SDS for the degree of their depression and with the MESSS for their muscle strength before andafter treatment.Results The anti-depression therapies showed significantly different effects in improving depression.After eight weeks,group D showed significantly less depression than the others.However,muscle strength did not show statistically significant differences until twelve weeks,when group D again showed better progress than the others.Conclusion Psychothera- py combined with serotonin reuptake inhibitor can promote the rehabilitation of nervous function-after stroke.

OBJECTIVE To offer the clinical physician the basis of optimal application of antibiotic,we have investigated the variation of antibiotic resistance and the bacterial spectra in the blood culture.METHODS Blood was cultured in BACTEC9120 of BD.The clinical isolates were identified by API and VITEK-2 of Bio-Merieux of France.Antibiotic susceptive test was done by Kirby-Bauer method and the result which was analyzed by WHONET5.3 and SPSS11.5 software was determined by the NCCLS standard of 2005′s edition.RESULTS Organisms were isolated from the blood specimen of 1468 patients,and there were 743 strains of Gram-positive cocci accounted for 50.7%,565 strains of Gram-negative bacilli accounted for 38.5%.Ninety three strains of fungi accounted for 6.3%.We analyzed the drug-susceptive result of Staphylococcus,Escherichia coli,and Klebsiella pneumoniae during five years,and found that all the antibacterial drug lost efficacy in some degree,except that the sensitivity of the staphylococci to vancomycin was 100%.CONCLUSIONS Gram-positive cocci are the main bacteria in blood culture,the species from which are diversified,and the rate of the drug resistance of some bacteria is high.It indicated that doctors should take more blood culture and monitor the bacteria drug resistant for the data of etiology,so that they can utilize antibiotic more reasonably.

OBJECTIVE To learn the profile of Gram-negative bacilli in ICU ward during the eight years and analyze the drug resistant rates in order to provide the basis for empirical treatment of infection.METHODS The bacteria were identified by VITEK-2 and API system.Antibiotic sensitivity test adopted Kirby-Bauer method.Data were analyzed by WHONET5.4 software.RESULTS Totally 1492 strains of Gram-negative bacilli were isolated from ICU ward,which included 1146 strains of non-fermentaters,accounted for 76.8% and 346 strains of Enterobacteriaceae,accounted for 23.2%.The first five bacteria were Pseudomonas aeruginosa,Burkholderia cepacia,Acinetobacter baumannii,Stenotrophomonas maltophilia,and Escherichia coli by turns.The drug resistant rates were higher and had the tendency of increase by years.CONCLUSIONS Non-fermentaters are the main organisms in ICU ward.The species of bacteria are diversified and the drug resistant rates of them are serious,which should be monitored not only because helping clinical therapy but also discovering the prevalence of drug resistant strains.

OBJECTIVE To learn the epidemiology of respiratory infection in ICU and non-ICU wards,and analyze the difference of drug resistance of Gram-negative bacilli between those two wards in order to provide the basis of empirical therapy for the respiratory infection from the different wards.METHODS The bacteria were identified by VITEK-2 and API system.Antibiotic sensitivity test adopted by K-B method.Data were analyzed by WHONET 5.3 software.RESULTS Totally 2184 strains of Gram-negative bacilli were isolated all from the respiratory tract,among which 655 strains were isolated from ICU ward and 1529 strains were from non-ICU ward.In ICU ward,the first five bacteria were Pseudomonas aeruginosa,Burkholderia cepacia,Acinetobacter baumannii,Chryseobacterium meningosepticum,and Stenotrophomonas maltophilia.It showed that non-fermentatives were the main pathogenic bacteria in ICU.In non-ICU ward,the first five bacteria were P.aeruginosa,Klebsiella pneumoniae,A.baumannii,B.cepacia,and S.maltophilia.Drug resistant rate of strain from ICU ward was generally higher than that from non-ICU ward,while levofloxacin in ICU ward showed the better activity than in non-ICU ward.CONCLUSIONS The respiratory infection is one of the hazards in nosocomial infection,drug resistant rate of Gram-negative bacilli from respiratory specimen in ICU is generally higher than that in non-ICU,and the main strains are the mlti-resistant non-fermentatives,which should attract the clinician′s more attention.

A simple method for the isolation and purification of ginkgolide A, B and bilobalide(ginkgo terpene trialctone) was developed. A commercially available extract of leaves of Ginkgo biloba L.containing ＞6％ ginkgo terpene trilactone was used as the raw material. After partition in EtOAc, the en-riched extract was separated to give individual terpenes by preparative liquid chromatography. GinkgolideA, B and bilobalide could be isolated with high purity by recrystallizing in MeOH-H2O.

Objective To investigate the effect of nicorandil pretreatment on myocardial mitochondria in a rabbit model of myocardial ischemia-reperfusion (I/R). Methods Tirty-two healthy male New Zealand white rabbits weighing 2.0-2.5 kg aged 4 months were randomly allocated into 4 groups ( n = 8 each): Ⅰ group sham operation (group S); Ⅱ group I/R; Ⅲ group nicorandil pretreatment (group N) and Ⅳ group nicorandil + 5 hydroxydecanoic acid (group N + 5-HD). Myocardial I/R was induced by 30 min occlusion of left circumflex coronary artery followed by 120 min reperfusion. In group N and N + 5-HD a bolus of nicorandil 100 μg/kg was given iv at 10 min before myocardial ischemia followed by continuous infusion at 10 μg· kg-1 · min-1 until the beginning of myocardial ischemia. In group Ⅳ a bolus of 5-HD 5 mg/kg was injected iv at 20 min before myocardial ischemia.The animals were sacrificed at the end of 120 min reperfusion. The mitochondrial membrane potential was measured by flow cytometry using JC-1 fluorescence probe as indicator. Bcl-2, Bax and cytochrome c protein expression was determined by immuno-histochemistry. Myocardial ultrastructure was examined with transmission electron microscope. Results Red fluovescence intensity indicating normal live cells was significantly higher, the green fluorescence intensity indicating apoptotic cells was lower and red/green fluorescence intensity ratio was higher; the Bcl-2/Bax ratio was significantly higher and cytochrome c protein expression lower in group N than in group I/R.5-HD administration negated the protective effect of nicorandil pretreatment against myocardial I/R injury. Conclusion Nicorandil stabilizes mitochondrial membrane potential, decreases cytochrome c protein releasing, and suppresses mitochondrial apoptotic signal transduction by opening the mito-KATP channels.

Objective To investigate the application of prenatal ultrasonograpy in diagnosis of fetal heart disease during the medium-term and terminal pregnancy,and to avoid misdiagnosis.Methods The prenatal ultrasonographic screening was conducted in 7020 pregnant women with medium-term and terminal pregnancy.All confirmed and suspicious cases of fetal heart disease were observed by echocardiography once 4 weeks until postnatal sixth month to 1 year while normal cases was traced at the intervals of 8 weeks.All the cases were confirmed by autopsy or surgery while part of them were confirmed by postnatal angiocardiography before surgery.The reasons of misdiagnosis were analyzed.Results In fifty-three cases of fetal cardiovascular abnormality,43 cases were found,2 cases were misdiagnosis while 8 cases were missed diagnosis.2 cases of misdiagnosis included 1 case of pulmonary valve stenosis and 1 case of tetralogy of Fallot.8 cases of miss diagnosis included 2 cases of inferior vena cava in ectopic drainage and 6 cases of ventricular septal defect (defect diameter ＜ 5 mm).The accuracy rate of diagnosis of fetal heart disease was 81.1 ％ by echocardiography.Conclusions Using high frequency probe,image zoom,enhancing the detection of vein-atrium connection and the structure of right ventricular outflow with pulmonary artery are important factors to avoid missed diagnosis and incomplete diagnosis.