Objective The changing patterns of pathogenic isolates and antibiotic susceptibility in Chongqing's neonates between 2010 and 2015 were investigated for the purpose to provide evidence for rational use of antibiotics and control of nosocomial infections.Methods The distribution of pathogenic bacteria and antibiotic susceptibility were analyzed.Identification and antibiotic susceptibility testing were carried out using BD Phoenix 100 automated system and the conventional Kirby-Bauer method.The results were interpreted in accordance with the breakpoints of the Clinical and Laboratory Standards Institute.Results A total of 10 569 pathogenic bacterial strains were isolated during the period,most of which were gram-negative bacteria (80.8 ％,8 540/10 569),primarily Klebsiella pneumoniae (29.3 ％),followed by Escherichia coli (16.7 ％),Acinetobacter baumanmii (9.9 ％),Enterobacter cloacae (8.6 ％) and Pseudornonas aeruginosa (3.3 ％).Gram-positive strains accounted for 14.1％ (1 490/10 569),mainly Staphylococcus aureus (7.8％),Staphylococcus epidermidis (2.2 ％),and Staphylococcus haemolyticus (1.8 ％).Imipenem and meropenem showed high activity against Enterobacteriaceae (＜ 10％ resistant),followed by P.aeruginosa (＞ 10 ％ resistant),and A.baumannii (＞20％ resistant).The prevalence of carbapenem-resistant strains was 8,4 ％ in K.pneumoniae and 2.9 ％ in E.coli isolates,No gram-positive isolates were resistant to vancomycin,teicoplanin or linezolid.Conclusions K.pneumoniae was the most frequently isolated pathogen in the neonates treated in Children's Hospital of Chongqing Medical University.The prevalence of A.baumannii isolates is increasing.Carbapenem-resistant Enterobacteriaceae strains are emerging.

Objective To investigate the relationship between omentin-1 and Coronary heart disease in different glucose tolerance populations. Methods Serum omentin-1 levels were determined by ELISA in 143 subjects with normal glucose tolerance,impaired glucose tolerance with CHD, type 2 diabetes mellitus with CHD. The relationships between omentin-1 and waist- to-hip ratio, body mass index (BMI), blood Glucose, serum insulin,HOMA-IR and blood fat were also explored.Coronary artery stenosis was screnned by coronary interventional angiography and assessed by Gensini scoring system. Results Serum omentin-1 levels were all lower in T2DM and IGT subjects than those in control subjects (P<0.01). Serum omentin-1 was correlated positively with high density lipoprotein-cholesterol (P < 0.01),and inversely with body mass index,waist-hip ratio,diastolic blood pressure, triglyceride,fasting blood glucose,fasting insulin,HbA1c,[w1]and insulin resistance(HOMA-IR)(P<0.05 or P <0.01).Omentin-1 levels was negative related with Gensini coronary artery score (P < 0.01). Multiple linear regression showed body mass index,HOMA-IR,diastolic blood pressure were independently associated with omentin-1 levels (P<0.05 or P<0.01). Conclusions Serum omentin-1 levels, associated with fat,insulin sensitivity, are likely to play an important role in insulin resistance and the development of CHD in populations with different glucose tolerance.

Objective To translate LARS Score into Chinese and examine the reliability and validity of the LARS Score to predict patient bowel function.Methods A convenience sample of 40 Chinese rectal patients was recruited sequentially from a tertiary first-class hospital in Tianjin.The patients were assessed for bowel function using the LARS Score after anterior resection.Data were collected to conduct reliability tests on test-retest,inter-rater and constant,construction validity.Results The field test demonstrated excellent repeatability with an ICC value of 0.9615 (95％CI 0.9272～0.9796); inter-rater reliability was high with an ICC value of 0.9394 (95％CI 0.8854～0.9680).Content validity was excellent which CVR was 0.90.Constructive validity was good,factor analysis extracted two common factors,which could explain 60.659％ of the total variance,and each item on the corresponding factor had satisfactory factor loading quantity (＞0.4).Conclusions The Chinese version of LARS Score is easy to use and convenient to understand; the evidence collected in this study has shown good reliability and validity of using the LARS Score in assessing bowel function of Chinese rectal cancer patients.

Objective To introduce the method, indications and the usage of abdominal double layer subcutaneous flap for the repair of late complicated hand injury. Methods A new type of flap was designed to repair the complicated hand injury. Sixteen cases were treated with this method since 1998. Results The duration of the follow up ranged from 3 to 24 months with an average of 13 months. All of the flaps survived well. After physiotherapy, the overall excellent and good rate of joint movement was 80%(TAM standard). No further surgery was required in all of the cases. Conclusion The abdominal double layer subcutaneous flap was especially indicated in those cases with bone nonunion, tendon and nerve defect and tendonous adhesions. This kind of flap not only provide a good skin covering, but also offer a soft bed for the tendons, nerves, and bones.

Objective To investigate the appropriate setting up of normal reference ranges of lymphocyte subsets in some flow cytometry laboratories and to study the effects of different flow cytometers and various reagents by different manufacturers on the analysis of peripheral blood lymphocyte subsets. Methods Three FCM labs (named A, B and C) in Beijing region were selected representing 3 commonly used flow cytometers (Beckman Coulter Epics XL, Beckman Coulter Cytomics FC500, BD FACS Calibur). 50 samples from healthy donors were distributed to 3 labs and tested according to individual lab's standard operating procedure to verify whether the normal reference ranges of peripheral blood lymphocyte subsets established were appropriate. The application of internal quality control was also investigated. Commercial blood quality control reagents were given to the 3 FCM labs and tested within 20 working days paralleled with routine samples. In addition, 20 patients' samples were prepared using 4 different combinations of reagents ( a , b , c and d). The results from combination a, which used the Beckman Coulter reagents and instrument, were compared to the results from combination b, c and d, which used reagents from different manufacturers. Then the prepared samples were tested on Beckman Coulter Epics XL to evaluate the effects of different combinations of reagents on the results of peripheral blood lymphocyte subsets analyzed by the same instrument. Furthermore, 24 patients' samples prepared by same reagents from Beckman Coulter company were tested on both Beckman Coulter Epics XL and BD FACS Calibur respectively to assess the effects of different instruments on peripheral blood lymphocyte subsets. 20 patients' samples prepared by same reagents and instruments were analyzed by Beckman Coulter Epics XL analytic system and BD FACS Calibur analytic system respectively to assess the effects of the two analytic systems on the lymphocyte subsets. Results Over 10% of the results for NK and T4/T8 in lab A as well as T4 in labs B and C fell outside of their normal reference ranges. The probabilities exceeding corresponding normal reference ranges were 16% ( 9/50 ), 24% ( 12/50 ), 22% (11/50) and 12% ( 6/50 ), respectively. The results using internal blood quality control in 3 FCM labs within 20 working days were all within the reference ranges of the quality control provided by the kit. The biases from b and c reagent combinations were substantial compared with that of reagent a combination. Among the biases from b and c reagent combinations, the lowest probability of bias exceeding 10% was T8 of combination b, which had probability of 70% (14/20). The highest probabilities of hias exceeding 10% were T3 and T4 of b and c reagent combinations, which reached 100% (20/20) . Furthermore, the biases of T3, T8 and B of d reagent combination compared with that of reagent a combination were also substantial. The probabilities of bias exceeding 10% were 35% (7/20) ,85% (17/20) and 75% (15/20), respectively. Comparing the results of samples prepared and analyzed by reagents and instruments from different manufacturers to that of samples prepared and analyzed by the same company's reagents and instruments showed that there were great discrepancies in T3, T4 , T8 , B and NK. The probabilities of bias exceeding 10% were 71% ( 17/24), 80% (19/24) ,38% (9/24), 33% (8/24) and 92% (22/24), respectively. The biases of T8, NK and B were substantial when compared the results from Beckman Coulter Epics XL analytic systems and BD FACS Calibur analytic systems. The probabilities of bias exceeding 10% were 55% (11/20 ), 70% ( 14/20 ) and 55% (11/20), respectively. Conclusions FCM labs should set up their own normal reference range for peripheral blood lymphocyte subsets. The normal reference range should be verified periodically. It is important to apply internal blood quality control regularly and accumulate the quality control results. The reagents and instrument for preparing peripheral blood samples should be from the same manufacturers.

Objective To explore the expression of the Merlin protein in normal cervix and cervical can-cer of the Han,Tibetan and Hui nationalities in Qinghai. Methods Immunohisto-chemical staining was per-formed to detect the expression of Merlin in 108 cases of cervical carcinoma(40 cases of Han,38 cases of Tibetan and 30 cases of Hui nationality)and 107 cases of normal cervix(40 cases of Han,37 cases of Tibetan and 30 cas-es of Hui nationality). Results The positive expression rates of Merlin in normal cervix were 90.0%,91.9%and 86.7%respectively and those in cervical carcinoma were 17.5%,18.4%and 16.7%respectively. There was signifi-cantly statistical difference(P<0.05). However,there was no significant difference in the positive rates of Merlin between cervical carcinoma among different ethnic groups(P>0.05). The expression of Merlin was not correlated with age,FIGO stage,lymph metastasis and cell differentiation(P > 0.05)in cervical carcinoma of three ethnic groups. Conclusion The decrease or even deletion of Merlin may be involved in the development of cervical can-cer,and it plays an important role in cervical cancer. The expression of Merlin exerts no effect on the occurrence of cervical cancer and it is not associated with the clinical characteristics of the patients ,suggesting that it may not be involved in the invasion and metastasis of cervical cancer.

OBJECTIVE: To investigate the incidence rate of the ampC gene and AmpC enzyme of gram-negative(G-) bacterium in children,to analyze drug resistance of produced AmpC enzyme and un-produced AmpC enzyme strain.METHO_DS: 4 022 clinical G-isolates collected from 2002 to 2004 were identified and tested using K-B method.Selection 108 ESBLs bacterium,the ampC genes were amplified by PCR using common primers to AmpC and the AmpC enzymes were tested using the enzymatic rough extraction cefoxitin three-dimensional test.The drug resistance of bacterium produced AmpC enzymes were compared with the ones without AmpC enzymes.RESULTS: In 108 G-bacterium,the ampC genes positive bacterium were 70 strain(accounting for 64.8%),and 7 bacterium produced AmpC enzymes(accounting for 6.5%) were detected.The drug resistance of bacterium produced AmpC enzymes to ceftazidime(CAZ),ceftriaxone(CRO),piperacillin(PIP),ampicillin(AMP),aztreonam(ATM) were 85.7%,85.7%,71.4%,79.4%,79.4% respectively.The drug resistance of bacterium non-produced AmpC enzymes to CRO,PIP,gentamicin,AMP,ATM were 50.8%,55.6%,55.6%,70.3%,54.0% respectively,the drug resistance of bacterium to imipenem were the lowest,lower to ciprofloxacin.CONCLUSIONS: Detection rate of ampC gene were higher than AmpC-producing enzymes strains obviously,whereas the drug resistance to antibiotic of AmpC-producing enzymes strains were higher than non-producing enzymes strains.

2h.The shape of bacterium was changed by amikacin from sphero-rhabditiform to dolicho-rhabditiform,while by ceftriaxone changed from rhabditiform to long-chain-form or filament-form.Conclusion The capability of ceftriaxone-induced release of endotoxin from Escherichia coli is significantly stronger than that of amikacin,and the morphologic changes of bacteria caused by ceftriaxone were more significant.For clinical treatmentg of infectious diseases the first dosage of medication should increase to reach the effective bactericidal concentration but not the bacteriostasis concentration in order to receive better therapeutic effects.

Objective To investigate the value of adenosine stress myocardial contrast echocardiography(MCE) in evaluating the myocardial perfusion in patients with coronary artery stenosis in different degrees. Methods The 384 myocardial segments governed by the corresponding coronary arteries with different degrees of stenosis in 24 patients with coronary artery disease (CAD) were divided into group A (normal),B (50%～75%) ,C (76%～89%) and D (≥90%). Parametric quantification(PQ) was applied at rest and adenosine stress MCE to analyze myocardial perfusion by parameters (A,β and A×β). Then the receiver operating characteristic (ROC) curves were constructed according to the rangeability of the parameters and the cutoff points, sensibility and specificity were obtained. Results At rest, A,β and A ×β in group A,B,C and D decreased by degrees,while there were no significant differences between group A and B. At adenosine stress, the parameter rangeability increased in group A and B, while decreased in group C and D. The ROC curve analyses of parameter rangeability showed that the area under the curve of the rangeability of parameter A ×β was the largest when the rangeability was applied to diagnose stenosis of coronary artery,and the sensibility and specificity were 81.3% and 94. 9% for group B,82.6% and 84.5% for group C,71.9 % and 86. 3 % for group D. Conclusions Adenosine stress MCE can be applied to diagnose the various degrees of stenosis of coronary artery.

Objective To assess the value of the myocardial segment number of color change in the bull's eyes of three-dimensional speckle tracking echocardiography (3D-STE)in the detection of multi-vessel coronary stenosis at the resting state.Methods A total of 125 consecutive patients were enrolled and divided into the following three groups according to the coronary angiography(CAG):multi-vessel coronary stenosis group (n=48),single-vessel stenosis group(n =34)and control group (n =43).All patients underwent two-dimensional (2D)and three-dimensional echocardiography (3D)and three-dimensional speckle tracking echocardiography (STE).The bull's eyes of left ventricular 17 myocardial segments including longitudinal strain(LS),circumferential strain (CS),area strain(AS)and radial strain(RS)were acquired by 3D-STE.The homogeneous colors were regarded as normal wall motion myocardial segment (LS,CS,AS is a uniform red,RS for uniform blue ),the colors were uneven or shallower,or changes were regarded as abnormal wall motion myocardial segment.The myocardial segment number of color change in the bull's eyes can be calculated.Receiver operating characteristic (ROC ) curves were computed to determine optimal strain cutoff values to predict multi-vessel coronary stenosis.Results The myocardial segments of abnormal wall motion in the bull's eyes (LS,CS,AS,and RS)were significantly increased compared with the control group(P <0.001).In particular,the multi-vessel coronary stenosis group were dramatically increased than the single-vessel coronary stenosis group.Meanwhile,these parameters were higher in patients with multi-vessel coronary stenosis than in those with single-vessel coronary stenosis (P <0.05).ROC analysis demonstrated areas under the curve of 0.84 for 3D GLS,0.89 for 3D GCS,0.95 for 3D GAS,and 0.89 for 3D GRS.An optimal cutoff value of magnitude,sensitivity and specificity were LS,12,89.6%,76.7%;CS,11,89.6%,74.4%;AS,12,91.7%,88.4%;RS,13,81.2%,86.0%,respectively. Conclusions The myocardial segment number of color change in the bull's eyes by 3D-STE is useful to detect multi-vessel coronary stenosis,where in GAS are more valuable indicators with higher sensitivity and specificity.