Objective To investigate the mechanism of Acinetobacter baumannii resistant to carbapenems.Methods E test and microdilution were used to determine the minimum inhibitory concentrations(MIC) of 11 antibiotics against 30 isolates of imipenem-resistant Acinetobacter baumannii strains.The production of ?-lactamase was detected by improved three-dimensional test.Nine coding genes of?-lactamase were detected by PCR.Results The resistance rates of 11 antibiotics were over 90% except for polymyxin B(23.3%) and ciprofloxacin(87.7%).Among 30 isolates of Acinetobacter baumannii the positive rate of single ESBLs,single AmpC,ESBLs+AmpC,non-ESBLs non AmpC?-lactamase was 33.3%(10/30),3.3%(1/30),23.3%(7/30) and 26.7%(8/30) respectively by three-dimensional test.The coding genes:VIM-1,VIM-2,OXA-24,CTX-M-2,IMP-1 and VEB-1 were undetectable.Two or three of coding genes:OXA-23,PER-1 and AmpC were detectable in 27 isolates,and their homologies compared with corresponding sequences of GenBank were more than 98%.A nucleotide mutation(A→C) at 617 site of PER-1 gene was found in No.26 strain,so this sequence was registered in GenBank(Accession No.DQ341275).Conclusions Carbapenems resistance in Acinetobacter baumannii related with the production of OXA-23,PER-1 and AmpC.

At present,transjugular intrahepatic portosystemic shunt (TIPS) is an effective procedure widely used in the clinical treatment of portal hypertension.The blood stream in the portal vein can be directly shunted into the hepatic vein through the inserted stent,which helps to reduce portal vein pressure.TIPS provides treatment opportunities for the patients with advanced portal hypertension complicated by intractable ascites and gastroesophageal variceal bleeding and those who are waiting for transplantation or cannot tolerate surgery.The key to success of TIPS is to maintain stent patency after placement,and therefore,post-TIPS monitoring is of vital importance.As a noninvasive,cheap,practical,and repeatable procedure,ultrasound has an important value in post-TIPS monitoring.This article summarizes the role of color Doppler and contrast-enhanced ultrasound in evaluating stent function after TIPS.

Objective To analyze the DSA manifestations of arteriovenous fistulae in hepatic cancer and to discuss the appropriate method for obstructing the fistulae in order to improve the therapeutic results for hepatic cancer associated with arteriovenous fistulae. Methods The imaging findings in 183 patients of hepatic cancer with urteriovenous fistulae, which were. selected from 637 patients with liver cancer, were retrospectively analyzed. For cases with mild arteriovenous fistulae (n = 89) the tumor-feeding arteries were embolized after iodized oil embolization procedure, while for cases with moderate and severe aneriovenous fistulae (n = 94) the abnormal shunts were obstructed before performing chemoembolization of the tumor in order to ensure that the effective infusion of the drug into the lesion and the sufficient deposit of iodized oil in the tumor could be obtained. Results The tumor-feeding arteries were successfully embolized in all 89 patients with mild arteriovenous fistulae. Of 94 cases with moderate and severe arteriovenous fistulae,excellent deposit of iodized oil was seen in 64 (68.1%), incomplete embolization in 13 (14.83%), poor oil deposit due to over-embolization in 11 (11.7%) and failure to block the fistulae as the fistulae were too large or too diffuse in 6 (6.4%). No serious complications occurred. Conclusion The arteriovenous fistulae accompanied with hepatic cancer can be effectively obstructed in most patients, with resultant clinical improvement of the patients' condition. This therapeutic technique is safe and reliable.

Objective To explore the prevalence and risk factors of knee osteoarthritis (OA) among the elderly in Tianjin. Methods Totally 2038 elderly in Tianjin were investigated from January 2010 to June 2011 according to protocol of APLA-COPCORD Core Questionnaire to identification of risk factors for knee OA. Results The prevalence rates of knee pain and knee OA were 23.1％ and 21.7％,respectively. Knee OA appeared much frequently in women than men (27.6 ％ vs.16.1 ％,x2 =46.893,P＜0.001 ) in the trend of increase with aging(x2 =764.34,P＜0.001).BMI in knee OA group [(25.4±3.3) kg/m2]was significantly higher than in non-knee OA group [(23.8± 2.9) kg/m2],(t =7.944,P＜0.001).Menopause age in female knee OA group was younger than in female non-knee OA group [(50.2±3.7) years vs.(52.8±4.1) years,t=7.665,P＜0.001].Binary logistic regression revealed that age,sex,BMI and age of menopause were risk factors of knee OA,and eating vegetable might prevent from osteoarthritis,whereas there were no significantly association between knee OA and the other factors such as smoking and drinking.Conclusions Age,female and overweight are identified as risk factors of knee OA.

Objective To identify the effects of parenteral nutrition (PN) on the gene expressions of rat intestinal inflammatory cytokincs and receptors and to explore the role of these changes in PN-related intestinal impairment. Methods Totally 12 male Sprague-Dawley rats were equally divided into the control group and the PN group. A silastic catheter was inserted into the right jugular vein of each rat. No food or water was administered to the PN group except for a continuous 24-hour PN infusion through the silastic catheter in the jugular vein. The control group, while being regularly fed, was administered with an infusion of normal saline through the silastic catheter in thc jugular vein. After 7 days, intestinal tissues were taken for electron microscopy and real-time PCR array to analyze thc microstructure change in rat intestine and thc gene expressions of inflammatory cytokines and their receptors. Results Electron microscopy revealed atrophy of microvillus, engorgement of mitochondria, cell-cell junction breakage, and several apoptotic bodies in the PN group and normal intestinal microstructure in the control group. Compared with the control group, the PN group showed an up-regulation in the gene expressions of interferon γ, interleukin-1 receptor type I , interlcukin-8 receptor type b and a down-regulation in the gene expressions of CC chemokine ligand 17 (CCL17) , CCL19, CCL21, CCL22, CCL9, CXC chemokine receptor 3, CC chemokine receptor 3 ( CCP3 ), CCR7, CCR5, C-reactive protein, and interleukin-10. Conclusions PN influences the gene expressions of rat intestinal inflammatory cytokincs and receptors. The expression of cytokine interferon γ increases and that of interleukin-10 declines, and the expressions of CCL19, CCL21, CXC chemokine receptor 3, CCR3,CCR7, and CCR5 decline. The alterations of these genes may be associated with the impairment of intestinal immune and mechanical functions.

Objective To comprehend the current difference of sequence variation of p24 coding region in gag gene and subtype distribution of HIV 1 in Henan province and Shanghai in China. Methods Plasma specimens were collected from 37 HIV 1 patients, of which 25 were from Henan province and 12 were from Shanghai. Most patients in Henan were infected by illegally donating blood while in Shanghai the major transmission routes were blood or blood product transfusion and sexuality. RNAs from plasma specimens were extracted and target gene were amplified by the method of RT PCR and Nested PCR. The sequences of p24 region, 693 nucleotides were determined, then phylogenetic analyses were performed. Results Subtyping showed that 83.8% (31/37) were B subtype. Of 25 Henan specimens, 23(92%)were B subtype and 2 were A subtype. Of 12 Shanghai specimens, 8(66.7%)were B subtype, 1 was A subtype, 2 were CRF01 -AE and 1 was CRF02 -AG. Comparing with the Consensus sequence (Consensus -B, from HIV database), nucleotide variation in B subtype of Henan was 1.6%～4.2%, with an average of 3.2%, while that of Shanghai was 2.0%～3.8%, with an average of 3.4%. No G to A hypermutation was observed in all variations. The median intrasubtype distance for B subtype in Henan and Shanghai was 2.9% and 3.5%, and the intersubtype distance between B subtype and other subtypes was 11.1%～12.5%. The two Consensus sequences of Henan and Shanghai B subtype obtained by CLUSTAL X were aligned to Consensus -B, both the substitution for predicted amino acid were 2.2%(5/231). Of all the variations,they shared the same three mutations: A14P、I91V and E180D. However, the disparity between the two Consensus sequences was not significant (0.9%). Phylogenetic analyses implied that many specimens were B subtype, and all the B subtype specimens from Henan and most of Shanghai B subtype specimens were close to the isolates in Thailand. Conclusion B subtype was the dominant HIV 1 isolate in Henan and Shanghai of China.The HIV 1 B subtype in Henan and Shanghai had coincident homology and shared some identical variations of amino acid.

Objective To investigate the relationship between Epstein-Barr virus (EBV) DNA and EBV serology markers and evaluate the clinical application values in different diseases.Methods Plasma samples from 397 diagnosed EBV infection-associated patients and 120 health donors from May 2014 to November 2015 in Wuhan Tongji Hospital were collected.Real-time fluorescent quantitative PCR was performed to detect the levels of EBV-DNA in peripheral blood mononuclear cell and plasma.ELISA was used to detect VCA IgA,VCA IgM,VCA IgG,EA(D) IgG and EBNA IgG antibodies in plasma.The positive rate of EBV-DNA and EBV antibodies were counted in each group according to the detection threshold.Kappa statistic and Spearman sank correlation test were used to analysis the correlation and uniformity between EBV-DNA and EBV serology indicators.Results The positive rate of VCA IgG in patient and health control was 94.2% (374/397) and 93.3% (112/120) respectively (χ2=0.125,P=0.67);The positive rate of EBNA IgG in patient and health control was 95.4% (379/397) and 95.0% (114/120) respectively (χ2=0.045,P=0.807);but the positive rate of VCA IgM was 5.5% (22/397) and 0% (0/120) respectively (χ2=6.9,P<0.01);The positive rate of VCA IgA was 43.3% (172/397) and 9.2% (10/120) respectively (χ2=49.5,P<0.01);The positive rate of EA(D) IgG was 42.0% (167/397) and 7.5% (9/120) respectively (χ2=49,P<0.01).The positive rate of EBV-DNA was 65.5% (260/397) and 16.7% (20/120) respectively (χ2=88.5,P<0.01);The positive rate of EBV-DNA in plasma was 45.8% (182/397) and 5.0% (6/120) respectively (χ2=66.4,P<0.01).Furthermore,the uniformity and Spearman correlation analysis showed that there was no significant correlation between EBV-DNA and EBV serology indicators.The correlation analysis between PBMC EBV-DNA and VCA IgM,VCA IgA,EA(D) IgG showed the Kappa was 0.073,0.147,0.073,respectively;the correlation analysis between plasma EBV-DNA and VCA IgM,VCA IgA,EA(D) IgG showed the Kappa was 0.144,0.369,0.288,respectively.Thus,the patients were divided into different groups according to the discharge diagnosis,it was observed that the positive rates of EBV-DNA is more than 90% in extra-nodal NK/T cells lymphoma,EBV-associated hemophagocytic lymphoid tissue hyperplasia,chronic active EBV infection and infectious mononucleosis.In nasopharyngeal carcinoma patients,the positive rate of EBV antibodies (VCA IgA and EA(D) IgG) were higher than the detection of EBV-DNA.Conclusions There was no significant correlation between EBV-DNA and EBV serology markers for the same sample.The clinical application values of EBV DNA and EBV serology markers were not identical in nasopharyngeal carcinoma,extra-nodal NK/T cells lymphoma,infectious mononucleosis and EBV-associated hemophagocytic lymphoid tissue hyperplasia.

Objective: To observe stent patency after TIPS with color Doppler and contrast-enhanced ultrasound, and to analyze the hemodynamic characteristics of the stent. Methods: Postoperative ultrasonographic data of 32 patients underwent TIPS were retrospectively analyzed. The patency of stent was evaluated using color Doppler and contrast-enhanced ultrasound (defined into grade 0-3), and the flow velocities of the portal vein site, middle site and hepatic vein site of the stent were measured. Stent patency after TIPS was analyzed and compared between different ultrasound techniques, and the flow velocities in different sites of stent were compared in stents with excellent patency (grade 3). Results: There was significantly statistical difference of stent patency between color Doppler ultrasound and contrast-enhanced ultrasound (Z=-3.589, P<0.001). Contrast-enhanced ultrasound showed mild stenosis of stents (grade 2) in 8 times examination, severe stenosis (grade 1) in 6 times examination and stent occlusion in 2 times examination, while color Doppler ultrasound showed excellent patency (grade 3). There was significantly statistical difference of blood flow velocities among the portal vein site ([71.52±36.84]cm/s), middle site ([94.35±39.94]cm/s) and hepatic vein site([99.83±32.63]cm/s) of the stent (F=22.617, P<0.001). Besides, the flow velocitie of middle site (P=0.001) and the hepatic vein site (P<0.001) were respectively higher than that of portal vein site through pairwise comparison. Conclusion: Color Doppler combined with contrast-enhanced ultrasound can improve the accuracy of the evaluation of stent patency after TIPS. Significant difference of flow velocities exist in different sites of the stent.

Objective To investigate the effects of desflurane on the delayed rectifier potassium current (Ik ) in acutely dissociated rat parietal cortical neurons. Methods Wistar rats between 10- and 14-day old of both sexes were used. The parietal cortical neurons were acutely dissociated enzymatically. The extracellular fluid saturated with 0.3,0.6 and 0.9 mmol/L desflurane was added to the culture dish, then the effects of different concentrations of desflurane on Ik were investigated by using the whole-cell patch-clamp technique in acutely dissociated rat parietal cortical neurons. Results IK was inhibited by desflurane in a concentration-dependent manner ( P ＜0.01). The V1/2 of the activation and inactivation curves and the slop factor had no change after giving 0.6 mmol/L desflurane (P ＞ 0.05). Conclusion Desflurane inhibits delayed rectifier potassium channels of parietal cortical neurons of rats in a concentration-dependent manner, and has no effect on the activation and inactivation of delayed rectifier potassium channels, indicating that the change in the excitability of the channel is not involved in the mechanism of inhibitory effect of desflurane, and the other reasons may be involved in the mechanism.