Objective To investigate the distribution and antibiotic susceptibilities of quantitatively cultivated bacteria from bronchoalveolar lavage fluid (BALF) samples. Methods Totally 312 BALF samples were streak inoculated to chocolate,blood and MAC plates with 10 μL annulus,and the bacterial colony ＞ 104 CFU/mL was considered pathogenic bacteria. The identification of pathogenic bacteria was carried out with Vitek 2-Compact,and Kirby-Bauer disc agar diffusion method,Etest and dilution method were used for antibiotics sensitivity test.Results Totally 216 (69.2％) strains of pathogenic bacteria were isolated.The major gram-negative strains were Pseudomonas aeruginosa,Acinetobacter baumannii,Klebsiella pneumoniae and Escherichia coli, and the major gram-positive strains were Staphylococcus aureus,Streptococcus pneumoniae and Staphylococcus epidermidis.The resistance rate of Pseudomonas aeruginosa to aztreonam was high,but lower than 30％ to piperacillin/tazobactam,imipenem,cefepime,ofloxacin,ceftazidime and amikacin.Staphylococcus aureus was highly resistant to erythromycin,benzylpenicillin and clindamycin,but it was sensitive to furadantin,vancomycin,quinupristin/dalfoprisdn,tigecycline and linezolid.Conclusion The positive rate of BALF cultivation is high,and the main pathogenic bacteria Pseudomonas aeruginosa, Acinetobacter baumannii, Klebsiella pneumoniae, Staphylococcus aureus and Escherichia coli are resistant to several commonly used antibiotics.

Objective To investigate the effect of resveratrol on murine macrophage cell line (RAW264 .7 cells) polarizing phenotype induced by lipopolysaccharide .Methods RAW264 .7 mouse macrophages seeded in a 6 well plate ,then randomly divided into phosphate buffer saline(PBS) control group ,LPS (100 ng/mL) group ,and LPS (100 ng/mL)+ resveratrol (30 μmol/L) group .In the LPS+ resveratrol group ,LPS was added after incubation with resveratrol for 12 h .Cells were harvested and superna‐tant were collected after incubation with LPS for 12 h .Both the mRNA expression levels of M1 associated markers iNOS and TNF‐αand M2 associated markers IL‐10 ,PPARγ and Arg‐1 were measured by real time quantitative PCR .Expression of iNOS ,Arg‐1 protein were detected by Western blot ,inflammatory factor IL‐12 p40 ,IL‐10 and TNF‐αprotein in the supernatant of were assayed by ELISA .Results PCR detection showed that the mRNA expression levels of M1 associated markers iNOS and TNF‐αin the LPS group were significantly higher than that of LPS+ resveratrol group(P<0 .05) ,but the mRNA expression levels of M2 associated markers IL‐10 ,PPARγand Arg‐1 were significantly lower than that of LPS+ resveratrol group(P<0 .05) .Compared with LPS+resveratrol group ,western blot assay showed that iNOS protein level in LPS group was significantly higher than it (P<0 .05) ,but Arg‐1 protein level was significantly lower than it(P<0 .05) .The levels of IL‐12 p40 and TNF‐αin LPS group were significantly higher than that in LPS+ resveratrol group(P<0 .05) ,but the levels of IL‐10 was significantly lower than it(P<0 .05) .Conclusion Resveratrol may promote LPS stimulated RAW264 .7 macrophage polarization to M2 phenotype .

Objective To compare the drug resistance of mucoid Pseudomonas aeFagillosa with that of non-mucoid.Methods All specimens isolated and cultured from patients were identified and the antibiotic sensitivity was tested by automatic microorganism analyzer VITEK-32,GNI+,GNS-448,E-teat and K-B.Results Drug resistant rates of mucoid Pseudomonas aeruginosa to imipenem.levofloxacin.meropenem,cefepime,cefoperazone/sulbactam,amikacin,gentamicin,piperacillin.tazobactam,ceftazidime and cefotaxime were 5.3%, 16.1%, 5.6%, 20.6%, 1.1%, 10.5%,26.9%,5.3%.31.5% and 60.2%,respectively.The drug resistant rates of mucoid Pseudomonas aeruginosa were lower than those of non-mucoid except to ceftazidime.Conclusion Compared with non-mucoid Pseudomonas aeruginosa,antibiotic resistance of mucoid Pseudomonas aeruginosa is weaker in vitro.

Objective To analyze the antibiotic resistance of Branhemella catarrhalis strains isolated from sputum specimens of patients with lower respiratory tract infections from Linyi, Shandong Province, and to explore the relationship between bro genotypes of the strains and their resistance to antibiotic agents.Methods Sputum specimens were colleted from the patients with lower respiratory tract infections in Linyi People ’ s Hospital from the January 2010 to December 2014.The specimens were inoculated into 4 different disks for bacterial isolation and cultivation.β-lactamase detection and drug sensitivity tests were performed, and PCR coupled with restriction endonuclease analysis was employed for bro genotyping.χ2 test was used to compare drug resistance of strains with different bro genotypes.Results A total of 497 Branhemella catarrhalis strains were isolated in five years, among which 221 strains were isolated in winter.All strains were sensitive to ertapenem and chloramphenicol, and the resistance rates to amoxicillin/clavulanate and cefaclor were low (≤2.8%).The strains were highly resistant to compound sulfamethoxazole, erythromycin and ampicillin (47.6%-89.8%), and there was a trend of increasing resistance rates with the year, but no statistically significant difference was observed ( P >0.05 ) .β-lactamases was positive in 412 strains (82.9%), and all of these strains were positive for bro gene, and the resistances to erythromycin, compound sulfamethoxazole, levofloxacin and ampicillin were higher in bro positive strains than those in bro negative strains (χ2 =12.16, 16.18, 8.41 and 200.00,P<0.05).Among bro positive strains, 391 (94.9%) were of genotype bro-1, 21 (5.1%) were of genotype bro-2, and their resistance to antibiotic agents was not of statistical difference ( P >0.05 ).Conclusions Most of Branhemella catarrhalis clinical isolates are β-lactamase producing strains, and bro-1 is the most common genotype.Strains are highly sensitive to carbapenems, cephalosporins andβ-Lactamaseinhibitors, which can be recommended for the treatment of Branhemella catarrhalis-related respiratory tract infections.

Objective To discuss the distributional characteristics and drug-resistance of Enterococcus species isolated from urine specimens.Methods 3096 middle-segment urine specimens were collected since January to December in 2011 for culture.The identification of pathogenic bacteria and antibiotics sensitivity tests were carried out with VITEK2-compact combined with GN,AST-GN13,GP,AST-GP67,and antibiotics sensitivity tested performed by K-B and E-test at the same time.The results were determined by CLSI 2011.Results 1248 of 3096 pathogenic bacteria were isolated (40.31％).549 strains of Escherichia coli were detected (43.99％) which was the most common and 159 strains of Enterococcus were detected (12.74％) which was the second most common.The Enterococcus detection rate in woman (15.02％)was higher than that in man (10.35％),in out-patients (15.54％) than the that in hospitalized patients (12.49％),and in the patients of non-surgical departments (13.65％) than those of surgical departments (11.38％).The Enterococcus was absolutely sensitive to tigecycline,and the sensitive rate to vancomycin and linezolid were over 90％.The antibiotics sensitivity was higher for Enterococcus faecalis than that for Enterococcus faecium,and in surgical departments than non-surgical departments.Conclusions The detection rate of Enterococcus in urinary tract infection patients is quite high and varied between sexes and departments.The difference of drug resistance between species is obvious,and the bacteria species should be identified in order to use the antibiotics reasonably to postpone the development of drug resistant strains.

Employee motivation is to meet their needs and improve their productivity and work enthusiasm for the organization.Therefore,an accurate understanding of their needs is a prerequisite for the implementation of effective motivation.In view of this,we conducted a questionnaire survey of incentive factors for young medical staff at a public hospital.This study aimed at analyzing different incentive factors among medical staff with different seniority and job categories as well as their differences,in an effort to provide references for fine human resource management and motivation implementation at public hospitals.

Objective To investigate the drug sensitivity of mucoid Pseudomonas aeruginosa to common antibiotics and the expression of β-lactamase-resistant phenotype.Methods The specimens were inoculated onto different disks to isolate and cultivate bacteria.The antibiotic susceptibility of mucoid Pseudomonas aeruginosa isolates was detected and judged by CLSI 2013.The detection of drug resistance was done by Kirby-Bauer (K-B) method and β lactamase-resistant phenotype was detected by E-test.SPSS19.0 was used to statistic data and x2 test was used to compare the antibiotic susceptibility between different groups.For all statistical test,a P values less than 0.05 was defined as statistically significant.Results The susceptibilities of mucoid Pseudomonas aeruginosa to the regular antibiotics were above 70％,of which the sensitivities to amikacin,to bramycin,gentamicin,imipenem and meropenem were higher than 90％.The positive rate of ampler class C β-lactamase (AmpC) was 28.3％ (56/198).The drug sensitivity of positive strains was lower than that of the negative strains,and the differentiation was significant to piperacillin-tazobactam,amikacin,ceftazidime,levofloxacin,ciprofloxacin and aztreonam (x2 =3.89-14.45,all P ＜0.05).The positive rate of extended spectrum β-lactamase(ESBLs) was 10.6％ (21/198).The drug sensitivity to ceftazidime and aztreonam of positive strains[42.9％ (9/21) and 57.1％ (12/21),respectively].It was lower than that of the negative strains [73.5％ (130/177) and 72.3％ (128/177)],x2 =5.06 and 19.24,both P ＜ 0.05.The difference of the other antibiotics was not significant(x2 =0.01-3.47,all P ＞0.05).The positive rate of metallo-β-lactamase (MBL) was 19.7％ (39/198),and the drug susceptibility of positive strains was lower than that of negative strains except gentamicin and aztreonam(x2 =4.07-15.99,all P ＜ 0.05).All the detected strains were Klebsiella pneumonia carbapenemase (KPC) negative.Conclusions The antibiotic susceptible rate of mucoid Pseudomonas aeruginosa was high,but some enzyme-produced strains were lower.The clinician should adjust medicine program by the results of laboratory.

AIM:To develop the HPLC fingerprinting of Gynostemma pentaphyllum and evaluate the quality of different sources of G.pentaphyllum by fractal expression and wavelet analysis based on similarity calculation.METHODS:Flavones of G.pentaphyllum were extracted by using methanol and the HPLC fingerprint analysis on an HPLC/DAD system was developed.The signal of chromatogram was decomposed into components at different resolution by wavelet transform.Furthermore,the fractal dimensions of these components were computed for similarity calculation.RESULTS:With the optimized extraction and analytic tool,the fingerprint of G.pentaphyllum was developed.The similarity was effective in evaluating the quality of G.pentaphyllum.CONCLUSION:To describe a fingerprint profile by factors based on fractal and wavelet transform was a more objective method.G.pentaphyllum from Zhejiang province can be used as a substituent for raw drug from Ankang,Shanxi province.

The cultivation of medical students' scientific research and innovation ability is the need of our country to accelerate the construction of an innovative country. This paper starts from the significance of strengthening the cultivation of medical students' scientific research and innovation ability, emphasizes participation in teacher's scientific research in colleges and universities to strengthen the feasibility of the medical students' scientific research and innovation ability cultivation, and summarizes the practical experience of cultivating medical students' scientific research ability based on scientific research projects of teachers in colleges and universities, which can provide reference for peers.

Objective To observe the clinical effect of the club exercise designed ourselves on the prevention of should-hand syndromeafter stroke. Methods 100 stroke patients in early stage, whose motor function of upper limb were lower than Grade Ⅲ evaluated byBrunnstrom assessment and without shoulder pain and swelling of hand, were randomly divided into control group (n=50) and observationgroup (n=50). All of them received routine rehabilitation therapy, and the observation group received club exercise in addition. The incidenceof shoulder pain, the active range of motion of shoulder, the motor function of upper limb and activities of daily living (ADL) of 2groups were evaluated before and 2 courses (60 d) after treatment. Results There was no statistical difference between 2 groups before thetreatment (P>0.05). After 2-course treatment, the incidence of shoulder pain was significantly lower in the observation group than in the controlgroup (P<0.001), the active range of motion of shoulder, motor function of upper limb and ADL were significantly better in the observationgroup than in the control group (P<0.001). Conclusion The club exercise can prevent the pain of shoulder joint, increase the activerange of motion of shoulder joint and improve the motor function of upper limb and ADL in patients after stroke.