Objective To investigate the isolation and antimicrobial resistance of hypermutable Pseudomonas aeruginosa strains.Methods The cultured bacteria were identified by API 20NE system.The susceptibilities of bacteria were detected by disk diffusion method and the results were confirmed with the rules of NCCLS/CLSI.The hypermutable strains were identified byhigh concentration of rifampin-resistant growth assay.Results Among analyzed 100 strains,37 strains(37.0%) were hypermutable.The resistant rates of hypermutable strains to imipenem,meropenem,cefoperazone/sulbactam,piperacillin/tazobactam,ceftazidime,cephfime,aztreonam,amikacin and ciprofloxacin were significantly higher than those of non-hypermutable strains.The multidrug resistance rates of hypermutable strains were also higher than those of non-hypermutable strains.Conclusion The hypermutable strains of Pseudomonas aeruginosa sourced from chronic respiratory tract infections dominantly.The hypermutable strains were hyper-resistant and multidrug resistant to many antibiotics,so strengthened monitoring should be encouraged to control the prevalence of hypermutable Pseudomonas aeruginosa strains.

Objective To observe the curative effect of using artificial liver bilirubin specific adsorption for treatment of patients with hyperbilirubinemia and its effect on nursing.Methods A prospective study was conducted, 146 patients with hyperbilirubinemia admitted to Mianyang Central Hospital from January 2015 to December 2016 were enrolled, and they were divided into an observation group (77 cases) and a control group (69 cases) according to random number table method. The observation group was treated by medical treatment and the artificial specific liver bilirubin adsorption, while the control group only treated by medical therapy. The changes of levels of liver function indexes alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil), direct bilirubin (DBil) before and after treatment and clinical curative effect were observed in the two groups.Results Before treatment, there were no statistical significant differences in levels of the ALT, AST, TBil, DBil between the two groups (allP > 0.05), after treatment, the above indexes were significantly decreased compared to those before treatment, and the degrees of decrease in observation group were more obvious than those in control group [ALT (U/L): 341±42 vs. 455±37, AST (U/L): 120±35 vs. 197±37, TBil (μmol/L): 185.4±20.6 vs. 302.6±30.6, DBil (μmol/L): 42.6±10.8 vs. 87.5±11.6, allP < 0.05]. The total effective rate in observation group was obviously higher than that of control group [62.3% (48/77) vs. 40.6% (28/69),P < 0.05].Conclusions Based on liver protection, symptomatic and supportive medical treatment, using artificial liver bilirubin specific adsorption for treatment of patients with hyperbilirubinemia is safe and effective, and in addition, close observation and careful nursing is beneficial to the reduction of incidence of complications and elevation of therapeutic efficiency.

Objective To produce an erythrocytic stage chimeric protein of Plasmodium berghei in Pichia pastoris and evaluate its immunogenicity. Methods The DNA sequences of AMA1 (Ⅲ) and MSP1-19 from P. berghei homologous to the corresponding sequences of P. falciparum chimeric antigen 2.9 (PfCP-2.9) were fused to generate a chimeric gene, designated as PbCP-2.9. The resulting gene was redesigned using Pichia preferential coden usage and expressed in P. pastoris in the secreted form. The recombinant protein was purified by Ni-NTA affinity chromatography. Three groups each with 10 BALB/c mice were im- munized subcutaneously with 20 ?g of purified PbCP-2.9 antigen formulated in Freund’s adjuvant, Montanide ISA720 and Montanide IMS 1 312, respectively. Three control groups each with 10 mice received only adjuvants emulsified with PBS. All the mice received three immunizations at 2-week intervals with the same dose of antigen. Serum samples were collected at preimmunization and one week after each immunization, and were analyzed for specific antibodies by ELISA and reaction with natural P. berghei proteins by IFAT. Results The PbCP-2.9 antigen with Mr 26 400 was successfully expressed in P. pastoris in secret- ed form. The recombinant protein can be recognized by the serum against blood stage parasites of P. berghei. High antibody responses were detected in all three PbCP-2.9-immune groups of mice by ELISA. However, mice immunized with PbCP-2.9 antigen in Freund’s adjuvant produced higher antibody titers than those with PbCP-2.9 antigen in Montanide ISA 206 and Montanide IMS 1312 adjuvants. The mean antibody titer in Freund’s adjuvant was 6.9-fold higher than in Montanide ISA 206 adjuvant and 5.6-fold higher than in Montanide IMS 1312 adjuvant after the second immunization (F=81.06, P

To verify the role of introvascular ultrasound(IVUS) in diagnosis of atherosclerosis. MethodsINUS wasused to measure the position, quality and the thickness of the plaque in the elastic artery and biopsy materials. After using HE andHart stains, a micrometer was used to measuse the thickness of plaques and arterious walls. And electron microscopy was used to ob serve the pathological changs of the plaque. ResultsBy histological observation compared with IVUS, the conformable rate of plaque anmounted to 94%. The plaque could be seen in 12 sites of control group. Among 33 sites, 32 plaques were found pathologic exmination while IVUS showed 30 plaques in the experimental group. The two methods had a gcod correlation on the thick measurement of plaque and the media( r = 0.835, P＜0.05 and r = 0.814, P＜ 0.05). But they had a poor correlation on the measurement of the intirna( r = 0.055). ConclusionsBy pathological examination and the quantitative analysis, IVUS can obtain the common purpose in diagnosing atherosclerosis and measuring the media thickness. But it can not be used in measurement of the intima.

ObjectiveTo study the clinical application value of screening cervical precancerous lesions of high risk human papillomavirus(HPV) testing combined with thin-prep cell test(TCT) in prevention of cervical intraepithelial neoplasma (CIN) and cervical carcinoma. MethodsSeven hundred and sixty-three women were screened by high risk HPV test, TCT and pathology test of biopsy more. The positive coincident rate with the pathology test positive rate during the three technologies was compared.ResultsHigh risk HPV positive was 287 cases, the rate of infection was 37.61％(287/763), and pathology test positive was 82 cases, the coincident rate of which was 28.57％ ( 82/287 ) ; TCT positive was 78 cases, the rate of infection was 10.22％ (78/763), and pathology test positive was 50 cases, the coincident rate of which was 64.10％ (50/78) ; TCT + high risk HPV positive was 59 cases, pathology test positive was 47 cases, and the coincident rate of which was 79.66％ (47/59). Among each coincident rate,the differences were statistically significant (P＜ 0.05). The positive rate of high risk HPV infection CIN I was 32.26％( 10/31 ),CIN Ⅱ 41.38％ (12/29), CIN Ⅲ 93.55％ (29/31), squamous carcinoma of the cervix 96.88％ (31/32),respectively. ConclusionsThe positive rate of high risk HPV increases significantly with the grade of cervical precancerous lesions. It is of great significance to screen in the population for HPV and TCT in a regular time span,since it could not only decrease HPV infection rate and the incidence of cervical lesions,but also prevent the cervical cancer.

Objective To investigate the clinical value of the variety of serum levels of soL-CXCL16 and NT-proBNP peripercutaneous coronary intervention(PCI) in patients with acute myocardial infarction (AMI).Methods A total of 77 cases received PCI were selected to research group.And the contemporaneous 30 healthy persons were chosen to control group.The serum levels of soL-CXCL16,NT-proBNP and cTnT were detected by ELISA.The relationships of soL-CXCL16 and NT-proBNP to cTnT were detected by Pearson linear correlation analysis.Results Compared to pre-PCI,the serum levels of CXCL16 were rising to the peak point at 0.5 h post-PCI,and were decreasing from 2.0 h post-PCI,then the serum levels of CXCL16 were declining to the levels of pre-PCI at 24.0 h post-PCI (P＜0.05).And the serum levels of NT-proBNP were rising from 0.5 h post-PCI,and the peak point was at 24.0 h post-PCI (P＜0.05).The postive relationships of the serum levels of CXCL16 and NT-proBNP to the serum levels of cTnT were confirmed by Pearson linear correlation analysis(P＜0.01).Conclusion Monitoring of soL-CXCL16 and NT-proBNP for patients with percutaneous coronary stenting could provide foundation for prognosis evaluation of PCI.

Objective:To analyze the success rate and safety of artery blood-collection from related artery and provide reference for clinical work.Methods:A total of 600 patients in need of artery blood-collection ,who visited to our hospital from Jul 2013 to Sep 2013,were selected.They were randomly divided into femoral artery blood-collection group (n=120,femoral group),radial artery blood-collection group (n= 240,radial group)and brachial artery blood-collection group (n=240,brachial group).Success rate of puncture and incidence rate of adverse reactions were compared among three groups.Results:Success rates of puncture in femoral group and brachial group were sig-nificantly higher than that of radial group (95.00%,92.92% vs.86.67%,P <0.01 all),there was no significant difference between femoral group and brachial group,P >0.05;incidence rate of adverse reactions in femoral group was significantly higher than those of radial group and brachial group (11.67% vs.5.83%,5.00%),there was no significant difference between radial group and brachial group,P >0.05. Conclusion:Synthetic judgment:Success rate of puncture is higher and incidence rate of adverse reactions is lower for brachial artery blood-collection,so it may be regarded as preferred.

Oral feeding of water cannot be accomplished in some critical patients due to coma, mouth-breathing or long-term indwelling of gastric tube, causing dry mouth which results in oral pain, ulcer, or infection, aggravating patients' discomfort and even affecting the prognosis. To solve this problem, the medical staff of the First Hospital of Jiaxing developed a novel oral humidifier and obtained the National Utility Model Patent of China (ZL 2019 2 0066979.0). The oral humidifier consists of a spraying device and a fixation device. The spraying device is a spraying housing with a water tank, and a spraying port where nanometer water mist can be emitted. The spraying housing is also equipped with a flashlight with a switch, and a schematic diagram of pupil size, which can be used to assess the pupil size conveniently. The fixing device is composed of a fixing frame, an adjustable rod and a clamp. The two ends of the adjustable rod are connected to the fixing frame and the clamp respectively, and can be adjusted to proper shape. The spraying housing can be placed on the fixing frame and installed on the bed and adjusted to the proper position quickly. This novel oral humidifier is a simple device which combines a spraying system with a pupil evaluation tool, implying significant clinical application in improving the convenience of nursing and alleviating dry mouth of critical patients.

To observe the clinical effect of compound Yimucao oral liquid on postpartum lochiorrhea. Methods:A to-tal of 200 patients with postpartum lochiorrhea were randomly divided into the observation group ( 100 cases ) and the control group (100 cases). The patients in the observation group received 20ml compound Yimucao oral liquid three times a day for seven days, while those in the control group were given 15g Yimucao granules three times a day for seven days. After the treatment, the duration, amount, color and quality of lochia, lower abdominal pain, uterine involution and the status of postpartum infection in the two groups were compared. Results: The total effective rate in the observation (94. 0%) was higher than that in the control group(84. 0%). Compared with that in the control group, less average hemostasis time, better situation of abdominal pain, uterine involution and lower postpartum infection rate in the observation group were observed after the treatment(P<0. 05). Conclusion:Compound Yimucao oral liquid can promote the uterine involution. It’ s effective and safe in the treatment of postpartum lochirrhea.

Objective To evaluate the effect of dexmedetomidine on acute liver injury in rats with endotoxemia.Methods Eighteen adult male Sprague-Dawley rats, aged 3-4 months, weighing 250-300 g, were randomly divided into 3 groups (n=6 each) using a random number table: control group (group C), endotoxin group (group E), and dexmedetomidine group (group D).In E and D groups, lipopo-lysaccharide 5 mg/kg was injected via the femoral vein of rats anesthetized with chloral hydrate.In group D, dexmedetomidine was infused with a 7 μg/kg loading bolus over 15 min after injection of lipopolysaccharide, followed by a 6 h continuous infusion of 5 μg · kg-1 · h-1.The equal volume of normal saline was given instead in E and C groups.After the end of administration, blood samples from the femoral vein were drawn for determination of tumor necrosis factor-alpha (TNF-α) and interleukin-1β (IL-1β) concentrations in serum (by using enzyme-linked immunosorbent assay), and alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activities in serum (using the International Federation of Clinical Chemistry and Laboratory Medicine reference procedures).Liver specimens were obtained for examination of pathologic changes with electron microscope.Results Compared with group C, the serum ALT and AST activities and TNF-α and IL-lβ concentrations were significantly increased in E and D groups.Compared with group E, the serum ALT and AST activities and TNF-α and IL-1β concentrations were significantly decreased in group D.The pathologic changes of livers were obvious in group E, and were significantly reduced in group D compared with group E.Conclusion Dexmedetomidine can alleviate acute liver injury in rats with endotoxemia, and the underlying mechanism is associated with inhibition of systemic inflammatory responses.