Objective To study the drug resistance and production status of highly producing AmpC enzymes, extended-spectrum β-lactamases (ESBLs) and drug resistance in Acinetobacter bau-mannii. Methods Drug sensitivity test was performed with Kirby-Bauer method. ESBLs were detected with phenotype confirmatory test (double-disk synergy test), and highly producing AmpC enzymes were measured with phenotype screening method. Results 93 strains of Acinetobacter baumannii were mainly obtained from respiratory department and neurosurgery, and isolated from sputum/pharyngeal stab, raw surface/wound secretion and urine samples. 15 strains (16.1%) of highly producing AmpCenzyme-producing Acinetobacter baumannii were detected, so were 10 strains (10. 8%) of ESBLs-pro-ducing isolates. All enzymes-producing strains displayed multi-resistant, and their resistant rates to the third cephalosporin, penicillins and aztreonam were much higher than enzymes non-producing ones. None was detected resistant to imipenem. Conclusion Occurrence of highly producing AmpC en-zymes and extended-spectrum β-lactamases (ESBLs) is one of causes for Acinetobacter baumannii multi-resistance. It suggests that detection of ESBLs-producing isolates should be strengthened so as to prevent their outbreak and spread.

Objective To analyze the effect of cigarette smoking on replantation of amputed digit, investigate the pathologic mechanism of vascular crisis(VC) caused by smoking. Methods 1)The replantation risk factor such as smoking to VC and blood insufficiency of replanted digit was reviewed in 1 685 cases of digit replantation. 2)The complications after digit replantation in short and long terms among patients smoking were compared with those not smoking after operation. The results of management and time of appearance VC was assayed. 3)The possible pathologic mechanism of VC caused by smoking was analyzed. Results 1)A significant correlation between the ratio of VC, blood insufficiency of replanted digit and smoking index(SI, the number of cigarette in a day multiplies the years of smoking) was found. 2)The rate of VC, wound infection and unhealing in short term and the feeling of pain, numbness and cool in the long term in patients smoking after operation (92.6%,55.6%,48.1% and 71.6%) was obviously more than that in non smoking patients(17.8%,9.3%,2.0% and 3.0%,P

Objective To explore a novel operative management for irreducible atlantoaxial dislocation. Methods Fifty-four patients, which as 32 males and 22 females aged from 7 to 63 years old with a mean of 32 years, were diagnosed with irreducible atlantoaxial dislocation, including 18 patients with os odontoideum, 22 occipitalization, 5 malunion of odontoid fracture and 9 relaxation of transverse ligament of atlas. Forty patients presented signs and symptoms of myelopathy or spinal cord injury. All of the patients underwent the operation of open reduction and release by transoral approach. The longus collies muscles, longus capitis muscles, anterior longitudinal ligament, atlantoaxial articular capsules, the apical odontoid ligament and alar odontoid ligaments may be included, were transected, followed by arthrodesis via posterior approach in one stage. Different methods of posterior arthrodesis were conducted as followed: C1,2 transarticular screw fixation in 5 cases, occipitocervical fixation using pedicle screws of axis and occipitocervical plate in 37 cases, and C1,2 joint fixation with plates and screws in the lateral masses of the atlas and axis in 12 cases. Results A complete reduction was achieved in 41 cases, and the other 13 patients obtained partial reduction. Forty-eight patients were followed up from 4 to 40 months, 15.7 months at the average. All of them achieved solid arthrodesis. According to Odom's scoring system, among the 38 patients with preoperative upper cervical myelopathy, 15 patients were assessed as excellent, 14 good, 8 fair and 1 poor. During the operation, cerebral spinal fluid leakage occurred in 1 case, and pedicle screwing failed in 1 case. After the operation, respiratory failure was found in 1 case, nasal sound in 3 cases, dysphagia in 1 case. One patient became quadriplegia due to myelitis caused by septicemia at two weeks after the operation. The internal fixation loosened in 1 case at 2 months postoperatively. Conclusion Transorally surgical release for reduction and posterior arthrodeses could achieve satisfactory outcomes in patients with irreducible atlantoaxial dislocation.

Objective To investigate the usefulness of percentage of free prostate specific antigen(FPSA/TPSA)/PSA density[(F/T)/PSAD]in the diagnosis of prostate cancer of PSA level in 4~10ng/ml. Methods 88 patients of PSA level in 4~10ng/ml were carried out transrectal ultrasound guided prostate biopsy. Among them,21 patients were proved to be suffering from prostate cancer,and other 67 patients were identified as benign prostate hypertrophy. The effect of F/T ratio,PSAD and(F/T)/PSAD in the diagnosis of prostate cancer were investigated. Results The mean value of(F/T)/PSAD of prostate cancer were significantly lower than benign prostate hypertrophy for patients with PSA levels in 4.0-10ng/ml, This difference has arrived statistical significance(P

Objective To evaluate the relationship between hypertriglyceridemia and acute pancreatitis.Methods Data was analyzed from 41 patients with acute pancreatits from Apr.1998 to Oct.2000 in our hospital.Of the 13 patients(GroupⅠ) with plasma TG level being higher than 11.3 mmol/L, 8 accompanied with gallstone(61.5%)and 5 without gallstone(38.5%)of the 28 patients (GroupⅡ) with plasma TG level being lower than 11.3 mmol/L,19 accompanied with gallstone(47.3%)and 9 without gallstone(52.7%)RANSON score,morbidity of complications and the level of ALT and AST were compared between two groaps.The correlation between TG and RANSON score was analysed.Results There were significant difference between the two groups on RANSON score,morbidity of complications and level of ALT and AST(P0.05).Conclusion There is an close relationship between hypertriglyceridemia and acute pancreatitis,the high level of plasma TG plags a key a role in acute pancreatitis,patients with acute pancreatitis with hypertriglyceridemia are more likely to have higher morbidity of complications and liver function aggravating.

Objective Comprehensive geriatric assessment is the core technology,this paper describes the concept of comprehensive geriatric assessment,objects,content,assessment methods,interventions and research pro-gress,provide experience to carry out comprehensive geriatric assessment in Tibet,the Tibet region to explore for com-prehensive geriatric assessment mode.

Cas9 is a RNA-guided double stranded DNA nuclease that participates in the CRISPR/Cas9 system. Wide-type Cas9 directly silences the expression of target gene by gene splicing. The engineered dCas9 protein with the mutation at D10A and H840A lacks the Cas9' s endonuclease function but keeps its DNA binding activity. dCas9 can activate special genes by fusing with transcription activator. Meanwhile,it can inhibit the gene transcription by directly binding to the target gene and stop gene transcrip?tion. Combination of light sensitive structures and CRISPR can produce light-inducible CRISPR/Cas9 system for control of gene expres?sion. This system is able to activate or inhibit gene expression via the use of controlling blue light(470 nm). In this review,we mainly discuss the development of the light inducible CRISPR/Cas9 system as well as its application in the control of gene expression.

Objective To investigate the profile and mechanism of imipenem resistance in the clinical isolates of Serratia marcescens. Methods A total of 152 strains of S. marcescens were isolated from January 2013 to December 2014. Disk diffusion method?and?automated?systems?were?used?to?determine?the?susceptibility?of?the?isolates.?The?modified?Hodge?test?and?EDTA?synergy?test?were?employed?to?test?carbapenemase?phenotype.?Agar?dilution?method?in?combination?with?efflux?pump?inhibitor?MC207110?was used to observe the change of imipenem MIC values. The genes encoding carbapenemase, AmpC beta-lactamase and outer membrane protein were detected by polymerase chain reaction. Results? Imipenem?resistance?was?identified?in?87?of?the?152?strains?of S. marcescens.?Modified?Hodge?test?was?positive?for?12?of?the?87?imipenem-resistant?S. marcescens strains. EDTA synergy test was?positive?for?9?of?the?strains.?Imipenem?MIC?was?reduced?to?1/4?to?1/64?in?46?strains?by?agar?dilution?method?in?presence?of?efflux?pump inhibitor MC207110. Five strains were positive for KPC genes, 8 strains positive for IMP gene, and 6 strains positive for DHA gene. Loss of outer membrane protein was found in 16 strains by PCR. Conclusions Imipenem-resistant strains of S. marcescens are?prevalent?in?our?hospital.?KPC,?IMP,?DHA?genes,?and?loss?of?outer?membrane?proteins?and?efflux?pumps?may?all?contribute?to?imipenem resistance in S. marcescens isolates.

Objective To explore the expressions of autophagy-related gene Beclin-1 and LC3 in adriamycin induced eardiomyopathy rats,to prnve that autophagy might take part in the development of adriamycin induced eardiomyopathy in rats,so as to provide experimental and theoretical evidence for preventing and treating adriamycin induced cardiomyopathy.Methods Forty-five male SD rats were randomly divided into 3 groups,control groups,ADR group and ADR+3-MA group.The model of adriamycin induced cardiomyopathy rats was established.The tissue sample taken from the left ventricle wall was checked for the morphons of autophagosome by electron microscope. The expressions of Beelin-1 and LC3 of myocardium were detected.Results The morphons of autophagosome in ADR group was significantly increased compared with that in control and ADR +3-MA groups. The expression of Beclin-1 in myocardium of ADR group was significantly inereased compared with that in control and ADR +3-MA groups (P < 0.05).The level of LC3 in myocardium of ADR group was significantly increased compared with that in control and ADR+3-MA groups (P < 0.05).Conclusions Autophagy plays an important role in adriamycin induced cardiomyopathy.

Objective To explore the diagnostic value of serum and cerebral spinal fluid (CSF) aquaporin 4(AQP4)-IgG detected by indirect immunofluorescence assay (ⅡFA) using monkey optical nerve and AQP4 transfected cell as base in neuromyelitis optica (NMO).Methods Serum and CSF AQP4-IgG in 32 NMO patients,41 multiple sclerosis (MS) patients,33 non-inflammatory neurological disease (NIND) patients and serum AQP4-IgG in 20 healthy controls (HC) were detected by monkey optical nerve/AQP4 transfected cell-based IIFA.Results (1) In both optical nerve and AQP4 transfected cell based IIFA,compared with MS,NIND and HC,the patients with NMO had significantly higher positive rate of AQP4-IgG in both serum (optical nerve-based IIFA:NMO 46.9％ (15/32),MS 7.3％ (3/41),NIND 3.0％ (1/33),HC 0 (0/20),P ＜ 0.01 ; cell-based IIFA:NMO 84.4％ (27/32),MS 2.4％ (1/41),NIND 3.0％ (1/33),HC 0 (0/20),P ＜0.01) and CSF (optical nerve-based ⅡFA:NMO 21.9％ (7/32),MS 0 (0/41),NIND 0 (0/33),P ＜ 0.01 ; cell-based IIFA:NMO 56.3％ (18/32),MS 0 (0/41),NIND 0(0/33),P＜0.01); sensitivity of serum AQP4-IgG (optical nerve-based IIFA 46.9％; cell-based IIFA 84.4％) was significantly higher than that of CSF AQP4-IgG (optical nerve-based IIFA 21.9％,P ＜0.01 ; cell-based IIFA 56.3 ％,P ＜ 0.05),while no significant difference was found in specificity between serum and CSF AQP4-IgG in diagnosing NMO; using combination of serum and CSF AQP4-IgG applied,the sensitivity increased (optical nerve-based IlFA 46.9％ vs 50.0％ ; cell-based IIFA 84.4％ vs 87.5％) while specificity remained no change.(2) Compared with optical nerve-based IIFA (serum 46.9％,CSF 21.9％),cell-based IIFA had higher sensitivity in diagnosing NMO (serum 84.4％ ; CSF 56.3％,P ＜ 0.01),while no significant difference of specificity between these two methods.Conclusion It has better clinical value to detect serum and CSF AQP4-IgG at the same time by AQP4 transfected cell based IIFA in diagnosing NMO.