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 study the effect of extracellular signal-regulated kinase1/2 (ERK1/2)inhibitor U0126 on matrix metalloproteinase-9(MMP-9)in brain tissue after subarachnoid hemorrhage(SAH)in rats and to investigate the action mechanisms of ERK1/2 and M M P-9 in blood-brain barrier(BBB)injury and brain edema after SAH.Methods Seventy-two male Sprague-Dawley rats were randomly divided into four groups:SAH model,sham operation,U0126 intervention,and vehicle groups.A SAH model was induced by injection of autologous blood into cisterna magna once.The dry-wet weight method was used to detected brain tissue water content in order to evaluate cerebral edema.BBB permeability was evaluated by the Evans blue extravasation method.The immunohistochemical method was used to detect the expression of MMP-9 and phosphorylated ERK1/2.Results The expression of phosphorylated ERK1/2 and MMP-9 was lower in the sham operation group.The expression of both was up regulated at 24 hours after SAH.The brain water content and Evans blue content also increased.U0126 treatment decreased the phosphorylation of ERK1/2 and the expression of MMP-9,improved the BBB permeability,and alleviated brain edema.Conclusions MMP-9 is involved in the pathophysiological processes of early BBB injury and brain edema aft er SAH.ERK1/2 pathway may play a vital role in the expression of MMP-9.U0126 may protect BBB and reduce brain edema after SAH by inhibiting the phosphorylation of ERK1/2.

Low back pain caused by intervertebral disc degeneration is a common clinical chronic disease. The regenerative ability of intervertebral disc tissue is extremely poor. Meanwhile, current treating methods can not fundamentally solve such problems. With the increasing awareness of the mechanism of disc degeneration and the rapid development of the fields of cellular and molecular biology, gene and materials engineering, using stem cells and tissue engineering technology to slow down or reverse the progress of disc degeneration may become possible. The author reviewed the application of stem cells for treating degenerative discs from present researching status and concepts for the future in the combination of researches reported both at home and abroad.
Humans ; Intervertebral Disc ; pathology ; Intervertebral Disc Degeneration ; therapy ; Low Back Pain ; therapy ; Regeneration ; Stem Cell Transplantation ; Tissue Engineering

Objective To explore the rehabilitation nursing for sagittal sinus thrombosis. Methods One patient in sequelae stage of sagittal sinus thrombosis was reported.Results and Conclusion She has obtained remarkable improvement, including a good posture, larger ROM, walking under little assistance except four-corner crutch, clearer speech, improving swallowing, and need little assistance during daily life.

Objective To explore the feasibility and efficacy of selective arterial embolization for the treatment of hemobilia occurred after biliary tract surgery.Methods The clinical data of 16 patients with massive hemobilia after biliary tract operation,who were treated in our hospital during the period from March 1989 to August 2009,were retrospectively analyzed.Conservative treatment of hemobilia was initially adopted in all patients,and,if it failed,interventional management was carried out.Emergent artery angiography was performed in all patients,which was followed by selective arterial embolization of the bleeding arteries with Gelfoam particles and coils.Results Of the total 16 cases,15 received selective arterial embolization therapy and the remaining one died.No re-bleeding occurred during a follow-up period of 8 months to 3 years.Conclusion For the treatment of arterial hemobilia occurred after biliary tract surgery,selective arterial embolization with Gelfoam particles and coils is a safe,mini-invasive and effective therapy with few complications.

Objective To investigate the anti-microbial activity of genistein and its mechanism. Method The anti-microbial experiment was carried out by utilizing scanning and transmission electron microscope(SEM and TEM) ,and further analyzing the respiratory metabolism and change of SDS-PAGE protein spectra. Results Genistein could inhibit several kinds of bacteria obviously.The erose structures such as rugae and bubbles were observed on the surface of cells by SEM after 24h. Moreover,with TEM,we detected the shrinkage of cytoplasm,the plasmolyses,and then the breach of wall and membrane along with the outflow of protoplasm in Staphylococcus aureus treated with genistein for 4h,14h and 24h respectively. Notablely the respiratory inhibition experiment revealed that the genistein mainly inhibits the TCA cycle of bacteria. Besides,the SDS-PAGE elucidated that the total expression of proteins was decreased in the cell treated with genistein,and especially the larger proteins were reduced with 90.1%. Conclusion Genistein showed obvious anti-microbial activity to Staphylococcus aureus. It could destroy the integrity of cell wall and membrane,prevent the respiratory metabolism and protein synthesis of the bacteria.

Objective To investigate the value of multivoxel proton magnetic resonance spectroscopy(1H-MRS) in contusion and laceration area of mild-to-moderate traumatic brain injury(TBI) in adults.Methods Twenty-eight TBI patients definitely diagnosed were recruited in this study,including 16 moderate TBI whose Glasgow coma scores were in 9-12 and 12 mild TBI whose Glasgow coma scores were in 13-15.The spectrum for NAA,Cho,Cr and other metabolite peaks in contusion and laceration area were measured and NAA/Cr,NAA/Cho,Cho/Cr ratios were calculated for each voxel.Results In multivoxel 1H-MRS for the lesion areas,the ratios of NAA/Cr,NAA/Cho and Cho/Cr changed significantly compared with those of 16 normal controls(P0.05).Conclusion Multivoxel 1H-MRS may have an important clinical value in detecting and assessing early mild-to-moderate brain trauma.NAA/Cr ratio of the injured region can reflect the severity of cerebral injury.

Objective To study the effect of intercostal bronchial artery embolization(BAE) with gelatinum sponge(GS) or polyvinyl alcohol(PVA) in treating acute massive hemoptysis.Methods Fifty-two patients with acute massive hemoptysis underwent selective bronchial arteries angiogaphy first,then superselective bronchial arteries embolization using 3F SP catheter with GS in group A(n=24) and with PVA in group B(n=28).Results In group A,immediate control of hemoptysis was achieved in 16 patients(66.67%),marked reduce in bleeding was seen in 7 patients(29.17%),the effective rate was 95.83%.In group B,immediate control of hemoptysis was achieved in 24 patients(85.71%),marked reduce in bleeding was seen in one patients(14.29%),the effective rate was 100%(P﹥0.05).All patients were followed-up for one year.The recurrent rate was 25%(6 cases) in group A and 3.57%(1 case) in group B(P﹤0.05).Conclusion BAE with PVA is effective and safe method in treating serious hemoptysis.

Objective To summarize the progress of research on the influence of nutrition support on quality adjusted life year (QALY) in elderly patients with nutritional risk, and to evaluate the feasibility of QALY as an outcome indicator.Methods Literature in Chinese, English and Japanese relating to the feasibility of QALY and cost-utility in evaluating the influence of nutrition support on the outcomes of patients with nutritional risk published from 1980 to 2013 were searched in Wanfang, China National Knowledge Infrastructure,PubMed, Nature databases.The methodological quality of randomized controlled trials was assessed using Jadad scale combined with Schulz allocation concealment, and the quality of cohort studies with Newcastle-Ottawa scale.Results Totally 10 articles were fotnd, in which 8 were selected, including 6 randomized controlled trial and 2 cohort studies, covering 1 130 patients;the other 2 were excluded for not conforming to inclusion criteria.Four of the 6 randomized controlled trial indicate that QALY is higher and all-cost is lower in the treatment group compared with the control group (or cost-utility is higher in the treatment group).The 2 cohort studies indicate that total parenteral nutrition support at home could improve the QALY of malnourished patients and could save cost compared with nutrition support at hospital when necessary.Conclusions Nutrition support for patients with nutritional risk can improve prognosis, reduce cost, and increase QALY.More large-scale, high-quality randomized controlled trials are needed to evaluate the effect of nutrition support on the QALY of elderly patients with nutritional risk.

Objective To investigate the effect of recombinant human endostatin(rh-Endostatin) combined with transcatheter arterial chemoembolization(TACE) on the growth and metastasis of the implanted hepatic tumor in rabbits.Methods Thirty New Zealand white rabbits were randomly divided into three groups (10 in each group)and VX_2 carcinomas were implanted in the left lobes of the livers. Fourteen days later, a catheter was inserted into the hepatic artery of rabbits with VX2 hepatic tumor and infusion was performed via the hepatic artery using physiological saline (group A), TACE (group B) and rh-Endostatin combined with TACE (group C),respectively. Five weeks later, all ribbits were sacrificed, the body weight and liver weight of animals were assessed, the hepatic index(HI) was calculated, the volume and necrotic area of the implanted tumor were measured. The presence of metastases in the liver, lungs were recorded. Results Five weeks after inoculation, the body weight of all animals decreased, the liver weight increased, His were 10.2±2.8, 8.5±6.1and 6.2±4.4 in groups A, B and C, respectively. The mean volume and necrostic areas of the implanted tumor were (36.2±3.4) cm~3 and (52.0±2.3)% in group A, (23.6±4.5) cm~3 and (63.6±3.5)% in group B, (10.9±5.1) cm~3 and (78.6±4.8)% in group C, respectively. There were statistical significance about tumor volume and necrostic areas of the tumors between group C and group A,B ( P<0.01). The numbers of metastases in the lungs were 50.3±31.3,53.6±35.1 and 16.8±18.4 , and the diameters of metastases in the lungs were (3.6±1.4) mm, (3.8±0.6) mm and (1.2±0.6) mm in groups A, B and C, respectively, the difference between group C versus other groups( P<0.01) was statistically significant. The differences of opportunity, tumor numbers and size of metastases in the liver were statistically significant. (P<0.01).Conclusion Treatment with rh-Endostatin combined with TACE can suppress the growth of tumor and tumor's metastases in lungs inVX2 implanted tumors of rabbits.