Objective To study the relationship between the mutation of the inverted repeat (IR) gene in the multiple transferable resistant (mtr) system and multiple antibiotic resistance of Neisseria gonorrhoeae. Methods The antimicrobial susceptibilities of isolated strains were tested. An agar plate dilution method was used to determine the minimum inhibitory concentrations. The target genes were amplified by PCR and subjected to sequencing. Results No mutation was found in the IR gene of either of 2 sensitive or 5 penicillin-resistant Neisseria gonorrhoeas strains. Among the 17 multiple-antibiotic-resistant strains, a strain with both azithromycin- and penicillin-resistance had T/A and T/A insertions, and another had A/T deletion. Conclusion Mutations in the IR gene of the mtr system of Neisseria gonorrhoeae might result in multiple antibiotic resistance.

Objective To evaluate the diagnostic value of colonoscopy for patients with chronic diarrhea.Methods Data of 2449 patients with chronic diarrhea who underwent colonoscopy from January,1999 to December,2008 were reviewed.A total of 2110 patients who underwent colonoscopy screening for health checkup during the same period were used as controls.The rates of clinic-relevant abnormal endoscopic findings and negative finding were compared between two groups.Results Lesions with clinic significance were found in 44.1％ of patients with chronic diarrhea (1080/2449) and in 41.7％ of controls (870/2110,x2 =2.756,P =0.097).Compared with controls,incidence of non-IBD and noninfectious colitis (x2 =58.578,P ＜ 0.001),IBD (x2 =59.609,P ＜ 0.001),malignant tumor (x2 =21.649,P ＜0.001),terminal ileitis (x2 =6.275,P =0.012),infectious colitis (x2 =17.019,P ＜0.001),intestinal tuberculosis (x2 =7.021,P =0.008),melanosis coli (x2 =6.040,P =0.014) and parasitic infection (x2 =4.245,P =0.039) were all significantly higher in patients with chronic diarrhea.However,incidences of adenomatous polyps (x2 =14.124,P ＜ 0.001),non-adenomatous polyps (x2 =33.427,P ＜0.001) and diverticular disease (x2 =9.921,P =0.002) were significantly higher in the control group.There was no significant difference in incidences of the benign tumor (x2 =1.627,P =0.202) and angiodysplasia (x2 =0.231,P =0.631) between the two groups.The overall screening rate of colonic polyps,diverticulosis,and vascular lesions was 37.3％ in chronic diarrhea group.Conclusion Colonic polyps,diverticulitis,benign tumors and angiodysplasia may not be the causes of chronic diarrhea.Etiology of more than 1/3 patients with chronic diarrhea remains unknown after colonoscopy.

Objective To investigate the clinical therapeutic effect of Xuebijing injection for treatment of patients with ventilator-associated pneumonia (VAP).Methods A prospective study was conducted. Forty-eight patients with confirmed diagnosis of VAP requiring mechanical ventilation admitted into intensive care unit (ICU) of Hubei Provincial Hospital of Integrated Traditional Chinese and Western Medicine between May 2013 and September 2014 were enrolled. The patients were randomly divided into observation group (26 cases) and control group (22 cases) by random number table. All patients in both groups received western conventional treatment, and the patients in observation group were treated additionally with 50 mL Xuebijing injection intravenous drip twice a day, and control group received only routine western medicine, the therapeutic course in both groups being 7 days. The changes of white blood cell count (WBC), serum procalcitonin (PCT) levels and the clinical pulmonary infection score (CPIS) were observed, and the clinical therapeutic effect and 28-day prognosis were analyzed in both groups.Results After treatment for 7 days, the WBC, PCT levels and CPIS score were decreased compared with those before treatment in the two groups, and the degree of descent in observation group was more significant than that in the control group [WBC (×109/L): 9.16±1.62 vs. 12.03±2.34, PCT (μg/L): 0.17±0.04 vs. 0.28±0.69, CPIS score: 3.31±0.97 vs. 4.23±1.15, allP < 0.05]. The effective rate of observation group was higher than that of the control group [84.6% (22/26) vs. 54.5% (12/22), P < 0.05], while the 28-day fatality rate in the observation group was lower than that of control group [11.5% (3/26) vs. 36.4% (8/22),P < 0.05].Conclusion The clinical therapeutic effect is good when patients with VAP is treated with addition of Xuebijing injection on the basis of conventional western medicine therapy, as the injection can improve the therapeutic efficacy and reduce the fatality rate.

60 years) received parenteral nutritional support in the period of perioperation.When parenteral nutrition was applied,average non protein calorie intake was 85.4 kJ/(kg?d), and NPC∶N value was 118∶1. Results:PA,TRF and electrolyte were significantly increased after parenteral nutritional support.The nutritional indices did not change and were kept within normal range during parenteral nutrition. Conclusions:Parenteral nutrition is one of the important perioperative treatments in elderly patients with obstruction caused by colon cancer.It is safe and effective to use parenteral nutrition with low fat and glucose in elderly patients.

BACKGROUND: Earthworms are one of the most important constituents in the ecosystem and become an environmental information carrier between terrestrial organisms and soil ecosystem. They were known as important non-target terrestrial soil organisms for assessing the general impact of pollution on the soil community. Protein content and growth rate in response to organic and heavy metal contaminants in soil are often used to assess the soil ecotoxicity.OBJECTIVES: To investigate the effects of 1, 8-dihydroxyanthraquinone,one representative of hydroxyanthraquinones, on the earthworm eisenia foetide under laboratory conditions of the growth rate and protein content.DESIGN: Experimental study based on the experimental animals.SETTING: Eco-toxicological laboratory and genetic laboratory in a university.MATERIALS: The experiment was conducted in the Eco-toxicological Laboratory and the Genetic Laboratory, Dalian University of Technology from February to July 2004. Eisenia foetide, a kind of international standard earthworm, were maintained in a soil mixture before experiments. Earthworms used in this study were healthy adults with 1 -2 month old and 200 - 300 mg mass and the number of the earthworms in each analytical experiment was 10.METHODS: The earthworms were removed from the soil 12 hours before use and stored in Petri dishes on damp filter paper to void gut contents.Then, these earthworms were exposed for various durations to soils contaminated. The earthworm weight and protein content were determined respectively at every 7 days interval.MAIN OUTCOME MEASURES: Effects of 1, 8-dihydroxyanthraquinone on growth rate and protein content of earthworms.RESULTS: No lethal effect of 1, 8-dihydroxyanthraquinone was observed even at the highest concentration(1.0 g/kg soil) of exposure. The sub-lethal effect, however, was evident at all the concentration scale. 1,8-dihydroxyanthraquinone caused a significant reduction in the growth rate (maximum -22. 5% ) at the dosage of 1.0 g/kg and 28 days contact time.Additionally a reduction in total soluble protein was observed in all treated worms(maximum- 39.6% ) at the dosage of 0. 8 g/kg and 7 days contact time.CONCLUSION: 1, 8-dihydroxyanthraquinone was potentially dangerous to the soil ecosystem and more ecological risk assessment of this chemical material should be thoroughly carried out.

ObjectiveTo investigate the safety and efficacy of carbon dioxide ( CO2 ) insufflation during ERCP.MethodsBetween January and August 2011,a total of 102 consecutive patients who underwent ERCP were randomized to accept CO2 insufflation ( n =52 ) of air insufflation ( n =50 ) during the procedure.ERCP was carried out with the same instrument by an expert endoscopist who was blinded to the insufflation gas used and the procedure was controlled at 30 minutes to 1 hour.The heart rate,oxygen saturation of the patient was continuously monitored during the procedure.Before the procedure and 1 hour after the end of operation,abdominal X-ray was taken to evaluate the width of intestine,and the degree of intestinal expansion was defined as normal,mild,moderate and severe according to the width increased.A questionnaire with 100 mm visual analogue scale (VAS) was used to quantify the abdominal pain and distention experienced at 1 hour,2 hours,and 6 hours after the procedure.The patients' vital signs,bowel dilatation,the average operating time,abdominal pain score and distention score on VAS,and complications in 2 groups were analyzed.ResultsThe baseline characteristics of 2 groups were comparable.ERCP was successfully performed in all the patients and no complication was observed.In CO2 group,the average operating time,mean heart rate and oxygen saturation were (45.2 ± 10.6) min,( 102.2 ± 10.3 ) bpm and ( 99.5 ± 0.5)％,which were (48.5 ± 11.2) min,( 100.3 ± 11.4) bpm and (98.9 ±0.6)％,respectively,in air group.There were no significant differences on these items between the 2 groups ( P ＞ 0.05 ).Moderate to severe intestinal expansion 1 hour after ERCP was found in 14 patients (26.9％ ) in CO2 group and in 28 patients (56.0％ ) in air group,and the latter was significantly higher than the former (x2 =11.61,P =0.009).Both of the mean abdominal pain and abdominal distention scores at 1 hour post-ERCP in CO2 group were lower than those in air group,but without significant difference (P ＞0.05).However,the mean abdominal pain scores at 2 hours and 6 hours post-ERCP in CO2 group were significantly lower than those of patients in air group (7.4 ±2.2 vs.18.7 ±4.6 at 2 hours post-ERCP,9.6 ±3.7 vs.20.1 ±4.5 at 6 hours post-ERCP,all P ＜ 0.05 ).Similarly,the mean abdominal distention scores at 2 hours and 6 hours post-ERCP in CO2 group were significant lower than those of patients in air group (7.6 ±3.6 vs.18.3 ±4.1 at 2 hours post-ERCP,8.9 ±3.7 vs.19.4 ±4.2 at 6 hours post-ERCP,all P ＜0.05).ConclusionThe use of CO2 insufflation instead of air during ERCP appears to be safe.Insufflation of CO2 during ERCP palliates the intestinal expansion,post-ERCP abdominal pain and distention comparison to insufflation of air.However,because of the single-center clinical observation with limited number of cases,the safety and efficacy of CO2insufflation during ERCP requires to be further evaluated.

Objective To improve the teaching quality of Sex and Reproductive Health for college students.Methods From February 2008 to June 2010,the general elective course of SeX and reproductive health were offered for students from all the majors in Shanghai Jiao Tong University.The lessons were conducted in the form of lectures,group discussions,role-plays and debates.The self-designed questionnaires were respectively given out after the first class and at the end of the last class in order to have an understanding of the rate of the relevant knowledge known by the students and their suggestions.Results The rate of the relevant knowledge known by the students significantly increased.Some suggestions about the educational reform were received through questionnaire and educational feedback.Conclusion The reproductive health service is needed for college students.Group discussions and role-plays are ideal methods for interactive teaching.

Objective To study the value of deferred stent implantation in patients with high thrombus burden of acute ST-segment elevation myocardial infarction (STEMI). Methods Select 106 cases with a high thrombus burden within 12 hours of onset in patients with STEMI ,the infarct-related artery thrombus aspiration after antegrade flow of TIMI 2-3 and≤2 points of the thrombus aspiration(TS)patients were randomly divided into immediate stenting group(n = 43)and deferred stenting group(n = 40). Two groups of patients were compared with the myocardial blush grade(MBG),the incidence of slow-/no-reflow ,the incidence of compound endpoints in 6 months and the cardiac function after PCI for 6 months. Results After stenting,the MBG of deferred group was significantly higher than that of immediate group ,the incidence of slow-/no-reflow and the compound endpoints events within 6 months in deferred group was significantly lower than that in the immediate group. After PCI for 6 months,the improvement of LVEF in the deferred group was significantly higher than that in the immediate group, the left ventricular end diastolic dimension(LVEDD)in deferred group was significantly lower than that in immedi-ate group,and the differences were statistically significant(P < 0.05). Conclusions The high thrombus burden in patients with acute STEMI after thrombus aspiration ,deferred stent implantation can significantly reduce the rate of slow-/no-reflow ,improve myocardial perfusion ,reduce the incidence of compound endpoints events ,im-prove cardiac function in patients.