Objective To investigate the influence of plasmid spread and ampD mutation to Enterobacter cloacae that leads to the AmpC β-lactamase change from inducible type to constitutive type. Methods The Enterobacter cloacae were isolated from the patients with nosocomial infection. The inducible type isolations and their constitutive type changers were put into the same group. The plasmid ampC gene and chromatin ampD gene in pairs in each group were amplified, sequenced and compared. Results Of 195 patients infected by Enterobacter cloacae of inducible type, 25 (12.82%) were changed to the ones of constitutive high type. In these 25 changed groups, 10 were caused by plasmid spread, 10 by ampD mutation, 1 by both, and 4 by neither. Twelve changed constitutive type strains had ampD significant mutations, in which 7 were frame-shift mutations and 5 were spot mutations. Conclusions The change ratio of Enterobacter cloacae from inducible type to constitutive type is rather high. Both plasmid spread and ampD mutation are possibly the mechanism of such change. Plasmid mediated AmpC β-lactamase spreads among different species and interregionally. The mutation rate of chromatin ampD gene is also higher than the natural mutation rate. These two mechanisms should be considered in clinical treatment.

0.05),and T max had signif?icant differences(P

Objective To reveal the influence factor of ampD specific mutation on the transformation of AmpC β-lactamase from non-high-productive type to derepressed the high-productive type in Enterobacter cloacae. Methods The selected cbromatin-mediated derepressed high-productive strains of Enterobacter cloacae and genomic DNA were extracted, and genomic ampD was amplified by using PCR, and then sequenced and confirmed by specific mutation. Use site-directed mutagenesis to mutate the wild-type Enterobacter cloacae for the above site. The changes of AmpCβ-lactamase types were detected by the improved Cefotaxime three-dimensional test. Results Of the 121 strains of Enterobacter cloacae,15 strains were ehromatin-mediated derepressed high-productive type,8 strains had significant mutations and 7 strains of site-directed mutagenesis were established. Ecl MA(274 inser-ting A)、Ecl MC(327 missing C)and Ecl MF(27 inserting G)were changed from non-high-productive type to derepressed-high-pro-ductive type,but Ecl MB(371 inserting T), Ecl MD(515 missing C), Ecl ME(324 C→A), Ecl MG(238C→A 302T→A)did not change in AmpC β-lactamase types. Conclusion The significant mutations that could lead to the transformation of AmpC β-lacta-mase were the Frame-shift mutations that could create the change of large region of amino acid. However, other mechanisms for the derepressed high-productive AmpC β-lactamase were not excluded in the study.

Objective:To study the effect of gypenosides (GPs) on the hepatic function and fibrosis progression in Wistar rats with immune fibrosis. Methods: The model of immune fibrosis was established by injection of human albumin. Rats in treated group were also administered with 0. 5 mg GPs during 30 d human albumin attack. The hepatic function of rats was e-valuated by determining the levels of ALT, TBIL and TBA in serum. The progression of hepatic fibrosis was evaluated by the levels of HA, PC Ⅲ and LN by radioimmunoassay (RIA) and confirmed by rats tissue pathology analysis. Results: Albumin injection significantly elevated the levels ALT, TBIL, TBA, HA, PCⅢ(P

Objective To compare the difference of effect between principal component regression analysis and projection pursuit regression analysis when collinearity exists in data.Methods Evaluating the advantages and disadvantages of the two modeling methods by using the actual data on two aspects:the fitting effect and the predicting effect.Results The principal component regression model showed that the coefficient of determination was 0.8172,the mean of absolute relative error was 6.42％ and the mean square of prediction error was 0.61.The projection pursuit regression model,on the other hand,showed that the coefficient of determination ranged from 0.8851 to 0.9944,the mean of absolute relative error ranged from1.11％ to 4.81％ and the mean square of prediction error ranged from 0.03 to 0.38.Conclusion The analysis results based on the actual data with collinearity indicate that the projection pursuit regression analysis outperforms the principal component regression analysis both in fitting and predicting effect.

0.05) and decrease to higher than normal in CH and in 4 cases of SH (P

Objective: To determine plasma levels of soluble tumor necrosis factor-related apoptosis inducing ligand (sTRAIL) and its soluble death receptor (sDR4, sDR5) in essential hypertension (EH) patients with left ventricular hypertrophy (LVH). Methods: Enzyme linked immunosorbent assay (ELISA) was used to measure plasma levels of sTRAIL, sDR4 and sDR5 in 50 EH + LVH patients (EH + LVH group), 50 EH patients without LVH (EH group) and 50 healthy subjects (healthy control group), and the results were compared and analyzed among three groups. Results: ① Compared with healthy control group and EH group, there were significant increase in plasma levels of sTRAIL [(0.95±0.11) ng/ml vs. (1.12±0.86) ng/ml vs. (1.74±1.19) ng/ml], sDR4[(2.38±0.32) pg/ml vs. (5.63±1.05) pg/ml vs. (8.72±1.14) pg/ml] and sDR5[(< 6 pg/ml) vs. (39.19±8.23) pg/ml vs. (78.21±11.2) pg/ml] in EH + LVH group, P<0.01 all; and levels of sDR4 and sDR5 in EH group were significantly higher than those of healthy control group (P<0.01 both), but there was no significant difference in sTRAIL level between the two groups (P>0.05); ② Pearson correlation analysis indicated that there were significant positive correlation among levels of sTRAIL, sDR4 and sDR5 in EH + LVH patients (r=0.325~0.410, P<0.05 or <0.01). Conclusion: Plasma levels of sTRAIL, sDR4 and sDR5 may be valuable indexes for prediction of left ventricular hypertrophy in patients with hypertension.

Objective To observe the effect of alpha lipoic acid on quality of life in patients with type 2 diabetic peripheral neuropathy.Methods 76 cases diagnosed with type 2 diabetic peripheral neuropathy,in accordance with the random number table,were divided into the control group (37cases)and treatment group (39cases).All the patients received diabetic diet,exercise guidance and blood glucose control.The control group was treated with methy-cobal 500μg muscle injection once a day for 2 weeks.The treatment group was treated besides above treatment with intravenous drip alpha lipoic acid 600mg once a day was added for 2 weeks.Then,the changes of motor nerve conduc-tion velocity,sensory nerve conduction velocity and quality of life (QoL)score (somatic symptoms,cognitive func-tion,health happy feeling,social participation,emotional state,work performance,life satisfaction and total score)of the two groups after treatment were observed.Results After treatment,the motor nerve conduction velocity of the control group were as follows:median nerve (40.7 ±4.5)cm/s,common peroneal nerves (41.3 ±4.9)cm/s,The sensory nerve conduction velocity of the control group were as follows:median nerve (38.6 ±4.3)cm/s,common per-oneal nerves (38.3 ±4.5)cm/s.After treatment,the motor nerve conduction velocity of the treatment group were as follows:Median nerve (45.4 ±5.7)cm/s,common peroneal nerves (44.9 ±6.4)cm/s,The sensory nerve conduction velocity of the treatment group were as follows:Median nerve (45.0 ±2.0)cm/s,common peroneal nerves (43.6 ± 3.2)cm/s.Both the two groups′motor nerve conduction velocity and sensory nerve conduction velocity were significantly increased after treatment (P <0.05).Compared with control group,the motor nerve conduction velocity and sensory nerve conduction velocity in the treatment group were significantly improved after treatment,which had statistically significance,(t =2.63,2.51,2.85,2.79,all P <0.05).After treatment,the somatic symptoms,cognitive function,health happy feeling,job performance,social participation,emotional state,life satisfaction and the total score of control group were (52.4 ±9.6)points,(27.0 ±7.8)points,(35.7 ±10.3)points,(19.6 ±7.3)points,(17.4 ± 3.1)points,(16.5 ±3.9)points,(185.4 ±40.7)points,respectively.After treatment,the somatic symptoms,cogni-tive function,health happy feeling,job performance,social participation,emotional state,life satisfaction and total score of treatment group were (41.9 ±7.4)points,(24.1 ±8.6)points,(28.3 ±9.2)points,(14.5 ±5.5)points, (12.6 ±5.6)points,(11.9 ±4.7)points,(135.0 ±38.7)points,respectively.The quality of life score of the treat-ment group was obviously lower than the control group,which had statistically significance,(t =5.14,2.54,2.96, 2.87,2.69,3.05,6.25,all P <0.05).Conclusion Alpha lipoic acid can improve the nerve conduction function of patients with type 2 diabetes peripheral neuropathy,and improve the quality of life.

Objective To investigate the correlation between the walking function status and the quality of bowel preparation for colonoscopy in the elderly patients. Methods Two hundreds elderly (over 70 years) patients undergoing colonoscopy were selected. The walking function status was evaluated by the ability of daily living scale (Schonberg index), and the patients were divided into normal walking group (114 cases) and difficulty walking group (86 cases). Patients in the 2 groups accepted the unified intestinal preparation programs and education guidance. The patients′ compliances to preparation instructions were observed. The causes of non-compliance were investigated. The quality of bowel preparation was assessed using the Boston bowel preparation scale (BBPS). The correlation between walking function status and compliance or quality of bowel preparation was analyzed with the Spearman rank correlation test. Results The proportion of failing to completely take the intestinal cleanser was lower in the difficulty walking group than that in the normal walking group: 53.5% (46/86) vs. 26.3%(30/114), and there was statistical difference (χ2=15.362, P<0.05). The reasons for failing to completely take the intestinal cleanser in the difficulty walking group were as follows: unconvenient of frequently walking to the restroom to defecate (39 cases) , forgetting (4 cases) and adverse reactions (3 cases). The good proportion of bowel preparation compliance and sufficient rate of bowel preparation in difficulty walking group were significantly lower than that in normal walking group: 41.9% (36/86) vs. 65.8%(75/114) and 55.8% (48/86) vs. 72.8% (83/114), and there were statistical differences (χ2 = 11.365 and 6.264, P<0.01 or<0.05). There was no significant difference between 2 groups in the constituent ratio of strictly implementing the bowel preparation program (P>0.05). The correlation analysis result showed that the walking function status was positively correlated with compliance and quality of bowel preparation in the elderly patients (r=0.238 and 0.177, P<0.05). Conclusions The walking function status is correlated to the quality of bowel preparation in elderly patients undergoing colonoscopy. Difficulty walking may indicate the poor compliance and poor colonoscopy preparation in the aged.

Based on the statistics of the tide and key words of three magazines in 2015,a total of 30 documents and after expert consultation and analysis,the literature was divided into 10 research fields,and four aspects including correlation with teaching,talent cultivation,development of student and assessment were elaborated on to explore the current hot issues of medical education in China.In the ending part,the author summarized and put forward four shortages that covered deficiency of theoretical research,illegibility of talent orientation,teaching reform combining without actual condition and not paying attention to the development of teachers in study of medical education research,and provide suggestions and references for further research on medical education.