OBJECTIVE To investigate the prevalence of ?-lactamases in nosocomial infections of Enterobacter cloacae,study the different genotyping of ?-lactamases,and analyze its independence in drug resistance. METHODS AmpC ?-lactamases and ESBLs were detected by three-dimensional extract tests.PCR was used to determine the genotype of ?-lactamases and their resistance to 13 kinds of antibiotics was detected by Kirby-Bauer method. RESULTS The sensitivity test showed that they were resistant to the most antibiotics.Among the 80 ESBLs strains,29 strains carried ESBLs gene,3 strains carried two different gene.Such as:TEM existed in 6,SHV-Ⅰ existed in 2,CTX-M-2 existed in 5,CTX-M-3 existed in 8 and CTX-M-9 existed in 11 strains.Twenty-six strains carried ampC.The resistant rate of SSBLs-producing E.cloacae to 12 antibiotics except merapenem was 66.7-100.0%.SSBLs strains of E.cloacae were higher than AmpC ?-lactamases in resistance to levofloxacin,cefepime,aztronem and trimethoprim sulpfamethoxazole with significant difference(P

Hepatocellular carcinoma(HCC)is one of the malignant tumors with the highest cause of death and increasing incidence worldwide.Accurate diagnosis in early stage is vital for the treatment of patients.Presently,routine screening strategies including ?-fetoprotein(AFP)and ultrasound every 6 months have been recommended for early detection in patients with liver cirrhosis to detect HCC at earlier stages.However,the sensitivity and specificity of AFP are far from satisfaction.With the development of recently techniques such as proteomics,it is possible for new HCC-specific markers being available in the near future.Golgi Protein 73(GP73)is most likely to be a promising serum marker.In a few available literatures,GP73 has sensitivity and specificity of 69% and 90%.And fucose-studded GP73 has sensitivity and specificity of 90% and 100%.Apart from GP73,lens culinaris agglutinin-reactive AFP,des-gamma carboxyprothrombin,?-L-fucosidase,glypican-3,hepatocyte growth factor,transforming growth factor-?1,vascular endothelial growth factor,and mucin 1 have been proposed as markers for HCC detection.Clinical trials are undergoing to estimate the value of the above markers,and may change the status in quo ofthe diagnosis of HCC.We have started a multi-centeral trial to investigate GP73 in HBV and HBV related HCC patients with positive preliminary results.

Objective To investigate the relativity between c.553G/T polymorphism in exon 4 of Apolipoprotein A5 gene and hypertriglyceridemia (HTG) in Zunyi Han Nationality. Methods c.553G/T polymorphism of 103 HTG patients and 165 healthy individuals were tested by polymerase chain reaction and restriction fragment length (PCR-RFLP) assay. The distributions of genotypes and allele frequencies in HTG patients and healthy group were analyzed between Zunyi population and others. Results The genotype frequency of the Apo A5 gene c.553G/T showed statistical difference between patients group and normal groups (P < 0.05). The distribution of ApoA5 c.553T gene in HTG was higher than the normal group significantly (P < 0.05), and it had effect on triglyceridemia level independently (OR = 15.768, 95%CI: 5.916 ~ 42.025, P < 0.001). In the normal Han nationality groups, gene frequency of Zunyi was lower than that in Taiwan, Jiangsu and Hubei (P < 0.05), but similar to that in Hunan and Xinjiang (P > 0.05). In HTG groups, gene frequency of Zunyi was similar to that in Jiangsu (P>0.05), but higher than that in Xinjiang (P<0.05) and lower than that in Taiwan (P > 0.05). Conclusion There is relativity between Apo A5 gene c.553G/T polymorphisms and HTG in Zunyi Han nationality and the differences vary across different areas. It could be an independent risk factor for HTG.

Objective To adopt the method performance decision chart to evaluate the performance of the Stago R Evolution au-tomatic blood coagulation analyzer .Methods The method performance decision chart was drawn by the results of external quality assessment and internal quality control according to the requirement of the total error in the clinical laboratory improvement amend-ment (CLIA′88) .The 6 indexes of 3 items including prothrombin time(PT) ,activated partial thromboplastin time(APTT) and fi-brin (Fg) were analyzed .Results The 2 indexes of the PT normal level and APTT abnormal level in the automatic blood coagula-tion analyzer were qualified .The PT abnormal level was fine and 3 indexes of the APTT normal level ,Fg normal level and abnormal level were excellent .Conclusion Six indexes of automatic blood coagulation analyzer could be evaluated by the method evaluation decision chart and it was more directly and clearly compared with σvalue statistical table .

As the expansion of classroom teaching,the emerging network-aided instruction could provid novel methods to improve pathophysiological teaching.With the methodological superiority of network and information technology,the network-aided pathophysiological teaching protocol should be well designed to attract learning interest and improve comprehensive abilities of the students.

Objective To investigate changes of GP73 after hepatectomy and its correlations with hepatocellular carcinoma (HCC) recurrence. Methods Perioperative serum GP73 was monitored in hepatic hemangioma and HCC patients undergoing hepatectomy. Clinicopathologic features and follow-up results were collected to evaluate the relationship between serum GP73 level and patients' prognosis.Results There was no statistical difference between preoperative GP73 and postoperative GP73 in hepatic hemangioma group.While preoperative GP73 in HCC group was 9.9(3.7 - 15.8) relative unit (RU),and that on POD3 (postoperative day 3 ) was 9.1 ( 3.4 - 13.3 ) RU,on POD7 was 74.3 ( 1.7 - 9.0) RU,on POD14 was 3.3(2.1 -5.4) RU ( F =72.606,P ＜ 0.001 ).HCC recurred in 21 cases during follow-up,GP73 in recurrent cases [ 11.0 (8.4 - 13.8 ) RU ] was significantly higher than postoperative trough values while it was not different from their preoperative GP73 level [ 9.9 ( 2.9 - 15.0) RU ] ( Z =1.185,P ＞0.05). The preoperative GP73 level between recurrent subgroup and nonrecurrent subgroup was not significantly different (Z =- 1.546,P ＞ 0.05 ).Preoperative GP73 did not correlate to patients' survival.Conclusions Hepatectomy for HCC leads to a significant decrease of GP73 and postoperative HCC recurrence accompanies reelevation of GP73. GP73 could be used as a postoperative monitor for HCC recurrence.

Objective To explore the reasonable radiologic nodal size criterion of retropharyngeal lymph node (RLN) metastasis in patients with nasopharyngeal cancer (NPC).Methods Imaging and clinical data of 817 NPC patients were analyzed retrospectively.The patients with RLN metastasis were classified into two groups according to the nodal size of 5 mm or 6 mm as standard in diagnosis.Overall survival (OS),distant metastasis-free survival (DMFS) and the local-relapse-free survival (LRFS) were assessed between the two groups taking 5 mm or 6 mm as standard in diagnosis of RLN.Results No significant difference was found for OS,DMFS,LRFS between nodal size ＜5 mm group and ≥5 mm group.Difference of OS (P＜0.001),DMFS (P=0.001) were significant statistical and difference of LRFS (P=0.380) had no significant statistical between nodal size ＜6 mm group and ≥6 mm group.OS,DMFS,LRFS were not an independent prognostic factor for NPC.Conclusion Using the minimal axial diameter of 6 mm as the nodal size criterion in diagosis of RLN metastasis in patients with NPC may be more reasonable.

AIM:To explore the influence of long-term swimming on peripheral neuropathy in type 2 diabetic rats.METHODS:Male Wistar rats were fed with a high-fat and high-fructose diet, and injected with streptozocin to estab-lish a model of type 2 diabetes mellitus.The rats were randomly divided into 4 groups:blank control group (C group), ex-ercise control group ( CE group ) , diabetes mellitus group ( DM group ) and diabetes mellitus +exercise group ( DME group).The rats in CE group and DME group received 8-week swimming training (6 d/week).The training time was 20, 30 and 45 min in the first 3 d,respectively, and then it increased to 60 min a day.Eight weeks later, the motor nerve conduc-tion velocity ( MNCV ) and the levels of tumor necrosis factor α( TNF-α) , interleukin 6 ( IL-6 ) and C-reactive protein ( CRP) in sciatic nerve tissues of the rats were measured .The morphological changes of the sciatic nerve were also observed under light microscope .RESULTS:Compared with DM group , 8-week swimming obviously accelerated the MNCV ( P<0.05), decreased the levels of TNF-α, IL-6 and CRP in DME group (but no significant difference, P>0.05).The obvi-ous nerve injury in DM group was observed .However , the pathological change of the sciatic nerve in DME group was re-lieved.CONCLUSION:Eight-week swimming training significantly accelerates the MNCV , attenuates the nerve injury in diabetic rats and has protective effect on peripheral nerve , which may be correlated with relieving the inflammatory reaction .

Objective To investigate the different biochemical testing system inter laboratory comparability of results,provide reference for promoting inter laboratory test results of the recognition.Methods Five patients with laboratory detection of fresh mixed serum,20 consecutive determination of 10 biochemical items,precision analysis.According to America clinical and Laboratory Standards Institute (CLSI)Document EP9-A2,the Panzhihua Iron and Steel Group General Hospital detec-tion system as the reference system,the remaining four hospital detection system as the detection system,with a fresh mixed serum,determination of five biochemical items (Urea,Cr),(AST,ALT),(TP,ALB),(TG,TC)and (HDL-C,LDL-C),the determination results were compared and analyzed,calculated reference system and the correlation coefficient,linear regres-sion equation between the system and the various medical decision level relative deviation (SE%),and to America Clinical Laboratory Improvement Amendment ability test (CLIA’88)allowed total error of 1/2 as the standard,to the assessment system and the reference system between the comparability and clinical acceptability.Results In Urea,Cr determination for example,CV of five laboratories on Urea and Cr two project was less than CLIA’88 allowed total error of 1/3,the precision could meet the clinical requirements.The detection results significantly correlated (r2 >0.975).The evaluation of clinical ac-ceptability,in Urea low at medical decision level,there were two laboratory determination results that could not be accepted for clinical.In Urea high at medical decision level,there was a laboratory measurement result that could not be accepted for clinical.In the low Cr at medical decision level,there were two laboratory determination results that could not be accepted for clinical.The rest of the system Urea,Cr projects in various medical decision level compared with the system,the SE% was less than CLIA’88 allowed total error of 1/2,for clinical acceptable.Conclusion Laboratory determination results between different biochemical testing system had bias in different degrees,bias part of the project exceeds the allowed error range.

Objective To investigate the clinical value of hemostatic silk in prevention of wound bleeding and wound healing after endoscopic submucosal dissection (ESD). Methods Experiment group: animal model was made by rabbit underwent ESD simulation in its' stomach and laying hemostatic silk on its' wound;control group: animal model was made by pig underwent ESD simulation in its' colon without any healing management. All the ulcers sites were endoscopically and pathologically examined to evaluate the hemorrhage and healing of the wound on 3 days, 1 week, 2 weeks and 4 weeks after the procedure. Results The blood loss in experiment group was significantly lower than that in control group. The wounds of all the experimental pigs underwent colon ESD successfully covered with hemostatic silk postoperatively. Endoscopic pathological examination shown better healing procedure in experiment group. No procedure-related adverse event occurred in both groups. Conclusions Hemostatic silk has potential application value in healing the wound after ESD demonstrated by animal experiment.