Objective To investigate the impact and the associated parameters of malnutrition and inflammation status on hospitalization and mortality of maintenance hemodialysis (MHD) patients. Method A total of 118 MHD patients were included in the study with 1 year's follow-up.The malnutrition and inflammation parameters were compared between the hospitalized patients and out-patients.Cox's proportional hazard regression model was used to explore the malnutrition and inflammation parameters which could forecast the risk of hospitalization and mortality. Result The hospitalization rate of MHD patients with mild,moderate and severe malnuttition was 32.93％,56.67％ and 83.33％ respectively,and the mortality was 3.66％,6.67％ and 80.00％ respectively.The hospitalization rate of MHD patients with or without microinflammation status was 56.45％ and 46.43％,and the mortality was 14.29％ and 1.61％.Inpatients had a higher malnutrition-inflammation score(MIS,8.36 vs 5.86,P＜0.05) and subjective global assessment of nutrition (MQSGA,14.49 vs 12.88,P＜0.05),a lower creatinine level (886.83 μmol/L vs 991.76 μmol/L,P＜0.05 ) and a lower albumin level (38.57 g/L vs 40.27 g/L,P＜0.05) than out-patients.Inpatients also had a higher level of TNF-α (65.41 μg/L vs 59.76 μg/L,P＜0.05) than out-patients.Cox proportional hazard model analysis showed that MIS and TNF-α were associated with patient's first hospitalization risk. Conclusions For the MHD patients,the more severe the malnutrition and micro-inflammation status is,the worse the clinical outcome is.The higher levels of MIS and TNF-α result in greater risk of hospitalization.

OBJECTIVE To investigate the antibiotical resistance and to understand the phenotype and genotype of metallo-?-lactamase in Chryseobacterium indologenes.METHODS The MIC to 25 C.!indologenes strains was detected by agar dilution method.Phenotype of metallo-?-lactamase was detected by three-disc synergy test and modified three dimension test.Polymerase chain reaction(PCR)amplification for both metallo?-lactamase and integrase gene was conducted for all isolates.Complete coding gene of metallo-?-lactamase and their DNA sequence analysis was conducted.Conjugation experiment was used to study the transmission of metallo-?-lactamase encoding gene.pIs Of ?-lactamase was measured by isoelectric focusing assay.RESULTS The antibiotical resistance of C.indologenes to imipenem and meropenem was 88.0%,respectively.However,gatifloxacin,levofloxacin and rifampin had better antimicrobiotial ability to C.indologenes compared with other antibiotics in MIC Nineteen strains were identified to produce metallo-?-lactamase using three-disc synergy test and modified three dimension test.Twenty strains were detected to have metallo-?-lactamase genotype by PCR amplification using IND-like common prime sets and four prime sets of complete coding gene.Among them,9 strains were detected to have blaIND-1 genotype and 10 strains to have blaIND-2 genotype,strain CI-25 was identified to have blaIND-like genotype.The mutation of base sequences and amino acid sequences in 5 strains were found simultaneously.Conjugation experiment showed that metallo-?-lactamase encoding gene couldn′t transfer.Nineteen strains had 1 or 2 bands on isoelectric focusing electrophoresis.Strain CI-5 was proved to have blaIND-1,but phenotype of metallo-?-lactamase was negative.CONCLUSIONS C.indologenes has high rate of metallo-?-lactamase producing,and thus it is difficult to treat.The major genotype of metallo-?-lactamase for C.indologenes is blaIND-1 and blaIND-2 in Hefei.The expression of blaIND could exist negative or low level occasionally.