OBJECTIVE To study the change in drug-resistance to antibiotics in Gram-negative bacteria in Jinhua region in order to guide clinical application of antibiotics reasonably.METHODS The antibiotics resistance of Gram-negative bacteria from clinical samples in four general hospitals in Jinhua region during from Jan 2005 to Dec 2007 was studied retrospectively.RESULTS The detecting rates of extended-spectrum ?-lactamases in Escherichia coli and Klebsiella pneumoniae were rising from 41.0%and 25.3% in 2005 to 56.0%and 53.2% in 2007,respectively.Furthermore,0.8% isolates were resistant to carbapenemase from all E.coli and K.pneumoniae strains.The rate of antimicrobial resistance to carbapenemase was 20.0% in Pseudomonas aeruginosa and was increased from 27.0% in 2005 to 41.0% in 2007 in Acinetobacter baumannii.CONCLUSIONS The drug-resistance rate in Gram-negative bacteria hase increased obviously in past three years in Jinhua region.It suggests that there be an urgent need for surveillance of Gram-negative bacterial resistance in different hospitals and rational antibiotics usage be emphasized during clinical therapy.

To explore anatomical material basis of the lung meridian and its three-dimensional position in vivo.

Objective To explore the diagnesticvalue of the inhalant allergens in patients with allergic disea-ses. Methods The intradermal tests(IT) of 20 types of the inhalant allergens which were supplied by Diagnosis Rea-gent Factory of Beijing Union Hospital were made on 1434 cases with allergic diseases. The samples were divided into two age groups:4～18 year-old(children group,n=318) and 19-80 year-old( adults group,n=1116). Distribution of the inhalant allergens of the two groups was investigated. Results A total of 1434 cases (male :702, female:732) were diagnosed with allergic diseases. There were 8 kinds of allergic diseases. The number of allergic rhinitis was the first place( 1130 cases,78.80% ). The first 9 positive allergens separately were: polyvalent pollen Ⅰ (51.05%),house dust(48.81% ) ,mixed inhalant allergens( 48.61% ), artemisia pollen( 46.86% ), dust mite( 45.19% ) , poly-valent insects(36.82% ) ,spring poLlen Ⅰ(33.99% ) ,ragweed pollen(31.24% ) ,spring pollen Ⅱ (30.68% ). There were 1289 cases(89.89% ) at ]east one type positively on allergens. The 19～40 aged patients were the most in dif-ferent age groups. The difference of positive detection rate of allergens was significant in different quarters ( P<0.01 ). Conclusion The youth and middle aged is easoer to suffer loom allergic diseases. Allergic rhinitis was the most common disease,and polyvalent pollen Ⅰ ,house dust,artemisia pollen,dust mite,ragweed pollen were the main allergens.

Objective To observe the hypoglycemic mechanism of total saponins of Momordica charantia (MC) in type 2 diabetes mellitus (DM) rats. Methods Among the selected 60 male Specific Pathogen Free (SPF)rats, 8 were random- ly chosen as control group, while others were fed with high fat and high glucose diet following streptozotocin injection from caudal vein 8 weeks after to construct type 2 DM models. After the DM models were successfully built, rats were then ran- domized into five groups: DM control group (n=8), the metformin group (n=8) and three groups of total saponins of MC with different dosage (n=8 in each group). The total saponins of MC groups include DM rats administrated with total saponins of MC 100, 200, 400 mg/(kg·d) for 8 weeks, the metformin group include DM rats administrated with metformin 50 mg/(kg·d) for 8 weeks. At the end of the experiment, the fasting blood glucose and insulin were examed. At the same time, a part of pan- creas islet, liver and skeletal muscle were preserved. The pancreas islet structure, the hepatic glycogen and Glucose trans- porter 4 (GLUT4) expression were observed by electron microscope, glycogen dyeing and immunoblot respectively. Results After 8 weeks treatment, compared to type 2 DM control group, fasting blood glucose and insulin values in MC groups were reduced more obviously. However, skeletal muscle GLUT4 expression level, insulin granules and hepatic glycogen increased obviously in MC groups. Conclusion Total saponins of MC has hypoglycemic effect. It’s mechanisms maybe include pro- moting the hepatic glycogen synthesis, inhibiting the hepatic glycogen decomposition and promoting insulin sensitivity by in- creasing peripheral tissue’s GLUT4 expression.

Objective To investigate the effect of informationalized monitoring processing system in prevention and control of pressure ulcer. Methods The informationalized monitoring processing system was constructed to collect information. The nursing department sent it to the ulcer treatment group and they worked together to treat and control the ulcers in patients in a dynamic and real-time way. The effect was compared before and after application. Results After use of the system, the pressure ulcers incidence in the hospital was significantly decreased as compared with pre-construct of the system. The reporting and improvement rates were significantly improved than those before(P<0.05). Conclusion The use of the informationalized monitoring processing system makes the reporting of pressure ulcers timely and accurate, helping control the occurrence and treatment of ulcers dynamically, so that the quality of pressure ulcer prevention and control is improved.

Objective To develop a rapid detection method of flow cytometry for antifungal susceptibility testing.Methods The experiment conditions of flow cytometry were optimized and the minimum inhibitory concentrations (M1Cs) of 230 strains of Candida spp to flucytosin,fluconazol,itraconazole,amphotericin B were detected.The MIC results obtained by flow cytometry were compared with M27-A2 reference assay.Results The agreement of MIC results between flow cytometry and M27-A2method was 85.0％ - 100％.Conclusion Flow cytometry can be used as a rapid and reliable method for antifungal susceptibility testing.

Objective To assess the effect of leukocyte fihration on systemic inflammatory response to cardiopulmonary bypass.Methods Twelve mongrel dogs weighing 25-30 kg were randomly divided into 2 groups (n=6 each):control group(C)and leukocyte depletion group(LD).The dogs were anesthetized with intraperitoneal pentobarbital 25 mg?kg~(-1).The trachea was intubated.The arterial line of CPB was connected with aortic cannula and the venous line with a cannula inserted into right atrium.The leukocyte-depletion filter LD-1 was positioned in the venous line of CPB circuit.Aorta was clamped at 10 min of CPB and St.Thomas cardioplegic solution 20 ml?kg~(-1) was injected into the root of aorta.The filter was used for 5 min starting from 2 min of CPB. Aorta was clamped for 60 min.Blood samples were taken from femoral vein before CPB(T_0,baseline), immediately after aortic clamping(T_1)at 30 min of aortic clamping(T_2)5 min after aortic unclamping(T_3)at the termination of CPB(T_4)and 2 h after termination of CPB(T_5)for leukocyte count and determination of plasma L-selectin,IL-6 and IL-8 concentrations and MPO activity.The IL-6 and IL-8 concentrations in the filter LD-1 were measured at 30,60 and 90 rain after leukocyte filtration.The membrane of filter LD-1 was taken at 90 min after filtration for microscopic examination.Results The leukocyte count was significantly lower at T_1 in LD group than in C group.The plasma L-selectin,IL-6,IL-8 concentrations and MPO activity were significantly increased during CPB as compared to the baseline at T_0 in both groups but were lower at T_5 in LD group than in C group.The IL-6 and IL-8 concentrations in LD-1 filter were increased at 60 and 90 min after filtration as compared to those at 30 min.The filter membrane was covered with enormous number of leukocytes.Conclusion Leukocyte filtration can decrease systemic inflammatory response to CPB in dogs.

Objective To observe the incidence of spontaneous clearance of hepatitis B virus (HBV) DNA in chronic hepatitis B (CHB) patients ,and to investigate the related factors of the spontaneous clearance of HBV DNA and to determine the time to start antiviral therapy .Methods Patients who met the inclusion criteria were recruited from the follow-up cohort of chronic HBV infection from January 2008 to August 2017 for observation .The liver function including alanine aminotransferase (ALT) levels ,HBV DNA load and serum markers of HBV were measured at baseline ,month 1 ,month 3 and month 6 of follow-up . Evaluation index included cumulative HBV DNA negative conversion rate and cumulative HBeAg negative conversion rate .Multivariable analysis was used to analyze the factors associated with the spontaneous clearance of HBV DNA .Results A total of 116 patients were recruited in this study .All the patients showed ALT level elevation at baseline .Without antiviral treatment ,the cumulative HBV DNA negative conversion rate was 12 .9％ after 6-month observation .HBeAg negative conversion rate was 22 .5％ .Multivariable analysis showed that patients without a family history of HBV infection ,baseline ALT level >3 times the upper limit of normal (ULN) and HBV DNA level <6 lg copies/mL had higher cumulative HBV DNA spontaneous clearance rate .HBV DNA negative conversion rate in patients whomet all the above three conditions was up to 75％ .Conclusions In CHB patients and ALT level elevation for the first time , some patients could achieve spontaneous clearance of HBV DNA without antiviral therapy .Patients without a family history of HBV infection ,baseline ALT level >3 ULN and HBV DNA level <6 lg copies/mL have higher rate of cumulative HBV DNA spontaneous clearance .

Objective To observe the effects of different frequencies of electroacupuncture on the degree of atrophy of quadriceps femoris in rabbits with anterior cruciate ligament(ACL)injury model;To explore the possible mechanisms of electroacupuncture in treating ACL injury.Methods Totally 24 New Zealand rabbits were randomly divided into blank group,model group,low-frequency electroacupuncture group and high-frequency electroacupuncture group,with 6 rabbits in each group.Except for the blank group,ACL injury models were established in the other groups.On the 7th day after modeling,the low-frequency electroacupuncture group and the high-frequency electroacupuncture group performed electroacupuncture treatment(continuous wave,frequency of 2 Hz and 100 Hz respectively,and left the needle in place for 20 min)at"Xuehai"and"Liangqiu"of the operation side,and the remaining groups were only grasped and immobilized,for 21 days.The mass ratio of the quadriceps femoris was calculated,the histopathological morphology of the quadriceps femoris tissue of the rabbits in each group was observed by HE staining,the expressions of NO,iNOS in quadriceps femoris tissue were detected by ELISA,the content of ROS in quadriceps femoris tissue was detected by fluorescent probe,the protein expressions of PERK,ATF6,IRE1,MuRF1,MAFbx in quadriceps femoris tissue were detected by Western blot.Results Compared with the blank group,the quadriceps femoris muscle mass ratio of the model group rabbits was significantly reduced(P<0.01),with irregular arrangement of muscle cells,accompanied by swelling and atrophy,significant interstitial edema,and extensive inflammatory infiltration,the contents of NO,iNOS and ROS in quadriceps femoris tissue significantly increased(P<0.01),while the expressions of PERK,ATF6,IRE1,MuRF1 and MAFbx proteins significantly increased(P<0.01).Compared with the model group,the quadriceps femoris muscle mass ratio in the low-frequency and high-frequency electroacupuncture groups significantly increased(P<0.01),with regular arrangement of muscle cells,improved swelling and atrophy of cells,and reduced interstitial edema and inflammation,the contents of NO,iNOS and ROS in quadriceps femoris tissue were significantly reduced(P<0.01),and the expressions of PERK,ATF6,IRE1,MuRF1 and MAFbx proteins significantly decreased(P<0.01).Moreover,the low-frequency electroacupuncture group had better effects than the high-frequency electroacupuncture group(P<0.05).Conclusion Different frequencies of electroacupuncture intervention in ACL injury rabbits can better delay the degree of quadriceps femoris atrophy,and its mechanism may be related to reducing the expressions of oxidative metabolites NO,iNOS,ROS,and reducing the expressions of endoplasmic reticulum stress-related proteins PERK,ATF6,IRE1 in quadriceps fermoris,which in turn inhibit the expressions of quadriceps atrophy factors MuRF1,MAFbx,and delaying the degradation of quadriceps muscle proteins.The effect of low-frequency electroacupuncture is superior to the high-frequency electroacupuncture.

Objective To analyze and summarize the acupoint selection law of acupuncture and moxibustion for the treatment of temporomandibular joint dysfunction syndrome(TMD)using data mining technology.Methods Clinical literature about acupuncture and moxibustion for the treatment of TMD was retrieved from CNKI,Wanfang Data,VIP,CBM,PubMed,Web of Science,Embase and Cochrane Library from the establishment of the databases to March 1,2024.Excel 2021 was used to establish a prescription database of acupoints.SPSS Modeler 18.0 and SPSS Statistics 27.0 were used to analyze the frequency of use of acupoints,meridians,locations,specific acupoints,and the analysis of association rules,factor analysis,and clustering analysis.Results A total of 480 articles and 480 prescriptions were included in the study,containing 90 acupoints,with a total frequency of 2 290 times.The high-frequency acupoints were Xiaguan,Hegu,Jiache,Tinggong and Ashi point;the commonly used meridians were the stomach meridian,large intestine meridian,small intestine meridian,bile meridian,and triple-energizer meridian;the most frequently chosen acupoints were the Jiaohui acupoints,Yuan acupoints and Wushu acupoints;and mostly involved acupoints were located at the head and neck area,the upper limb area and the lower limb area.The association analysis showed that the top five combinations were"Xiaguan-Hegu","Xiaguan-Jiache","Xiaguan-Hegu-Jiache","Xiaguan-Tinggong","Xiaguan-Tinggong-Jiache";clustering analysis showed that five valid clusters were extracted;factor analysis extracted seven valid common factors.Conclusion The core acupoints of acupuncture and moxibustion for the treatment of TMD is Xiaguan-Hegu-Jiache-Tinggong,and mainly follows the principle of combining proximal and distal acupoints.