OBJECTIVE To find out the clinical characteristics of nosocomial infections with Stenotrophomonas maltophilia(SMA) and investigate the disinfectant resistant gene of qacE△1,improve the diagnosis and decrease of nosocomial infection cases.METHODS Toally 165 strains of SMA were clinically isolated from 2004 to 2007.The gene of qacE△1 was analyzed by polymerase chain reation(PCR) and homology of the strains was analyzed by the method of by pulsed field gel electrophoresis(PFGE) genotype.RESULTS Susceptible factors were old age,seriousness of underlying disease,prolonged hospitalization and invasive operation with infection of SMA.The lower respiratory tract infection was mostly common with SMA,rate of which was 87.9%.Antibiotic sensitive rate more than 80% against SMA was minocycline,trimethoprim-sulfamethoxazole and levofloxacin.The positive rate of gene qacE△1 was 13.3% in 60 strains tested.Two genotypes in SMA strains from respiratory ICU(RICU) were with the same clone.This result proved that clone transmission occurred in RICU.CONCLUSIONS SMA is an important nosocomial infection pathogen.With the multi-drug resistance,the therapy of infection with SMA is very hard in clinic.As result of gene of qacE△1 and the same clone transmission,clinicians should play an important role of surveillance of effect of disinfection.

Burns are difficult to treat.Burn wounds complicated with serious infection and multiple organ dysfunction with high mortality.Burns wounds often heal slowly with scars and contractures.Glycosaminoglycan(GAG) has been used in parenteral and topical applicarion studies.These studies have uncovered anticoagulative,antiinflammatory and neoangiogenic properties,which may stimulate tissue repair and reepithelializing effects.The GAGs utilized in treating bruns are heparin,dermatan sulfate,heparan sulfate,keratin sulfate,chondroitin 4 and chondroitin 6 sulfate,and hyaluronic acid.Heparin,the most sulgated and acidic GAG,has been used parenterally,topically,by inhalation,in pellet,and in bioengineered membranes.Heparin relieved pain,inhibited clotting and inflammation,restored blood flow, and enhanced healing.The healed skin was smooth.Heparin preserved lung and improved function.Heparin preserved intestinal intergrity and reduced bacterial translocation.Collagen restoration was enhanced.Potential adverse effects with heparin use are bleeding,thrombocytopenia and allergy.It is important to know when heparin is contraindicated.And the coagulation time should be tested.Although not as yet fully substantiated,topical heparin therapy of burns is a useful addition to the range of available treatments for burn wounds.

Objectives:To study the effect of triptolide(Tri) on fibroblast cells in vitro culture, morphologically and kinetically. Methods:Light microscope(LM)and electron microscope(EM)were employed to detect the morphological changes in Tri group. Cell DNA content and apoptosis were assayed by flow cytometry (FCM). Results:In Tri group, fibroblast cells showed less density, slimmer body, abnormally and typical apoptosis under LM, while rarefaction and content of rough endoplasmic reticulum(RER) decrease, and apoptosis in different stages could be seen under EM. In FCM,AI elevated remarkably in Tri groups, and the effect is dose dependent, with cell cycle uninfluenced at all. Conclusions:The mechanism of triptolide on hypertrophic scars is related to its promotion on fibroblast apoptosis and inhibition of collagen excretion.

Integrins are the main mediators of the complicated interaction between hepatic stellate cells (HSCs) and extracellular matrix (ECM) components. Signal transduction by integrins is initiated by both occupancy and crosslinking of integrins by ECM components. Focal adhesion kinase (FAK) and mitogen- activated protein kinase (MAPK), which are the downstream molecules, involve in integrin-mediated cellular behaviors. In this review, we briefly summarize the integrin's structure, intracellular signaling cascades and its role in HSC behaviors,such as activation,proliferation and apoptosis.

AIM:To explore the role of tumor n ecrosis factor alpha(TN F-?) in the pathogenesis of liver fibrosis. METHODS:The proliferation and apoptosis of hepatic stellate cells (HSCs) in vitro were detected with flow cytometry, electron microscopy and TUNEL. RESULTS:The flow cytometry analysis showed that the cell pr oliferation index (PI) in the TNF-?(0.5 ?g/L, 2.0 ?g/L, 8.0 ?g/L) groups was evidently l ower than that in the control group ( P

Objective To investigated the analgesic effect of processed Aconiti tuber(PAT) in rats with a sciatic nerve chronic constriction injury(CCI) .Methods The study was conducted in two parts. CCI model was developed with four ligatures placed around the right sciatic nerve and tied without obstructing the blood supply of the nerve. In part Ⅰ, forty rats were randomly divided into five groups(n = 8) . In group Ⅰ normal saline 1 ml , In group Ⅱ-Ⅴ PAT 0.5 ,1, 2 ,or 4 g/kg was administered orally 14 days after CCI respectively. In part Ⅱ , thirty-two rats were randomly divided into four groups (n = 8) . In group Ⅰ oral normal saline 1 ml, in group Ⅱ oral PAT 2 g/kg, in group Ⅲ oral PAT 2 g/kg + intraperitoneal nor-binaltorphimine (nor-BNI) 2 mg/kg, in group Ⅳ oral PAT 2 g/kg + intrathecal nor-BNI 100 ?g was administered 14 days after CCI. As indicators of mechanical and heat hyperalgesia, the paw withdrawal pressure threshold (PWPT) in response to a graded pressure stimulus with a filament and the paw withdrawal latency (PWL) in response to radiant heat were measured in both hind paws before and after drugs administration.Results In part Ⅰ, in group Ⅲ-Ⅴ PWL was prolonged significantly and in group Ⅳ - Ⅴ PWPT were significantly increased compared with those in group I . There was no significant difference in PWL and PWPT between group Ⅰ and group Ⅱ . In part Ⅱ , in group Ⅲ, Ⅳ PWPT and PWL were significantly lower than those in group Ⅱ . There was no significantly difference in PWL and PWPT between group Ⅰ and group Ⅲ, Ⅳ . Conclusion In rat with neuropathic pain processed Aconiti tuber exerts analgesic effect via the spinal ?-opioid receptor activation.

Objective: To investigate the management of NH~-_3 burned cases with inhalation injury. Methods:The clinic treatments of 15 NH~-_3 burned cases complicated with inhalation injury in his hospital between January 1998 and April 2004 were analyzed retrospectively.His management included reasonable fluid therapy,prompt and efficient usage of antibiotics ,tracheotomy after diagnosis,mechanical ventilation,bronchoalveolar lavage using fibrobrochoscope after the shock period and short-time usage of glucocorticoid. Results: Of the 15 cases,14 patients were cured and 1 patient was improved without any death.The cure rate was 93.3%. Conclusion: All of the managements should be performed as quickly as possible.Paying much attention to prevent the complications could improve the cure rate.Tracheotomy and bronchoalveolar lavage in the early stage are vital to patients.

0.05),but positively on PBD 7(r= 0.890,P

Objective: To study the relationship of resting energy expenditure(REE) with wound depth in burn patients and offer some guidance for the nutrition treatment of burn.Methods: Twenty-three burn patients with a similar total burn surface were randomly divided in accordance with the Ⅲ? wound area into Goups A,B,C and D,their total burn surface and Ⅲ?wound area were(66?18)% and(12?9)%,(59?18)% and(20?5)%,(62?6)% and(39?5)%,and(65?16)% and(54?4)%,respectively.Their REE was determined on PBD(postburn day) 1,2,3,7,14,21 and 28 with the indirect measuring method.The measured values of 13 normal adults were used for comparison.Results: The mean value of REE of each burn group was higher than the normal control.REE enhanced significantly with the increase of the Ⅲ? wound area.Conclusion: REE obviously increases in burn patients,and,with a similar total burn surface,the larger the Ⅲ? wound area,the higher REE.Therefore,increased calories should be furnished in the nutrition treatment of burn patients with a larger Ⅲ? wound area.

Objective To study the expression site and the role of low-affinity nerve growth factor receptor(P75) in hepatic stellate cells(HSCs) of fibrotic human and rat liver.Methods Left lobe of liver was removed from CCl-4-induced rats fibrosis model and human fibrotic tissue sample was taken from liver puncture.The tissue specimen was routinely paraffin embedded and expression of P75 was detected by histochemical staining using polyclonal antibody against P75.Additionally,HSCs was cultivated and P75 was immunochemically assayed for P75 binding activity. Results P75 was seen abundantly on cell membrane of the cultured HSCs.In the fibrotic tissue of rat liver as well as human fibrotic liver P75 was also positively expressed.Similarly,P75 was found mainly a hepatocye surface in histochemical staining.P75 was not seen by histochemical staining in the normal tissue of human and rat liver.Conclusion P75 used as a new target for the treatment of hepatic fibrosis.