IgA nephropathy ( IgAN) , which is characterized by the presence of IgA deposits in the glomerular mesangi-um, is the most common form of primary glomerulonephritis in the world .Some studies have revealed that the expression and changes of certain factors involved in IgAN pathology lesion in urine can provide facilitate the diagnosis , assessment and prognosis of IgAN .Studies on urine biomarkers in recent years were reviewed in this paper .

Objetive To elucidate the mechanism of antibiotic resistance of Pseudomonas aeruginosa(P.a.) in an effort to provide a basis in clinical combined use of antibiotics against P.a.infection in clinical settings.Methods All P.a.strains were isolated by routine procedures and identified with VITEK-2 automatic bacterial identification console.The minimum inhibitory concentration(MIC) was detected using dilution method on agar plate following the instruction of CLSI.Results Ninety-two strains of P.a.were isolated from clinical infection specimens,most of them were obtained from respiratory tract(88.04%).Of the 92 strains,45(48.91%) were metallo-?-lactmases positive,and 25(27.17%) were AmpC positive.When treated with a combination of meropenem and imipenem,MIC≥1 was found in 17 strains(18.48%).The bacteriostatic rate of polymixin B and meropenem was 95.65% and 80.43%,respectively,that of amikaein,piperacillin/tazohaetam(PIT) and imipenem was 48.91%-71.74%,and that of cefoperazone/sulbactam(SUP) was 36.96%.The synergistic action of PIT,and SUP with amikacin was 60.87% and 58.70%,respectively,and that of PIT,SUP with minocycline were 44.57% and 43.48%,and of PIT,SUP with PLB were 28.26% and 7.61%,respectively.Conclusions P.a.strains in this study are mainly isolated from respiratory tract infection specimens.Multiple drug-resistant mechanisms are involved in the drug resistance of P.a.Enzyme inhibitors,such as PIT or SUP,with amikacin or polymixin B should be first selected for clinical treatment of P.a.caused infection.Meanwhile,antibiotics should be rationally administered in accordance with the seriousness of disease,and with the drug-resistant phenotype of the isolated strains.

OBJECTIVE:To evaluate therapeutic efficacy and safety of ubenimex combined with chemotherapy in the treatment of malignant tumor,and to provide evidence-based reference in clinic.METHODS:Retrieved from Central,PubMed,CJFD,VIP and Wanfang database,randomized controlled trials (RCTs) about ubenimex combined with chemotherapy (trial group) vs.single chemotherapy (control group) in the treatment of malignant tumor were collected.The quality of studies were evaluated by bias risk evaluation criteria of Cochrane system evaluator manual 5.1.0 after screening literatures and extracting data.Meta-analysis was performed by using Rev Man 5.3 statistical software.RESULTS:A total of 12 RCTs were included,involving 762 patients.The resuits of Meta-analysis showed that:shorter-term response rate [RR=1.24,95 ％ CI (1.08,1.43),P=0.002] and the improvement rate of life quality Karnofsky score [RR=1.69,95％ CI(1.46,1.95),P＜0.001] in trial group were significantly higher than control group;the incidence of gastrointestinal toxicity [RR=0.74,95％CI(0.57,0.94),P=0.02] and leucocyte suppression rate[Ⅰ °-Ⅳ°(＜3 months):RR=0.54,95％CI(0.37,0.79),P=0.002;Ⅲ°-Ⅳ°:RR=0.44,95％CI(0.29,0.68),P＜0.001] were significantly lower than control group,with statistical significance.CONCLUSIONS:Ubenimex combined with chemotherapy can improve malignant tumor,shorter-term efficacy and life quality,and reduce gastrointestinal and marrow toxicity.

Objective To compare the sensitivity of four kinds of drug susceptibility test method in detecting sensitivity of tigecycline against Acinetobacter baumannii.Methods The susceptibility of 72 clinically isolated strains of carbapenemase-resistant Acinetobacter baumannii(CRAB) to tigecycline in vitro was detected with disk diffusion method,VITEK 2 Compact system,E-test and MIC test strip(MTS) test strip respectively,according to FDA standards,and the differences of four kinds of drug susceptibility test methods were compared.Results The susceptibility rates of 72 strains of CRAB to tigecycline by disk diffusion method,VITEK 2 Compact system,E-test and MIC test strip were 50.00%,69.44%,36.11% and 98.61% respectively,the intermediate rates were 48.61%,29.17%,26.39% and 1.39% respectively,the resistant rates were 1.39%,1.39%,37.50% and 0.00% respectively.Compared with MTS,the classification consistency rates of E-test,disk diffusion method and VITEK 2 Compact system were 36.11%,51.39% and 70.83% respectively.Conclusion There is difference among four kinds of method for conducting the drug susceptibility testing of tigecycline against CRAB,the consistency of disk diffusion method,VITEK 2 Compact system and E-test is lower.Detecting mediation or drug resistant strains of CRAB by disk diffusion method,VITEK 2 Compact system and E-test needs to be verified by MTS or Broth dilution method.

Objective To explore the condition of cortistatin (CST)expression in human renal tissue and the changes in the level of CST in IgA nephropathy (IgAN)of different degrees.Methods Ten tumor adjacent normal renal tissue samples were collected.The mRNA and protein expressions of CST in human renal tissue were detected by reverse transcription-polymerase chain reaction (RT-PCR)and Western blotting,respectively.Immunohistochemisty (IHC)was performed to locate the expression of CST in renal tissue.According to the grading system of Lee et al,IgAN was divided into three groups:grade Ⅰ -Ⅱ (group A),grade Ⅲ -Ⅳ (group B),and grade Ⅴ (group C),and ten renal biopsy tissue samples were collected for each group.IHC was performed to detect the change in the level of CST in normal and IgAN renal tissue of different degrees.The effect of clinical indices on the level of CST in IgAN renal tissue was assessed by multiple linear regression analysis.Results RT-PCR and Western blotting showed that CST was expressed in renal tissue and IHC showed that CST was expressed on renal tubular epithelial cells.In IgAN,the higher the pathological grade was, the higher the expression of CST in renal tubules was.Multiple linear regression analysis showed that the pathological grade was associated with the expression of CST in renal tissue (r =0.875,P <0.01).Conclusion CST may participate in the inflammatory reaction of IgAN pathological injury and exert anti-inflammation effects.

OBJECTIVE:To systematically review the efficacy and safety of Elemene injection combined with chemotherapy in the treatment of gastric carcinoma,and provide evidence-based reference for clinical treatment. METHODS:Retrieved from CBM, CJFD,VIP Database,Wanfang Database,Medline,EMBase,Cochrane Library and American Medical Association Database,ran-domized clinical trials(RCT)about Elemene injection combined with chemotherapy in the treatment of gastric carcinoma were col-lected,Meta-analysis was performed by using Rev Man 5.3 software after data extracting and quality evaluating by Cochrane 5.1.0. RESULTS:Totally 7 RCTs were enrolled,involving 434 patients. Results of Meta-analysis showed recent efficacy [RR=1.38,95%CI(1.14,1.67),P=0.001] and improvement rate of life quality [RR=1.36,95% CI(1.15,1.60),P<0.001] of Elemene injection combined with chemotherapy in the treatment of gastric carcinoma were significantly higher than only chemotherapy. The incidence of Ⅲ-Ⅳ leukemia inhibition [RR=0.58,95%CI(0.37,0.91),P=0.02],incidence of Ⅰ-Ⅳ hemoglobin inhibition [RR=0.76,95%CI(0.60,0.95),P=0.02],incidence of Ⅰ-Ⅳ platelet inhibition [RR=0.69,95%CI(0.52,0.91),P<0.001] and Ⅲ-Ⅳ[RR=0.53, 95%CI(0.30,0.93),P=0.03] and incidence of Ⅰ-Ⅳ neurotoxicity[RR=0.69,95%CI(0.52,0.93),P=0.01] in test group were sig-nificantly lower than control group,the differences were statistically significant. CONCLUSIONS:Both efficacy and safety of El-emene injection combined with chemotherapy in the treatment of gastric carcinoma are good.

Objective To investigate the distribution and antimicrobial resistance of multidrug‐resistant organisms(MDROs) . Methods The distribution and antimicrobial resistance of MDROs ,isolated from 2010 to 2014 ,were retrospectively analyzed . MDROs were identified according to international consensus .The WHONET5 .6 software was used to analyze data .Results A to‐tal of 5 709 strains of MDROs were isolated in five years ,in which 2 441 strains were Staphylococcus(42 .76% ) ,2 091 strains were non‐fermentive bacterial(36 .63% ) ,737 strains were Enterococcus(12 .90% ) ,440 strains were Enterobacter(7 .71% ) .Of the 5 709 MDROs isolates ,55 .04% were isolated from respiratory tract specimens .The resistant rate of multidrug‐resistant E .coli and K . pneumoniae against cefoperazone/sulbactam ,imipenem and meropenem was less than 30% .The resistance of multidrug‐resistant A . baumanii was higher than 90% ,except to minocycline and cefoperazone/sulbactam ,20 .2% and 50 .6% respectively .The resistant rate of multidrug‐resistant P .aeruginosa was 71 .4% -97 .0% against other antimicrobial agents ,except to polymyxin B .The resist‐ance of multidrug‐resistant E .faecium against the antimicrobials was higher than 90% ,except 13 .8% to minocycline and less than 3% to linezolid ,teicoplanin and vancomycin .Meanwhile ,1 linezolid resistant strain was identified in 1 914 methicillin resistant S .au‐reus(MRSA) strains and all MRSA strains were susceptible to vancomycin and teicoplanin .Conclusion MDROs could be predomi‐nated by A .bauman and MRSA in this hospital .Monitoring and control measures to healthcare‐associated infections should be in‐tensified to prevent the spread of MDROs .

Objective To investigate antifungal activities of AMB, ICZ, VRC, CBF against 72 strains of filamentous fungi in vitro. Methods Based on CLSI M38-P and M38-A scheme, MIC of antifungal drugs were determined. The growing inhibitory concentration of 100%, 100%,≥80%, for AMB, VRC ,ICZ act as respective MIC. For caspofungin, the minimal effective concentration (MEC) was determined as the lowest drug concentration showing morphology change of filaments. The fractional inhibitory concentration (FIC) was used to evaluate the effect of combination therapy. FIC was calculated by the following equation: FIC = MICcombination/MICA drug alone+ MICcombination/MICB drug alone. Results MIC90 of AMB, ICZ, CBF, VRC against 72 isolates of filamentous fungi were 8 μg/ml, 4 μg/ml, 2 μg/ml, 8 μg/ml, respectively. MICs range of combined AMB + ICZ, AMB + VRC, ICZ + VRC were 0. 125-16. 97, 0. 2452-1.25, and 0.0625-8. 25 μg/ml respectively. The percent of synergistic interaction of AMB + VRC against filamentous fungi (20.0%-88.9% ) was higher than those of AMB + ICZ ( 10.0% -62.5% ) and ICZ + VRC ( 20.0% - 44.4% ) ( P=0.007 <0.05 ). Conclusions The antifungal activities of four kinds antifungal drugs against 72 strains of filamentous fungi vary in vitro. The therapy of AMB combined with VRC is maybe better than AMB + ICZ and ICZ + VRC for severe fungi infection.

Objective To study the characteristics of antimicrobial resistance and molecular epidemiology of Staphylococcus aureus (S .aureus)in the intensive care units(ICUs)of a hospital.Methods Clinical isolates of S .aureus collected from ICUs between January and December 2014 were identified and performed antimicrobial susceptibility testing,then typed by staphylococcal protein A (spa)typing and multilocus sequence typing (MLST) methods.Results Of 160 isolates of S .aureus ,120 (75.00%)were methicillin-resistant S .aureus (MRSA). Resistance rates of MRSA to erythromycin,clindamycin,and levofloxacin were all > 80%;methicillin-sensitive S .aureus (MSSA)were sensitive to cefazolin,resistance rates to erythromycin,clindamycin,and levofloxacin were 62.50%,35.00%,and 10.00% respectively.spa typing and MLST results showed that the main types of 120 isolates of MRSA were ST239-t030,ST239-t037,and ST5-t2460,the major epidemic strains were ST239-t030 (n=105,87.50%),and were isolated from 8 ICUs;MSSA had more types,ST59-t437 were detected only from depart-ment of neurology(n =8)and department of digestive diseases(n =2),ST6-t701 ,ST398-t3625,ST398-t1793,and ST121-t2092 were isolated from departments of neurology(n=7),anesthesiology(n=5),neurosurgery(n=4),and cardiac surgery(n=4)respectively.Conclusion Isolation rate of MRSA in ICUs in this hospital is high,ST239-t030 is the main type,which prevailed in hospital;different types of MSSA have epidemic trends in various departments.

Objective To understand the clindamycin resistance gene and molecular epidemic of Staphylococcus aureus in the pa‐tients with bloodstream infection in our hospital during 2014 .Methods The clinical isolates of Staphylococcus aureus in clinical bloodstream infection were collected during 2014 .The phenotype of erythromycin to clindamycin induced resistance was assessed by D test .The erm gene was detected by PCR .The different erm types of the molecular epidemiology of Staphylococcus aureus were studied by spa and MLST typing .Results In 33 strains of Staphylococcus aureus ,the isolation rate of MRSA strains were 78 .79% ,moreover all of MRSA strains carried ermA gene .In 7 strains of methicillin sensitive Staphylococcus aureus(MSSA) ,4 strains respectively carried ermB or ermC gene .The results of MLST and spa results showed that the main type of MRSA in our hospital was ST239‐t030 .But MSSA had more types ,such as ST59‐t437 ,ST398‐t3625 and so on .Conclusion MRSA has higher i‐solation rate in our hospital ,which is dominated by ST239‐t030 type .For the detection of gene erm ,ermA (86 .67% ) is the main type .The strains are obviously resistant to antibacterial drugs .The laboratory should strengthen the detection of clindamycin in‐duced resistance for guiding the clinical rational use of antibacterial drugs .