Objective To evaluate the effect of multidisciplinary intervention on antimicrobial prophylaxis in neurosurgical patients undergoing craniotomy for tumor resection.Methods By standardizing preoperative disinfection and surgical procedures, training and education of antimicrobial use, conducting quality control activities, and performing periodic feedback of supervised results, efficacy of improvement of antimicrobial prophylaxis in neurosurgical patients undergoing craniotomy for tumor resection in a hospital was observed.Results In 2013 and 2014, incidences of surgical site infection(SSI) were 7.66%(17/222)and 6.80%(27/397) respectively,there was no significant difference between two groups(X2 =0.158,P>0.05).Prophylactic use of antimicrobial agents in surgical patients were as follows: cefuroxime(n=495), cefazolin(n=103), cefathiamidine(n=9), clindamycin(n=8), and cefotaxime(n=4), types of used antimicrobial agents were rational.In 2014, the implementation rate of necessary intra-operative antimicrobial adding was 95.02%, which was higher than 87.66% in 2013(X2=7.969,P<0.05), 30.73% of patients received antimicrobial prophylaxis for>48 hours, which was lower than 57.66% in 2013, difference was significant(X2=42.88,P<0.05).Conclusion Multi-intervention measures, including standard preoperative disinfection and surgical procedures, education and training, quality control circle, and feedback of supervised results can improve standard antimicrobial prophylaxis in neurosurgical patients undergoing craniotomy for tumor resection.

OBJECTIVE To investigate the drug-resistance rate of strains isolated from nosocomial infection patients with Acinetobacter spp.METHODS A total of 198 patients with Acinetobacter spp nosocomial infection were studied retrospectively from 2003 to 2005.The antibiotic resistance profiles were specifically analyzed.RESULTS The strains of Acinetobacter spp were mainly isolated from sputum(74.75%) and wound secretion(11.61%) specimens.There were no significant differences in the resistance of Acinetobacter spp against antibiotics in 3 years except piperacillin/tazobactam and meropenem.The resistance rate of all 198 strains to 13 kinds of antibiotics were as following:imipenem/cilastatin 2.53%,meropenem 2.02%,cefoperazone/sulbactam 30.81%,piperacillin/tazobactam 38.38%,amikacin 53.54%,cefepime 61.11%,levofloxacin 66.67%,ceftazidime 66.16%,ciprofloxacin 68.69%,gentamicin 67.68%,sulfamethoxazole/trimethoprim 63.64%,piperacillin 70.72%,and aztreonam 85.35%.CONCLUSIONS It is indicated that Acinetobacter spp are highly resistant to the common antibiotics,but still sensitive to imipenem/cilastatin and meropenem.

OBJECTIVE: To discuss the new work mode of clinical pharmacists participating in ward round and to promote rational use of antibiotics. METHODS: The status quo of clinical pharmacists participating in analysis of antibacterials used before and after ward round was analyzed statistically. RESULTS: After pharmacists participating in ward round, the cost ratio of antibiotics to total drugs was decreased by 5.56%. Rationality of antibacterial used in perioperative period or by infectious patients was improved significantly. CONCLUSIONS: The work mode of clinical pharmacists participating in ward round is effective and feasible, which plays a key role in promoting rational use of antibacterial and medical quality.

Objective To investigate the expression and resistant gene of integron in multidrug-resistant Acinetobacter baumannii (MDR-Ab).Methods 51 strains of MDR-Ab isolated from a hospital in August-October 2012 were collected, antimicrobial susceptibility testing was performed.Class I(Int I),II (Int II)and III (Int III)of integrase genes and inte-gron variable region gene cassettes were detected by polymerase chain reaction (PCR),and the homology of integron varia-ble region was analyzed by detection results of restriction fragment length polymorphism (RFLP)and DNA sequencing. Results Positive rate of integrase gene in MDR-Ab was 78.43%(40/51).All genes belonged to Int I,while IntⅡand IntⅢ were not found.Variable region cassettes were detected in 97.50% (n=39)of Int I,there were 5 types of integron gene cassettes:aacA4 in 14 strains,aacA4+catB8 in 22 strains,arr-3 +aacA4 in 1 strain,dfrA15 in 1 strain and arr-3 in 1 strain.Conclusion MDR-Ab isolated from this hospital may be related with Int I expression.Int I carried gene cassettes as follows:aacA4,aacA4+catB8,arr-3+aacA4,dfrA15 and arr-3.

Objective To evaluate the effect of comprehensive intervention on perioperative antimicrobial prophy-laxis in clean incision surgery in a hospital.Methods From 2011 ,clean incision surgery cases were performed com-prehensive intervention,antimicrobial use in 2011 -2013 were compared.Results A total of 5 945 cases of clean in-cision surgeries were investigated between 2011 and 2013,3 827 cases (64.37%)received prophylactic use of anti-microbial agents.Prophylactic antimicrobial usage rates in 2011 -2013 were 84.95%,69.99%,and 52.97% re-spectively(χ2 =380.94,P <0.001);the correct rates of medication time were 50.97%,79.99%,and 98.95% re-spectively(χ2 =827.02,P <0.001 );the percentages of prophylactic antimicrobial use ≤24 hours were 24.91 %, 39.96%,and 64.95% respectively(χ2 =422.55,P <0.001 );additional antimicrobial usage rates during surgery were 50.00%,60.00%,and 80.00% respectively(χ2 =59.47,P <0.001 ).Conclusion The implementation of comprehensive intervention measures can standardize antimicrobial use,reduce prophylactic antimicrobial usage rate,improve the correct rate of medication time,shorten the duration of antimicrobial use,and implement addition-al use of antimicrobial agents during surgery.

In order to investigate the molecular mechanism of silk/threonine protein kinase (STK)-mediated blue light response in the algal Chlamydomonas reinhardtii, phenotype identification and transcriptome analysis were conducted for C. reinhardtii STK mutant strain crstk11 (with an AphvIII box reverse insertion in stk11 gene coding region) under blue light stress. Phenotypic examination showed that under normal light (white light), there was a slight difference in growth and pigment contents between the wild-type strain CC5325 and the mutant strain crstk11. Blue light inhibited the growth and chlorophyll synthesis in crstk11 cells, but significantly promoted the accumulation of carotenoids in crstk11. Transcriptome analysis showed that 860 differential expression genes (DEG) (559 up-regulated and 301 down-regulated) were detected in mutant (STK4) vs. wild type (WT4) upon treatment under high intensity blue light for 4 days. After being treated under high intensity blue light for 8 days, a total of 1 088 DEGs (468 upregulated and 620 downregulated) were obtained in STK8 vs. WT8. KEGG enrichment analysis revealed that compared to CC5325, the crstk11 blue light responsive genes were mainly involved in catalytic activity of intracellular photosynthesis, carbon metabolism, and pigment synthesis. Among them, upregulated genes included psaA, psaB, and psaC, psbA, psbB, psbC, psbD, psbH, and L, petA, petB, and petD, as well as genes encoding ATP synthase α, β and c subunits. Downregulated genes included petF and petJ. The present study uncovered that the protein kinase CrSTK11 of C. reinhardtii may participate in the blue light response of algal cells by mediating photosynthesis as well as pigment and carbon metabolism, providing new knowledge for in-depth analysis of the mechanism of light stress resistance in the algae.
Chlamydomonas reinhardtii/genetics* ; Photosynthesis/genetics* ; Plants/metabolism* ; Protein Kinases ; Threonine/metabolism* ; Carbon/metabolism* ; Serine/metabolism*