Objective To investigate the distribution and the antibiotic resistance genes carried by classⅠintegron and insertion sequence common region(ISCR1)among clinical isolates of Acinetobacter baumannii. Methods Fifty-one clinical isolates of multidrug-resistant Acinetobacter baumannii were collected. Polymerase chain reaction method was used to detect the classⅠintegrase gene, variable region of classⅠintegron, ISCR1 and genes related to antibiotics resistance lo-cated downstream of ISCR1 in 51 multidrug-resistant Acinetobacter baumannii. Antibiotics resistance genes carried by classⅠintegron and ISCR1 were performed by DNA sequencing. The relationship between classⅠintegron and ISCR1 was detected by PCR-mapping. Results Among 51 multidrug-resistant Acinetobacter baumannii isolates, 45 strains were found con-taining classⅠintegrase genes, 32 strains were found containing variable regions. Sequencing results showed that the gene cassette arrays were aacA4-catB8-aadA1, aacC1-orfA-orf-B-aadA1 and blaPSE-1-aadA2-cmlA1-aadA1. Twenty-two strains were found containing ISCR1 and 5 strains were found containing resistance genes located downstream of ISCR1. DNA sequencing results showed the resistant gene of qnrA1-ampR. The results of PCR-mapping showed that ISCR1 located directly downstream of 3' conserved segment of classⅠintegron in 20 Acinetobacter baumannii strains. Conclusion ClassⅠintegron and ISCR1 play an important role in mechanisms of drug resistance of Acinetobacter baumannii. ClassⅠintegron and ISCR1 could connect in series in Acinetobacter baumannii.

Objective To evaluate the correlation between serum procalcitonin concentration and systemic inflam-matory response syndrome (SIRS)score in patients with bacterial bloodstream infection.Methods In January-De-cember,2012,96 patients with bacterial bloodstream infection in a hospital were selected as trial group,and these patients were divided into three groups(group A,B and C)according to SIRS score;84 patients without bacterial in-fection was as control group,PCT concentration of all patients were detected,and the correlation between PCT con-centration and SIRS score was analyzed.Results Among 96 patients with bacterial bloodstream infection,7 (7.29%)died (4 were in group B and 3 in group C);there was no death case in control group.PCT concentration in control group,group A,B and C of trial group were (0.28±0.09)ng/mL,(0.63±0.13)ng/mL,(3.68±1.01)ng/mL,and(7.45±1.53)ng/mL,respectively,the difference between each group was significant(P<0.01).Pairwise comparison of four groups showed statistical difference (P<0.001).Spearman correlation analysis on PCT concen-tration and SIRS score was conducted,correlation coefficient r=0.874(P<0.001)suggested positive correlation be-tween serum PCT concentration and SIRS score.Conclusion PCT concentration in patients with bacterial blood-stream infection and SIRS score is positively correlated,PCT concentration and SIRS score can be used as two mark-ers for assessing the extent and prognosis of bacterial bloodstream infection.

Objective To study the application effect of health education guided by the theory of cross-theoretical model in the training of the first aid training in the basic units of the plateau. Methods Choosing 386 long-term presence of plateau soldiers, and divided them into the control group and the experimental group, the control group was educated by traditional method, in the experimental group, the health education was carried out with the trans-theoretical model, nursing experts gave them targeted intervention. The number of groups at each stage was analyzed in different stages, the same to examination results and pass rate. Results After 6 months of intervention, there was a significant improvement in the mastering of the battlefield Five emergency technology of the experimental group and the scores were better than those of the control group (P<0.05). Theoretical results showed that pass rate of the control group was 89.1%(172/193), the experimental group was 99.5%(192/193), the difference between the two groups was statistically significant (χ2=7.129, P=0.039). In the survey of technical operation, ventilation, hemostasis, bandaging, fixing and handling examination pass rate of the control group respectively were 88.1%(170/193), 89.1%(172/193), 89.1%(172/193), 88.1%(170/193), 88.6%(171/193), the experimental group were 99.5%(192/193), 97.9%(189/193), 99.5%(192/193), 96.9%(187/193), 97.4%(188/193), there were significant differences between the two groups (χ2=7.896-12.759, P=0.001-0.043). Conclusions Cross theoretical model has good effect on the application ofFiveemergency technology training in the high altitude troops battlefield, and can effectively improve the troops self- help and mutual aid capabilities, it is worthy of popularization and application.

ObjectiveTo explore the effect of nursing management emergency project in the treatment of batches of wounded persons in sudden disasters.Method The overall emergency system was set up,the emergency project on nursing management was made including non-stop nosocomial transmission mode,standardization of nursing management in the wards,specialized nursing and individualized nursing for critically ill patients.Result All 139 injured were successfully rescued and discharged after a quick pre-hospital care and effective in-hospital care,with effective rescue time (33.5±19.6)min and the rescue success rate 100.0%. Conclusion The nursing management emergency project for sudden disasters is effective for rescuing batches of wounded persons and improving the success rate of rescue.

Objective To evaluate the two methods for quantitative hepatitis B virus (HBV) DNA test. Methods The Hybrid Capture II system from Digene Co. and Real Time PCR fluorimetry quantitative HBV DNA test kit from PIJI Bio Technical Development Company Ltd. were used to detect sera HBV DNA in sera of patients with chronic hepatitis B. Results With the two quantitative methods, the positive rates of HBV DNA were 98 6% and 94.6% respectively. The concordant rate of these two methods was 93.2%. In assessing the sensitivity of the two kits with a serial of 10 fold diluted patients′s sera, PG kit could test 10 -7 of diluted serum, and HC II could test 10 -6 . The test value of HC II was more accurate in quantitation than PG kit especially in higher titer of HBV DNA. Whereas in the case of low titer of HBV DNA, the deviation of test value increased in both two methods. For monitoring the anti virus effect with quantitative HBV DNA in CHB patients, these two methods had same sensitivity, and the test value of HBV DNA had the same trend of change. Conclusion HC II system and PG test kit were sensitive and reliable, and they were worthy of monitoring the anti virus efficacy and of clinical practice.

OBJECTIVETo confirm the inhibitory effect of Chinese herbs of acid taste on melanin synthesis.

METHODSActive ingredients of 22 kinds Chinese herbs of acid tastes were extracted by alkali extraction and acid precipitation, alcohol extraction, and water extraction, respectively, which was then dispensed into 25.00, 12.50, and 6.25 g/L suspension. Their effects on activities of tyrosinase were detected using mushroom-tyrosinase-DOPA speed oxidation. Their inhibition rates on activities of tyrosinase were respectively compared with inhibition rates of 1.0, 0.5, and 0.1 mmol/L arbutin.

RESULTSThe 22 kinds Chinese herbs of acid taste included Cornus Officinalis, Crataegus pinnatifida, dark plum fruit, Schisandra Chinensis, Chaenomeles sinensis Koehne, Reynoutria japonica Houtt, Achyranthes Bidentata, Sanguisorba officinalis L., Semen Ziziphi Spinosae, Herba Ecliptae, blueberry, immature bitter orange, submature bitter orange, Prunus mume Var, Hovenia acerba Lindl., Fructus Mori, Pomegranate Rind, white paeony root, Rosa laevigata Michx., Portulaca oleracea L, Terminalia chebula Retz, Rhus chinensis Mill. Their alkaline extractions showed inhibition to activities of tyrosinase to different degrees except Herba Ecliptae. Of them, the highest inhibition rate (88.49% ± 9.98%) was got by dark plum fruit at 25 g/L, while the lowest inhibition rate (11.22% ± 3.36%) was got by immature bitter orange at 6.25 g/L. Their alcohol extractions showed inhibition to activities of tyrosinase to different degrees except Herba Ecliptae. Of them, the highest inhibition rate (75.92% ± 5.57%) was got by Hovenia acerba Lindl. at 25 g/L, while the lowest inhibition rate (9.60% ± 1.15%) was got by submature bitter orange at 6.25 g/L. Their water extractions all had inhibition on activities of tyrosinase. Of them, the highest inhibition rate (54.23% ± 3.56%) was got by Fructus Mori at 25 g/L, while the lowest inhibition rate (10.25% ± 1.83%) was got by Semen Ziziphi Spinosae at 6.25 g/L. Compared with 1 mmol/L arbutin water solution, alkaline extractions of dark plum fruit, Schisandra Chinensis, Rhus chinensis Mill., Rosa laevigata Michx., blueberry, Chaenomeles sinensis Koehne, Portulaca oleracea L, Fructus Mori, Achyranthes Bidentata, Pomegranate Rind; alcohol extractions of dark plum fruit, Rhus chinensis Mill., Pomegranate Rind, Hovenia acerba Lindl., Crataegus pinnatifida, Achyranthes Bidentata; water extractions of Chaenomeles sinensis Koehne, blueberry, and Fructus Mori at 25 g/L got obviously higher inhibition rates (P < 0.05, P < 0.01). Compared with 0.5 mmol/L arbutin water solution, alcohol extraction of Chaenomeles sinensis Koehne and alcohol extraction of dark plum fruit at 12.5 g/L got obviously higher inhibition rates (P < 0.05, P < 0.01).

CONCLUSIONChinese herbs of acid taste could inhibit melanin synthesis, and its mechanism was related to inhibiting activities of tyrosinase.

Drugs, Chinese Herbal ; pharmacology ; Humans ; Melanins ; metabolism ; Monophenol Monooxygenase ; metabolism ; Oxidation-Reduction ; Schisandra ; Taste

Objective By virtual screening in MDL,to search for a novel γ-secretase inhibitor.Methods A series of compounds were designed,synthesized,and evaluated based on pharmacophore model of γ-secretase inhibitors by virtual screening in MDL.Results The drug-likeness analytic data synthesized indicated that target compounds had drug-likeness.Each svnthesized compound was checked by IR spectroscopy,~1H and ~(13)C-NMR spectroscopy.Conclusion The designed compounds had better activity by model prediction.And the optimal compound showed a significant estimated activity value of 0.025 nmol/L and can be used as a lead for further drug development.

Antiphospholipid Syndrome ; pathology ; physiopathology ; Child ; Female ; Follow-Up Studies ; Humans

The introduction of problem-based learning techniques into the teaching of anatomy has been subject to great contro- versies.This paper debates the rationale behind this concept using the example of the curriculum of Harvard Medical School.The anatomy curriculum is covered during the eight first weeks of the medical studies,and is an original combination of discussions of clinical cases in small groups,and work in gross anatomy,histology and radiology laboratories.The lectures are reduced to the minimum and emphasize general concepts.

Objective:To explore the effect of therapeutic communication on infusion safety, disease uncertainty, coping styles, anxiety and depression in patients with emergency infusion.Methods:A total of 126 patients treated with infusion patients in emergency department in Jiangsu Provincial People's Hospital, the First Affiliated Hospital of Nanjing Medical University from July 2019 to December 2019 were selected and divided into two groups by random digits table method with 63 cases in each group. Patients in the control group received routine nursing, and patients in the intervention group received therapeutic communication nursing intervention on this basis. The incidence of adverse events of infusion during the intervention of the two groups of patients was observed. The disease uncertainty, coping styles, anxiety and depression were evaluated by Mishel's Uncertainty in Illness Scale (MUIS), Medical Coping Mode Questionnaire (MCMQ), Self-rating Anxiety Scale (SAS) and Self-rating Depressive Scale (SDS) before and after intervention.Results:The final collection of 109 patients with complete questionnaire, the recovery rate was 86.51% (109/126), including 55 cases in the intervention group, 54 cases in the control group. The incidence of adverse events of infusion was 16.36%(9/55) in the intervention group and 29.63%(16/54) in the control group, and there was significant difference( χ2 value was 5.057, P<0.05). There was no significant difference in the score of MUIS, MCMQ, SAS, SDS before the intervention between the two groups ( P>0.05). After the intervention, the uncertainty, unpredictability, lack of information and complexity dimension of the intervention group patients' MUIS scores were respectively (17.76 ± 2.49), (12.03 ± 2.51), (11.82 ± 2.12), (11.74 ± 2.24), which were lower than those in the control group (24.72 ± 2.94), (16.31 ± 2.27), (16.13 ± 2.51), (15.39 ± 2.31), the differences were significant( t values were -13.346- -8.375, P<0.05). The confront score of the intervention group patients' MCMQ was (19.13 ± 2.62) higher than that in the control group(13.79 ± 1.96), the avoidance and yield scores were respectively (8.71 ± 1.34), (9.81 ± 1.17), which were lower than those in the control group (14.57 ± 1.93), (15.12 ± 1.86), the differences were significant( t values were 12.031, -18.441, -17.875, P<0.05). The scores of SAS and SDS in the intervention group were (29.43 ± 3.62), (27.67 ± 3.11) respectively, which were lower than those in the control group (37.44 ± 5.31), (40.12 ± 4.92), the differences were significant( t values were -9.216, -15.821, P<0.05). Conclusions:Therapeutic communication can reduce the risk of emergency infusion, reduce the uncertainty of patients to the disease, improve patients' countermeasures to the disease, relieve patients' anxiety and depression, and improve the nursing quality of emergency infusion patients.