Objective To investigate the drug resistance of fungi and bacteria detected by using blood culture from 2010 to 2013. Methods BacT/Alert 3D blood culture system was used,Then VITEK microbiological analyzer was used to identify the bacteria and perform drug sensitivity test,the results were analyzed using WHONET5.4 software.Results There were 108 positive speci-mens among 1 176 samples,the detection rate was 9.18%.Among 123 isolates,60 strains were gram positive(48.78%),47 strains were gram negative(38.21%),16 strains was fungus(13.01%).The major five kinds of pathogenic bacteria were coagulase nega-tive staphylococcus(CNS,44 strains),Escherichia coli (18 strains),Klebsiella pneumoniae (15 strains),candida albicans (10 strains)and Staphylococcus aureus(7 strains).The detection rate of methicillin resistant coagulase negative staphylococci(MRCNS) and Staphylococcus aureus(MRSA)were 72.73%(32/44)in CNS strains and 57.14% (4/7)in Staphylococcus aureus strains,the antibiotic resistance rates of MRSA and MRCNS were significantly higher than that of MSSA and MSCNS,none of Staphylococcus aureus strain was resistant to vancomycin and linezolid.The sensitive rate of Candida albicans to fluconazole,ketoconazole and mi-conazole was high.50% of Escherichia coli strains and 40% percent of Klebsiella pneumoniae strains produced extended spectrum beta-lactamases(ESBLs).The sensitive rate of Enterobacteriaceae to imipenem and meropenem were both 100.00%.The sensitive rate of Pseudomonas aeruginosa to cefoperazone/shubatan,piperacillin/tazobactam were both high.Conclusion CNS is the major kind of bacteria in blood culture.The antibiotic resistance of bacteria is increasing and it is necessary to pay attention to blood cul-ture results in order to guide the clinical use of drugs.

Objective To investigate the value of transoral carotid ultrasonography (TOCU) in detecting the change of distal extracranial internal carotid artery(ICA) with stenosis and occlusion in its initial segmen.Methods One hundred and ten patients with stenosis at least 50％ or occlusion in the initial segment of ICA diagnosed by high-frequency linear probe were enrolled as case group,while thirty two with healthy carotid arteries as control group.Both of the case and control groups were undergone high-frequency linear probe to examine CCA and the initial segment of ICA,and TOCU to observe their lumen transparency,color Doppler flow display and change of Doppler flow spectrum,even measuring the internal diameter,peak systolic velocity (PSV),end-diastolic velocity(EDV) and PSVICA/PSVCCA ratio,respectively.Digital subtraction angiography (DSA)were performed within two weeks,then compared with ultrasonography.Results 92.7％ patients were performed TOCU examination in case group and 93.8％ in control group.The internal diameter and PSV of the distal extracranial ICA became gradually smaller from control group to near occlusion group,and there were statistical significance between groups ( P ＜0.05),however,near occlusion group had no statistical significance compared with occlusion group( P ＞0.05).There were 80％ arteries having thrombus echo in occlusion group,and the others in this group having no thrombus had gloomy colour flow,even got low-velocity artery spectrum.Doppler flow spectrum of distal extracranial ICA showed characteristics of slow wave or single peak in near occlusion group,and spike shape or slow wave in 76.7 ％ arteries of 70％ ～near-occlusion stenosis group,but spike shape in 30.8％ arteries of 50％～69％ stenosis group,and the others were normal.Conclusions TOCU is useful for detecting the changing regularity of distal extracranial ICA with stenosis or occlusion in its initial segment and has the value of clinical application in association with high-frequency linear probe.

Objective To investigate the effects of spontaneous agonal respiration on coronary perfusion pressure (CPP) during untreated cardiac arrest (ventricular fibrillation) in swine model.Methods Ten male healthy domestic swines (25.0 ± 1.5) kg were anaesthetised,intubated and mechanically ventilated.The catheterizations were separately inserted into the right atrium and thoracic aorta to monitor aortic pressure (AOP) and right atrial pressure (RAP).A pacing electrode was inserted into the right ventricle to induce ventricular fibrillation (VF).VF was induced by intra-ventricular stimulation withalternating electric current and untreated for 8 minutes.AOP and RAP were recorded until respiratory activity ceased.The CPP before and after agonal respiration was calculated and analyzed by paired-sample T test.Results All animals presented with agonal respiration from 1 to 6 minutes after VF during the first attempt.The CPP was (7.18 ±4.22) mmHg at 1 sec before agonal respiration,(11.78 ±5.16) mmHg at 0 sec after agonal respiration,(8.75 t:4.38) mmHg at 5 sec after agonal respiration and (8.23 ± 4.55)mmHg at 6 sec after agonal respiration.The CPP at 0 sec after agonal respiration was higher than that before agonal respiration (t =-3.140,P =0.012).The CPP at 5 sec after agonal respiration was higher than that at 1 sec before agonal respiration (t =-2.828,P =0.020).There was no difference in CPP between at 6 sec after agonal respiration and at 1 sec before agonal respiration (t =-1.778,P =0.109).Conclusions Agonal respiration accompanies ventricular fibrillation.After agonal respiration,the coronary perfusion pressure is increased for 5 seconds being in favor of cardiaopulmonary resuscitation.

Objective To investigate the effects of ultrasound radiation force(USRF) on adhering of targeted microbubbles in vivo.Methods A rat model of cremaster muscle Inflammation was developed,and microbubble(MB) or targeted microbubble of intercellular adhesion molecule-1 (MBICAM) was injected through the caudal vein.Immediately after intravenous MB or MBICAM injection,the cremaster was insonated for 5 minutes and the control group was in sham ultrasound exposure.All mice were divided into four groups randomly:① MB + false USRF; ② MB + USRF; ③ MBICAM + false USRF; ④ MBICAM + USRF.Fluorescence microscope was performed in twenty mice to evaluate microbubbles adhesion and video recordings were made with a high-resolution camera.Results The adhesion number of MBICAM was significantly greater in USRF group than that of MBICAM in false USRF group [(43.4 ± 2.1)/view vs (14.8± 1.8)/view,P =0.000].The adhesion number of MB in USRF group was greater than in false USRF group [(6.2 ± 1.3)/view vs (4.6 ± 0.9)/view].But there is no statistical significance (P =0.129).The adhesion number of MBICAM in both USRF group and false USRF group was significantly greater than the adhesion number of MB.Conclusions The ultrasound radiation force can significantly improve the adhesion of targeted microbubbles in vivo.

ObjectiveTo assess the feasibility of evaluation of renal allograft acute rejection in rat withcontrast-enhancedultrasound( CEUS )andtargetedmicrobubbles.MethodsPhospholipid microbubbles targeted to intercellular adhesion molecule -1 (ICAM-1)(MBI) and control microbubbles (MB) were created by conjugating monoclonal antibody against ICAM-1 or isotype control antibody to the lipid capsule via “avidin-biotin” bridging.Ten SD rats with acute renal allograft rejection were injected intravenous of MBI and MB in random order with a 30-min interval.After 3 min of intravenous injection of microbubbles,targeted CEUS imaging was performed in all rats.And then the video intensity (VI) was determined.ResultsIn MBI group,a significant ultrasonic enhancement was observed,but it was not very obvious in MB group.Increment in VI value of transplant kidney in MBI group was great and it amounted to (27.0 ± 7.4)U,however,increment in VI value of in MB group was minor and it was merely (10.2 ± 2.4) U,Difference was evident in transplant kidney between of the two groups (P ＜ 0.05).Conclusions Molecular imaging of ICAM-1 with targeted CEUS can evaluate renal allograft acute rejection effectively.

Objective To investigate the nutrition status and quality of life(QOL)in the perioperative patients with laryngeal cancer and to analyze the effect of nutrition status on quality of life.Methods Sixty-six patients with laryngeal cancer were surveyed respectively by self-designed general situation questionnaire,nutritional risk srcreening 2002(NRS2002)and European organization for research and treatment of cancer quality of life core questionnaire(EORTC QLQ-C30).The impact of nutritional status on QOL was analyzed by the multiple linear regression analysis.Results The total score of nutritional risk of perioperative patients with laryngeal cancer was 3.53±1.51 and the incidence of nutritional risk was 28.79%.The nutrition status influenced on QOL, physiological function,cognitive function and pain area(P<0.05).Conclusion Nurses should assess the nutritional status of the patients and correct malnutrition without delay in order to improve the physical function and QOL of the patients.

Aim To observe the expression of epider-mal growth factor receptor ( EGFR) in cerebral tissues around hematomas after intracerebral hemorrhage, and explore the effects of EGFR on activation of astrocytes derived from rats and the involved mechanisms. Meth-ods The specimens of cerebral tissues around hemo-tomas after intracerebral hemorrhage undergoing hemo-tomas removal operation were collected and then divid-ed into 4 groups according to the time of intracerebral hemorrhage: <1 d, 1 ~5 d, 6 ~10 d and >10 d groups. Each group included 20 cases. At the same time, 20 dropped brain tissues distant to hemorrhage in the operative process were collected as control group. Immunohistostaining and Western blot were used to measure the expression of EGFR. After isolation and culturing, the astrocytes of rat cortex were treated with culture solution ( control group) , CNTF that was used to activate astrocytes, scramble siRNA + CNTF and EGFR siRNA +CNTF for 24h, respectively. The ex-pression of glial fibrillary acidic protein ( GFAP) mR-NA was detected through fluorescence real-time quanti-tative PCR. In addition, the protein levels of GFAP, signal transducers and activators of transcription 3 ( STAT3 ) and phosphorylated STAT3 ( p-STAT3 ) were examined using Western blot. Results With the ex-tension of intracerebral hemorrhage time, positive sig-nal index and protein expression levels of EGFR gradu-ally elevated, reached the peak on 6 ~10d, and then decreased after 10 d. There was statistical difference ( P<0. 01 ) . The expression levels of GFAP mRNA and protein as well as p-STAT3 were significantly in-creased in cells treated with CNTF alone as compared to control group ( P <0. 01 ) , whereas these effects were almost completely reversed by EGFR siRNA transfection ( P <0. 01 ) . Additionally, there was no statistical difference in STAT3 protein levels among groups ( P >0. 05 ) . Conclusions EGFR expression is upregulated in the cerebral tissues around hemotomas after intracerebral hemorrhage. Gene silence of EGFR contributes to suppressing the activation of astrocytes derived from rats, which may be involved in the block-ade of STAT3 phosphorylation.

Objective To analyze the effect of siRNA targeting MIF( MIFsiRNA) on the growth of colorectal cancer xenografts and the life quality of tumor-bearing mice.Methods BALB/C mouse model carring colorectal cancer was established.Thirty mice were divided into three groups randomly and managed respectively with intratumor injection of DEPC water, MIFsiRNA(0.15 nmol/g) and non-specific siRNA (0.15 nmol/g), respectively twice a week for consecutively 4 weeks.Drinking water, fodder consumed and body weight was recorded daily, and tumor volume was measured once a week.Mice were sacrificed after four weeks.ELISA and immunohistochemistry were used to detect the expression of MIF in serum and in tumor tissues.Spectrophotometric detection was used to detect caspase-3 protein.TUNEL was used to detect apoptotic cells.Results MIF expression in serum in MIFsiRNA group was lower than the other two groups [(22 ± 6) ng/ml vs (32 ± 8) ng/ml and (33 ± 8) ng/ml, P ＜ 0.01]; MIF expression in tissues was less than the other two groups [(85 ± 20) /500 vs.(423 ± 23) /500 and (442 ± 31) /500, P ＜ 0.01]; Tumor was smaller than the other two groups at third and fourth week (P ＜ 0.01) ; Tumor weight was significantly less than the other two groups [(1.93 ±0.21) g vs (4.40 ±0.30) g and (5.25 ±0.44) g, P＜0.01]; Mice in MIFsiRNA group were healthier than the other two groups as judged by water and fodder consumption (P ＜ 0.01 ) , while weight change was not significantly different among the three groups ( P ＞ 0.05 ).Caspase-3 protein in tissues was higher than the other two groups [(0.74 ±0.06) μg vs (0.57 ±0.08) μg and (0.56 ±0.02) μg, P ＜0.01]; Apoptosis cells in tissues were higher than the other two groups [(12 ± 2)/ 100 个vs 0 and 0, P ＜ 0.01].Conclusions Knockdowning MIF gene expression inhibits the growth of colorectal cancer xenografts and improves life quality of tumor-bearing mice, possibly by a mechanism in which MIFsiRNA activates caspase-3 promoting cell apoptosis.

Objective To construct targeted ultrasound contrast agent carried goat anti-mouse IgG antibody (UCA-IgG) and evaluate the effectiveness of its targeted adhesion using parallel plate flow chamber. Methods The ultrasound contrast agent targeted to mouse IgG was designed by conjugating monoclonal antibodies against mouse lgG to the lipid monolayer shell of the agent using biotin-streptavidin. The binding of IgG antibodies to the ultrasound contrast agent were identified by fluorescence in vitro. The attachment and detachment of UCA-IgG to mouse IgG immobilized on a culture dish were assessed in a parallel-plate flow chamber. While the plate lacked mouse IgG,or blocked with large number of goat anti-mouse IgG were served as two control groups. Results UCA-IgG issued a bright green fluorescence, while the contral lipid ultrasound contrast agent didn't show fluorescence. The number of UCA-IgG bound to mouse IgG of experimental group was greater than two control groups,increased with increasing coverslips surface antibody concentrations (P<0. 05),and there was significant positive correlation between the number of UCA-IgG bound to mouse IgG and time of combination (P<0.05). The adhesion rate of experimental group increased with shear stress before 0. 5×10-5 N/cm2 (P<0.05) and then decreased (P<0. 05). There was limited adherence of control groups to the UCA-IgG. The stess of half-maximal detachment was increased with increasing coverslips surface antibody concentrations (P<0.05). Conclusions UCA-IgG could adhere to mouse IgG in the physical conditions. It may provide strong supports for studying other targeted ultrasound contrast agent preliminary and fatherly in vitro.

Objective To analysis the incidence and management of monozygotic twin (MZT) conceived by assisted reproductive techniques (ART). Methods A retrospective analysis of clinical pregnancies and MZT that resulted from ART was performed in Reproductive Medical Center,the First Affiliated Hospital,Wenzhou Medical University between January 2011 and January 2014. Results A total of 5 908 pregnancies were diagnosed: 2 012 twins, 157 high-order multiple pregnancy (HOMP), including 4 quadruplets. Overall, 51 MZT pregnancies were identified of them including 32 cases HOMP and 19 cases MZT. The incidence of MZT resulting from cleavage-stage embryo transfer was similar to blastocyst transfer (P=0.960). The percent of MZT resulting from in vitro fertilization [0.93% (28/3 022)], frozen-thawed embryo transfer [0.87% (13/1 502)] and intracytoplamic sperm injection [0.72% (10/1 384)] did not show statistical significance (P=0.794). The expectantly managed MZT was associated with a significantly greater likelihood of miscarriage [6/19 vs 5.11% (101/1 976)], and low birth weight infant [73.91% (17/23) vs 42.89% (1 453/3 388), P<0.01], when compared with dizygotic twin (DZT) did not undergo selective embryo reduction(SER). In monozygotic (MZ)-triplets with SER to 2 fetuses or to 1 fetus, there was no cases of preterm birth or low birth weight infant observed in MZ-triplets with SER to 1 fetus;when compared with MZ-triplets with SER to 2 fetuses, the low birth weight infant [56.00% (14/25), P=0.021] has statistical significance. The likelihood of the survival of two babies was lower in MZ-triplets with SER to 2 fetuses when compared with non-MZ triplets with SER to 2 fetuses [42.86%(9/21)vs 75.21%(91/121), P=0.003]. Conclusions The incidence of MZT pregnancies following ART is high. It plays a significant role in the occurrence of HOMP. MZT pregnancies are at an increased risk of adverse outcomes , it should transform to a single embryo thansfer (SET) program to reduce them incideuce. Reduction of MZT contained in multiple pregnancies appears to be a safe option.