OBJECTIVE To investigate the qacE△1-sul1 genes in multidrug-resistant Gram-negative bacilli and their significance.METHODS A total of 225 strains of multidrug-resistant Gram-negative bacilli were clinically isolated.The genes of qacE△1-sul1 were analyzed using polymerase chain reaction(PCR).RESULTS From them 120 strains of multidrug-resistant Gram-negative bacilli were found the qacE△1-sul1 genes.The positive rate of qacE△1-sul1 was 53.3%.CONCLUSIONS There are high percentages of qacE△1-sul1 genes in multidrug-resistant Gram-negative bacilli.

The standardized training for residents (medical specialists) is an important aspect to fulfill the post-graduated medical education in China. It not only can bring up outstanding qualified specialists,but also is in line with international trends in medical education. According to the situation and existing problems of current standardized training for obstetrics and gynecology specialist,a lot of advice was given for further improvement of the standardization of training in obstetrics and gynecology specialist.

Aim To develop a rapid and inexpensive method for purification of human albumin, a method of immunomagnetic microspheres (IMMS) based on enzyme-linked immunosorbent assay (ELISA)for the purification of human albumin from human serum. Methods Polystyrene magnetic microspheres with carboxyl groups as carriers were prepared, and then the carboxyl groups on the surface of the microspheres were activated by ethylcarbodiimide (EDC). Finally rabbit anti-human serum albumin (HSA) antibodies were covalently bound to it and the complex can specifically capture HSA. After the procedure of capturing HSA, through taking rabbit anti-human albumin protein antibodies as a capture antibody, and goat anti-human albumin protein antibodies as a detection antibody, an ELISA on IMMS was developed, which can determine the recovery yield of HSA from the human serum. Results The result of the experiment was that the recovery of human albumin with IMMS was (86 ± 4) % , and IMMS were reused for two other purifying cycles, the results of which were (69.0 ± 0.6) % and (40.8 ± 0.8) % , and the purity of the product was about 90%. Conclusion The results above prove that the immunomagnetic purifiying strategy was shown to be efficient and offers an new thought for a large scale production of highpurity HSA.

BACKGROUND:Because of its advantages, Endobutton has been widely used in clinic. Currently, its shortcomings are increasingly recognized. Tightrope that overcomes the shortcomings of Endobutton has been gradualy accepted by a doctor skiled in sports injuries.
OBJECTIVE: To analyze and compare the differences in the effects of Tightrope and Endobutton in the reconstruction of the cruciate ligament.
METHODS:Totaly 60 cases of anterior cruciate ligament rupture were selected and subjected to anterior cruciate ligament reconstruction under arthroscopy, of which 30 cases were randomly assigned to reconstruction by Endobutton device and 30 cases underwent reconstruction by Tightrope device. Al operations were performed by the same surgeon. Al patients were subjected to regular functional exercise and were folowed up regularly after operation. Effects of Tightrope and Endobutton in the cruciate ligament reconstruction were evaluated by comparing various indexes in the two groups.
RESULTS AND CONCLUSION:Compared to the Endobutton fixation system, the Tightrope fixation system could shorten the operation time, reduce the length of tendon incision, and decrease the loss of bone mass in the femoral bone tunnel. There were no significant differences in the maximum knee flexion, knee joint score and Tegner movement level score between the two groups at 3 and 6 months after operation. These findings indicate that the Tightrope fixation system is superior to the Endobutton fixation system, because it is more simple and convenient to operate and has less bone loss. However, their clinical efficacy has no difference after 6 months.

Objective To investigate the relationship between anti-HCV antibody level and hepatitis C virus genotype in the patients.Methods Total of 603 anti-HCV positive serum samples were collected during 2013 to 2014 by retrospective research method.HCV RNA were detected in anti-HCV positive samples by repeat test and the genotype were detected in HCV RNA positive samples.The distribution of anti-HCV level in different hepatitis C genotype patients was analyzed and the body's response to viral antibodies and viral genotype correlation with anti-HCV concentration interquartile range was explored.Rates among genotype groups were compared using chi-square test.Results Totally 412 of 603 (68.33％) samples were anti-HCV positive by double reagent screening.174(42.3％) samples were detected as HCV RNA positive.The distributions of different anti-HCV level in different genotype patients were 1a(n =8) 1/8,1/8,4/8,2/8;1b(n =112)25.9％ (29/112),17.0％ (19/112),25.9％ (29/112),31.3％ (35/112);2a(n =14)3/14,4/14,5/14,2/14;3a(n =11)3/11,6/11,2/11,0/11;3b(n =16)4/16,11/16,1/16,0/16;6a(n =8)2/8,2/8,1/8,3/8 with anti-HCV concentration interquartile range respectively.The anti-HCV concentration distribution was different in patients with different HCV genotypes.The anti-HCV concentration distribution in patients of 1 b,2a and 6a genotypes were evently,while anti-HCV level was relatively high in 1a (13.65) and relatively low in 3b (8.77).There were differences in different genotypes of antibody concentrations (x2 =35.2,P ＜ 0.05).Conclusions There was correlation between anti-HCV level and HCV genotype.Because there were fewer cases in some genotypes,it was necessary to investigate more samples to corfirm the above results.

OBJECTIVE:To establish the HS-GC method for the content determination of menthol in Qiangli Pipa syrup,and the content of menthol in 56 batches of Qiangli Pipa syrup commercially available was determined. METHODS:HS-GC was per-formed on the column of Agilent HP-INNOWAX,column temperature was 130 ℃(maintaining 7 min),FID was used as detector, inlet temperature was 200 ℃,detector temperature was 250 ℃,carrier gas was high-purity nitrogen,flow rate was 3 ml/min,split ratio was 10∶1 and the injection volume was 1 000 μl. RESULTS:The linear range of menthol was 0.007 07-0.141 40 mg/ml(r=0.999 1);RSDs of precision,reproducibility and stability tests were no more than 3.37%;average recovery was 94.3%-99.6%(RSD=1.86%,n=6). There was significant difference in the contents of menthol in 56 batches Qiangli Pipa syrup. CONCLU-SIONS:The method is simple,sensitive,accurate and reliable,and can be used for content determination of menthol in Qiangli Pi-pa syrup. The sampling results show it is necessary to update the detecting items for the content of Qiangli pipa loquat and strength-en the quality control of it.

Objective:To discuss the results interpretation and clinical significance of Acinetobacter Baumanni ( AB) positive spu-tum samples .Methods:The anti-infection treatment of one patient with lung infection after colon cancer surgery in ICU was analyzed , and the results interpretation and clinical significance of AB positive sputum samples were discussed .Results:Although the culture re-sults of sputum samples were positive , the quality of sputum samples was low and the credibility was poor .The possibility of multiple drug resistance AB ( XDR-AB) screened by antibiotics selective stress was small .Meanwhile, the clinical infection symptoms were mild, and the treatment with imipenem was effective .Although the patient had high risk factors for the colonization of Baumanni infec-tion, XDR-AB was not a pathogen .Conclusion:When respiratory samples are AB positive , the quality of samples should be evaluated by smear results firstly , especially the existence of white blood cell phagocytosis or accompanying should be paid attention to , and then the possibility of AB screened by antibiotics selective stress and high risk factors for colonization should be analyzed .Finally, combined with the clinical symptoms of patients and the treatment efficacy before drug sensitivity tests , whether XDR-AB is pathogenic bacteria should be judged , and then the corresponding anti-infection treatment plan should be determined .

Objective To develop a rapid and specific method for identification of listerial species and differentiation of Listeria monocytogenes。 Method Primers targeting the iap and hly genes specific for listerial species and L monocytogenes were designed。 The dulplex PCR and triplex PCR were compared for their ability to identify and differentiate the listerial species。 Results Both dulplex PCR and triplex PCR are specific to all listerial reference strains. The dulplex-PCR could not identify some of the L. monocytogenes isolates while the triplex PCR did. Conclusion The triplex PCR method could be used not only for identification of listerial species but also for differentiation of L. monocytogenes from the mixed listerial suspensions.

Objective To explore the application of clinical pathway in the management of single disease cost. Methods Inpatients with breast cancer from June 2006 to June 2007 were divided into the test group and the control group according to different payment models.Patients in the test group had medical insurance while patients in the control group did not.The general data in the two groups had no statistical difference.The test group were given nursing intervention by clinical pathway while the control group received routine nursing measures. Results The mean inhospital days,mean days waiting for operations and mean inhospital expenses in the test group were shorter or lower than those in the control group (P ＜ 0.05).The mastering degree of health knowledge and the satisfaction degree of patients in the test group were higher than those in the control group (P ＜ 0.05). Conclusions The application of chnical pathway in the single disease cost patients with medical insurance could effectively control the medical expenses and guarantee the quality.So we consider that the application of clinical pathway in single disease cost is applicable.

Objective To Know the present situation of diabetes′ self-management ,explore its influencing factors and provide theoretical evidences for conducting diabetic health education and improving patients′ level of self-management .Methods Using random sampling method ,we took 483 cases of diabetic patients concluded inpatient and outpatient from a first class hospital and two community hospitals who meet the inclusion criteria from March 2011 to April 2013 in Chongqing city .All patient were investi-gated with diabetes self-management questionnaire scale .Results 500 questionnaires ,received 483 valid questionnaires ,and the ef-fective rate of recovery is 96 .6% .Among 483 cases of diabetic patients in the investigation ,78 .7% of patients understood diabetes knowledge from medical staffs .In the aspect of following the treatment plan :drug plan had the best executive power with 59% ;the average score of diabetes knowledge was (41 .747 ± 10 .23) ,score index was 51 .5% ;82 .2% of patients did ,not understand their value of glycated hemoglobin ,44 .5% of patients did not understand the two-hour postprandial blood glucose ;The average score of diabetes′self-care behaviors was(3 .59 ± 1 .249) ,score index was 51 .29% ,different score index accompany with different self-man-agement levels .Educational level ,retirees ,diet control ,blood glucose monitoring ,the understanding of diabetes knowledge were pro-tective factors for receiving health education .Conclusion Patients grasp diabetic knowledge are poorly in average ,the present situa-tion of patients′self-management is not optimistic ,it is better to increase the health education of diabetes′ self-management ,and make great efforts to improve diabetes′self-management skills .