OBJECTIVE To study the metallo-?-lactamases of 5 carbapenem resistant Pseudomonas aeruginosa isolates,which were recovered at 2006 in the Third People's Hospital of Yueqing. METHODS K-B method was used to determine the antimicrobial agents susceptibility in 5 isolates. The minimal inhibitive concentrations (MICs) of antimicrobial agents to these strains were determined by agar dilution method. Double disk synergy test was used to detect the metallo-?-lactamase. Molecular screening for blaIMP,blaVIM,and blaSPM was carried out using PCR method. The PCR product was sequenced. RESULTS One out of the 5 carbapenem resistant P. aeruginosa was positive for MBL double disk synergy test,and confirmed to contain blaVIM-2 gene. CONCLUSIONS A blaVIM-2-producing isolate of P. aeruginosa is identified. This carbapenem-resistant isolate is all multi-drug resistant.

ObjectiveTo investigate the effect of infusion of esmolol on expression of hypoxia inducible factor-1α following spinal ischemia-reperfusion (I/R) in rats.MethodsThirty-six healthy male Wistar rats weighing 300-350 g were randomly assigned into 3 groups (n =12 each):group Ⅰ sham operation (group S); group Ⅱ spinal I/R and group Ⅲ esmolol pretreatment (group E).Spinal ischemia was produced by cross-clamping of abdominal aorta distal to renal artery for 20 min in I/R and E groups,Infusion of esmolol 200 g· kg- 1 ·min- 1 was initated 30 min before spinal ischemia and continued for the subsequent 1 h reperfusion in group Ⅲ (E).In groups S and I/R the animals received equal volumes of NS instead of lidocaine.Neurological behavior was assessed according to Tarlov scoring system at 24 and 48 h of reperfusion.The lumbar segment ( L4、5 ) spinal cord was resected at 24 and 48 h ofreperfusion for microscopic examination.The expression of HIF-Ia in spinal cord was detected by immunohistochemistry analysis.ResultsCompared with group S,the expression of HIF-Iα in spinal cord was down-regulated,and Tarlov score was significantly decreased in groups S and l/R.The spinal cord injury was attenuated in group E compared with group I/R.CondusionEsmolol infusion can protect the spinal cord against I/R injury,and inhibition of the expression of HIF-1α is involved in the mechanism.

Objective To investigate the effects of different doses of sufentanil on the minimum alveolar concentration (MAC) of sevoflurane for sedation in patients undergoing bronchoscopy. Methods ASA physical status I orⅡpatients of both genders, aged 20 ~ 65, undergoing bronchoscopy under general anesthesia,were randomly divided into 4 groups (n=20 each):control group (group C) and different doses of sufentanil groups (Sl, S2 and S3 groups). Sufentanil 0.1, 0.2 and 0.3 μg/kg in 5 mL of normal saline was intravenously infused before induction of anesthesia in groups of SI S2 and S3 respectively. While 5 mL of the normal saline was given instead in the group C The patients were mechanically ventilated after insert laryngeal mask. Anesthesia was maintained with inhalation of sevoflurane. Each time the concentration of sevoflurane at end expiration increased/decreased in the next patient depending on the concentration of sevoflurane at end expiration with which the former had no cough. The ratio between the two consecutive concentrations was 1.1. The middle point between the positive response and negative response served as a crossover pair. After at least 7 independent crossover pairs were observed in each group. The MAC and 95%confidence interval of sevoflurane were calculated. The time of anesthesia induction and analepsis was recorded. Results The MAC (95%CI) of sevoflurane was 3.0%(2.8%~3.3%), 2.3%(2.1%~2.5%), 1.9%(1.6% ~ 2.2%) and 1.6% (1.3% ~ 1.9%) in groups of C, S1, S2 and S3 respectively. The MAC of sevoflurane was significantly lower in groups of S1, S2, S3 than in the group C, and in groups S3 than in the group S1 (P<0.05). The time of anesthesia induction was significantly shorter in groups of S2, S3 than in the group C and significantly longer in groups S3 than in the group C. Conclusion Sufentanil of 0.1, 0.2, 0.3 μg/kg can significantly decrease the MAC of sevoflurane in patients undergoing bronchoscopy in a dose-dependent manner.

AIM: To study the effects of cyproheptadine (Cyp) and anisodamine (Ani)on the changes of intracellular free Ca 2+ concentration ([Ca 2+ ] i) induced by tumor necrosis factor (TNF ?) in single endothelial cells, and to explore the mechanisms of TNF ?-mediated shock and antishock actions of Cyp and Ani. METHODS: Human umbilical vein endothelial cell strains(ECV304) were seed in 35 mm tissue culture dish with 2 mL DMEM culture medium. The cultured cells were loaded by Fluo-3/AM. The spatial distribution and the dynamic changes of [Ca 2+ ] i in single endothelial cell was determined by laser scanning confocal microscopy(LSCM). RESULTS: [Ca 2+ ] i in single endothelial cell after stimulation of TNF ? rapidly increased in a dose-dependent manner and approached the peak value within 60 seconds, afterwards, decreased and kept above the basal level. The confocal scanning image showed that [Ca 2+ ] i elevation was more obvious in nuclear than in cytoplasma, and decreased slowly. Cyp (3?10 -5 , 6?10 -5 mol/L) and Ani (2?10 -5 , 4?10 -5 mol?L -1 ) markedly inhibited TNF ? (1.2?10 -9 mol?L -1 )-induced [Ca 2+ ] i elevation. CONCLUSIONS: TNF ? markedly induces elevation of [Ca 2+ ] i in single endothelial cell, it may be an important mechanism of TNF ?-induced shock and tissue injury. Cyp and Ani obviously suppress TNF ?-induced [Ca 2+ ] i elevation, which probably is one of the mechanisms of their antishock effects.

Adolescent ; Adult ; Child ; Child, Preschool ; China ; epidemiology ; Hepatitis B ; epidemiology ; Humans ; Infant ; Middle Aged ; Risk Factors ; Seroepidemiologic Studies ; Young Adult

Adolescent ; Adult ; Automobile Driving ; China ; Electrocardiography ; Female ; Heart ; physiopathology ; Humans ; Male ; Middle Aged ; Noise, Occupational ; adverse effects ; Occupational Exposure ; adverse effects ; Stress, Psychological ; etiology ; physiopathology ; Vibration ; adverse effects

OBJECTIVE:To establish a scientific evidence for evaluation of individualized administration among children.METHODS:Hydrocortisone probe was used for determination of CYP3A activity in children with quantitative method.RESULTS:CYP3A activity in the health children volunteers showed Gaussian distribution in the form of natural logarithm,the average value was1.69?1.04,with the value of1.63?0.99in males and1.75?1.09in females.CONCLUSION:There is no significant difference in CYP3A activity between the two sexes.

Purpose To investigate the expression of tumor buds and its relationship with clinicopathological characteristics in endome-trial carcinoma. Methods 47 cases of endometrial carcinoma were observed and analyzed by means of clinicopathologic data and im-munohistochemical staining. The connections between tumor buds and clinicopathologic parameters were studied by statistics. Results Of the 47 endometrial carcinoma cases, tumor buds were seen in 18 cases. Tumor buds were correlated with histological grade, lymph node metastases, vascular invasion, Ki-67 index and survival. There were no associations between tumor buds with age, tumor size, pTNM stage or myometrial invasion depth. Immunohistochemistry demonstrated that the level of N-cadherin, vimentin in bud cells was higher than normal carcinoma cells while the level of CK(AE1/AE3),β-catenin and E-cadherin got the opposite results. Conclu-sion Tumor buds may play an important role in the progression of endometrial carcinoma. The immunohistochemical features of bud cells indicated that tumor buds may be a key step in epithelial-mesenchymal transition.

Objective To evaluate the effects of long?term glucocorticoid administration on cisatra?curium?induced neuromuscular blockade in the patients undergoing laparoscopic operation. Methods Six?ty?four patients of both sexes, aged 40-64 yr, with body mass index of 18-22 kg∕m2 , of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, scheduled for elective laparoscopic operation under general anesthesia, were assigned into 4 groups ( n=16 each) according to whether or not glucocorticoid was used for a long?term period: control ( non?hormone and non?laparoscopic operation ) group ( group C ) , hor?mone + laparoscopic operation group ( group HL ) , non?hormone + laparoscopic operation group ( group NHL) and hormone +non?laparoscopic operation group ( group HNL) . Midazolam 0.03 mg∕kg was injected intravenously, 8% sevoflurane was inhaled by mask, and the concentration of sevoflurane was decreased by 2% every 30 s until the concentration of 4% was reached. After loss of eyelash reflex, remifentanil 2μg∕kg was injected intravenously over 1 min, and 30 s later sevoflurane inhalation was stopped. The patients were tracheally intubated and mechanically ventilated. Anesthesia was maintained with propofol and remifentanil given by target?controlled infusion. Neuromuscular blockade was monitored with accelerograph TOF?watch
SX. At 20 min of pneumoperitoneum in NHL and HL groups or 20 min after intubation in C and HNL groups, cisatracurium 0. 15 mg∕kg was injected intravenously. The onset time, maximal degree of N?M block, clinical duration and recovery index of cisatracurium were recorded. Results Compared with group C, the onset time was significantly prolonged, the maximal degree of N?M block was decreased, the clini?cal duration was shortened, and the recovery index was decreased in HL and HNL groups ( P<0.05) , and the clinical duration was significantly prolonged, the recovery index was increased ( P<0.05) , and no sig?nificant change was found in the onset time in group NHL ( P>0.05) . Compared with group HNL, the clin?ical duration was significantly prolonged, the recovery index was increased (P<0.05), and no significant change was found in the onset time in group HL ( P>0.05) , and the onset time was significantly shortened, the clinical duration was prolonged, and the recovery index was increased in group NHL ( P<0.05) . Com?pared with group NHL, the onset time was significantly prolonged, the maximal degree of N?M block was decreased, the clinical duration was shortened, and the recovery index was decreased in group HL ( P<0.05) . Conclusion Long?term glucocorticoid administration can weaken cisatracurium?induced neuromus?cular blockade in the patients undergoing laparoscopic operation.

Objective To evaluate the feasibility of using ultrasound-guided lumbosacral plexus block combined with nasopharyngeal airway in hip replacement in elderly patients with pulmonary and lumbar diseases.Methods Eighteen elderly patients who were diagnosed as having puhnonary and lumbar diseases before operation,aged 75-97 yr,with body mass index of 18-22 kg/m2,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ,scheduled for elective unilateral total hip replacement,were enrolled in this study.Unilateral lumbosacral plexus block was performed under the guidance of ultrasound.After completion of block,mild sedation was carried out with propofol,nasopharyngeal airway was implanted,oxygen was inhaled by mask,and sedation was maintained with small doses of propofol during operation.Bispectral index value was maintained at 60-75 during operation.Mean arterial pressure and heart rate were recorded before block,at 15 min after completion of block,before implantation of nasopharyngeal airway and at 1 min after implantation of nasopharyngeal airway.The postoperative nasopharyngeal airway removal time,development of cognitive dysfunction within 7 days after operation and recurrent puhnonary complications and mortality within 30 days after operation were recorded.Results All the patients underwent operation successfully,and vital signs were stable during operation.Nasopharyngeal airway was removed within 5 min after the end of operation,recurrent pulmonary complications were not found,and no patients developed cognitive dysfunction within 7 days after operation.No patient died within 30 days after operation.Conclusion Ultrasound-guided lumbosacral plexus block combined with nasopharyngeal airway produces reliable efficacy and fewer complications when applied to hip replacement and is suitable for elderly patients with pulmonary and lumbar diseases.