Objective To investigate the distribution and drug resistance of Chryseobacterium meningosepticum(CM)in our hospital.Methods The status of drug resistance of 73 strains of CM isolated from our hospital in the past 5 years was statistically analyzed.Metallo-β-lactamase producing isolates were screened by double-disk synergy test.Results The rate of metallo-β-laetamase producing Chryseobacterium meningosepticum(CM) accounted for 37.0%,which mainly distributed at intensive care unit(ICU).The resistant rates of CM clinical isolates to piperacillin/tazobactam,vancomycin and levofloxacin were 45.2%,40.6% and 28.5%,respectively.Conclusion CM displays multi-resistance to antibiotics.Antimicrobial agents should be selected rationally by clinicians according to antimicrobial susceptibility test results.

Objective To assess the related risk factors of endoscopic retrograde cholangiopancreatography(ERCP)on postoperative pancreatitis.To improve the level of diagnostic and therapeutic ERCP,to reduce the incidence of postoperative pancreatitis.Methods A total of 346 patients in our hospital referred to diagnostic and therapeutic ERCP(399 frequency)were divided into 8 groups;the differences of postoperative serum amylase in 24 hour as well as clinical symptoms were compared among different groups.Results The incidence of postoperative hyperamylasaemia was 12.5 %.The incidence of postoperative acute pancreatitis was 1.5 %.ERCP+STENT therapeutic group(38.9%)had the highest incidence of postoperative hyperamylasaemia and postoperative acute pancreatitis among the groups.(respectively 38.9%,11.1%).There was the different incidence of postoperative actcte pancreatitis between the period from June 2003 to June 2005 and from July 2005 to July 2007,respectively 3.3%,0.4%.Conclusion Pancreatic duct contrast filling and deficient experience of doctor during ERCP manipulation are the main risk factors for postoperative pancreatitis.

Objective To investgate role of TLR2 in the activation, the innate immune and inflammation of human platelets. Methods Human washed platelets were separated from healthy people(n=5) and were stimulated with different concentrations(1μg/ml, 5μg/ml, 10μg/ml) of TLR2 agonistPam3CSK4(a synthetic bacterial lipoproteins). Then the platelet aggregation rate, the expression of CD62p and TLR2 on the platelet surface were measured. Results The platelet aggregation rate were (28.32±5.67)%, (52.56±8.54)% and (76.24±11.23)%, respectively, at concentration of 1μg/ml, 5μg/mland 10μg/ml of Pam3CSK4, more than (12.83±2.43)% at 0μg/ml of it. In addition, the expression of CD62p were (18.45±2.66)%, (22.45±2.04)%, (29.53±4.08)%, respectively at above concentration of Pam3 CSK4, more than (11.20±1.67)% of CD62p at control group(P<0.01). The expression of TLR2 was not significantly increased at a lower concentration of Pam3CSK4(1μg/ml) with (16.85±6.10)% compared with(10.81±3.99)% at the control group. However, it were (21.15±9.90)% and (22.52±9.26)%, respectively, at a higher concentration(5μg/ml, 10μg/ml)more than(10.81±3.99)% at the control group(P<0.05). Conclusion Pam3CSK4 induce aggregation, activation and the up-regulation of TLR2 of platelet by stimulating TLR2 receptor of it. Thereafter, TLR2 play an important role in the innate immune of platelet.

Objective To explore the effects of two-dimensional code on nursing instruments management.Methods Information regarding nursing instruments were edited and corresponding two-dimensional codes were generated which would be pasted on both the instruments and the registration book,and nurses were notified about the twodimensional codes.The effects of the application of two-dimensional code were assessed among 145 nurses using questionnaires,and 40 nurses were evaluated for theoretical and operational skills of the instrument.Results After applying two-dimensional code in management of nursing instruments,nurses' scores for utilizing,maintenance,addressing malfunction,storage and counting were higher than previous management method for instruments(P＜0.05),and the performance of theoretical and operational skills of 40 nurses were increased significantly(P＜0.05).Conclusion Two-dimensional code provides valuable benefits for information storage,instrument tracking,etc.,shows great convenience and efficiency to nursing instruments management,and helps to improve nurses' application skills of instruments.

AIM:To explore the clinical therapeutic effect and safety of cervical cancer treated with neoadjuvant chemotherapy with gemcitabine hydrochloride.METHODS:60 patients with cervical cancer were randomly divided into the intervention group(30 cases) and control group(30 cases).The intervention group were treated with neoadjuvant chemotherapy with gemcitabine hydrochloride and cisplatin,the control group were treated with mitomycin and cisplatin.The status of clinical symptoms,size of tumor,side effect of chemotherapy and postoperative pathological analysis were observed and compared.RESULTS:Comparing the re- sults of two groups of patients,the intervention group was significantly higher than control group(P

Objective To investigate the trough and peak vancomycin plasma concentrations in steady-state following regular dosage and to improve dosing regimen based on pharmacokinetic modeling, providing reference for clinical practice in children.Methods we retrospectively analyzed pharmacokinetics of vancomycin in 50 cases admitted in our PICU who had been confirmed or suspected with gram-positive bacterial infections following regular dosage[40 mg /(kg?d)].Then we tried to optimize dosing regimens with Monte Carlo simulation to evaluate different dosing regimens of vancomycin in children.Results with regular dosage of vancomycin,mean trough concentrations of vancomycin were (1 1.02 ±4.44 )mg /L, trough concentrations higher than 15 mg /L accounted for only 12%.In the actual program,the extension of a single intravenous infusion to 3 hours after administration would result in 26% of trough concentrations dis-tributing in the range above 15 mg /L.If we increased daily dose to 50 mg /kg and 60 mg /kg with simulation, the trough concentration distribution frequency above 15 mg /L would increase from 12% to 32% and 40%. If minimum inhibitory concentration of vancomycin to pathogenic bacteria (Staphylococcus aureus )was 1 mg/L,the probabilities of target attainment for pharmacokinetic/pharmacodynamic evaluation were 51.73%, 76.54% and 87.5% for three dosages [40 mg/(kg?d),50 mg/(kg?d)and 60 mg/(kg?d)]of vancomycin, respectively.we suspected that dosage of 60 mg/(kg?d)was a good choice.with this dosage regimen,we could achieve a substantial increase in the probability of target attainment.Conclusion Following regular dosages, trough concentration distribution frequency from 15 to 20 mg /kg is low.The extension of a single intravenous infusion time can not achieve a good result.According to the result of pathogenic bacteria and anti-microbial susceptibility tests,increasing daily dosage of vancomycin to 60 mg /(kg?d)will help to improve the trough concentration and get more clinic achievements.

Objective:To explore the relationship between Tongren analysis EV 71 intestinal virus genotyping and humoral immune function ,for further clinical understanding of enterovirus EV 71 provide references.Methods:February to August 2014 Tongren to our hospital for treatment of intestinal virus EV 71 HFMD infected children ,according to the genetic type of virus infection is mainly divided into three groups ,namely group A,there were A type of intestinal virus EV 71 infection,20 patients;group B,there were B-type intestinal virus EV71 infection,20 patients;group C,there were C-type intestinal virus EV71 infection,20 cases of children.Three groups of patients by detecting immunoglobulin levels and TNF-ɑ, IL-6 and IL-10 levels, and to compare different genotypes affect intestinal virus EV71 HFMD children humoral immune function.Results:After testing,A group of patients with TNF-ɑ,IL-6 and IL-10 levels were (285.60 ±30.50) pg/L,(60.50 ±5.60) pg/L,(25.50 ±4.50) pg/L,than those in group B,high levels of three indicators of group C patients ,a significant difference ( P<0.05 ) ,group C patients with TNF-ɑ,IL-6 and IL-10 levels in three groups of patients than B high level indicators ,with a significant difference ( P<0.05 );tested three groups of patients with IgA ,IgG level pairwise comparisons showed that there were significant differences (P<0.05),the highest a group of patients with IgA,IgG level,group C, followed by the lowest level of group B patients;levels of the three groups of patients with IgM pairwise no significant difference ( P>0.05 ) .Conclusion:Different genotypes of enterovirus EV 71 can cause serious foot and mouth disease ,and could significantly improve the level of serum immunoglobulin levels of inflammatory cytokines ,but the intensity of different genotypes of different pathogenic ,there are some differences ,but the specific mechanisms need to be further explored.

OBJECTIVE To analyze the susceptible factors and resistance of Acinetobacter baumannii in ICU,in order to create a novel thought of effective prevention and control of A. baumannii cross-infection. METHODS Specimens were collected from ICU patients with infections from Sep 2006 to Sep 2008. The infection characteristic was analyzed and the drug sensitivity was tested to know the risk factors of infection retrospectively. RESULTS The factors of low immunity,severe wound,invasive operation and using ventilator led to the serious cross-infection of A. baumannii in ICU .In vitro drug susceptibility test,the sensitive rates only to cefoperazone/sulbactam and amikacin were higher. They were 65.09% and 72.64%,respectively. CONCLUSIONS It has great significance in the prevention and control of A. baumannii cross-infection in ICU to strengthen the environment disinfection,were education of nosocomial infection knowledge among medical staff,executeing the hand-washing system strictly,useing the antibiotics rationally,keeping the susceptible crowd and adopting de-escalation strategy of prevention and control.

Objective To investigate the effects of peritoneal injection of cobaltic protoporphyrin Ⅸ chloride(CoPP)to induce heme oxygenase-1(Ho-1)upregulation in rat islet cells.Mthods Forty rats were divided into 5 groups by management 24 h before islets isolation:group A received inlzaporitoneal injection with 2.5 ms/ks CoPP,group B with 5 ms/ks CoPP,group C with 7.5 ms/kg CoPP,and group D with 10 mg/kg CoPP.In control group NS was used instead.A modified Goth approach was used for islet isolation.the yield and purity of the islets were assessed.The expression of Ho-1 mRNA and protein were detected by real time-PCR and Western blotting respectively.Islet function was tested by glucose stimulation test.Result Severe damage was found in tlle rats in group C and D.There was no difference in islet yield and purity for group A、B、C and control(P＞0.05).Group B had the highest Ho-1 mRNA and protein expression among the 4 groups.Though there was no difference in insulin secretion by low glucose challenge for group A、B and control's islets(P＞0.05),when challenged by hish level of glucose,significant deviation was observed.The imulin secretion level was(172.37±16.4)、(187.68±19.93)and(91.25±Conclusion Peritoneal iajection of 5 mg/kg CoPP can significantly enhance the expression of Ho-1 mRNA and protein in tat islet safely and enhance the function of islet when challenged by hish concentration of glucose.

ObjectiveTo investigate the correlation between the methylation status of HLA class Ⅰ genes(HLA-A, -B and -C) in psoriatic epidermis and disease severity in patients with psoriasis vulgaris. MethodsDNA specimens were obtained from the lesional and nonlesional epidermis of 46 patients with psoriasis vulgaris and from the normal skin of 28 human controls. Methylation specific PCR (MSP) was conducted to detect the methylation status of CpG islands in the promoter region of HLA-A, -B and -C genes. The severity of psoriasis was evaluated by psoriasis area and severity index(PASI) scores. ResultsThe percentage of promoter methylation of HLA-B and HLA-C genes was 4.35％(2/46) and 21.74％(10/46), respectively in nonlesional epidermis, 4.35％ (2/46) and 4.35％ (2/46), respectively in lesional epidermis from these patients. No methylation was observed for the promoter of HLA-A, -B or -C gene in the normal control epidermis or for that of HLA-A gene in the nonlesional or lesional epidermis from the patients. The frequency of HLA-C gene promoter methylation in the nonlesional epidermis was significantly higher than that in the lesional epidermis and control epidermis, but was uncorrelated to the disease severity. No significant difference was observed for the methylation frequency of HLA-A or -B gene promoter among the three groups of specimens. Conclusion Abnormal methylation of HLA-C gene promoter is observed in patients with psoriasis vulgaris.