OBJECTIVE With surveillance of the distribution and antibiotic resistance of Escherichia coli during the last six years in our hospital,the basis for the reasonable clinical use of antibiotic is provided to doctor.METHODS A total of 1 907 strains of E.coli isolated during the last six years were analyzed by Kirby-Bauer disk or VITEK-2 system.RESULTS Among 1 907 strains of E.coli,1 114 strains were isolated from urine,accounted for 58.4%;215 from pus or secret,accounted for 11.3%;165 from sputum,accounted for 8.7%;and 159 from blood,accounted for 8.3%.ESBLs production rate of E.coli increased steadily from 5.11%,10.34%,14.56%,15.14%,33.79% to 29.96%,separately during the six years.The resistance of E.coli with ESBLs to most antibiotics was much higher than those without ESBLs.And E.coli demonstrated much higher resistant rate to ciprofloxacin,penicillins,and first or second generation cephalosporins,and much lower to amikacin and cefoperazone/sulbactam.No strains were found to be resistant to imipenem.CONCLUSIONS E.coli is the major pathogen,causing nosocomial infection with multi-resistant mechanism, since ESBLs-producing strain is increasing as years gone,reasonable choice of antibiotic should be in term of result of antibiotic resistant test and patient symptom to cure the E.coli infection induced.

Objective to observe plasma Brain Natriuretic Peptide level by use of low dose Betaloc for congestive heart failure.Methods We chose 31 heart failure patients with Ⅲ～Ⅳ New York Heart Association (NYHA)functional classification,and used low dose Betaloc on the basis of traditional treatment,then observed the changement of plasma Brain Natriuretic Peptide level during treatment. Results After treatment,patients' heart rate, blood pressure ,cardio-thoracic ratio and LVDd all descended,but LVEF increased.The value of BNP declined obviously,after the use of the Betaloc.Conclusions We treated congestive heart failure with low dose Betaloc,the availability ratio was more than 80%,and the value of BNP declined obviously.It implied dynamic monitoring plasma Brain Natriuretic Peptide was helpful in understanding treatment effect and prognosis.

Background Hypertension and dyslipidemia are the 2 important risk factors of cardiovascular affecting the prognosis of cardiovascular disease. However paucity data of characteristics of lipid metabolism and prognosis of cardiovascular diseases in high-risk groups with hypertension are available. Objective To analyze the lipid metabolism level and the relevant risk factors of inpatients with essential hypertension (EH) from 2000 to 2007. Methods Retrospective study was performed based on the clinical characteristic and the relationship between different kinds of hyperlipidemia and target organ damages in inpatient with EH. Results For the level of triglyceride (TG) and the prevalence of hypertriglyceridemia,males(n=3056) were significantly higher than females(n=1932)(P

ObjectiveTo investigate the expressions of nerve growth factor (NGF) and its receptors TrkA and p75NTR in dermatofibrosarcoma protuberans and dermatofibroma.MethodsAvidin-biotin immunohistochemical(ABC) method was used to detect the expressions of NGF and its receptors TrkA and p75NTR in paraffin-embedded tissue specimens from 17 cases of DFSP and 15 cases of dermatofibroma.Results NGF and TrkA were highly expressed in both DFSP and dermatofibroma specimens,with no significant difference between the two groups of specimens (x2 =0.11,0.02,respectively,both P ＞ 0.05),while the expression of p75NTR was significantly higher in DFSP than in dermatofibroma specimens(x2 =32,P ＜ 0.01 ).The expression of NGF was positively correlated with that of p75NTR in DFSP(R2 =0.623,P ＜ 0.01 ).ConclusionNGF may play a certain role in the development of DFSP via its high-affinity receptor TrkA and low-affinity receptor p75NTR.

AIM: To examine the effect of protamine sulfate, lipopolysaccharide(LPS),tumor necrosis factor(TNF), epidermal growth factor(EGF) and " Bushen Huoxue Xiezhuo" (BHX) decoction on the proliferation of extracorporeal cultured rat glomerular epithelial cells (GEC). METHODS: Their action on the proliferation of rat GEC were investigated using the -TdR incorporation. Meanwhile, the serum of rats treated with BHX decoction was extracted pharmacologically and its effects on the growth of GEC were also studied. RESULTS: LPS, protamine sulfate, TNF-? and EGF could significantly inhibit the -TdR incorporation of GEC in a dose- and time-dependent manner. However, this inhibition could be efficiently reversed by the serum containing BHX decoction. CONCLUSION: GEC is one of the main target cells on which BHX decoction act, and the protection on GEC might be one of the mechanisms underlying the role of BHX decoction in preventing the progression of nephrosis.

In order to study whether marrow stromal cells (MSCs) can be induced into nerve-like cells in vitro, and the mechanism, the MSCs in Wistar rats were isolated and cultured, and then induced with DMSO and BHA in vitro. The expression of specific marking proteins in neurons, glia and neural stem cells were detected before preinduction, at 24 h of preinduction, at 6 h, 24 h, and 48 h of neuronal induction by using immunohistochemistry and Western blotting. The ultrastructural changes after the inducement were observed. The results showed that after the inducement, many MSCs turned into bipolar, multipolar and taper, and then intersected as network structure. At the same time, some MSCs had the typical neuron-like ultrastructure. Immunohistochemistry revealed that NeuN and Nestin expression was detectable after inducement, but there was no GFAP and CNP expression. Western blotting showed the expression of Nestin was strong at 6 h of neuronal induction, and decreased at 24 h, 48 h of the induction. NeuN was detectable at 6 h of neuronal induction, and increased at 24 h, 48 h of the induction. It was concluded MSCs were induced into neural stem cells, and then differentiated into neuron-like cells in vitro.
Bone Marrow Cells/*cytology ; *Cell Differentiation ; Cells, Cultured ; Glial Fibrillary Acidic Protein/metabolism ; Neurons/*cytology ; Rats, Wistar ; Stromal Cells/cytology

AIM: To determine the optimal operation method and reduce operative complications by retrospective analysis of outcomes of different operative manipulation for patients with congenital ectopia lentis ( CEL) .
●METHODS: A retrospective study ranged from Jan. 1, 2010 to Jan. 1, 2015 was conducted and 31 CEL patients (57 eyes) treated with different operations were taken into this study. The postoperative outcome, operation related complications was analyzed in terms of different operative manipulations.
● RESULTS: The most common types of CEL are idiopathic and Marfan - related CEL. All eyes ( 98%) benefited from operation except 1 Marchesani syndrome eye concurrent with optic atrophy induced by glaucoma. A total of 3 eyes ( 5%) were treated by phacoemulsification combined with intraocular lens implantation; 8 eyes ( 14%) were treated by phacoemulsification, capsular tension ring implantation combined with intraocular lens implantation, among these 8 eyes, 1 eye was treated with capsular tension ring implantation combined with suture fixation; 39 eyes ( 68%) were treated by lens excision and anterior vitrectomy through corneal incision combined with intraocular lens implantation with suture fixation, among these 39 eyes, 2 eyes were treated with trabeculectomy , but not combined with intraocular lens implantation; 5 eyes ( 9%) were treated by intracapsular cataract extraction and anterior vitrectomy combined with intraocular lens implantation with suture fixation; 2 eyes ( 4%) were treated by lens excision and vitrectomy through pars plana combined with silicon oil injection.
● CONCLUSION: Almost all patients can obtain satisfactory outcomes through various operative manipulations. Phacoemulsification combined with intraocular lens implantation was the first choice for patients with lens dislocation range less than 90°. Phacoemulsification, capsular tension ring implantation combined with intraocular lens implantation was recommended for 90° - 180°, and lens excision and anterior vitrectomy through corneal incision combined with intraocular lens implantation with suture fixation was more suitable for lens dislocation range more than 180°. The appropriate operative methods for different types of CEL patients is the key to success.

Objective: To investigate the current status of knowledge and practice pertaining to nosocomial infection control among medical professionals in grassroots healthcare institutions, so as to provide the evidence of improving the level of infection control in grassroots healthcare institutions. Methods: All medical professionals working in grassroots healthcare institutions in Pukou District, Nanjing City, were enrolled. The participants' demographic features and knowledge and practice of nosocomial infection control were collected using self-designed questionnaires and descriptively analyzed. Results: A total of 402 participants were enrolled, included 116 men ( 28.86% ) and 286 women ( 71.14% ). The respondents were predominantly at ages of 41 years and older ( 187 subjects, 46.52% ), with bachelor and above as the predominant educational level ( 200 subjects, 49.75% ) and intermediate title and above as the predominant professional title ( 168 subjects, 41.79%) , and there were 236 participants ( 58.71% ) with the length of service for more than 10 years. The awareness rate of nosocomial infection control knowledge was 56.22% among medical professionals working in grassroots healthcare institutions, with the highest awareness for COVID-19 prevention and control ( 89.55% ) and the lowest awareness for the key aspects in nosocomial infection control ( 39.55% ). The formation rate of implementing nosocomial infection control practices was 84.08%, with a low rate for “Implement satisfactorily the isolation interventions for patients with multidrug resistant bacteria” ( 71.14% ) and “Implement satisfactorily the control measures for nosocomial infections in key departments and key aspects”( 64.68% ). Conclusions Low levels are seen in the awareness of nosocomial infection control, behaviors of multidrug resistance management and key aspects in nosocomial infection control among medical professionals in grassroots healthcare institutions in Pukou District.

BACKGROUND: Nano-hydroxyapatite has been widely used as reconstructive and prosthetic material for osseous tissue, owing to its excellent biocompatibility and bioactivity. But, its brittleness is one of the most serious obstacles for its wider applications as load-bearing implants. Therefore, hydroxyapatite/chitosan composites have been widely studied as bone substitute, due to their excellent biocompatibUity and suitable mechanical properties.OBJECTIVE: To review various preparation methods of hydroxya patite/chitosan composites and the development trend in this field.METHODS: Articles were searched in Medline Database (1995-01/2009-03), VIP Database (1995-01/2009-03) and "qinghuatongfang" Database (1995-01/2009-03) with the keywords of "nano-hydroxyapatite, chitosan, preparation, development trend".RESULTS AND CONCLUSION: Total 2 034 related articles were collected, including 1 634 in Chinese and 670 in English. Following excluding earilier published, duplicate, and similar studies, we brought into 37 sub-standard literatures. Hydroxyapatite/chitosan composite in nanometer size, with similar structure as natural bone, has better biological function compared with corresponding micrometer composite. Simultaneously, optimized material composition, structure and technology will obtain more suitable bone substitute in mechanical property compared with natural bone. This paper reviews preparation methods at home and abroad in recent years, with the rapid development of biological materials, hydroxyapatite compositematerials have been wisely used in bone tissue repair and replacement surgery, but its poor mechanical properties limits its clinical application.