Objective To implement active screening measures for patients in intensive care unit (ICU),early de-tect patients with multidrug-resistant organism (MDRO)colonization,implement contact isolation measures,pre-vent and control MDRO cross transmission.Methods The nasal and rectal swabs of 240 patients who were admit-ted to ICU from September 2012 to May 2013 were performed bacterial culture,patients with colonization of methi-cillin-resistant Staphylococcus aureus (MRSA),extended-spectrum β-lactamases (ESBLs)-producing Escherichia coli ,and ESBLs-producing Klebsiella pneumoniae were conducted contact isolation.Clinically isolated MDROs from ICU patients in September 2011-August 2012 (before active screening)and September 2012-August 2013 (after active screening)were collected and performed antimicrobial resistance analysis.Results Of 240 patients, nasal swabs screening test showed that there were 56(23.33%)patients who were colonized with MRSA,including 22(39.29%)were colonized at the admission to ICU and 34(60.71%)during the ICU stay.Rectal swabs screening test showed that there were 105(43.75%)patients who were colonized with ESBLs-producing Escherichia coli and Klebsiella pneumoniae ,72(68.57%)were colonized at the admission to ICU,and 33(31.43%)were colonized dur-ing the period of ICU stay.The incidence density of MDROs before and after implementing active screening were 28.56‰ and 13.71‰ respectively,difference was significant (P < 0.05;RR,2.08 [95%CI ,1.582 - 2.743]). Conclusion MDRO colonization rate is high among ICU inpatients,implementation of comprehensive prevention and control measures against MDROs based on active screening can reduce the spread of MDROs in ICU.

As one of endocrine dysfunction related diseases among children,precocious puberty has trend for increased rates in recent years.Widespread children exposure to known or suspected endocrine disrupting chemicals has been documented in worldwide,in which exogenous estrogen chemicals trigger precocious puberty onset have been attracting more and more attentions.Zearalenone widely contaminates foods such as grain,milk,meat and eggs,which displayed its estrogen effect to disrupt organism development.In this review,Zearalenone is suspected as triggering factor for precocious pubertal to be discussed,will lead to people pay more attentions to food safety and the prevention of precocious puberty.

AlM:To explore the efficacy and safety of mitomycin C used in trabeculectomy by analyzing intraocular pressure and blood flow.METHODS:A total of 103 patients with glaucoma were divided into 2 groups randomly, and all patients were treated with trabeculectomy, while patients in the observation group were given mitomycin C extra. At 6~12mo follow-up were completed after operation, and the clinical efficacy, complications and hemodynamic characteristics of central retinal artery were compared between groups.RESULTS: The clinical efficacy of the observation group was higher than that of the controls (P<0. 05). There was no significant difference in complication rate between groups (P>0. 05), but the complication type was differentiate to some extent. Low intraocular pressure and photophobia symptoms occurred mostly in the observation group, while cicatricial obstruction occurred mostly in the controls. Before treatment, there was no significant difference in hemodynamic characteristics between groups (P>0. 05). One month after treatment, the peak systolic velocity ( PSV) and end diastolic velocity ( EDV ) of the observation group were obviously lower, while resistance index ( Rl ) and pulsatility index ( Pl ) were higher than those of the controls, the difference was statistically significant ( P<0. 05). Six months after treatment, the PSV and EDV of the observation group were obviously higher, while Rl and Pl were lower than those of the controls, the difference was statistically significant (P<0. 05).CONCLUSlON:Mitomycin C has a short-term harmful effect on glaucoma patients after trabeculectomy, but its long-term effect is safe and reliable.

Objective To investigate the expression of DNA methyltransferase 1,3a,3b (DNMT1,DNMT3a,DNMT3b) in human hepatocellular carcinoma (HCC) and to determine their clinical significance.Methods The expression of DNMT1,3a,3b proteins was detected in 47 HCC tumor specimens and 42 HCC paracarcinoma liver tissues by immunohistochemistry.12 normal liver tissues were used as control.The results and clinicopathological parameters were analyzed.Results The positive expression rates of DNMT1,3a and 3b in HCC tissues were 80.9％,68.1％ and 78.7％ respectively.The positive expression rates of DNMT1,DNMT3a and DNMT3b in paracarcinoma tissues were 50.0％,52.4％ and 57.1％ respectively.The expression rates of DNMT1,3a and 3b in both HCC tissues and paracarcinoma tissues were significantly higher than normal liver tissues.The expression of DNMT1,DNMT3a,DNMT3b was correlated with tumor differentiation (P＜0.05) and hepatitis B surface antigen (HBsAg) positivity.Conclusions DNMT1,3a and 3b play important roles in carcinog(c)n(c)sis and development of HCC.

Iliac vein compression syndrome is one of the most common lower extremity venous backflow obstruction disorders,which often causes lower limb swelling,venous stasis dermatitis,lower extremity deep venous thrombosis,lower extremity venous valvular insufficiency,etc.At present the commonly used imaging diagnostic means include ultrasonography,multi-slice computed tomography,magnetic resonance and digital subtraction angiography.This paper aims to review the recent progresses in the imaging diagnosis of iliac vein compression syndrome.

AIM: To observe the effect of phagotrophic ability of macrophage on pseudomonas aeruginosa which was cocultured with low concentration of erythromycin. METHODS: The pseudomonas aeruginosa ATCC 27853 was cultured in LB both with low concentration of erythromycin (Group A) and without erythromycin (Group B) for 18 h separately, then incubated with macrophage from murine abdominal cavity for 2 h. The ratio of phagocytosis of macrophage was determined by microscope detection. RESULTS: The ratio of phagocytosis of group A in which erythromycin was added was higher than the group B, and the pseudopodia of macrophage were increased in the group A under electron microscope. CONCLUSION: Low concentration of erythromycin may enhance the phagocytosis ability of macrophage in vitro by influencing the virulent factors of PA.

Object To develop a method for the identification of Fritillaria walujewii Regel by UV spectrum. Methods UV spectrum of the absolute alcoholic extract of F. walujewii was determined and compared with that of four other similarly treated Fritillaria species. Results The UV spectrum of F. walujewii was consistently different with that of the other four species. Conclusion UV spectrum can be used to differentiate F. walujewii from other species of Fritillaria.

Objective:To establish the quality standard for Qiyeling granules. Methods:Astragali Radix and naringin were identi-fied by TLC. The content of astragaloside A was determined by HPLC. Results:The qualitative identification was with high resolution and without interference from the negative substances. The linear range of astragaloside A was 0. 166-1. 104 μg(r=0. 999 1), and the average recovery was 97. 27%(RSD=1. 3%,n=6). Conclusion:The method can be used in the quality control of Qiyeling granules.

ObjectiveTo observe the clinical efficacy of acupoint application plusXiao Pi Jianin treating hyperplasia of mammary glands.MethodTotally 103 patients with hyperplasia of mammary glands were randomized into a treatment group of 52 cases and a control group of 51 cases. The treatment group was intervened by acupoint application plus oral administration ofXiao Pi Jian, while the control group was by oral administrationofXiao Pi Jianalone. The criteria for diagnosis and therapeutic evaluation of hyperplasia of mammary glands were adopted in the study.ResultThe total effective rate was 94.2% in the treatment group, significantly higher than 82.4% in the control group(P<0.05).ConclusionAcupoint application plusXiao Pi Jiancan produce a significant efficacy in treating hyperplasia of mammary glands.

Objective To investigate the spreading characteristics of plasmid-mediated resistance and the clones dissemination in multidrug resistant Klebsiella pneumoniae.Methods A total of 53 strains of multidrug resistant Klebsiella pneumoniae were successively collected from the First Affiliated Hospital,Zhejiang University School of Medicine during December 2009 and February 2012.Antimicrobial agents susceptibility was determined by Kirby-Bauer (K-B) method,and pulsed field gel electrophoresis (PFGE) was used to investigate the clonality of clinical isolates.Filter mating method was used for plasmid conjugation,and the relative molecular mass of the plasmid was determined using S1-PFGE assay.PCR amplification and sequencing were used to screen common antimicrobial resistance genes.Results Fiftythree clinical isolated Klebsiella pneumoniae strains were all resistant to penicillins,and their sensitive rates to piperacillin/tazobactam,cefoperazone/sulbactam were below 15％.More than 86％ strains were resistant to cephalosporins,and 60％-70％ strains were resistant to quinolones,sulfonamides and tetracyclines.About 50％ strains were resistant or intermediate sensitive to carbapenems.PFGE results did not support the evidence of clone dissemination.Resistant isolates harbored conjugant plasmid with 34 000-355 000 bp size,which encoded penicillins,cephalosporins,carbapenems or aminoglycoside resistant determinants,including CTX-M,TEM,KPC type β-1actamase genes and plasmid-mediated quinolone resistance gene qnr.Conclusions Multidrug resistance is prevalent in clinical Klebsiella pneumoniae isolates.Rapid prevalence of resistance is mainly determined by conjugant plasmid horizontal transfer rather than simple clone dissemination.