Child ; Clinical Laboratory Techniques ; Humans ; Tuberculosis ; diagnosis

Objective To evaluate the activity of antibiotics against pan-drug-resistant (PDR) Acinetobacter baumannii by combination antimicrobial susceptibility test in viro with epsilometric methods (Etest method) and microdilution checkerboard (CB method),and to detect a good correlation between timekill curve with the above mentioned two assays.Methods Thirty-one clinical isolates of PDR Acinetobacter baumannii were selected for mono and combination antimicrobial susceptibility test in vitro by E-test and CB method,then a comparison was conducted between the test results and the time-kill curve.Mono drugs involved tigecycline,colistin,imipenem and amikacin,and combinations involved two of drugs above,and three drugs involved imipenem/tigecycline,plus amikacin combination.Results Synergistic effect was detected in imipenem plus colistin and tigecycline plus imipenem combination.A high comparability was revealed between the E-test method with antimicrobial drugs added into the culture medium and the time-kill curves.Synergy in the combination of imipenem/tigecycline,plus amikacin was detected by the CB method and time-kill curves.Conclusion The results showed that the effect of specific combination of antibiotics against PDR Acinetobacter baumannii could be predicted by testing their synergistic effect with combination antimicrobial susceptibility test.

Objective To investigate the correlation of serum alpha-fetoprotein (AFP) with clinical pathological factors and prognosis of hepatocellular carcinoma ( HCC ).Methods Two hundred and twenty patients with HCC who hospitalized in our hospital from January 2007 to June 2009 were enrolled in this study.The relationship of AFP levels before operation to clinical pathological factors such as pathological grade,tumor size,tumor encapsulation,tumor numbers,portal vein tumor thrombus,TNM stage and postoperative recurrence were analyzed.Results Serum AFP concentration before operation were related with tumor size ( x2 =11.76,P ＜ 0.05 ),tumor encapsulation ( x2 =17.07,P ＜ 0.05 ),portal vein tumor thrombus ( x2 =8.944,P ＜ 0.05 ),higher TNM stage ( x2 =4.929,P ＜ 0.05 ) and early postoperative recurrence rate ( x2 =5.569,P ＜ 0.05 ).However,it had no correlation with pathological edmondson grade tumor numbers.Conclusion HCC patients with high serum AFP concentration often has greater tumor without encapsulation,high occurrence rate of portal vein tumor thrombus and higher TNM stage,they are more likely to early postoperative recurrence.Serum AFP before operation is useful not only for diagnosis,but also as a prognostic biomarker to predict prognosis and recurrence.

Objective To evaluate the activities of 18 pairs of antimicrobials combinations against non - duplicate clinical isolates of multidrug resistant Acinetobacter baumannii (MDRAB) in vitro.Methods Collect isolates of Acinetobacter baumannii from different patients from October 2009 to May 2010,which were isolated in Clinical Laboratory Center of Beijing Friendship Hospital,Capital Medical University.Use broth microdilution method to detect MIC of mono-antimicrobial,and checkerboard broth microdilution method to detect combinatied MIC,and calculate fractional inhibitory concentration (FIC) index to determine drug combinations effects.When the performance of the same drug combinations conflicted,appropriate strains were selected for screening of drug-resistant mechanisms by polymerase chain reaction( PCR),including efflux pump genes.Results In tests in vitro,rifampicin and polymyxin B,imipenem and gentamicin,cefepime and levofloxacin showed synergy at high proportion,68.1％,45.5％,40.9％,respectively.Minocycline and rifampicin,ampicillin/sulbactam and tobramycin.Ceftazidime and ciprofloxacin showed additive effect at high proportion,81.8％,68.2％,68.2％,respectively.There were several combinations which appeared the opposite effects to tested strains.Strains No.19 corresponding reaction was synergy and No.21,No.26 corresponding reactions were antagonism.The three strains above were selected for screening resistant mechanisms.The difference is that genotypes of adeS were negative in No.19 and positive in No.21 and No.26.Conclusion Rifampicin and polymyxin B combination showed synergy against the MDRAB in vitro,which can be considered as the treatment choice for critical infections caused by MDRAB.Imipenem and gentamicin,cefepime and levofloxacin also showed synergy in vitro,but in some isolates showed antagonism.This phenomenon may be due to the gene adeS activated by certain antibiotics,and the activated adeS drived efflux pump express or overexpress,which made the drugs in bacterial cells pumped out,causing antagonistic effect.The individual differences in strains should be considered when clinic strain apply these two combinations above.

AIM To express recombinant human cytochrome P450 3A4 mutants CYP3A4.3, CYP3A4.4, CYP3A4.5 and CYP3A4.18, and to employ them for in vitro metabolism studies of CYP3A4. METHODS Use Bac-to-Bac baculovirus expression system to recombinant baculovirus carrying cDNA of CYP3A4 mutants CYP3A4.3, CYP3A4.4, CYP3A4.5 and CYP3A4.18. Spodoptera frugiperda 9 (Sf9), cells were co-infected by recombinant viruses of CYP3A4 mutants, human NADPH-P450 oxidoreductase and cytochrome b5 to obtain recombinant proteins CYP3A4.3, CYP3A4.4, CYP3A4.5 and CYP3A4.18 with metabolic activity. RESULTS The mRNA transcription of CYP3A4 mutants in Sf9 cells were validated by RT-PCR. Testosterone and 7-benzyloxy-4-(trifluoromethyl) coumarin were metabolized by the lysates of Sf9 cells infected by the recombinant viruses. CONCLUSION CYP3A4 mutants CYP3A4.3, CYP3A4.4, CYP3A4.5 and CYP3A4.18 with metabolic activity were successfully expressed by baculovirus-insect cell expression system. The results indicated that recombinant CYP3A4. 5 showed lower activity comparing to the wild type protein towards testosterone, while CYP3A4. 18 with higher activity, and for CYP3A4.3 and CYP3A4.4 showing similar activity to the wild type protein.

Objective To investigate the self-management self-efficacy,health-related quality of life of hemodialysis patients and explore the relationship between them. Methods Self-management self-efficacy questionnaire and SF-36 were used,and 55 hemodialysis patients participated in this study. Pearson correlate and regression analysis were used to test the relationship between them. Results 55 questionnaires were available. Positively associated between self-management self-efficacy and HRQOL(r=0.268,P＜0.05);significantly positively associated between physical activity self-efficacy and HRQOL(r=0.409,P＜0.01). Regression analysis showed that physical activity self-efficacy is the factor of HRQOL (t=3.261,P＜0.01).Conclusion Physical activity self-efficacy is the factor of HRQOL in hemodialysis patients,increasing self-management self-efficacy is benefit to their HRQOL.

Objective To investigate the ability of theory of mind use in elders,and determine the role of inhibitory control in the use of theory of mind. Methods The participants included 30 young-old people ,30 oldold people and 30 young people. Their ability of theory of mind use and inhibitory control were examined with The Referential Communication Task and Hayling Sentence Completion Test,respectively. Results The correct rate of referential communication task was significantly lower in old-old people (0.43 ± 0.32) than those of young-old people (0.69 ±0.24, P=0. 001 ) and young people (0. 77 ±0. 25, P＜0. 001 ). Partial correlation analysis showed that the total errors in Hayling Test-B was negatively correlated with the correct rate of Referential Communication Task ( r= -0.442, P＜0.001 ). Hiberarchy regression analysis showed that the total errors in Hayling Test-B entered the equation ( β = -0.451, P＜0. 001 ) and could independently explained 16.8% of the variance (△R2 = 0. 168, △F = 19.359, P ＜ 0.001 ) after controlling for age. Conclusion Old-old people show worse performance in the use of theory of mind. The impairment of inhibitory control can partly explain the decline of theory of mind use in old-old people.

Gastrodin (GAS) is the major bioactive component of the extracts from the rhizome of Gastrodia elata Blume. The aim of this study is to investigate the transport of GAS in Caco-2 cells and the interaction of P-glycoprotein and GAS. The apparent permeability coefficients (Papp) of GAS were measured as a function of directions and concentrations. It was demonstrated that the efflux ratio was < 2.0 over the range of 50-500 micromol x L(-1) of GAS from bi-directional transport studies. The transport rate of GAS was dependent on the concentrations. Papp of GAS was not affected by transport directions, GAS concentration or the classical inhibitors of P-glycoprotein (verapamil and GF 120918). The cellular accumulation of GAS in Bcap37/MDR1 cells transected with hMDR1 gene, was similar to that in Bcap37 cells. The accumulation in both cell lines was concentration dependent. GAS did not affect the accumulation of Rhodamine 123 in Bcap37/MDR1 cells over the range of 50-500 micromol x L(-1). It indicated that the transport of GAS in Caco-2 cell monolayers mainly is by passive paracellular transport pathway. P-glycoprotein did not participate in the absorption of GAS in the intestine or the transport across the blood-brain barrier.

Objective To analyze the distribution of Escherichia(E .) coli in clinical infection and its drug resistance situation to provide the scientific evidence for the control of outside hospital infection and nosocomial infection and clinical rational drug use . Methods E .coli isolated situation among various types of clinical samples in our hospital during 5 years from January 2010 to De‐cember 2014 ,its department distribution and drug resistance were analyzed .Results The isolated 2 405 strains of E .coli were mainly originated from urine samples (1 049 strains ,43 .60% ) and sputum samples (562 strains ,3 .4% ) .In which the detection rate of extended‐spectrum beta‐lactamase(ESBLs)producing E .coli was 57 .92% ;the resistance rate of E .coli to the most antibacterial drugs including penicillins ,cephalosporins ,fluroquinolones ,aminoglycosides and sulfonamides was more than 50% ,the drugs with the resistance less than 10% were imipenem(0) ,meropenem(0) ,piperacillin/tazobactam(4 .6% ) ,cefoperazone/sulbactam(6 .4% ) and cefoxitin (7 .7% ) ,the resistance to partial third and fourth generation cephalosporins of ceftriaxone ,cefotaxime and cefepime showed the significantly increasing trend .Conclusion E .coli has relatively serious drug resistance situation in hospital‐acquired in‐fections ,clinic should strengthen the pathogen distribution monitoring and drug resistance detection for avoiding the generation of more drug resistant strains in order to reduce the bacterial drug resistance and the hospital infection rate .

It has long been concerned about the mechanism , pathology and toxicology of anaesthetic involving drug addiction and its influence on human body .In recent years , as a short non-coding RNA negatively regulating the genes in cells , MicroRNAs (miRNAs) may turn out to be a focus issue which is related to apoptosis , metabolism, inflammation, and tumorigenesis.This article illuminates the influence on gene expression introduced by common anaesthetics and the interaction between gene and its target site . Analyzing the potential medical applications of miRNA , this article reviews the correlation between miRNAs and anaesthetic to provide new evidences in this emerging field .