OBJECTIVE To understand the distribution of common pathogens and their drug resistance trend and to provide the basis of the correct selection of antibiotics for clinic.METHODS Retrospective analysis was taken for blood culture specimens during 2 years in our hospital.And statistical analysis was done.All of 4028 cases of blood culture specimens were detected on automatic BacT/Alert3D rapid blood culture system,strains isolated were taken to VITEK-2 automatic microbiological analysis/sensitivity system for identification and drug susceptibility testing.Drug susceptibility results were analyzed using WHONET 5.3 software.RESULTS Totally 435 pathogen were isolated from 4028 cases of blood culture sample and the positive rate was 10.8%.195 Gram-negative bacteria strains accounted for 44.8%,mainly Escherichia coli,Klebsiella pneumoniae,Burkholderia cepacia,Acinetobacter baumannii,and Pseudomonas aeruginosa.Gram-positive bacteria accounted for 49.9%;mainly Staphylococcus epidermidis,S.haemolyticus and S.aureus dominated.Fungi were 23 strains(5.3%),mainly Candida albicans.Among them,extended-spectrum ?-lactamases(ESBLs) produced by E.coli and K.pneumoniae strains were 43.9% and 48.8%,respectively.Meticillin-resistant S.aureus and coagulase-negative staphylococci were 35.3% and 72.9%,respectively.But vancomycin-resistant S.aureus was not found.CONCLUSIONS The bacteria identification detected in blood culture class is quite complicated,and the drug resistance is high.Laboratories should increase the detection rate of bacterial culture and provide drug monitoring results for the clinics on time based on CLSI norms.Clinicians should use the antibiotics reasonably based on the drug susceptibility results in order to reduce nosocomial infections and the emergency of multiple drug-resistant strains.

Objective To establish a method for the rapid detection of hepatitis E virus (HEV)from serum samples based on fluorescence quantitative PCR.Methods (1 )One-hundred HEV sequences including our country popular three major genotypes were obtained from the GeneBank with the Vector NTI software.The proper sequence was selected to design and synthesize the primers of the fluorescence quantitation and the Taqman probe.(2)The amplification region PCR fragment was transcribed in vitro to synthesize cRNA standard,at the same time the trace serum virus lysate was introduced into a universal real-time TaqMan PCR assay.(3)10 clinical serum samples were collected from the patients with clinical hepatitis E and detected by using the established method for further verifying this method.Results This detection technique could effectively detect the serum samples in the pa-tients with genotype I and genotype IV hepatitis E positive,while the serum detection in the patients with other virus infectious dis-eases had the negative results,which verified that this RT-PCR detection technique had higher specificity and good reliability.The detection results from 10 clinical serum samples further verified that this method was rapid,convenient and sensitive with good re-peatability.Conclusion A fluorescence quantitative RT-PCR detection technique suitable for detecting main genotypes of HEV in China population is established,which can meet the demand of early and rapid diagnosis for HEV.

Magnetic Resonance Imaging(MRI) with 2.0 Tesla superconductive magnet developed by Korea Advanced Institute ofScience was performed in 25 patients with various abdominal diseases and compared with x-ray CT. MRI was obtainedwith spin echo technique using a variety of pulse sequence and various slice orientation including axial, sgittaland coronal section in order to evaluate the diagnostic value, limitation and to determine the optimal pulsesequency in various abdominal diseases. MRI demonstrated the capability of detecting the lesions shown on CT inall cases and also detected one case of diffuse hepatocellular carcinoma which was not seen on CT. MRI showedcapability of differentiation of various liver mass including hepatocellular carcinoma, hemangnioma and simplecyst. MRI showed better anatomical resolution of tumor in retroperitoneum and pelvis, however CT delineatedalimentary tract disease better than MRI did.
Carcinoma, Hepatocellular ; Humans ; Korea ; Liver ; Magnetic Resonance Imaging ; Pelvis

In order to observe the pattern of a flow image on multisection MR imaging technique, a flow phantom experiment was preformed using a superconducting high filed 2.0 Tesla MRI scanner. The pattren of the first section images was homogeneous round at all flow velocities until the turbulence forming level. The patterns of the second section images,however,changed into a homogeneous round shape, a ring shape, a target shape, and a small round shape as the velocity increased. When scanned at velocities higher than the trubulence forming level, the images become distored and irregular, and eventually disappeared after the cut-off velocity. The homogeneous round image senn at the lower velocity levels in throught to be due to the overwhelming effects of fully managetized spins influxed into the imaging section during the prior repetition time(TR). Later in the higer velocity levels the effects of the partially saturated spins and fully magnetized spins influxed during the section transit time(TR/slice number) are added, and result in ring, target, and small round patterns in the second section image.
Magnetic Resonance Imaging*

This study aims to analyze the molecular epidemiological characteristics of HIV-1 strains prevailing among men who have sex with men (MSM) in Beijing, China. The pol gene fragments from 250 newly diagnosed HIV-1-infected MSM individuals during 2006-2010 in Beijing were amplified by RT-nested PCR, sequenced, and phylogenetically analyzed. HIV-1 pol gene from 189 individuals were amplified and analyzed; 81 (42. 9%), 3 (1. 6%), 2 (1.0%), 88 (46. 6%), and 15 (7.9%) individuals were infected with HIV-1 subtypes B, B', C, CRF01_AE, and CRF07_BC, respectively. The subtypes B and CRF01_AE could both be grouped into two clusters, and CRFO7_BC strains shared high homology and were presumed to originate from a common ancestor. The HIV-1 circulating in MSM in Beijing had a lower genetic diversity than in heterosexuals. The HIV-1 epidemic (2006-2010) in MSM in Beijing was actually a rapid spread of HIV-1 CRF01 AE and B, or rather native strains of the two viruses.
Adult ; China ; epidemiology ; Epidemics ; Genetic Variation ; HIV Infections ; diagnosis ; epidemiology ; virology ; HIV-1 ; classification ; genetics ; isolation & purification ; Homosexuality, Male ; statistics & numerical data ; Humans ; Male ; Middle Aged ; Molecular Epidemiology ; Molecular Sequence Data ; Phylogeny ; Young Adult

Magrjetic resonance (MR) imagings with 0.15 Tesla resistive magnet developed by Korea Advanced Institute of 5cience were performed in 27 patients with various neurologic diseases and compared with X-ray computed tomography (CT). The purpose óf the paper is to evaluate the image quality, the diagnostic value and limitation, and the optimal pulse sequence of MR imagings with a resistive magnet. The MR images were obtained by using a variety of pulse sequence with spin echo technique includïng saturation recovery, T2-weighted spin echo, and/or inversion recovery with various pulse repetition(TR) and echo delay (TE) times. The M R imaging demonstrated the capability of detecting the lesions shown on CT in all cases and also detected an additional finding in one case (multiple sclerosis) which was not seen on CT. The MR imaging appeared to be more useful than CT in the evaluation of syringomyelia of spinal cord and white matter disease, while it failed to demonstrate small calcific lesion or inflammatory nodule (less than 1 cm) shown on CT and has shown somewhat poor contrast resolution in the case of meningioma. The spatial resolution of saturation recovery images was similar or superior to CT, whereas the contrast resolution of saturation recovery was inferior to CT. While the saturation recovery images have shown false negative findings in 5 patients (19%), the inversion recovery and T2-weighted spin echo have shown consistently positive findings. The inversion recovery and T2-weighted spin echo images demonstrated better contrast discrimination between normal and pathologic conditions than the saturation recovery images, but somewhat poorer spatial resolution. Authors suggest that the MR images of both the saturation recovery with 300/30 and T2-weighted spin echo with 1000/90 be used as a routine procedure and additional iversion recovery of 1300/300/30 sequence as a option if white matter disease is suspected.
Discrimination (Psychology) ; Humans ; Korea ; Leukoencephalopathies ; Magnetic Resonance Imaging ; Meningioma ; Spinal Cord ; Syringomyelia ; Tomography, X-Ray Computed

Using KAIS 0.15 Telsla resistive magnetic imaging system, ECG gated magnetic resonance (MR) image of variouscardiovascular disease was obtained in 10 patients. The findings of MR image of the cardiovascular disesase wereanlaysed and the results were as follows: 1. In 6 cases of acquired and congenital cardiac disease, there were 2cases of myocardial infarction, 1 case of mitral stenosis and 3 cases of corrected transpossition of greatvessels. The others were 3 cases of aortic disease and 1 case of pericardial effusion with lymphoma. 2. Myocardialthinning left ventricular aneurysm were detected in MR images of myocardial infarction. The left atrium was welldelineated and enlarged in the case of mitral stenosis. And segmental analysis was possible in the cases ofcorrected transposition since all cardiac structures were well delineated anatomically. 3. In aortic disease, thefindings of MR image were enlarged lumen, compressed cardic chambers in ascending aortic aneurysm, intimal flap,enhanced false lumen in dissecting aneurysm and irregular narrowing of aorta with arterial obstruction inTakayasu's arteritis. 4. Pericardial effusion revealed a conspicuous contrast with neighboring meidastinal fat andcardiac wall due to it low signal encircling cardiac wall. 5. ECG gated MR image is an accurate non-invasive imaging modality for the diagnosis of cardiovascular disease and better results of its clinical application areexpected in the futher development in the imaging system and more clinical experiences.
Aneurysm ; Aneurysm, Dissecting ; Aorta ; Aortic Aneurysm ; Aortic Diseases ; Arteritis ; Cardiovascular Diseases ; Diagnosis ; Electrocardiography ; Heart Atria ; Heart Diseases ; Humans ; Lymphoma ; Magnetic Resonance Imaging ; Mitral Valve Stenosis ; Myocardial Infarction ; Pericardial Effusion

Objective:To investigate the role of receptor-interacting protein kinse3 (RIPK3)-mediated necroptosis in diabetic mellitus-caused abolition of cardioprotection induced by sevoflurane postconditioning in rats.Methods:Eighty rats with diabetes mellitus, aged 4-5 weeks, weighing 90-100 g, were divided into 4 groups ( n=20 each) using a random number table method: sham operation group (group Sham), myocardial ischemia-reperfusion (I/R) group (group I/R), sevoflurane postconditioning group (group SP) and sevoflurane postconditiong plus RIPK3 inhibitor GSK-872 group (group GSK). Myocardial I/R was induced by 40 min occlusion of the left anterior descending branch of the coronary artery followed by 120 min reperfusion.In group SP, 2.4% sevoflurane was inhaled for 15 min at the beginning of reperfusion.In group GSK, GSK-872 3.3 mg/kg (dissolved in normal saline) was intraperitoneally injected at 24 and 2 h before surgery, and the other treatments were similar to those previously described in group SP.After 120 min of reperfusion, blood samples from the abdominal aorta were collected for determination of concentrations of serum lactate dehydrogenase (LDH) and creatine kinase-MB (CK-MB). Myocardial tissues were taken for determination of percentage of myocardial infarct size (by TTC staining) and expression of RIPK3, phospho-Ca 2+ -calmodulin-dependent protein kinase Ⅱ (p-CaMKⅡ) and phospho-mixed lineage kinase domain-like protein (p-MLKL) (by Western blot), and the ultrastructure of myocardium was observed by transmission electron microscopy. Results:Compared with group Sham, the serum LDH and CK-MB concentrations and percentage of myocardial infarct size were significantly increased, the expression of RIPK3, p-MLKL and p-CaMKⅡ in myocardial tissues was up-regulated ( P<0.05), and the damage to cardiomyocytes was severe in group I/R.Compared with group I/R, no significant change was found in the parameters mentioned above in group SP ( P>0.05). Compared with group SP, the serum LDH and CK-MB concentrations and percentage of myocardial infarct size were significantly decreased, the expression of RIPK3, p-MLKL and p-CaMKⅡ in myocardial tissues was down-regulated ( P<0.05), and the damage to cardiomyocytes was reduced in group GSK. Conclusion:The mechanism of diabetic mellitus-caused abolition of cardioprotection induced by sevoflurane postconditioning is related to excessive activation of RIPK3-mediated necroptosis in rats.

Objective To explore the dosing optimization of irinotecan according to the UGT1 A1*6/*28 genoptype.Methods Clinical phar-macists assisted clinicians to optimize the dosage of irinotecan for the patient with the wide -type of UGT1A1*6 and UGT1A1*28, and discovered and corrected the adverse drug reactions in time.Results and Conclusion Clinical pharmacists suggested increasing the dose of irino-tecan and clinicians accepted it.The patient successfully received the 6 cycles of chemotherapy.The initial dose of irinotecan increased from 280 mg to 440 mg.The progression free survival was 4.5 months.There was not obvious adverse drug reactions occurred during the chemotherapy.