OBJECTIVE To investigate the epidemiology of bacterial infections in patients with severe liver disease in intensive care unit(ICU) and analyze the antimicrobial susceptibility of major pathogens to provide reference for clinical therapy.METHODS A retrospective survey was conducted in 206 patients with severe liver disease in ICU of our hospital from Oct 2005 to Dec 2006.Identification and susceptibility of pathogens were assayed by MicroScan Auto-4 System.RESULTS Infection was identified in 70.87% of the 206 patients with severe liver disease.Most infections were caused by single pathogen.The infection was frequently identified in respiratory tract,blood stream or intra-abdominal cavity.The top 5 pathogens were Escherichia coli(12.8%),Klebsiella pneumoniae(9.9%),Staphylococcus haemolyticus(8.5%),Pseudomonas aeruginosa(7.8%) and Stenotrophomonas maltophilia(6.4%).Gram-negative bacilli were usually resistant to multiple antimicrobial agents,but less resistant to piperacillin-tazobactam or imipenem.Most of S.haemolyticus isolates were meticillin-resistant(MRSH)(25%),which were susceptible to penicillin,ampicillin and vancomycin.CONCLUSIONS Pathogens of patients with severe liver disease in ICU are mostly multi-drug resistant.The microbiological surveillance is important for guiding clinical therapy.

Objective To study the dynamic etiological effects of degeneration structure in cervical spine with motion MRI image, and to obtain the early diagnosis of CSM. Methods By flexing the patient forward and backward with the joint motion device, a total of 60 cases received MRI study in open MR feature. The motion MRI technique included the multi-angle scan, the joint motion scan, and the MR Fluoroscopy. Results (1) The spinal cord compression due to degeneration structure in flexion-extension was more significant than that in static position, it even had pile up effect. (2) The disc herniation (in 29 cases), the vertebral osteophyte, the segmental instability (in 7 cases), and the thickening of posterior longitudinal ligament (in 36 cases) could cause more serious mixture compression to the cord in anteflexion than in natural position. (3) In extension, the degenerative yellow ligaments (in 34 cases) often folded and encroached upon the spinal canal, which usually formed pincers effect with anterior compression (in 9 cases). (4) The flexion-extension movement could cause lower cervical instability founded in 14 cases. (5) The anterior space of dural sac could be decreased in flexion (in 41 cases) as well as in extension(in 16 cases), and in 43 cases, the posterior space could also be narrowed in extension, but not evident in flexion(in only 4 cases). Conclusion By using the motion MRI scan, the early, potential and dynamic compression factors of cervical spinal cord could be demonstrated not only in shape but also in pathogenesis. So the motion scan can make the diagnosis of CMS earlier than static scan does.

Objective To investigate the value of diffusion weighted magnetie resonance imaging and apparent diffusion coefficient (ADC) value in the diagnosis of pancreatic cancer.MethodsThe clinical data of 36 patients with pancreatie cancer who were admitted to the Wuxi No.2 People's Hospital from March 2009 to June 2011 were retrospectively analyzed,and the clinical data of 30 healthy volunteers were collected.All candidates received diffusion weighted magnetie resonance imaging examination.The signal intensity ratios ( SIRs ) of the cancer and the pericancerous tissues in the T1 weighted-images (T1WI),T2 weighted-images (T2WI)and diffusion weighted-images (DWI) were compared by using one-way analysis of variance.The ADC values of the cancer and the paricancerous tissues were compared using the paired t test.The differences of the ADC values of the cancer and pericancerous tissues compared with those of healthy individuals were analyzed using an independent sample t test.ResultsThe accuracy rate of preoperative magnetic resonance imaging examination was 92％.The relative SIRs were 0.203 ± 0.190 in the T2 WI,0.399 ± 0.201 in the T1 WI and 0.579 ± 0.291 in the DWI,respectively,with no significant differences across the 3 kinds of images (F=5.92,6.15,6.83,P ＜ 0.05 ),while SIRs of the T1 WI and DWI were significantly higher than that of the T2 WI ( P ＜ 0.05 ).There was no significant difference in SIRs when comparing T1 WI and DWI ( P ＞ 0.05 ).The mean ADC values of the cancer and pericancerous tissues of the pancreatic cancer patients and the pancreatic tissues of healthy individuals were (1.40±0.24) ×10 3 mm2/s,(1.71 ±0.10) ×10-3 mm2/s and (1.73±0.30) ×10-3 mm2/s,respectively,with significant differences across the 3 modes of images (t =10.54,12.08,P ＜ 0.05).ConclusionDWI can show high quality images of the lesions,and ADC value is helpful in the diagnosis of pancreatic cancer.

Objective To explore the value of cardiac troponin-I (cTnI), B-type natriuretic peptide (BNP) and blood lactic acid (Lac) on evaluation of severity and prognosis in patients with septic myocardial dysfunction (SMD). Methods According to retrospective analysis of clinical data,161 cases with sepsis were divided in to SMD group and non-SMD group. And the SMD group was further divided in to death group and survival group. Blood cTnI, BNP and Lac value in each group were detected respectively. The ROC curve was used to evaluate the forecast value of cTnI, BNP and Lac on prognosis for patients. Results The value of cTnI, BNP and Lac in SMD group were significantly higher than those in non-SMD group(P<0.05);The value of cTnI, BNP and Lac in death group among the SMD patients were significantly higher than those in survival group(P<0.05);cTnI, BNP and Lac contribute to predict the 28 day mortality rate of SMD. Conclusions Blood cTnI, BNP and Lac contributes to the assessment of the severity and the prognosis of septic patients with myocardial dysfunction.

Objective To assess the prognostic significance of pre-treatment hypercoagulable state in cervical cancer patients. Methods With retrospective analysis, pre-treatment coagulation indicators and platelets from 321 cervical cancer patients from stages I to IV were collected. The pre-treatment coagulation parameters were investigated along with tumor stage and survival data. Result Advanced tumor stage was associated with elevated fibrinogen (Fbg) and platelet (PLT) levels (P < 0.05). Patients with higher levels of Fgb, PTA and PLT suffered from higher risk of recurrence (P<0.05). Multivariate survival analyses showed that tumor stage, Fgb and PTA were independent prognostic factors for disease free survival. Conclusion Coagulation parameters can be served as useful tool for predicting recurrence of cervical cancer.

Objective To observe the effect of Sirt1 on the phosphorylation of Tau protein in neuroblastoma SK-N-SH cell line.Methods We cultured SK-N-SH cells in vitro with adenovirus packaging of Sirt1 and SirtM (Sirt mutant),and then observed the expression of Sirt1 under an inverted fluorescence microscope.The expressions of Sirt1and SirtM were detected by Western blot;t-Tau protein and phosphorylation of Tau protein were detected by Western blot,Real-time PCR,immunohistochemistry and immunofluorescence;and the effect of Sirt1 on SK-N-SH apoptosis was investigated by flow cytometry.Results The t-Tau protein level and its phosphorylation were significantly decreased in Sirt1 and SirtM groups compared with those in control group,and Sirt1 group showed more significantly decreased ser404,thr231 phosphorylation of tau protein and the mRNA level of Tau.Flow cytometry showed that Sirt1 could significantly reduce the apoptosis of SK-N-SH cells compared with the control group.Conclusion Sirt1 can decrease the phosphorylation of Tau protein and reduce the apoptosis of SK-N-SH,which provides an important laboratory basis for studies on Tau protein disease and other neurodegenerative diseases.

Objective To observe the effects of statins on ATP-binding cassette transporter 1(ABCA1) gene expression in neurons and astrocytes.Methods Primary human astrocytes and neuron cell line HCN-2 were incubated with simvastatin and pravastatin at different concentrations and under different conditions.Using RNA isolated from the cultured cells,we performed quantitative PCR to measure the ABCA1 gene expression in astrocytes and neurons.The protein expression of ABCA1 was measured by Western blot.Results The two statins significantly decreased the ABCA1 gene and protein expressions.Compared with pravastatin,simvastatin significantly reduced the expression of ABCA1 in neurons and astrocytes by 95% and 75%,respectively(both P

Objective To simulate the three-dimensional(3-D) growth pattern of stem cells in vivo by a 3-D culture system in vitro constructed by rat tail collagen scaffold.Methods Circular strands were prepared by mixing suspended murine embryonic stem cells(mESCs) with rat tail collagen.Growth profile of mESCs within the collagen strand was observed with phase contrast microscopy.Their metabolic activity was evaluated by glucose/lactic acid contents.To evaluate the effect of 3D culture system on ESCs differentiation,ES-derived cardiomyocytes were detected by immunohistochemistry,RT-PCR and transmission electron microscopy respectively.Results ESCs grew well in the 3-D culture system constructed by rat tail collagen.Cell connections can be found in those cell clusters formed within collagen stands,which indicated that tissue-like cultures should be produced during the process of 3-D culture in vitro.ESCs cultured by 3-D collagen strand differentiated into cardiomyocytes spontaneously.Conclusion Collagen provides an ideal growth matrix for ESCs proliferation in vitro and promotes ESCs differentiation towards tissue-like structures.Thus,the three dimensional culture system constructed by rat tail collagen can be applied to study ESCs differentiation in vivo.

OBJECTIVE To investigate the epidemiology of bacterial infections isolated from liver disease patients with septic shock and analyze the antimicrobial susceptibility of major pathogens to provide reference for clinical therapy. METHODS A retrospective survey was conducted in 83 liver disease patients with septic shock of our hospital from Jan 2005 to Aug 2006. Identification and susceptibility of pathogens were assayed by MicroScan Auto-4 System. RESULTS The infection was frequently identified in intra-abdominal cavity (73.5%),blood stream (24.1%) or respiratory tract (13.3%). The top 3 pathogens were Escherichia coli (36.6%),Klebsiella pneumoniae (15.9%) and Staphylococcus aureus (6.1%). Gram-negative bacilli were usually resistant to multiple antimicrobial agents,but less resistant to imipenem,levofloxacin or piperacillin-tazobactam. Extended-spectrum ?-lactamases (ESBLs) positive rates of E. coli and K. pneumoniae were 53.3% and 7.7%. Asprergillus and Candida glabrata were the predominant pathogens from fungal infections,and they were mostly resistant to fluconazole. CONCLUSIONS Pathogens of liver disease patients with septic shock are mostly multi-drug resistant. The microbiological surveillance is important for guiding clinical therapy.

Purpose To prepare the sustained-release tablet of tetramethylpyrazine phosphate with hydroxypropylmethylcelluose(HPMC) as matrix material. MethodsThe paddle method and the HPLC method were erspectively used determined the cumulative drug released in vitro and the serum concentration in vivo.ResultsThe cumulative drug released in the first hour was about 20%, while in 12 hours it was above 85%. Drug release behavior can be best described by Higuchi equation, and the release rate decreased as the viscosity and/or the amount of HPMC increased. Compared with the market tablet on the rabbits, the sustained release tablet had the decreased peak concentration (P < 0.05 ); the prolonged peak time and mean residence time (P< 0.05).ConclusionsThe matrix tablet was a good sustained-release dosage form and it had a good in vitro-in vivo correlation.