With the development and wide application of antibiotics, the number of resistant strains keeps growing and there is a trend towards a higher isolation rate of methicillin-resistant staphylococcus aureus (MRSA) year by year, accompanied by the increasing drug resistance.As reported in recent years, vancomycin resistant or intermediate staphylococcus aureus was isolated from different geographical regions.The prevalence of MRSA infection has become a serious public health problem, which is also the global focus in the medical field.This review focuses on the prevalence of MRSA colonization and infection, drug resistance mechanism,mode of transmission, prevention and efficacy in neonatal intensive care unit.

Objective To investigate the distribution of the bacteria in ascites of spontaneous bacterial peritonitis (SBP), and to find out the resistance of the bacteria to antibacterial agents. Methods 44 inpatients from 1999 to 2003 with SBP and positive bacterial culture in ascites were selected, and the bacterial distribution, resistance to drugs and the application of antibacterial agents were analyzed. Results 88.6% (39/44) of the 44 isolations were gram-negative bacillus, among them 28 isolations were E. coli. The results of drug sensitive test revealed that 90% of E. coli, Aeromonas sobria, Klebsiella pneumoniae were sensitive to the third generation of cephalosporin. The resistant rate of E. coli to cefotriaxone and cefotaxime were 11.54% and 12.50%, respectively. Conclusion The third generation of cephalosporin was the experiential selection in treating SBP before getting the report of drug sensitive test. Anti-bacterial agents combined with ?-lactamase inhibitors may be used in treating some severe cases.

Objective To observe the clinical efficacy and the economic effectiveness of different therapeutic schemes for Chronic hepatitis UB.Methods Patients with Chronic Hepatitis B were treated by using different drugs:Interferon ?1b(group A),Lamivudine(group B),Interferon ?1b combination with Lamivudine(group C),Interferon ?1b combination with thymotentin(group D),Interferon ?1b combination with thymosin alphal(group E).Evaluation was carried out with pharmacoeconomic cost-effectiveness.Results At the end of therapy,the clearance rate of serum HbeAg was lowest in group B(10 94%),the other groups were more than 50%.The clearance rate of serum HBV-DNA was higher in group B and C than in the other groups,it was 85 94%,87 93% respectively.Normalizing ALT values was higher in group C,group D and group E than in group A and group B.The costs of several therapeutic schemes were RMB 8156 7(group A),6935(group B),15091 7(group C),26033 4(group D) and 89978 4(group E) yuans,respectively.Conclusions According to the evaluation with pharmacoeconomic cost-effectiveness analysis,the therapeutic scheme of Interferon ?1b,Lamivudine and Interferon ?1b combination with Lamivudine is best one for treating chronic hepatitsi B,in this groups,Interferon ?1b combination with Lamivudine was better than the other two groups.

BACKGROUND: The mitofusin 2 (Mfn2) may affects vascular smooth muscle cell Ras protein and suppress cellular proliferation through inhibition of extracellular signal-regulated protein kinase signaling pathway, which plays an important role in pathogenesis of vascular disorders such as hypertension, atherosclerosis and post-angioplasty restenosis. Mfn-2 gene amino acid sequence of the first 442 serine serves as protein kinase A (PKA) phosphorylation site, which is closely related to its phosphorylation status and may be involved in its functional regulation.OBJECTIVE: To investigate the effect of Mfn2 gene with PKA phosphorylation site deletion[Mfn2-PKA (△)] on inhibiting the proliferation of vascular smooth muscle cells and related signaling pathway.METHODS: Vascular smooth muscle cells of rats infected by recombinational adenovirus carrying green fluorescent protein,Mfn2 gane and Mfn2-PKA (△), were subcultured for 3-10 passages and randomly divided into 4 groups: ① Control group without intervention. ② Control group infected with adenovirus carrying green fluorescent protein. ③ Experiment group infected with adenovirus carrying Mfn-2 gene.④ Experiment group infected with adenovirus carrying Mfn2-PKA (△). Laser confocal microscopy was used to observe the locations of Mfn2 gene with and without PKA in cells. The expressions of extracallular signal-regulated protein kinase, Mfn2 gone and Mfn2-PKA (△) were determined by Western blot analysis. The growth curve of the vascular smooth muscle cells was explored by MTT.RESULTS AND CONCLUSION: The Mfn-2 and Mfn2-PKA (△) both expressed protein-specific bands in vascular smooth muscle cells. Two kinds of gone expression products were mainly located at the out membrane of mitochondria. Compared with the control group and adenovirus carrying green fluorescent protein group, the absorbance values at 3, 4, 5, 6 days were significantly reduced in adenovirus carrying Mfn2 group (P ＜ 0.01), and no obvious changes were observed in adenovirus carrying Mfn2-PKA (△) group. Compared with the control group and adenovirus carrying green fluorescent protein group, the extracellular signal-regulated protein kinase expression was significantly reduced in adenovirus carrying Mfn2 group (P ＜ 0.01), and no obvious changes were observed in adenovirus carrying Mfn2-PKA (△) group. Mfn2-PKA (△) located at the out membrane of mitochondria, has no effect on suppressing the proliferation of vascular smooth muscle cells, and no inhibition effect on extracellular signal-regulated protein kinase signaling pathway.

To explore the clinical effect of ganglioside sodium in the treatment of acute cerebral infarction and its influ-ence on hs-CRP and TNF-α in serum. Methods:A total of 216 patients with acute cerebral infarction were randomly divided into the observation group and the control group. The control group (108 cases) was given regular treatment, and the observation group (108 cases) was given 100 mg ganglioside in 250 ml 0. 9% sodium chloride, ivd, qd additionally, and the treatment course was 14d. The clinical effect of the two groups was compared, and the change of hs-CRP and TNF-αin serum was also researched in both groups. Re-sults:The total effective rate of the observation group was 90. 7%, which was obviously higher than that of the control group (71. 3%, P<0. 05). After the treatment, the NDS score of the observation group was lower than that before the treatment, while the ADL score was higher than that before the treatment (P<0. 05). After the treatment, the level of hs-CRP and TNF-α in serum was higher than that before the treatment in the two groups (P<0. 05), and that in the observation group was higher than that in the control group (P<0. 05). During the treatment, no adverse reaction was shown in the two groups. Conclusion:The clinical effect of ganglioside sodi-um in the treatment of acute cerebral infarction is promising, which can reduce the level of hs-CRP and TNF-αin serum of the patients and improve the scores of NDS and ADL with good safety, and is worthy of further clinical application.

OBJECTIVE:To evaluate the cost and effectiveness of three pharmacotherapeutic schemes for hemorrhage of upper digestive tract caused by liver cirrhosis.METHODS:132 patients with hemorrhage of upper digestive tract were treated by different drugs:octreotide(49),somatostatin(42),pituitrin(41).Evaluation was carried out with pharmacoeconomic cost-ef_fectiveness analysis.RESULTS:The hemostatic rates of octreotide,somatostatin and pituitrin for rupture of esophageal varicosis were 88.89%,80% and 46.15%;for peptic ulcer bleeding associated with liver cirrhosis 88.89%,87.50% and 50.00% and for hemorrhage from acute gastric mucosa erosion combined with liver cirrhosis 100.00%,94.44% and 68.18%,respectively.The costs of octreotide,somatostatin and pituitrin schemes were RMB 2 242.8,3 294 and 996.2 yuans,respectively.CONCLU_SION:According to the evaluation with pharmacoeconomic cost-effectiveness analysis,the therapeutic scheme of pituitrin seems to be the best one for treating hemorrhage of upper digestive tract resulting from liver cirrhosis.

Objective To investigate effects of Tanshinone Ⅱ A (Tan Ⅱ) on proliferation and apoptosis of myeloblastic leukemia cell lines.Methods NB4,K562 and THP-1 cells were incubated with TanⅡA for 24,48 and 72 hours.Ddaunorubicin was used as a positive control.Cell proliferation was monitored by MTT assay.Cell apoptosis and cell cycle were determined by Annexin Ⅴ-FITC/PI flow cytometry.Expression of Caspase-3 was quantified by spectrophotometry.Results After incubation with various leukemia cells for 24,48 and 72 hours,Tan Ⅱ inhibited proliferation of NB4 cells with IC50 of 24.11,9.60 and 7.28 μmol/L,inhibited K562 cells with IC50 of 31.75,11.88 and 6.81 μmol/L and inhibited THP-1 cells with IC50 of 111.10,32.82 and 11.82,respectively.After treatment with Tan Ⅱ for 48 hours,cell apoptosis,the number of G1 phase cells and the expression of Caspase-3 in all three leukemia cell lines were increased significantly comparing with the blank control group (P ＜ 0.05).Conclusions Tan Ⅱ A has proliferation inhibitory effect on myeloblastic leukemia cell lines by the order of effect NB4＞K562＞THP-1.Tan ⅡA displays anti-leukemia activity possibly through arresting leukemia cells in G1 phase and inducing apoptosis by increasing Caspase-3 expression.

ObjectiveTo evaluate the significance of the detection of serum C-reactive protein (CRP) in elderly patients with diabetes mellitus and cerebral infarction.MethodsSeventy-two patients with diabetes mellitus and cerebral infarction (diabetic cerebral infarction group),66 patients with cerebral infarction and without diabetes mellitus (non-diabetic cerebral infarction group) and 60 healthy persons (control group) from October 2008 to January 2011 were selected.The level of serum CRP was detceted.ResultsThe level of CRP was ( 3.81 ± 2.23 ) mg/L in diabetic cerebral infarction group,( 2.48 ± 2.24 ) mg/L in non-diabetic cerebral infarction group and (0.68±0.16) mg/L in control group.The levels of CRP in diabetic cerebral infarction group and non-diabetic cerebral infarction group were significantly higher than that in control group (P ＜ 0.05).The level of CRP in diabetic cerebral infarction group was obviously higher than that in non-diabetic cerebral infarction group(P ＜0.05).CRP abnormal rate was 70.8％(51/72) in diabetic cerebral infarction group and 43.9％ (29/66) in non-diabetic cerebral infarction group,which had statistical significance (P ＜ 0.05).ConcluslonCRP has important predictive value to the occurrence and development of diabetic cerebral infarction.

Objective To explore the influence of atorvastatin on the carotid atherosclerotic plaque and prognosis of older apoplexy.Methods 124 patients with carotid atherosclerotic plaque were randomly divided into 2groups,64 cases in the observetion group who had given atorvastatin(20mg) and general,and 60 cases in control group who had given genenal treatment.The relapse rate of apoplexy,the level of blood-fat and live viability condition were compared.Results ( 1 ) In the treatment group,the recurrence rate was 4.7％,and 18.3 ％ in the control group,the difference was statistically significant(x2=5.76,P ＜ 0.05 ).The two groups of adverse events had no significant difference ( x2=0.00,P ＞ 0.05 ).(2) In the treatment group,after treatment compared with before treatment,after the treatment group compared with the control group after treatment,TC,TG,LDL-C,HDL-C levels were statistically different ( all P ＜　0.05 ).(3) The life skills of the treatment group after treatment was signiflcantly better than the control group,the difference was statistically significant( x2 =24.18,P ＜ 0.05 ).Conclusion A torvastatin could significantly reduce the level of blood fat,improve prognosis,and reduce the rate of apoplexy,and had good effect.

Objective To investigate the correlation between neuronal injury and the expression of caspase-3 and caspase-activated deoxyribonuclease (CAD) after focal cerebral ischemia-reperfusion in rats, also to study the effect of caspase-3 particular inhibitor. Methods The focal cerebral ischemia model (occluding middle cerebral artery of the rats) was made by using modified inserting thread method and reperfusion after embolizing for one hour. Using HE staining, TUNEL staining and microscopy to observe the morphological changes of ischemic neurons at six different time points including 6,12,24,48 and 72 h, using immunohistochemistry to observe the changes of caspase-3 and CAD protein in two groups (model group and interfere group). Results There was no significant difference between the two groups using HE staining and microscopy. While there was difference of TUNEL staining positive cells in all time points, except 6 h time point; Both the two groups reached the expression peak of caspase-3 in 24 h, and the number was 2. 360± 0. 318 and 0. 804 ± 0. 206 respectively(t' = 10. 039, P < 0. 01), there was statistical significance from 12 h to 48 h between the two groups ; The expression peak time of CAD protein in two groups was 48 h, and the number was 3.061 ± 0. 567 and 0. 812 ± 0. 240 respectively (t' = 8. 960, P < 0. 01), there was statistical significance from 12 to 72 h between two groups. Conclusions Caspase-3-CAD-DNA degradation is one important way of neuronal injury in cerebral ischemia-reperfusion of rats, caspase-3 inhibitor can protect neuron in a certain degree.