OBJECTIVE To investigate the distribution and drug resistance of Pseudomonas aeruginosa.METHODS All specimens isolated and cultured from patients in our hospital were identified by using the automatic microorganism analyzer WalkAway-40,Dade Behring made in America,and bacteria′s drug susceptibility test and identifications were performed on strains using NC21 Microscan Panel.RESULTS From sixty-two strains of P.aeruginosa 36 strains were isolated of sputum.The resistance rate to the third generation of cephalosporins cefotaxime and ceftriaxone was 55.6% and 47.5%,respectively.The resistance rate to the other ?-lactamases antibiotics such as ceftazidime was 7.5%,piperacillin/tazobactam 11.0%,cefepime 14.8% and penicillin was 30.0%,the ratio of resistance for imipenem was 20.0%,the lowest one was amikacin(4.6%).CONCLUSIONS P.aeruginosa is one of the main bacteria in the lower respiratory tract infection.The drug-resistant mechanism of P.aeruginosa is very complex,including multidrug resistance characteristics,and it is originally resistant to several antibiotics.To avoid being produced ?-lactamases and result in resisting drug widely,the antibiotics should be selected according to low drug-resistant rate and taking into account sufficiently its drug resistance mechanism in the treatment of P.aeruginosa infection.

Objective To investigate the effect of levodopa on melanogenesis in Penicillium mameffei (PM),and to determine if melanization affects the antifungal drug susceptibility of PM.Methods A clinical isolate of PM,GXMU121011,was inoculated onto Sabouraud's dextrose agar (SDA) containing different concentrations (0.1-10 mmol/L) of levodopa at an inoculum density of 1.0 × 106 cfu/ml,or onto SDA containing 1 mmol/L levodopa at three inoculum densities (1.0 × 105,1.0 × 106,1.0 × 107 cfu/ml),and cultured at 37 ℃ for 7 days.Subsequently,melanization of PM colonies was observed.The paper-disk method was used for antifungal susceptibility testing,and the diameter of inhibition zones of itraconazole,fluconazole and amphotericin B against 8 clinical strains of PM was determined on SDA with or without levodopa.Results The melanization of PM colonies increased when the concentration of levodopa increased from 0.1 to 1.0 mmol/L,peaked when that reached 1.0 and 3.0 mmol/L,but mildly decreased when that continuously increased beyond 3.0 mmol/L,and a slight shrinkage was observed in PM colonies when that was 10.0 mmol/L.The color of colonies deepened along with the increase in inoculum density of PM.The average diameters of inhibition zones of itraconazole,fluconazole and amphotericin B against PM were all significantly lower on SDA with levodopa than on SDA without levodopa (all P ＜ 0.05).Conclusions Levodopa concentration and inoculum density both affect melanogenesis in PM.Melanization may decrease the susceptibility of PM in yeast phase to itraconazole,fluconazole and amphotericin B in vitro.

Objective To investigate the effect of the decoction to help recover intestinal function on the intestinal mucosal barrier of rats with gut ischemia-reperfusion injury. Methods Forty-five SD rats were divided into three groups randomly: control group,gut ischemia-reperfusion injury group and decoction group.We detected the content of DAO and D-lactate in serum and lysozyme in perfusate of intestine in each group.We observed the bacteria translocation,the change of ileum mucous membrane in pathomorphology and intestinal villi. Results Compared with those in gut ischemia-reperfusion injury group,the contents of DAO and D-lactate and bacteria translocation ratio were all lower in decoction group(P

Objective To investigate the association of AcrAB-tolC efflux pump and marA-soxS-rob regulon with ciprofloxacin-resistance in Shigella flexneri isolates.Methods Forty five strains of Shigella flexneri were isolated in stool samples collected from outpatient diarrhea clinics in Tianjin from 2009 to 2013.The antimicrobial susceptibility of bacteria was analyzed by Kirby-Bauer disk diffusion method.Ten ciprofloxacin-resistant Shigella flexneri isolates and 10 ciprofloxacin-sensitive isolates were randomly selected.The gyrA and parC genes,plasmid mediated quinolone resistant (PMQR) determinants,efflux pump genes (acrA,acrB) and regulation genes (marA,soxS,rob) were screened and sequenced.Minimum inhibition concentrations (MICs) of the strains were determined before and after efflux pump inhibitor carbonyl cyanide m-chlorophenylhydrazone (CCCP) was added.The expression of acrA,acrB,marA,soxS and rob genes in ciprofloxacin-resistant and ciprofloxacin-sensitive strains was detected by realtime fluorescence quantitative RCR (RT-PCR),and the differences of expression were evaluated using t test.Results Both gyrA and parC mutations were detected in all ciprofloxacin-resistant strains; qnrS1 was positive in ciprofloxacin-resistant strain CR2 and aac(6')-Ib-cr was positive in ciprofloxacin-resistant strain CR5.Efflux pump genes and regulation genes were not detected in ciprofloxacin-sensitive strains,while soxRS mutation was detected in all ciprofloxacin-resistant strains except CR10.MICs of quinolones in ciprofloxacin-resistant strains decreased to one-fourth or one-eighth when CCCP added,while not changed or only decreased to one-half in ciprofloxacin-sensitive strains.Expressions of acrA,acrB,marA and soxS were significantly higher in ciprofloxacin-resistant strains than those in ciprofloxacin-sensitive strains (P ＜ 0.05 or P ＜ 0.01).Conclusion Efflux pump may involve in the high-level ciprofloxacin resistance in Shigella flexneri through activating transcription of efflux pump genes by marA-soxS-rob regulon,in which soxRS mutation may play an important role.

In order to explore more reasonable and scientific accounting method of community health service costs, to improve the accounting method system of community health service cost. In the current existing community health services costing methods, based on the analysis of hospital cost accounting methods system, analyze and imitate the accounting method of hospital costs, establish a more scientific and implemented accounting method system of community health service costs: divide parts of clinics scientifically, redesign the center acollation method of indirect cost, confirm different cost accounting methods for different cost accounting objective and provide suggestion for the improvement of project cost accounting.

Objective: Under the methodology of differential proteomics and bioinformatics, the impact of the exogenous gene on the expression of rice in the proteome is discussed, aiming to explore into the study of genetically modified rice in the proteomics. Methods: The total protein was extracted from genetically modified rice Huahui No.1(HH1) and non-transgenic rice Minghui 63(MH63), the method of two-dimensional gel electrophoresis was applied to generate corresponding proteome two-dimensional polyacrylamide gel(2D-PAGE) electrophoresis spectrum; then, the mass spectrometry and bioinformatics analysis were conducted after the selection of protein spots with significant differences. Results: The comparing and matching of protein spots between transgenic Bt(cry1Ab/1Ac) rice and non-transgenic rice 2D-PAGE profiles identified 28 protein spots with significant differences. With non-transgenic rice as a reference, transgenic Bt rice held 18 relatively high and 10 relatively low expressions; mass spectrometry and bioinformatics retrieval were made on the different protein spots. It was found that the differentiated protein was mainly involved in energy metabolism, protein synthesis, redox stress response and other biological processes. Conclusion: Differences exist between transgenic Bt HH1 and its parental rice MH63 on the expression of proteome; however, there are neither anti-nutritional and allergenic protein, nor new or toxic proteins among these differentiated proteins.

Objective To observe the clinical efficacy of plasma exchange(PE),PE combined with plasma bilirubin absorp-tion(PE+PBA),and PE combined with double plasma molecule absorption system(PE+DPMAS),to investigate the best treat-ment options for the patients of hepatitis B-associated subacute severe.Methods Totally 140 patients who had hepatitis B-associat-ed were randomly divided into a PE group,a PE+PBA group,and a PE+DPMAS group.The dinical symptoms and blood rontine, electrolytc and the main biochemical indexes were recorded both before and after treatment and compared among the three groups. Results The total effective rate was higher in the PE +DPMAS group than in the PE group and PE+PBA group,which were 70.8%,60.9%,67.4% respectively,but there was no significant difference(P >0.05).compared with before treatment,serum total bilirubin (TBIL),alanine aminotransferase (ALT),aspartic acid amino shift enzyme (AST),valley aminoacyl transfer peptidase (GGT),alkaline phosphatase (ALP),globulin (GLB)and other biochemical indexes decreased significantly after treatment in 3 groups (P <0.001).PA was increased in the PE group and decreased in the PE+PBA and PE+DPMAS group after treatment,the differences were significant(P <0.05).After treatment,PT was shortened in the PE group,the differences were significant(P <0.05),but there were no significant difference between the PE+PBA and PE+DPMAS groups(P >0.05).Serum K+ and Cl- was obviously declined after treatment in the PE group,there was significant difference(P <0.001).Serum Na+ was obviously declined after treatment between the PE + PBA and PE + DPMAS groups (P < 0.001 ),but the difference was no significant in the PE groups.Serum Ca2+ was significantly decreased in the three groups of patients after treatment(P <0.001).WBC,Hb and PLT were significantly statistical difference after treatment(P <0.05).Conclusion The three groups also can improve liver function and the treatment rate for the patients of subacute hepatitis B-associated severe hepatitis.PE+PBA and PE+DPMAS groups can effective-ly reduce two thirds of the overall usage of the plasma.PE+DPMAS groups that the quantity of Cl- ,Ca2+ ,Hb decline much least in the three groups show larger value in the clinical application.

Objective To investigate the effect of bronchodilators on dyspnea and pulmonary function in patients with chronic obstruction pulmonary disease (COPD) at different degrees.Methods 50 patients with COPD from January 2014 to January 2015 in pneumology department of Tongchuan City People's Hospital were selected.According to the standard of Global initiative for chronic obstructive lung disease (GOLD), the patients were divided into mild degree of 14 cases, moderate degree of 18 cases and severe degree of 18 case.The changes of Borg score of dyspnea, forced expiratory volume in one second (FEV1), forced vital capacity (FVC), peak expiratory flow (PEF) and inspiratory capacity (IC) after received tiotropium bromide inhalation in each group.Results FEV1, FVC, PEF and IC values significant improved in mild, moderate and severe degree groups after received tiotropium bromide inhalation and the values of improvement rate changed significantly with degrees of disease ( P <0.05 ).The improvement rates of FEV1, FVC and IC were highest in patients at severe degree, improvement rate of PEF was highest in patients at mild degree (P<0.05).After received tiotropium bromide inhalation, the Borg score improved significantly compared with that of pre-treatment in mild, moderate and severe degree groups (P<0.05), the improvement rate of Borg score was highest in severe degree group(P<0.05).There were significantly positive correlations between Borg score and FEV1(r=0.372),FVC(r=0.296),PEF(r=0.284),IC(r=0.704)(all P<0.05).Conclusion Bronchodilator could significantly improve dyspnea and lung function in patients with COPD, and the improvement rate of FEV1, FVC and IC is highest in patients with COPD at server degree, PEF is highest at mild degree and Borg score is highest at server degree, which need the comprehensive analysis of each indicators for reversibility of airflow obstruction.

Objective To study the efficiency of the first time platelet transfusion in patients with blood diseases.Methods Investigate the effect of platelet transfusion in 87 patients with blood diseases.All the patients were transfused 10U platelet (platelet≥2.5×1011 ).Observe CCI after platelet transfusion and analyse the influence factors to the efficiency of the first time platelet transfusion such as the kind of diseases,splenomegaly,fever,age and sex.Results After platelet transfusion,66 patients (75.9 ％) were effective.The efficancy rates were 80.0 ％,78.1％,65.2 ％,82.3 ％ in AA,ITP,AL,MDS (x2=2.88,P＞0.05).In 31 patients with a fever and infaction the efficancy rate was 58.1％,but it was 85.7％ in 56 patients without a fever and infaction (x2=8.3308,P＜0.01).The efficancy rate in 59 patients with non-splenomegaly was 86.4 ％.It was higher than that in 28 patients with splenomegaly which was 53.6％(x2=11.2033,P＜0.01).The efficancy rate was 76.0％ in male patients and it was 75.7 ％ in female patients (x2=- 0.0012,P＞0.05).The efficancy rate was 74.5 ％ in young group (＜60 years old)and 77.8 ％ in old group (≥60 years old)(x2=0.1231,P＞0.05).Conclusion Fever and splenomegaly are the influence factors to the efficiency of the first time platelet transfusion.

Objective To investigate the differences of hepatic pathology between the chronic hepatitis B (CHB) with pulmonary tuberculosis patients and CHB patients.Methods Seventy-nine treatment-naive patients with CHB complicated with pulmonary tuberculosis (co-infection group) were collected from January 2009 to December 2014,and 79 CHB patients were selected randomly during the same period as CHB group.Hepatic tissue inflammation and fibrosis between the two groups were compared according to Ishak scoring system.Comparison between two groups were conducted by t test when the variance was equal and Mann-Whitney U test when the variance was unequal.Categorical data were compared by x2 test.Results A total of 59 (74.7％) patients in co-infection group had inflammation≥ G2,compared to 59.5％ in the CHB group.The difference between the two groups was statistically significant (x2=4.128,P=0.042).Forty-one (51.9％) patients in co-infection group had fibrosis≥S2,compared with 44.3％ in the CHB group.The difference was not statistically significant (x2 =0.913,P=0.339).Ishak scoring system showed that piecemeal necrosis,portal area inflammation score and totalscore in co-infection group were all significantly higher than those in CHB group (2.45± 1.19 vs 2.05± 1.28,2.70±1.22 vs 2.32±1.08,13.16±6.51 vs 11.22±5.72,respectively),with all the differences statistically significant (t=2.055,2.068 and 1.984,respectively;P=0.042,0.040 and 0.049,respectively).However,the confluent necrosis in co infection group was 2.60±1.91 compared to 2.13± 1.68 in CHB group (Z=1.137,P=0.257),focal (dot) soluble necrosis was 2.35± 1.06 versus 2.16± 0.86 (Z=-1.148,P=0.251),and fibrosis was 3.03±1.63 versus 2.45±1.53 (Z=I.541,P=0.125).Conclusion The liver damage in co-infection patients is more severe compared with CHB patients.