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 analyze electromyographic (EMG) activities of vastus medialis obliquus (VMO) and vastus lateralis (VL) in patients with patellofemoral pain syndrome (PFPS) before and after an exercise program.Methods 26 subjects with PFPS were randomly divided into the EMG biofeedback plus exercise group (group A) and exercise only group (group B) with 13 cases in each group. All patients in two groups were trained with family exercise program, but the patients of the group A used a EMG biofeedback while training. The relative activities of VMO and VL of all patients in two groups were assessed with the EMG apparatus for a continuous 6 hours period before and 8 weeks after training. At the same time the intensity of the knee pain was also assessed.Results There was no statistics difference in VMO/VL EMG ratio of the group B ( P>0.05), whereas the group A had significantly higher VMO/VL EMG ratio ( P<0.05).Conclusion The EMG biofeedback apparatus used in home exercise program of PFPS patients can improve the recruitment of VMO.

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.

Objective To investigate whether terminal QRS distortion on the electrocardiogram in acute inferior myocardial infarction could be as a standard for the infarct-related artery,through comparing to coronary angiography.Methods Fifty-seven patients with acute inferior myocardial infarction were enrolled,among which,the right coronary artery (RCA) occlusion (RCA occlusion group) was present in 29 cases,and left circumflex coronary artery (LCX) occlusion (LCX occlusion group) was in 28 cases.The changes of electrocardiogram was analyzed in 12 hours after the acute episode.Results The incidence of terminal QRS distortion in leads Ⅱ,Ⅲ,aVF in RCA occlusion group was 44.8％(13/29) and 39.3％(11/28)in LCX occlusion group,and there was no significant difference (P ＞ 0.05).The incidence of terminal QRS distortion in leads V4R-V5R in RCA occlusion group was 17.2％(5/29) and 7.1％(2/28) in LCX occlusion group,and there was no significant difference (P ＞ 0.05).The incidence of terminal QRS distortion in leads V7-V9 in RCA occlusion group was 6.9％(2/29),which was lower than that in LCX occlusion group[53.6％(15/28)],and there was significant difference (P ＜ 0.05).For identifying LCX as the infarct-related artery of acute inferior myocardial infarction,the sensitivity,specificity,positive and negative value in terminal QRS distortion in leads V7-V9 were 53.6％ (15/28),93.1％ (27/29),88.2％ (15/17),67.5％ (27/40).The area under curve of terminal QRS distortion in leads V7-V9 in identifying LCX as the infarct-related artery of acute inferior myocardial infarction was 0.733 (95％ CI 0.599-0.868).Conclusion Terminal QRS distortion in leads V7-V9 may be of diagnostic value in identifying the infarct-related artery in acute inferior myocardial infarction.

Recombinant PCR applies to fulfill gene recombination by PCR thermal reaction.Over the twenty years,it has branched into three characteristic strategies:splicing by overlapping extension(SOE),jumping polymerase chain reaction(JPCR)and DNA shuffling.Recently,the technique aimed with exploiting natural source of different allele genes is developing up on simplification of experimental procedure,on trap for mutation and variation,and on highthroughput screening with technology of surface display and fluorescent probe.The recombinant PCR is increasesing value in broad range from biological basic research to bioengineering study.

Objective To verify the validity and feasibility of national early warning score (NEWS) in evaluation of death risk in elderly patients with critical illness,in order to find out which scoring method is more suitable for elderly critical illness patients.Methods A prospective case-control study was conducted.The critical illness patients aged over 60 years old with the length of hospital stay over 24 hours,and admitted to Department of Emergency of Qingdao Municipal Hospital from January to December 2015 were enrolled.The clinical data including in emergency and the actual outcome of patients were collected,and the patients were divided into death group and survival group according to 30-day outcome.Patients in the two groups were assessed by using NEWS and risk classification according to the first results of vital signs monitoring.Multivariate logistic regression model was used to analyze the relationship between the NEWS classification and the risk of death in elderly critical ill patients.Results 1 950 emergency elderly patients with critical illness were enrolled,with 78 cases (4.0％) dead within 30 days and 1 872 survived (96.0％).Compared with the survival group,patients in death group were older (years:79.8 ± 10.8 vs.75.3 ± 8.9,t =4.335,P ＜0.001),and had higher acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score (22.9± 4.6 vs.18.2 ± 4.8,t =8.487,P ＜ 0.001),lower Glasgow coma scale (GCS) score (12.2 ± 4.5 vs.13.4 ± 5.2,t =-2.007,P =0.045),higher incidence of respiratory system diseases (29.5％ vs.17.9％,x 2 =12.742,P =0.013),higher NEWS score (11.2 ± 5.5 vs.3.9 ± 2.7,t =22.063,P ＜ 0.001),as well as higher proportion of patients with NEWS classification of high risk and very high risk (65.4％ vs.15.8％,x 2 =263.125,P ＜ 0.001).With the increase of NEWS risk classification,mortality rate was also increased,and the mortality rate in the patients with low,medium,high and very high risk were 0.81％ (9/1 108),3.63％ (18/496),5.83％ (13/223),30.89％ (38/123),respectively,with statistically significant difference (x 2 =179.741,P ＜ 0.001).It was showed by logistic regression analysis that the NEWS score of elderly patients with critical illness were positively correlated with 30-day death.The 30-day death risk of patients with middle risk,high risk and very high risk was 4.600,9.052 and 54.598 folds of the patients with low risk respectively.Conclusion NEWS score can be used to assess the risk of death in emergency elderly patients with critical illness.NEWS risk classification can quantify and classify the risk of death in the elderly patients with critical illness.

Adult ; Arthroplasty, Replacement, Hip ; Bone Cysts, Aneurysmal ; pathology ; Bone Neoplasms ; metabolism ; pathology ; surgery ; Chondroblastoma ; pathology ; Chondrosarcoma ; metabolism ; pathology ; surgery ; Diagnosis, Differential ; Female ; Femur Head ; metabolism ; pathology ; surgery ; Follow-Up Studies ; Humans ; Osteosarcoma ; pathology ; S100 Proteins ; metabolism

Objective To develop a PCR-ELISA assay for the rapid, specific and sensitive detec-tion of human seasonal influenza virus ( H1, H3 and B) by using molecular biological and immunological methods in combination.Methods The primers were designed according to the genes encoding the matrix protein ( M) , the H1 and H3 hemagglutinin ( HA) of influenza A virus and the nonstructural proteins ( B-NS) of influenza B virus and then were labeled with biotin.The PCR products were detected by ELISA by use of an internal catching probe labeled with DIG.Results The minimum copy numbers of genes encoding the M, H1, H3 and B-NS proteins detected by the established assay were 1.43?103 , 8.67?102 , 3.86?103 and 5.45?103 copies/μl, respectively, which indicated that the PCR-ELISA assay was about 10 times more sensitive than agarose gel electrophoresis in the detection of PCR products.No cross-reactions between the different subtypes of influenza virus or different species of virus were observed.Moreover, a total of 104 clin-ical specimens of influenza virus were examined by the PCR-ELISA assay, the results of which were consist-ent with those of the virus isolation method.Conclusion The newly developed PCR-ELISA assay was a highly sensitive and specific method for the rapid detection and subtyping of influenza virus, suggesting the possibility of using it in laboratory for the surveillance and detection of influenza virus.

0.05) for the index of renal function(Cr-s,UA,UREA).The patients treated by general low protein diet had worse nutrition state and worse compliance than those before treatment.Better nutrition state and better compliance were found in personal diet group.Conclusion: The personal diet model should be used to the patients basing on the different conditions.