Chronic rhinosinusitis(CRS) is a common infectious disease and a subpopulation of patients fail to respond to either medical or surgical intervention.Bacterial biofilms(BBF) are 3-dimensional aggregates of bacteria, which have special properties due to their group structure,including increased resistance to antibiotics in some forms.Evidence suggests that BBF may play an important role in CRS.The goal of this article is to provide an overview of BBF with the special focus on CRS.A further understanding of the role of BBF may lead to the development of more appropriate therapies for CRS.

The nasal route is one of the most permeable and highly vascularized site for ensuring rapid drug absorption and onset of therapeutic action. It has been potentially explored as an alternative route for delivery of drugs with poor bioavailability and for the biosensitive and high molecular weight compounds such as proteins, peptides, steroids, vaccines,etc. In this review nasal drug delivery approach and its limitations, some factors influencing drug absorption,mucoadhesion, and the safety of nasal mucoadhesive drug delivery systems as well were discussed.

OBJECTIVE To study penicillin resistance in Staphylococcus aureus and the activity of ?-lactamase.METHODS The strains of S.aureus both sensitive and resistant to penicillin were inoculated into the media with penicillin and then incubated in 37 ℃.The number of the bacteria and the activities of ?-lactamase,were determined respectively at varying times.RESULTS In the media with 64 ?g/ml penicillin,the number of the sensitive strain decreased gradually in 24 h of culturing.The number of the resistant strains decreased at first 6 h and then the number increased in subsequent 24 h.The activity of penicillin did not be changed in the media with the sensitive strain.The activitiy of penicillin was decreased obviously with the resistant stains.In the media without penicillin,the ?-lactamase activities of the resistant stains were stable until 24 h of culturing,while the ?-lactamase activities were increased gradually in the media with penicillin.CONCLUSIONS The growth of early stage of S.aureus can be inhibited obviously by penicillin.?-Lactamase would be induced largely in resistant S.aureus.

Objective To discuss the protective effect of intra-aortic balloon pump(IABP) on renal function in patients with chronic renal insufficiency undergoing cardiac operations.Methods From May 2010 to May 2012,17 patients with moderate renal insufficiency who underwent cardiac surgery using cardiac pulmonary bypass(CPB) were randomized to divide into IABP group and control group.IABP was inserted before the cardiac operation,the support was maintained perioperatively in IABP group.In control group the IABP was never used during the operation.The clinical parameters related to renal function including the output of urine,the serum creatinine levels were documented perioperatively.Results The serum creatinine levels were increased obviously post-operation in both groups.But the degree of increase was significantly smaller in IABP group.Conclusion To patients with moderate renal insufficiency undergoing CPB cardiac operations,perioperative application of IABP is beneficial to protect renal function and may help to improve the outcome.

Right ventricular failure(RVF)is a severe clinical syndrome that affects human health seriously.The establishment and application of experimental animal models are critical to research the pathogenesis, pathophysiology, prevention and treatment of RVF.Recently, numerous researchers have studied the modeling methods and testing indexes of RVF of animal models, which has improved the success rate and quality of the models.However, even if so many models, there is still no widely accepted experimental animal model of RVF because of the different and complex modeling methods, material selection and experimental conditions.This article reviews the methods and mechanism of multiple experimental animal models of RVF and compares them, so as to provide reference for choosing and applying experimental animal models of RVF in the study.

Objective To understand the status of intensive care unit-acquired lower respiratory tract infection (ICU-LRTI),and the distribution characteristics of pathogens,so as to provide the basis for taking preventive and control meas-ures,and scientific diagnosis and treatment for patients.Methods Targeted monitoring data on healthcare-associated infec-tion (HAI)in ICUs of 32 hospitals in a province in 2013 were investigated retrospectively.Results The incidence of ICU-LRTI was 5.79%,ventilator usage rate was 31.25%,incidence of ventilator-associated pneumonia(VAP)was 26.93‰;There was no linear correlation between ventilator usage rate and incidence of VAP(r=0.160,P=0.380).A total of 1 593 pathogens causing LRTI were detected,the major were gram-negative bacteria (75.77 %,n=1 207),followed by gram-positive bacteria(18.21%,n=290),fungi(5.90%,n=94),Mycoplasma pneumonia and other pathogens(0.12 %,n= 1 for each).The top five detected pathogens causing LRTI were Acinetobacter baumannii ,Pseudomonas aeruginosa ,Staph-ylococcus aureus ,Klebsiella pneumoniae and Escherichia coli ,accounting for 25.49%,15.26%,14.63%,13.37% and 5.09% respectively.Conclusion Targeted monitoring on ICU is helpful for realizing healthcare-associated LRTI, each hospital should conduct targeted monitor to find out the causes of HAI,as well as improve the awareness of VAP among ICU health care workers.

Objective To explore a clear picture of the health human resources allocation in tertiary general hospitals in Beijing ,and propose strategies to optimize the configuration of human resources at the same level hospitals ,so as to improve the medical service quality for society. Methods Basic operational data and human resources configuration of 16 tertiary general hospitals with more than 800 beds in Beijing were col?lected by using clustering sampling and literature review ,and then a descriptive analysis of the human resource configuration data at the same level hospitals was carried out by SPSS18.0 and Excel2010. Results The number of patients increased year by year,but the average days of hospitaliza?tion showed a downward trends during 2009?2011. According to the previous way of beds to determine personnel ,there was significantly different from the actual situation. A significant quantitative correlation was foung between the physicians and the nurses,pharmacists,medical laboratory technician,and the ratio between physicians and these staffs is stable. Conclusion With the development of hospital service and increase of health human resources,health manpower ratio has changed significantly in tertiary general hospitals. A stable proportion of physicians can be used as the reference standard for hospital human resources configuration at the same level hospitals.

Objectives:To explore the pathogenesis of nasal polyposis by examining the expression of transforming growth factor beta (TGF-β) in human inflammatory nasal polyps. 　Methods: Twenty five polyposis patients were selected, tissue TGF-β1～3 from nasal polyps and inferior turbinate mucosa were determined with immunohistochemistry APAAP method .The inferior turbinate mucosa from eight healthy volunteers were selected as control. Six polyp tissues were estimated with western-blot analyses to compare the characteristics of TGF-beta isoforms expression. 　Results: ①The expression of TGF-β1～3 in nasal polyps was significantly higher than that in nasal mucosa, it was undetectable in nasal mucosa from healthy volunteers;②TGF-β1 was the main isoform detected in nasal polyps. 　Conclusions: TGF-β, especially TGF-β1 is strongly expressed in inflammatory nasal polyps and its mucosa. TGF-β could induce modification of epithelium and connective tissue and therefore be involved in the pathogenesis of nasal polyposis.

Objective: To study the preparation and releasing properties of total salvanolic acid. Methods: The tablets were prepared using HPMC, MCC, CETOS, and CMS-Na as excipients. Results: The releasing rate of the tablets was conformed to zero kinetics. Conclusion: The study was found to be effective in the process of total salvanolic acid gastric residential tablets.

Objective To evaluate the diagnostic accuracy of Streptocuccus pneumoniae urinary antigen test (SpUAT) in patients with community acquired Streptocuccus pneumoniae pneumoniae (SPP). Methods The clinical studies relating SpUAT diagnostic accuracy for community acquired Streptocuccus pneumoniae infection were searched via computer and manual screening of Chinese databases including China National Knowledge Internet (CNKI), China Biology Medicine disc, China Technical Journal Full-text Database, and Wanfang Database as well as English databases such as PubMed, EBSCO, Elsevier Science, Ovid Technologies, and Springer. Data were extracted according to appropriate inclusion and exclusion criteria and analyzed with Meta-disc 1.4 and Stata 12.0 software. Pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio as well as diagnostic odds ratio (DOR) were calculated, and summary receiver operating characteristic curve (SROC) was plotted and area under SROC (AUC) was calculated to analyze the diagnostic accuracy of SpUAT for adult community acquired SPP. Results A total of 15 studies enrolling 6 866 patients were included, all of which with a quality assessment of diagnostic accuracy studies (QUADAS) score not lower than 10, indicating a high study quality. Random effect model was applied owing to non-threshold effect associated heterogeneity. It was shown by Meta analysis that compared with routine pathogen diagnosis (hemoculture, sputum smears, sputum culture and trachea and bronchus attractive culture), the pooled sensitivity, pooled specificity, pooled positive likelihood ratio, and pooled negative likelihood ratio was 73% [95% confidence interval (95%CI) = 71%-76%,] 91% (95%CI = 90%-92%), 6.97 (95%CI = 4.13-11.77), and 0.30 (95%CI = 0.26-0.34), respectively, pooled DOR was 24.34 (95%CI = 13.14-45.11), and AUC of SROC was 0.8051±0.0362. It was indicated by heterogeneity test that experiment design (prospective or retrospective), sample sizes (lower than 200 or higher than or equal to 200), reference test (fewer than 3 or more than or equal to 3 test methods), or literature language (Hispanic or non-Hispanic) had no effect on study heterogeneity, indicating certain other unknown factors may be involved. Funnel plot suggested that 15 involved studies uniformly distributed along the two sides of regression line, indicating no publication bias. Conclusions The use of SpUAT for the diagnosis of adult community acquired SPP has a moderate sensitivity and high specificity. Although the overall accuracy of SpUAT diagnosis is relatively high, there is significant heterogeneity among the studies, so more high-quality studies are needed.