Objective To investigate pathogens distribution and their drug resistance of hospital acquired pneumonia (HAP) in local elderly paraplegic patients,and to help to gain experience in early using antibiotics.Methods One hundred and thirty six elderly patients diagnosed as HAP from January 2007 to December 2010 in our hospital were selected.Pathogens distribution and their drug resistance were detected.Results One hundred and fifty two pathogens are isolated from the 136 patients,and most of them are gram negative bacteria which accounts for 70.4％.The first three pathogens are Klebsiella pneumonia(24.3％),Escherichia coli (20.4％) and Pseudomonas Aeruginosa (18.4％).Gram-positive cocci accounts for 25.0％ in total pathogens,among them,staphylococcus aureus and streptococcus pneumoniae account for the most,and the number of Fungi is the fewest.Drug resistance rate of gram-negative bacteria is higher than that of Gram-positive bacteria.Gram-negative bacteria has higher resistance to ampicillin,cefoperazone,ciprofloxacin,levofloxacin and eotrimoxazole.Gram-positive bacteria has higher resistance to penicillin,cefazolin and gentamicin.Conclusion To elderly paraplegic HAP patients,the main pathogenic flora is gram-negative bacterium which shows multiple resistances.Being familiar with the features of pathogens and their drug resistance will provide better guidance on early treatment and improve prognosis of elderly paraplegic HAP patients.

Objective To investigate the protective effects of prescription for nourishing liver- kidney (PNLK) on PC12 cell injyred by 1- methyl- 4- phenylpyridinium (MPP+ ).Methods The rabbit serum contained PNLK was preparing by the method of sero- pharmacology.PC12 cell was cloned from pheochromocytoma of adrenal medulla and the MPP+ injured models were induced by nerve growth factor.The effect of serum containing PNLK on PC12 cell from MPP+ injured models was assayed by morphological, MTT staining and LDH measurement.Results The equivalent dosage of the serum of PNLK possessed obvious protective effects on PC12 cell,increased the number of survival cells and relieved the injury significantly.Conclusion Serum of PNLK can counteract the injuryof PC12 cell induced by MPP+ and has protective effect on PC12 cell in vitro.

Objective: Based on optimized method of DNA ligase chain reaction in medium/low throughput genotyping, we assessed the relationship between NOD-like receptor genes NOD1, NOD2 and coronary artery disease (CAD) occurrence. Methods: A multiplex PCR was conducted to enrich DNA template; probe design, annealing temperature, time and number of circulation of PCR were opfimizecl for allele specific ligation; allele specific products were identified by fluorescence PCR and capillary electrophoresis; the accuracy was verified by Sanger sequencing. Single nucleotide polymorphisms (SNPs) on NOD1 gene and NOD2 gene were examined in 1555 CAD patients and 1887 control subjects; the relationship between SNPs and CAD occurrence was studied. Results: Based on optimized PCR condition and allele specific probe design, 30 allele loci genotyping can be genotyped by 10ng DNA template at one time. Association study presented that rs751271 and rs1861759 on NOD2 gene were related to non-hypertensive CAD, allP<0.05; with Bonferroni correction, such correlation was still significant, allP<0.05. Conclusion: We optimized DNA ligase chain reaction and established a novel high accuracy, low cost method for the demand of medium/low throughput genotyping in clinical molecular diagnosis. With this method, we identified that rs1861759 and rs751271 on NOD2 gene were associated with non-hypertensive CAD.

Objective To study the uptake property of punicalagin in Caco-2 cells.Methods Caco-2 cell monolayer model was used to research the effects of punicalagin on cell uptake in different times, concentrations, pH values, temperatures and P-gp inhibitors. HPLC was used to determine the content of punicalagin in cells.Results The linearity of punicalagin concentration curve was found in the range of 0.024 8-0.992μg (r=0.997 9). Uptake determination of punicalagin in Caco-2 cells absorbed a certain amount of time, concentration and pH dependence and P-gp inhibitors could significantly increase the punicalagin uptake.Conclusion This method is simple and sensitive to determine the punicalagin concentration in Caco-2 cells, which is mainly passively transported. P-gp is involved in punicalagin transport process.

0.05). The difference of CT values among the regions of middle portion had statistical significance(F=4.539,P

Objective To study the main influence factors of nosocomial infection(NI) and establish a model to predict and forecast the risk of NI on patients in hospitals. Methods Clinical data of 27352 inpatients extracted from hospital information system were sorted out and coded, and a logistic regression model about the probability of NI was established. The risk of NI was divided into four scales. Results With multiple factor analysis,16 risk factors of NI were identified, which were age, high body temperature, numbers of diagnosis, days of staying in hospital and seriousness, numbers of routine test for urine, times of blood transfusion, use or without use of antibiotic and radiotherapy, turning over the bodies or not, relationships between infection and interventional operations, with or without diabetes, categories of diseases based on ICD-9, numbers of interventional operations, type of anesthesia and department of admission. If NI was judged when predicted probability(Pr)of logistic regression model exceeded 0 35, the specificity and false diagnostic rate of diagnostic test were 0 995 and 0 005 respectively, and the area under ROC curve was 0 986. According to decision tree method, the risk of NI was classified into four degrees: low (Pr

Objective To study the clinical significance of liver failure staging and MELD in predicting the short term prognosis of HBV-acute-on-chronic liver failure (HBV-ACLF).Methods One hundred and ten HBV-ACLF patients admitted to our hospital from July 2013 to July 2015 were included into this study.They were divided into early stage group (n=18),middle stage group (n=48) and end stage group (n=44),the fatality rate in each group was evaluated.According to the MELD score at baseline,they were divided into four groups,MELD＜20 (n =24),20≤ MELD＜30 (n=54),30≤MELD＜40(n =28),40≤MELD (n =4).The fatality rate in each group was evaluated.In the middle stage group,they were be divided into two groups,/△MELD＜0 and △MELD＞0(△MELD=MELD1w-MELDbaseline).The fatality rate in each group was evaluated.Results The fatality rate of the 3 groups(Early,Middle and End stage group) at 3th month was 0,50％,95 ％ respectively(P＜ 0.05).The fatality rate of the 4 groups (MELD＜20,20≤MELD＜30,30≤MELD＜40,40≤MELD)was 31.58％,66.67％,85.71％ and 100％ respectively (P＜ 0.05).In the middle stage group,the fatality rate of the two groups was (△MELD＜0 and △MELD＞ 0)41.18％ and 85.71％ (P=0.001).Conclusion It can be shown that the survival probability of early stage group was high,the probability of death in end stage group and middle stage group with△MELD＞0 was high.

Objective To analyze factors affecting quality of life (QOL)in patients with chronic hepatitis B (CHB),and provide reference for improving QOL of patients. Methods The MOS 36-item short form health sur-vey (SF-36)was adopted to survey QOL of patients with CHB,Morisky medication adherence scale was used to measure patients'adherence to medication,factors affecting QOL of patients with CHB were analyzed. Results Of 357 CHB patients,271(75.91% )were married,107(29.97% )received college or above education,163(45.66% ) patients'average household monthly income were ￥ 2000-￥ 5000,138(38.66% )patients'family members were also with CHB,198 (55.46% )patients smoked,150 (42.02% )drank. The average score of CHB patients' adherence to medication was (2.15±1.29). Factors affecting QOL in patients with CHB were age,education level, duration of disease,whether or not hospitalized,whether or not drink,as well as adherence to medication. Age, drink,and duration of hepatitis B,and previous hospitalization were negative factors affecting QOL in patients with CHB,education level and adherence to medication were positive factors affecting QOL in patients with CHB. Conclusion Strengthening CHB patients'understanding on disease and improving their medication adherence can help them to improve QOL.

Objective To investigate the distribution and drug resistance of pathogens isolated from blood culture samples from January 2012 to October 2013 to provide the basis for clinical lection of antibacterial drugs.Methods The blood samples were col-lected from the patients with suspected blood infection and cultured by the BD BACTEC 9120 automatic blood culture instrument. The samples with positive results were performed the bacterial identification and the drug sensitivity test by using the VITEK-2 COMPACT automatic bacterial identification instrument.Results A total of 969 strains of pathogens were isolated from blood cul-ture samples,including 540 strains(55.7%)of Gram-positive bacteria,413 strains(42.6%)of Gram-negative bacteria and 16 strains (1.7%)of fungi.The top 3 isolated pathogenic bacteria were Staphylococcus epidermidis,Escherichia coli and Staphylococcus au-reus.Staphylococcus epidermidis and Staphylococcus aureus were highly resistant to penicillin,sensitive to vancomycin and linezol-id;Escherichia coli and Klebsiella pneumoniae were highly sensitive to imipenem and Piperacillin/tazobactam.Conclusion It is nec-essary to understand the blood culture results timely so as to provide the basis for clinical antibacterial therapy and the improvement of the cure rate.

Objective　To investigate the protective effects of alcoholic extracts of Ganoderma lucidum (GL) and its combination with Rad ix Salviae Miltiorrhizae (RSM), Radix Bupleuri (RB), and Fructus Schisandrae Chi nensis (FSC) respectively on experimental hepatic injuries. Methods　Hepatic injury models were established with the injections of carbon tetrac hloride (CCl4) or D-galactosamine(D-GlaN) into mouse, and then the therapeut ic agents at same dose were given respectively. The activity of cholinesterase(C hE) and alaline aminotransferase(ALT) in the serum and hepatic homogenate, the c ontents of malonyl dialdehyde (MDA), alkaline phosphatase (ALP) and reduced glut athione (GSH) in hepatic homogenate from all mouse were determined. The morpholo gic changes of the livers were also observed with VG staining. Results 　In CCl4 treated mice, serum ALT activity was increased markedly wh ile ChE acti vity decreased significantly. GL and GL+RB, GL +FSC could relieve these changes ; GL combined with all other agents could inhibit the GSH accumulation, but only GL+FSC had a suppressive effect on MDA increase and made it return to normal. For D-GlaN treated mice, all agent groups had little effect on the activity of ChE; Only GL dramatically reduced the increased activity of ALT; GL +RSM could e liminate the GSH, but not significant; GL and all GL combinations could decrease the increased MDA (P<0.01). Pathological observation showed that hepatocyte damage in GL group and GL+FSC group incline d to recover. Conclusion　The results indicate that Ganoderma lucidum is an effective agent against hepatic injuries, especially combined wi th F ructus Schisandrae Chinensis, which may be associated with its anti-hepatocyte oxidation.