OBJECTIVE To test and analyze the new drug-resistant characteristics of Acinetobacter baumannii.METHODS The bacteria identification was determined by the routine method.Antimicrobial susceptibility was detected by K-B test.RESULTS In 95 A.baumannii strains,in addition to imipenem,the drug-resistant incidence was above 49%.There were two A.baumannii strains resistant to imipenem,and were seen panresistant strains The new characteristics of drug-resistance were found.CONCLUSIONS A new drug-resistant mode about A.baumannii to amikacin is found.The high drug-resistant incidence of A.baumannii becomes a very important problem.

OBJECTIVE To investigate the ?-lactamases gene of multi-drug resistant Acinetobactor baumannii(MDR-ABA).METHODS The blaTEM,blaSHV,blaPER,blaGES,blaIMP,blaVIM,blaSIM,blaOXA-23,blaADC and blaDHA genes of 20 MDR-ABA strains were detected by PCR.RESULTS Among 20 MDR-ABA strains,18 strains were with positive blaADC,11 strains were with positive blaTEM;the others were negative.Totally 19 strains were with genes correlated to ?-lactam antibiotics.The results indicated that the blaADC DNA sequence was a new subtype type compared with the blaADC sequence which had registered on America GenBank.CONCLUSIONS blaADC Gene and blaTEM gene have spread in the MDR-ABA group and a new blaADC subtype has been found.

OBJECTIVE To investigae the gene resistant to quaternary ammonium compounds of multiple drug resistant Acinetobacter baumannii(MDR-ABA).METHODS The quaternary ammonium compounds qacE?1 gene in 20 MDR-ABA strains were detected by PCR.RESULTS The 20 MDR-ABA strains showed multiple resistance,its sensitivity to imipenm was 65% only.Among twenty strains of MDR-ABA qacE?1 gene were all positive.CONCLUSIONS The results indicate that qacE?1 gene were all carred class 1 integron.The chlorhexidine usage in prevnting hospital infection after surgery should be reevaluated.

Objective: Separation and purification of a new curcuminoid from the rhizome of Curcuma longa by guided separation method. Methods: The chemical constituent was separated and purified through various kinds of chromatographic methods, including MCI-Gel, ODS-C18 reverse phase column, and RP-HPLC. The structure was elucidated by physicochemical properties and spectral data. Results: A new curcuminoid, 3,4'''-epoxy-5'''-C-(1α,2β,3β-bisabola-4,10-diene-9-one)-(2→5''')-curcumin (1), was isolated from the low polar fraction of methanol extracts from the rhizome of C. longa, named as curcuterpene G. This compound exhibited the inhibitory effect to HepG2, A549, and CT-26 tumor cells with the IC50 values of 4.82, 8.81, and 5.40 μmol/L, respectively. Conclusion: A new curcuminoid is isolated from the rhizome of C. longa by guided discovery method, and it exhibits notable cytotoxic activities.

Objective To investigate the pathogen of 21 infective endocarditis (IE) cases treated with operation in Shanghai Children's Medical Center from 2007 to 2010.Methods Blood culture,vegetation culture and vegetation PCR assay(target gene to the conserved region V3 in 16SrRNA gene) were detected in 21 IE patients; multiplex PCR amplification of staphylococci for methicillin-resistant staphylococcus was performed.Results Of 21 IE cases,20 cases were detected positive by vegetation PCR with the detection rate of 95.2％,12 IE cases were detected positive by blood culture with the detection rate of 57.1％,2 IE cases were detected positive by vegetation culture with the detection rate of 9.5％.The difference of the positive rates of the three methods was statistically significant (P ＜ 0.0001).The vegetation PCR of one case was actinobacillus actinomycetemcomitans,while the blood culture was haemolysis pasteurell which was inconsistent with the vegetation PCR result.Howerver,the PCR result of colony obtained by blood culture was consistent with vegetation PCR that was confirmed as actinobacillus actinomycetemcomitans.The endocardium PCR results of 11 IE cases were consistent with the results of blood culture.MecA gene was detected by multiplex PCR,which could identify methicillin-resistant staphylococcus quickly,sensitively and accurately and could also effectively identify methicillin resistant staphylococcus aureus,when coupled with femA gene detection,thus glycopeptides antibiotic could be prescribed promptly.All the 21 patients recovered and discharged without infection recurrence in the follow-up.Conclusion Universal primer V3 coupled with multiplex PCR can improve vegetation pathogen detection rate of IE patients and is minimally influenced by antibiotic therapy.Multiplex PCR can be applied for etiological diagnosis of IE patients with indication of surgery and negative blood culture or difficult diagnosis,contributing to post-surgery antibiotics selection and improvement of recovery rate of IE patients.

Objective To compare the early analgesic effects of continuous femoral nerve block analgesia (CFNB) and patient controlled intravenous analgesia (PCIA) and their effects on functional recovery after total knee arthroplasty.Methods Retrospective analysis was conducted on 60 ASA Ⅰ and ASA Ⅱ patients with unilateral total knee arthroplasty in our hospital from January 2014 to January 2015.The patients were divided into two groups,CFBN group (treatment group) and PCIA group (control group),with 30 patients in each group.VAS scores of postoperative ipsilateral knee resting and movement pain,range of postoperative knee joint motion (ROM),muscle strength of femoral quadriceps,incidence rates of adverse reaction within 7 days after operation,HSS score 3 months before and after the operation,and discharge time were observed.Results Postoperative VIS score in CFNB group was lower than that in PCIA group.ROM and muscle strength of femoral quadriceps in CFBN group were better than those in PCIA group on day 1,2,3,5,and 7 after the operation.Postoperative adverse reaction rate within 7 days in PCIA group was significantly higher than that in CFNB group.HSS score three months after the operation in CFNB group was higher than that in PCIA group.Discharge time of CFNB group was significantly earlier than that of PCIA group (P＜0.05).Conclusion Compared with PCIA analgesia,CFNB analgesia shows better analgesic effect.It can alleviate early knee joint pain after TKA,increase joint motion,significantly shorten the hospitalization time,promote joint exercises which are effective in functional rehabilitation,and decrease the incidence of adverse reactions like nausea and vomiting.

Objective To observe the effect of patient-controlled intravenous analgesia (PCIA)with dezocine combined with sufentanil on inflammatory response and pain after laparoscopic hepatectomy for hepatocellular carcinoma.Methods Sixty patients (43 males,17 females,aged 18-60 years,ASA grade Ⅰ or Ⅱ) scheduled for laparoscopic hepatectomy for hepatocellular carcinoma were divided into sufentanil group (group S) and dezocine+sufentanil group (group DS) according to the random number table,n=30 each.Patients in group S were given 100 ml normal saline containing sufentanil 2.0 μg/kg and tropisetron 5 mg.Patients in group DS were given 100 ml normal saline containing sufentanil 2.0 μg/kg,dezocine 0.5 mg/kg and tropisetron 5 mg.VAS scores and numeric sedation scale (NSS) scores were recorded at 4,24,48 h after operation and patients' satisfaction scores were recorded at 48 h after operation.The levels of serum tumor necrosis factor-α (TNF-α),interleukin-2 (IL-2),interleukin-6 (IL-6) in blood samples harvested before induction of anesthesia and 0,4,24 and 48 h after operation were measured by ELISA.The times of efficient injection and incidence of adverse effect within 48 h after operation were recored.Results Compared with group S,the VAS scores in group DS were decreased significantly while the satisfaction of patients to analgesia were increased significantly at 4,24,48 h after operation (P<0.05).There were no obvious differences in NSS scores between two groups.Compared with before induction of anesthesia,the concentrations of TNF-α and IL-6 were increased significantly while the concentrations of IL-2 was decreased significantly in both groups at 4,24,48 h after operation (P<0.05).Compared with group S,the concentrations of TNF-α and IL-6 were decreased significantly while the concentrations of IL-2 was increased significantly in group DS at 24,48 h after operation (P<0.05).The times of efficient injection in group DS were less than that in group S significantly within 48 h after operation [(2.0±0.7) times vs.(7.2±1.3) times] (P<0.05).There were no obvious differences in adverse effects between two groups.Conclusion PCIA with dezocine 0.5 mg/kg combined with sufentanil 2.0 μg/kg can alleviate the inflammatory response to some extent in patients after laparoscopic hepatectomy for hepatocellular carcinoma,and it can offer a safe and effective analgesic effect.

Objective To construct staphylococcal enterotoxin D (SED) mutants expressed in Escherichia coli ( E. coli ). Methods The expected mutants were introduced into the SED DNA by megaprimer PCR method. The PCR products ligated to plasmid pTrcHis B were transformed into E. coli DH5? for IPTG induced expression. The target protein was purified by Ni NTA metal affinity chromatography and analyzed by SDS PAGE and immunoblotting. Results The sequencing results showed that mutant nucleic acids were successfully introduced at the expected sites of SED gene. SDS PAGE and immunoblotting confirmed that the proteins of SED mutants were obtained by Ni NTA metal affinity chromatography. The mutants were named as SEDN23A, SEDN23A/H26R, SEDF45A, SEDL59A, SEDN61A, SEDI92A, and SEDF203A, respectively. Conclusion Several SED mutants are successfully constructed, which lays a foundation for subsequent studies of immune recognition of SED.

Objective To evaluate the efficacy of high frequency two-lung ventilation (TLV) with low tidal volume assisted by CO2 pneumothorax for airway management in patients undergoing thoracoscopic radical resection of esophagus cancer.Methods Thirty patients of both sexes,aged 48-64 yr,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective thoracoscopic radical resection of esophagus cancer,were divided into 2 groups (n =15 each) using a random number table:onelung ventilation group (group O) and TLV group (group T).A left-sided double-lumen tube was inserted orally in group O,and a single-lumen tube was placed orally in group T.During thoracoscopic surgery,the left lung was ventilated,with tidal volume 8 ml/kg and respiratory rate 14 breaths/min in group O.In group T,artificial pneumothorax was induced by continuous CO2 insufflation with CO2 pressure at 10 mmHg,and bilateral lungs were ventilated,with tidal volume 5 ml/kg and respiratory rate 20 breaths/min.Mean arterial pressure and heart rate were recorded before induction of anesthesia,immediately after intubation (T1),at 10 min after intubation (T2),at 30 min after the start of thoracoscopic surgery (T3),immediately after the end of thoracoscopic surgery (T4) and at 30 min of TLV (T5).Arterial blood samples were collected for blood gas analysis at T2,T3,T4 and T5.The exposure of the surgical field and the number of lymph node dissection in the left recurrent laryngeal nerve chain were recorded during surgery.The emergence time,extubation time and time for recovery of consciousness were recorded.Results Arterial oxygen partial pressure was significantly lower at T3,4 than at T2 in the two groups,and arterial carbon dioxide partial pressure was significantly higher,and the pH value was lower at T3,4 than at T2 in group T (P＜0.05).Compared with group O,arterial carbon dioxide partial pressure was significantly increased,the pH value was decreased,and the number of lymph node dissection in the left recurrent laryngeal nerve chain was increased at T3,4 in group T (P＜0.05).There were no significant differences between the two groups in the good exposure of the surgical field,emergence time,extubation time and time for recovery of consciousness (P＞0.05).Conclusion High frequency TLV with low tidal volume when assisted by CO2 pneumothorax can serve as a feasible mode for airway management in patients undergoing thoracoscopic radical resection of esophagus cancer.

A simple,rapid and sensitive liquid chromatography-mass spectrometry（LC-MS）method was developed for the determination of salidroside in rat plasma and study of its pharmacokinetics after oral administration of suspension of Erzhi Wan and Fructus Ligustri lucidi into Wistar rats.Plasma sample of 200 μL was extracted with acetic ether-isopropanol（2∶1）and the extraction was performed on a Kromasil C18 column（150 mm×4.6 mm,5 μm）with the mobile phase of methanol-water（41∶59,v/v）within a run time of 6.0 min.The analyte was monitored with positive electrospray ionization（ESI）by selected ion monitoring（SIM）mode.The target ions were m/z 323.05 for salidroside and m/z 411.05 for internal standard（IS）geniposide.A good linear relationship was obtained over the range of 5.0-500.0 ng/mL and the lower limit of quantification was 5.0 ng/mL.The validated method was successfully applied to the pharmacokinetic study of salidroside in rat plasma after oral administration of suspension of Erzhi Wan and Fructus Ligustri lucidi.