Staphylococcus aureus continues to be a major pathogen in both community and healthcare associated infections.The pathogenicity of staphylococcus aureus is a complex process involving a variety of extracellular and cell wall components that are coordinately expressed during different stages of infection.Accessory gene regulator (agr)-mediated quorum sensing plays a major role in staphylococcal pathogenesis.However,agr dysfunction strains exist extensively in staphylococcus aureus clinical isolates.This review will mainly focus on the influence of agr dysfunction on staphylococcus aureus biofilm formation,clinical course and outcome of infectious diseases,and antibiotic resistance.

Sepsis is a complex systemic inflammatory response syndrome caused by infection.Sepsis can deteriorate to severe sepsis,septic shock,and multiple organ dysfunction syndrome.Due to the use of antimicrobial agents,fluid resuscitation and the developments of all kinds of support life,the treatment of sepsis has greatly improved over the past years.However,the mortality rates of sepsis still remain high.Rapid,accurate and early diagnosis of sepsis is a key factor to lower the high mortality rate of sepsis.Recently,it has been found that some biomarkers are closely associated with early diagnosis of sepsis and are helpful for the treatment.These biomarkers for early diagnosis include presepsin(sCD14-subtype),neutrophil CD64,soluble triggering receptor expressed on myeloid cells-1 (sTREM-1),soluble CD163,microRNAs,copeptin,and so on.Examining these biomarkers alone or in combination will bring new opportunities for the early diagnosis of sepsis,and hopefully provide new ideas for the treatment of sepsis.This article reviews the progress on the current emerging biomarkers for early diagnosis of sepsis.

Diabetes-related macular exudation is a common fundus change associated with diabetes mellitus,charactered by hard exudates of macular area.It is one of main causes of lowing vision in diabetic patients.The incidence of diabetes-related macular exudation is increasing recent years,and therefore the diabetic maculopathy is also a matter of urgent concern.Domestic and international studies suggested that many systemic factors,such as blood glucose level,blood pressure,hypertension,higher blood lipid,inflammatory factors and genetic predisposition,exert impacts in the pathogenesis and development of diabetic retinopathy.However,whether the hard exudates of macular area also is associated with systemic factors mentioned above is unclear up to now.Since the hard exudates of diabetic maculopathy may leads to permanent loss of visual function,it is very important for us to find the effective prevent and managing approaches.This paper aimed to review the progress in this field and summarize the relevant risk factors that must be strictly controlled.

Mammalian target of rapamycin(mTOR) inhibitors have the anti-tumor ettect,which have been known early.The traditional mTOR inhibitors include rapamycin and its derivatives,which have been applied in clinical use early.Nowadays,some new small molecule inhibitors such as the PI3K/mTOR duel inhibitor,Torinl,one after another are found to play a unique role in the tumor therapy.

Acute leukemia (AL) is a malignant disease of clonal hematopoietic stem cell abnormalities.Chemotherapy is the main method for the treatment of AL,but the chemotherapy drug resistance has become a major obstacle to successful treatment.There is often a series of drug cooccurrence of drug resistance,and that is multidrug resistance.

Objectives To provide outline for the Research & Development department of hospitals making research strategy by analyzing the quantity of publications and their cited status for the top 20 hospitals in SCI and MEDLINE, and the top 100 hospitals in domestic publications in 2008. Methods The number of publications and their cited times for the first 20 hospitals in SCI and MEDLINE, and the top 100hospitals in domestic publications in 2008 were analyzed with bibliometric analysis. Results Compared with 2007, the increased number and ratio of publications in SCI and MEDLINE for the top 20 hospitals were 1050, 51.19% and 658, 15.04%, respectively; for top 100 hospitals, the average decreased number of domestic publications was 2.08, and the number of cited publications was increased 202.52 and the increased ratio was 13.51%. Conclusions The SCI publications from top 20 hospitals increase sharply, the increase of the MEDLINE articles from the top 20 hospitals is slowly. The negative growth is showed in the number of domestic articles for the top 100 hospitals. In addition, the increase of cited articles is slowly and disproportion.

Objective Investigation of satisfaction of clinical nurses and analysis of the influence factors.Methods The ERG theory of Clayton Alderfer is used as the framework to design the questionnaires,for questionnaire investigation of 249 nurses in the hospital in a stratified sampling,Results The score of general satisfaction of nurses for their work is 3.40±0.58;the satisfaction of nurses for the management of their leaders and teamwork is high,as the satisfaction scores are 4.01±0.76 and 3.60±0.71 respectively;their satisfaction for salary,welfare and social identity is low,as the scores are 2.46±0.86 and 2.50±1.02 respectively.Work satisfaction varies with departments,academic levels,monthly income,work shifts,age,seniority,and objectives for their choice of nursing as profession.Conclusion Managers are prompted to enhance their work in view of the satisfaction scores on survival,mutual relations and growth,as well as factors affecting satisfaction,and take various incentives to improve overall satisfaction of nurses.

This article introduces the classifications of medical devices by FDA and EU and compares them with the situation in China. Towards the problems found, several reasonable advices are put forward.
China ; Durable Medical Equipment ; classification

Objective To investigate the expressions of excision repair cross complementation group 1 ( ERCC1) and Ki67 in patients with breast cancer, and the relationships between their expressions and sensitivity of platinum-based chemotherapy. Methods Totally, 129 cases were pathologically diagnosed as breast cancer.Paclitaxel and carboplatin were used simultaneously. Chemotherapy regimen was as follows:Gemcitabine 1 000 mg??( m2 )-1 , IV drop on day 1 and 8;cisplatin 25 mg??( m2 )-1 , IV drop on day 1-3, for six cycles ( 21 days a cycle ) . ERCC1 and Ki67 expression in tumor tissue was observed by immunohistochemical analysis.Platinum-based chemotherapy sensitivity and survival of patients with different levels of ERCC1 and Ki67 expression were analyzed. Results In 129 patients, 18 cases were ERCC1 and Ki67 double-negative ( ERCC1-Ki67-) , and the clinical effective rate and 3-year cumulative survival rate were 88.89%and 83.33%, respectively.Twenty-four cases were ERCC1 positive but Ki67 negative ( ERCC1+Ki67-) , and the clinical effective rate and 3-year cumulative survival rate were 50. 00% and 62.50%, respectively.Thirty-three cases were ERCC1 negative but Ki67 positive (ERCC1-Ki67+), and the clinical effective rate and 3-year cumulative survival rate were 54. 55% and 60. 60%, respectively. Fifty-four patients were ERCC1 and Ki67 double-positive ( ERCC1+Ki67+) , and the clinical effective rate and 3-year cumulative survival rate were 22.78% and 31. 48%, respectively.Compared with ERCC1-Ki67- group, the clinical treatment efficiencies of cisplatin-based chemotherapy in ERCC1+Ki67- group, ERCC1-Ki67+ group, and ERCC1+Ki67+ group were significantly decreased ( P<0. 05 ) . The clinical treatment efficiency in patients of ERCC1+Ki67+ group with cisplatin-based chemotherapy was significantly decreased as compared with ERCC1+Ki67- group and ERCC1-Ki67+ group (P<0.05).Compared with ERCC1- Ki67- group, three-year cumulative survival rate in patients of ERCC1+ Ki67- group and ERCC1- Ki67+ group, ERCC1+Ki67+ group was significantly decreased ( P<0. 05 ) . Compared with ERCC1+Ki67-group and ERCC1-Ki67+group, three-year cumulative survival rate in patients of the ERCC1+Ki67+group was significantly decreased ( P<0.05) . Conclusion The expression levels of ERCC1 and Ki67 in breast cancer were high. Their expression levels are closely related with clinical efficiency of platinum-based chemotherapy.

Objective:To analyze and evaluate the effect after the PIVAS workflow optimization in our hospital. Methods: One-for-one grouping preparation was carried out by pharmacists and nurses. The checking of medicines, solvents and empty ampoules be-fore and after the preparation was performed by pharmacists, and the preparation of infusions was operated by nurses according to the operation specification. The preparation workload, error number in each link and damage of ampoules and finished goods before the op-timization and in 5 months after the optimization were compared. Results:The working efficiency was obviously improved with less time of about 0. 5 h for the same workload, the error rate was decreased by 40%, and the ampoule damage was reduced by 60% before and during the preparation. Conclusion:The PIVAS workflow optimization improves the working efficiency and management level.