Objective To investigate the types of staphylococcal cassette chromosome mec (SCCmec)gene and an-timicrobial resistance of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA)isolated from outpatients and inpatients in a hospital.Methods MRSA strains isolated between May 2011 and August 2015 in a hospi-tal and the relevant case data were collected,polymerase chain reaction(PCR)method was used to identify mecA gene of MRSA and SCCmec gene of CA-MRSA,antimicrobial susceptibility testing of CA-MRSA were performed and analyzed. Results A total of 305 MRSA isolates were collected,296 of which were mecA positive,29.73% (88/296)were CA-MR-SA. The genotyping of CA-MRSA showed that 48 strains were SCCmec type Ⅳ,36 were SCCmec type V,the other 4 strains were undefined. Antimicrobial susceptibility testing results showed that susceptibility rates of CA-MRSA to vanco-mycin,linezolid,and tigecycline were all 100% ,resistance rates to penicillin and oxacillin were both 100% ;resistance rates of SCCmec type IV and SCCmec type V CA-MRSA strains to levofloxacin,rifampicin,and ciprofloxacin were all signifi-cantly different (all P<0.05),to ampicillin/sulbactam,furantoin,and erythromycin were all >58% .Conclusion The main SCCmec type of CA-MRSA are type IV and type V in this hospital,antimicrobial resistance rate is high,clinicians should pay high attention,and use antimicrobial agents according to antimicrobial susceptibility testing results.

Objective To analyze antimicrobial resistance of hospital-associated methicillin-resistant Staphylococ-cusaureus(HA-MRSA)and community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA),and provide reference for clinical treatment and rational antimicrobial use. Methods From May 2013 to June 2014, Staphylococcus aureus in a hospital were collected and analyzed,strains were identified and performed antimicrobial susceptibility testing by using VITEK 2 Compact system,diagnosis of HA-MRSA and CA-MRSA were confirmed in combined with clinical symptoms.Results A total of 84 MRSA isolates were isolated (61 were HA-MRSA strains,23 were CA-MRSA).Resistant rates of HA-MRSA and CA-MRSA to penicillin G and oxacillin were both 100.00% ;to ampicillin/sulbactam was 100.00% and 95.65% respectively;to compound sulfamethoxazole was 39.34% and 34.78% respectively. Antimicrobial resistant rates of HA-MRSA to gentamicin,tetracycline,erythro-mycin,clindamycin,levofloxacin,ciprofloxacin,moxifloxacin,nitrofurantoin,and rifampicin were all higher than CA-MRSA,the difference were significant(all P<0.001).Conclusion Antimicrobial resistance of HA-MRSA and CA-MRSA are all serious,monitor should be intensified,antimicrobial use should be chosen according to antimicro-bial susceptibility testing result.

Objective:To prepare pioglitazone hydrochloride ( PGH) sustained-release pellet capsules and study the in vitro disso-lution. Methods:The preparation was prepared with a bottom spray fluidized bed, and the formula and technology were optimized by orthogonal test. Results:The method was simple and easy to operate, the reproducibility of the formula and technology was good, and the pellets had obvious sustained-release property. Conclusion:The formula and technology are easy and controllable, and the stability of sustained release pellets is good.

Objective:To study the differential gene expression pattern between autosomal dominant polycystic and normal kidney tissue,and to deduce the etiological factor and treatment for autosomal dominant polycystic kidney disease(ADPKD).Methods: The cDNA probes were prepared by labelling normal kidney tissue mRNA and ADPKD tissue mRNA with Cy3-dUTP and Cy5-dUTP separately through reverse transcription.The probes were then hybridized with the DNA microarrays(PCR products of(4 096) human cDNAs onto specially treated glass slides) and the fluorescent signals were scanned with ScanArray 4000 scanner.Semi-quantitive RT-PCR was performed to test the expression level of 4 related genes.Results: Of the 4 096 genes screened,463 genes showed obvious changes.Expression of 206 genes was upregulated in the polycystic kidney tissue,especially cyclin D_(2),MMPs,TIMP1 and fibroblast activation protein;expression of 257 genes was downregulated,especially phosphatase 1A and acid phosphatase 1.The expression of genes tested by RT-PCR was in accordance with those detected by cDNA microarray.Conclusion: ADPKD may be related to the upregulation of cyclin,MMPs,and various kinds of growth factors,and drugs like inhibitors of CaM and MMPs might have therapeutical effects on ADPKD.

Objective To analyze and evaluate the role of IABP in the treatment of patients with acute myocardial infarction.Methods The clinical data of all patients with acute myocardial infarction treated with IABP admitted into the Peking University First Hospital from January 1st 2000 to December 31st 2006 were collected.The treatment effects of IABP were analyzed with statistical methods.Results A total number of 48 patients with acute myocardial infarction were treated with IABP in the past 6 years and 26 of them were presented with cardiogenic shock at the time of admission.The short-term condition was stabilized in 81.3%(39/48) of the patients with IABP treatment which was demonstrated by restoration of stable heart rate and blood pressure,increase in urine volume,symptoms relief and decreasing need of vasoactive drug.The in-hospital mortality was lower in patients received revascularization therapy in additional to IABP compared with patients who had IABP support alone(37.5% vs.93.8%,P

Objective To evaluate the effect and safety of low or medium heparinization in porcine model for coronary artery restenosis and investigate the rational dose of unfractionated heparin.Methods According to the doses of unfractionated heparin given to the animal models 24 porcines were randomized into low heparinization group(100 U/kg) and medium heparinization group(150 U/kg).We took blood samples from each porcine and measured the ACT value before intravenous injection of unfractionated heparin and 5 minutes,20 minutes,30 minutes and 60 minutes after heparinization.We compared the effects of anticoagulation,compression hemostasis and the occurance of adverse events.Results Both low and medium heparinization groups achieved the ACT peak value(245.3?93.64 s vs.241.0?37.29 s,P=0.824) 5 minute after intravenous injection of heparin and maintained high ACT value(191.8?53.06 s vs.184.6?42.82 s,P=0.707) within 20 minutes.The ACT value of medium heparinization group was higher than low heparinization group 30 minute later(193.9?58.95 s vs.154.0?28.20 s,P=0.005).The compression time for hemostasis in medium heparinization group was longer than low heparinization group(17.7?2.96 mins vs.14.3?4.44 mins,P=0.042).No peri-operation adverse events were found in both groups.Conclusion Low heparinization can provide adequate anticongulation for a 20-minute-operation and at the same time reduce the compression time for hemostasis in the porcine model for coronary artery restenosis.

Objective To explore the effect of acupuncture on trunk control ability and balance function in patients with spinal cord injury above lumbar. Methods 40 patients with spinal cord injury were randomly divided into observation group and control group with 20 cases in each group. The control group received limb joint training method, the observation group received acupuncture in addition. Fugl-Meyer Assessment and Flex Comp Infiniti EMG system were used to evaluate the balance function and trunk muscle strength before and 8 weeks after treatment. Results After treatment, the balance function and trunk control ability improved in both groups (P<0.01), and were better in the observation group than in the control group (P<0.05). Conclusion Limb linkage combined with acupuncture can further improve the balance function and trunk control ability in patients with spinal cord injury above lumbar.

Objective To study demographic features,clinical characteristics and in-hospital cost of patients due to different causes in one center in 2007-2011 and discuss their correlation.Methods A retrospective analysis was conducted on all patients who were treated with amputation from 2007 to the first half of 2011 in the Second Affiliated Hospital of Zhejiang University to carefully record their data,such as demographic characteristics,entity,medical history,clinical information,amputation location,amputation level,hospital day and medical cost.Results A total of 805 patients at age of (42.1 ± 18.1)years underwent amputation from 2007 to the first half of2011.Among them,the male patients accounted for 72.3％.The patients engaged in farm,industry and transportation accounted for 69.7％.Traumatic amputation occupied 66.1％,followed by 15.3％ of tumor amputation and diabetic amputation proportioned 4.5％,occupying 13.2％ of non-traumatic amputation.Ratios of lower limb amputations and amputations above levels of joints of palmar digitals and toes were 64.9％ and 61.7％.Mean hospital day was 20 days (range,14-34 days) and mean medical cost was 15 000 RMB (range,8 881-31 975 RMB).Conclusions Amputation largely occurs in the male adults and mainly results from trauma.High amputation,long hospital stay and high medical cost are the main characteristics.

Objective To explore the classification of intracranial arachroid cysts(IAC) in CT cisternography(CTC) and its clinicalapplication.Methods 22 cases of IAC diagnosed by plain CT underwent CTC exminaton. IACs were classified into noncommnicatingintracranial arachnoid cyst (NCIAC) and commnicating intracranial arachnoid cyst (CIAC) by wheather or not filled with contrast media in cysts on CTC. NCIAC cases were selected and treated with neuroendoscopic fenestration.Results 15 cases of NCIAC were found by CTC examination. All the NCIAC patients had definite neurologic findings. Postoperatively, all the patients were improved or cured. Follow-upplain CT scan of 9 NCIAC cases showed the cysts were decreased markedly in size, most of the space around the cysts were replaced bynormal cerebral tissue.Conclusion (1)CTC is simple ,safe and specific for making a final diagnosis of IAC. IACs can be classified into CIAC and NCIAC by CTC findings.(2)Neurosurgical indication for IAC is NCIAC patients with symptoms.

Objective To explore the correlation of metabolic disorder of newly diagnosed type 2 metabolism(T2DM) and nonalcoholic fatty liver disease (NAFLD).Methods A total of 117 patients with newly diagnosed T2DM in Beijing Ditan Hospital Affiliated to Capital Medical University from June 2014 to June 2015 were enrolled.Patients were divided into two groups:T2DM with NAFLD of 57 cases and T2DM without NAFLD of 60 cases.Body mass index (BMI),waist circumference (WC),liver and kidney function,serum lipid,glycosylated hemoglobin A1c (HbA1c),fasting glucose,fasting insulin and C-peptide (FCP) were detected.The insulin resistance and β-cell function were assessed by homeostasis model assessment insulin resistance (HOMA-IR) and HOMA-β.Results The incidence of NAFLD in T2DM patients was 51％ (that was,60 cases of T2DM patients with NAFLD),compared with 2TDM group,the metabolic index of T2DM without NAFLD was significantly increased (blood triglyceride (TG):(2.58 + 1.8) mmol/1 vs.(1.22 + 0.4) mmol/l,fasting blood glucose:(11.5+6.1) mmol/l vs.(9.2+4.3) mmol/l,serum uric acid:(465.3+65) umol/l vs.(325.3+72) umoL/l;P =0.03,0.03,0.02);HOMA-IR was more serious ((4.9 ± 2.8) vs.(3.8 ± 2.7);P =0.03);insulin β-cell function was compensatory more obvious ((49.2 ± 27) vs.(29.5 ± 18);P =0.02);prevalence rate of obesity,hypertension and diabetic ketoacidosis (DKD),diabetic retinopathy (DR),diabetic peripheral neuropathy(DPN) were significantly increased(P＜0.05).Logistic regression analysis showed that,smoking(OR=1.405,95％CI:1.262-1.567),male(OR=1.037,95％CI:1.015-1.063),BMI(OR=1.113,95％CI:1.278-2.531),WC (OR =1.624,95％ CI:1.162-1.761) and TG (OR =1.823,95％ CI:1.2822.563) were risk factors of NAFLD (P ＜ 0.05).Conclusion T2DM patients with NAFLD have severer insulin resistance than those without NAFLD.The β-cell function of those patients is compensatory increased.NAFLD prevalence rate significantly increase in patients with obesity,especially in male diabetic patients who smoking.