OBJECTIVE To study the resistant characteristics and the resistant mechanisms of Gram-negative bacilli(G-) to ?-lactam antibiotics in the local nosocomial infections.METHODS The effects of efflux pump inhibitor on MICs were determined.Phenotypes and isoelectric points of ?-lactamases(Bla) were determined.Bla Genes were amplified and sequenced.RESULTS Of all tested isolates,the resistant rates to the most antibiotics were high.Besides 10.5% isolates with the efflux pumps,all tested isolates produced Bla,among which extended spectrum ?-lactamases(ESBLs),cephalosporin ?-lactamase(AmpC Bla) and metallo-?-lactamase were responsible for 42.1%,17.5% and 7.0% isolates,respectively.The complete nucleotide sequences of the ampC genes in 8 Enterobacter cloacae isolates had very high homology with the ampC gene in E.cloacae ECLC074.CONCLUSIONS The production of Bla is the main resistant mechanism of G-to ?-lactam antibiotics.ESBLs are the most frequent Bla.All of the ampC genes of AmpC Bla-producing E.cloacae originate from the ampC gene in E.cloacae ECLC074.Imipenen is the best choice for the treatment of the infections caused by multidrug resistant G-.Piperacillin/tazobactam and cefoperazone/sulbactam can be used to treat the infections caused by drug-resistant non-fermentative bacilli.Amikacin is effective to treat the infections caused by AmpC Bla-producing E.cloacae.

Cancer stem cell(CSC)plays a very important role in the genesis、relapse、metastasis and drug resistance of cancer.Traditional chemotherapeutics may kill a large part of malignant cells,but it has little effect on scanty CSC.It is enough for the relic CSC to make cancer relapse and metastasis.Targeted therapy aimed directly at CSC is the only way to cure cancer fundamentally.The specific biologic character of CSC is helpful for studying and developing targeted therapy to CSC.

Objective To investigate the methylation status of the promoter of RASSF2A gene in the tissues of cervical cancer and its impacts in tumorigenesis.Methods Methylation-specific PCR (MSP) and RT-PCR techniques were applied to detect methylation status of RASSF2A gene promoter region and RASSF2A expression in tissues of 62 cervical cancer and 30 normal cervical specimens,respectively.Results Methylation frequency of RASSF2A gene in cancer tissue was higher than that in normal tissue (53.2 ％ vs 13.3 ％,P ＜ 0.05).The mRNA expression of RASSF2A in cancer tissue were less than those in normal tissue significantly (0.254 3 ±0.102 7 vs 0.623 4 ± 0.063 8,t =0.932,P ＜ 0.05).The mRNA expressed of RASSF2A gene was lower in methylated promoter group than that in unmethylated promoter group in cancer tissue samples significantly (0.118 2 ± 0.035 2 vs 0.301 2 ± 0.076 4,t =0.481,P ＜ 0.05).Conclusion Hypermethylation of RASSF2A gene in promoter region,which lead to the loss of RASSF2A gene expression,might play an important role in tumorigenesis of cervical cancer.

Objective To establish an RP-HPLC method for determining serum level of valproate.Methods A symmetryshield RP18 column (5?m,3.9mm?150mm) was used.The mobile phase,methanol-water(80:20) was used at a flow rate of 1.0ml/min.The detector was Waters 2487 dual?absorbance detector,which was set at the wavelength of 248nm.Serum sample was extracted with 2ml acetic n-hexane,then valproic acid in organic layer was derived by adding into?-bromoacetophenone,and cyclohcxanecarboxyiic acid was selected as an internal stan- dard.Results The calibration curve was linear in the range of 5.0 to 250.0vtg/ml.The average recovery rate was 98.23%,and the RSD within-day and between-day were both less than 3 %.Conclusion This method is suitable for therapeutic drug monitoring of phenytoin.

Objective: To isolate and identify the chemical constituents in the rhizome of the Petasites ja ponicus. Methods: Dried rhizome of Petasites ja ponicus were subjected to extraction with EtOH, and the chemical constituents in the extract were isolated and their structures were identified by physicochemical properties and spectral analysis. Results: Five compounds were obtained and identified from the rhizome of Petasites ja ponicus, inlcuding as β-sitoterol (I), ergosterol (II), bakkenolide-B (III), bakkenolide-D (IV) and furanofukinol (V). Conclusion: Compound (II) has been obtained from Petasites japonicus for the first time.

Adult ; Brachiocephalic Trunk ; injuries ; Emergency Treatment ; Humans ; Male ; Middle Aged ; Rupture ; Tracheostomy ; adverse effects ; Young Adult

The internship is the transition period of a medico becoming a doctor,the cultivation of clinical work ability of interns is a comprehensive ability cultivation which includes the foundation theories' consolidation and use,the practical operative train- ing,the cultivation of clinical thought ability and communication between doctors and patients,etc.To educate pediatrics intern has its characteristics.