Objective To predict the effectiveness of gentamicin combined with trisodium citrate for locking solution in preventing catheter-related bloodstream infection.Methods This is a retrospective study,ten kinds of common pathogens in catheter-related bloodstream infections were selected from medical intensive care unit (n =9) and cardiac care unit (n =1) between July 2011 and July 2012,and the diffusion method was used to analyze the inhibitory effect of gentamicin combined with trisodium citrate against tested pathogens.Results When trisodium citrate was tested alone,a certain antimicrobial activity could be detected from 10％ trisodium citrate,only Staphylococcus aureus and Staphylococci haemolyticus were inhibited,and then Enterococcus faecium was inhibited by 30％ trisodium citrate.Compared with trisodium citrate,gentamicin showed stronger antimicrobial activity.Staphylococcus aureus,Staphylococci haemolyticus,Enterococcus faecium and Escherichia coli could be inhibited by 0.32 g/L gentamicin and the antimicrobial activity was enhanced by increasing concentrations.The maximum activity was in 5 g/L gentamicin with 7-17 mm diameters.However,the antimicrobial activity of gentamicin didn't increase when combined with trisodium citrate,especially in 4％ trisodium citrate,the Staphylococci haemolyticus was not inhibited by all of the combinations with any concentration of gentamicin.In 0.32 g/L gentamicin,only the combination with 50％ trisodium citrate could inhibit the four kinds of pathogens (Staphylococcus aureus,Staphylococci haemolyticus,Enterococcusfaecium and Escherichia coli) with 8-21 mm diameters,while in 1 g/L,2 g/L,and 5 g/L gentamicin,these pathogens could be inhibited by the combination with only 10％ trisodium citrate,and the diameters were 5-24 mm,12-27 mm,and 17-28 mm,respectively.Conclusion Based on the data,gentamicin combined with trisodium citrate lock solution may play an important role in preventing catheter-related bloodstream infections caused by Gram-positive bacteria and Escherichia coli.

BACKGROUND:Researchers have done much work to investigate semantic priming with event-related potentials (ERPs) method. The ERPs component of N400 is of great importance in this research domain. N400 is a negative wave occurs at about 400 ms after the stimulus onset. It has been accepted that N400 represents the processing of semantic information. In many studies, amplitude of N400 could be reduced by semantic priming. Relatively, ERPs studies on phonological priming, especially by auditory stimuli, deserve to be further investigated. OBJECTIVE: To investigate the EPR characteristics of semantic and phonological priming with spoken two-character Chinese words, and also to testify theories about auditory word recognition.DESIGN: Repeated measurement experiment.SETTING: Center for Psychology and Behavior Studies, Tianjin Normal University. PARTICIPANTS: This experiment was carried out between August and October 2003 in Tianjin Normal University. Seventeen healthy college students (8 male and 9 female, age ranging from 19 to 23 years) with no hearing defect were involved in this experiment. All of them were Chinese native speakers. All except one male participant were right handed. Informed consents of detected items were obtained from all the participants.METHODS: In the study, lexical dicision task which required participants was used to judge if the latter words were real words or pseudowords in the auditorily presented word-pairs by pressing buttons. The stimuli materials were 640 two-character word-pairs including semantic related, initial phonological overlap, final phonological overlap, phonological and semantic unrelated and word-pseudoword (control) conditions. These five kinds of word-pairs presented randomly in the experiment. The presentation of stimuli and recording of behavioral data were realized by STIM software. The error rate and mean reaction time (RT) of reaction of subjects were calculated under four experimental conditions. The word-pseudoword items were not included in the analysis (just served as fillers). EEG were recorded referring to linked mastoids with Scan 4.3 software made by Neuroscan company in America. Participants wore the Quick-Cap32 electrode cap (International 10/20 System). EEG data were amplified and acquired with a sampling rate of 500 Hz. Offline exclusion of occular artifacts was done on the acquired continuous EEG data after experiment. Then the EEG data were segmented to epochs of 1 700 ms, each epoch was time-locked to the onset of target stimulus with a 200 ms pre-target baseline. Then the operation of baseline (with a 200ms pre-target baseline), artifact rejection (epochs with amplitude exceeded the range of -100 μV to +100 μV were rejected) and average were realized. MAIN OUTCOME MEASURES: Error rate, reaction time and caused N400 waveform change of target words under different experimental conditions.RESULTS: Data from 17 subjects were involved in the final analysis. The error rate of subjects under semantic related condition was lower (P＜ 0.05) while RT was shorter (P＜ 0.01) than that under phonological and semantic unrelated condition. The error rates of subjects under initial phonological overlap and final phonological over lap conditions were higher than that under phonological and semantic unrelated condition (P ＜ 0.01). The error reactions were discarded and the mean value of RT under 4 conditions (semantic related, initial phonological overlap, final phonological overlap and phonological and semantic unrelated) were 830 ms, 891 ms, 864 ms and 903 ms, respectively. There were significant differences of error rate and RT between semantic related and phonological and semantic unrelated conditions (P ＜ 0.01). Error rate and RT under final phonological overlap condition were significantly different from those under initial phonological overlap and phonological and semantic unrelated conditions (P ＜ 0.01). Since the largest amplitude of N400 occurred at FCZ electrode, FCZ was chosen for analyzing the effects under four different experimental conditions. The LSD multiple comparison showed that amplitude under control condition was significantly higher than that under semantic related condition (P ＜ 0.01). Latency under the control condition was the longest, then decreased gradually according to the sequence of semantic related, final phonological overlap and initial phonological overlap condition. As the results of LSD multiple comparison revealed, initial phonological overlap condition had a tendency of shortened latency, with significant difference when compared with control condition (P ＜ 0.05). Another five electrodes were selected besides FCZ standing for anterior, parietal, posterior, left and right brain area in order to investigate the scalp distribution difference of N400 under different experimental conditions. Two factors repeated measured ANOVA (Analysis of variance) was carried out for amplitude analysis, with different experimental conditions (4 levels) as the first factor and electrode positions (6 levels) as the second factor. The main effect of electrode positions was significant [F(5,80)= 13.376, P =0.000]. Among the chosen electrodes, FCZ had the largest amplitude (-7.946 μV), the second was CZ (-7.285 μV) and the other top-downsequence was FZ (-6.849 μV), PZ (-4.324 μV), T8 (-3.501 μV ) and T7 (-3.484 μV), respectively. Results of LSD multiple comparison revealed that the amplitude of FCZ was higher than all other electrodes but CZ. CONCLUSION: Two-character Chinese words presented auditorily in lexical decision task. Semantic relationship can facilitate the recognition of target words, which is shown by lower error rate, shorter RT and decreased amplitude of N400 component. Phonological congruence between prime and target words has both facilitory and interferential effects on target words, which is shown by increased error rate, shorter RT and the tendency of decreasing N400 amplitude.Interferential effect of initial phonological overlap between prime and target words is stronger than that of final phonological overlap. This finding provides evidence for initial phonological information's special function during auditory word recognition which is supported by Cohort Theory. No evidence for the existence of separate intracranial sources of semantic priming and phonological priming has been found. However, Cohort Theory should be revised while applying to the recognition of two-character words of Chinese.

Purpose Chronic nephropathy model was established with New Zealand rabbit, and the development of chronic nephropathy was monitored using virtual touch tissue quantification (VTQ) technique, to provide the experimental basis for chronic renal fibrosis assessment using VTQ technique. Materials and Methods Thirty-eight healthy New Zealand white rabbits were selected, of which 32 were induced into chronic nephropathy model with daily intravenous ear vein injection of cationic bovine serum albumin (C-BSA), with the other 6 rabbits without C-BSA injection as control group. At the end of 0, 2, 4, 6, 8 weeks, VTQ was used to measure the hardness of renal cortex in rabbits, then the rabbits were slaughtered to assess the pathological changes in kidney, correlation analysis between the VTQ parameters and the pathological parameters was performed. Results VTQ value of rabbit kidney cortex at 0 week, 2 weeks, 4 weeks, 6 weeks and 8 weeks was (1.68±0.25) m/s, (1.70±0.31) m/s, (1.87±0.35) m/s, (2.19±0.31) m/s and (2.46±0.46) m/s respectively, difference of VTQ values between 6 weeks and 4 weeks was statistically signiifcant (P<0.05), and also signiifcant when compared 8 weeks with 4 weeks and 6 weeks (P<0.05). Glomerulosclerosis index of 4 weeks, 6 weeks, 8 weeks were 0.81±0.40, 1.43±0.46 and 2.15±0.46 respectively, and tubular interstitial collagen deposition score were (14.29±4.62)%, (26.28±11.06)%, (42.37±10.09)%, which were all significantly higher than that in 0 week and 2 weeks, fibrosis increased gradually with the course, the difference was statistically signiifcant (P<0.05). Correlation analysis showed that the VTQ value of renal cortex was positively correlated with glomerulosclerosis index (r=0.663, P<0.05) and tubular interstitial collagen deposition score (r=0.652, P<0.05). Conclusion VTQ technique is able to detect the VTQ change of renal cortex as the disease progressed in rabbits with chronic renal nephropathy, which was in a positive association with fibrosis index, suggesting that virtual touch tissues quantitative technology can be an important method to evaluate renal ifbrosis in chronic renal nephropathy.

Objective To understand the occurrence of catheter-associated urinary tract infection(CAUTI)in pa-tients with catheterization,and provide evidence for reducing the incidence of CAUTI.Methods Based on monito-ring requirement for CAUTI in competency building project of healthcare-associated infection(HAI)prevention and control established by Hospital Infection Management Committee of Chinese Hospital Association,CAUTI among patients who hospitalized and received urinary catheterization ≥2 days in a hospital from January to December 2014 were analyzed prospectively,incidences of CAUTI in different patients were compared.Results A total of 6 046 patients with urinary catheterization were monitored,166 of whom developed CAUTI,incidence of CAUTI was 2.75%,the total urinary catheter days were 31 833 days,incidence of CAUTI was 5.21 per 1 000 urinary catheter days.There was no significant difference in the incidence of CAUTI among patients of different genders (χ2 =1 .23, P =0.54);incidence of CAUTI in patients > 60 years old was higher than those ≤60 years (4.72% vs 2.07%,χ2=30.38,P <0.01);incidence of CAUTI in patients with different duration of catheterization was significantly dif-ferent(χ2 = 251 .14,P <0.01 );with the prolongation of duration of catheterization,incidence of CAUTI also in-creased(trendχ2 =211 .82,P <0.001 ).Patients in department of neurology had the longest average catheterization time(14.84 days)and highest incidence of CAUTI(15.00%,10.11 ‰);patients in the other departments of surgery had the shortest average catheterization time(3.56 days)and lowest incidence of CAUTI(0.97%,2.74‰);inci-dences of CAUTI in patients with urinary catheterization in different departments were significantly different(χ2 =302.24,P <0.001).166 CAUTI patients were isolated 66 isolates of pathogenic strains,86.36% were gram-nega-tive bacilli,33.33% of which were Escherichia coli .Conclusion CAUTI is related to the age of patients and dura-tion of indwelling urinary catheter.Daily assessment on the necessity of indwelling catheter and timely removal of catheter is helpful for reducing the occurrence of CAUTI.

ObjectiveTo explore the correlation of contrast-enhanced ultrasound (CEUS) parameters and the pathologic parameter of renal fibrosis.MethodsThirty-eight healthy New Zealand rabbits were randomly divided into the blank control group and the experimental group. The rabbits model was built by intravenous injection of C-bovine serum albumin (C-BSA) to rabbits of the experimental group. According to the different time points (2, 4, 6 and 8 weeks) after the injection of C-BSA, the rabbits in experimental group were randomly divided into 4 sub groups, 8 in each group. We collected the data of the CEUS parameters in the control group and the experimental group. Moreover, the renal tissues of the rabbits underwent pathologic examinations. Then, correlation analysis of CEUS parameters with parameters of renal fibrosis was performed.ResultsDynamic changes of CEUS parameters: Renal cortical perfusion reduced from 6 weeks after the injection, manifested as the time to peak (TTP) and mean transit time (MTT) of the experimental group were longer than those of control group and the derived peak intensity (DPI) of the experimental group was lower than that of control group (P<0.05 respectively). The DPI and TTP at 8 weeks after the injection of the experimental group was significantly lower than those of the control group [(26.96±2.34) dbvs (35.04±1.62) db,P<0.05; (24.31±1.82) svs (18.64±1.15) s,P<0.01]. Changes of each renal fibrosis parameter: we found that the results of the glomerulosclerosis indexes of the experimental group (4 weeks, 6 weeks and 8 weeks after the injection) were significantly higher than those of the control group (0.81±0.36, 1.43±0.25 and 2.15±0.30vs 0.13±0.07, allP<0.01). The tubular interstitial collagen deposition scores of the experimental group (4 weeks, 6 weeks and 8 weeks after the injection) were significantly higher than those of the control group (14.29%±4.62%, 26.28%±10.09% and 42.37%±10.41%vs 1.21%±0.15%, allP<0.01). As the disease progressed, the results of each parameter increased. Pearson correlation analysis showed that the TTP of renal cortex was positively correlated with the glomerulosclerosis index and tubular interstitial collagen deposition score (r=0.866 and 0.785, bothP<0.01). The DPI of renal cortex was negatively correlated with the glomerulosclerosis index and tubular interstitial collagen deposition score (r=-0.724 and -0.739, bothP<0.01).ConclusionsThe results showed that CEUS could evaluate microcirculation perfusion of renal cortex. There is a positive association between TTP and fibrosis index. There is a negative association between DPI and fibrosis index. Thus, CEUS is an important method to evaluate the renal fibrosis in chronic renal nephropathy.

Objective The aim of this study is to define if early change ofprocalcitonin (PCT) may inform about the efficacy evaluation of severe bacterial pneumonia.Methods A prospective,single-center,observational study was conducted in patients with severe bacterial pneumonia admitted to ICU in 2010 years.PCT samples were collected in baseline,72 hours,7 days and the ending in the duration of therapy.The efficacy evaluation was assessed at the end of treatment 5 days after and divided into the efficacy group and nonefficacy group according to the guiding principle of clinical research on antibacterial drugs by the Ministry of Health.Sixty-five patients with a mean age of (62.1 ± 15.9) years were evaluated.Five patients were severe community acquired pneumonia,32 patients nosocomial pneumonia and 28 patients ventilator associated pneumonia.The clinical pulmonary infection score(CPIS) was 7.9 ± 1.8 ;APACHE Ⅱ score was 14.5 ±5.3.There were 44 patients as the efficacy group and 21 patients as the nonefficacy group.SPSS13.0 was used to analyse the results.Results The PCT levels between efficacy group and nonefficacy group were (3.83 ±2.18)vs(4.23 ±2.64) μg,/L (t =1.249,P =0.387),(2.44 ± 1.05)vs(3.48 ± 1.75) μg/L(t=-1.959,P=0.045),(1.15 ±0.87) vs (3.41 ±1.58) μg/L (t=-2.904,P=0.006),and (0.51 ±0.17) vs (2.63 ±1.08) μg/L (t=-3.772,P =0.000) in baseline,72 hours,7 days and the ending in the duration of therapy.The change of PCT within the first 72 hours were (32.5 ± 12.4)％ vs (14.5 ± 7.1) ％.The area under receiver operating characteristics curve (AUC) of prediction clinical efficacy of the change of PCT within the first 72 hours was 0.823 (P =0.002),the AUC of white blood cell,the neuter granulocyte percentage,body temperature and PCT level within 72 hours were 0.575,0.543,0.521,0.597,respectively (P ＞ 0.05).In multivariate analyses,the change of PCT ＜ 30.8％ (odds ratio,15.2,95％ confidence interval,3.3-21.7,P =0.01) was independent risk factors of effect predictor.The changes of PCT within the first 72 hours (＞30.8％) combined with CPIS(＜6) were the best performance to predict clinical efficacy with a AUC of 0.910,sensitivity of 85.2％ and specificity of 92.5％.Conclusions The change of PCT within the first 72 hours can be used early to evaluate the effect in bacterial pneumonia.Especially,combined with CPIS can further improve the prediction value.

Objective To analyse the graft impingement after anterior cruciate ligament (ACL) reconstruction based on three-dimensional graft and tunnel images of dual-source computer tomography (DSCT).Methods From November 2012 to November 2014,a consecutive 134 cases of ACL reconstruction with various techniques had their knees scanned by DSCT.Graft and femoral as well as tibial tunnel images were three-dimensionally reconstructed and carefully inspected if there was any impinging on the graft at knee extension,meanwhile the femoral and tibial tunnel location were measured.Of these 134 cases,a serial of 118 patients had been single-bundle reconstructed with same type of graft material.There were 83 males and 35 females aged from 15 to 64 years old (mean,32 years old).Special attention had been paid to examine if there was any graft impinging,and their origin and finally impingement types were identified and classified according to the position and origin of impingement.Bernard and Lorenz method were used to measure the relative locations of femoral and tibial tunnel respectively.Difference was statistically compared between impingement-free and impingement groups.Results Patients were divided into two groups,impingement-free group and impingement group according to graft impinging based on graft visible 3D-CT imaging postoperatively.Of 118 cases,39 (33％) were impingement-free and 79 (67％) existed various types of impingement.Impingement group was further divided into two subgroups according to different impingement location,outlet impingement of intercondylar notch group (77 cases,account for 65％ of total and 97％ of impingement group,respectively) and mid-way impingement of intercondylar notch group (2 cases,account for 2％ of total and 3％ of impingement group,respectively).The outlet impingement group was more further classified into three subtypes,bird beak impingement,10 cases (13％,10/77),tibial plateau impingement,46 cases (60％,46/77) and clamp impingement,21 cases (27％,21/77).Statistic analysis with NAONA revealed that no significant difference between impingement group and impingement-free group regardless of femoral or tibial tunnel placement.Conclusion Three new types of impingements are found based on visible 3D-CT graft imaging after ACL reconstruction which are mid-way impingement of intercondylar notch,tibial plateau impingement and clamp impingement.

OBJECTIVE To investigate the resistant patterns of ESBLs-producing Escherichia coli and Klebsiella spp isolated from 3 hospitals in Xinjiang and to determine the genotypes of ESBLs. METHODS Using 2-fold agar dilution test to determine MICs of ten antibiotics.Using polymerase chain reaction and DNA sequencing to determine ESBLs genotype;using isoelectric focusing to determine the isoelectric points of ?-lactamases produced by strains in which no ESBLs genes were amplified by PCR. RESULTS Strains had low susceptibility to aztreonam,cefotaxime and ceftazidime.The susceptibility to cefepime,cefoperazone/sulbactam,cefmetazole,piperacillin/tazobactam,and meropenem were relatively high.Fifty five strains mainly carried blaCTX-M-1 subgroup gene and blaCTX-M-9subgroup gene,and blaSHV-12 gene were also detected. CONCLUSIONS blaCTX-M-1 Group gene and blaCTX-M-9 group gene are prevalent in three hospitals of Xinjiang,blaSHV-12 gene also plays a part role in leading to resistance of E.coli and Klebsiella spp to ?-lactams.

Objectives To study the performance of different microbial automated inoculation systems and to evaluate the performance of the Probact microbial automated inoculation and incubation system ( Probact system) and its applications in clinical microbiology laboratory.Methods A total of 160 clinical specimens, including respiratory secretions ( n=61 ) , urine ( n=49 ) , and feces ( n=50 ) , that were submitted to the Clinical Microbiology Laboratory in Peking Union Medical College Hospital of Chinese Academy of Medical Sciences from February 2015 to April 2015 were evaluated.These specimens were processed with conventional manual method, the Probact automated inoculation system, and PREVI Isola Inoculator.The quantity of bacterial species recovery, number of effectively isolated colonies, total number of colonies recovery per plate, and time of processing the 160 specimens by the three methods were evaluated. Wilcoxon signed-rank test and Kruskal-Wallis rank sum test were used for statistical analysis.Results The Probact system had significantly higher quantity of bacterial species recovery (respiratory specimens 3.41 ±1.40, urine 1.92 ±0.86, and feces 1.16 ±0.79) than those by the Isola Inoculator (respiratory specimens 3.75 ±1.29, urine 2.24 ±0.97, and feces 1.92 ±0.72), (P=0.006, 0.011, <0.001).Compared to the manual method, Probact performed less quantity of bacterial species recovery for respiratory specimens(3.85 ±1.38), but higher in feces(0.80 ±0.81)( P<0.001).There is no significant differences for urine ( 1.84 ±1.23 ) ( P=0.266 ) .As for number of isolated colony, the Probact system ( respiratory specimens 12.16 ±7.72, urine 2.71 ±4.24, and feces 5.40 ±5.04 ) had significant smaller numbers than that of Isola Inoculator (respiratory specimens 16.56 ±5.76, urine 4.35 ± 4.89, and feces 8.40 ±3.70) (P<0.001,0.007,0.003).However, both system had larger numbers of isolated colonies than those by the manual method (respiratory specimens 11.30 ±8.42, urine 2.67 ±4.34, and feces 1.90 ±3.90) and the difference was significant for fecal specimens(P<0.001).Regarding the total number of colonies recovery, larger number was found by Isola Inoculator than that by the Probact system for fecal specimens, however, there were no significant differences for respiratory or urine specimens (P=0.524,0.738).Compared with manual method, the Probact system had significantly more numbers of colonies recovery for respiratory and fecal specimens ( P<0.001 ) . The total time for processing 160 specimens was shortest for manual method (281 min), followed by Probact system (419 min) and Isola Inoculator (495 min) .Conclusions The performance of the Probact system is better than the manual method but no superior to the Isola Inoculator.The Probact system can meet the clinical need in terms of full automation and standardization of specimen inoculation and prevention of bias of processing by laboratory staffs using manual method.