Objective To survey and control an extensively drug-resistant Acinetobacter baumannii (A.bauman-nii)(XDRAB)lower respiratory tract infection (LRTI)outbreak in intensive care unit (ICU)of a hospital. Methods From October 27,2013 to December 27,2013,5 cases of XDRAB LRTI occurred in ICU,epidemiological investigation was conducted,sources and transmission routes of infection were searched,intervention measures were performed.Results XDRAB were isolated from patients’sputum and environmental object surface,drug-resistant spectrums of isolated XDRAB were almost the same,suggesting the outbreak was due to the contamination of envi-ronment by the same pathogen.54 specimens were taken before disinfection,26 were positive,XDRAB were isola-ted from door handles,sheets and telephones.Investigation concluded that the outbreak of XDRAB infection was due to contamination of indoor environment and equipment,incomplete disinfection,and inadequate hand hygiene compliance of health care workers.After the implementation of a series of control measures,XDRAB was not found,and there was no new XDRAB infection cases.Conclusion Environment contamination is the main cause of this XDRAB healthcare-associated infection(HAI)outbreak,strict implementation of isolation,prevention and con-trol measures of MDROs can effectively control HAI outbreak caused by A.baumannii.

BACKGROUND: Homocysteine (HCY) has been verified as an independent risk factor of atherosclerosis and atherothrombosis of cardiovascular disease.OBJECTIVE: To observe the effects of HCY on the secretion and activity of matrix metallopotinase-1 (MMP-1) and tissue inhibitors of metalloproteinase-1 (TIMP-1) in vascular smooth muscle cells (VSMCs).DESIGN : Auto-control observation.SETTING: Pathology Room, Institute of Regeneration Medical Sciences, Jilin University.MATERIALS: In vitro cultured vascular smooth muscles cells (VSMCs) of rats were obtained from male Wistar rats with the body mass of about 150 g from weeks 4-6 supplied by Laboratory of Animals, Norman Bethune Medical Sciences Division, Jilin University.METHODS: The experiment was performed at the Pathology Room, Institute of Regeneration Medical Sciences, Jilin University from May 2001 to May 2003. VSMCs ofin vitro cultured rats were adopted and divided into 5 groups, 0(control group), 0.10, 0.25, 0.50 and 1.00 mmol/L HCY were added, respectively for 48 hours. Effect of HCY on activity of MMP-1 was observed with zymography. The secretions of MMP-1 and TIMP-1 and their mRNA expressions were studied with Western blot and semi-quantitative reverse transcription polymerase chin (RT-PCR).MAIN OUTCOME MEASURES: Activity of MMP-1, secretions of MMP-1 and TIMP-1 and their mRNA expressions.RESULTS: ①Secretions of MMP-1 and TIMP-1: The secretion of MMP-1 in the 0.25, 0.50 and 1.00 mmol/L HCY groups was lower significantly than that in the control group (P ＜ 0.05-0.01). The secretion of TIMP-1 in the 0.10, 0.25, 0.50 and 1.00 mmol/L HCY groups was higher than that in the control group (P＜ 0.05-0.01). ②The MMP-1 activity decreased with the increase of HCY, but reduced obviously in the 0.50 and 1.00 mmol/L HCY groups (P ＜ 0.01). ③The expression of MMP-1 mRNA in the 4 HCY groups was lower markedly than that in the control group (P ＜ 0.01). The expression of TIMP-1 mRNA in the 0.25 mmol/L HCY group was higher than that in the control group (P ＜ 0.05), and it was higher remarkably in the 0.50 and 1.00 mmol/L HCY groups than that in the control group (P ＜ 0.01).CONCLUSION: HCY can inhibit enzyme activity, decrease collagen degradation and induce collagen accumulation by inhibiting the secretion of MMP-1, which indicates that reduction of collagen degradation induced by HCY is one of the pathogenesies of atherosclerosis.

Objective To express and purify EGF-TCS fusion protein and observe the targeted and selective killing effect on cancer cells of the fusion protein.Methods The recombinant expression plasmid PQE30/EGF-TCS was transformed to E.coli.M15 and the fusion protein(EGF-TCS) was expressed.Ni-NTA Agrose affinity chromatography was used to purify the protein,flow cytometry to detect EGFR expression rate in cancer cells(BEL-7402,MCF-7,BGC-823) and normal liver LO2 cells,and the killing test to verify selective killing ability of EGF-TCS;The cell apoptosis detection by flow cytometry and microscopic observation were used to confirm the selective killing ability of EGF-TCS.Results Recombinant expression plasmid PQE30/EGF-TCS was expressed in E.coli.M15 stably and effectively.The purity of EGF-TCS was over 95% by chromatography.EGFR expression rate was highest in hepatoma cells BEL-7402(72.33%) and lowest in normal liver LO2 cells(5.51%).The killing ability of recombinant protein was more effective to cancer cells(IC50 of BEL-7402,MCF-7 and BGC-823 was 11.4,22.47 and 12.53 ?g/ml respectively) and was weak to normal cells(IC50 53.19 ?g/ml).Conclusion The recombinant protein EGF-TCS that induces apoptosis of cancer cells was successfully constructed by gene engineering technology.

Objective To explore the effect of carbohydrate administration on postoperative insulin resistance after gastroenteric tumor resection.Methods Sixty elective gastroenteric tumor resection patients were divided into observation group and control group by random number table method,with 30 cases in each.Observation group was given carbohydrate administration before surgery,that was 2 h before anesthesia oral carbohydrates 300 ml containing 50 g glucose;control group was treated according to the traditional methods,preoperative fasting 12 h,6 h forbidden to drink.The blood samples were collected to measure the levels of fasting blood glucose (FBG) and fasting insulin (FINS) at 3 h before operation and 1,3,7 d postoperation respectively.Homeostasis model assessment (HOMA) was applied to calculate the insulin resistance index.Results The levels of FBG,FINS,HOMA-IR at 1,3 d postoperation in two groups were significantly higher than those at 3 h preoperation [observation group:(10.65 ± 1.78),(7.32 ± 1.48) mmol/L vs.(5.09 ±0.43) mmol/L,(25.78 ± 12.43),(16.23 ±7.56) mU/L vs.(10.48 ± 1.57) mU/L,11.67 ±6.32,5.12 ± 2.11 vs.2.35 ± 0.54;control group:(11.18 ± 1.25),(8.04 ± 1.53) mmol/L vs.(5.12 ± 0.39) mmol/L,(39.67 ± 10.37),(24.34 ± 6.78) mU/L vs.(9.98 ± 2.04) mU/L,19.07 ± 5.49,8.56 ± 2.87 vs.2.28 ± 0.39](P ＜ 0.05).The levels of FINS,HOMA-IR at 1,3 d postoperation in control group were higher than those in observation group (P ＜ 0.05).The levels of FINS and HOMA-IR at 7 d postoperation in observation group were returned to the 3 h preoperative (P ＞ 0.05),while the levels in control group [(16.32 ± 4.56) mU/L,3.87 ± 1.12] was still higher than those at 3 h preoperation (P ＜0.05).Conclusion Carbohydrate administration may shorten the insulin resistance durion after gastroenteric tumor resection,and reduce the intensity of insulin resistance,thus contributing to the rehabilitation of patients.

To explore the effects of nutritional risks on clinical outcomes [length of stay (LOS),hospitalization expense & mortality] in chronic kidney disease (CKD) patients.A total of 127 CKD patients completed the screening of nutritional risks by Nutritional Risk Screening 2002 (NRS-2002) within 24-48 hours of admission.The data of nutritional supports within 2 weeks of admission,LOS,hospitalization expense and mortality were collected.① Among them,the prevalence of nutritional risks was 18.1％.And the values were 8.2％,9.4％ and 44.1％ in early,middle and advanced CKD groups respectively; ② LOS and hospitalization expense in nutritional risk group were significantly more than the non-nutritional risk group (12.5 d vs.5.2 d,P =0.00 ; 11 806 vs.5311 yuan,P =0.00).There was a positive correlation between NRS score and LOS or hospitalization expense; ③ The nutritional support rate of nutritional risk group was only 17.4％.The progression of CKD increased the nutritional risks leading to greater LOS and hospitalization expense.We should pay more attention to the nutritional risk screening and nutritional intervention in moderate-advanced CKD patients.

Objective To assess the clinical value of MPI with ATP intervention (ATP-MPI) in the diagnosis of coronary heart disease (CHD).Methods To collect published literatures on ATP-MPI studies for the diagnosis of CHD,the PubMed,the Excerpta Medica Database (EMbase),Chinese Biomedical Literature Database (CBMdis),Vip and China National Knowledge Infrastructure (CNKI) databases were searched with computer and manual method since the data were available until to 2014.According to the inclusion and exclusion criteria,the literatures were screened to extract data by two independent evaluators.Meta-analysis was conducted with Stata 12.0 software.Results A total of 11 studies involving 968 patients were included.In patient study,which included 9 literatures and 933 patients,the Se,Sp,LR+,LRand 95％ CI of ATP-MPI diagnosis of CHD were 0.89 (0.82-0.94),0.84 (0.74-091),6.00 (3.25-9.91),0.13 (0.07-0.22),respectively.The diagnostic odds ratio (DOR) was 45.04.The AUC of summary ROC (SROC) curve was 0.94.In the coronary artery study,which included 6 literatures and 1 079 coronary arteries,the Se,Sp,LR+,LR-and 95％ CI of ATP-MPI diagnosis of coronary stenosis were 0.83 (0.71-0.91),0.92 (0.86-0.95),10.00 (5.58-16.99),0.18 (0.09-0.34),respectively.The DOR was 53.24 and the SROC AUC was 0.94.Conclusion ATP-MPI has a significant value in the diagnosis of CHD.

Objective Probing into the changes of medical expenses by medical institutions for references to harnessing such expenses.Methods By means of the time sequence method,analyzing the dynamic changes of medical expenses of district of Beijing from 2004 to 2007,with a comparison for hospitals by levels.Results The study found that between 2004 and 2007,the medical expense per person of outpatients in 26 hospitals fell from 72.73 yuan to 70.09,with a relative ratio with a fixed base being-3.64%;the hospitalization expense per capital rose to 3044.35 yuan,with the same ratio being 13.15%;the percentage of pharmaceuticals sales among total income fell from 40.56% to 40.03%.Conclusions It is feasible to harness the rapid growth of medical expenses by means of normalizing medical charges,restricting the percentage of pharmaceuticals among total expense,improving hospital services at all levels,and promoting health education and health itself.

Objective To investigate the effect of preoperative carbohydrate fluid intake on postoperative insulin resistance and immune function.Methods Sixty elective gastroenteric tumor resection patients were randomly divided into test (n =30) and control (n =30) groups.Control group were fasted before surgery,while test group were given oral carbohydrate before surgery.The blood samples were collected to measure the levels of fasting blood glucose (FBG),fasting insulin (FINS),and cellular immunity (CD3 +,CD4 +,CD8 +,and CD4 +/CD8 +) before operation and 1,3,7 day postoperation,respectively.Homeostasis model assessment (HOMA) was applied to assess the status of insulin resistance.Results Compared to preoperation,the levels of CD4 +,CD4 + / CD8 +,and HOMA-IR at 1 day postoperation in both control and test groups were significantly higher (P ＜ 0.05).Compared to test group,the levels of CD4 +,CD4 +/CD8 +,and HOMA-IR at 1,3 day postoperation in control group were significantly higher (P ＜ 0.05).At the seventh day after surgery,HOMA-IR levels in the test group were returned to the preoperative level (P ＞ 0.05),while the control group was still higher than before surgery (P ＜ 0.05).There were no differences in CD4 + and CD4+/CD8 + at seventh days after surgery between two groups (P ＞ 0.05).Conclusions Preoperative carbohydrate administration may shorten the insulin resistance duration after gastrointestinal cancer surgery,reduce the intensity of insulin resistance,and improve immune function.Thus contributes to the rehabilitation of patients.

Breast Neoplasms ; metabolism ; pathology ; Cell Proliferation ; Female ; Humans ; Neoplasm Proteins ; metabolism

Objective To detect serum level of long noncoding RNA ( lncRNA) BC200 in gastric cancer(GC) patients, and investigate its relationship with clinical features , and evaluate its diagnostic value for GC.Methods A case-control study was performed.From November 2014 to July 2015, serum levels of lncRNA BC200 were detected by real-time quantitative polymerase chain reaction in 124 patients with GC , 41 patients with atrophic gastritis and 59 normal controls who were hospitalized in Qilu Hospital of Shandong University.Meanwhile , serum carcinoembryonic antigen ( CEA ) and carbohydrate antigen 72-4 ( CA72-4 ) were detected by electrochemical luminescence immunoassay .Serum levels of lncRNA BC200, before and 3, 7, 10, 30, 100 days after radical operation in another 31 patients with GC were determined.The sensitivity and specificity of serum lncRNA BC200, CEA and CA72-4 were analyzed by using of the receiver operating characteristic ( ROC) curve.The comparison between two groups was performed with Mann-Whitney U test and the comparison among many groups was conducted with Kruskal-Wallis H test.Results Serum levels of lncRNA BC200 in GC patients with stage Ⅰ and Ⅱ[1.041(0.794,1.462)] and stage Ⅲ and Ⅳ[1.290 (0.978,1.794)]were significantly higher than those in patients with precancerous lesion [0.969(0.699, 1.219)]and normal controls[0.801(0.556,1.599)](H =54.68,P<0.000 1).Compared with pre-operation[1.120 (0.859,1.663)], the serum BC200 levels decreased significantly in 10 days [0.903 (0.724,1.182)](U=55.0,P<0.000 1), 30 days[0.759(0.671,1.037)](U=299.0,P=0.026 1), and 100 days[0.478(0.378,0.635)](U=41.0,P<0.000 1) after surgery.The area under the receiver operating characteristics curve ( AUC) of serum lncRNA BC200 was 0.865 for GC diagnosis, which was significantly higher than that of serum CA 72-4 ( AUC =0.699 ) or CEA ( AUC =0.807 ) .The AUC of combined detection of three tests was 0.934.Conclusion Serum lncRNA BC200 levels are significantly increased in GC patients , which may be used as a potential biomarker in GC diagnosis and monitoring .