OBJECTIVE To evaluate the antibiotic susceptibility on coagulase negative staphylococci(CNS) in Xiangya Hospital and to investigate the role of slime in the resistance mechanism of biofilms.METHODS To isolate and identify CNS from clinical(specimens).The susceptibility of 15 antibiotics was tested by the disc diffusion method.The quantity of slime(produced) by CNS was measured by the colorimetric method.Slime was isolated from selected strains of CNS and analyzed by SDS-PAGE.The MICs to vancomycin,gentamicin and rifampin were determined with and(without) the addition of extracted slime by a standard microtiter method.RESULTS Of all these 15 antibiotics,the highest resistance to CNS was penicillin,followed by erythromycin and trimethoprim-sulfamethoxazole.CNS was more susceptible to ampicillin/sulbactam and rifampin.None was resistant to vancomycin.All of 158 CNS,except one strain,could produce slime.There was a statistical difference between the quantities of slime produced by CNS that produced high and low quantity slime.However,there was a non-statistical difference of resistance to these 15 antibiotics of above CNS. There was an increase in the MICs to vancomycin and gentamicin,but no in the MIC to rifampin,in the absence of 20mg/ml extracted slime.The extracted slime seemed to be similar to the glycosaminoglycans(GAG);it had mobility similar to that of chondroitin sulfate.CONCLUSIONS CNS can(produce slime) on some condition,universally,then to form biofilms.However,in vitro susceptibility testing(employed) cannot really reflect the susceptibility of bacteria in biofilms in vivo.Slime can increase the MICs to vancomycin and gentamicin because of interference with either the antimicrobial action of these drugs or the(perfusion) of these drugs through the medium to increase the resistance of biofilms.It does not affect the MIC to rifampin.

Objective To investigate the prognostic factors of life and functional outcome of the first hemiparetic stroke patients. Methods One hundred and eighteen stroke subjects were registered prospectively. The Barthel index (BI) , Rankin scale (RS) , Mortricity index(MI) , Mini-mental state examination (MMSE) , Montgomery-Asberg depression scale (MADRS) and a scale of general state and risk factors were used to evaluate at the 48th hour, the 15th day and the 90th day after stroke. Results The patients' performance, as demonstrated by their scores with all the evaluation instruments, changed significantly at all the time points of evaluation after stroke (P ＜0.05). There was no significant difference between the performance at the 48th hour and the 15th day after stroke ( P ＞ 0.05 ). But at the 90th day after stroke, the activity of daily living performance and the depression status recovered significantly (P ＜ 0.01 ). Logistic regression analysis showed that, such factors as pneumonia, urinary incontinence within 48th hour and deep sensation disturbance might adversely influence patients' activity of daily living performance at the 90th day after stroke; the muscle strength of upper extremities at the 48th hour, and MMSE scores at the 15th day after stroke acted as the protective factors. Conclusions The stroke patients improved significantly with regard to their clinical and functional manifestations when evaluated 90 days after stroke onset. The main factors influencing the activity of daily living performance 90 days after stroke onset included deep sensation disturbance,pneumonia, urinary incontinence and muscles strength of upper extremities at 48th hour, and MMSE scores at the 15th days after onset.

Objective To investigate the effect of local insulin injection on neurological function after crushed injury of facial nerve in rats. Methods Facial nerve was crushing injured in 30 Sprague-Dawley rats, from which 20 selected rats were divided into treatment group (n=10) and control group (n=10). The treatment group was injected with insulin 250 ng/kg at innervated muscle, and the control group was injected with normal saline. They were assessed with neurologic deficit score everyday within 7 days after injection, and the regeneration of nerve fiber was observed with retrograde fluorogold labeling. Results Compared with that in the control group, the neurological deficit score was improved more 5~7 days after injection in the treatment group, and the count of fluorogold labeling cells increased more in the treatment group. Conclusion Local injection of insulin can promote the recovery of neurological function after crushed injury of facial nerve.

Objective Through conducting the project of quality improvement for intrahospital transport of critically ill patients from ward to ICU,to establish graded management under early warning to improve transport efficiency and quality.Methods Through setting up project team,setting goals of quality improvement,measuring and analyzing transport status,the graded management under early warning was established from three aspects:condition,equipment and transport personnel.The graded management under early warning was applied to clinical nursing practice to evaluate the effects.Results There was no statistical difference before and after the implementation of graded management under early warning in gender,age and condition of critical ill patients between two groups,but the time of transport was significantly reduced after the implementation,while there was no equipment failure,and the incidence of adverse events associated with devices decreased effectively.Conclusion The establishment and application of graded management under early warning has effectively reduced the risks of transport,improved efficiency and quality of transport.

Objective To observe the differences of cerebral activation pattern with resting state functional magnetic resonance imaging (rs-fMRI) between patients with spasmodic torticollis (ST) and healthy controls,thus to investigate the pathogenesis of ST.Methods Nineteen ST patients and 21 age,sex and education-matched healthy controls,recruited from the Department of Neurology,First Affiliated Hospital of Guangxi Medical University between November 2012 and January 2016,were included in this study.rs-fMRI and factional amplitude of low frequency fluctuation (fALFF) were used to obtain differences between patients with ST and healthy controls,and correlative analysis was made on fALFF values of abnormal brain regions and ST patients' symptom severity (Tsui scores).Results Compared with healthy controls,patients with ST had significantly increased fALFF in the left cerebellum and significantly decreased fALFF in the left posterior cingulate cortex/precuneus,right posterior cingulate cortex/precuneus,left middle temporal gyrus,right angular gyrus,left post-central gyrus,right supplementary motor area (t =-5.714-5.920,P ＜0.01),and abnormal brain regions' fALFF values had no correlation with patients' age of onset,disease course,symptom severity (P ＞ 0.05).Conclusion Abnormal sensorimotor area,default mode network and cerebellum dysfunction may play a role in the pathophysiology of ST.

ObjectiveTo explore the diagnosis and prognosis value of clinical pneumonic infection score (CPIS) in patients with stroke-associated pneumonia (SAP).MethodsOne hundred and fifty stroke patients were evaluated and analyzed by CPIS.SAP was regarded as gold standard,and sensitivity,specificity,diagnose accordance rate,positive predictive value and negative predictive value were calculated.Results Thirty-nine patients had SAP and 111 patients did not have SAP by CPIS,and the incidence of SAP was 22.0％ (33/150).CPIS diagnostic sensitivity was 84.8％ (28/33),specificity was 90.6％ ( 106/117 ),positive predictive value was 71.8％ (28/39),negative predictive value was 95.5％ (106/111),and diagnose accordance rate was 89.3％(134/150).The patients of SAP were divided into good prognosis (28 cases) and bad prognosis (5 cases),and the CPIS was significantly lower in patients of good prognosis 7 days after SAP than that in patients of bad prognosis[(4.21 ± 2.23) scores vs. (6.05 ±2.32) scores,P ＜0.05].ConclusionsNot only CPIS has higher diagnosis rate in SAP incidence,but also has good judgment to prognosis.It is worthy of clinical application.

Objeetive To investigate the relationship among social avoidance and acceptance of disability in burn patients.Methods Totally 127 patients were investigated using Social Avoidance and Distress Scale (SADS),Acceptance of Disability Scale (AODS),demographic information questionnaire and disease related information sheet.Results The points of burn patients' SADS was (21.38±6.75),One-way ANOVA showed that gender,marital status,special parts burns,amputation affected social avoidance significantly.The total score and factors scores of acceptance of disability were all negatively related to the score of social avoidance.Regression analysis showed that acceptance of disability,head burns,gender were the independent risk factors of depression.Conclusions Acceptance of disability were negatively related to social avoidance; Nurse can help them accept the reality of disability,develop the confidence to partici-pate in social communication,and improve the social adaptability.

Objective To observe the effect of rosuvastatin calcium on lipid,vascular endothelial growth factor (VEGF),nitric oxide (NO),tumor necrosis factor (TNF)-α and interleukin (IL)-1 in hyperlipidemia patients.Methods One hundred and twenty-seven hyperlipidemia patients were randomly divided into two groups.Patients in the study group included 72 patients which were given rosuvastatin calcium 10 mg and enteric-coated aspirin 100 mg,orally,once a day for 8 weeks.The control group included 55 patients which were only given enteric-coated aspirin 100 mg,orally,once a day for 8 weeks.The change of lipid,VEGF,NO,TNF-α and IL-1 was observed before and after treatment.Results Before treatment,the level of total cholesterol(TC),triglyceride (TG),low density lipoprotein-cholesterol (LDL-C),high density lipoprotein-cholesterol (HDL-C),VEGF,NO,TNF-α and IL-1 in two groups had no significant difference (P ＞ 0.05).After treatment,the level of TC,TG,LDL-C,TNF-α and IL-1 in study group were significantly lower than those in control group [(4.410 ± 0.688) mmol/L vs.(6.491 ± 0.744) mmol/L,(1.762 ± 0.834) mmol/L vs.(2.632 ± 0.792) mmol/L,(2.256 ± 0.347) mmol/L vs.(4.544 ± 0.493) mmol/L,(41.14 ± 5.41) ng/L vs.(71.34 ± 6.76) ng/L,(0.22 ± 0.18) μ g/L vs.(0.42 ± 0.23) μ g/L] (P ＜ 0.05).The level of HDL-C,VEGF and NO in study group were significantly higer than those in control group [(1.807 ± 0.730) mmol/L vs.(1.432 ± 0.514) mmol/L,(564.86 ± 120.02) ng/L vs.(451.23 ± 100.72) ng/L,(42.39 ± 6.71) μ mol/L vs.(33.65 ± 6.24) μ mol/L](P＜ 0.05).No adverse reaction occurred in two groups.Conclusions Rosuvastatin calcium can obviously decrease the level of lipid,elevate the expression of VEGF and NO,and reduce the expression of TNF-α and IL-1.Rosuvastatin calcium can improve vascular endothelial function obviously in hyperlipidemia patients.

Objective To explore whether synergistic action occurs in development of depression-like behaviors using ovariectomy combined bondage stress,and whether hippocampal neural progenitor state is changed following depression-like behaviors in mice.Methods Forty female C57B/L mice were divided into four groups randomly,which included ovariectomy,bondage stress,ovariectomy combined bondage stress and sham groups.Depression-like behaviors were evaluated by open field test,sucrose preference and forced swimming test after animals had been treated for 21 days.All animals were fixed by 4％ PA perfusion through left ventricle,then brain was removed,and coronal serials sections were made.Expression of Ki67 and DCX was tested by immunohistochemistry or immunofluorescence in subgranular zone of hippocampal dentate gyrus (SGZ).Results Body weight((18.70± 0.25) g vs (20.96±0.24)g),novelty-seeking behavior and sucrose preference decreased in ovariectomy combined bondage stress-group compared with those in sham group (P＜0.05),but forced swimming time increased in shame group((165.6±9.6)s vs (140.28±12.3) s).Likewisely,Ki67-positive cells((8.6±2.4)/section) and DCX-positive cells((4.2±1.4)/section) in SGZ decreased in ovariectomy combined bondage stress-group compared with those in sham group(Ki67:(16.7±2.5/section),DCX:(12.6±2.3/section) (P＜0.05).Unsimilarly,depressionlike behaviors had little change in ovariectomy-or bondage stress-groups compared with those in sham-group.Conclusion Ovariectomy combined bondage stress has synergistic action in development of depression,and inhibits the active state of progenitor in SGZ in mice.

Objective To detect the levels of IL-1, IL-6,TNF-αand IFN-γin serum and colon tissue of rat mod-els of ulcerative colitis with spleen and kidney Yang deficiency, and to explore their roles in the pathogenesis of ulcerative colitis ( UC) .Methods The rat model of ulcerative colitis with Yang deficiency of spleen and kidney was induced by perfusion of rhubarb decoction plus intramuscular injection of hydrocortisone and combined with TNBS (2,4,6-trinitro-benzenesulfonic acid) and ethanol enema.Sixty SPF wistar rats ( body weight 180 ±10 g, male:female=1:1) were ran-domly divided into blank control group, UC model with spleen kidney Yang deficiency for 7 days, 14 days and 21 days groups, respectively.The levels of IL-1, IL-6, TNF-αand IFN-γin serum and colon tissue were detected by ELISA.Re-sults Compared with the blank group, the levels of IL-1, IL-6, TNF-αand IFN-γin serum and colon tissue of rat UC model group with spleen kidney Yang deficiency were greatly increased (P<0.05), especially evidently increased in the model group at 21 days.Conclusions The pro-inflammatory cytokines IL-1, IL-6, TNF-αand IFN-γplay an important role in the pathogenesis of ulcerative colitis with syndrome of spleen and kidney Yang deficiency.