OBJECTIVE To investigate the ?-lactamases producing rate in Haemophilus influenzae(HIN) and the antibiotics sensitivity,to guide the treatment of Haemophilus species infection.METHODS The strains from respiratory tract samples,were isolated and cultivated in chocolate cultures 2006 to 2007.Drug sensitivity test and beta-lactam enzyme test of Haemophilus species were taken.The results were analyzed by software SPSS11.5.RESULTS Totally 195 isolates of HIN were isolated 32 produced ?-lactamases(16.4%).The sensitivity of H.influenzae to cefuroxime,cefotaxime and ampicillin/sulbactam was 90.8%,93.8% and 95.4%,respectively.CONCLUSIONS Cefotaxime,ampicillin/sulbactam and cefuroxime are the most effective antibiotics for H.influenzae infection.

Objective To compare the effect of hemodiafiltration(HDF) on the incidence rate of intradialytie hypotension. Methods We followed up eighteen patients with symptomatic hypotension history and divided them into group A and group B.Group A was treated with conventional hemodialysis(CHD) and HDF, Group B adopted HDF with low temperture hemodialysis. The number of hypotensive episodes, blood temperature during cardiopulmonary bypass, energy transfer rates were assessed. Results The incidence of symptomatic hypotension of patients was found lower in CHD (40%) than in HDF (6%),P<0.01. Energy transfer rates were founded higher in CHD than in HDF and low temperture hemodialysis, P<0.01. Conclusions HDF significantly reduced hemodialysis-related side effects and increased the tolerance ability of patients.

Objective To assess the association of epidermal growth factor receptor (EGFR) mutation with histologic subtypes in lung adenocarcinoma .Methods Lung cancer tissues were collected from 3 028 cases of patients with non‐small cell lung cancer , DNA was extracted respectively ,and EGFR gene exons 18 ,19 ,20 and 2l mutations were dectected by ARMS‐PCR amplification . The association of EGFR mutation with histologic subtypes in lung adenocarcinoma was analyzed .Results The mutation rate of EGFR detection was 39 .7% ,most were exon 19 del and exon 21 L858R (proportion 89 .8% );according to the new classification , EGFR gene mutation in infiltrating lesions with micro infiltrating adenocarcinoma and infiltrating adenocarcinoma were different (P<0 .05) .EGFR mutation rates were higher in moderately differentiated lung adenocarcinoma ,degree of differentiation of EGFR mutation rates were statistically different(P<0 .05) .Conclusion The new classification showes a correlation with molecular diag‐nosis ,different subtypes of EGFR mutation rate is different .There is a certain correlation between EGFR gene mutation and the de‐gree of differentiation in adenocarcinoma .

Objective To compare the isolation rate of Ureaplasma urealyticum(Uu), Mycoplasma hominis(Mh) and Chlamydia trachomatis(CT), and to analyze the resistance of Mh and Uu to 6 kinds of antibiotics. Methods CT in genitourinary tract of 1 059 NGU patients was detected by kit of VIDAS. Uu and Mh in genitourinary tract was detected by kit of IST. Results From 1 059 tested samples, the total positive percentage for Mycoplasma and Chlamydia was 36.3% and 5.6% respectively, 14.8% and 3.7% for Mycoplasma and Chlamydia from male samples, 52.6% and 7.2% for Mycoplasma and Chlamydia from female samples. The colony counting result showed that the number of female samples with colonies more than 104 cfu/ml was greater than that of male samples, 73.2% versus 60.3% for Uu and 30.5% versus 25% for Mh. The sensitivity of Mycoplasma to antimicrobial agents was as follows from high to low: Pristinamycine, Doxycycline, Josamycin, Tetracycline, Ofloxacin, Erythromycin. Conclusions The isolation of Mycoplasma was more than that of Chlamydia from patients with genitourinary tract infection.Resistance monitoring of Mycoplasma periodically played an important role in clinical drug treatment.

Objective To investigate the localization of Smad protein 2, 3, 6, 7 and their changes of expression in experimental interstitial fibrosis model in rats. Methods Thirty-six rats were divided into normal control, sham operation, and unilateral ureteral obstruction(UUO) groups, and were sacrificed at postoperative day 3, 7, 14, 21. The level of TGF-?1 mRNA was examined by RT-PCR. The sites and levels of expression of Smad protein 2, 3, 6, 7 were examined by immunohistochemistry staining and Western blot . Renal fibrosis was assessed by measuring tissue hydroxyproline. Results Compared to sham operation group, TGF-?1 mRNA was significantly increased in UUO rats, and this trend was positively correlated to increased hydroxyproline content. Immunohistochemistry staining studies indicated that Smad protein 2, 3 mainly expressed in renal tubular cells, rarely in glomeruli, and Smad protein 6, 7 were presented in both the glomeruli and proximal renal tubular cells. Expression of the Smad protein 2, 3 were significantly increased from day 3 to 21 after UUO, while the Smad protein 6, 7 were significantly reduced in the obstructive kidney. Conclusions TGF-?1/Smad signaling is involved in the progression of renal tubulointerstitial fibrosis. The absence of up-regulation of these anti-Smads proteins may be the major cause of the interstitial fibrosis in this model.

To explore the relations of Morphology Immnuophe-notype Cytogenetics Molecular biology(MICM) detection on diagnosis andtreat,emt of leukemia． Methods: 68 cases of leukemia patients had beenanalyzed by morphology(FAB)． Immunohistochemistry(Flow Cytometry, FCM)． chromosome G banding technique and dual-color fluorescence insitu hybridization (D-FISH)．Technique:All patients were treated bychemotherapy． T test and X2 test of significance． Results: 7 cases have acute leukema aberration antigen expression． 5 out of 47 cases acutemyeliod leukemia patients accompany lymhocytic interrelated antigenexpression． 2/l5 cases acute lymphoid leukemia accompany myelocyteinterrelated antigen expression． 2 cases acute lmphoid leukemia are T cell and B cell interrelated antigen mingle expression． had been examined46,XY,t(8,2l) translocation of chromosome and bcr/abl fusion genes inthe acute leukemia patients． 16 out of 20 chronic myeloid leukemia patientshad philadelphia chromosome． 7 out of 20 patients had complicate karyotype． 5 out of 20 patients had bcr/abl fusion gene, l out of 4 patient had bcr/abl fusion gene that Ph chro mosome showed negative in CML． 3/4 cases patients had complicate chromosome． The ratio of CR use l time chemotherapy and the total ratio of CR using 2 times chemotherapywith aberration antigen expression in acute leukemia was significantly lessthan those of the acute leukemia patient had single system antigenexpression(P<0.05)． The time of CML-BC with complicate c hromosome karyotype was significantly short than those of Ph showed negative in CML(P<0.05)． Conclusion: The MICM classification is more acc urate for diagnosis of leukemia and more significant in guiding the leukemiatreamen．

[Objective]To investigate the relationship of TCM syndrome patterns with gastrointestinal motility and hormones in functional dyspepsia (FD). [Methods] Among 30 cases of dyskinetic FD, 16 with liver depression and qi stagnation were allocated to Group B, 14 with spleen and stomach deficiency to Group C and 20 healthy volunteers served as control group ( Group A). Gastric evacuation, elctrogastrogram (EGG), serum motilin and migrating motor complex (MMC) wave of gastric antrum and duodenum during digestion were examined and analysed statistically. [Results]Gastric evacuation, contraction index and amplitude of phase II MMC wave, contraction amplitude and coordinated contraction of phase III MMC wave, and the main power of emptying EGG in empty stomach were decreased in Group B and Group C as compared with those in Group A,and those in Group C were lower than those in Group B, the differences being significant (P

Objective To explore the damage effect of high level of glucose on ECV304 cells and the approaches in which high level of glucose plays its part to provide theoretical bases for the therapy of diabetes.Methods ECV304 cells were divided into four groups:normal control,high glucose group in which glucose was added to the cells with final concentration of 35 mmol?L-1,Radix Astragali(RA) group in which glucose was added to the cells with final concentration of 35 mmol?L-1,as well as RA with final concentration of 500 mg?L-1,mannitol group in which mannitol was added to the cells with final concentration of 25 mmol?L-1.The cells were cultivated for 24 h after the glucose,RA and mannitol were added to the cells and collected for the determination of intracellular Ca2+ concentration,mitochondrial membrane potential and the morphological changes of cells and mitochondria were observed under electronic microscope.Results The intracellular Ca2+ concentration in the cells of high glucose group was significantly higher than those of RA group,mannitol group and normal control group(P

Objective:To study the optimal pain control goal for preventing delirium in critical patients.Methods:A prospective cohort study were conducted. The patients admitted to general departments and transferred to the intensive care unit (ICU) due to critical illness in the First People's Hospital of Changde from January 2017 to November 2019 were enrolled. The General data of the patients were collected within 48 hours after admission. All patients admitted to the ICU were evaluated for pain level using the critical care pain observation tool (CPOT) every 8 hours by nurses, and confusion assessment method of ICU (CAM-ICU) was used to screen delirium patient every 8 hours by the leader of nursing team without knowing the pain level of the patients, until the subjects were transferred out of ICU. The receiver operating characteristic (ROC) curve was drawn, the area under ROC curve (AUC) and the optimal threshold were analyzed with delirium as the reference standard; according to the optimal threshold, multivariate Logistic regression analysis was used to evaluate the correlation between CPOT score and delirium.Results:During the study period, 575 patients were admitted to the participating departments and passed the preliminary screening according to the inclusion and exclusion criteria. During the study period, 34 patients were excluded due to incomplete data. Finally, a total of 541 patients were enrolled in the analysis, including 149 patients in delirium group and 392 patients in non-delirium group. There was no significant difference in gender, age, source of patients, education level, smoking history, drinking history, family mental history, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score or other general information between the two groups. There were 10.1% (15/149) of patients in the delirium group used opioids, which was significantly higher than 4.3% (17/392) in the non-delirium group, and the difference was statistically significant ( P < 0.05). The CPOT score in the delirium group was significantly higher than that in the non-delirium group (4.24±1.78 vs. 2.75±1.95, P < 0.01). The patients were subdivided into young group (< 40 years old), middle-aged group (40-65 years old) and old group (> 65 years old) according to age. The analysis results were consistent with the overall analysis results. ROC curve analysis showed that the AUC of CPOT score predicting delirium was 0.719; when the best threshold value of CPOT score was 2.5, the sensitivity was 91.3%, the specificity was 49.0%, the positive predictive value was 40.5% and the negative predictive value was 93.7%. Multivariate Logistic regression analysis showed that the risk of delirium in ICU patients with CPOT score ≥ 3 was 10.043 times higher than that in patients with CPOT score < 3 [odds ratio ( OR) = 10.043, 95% confidence interval (95% CI) was 5.498-18.345, P < 0.001]. When the gender, age, APACHEⅡ score, smoking history, drinking history, opioids usage were adjusted, the risk of delirium in patients with CPOT score ≥ 3 was 10.719 times higher than that in patients with CPOT score < 3 ( OR = 10.719, 95% CI was 5.689-20.196, P < 0.001). Conclusion:The best pain control goal for preventing the occurrence of delirium in ICU patients is a CPOT score of 3 or less.

Objective To investigate the structure of Tn1546 like elements,the molecular features and genetic background of VanB phenotype-vanA genotype VREs and to explain the difference between phenotype and genotype. Methods Twenty-one VREs were collected in Beijing Hospital from March 2008 to January 2009. Etest was used to determin MICs of ten antibiotics. PCR product sequencing, PFGE and MLST were performed to study the molecular features and genetic background of the 21 VREs. Results All VREs were vanA genotype, but 3 of them( 14. 3% ) exhibited the VanB phenotype. Based on PFGE analysis, 21 VREs belonged to 9 different patterns. Six STs were identified by MLST analysis. The analysis of the structure of Tn1546 like elements showed the deletion of vanY, vanZ and the insertion of ISEfa4 in orf2-vanR intergenic region may be related to the formation of VanB phenotype-wanA genotype. Conclutions VanB phenotype-vanA genotype VREs were rarely found in China. The results of vanA cluster rearrangements could partly explain the causes of difference between phenotype and genotype.