OBJECTIVE To study 39 kinds of resistant-related genes in a pan-resistant Alcaligenes xylosoxidans subsp xylosoxidans(AXXxx) in the sputum isolated from a severe hepatitis B patient.METHODS The susceptibility to antimicrobial agents were detected by MIC.16S rRNA and 39 resistant-related genes including 29 ?-lactamases genes,6 aminoglycoside-modifying enzymes(AMEs)genes,1 chlorhexidine-sulfadiazine resistant gene(qacE△1-sul1)and 3 intergron genes separated(intⅠ1,2,3) an AXXxx strain in the sputum of a severe hepatitis B patient were measured by PCR,and verified by DNA sequencing.RESULTS Among the strains,7 kinds of resistant-related genes(blaTEM-116,blaCARB-8,aac(6′)-Ⅱ,aac(3)-Ⅱ,ant(3″)-Ⅰ,qacE△1-sul1,and intI1)detected out.But other 27 kinds of ?-lactamases genes,3 kinds of AMEs(aac(6′)-Ⅰb,aac(3)-Ⅰ,ant(2″)-Ⅰ) genes,and 2 kinds of intⅠ(intⅠ2 and intⅠ3) genes were negative.CONCLUSIONS The pan-resistant A.xylosoxidans,mainly relates to 7 kinds of resistant-related genes(blaTEM-116,blaCARB-8,aac(6′)-Ⅱ,aac(3)-Ⅱ,ant(3″)-Ⅰ,qacE△1-sul1,and intⅠ1).

OBJECTIVE To study 39 kinds of resistant-related genes in a pan-resistant Burkholderia cenocepacia(BCE) strain,in the sputum from a severe hepatitis B patient.METHODS To detect the susceptibility to antimicrobial agents by MIC,16S rRNA,39 resistant-related genes including 29 ?-lactamases genes,6 aminoglycoside-modifying enzymes(AMEs) genes,chlorhexidine/sulfadiazine resistant gene(qacE△1-sul1),integron(intⅠ1,2,3),et al,of 1 strain of BCE in the sputum from a severe hepatitis B patient,were measured by PCR,and verified by DNA sequencing.RESULTS The strain was BCE conformed by 16S rRNA-PCR-DNA sequencing.It was susceptible to ceftazidime,cefepime,ciprofloxacin,levofloxacin,and trimethoprim/sulfamethoxazole,but resistant to piperacillin,aztreonam,cefotaxime,cefoxitin,meropenem,imipenem,nitrofurantoin,gentamicin and amikacin.There were positive of 6 kinds of resistant-related genes(blaTEM-116,aac(6′)-Ⅰb,aac(3)-Ⅰ,ant(2″)-Ⅰ,ant(3″)-Ⅰ,and intⅠ1),28 kinds of ?-lactamases genes,2 kinds of AMEs genes(aac(6′)-Ⅱ and aac(3)-Ⅱ),2 kinds genes of intⅠ(intⅠ2 and intⅠ3) were negative.CONCLUSIONS The multi-resistant BCE is with its multiple resistant mechanisms,and mainly relates to 6 kinds of resistant-related genes(blaTEM-116,aac(6′)-Ⅰb,aac(3)-Ⅰ,ant(2″)-Ⅰ,ant(3″)-Ⅰ and intⅠ1.

Primary biliary cirrhosis(PBC) is a chronic,progressive cholestatic liver disease of unknown cause that usually affects middle-aged women.Ursodeoxycholic acid(UDCA)is the first selected drug to PBC which has definite effect.Treament of PBC with UDCA combined with immunodepressant become presents research focuses.Liver transplantation is the only treatment of the final stage of PBC.

Objective To explore the prognostic factors of nosocomial infection in severe hepatitis and liver cirrhosis,and to assess its prevention and treatment.Methods A prospective study of nosocomial infection of severe hepatitis and liver cirrhosis was carried out in our hospital from Apr.1996 to Dec.2000.The prognostic factors of nosocomial infection in severe liver diseases was analyzed by logistic regression.Results The mortality of nosocomial infection in severe liver was 37 36%(34/91).Multiple regression analysis showed that prognosis was in order variables related to follow factors:Serum bilirubin,prothrombin time,complement C3,serum cholesterol,serum sodium,white blood cells count,polymorphonuclear cell rate,the kinds of nosocomial infection,severe complications and improper medical manipulations.The prognostic factors high correlated with nosocomial infection via analysis by logistic analysis were as follows:low serum complement C3 and low cholesterol.Conclusions The nosocomial infection were important factors that cause highly mortality in severe liver diseases.The prognositic factors high related with nosocomial infection of severe liver diseases were:low serum complement C3 and cholesterol level.

OBJECTIVE To study the antimicrobial susceptibility and distribution of the ?-lactamases producing Escherichia coli from hepatopathy patients.METHODS Thirty-six ?-lactamases producing E.coli strains from hepatopathy patients were detected with a multi-disk test(synergy test,antagonized test for the inducible AmpC ?-lactamases(IABLs)),AmpC ?-lactamases(ABLs)phenotype test and extended-spectrum ?-lactamases(ESBLs) comfirmation test,and the susceptibility of antimicrobial agents with K-B test.RESULTS Twenty-six strains of 38 strains produced the ?-lactamases(68.4%),13(34.2%)strains produced penicillinases,5(13.2%)strains produced broad-spectrum ?-lactamases or penicillinases and 8(21.1%)strains produced ESBLs alone.All were not detected out to produce ABLs and carbapenem-hydrolyzing ?-lactamases(CHBLs);All nonnproducing ?-lactamases strains were sensitive to 9 kinds of antimicrobial agents;but in the 26 strains producing ?-lactamases,the resistant rate to AMP,KZ,FTX,IMP,AK,CN,CIP,SXT and TET were 100.0%,50.0%,30.8%,0,61.5%,15.4%,73.1%,61.5%,and 69.2%,respectively.CONCLUSIONS The rate of ?-lactamases producing E.coli from hepatopathy patients is high.The main types of ?-lactamases are penicillinases and ESBLs.Most strains producing ?-lactamases are susceptible to imipenem and amikacin.

The principle, basis, necessity and significance of formulating the local standard of Microtu fortis as a laboratory animal were described in this paper, and the standard was compared with the relationship between this standard of Microtu fortis as laboratory animal and the existing laws, regulations of other standards of laboratory animals.The specific procedures and the degree of adoption of domestic standards and advanced foreign standards were introduced.Furthermore, the proposal and the reasons of recommendatory standards were presented.

Objective To evaluate the effectiveness of prophylactic antibiotic therapy on nosocomial infection in patients with severe viral hepatitis,and inquire into its applied mechanism.Methods 159 cases of severe viral hepatitis were divided into groups according to clinical stage and the applied circumstance of antibiotic medicine;Group A:receiving no prophylactic antibiotics therapy,Group B intravenous injection of the third generation cephalosporins and Group C intravenous injection of the semisymthetic penicillins.All cases had no infection on admission and received no antibiotics for 7 days before entering hospital and had stayed in hospital over 72 hours.Results Nosocomial infection occurred in 76 patients among the 159 selected cases.The incidence of nosocomial infection of Group A,Group B and Group C was 56.16%(41/73),34.0%(17/50) and 50.0% (18/36),respectively.The occurring time of nosocomial infection of Group B in early,middle and late stage patients with severe viral hepatitis was significantly later than Group A.The incidence of nosocomial infection in middle and later stage patients was significantly lower,and the mortality was significantly decreased in middle stage patients.There was significantly difference between group A and B(P0.05).Conclusion Prophylactic usage of antibiotics of third generation cephalosporins can not only delay nosocomial infection but also decrease the incidence of nosocomial infection in middle and late stage patients and mortality in middle stage patients with severe viral hepatitis.

Objective To investigate the relationship between lipopolysaccharide binding protein(LBP) in serum and degree of hepatic inflammation. Methods The levels of LBP in serum of 99 patients with chronic viral hepatitis (CVH) were detected by ELISA. The levels of LBP in 33 of all patients with chronic severe viral hepatitis were further detected 2～4 weeks after treatment. Results The serum levels of LBP in patients with chronic viral hepatitis were higher than that in normal patients [(79.62?45.52) ng/ml vs (50.22?31.44) ng/ml, P=0.001]. The serum levels of LBP in patients with chronic severe viral hepatitis were significantly higher than that in patients with moderate degree CVH group, severe degree CVH group, and normal group (P

Objective To investigate the significance of the expression of interleukin-10(IL-10),interleukin-13(IL-13)and interleukin-15(IL-15)in serums of patients with hepatitis B.Methods The expression of IL-10,IL-13 and IL-15 in serums of 109 patients was measured by ELISA.Results The serum levels of IL-10,IL-13 in patients with moderate degree chronic hepatitis B(CHB)group were significantly higher than that in patients with chronic severe hepatitis group,severe degree CHB group,acute hepatitis group and normal group.The serum level of IL-15 was increased in patients with acute hepatitis、moderate degree CHB group,severe degree CHB group and chronic severe hepatitis compared with normotensives.The proportion of IL-15/IL-10 and IL-15/IL-13 in patients with chronic severe hepatitis group,severe degree CHB group and acute hepatitis group were higher than that in patients with moderate degree CHB group and normotensives.The serum level of IL-15 and the proportion of IL-15/IL-10 and IL-15/IL-13 in dead group were significantly higher than that in improving group with chronic severe hepatitis.Conclusion There is an abnormal cell-mediated immune response in patients with hepatitis B.Combining detection on the levels of serum IL-10,IL-13 and IL-15,and the proportion of IL-15/IL-10 and IL-15/IL-13 would nicely show the cellular active status and be helpful to the prediction of prognosis and direction of therapy in patients with hepatitis B of different kinds of clinical type.

Objective To study the effect of low-dose dexamethasone after acute and subacute cerebral infarct.Methods One hundred and forty patients with acute ischemic stroke were randomly divided into acute ischemic stroke group (acute stage group),subacute ischemic stroke group (subacute stage group),placebo and control groups.Subjects in acute stage groups received conventional therapy and 1 mL (5 mg) dexamethasone injection from 1 day to 3 day after admission and in subacute stage group,received the same treatment as acute stage group from 4 day to 6 day after admission.In control and placebo groups,subjects received conventional therapy and conventional therapy + 1 mL normal saline for injection respectively.One week after treatments,complete blood count and erythrocyte sedimentation rate were tested.One month and three month after treatments,neurological function were evaluated by Barthel Index and modified Rankin Scale (mRS).Results The valuate of erythrocyte sedimentation rate in acute stage group were significantly different from it of placebo and control groups (P ＜ 0.05).Moreover,neurological function of subjects in acute stage group was significantly improved than that in placebo and control groups in by Barthel Index and mRS (P ＜ 0.05).However that in subacute stage group was not different from that placebo and control groups (P ＞ 0.05).Conclusion Low-dose dexamethasone plays a neuroprotection role after acutc cerebral ischemia.