Objective To investigate the prevalence and molecular characteristic of heterogeneous‐ vancomycin intermediate Staphylococcus aureus(hVISA) among methicillin‐resistant Staphylococcus aureus (MRSA)strains isolated from sterile body fluid specimens from 2009 to 2013 in Huangzhou District People′s Hospital in Huanggang City .Methods The minimum inhibitory con‐centrations (MIC) of antibiotics was determined by agar dilution method .The hVISA strains were detected by population analysis profile/area under the curve method (PAP/AUC) .The staphylococcal cassette chromosome mec (SCCmec) ,multilocus‐sequence typing (MLST) ,accessory gene regulator (agr) and Staphylococcus aureus protein A(spa) typing of hVISA strains were detected using PCR method .Results 32 hVISA strains were detected among 285 MRSA strains ,the prevalence rate of hVISA was 11 .2% , and the detection rates of hVISA from 2009 to 2013 were 0 .0% ,6 .4% ,9 .0% ,14 .3% and 18 .8% ,respectively ,showed an increas‐ing trend .The main hVISA epidemic clone was ST239‐SCCmecIII‐ t030‐agrI type(28strains ,accounting for 87 .5% ) .Conclusion The detection rate of hVISA showed an increasing trend in the past 5 years ,should be paid attention to strictly control the utiliza‐tion of glycopeptide drugs .

Objective To investigate the molecular characteristics and virulence genes of 488 Staphylococcus aureus ( S.aureus) strains isolated from the People′s Hospital of Huangzhou District in Hubei Province during 2009 to 2013.Methods The minimum inhibitory concentrations (MICs) of Oxacillin and Cefoxitin to S.aureus were determined by agar dilution method .PCR analysis was used for the detection of staphylococcal cassette chromosome mec ( SCCmec ) and multilocus-sequence typing ( MLST ) .Multiplex PCR analysis was performed to detect the 31 common virulence genes .Results A total of 227 methicillin-resistant S.aureus ( MRSA) strains were identified from 488 S.aureus strains with a prevalence rate of 46.5%.The SCCmec Ⅲtype was the prevalent genotype accounting for 81.5% of the 227 MRSA strains, followed by Ⅳtype which accounted for 10.1%.The predominant clonal complex ( CC) of MRSA strains was CC8 accounting for 81.1%, followed by CC59 (4.8%) and CC5 (3.1%).CC1 was the predominant clonal complex of methicillin-sensitive S.aureus (MSSA) strains, accounting for 34.1% of the 261 MSSA strains, followed by CC398 (21.8%), CC121 (14.9%) and CC59 (13.0%).The number of MSSA iso-lates carrying no less than 15 test virulence genes was 109 ( 48 .2%) , which was significantly higher than that of MRSA isolates (28.2%) (P=0.002).A close relationship between the enterotoxins genes (sed, sej and ser) and the CCs of CC8 and CC5 was identified.Exfoliatin genes (eta and etb) and lukED gene were detected only in strains that belonged to CC 1.Strains that belonged to CC 1 and CC59 clones showed higher rates of pvl gene as compared with those belonging to other CCs (P<0.05).Conclusion The prevalence rate of MRSA strains was 46.5%in Huangzhou District, Hubei Province, which was consistent with the na-tional average rate .The predominant genotype of MRSA strains was ST 239-MRSA-SCCmecIII , accounting for 79.3%.Effective measures should be taken by Health sectors to control the spread of MRSA strains .The MSSA isolates carried more virulence genes than MRSA strains .The spectrums of virulence genes were var-ied in strains belong to different CCs clones , indicating the close relationship between virulence genes and genetic backgrounds .

Objective To study the dynamic change of high-sensitivity C-reactive protein(hCRP),interleukin-1(IL-1?)interleukin-6(IL-6)in acute traumatic brain injury,and the correlation between the dynamic change and the scale of brain injury and the prognosis of the patients.Methods 192 cases patients were divided into different groups according to the Glasgow Coma Scale(GCS)and the Glasgow outcome Scale(GOS)three months later discharged from hospital respectively.The concentration of serum CRP,IL-1?,IL-6 were detected with immunoturbidimetry and ABC-ELISA 24 with in hours after traumatic brain injury and the concentration of serum after iniwn at ond day,three days and seven days was detected as well.Results Serum hCRP levels were remarkably elevated and reached peak value within 24 hours,and then gradually decreased.There were a negative correlation between hCRP,IL-1?,IL-6 and the patient's GCS groups(r=-0.162,P

Objective To investigate the early diagnostic value of traditional scoring systems in critical acute pancreatitis.Methods From Jan 2007 to Ju12013,consecutive 184 patients with AP who were admitted to the surgical intensive care unit of the Institute of General Surgery,Nanjing Generai Hospital of Najing Militery Region within 72 h from the onset of the disease were studied.Patients were assigned to four groups,including mild,moderate,severe and critical AP according to the determinant based classification and the receiver operating characteristics(ROC) curve was used to predict the presence of critical AP,and Z test and logistic regression was applied to determine the diagnostic value of traditional scoring systems.Results The area under ROC (AUC) of Sofa,BISAP and CTSI score for early diagnosis of critical AP was 0.896,0.877 and 0.862;the best cut off value was 4.5,9.5 and 2.5.Moreover,the AUC of APACHE Ⅱ and Ranson score was 0.807 and 0.707,and the best cut off value was 8.5 and 3.5,respectively.Z test showed early diagnosis rate of Sofa,BISAP,CTSI score was significantly higher than that in Ranson score,and the difference between the two groups was statistically significant (P ＜ 0.05);though they were higher than APACHE Ⅱ score,the difference between the two groups was not statistically significant (P ＞ O.05).Logistic regression showed that high APACHE Ⅱ,Sofa,BISAP and CTSI score were independent risk factors for the development of critical AP (P ＜ 0.05).Conclusions Sofa,CTSI and BISAP score may be clinically important for early diagnosis of critical AP.

In this paper, a qualitative and quantitative analysis method was established for the scopoletin in herba Artemisiae hedinii hy HPLC. The chromatographic column was Agilent TC-C18 (4.6 mm×250 mm, 5μm);the tem-perature of column was 30℃, eluted with a mobile phase consisted of methanol and 0.3%phosphoric acid solution and gradient elution at a flow rate of 1.0 mL·min-1. The detection wavelength was 344 nm. The results showed that the mass concentration and peak area of scopoletin had a good linear relationship within the range of measurement (r=0.999 9). The reproducibility was good;and the RSD was 1.51%. The average sample recovery rate was 101.42%. It was concluded that the established method was stable, reliable and simple. It provided theoretical evidences for the quality evaluation and quality control of herba A. hedinii.

Objective To study the effects of the intensive treatment with continuously subcutaneous in-sulin infusion(CSII) in patients with gestational diabetes and the nursing during the treatment. Methods From Jan 2007 to Aug 2008, 42 patients with gestational diabetes underwent continuously subcutaneous insulin infu-sion, and a standard nursing plan of patients was made up before treatment. The efficacy of treatment and nursing were analyzed. Results After using the CSII, the blood glucose of all patients was controlled at normal level after 7.0±1.5d. 88.1% of patients were satisfied with the effect and one patient was dissatisfied with the treatment because of losing the fetus for sever bleeding caused by placenta previa. 40.5% of patients with different degrees of anxiety accepted CSII therapy after psychological care by nurses;In 9.5% of patients the infusion bump a-larmed because of needle blockage or infusion tube bending, it restarted working and ran normally once the needle replaced or bending tube unwinded. 7.1% of patients developed hypoglycemia during CSII and recovered after eating. Conclusions Intensive treatment with CSII in gestational diabetes patients can effectively control blood glucose level The effect can be improved by taking specific nursing measures.

Objective: To explore mechanism of lung injury of rats induced by inhalation of white smoke from burning smoke pot. Methods: Forty-eight Sprague Dawley rats were divided into control group (n=12) and injury group (n=36) according to the random number table. Rats in injury group were placed in smoke-induced injury experimental equipment fulled with white smoke from burning smoke pot for 5 minutes to make lung injury, and rats in control group were placed in smoke-induced injury experimental equipment fulled with air for 5 minutes to make sham injury. Six rats in injury group at post injury hour (PIH) 6, 24, and 72 and six rats in control group at PIH 72 were collected to observe pathological changes of lung tissue and pathological score of rats in the two groups by hematoxylin-eosin staining, to detect expression of nuclear factor-κB (NF-κB) p65 mRNA in lung tissue of rats by reverse transcriptional polymerase chain reaction, and to detect content of tumor necrosis factor α (TNF-α), interleukin 1β (IL-1β), and IL-6 in lung tissue of rats by enzyme-linked immunosorbent assay. Data were processed with one-way analysis of variance and t test. Results: At PIH 72, lung tissue structure of rats in control group was clear and complete, with no inflammatory cell infiltration. At PIH 6, there was edema, hemorrhage, and inflammatory cell infiltration in lung tissue of rats in injury group. At PIH 24, edema, hemorrhage, and inflammatory cell infiltration in lung tissue of rats in injury group aggravated. At PIH 72, area of edema in lung tissue of rats in injury group was enlarged, with obvious hemorrhage and inflammatory cell infiltration. At PIH 6, 24, and 72, pathological score of lung tissue of rats in injury group was (3.43±0.86), (5.39±0.93), and (9.99±0.84) points, respectively, obviously higher than that of rats in control group at PIH 72 [(2.11±0.20) points, t=3.659, 8.450, 22.355, P<0.05]. As time post injury prolonged, pathological scores of lung tissue of rats in injury group were significantly increased (F=121.244, P<0.01). At PIH 6, 24, and 72, expression of NF-κB p65 mRNA in lung tissue of rats in injury group was 15.5±4.3, 25.9±1.8, 30.9±3.5 respectively, significantly higher than that of rats in control group at PIH 72 (7.8±0.8, t=4.315, 20.445, 14.408, P<0.01). As time post injury prolonged, expression of NF-κB p65 mRNA in lung tissue of rats in injury group gradually increased (F=32.691, P<0.01). At PIH 6, 24, and 72, content of TNF-α, IL-1β, and IL-6 in lung tissue of rats in injury group was significantly higher than that of rats in control group at PIH 72, respectively (t=7.650, 8.968, 6.827, 6.726, 8.978, 3.460, 5.420, 13.289, 16.438, P<0.01). At PIH 24, content of TNF-α and IL-1β in lung tissue of rats in injury group was higher than that of rats in the same group at PIH 6 and 72, respectively (t=3.409, -2.549, 4.047, -4.100, P<0.05). At PIH 24 and 72, content of IL-6 in lung tissue of rats in injury group was respectively higher than that of rats in the same group at PIH 6 (t=8.273, 9.711, P<0.05). Conclusions After inhaling white smoke from burning smoke pot, rats are inflicted with lung injury by increasing expression of NF-κB p65 mRNA and content of TNF-α, IL-1β, and IL-6, and induce pathological changes of edema, hemorrhage, and inflammatory cell infiltration of lung tissue.

Objective To evaluate the influence of dynamic fixation (rotating and sliding pedicle screws) on stability of the atlantoaxial joint. Methods A series of in vitro biomechanical tests were performed using six fresh adult cervical spines (occipital bone-C4 segment) to simulate different conditions in surgery， including the intact state, the injury state, rigid fixation, rotating pedicle screw fixation, sliding pedicle screw fixation. The repeated measurement design was employed, and under intact, injury and different fixation states, the pure moment of 1.5 N·m in flexion-extension, left-right lateral bending, left-right axial rotation directions were applied using the spinal testing machine. The movement of atlantoaxial spine was measured consecutively by three-dimensional （3D） measurement system in order to analyze the range of motion (ROM) and neutral zone (NZ) of atlantoaxial joints. Results Under injury state, ROM of atlantoaxial joints was significantly larger than that under intact state during flexion, extension, lateral bending and rotation, leading to the instability of atlantoaxial joints. ROM of fixation segments was significantly reduced during flexion, extension, lateral bending and rotation after rigid and dynamic fixation. Compared with rigid fixation, dynamic fixation showed a significant ROM increase during lateral bending. NZs of fixation segments after dynamic fixation were significantly reduced. There were no significant ROM differences between rigid fixation and dynamic fixation. Conclusions The stability of atlantoaxial joints by dynamic fixation during flexion, extension and rotation was comparable to that by rigid fixation, but weaker during lateral bending. Dynamic screw fixation can maintain the relative stability of atlantoaxial joints.

Delayed diabetic wound healing has placed an enormous burden on society. The key factors limiting wound healing include unresolved inflammation and impaired angiogenesis. Platelet-rich plasma (PRP) gel, a popular biomaterial in the field of regeneration, has limited applications due to its non-injectable properties and rapid release and degradation of growth factors. Here, we prepared an injectable hydrogel (DPLG) based on PRP and laponite by a simple one-step mixing method. Taking advantages of the non-covalent interactions, DPLG could overcome the limitations of PRP gels, which is injectable to fill irregular injures and could serve as a local drug reservoir to achieve the sustained release of growth factors in PRP and deferoxamine (an angiogenesis promoter). DPLG has an excellent ability in accelerating wound healing by promoting macrophage polarization and angiogenesis in a full-thickness skin defect model in type I diabetic rats and normal rats. Taken together, this study may provide the ingenious and simple bioactive wound dressing with a superior ability to promote wound healing.

OBJECTIVETo explore the safety and efficacy of pegylated recombinant human granulocyte colony-stimulating factor (PEG-rhG-CSF) in preventing chemotherapy-induced neutropenia in patients with breast cancer and non-small cell lung cancer (NSCLC), and to provide the basis for clinical application.

METHODSAccording to the principle of open-label, randomized, parallel-group controlled clinical trial, all patients were randomized by 1∶1∶1 into three groups to receive PEG-rhG-CSF 100 μg/kg, PEG-rhG-CSF 6 mg, or rhG-CSF 5 μg/kg, respectively. The patients with breast cancer received two chemotherapy cycles, and the NSCLC patients received 1-2 cycles of chemotherapy according to their condition. All patients were treated with the combination chemotherapy of TAC (docetaxel+ epirubicin+ cyclophosphamide) or TA (docetaxel+ epirubicin), or the chemotherapy of docetaxel combined with carboplatin, with a 21 day cycle.

RESULTSThe duration of grade 3-4 neutropenia in the PEG-rhG-CSF 100 μg/kg and PEG-rhG-CSF 6 mg groups were similar with that in the rhG-CSF 5 μg/kg group (P>0.05 for all). The incidence rate of grade 3-4 neutropenia in the PEG-rhG-CSF 100 μg/kg group, PEG-rhG-CSF 6 mg group, and G-CSF 5 μg/kg group were 69.7%, 68.4%, and 69.5%, respectively, with a non-significant difference among the three groups (P=0.963). The incidence rate of febrile neutropenia in the PEG-rhG-CSF 100 μg/kg group, PEG-rhG-CSF 6 mg group and G-CSF 5 μg/kg group were 6.1%, 6.4%, and 5.5%, respectively, showing no significant difference among them (P=0.935). The incidence rate of adverse events in the PEG-rhG-CSF 100 μg/kg group, PEG-rhG-CSF 6 mg group and G-CSF 5 μg / kg group were 6.7%, 4.1%, and 5.5%, respectively, showing a non-significant difference among them (P=0.581).

CONCLUSIONSIn patients with breast cancer and non-small cell lung cancer (NSCLC) undergoing TAC/TA chemotherapy, a single 100 μg/kg injection or a single fixed 6 mg dose of PEG-rhG-CSF at 48 hours after chemotherapy show definite therapeutic effect with a low incidence of adverse events and mild adverse reactions. Compared with the continuous daily injection of rhG-CSF 5 μg/kg/d, a single 100 μg/kg injection or a single fixed 6 mg dose of PEG-rhG-CSF has similar effect and is more advantageous in preventing chemotherapy-induced neutropenia.

Antineoplastic Agents ; adverse effects ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; Breast Neoplasms ; drug therapy ; Carboplatin ; administration & dosage ; adverse effects ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; Cyclophosphamide ; administration & dosage ; adverse effects ; Epirubicin ; administration & dosage ; adverse effects ; Female ; Granulocyte Colony-Stimulating Factor ; therapeutic use ; Humans ; Incidence ; Induction Chemotherapy ; Lung Neoplasms ; drug therapy ; Neutropenia ; chemically induced ; epidemiology ; prevention & control ; Polyethylene Glycols ; Recombinant Proteins ; administration & dosage ; Taxoids ; administration & dosage ; adverse effects