Objective To study Aeromonas hydrophila infection and the clinical status of the major causative factor Aerolysin gene.Methods Clinical isolates of Aeromonas hydrophila was collected from 2012 to 2013 year in People’s Hospital of Shenzhen Longhua Branch.Its identification and antibiotic susceptibility testing was analyzed by VITEK 2 compact.Clinical resistance rates and distribution was analyzed by WHONET5.6 software.Polymerase chain reaction (PCR)was used to de-tect the Aerolysin gene form in chromosomes and plasmids extracted genome.Results The clinical total of 48 isolated Aero-monas hydrophila ,distributed in 16 clinical samples of sputum,blood 11,10 secretions,urine 7 and stool 4.Distribution in ward decentralized,the central tendency was not detected.Drug resistance rates to ampicillin,ampicillin/sulbactam and ce-fazolin reached more than 80%,while amikacin,cefepime,levofloxacin,piperacillin/tazobactam and imipenem was low 10%or less.43.7% strains carried the Aerolysin gene.39.5% of Aerolysin gene was found on chromosome genome.Conclusion Aeromonas hydrophila clinical infection existed in dispersed form,most of which carried Aerolysin gene in chromosome ge-nome.Aeromonas hydrophila had serious resistance to penicillins and first generation cephalosporin,but to broad-spectrum drugs maintaining high sensitivity.Precaution of Aeromonas hydrophila ,as an important condition pathogenic bacteria,is some significant for preventing it’s proliferation of drug-resistant strains.

Objective To compare the clinical effect of application of gene chip microscopy technique for rapid identification of Mycobacterium and classic smear acid-fast staining,and to assess the advantages and disadvantages of the wo methods.Methods From 201 1 to 2014,gene chip microarray and smear acid fast staining were used to identify the mycobacterium tuberculosis in speci-mens suspicious of the infection from all the general hospitals of Shenzhen city.Chi-square test was used to compare the positive rates of the two methods.Results A total of 2 481 specimens were collected from clinic.With smear acid-fast staining technique, the positive specimens of 1 93 cases werefound and the positive rate was 7.8%.Meanwhile,31 7 positive samples were detected by the technology of gene chip microarray,and the positive rate was 12.8%.The positive rate of Gene chip microarray technology was higher than that of the smear acid fast staining,and there was significant difference between them (P < 0.05 ).The 31 7 positive samples identified by Gene chip microarray,included 263 cases of Mycobacterium tuberculosis,27 cases of Mycobacterium absces-sus,18 cases of Mycobacterium intracellulare,3 cases of Mycobacterium gastric uLcer,3 cases of Mycobacterium avium,1 case of Mycobacterium Gordonae,1 case of Mycobacterium marinum and 1 case of Mycobacterium Kansas.Conclusion The gene chip mi-croarray technology is fast,accurate,and its positive rate is higher than that of smear acid-fast staining technique.Classification and identification of Mycobacterium is very helpful for clinical individualized treatment of anti mycobacterium infection.

BACKGROUND: Posttraumatic stress disorder(PTSD) arises as a delayed and /or protracted response to a stressful event or situation of an exceptionally threatening or catastrophic nature. There have been reports about natural disasters causing PTSD, but there have been few reports about PTSDcaused by technological disasters. Our study investigated the mental status of those survivors after a serious explosion.OBJECTIVE: To investigate the characteristics and the factors of impact of PTSD caused by technological disasters.DESIGN: A case controlled study of the survivors of a momentous explosion.SETTING: A provincial mental health center.PARTICIPANTS: A serious explosion happened in Urumqi on September 8, 2000. Twenty-eight survivors(as the study group) who were still hospitalized for treatment 3 -5 months after the accident were involved in this study. And in the control group were 30 normal persons whose general demographic data were the same as those patients.METHODS: A psychiatrist told the subjects the following: The objective and meaning of the test, and explained the self-making questionnaire about their general condition, symptom checklist (SCL-90), self-rating anxiety scale (SAS), self-rating depression scale(SDS), cornell medical index(CMI), the questionnaire on dealing styles, the questionnaire on social support, and others-evaluating scale, incident effect scale(IES); a list of stress reaction symptoms.MAIN OUTCOME MEASURES:Main resulta:①Clinical feature of PTSD caused by the technological disaster.②the related factors to PTSD in the technologal disaster.Secondary results: Comparison of the results between the two groups in IES, CMI, SDS and SAS.RESULTS: A total of 22(79% ) survivors met the criteria as PTSD. There were significant differences in all the assessments(IES, CMI, SDS, SAS,SCL-90) between the study group and the control group (t =3.62-8.17, P ＜ 0.01 ) . The diagnosis of PTSD was positively correlated with the level of traumatic exposure( r = 0. 420, P ＜ 0. 05), and negatively correlated with the degree of satisfaction with the post-event solutions( r = 0. 420, P＜ 0.05), positively correlated with IES scoring and the level of heart pain ( r = 0. 389 - 0. 665, P ＜ 0. 01 ) . The total scores of IES were positively correlated with the level of exposure ( r = 0. 478, P ＜ 0.05 ).CONCLUSION: The incidence of PTSD after explosion was high, and its occurrence was related with the degree of exposure in the event and that of the satisfaction with the post-event solutions.

The authors probed systematically into the delicacy management measures adopted by the hospital in its internal mechanism reform, innovative medical service model, human resource optimization, and its performance appraisal system reform. Discussions in the paper include such topics as flat management for hospitals,intensification,centralization and integration in diagnose and treatment, as well as vertical nursing management, and the outsourced logistic services. The methods and paths to achieve these goals are summarized as “preciseness, accuracy, carefulness, and strictness”.

The reform of performance appraisal and salary system is key to public hospitals reform.This paper introduced practices of the factor performance and salary system reform based on the Balance Scorecard in hospitals.It established a four-dimension performance appraisal structure,a motive salary allocation model covering all members of a hospital.This would help build the performance appraisal and salary allocation system meeting present needs of public hospitals in China.

Objective:To observe the effect of blood glucose lfuctuation and the sustained high blood glucose on renal pathological change and collagen IV (Col IV) expression in diabetic rats.
Methods:hTe 60 male Sprague-Dawley (SD) rats were randomly assigned into a normal control group (NC) and a model group (DM). hTe rats in the normal control group were fed with normal diet, while the rats in the model group were fed with high-sucrose-high-fat diet for 6 weeks. Atfer that,streptozocin (STZ, 30 mg/kg) was injected to induce diabetic model. The model group was then randomly divided into 2 subgroups:a sustained high blood glucose group and a fluctuation blood glucose group (animals in the latter group were subcutaneously injected with insulin twice daily). Rats were sacriifced atfer 3 months and kidney tissues were dissected for HE and PAS staining, Col IV immunohistochemistry and Western blot.
Results:Compared with the normal control group, the renal glomeruli and capillary basal membrane in the diabetic rats was getting larger and thicker, respectively;the capsular space and ground substance was extended and increased, respectively;the volume of renal tubule, kidney hypertrophy index, glomeruler sclerosis index and Col IV content were all increased in the diabetic rats (P<0.01). Compared with the sustained high blood glucose group, the above mentioned pathological changes were more serious in the blood glucose lfuctuation group.
Conclusion:The capillary basal membrane of kidney in diabetic rats is thicker and the ground substance is increased. The degree of glomeruler sclerosis is more serious in the blood glucose lfuctuation group compared with the sustained high blood glucose group, which is conifrmed by the increased level of Col IV.

Objective To evaluate the method and clinical effect of subtalar joint distractor assisted open reduction and internal fixation of comminuted intra-articular calcaneal fracture.Methods Twenty-two patients with fresh closed calcaneal fracture treated with open reduction and internal fixation from May 2011 to July 2013 were included in the study.According to the modes of operation,the patients were randomly divided into two groups (n =11 in each):in group A patients underwent fracture reduction assisted by subtalar joint distractor and in group B patients underwent Steinmann pin traction and poking reduction.All were fixed using the lateral calcaneal plate.Operation time,B(o)hler angle,Gissanes angle,calcaneus height,incision healing time and complications of the two groups were investigated for evaluating the effect of operation.Clinical effect was evaluated using the American Orthopedic Foot & Ankle Society (AOFAS) score before the removal of internal fixation.Results Period of follow-up was (14.3±0.8)months (range,12 to 18 months).Two patients in group B had delayed wound healing,and were treated with regular wound care.At the final follow-up,no infection,nonunion,malunion and internal fixation failure were observed.B(o)hler angle,operation time and calcaneus height observed in group A were superior to those in group B (P ＜0.01).There was no significant difference in Gissanes angle between the two groups (P ＞ 0.05).Compared to the preoperative data,B(o)hler angle,Gissanes angle and calcaneus height were significantly improved in both groups (P ＜0.01).AOFAS score was (83.6 ± 1.4) points in group A and (81.7 ± 1.5) points in group B.Conclusion Subtalar joint distractor assisted open reduction and internal fixation is effective to shorten operation time,improve fracture reduction,reduce wound complications and increase the operative effect for comminuted intraarticular calcaneal fracture.

Objective To explore the correlative factors of sudden death in patients suspected with pulmonary thromboembolism (PTE) in emergency room (ER).Methods A retrospective analysis was conducted.The clinical data of 12 patients with sudden death suspected with PTE (sudden death group) in ER of the Air Force General Hospital from January 2011 to June 2014 were analyzed.The non-sudden death group included 35 patients during the same time period who were diagnosed with PTE based on findings of CT pulmonary arteriography (CTPA) and showed no sudden death in ER.Factors,including sex,age,previous operation,tumor,syncope,dyspnea,bilateral or unilateral edema of lower extremity,heart rate (HR),white blood cell count (WBC),D-dimer,arterial partial pressure of oxygen (PaO2),arterial partial pressure of carbon dioxide (PaCO2) and typical clinical manifestation of electrocardiogram (SⅠTⅢQⅢ),were compared between the two groups.The potential predictors of sudden death of PTE were analyzed by logistic regression analysis.Results Young age (years old:51.3±15.5 vs.62.3±14.4),lower PaO2 [mmHg (1 mmHg =0.133 kPa):49.9± 12.3 vs.62.7± 10.2],higher HR (bpm:122.0± 19.5 vs.89.1 ± 18.5) and higher WBC (× 109/L:13.8 ± 6.9 vs.7.2 ± 2.5) were found in sudden death group as compared with those in non-sudden death group (P ＜ 0.05 or P ＜ 0.01).There was no significant differences in D-dimer level and PaCO2 between sudden death group and non-sudden death group [D-dimer (pg/L):986 (891,3 230) vs.2089 (598,3 397),PaCO2 (mmHg):33.0 (28.6,43.4)vs.36.5 (32.9,41.0),both P ＞ 0.05].The syncope,antineoplaston treatment or tumor metastasis within 6 months,operation in previous 4 months,bilateral asymmetrical edema in sudden death group were more than those of the non-sudden death group,and chest pain was less (P ＜ 0.05 or P ＜ 0.01).Difference in gender,dyspnea and typical SⅠTⅢQⅢ in electrocardiogram were not significant between the two groups (all P ＞ 0.05).It was shown by multiple logistic regression analysis that higher HR [odds ratio (OR) =1.124,95％ confidence interval (95％CI) =1.024-1.235,P =0.014] and higher WBC (OR =1.347,95％CI =1.043-1.738,P =0.022) were identified as independent risk factors of sudden death for PTE.Conclusions Gender,dyspnea,typical S Ⅰ TⅢQⅢ in electrocardiogram,PaCO2 and D-dimer seem unrelated to sudden death of patients with PTE.Young age,chest pain,syncope,bilateral asymmetrical edema,antineoplaston treatment or tumor metastasis within 6 months,operation in previous 4 months and low PaO2 were potential predictors of sudden death according to the univariate analysis.Higher WBC and higher HR are independent risk factors of sudden death for PTE patients.

Objective To investigate the status and species of mycobacterial infections in Shenzhen for clinical diagnosis and treatment to provide a reliable scientific basis .Methods 1 096 of samples from patients with suspicious were detection by gene chip .Results Positive rate of microarray detection mycobacterium was 9 .40% (103/1 096) .103 cases of positive were 87 mycobac-teria by gene chip ,and 16 cases of non-tuberculosis(5 cases of M .abscessus ,3 cases of M .intracellulare ,3 cases of M .avium ,2 cases of M .fortuitum ,1 cases of M .kansas ,1 case of M .marinum ,1 case of M .gordonae .Conclusion The mycobacterial infections in Shenzhen ,tuberculosis infection as the main disease types (84 .47% ) .Non-tuberculous mycobacteria′s isolation ratio has reached 15 .53% ,including 7 kinds of species infection and one case of mixed infections .Identification of M ycobacterium by genechip have great significances for individualized treatment .

Aim To study the absorption mechanism of apigenin-7-O-glucronide, 3,4-Dihydroxycinnamic acid and chlorogenic acid in Erigeron breviscapus extract ( Ebe) by Caco-2 cell monolayer model. Methods The three active ingredients were quantified by UPLC-MS/MS method, and the effect of Ebe concentrations, conveying times, pH values and P-glycoprotein inhibi-tor on the transport of three active ingredients were also investigated. Results Apigenin-7-O-glucronide and chlorogenic acid in Caco-2 cell monolayer model were time-dependent and concentration-dependent. The 3, 4-Dihydroxycinnamic acid in Caco-2 cell uptake was concentration-saturate and P-glycoprotein inhibitor was involved in the uptake process. Conclusion The mechanism of apigenin-7-O-glucronide and chlorogenic acid absorption in cells is mainly through passive trans-port, and the absorption of 3, 4-Dihydroxycinnamic acid is mainly realized by the carrier transport.