Objective:To assess the genetic relationship of clinical isolates of carbapenem-resistant A.baumannii (resistant to both imipenem and meropenem) from January 2007 to March 2008 in Peking University Third Hospital for measures to decrease the isolates; to investigate the characteristics of patients with carbapenem-resistant A. baumannii colonization or infection and to evaluate antibiotic treatment for health care-associated infections caused by carbapenem-resistant A. baumannii. Methods: The medical records of patients with carbapenem-resistant A. baumannii colonization or infection were reviewed. Antibiotic susceptibilities of the isolates were determined by the standardized disk-diffusion method and the clonal relationship of the isolates was analyzed by pulsed-field gel electrophoresis. Results: A total of 49 carbapenem-resistant A. baumannii strains were isolated from the 49 patients hospitalized during the study period and pulsed-field gel electrophoresis typing yielded 7 different patterns. A total of 45 (91.8%)genotyped strains showed clonal relationship. The most frequently identified predisposing factors were intensive care unit stay, invasive procedures, and hypoalbuminemia. Chronic obstructive pulmonary disease (12 cases) and cerebrovascular disease (10 cases) were the most common comorbid conditions.The mortality of patients with carbapenem-resistant A. baumannii infection was 38. 1% (8 of 21 patients), and the acute physiology and chronic health evaluation Ⅱ score, initial antibiotic therapy failure rate and the presence of hypoalbuminemia were significantly increased in the death group. Combination therapy regimens had higher success rates than monotherapy regimens (11/13, 84. 6% vs. 3/17,17.6%). Conclusion: There has been clonal spread of carbapenem-resistant A. baumannii strains among patients in our hospital since 2007. Intensive care unit stay, invasive procedures, hypoalbuminemia, chronic obstructive pulmonary disease and cerebrovascular disease were common in patients with carbapenem-resistant A. baumannii colonization or infection. Antibiotic combination therapy may be effective for carbapenem-resistant A. baumannii infection.

Objective To analyze the antimicrobial resistance of Staphylococcus aureus isolated from clinical samples.Methods Staphylococcus aureus and methicillin-resistance Staphylococcus aureus were collected in the microorganism lab from 2004 to 2008,and the antimicrobial susceptibility test was conducted by disk diffusion technique(K-B method).Results A total of 1521 Staphylococcus aureus were collected in 5 years,of which 890 were MRSA(58.5%).Of all the SAU strains,255 were isolated from emergency room(16.8%),201 from surgery wards(13.2%)and 171 from surgical intensive care unit(SICU)(11.2%).Of all the MASA strains,199 were collected from emergency room(22.4%),148 from SICU(16.6%)and 131 from RICU(14.7%).Most of the MRSA strains(725,81.5%)were isolated from sputum,and the others from wound secretions(62,14.7%),blood(27,3.0%),throat(17,1.9%)and urine(16,1.8%),etc.MASA was resistant to most antibiotocs,but quite sensitive to SMZ.No strains resisted to vancomycin or teicoplanin were found in this study.MASA from all the departments showed a feature of highly resisting to variety antibiotics.Conclusion SAU,especially MASA were increasing in the past 5 years in our hospital.MASA was resistant to 90% of the ? lactan,macrolides and quinolones.No strains resistant to vancomycin or teicoplanin were found yet.It is of great value to monitoring the antimicrobial resistance of SAU and MRSA during the clinical practice.

OBJECTIVE To investigate the bacterial resistance of clinical isolates from pediatric hospital for the guidance of rational use of antibiotics.METHODS Disc diffusion test(Kirby-Bauer method) was used to study the antimicrobial resistance(fastidious bacteria were detected by E test).WHONET5 was applied for analysis.(RESULTS) In the period of study from 2002 to 2003,2 303 strains which were the first isolated from each patient were collected.Of 2 303 clinical isolates,Gram positive organisms accounted for 29.7%,Gram negative ones for 70.3%.Escherichia coli,Klebsiella spp,Staphylococcus aureus,coagulase-negative staphylococci and Pseudomonas aeruginosa were the most common strains among the isolates.Meticillin-resistant S.aureus(MRSA) and meticillin-resistant coagulase(-negative) staphylococci(MRCNS) accounted for 9.7% and 67.6% of S.aureus and coagulase-negative(staphylococci),respectively.Resistant rates of MRSA and MRCNS were higher than that of meticillin-susceptible S.aureus(MSSA) and meticillin-susceptible coagulase-negative staphylococci(MSCNS) to antimicrobial agents commonly used in clinic.No vancomycin resistant strains of staphylococci were found. 4.1% of Enterococcus spp were vancomycin resistant strains.Resistant rate of Streptococcus pneumoniae was 11.9% to penicillin. Most of isolates of Enterobacteriaceae were susceptible to imipenem.The incidences of E.coli and Klebsiella spp producing extended spectrum beta-lactamases(ESBLs) isolates were 49.7% and 63.1%,respectively.The resistance rates of(ESBLs) producing strains to antimicrobial agents(except carbapenems) were higher than those of ESBLs nonproducing ones.CONCLUSIONS Bacterial resistance is still or even a more serious clinical problem than before.The(surveillance) of antimicrobial susceptibility in pediatric hospital is of great significance.It is also very important to promote the rational use of antimicrobial agents so that resistance is minimized and take effective strategy for the control of the problem.

Objective:To analyze the characteristics of hospital infection of hematological disease, so as to provide reference for clinical therapy. Methods: Bacterial strains and antimicrobial resistance of pa-tients with hospital infection in Department of Hematology, Peking University Third Hospital from Jan. 2011 to Dec. 2013 were identified and analyzed retrospectively. The specimens were from their blood, urine, sputum, throat swabs and etc. Results:Among the total of 168 isolates of bacteria,the majority of the bacteria strains were from sputum (42. 9%);114(67. 9%) bacteria strains were gram negative and 54(32. 1%) bacteria strains were gram positive;the pathogen testing showed that 20. 8% were Pseudo-monas aeruginosa,18. 5% Escherichia coli,17. 9% Staphylococcus aureus, 9. 5% Klebsiellar pneumonia, 5. 9% Staphylococcus epidermis and 27. 4% other bacteria ;The gram negative bacilli to cefepime, ami-kacin and carbapenems showed the lowest antimicrobial resistance rates, and S. aureus showed the lowest antimicrobial resistance rates to vancomycin and linezolid. Conclusion:Patients with hemopathy are the main population of hospital infections, the gram negative bacteria are the most common pathogens. It is very important to promptly know the change in distribution of the pathogens in order to rationally select antibiotics and reduce the incidence of bacterial infections.

Objective To investigate current status of healthcare-associated infection(HAI)and community-associated infection(CAI)of different levels of hospitals in Xinjiang.Methods Infection,antimicrobial use and pathogen detection in patients in second-class and above hospitals in Xinjiang on March 20,2014 were performed cross-sectional survey by bedside visiting and medical record reviewing methods.Results A total of 66 208 patients in 132 hospitals were investigated,HAI prevalence rate and case prevalence rate was 1.83% and 2.02% respectively;CAI prevalence rate and case prevalence rate was 24.53% and 24.83% respectively.HAI prevalence rate in third-class hospitals was higher than second-class hospitals (2.58% vs 1.44%,P <0.001),while CAI prevalence rate was lower than second-class hospitals (17.84% vs 28.01%,P<0.001).HAI prevalence rate was highest in intensive care unit (14.91%),CAI was highest in pediatric department. The common infection sites were respiratory tract,surgical site and urinary tract.Antimicrobial usage rate was 31.27%, antimicrobial usage rate in second-class hospitals was higher than that of the third-class hospitals([35.95%,n=15 642]vs [22.32%,n=5 064],χ2 =1 288.974,P <0.001),pathogen detection rate in third-class hospitals was higher than that of the second-class hospitals([59.40%,n=2 224]vs [53.59%,n=6 436],χ2 =38.964,P <0.001 )Gram-negative bacilli were main isolated pathogens,the top 3 pathogens were Escherichia coli ,Klebsiella pneumoniae ,and Acinetobacter bau-mannii .Conclusion The cross-sectional survey can reflect infection status of different levels of hospitals,surveillance of targeted microbial detection and rational antimicrobial use should be strengthened,management of infection in high risk population and key sites should be paid close attention.

Objective To understand the effect of circumcision in reducing high-risk human papilloma virus (HPV) infection in male adults. Methods One hundred and twenty-eight married adults with phimosis who underwent circumcision enrolled in the case group and high-risk HPV of urethral discharge specimens were detected before and 2 years after operation. A total of 128 cases of phimosis without circumcision were recruited in the control group. High-risk HPV infection rates were compared between the two groups. Results The highrisk HPV infection rates in the two groups were comparable at baseline. In the circumcision group, high-risk HPV infection rate was 27. 3% preoperative and it significantly decreased to 12.5% two years after operation( x2 =8. 839 ,P =0. 005). In the control group,high risk HPV infection rate was 28. 1% at baseline and it was 25.0%two years later, with no significant difference (x2 =0.320,P = 0.671).Conclusion Circumcision can significantly reduce high-risk HPV infection. Promoting circumcision actively in our country may have an important role in preventing high-risk HPV infection.

BACKGROUND: Zein has excel ent solubility, heat resistance and biodegradability, but its biocompatibility and effect on periodontal defects repair are under discussion. OBJECTIVE: To analyze biocompatibility of zein and its effect on periodontal defect repair. METHODS: Zein scaffold was prepared by solvent casting/particulate leaching. In vitro test: Human periodontal ligament cel s were co-cultured with zein scaffold for 18 days, and cel growth was observed by scanning electron microscope. In vivo test: Eight Beagle dogs were enrol ed to establish periodontal defect models, which were randomly assigned to receive zein scaffold implantation as experimental group, or interrupted suture as control group. Afterwards, the defect region was observed by scanning electron microscope at 3 months. RESULTS AND CONCLUSION: In vitro results: Human periodontal ligament cel s adhered wel and tightly on the scaffold with a fusiform, and could grow around pores. In vivo results: In the experimental group the scaffold dissolved completely, bone trabecular arranged regularly, and mature tissues appeared, to be integrated with the surrounding tissues; in the control group, the defect region almost healed, but there were irregular fibers and obvious lacunae. Moreover, compared with the control group, the height of new alveolar bone and bone defect, as wel as the length of junctional epithelium were significantly decreased, and new cementum was significantly increased in the experimental group (P < 0.05). To conclude, zein scaffold has good biocompatibility and can promote periodontal defect repair.

Objective To investigate the expression and significance of estrogen receptor alpha in renal tissue of immunoglobulin A (IgA) nephropathy.Methods Fifty renal tissue samples including forty five cases of IgA nephropathy and five cases of normal expression were collected.The expression of estrogen receptor αt (ERα) was detected by immunohistochemistry method,and its relationship with clinical parameters and the degree of glomerular damage were analyzed.Results ERα was located in the glomerular and renal tubules.With the severity of the lesion,the expression of ERα in renal tissue of IgA nephropathy decreased gradually (P =0.001) and its expression was associated with estimated glomerular filtration rate (eGFR),serum creatinine (Scr),and pathologic grade of IgA nephropathy (r =0.876,-0.818,and -0.736,P ＜ 0.05),The expression of ERα was significantly decreased in hypertensive patients with IgA nephropathy,and the difference was statistically significant compared with that in non-hypertensive group (P =0.011).Conclusions The expression of ERα in renal tissue of IgA nephropathy was significantly decreased and there was a correlation between the degree of renal tissue damage,suggesting that ERα might play a role in the development of renal disease.

Objective To establish the quality standard for Yanyan syrup. Methods Thin layer chromatography ( TLC) was used for the qualitative identification of Puerariae Lobatae Radix and Scrophulariae Radix. High performance liquid chromatography (HPLC) was used to determine the content of puerarin on Diamonsil C18(200 mm×4.6 mm,5μm) column with mobile phase consisting of methanol-0.5% acetic acid (25:75) at a flow rate of 1.0 mL?min-1.The detection wavelength was set at 250 nm. Results TLC spots were clear and well-separated without negative interference.The linear range of puerarin was 3-120μg?mL-1( r=0.999 7) with an average recovery of 97.44% ( RSD=2.07%,n=6) . Conclusion The method for quality and quantity of Yanyan syrup is simple, specific, accurate and reliable.It can be used for the quality control of Yanyan syrup.

Dust ; analysis ; Humans ; Magnoliopsida ; Pneumoconiosis ; epidemiology ; Prevalence