Objective To clarify the clinical distribution and antimicrobial resistance characteris-tic of bacterial biofilm during catheter-associated urinary tract infection,and to simulate biofilm "real state" in vivo. Methods Totally 120 patients with catheter-associated urinary tract infections (UTIs) were enrolled in the study. The urine specimens were collected for screening biofilm strains and the corresponding planktonic strains. The biofilm was detected with semi-quantitative detecting method. Antibiotics susceptibility test were performed on the biofilm bacteria to clarify the difference of drug resistance in common MH medium the between biofilm strains and the corresponding planktonic strains,as well as the difference of drug resistance of positive strains of the biofilm between Poloxamer medium and common MH medium. Results Totally 48 strains (48/120,40%) of biofilm bacteria were detected. The antibiotic susceptibility test of planktonic and biofilm bacteria in Mueller-Hinton agar showed no significant difference (P>0.05), while the antibiotic resistance of biofilm bacteria in Muel-ler-Hinton agar and Poloxamer hydrogel was statistically different (P<0.05),and the former was stronger. Conclusion The biofilm bacteria during the urinary tract infection were mainly Staphylococci and Enterococci. The antimicrobial resistance of planktonic and biofilm bacteria have no significant difference in vitro, h is speculated that Poloxamer media may simulate the real living environment of biofilm bacteria and display their "true" drug resistance.

Autophagy is a biological process in which cells maintain homeostasis through degradation of cytoplasmic macromolecules and damaged organelles by membrane vesicle structure .Autophagy plays a critical role in maintai-ning survival of intestinal epithelial cells during intestinal mucosal barrier dysfunction .A negative regulator of auto-phagy may lead to intestinal inflammation and tumorigenesis .

To evaluate the clinical value of quantitative tissue velocity imaging (QTVI) in estimation of LV regional diastolic function in patients with coronary artery disease (CAD). The moving peak tissue velocity of LV wall in long axis direction during isovolumic relaxation (V IR ), early diastole (V E), atrial contraction (V A), and V E/V A ratio were measured and calculated by QTVI in 30 patients suffering from CAD and 40 healthy individuals. The results of QTVI were also compared with mitral valve peak flow velocities during early diastole (E), atrial contraction (A), and E/A ratio. In patients with CAD, V E was significantly lower than of nomal subjects( P

Objective To investigate the association of esp, gelE, ebpA and QS-fsr system and biofilm formation in Enterococcus faecalis. Methods Totally 24 isolates of Enterococcus faecalis were collected from urine and catheter of clinical urine tract infection patients in Third Xiangya Hospital from Oct. 2007 to Jun. 2008, and were divided into biofilm group and non-biofilm group. The luminance ratios of esp, gelE, ebpA and fsrrB of Enterococcus faecalis in biofilm group and non-biofilm group were detected by RT-PCR. And the expression of esp, gelE, ebpA, fsrrB genes in different groups were detected by real-time PCR and were relatively quantitated through 2-△△Ct method. Moreover, the relevancies between that fourgenes and biofilm formation in Enterococcus faecalis were analyzed respectively. Results The expression of esp and ebpA in biofilm group were 298 times and 59 times more than the non-biofilm group. The expression level ofgelE and fsrB in biofilm group were 1/244 and 1/249 times less than the non-biofilm group, and the luminance ratios of esp, gelE, ebpA and fsrB were not significant between the two groups (rank sum was 92,79, 42 and 34 respectively,all P ＞ 0. 05 ). Conclusions The results showed that the biofilm formation in Enterococcus faecalis was promoted by esp and ebpA, and was inhabited by gelE and fsrB, which suggested that the expression of esp, ebpA and gelE genes was regulated by fsr system.

Objective To analyze the clinicopathologic characteristics and evaluate the influence factors for the prognosis of rectum carcinoma patients who had undergone surgical resection. Methods A retrospective analysis of data of 272 patients with rectum carcinoma in TNM stage Ⅰ, Ⅱ, Ⅲ was made, all these patients underwent R0 surgical resection from 1998 to 2002 in the General Hospital of PLA. The survival rate was analyzed by Kaplan-Meier method. The clinical characteristics and pathologic features were compared with the aid of monofactorial and multifactorial Cox regression analyses. Results The median survival time was 58.5 months, and the 1-, 3- and 5-year survival rates of rectum carcinoma after surgical resection were 79%, 70% and 62%, respectively. With monofactorial analysis, preoperative CEA level, diameter of tumors, differentiation degree of tumor, depth of tumor invasion, the number of metastatic lymph nodes and TNM staging were found to be significant factors influencing the prognosis. Adjuvant chemotherapy after surgery had influence over the survival rates of stage Ⅱ and Ⅲ rectal carcinoma. Age, gender, histological type and infiltration of canalis haemalis were uncorrelated with prognosis. Preoperative CEA level, depth of tumor infiltration and the number of metastatic lymph nodes were proved independently to be the risk factors influencing prognosis by multifactorial analysis. Conclusions The tumor site was not the prognostic factor of rectal carcinoma after R0 surgical resection. Preoperative CEA level, infiltration and the number of metastatic lymph nodes were independent prognostic factors in predicting the postoperative outcome. Careful preoperative assessment, early radical surgery and adjuvant chemotherapy after operation can improve the survival rate in rectum carcinoma patients.

Surgical site infection (SSI)following spinal surgery is the most common complications, which is devastating for both the patient and the surgeon.There is strong evidence in the literature that opti-mizing specific preoperative,intraoperative,and postoperative variables can significantly lower the risk of developing an SSI.Evidence-based approach will allow surgeons to minimize the risk of SSI and,therefore, significantly improve patient care.Here,we review the current evidence.

Objective To evaluate the effectiveness of discharge planning and home care for patients with peritoneal dialysis (PD).Methods A total of 60 PD patients were randomly divided into the intervention group and control group,30 cases in each group.Discharge planning and home care were carried out in the intervention group, while routine nursing and telephone follow -up service after discharge were implemented in the control group.The patientsˊscores of Zung Self -Rating Anxiety Scale(SAS),Self -Rating Depression Scale(SDS),Self management ability of patients undergoing peritoneal dialysis,complication rate and readmission rate were compared between the two groups at the next day admission,discharge,lth month and 3th after discharge.Results The scores of SAS and SDS in the intervention group were significantly lower than that in the control group at 3th month after discharge,the difference was statistically significant(tSDS =5.263,tSAS =3.812,P <0.05).The Self management ability of patients undergoing peritoneal dialysis was significantly higher than that of the control group at lth and 3th month after discharge,the difference was statistically significant (t =6.845,t =7.231,P <0.05).No significant difference in the re -admission rate (16.67%,6.67%)was found between the two groups (χ2 =0.387,P >0.05).The complication rate in the intervention group was significantly lower than in the control group at 3th month after discharge(χ2 =5.124,P <0.05).Conclusion Discharge planning and home care can effectively relieve depression and anxiety in patients with peritoneal dialysis and improve the abilities of daily life.It is worth promoting and applying in clinic.

Objective To explore the effect of CYP2D6 gene polymorphism on blood concentration,therapeutic efficacy and adverse effects of anti-depression drug venlafaxine.Methods 69 cases of patients with depression were selected randomly from southern region of FuJian,China.The blood concentration of venlafaxine was detected by HPLC,and the CYP2D6 genotype was determined by sequencing with the amplified PCR products from peripheral blood DNA.The therapeutic efficacy and adverse effects of venlafaxine were evaluated by Hamilton depression scale(HAMD) and treatment emergent symptom scale(TESS) respectively.Results Subjects was divided into CC,CT,TT three groups based on rs16947 locus genotyping.The blood concentrations of venlafaxine were (157.35±15.63) ng/ml,(70.17±5.11) ng/ml,(115.72± 10.2) ng/ml respectively and there was no significant difference (F=1.257,P=0.301).The dose-corrected concentrations and normalized concentrations were not significantly different (F=1.683,1.547,P＞ 0.05).Similarly,the reduction rate of HAMD (CC:(40.6 ± 7.23) ％,CT:(51.7±7.09)％,TT:(42.8±14.1)％) and TESS scores (CC:1.3±0.21,CT:1.3±0.36,TT:1.2±0.28) were not significantly different either (P＞0.05).In 69 samples in this study,genotyping of rs3892097 locus only found GG type,and no further examination was performed.Genotyping divided rs1065852 locus into CC,CT,TT three groups.The blood concentrations of venlafaxine were (42.87±9.9) ng/ml,(64.25 ± 13.59) ng/ml,(181.56± 14.15) ng/ml respectively,and there was significant difference among the three groups (F=4.893,P=0.016).The dose-corrected concentrations and normalized concentrations were also significantly different (F=3.985,3.648,P＜0.05).The reduction rate of HAMD (CC:(42.6±8.23) ％,CT:(48.8± 10.8) ％,TT:(63.4±9.15) ％) was not significantly different (F=2.961,P=0.07).The difference of TESS scores was similar to that of HAMD reduction rate.Conclusion Among the 3 loci studied,only rs1065852 locus within CYP2D6 gene can affect its enzyme activity and then influence the therapeutic efficacy and adverse effects of venlafaxine.

ObjectiveTo assess the differential diagnostic value of serum intestinal fatty acid binding protein (I-FABP)in distinguishing intestinal ischemia patients from acute abdomen patients.MethodsA total of 151 patients with acute abdomen and 17 healthy controls from the PLA General Hospital were enrolled from November,2009 to August,2011. Serum I-FABP levels were measured by ELISA.According to the ROC curve,the cut-off value,sensitivity,specificity,positive likelihood ratio (PLR),negative likelihood ratio ( NLR),positive predietive value (PPV) and negative predictive value (NPV) were calculated. ResultsOf the 151 acute abdomen patients,there were 24 intestinal ischemia patients and 127 without intestinal ischemia.Serum I-FABP level in intestinal ischemia group [( 109.67 ±48.82) μg/L]was significantly higher than those in patients without intestinal ischemia [(36.78 ± 11.25) μg/L]and healthy controls[(8.33 ±6.25) μg/L]( all P values ＜0.01 ).The serum I-FABP cut-off value for the diagnosis of intestinal ischemia was 87.52 μg/L.Serum I-FABP was efficient in terms of sensitivity (0.762),NPV(0.963),PLR(3.05) and NLR (0.24) in the diagnosis of intestinal ischemia.ConclusionI-FABP is potentially useful for discriminating intestinal ischemia from acute abdomen.

Objective To evaluate the brain invasion in gliomas by diffusion tensor tractography(DTT).Methods Diffusion tensor imaging was preoperatively performed in 35 patients who histologically confirmed gliomas.13 of the 35 tumors were low-grade gliomas and 22 were high-grade gliomas. Then the spatial relationship between the lesions and white matter fiber tracts around tumor was analyzed. displacement, continuity and injured conditions of white matter fiber were observed. Results White matter fiber tract in all lesions could be observed clearly. Three patterns of white matter fibers involvement were identified:displaced,infiltrated and destructed. White matter fiber tracts around low-grade gliomas were primarily displaced ,but were mainly infiltrated and destructed around high-grade gliomas. Conclusion DTT was useful for showing white matter fiber tracts,observing the shape changes stereographically,and evaluating the relationship with gliomas in vivo.