Objective To investigate antimicrobial resistance of clinical isolates from 15 hospitals submitted to Guangzhou Surveillance of Antimicrobial Resistance (GSAR) in 2007,and to learn the feature of bacterial resistance in Guangzhou.Methods Disc diffusion test (K-B methods) was employed to study the antimicrobial resistance.Results Of 18 500 clinical isolates,Gram negative bacilli and Gram positive cocci accounted for 68.4% and 31.6%,respectively,and 45.7% isolates in Gram negative bacilli belonged to non-fermentative bacilli.The detection rotes of methiciHin-resistant strains was 55.9% in Staphylococcus aureus and 75.9% in coagulase negative Staphylococcus.All of the Staphylococcus pneumoniae isolates were penicillin-susceptible (PSSP) according to 2008 CLSI criterion.One strains of Enterobacter faecium were identified as vancomycin-resistance (VRE).The resistant rates of Enterobacter to imipenem and merpenem were the lowest.The prevalence of ESBLs-producing strains in Enterobacter coli and Klebsiella spp.isolates was 43.8% and 39.8%,respectively.Against all the ESBLs strains in Enterobacter coli and Klebsiella spp,meropenem,imipenem,cefoperazone/sulbactam,and piperacillin/tazobactam showed the lowest resistant rates,ranging from 0 to 14.1%,20.4%,24.4% and 25.4% isolates of Pseudomonas aernginosa were resistant to efoperazone/sulbactam,piperacillin/tazobactam and meropenem,while 75.6%,72.4% and 63.2% isolates of Pseudomonas aeruginosa were susceptible to piperacillin/tazobactam,meropenem and cefoperazone/sulbactam,respectively.The resistance rates of Acinetobacter spp.to cefoperazone/sulbactam and meropenem were 2.6% and 5.1%,respectively.Some panresistant isolates of Pseudomonas aeruginosa (5.5%) and Ac/naobacter baumannii (1.5%) emerged.The resistance of Pseudomonas aeruginosa and Aeinetobacter baumannii isolated from sputum sample was higher than those from blood sample.Conclusions The increase of isolated rates of non-fermentative Gram-negative bacilli and the emerging bacterial resistance and oandrug resistance in Pseudomonas aeruginosa and Acinetobacter baumannii warrants further enbancing the local surveillance of bacterial resistance and characterization of panresistance mechanism to inform the rational use of anfimicrobial agents and containment of bacterial resistance.

The problems in teaching infectious disease were discussed .The measures should be taken to improve the teaching quality from the varies of aspects, such as the aim and the model of the teaching, the arrangement of curricula, the cultivation of the clinical ability, and the method of examination and the application of multi-media materials.

BACKGROUND:Some studies have shown that hyperlipidemia can lead to osteoporosis in rats, and exercise can increase the bone mineral density of rats. But the effect of short-time exercise on the bone mineral density of hyperlipdemia induced osteoporosis male rats is unclear yet.
OBJECTIVE:To investigate the effect of short-time middle-load treadmil exercise on the bone mineral density of hyperlipidemia male rats.
METHODS:Twenty-six male Sprague Dawley rats were randomly divided into three groups:control group (n=8), hyperlipidemia group (n=9) and exercise intervention group (n=9). The rats in the control group were fed with normal diet, and the rats in the other two groups were fed with high-fat diet and lasted for 4 weeks to establish the hyperlipidemia models. The rats in the exercise intervention group received treadmil exercise 5 days per week for 4 weeks according to the fol owing schedule:15 m/min for 15 minutes in the 1st week, 15 m/min for 20 minutes in the 2nd week, and then 20 m/min for 20 minutes in the last 2 weeks. Slope grade of the treadmil was adjusted at 0°. At the end of experiment, the rats were sacrificed, and the bone mineral density of the right femur, the morphological change of tibia, the level of plasma alkaline phosphates and calcium content were examined.
RESULTS AND CONCLUSION:Compared with the control group, the distal femur bone mineral density in hyperlipidemia group was significantly decreased (P<0.05);histological analysis of the proximal tibia showed thinning and loss of bony trabeculae arrangement, the gap was widened, and a large amount of fat cel s infiltration or integration into vacuoles in the marrow was observed, the plasma alkaline phosphates was significantly increased (P<0.01). Compared with the hyperlipidemia group, distal femur bone mineral density in the exercise intervention group was increased (P<0.05). After adjust body weight, the whole femur bone mineral density was significantly greater in exercise intervention group compared to hyperlipidemia group (P<0.05). The histological analysis of the proximal tibia showed that the spaces of bone trabeculae decreased and the structure of bone trabeculae compacted, the alkaline phosphates activities were increased (P<0.01). There were no significant differences in serum calcium and phosphates levels between groups. The results show that short-time middle-load treadmil exercise can increase the bone mineral density of hyperlipidemia male rats.

This paper analyzed innovative education management system,innovative education resources,innovative education mode and innovative education evaluation standard through practicing‘integration of production,study and research’ teaching platform. Meanwhile,this paper explored the optimization system of innovative education in medical undergraduate teaching.

Objective To evaluate the in vitro antimicrobial activity of piperacillin-sulbactam against clinical isolates of non-fermentative bacilli isolated from common infections. Methods Microdilution was employed to study the antimicrobial resistance. Results A total of 770 strains were collected from 6 hospitals in Guangzhou, including Pseudomonas aeruginosa, Acinetobacter baumannii, Stenotrophomonas maltophilia , Burkholderia cepacia , Flavobacterium , and Alcaligenes. Compared with other β-lactams,piperacillin-sulbactam displayed the highest activity against all the isolates of P. aeruginosa, especially for imipenem non-sensitive isolates, with the susceptibility of 71.9% and 55.8%, respectively. Piperacillinsulbactam and cefoperazone-sulbactam kept good activity against imipenem sensitive isolates of A. baumannii,with the susceptibility of 71.0% and 73. 0%, respectively. For the strains of Burkholderia cepacia, 69% strains exhibited minimal inhibitory concentration (MIC) of ≤ 16 mg/L for piperacillin-sulbactam. For the strains of Flavobacterium, and Alcaligenes, piperacillin-sulbactam also had excellent activity, with the susceptibility of 70. 2% and 94. 4%, respectively. Conclusion Piperacillin-sulbactam exhibits good activity again non-fermentative bacilli, especial for imipenem non-sensitive isolates of P. aeruginosa.

Objective To study the relationship between gene polymorphism of apolipoprotein E (apolipoproteinE,ApoE)of peripheral blood and Mycoplasma pneumoniae infection in children.Methods Collected 236 cases serum of inpatient and outpatient screening in children with Mycoplasma pneumoniae infection and healthy children between March 2011 and March 2014 in the First Affiliated Hospital of Xi’an Medical University and Xi’an Children’s Hospital,at the age of 3~8 years old,divided into two groups:110 cases of control group and 126 cases of Mycoplasma pneumoniae infection in chil-dren.Used multiple allele-specific PCR (multi-AS PCR)to detect gene polymorphism of ApoE in each group.Results ApoE gene was polymorphic and 6 genotypes:3 homozygous (ε2/2,ε3/3,ε4/4)and 3 heterozygote (ε3/2,ε3/4,ε4/2).Theε3/2 had four bands,ε3/3,ε3/4 and 4/2 had three bands,ε2/2 andε4/4 had two bands.ε3/3 of ApoE genotype distribution in two groups was the most common,control group was 66.7%,infection group was 46.4%.Allele frequencies ofε3 and genotype frequencies ofε3/3 inMycoplasmapneumoniae infection of children were lower than those in control group (P<0.05).But allele frequencies ofε4 and genotype frequency ofε4/4 in Mycoplasma pneumoniae infection of children were increased, which were compared with those in control group (P<0.05).Conclusion There were an association between ApoE gene polymorphism and the incidence of Mycoplasma pneumoniae infection in children.Allelesε3 seems to be a protective factor and allelesε4 may contribute to the development of Mycoplasma pneumoniae infection of children.

OBJECTIVE To study the Pseudomonas aeruginosas drug resistance in intensive care unit and its fluoroquinolone-resistant molecular mechanism,and provide scientific basis for rational employment of antibiotics in clinic. METHODS E test was used to determine the minimal inhibitory concentrations(MIC) of 13 antibiotics against 83 P. aeruginosa strains. Twenty-eight fluoroquinolone-resistant strains were selected with standard sensitive strain-ATCC27853 as control. The quinolone resistance-determining region(QRDR)of the gyrA and parC genes was amplified by PCR and sequenced. RESULTS The positive rate of P. aeruginosa in sputum specimen was the highest from 83 strains (71.08%). gyrA Genes of all resistant strains had an ACC to ATC mutation in codon 83,leading to the amino acid substitution of threonine for a an isoleucine and 11 high level resistant strains also showed a GAC to GGC mutation in codon 87,leading to the substitution of an aspartic acid a glycine for. In addition,14 resistant strains also had an TCG to TTG mutation in codon 87 of parC gene,leading to the amino acid substitution of a serine for a leucine. We didn't find parC gene mutation existing independent in fluoroquinolone-resistant P. aeruginosa. CONCLUSIONS Meropenem remains highly active against P. aeruginosa. But the abuse of imipenem and other fluoroquinolones leads to rise in their drug-resistance rate. Fluoroquinolone-resistance has increased rapidly,the mechanism of resistance is gene mutant. It displayed that gyrA and parC gene mutation is associated with fluoroquinolone resistance.

In this article, we clarify the most important four facets about developing the Relationship Between Patients and Medical Houseman , including experienced mastery of the basic medical theories, comprehending basic medical skills, cultivating favorable occupation morality , and bringing out the means to advance the Relationship Between Patients and Medical Houseman in order to acquire the better social effect .

AIM: To research how to separate the active component in Ligusticum chuanxiong Hort by high speed counter current chromatography. METHODS: Senkyunolide A and Z-ligustilide,the main components of volatile oil in Ligusticum chuanxiong Hort were one step separated by high speed counter current chromatography. n-hexane-ethyl acetate-ethanol-water,1 ∶ 1 ∶ 1 ∶ 1(v/v),was used as the solvent system for HSCCC. Top phase and bottom phase were respectively used as static phase and mobile phase. Optimum speed and flow rate were 900 r/min and 1. 2 mL/min respectively. RESULTS: Collected fractions were analyzed by HPLC and identified by EI-MS and 1HNMR. Purity could reach more than 95% . CONCLUSION: Lactone is fit to be separated and prepared by high speed counter current chromatography with good resolution and high purity. We find a fast and efficient way to separate these.

Objective To understand the experiences of patients prior to operation with recurrent glioma based on the Corbin and Strauss chronic illness trajectory framework. Methods Fourteen patients participated in the semi-structure interviews.Data were analyzed with Colaizzi′s phenomenologica l procedure. Results Based on the Corbin and Strauss chronic illness trajectory framework, experiences of patients prior to operation with recurrent glioma were extracted. (1) Illness-related work including severe symptoms of illness and lack of knowledge of illness. (2) Biographical work including loss of biography and identity of self. (3) Everyday life work including change of social roles, complicated mood combined negative experience and positive experience, heavy economic burden. Conclusions Nursing staff should attach importance to experiences of patients, and provide targeted interventions for successful operations and recovery of physical and spiritual healing.