Objective To investigate antimicrobial resistance characteristics and mechanisms of imipenem-resistant Pseudomonas aeruginosa (P .aeruginosa)isolated from clinical specimens.Methods Bacterial strains were identi-fied by BD Phoenix 100 automatic microbial analysis system,antimicrobial susceptibility testing was performed by Kirby-Bauer method;Carbapenemase genes (IMP ,VIM ,OXA,GES )and outer membrane protein gene oprD2 were detected by polymerase chain reaction.Results Resistant rates of imipenem-resistant P .aeruginosa strains to ami-kacin was the lowest (8.33%);resistant rates to gentamicin and tobramycin were<20%;resistant rates to the third and fourth generation cephalosporins,aztreonam,meropenem,compound sulfamethoxazole and minocycline were all>60%,and all strains were resistant to ampicillin/sulbactam.The positive rate of OXA-17 gene was 2.78%(n=1 ),deletion rate of oprD2 was 38.89%,the other drug-resistant genes were not detected.Conclusion Except aminoglycosides,resistance of imipenem-resistant P .aeruginosa to other antimicrobial agents is serious;resistance of P .aeruginosa to imipenem may be due to lacking of OprD2 and production of carbapenemases.

Adaptor Proteins, Signal Transducing ; metabolism ; Adenocarcinoma, Clear Cell ; genetics ; metabolism ; pathology ; surgery ; Adenosine Triphosphatases ; metabolism ; Age Factors ; Carcinoma, Endometrioid ; genetics ; metabolism ; pathology ; surgery ; Colorectal Neoplasms, Hereditary Nonpolyposis ; genetics ; metabolism ; pathology ; surgery ; Cystadenocarcinoma, Serous ; genetics ; metabolism ; pathology ; surgery ; DNA Mismatch Repair ; DNA Repair Enzymes ; metabolism ; DNA-Binding Proteins ; metabolism ; Endometrial Neoplasms ; genetics ; metabolism ; pathology ; surgery ; Female ; Humans ; Mismatch Repair Endonuclease PMS2 ; MutL Protein Homolog 1 ; MutS Homolog 2 Protein ; metabolism ; Neoplasms, Multiple Primary ; genetics ; metabolism ; pathology ; surgery ; Nuclear Proteins ; metabolism

Objective To study the fouling mechanism during the filtration of traditional Chinese medicine decoction by inorganic ceramic membrane so as to make a valuable exploration both on membrane fouling prevention and the industrialization of membrane separation technology in the field of Chinese materia medica. Methods Micro-filtrating Qingluo Tongbi Decoction using alumina ceramic membrane, researching the applicability of the membrane with different pore sizes, observing the fouling on membrane surface by scanning electron microscopy, studying the resistance distribution of membrane in filtration process, analyzing the fouling existence shape, position, and forming rule. Results In this system, alumina membrane with the pore size of 0.2 ?m was most suitable, which had the biggest permeating flux and reservation rate of effective component with less fouling. Among the alumina membranes with three different pore sizes, auto resistance and pore block resistance made up inferior percentage in total resistance, fouling resistance distribution mainly consisted of the reversible resistance, such as concentration polarization and gel layer resistance. Conclusion Optimizing parameters of the techniques in membrane process, using suitable pretreatment method and cleaning method can reduce membrance fouling and make the memberane property recover.

Objective To study proteome variation between uropathogenic E. coil (UPEC)132, UPEC J96 and non-uropathogenic E. coli K-12 MG1655. Methods Two-dimensional gel electrophoresis(2-DE) was applied to compare the differential expression proteins between UPEC 132, UPEC J96 and non-uro-pathogenic E.coli K-12 MG1655. The differential expression proteins were digested in gel by enzyme. The mass of generated peptides were measured by matrix assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF-MS). The data obtained from peptide mass fingerprinting (PMF) were re-searched using the internet available database. Results The number of protein spots recognized from UPEC 132 was 466±11, significantly more than that of E. coli K-12 MG1655 (338±15) and UPEC J96 (382±12); there were 298 protein spots shared by the three E.coli strains, 56 protein spots shared by two UPEC strains, and 89 protein spots characterized by UPEC 132. Twenty-two differential expression or significantly increased expression protein spots, involved in virulence factors, metabolism and transportation, regulation of protein synthesis, biological oxidation and unknown functions, were successfully identified by MALDI-TOF-MS. Condusion The proteome from UPEC 132 and non-uropathogenic E. coli K-12 MG1655, or UPEC 132 and UPEC J96 was differentially expressed. It will provide important information on the pathogen-esis of UPEC 132.

OBJECTIVE: To evaluate the effects of Xuefu Zhuyu Decoction (XFZYD) on functions of vascular endothelium in patients with unstable angina pectoris (UAP). METHODS: Fifty patients with UAP were randomly divided into two groups: XFZYD-treated group with 32 cases and control group with 18 cases. The patients in the control group were given regular therapy, while the patients in the XFZYD-treated group were given XFZYD additionally on the basis of regular therapy. All patients in both groups were treated for 8 weeks. Then the contents of serum endothelin (ET), nitric oxide (NO), soluble vascular cell adhesive molecule-1 (sVCAM-1) and soluble intercellular adhesion molecule-1 (sICAM-1) were examined by radioimmunoassay, enzymic method and enzyme-linked immunosorbent assay (ELISA) respectively. RESULTS: The total response rate in the XFZYD-treated group was 93.75%, which was significantly higher than 66.67% in the control group (P<0.05). The contents of serum ET, sVCAM-1 and sICAM-1 in the XFZYD-treated group were much lower than those in the control group (P<0.01), while the content of serum NO was obviously higher than that in the control group (P<0.01). CONCLUSION: XFZYD can improve the functions of vascular endothelium by lowering the levels of endothelium-derived contracting substances, enhancing the levels of endothelium-derived relaxing substances, and reducing the cell adhesions, and hence to raise the therapeutic effects on UAP.

Objective To observe the efficacy of multifactor intensive nursing intervention on chronic heart failure patients with outside hospital treatment,including self-management ability and related clinical indicators.Methods By application of prospective study,a total of 215 patients with chronic heart failure discharged from hospital were randomized into the usual care group (105 cases) and the intensive nursing intervention group (1 10 cases).Patients were followed up for 12 months,and 205 patients completed the follow-up.The usual care group only received conventional outpatient follow-up,the intensive intervention group patients received telephone counseling,more detailed clinical follow-up and regular health education.The intervention effect was compared between two groups.Results Compared with the usual care group,the passing rate of sodium/water limit and daily monitoring of weight was higher in the intensive intervention group.Left ventricular ejection fraction and six-minute walking test were better in the intensive intervention group,while the level of NT-pro-BNP was lower in the intensive intervention group.Compared with the usual care group,re-hospitalization rate and incidence of cardiovascular events were lower in the intensive intervention group.Conclusions Multifactor intensive nursing intervention is helpful on improving self-management ability,alleviate cardiac function,reduce re-hospitalization rate and incidence of cardiovascular events for chronic heart failure patients.

Objective To study the clinical characteristics,pathology,and treatment for papillary carcinoma of the breast.Methods The clinical data of 17 patients of papillary carcinoma of the breast admitted in the First Affiliated Hospital of Wen Zhou Medical College were retrospectively analyzed.Results Papillary carcinoma of the breast accounted for 0.64％ of all breast cancer cases hospitalized during last 10 years.All cases had palpable lumps in the breast.12 cases received modified radical mastectomy,2 cases received simple mastectomy,2 cases underwent breast conservation therapy,1 case underwent simple mastectomy plus sentinel lymph node biopsy.15 patients received postoperative chemotherapy,among those 5 cases also received radiotherapy.During a 32.5-month median follow-up ( 1 month to 8 years),one case with bone metastases died 2 years postoperatively and another one died of multimetastases 7 years later.Conclusions The prognosis of papillary carcinoma of the breast is closely related with its pathology type.For intraductal papillary carcinoma low-traumatic therapy is applicable,while in case of infiltrating papillary carcinoma or invasive micropapillary carcinoma ( IMPC ),more aggressive therapies like that adopted for infiltrating ductal carcinoma are recommended.

Objective To explore the expression and clinical significance of EphA2 and E-eadherin in colorectal carcinoma.Methods The expression of EphA2 and E-eadherin in 67 cases of eoloreetal carcinoma and 28 cases of normal large intestine tissues were determined by immunohistochemieal method(S-P method),and their relationship to elinicopathological characteristics were analyzed.Results The positive expression of EphA2 and negative expression of E-cadherin in colorectul carcinoma tissues were significantly higher than those in normal intestine tissues(P<0.01).F111e positive expression of EphA2 and negative expression of E-eadherin were positively correlated with tumor histological grade,invasive depth and lymph node metastasis(P<0.01 orP<0.05),but not correlated with tumor～ross type(P> O.05).The expression of EphA2 was negatively related with E-cadherin.Conclusions The abnormal expression of EphA2 and E-cadherin may be together involved in the development and progression of eolorectal carcinoma,It may be a good marker for monitoring the malignant degree and the prognosis of colorectal carcinoma by combining E-eadherin and EphA2.

OBJECTIVETo analyzed the relationship between lumbar endplate Modic area changes rate and low back pain by measuring MRI T2 sagittal image of lumbar endplate Modic area changes rate.

METHODSFrom December 2011 to June 2012,70 patients with low back pain in operation were evaluated on pain by VAS and function by JOA,and examined by MRI including 39 males and 31 females with an average age of (51.00 +/- 11.89) years ranging from 29 to 72 years old. Among them, 54 cases had lumbar endplate Modic changes involving 15 cases in types Modic I ,21 cases in type Modic II, 11 cases in type Modic III ,mixed type Modic in 7 cases (eliminated for too few cases). Modic area changes and corresponding vertebral area were measured on MRI T2 median sagittal. The areas of two ways were compared to yield the rate of changes for Modic, for multisegmental Modic changes to calculate the total ratios. A correlation was observed among JOA, VAS and the rate of Modic changes.

RESULTSThe correlation coefficient of change rate of Modic I with JOA score was r = -0.308, P = 0.048 < 0.05, there was a negative correlation;the correlation coefficient of change rate of Modic I with VAS scores was r = 0.428,P = 0.021 < 0.05, there was a positive correlation. The correlation coefficient of change rate of Modic II with JOA score was r = -0.375, P = 0.043 < 0.05, there was a negative correlation;the correlation coefficient of change rate of Modic II with VAS score was r = 0.352, P = 0.041 < 0.05, there was a positive correlation. The area change rate of Modic III had no significant correlation with low back pain degree (P > 0.05).

CONCLUSIONModic I and II area changes rate of of patients with low back pain is closely related to the degree of pain low back pain, Modic III area changes rate is not significant correlated to the degree of lower back pain.

Adult ; Aged ; Female ; Humans ; Low Back Pain ; diagnosis ; diagnostic imaging ; Lumbar Vertebrae ; diagnostic imaging ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Radiography

OBJECTIVE: To explore the application of therapy drug monitoring of imipenem in ICU, and to provide evidence for the use of imipenem in critically ill patients. METHODS: A cross-sectional survey was conducted to collect clinical data of 67 patients receiving therapeutic drug monitoring of imipenem in ICU from January 1, 2016 to December 31, 2018. Using SPSS21.0 statistical software, 71 cases of therapeutic drug monitoring data (blood drug concentration, f%T>MIC) and related clinical data were analyzed. RESULTS: Of all 71 cases of therapeutic drug monitoring, there are 37 cases (52.11%) f%TMIC≥40%,26 cases(36.62%)f%TMIC70%,and 10 cases(14.08%) f%TMIC=100%. f%TMIC of all cases with 0.25 g q6h were 70%. Among other dosage regimens, the highest proportion of f%T>MIC>40% was 1 g q12h (66.67%) and the highest proportion of f%T>MIC>70% was 0.5 g q8h(43.59%). According to different f%T>MIC, those patients were divided into ≤40% group, >40%-70% group and>70%group. Only group>70% showed a downward trend in the infection index of patients before and after medication. The body temperature decreased significantly (P=0.004), while the average PCT level of group < 40% increased after medication (P=0.46). In terms of renal function, only f%T>MIC>70% group showed a downward trend in serum creatinine after treatment, but there was no significant difference (P=0.285). The serum drug concentration in CRRT group was slightly higher than that in non-CRRT group, and there was no significant difference in f%T>MIC (P=0.376, P=0.209, P=0.988). CONCLUSION: The level of f%T>MIC of imipenem in ICU is unsatisfactory. For critically ill patients, when imipenem f%T>MIC>70%, the antimicrobial effect is better.