Objective To analyze drug resistance phenotypes and clinical distribution characteristics of clinically isolated carbapenem-resistant Klebsiella pneumoniae(CRKP),and provide evidence for rational use of antimicrobial agents and control of healthcare-associated infection(HAI). Methods CRKP isolated from inpatients in a hospital in 2013-2015 were collected,sources of specimens and homology of antimicrobial susceptibility of pathogens were analyzed. Results Of 949 non-repetitive strains of Klebsiella pneumoniae,75 (7.90% )were CRKP strains. The detection rates of CRKP from 2013 to 2015 were 1.35% ,7.77% ,and 17.04% respectively,which showed an up-ward trend year by year,difference was statistically significant(P<0.01). The main infection sites of CRKP were respiratory tract and urinary tract,CRKP mainly distributed in intensive care unit(ICU),geriatrics and emergency departments. Susceptibility rates of CRKP to amikacin and trimethoprim/sulfamethoxazole were 57.33% and 48. 00% respectively. 22 (29.33% )cases of CRKP infection were community-acquired and 53 (70.67% )were health-care-associated infection. 18 (24.00% )cases died among 75 CRKP infected patients. According to drug resistance phenotype analysis,there were 5 clones of CRKP strains,mainly distributed in ICU,geriatrics and emergency de-partments.Conclusion The proportion of CRKP infection is increasing year by year,clinical monitoring on CRKP should be strengthened,intensive infection control measures should be tarken,so as to prevent and control the spread and prevalence of CRKP.

Objective To study the effect of dexmedetomidine combined with ketamine anesthesia on interventional therapy of children with congenital heart disease (CHD). Methods 40 cases of congenital heart disease were treated with catheter intervention from January 2013 to January 2017. The changes of pulmonary arterial pressure and the effect of anesthesia were compared before and after operation. Results 40 cases of children without surgical deaths, 36 cases of successful closure, the success rate of 90% of the operation, the patient after catheter intervention surgery after the results of the test were better than before and after treatment of children with pulmonary artery pressure (P<0.05), and the anesthesia effect was good in children. Conclusion The effect of dexmedetomidine combined with ketamine on the treatment of cardiac catheterization in children with congenital heart disease can achieve good results. The success rate of operation is high and safe, and it is highly reliable.

ObjectiveTo measure levels of serum resistin in patients with nonalcoholic fatty liver disease (NAFLD) and explore the relationship between serum resistin and insulin resistance,and the role of serum resistin in the pathogenesis and progression of NAFLD.Methods 53 patients (including 30males and 23 females) with NAFLD and the 28 control subjects (including 16males and 12females) were enrolled in this study.The height,weight,waist circumstance,hip girth and blood pressure of all subjects were obtained by standard methods.To all the subjects,the parameters including fasting blood glucose (FBG),triglyceride ( TG),total cholesterol (TC),high-density lipoprotein cholesterol ( HDL-c ),lowdensity lipoprotein cholesterol ( LDL-c ),alanine aminotransferase ( ALT),aspartate aminotransferase (AST)and gamma glutamyl transferase (GGT) were measured.Serum resistin was measured by electrochemiluminescence immunoassay (ECLIA) and fasting serum insulin (FINS) were measured by enzymelinked immunosorbent assay (ELISA).Body mass indexes (BMI),waist hip ratio (WHR),body fat percentage ( BF％ ) were calculated with formula.Homeostasis model assessment was applied to assess the status of insulin resistance index (HOMA-IR).The relationships between serum resistin and various parameters in patients with NAFLD were observed and analyzed by statistical methods.ResultsThere were no significant differences in the number of cases,average age,compositions of sex and BF％ between the NAFLD group and the control group ( P ＞ 0.05).In the NAFLD group,systolic blood pressure ( SBP),diastolic blood pressure(DBP).The waist circumference,hip girth and BMI and WHR were higher than those of control group ( t =3.54,3.32,3.56,5.85,5.56,4.10,P =0.001).There were no significant differences on the level of TC,HDL-c,LDL-c between the NAFLD group and the control group ( P ＞0.05).In the NAFLD group,FBG,TG,AST were higher than those of control group ( P =0.001,P =0.004,P =0.001 ).The levels of serum resistin,FINS,HOMA-IR,ALT and GGT in NAFLD group were significantly higher than those of control group,and there was significant difference between two groups ( P =0.0005).There was no significant correlation between serum resistin and age,BMI,WHR,BF％,FBG,TG,TC,HDL-C,LDL-C,AST in NAFLD group ( P ＞ 0.05).The levels of serum resistin in patients with NAFLD were positively correlated with GGT,ALT,FINS,HOMA-IR ( r =0.354,0.391,0.875,0.881,P ＜0.05 or ＜0.01 ).After multiple stepwise regression analysis,the results showed that HOMA-IR was the most important factor for affecting the levels of serum resistin.The levels of serum resistin in male and female patients with NAFLD were higher than those of control group ( P ＜0.05).But no statistical difference was found between males and females in two groups ( P ＞ 0.05).ConclusionsThe levels of serum resistin in patients with NAFLD were significantly higher than those of controls.Serum resistin in patients with NAFLD was closely correlated with insulin resistance,and it may participate in the pathogenetic progress of NAFLD.Serum resistin in patients with NAFLD might be associated with hepatic insulin resistance,and it has no correlations with obesity-related insulin resistance.Serum resistin in patients with NAFLD may participate in the inflammation of fatty liver disease as inflammatory cytokines.

Hypoxia-inducible factor-I is the critical factor existed in mammal and human cells which plays an important role in maintaining the oxygen balance. Many hypoxia-responding genes can be activated by H1F-1. So, the relationship between HIF-land matrix matalloproteinases/stromal-derived factor-I/special CXC chemokin receptor/angiogenesis related factors is the hot spot in research of the tumor invasion and me-tastasis.

OBJECTIVETo study the effect of nadroparin in the migration of breast cancer cells MDA-MB-231 and its action mechanism.

METHODThe MTT test was adopted to observe the effect of different concentrations of naringenin on the growth capacity of breast cancer cells MDA-MB-231. Wound healing and transwell experiment analysis were conducted to detect the effect of naringenin on the migration of breast cancer cells MDA-MB-231. Western blotting was adopted to investigate the effect of naringenin on protein expressions of MDA-MB-231 cell Integrin β3, β1 and matrix metalloproteinase MMP-2 and MMP-9. The computer virtual docking technique was used to evaluate the combining capacity of naringenin and Integrin β3 in vitro.

RESULTNaringenin inhibited the migration of MDA-MB-231 cells in a dose-dependent manner. In wound healing and transwell experiments, with the increase in the concentration of naringenin, the number of migrant MDA-MB-231 cells and the invasion capacity of breast cancer cells decreased. Naringenin could inhibit the protein expression of Integrin β3 in a dose-dependent manner, but with unobvious effect on expression of Integrin β1. Besides, naringenin could significantly inhibit the protein expressions of MMP-2 and MMP-9. The results of the computer virtual docking showed a negative value in the combining capacity between naringenin and Integrin β3, indicating the high affinity between them.

CONCLUSIONNaringenin can inhibit the growth capacity of breast cancer cells MDA-MB-231 and block the migration and invasion of breast cancer cells MDA-MB-231. Its mechanism is to down-regulate MMP-2 and MMP-9 expressions after combining with Integrin β3.

Breast Neoplasms ; drug therapy ; genetics ; metabolism ; pathology ; Cell Line, Tumor ; Cell Movement ; drug effects ; Drugs, Chinese Herbal ; pharmacology ; Female ; Flavanones ; pharmacology ; Gene Expression Regulation, Neoplastic ; drug effects ; Humans ; Integrins ; genetics ; metabolism ; Matrix Metalloproteinase 2 ; genetics ; metabolism ; Matrix Metalloproteinase 9 ; genetics ; metabolism ; Neoplasm Invasiveness

Objective To assess the effect of inhalation of 20ppm nitric oxide(NO) on gas exchange and hemodynamics in acute lung injury induced by surfactant depletion in piglet.Methods Sixteen female piglets weighing 25-30 kg were induced with thiopental and pancuronium and maintained with continuous infusion of thiopental,fentanyl and pancuronium. The animals were tracheotomized and mechanically ventilated with oxygen(FiO 2=1.0). Femoral artery was cannulated for arterial blood sampling and blood gas analysis.Pulmonary catheter was inserted through the femoral vein for measurement of CVP, mean pulmonary artery pressure(MPAP), PCWP, cardiac output (CO) and sampling of mixed venous blood. Acute lung injury was induced by lung lavage after the method described by Lachmann until PaO 2 was lower than 100mm Hg(PaO 2/FiO 2

The present state of industrial production and usage of the artificial wood board, the main cause of formaldehyde release in its applications, the adverse effects of formaldehyde on human health and the method of lowering formaldehyde emission were discussed in the present paper. Through decreasing the mole ratio of F/U, using two or many times condensation technology, adding formaldehyde scavenger and modifier to the urea-formaldehyde adhesive resin, eliciting free formaldehyde by vacuum dehydration, the urea-formaldehyde (UF) resin adhesive that reaches the environmental standard will be developed.

ObjectiveTo probe into the influence of the zero price margin for drugs on the revenue-expenditure structure at primary healthcare organizations.MethodsOne of the pilot districts experimenting with this system in Ningbo city was earmarked as the research object.Within this district,the data of their revenue,expenditure and surplus were collected from 20 primary healthcare organizations prior to and after the zero price margin for drugs was in place for classification analysis.ResultsThe percentage of service revenue among the total revenue has dropped from 68.34％ before the system was in place to 65.44％ after,reducing 4.24％.The percentage of drug revenue has dropped from 71.68％ before to 63.57％ after,reducing 11.31％.The percentage of service surplus has dropped from 15.81％ before to - 23.07％ after,reducing 245.94％.The total standard workload has increased 61.77％.Average medical expense per outpatient and per inpatient has reduced 32.85％ and 57.18％,from 71.44yuan and 2642.08 yuan before to 48.33 yuan and 1131.28 yuan after respectively.ConclusionThe deficit rise and higher percentage of drug revenue at primary healthcare organizations deserve attention.A comprehensive reform is recommended to establish a regular government financial support mechanism,further adjust the revenue-expenditure structure,set up the system of rational drug use,and effectively reduce the medical expense of patients.

OBJECTIVE:To observe the effects of epalrestat combined with lipoic acid on nerve function,oxidative stress and inflammatory reaction in patients with diabetic peripheral neuropathy(DPN). METHODS:From Jan. 2013 to Jan. 2016,150 pa-tients were selected from our hospital and then divided into group A,B,C according to random number table,with 50 cases in each group. Group A was given Lipoic acid injection 600 mg,ivgtt,qd;group B was given Epalrestat tablet 50 mg,po,tid;group C was given lipoic acid+epalrestat,same usage and dosage as above. TSS score,MNCV,SNCV,oxidative stress indexes (SOD and MDA)and inflammatory indexes(TNF-α and IL-6),as well as blood pressure,blood lipid and blood glucose indexes were compared among 3 groups before and after treatment. The occurrence of ADR were observed. RESULTS:Before treatment, there was no statistical significance in above indexes among 3 groups (P>0.05). Compared to before treatment,TSS score, MDA,TNF-α and IL-6 levels of 3 groups were decreased significantly after treatment;MNCV and SNCV were speeded up signifi-cantly,and SOD level was increased significantly;each index of group C was better than that of group A and B,with statistical significance(P<0.05),but there was no statistical significance between group A and B(P>0.05). SBP and FPG after treatment of 3 groups were decreased significantly than before treatment,while HDL-C was increased significantly,with statistical signifi-cance(P<0.05);there was no statistical significance among 3 groups(P>0.05). No obvious ADR was found in 3 groups. CON-CLUSIONS:Epalrestat combined with lipoic acid can effectively improve nerve function in DPN patients by inhibiting oxidant stress and inflammatory reaction with good safety. The effect of drug combination is better than single drug.

Objective To analysis the risk factors for elevated ALT level in patients with Non-alcoholic fatty liver diseases (NAFLD).Method Fifty-six (male 25,female 31) NAFLD patients with elevated ALT and 153 NAFLD patients (male 64,female 89) with normal ALT and 160 (male 80,female 80) health subjects were selected.ALT was detected by rate assay,total cholesterol (TC),triglycerides (TG),low-density lipoprotein cholesterols (LDL-C),high-density cholesterol (HDL-C) and uric acid (UA) were detected by enzymatic method.Free fatty acid (FFA) was detected by immunoturbidimetry assay.Spearman correlation was used to analysis the relation between ALT and TC,TG,LDL-C,HDL-C,UA and FFA.Logistic regression was used to analyses the risk factor for elevated ALT level.Results TC,TG,LDL-C,UA and FFA levels were significantly higher in NAFLD group (including normal ALT group and elevated ALT group) than those in health group no matter male and female,HDL-C was significantly lower in these two groups when compared to control group,but binary logistic regression and spearman analysis showed that only UA and FFA were the risk factors for elevated ALT level and significantly positively correlated with ALT level,abnormal UA and FFA for male were associated with 3.96-fold(95CI％ =1.40～ 11.22,P=0.010) and 3.27-fold (95 ％ CI =1.14 ～ 9.40,P =0.028) of increased risk of elevated ALT level respectinely,correlation coefficient were 0.40(P=0.000),0.29(P=0.006),Meanwhile Exp(B) of elevated ALT level for female with abnormal UA,FFA were 4.49 (95CI％=1.79～11.28,P=0.001) and 3.17 (95CI％ =1.25～8.04,P=0.015),correlation coefficient were 0.34 (P =0.000),0.27 (P =0.003).Conclusion Elevated ALT level was not associated with dyslipidemias,but related to UA and FFA.They can be used as candidate markers for predicting severity of liver damage.