Objective To investigate the clinical characteristics of the infections caused by carbapenem-resistant Pseudomonas aeruginosa (CRPA) for better prevention and treatment of CRPA infections. Methods A retrospective study was conducted to compare the features of CRPA infections (n=85) and carbapenem-susceptible P. aeruginosa (CSPA) infections (n=94) treated in Huashan Hospital from January 1, 2013 to December 31, 2013. Results? The?proportion?of?CRPA?infections?was?significantly?higher?than CSPA in Neurosurgery (40.0% versus 16.0%) and Intensive Care Unit (22.4%, 9.6%). Traumatic brain injury (30.6%) and vascular accidents (21.2%) were the main underlying diseases in CRPA patients, which was higher than in CSPA patients (11.7%and?8.5%,?respectively).?CRPA?infection?was?associated?with?significantly?higher?incidence?of?fever,?altered?mental?status,?and?severe hypoproteinemia than CSPA infection. Multiple bacterial infection was found in more CRPA patients (45.9%, 39/85) than in CSPA patients (24.5%, 23/94). Fewer CRPA patients showed positive treatment response (44.7%, 38/85) than CSPA patients (78.7%, 74/94). CRPA was associated with significantly more cases of disease progression (55.3%, 47/85) and more deaths (16.5%, 14/85) than CSPA (21.3% and 1.1%, respectively). Logistic regression analysis indicated that stay in Department of Neurosurgery, prior carbapenem use, peripherally inserted central catheter, nasal feeding, and mechanical ventilation were the risk factors for CRPA infection. Conclusions No specific clinical manifestation is associated with CRPA infection, which poses a therapeutic challenge and results in unfavorable prognosis. Rational use of antibacterial agents and appropriate supporting treatments are essential for control of CRPA in Huashan Hospital.

Objective To investigate the diagnosis and treatment of pseudomyxoma peritonei (PMP) and provide a reference for diagnosis and treatment of PMP.Methods The clinical features,laboratory examinations,treatment and outcomes of 8 PMP misdiagnosed cases were analyzed with recent relevant reference.Results Ultrasonography,CT,peritoneal cytological examination,tumor markers results are helpful for diagnosis of PMP.PMP will be confirmed and classified by pathological examination after operation.Complete cytoreductive surgery (CRS)or major debulking surgery (MDS) of the tumor combined intraperitoneal chemotherapy and systemic chemotherapy,eight patients in seven cases survived 4-71 month range,one patient died of respiratory failure of pulmonary infection after the third operation.Conclusions Ultrasonography,CT,peritoneal cytological examination,tumor markers tests help avoid misdiagnosis of PMP before operations.Intraoperative findings follow after PMP,CRS or MDS should be executed in the operation or the next time.Intraperitoneal chemotherapy and conventional chemotherapy can improve survival in patients with PMP and prolong their survival time.

Objective To investigate the antibiotic resistance pattern and molecular epidemiology of carbapenem-resistant Pseudomonas aeruginosa.Methods The antimicrobial susceptibility was measured by agar dilution method for the 104 strains of carbapenem-resistant P.aeruginosa (CRPA) collected from Huashan Hospital.The homology between these strains was evaluated by pulsed field gel electrophoresis (PFGE).Results Of thel04 CRPA strains,85.6％ were resistant to meropenem and 98.1％ to imipenem.These strains also showed various percentages of resistance to amikacin (18.3％),gentamicin (40.4％),ceftazidime (26.9％),cefepime (21.2％),ciprofloxacin (44.2％),levofloxacin (50.0％),piperacillin-tazobactam (19.2％),cefoperazone-sulbactam (26.9％),ticarcillin-clavulanic acid (52.9％),aztreonam (26.9％),and colistin (5.8％).PFGE analysis showed that these strains were divided into 48 types,belonging to 9 clones.Only 3 strains were non-typeable.Clone A was the primary epidemic strain (41.6％,42/101),which was mainly isolated from Neurosurgery,Geriatrics and General Ward.Clone B accounted for 5.9％ (6/101) of the strains.Conclusions Multiple clones of carbapenem resistant Pseudomonas aeruginosa were prevalent in Huashan hospital.Effective infection control approaches should be adopted to prevent the development and the further spreading of antimicrobial resistance.

In this study,a series of new sildenafil analogues 11-27 possessing a guanidine group were synthesized to investigate their PDE5 inhibitory activity and selectivity using[~3H]cGMP SPA kit in vitro and efficacy in the rat model of erection.Most of the compounds showed potent activity against PDE5,and more importantly,several compounds exhibited higher PDE5 selectivity over PDE6 than that of sildenafil.Structure-activity relationship of these sildenafil analogues was also discussed.Within this series of compounds,compound 15(IC_(50) =1.7 nmol/L)not only exhibited more potent PDE5 inhibitory activity than that of sildenafil (IC_(50) = 6.5 nmol/L),but also showed functional efficacy in the rat model of erection.

Objective:To study the expression and function of Mitofusin 2(Mfn2)in cultured neonatal rat cardiomyocytes during PE-induced hypertrophy.Methods:The hypertrophy neonatal rat cardiomyocytes model was induced by 0.01 mol/L PE.RT-PCR and Western blot were applied to assess Mfn2 mRNA expression and protein level respectively.Cultured neonatal rat cardiomyocytes were treated by PE after Ad GFP or Ad Mfn2 infection,the protein synthesis was determined by 3H-leucine incorporation assay.Results:PE led to ANF mRNA level(by~1 fold,P

Objective To evaluate the effect of metabolic syndrome(MS)on prognosis of patients with cardiovascular diseases(CVD).Methods The data of 143 CVD patients including the age,waistline,blood pressure,body mass index(BMI),coronary arteriongraphy,ultrasound and blood glucoset,total cholesterol(TC),triglycerides(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),uric acid(UA),creatinine(Cr)were analyzed to detect the incidence of MS,the position and degree of coronary atherosclerosis,organ functional failure(OFF)and ventricular remodelling in the MS patients and those without MS.Results Of 143 CVD patients,72 cases(50.35%)were diagnosed with MS,and UA,Cr,waistline,systolic blood pressure(SBP),diastolic blood pressure(DBP),blood sugar,TG,body mass index(BMI),MS index,HDL-C,left ventricular end-systolic diameter(LVESD),ejection fraction(EF),left atrial dimension(LAD),interventricular septum thickness(IVST),posterior wall thickness(PWT),left ventricular mass(LVM),left ventricular mass index(LVMI),myocardial infraction(MI),stroke,cardia insufficiency,the position and degree of coronary atherosclerosis had difference between the patients with MS and without MS(P<0.05).Conclusion MS is a condition characterized by clustering of CVD risk factors.MS not only increases the incidence of CVD and OFF in the patients,but also effects the prognosis.

Objective To evaluate the feasibility of the lateralization of unilateral medial temporal lobe epilepsy(mTLE)by using arterial-spin-labeling(ASL)based perfusion MR imaging and investigate the changes of perfusion in the regions related to mTLE network and the relationship between the perfusion and the clinical status.Methods Twenty-five patients with left-sided and 23 with right-sided mTLE were enroiled,and 30 healthy volunteers were recruited.The cerebral blood flow(CBF)of related region was measured based on pulsed-ASL sequence on Siemens 3 T scanner.The CBF of the mTLE group were compared with that in the controls by using ANOVA analysis.The asymmetric indices of CBF in the medial temporal lobe were calculated as the lesion side compared with the normal side in matched region in mTLE group.Results Compared with the volunteers,the patients with mTLE showed the decrease of CBF in the bilateral medial and lateral temporal,the frontal and parietal regions relating to the default-mode network and more serious in lesion side.The CBF values of the medial temporal lobe were negatively correlated with the epilepsy duration(r =-0.51,P ＜0.01).The asymmetric index of CBF as-0.01 has a 76.0％(19/25)sensitivity and a 78.3％(18/23)specificity to distinguish the lesion side.Conclusions The decrease of CBF in the temporal and extra-temporal region by ASL-based MRI suggests the functional abnormalities in the network involved by mTLE.The ASL technique is a useful tool for lateralizing the unilateral mTLE.

Objective To investigate the prevalence of vitiligo in China through a multi-center and larse-population epidemiological survey.Methods A community-based survey was conducted in 6 cities from 6 provinces.Cluster sampling method was used.Subjects were required to fulfill the self-report questionnaires and received physical examination by dermatologists.EpiData and SPSS11.5 were utilized for statistical analysis. Results Totally,19 974 patients participated in this study,and 17 345 valid questionnaires were retrieved with a return rate of 86.84%.Of them,122 were found to have vitiligo.The prevalence and standardized prevalence of vitiligo was 0.70% and 0.56% in all patients,0.95% (75) and 0.69% in male patients and 0.50% (47) and O.45% in female patients.respectively.A significant elevation was observed in the prevalence of vitiligo in males than in females (P<0.01).The prevalence of vitiligo was increased with age and peaked in patients aging from 60 to 69 years and those over 70 years.The age at onset of vitiligo varied from 0 to 19 years in 21.85% of these patients,from 20 to 49 years in 47.05%.The most connnon type was focal vitiligo,which accounted for 36.06%,while the rarest type wag segmental type (2.46%).The pesitivity rate of family history of vitiligo was 9.84% in patients and 1.31% in community population (P<0.01).About 31.97% of the patients complained of negative influence of vitiligo on quality of life.Conclusions The standardized prevalence of vitiligo is 0.56%in 6 provinces from China.Males seem to have a higher prevalence of vifiligo than females.

Objective To retrospectively compare the efficacy of Serva NB1 collagenase with Vitacyte GOLD collagenase on islet isolation of pancreas.Methods All the human pancreata were obtained from Chinese organ donors.In GMP laboratory,the pancreata were trimmed and distended with Serva NB1 collagenase (Serva NB1,n =12) or Vitacyte GOLD collagenase (Vitacyte GOLD,n =5) and digested according to a modified Ricordi semi-automatic protocol,and the digestion duration was recorded.The digested islets were then collected and washed,followed by the continuous density purification in a Cobe 2991 cell separator.The islet yield,purity,viability and glucose-stimulated insulin release (GSI) were determined each time after purification.Quantity and quality of isolated islets were determined by digestion efficacy.Results The digestion duration in Vitacyte GOLD collagenase group was significantly shorter than in Serva NB1 collagenase group to achieve the same digestion endpoint (P＜ 0.05).The islets yields of different sizes were variable between the two groups.The Vitacyte GOLD collagenase digestion produced more islets with a diameter range of 50-100 μm than the ServaNB1 collagenase digestion (P＜0.05),but the latter yielded more islets with a diameter range of 251-300 μm and 301-350μm (P＜0.05).There was no significant difference in total islets yields,viability,and GSI between two collagenase digestions (P＞0.05).Conclusion Both Vitacyte GOLD collagenase and Serva NB1 collagenase can be used for the clinical islet isolation in China.

Objective: To investigate the effect factors of liver enzymes elevation by monitoring the liver function changes before and after intraportal islet transplantation. Methods: 16 diabetic patients who received intraportal islet transplantation in our hospital were analyzed. The levels of aspartic aminotransferase (AST), alanine aminotransferase (ALT)and total bilirubin (TBil)were monitored after islet transplantation. Results: Among those 16 diabetic patients who received intraportal islet transplantation, 11 patients showed an increased AST and 8 patients showed an increased ALT, among which a 2.5-fold increase in AST was observed in 4 patients and over 1.5-fold elevation of ALT was observed in 3 patients. The level of TBil were in the normal range before and after transplantation in all patients. Transplanted tissue volume of islet was the main factor for significantly increased AST (P<0.05) in this study. It is also shown that the change in portal pressure is related to the AST elevation after islet transplantation. Conclusions The amount of transplanted islet tissue volume is related to the liver enzymes elevation after intraportal islet transplantation. Therefore, the improvement of the purity of islet to reduce the amount of transplanted tissue could be benefit to prevent the liver injury after islet transplantation. Meanwhile, the purified islets should be injected as slowly as possible to maintain a stable portal pressure.