Objective To investigate the contamination of carbapenem-resistant Acinetobacter baumannii (CRAB) from object surface of key departments in a hospital,and identify whether these CRAB were homologous. Methods Environmental hygienic monitoring in intensive care unit (ICU),emergency intensive care unit(EICU), hemodialysis room and operating room was conducted.Acinetobacter baumannii (A.baumannii)isolated from ICU and EICU environmental specimens were amplified and typed by enterobacterial repetitive intergenic consensus-poly-merase chain reaction (ERIC-PCR).Results Except hand hygiene of health care workers in EICU was qualified, bacterial count of object surface of ICU and EICU were all unqualified;detection results of specimens from hemodi-alysis room and operating room were all qualified.A total of 53 specimens were taken from object surface of ICU and EICU,7 (13.21 %)A.baumannii isolates were isolated,and all were CRAB isolates,6 of which were of the same genotype and were identical with A.baumannii from patients’sputum.Conclusion CRAB isolated from object surface in key departments is homologous,cleaning and disinfection of environmental object surface should be inten-sified to reduce the occurrence of healthcare-associated infection.

Objective To evaluate the effect of subfascial endoscopic perforator surgery(SEPS) for the(treatment) of recurrent venous ulcer.Methods SEPS Was preformed on 56 limbs with recurrent venous(ulcer),and ulcer healing was assessed at follow up.Results Fifty-five limb ulcers healed in 10～49 days,one limb ulcer was not healed after 90 days,but healed after ligation of lesser saphenous vein.The patients were followed up for 1 to 3 years,1 case recurred after 6 months and it healed with antibiotic treatment;2 cases recurred after 18 months,and both healed after high ligation of lesser saphenous vein.Conclusions SEPS is effective and safe in the treatment of recurrent venous ulcer.SEPS is minitraumatic with few(complications).

Doxorubicin loaded micelles were prepared by film-hydration method using stearyl sulfadiazine (SA-SD) which is pH sensitive, methoxy (polyethylene glycol)-2000-1, 2-dioleoyl-sn-glycero-3-phosphoethanolamine (mPEG-DOPE) and transactivator of transcription (TAT) peptide conjugated PEG-DOPE. Mean diameter of the pH-sensitive micelles was about 20 nm with a (99.1 +/- 2.1) % drug entrapment efficiency at pH 7.4. Flow cytometry studies revealed that the simple TAT micelles was taken up rapidly at the same level at pH 6.8 and pH 7.4. However, the pH-sensitive micelles entered the tumor cell less at pH 7.4 and significantly increase at pH 6.8. After 1 h incubation at pH 6.8, the amount of the pH-sensitive micelles taken up by cancer cell 4T1 was almost similar to simple TAT micelles. The confocal microscopy indicated that the pH-sensitive micelles entered the 4T1 cells at pH 6.8 more than at pH 7.4. It was indicated that the pH-sensitive micelles could shield TAT peptide at normal pH 7.4 and deshield it at pH 6.8. Hence, TAT peptides lead the drug-loaded micelles into the tumor cells and killed them selectively. The pH-sensitive micelle may provide a novel strategy for design of cancer targeting drug delivery system.

OBJECTIVE To investigate the staphylococcal cassette chromosome mec(SCCmec) genotype characteristics and antibiotic-resistant genes in meticillin-resistant Staphylococcus aureus(MRSA) isolated from Lianyungang.METHODS The SCCmec of clinically isolated MRSA strains were genotyped with a novel multiplex PCR strategy reported by Zhangetal.Antibiotic-resistant genes of aac(6′)/aph(2″),aph(3′)Ⅲ,tetM,erm,TEM,and ant(4′,4″) were analyzed by traditional PCR.RESULTS The isolates were almost SCCmec Ⅲ positve,only one isolate couldn′t be typed.The positive rates of aac(6′)/aph(2″),aph(3′)Ⅲ,tetM,and erm were 98%,46%,72% and 86%,respectively.TEM and ant(4′,4″) tested were all negative.CONCLUSIONS Almost all genotypes of MRSA prevailing in Lianyungang carry the SCCmec Ⅲ gene.There are high positive percentages of antibiotic-resistant genes of aac(6′)/aph(2″),aph(3′)Ⅲ,tetM and erm in the isolates.The novel multiplex PCR strategy recommended by Zhang et al can be applied into genotyping study of MRSA SCCmec effectively.

Objective To evaluate the safety and efficacy of CT-guided transgluteal approach for drainage of deep pelvic abscesses. Methods From April 2000 to August 2007, 12 patients with deep pelvic abscesses underwent CT-guided transgluteal drainage. The clinical data, number of drainage cathete rsplaced, amount of drain, duration of placement, complications and follow-up were retrospectively analysed.Results One drainage catheter was successfully placed for each patient. The amount of abscess drained was30 to 180 ml (mean 52 ml) and the duration of placement was 6 to 34 days (mean 11 days). No major complications occurred. Conclusion The transgluteal approach to the drainage of deep pelvic abscess under CT guidance was safe and effective.

Interventional therapy is an important treatment for biliary stenosis.The treatment methods are different ac cording to the different causes.Conventional interventional therapy include biliary drainage,balloon dilatation and stent implantation.There are some new treatment methods such as radiofrequency catheter ablation and biliary stent loaded with 125I seeds.The applications of interventional therapy in biliary stenosis were reviewed in this article.

Objective To investigate the clinical liver function protective effect of Shuganning injection for treatment of patients with drug poisoning.Methods One hundred and forty patients with drug poisoning consistent with thecriteria of enrollment into the study were admitted into the Department of Emergency Medicine in the First Hospital of Jilin University-the Eastern Division from January 2015 to August 2016, and they were randomly divided into observation group and control group by the computer generated random numbers, 70 cases in each group. After admission, all the cases were treated with routine treatment including detoxification, removal of toxin, organ protection, symptomatic and supporting treatment, etc. Based on the routine treatment, additionally, Shuganning injection 20 mL+ 10% glucose injection 250 mL, intravenous drip slowly, once a day was given in the observation group; the therapeutic course was 14 days in both groups. The changes of serum glutamic transaminase (ALT), aspartate aminotransferase (AST) and total bilirubin (TBiL) levels were determined before and 7 and 14 days after treatment respectively to evaluate the situation of liver function in the two groups.Results Before treatment, there were no statistical significant differences in the levels of serum ALT, AST and TBil in the two groups (allP > 0.05); with the prolongation of treatment, the above-mentioned indexes of the two groups were gradually reduced, on the 14th day after treatment, they reached the lowest levels, and the degree of decrease in level on the 14th day in the observation group was more significant than that in the control group [ALT (U/L): 32.6±10.8 vs. 98.3±34.5, AST (U/L): 39.4±14.3 vs. 138.5±25.6, TBil (μmol/L): 4.8±1.7 vs. 13.2±2.3, allP < 0.05].Conclusion Shuganning injection has a protective effect on liver function in patients with drug poisoning.

Objective:To study the biological effects of new monomer 3 from Radix Curcumae on proliferation of human gastric cancer cells SGC-7901.Methods:Uing fluorescence microscope to observe the impact on SGC-7901 cells with different concentrations of the new monomer 3 at different times,using MTT assay to observe the growth inhibition rate of SGC-7901 cells,using flow cytometry to observe the apoptosis rate and cell cycle distribution of SGC-7901 cell.Results:Pronounced apoptosis had been found by fluorescence microscopy,apoptosis had a certain amount of time-dependent and concentration-dependent;Early apoptotic cells near normal morphology,normal nuclear morphology;late apoptotic cells'size shrink or round in shape,nuclear pyknosis or fragmentation.MTT method showed that the new monomer 3 had significantly inhibition on SGC-7901 cells,the half inhibition rate(IC50) was 30.14?g/mL.Flow cytometry(FCM) showed that:the new monomer 3 can increase the SGC-7901 cells in the S phase and G0/G1 and reduce it in G2/M.The change had time and concentration dependence;The apoptotic rates of dosing unit(24h,48h) compared with the control group had significant differences.The maximum apoptosis rate was 60.07%.Conclusion:The new monomer 3 inhibited human gastric cancer SGC-7901 cells significantly and had the impact on cell cycle distribution of the SGC-7901 cells and induction of apoptosis.

Objective To explore exenatide in the treatment of metformin(MET)alone,sulfonylurea (SU)alone or MET + SU combination therapy with poor glycemic control in type 2 diabetic pa-tients and to find effective nursing measures.Methods 24 patients were randomly divided into the con-trol group and the exenatide group with 12 patients in each group.In the exenatide group,exenatide 5μg twice a day for 4weeks,then 10μg twice a day for 12 weeks.Changes of HbAlc,body weight,BMI,FBG,P2hBG,and rate of adverse reaction were compared between two groups.Results Glycosylated hemoglobin (HbAlc),body weight,BMI,FBG,P2hBG in the control group before and after treatment showed no significant difference,while the exenatide group showed better results compared with those before treatment and the control group.Nursing intervention played evident effect on reducing adverse effect such as nausea,vomiting,diarrhea,low blood sugar,headache.Conclusions For patients with type 2 diabetes,using MET,SU alone or MET + SU combination therapy showed poor results of blood sugar control,addition of exenatide therapy can effectively control blood sugar,nursing intervention can significantly alleviate the adverse effects of patients.