Objective To investigate the distribution of aminoglycoside modifying enzyme genes (AMEs) and 16S rRNA methylase genes in drug-resistant strains of Pseudomonas aeruginosa. Methods Twenty strains of drug-resistant Pseudomonas aeruginosa were isolated from sputum and wound secretion samples collected from the First People's Hospital of Huai' an in Jiangsu province. Eight AMEs [aac(3)-Ⅰ , aac(3)-Ⅱ, aac(6')-Ⅰb,aac(6')-Ⅱ, ant{2)-Ⅰ ,ant(3)-Ⅰ , ant(4')-Ⅰ , aph(3')-Ⅱb] and 6 16S rRNA methylase genes (armA, rmtA, rmtB, rmtC, rmtD, npmA) were analyzed by PCR and verified by DNA sequencing. Results Out of 20 strains of Pseudomonas aeruginosa, aac(6')-Ⅱ was positive in 8 strains (40.0% ) , ant2- Ⅰ in 8 strains (40.0% ) , aac(3)-Ⅱ in 5 strains (25.0% ) , aac(6')- Ⅰ b in 2 strains (10.0% ) and rmtB in 1 strains (5.0% ) , respectively. The rest 9 genes were not detected. Among 2 strains harboring aac(6')- Ⅰ b, DNA sequencing confirmed that 1 was aac(6')- Ⅰ b (the clssical type) and another was aac(6')- Ⅰ b-cr. Conclusion Gene aac(6')- Ⅰ b-cr exists in drug-resistant Pseudomonas aeruginosa, and it has modifying effect on both aminoglycosides and quinolones.

Objective:To observe the application of pulse indicator continuous cardiac output (PICCO) system monitoring in the treatment of patients with severe thoracic trauma with the complication of acute respiratory distress syndrome (ARDS).Methods: 60 patients with severe thoracic trauma with complication of ARDS were randomly divided into the PICCO group (30cases) and the PAC group (30cases). The differences of PaO2/FiO2 score, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, mortality, mechanical ventilation time, ICU stay time and total treatment cost between the two groups were observed.Results: The PaO2/FiO2 of PICCO group in 1d, 3d and 7d were significantly higher than that of PAC group, respectively (t=4.46,t=3.87, t=5.15,P<0.05). In the 7th day, the APACHE II of PICCO group was significantly lower than that of PAC group (t=1.94,P<0.05). Besides, the mechanical ventilation time, ICU stay time and total treatment cost of PICCO group were significantly lower than these of PAC group, respectively (t=3.36, t=2.58,t=5.53,P<0.05). While there was no difference for mortality between the two groups (x2=0,P>0.05). Conclusion: In the treatment for patients with severe thoracic trauma with ARDS, PICCO system monitoring could reduce the mechanical ventilation time, ICU stay time and total treatment costs of patients, and enhance the treatment effect of patients.

Life education is the education based on perception and experience of life,the very nature of which is the cultivation of life awareness.It is the urgent requirement to carry out life education for university students,because it helps them to adjust to the developing and changing society and promotes their physical and psychological development coordinated.In order to strengthen college students' rational thinking on the value and significance of life,enhance their humanistic quality,life education should be incorporated into higher education system independently.

Strengthening the capacity of medical students' clinical thinking is an important aspect of medical education,the writers believe that medical students' clinical thinking ability can be improved through three aspects which include basic teaching practice,thinking knowledge based learning and clinical teaching.

OBJECTIVE To investigate the genetic markers of integron and transposon in multidrug-resistant strains of Escherichia coli.METHODS The genetic markers of integron(qacE△1-sul1) and transposons(merA,tnpA and tnpU) were detected by polymerase chain reaction(PCR).RESULTS In 20 strains,14 strains carried qacE△1-sul1,and 3 strains carried merA.CONCLUSIONS There are high percentages of the genetic markers of integron(qacE△1-sul1) and transposon(merA) in multidrug-resistant strains of E.coli.

OBJECTIVE To investigate the resistance gene spectrum and phylogenetic analysis in multidrug-resistant strains of Escherichia coli.METHODS The 34 kinds of resistant genes were detected by polymerase chain reaction and cluster analysis.RESULTS The positive rates of TEM,SHV,CTX-M-1 group,OXA-1 group,aac(3)-Ⅱ,aac(6′)-Ⅰb,ant(3″)-Ⅰ,rmtB,dfrA1,dfrA12,dfrA17,sul1,catB and cmlA were 95%,55%,40%,10%,75%,40%,15%,5%,10%,5%,75%,90%,15% and 35%,respectively.There was clone transmitted phenomenon.CONCLUSIONS There are very high positive percentages of TEM,SHV,CTX-M-1 group,aac(3)-Ⅱ,aac(6′)-Ⅰb,dfrA17,sul1 and cmlA genes in multidrug-resistant strains of E.coli.The multidrug-resistant strains of E.coli can induce clone transmitted hospital infection.

Objective To research the precise location algorithm of onset and end of one wave for QRS in ECG. Methods During monitoring the ambulatory electrocardiograph (AECG),it was necessary to design new automatic analysis algorithms. The windows formed by filtering and integrating process could be considered as the fiducially mark. From the window,the apex of Q wave and S wave could be recognized. Results Introducing an auxiliary line from the apex,we could judge the boundary of the Q and S wave with the distance from ECG curve to the line. Conclusion Many cases studies inelicate that the algorithm is of low level locating error,about one sample point,and the accuracy of judgement of S wave boundary is raised obviously compared with the same kind of software in the world.

Objective To systematically review the myocardial protective effect of ischemic preconditioning in patients undergoing open heart surgery.Methods PubMed,EMBASE,Highwire,CENTREN and its affiliated clinical trial registration data center,CBM and CNKI were searched to identify all randomized controlled trials involving the myocardial protective effect of ischemic preconditioning in patients undergoing open heart surgery under general anesthesia.The quality of the studies was evaluated by the method recommended by Cochrane Collaboration.Evaluation indexes included the incidences of postoperative cardiac death,myocardial infarction and ventricular arrhythmias and postoperative inotropic drug requirement.Meta-analysis was conducted using the Cochrane Collaboration's RevMan 5.0 software.Results Twelve randomized controlled trials (8 high-quality trials and 4 medium-quality trials) involving 626 patients were included in our Meta-analysis.Meta-analysis indicated that ischemic proconditioning significantly reduced the incidence of postoperative ventricular arrhythmias and postoperative inotropic drug requirement (P ＜ 0.05) and had no effect on the incidences of postoperative cardiac death and myocardial infarction (P ＞ 0.05).Conclusion Ischemic preconditioning can reduce the postoperative ventricular arrhythmias and have no effect on postoperative cardiac death and myocardial infarction in patients undergoing open heart surgery.

ALM To study the effects of ginkgo biloba extract (GbE) on expressions of neuron specific enolase (NSE) and S 100 protein(S 100) mRNA in newborn rat brain after hypoxic ischemic brain damage (HIBD) and the mechanism of GbE against HIBD. METHODS The dynamic changes of expressions of NSE S 100 mRNA in brain tissue and effects of GbE were studied using 7 d SD rat hypoxic ischemic brain damage model and RT PCR techniques. RESULTS The peak expressions of mRNA for NSE and S 100 occurred 24 and 48 hours after HIBD respectively, and their expressions decreased gradually. The expressions of mRNA for NSE S 100 in 24, 48, 72 hours were increased after treatment with GbE ( P

Objective To analyse the kidney damage situation of the elderly health examination people,and identify its characteristic.Methods A cross-sectional study was held which enrolled 1088 elderly health examination people.Urine routine,random urine albumin/creatinine ratio (ACR),serum creatinine,urea nitrogen were detected by biochemical analyzer,and estimated glomerular filtration rate (GFR) with CKD-EPI formula.Kidney structure change was examined by Color doppler ultrasound detector.Results The prevalence of hypertension,hyperlipemia,diabetes mellitus was 61.5％,62.1％,11.6％,respectively.The abnormal detection rate of urine routine was 19.0％,including 2.6％ proteinuria,14.1％ hematuresis and 5.4％ leucocyturia.The abnormal detection rate in the people with was higher than those without (P＜0.01).However,the albuminuria detection rate with random urine ACR was 25.1％,obviously higher than that of urine routine (P＜0.01).The ultrasound results showed that 6.8％ of the total were examined with elderly characteristic kidney change,the proportion of renal cyst was the highest,accounted for 21.8％.70.7％ of all people were in the level of eGFR more than 60 ml· min-1 · 1.73 m-2.The level of eGFR＜60 ml· min-1 · 1.73m-2 in the people with was higher than those without (P＜0.01).eGFR was declined with age.When age increased every 10 years,eGFR was decreased 7 ml · min-1 · 1.73 m-2.Conclusions No matter in structure or function,the elderly people's kidney damage has its characteristic.We should make it clear to correctly diagnose and cure elderly kidney disease.