Objective To investigate the prevalence of 16S rRNA methylase genes, armA and rmtB, which mediate high level aminoglycoside resistance, in gram-negative bacteria isolated from 2 hospitals in Dalian and study the mechanism of aminoglycoside resistance.Methods A total of 134 amikacin-resistant clinical isolates of gram-negative bacteria were collected. Two 16S rRNA methylase genes, armA and rmtB, were identified by PCR-based assays. PCR products were extracted for DNA sequencing analysis. armA and rmtB gene mapping were conducted by plasmid extraction, conjugation and transformation. The MICs of amikacin, gentamicin and tobramycin were determined for the positive isolates, transconjugants and the resultant strain of transformation using agar dilution technique. Results Overall armA was identified in 21 strains of Acinetobacter baumannii, rmtB in 5 strains of Escherichia coli and 5 strains of Klebsiella pneumoniae. Plasmid extraction and conjugation experiments were only successful for rmtB-positive isolates. Transconjugant and DH5a (pMDarmA) exhibited high-level resistance to aminoglycosides.Conclusions The 16S rRNA methylase genes, armA and rmtB are identified in Dalian. armA gene is identified in A. baumannii. rmtB gene is located on the plasmid of E. coli and K. pneumoniae. armA and rmtB can induce high-level resistance to aminoglycosides.

Objective To investigate the diagnosis and treatment of cerebral venous sinus thrombosis ( CVST) in early pregnancy.Methods The clinical data of 4 patients with CVST in early pregnancy were analyzed retrospectively.Results The age of the 4 patients with CVST during early pregnancy was 22 -28 years old.The clinical symptom was headache, and 1 case with seizure.The clinical sign was papilledema.The MRI and MRV examination showed that the superior sagittal sinus thrombosis in 1 case, the superior sagittal sinus and left transverse sinus thrombosis in 1 case, and the left transverse sinus and sigmoid sinus thrombosis in 2 cases.The patients were received anticoagulant therapy with low molecular weight heparin, 1 case was added endovascular thrombolytic therapy.After therapy, 2 cases were cured, and 2 cases improved.Conclusions CVST in early pregnancy is easy to be misdiagnosed.MRI and MRV are helpful to diagnose it.The mainly therapies are endovascular thrombolysis and anticoagulation therapy with low molecular weight heparin.

To explore the expression and function of MG 7 Ag on gastric cancer cell line SGC7901 and its drug resistant subline,SGC7901/VCR, with different resistance index (0 3, 0 7, 1 0) The expression of MG 7 Ag on SGC7901 and SGC7901/VCR cells was determined by immunohistochemical method and flow cytometry (FCM) MTT assay was used to explore the effects of monoclonal antibody MG 7 on drug sensitivity of gastric cancer cells FCM was used to explore the effects of MG 7 on adriamicine accumulation of SGC7901/VCR cells SGC7901/VCR cells exhibit increasing positive staining of MG 7 than SGC7901, according to the increasing resistance index Sensitivity of vincristine of both SGC7901 and SGC7901/VCR cells was reduced after being treated with MG 7 And SGC7901/VCR cells showed decreased adriamicine accumulation when they were incubated with MG 7 Therefore, the conclusion is that MG 7 Ag may be a novel molecule associated with multidrug resistance of gastric cancer, and play an important role in maintaining the drug resistant phenotype of SGC7901/VCR cells.

Objective To investigate the evaluation of cardiopulmonary exercise test (CPET) in the patients with chronic obstructive pulmonary disease (COPD), and the relationship with the pulmonary function test (PFT). Methods 26 COPD patients and 30 normal controls were examined with CPET and PFT. Results The parameters of CPET, including maximum oxygen uptake (VO2max), anaerobic threshold (AT), maximum minute ventilation (VEmax) and breathing reserve (BR) were lower in COPD group than those in control group (P<0.05). There were no significant differences in Wmax, oxygen pulse (O2pulse) between two groups (P>0.05). VO2max, AT, VEmax and BR were positively correlated with forced expiratory volume in one second (FEV1) and peak expiratory flow (PEF) in COPD group （P<0.05）, but were not correlated with forced vital capacity (FVC) and FEV1/FVC (P>0.05).Conclusion The pulmonary function of COPD patients can be evaluated with CPET, especially VO2max, AT, VEmax and BR.

Objective To explore the mechanism underlying the superiority of the biphasic waveform to monophasic waveform in defibrillation.Method The Luo-Rudy model was adjusted so that it could be used to study defibrillation.Based on the adjusted model the effects of different defibrillation waveforms on cell action potential duration(APD) were studied.Result Biphasic electrical field pulse extended the APD longer than that with monophasic one.Moreover,biphasic waveforms with different strengths could prolong the APD almost equally,while monophasic pulses with different strengths showed different ability to prolong the APD and the spatial distribution of the APD became dispersed.It was also found that the strength of electrical fields pulse contributed much to the change of APD while the duration showed little effect.Conclusion The clinical superiority of biphasic pulses to monophasic pulses in defibrillation is resulted from its ability to prolong the time course of the APD and more importantly,it causes even spatial distribution of the APD.

Objective To evaluate the efficacy of imipenem-cilastin sodium as subsequent therapy on peritoneal dialysis(PD)-related peritonitis.Methods From January 2007 to December 2010,44 PD-related peritonitis patients in our hospital were enrolled in the study.These patients presented cloudy fluid after 3 days initial treatment,and bacterial culture was Gram-negative bacteria or negative.Thirteen peritonitis episodes were treated with ceftazidime,while 36 episodes with imipenem-cilastin sodium.Efficacy,outcome,pathogen and drug-resistance were analyzed retrospectively.Results The effective rates 2 d later of ceftazidime and imipenem-cilastin sodium were 23.1％ and 72.2％ respectively with significant difference (P＜0.05).Gram-negative bacteria of ceftazidime and imipenem-cilastin sodium groups were 69.4％ and 65.2％ respectively without significant difference (P＞0.05).The cure rates 3 weeks later of ceftazidime and imipenemcilastin sodium groups were 23.1％ and 72.2％ respectively with significant difference (P＜0.05).Conclusion As subsequent therapy for PD-related peritonitis,imipenem-cilastin sodium can improve the cure rate.

Objective The aim of this study is to evaluate clinical application of BODE (body mass index, airflow obstruction, dyspnea, and exercise capacity) index in patients with chronic obstructive pulmonary disease (COPD). Methods Forty patients with stable COPD in Xuanwu Hospital of Beijing during September 2003 to December 2007, were recruited in the study, including 25 men and 15 women, aged 38 to 85 years (with a mean of 62 ± 13 years). BODE index was measured for each patient, one year and three years after recruitment, respectively. Severity of COPD, including number and duration of episodes, length of each hospital stay and times of hospitalization due to acute exacerbation of COPD (AECOPD), were recorded. All data were statistically analyzed with SPSS 13.0 software for windows. Results ①There was a remarkable difference in COPD severity between patients with BODE score equal to or greater than five and these with less than five (P <0.01 ). ①BODE score inversely correlated with forced expired volume at the first second ( FEV1 ) in COPD patients (P < 0.01 for those with BODE score equal to or greater than five and P <0.05 for these with BODE score less than five, respectively). ③BODE score positively correlated with number and duration of acute exacerbation, length of hospital stay and times of hospitalization due to AECOPD (P <0. 01 for those with BODE score equal to or greater than five and P < 0. 05 for those with BODE score less than five, respectively). For patients with COPD, their BODE score in the first year positively correlated with that in the third year ( r = 0.834, P < 0.01 ). Conclusions BODE index is a better indicator to evaluate their condition severity in patients with COPD.

To investigate association between prognosis of patients of peritoneal dialysis with their initial high peritoneal solute transport and complications. Two hundred and two patients with end-stage renal disease who began peritoneal dialysis during September 1,2006 to September 1, 2008 at Peking University Third Hospital, Beijing were recruited in the study. They were undergone peritoneal equilibration test within six weeks after initiating peritoneal dialysis, and their types of peritoneal solute transport, complications,nutrition status and outcomes were all recorded until August 31,2010. Their survival rate was estimated by Kaplan-Meier method. Compare to those with other types of solute transport, patients with high peritoneal solute transport showed higher proportion of complications ( P < 0. 05 ) during dialysis, but less ultrafiltration function ( P < 0. 05 ), worse nutrition status ( P < 0. 05 ) and lower cumulative survival rate ( P < 0. 01 ).Among patients with high peritoneal solute transport, cumulative survival rate in those with complication was lower than those without it ( P = 0. 031 ). Prognosis of patients with high peritoneal solute transport possibly varies with their complications in dialysis.

Objective To establish the quality standard for Yangxue Yishen Capsules. Methods Rhizoma Gastrodiae, Herba Epimedii and Radix et Rhizoma Salviae Miltiorrhizae in the formula were identified qualitatively by TLC. The content of Astragaloside IV was determined by HPLC-ELSD method. The Diamonsil C18(2) column (4.6 mm×250 mm, 5 μm) was used. The mobile phase was acetonitrile-water (33∶67) with 1.0 mL/min flow rate at 35 ℃. The temperature of drift tube for ELSD was 105 ℃, the air flow rate was 2.7 L/min. Results The TLC displayed clear spots on their right positions repeatedly. The linear range of Astragaloside IV was 0.397 0-5.955 0 μg (r=0.999 9). The average recovery was 102.0%, RSD was 1.5% (n=6). Conclusion The method is simple and quick. It can be used as quality control method of Yangxue Yishen Capsules.

Objective To investigate effect of artesunate on expressions of Toll-like receotor-4 (TLR4) and interleu?kin-8 (IL-8) in renal tissue of diabetic nephropathy rats. Methods Male SD rats of over 200 g in body weight (n=45) were injected with low dosage streptozotocin and fed with high fat and sucrose diets to establish diabetes nephropathy (DN) model. Among all rats of successful model, thirty-two were randomly selected and divided into four groups (n=8 in each group), Mod?el group (Group B), Artesunate at high dose treatment group [30 mg/(kg · d)] (Group C), Artesunate at low dose treatment group [10 mg/(kg·d)] (Group D), Enalapril treatment group [10 mg/(kg·d)] (Group E). Another eight rats without STZ injec?tion whose body weight is under 200 g were assigned as Normal group (Group A). Then, rats in Group A and B were given the same volume of normal saline [10 mg/(kg·d)] while rats in Group C, D and E were given 30 mg/(kg·d) Artesunate, 10 mg/(kg·d) Artesunate and 10 mg/(kg · d) Enalapril respectively intragastrically for consecutive 12 weeks. Fasting blood glucose, body weight, kidney index, 24-hours proteinuria, serum creatinine (Cr) and blood urea nitrogen (BUN) were measured. Expression level of TLR4 in renal tissue of rats were examined by Western blot;ELISA was used to quantify the concentration of IL-8 in serum and renal tissue of rats. Results Compared with rats in Group A, the levels of Fasting blood glucose, kidney index , 24-hours proteinuria, Cr and BUN as well as the level of TLR4 in kidney, levels of IL-8 in serum and kidney all significant?ly increased in rats in Group B, C, D and E(P<0.05). On the other hand, body weight were decreased in rats of Group B, C, D and E compared to rats in Group A(P<0.05). The level of TLR4 in kidney, levels of IL-8 in serum and kidney, 24-hours proteinuria, Cr and BUN in rats of Group C, D and E were significantly lower than those in rats of Group B(P<0.05). Furthermore, compared with rats in Group D, the levels of TLR4 in kidney, IL-8 in serum and kidney, 24-hours proteinuria, Cr and BUN were decreased in rats in Group C and E(P<0.05). Pearson correlation analysis showed that the expression lev?el of TLR4 positively correlated with IL-8 level in serum (r=0.969, P<0.05), IL-8 level in kidney (r=0.972, P<0.05), 24-hours proteinuria(r=0.965, P<0.05), Cr(r=0.944, P<0.05)and BUN(r=0.903, P<0.05). IL-8 level in kidney positively correlated with 24-hours proteinuria(r=0.962, P<0.05), Cr(r=0.929, P<0.05)and BUN(r=0.940, P<0.05). Conclu?sion Artesunate decreases expression of TLR4 and IL-8, reduce 24-hours proteinuria, inhibits the inflammation of the DN,relives the pathological lesions of nephron rats with diabetic nephropathy.