OBJECTIVE To analyze the bacterial distribution and drug resistance in lower respiratory tract nosocomial infection(NI).METHODS To investigate 351 patients suffered from lower respiratory tract NI using the prospective monitoring methods,and doing the pathogenic bacterium cultivation for sputums of 351 patients and then taking the susceptibility test.RESULTS Totally 346 pathogenic bacteria were found in sputums of 351 patients.The major pathogenic bacteria were Pseudomonas aeruginosa,Escherichia coli,Klebsiella and Staphylococcus aureus.ESBLs were 36.0% and 40.0%,respectively in E.coli and Klebsiella,and MRSA were 82.1% in S.aureus.Drug resistances were common in Gram-negative bacilli(GNB) and Gram-positive cocci.Piperacillin/tazobactam and cefoperazone/sulbactam and imipenem were the most sensitive for GNB,S.aureus,S.epidermidis and Enterococcus were all sensitive to vancomycin.CONCLUSIONS Drug resistance of the pathogenic bacteria in lower respiratory tract NI is common,so it′s necessary to emphasize pathogenic bacterium monitoring and use the antibacterials exactly.

Objective To investigate upper esophageal sphincter (UES)abnormalities in patients with achalasia (AC),and to analyze the correlation between UES abnormalities and clinical symptoms, treatment efficacy.Methods From February 2012 to December 2014,158 patients with AC and received high resolution manometry (HRM)examination were retrospectivly analyzed.According to whether with UES abnormalities,patients were divided into UES normal group and UES abnormal group.Patients of UES abnormal group were sub-divided into UES hypotensive group (UES resting pressure<34 mmHg, 1 mmHg=0.133 kPa),hypertensive group (UES resting pressure>104 mmHg)and impaired relaxation group (residual pressure>12 mmHg).Analysis of Variance,Kruskal-Wallis H test and Chi square test were performed to compare the clinical data and dynamic characteristics of the patients in each group. Results A total of 74 (46.8%)AC patients had UES abnormalities,the majority of whom were impaired relaxation (35 cases,47.3%).The age of patients in hypotensive group ((60.6 ± 10.1 )years)was significantly older than that of hypertensive group ((43.9 ±11 .1 )years)and impaired relaxation group ((46.8±16.3)years),and the disease course (10 years,4 to 30 years)was obviously longer than that of hypertensive group (6 years,1 to 10 years)and impaired relaxation group (8 years,3 to 15 years),and the differences were statistically significant (F = 7.983,H = 13.816,both P < 0.01).There was no correlation between UES abnormalities and clinical symptoms (P >0.05 ).The results of AC subtyping indicated that type Ⅱ AC accounted 55 .7% (88/158).Type Ⅱ AC cases number of UES normal group and abnormal group was 46 and 42 cases,both was majority (54.8% and 56.8%).Among these patients,123 patients finally received peroral endoscopic myotomy (POEM),47.2%(58/123 )of whom had abnormal UES.More than 85 % patients were satisfied at one month after the operation.And Eckardt scores significantly decreased.There was no significant difference in treatment efficacy between the two groups.Conclusions Most AC patients are with UES abnormality,and impaired relaxation is more common.There is no correlation between UES abnormalities and major symptoms.There is no predictive role of UES abnormalities in treatment efficacy of POEM in AC patients.

Background Intracameral or intracorneal administration of amphotericin B (AMB) can achieve significant therapeutic efficacy in the treatment of recalcitrant fungal keratitis in cases that do not respond to conventional antifungal therapy. However, the ocular pharmacokinetics of the two routes of administration is unclear.Objective The goal of this study was to investigate the level of amphotericin B in cornea and aqueous humor of rabbits after administration of AMB via three different routes. Methods Forty-five healthy domestic rabbits were randomly divided into three groups. 1% amphotericin B of 10 μg was intrastromally or intracamerally injected into 15 rabbits, respectively,in group A and group B. Topical 0. 25% amphotericin B was topically administered to the eyes with corneal epithelial debridement (group C). Experimental animals were sacrificed and the corneas and aqueous humor samples were obtained for the detection of levels of amphotericin B at 30 minutes,6 hours, 1 day,3 and 7 days by high-performance liquid chromatography (HPLC). Results Calibration curves were linear over the range of 0. 10-100. 00 mg/L. The concentration of 0. 10 mg/L was the lowest quantifiable limit. The recovery of amphotericin B ranged from 89. 1% -95.7% from aqueous humor samples and 81.4% -83.6% from the cornea samples. After a single injection,effective drug levels were achieved and maintained for 7 days in cornea in group A, exceeding the minimum inhibitory concentration at which 90% of isolates are inhibited (MIC90) for a wide spectrum of fungi and molds with significant differences in comparison with group B and group C ( P＜0. 05 ). Effective drug levels were achieved in the aqueous humor in group B at 30 minutes after a single injection, but drug levels decreased dramatically within 6 hours. The evident differences were found between group B and group A or group C (P＜ 0.05). A considerable amount of amphotericin B was detected in the cornea and aqueous humor in group C within 1 day.Conclusion Effective high drug levels can be reached in rabbit cornea and aqueous humor after intrastromal and intracameral injection, respectively. Penetration of topical amphotericin B was greatly elevated after epithelial debridement.

OBJECTIVETo identify the expression characteristics of the 1700001022RIK (RIKEN cDNA 1700001022) gene in mice and explore its function by bioinformatic analysis.

METHODSUsing the expression profile of gene microarray, we detected the expression of a new testis-specific gene, 1700001022RIK, in mice. We analyzed its expression characteristics in the testis tissue and their changes in different developmental stages of the testis by RT-PCR, real-time RT-PCR, Western blot, and immunohistochemistry. We performed bioinformatic analysis using a bioinformatic software.

RESULTSThe 1700001022RIK gene was specifically expressed in the mouse testis in an age-dependent manner, most highly in the adult mice. The 1700001022RIK protein was mainly expressed in the spermatogonia, spermatocytes, and round spermatids of the adult mice. Bioinformatic analysis showed that the 1700001022RIK protein amino acid sequence had a high similarity in human and mice, which indicated that this gene was highly conserved in mammals.

CONCLUSION1700001022RIK is a testis-specific gene mainly expressed in the spermatogonia, spermatocytes, and round spermatids of seminiferous tubules, which might be involved in the regulation of spermatogenesis.

Age Factors ; Animals ; Blotting, Western ; Computational Biology ; DNA, Complementary ; Gene Expression ; Genomics ; Male ; Mice ; Molecular Chaperones ; genetics ; Seminiferous Tubules ; Spermatids ; Spermatocytes ; Spermatogenesis ; genetics ; Spermatogonia ; Testis

OBJECTIVETo investigate the relationship of disease severity with angiotensin converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism and serum ACE activity in preterm infants during the first 7 days of life.

METHODSACE genotypes were determined in 85 preterm infants admitted to the neonatal intensive care unit (NICU). Serum ACE activity was measured and disease severity was evaluated by the Neonatal Critical Score (draft) 1, 3 and 7 days after birth.

RESULTSOf the 85 preterm infants, DD genotype was found in 19 cases, ID genotype in 34 cases and II genotype in 32 cases. On the 1st day of life, serum ACE activity in the DD genotype (33.42+/-7.93 U/L) and the ID genotype groups (31.53+/-7.56 U/L) were significantly higher than that in the II genotype group (25.53+/-7.56 U/L) (P<0.01). After 3 and 7 days of life, serum ACE activity decreased in the three groups, but the DD genotype group remained the highest ACE activity, followed by the ID genotype and the II genotype groups. On the 1st day of life, the critical score of the DD genotype group (87.37+/-8.30) was lower than the ID genotype (95.82+/-5.85) and the II genotype groups (95.88+/-6.85) (P<0.01). On the 3rd day, the critical score of the DD genotype group was still lower than the ID genotype group (92.95+/-7.10 vs 96.94+/-5.85) (P<0.05).

CONCLUSIONSACE gene I/D polymorphism may be associated with the disease severity in preterm infants. The DD genotype carriers present more severe disease status, with higher serum ACE activity. Although the disease status can influence serum ACE activity, serum ACE activity is determined by the ACE genotype.

Female ; Humans ; Infant, Newborn ; Infant, Premature ; Intensive Care Units, Neonatal ; Male ; Peptidyl-Dipeptidase A ; blood ; genetics ; Polymorphism, Genetic ; Time Factors

OBJECTIVETo study serum gastrin levels in response to early minimal feeding in premature infants and evaluate the clinical effect of early minimal feeding.

METHODSPremature infants with critical score < or = 90 were randomly assigned into two groups: early minimal feeding group (n = 48), non-early minimal feeding group (n = 47). Other premature infants (n = 30) without any complications (critical score > 90) were assigned as normal control group. The premature infants in normal control group were fed with water at 6 h after birth, 1 - 2 ml/kg every time, after once or twice, they were fed with formula, increasing in the amount of formula gradually, until adequate. The premature infants in early minimal feeding group were fed with formula within 72 h after birth, 0.5 - 1 ml/kg, once every 3 h, the amount of formula was increased gradually, until adequate. The premature infants without early minimal feeding were not fed with formula until the illness was stable, the amount of formula was increased gradually until adequate. Situation of gastrointestinal feeding tolerance, growth and development, and clinical symptoms were observed and recorded for the three groups. Serum gastrin levels were monitored at 1, 3, 7 day after birth by radioimmunoassay.

RESULTSSerum gastrin concentrations in the three groups elevated from 1 to 7 days. In early minimal feeding group [(82.4 +/- 24.5) ng/L] and non-early minimal feeding group [(87.0 +/- 40.2) ng/L], the concentrations were significantly higher than those in normal control group [(66.4 +/- 19.7) ng/L] at day 1 (F = 3.36, P < 0.05). At day 3 and 7, the concentrations in early minimal feeding group [(96.3 +/- 14.6) ng/L, (113.0 +/- 16.5) ng/L] were significantly higher than those in non-early minimal feeding group [(73.9 +/- 13.5) ng/L, (92.4 +/- 12.2) ng/L] (P < 0.05). There were significant differences among the three groups in infants with feeding intolerance (2/30, 5/48, 14/47), the period reached full enteral feeding [(20.6 +/- 5.7) d, (27.8 +/- 6.1) d, (39.5 +/- 4.7) d], and in number of hospital day [(29.0 +/- 4.6) d, (39.0 +/- 4.8) d, (48.0 +/- 5.6) d] (P < 0.05). There were significant differences between early minimal feeding group and non-early minimal feeding group in the weight gain three and four weeks after birth [(19.1 +/- 2.4) g/d, (11.9 +/- 3.3) g/d], the period reached birthweight [(19.8 +/- 4.2) d, (25.2 +/- 5.1) d] (P < 0.05). There were no significant difference among the three groups in the weight gain in one and two weeks after birth [(5.9 +/- 2.9) g/d vs. (5.0 +/- 2.1) g/d], the numbers of premature infants with infection, anemia, apnea, or hypoglycemia.

CONCLUSIONEarly minimal feeding in premature infants leads to secretion of gastrin, promotes the development of gastrointestine and may not be associated with occurrence of complications.

Birth Weight ; Enteral Nutrition ; methods ; Female ; Gastrins ; blood ; Gastrointestinal Tract ; growth & development ; Humans ; Infant Nutritional Physiological Phenomena ; Infant, Newborn ; Infant, Premature ; blood ; Infant, Small for Gestational Age ; Male

Objective To compare the simple cases of hand-foot-mouth disease(HFMD) with HFMD patients complicated with encephalitis and HFMD cases complicated with pulmonary edema (PE). To explore predictor factors of disease progression and unfavorable prognosis. Methods Forty-one EV71-infected children admitted to the Fuyang First People's Hospital in Anhui Province from March to May in 2008 were investigated in the research, who were classified as encephalitis-complicated cases ( encephalitis group, n = 15 ), PE-complicated cases ( PE group, n = 15 ) and simple cases (simple group, n= 11 ). Their clinical manifestation, laboratory findings, and immunophenotypes of peripheral blood lymphocyte were analyzed to find predictors associated with disease progression and unfavorable outcomes. Results The mortality rate in PE group was 66.7%, which was significantly higher than that in encephalitis group. Ninty-three point three percent cases in PE group and encephalitis group were younger than 3 years old, with statistic difference compared to simple group. Patients in PE group had higher total blood white cell (WBC) counts and higher absolute neutrophil counts and tended to have higher breathing rate, heart i'ate and glucose level than encephalitis group. The percentages of T cells and natural killer (NK) cells were significantly lower among patients complicated with encephalitis than simple HFMD patients.Conclusions PE is one predictor for poor prognosis. Factors correlated with unfavorable outcome include high WBC, high absolute neutrophil counts; elevated breathing rate, heart rate and glucose level. The immunophenotypes of peripheral blood lymphocytes can also predict the disease progression.

In order to provide plenty of information about the relationship between its structure and function,the structure of a novel housefly pupae D-galactose binding lectin with the molecular weight 55kDa and immune acitivity was analyzed preliminarily.In the first place,oligosaccharide chain was confirmed to be existed in this kind of novel housefly pupae lectin by the method of gel staining,and then its structure was analyzed with the help of protein sequencing instrument,spectrophotometer color contrast,?-elimination reaction,infrared spectroscopy and atomic force microscopy.This kind lectin was a global-shaped monomer with the diameter 75 nm or so and the protein and oligosaccharide content 97.36% and 2.1% respectively.Peptide chain and oligosaccharide chain was linked by O-glycoside bond with the N-terminal blocked and the sugar ring alpinum type.All above was the reliable theory for further analysis of structure.

Objective To investigate the optimal scheme about the external loading of resetting tensile stress for clavicular fracture,so as to provide some mechanical references for optimal design of external fixators for clavicular fracture.Methods The shoulder CT scanning data from a volunteer were used to establish the three-dimensional model of human left shoulder by Mimics software.In order to better simulate the actual human shoulder,the ligament tissues were added in the model and the constraints of muscles were considered,and the experimental model for simulation analysis on resetting tensile stress was established.By 3 simulation experiments,the impacts from directions of resetting tensile stress,positions of action points and value ranges were simulated and analyzed,respectively.The resetting tensile stresses obtained from clavicle of the shoulder model under various external loading cases were simulated by orthogonal test methods.Results When the θ (angle between the horizontal plane projection of shoulder force which was loaded by external fixator and the coronal axis) was greater than 45°,clavicle could obtain the resetting tensile stress,which became greater with the angle θ increasing.When η (angle between the sagittal plane projection of shoulder force which was loaded by external fixator and the sagittal axis) was 30°-45°,the resetting tensile stress of clavicle was the maximum.The farther the position on which the loads from external fixator was exerted from the horizontal position of clavicle,the larger the resetting tensile stress of clavicle was.Conclusions The results of orthogonal test show that the optimal resetting tensile stress is produced with parameter combination of θ =65°,η =50°,acting on the center of humerus head of the shoulder.

Objective To explore the changes of white matter integrity in first-episode medication-flee patients with schizophrenia. Methods Diffusion tensor images (DTI) of whole brains of 40 first-episode medication-flee patients with schizophrenia and 68 healthy controls were acquired with a single-shot echo planar imaging (EPI) sequence aligned to the straight axial plane. Two-sample t-test by with voxel-based analysis in SPM5 software was performed on the fractional anisotropy (FA)images of the 2 groups after being preprocessed with DTI-studio and SPM5 software.Results Subjects of schizophrenia showed reduced white matter FA in these regions: the right amygdale (MNI:24, 2, -14; cluster=347 voxels), bilateral anterior cingulate (MNI: 6, 42, 2; cluster=586 voxels), right orbitofrontal (MNI: 20, 18, -10; cluster=166 voxels) as compared with healthy controls. Conclusion Abnormal white matter in the corticolimbic system circuit exists in patients with schizophrenia, which maybe involve in the neural mechanism of schizophrenia.