OBJECTIVE To find out the clinical characteristics of nosocomial infections with Stenotrophomonas maltophilia(SMA) and investigate the disinfectant resistant gene of qacE△1,improve the diagnosis and decrease of nosocomial infection cases.METHODS Toally 165 strains of SMA were clinically isolated from 2004 to 2007.The gene of qacE△1 was analyzed by polymerase chain reation(PCR) and homology of the strains was analyzed by the method of by pulsed field gel electrophoresis(PFGE) genotype.RESULTS Susceptible factors were old age,seriousness of underlying disease,prolonged hospitalization and invasive operation with infection of SMA.The lower respiratory tract infection was mostly common with SMA,rate of which was 87.9%.Antibiotic sensitive rate more than 80% against SMA was minocycline,trimethoprim-sulfamethoxazole and levofloxacin.The positive rate of gene qacE△1 was 13.3% in 60 strains tested.Two genotypes in SMA strains from respiratory ICU(RICU) were with the same clone.This result proved that clone transmission occurred in RICU.CONCLUSIONS SMA is an important nosocomial infection pathogen.With the multi-drug resistance,the therapy of infection with SMA is very hard in clinic.As result of gene of qacE△1 and the same clone transmission,clinicians should play an important role of surveillance of effect of disinfection.

Objective To observe the effects of sympathectomy on the function and the expression level of angiotensin Ⅱ type 1 receptor(AT_(1)R).Methods Newborn male Wistar rats' sympathetic nerve was destroyed by 6-hydroxydopamine(6-OHDA),and then following parameters were observed after 11 weeks: pressor and vasoconstrictive effects of AngⅡ,the affinity of -AngⅡ to AT_(1)R in myocardium,the level of mRNA expression of AT_(1)R in vessel smooth muscle.Results The pressor and vasoconstrictive effects induced by AngⅡand the mRNA expression of AT_(1)R in vessel smooth muscle enhanced substantially in adult rats who had been performed sympathectomy at juvenile period.There was also an enhancement in B_(max) of AT_(1)R in myocardium of the rats performed with sympathectomy,while no change occurred in K_(D).Conclusion In rats performed with sympathectomy,the expression level of AT_(1)R rises remarkably.The pressor and vasoconstrictive effects induced by AngⅡenhance consequently. These might be the reasons that blood pressure and heart rate do not reduce after sympathectomy.

[ ABSTRACT] AIM:To explore the effect of sterol regulatory element-binding protein 2 ( SREBP-2) on tunicamy-cin-induced endoplasmic reticulum stress ( ERS) in chondrocytes.METHODS:After isolation of human normal chondro-cytes and osteoarthritis ( OA) chondrocytes, the normal cells were cultured and treated with tunicamycin and SREBP-2 siR-NA.After 24 h treatment, fluorescent quantitative RT-PCR ( RT-qPCR) was applied to quantify microRNA-185 ( miR-185) levels.The cell apoptotic rate was determined by flow cytometry.The expression of SREBP-2 and ERS-related pro-teins, C/EBP homologous protein (CHOP), phosphorylated eukaryotic initiation factor-2α(p-eIF2α) and activating tran-scription factor 4 (ATF4), and the expression of apoptosis-related proteins, Bcl-2, Bax and caspase-3, were determined by Western blot.The caspase-3 activity kit was used to determine the caspase-3 activity.RESULTS: Compared with hu-man normal chondrocytes, both SREBP-2 up-regulation and miR-185 down-regulation were observed in OA chondrocytes (P<0.05).SREBP-2 siRNA transfection enhanced tunicamycin-inhibited miR-185 level (P<0.05).miR-185 overex-pression reduced tunicamycin-induced SREBP-2 expression ( P <0.05 ) .OA control group and tunicamycin treatment group consistently resulted in ERS and cell apoptosis with concomitant enhancement of CHOP, p-eIF2αand ATF4 proteins, increases in Bax and caspase-3 proteins, and reduction of Bcl-2 (P<0.05).However, SREBP-2 silencing significantly re-versed these effects ( P<0.05) .The apoptotic rates were consistent with the expression tendency of apoptosis-related pro-teins (P<0.05).SREBP-2 siRNA transfection markedly down-regulated tunicamycin-induced caspase-3 activity, which was notably blocked by miR-185 inhibition (P<0.05).CONCLUSION:SREBP-2 silencing may inhibit tunicamycin-in-duced ERS and cell apoptosis via up-regulating miR-185 expression.

Objective To identify the genotype of clinical stenotrophomonas maltophilia(SMA) isolates and investigate the characteristics of SMA in nosocomial infections.Methods Totally 165 strains of SMA were clinically isolated during the period of 2004 to 2007.Disc diffusion test(K-B method) was used for antibiotic susceptibility.qacE△1 gene was detected by polymerase chain reation(PCR).The gene homology in the SMA strains was analyzed by pulsed field gel electrophoresis(PFGE).Results Among the tested SMA strains 87.9% sourced from low respiratory tract infection.The antibiotics with more than 80% of sensitive rate against SMA were minocycline,trimethoprim-sulfamethoxazole and levofloxacin.The positive rate of qacE△1 gene was 13.3% in 60 tested strains.The analysis of gene homology for the 11 clinical strains showed that two genotypes from identical clone were found in both respiratory ICU and emergency ICU respectively.Conclusions SMA was an important pathogenic bacterium in nosocomial infections.The treatment for SMA infection is very difficult since its multi-drug resistance.More attention for effective sterilization and isolation of patients must be paid to prevent the transmission of SMA from same clone.

Objective To investigate changes of platelet activation in the elderly patients with obstructive sleep apnea-hypopnea syndrome(OSAHS)before and after the application of nasal continuous positive airway pressure(nCPAP). Methods Ninety patients diagnosed as OSAHS by polysomnography(PSG)were selected as trial group,30 non-OSAHS by PSG were as control group, and 16 severe OSAHS patients were treated by nCPAP and taken as nCPAP therapy group. GMP-140 and GPⅡb/Ⅲa were measured by ELISA and compared in these groups. Results Plasma levels of GMP-140 and GPⅡb/Ⅲa of patients with moderate and severe OSAHS were (16.6?2.3)?g/L vs (18.9?3.1)?g/L, and 38 468?952/ 49 673?1037 vs 39 867?1264/50 899?2476 respectively; and those of control group were (14.8?2.1) ?g/L, 37 672?769/ 48 469?1672 respectively.Plasma levels of GMP-140 and GPⅡb/Ⅲa were significantly higher in patients with moderate to severe OSAHS than those in control group(P

Objective To discuss the application of transanal placement of ileus tube in treatment of colonic obstruction in left colorectal cancer.Methods Thirty-two patients with left malignant colorectal obstruction were divided into ordinary colonoscope group (16 cases) and superslim endoscope group (16 cases) by random digits table.The catheter success rate,catheter operating time and exposure to X-ray time was compared between two groups.Results Fifteen cases were successful and 1 case was failed in ordinary colonoscope group.Thirteen cases were successful and 3 cases were failed in superslim endoscope group.There was no significant difference in the catheter success rate between two groups (x2 =1.143,P =0.285).The catheter operating time was (42 + 15),(20 +6) min in ordinary colonoscope group and superslim endoscope group,and there was significant difference between two groups (t =3.895,P =0.005).The exposure to X-ray time was (20 + 12),(5 + 2) min,and there was significant difference between two groups (t =-3.596,P =0.007).Conclusion Transanal placement of ileus tube is more successful and convenient by superslim endoscope combined with anesthesia than by ordinary colonoscope.

Objective To observe the effect and safety of butyl cyanoacrylate used to close type Ⅰ and Ⅱ skin incisions in non-emergency operations of general surgery.Methods We have enrolled 31 cases with written consent.Upon completion of the surgery butyl cyanoacrylate was used to close skin incisions instead of surgical sutures after suturing subcutaneous tissue with 4-0 absorbable thread.Results The length of incisions was 12 - 180 mm (32 ± 32) mm.On the first post-op day,2 cases had redness and 1 had some effusion within the incision subsiding on the second day,there were no fever.Moderate pain was recorded in 3 cases on the first day after operation.The number of cases reporting slight pain on the first day,third day and fifth day were respectively 28,18 and 5.The others had no any pain.The healing time was (6.3 ± 1.1 ) d,there was no delayed healing,no other complications.Conclusions The tissue adhesive method,using butyl cyanoacrylate is of value in closing type Ⅰ and Ⅱskin incisions in general surgery.It has the advantage of reducing scar and inflammation.

Foreign specialist physician system has been implemented for more than 100 years. China piloted its own specialist physician system from 2004. The article compared foreign specialist physician system with China’s pilot system. Combined with TCM clinical characteristics and laws, the article also discussed to set up Chinese medical specialist system which is in accordance with both international conventions and TCM laws of development as well as docking the pilot system.

Objective:To observe the changes of blood glucose,insulin and dipeptidyl peptidase-Ⅳ(DPP-Ⅳ/CD26)on type 2 diabetes mellitus in rabbits after HUCBSC( human umbilical cord blood stem cells) transplantation. Methods:18 rabbits were randomly divided into normal control group (6 rats,Group C) and diabetic model group (12 rats). After preparation model of type 2 diabetes,and 6 rats of them were treated with HUCBSC ( CD45+,CD34-) transplantation by ear vein transfusion ( Group A) ,and 6 rats were treated with PBS(Group B). All three groups of rabbits were fed for 4 weeks,and the blood glucose was monitored every day,and the level of blood insulin and DPP-IV/CD26 were measured every week. Results:The negative expression rate of CD34 in HUCBSC was 96. 5%. The positive expression rate of CD45 in HUCBSC was 100%. Compared with non transplantation group,the blood glucose and DPP-IV/CD26 in the umbilical cord blood stem cell transplantation group were gradually decreased,and insulin level was gradually increased, the difference was statistically significant (P<0. 01). Conclusion:HUCBSC were round or oval,with adherent growth,HUCBSC trans-plantation can significantly reduce blood glucose, increase insulin secretion, reduce the level of DPP-IV/CD26, the immunological phenotype of HUCBSC was CD45+,CD34-,thus providing a new theoretical basis for the clinical treatment of diabetes and its complica-tions.

ObjectiveTo investigate the effect of IκB kinase (IKK-β) on migration and proliferation of bone marrow mesenchymal stem cells(BMSCs) from patients with systemic lupus erythematosus (SLE).MethodsHuman bone marrow aspirates were collected from iliac of six donors and six SLE patients and cultured in vitro.Migration of BMSCs were observed by wound healing and transwell migration assays.Proliferation of BMSCs was quantified by cell counting kit-8 assay.Total RNA was extracted and reverse transcribed into complementary DNA.Real-time PCR technique was used to determine the gene expression of IKK-β at transcription level.The expression of IKK-β and phospho-IKK-β(p-IKK-β) protein were determined by Western blotting analysis.Statistical analysis was conducted with or Mann-Whitney rank test.Results① The migration rate of BMSCs from SLE patients(5.2±3.8)‰ were significantly reduced as compared with normal controls (7.0±2.9)‰(P＜0.05 ).The proliferation of BMSCs of SLE patients (0.21±0.49)was lower than that from healthy controls ( 1.00±0.35 )(P＜0.05 ).②) No difference in IKK-β3 mRNA expression between SLE ( 1.9± 1.4) subjects and normal controls (1.9±2.4) (P＞0.05).IKK-β protein expression of BMSCs from SLE patients (1.41 ±0.19) increased significantly compared with healthy controls (0.93±1.24) (P＜0.05).③ Inhibitor of IKK-β caused a significant increase in cell migration (3.3±1.6)‰ and proliferation (1.13±0.26) of BMSCs from SLE patients compared with untreated cells (2.3±1.1)‰ and (0.81±0.17),respectively (P＜0.05).ConclusionMigration and proliferation of BMSCs are significantly decreased in SLE patients.IKK-β may be involved in migration and proliferation of BMSCs.