OBJECTIVE To investigate the risk factors for nosocomial pneumonia(NP) caused by imipenem-resistant Acinetobacter baumannii(IRAB) and its antimicrobial susceptibility in vitro. METHODS The data of 34 cases of IRAB-NP were analyzed and 68 cases of NP caused by imipenem-susceptible A.baumannii(ISAB) were randomized as control.Antimicrobial susceptibility(MIC) was determined with the method of agar dilution. RESULTS The two independent factors associated with the development of IRAB-NP: previous fluoroquinolone(OR=5.738) and imipenem/meropenem(OR=7.129) use.The drug sensitivity test in vitro showed that these strains were multiresistant to commonly used antibiotics,and only ampicillin/sulbactam and cefoperazone/sulbactam whose resistance rate was less than 30%. CONCLUSIONS Previous imipenem/meropenem and fluoroquinolone use is independent risk factors for IRAB-NP.These strains are high drug resistant.

Objective To study the efficacy and safety of T-614 in treating rheumatoid arthritis(RA). Methods Two hundred and eighty patients with active RA were randomly allocated to 3 groups:T-614 50 mg each day,25 mg each day or placebo.Clinical and laboratory parameters were analyzed at baseline,2,4,6,12, 18 and 24 weeks.Results The ACR response rate was significantly higher in the T-614 treatment group com- pared with the placebo group during the first 6 weeks.After 24 weeks,25 mg/d,50 mg/d dosage group and the placebo group showed 39.1%,61.3% and 24.2% in ACR20,23.9%,31.2% and 7.4% in ACR50 respectively.A time-response in ACR response after 24 weeks was observed,with clear superiority of the 25 mg/d and 50 mg/d dosage groups compared to the placebo,and 50 mg/d dosage group compared to 25 mg/d dosage group(P

Objective To evaluation in vitro activity and synergy of Yin-hua Miyan Ling against main clinical isolated strains.Methods All of 285 stains from 18 tertiary hospitals in recent three years were studied. Minimal inhibition concentrations ( MIC ) were tested by Agar dilution method and combination effects were measured by Checkerboard method. Results Yinhua Miyan Ling showed more in vitro activity against Sta-phylococcus and Proteus mirabilis, MIC values from 3.13~6.25 mg? mL-1 . On the other hand, Yinhua Miyan Ling showed the same antibiotic activi-ty against extended-spectrumβlactamases ( ESBLs) positive and nega-tive strains or methecillin susceptible and resistant Staphylococcus.Syner-gy was detected with Yinhua Miyan Ling in combination with amoxillin/clavulanate, cefuroxime and levofloxacin against gram-positive strains, especially methicillin-resistant Staphylococcus aureus ( MRSA).Against E.faecalis, synergy was observed in Yinhua Miyan Ling and cefuroxime. Additive effect was found between Yinhua Miyan Ling and amoxillin/clavulanate against 100%E.coli.Conclusion Synergy was found with Yinhua Miyan Ling in combination withβlactams and quinolones against gram -positive strains and additive effect was found against gram-negative bacilli.

Objective To understand the resistance, molecular charac-teristics of oxacillin susceptible methicillin-resistant Staphylococcus au-reus ( OS-MRSA) strains isolated 2011-2012 in China.Methods A total of 297 methicillin -resistant Staphylococcus aureus ( MRSA ) were collected in the Ministry of Health National Antimicrobial Resistance Sur-veillance Net program and the susceptibility test were performed by agar dilution method.All the oxacillin-susceptible MRSA strains were con-firmed to be Staphylococcus aureus by detecting nuc gene.The molecular typing methods included SCCmec and spa typing.Results A total of 14 isolates ( 4.9%) were oxacillin susceptible methicillin-resistant Staphy-lococcus aureus among 288 MRSA isolates and most of them were from se-cretion (50%, 7/14) and blood (28.6%, 4/14).The susceptibility rate to gentamicin, amikacin, rifampicin and trimethroprim/sulfamethox-azole was more than 90% and the rate to quinolones, tetracycline and chloramphenicol was about 80%, 28.6%, 28.6%, respectively.Moreo-ver, the resistance rate to erythromycin, azithromycin and clindamycin was more than 90%.PCR revealed that 14 isolates were Staphylococcus aureus and mecA positive and the most predominant clone was SCCmecⅤ-spat437 (42.9%,6/14).Conclusion The most predominant clone of the OS-MRSA isolates in China was SCCmecⅤ-spat437; most of OS-MRSA isolates were susceptible to the majority of antibacterial agents except macrolides, tetracycline and chloramphenicol.

Objective To understand the relationship between the concentration of air pollutants and daily emergency department visits for different diseases (circulatory system disease, digestive system disease, nervous system disease and respiratory system disease) in Guangzhou, Guangdong Province. Methods The daily average concentrations of sulfur dioxide (SO2), nitrogen dioxide (NO2, carbon monoxide (CO) and PM2.5 and the daily maximum 8-hour concentrations of O3, the daily average temperature, the relative humidity and cause -specific emergency department visits of the four major diseases from 2015 to 2017 were collected in Guangzhou. Semi-parametric generalized additive model was used to analyze the relationship between the concentration of pollutants and daily cause-specific emergency department visits. Results The daily average concentrations of SO2, NO2, CO, O3 and PM2.5 during the study period were 13.24 μg /m3, 45.96 μg /m3, 0.97 mg /m3, 123.77 μg /m3 and 36.22 μg /m3, respectively. For circulatory system disease，the independently significant associations of SO2 with emergency department visits in single-pollutant models (2.91%, 95% CI: 1.00%-4.85%), and multipollutant models (4.39%, 95% CI: 1.22%-7.67%) were observed. Conclusion The ambient SO2 increases the risk of emergency department visits due to circulatory diseases in Guangzhou. Comprehensive prevention and control measures should be taken to reduce the emission of SO2.

OBJECTIVETo evaluate the relation between different therapy and survival rate of liver metastasis of colorectal cancer (LMCC).

METHODSClinical data of 669 LMCC patients,collected from Fudan University Zhongshan Hospital from January 2000 to July 2008, were analyzed retrospectively.

RESULTSOf the 669 cases, 379 cases were synchronous liver metastases(SLM) and 290 cases were metachronous liver metastases(MLM). There were no significant differences in age, gender and position of primary tumor between SLM and MLM groups(P>0.05), but as to liver metastasis characteristics(liver lobe involved, focus number and maximal focus diameter) and CEA, CA19-9 before therapy,there were significant differences(P<0.05). Two hundred and fifty-three cases underwent curative hepatic resection, including 123 cases in SLM and 130 cases in MLM. Until October 31, 2008, all the cases were followed up. The median survival time of SLM was(11+/-1) months and of MLM(23+/-2) months(P<0.01). Five-year survival rate of SLM was 6.4% and of MLM 11.4%(P<0.01). As to different treatments, median survival time and 5-year survival rate of curative hepatic resection group were 37 months and 35.6%, and of non-operation groups(i.e. intervention, chemotherapy, radiofrequency therapy and percutaneous ethanol injection) were 5 to 26 months and 0 to 3.6% respectively(P<0.05).

CONCLUSIONSCurative hepatic resection is the first choice of liver metastasis of colorectal cancer, which can improve the survival rate. Resection rate and survival of MLM are better than those of SLM.

Adult ; Aged ; Colorectal Neoplasms ; pathology ; therapy ; Female ; Follow-Up Studies ; Hepatectomy ; Humans ; Liver Neoplasms ; secondary ; therapy ; Male ; Middle Aged ; Neoplasm Metastasis ; Prognosis ; Retrospective Studies ; Survival Rate

OBJECTIVETo investigate the protective effect of insulin on oxygen-radical induced hepatic injury in severely scalded rats in early stage of severe scald.

METHODSEighty-four male Sprague-Dawley rats were randomly divided into three groups: i. e, normal group, saline group, and insulin group, with 28 rat in each group. The rats in the latter two groups were subjected to 30% TBSA full-thickness scald on the back, and received intra-peritoneal injection of 40ml/kg isotonic saline, and subcutaneous injection of 3 IU/kg insulin, respectively. The total anti-oxygen capability (T-AOC), the expression of superoxide dismutase (SOD), reactive oxygen species (ROS) and intercellular adhesion molecule (ICAM-1) in hepatic tissue, and serum alanine transaminase (ALT) were determined in each group at 6, 12, 24, 48 post-scald hours (PSH) with corresponding methods.

RESULTSThe hepatic T-AOC and SOD content were obviously decreased, while the ROS content were markedly increased at 6 PSH in saline group compared with that in normal group (P < 0.05 or P < 0.01). The expression of ICAM-1 and serum content of ALT were significantly higher than that in normal group at 12 PSH and 48 PSH (P < 0.01). At 24 PSH, the hepatic T-AOC (386 +/- 75) U/g and SOD content (210 +/- 39 ) U/g were obviously higher in insulin group than those in saline group [(124 +/- 18), (111 +/- 9) U/g, respectively, P < 0.01), but the ROS content (154 +/- 29 ) U/g was much lower than that in saline group [(351 +/- 41) U/g, respectively, P < 0.01]. At 48 PSH, the serum content of ALT and hepatic expression of ICAM-1 in insulin group exhibited obvious difference when compared with those in saline group (P < 0.01). Meanwhile, Pathological examination showed that hepatic injury was alleviated by insulin administration after scald.

CONCLUSIONInsulin administration early after severe scald exhibits protective effect on liver function by improving anti-oxygen radical ability of rat liver.

Alanine Transaminase ; blood ; Animals ; Burns ; metabolism ; pathology ; Insulin ; pharmacology ; Liver ; drug effects ; metabolism ; pathology ; Male ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Reactive Oxygen Species ; metabolism ; Superoxide Dismutase ; metabolism

OBJECTIVETo compare the in vitro inhibitory effect of expolysaccharides from Streptomyces, polysaccharides of Ganoderma lucidum and rice bran on six-alpha-helix bundle formation of HIV gp41 protein.

METHODSThe amount of six-alpha-helix bundle formed in the presence of N36 and C34 was tested by ELISA in response to treatments with different doses of polysaccharides.

RESULTSExpolysaccharides from Streptomyces potentially inhibited six-alpha-helix bundle formation with the effective concentration (IC(50)) of 145.48-/+7.25 mg /L. Polysaccharides of Ganoderma lucidum and rice bran showed no effect on the six-alpha-helix bundle formation.

CONCLUSIONExpolysaccharides from Streptomyces can inhibit the six-alpha-helix bundle formation of HIV gp41, whereas polysaccharides of Ganoderma lucidum and rice bran do not exhibit such activity.

HIV Envelope Protein gp41 ; chemistry ; Kinetics ; Oryza ; chemistry ; Polysaccharides ; pharmacology ; Protein Structure, Secondary ; drug effects ; Reishi ; chemistry ; Streptomyces ; chemistry

Objective To investigate the uptake mechanism of HepG2.2.15 cells to the nanoparticles co-loaded with syringopicroside and hydroxytyrosol (SH-NPs). Methods The nanoparticles were prepared by using a nanoprecipitation method with mPEG-PLGA as nano-carrier co-loaded with syringopicroside and hydroxytyrosol. The uptake mechanism of HepG2.2.15 cells to SH-NPs was studied by fluorescence microscopy and flow cytometry using fluoresceineisothiocyanate (FITC) as a fluorescent marker. Results With colchicine as the inhibitor, the incubation time ranged from 0.5 to 24 h, the percentage of positive cells increased from 1.9% to 56.4%; When the drug concentration was 125, 250 μg/mL and 500 μg/mL, the positive cell percentages were 4.9%, 3.4% and 3.9%. With chloroquine as the inhibitor; the incubation time ranged from 0.5 to 24 h, the percentage of positive cells increased from 7.4% to 55.4%; When the drug concentration was 125, 250 and 500 μg/mL, the percentage of positive cells was 19.5%, 22.5% and 27.6%. Conclusion Colchicine and chloroquine have an inhibitory effect on HepG2.2.15 cells uptake, and the uptake of SH-NPs in HepG2.2.15 cells was positively correlated with drug concentration and incubation time. It can be concluded that the uptake mechanism of HepG2.2.15 cells to SH-NPs was nonspecific adsorption endocytosis.

This study was aimed to explore the feasibility of identification of traditional Chinese medicine (TCM) constitution based on photoplethysmography (PPG) frequency domain analysis,and to establish an automatic identification system (AIS) of TCM constitution with simple operation and good generalization.The Classification and Determination of Constitution in TCM was used to evaluate the subjects' constitutional state.Pulse wave sensor was used to collect the pulse wave signal.Spectral characteristics were analyzed by power spectrum analysis.Eight classification algorithms of data mining were used to establish the model of qi-insufficiency constitution.The results showed that the pulse wave harmonic peak was that qi-insufficiency constitution was higher than health group;the model was optimal when random forest algorithm was used;and the accuracy of 10-CV test was 80.4％.Sensitivity reached 73.2％.Specificity and receiver operator characteristic were all above 0.8.The model has certain reliability.It was concluded that it was feasible to identify qiinsufficiency constitution by means of frequency domain analysis of PPG.It provides preliminary work for the construction of AIS of TCM constitution as well as a simple and quick assistant tool for the constitution identification of subhealth group in family health care.