Objective To investigate the binding capacities of two variants of quinolone resistance-determining region in the DNA gyrase subunit A to substrates in Klebsiella pneumonia (K.pneumonia).Methods Tertiary structures of two variants (type Ⅰ and type FH) of quinolone resistance-determining region in the DNA gyrase subunit A in K.pneumonia were predicted by homology modeling referring to that of wild type.Then,DOCK module in ArgusLab 4.1 software was used to perform molecular docking of two variants and wild type to seven kinds of quinolones substrates,and calculate binding free energies (△G).Moreover,numbers and distances of interaction between amino acid residues of DNA gyrase subunit A and ciprofloxacin were calculated.Results Molecular docking showed that binding free energies of type Ⅰ and type FH to pipemidic acid,ciprofloxacin,gatifloxacin were-26.607 50,-29.530 39,-29.493 09 kJ/mol and-26.696 44,-28.972 83,-29.590 50 kJ/mol,respectively,which declined greater than those of wild type (-27.188 82,-30.872 00 and-30.244 04 kJ/mol,respectively) and showed drug resistance.While binding free energies of type Ⅰ and type FH to levofloxacin were-29.013 81 and-29.497 57kJ/mol,respectively,and that of wild type was-28.016 20 kJ/mol.The binding free energies of type Ⅰ and type FH to nalidixic acid,norfloxacin,ofloxacin increased or declined.Moreover,if distance was less than 5 angstroms,atom pairs formed between wild type of DNA gyrase subunit A and ciprofloxacin had 16 pairs,while type Ⅰ and type FH had 2 pairs and 4 pairs,respectively.If distance was less than 4 angstroms,atom pairs formed between wild type and ciprofloxacin had 8 pairs,while type Ⅰ and type FH had no atom pairs.Conclusion Decline of binding capacities of two variants of DNA gyrase subunit A in K.pneumonia to ciprofloxacin played a role in drug resistance.

Objective:To collect and summarize evidence for improvement of readiness for hospital discharge of patients after PCI.Methods:BMJ Best Practice, UpToDate, Joanna Briggs Institute (JBI) evidence-based health care center database, National Institutes of Health and Clinical Optimization Guidelines Network, Scotland Inter Hospital Guidelines Network, Ontario Registered Nurses Association, International Guidelines Collaboration Network, American Heart Association website, European Heart Association website, Cochrane The literatures about improving the discharge readiness of patients after PCI in library, PubMed, CINAHL, CNKI and Wanfang databases included guidelines, system reviews, best practice information books, evidence summary, expert consensus, and randomized controlled studies. The retrieval time limit was from the establishment of the database to October 2019. Four researchers evaluated the quality of the literature, and extracted evidence from the literature that met the quality standards.Results:A total of 5 articles were included, including 2 guidelines, 2 expert consensus, 1 systematic reviews,3 randomized controlled trials. The best evidence included evaluation of discharge readiness, education of knowledge and skills to patients and caregivers, improvement of self-efficacy of patients and caregivers in disease management, and assurance of social support and health resources for patients and caregivers after discharge.Conclusion:It is suggested that in clinical practice, medical personnel should use the discharge readiness assessment tool to comprehensively evaluate patients after PCI, carry out programmed health education, improve patients' self-efficacy in disease management, and ensure social and medical support for patients and caregivers after discharge as much as possible.

A polydimethylsiloxane ( PDMS )/glass microfluidic chip consisting of a three-layer sandwich structure and three-parallel micro-electrode system was fabricated for the separation of polystyrene microspheres according to the particle size in high conductive solution by electric field produced by alternating current. The principle of electrokinetics of microspheres directional movement was investigated. The results showed that, when the applied voltage was 14 V at 100 kHz, the separation efficiency of 10 and 25 μm polystyrene microspheres was the best. Similarly, with a voltage of 10 V at 2 MHz, the separation efficiency of 5 and 25 μm polystyrene microspheres could achieve the highest value. Meanwhile, the voltage of 11 V at 1 MHz was suitable for the separation of 5 , 10 and 25 μm polystyrene microspheres with the separation efficiency of over 90%. At the same time, the formation of the laminar region in the middle of the electrode gap was the key role of microsphere separation.

Objective To compare the clinical efficacy of nedaplatin and cisplatin combined with docetaxel in the treatment of cervical cancer.Methods 80 patients with cervical cancer were selected as the research subjects.According to different chemotherapy regimens,they were divided into observation group(40 cases)and control group(40 cases).The observation group adopted nedaplatin combined with docetaxel chemotherapy regimen,while the control group used cisplatin plus docetaxel chemotherapy regimens.The clinical curative effect,adverse reaction of chemotherapy,hospitalization related indicators,etc were compared between the two groups.Results The total effective rate of the observation group was 85.0%,which of the control group was 77.5%,the difference was not statistically significant(x2=0.739,P=0.739).The incidence rate of gastrointestinal reaction(Ⅰ-Ⅳ)in the observation group was 25.0%,which was lower than 82.5% in the control group(x2=26.560,P=0.000).The incidence rate of renal toxicity(grade Ⅰ-Ⅱ)of the observation group was 2.5%,which was lower than 17.5% of the control group(x2=5.000,P=0.025).The length of hospital stay of the observation group was(2.93 ±0.39)days,which was shorter than(4.97 ±0.81)days of the control group(t=14.352,P=0.000).The incidence rate of bone marrow inhibition(grade Ⅰ-Ⅱ)of the observation group was 43.0%,which was significantly higher than 25.0% of the control group(x2=4.381,P=0.036).1 year overall survival(OS),no local recurrence rate(LRF)and no distant metastasis survival rate(DMF)between the two groups had no statistically significant differences(all P>0.05).Conclusion Efficacy of nedaplatin or cisplatin combined with docetaxel in adjuvant chemotherapy of cervical cancer has similar prognosis,nedaplatin has less toxicity,and can shorten the time of hospitalization,patients are more likely to accept,it is worthy of clinical promotion.

OBJECTIVE To analyze the resistant rates of Staphylococcus spp and Enterococcus spp isolated from clinical infections to antibiotics,and to provide reference method for effective control infections of Staphylococcus.METHODS The Staphylococcus spp and Enterococcus spp were identified with VITEK-32 automicrobiology system(AMS) and GPI card,drug resistance was detected with VITEK-32 AMS and GPS-107 card.Laboratory data were analyzed by WHONET-5 statistic software.RESULTS Among 1 445 Staphylococcus spp and Enterococcus spp strains isolated from clinical samples,330 strains(22.8%) were Staphylococcus aureus,872 strains(60.3%) were coagulase negative Staphylococcus,213 strains(14.7%) were Enterococcus faecalis,and 30 strains(2.1%) were E.faecium.From S.aureus 223 strains(67.6%) were MRSA,718 strains(82.3%) of coagulase negative Staphylococcus were MRCNS.The detectable rates of MRSA and MRCNS in 2004 were 75.3% and(82.3%,) which were higher than those in 2003(48.4% and 78.4%).Neither strains of S.aureus nor strains of coagulase negative Staphylococcus were found resistant to vancomycin.MRSA and MRCNS resistant rates were found(higher) than MSSA and MSCNS.From the isolated strains of E.faecalis in 2004,the resistance rates to(ciprofloxacin,) nitrofurantoin,gentamicin-500,levofloxacin,and penicillin G were found higher than that in 2003.(E.faecium)(resistant) rates were found significantly higher than E.faecalis.CONCLUSIONS Staphylococcus spp and Enterococcus spp are the main pathogens leading to clinical infections.The findings of these(surveillance)(studies) will enhance our knowledge regarding the problem of antimicrobial resistance and will serve as a basis for future policies and practice styles.

Objective To study the application effect of antiskid steel plate internal fixation via exposing lateral and posterior ankle fracture through fibula posterolateral approach in the treatment of Lauge-Hansen supination-eversion ankle fracture.Methods From January 2009 to December 2012,exposed the lateral and posterior ankle fracture through fibula posterolateral approach of 36 patients suffering from the Lauge-Hansen supination-eversion ankle fracture,and fixed the lateral and posterior ankle by the antiskid steel plate.Adopt Olerud-Molander ankle function scoring system to evaluate the postoperative effect of the ankle.Results All the patients were followed up for 7-27 months,with an average follow-up of 19 months.There was no complications such as incision infection and cutaneous necrosis.Only 1 patient occurred with peroneus myotenositis,and the symptom was relieved after taking out the steel plate.The fracture was healed within 16 weeks.Among the 36 cases,22 cases were excellent,9 cases were good,4 cases were medium and 1 case was poor.The fine rate was 86.1％(31/36).Conclusion Using the antiskid steel plate to treat the lateral and posterior ankle fracture through fibula posterolateral approach,can fully expose a single incision,fix the lateral and posterior ankle and reduce the tension in suture,improve the incision healing rate and fracture stability,provide a new method for treating ankle fracture.

BioNetSim, a Petri net-based software for modeling and simulating biochemistry processes, is developed, whose design and implement are presented in this paper, including logic construction, real-time access to KEGG (Kyoto Encyclopedia of Genes and Genomes), and BioModel database. Furthermore, glycolysis is simulated as an example of its application. BioNetSim is a helpful tool for researchers to download data, model biological network, and simulate complicated biochemistry processes. Gene regulatory networks, metabolic pathways, signaling pathways, and kinetics of cell interaction are all available in BioNetSim, which makes modeling more efficient and effective. Similar to other Petri net-based softwares, BioNetSim does well in graphic application and mathematic construction. Moreover, it shows several powerful predominances. (1) It creates models in database. (2) It realizes the real-time access to KEGG and BioModel and transfers data to Petri net. (3) It provides qualitative analysis, such as computation of constants. (4) It generates graphs for tracing the concentration of every molecule during the simulation processes.
Databases, Factual ; Gene Regulatory Networks ; Kinetics ; Metabolic Networks and Pathways ; Models, Biological ; Signal Transduction ; Software ; User-Computer Interface

OBJECTIVE:To investigate the effects of glutamine on neurological and gastrointestinal function of severe organo-phosphate poisoning patients. METHODS:46 patients with severe organic phosphorus poisoning in our hospital were enrolled and ran-domly divided into control group and observation group,with 23 cases in each group. Control group was given antidote atropine,en-ergy recovery agent pralidoxime chloride,blood perfusion and other symptomatic treatment. Observation group was additionally given Glutamine dipeptide injection 0.5 g/kg,ivgtt,qd,on the basis of control group. Both groups received the treatment for consecutive 3 d. The time of poisoning symptom disappearance,the time of blood cholinesterase recovery,hospitalization time,neurological and gastrointestinal function indexes were compared between 2 groups. RESULTS:The time of poisoning symptom disappearance,the time of blood cholinesterase recovery and hospitalization time of observation group were significantly shorter than those of control group,with statistical significance (P<0.05). After treatment,serum diamine oxidase and lactulose/mannitol of observation group were significantly lower than those of control group,while the serum content of citrulline was higher than in control group,with sta-tistical significance (P<0.05). After treatment,MCV and SCV of observation group were significantly higher than those of control group,while F wave latency was significantly shorter than control group,with statistical significance(P<0.05). CONCLUSIONS:Glutamine dipeptide is helpful to promote remission,improve gastrointestinal and neurological function.

Objective To investigate the blood-saving effect of tranexamic acid in patients undergoing Stanford type A aortic dissection surgery.Methods Fifty-six patients of both sexes with acute Stanford type A aortic dissection, aged 34-58 yr, weighing 62-84 kg, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ , with their left ventricular ejection fraction ＞ 40％, undergoing emergency surgery, were randomly divided into 2 groups: control group (group C, n=26) and tranexamic acid group (group TA, n=30).Tranexamic acid was infused as a bolus of 10 mg/kg over 30 min before skin incision followed by an infusion of 10 mg · kg-1 · h-1 throughout the surgery in group TA.The equal volume of normal saline was given instead in group C.The total volume of drainage at 24 h after operation, the postoperative requirement of allogeneic red blood cells, fresh frozen plasma and platelets, and re-thoracotomy for bleeding were recorded.The postoperative mechanical ventilation time, duration of intensive care unit stay, and complications after operation were also recorded.Results Compared with group C, the total volume of drainage at 24 h after operation, and the requirement of allogeneic red blood cells, fresh frozen plasma and platelets were significantly reduced, the incidence of rethoracotomy for bleeding was decreased, the postoperative mechanical ventilation time, and duration of intensive care unit stay were shortened, and the incidence of postoperative acute lung injury and transient neurological dysfunction were decreased in group TA.Conclusion Tranexamic acid has blood-saving effect and can reduce postoperative bleeding and allogeneic blood transfusion in patients undergoing Stanford type A aortic dissection surgery.

The particles suspended in seawater have great influence on pollutant migration and transformation in marine environment, while the lipophilic algae toxins enriched by the particles suspended in seawater will lead more serious toxicity to marine filter feeders. In this study, a new method was developed for the simultaneous determination of eight lipophilic algae toxins in suspended particles by ultra performance liquid chromatography-tandem mass spectrometry ( UPLC-MS/MS ) . After extracted with methanol by ultrasonic-assisted extraction, the sample was separated on an Acquity UPLC BEH C18 column (50 mm×2. 1 mm, 1. 7 μm) using gradient elution of acetonitrile and water containing 5 mmol/L ammonium acetate as eluent modifiers. The qualitative and quantitative analyses were carried out by electrospray ionization ( ESI) tandem mass spectrometry in multiple reaction monitoring ( MRM) mode. Under the optimal conditions, satisfactory precision (relative standard deviations (RSD≤14. 1%), recoveries (83. 8%-110. 4%) and detection limits (2. 9-103 pg/g) of the method were achieved. Good linearity (R2≥0. 99) was also obtained for all studied analytes. Then, the method was applied to determine the amounts of the eight lipophilic marine toxins in authentic suspended particle samples collected from Qingdao near-shore area. Pectenotoxin 2 ( PTX2 ) was detected in the samples from Shilaoren beach and No. 3 bathing beach with concentration ranges of 717 and 790 pg/g, respectively.