0.05), but hospitalization duration was shorter in the invasive group than in the conservative group (10.3?5.6 days vs 14.6?10.7 days, P

0.05). The total cost of two drugs were 163.85 yuan and 104.04 yuan respectively,showing significant difference (P

OBJECTIVE To analyze the homology of carbapenem-resistant Klebsiella pneumoniae(KPN),offering help for clinical therapy and nosocomial infection control.METHODS The antimicrobial-resistant phenotype of forty carbapenem-resistant K.pneumoniae strains was analyzed by the WHONET 5.4 soft and the resistant genotypes were determined by plasmid profile analysis and pulse-field gel electrophoresis(PFGE).RESULTS Analyzing antimicrobial-resistant phenotype to usual eighteen clinical drugs,the main drug resistant profiles were pan-resistant and only sensitive to tobramycin among the eight antimicrobial-resistant profiles(72.5%).Additionally,the main strains were type Ⅰ and type Ⅱ among the five strains analyzed by plasmid profile(82.5%).When analyzed by PFGE,five types were identified and among these strains type Ⅰ was predominant in 34 strains(85.0%).CONCLUSIONS The strains used in this study exhibit higher homology.Therefore,clinical departments and nosocomial infection departments should pay more attention to these strains to avoid outbreak.

OBJECTIVE To understand the drug resistance genes in Klebsiella pneumoniae (KPN) isolate resistance to 18 kinds of antibacterials which included imipenem and meropenem. METHODS We detected 36 kinds of drug resistance genes for the strain of KPN by PCR method,included the beta-lactamases genes,blaTEM,blaSHV,blaLEN,blaOKP,(blaCTX-M-1,2 and 9) groups,(blaOXA-1,2 and 10) groups,CARB,PER,VEB and GES; the genes of metallo-beta-lactamases genes,IMP,VIM and KPC; the AmpC genes,DHA,ACT,MOX and LAT; the aminoglycosides resistant genes,aac(3)-Ⅰ,aac(3)-Ⅱ,aac(6')-Ⅰb,aac(6')-Ⅱ,ant(2″)-Ⅰ and ant(3″)-Ⅰ; the quinolones resistant gene qnr; the TMP resistant genes,dfrA1 and dfrA17; the disinfectant-sulfanilamide resistantgene,qacE△1-sul1;the integron genes,intⅠ-1,intⅠ-2 and intⅠ-3; and the transposon genes,tnpA and merA.RESULTS We found 9 kinds of drug resistance genes in this KPN isolate. They were the beta-lactamases genes,blaTEM and blaSHV; the metallo-beta-lactamasesgene blaKPC-2; the aminoglycosides resistant genes,aac(3)-Ⅱ and ant(3″)-Ⅰ; the quinolones resistant gene qnr; the TMP resistant gene dfrA17; the disinfectant-sulfanilamide resistant gene qacE△1-sul1 and the integron genes intⅠ-1. CONCLUSIONS We discovere multiple drug resistant genes (some in the chromosome,some are plasmid-mediated) in this isolate. We also find the infrequent plasmid-mediated drug resistant gene blaKPC-2. We think it's concerned with the pan-resistant and the multi-drug resistant genes in this KPN,and we must pay highly attention to this isolate in clinic.

Objective:To express and purify a new fusion protein harboring human epidermal growth factor receptor(EGFR) binding domain and Interleukin-18(IL-18), as well as preliminary assay biological activity of recombinant proteins.Methods:Fusion protein was expressed in insect cells Spodoptera frugiperda cell (Sf9) by using Bac-to-Bac system, and an abbreviation purification procedure was used to purify fusion protein. IFN-?induction assay and EGF Receptor competitive test was used to determine fusion protein's biological activity.Results:SDS-PAGE and western blot assay showed that purified EGF-IL-18 fusion protein had high purity in 20 kD as expected and had the same antigenic specificity as human IL-18. IFN-?induction assay and EGF Receptor competitive test showed that fusion protein induced production of IFN-?in human PBMC and bound with tumor cells.Conclusion:EGF-IL-18 fusion protein has been successfully expressed and purified in insect cells and shows potential to apply in targeting therapy for tumor.

Objective:To develop a real-time PCR assays based on TaqMan chemistry for the identification of recombinant baculovirus and determination of virus physical titers in Bac-to-Bac system.Methods:The recombinant baculovirus containing human IL-18 gene was produced using Bac-to-Bac system.A 10-fold series diluted primary viral stocks were used for plaque assay and DNA extraction.Bacmid(baculovirus plasmid) was 10-fold series diluted and served as standards.Real-time PCR amplification of the IL-18 gene was performed in triplicate for each diluted recombinant virus.At the same time,plaque assays were performed using overlay agarose method.Results:The standard linear(101 to 108 copies) from quantitation was achieved with the standard curve.We also find that the "vg/ml" titer value is generally about 10 times than "pfu/ml" titer of the same recombinant virus stock.Conclusion:A TaqMan real-time PCR method is established to identify the recombinant baculovirus and determine the "vg/ml" titer of virus.The method is rapid and quantitative over a wide range of virus titers.

Objective: To explore the factors affecting carotid plaque formation among high-risk populations for stroke, so as to provide the reference for early intervention for carotid atherosclerosis among the populations. Methods: Permanent residents were selected from Minhang District, Shanghai Municipality using the multi-staged cluster random sampling method from April to September 2021. Basic information, family history of stroke and past medical history were collected by the Community and Township Population Screening Scale for Cardiovascular and Cerebrovascular Disease Risk Factors. High-risk populations for stroke were identified according to the Technical Specifications for Stroke Screening and Prevention. Carotid plaque status was assessed using carotid ultrasonography. Factors affecting carotid plaque formation were analyzed using a multivariable logistic regression model. Results: Among the 25 666 permanent residents surveyed, 8 459 were identified as high-risk populations for stroke, including 3 362 males and 5 097 females, with a male-to-female ratio of 0.66︰1. The median age was 66.00 (quartile range, 11.00) years. Carotid plaque were detected in 4 305 cases among high-risk population for stroke, accounting for 50.89%. Multivariable logistic regression analysis showed that advanced age (OR=1.052, 95%CI: 1.043-1.061), family history of stroke (OR=1.297, 95%CI: 1.103-1.526), hypertension (OR=1.245, 95%CI: 1.025-1.512) and diabetes (OR=1.439, 95%CI: 1.241-1.669) were associated with a higher risk of carotid plaque formation in male high-risk population for stroke, advanced age (OR=1.058, 95%CI: 1.051-1.066), lack of exercise (OR=1.138, 95%CI: 1.001-1.294), family history of stroke (OR=1.201, 95%CI: 1.062-1.357), significant overweight or obesity (OR=1.269, 95%CI: 1.127-1.430) and hypertension (OR=1.169, 95%CI: 1.003-1.362) were associated with a higher risk of carotid plaque formation in female high-risk population for stroke. Conclusion The main influencing factors for carotid plaque formation among high-risk populations for stroke include age, family history of stroke, exercise, significant overweight or obesity, hypertension and diabetes, with gender differences observed.

Accommodation of the human eye ian extremely complex and dynamiprocess,which iaccomplished by the interaction between the central nervousystem and variouoculastructurethaare relevanto accommodation.Varioumechanismof accommodation have been puforward since the beginning of the 19th century,among which Helmhohz'theory ithe mosfamous.However,iistill challenged by othetheories.So far,the mechanism of accommodation hanobeen fully understood.The mosdirecmethod to study accommodation ito observe changein the biometry of the oculastructureduring accommodation,which ialso the mosobjective interpretation of accommodative mechanisms.The rapid developmenof imaging technologiein regardto ophthalmology makethipossible.Thiarticle aimto describe the use of variouimaging technologiein oculaaccommodative studiein vivo from the perspective of morphology.

Background and Objectives: Anticoagulation clinics are widely used for anticoagulation management in many countries, but have only recently began to gain acceptance in Taiwan. Our service model is a physician-managed outpatient clinic collaborating with clinical pharmacist and nurse. This study aimed to evaluate the adequacy of anticoagulation and rates of warfarin-related complications before and after referral to our collaborative anticoagulation clinic (CAC). Methods: Stroke patients taking warfarin from the neurology department were identifi ed and referred to the CAC during the 12-month period from February 2009 to January 2010. Quality markers include percentage of international normalized ratio (INR) values in the therapeutic range, frequency of INR monitoring, and frequency of follow-up visits and the mean interval of next INR monitoring after non-therapeutic INRs were compared one year before and after management in the CAC. Using studied patients as self-control, they were included in the analysis if patients had at least 3 months follow-up or 3 INR values both before and after referral. Results: A total of 44 stroke patients were included: mean age of 75.0 ± 9.7 years, with a CHADS2 score of 3.71 ± 0.69. The adequacy of anticoagulation was signifi cantly greater during CAC care compared with the period before referral; the percentage of INR within expanded therapeutic range was 60.9% versus 53.7%, respectively (p=0.049). Reduction in sub-therapeutic INR values from 31.8% to 24.2% (p=0.023) contributed mostly to the improved quality of care. The time interval of next INR monitoring after non-therapeutic INRs ( 4.0 or 1.5) was also signifi cantly shorter. However, there was no signifi cant difference in the rates of thromboembolic and hemorrhagic events which may be attributed to a small sample size. Conclusion: Based on results of our study, a CAC may be the optimal structure for anticoagulation management service in the future.

Objective: To observe the acute hypotensive effect of compound coenzyme for injection on cats,and to establish a method for examination of depressor substance.
Methods: Ten batches of compound coenzyme for injection and histamine depressor substance were compared by cat blood pressure method to determine the limit value of depressor substance test method. According to the limit value, 22 batches of samples were tested for depressor substance.
Results: The limit of compound coenzyme for injection was 3 IU·kg^-1 (calculated by coenzyme A). Two batches of 22 batches of compound coenzyme for injection did not meet the requirements.
Conclusion: The method of compound coenzyme for injection is feasible according to the proposed limit value. It is suggested that the quality standard of compound coenzyme for injection should be added with the examination of depressor substance.