Objective To investigate the distribution and the antibiotic resistance genes carried by classⅠintegron and insertion sequence common region(ISCR1)among clinical isolates of Acinetobacter baumannii. Methods Fifty-one clinical isolates of multidrug-resistant Acinetobacter baumannii were collected. Polymerase chain reaction method was used to detect the classⅠintegrase gene, variable region of classⅠintegron, ISCR1 and genes related to antibiotics resistance lo-cated downstream of ISCR1 in 51 multidrug-resistant Acinetobacter baumannii. Antibiotics resistance genes carried by classⅠintegron and ISCR1 were performed by DNA sequencing. The relationship between classⅠintegron and ISCR1 was detected by PCR-mapping. Results Among 51 multidrug-resistant Acinetobacter baumannii isolates, 45 strains were found con-taining classⅠintegrase genes, 32 strains were found containing variable regions. Sequencing results showed that the gene cassette arrays were aacA4-catB8-aadA1, aacC1-orfA-orf-B-aadA1 and blaPSE-1-aadA2-cmlA1-aadA1. Twenty-two strains were found containing ISCR1 and 5 strains were found containing resistance genes located downstream of ISCR1. DNA sequencing results showed the resistant gene of qnrA1-ampR. The results of PCR-mapping showed that ISCR1 located directly downstream of 3' conserved segment of classⅠintegron in 20 Acinetobacter baumannii strains. Conclusion ClassⅠintegron and ISCR1 play an important role in mechanisms of drug resistance of Acinetobacter baumannii. ClassⅠintegron and ISCR1 could connect in series in Acinetobacter baumannii.

Objective To evaluate the correlation between serum procalcitonin concentration and systemic inflam-matory response syndrome (SIRS)score in patients with bacterial bloodstream infection.Methods In January-De-cember,2012,96 patients with bacterial bloodstream infection in a hospital were selected as trial group,and these patients were divided into three groups(group A,B and C)according to SIRS score;84 patients without bacterial in-fection was as control group,PCT concentration of all patients were detected,and the correlation between PCT con-centration and SIRS score was analyzed.Results Among 96 patients with bacterial bloodstream infection,7 (7.29%)died (4 were in group B and 3 in group C);there was no death case in control group.PCT concentration in control group,group A,B and C of trial group were (0.28±0.09)ng/mL,(0.63±0.13)ng/mL,(3.68±1.01)ng/mL,and(7.45±1.53)ng/mL,respectively,the difference between each group was significant(P<0.01).Pairwise comparison of four groups showed statistical difference (P<0.001).Spearman correlation analysis on PCT concen-tration and SIRS score was conducted,correlation coefficient r=0.874(P<0.001)suggested positive correlation be-tween serum PCT concentration and SIRS score.Conclusion PCT concentration in patients with bacterial blood-stream infection and SIRS score is positively correlated,PCT concentration and SIRS score can be used as two mark-ers for assessing the extent and prognosis of bacterial bloodstream infection.

Objective To study the application effect of health education guided by the theory of cross-theoretical model in the training of the first aid training in the basic units of the plateau. Methods Choosing 386 long-term presence of plateau soldiers, and divided them into the control group and the experimental group, the control group was educated by traditional method, in the experimental group, the health education was carried out with the trans-theoretical model, nursing experts gave them targeted intervention. The number of groups at each stage was analyzed in different stages, the same to examination results and pass rate. Results After 6 months of intervention, there was a significant improvement in the mastering of the battlefield Five emergency technology of the experimental group and the scores were better than those of the control group (P<0.05). Theoretical results showed that pass rate of the control group was 89.1%(172/193), the experimental group was 99.5%(192/193), the difference between the two groups was statistically significant (χ2=7.129, P=0.039). In the survey of technical operation, ventilation, hemostasis, bandaging, fixing and handling examination pass rate of the control group respectively were 88.1%(170/193), 89.1%(172/193), 89.1%(172/193), 88.1%(170/193), 88.6%(171/193), the experimental group were 99.5%(192/193), 97.9%(189/193), 99.5%(192/193), 96.9%(187/193), 97.4%(188/193), there were significant differences between the two groups (χ2=7.896-12.759, P=0.001-0.043). Conclusions Cross theoretical model has good effect on the application ofFiveemergency technology training in the high altitude troops battlefield, and can effectively improve the troops self- help and mutual aid capabilities, it is worthy of popularization and application.

Objective By virtual screening in MDL,to search for a novel γ-secretase inhibitor.Methods A series of compounds were designed,synthesized,and evaluated based on pharmacophore model of γ-secretase inhibitors by virtual screening in MDL.Results The drug-likeness analytic data synthesized indicated that target compounds had drug-likeness.Each svnthesized compound was checked by IR spectroscopy,~1H and ~(13)C-NMR spectroscopy.Conclusion The designed compounds had better activity by model prediction.And the optimal compound showed a significant estimated activity value of 0.025 nmol/L and can be used as a lead for further drug development.

The introduction of problem-based learning techniques into the teaching of anatomy has been subject to great contro- versies.This paper debates the rationale behind this concept using the example of the curriculum of Harvard Medical School.The anatomy curriculum is covered during the eight first weeks of the medical studies,and is an original combination of discussions of clinical cases in small groups,and work in gross anatomy,histology and radiology laboratories.The lectures are reduced to the minimum and emphasize general concepts.

To investigate the advantage of using the medical sodium hyaluronate gel undergo goniosynechialysis, and to compare the difference of the viscoelastic agent and perfusion fluid by clinical control study.
●METHODS:Totally 103 cases (103 eyes) patients who had angle- closure glaucoma (ACG) with cataract all in Beijing Tongren Hospital affiliated to Capital Medical University, from September 2012 to February 2013. All the patients had primary glaucoma or recurrence ACG with cataract. Their intraocular pressure (lOP) could be controlled in normal value using one or two anti -glaucoma medications. We divided all the patients into two groups by chance. Experimental group had 53 cases (50 eyes), and control group had 50 cases (53 eyes). Two groups all had been performed phacoemulsification combined with goniosynechialysis by the same experiential operator. But experimental group did goniosynechialysis using the medical sodium hyaluronate gel, control group did goniosynechialysis using perfusion fluid. We observed the change of lOP, central anterior chamber depth and anterior chamber structure of two groups in postoperative 1mo.
●RESULTS: SPSS19. 0 statistics software was utilized to analyze the data, This study selected one- side test α =0. 05, adopted paired t - test or two- sample t - test. We obtained that experimental group lOP decreased 12. 42 ± 0. 04mmHg, anterior chamber depth increased 1. 276 ± 0. 201mm; that control group lOP decreased 6. 56 ± 0. 08mmHg, anterior chamber depth increased 0. 852 ± 0. 132mm. And experimental group anterior chamber angle opened more widely than the other group, the comparison had statistical significance (P<0. 05).
●CONCLUSlON: ln phacoemulsification combine with goniosynechialysis,use medical sodium hyaluronate gel do goniosynechialysis can more effectively decrease lOP. This because the medical sodium hyaluronate gel has high glutinousness, it can separate angle of anterior chamber and controlling lOP effectively.

Objective To investigate the related factors of clinical stage and prognosis in the patients with endometrial carcinoma and their relation with proto-oncogene Wip1 expression level.Methods The paraffin samples of resected endometrial carcinoma in 120 cases of endometrial carcinoma in our hospital from January 2002 to January 2012 were collected as the experimental group,the samples were verified by pathology.Contemporaneous 120 samples of biopsy normal endometrial tissue served as the control group.The expression leve of Wipl were detected in turo groups.Results (1) In the Wip1 immunohistochemical staining results:Wip1 immunohistochemical staining was negative or weak in normal endometrial tissue cells,while showed pale yellow to yellowish-brown in endometrial cancer tissue.The positive expression rate of Wip1 protein in endometrial carcinoma tissue was 77.5%(93/120),which was higher than 22.5%(27/120) in normal endometrial tissue,the difference was statistically significant (P<0.05).(2)In the Western blot results of Wip1 protein in endometrial cancer tissue and normal endometrial tissue:the relative amount of Wip1 protein in endometrial carcinoma tissue was 0.635±0.023,which was significantly higher than 0.325±0.018 in normal endometrial tissue,the difference between the two groups was statistically significant (P<0.05).(3)In the real time quantitative qRT-PCR results of various samples:Wip1 mRNA expression level was higher than that in normal endometrial tissue,which were 0.628±0.053 and 0.191±0.009 respectively,the difference between the two groups was statistically significant(P<0.05).(4) The expression level of Wip1 had no correlation with age,estrogen and progesterone status,HER2,lymph node status and TNM stage,but had correlation with P53 expression level.Conclusion (1) The Wip1 expression amount is high in endometrial carcinoma and low in normal endometrial tissue.(2)The Wip1 expression level has no relation with age,estrogen and progesterone status,HER2,lymph node status and TNM stage,while has association with P53 expression level.

Objective To analyze MRI features of breast intraductal papilloma,to improve the acquaintance of this disease.Methods The preoperative MRI images (T2 WI-SPAIR,DWI,ADC,TIC and MIP)of eight patients with breast intraductal papilloma confirmed by surgery were reviewed retrospectively,which were compared with the postoperative pathology.The morphology,distribution, enhanced methods and signal characteristics of the lesion were summarized.Results Of 8 cases,the lession was dormant,and MRI revealed three patterns:the first type was occult papilloma,which presented distention of ducts and no solid nodule in 3 cases (37.5%);the second type showed tiny nodules in bar-like dilatation of ducts in 3 cases (37.5%);and the third type presented small round nodules scattering distribued in terminal ductules in 2 cases (25%).The maximum diameter of nodular lesions was 0.4-1.0 cm(average 0.7 cm).The lesions on T2 WI-SPAIR showed equal signal intensity or mixed signals with isointensity/hypointensity,and dilatation catheter.enhancement. The ADC and TIC value were various,therefore,diagnosis of the tumor should be combined with morphology and associated symptoms. Conclusion At early stage,the occult focus of breast intraductal papilloma can be sensitively detected and localized on MRI.It reveals that MRI has advantage in showing morphology of lesion and functional imaging,which is of important value in clinical diagnosis and early treatment.

Objective To explore the perioperative nursing of patients from high altitude earthquake-stricken regions. Method The perioperative nursing histories of 18 patients from high altitude earthquake-stricken regions were retrospectively analyzed to summarize the nursing experience.Results No wound infection,crush injury or complications occurred.Sixteen patients had good functional recovery,1 patient was at the stage of recovery about limb movement and another one was also at the recovery period from lumbar vertebral burst fracture complicated with nerve injury.Conclusion Close observation,psychological nursing and functional exercise are important for improved success rate of treatment for the patients from the earthquake-stricken regions.

Objective To evaluate the two methods for quantitative hepatitis B virus (HBV) DNA test. Methods The Hybrid Capture II system from Digene Co. and Real Time PCR fluorimetry quantitative HBV DNA test kit from PIJI Bio Technical Development Company Ltd. were used to detect sera HBV DNA in sera of patients with chronic hepatitis B. Results With the two quantitative methods, the positive rates of HBV DNA were 98 6% and 94.6% respectively. The concordant rate of these two methods was 93.2%. In assessing the sensitivity of the two kits with a serial of 10 fold diluted patients′s sera, PG kit could test 10 -7 of diluted serum, and HC II could test 10 -6 . The test value of HC II was more accurate in quantitation than PG kit especially in higher titer of HBV DNA. Whereas in the case of low titer of HBV DNA, the deviation of test value increased in both two methods. For monitoring the anti virus effect with quantitative HBV DNA in CHB patients, these two methods had same sensitivity, and the test value of HBV DNA had the same trend of change. Conclusion HC II system and PG test kit were sensitive and reliable, and they were worthy of monitoring the anti virus efficacy and of clinical practice.