Objective To investigate the molecular epidemiology and risk factors of the expression of the efflux pumps of multidrug resistant Pseudomonas aeruginosa (Pa). Method From April 2014 to October 2014 , clinical features of 100 patients infected with multidrug resistant Pa were retrospectivly analyzed . Results MexAB-OprM was expressed in all multidrug resistant Pa strains (100%). The expression rates of MexEF-OprN and MexCD-OprJin the multidrug resistant Pa strains were 50% and 36%, respectively. The risk factor of the three efflux pumps expression was analyzed and the results were as follows: the use of carbapenems and glycopeptides antibiotics was the risk factor of MexAB-OprM overexpression which was induced. The use of macrolide and carbapenems antibiotics was the risk factor of the induced MexEF-OprN and MexCD-OprJ expression. Invasive procedures, low WBC, anaemia, chronic fundamental disease and hospitalized in ICU ward were the common risk factors of communicable expression or overexpression of the three efflux pumps. Invasive procedures, low WBC, anaemia, chronic fundamental disease and hospitalized in ICU ward were commonly independent risk factors of expression of the three efflux pumps. Conclusion The normalized use of carbapenems and glycopeptides antibiotics , the reduction of unnecessary invasive procedures , the severely grasped standard of hospitalized in ICU ward , curing the fundamental diseases and improving the immunonity played important roles in the prevention of the expression or overexpression of the efflux pumps of multidrug resistant Pa.

Objective To investigate the changes of fractional exhaled nitric oxide (FENO)) and their relation with lung function in bronchial asthma.Methods FENO and forced expiratory volume in the first second (FEV1) were measured during the periods of acute onset,chronic persistence and paracmasis in 54 patients with asthma and 19 healthy persons.Results There were significant differences in the levels of FENO and FEV1 among the course of acute onset [(57.59 ± 32.24) ppb and (1.72± 0.33) L],chronic persistent course [(40.02 ± 15.68) ppb and (2.41 ± 0.23) L],paracmasis [(26.71±6.07) ppb and (2.82±0.29 )L]and control[(14.74±3.42 ) ppb and (2.93±0.13)L] (F=19.555,163.096,P＜0.01) except for the levels of FEV1 between paracmasis and control group(P＞0.05).The negative correlation between FENO and FEV1 was found in the course of acute onset(r=- 0.666,P =0.005 ),but not in the chronic persistent course ( r =- 0.288,P =0.176) and paracmasis(r=-0.246,P=0.457).Conclusions The level of FENO is increased and may be useful to evaluate control degree in patients with asthma.

Objective To investigate the early diagnosis and treatment of pelvic fracture with vaginal injury.Methods From January 2000 to July 2010,13 patients suffered from pelvic fracture with vaginal injury were treated in our hospital,whose average age was 31.7 years.According to the Tile classification,there were 4 cases of type B1,1 case of type B2,4 cases of type B3,3 cases of type C1,and 1 case of type C2.Emergency repair of vagina together with open reduction and internal fixation of pelvic fracture was performed in 3 patients.After the patients' condition became stable,5 patients with shock were treated with emergency repair of vagina together with primary external fixation of pelvic fracture.Prompt repair of vagina together with open reduction and internal fixation or primary external fixation of pelvic fracture was performed in 2 patients who underwent delayed diagnosis.Two cases of extensive pelvic abscess due to missed diagnosis of vaginal laceration were treated with debridement and external fixation of pelvic fracture,and reconstructions of vagina were performed after infection control.Results Twelve patients survived,and 1 patient died 6 h after admission.Eleven patients were followed up for 8 to 36 months (average,17 months).Among 9 patients who underwent one-stage repair of vagina,5 married patients had normal sexual life,1 suffered from pain during sexual intercourse,and 3 unmarried patients had normal menses.Two patients who underwent second-stage reconstruction of vagina suffered from pain during sexual intercourse.At final follow-up,the mean Majeed score was 82.2 (range,56 to 96),and the results were excellent in 6 cases,good in 3 cases,fair in 2 cases.Conclusion Vaginal injury should be highly suspected in females with anterior pelvic ring fracture.Early diagnosis and repair of vaginal injury is crucial to good clinical outcomes.Delayed diagnosis and treatment may lead to severe complications.

Objective To study the effect of various methods determining lung volume and fraction dose on the lung dose-volume parameters for lung cancer patients. Methods Twenty patients with lung cancer were rantdomly enrolled into our study and the plan of three dimensional eonformal radiation therapy(3DCRT)was designed by Varian Eclipse TPS.The lung volumes and the dose-volume parameters were measured under CT value of-300- -980, -400- -980 and -500- -980.Under CT value of -400- -980,total lung volumes were confirmed.The dose-volume parameters of V30,V20,V10 and mean lung dose(MLD)were reevaluated after GTV,CTV and PTV were subtracted from the total lung volumes and when the fraction dose was elevated from 2.0 Gy to 10.0 Gy. Results When the CT value ranged from-300--980 to-500--980,the median reduction of the total lung volumes(-9.10%)was significantly higher than that of V30,V20,V10 and MLD(-3.18%,-1.13%,0.82%and-0.79%,respectively).When the total lung volume was fixed at CT value of-400--980,the alterations of V30,V20,V10 and MLD became more apparent as the increase of the subtracted lung volume,among which the alteration of V30 was most significant while V10 the least.Among five cases with a fixed total dose of 60 Gy and PTV less than 140 cm3,the V30,V20,V10 and MLD were increased to a similar extent(about 40%)when the fraction dose was increased from 2.0 Gy to 10.0 Gy.MLD was increased(36%)when the fraction dose was above 6.0 Gy. Conclusions When CT value ranges from-300- -980 to-500- -980,the total lung volume is influenced most.The alteration of V30,being statistically significant,might have some significance but is not enough to determine the plan of radiotherapy clinically.The alteration of V20、V10 and MLD is not statistically significant.When the overlapped target volume is subtracted from the total lung volumes,the alteration of V30 is the most sign:tifhcant while V10 the least.The fraction dose,being the most consuming factor(＞10%)when comparing with the CT valHe and targeted volume,can significantly influence the dose-volume parameter.

AIM: To determine gallic acid,paeoniflorin and safflor yellow in Taohong Siwu Decoction(Semen Persicae,Flos Carthamietc.) METHODS: To analyse three constituents by HPLC on a Hypersil BDS C_(18) column and gallic acid detection wavelength was set at 271 nm.The mobile phase was methanol-water(5∶95) (adjusted to pH=3.0 with H_3PO_4) at a flow rate of 1.0 mL/min. Safflor yellow detection wavelength was set at 403 nm.The mobile phase was methanol-water(80∶20) (adjusted to pH=3.0 with H_3PO_4) at a flow rate of 1.0 mL/min. Paeoniflorin detection wavelength was set at 230 nm.The mobile phase was methanol-KH_2PO_4 at a flow rate of 1.0 mL/min. RESULTS: Gallic acid showed a good linear relationship at the range of 4.547?10~(-3)-1.455?10~(-1) ?g/?L(r=0.999 3).Paeoniflorin showed a good linear relationship at the range of 0.010-0.200 ?g/?L(r=(0.999 8)) and safflor yellow showed a good linear relationship at the range of 2.34?10~(-2)-7.50?10~(-1) ?g/?L(r=(0.999 4)).The average recoveries were 98.0% for gallic acid,98.4% for paeoniflorin and 99.2% for safflor yellow.The RSD of the method were 1.8%,0.69% and 0.88%,respectively. CONCLUSION: The method is proved to be fast,feasible,simple,and can be used for quality control of gallic acid,paeoniflorin and safflor yellow in Taohong Siwu Decoction.

Objective To investigate the suppression to 2-glycoprotein-1-specific B cell response by human recombinant 2-glycoprotein-1 domain Ⅰ dimer(rh?2-GP1-DⅠ2) in rh?2-GP1 immunized mice.Methods The effects of treatment using rh?2-GP1-DⅠ2 on titer and ratio of anti-?2-GP1 were analyzed by solid phase ELISA.The number of splenic ?2-GP1-specific antibody-forming cells(AFC) was counted by ELISPOT.Results The levels of anti-?2-GP1 from rh?2-GP1 immunized mice treated with rh?2-GP1-DⅠ2 were significantly decreased compared with those in negative controls(P

Objective To study the relationship between intrarenal arterial lesions(IAL)and carotid atherosclerosis(AS)in patients with renal glomerular disease.Methods 251 cases with IAL were selected and 129 age-,pressure-and eGFR-matched renal glomerular disease cases without IAL were randomly selected.The carotid intima-media thickness(IMT)was detected.Clinical and laboratory examination and renal histological characteristics were compared the two guoups.Results ①The detection rate of carotid AS was higher in patients with IAL than those without IAL(38.2%vs.20.2%),and higher in patients≥40 years than in patients＜40 years(51.3%vs.13.1%)(P<0.05 for each). ②The carotid AS group was older and had higher frequencey of fasting blood glucose,body mass index,smoking,and family history of hypertension,longer duration of established hypertension and renal glomerular disease,higher prevalence of hypertension,IAL and renal lesions,and had lower eGFR than the carotid normal group(all P＜0.05).Binary logistic regression analysis revealed that IAL and age emerged as an independent risk factor for carotid AS(OR=1.826 and 1.129,P=0.001 and 0.003).Conclusion The intrarenal arterial lesion is an independent risk factor for carotid atherosclerosis in patients with renal glomerular disease.Controlling blood glucose,blood pressure,weight,smoking quit and delaying progression of kidney disease have important significance in relieving or preventing atherosclerosis and intrarenal arterial lesions of patients with renal glomerular diseases.

AIM and METHODS: To investigate the functional connection between the preoptic anterior hypothalamus (POAH) and the ventral septal area (VSA) in fever mechanism, the firing rates of thermosensitive neurons in the VSA of 26 New Zealand white rabbits were recorded using extracellular microelectrode technique. RESULTS: The firing rates in both types of thermosensitive neurons in the VSA had no significant changes after intracerebroventricular (icv) injection of artificial cerebrospinal fluid(ACSF). When interleukin-1β (IL-1β) was given (icv), the firing rate of the warm-sensitive neurons was increased significantly and that of the cold-sensitive neurons was decreased remarkably. The effects of IL-1β on the changes of firing rate in thermosensitive neurons of the VSA were reversed by electrical stimulation of the POAH. CONCLUSION: The roles of positive and negative thermoregulatory centers in the interaction between the POAH and VSA are closely linked during endogenous pyrogen induced fever.

Objective To analyze the long-term prognosis and prognostic factors of idiopathic collapsing focal segmental glomerulosclerosis (FSGS) and not otherwise specified FSGS in children. Methods The clinical, pathology and follow-up data of patients with idiopathic collapsing FSGS and not otherwise specified FSGS were analyzed retrospectively by Kaplan-Meier method, univariate and multivariate Cox regression analysis. Results A total of 64 patients (29 idiopathic collapsing FSGS and 35 not otherwise specified FSGS) were diagnosed by renal biopsy. The 4-year renal survival rate of idiopathic collapsing FSGS and not otherwise specified FSGS were 48.3%, 74.3% respectively. Univariate analysis revealed that the renal survival time were 25.41±3.28 months in idiopathic collapsing patients, and 35.53±2.73 months in not otherwise specified patients. The different is significant (χ2=4.07,P=0.044). Multivariate Cox regression analysis showed that poor treatment response (HR=5.92, P<0.05) and renal insufficiency at early stage (HR=2.45, P<0.05) were independent risk factors of prognosis. Conclusions Compared with patients with not otherwise specified FSGS, the renal survival time is shorter in idiopathic collapsing FSGS patients. Patients with renal insufficiency and poor response to treatment have poorer prognosis.

Aims To study the effects of clenbuterol on anoxia/reoxygenation( A/R) injury in neonatal Wistar rat cardiomyocytes and to explore whether its mecha-nism is related to reperfusion injury salvage kinase ( RISK) or not. Methods The cultured primary neo-natal cardiomyocytes were randomly divided into eight groups: ①normal culture group; ②anoxia/reoxygen-ation( A/R) group;③ clenbuterol ( 1 μmol · L-1 ) +A/R;④ICI118,551(10 μmol·L-1) + clenbuterol ( 1 μmol · L-1 ) + A/R; ⑤Metoprolol ( 10μmol · L-1 ) + clenbuterol(1μmol·L-1 ) + A/R group;⑥Metoprolol ( 10 μmol · L-1 ) + A/R group; ⑦PD98059 ( 20 μmol · L-1 ) + clenbuterol ( 1 μmol · L-1 ) + A/R group;⑧ LY294002(10 μmol·L-1 ) +clenbuterol(1 μmol · L-1 ) + A/R group. Cell via-bility was determined by the conventional MTT reduc-tion assay. The content of LDH in cultured medium was measured with colorimetry. Cardiomyocyte apopto-sis was determined by Hoechst33342 . Intracellular re-active species( ROS) were monitored by the fluorescent DCFH-DA. Total ERK2 and phosphorylated ERK were detected by western blot. Results Compared with A/R group, clenbuterol significantly increased vaibility of cells, reduced LDH release, lowered the rate of apop-tosis and ROS production. When addedβ2 receptor an-tagonist ICI118 , 551 , PI3 K inhibitor LY294002 and ERK inhibitor PD98059 , the effects of clenbuterol a-bove were inhibited; but β1 receptor antagonist Meto-prolol protected the cardiomyocytes from A/R injury, as evidenced by decreased LDH release and increased cell viability. There were no synergistic effects in the combined use of clenbuterol and Metoprolol. Conclu-sion clenbuterol exerts cardioprotective effects against A/R injury by inhibiting oxidative stress and apopto-sis. The protection of clenbuterol is inhibited by ICI118 , 551 , LY294002 and PD98059 . clenbuterol protects cardiomyocytes against A/R injury via RISK pathway by activation of β2 receptor.