Objective To investigate the bacterial spectrum changes and characteristics of drug resistance of patients with severe acute pancreatitis (SAP) and to guide clinical proper use of antibiotics medicine .Methods Clinical specimens of 50 patients with SAP were analyzed including sputum ,blood , urine ,central venous catheter ,bile ,et al .Bacterial strains were regularly isolated and drug sensitivity test was made by disc diffusion method .Chi-square test was performed for statistical analysis .Results One hundred and fifty-six bacterial strains were isolated .The number of strains isolated from the sputum , blood ,pancreas and abdominal cavity ,bile ,urine tract ,surgical incision ,oral secretion was 51 ,37 ,24 , 23 ,11 , 8 and 2 , respectively . The most common bacterial strains were Acinetobacter baumannii , Escherichia coli ,Pseudomonas aeruginosa and Enterococcus f aecium ,the number of strains was 30 ,21 , 20 and 14 ,respectively .The drug resistance rate of Acinetobacter baumannii to imipenem and meropenem was no less than 90% .The drug resistance rate to cefoperazone/sulbactam was lower ,but still over 60% . The drug resistance rate of Escherichia coli to penicillins ,majority of cephalosporins and quinolones was over 90% . The drug resistance rate of Pseudomonas aeruginosa to partial cephalosporins was high (90% ) ,and the drug resistance rate to imipenem was also up to 65% . T he drug resistance rate of Enterococcus faecium to penicillin G and quinolones was up to 100% . No Enterococcus resistant to tigecycline ,vancomycin and linezolid was found .The infection rate of patients received invasive operation was higher than that of patients received no invasive operation .Conclusions The main bacteria of patients with SAP complicated with infection was Gram-negative bacteria ,which has high drug resistance .The common locations of infection were respiratory tract ,blood ,abdominal cavity ,biliary system and urinary tract .The infection in respiratory tract and blood may be related with invasive medical operations .

Objective:To study the antibacterial properties of pure titanium treated with benzalkonium chloride solution.Meth-ods:10 mm ×10 mm ×1 mm titanium specimens were processed by the benzalkonium chloride solution at 1%,0.5% and 0.1%respectively followed by treatment in the cultured bacterial suspension,and then the antibacterial properties of the titanium plates were examined.Additionally,the thermal cycling test was carried out for the 1% benzalkonium chloride-treated titanium plates, and subsequently put the plates into cultured bacterial suspension,the duration of antibacterial properties was observed.Results:0.5% and 1% benzalkonium chloride solution-treated titanium plates significantly inhibited the growth of candida albicans(P <0. 05),1% solution was more effective than 0.5% solution.After 1 000 and 2 500 thermal cycling,the pure titanium still retained the antibacterial ability,but the plates treated by 5 000 cycling showed no antibacterial effect.Conclusion:A certain concentration of benzalkonium chloride can make the pure titanium obtain antibacterial properties.The treated plates may maintain the antibacte-rial properties for a minimum of 3 months.

Objective To investigate the clinical efficacy of target fire red-hot needling in treating articular deformity due to rheumatoid arthritis.Methods Ninety-six rheumatoid arthritis patients with articular swelling and deformity were randomly allocated to treatment and control groups, 48 cases each. The treatment group received target scattered fire red-hot needling and the control group, conventional acupuncture. After two courses of treatment, pre-/post-treatment changes in the self-reported pain score, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and immunoglobulins (IgA, IgG and IgM) were observed in the two groups and the clinical therapeutic effects were compared between the two groups. Results The total efficacy rate was 89.6% in the treatment group and 50.0% in the control group; there was a statistically significant difference between the two groups (P<0.01). There were statistically significant pre-/post-treatment differences in ESR, CRP, IgA, IgG and IgM in the treatment groups (P<0.05). There were statistically significant pre-/post-treatment differences in ESR, CRP, and IgG in the treatment groups (P<0.05). There were statistically significant post-treatment differences in ESR, CRP, IgA, IgG and IgM in the treatment and control groups (P<0.05).Conclusion Target fire red-hot needling is an effective way to treat articular deformity due to rheumatoid arthritis.

ObjectiveTo investigate the relationship between nephrogenic rests and the genetic steps occurring in the development of Wilms' tumor.MethodsThirteen Wilms' tumor with nephrogenic rests were microdissected from paraffin sections.Using polymerase chain reaction-based polymorphic markers,the loss of heterozygosity (LOH) or the putative tumor suppressor genes were studied at 11p13,11p15 and 16q LOH loci.ResultsLOH was detected in two cases at 11p13 and in three cases at 11p15,and in one of these cases LOH at both loci.All rests showing LOH also showed LOH in the tumor.Two cases showing LOH at 16q were identified only in the tumor but nor in the associated rest,and they had recurrence of the tumor.ConclusionsThis study suggests that LOH at 11p13 and 11p15 mutations are the early events whereas LOH at 16q occurs late in the pathogenesis of Wilms' tumor denoting a multistep model of Wilms' tumor pathogenesis.

Hypoxia-inducible factor(HIF) plays a key role in the adaptation of tumour cells under hypoxic circumstance,there are some advances in the literatures regarding HIF as an important target for anticancer agents and gene therapy.In this review,the molecular mechanism and clinical significance of compounds targeting on hypoxia- inducing factor was summarized.

Objective To investigate the effect of pigment epithelium- derived factor (PEDF) on p38MAPK-CREB pathway and the expression of fibronectin (FN) in human mesangial cells (HMCs) cultured with high glucose. Methods HMCs were treated with different concentrations of glucose and the osmotic control respectively in the presence or absence of PEDF for 24 h:normal glucose (5.6 mmol/L),24.4 mmol/L mannitol,high glucose (30 mmol/L),high glucose+PEDF(30 mmol/L glucose with 10 nmol/L PEDF,40 nmol/L PEDF or 100 nmol/L PEDF).After samples were collected,the expression of phospho-p38MAPK (p-p38) and p-CREB was assessed by Western blotting,while FN mRNA and protein expression was assessed with RT-PCR and ELISA respectively. Results In contrast to normal glucose and mannitol treatments,the expression of p-p38MAPK,p-CREB and FN increased significantly in high glucose group (all P＜ 0.01).However,PEDF abolished the up-regulation of p-p38MAPK,p-CREB and FN induced by high glucose (all P＜0.05). Conclusion PEDF may inhibit fibrosis through P38MAPK-CREB pathway in diabetic nephropathy.

Objective:To investigate the effect of different ventilation time in the prone position on patients with endogenous/exogenous ARDS.Methods:30 endogenous/30 exogenous ARDS patients were randomly devided into 4 groups,ventilation in the prone position for 2 h and 4 h.Recording the score of APCHEII,oxygenation index,the absorption situation in X-ray,HR,MAP,extubation time,the time out of ICU.Results:The APCHEII scores HR and MAP in four groups have no significant statistics (P＞0.05);4h ventilation for endogenous ARDS patients has a better indicators than 2 h in oxygenation index,the absorption situation in X-ray,extubation time and the time out of ICU (P＜0.05);2 h and 4 h ventilation for exogenous ARDS patients can improve indicators above,two groups have no significant statistics (P＞0.05),the results of exogenous groups are precede than endogenous group (P＜0.05).Conclusion:Ventilation in the prone position can improve the situation of ARDS patients,both endogenous patients and exogenous patients.Exogenous ARDS patients have a better treatment effect after the ventilation of 2h,however,endogenous patients need longer time and have a non-ideal prognosis.

Moyamoya disease is a rare cerebrovascular disorder, characterised by progressive stenosis and/or occlusion of the intracranial internal carotid artery and its proximal branches with the development of a basal collateral network. Moyamoya disease has a high prevalence in Asia, particularly in Japan, Korea and China. Ischemic events and intracranial bleeding are the most common clinical manifestation of moyamoya disease. Although the benefi cial effect on hemorrhage is still not clear, revascularisation surgery remains the most effective way to prevent the progression of ischemic symptoms. Moyamoya disease has been investigated by numerous studies since it was fi rst described 50 years ago, many conundrums remain to be solved. In this article, we review the history, epidemiology, aetiology, clinical manifestation, diagnosis and treatment of moyamoya disease. Recent advances and future challenges of moyamoya disease are also discussed.

Objective: To explore the impact of renal function injury on diagnostic value of NT-proBNP in patients with heart failure (HF).
Methods: A total of 420 patients with cardiovascular disease at (50-75) years of age were divided into 2 groups based on left ventricular ejection fraction (LVEF): Control group, the patients with normal cardiac function, LVEF≥40%,n=232 and HF group, LVEF<40%,n=188. According to estimated glomerular ifltration rate (eGFR), each group contained 4 subgroups by Normal renal function (eGFR≥90 ml/min·1.73m2), Mild renal injury (90>eGFR≥60 ml/min·1.73m2), Moderate renal injury (60>eGFR≥30 ml/min·1.73m2) and Severe renal injury (eGFR<30 ml/min·1.73m2). The changes of NT-proBNP level at different subgroups were observed and the optimal cut-off values of NT-proBNP for HF diagnosis were measured.
Results: Compared with Control group, HF group had increased blood level of NT-proBNP,P<0.05; NT-proBNP level was negatively related to eGFR (in all patients:r=-0.664, in Control group:r=-0.686 and in HF group:r=-0.721,P<0.05). Within Control group, NT-proBNP level was similar between Normal renal function and Mild renal injury subgroups,P>0.05, while it was much higher in Moderate and Severe renal injury subgroups than Normal renal function subgroup,P<0.05. Within HF group, Severe renal injury subgroup had increased NT-proBNP level than other subgroups,P<0.05. The best cut-off value of NT-proBNP for HF diagnosis in patients with normal or mild renal injury was 1070 pg/mL (sensitivity: 91.8% and speciifcity 72.6%); with moderate renal injury was 7121 pg/mL (sensitivity: 80.2% and speciifcity: 89.7%); with severe renal injury was 33344 pg/mL (sensitivity: 83.3% and speciifcity: 80%).
Conclusion: Moderate to severe renal function injury could increase circulating level of NT-proBNP and therefore, the cut-off value of NT-proBNP for HF diagnosis should be elevated accordingly in patients of HF combing renal injury.

Objective To study the effect of phonophoresis on transdermal delivery of sinomenine hydrochloride ( SH ) gel in vitro. Methods Ultrasound at one of two frequencies ( 800 kHz or 1 MHz) was applied with a sonicator with a transducer in this study. The skin of male Sprague-Dawley rats was used as the model and SH gel was used as the ultrasound couplant. The permeation rate of SH was detected using a modified Franz diffusion cell maintained at 32±0.5℃ and filled with 20% polyethylene glycol 400 physiological saline solution. The transdermal phonophoresis experiments were carried out in five groups: Group Ta, f=800 kHz, / = 0.75 W/cm2, t = 10 min:Group Tb,f=1 MHz,I=0.7 W/cm2, t=10 min; Group Tc,f=1 MHz,I=0.35 W/cm2, t=10 min; Group Td,f=800 kHz, I = 1.5 W/cm2, t = 10 min and Group Tc,f=800 kHz, I=1.5 W/cm2,t=5 min. There was also a control group (C) in which the SH was allowed to diffused passively. Samples were withdrawn at the indicated intervals and the concentration of SH was determined by high-performance liquid chromatography. The transdermal parameters such as average accumulated delivery quantity per unit area Q8h, average transdermal steady delivery rate J, and Tlag were calculated. Results The Q8h and Js of the control group were 20.65±10.23 μ/cm2 and 3.02±0.11μ/cm2/h respectively. The phonophoresis parameters in groups Ta and Tb were, on average, significantly higher than in the control group. The parameters in group Tb were significantly larger, on average, than in Te. In group Td the parameters were significantly larger than in groups Ta and Te. Conclusions The results show that phonophoresis can enhance the transdermal delivery of SH. Phonophoresis variables such as frequency and time influence its effects on drug permeation. Almost no change was observed in the structure of the skin after phonophoresis, though under a scanning electron microscope the surface of the corneum appeared rough and porous. Phonophoresis is there-fore an effective and safe method for SH transdermal delivery, and the effect is positively relation with the applied intensity and exposure time.