Objective: To explore the possible mechanism of statins improving endothelial function via observing the effect of a high single dose atorvastatin on endothelial dysfunction and peripheral blood leucocyte Rho kinase activity in patients with unstable angina (UA). Methods: A total of 78 consecutive UA patients admitted in our hospital from 2012-08 to 2014-02 were enrolled. The patients received a single dose of atorvastatin 80 mg on the day of admission. Flow-mediated vasodilation (FMD) of brachial artery was examined by high-resolution ultrasound at before and 12 hours after medication. Protein expression of phospho-speciifc Thr853-MYPT1 (p-MYPT1Thr853) and MYPT1 was measured by Western blot analysis; peripheral blood leukocyte Rho kinase activity was assayed by the proportion of phospho-Thr853 in myosin binding subunit of light chain phosphatase (MYPT1). Results: Compared to prior medication, with atorvastatin 80 mg for 12 hours, FMD was increased 28.15% as (6.50 ±1.68) % vs (8.33 ± 1.93) %,P<0.001 and peripheral blood leucocyte Rho kinase activity was decreased 32.78% as (58.91 ± 5.22) % vs (39.6 ± 3.85 ) %,P=0.002. Conclusion: High dose atorvastatin could rapidly improve vascular endothelial dysfunction in UA patients. inhibiting of RhoA/Rho kinase pathway may involve in the effect of statins improving endothelial function.

Objective To observe the effects of the chronic adventitia injury on the vasoconstriction of the rat carotid artery. Methods A non-occlusive silicone collar was positioned around the right carotid artery of rats. Blood flow and vascular reactivity to 5-HT were examined, and both carotids were harvested for morphometry at day 3,7 and 14 after operation. Results In the early stage of advenfitia injury induced by positioning a silicone collar around file rat carotid artery, there appeared the characteristic histological changes of chronic vasospasm in collared artery, such as the reduction of the luminal area for （12.15±2.29）% at day 3 after operation （P =0.003 ） and （45.17±3.84）% at day 7 （P 〈 0.001 ）] ,corrugation of the internal elastic lamina,medial thickening up to [ （23.04±5.96）% at day 3 （P =0.009）, （61.65±10.32）% for day 7 （P 〈 0.001 ）] ,the reduction of the blood flow and the increase of vascular reactivity to 5-HT when compared to con- tralateral arteries. Two weeks after collar placement, the vascular wall remodeling was observed in injured artery, such as the medial thickening for [（31.52±4.56） %,P =0.012] and a diffuse intimal hyperplasia,the reduction of the lunfinal area [（37.17±4.57）% （P 〈 0.001）] and the carotid artery blood flow. The average neointima area was （0.19±0.05） rom2 in collared arteries. The vascular reactivity to 5-HT came back to the normal level. Conclusions Collar-induced advenfitia injury caused the enhancement of vascular contractility and the neointima formation. The change of vascular contractility appeared before the formation of neointima.

BACKGROUND: Silk fibroin film showed an anti-coagulated blood activity following sulfurous acid treatment; however, its flexibility and anti-tension were poor. If the silk flbroin film was coated on small-caliber expanded poly(tetrafiuoroethylene) (ePTFE) vascular grafts prior to surface sulfonation, the adverse effects were improved and the blood compatibility of ePTFE vascular grafts were remarkably enhanced. OBJECTIVE: To research the preparation of ePTFE vascular grafts applied by surface sulfonation of silk flbroin film by low temperature plasma treatment. METHODS: The ePTFE vascular grafts were treated with low temperature plasma and coated on the surface of silk fibroin. The compound was then sulfonated with low temperature plasma. The ePTFE vascular grafts were considered as the controls to detect contact angle and sulfonation. RESULTS AND CONCLUSION: The contact angle was decreased gradually form 87.7°to 65.1° following low temperature plasma treatment. Moreover, the contact angle was 106.2° following coating silk flbroin film and 92.9°following sulfonation. X-raylight-electron spectrometer demonstrated that percents of sulfur element on the surfaces of the combined blood vessel was 2.89%, respectively, while that of the control film was only 0.12%. The X-ray light-electron spectrometer also showed that most of the sulfur element were sulfonic group (-SO_3H). The results suggested the feasibility of the preparation of the combined blood vessel.

Objective To evaluate the influences of susceptibility interpretation of Escherichia coli,Klebsiella pneumonia and Proteus mirabilis in China mainland according to the old and new ceftazidime,cefotaxime and ceftriaxone breakpoints in CLSI M100-S20 and CLSI M100-S19. Methods First, We analyzed the antibacterial susceptibility results of the three bacteria by agar dilution method in the SEANIR surveillance item, which were collected from 15 national hospitals between the year of 2005 and 2007 and excluded the AmpC enzyme positive isolates according to the PGR-DNA sequencing method and/or the antibacterial susceptibility phenotype. ESBL phenotype was confirmed by the CLSI phenotypic confirmatory test. Antibacterial susceptibility of the total 2733 Escherichia coli, Klebsiella pneumonia, Proteus mirabilis isolates was retrospectively analyzed by WHONET 5. 4 software according to the breakpoints of the CLSI M100-S19 (S19) and CLSI M100-S20 (S20). Second, 207 isolates of Peking Union Medical College Hospital with the results of both agar dilution method and disk diffusion method were performed by recurrent analysis. Then we observed the inter-method agreement through the scatter diagram according to the breakpoints of S19 and S20. Results First, as to the ESBL positive Escherichia coli, Klebsiella pneumonia and Proteus mirabili.s, the resistant rate of cefotaxime increased from 65.2% , 55.5%, 14. 6% under S19 (64 μg/ml) to 99. 7%, 96. 2% , 93. 8% under S20 (4 μg/ml). The susceptibility rates decreased from 6. 0%, 11.5%, 33.3% under S19 (8 μg/ml) to 0%, 0. 2%, 0% under S20 ( 1 μg/ml). Ceftriaxone had the same trend as cefotaxime. Though ceftazidime was more active than cefotaxime and ceftriaxone, as to the ESBL positive Escherichia coli and Klebsiella pneumonia, the resistant rates slightly increased from 30. 3%,43. 2% under S19 (32 μg/ml) to42.0%, 56. 0% under S20 (16 μg/ml). The susceptibility rates slightly decreased from 58. 1%, 44. 1% under S19 (8 μg/ml) to 44. 7%, 28.0% under S20 (4 μg/ml). Second,as to the ESBL negative Escherichia coli, Klebsiella pneumonia and Proteus mirabilis, all the susceptibility rates of ceftazidime, cefotaxime and ceftriaxone were between 99. 2%-100. 0%, the resistant rate were between 0%-0. 4%. Third, the S20 MIC breakpoints had a good correspondence with the ESBL phenotype.Fourth, according to the recurrent analysis of MIC testing and disk dilution method, r value was 0. 67,0. 79, 0. 77 for ceftazidime, cefotaxime and ceftriaxone, respectively, and all P value were under 0. 01. The intermethod rates of S19 and S20 were both acceptable. Conclusions If the cefotaxime and ceftriaxone S20 new breakpoints were used, the concordance of antibacterial susceptibility results and ESBL phenotype would increase greatly. The clinician could select proper antibiotics according to the antibacterial susceptibility results and clinical symptoms. It is no longer necessary to edit results for cephalosporins, aztreonam, or penicillins from susceptible to resistant. However, until laboratories implement the new interpretive criteria,ESBL testing should be performed as described in Supplemental Table 2A-S1. The relationship between the new breakpoints of ceftazidime and clinical outcomes need to be further evaluated.

Objective To evaluate the performance of modified Hodge test on the detection of carbapenemases among Enterobacteriaceae with decreased susceptibility to carbapenems. Methods Fortynine Enterobacteriaceae isolates with decreased susceptibility to carbapenems ( MIC of imipenem, meropenem or ertapenem was ≥ 2 μg/ml ) were collected from 16 teaching hospitals from 2004 to 2008. MICs of imipenem, meropenem and etapenem were determined by agar dilution method. Carbapenemases were detected by modified Hodge test. Carbepenemase-causing positive results and AmpCs-causing positive results were differentiated by phenyl boronic acid and oxacillin. Beta-lactamases encoding genes including blaNDM-1were detected by PCR and sequencing. Results Thirty-six of 49 isolates were non-susceptible to imipenem (MIC >4 μg/ml), 31 were non-susceptible to meropenem (MIC > 4 μg/ml) and 47 were non-susceptible to ertapenem (MIC > 2 μg/ml). Twenty-three isolates showed positive modified Hodge test result, including 9 weak-positive results and 14 strong-positive results. Through PCR detection and sequencing, 2 out of 9 isolates showing weak-positive results carried blaKPC-2 and other 7 did not carry any carbapenemase genes but AmpCs/ESBLs genes. Among the 14 isolates showing strong-positive results, 4 carried blaKPC-2, 8 carried blaIMP-4 and 2 caried blaIMP-8. All 26 isolates with negative modified Hodge test result didn't carry any carbapenemase genes. No isolate carried blaNDM-1. Carbapenemases genes PCR detection was regarded as a gold standard, and the sensitivity, specificity, positive predictive value and negative predictive value of modified hodge test was 100%, 79%, 70% and 100% on the detection of carbapenemases among Enterobacteriaceae with decreased susceptibility to carbapenems. Conclusions Modified Hodge test revealed great sensitivity but showed a few false positive results. True and false positive results can be effectively differentiated by phynel boronic acid and oxacillin.