Objective:The drug resistance of E.coli to fluoroquinolones is getting stronger in the recent years.This study aimed at the drug resistance of E.coli induced by fluoroquinolones in vitro,so as to provide a guidance for the rational use of antibiotics and effective control of nosocomial infections.Methods: Drug resistance was induced in vitro by a multi-step method in 10 strains of E.coli from clinical isolates with Ciprofloxacin,Levofloxacin and Gatifloxacin.The minimal inhibition concentration(MIC) of the E.coli was determined by the agar dilution method before and after the induction.Results: After in vitro induction,the E.coli acquired a high resistance(MIC ≥ 128 ?g/ml).And one drug could induce different degrees of resistance to the other two.Conclusion: The MIC of the E.coli induced by fluoroquinolones in vitro was increased by 8 to 8 205 folds compared with that before induction,which demonstrated a gradually developed resistance of E.coli strains to fluoroquinolones.

Vitexin, a natural flavonoid compound, has extensive pharmacological activity. In recent years, many studies have re-vealed that vitexin has significant protective effects on central nervous system and peripheral nervous system, including anti-memory impairment, anti-epilepsy, anti-ischemic hypoxic brain damage, anti-depression, analgesia, etc. Vitexin exerts neuro-protective effects through the mechanisms of multiple pathways and multi-targets, such as reducing free radical level, inhibiting neuronal apoptosis, modulating inflammatory factors and related pathways, and regulating neurotransmitters and related recep-tors. This review mainly discusses the neuroprotective effects of vitexin and its underlying mechanisms.

Objective To investigate the relationship between depression and personality and social support of the urban and rural empty-nest, clear the influence factors of depression in the empty-nest elderly. Methods 398 cases of urban and rural empty-nesters selected from the Chifeng district, were valuated with the general information questionnaire, the Geriatric Depression Scale (GDS), Eysenck personality Questionnaire- Revised Short Scalr for Chinese (EPQ-RSC) and the Social Support Scale (SSRS), and to investigate the demographic data, depression, personality and social support. Results Rural cases had a higher level (14.41±3.09) points of depression than (12.90±2.64) points of urban cases, and the difference was statistically significant (t=5.254, P<0.01);rural empty nesters′subjective support (18.35 ± 2.14) points, objective support (6.37 ± 1.40) points, support utilization degree (6.01 ± 1.17) points and social support score (30.37 ± 4.24) points, were lower than (19.83 ± 2.27) points, (7.34 ± 1.13) points, (6.95 ± 1.12) points, (34.12 ± 3.73) points of urban′s, and the difference was statistically significant (t=6.673-8.490, P<0.01); the extraversion score of urban empty nesters was (7.58 ± 2.51) points which was higher than (6.37 ± 2.02) points of rural empty nesters, and the difference was statistically significant (t=5.273, P<0.01);the neuroticism score (10.38 ± 2.06) points and psychoticism score (9.42 ± 2.17) points of urban empty-nest were lower than (12.41 ± 2.25) points, (10.94 ± 2.10) points of empty-nest′s, and the difference was statistically significant (t=9.401, 7.107, P<0.01). Neuroticism and psychoticism was shown to be positively associated with depression while extraversion and social support to be negatively associated with depression (P<0.01). Regression analysis showed that marital status, income, children visit frequency and the education level were the main influencing factors of depression in the urban and rural empty-nesters. Conclusions There are differences between rural and urban empty-nest elderly in the aspect of general data, depression status, personality and social support, and should intervention them effectively according to their different characteristics.

Objective To analyze the distribution characteristics and influencing factors of brachial-ankle pulse wave velocity (baPWV) in elderly population in order to direct the early diagnosis and prevention of arteriosclerosis in the elderly.Methods A total of 927 cases of elderly residents were randomly selected from 19 villages in Shengze area,Jiangsu Province.The indexes such as age,gender,height,weight,waist circumference,hip circumference and blood pressure were collected through standardized questionnaire and physical examination.The biochemical indicators including serum bilirubin,creatinine,uric acid,fasting blood glucose and blood lipids were measured,and baPWV was tested by automatic arteriosclerosis measurement system.Results The differences in age,systolic blood pressure,heart rate,serum bilirubin,creatinine,uric acid,triglycerides levels and baPWV were statistically significant between the male and female (all P＜0.05).BaPWV rised with the increase of age.Overall,baPWV was faster in the female than in male (P＜0.01).Blood pressure (r=0.36,0.59,P＜0.001),age (r=0.26,0.30,P＜0.001) and heart rate (r=0.30,0.33,P＜ 0.001) were correlated with baPWV,while uric acid had a correlation with baPWV (r=0.12,0.21,P＜0.01).A correlation was found between total cholesterol and baPWV (r=0.09,0.11,P＜0.05) Multi-variable linear stepwise regression analysis showed that systolic blood pressure,heart rate and age were the influencing factors for baPWV,of which systolic blood pressure had the greatest influence on baPWV (β＞0.5,P＜0.001).Conclusions With the increase of age,the baPWV shows rising trend.The monitor of baPWV may be useful in the elderly,especially in females.Blood pressure control,especially the control of systolic blood pressure can slow the progression of atherosclerosis.

Objective To investigate the efficacy and feasibility of extra-peritoneal larparoscopic radical prostatectomy (eLRP) in the treatment of patients with high-risk prostate cancer (HRPC).Methods From February 2009 to December 2013,121 patients,who were diagnosed as HRPC according to the D'Amico definition,were received eLRP.The mean age was 70 years old (range 54 ～ 82 years old).The mean PSA level was 25.45 (range 2.40 ～ 111.31) μg/L and mean Gleason score was 8 (range 6 ～ 10).The classification of clinic stage in this study included 52 cases in cT1-cT2b,58 cases in cT2c,8 cases in cT3a,and 3 cases incT3b,respectively.The perioperative data were collected,including operative time,blood loss,intraoperative complications,urine leakage,lymph leakage,incontinent ability,erectile function and changing of PSA level.Results All the operations were successfully performed.The mean operative time was 165 minutes (range 105 ～341min),the average blood loss was 150 ml(range 50 ～ 1500ml).The intraoperative complications included hemorrhage in 4 cases and intra-operative obturator nerve injury in 3 cases.The mean duration of intestinal function recovery was 35h (range 24 ～72h) The mean interval of catheter indwelling was 9 days (range 7 ～14 days).The anastomotic leakage was found in 12 cases,including 1 day after surgery in 5 cases,2 days after surgery in 3 cases,3 days after surgery in 2 cases,4 day after surgery in 1 case and 5 day after surgery in 1 case.The anastomotic stricture in 3 cases within 2 to 4 months after operation,which the symptom improved after urethral dilation in 2 cases and urethrotomy in 1 case.Deep vein thrombosis was noticed in 1 case 5 days after the procedure.And lymphatic fistula was recorded in 1 case after the operation.Positive surgical margin,seminal vesicle invasion,and positive iliac vessel lymph node were found in 18,21,and 9 patients,respectively.The mean hospitalization duration was 10 days (range 5 ～ 22 d).Of the 107 patients followed-up,Ninety-six patients were continent in 1 year,except other 11 patients.Nerve sparing procedure was performed in 51 patients,and thirty-three of them were potent.The mean PSA level was 0.14 μg/L (range 0 ～8.75 μg/L) six weeks after the surgey.Fourty-eight patients had biochemical recurrence with 5 ～36 months followed-up,mean 18 months.Conclusions Extraperitoneal LRP is an efficacious approach for patients with high-risk prostate cancer.

Objective: To explore the correlation among overweight, obesity and markers of prethrombotic state in patients with coronary heart disease (CHD). Methods: A total of 288 patients to hospital from 2013 to 2014 and diagnosed as CHD by coronary angiography were selected. According to body mass index (BMI), they were divided into CHD control group (n=106), overweight group (n=121) and obesity group (n=61). Levels of fibrinogen (Fg), plasma D dimmer (D-D), von Willebrand factor (vWF), antithrombin Ⅲ (AT-Ⅲ) and plasminogen activator inhibitor (PAI)-1 were compared among three groups, then received correlation analysis.Results: Compared with CHD control group, there were significant rise in levels of triglyceride, total cholesterol, fasting blood glucose and mean arterial pressure, morbidity rates of hypertension and diabetes mellitus in overweight group and obesity group, P<0.05 or <0.01. Compared with CHD control group, there were significant rise in levels of Fg [(2.89±0.60) g/L vs. (3.54±0.63) g/L vs. (3.92±0.94) g/L], D-D [(282.13±73.15) ng/ml vs. (390.04±73.54) ng/ml vs. (471.92±80.38) ng/ml], vWF [(108.62±24.66)% vs. (138.45±25.96)% vs. (161.20±29.39)%] and PAI-1 [(6.97±1.28) ng/ml vs. (9.60±1.73) ng/ml vs. (12.33±2.16) ng/ml] in overweight group and obesity group, P<0.01 all, and those of obesity group were significantly higher than those of overweight group, P<0.01 or <0.05; AT-Ⅲ level [(89.94±17.99)% vs. (69.89±20.22)%] significantly reduced in obesity group (P<0.05). Pearson correlation analysis indicated that BMI was positively correlated with markers of prethrombotic state [Fg: r=0.536, P<0.001; D-D: r=0.250, P<0.001; vWF: r=0.611, P<0.001;PAI-1: r=0.788,P<0.001). Conclusion: BMI is positively correlated with markers of prothrombotic state in CHD patients.

Objective To investigate the relationship between autophagy and metastasis of nasopharyngeal cancer ( NPC) cell lines 5?8F and 6?10B after X?ray irradiation and the related mechanism. Methods Two substrains, 5?8F and 6?10B, of the NPC cell line SUNE1, with high and low metastatic potentials, respectively, were used in our study. After 4 Gy X?ray irradiation, 5?8F cells were treated with rapamycin ( 20 μmol/L) to induce autophagy and 6?10B cells were treated with LY294002( 10μmol/L) to inhibit autophagy. The autophagy and metastatic activity of NPC cells were determined using qRT?PCR, Western blot, Transwell assay, laser confocal microscopy, and transmission electron microscopy. Results 5?8F cells showed a lower level of autophagy than 6?10B cells after X?ray irradiation. Rapamycin increased the autophagy and inhibited the metastasis of 5?8F cells after irradiation, while LY294002 inhibited the autophagy and increased the metastasis of 6?10B cells. Conclusions NPC 5?8F cells, which have a high metastatic potential, have a lower level of autophagy than 6?10B cells, which have a low metastatic potential. Autophagic inhibition could increase the metastatic activity of NPC cells, while autophagic activation could reduce their metastatic activity. Mechanistic analysis indicates that the PI3K/AKT/mTOR pathway is involved in this process.

This study was aimed to evaluate the feasibility of wind-warm lung-heat disease (non-severe community-acquired pneumonia, CAP) from the clinical curative effect, hospitalization days, medical expenses and other aspects. This study selected 198 wind-warm lung-heat disease (non-severe CAP) inpatients from January, 2012 to December, 2012 with the conventional therapy in the Respiratory Department, Wuhan Integrated Traditional Chinese Medicine (TCM) & Western Medicine Hospital as the control group. And another 179 wind-warm lung-heat disease (non-severe CAP) inpatients were selected from January, 2013 to December, 2013 with the TCM clinical pathway treatment in the Respiratory Department of the same hospital as the treatment group. Retrospective analysis was used to compare the clinical curative effects, hospitalization days, and medical cost differences. The results showed that TCM clinical pathway for wind-warm lung-heat disease (non-severe CAP) can shorten the hospitalization days and reduce patients’ medical costs, and ensure the clinical curative effects. It was concluded that the standardized TCM clinical pathway had positive effect on wind-warm lung-heat disease (non-severe CAP). Therefore, the formulation and implementation of TCM clinical pathway was of great significance in the treatment of wind-warm lung-heat disease (non-severe CAP).

Type 2 diabetes mellitus(T2DM)is a serious public health issue in China.Poor glycemic control is closely related to increased risks of microvascular,macrovascular events and mortality.Self-management ability and treatment adherence are key factors affecting glycemic control.Based on this,this review summarizes the findings on medication adherence related to different glucose-lowering regimens,analyzes the factors affecting patient treatment adherence and discusses the roles of drug characteristics,patient factors and shared decision-making in optimizing T2DM management strategies,in the hope of improving clinical outcomes.

Objective:To evaluate the effect of high-concentration hydrogen inhalation on sepsis-associated encephalopathy (SAE) in mice.Methods:Healthy male ICR mice, aged 6-8 weeks, weighing 20-25 g, were divided into 4 groups ( n=50 each) using the random number table method: sham operation group (Sham group), SAE group, sham operation plus high-concentration hydrogen group (Sham+ H 2 group), and SAE plus high-concentration hydrogen group (SAE+ H 2 group). SAE model was prepared by cecal ligation and puncture (CLP) in anesthetized animals.At 1 and 6 h after operation, Sham+ H 2 and SAE+ H 2 groups inhaled the mixture of hydrogen and oxygen (67% hydrogen-33% oxygen) for 1 h, and Sham and SAE groups inhaled the mixture of nitrogen and oxygen (67% nitrogen-33% oxygen) for 1 h. The postoperative 7-day survival rate was recorded.Cognitive function was assessed by Y maze test at days 3, 5 and 7 after operation.The mice were sacrificed at 24 h after operation, and hippocampal tissues were obtained for microscopic examination of the pathological changes of neurons in hippocampal CA1 region (with a light microscope) and for determination of normal neuron count, contents of tumor necrosis factor-ɑ (TNF-α) and high mobility group box-1 (HMGB1) (by enzyme-linked immunosorbent assay), mitochondrial membrane potential (MMP) (by fluorescence spectrophotometry) and content of mitochondrial ATP (by fluorescein-fluorescent enzyme luminescence method). Results:Compared with Sham group, the 7-day survival rate after operation, percentage of spontaneous alternation at each time point after operation, and the number of normal neurons were significantly decreased, the contents of TNF-ɑ and HMGB1 were increased, and the contents of ATP and MMP were decreased in SAE and SAE+ H 2 groups ( P<0.05), and no significant change was found in Sham+ H 2 group ( P>0.05). Compared with SAE group, the 7-day survival rate after operation, percentage of spontaneous alternation at each time point after operation, and the number of normal neurons were significantly increased, the contents of TNF-ɑ and HMGB1 were decreased, and the contents of ATP and MMP were increased in SAE+ H 2 group ( P<0.05). Conclusions:High-concentration hydrogen inhalation can reduce SAE, and the mechanism may be related to reduction of hippocampal inflammatory responses and improvement in mitochondrial function in mice.