Objective To investiGate the distribution of clinical infectious pathoGens and druG resistance status of common bacteria in the Ninth Peopleˊs Hospital Affiliated to medicine School of ShanGhai Jiao TonG University in 20l2. Methods Clinical isolated bacterial strains were collected from the Ninth Peopleˊs Hospital Affiliated to medicine School of ShanGhai Jiao TonG University durinG 20l2. The identification of bacteria and antimicrobial susceptibility were determined by VITEK 2 COMPACT automatic microbioloGy analyzer. The data were analyzed by WHONET 5. 4 software. Results A total of 3456 pathoGenic strains were collected. Of them,Gram positive cocci,Gram neGative bacilli and funGus accounted for 20. 3%,76. 8% and 2. 9% respectively. Methicillin resistant strains in S. aureus( MRSA ) and coaGulase neGative Staphylococcus ( MRCNS)accounted for averaGe of 44. 4% and 85. 5% respectively. No vancomycin and linezolid resistant strains were found. Extended spectrumβ-lactamases strains accounted for 66. 4% and 30. 6% in Escherichia coli ( E. coli)and Klebsiella spp respectively. Strains of E. coli and Klebsiella spp were still hiGhly susceptible to imipenem. Resistance rates of P. aeruGinosa and A. baumannii sppstrains to imipenem were 8. 3% and 58. 4%respectively. Conclusion The major clinical pathoGenic microorGanisms in the Ninth Peopleˊs Hospital Affiliated to medicine School of ShanGhai Jiao TonG University are still Gram neGative bacilli. Baterial resistance is serious. It is important to strenGthen the detection of resistant bacteria in routine work,which is useful for rational use of antimicrobial aGents.

Objective To explore the relationship of delivery of parenteral fat emulsion and lipid peroxidation,and to observe the safety and effectiveness of parenteral nutrition(PN)in infants with very low birth weight(VLBWI).Methods Thirty infants with VLBWI were randomly divided into 3 groups:the preterm infants received pareneral nutrition containing amino acids and dextrose and soluvit,while intralipid provided separately,intralipid were light exposed(group A,n=10)or light protected(group B,n=10).In group C(n=10),soluvit and vitlipid were co-administered with intralipid and light protected.All the prematures received PN for 7 days and 10 cases of VLBWI not recei-ving PN were collected as control group.Anti-oxidation level,ascorbate,blood glucose,oxygen saturation,serum biochemistry index and body weight were determined before and after experiment.Results Seven days after PN,the MDA concentrations in the test groups all increased(⊿dA was the most,⊿dB was the next,⊿dC was the least).For superoxidedimutuse(SOD)reduction concentrations,⊿dA decreased sharply,then was ⊿dB,⊿dc decreased little,The blood Vit C increase in group B and C were more than group A.Significant changes of MDA,SOD and Vit C existed among the group B,C and A.In the 3 test groups,bilirubin,albumin,prealbumin concentrations were higher after the experiment,but there were no significant changes compared with control group.No significant changes in blood biochemistry,oxygen saturations were found before and after the observation in every group.Conclusions Multivitamin preparations protect fat emulsion against light-induced formation of lipid hydroperoxides,and administering multivitamins with fat emulsion via dark delivery tubing provide a practical way of preventing peroxidation of the lipid while limiting vitamin loss.Furthermore,it is relatively safe to apply fat emulsion intravenously with suitable dose and infusion rate for a few days to VLBWI from the second day of birth who require partial parenteral nutrition.

Objective To analyze the importance of procalcitonin (PCT) and high-sensitivity Creactive protein (hsCRP) in assessing the severity of pneumonia and sepsis patients as well as prognostic evaluation.Methods A total of 77 patients with pneumonia complicated with sepsis were randomly (random number) selected from May 2013 to May 2016 in our hospital and 50 patients with simple pneumonia were enrolled as control group.The sepsis pneumonia patients were divided into three groups,namely sepsis group,severe sepsis group and septic shock group.The sepsis patient were further divided into survival group and death group according to the death of patient within 2 weeks.Statistics was employed to study the roles of PCT and hsCRP in evaluating the severity of pneumonia and sepsis patients as well as prognostic evaluation.Results Compared with control group,the levels of PCT and hsCRP were higher in patients of sepsis groups (P ＜ 0.05).The levels of PCT and hsCRP were gradually increased as the severity of the patient getting worse (P ＜ 0.05).The levels of PCT and hsCRP in the death group were higher than those in the survival group.The areas under ROC curve of PCT and hsCRP for diagnosis of sepsis and septic shock as the optimal cut-off point at ≥ 2 ng/mL and at ≥ 75 mg/L,had the sensitivity of 62.1％ and 81.2％,respectively,and the specificity of 89.2％ and 68.2％,respectively.Conclution PCT and hs CRP levels have a certain value in assessing the severity of pneumonia and sepsis patients as well as prognostic evaluation.

Objective To evaluate the clinical effect of salmeterol xinafoate and fluticasone propionate powder for inhalation combined ipratropium bromide aerosol in patients with stable chronic obstructive pulmonary disease (COPD).Methods One hundred and twenty patients with stable COPD was randomly divided into control group and observation group with 60 patients each.The control group was received ipratropium bromide aerosol inhalation,and the observation group was given salmeterol xinafoate and fluticasone propionate powder for inhalation and ipratropium bromide aerosol for 6 months.BODE index,SGRQ scores,plasma cortisol and bone mineral density were compared between two groups before and after treatment.Results BODE index scores had no significant difference between two groups before treatment (P＞0.05).After treatment,BODE index scores,dyspnea scale,FEV1％,6MWD and BODE index total scores in observation group were superior to those in control group [ (1.9 ± 0.5) grades vs. (2.3 ± 0.5)grades,(58.5 ± 7.3)％ vs.(50.4 ± 6.2)％,(411.1 ± 56.8) m vs.(347.5 ± 60.4) m,(3.3 ± 1.0) scores vs.(3.8 ± 1.3 ) scores ],there were significant differences (P＜0.05 ).SGRQ scores had no significant difference between two groups before treatment (P＞0.05 ).After treatment and in SGRQ scores,respiration symptom,limitation of activity,disease influence scores in observation group were significantly lower than those in control group [ (20.7 ± 10.3 ) scores vs.(37.9 ± 14.4) scores,(20.7 ± 9.5 ) scores vs.(34.8 ± 13.0) scores,(16.3 ± 6.7) scores vs.(27.2 ± 11.8) scores,(17.5 ± 7.0) scores vs. (34.6 ± 12.3) scores],there were signiticant differences (P＜0.01 ).There were no significant difference of plasma cortisol and bone mineral density between two groups (P＞0.05).Conclusions Salmeterol xinafoate and fluticasone propionate powder for inhalation and ipratropium bromide aerosol in patients with stable COPD can greatly improve the lung function and life quality and with less adverse reaction.

Objective To analyze the basics and influencing factors for the medical expenditure of poor patients of tumor and end-stage renal diseases in Hubei province,and put forward policy recommendations for the critical illness insurance and health poverty alleviation.Methods 535 patients with tumor and end-stage renal diseases in Wuhan,Xiangyan and Shiyan in Hubei province were selected for a questionnaire survey,with 415 of the questionnaires subject to data analysis.Single factor variance analysis and multiple linear regression were used to analyze the influencing factors for their medical expenditure.Results 83.9% of the patients held their medical costs as too high;84.6% of them complaining significant drop of their annual family income due to their diseases; disposable household income of urban patients higher than their rural counterparts both before and after their disease; types of medical insurance and diseases are significant influencing factors for medical expenditure.Conclusions Poverty rate is high among patients of such patients.To reduce their financial burden,the government is recommended to cover more major diseases,enhance support for those of critical illness and improve the medical assistance system.

Adult ; Drug-Related Side Effects and Adverse Reactions ; Female ; Humans ; Medical Staff, Hospital ; Occupational Exposure ; Surveys and Questionnaires ; Women's Health

OBJECTIVETo investigate the effects of advanced glycosylation end products (AGEs) modified bovine serum albumin (AGE-BSA) on the expression of reactive oxygen species (ROS) and monocyte chemoattractant protein-1 (MCP-1) in human renal mesangial cells (HRMCs).

METHODSHRMCs were cultured in vitro with medium containing different doses of AGE-BSA or BSA (50,100, 200, 400 mg/L) for 48 hours, or with AGE-BSA (200 mg/L) for different times (12, 24, 48, 72 h). Immunocytochemistry assay was used to estimate the protein level of RAGE. The ROS in cells were measured by flow cytometry and the mRNA expression of MCP-1 were analyzed by semi-quantiative reverse transcription-polymerase chain reaction (RT-PCR) after treatment with AGE-BSA or BSA.

RESULTSThe protein level of RAGE was upregulated in the HRMCs with AGE-BSA. The expression of ROS and MCP-1 significantly enhanced by incubation of AGE-BSA in a time- and dose-dependent manner. The effects of AGE-BSA-induced up-regulation of ROS and MCP-1 level was significantly blocked by neutralizing antibodies to RAGE, while the expression of ROS and MCP-1 stood nearly unchanged after cultured with huamn IgG.

CONCLUSIONThe expression of ROS and MCP-1 in HRMCs is induced by AGE-BSA through RAGE, which may have potential effects in the pathgenic mechanism of diabetic nephropathy.

Cells, Cultured ; Chemokine CCL2 ; metabolism ; Glycation End Products, Advanced ; pharmacology ; Humans ; Mesangial Cells ; drug effects ; metabolism ; Oxidative Stress ; drug effects ; Reactive Oxygen Species ; metabolism ; Receptor for Advanced Glycation End Products ; Receptors, Immunologic ; metabolism ; Serum Albumin, Bovine ; pharmacology

Objective Rapamycin can improve characteristic pathology of AD by improving the level of autophagy.But, its internal mechanism still needs further study.This study was aimed to observe the protective effect of Rapamycin (RAPA) on the injury of rat pheochromocytoma (PC12) cells induced by β-amyloid protein25-35 (Aβ25-35).Methods PC12 cells in the logarithmic phase were randomly divided into 5 groups: control group(similar free-serum DMEM), model group, 10μmol/L RAPA treated group, 40μmol/L RAPA treated group and 160μmol/L RAPA treated group(add 10μmol/L, 40μmol/L RAPA, 160μmol/L respectively).Except the control group, each group was cultured with 20μmol/L Aβ25-35 to established the cell injury model.Results ①Compared with the survival rate of cells[(51.47±2.59)%] and the apoptosis rate of cells[(52.22±2.33)%] of the model group,the survival rate of cells in 10、40、160μmol/L RAPA treated groups and control group[(54.64±2.42)%, (64.79±2.91)% ,(56.50±2.55)% and (99.98±0.73)%] significantly increased, but the apoptosis rate of cells [(45.33±2.83)%, (36.89±2.85)%, (48.00±2.83)% and (3.33±2.45)%] significantly decreased(All P<0.05).②In model group,the expressions of p-PKB is 0.33±0.01, p-mTOR is 1.97±0.05, p-tau is 2.09±0.19.Compared with model group, in 10、40、160μmol/L RAPA treated groups and control group,these expressions of p-PKB (0.37±0.01, 0.42±0.01, 0.40±0.01 and 0.44±0.02) were significantly increased, however p-mTOR (1.64±0.05, 0.66±0.04, 0.35±0.01 and 0.62±0.01) and p-tau (2.02±0.15, 1.79±0.05, 1.86±0.06 and1.53±0.04) were decreased(All, P<0.05).ConclusionRAPA can increase Aβ25-35-induced PC12 cells viability, decrease cells apoptosis rates, and have a protective effect on Aβ25-35-induced PC12 cells death.The mechanism of its protective effect may be related to the inhibition of mTOR regulating PI3K/PKB/mTOR signal transduction pathway by negative feedback and the reduction of tau protein hyperphosphorylation.

Objective To investigate the changes of protein kinase C(PKC)activity in peripheral blood T lymphocytes in children with chronic idiopathic thrombocytopenic purpura(CITP)and the relationship between PKC activity,T lymphocytes activation and thrombocytes decrease.Methods Collecting sterile peripheral blood from CITP children(n=30)and healthy children(n=30),T lymphocytes were isolated and purified by the T cell segregation enrichment column,the PKC activity was detected by non-radioactive assay.Soluble interleukin-2 receptor(sIL-2R),which was T cell activated marker,was determined by enzyme-linked immunoabsorbent assay(ELISA),platelet was counted by cell counting meter.Results Compared with healthy children,PKC activity was significantly enhanced in CITP children[(0.94?0.23)mmol/(min?L)vs(0.50?0.17)mmol/(min?L),t= 8.42 P

AIM: To analyze the genotype of the allele distribution of a polymorphic G-954C within the 5 upstream promoter region of the nitric oxide synthetase 2A gene (NOS2A) in samples of diabetic retinopathy in patients with cystoid macular edema in the mainland of China.METHODS: Eighty-nine patients with diabetic retinopathy and cystoid macular edema and 90 healthy controls were enrolled in this study. Nest polymerase chain reaction (PCR)was performed, and restriction endonudease digestion and gene fragments sequence were examined to detect the genotype of NOS24 G-954C.RESULTS: The genotypes of the sample population of 89 cases and 90 healthy controls were all detected as GG.CONCLUSION: The distribution of G-954C of NOS2A polymorphism are at a lower frequency in China, with little relevancy to the frequency of diabetic retinopathy combined with cystoid macular edema.