Objective To investigate the reliability of appraising biofilm of Klebsiella with silver staining method.Methods Apply improved flat culture to make biofilm of Klebsiella,adopting silver staining method and scanning electron microscopy to observe and appraise.Results Observation with general optical microscope after silver staining to appraise biofolm is identical with that using scanning electron microscope.Conclusions Silver staining method used to appraise biofilm of Klebsiella is reliable and simple.

OBJECTIVE To evaluate the mechanism that bacteria growing in biofilm(BF) always resist to antimicrobial agents,and to provide the theoretical basis for selecting antimicrobial agents in clinic. METHODS Model of Klebsiella pneumoniae and Escherichia coli bacterial biofilm was built up with the modified flat-board method and identified with the AgNO_3 staining and confocal scanning laser microscopy.We used imipenem to induce the ESBLs production of BF bacteria.ESBLs production was performed by the standard disk diffusion method. RESULTS The isolation rate of ESBLs producing strains in Klebsiella and E.coli planktonically was 20.0% and 22.5%,respectively.The isolation rate of ESBLs producing strains in Klebsiella biofilm and E.coli was 42.5% and 47.5%,respectively.The isolation rate of ESBLs producing strains in above two biofilms and(E.coli) biofilm being induced by imipenem was 65.0% and 70.0%,respectively.The isolation rate of groups A_1 and B_1,groups B_1 and C_1,groups A_2 and B_2,groups B_2 and C_2 was different from each other significantly with the statistic method of ?~2 test. CONCLUSIONS One of the main reasons that Klebsiella and E.coli resist to antibiotics is the synergetic effect of BF and ESBLs.

Objective To investigate the effect of azithromycin,erythromycin and roxithromyein at varying concentration on the β-lactamase produced in the biofilm of Klebsiella pneumoniae.Methods Models of Klebsiella pneumoniae were built up with the modified flat-board method and identified with the confocal scanning laser microscopy.Thirty Klebsiella pneumoniae were incubated at 37 ℃for 24 h,and allocated into 7 groups:biofilm (group A),by 1 MIC azithromycin (group B1),by 1/8 MIC azithromycin (group B2),by 1 MIC erythromycin (group C1),by 1/8 MIC erythromycin (group C2),by 1 MIC roxithromycin (group D1),and biofilm induced by 1/8 MIC roxithromycin (group D2),with 200 μ1 each.The β-lactamase activity in each group was quantitated.Results The β-lactamase activity in group A,group B1,group B2,group C1,group C2,group D1 and group D2 was 0.6534,0.3196,0.4260,0.5028,0.5108,0.6524 and 0.6470 U/mg respectively.The β-lactamase activity in group B1,group B2,group C1 and group C2 was lower than that in group A,and statistically significant difference was observed (P＜0.05).The B-lactamase activity in group D1 and group D2 was similar to that in group A,and no statistically significant differences was observed between them (P＞0.05).The β-lactamase activity in group B1 was lower than that in group B2,and statistically significant difference was observed (P <0.05).No statistically significant difference was observed between group C1 and group C2 (P＞0.05).Conclusion Azithromycin at higher concentration exerts better effects on biofilm formation than other macrolides.

Objective To explore the role of ureteroacopy for acute upper urinary tract obstructive anuria.Methods Clinical data of 37 cases with acute upper urinary tract obstructive anuria were analyzed.Results Among 37 cases,34 cases were successfully performed ureteroseopy or ureteroseopic lithotripsy with double-J sent incubation (successful rate was 91.9%).Renal function were recovery in 32 cases.4 Cases returned to 180μmol/L,1 case need hemodialysis periodically.Conclusion Ureteroscopy could rapidly remove the obstruction and protect renal function in management of acute upper urinary tract obstruction anuria,which was contributed to the diagnosis.It was safe,effective and the preferred method.

Objective To develop a detection method based on the technology of gene chips which can quickly distinguish genes of Enterococcus faecalis, E.faecium and vancomycin resistance.Methods Based on the specific gene ( ddl) sequences of two types of Enterococcus from GenBank, oligonucleotide probes which could detect and distinguish special genes and drug resistance genes ( vanA,vanB) of Enterococcus were designed and compounded.Then,the probes were dotted to modified slide.The target DNA fragments of vancomycin-resistant Enterococcus ( VRE) were labeled with biotin by multiple PCR amplification, and then hybridized with oligonucleotide probes on slide.The results were analyzed by portable imager.The multiple PCR system, hybridization reaction and condition of the chemiluminescence method were optimized before the specificity, sensitivity and reproducibility of the chip were evaluated.Results One universal primer, four specific primers, one universal probe and four specific probes were selected.This gene chip was demonstrated of high specificity and repeatability.The detection sensitivity was 103 CFU/ml.The gene chip detection results of 10 clinical samples were basically consistent with the drug sensitivity test ( 8/10 ) .Conclusion A gene chip technique for the detection of VRE is established successfully.It is possible to distinguish the type of VRE and detect the genetic phenotypes of drug resistance by gene chip technique.

With the rapid development of information technology, artificial intelligence technology (AI) and how to use it have become the focus of current researches. The application of AI in the field of TCM has shown its uniqueness. The combination of artificial intelligence technology and traditional Chinese medicine provides a new direction and idea for the development of TCM. This paper analyzes the strengths, weaknesses, opportunities and threats (SWOT) of TCM development against the background of AI technology in China by SWOT analysis method. Based on these analyses, this paper puts forward some counter measures such as protecting personal information, avoiding negative effects and medical regulations etc. In order to facilitate and guarantee the development of TCM, we should take advantage of the AI, and avoid its disadvantages.

OBJECTIVETo observe the effectiveness and safety of electrothermal acupuncture in the prevention and treatment of chemotherapy-induced nausea and vomiting (CINV) in the cancerous patients of phlegm-stasis interaction in cisplatin-containing chemotherapy.

METHODSSixty cases of phlegm-stasis interaction in cisplatin-containing chemotherapy were randomized into a trial group and a control group, 30 cases in each one. In the control group, the intravenous drip of granisetron hydrochloride injection was adopted, 3 mg before and after cisplatin-containing chemotherapy 30 min, continuously for 3 days. 43 to 45℃ electrothermal acupuncture at zusanli(ST 36) for 30 min was used on the basis of the treatment as the control group in the trial group,once a day for 3 days. CINV, anti-nausea effects, Karnofsky score, the syndrome score of phlegm-stasis interaction, and relevant indices of safety were observed on the 1st and 7th days of cisplatin-containing chemotherapy separately.

RESULTS1.Regarding CINV and anti-nausea effect, CINV did not occur before chemotherapy in the patients of the two groups. On the 1st and 7th days of chemotherapy, CINV in the trial group were milder than those in the control group (both<0.05).The anti-nausea effects in the trail group were better than those of the control group.2.Regarding Karnofsky score and the syndrome score of phlegm-stasis interaction, the improvements on the 7th days of chemotherapy in the trial group were better than those in the control group, indicating the significant differences (both<0.05). 3.Regarding the safety indies, there was no adverse reaction during the treatment in the two groups.

CONCLUSIONSThe electrothermal acupuncture effectively relieves CINV, and improves self-care dbility and the symptoms of phlegm-stasis interaction.