OBJECTIVE To evaluate the spectrum of imipenem-resistant Pseudomnas aeruginosa and the production of metallo-?-lactamase.METHODS The clinical strains of P.aeruginosa were collected from Jan to Dec 2007.The results of antimicrobial susceptibility tests and detection of metallo-?-lactamase were analyzed.Antimicrobial susceptibility tests were performed by K-B methods;the production of metallo-?-lactamase was tested by CAZ-EDTA synergy method.RESULTS Sixty strains were isolated,imipenem-sensitive and resistant strains were 40(66.7%) and 20(33.3%),respectively,and 7 strains with metallo-?-lactamase were detected.Among imipenem-resistant strains,at least 90.0% strains were resistant to meropenem,gentamicin,tobramycin,ciprofloxacin and SMZ-TMP;at least 80.0% strains were resistant to piperacillin and piperacillin/tazobactam;50.0% strains were resistant to ceftazidime and cefepime;polymyxin E was less resistant than others.Twenty strains were resistant to at least 3 antimicrobial agents,which was obviously higher than 27.5% of imipenem-resistant strains.CONCLUSIONS The resistance rate of imipenem-resistant P.aeruginosa is higher than imipenem-sensitive ones.The production of metallo-?-lactamase is one of the mechanisms of P.aeruginosa resistance to imipenem and shou1d be detected carefully,which could help us medicate reasonably in clinic and avoid using medicine which could induce and strengthen the resistance.

Objective To investigate the prevalence and risk factors of intracranial vertebrobasilar artery stenosis. Methods By cluster sampling, adult Han people were recruited from residential communities. Medical history was documented and body height, body weight, waist circumference, hip circumference and blood pressure were measured. Venous blood samples were collected to determine serum fasting glucose, total cholesterol and triglycerides concentrations. Intracranial vertebrobasilar artery stenosis was diagnosed with transcranial Doppler. The SPSS 11.0 software package was used for data analysis. Results Among 1035 people conforming to the inclusion criteria, intracranial vertebrobasilar artery stenosis was found in 58 (5.6%), 17 with left VA stenosis, 23 with right VA stenosis and 30 with BA stenosis.Univariate analysis showed that subjects with diabetes mellitus had a significantly higher prevalence ( 10. 3% ) of intracranial vertebrobasilar artery stenosis (χ2 = 6. 221, P = 0. 013 ) and the mean systolic blood pressure (( 131.1 ± 25.5) mm Hg, 1 mm Hg = 0. 133 kPa) in the subjects with stenosis was significantly higher than those without (3.2%, ( 124. 1 ± 21.6) mm Hg) (t = 2. 228, P = 0. 026). Logistic regression indicated that diabetes mellitus and systolic blood pressure were independent risk factors for intracranial vertebrobasilar artery stenosis ( diabetes mellitus: OR = 3. 305, P = 0. 023; elevated systolic blood pressure 1 mm Hg: OR = 1. 012, P =0. 047). Conclusions This study demonstrated a considerably high prevalence of intracranial vertebrobasilar artery stenosis in a southern Chinese population. Diabetes mellitus and systolic blood pressure play potent roles in intracranial vertebrobasilar artery stenosis.

Objective To evaluate left ventricular myocardial function of rabbit after ischemiareperfusion using speckle tracking imaging (STI),and to explore the myocardial protect effects of ischemia postconditioning (I-PostC) on reperfusion injury.Methods 24 Japanese rabbits were divided into ischemiareperfusion group (group Ⅰ) and I-PostC group (group Ⅱ) randomly.The characteristic changes of left ventricular global and regional myocardial strain and twist function of two groups were evaluated quantitatively by STI and compared with pathological results.Results ① Global longitudinal systolic strain rate(GLSrsys),global longitudinal systolic strain (GLSsys) and global longitudinal peak strain(GLSp) decreased in both groups,longitudinal systolic strain rate(SrLsys),longitudinal systolic strain(SLsys) and longitudinal peak strain(SLp) in the lateral wall of left ventricle decreased significantly and negative peak of SrLivr and PSI increased after the left ventricular branch of coronary artery was occluded;The values of Ptw and untwR of left ventricle were smaller.② After the artery was released,GLSp recovered in group Ⅱ,which was not seen in group Ⅰ.The values of SrLsys,SLsys and SLp increased significantly and negative peak of SrLivr and PSI decreased in group Ⅱ.However,only Slsys and SLp rebounded in group Ⅰ.Between the 2 groups,SrLsys andSLp in group Ⅱ were higher than that of group Ⅰ (P＜0.05 or 0.01),and SrLivr was lower compared with group Ⅰ (P ＜0.05).In group Ⅱ,Ptw and untwR changed back to a normal range (P ＜0.05 or 0.01),and no index has changed in group Ⅰ ;Between the 2 groups,Ptw and untwR in group Ⅱ were higher than that of group Ⅰ (P ＜0.05).③ The sensitivity and specificity of GLSrsys,GLSsys,SrLsys,SLsys and Ptw to detect rabbit myocardial infarction were 81.3 ％ and 75.0 ％,62.5 ％ and 81.2％,87.5％ and 87.5％,93.8％ and 75.0％,81.3％ and 68.7％ respectively.Conclusions STI may provide a promising approach to evaluate the global and regional myocardial function.It also can observe the protect effects of I-PostC on myocardial reperfusion injury accurately.

Objective To discuss the feasibility of Mongolian medicine pulse diagnosis in assessment of the disease situation of acute critically ill patients. Methods The clinical data of acute critically ill patients admitted in the Department of Emergency of Inner Mongolia International Mongolian Medical Hospital from December 2015 to December 2017 were retrospectively analyzed, and the role of Mongolian medicine pulse diagnosis in the evaluation of disease situations of patients with acute critical illness was observed. Results The improved early warning score (MEWS) at admission was carried out for all the patients in the Emergency Department of this hospital, 996 critically ill patients with their MEWS score ≥ 5 scores in accord with the inclusion criteria were allowed to undergo the Mongolian medicine pulse diagnosis, and of them, 654 patients showed specific changes in pulse condition. Shock appeared rapid pulse, microphygmia in pulse diagnosis of Mongolian medicine, severe anemia appeared the slippery pulse and rapid pulse in pulse diagnosis of Mongolian medicine, severe arrhythmia appeared rapid pulse and slow pulse in pulse diagnosis of Mongolian medicine, acute myocardial infarction appeared rapid pulse, weak pulse and slow pulse in pulse diagnosis of Mongolian medicine, insufficiency of heart function appeared rapid pulse and weak pulse in pulse diagnosis of Mongolian medicine, hypertension complicated with cerebral hemorrhage with forceful pulse and pulsus pulse are all suggestive of critical condition. Conclusions The specific changes in pulse condition of patients with acute critical illness in Mongolian medicine are helpful to the assessment of the patient's condition. This method can also be used as one of the tools for rapid assessment of disease situation in critical patients before going to hospital or in the hospital.

ObjectiveTo make statistics on the biological characteristics， medicinal parts， chemical components， and other aspects of thorny medicinal plants and systematically analyze the correlations between their natures， tastes， and meridian tropism， so as to provide a theoretical basis for the clinical application and resource development of these plants. MethodThe Chinese Pharmacopoeia （2020 edition） and the processing standards of various provinces and cities and other related documents were reviewed， on the basis of which 46 species of thorny medicinal plants were selected. The natures， tastes， meridian tropism， medicinal parts， chemical components， pharmacological activities， and geographical distribution of these plants were summarized and analyzed in Excel 2013 and SPSS Statistics 26.0. ResultThe 46 species of thorny medicinal plants belonged to 25 families， 1 class， 1 phylum of 1 kingdom. In terms of the location of thorns， the frequency of these medicinal plants followed the trend of leaf thorns>peel thorns>branch thorns>fruit thorns. In terms of the nature， taste， and meridian tropism， the frequency of these plants was in the orders of warm>plain>cold>cool>hot， bitter>sweet>pungent>sour>salty， and liver>lung>spleen=large intestine>heart>kidney， respectively. In terms of the medicinal parts， the frequency followed the trend of roots and rhizomes>fruits>whole plants>flowers>leaves. The thorny medicinal plants were mainly distributed in north and southwest China. The thorny medicinal plants mainly contained flavonoids， alkaloids， and saponins and had the effects of clearing heat and detoxifying， resolving stasis and eliminating carbuncle， moving Qi and relieving pain， and alleviating edema and expelling pus. Moreover， 24 of them had anti-tumor activity. ConclusionMost of the thorny medicinal plants belong to Compositae， Leguminosae， and Rosaceae， have leaf thorns， a warm nature， a bitter taste， tropism to the liver meridian， and roots as the medicinal part. These plants are mainly distributed in north China， with the effects of clearing heat and detoxifying， resolving stasis and eliminating carbuncle. In summary， the thorn location， distribution， and medicinal parts of thorny medicinal plants are correlated with the natures， tastes， and meridian tropism. The findings provide clues for the development and utilization of these plants.