ColV~+ strains of Escherichia coli produced larger inhibitory zones when these strains grown on nutrient agar containing phosphate after overlaid sensitive indicators. This appears that production of colicin V is increased by the addition of phosphate to nutrient agar. It was sure that stimulation of phosphate to colicin V formation results from its effect in reducing divalent cation levels in nutrient agar since adding EDTA to nutrient agar had the same effect as phosphate, but the addition of Mg~(2+) or Ca~(2+) had the oppsite effect. Therefore nutrient agar supplemented with phosphate can be used to isolate and identificate ColV~+ strains of E. coli.

OBJECTIVE To assess the pathogen features and risk factors among diabetic patients complicated by lower respiratory tract nosocomial infection.METHODS A retrospective study was carried out to survey the clinical data of diabetic patients complicated by lower respiratory tract infection during from 2002 to 2005.RESULTS The main responsible pathogens were Gram-negative bacteria,their rate was 54.5%.While the rate of Gram-positive bacteria was 35.7 %.The rate of fungi was 9.8%.The risk factors of nosocomial infection included:old age,high level of blood sugar,consciousless status,longtime usage of antibiotics,oxygen inhalation and other aggressive manipulations.CONCLUSIONS In diabetic patients with lower respiratory tract infection,the incidence and mortality were all onrelatively high level.They must be given to pay attention.The chief pathogens were Gram-negative bacteria or fungi.So we should strengthen supervision and avoid risk factors,which are the keys in saving critical diabetic patients.

Objective:Our aim was to To clarify the roles of p16 and p15 proteins in the genesis of acute lymphoblastic leukemia(ALL).Methods:Twenty-three samples of ALL were studied by the method of indirect immunofluorescence.Flow cytometer was used to estimate the cellular fluorescent intensity to determine the levels of p16 and p15 proteins.Results:Negative expression for p16 protein was found in 10 of 23 samples,and 8 of 23 were p15 negative expression.Both kinds of proteins were abscent in 6 samples.2 of 3 cases of T-ALL were negative expression of p16,p15 protein.In non T-ALL,6 of 13 were negative expression for p16 protein,5 of 13 were p15 protein deficient.The expression rates of p16,p15 protein in high leukocyte group were lower than those of non-high leukocyte group(P<0.05).The expression rates of p16,p15 proteins in HR-ALL were lower than those of SR-ALL(P<0.05).Conclusion:The p16 and p15 proteins take part in the genesis of ALL.Negative expression of p16,p15 proteins might imply the poor clinical outcome.

Human embryonic stem ceIIs(hESC),characterized by unique capacities of seIf-renewaI and differentiation into cardiomyocytes and hepatocytes,can be used in new drug screening and drug safety evaIuation processes. Cardiotoxicity and hepatotoxicity are major obstacIes to deveIopment and marketing of new drugs. hESC-derived cardiomyocytes and hepatocytes have structuraI and functionaI characteristics,which can be used for cardiotoxicity and hepatotoxicity testing in vitroand for buiIding a drug safety evaIuation system invitrothat has the advantage of short experiment cycIes,smaII dose,Iow cost and few species differences. hESC-derived cardiomyocytes and hepatocytes have broad prospects of appIication in toxicoIogy.

Objective To investigate the distribution and antibiotic resistance of clinical isolates in People’s Hospital of Qingyang during 2014 to provide evidence for rational antimicrobial therapy.Methods Bacterial strains were isolated and identified by routine methods and tested by disk diffusion method and E-test for antimicrobial susceptibility. The data were analyzed according to CLSI breakpoints using WHONET 5.6 software.Results Of the 2 121 nonduplicate strains isolated from January through December 2014, 1 565 (73.8%) were gram-negative and 556 (26.2%) were gram-positive strains. The top ifve pathogens wereE. coli, K. pneumoniae, A. baumannii, S. aureusand P. aeruginosa. The prevalence of methicillin-resistantStaphylococcus aureus (MRSA) and methicillin-resistant coagulase negativeStaphylococcus (MRCNS) was 44.6% and 15.4%, respectively.E. coli was the most common gram-negative bacterial species, whileS. aureus was the most common gram-positive bacteria species. Gram-positive bacteria were still highly susceptible to vancomycin, and gram-negative bacteria (such as Enterobacteriaceae) were still highly susceptible to carbapenems.ConclusionsE. coli is the most prevalent pathogen isolated from inpatients in this hospital during 2014. The prevalence of ESBLs-producing strains is the highest inE. coli isolates. The pathogenic bacteria in this hospital showed increasing resistance to a variety of antibacterial agents. Surveillance of antibiotic resistance and effective control measures are necessary to control the growing antimicrobial resistance.

ObjectiveTo evaluate whether AN69 ST membrane would prolong filter lifetime in continuous renal replacement therapy (CRRT) without anticoagulation in patients with high risk of bleeding.Methods A single-center, prospective, randomized, double-blind control trial with crossover design was conducted. From March 1st to December 31st in 2013, patients who were admitted to Department of Critical Care Medicine of the Fourth Hospital of Hebei Medical University meeting CRRT treatment indications, but could not receive systemic anticoagulation because of high risk of bleeding were studied. The selected patients were randomly divided into two groups according to a random number table, and four filters consisting of two AN69 ST100 membrane filters (A) and two traditional AN69 M100 membrane filters (B) were used for them. GroupⅠ with the filter order of A-B-A-B, and groupⅡ with the order of B-A-B-A. The clinical data of patients was recorded in detail, and conventional AN69 ST and AN69 membrane filter lifetime, their influence on coagulability, and the incidence of bleeding complications were compared.Results Seventeen patients were enrolled, with 10 in groupⅠ, and 7 in groupⅡ. The basic medical characteristics including gender, age, acute physiology and chronic health evaluationⅡ (APAECHⅡ) score, sequential organ failure score (SOFA), Acute Renal Injury Network (AKIN) stage, activated partial thromboplastin time (APTT), prothrombin time (PT), international normalized ratio (INR), platelet count (PLT), and use of mechanical ventilation were not significantly different between two groups. But the use of vasoactive drug was more frequent in groupⅡcompared with that of groupⅠ[100.0% (7/7) vs. 30.0% (3/10),χ2 = 8.330,P = 0.010]. AN69 ST filter lifetime (n =34) was (15.92±2.10) hours, there was no statistically significant difference compared with that of AN69 membrane (t = 0.088,P = 0.942), filter lifetime of which (n = 34) was (16.12±1.38) hours. It was also found by Kaplan-Meier survival analysis that there was no significant difference between the two membrane filter lifetime (χ2=1.589,P =0.208). Logistic regression analysis showed that the life of the first filter was not correlated with coagulation indicators, including APTT, PT, INR, and PLT [APTT: odds ratio (OR) = 0.977, 95% confidence interval (95%CI) = 0.892-1.071, P = 0.623; PT:OR = 1.001, 95%CI = 0.901-1.109,P = 0.988; INR:OR = 1.078, 95%CI = 0.348-3.340,P = 0.896;PLT:OR = 0.996, 95%CI = 0.974-1.019,P = 0.735]. The application rate of vasoactive drugs, which was different between two groups for basic medical indications showed no effect on filter life time (OR = 2.541, 95%CI = 0.239-26.955,P = 0.439). Reasons of clotting in filters were also analyzed, and it was found that blood coagulation in the filter ranked the top (88.2%), and the other reasons were catheter-related problems, death, and unscheduled transport. No difference in blood coagulation function was found in both groups after treatment for 12 hours, and there was no bleeding complication.ConclusionDuring the CRRT without systemic anticoagulant, both surface-treatment with polyethyleneimine AN69 and AN69 ST membrane cannot prolong filter lifetime.

OBJECTIVEThe purpose of this study was to investigate the risk factors involving lymph node metastasis of squamous cell carcinoma and evaluate if the risk factors would be effective in predicting neck lymph node metastasis.

METHODSBased on the original data of 106 cases with carcinoma of tongue, four related factors, including maximal diameter, degree of differentiation, mode of invasion and histological grade of malignancy were analyzed statistically.

RESULTSThe maximal diameter and the grade of tumor cell differentiation showed no significant correlation with cervical lymph node metastasis; but the mode of invasion and the histological grade of malignancy demonstrated a significant correlation.

CONCLUSIONThe results obtained suggested that the mode of invasion and the histological grade of malignancy were closely related to cervical lymph node metastasis.

Adult ; Carcinoma, Squamous Cell ; pathology ; surgery ; Female ; Humans ; Lymph Node Excision ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Male ; Neoplasm Invasiveness ; Risk Assessment ; Risk Factors ; Tongue Neoplasms ; pathology ; surgery

Objective:To explore the clinical features of recurrence after choledocholithotomy and to analyze the risk factors.Methods:The clinical data of 730 patients with choledocholithiasis who were treated in our hospital from January 2005 to July 2016 were analyzed retrospectively,550 cases who were received choledocholithotomy were defined as laparotomy group,30 cases with laparoscopic common bile duct exploration (LCBDE) were defined as the LCBDE group,and 150 cases with endoscopic sphincterotomy (EST) were defined as EST group.The recurrence rate of the three groups were compared.The patients of three groups were divided into recurrence group (n=227) and non recurrence group (n=503) according to the recurrent situation,then the clinical features and risk factors of recurrent patients were analyzed by univariate and multivariate Logistic regression analysis.Results:The recurrence rate of EST group was 38.67％,which was significantly higher than that of LCBDE group with 26.67％ and the laparotomy group with 29.27％,and there was statistical difference (P＜0.05).The results of univariate analysis showed that there were statistically significant differences in age,history of HBV infection,jaundice,abnormal total bilirubin,peripapillary diverticulum,biliary infection,biliary stricture,papillary stenosis,sphincter of Oddis dysfunction,history of biliary surgery,cholecystectomy,bile duct diameter ≥ 15 mm,bile duct angle ≤120°,operation type,stone quantity ≥ 2 grains,stone diameter ≥ 10 mm,with or without gallstones (P＜0.05).The results of Logistic multivariate regression analysis showed that age,having peripapillary diverticulum,having history of biliary surgery,bile duct diameter ≥ 15 mm,stone quantity ≥ 2grains and EST operation type were the independent risk factors of the recurrence after choledocholithotomy (P＜0.05).Conclusion:There are many risk factors of recurrence after choledocholithotomy,and operation method should be based on the size and the number of the stones,and the constitution of patients.Preventive measures should be strengthened to control the recurrence after choledocholithotomy.

To evaluate the value of serum human epididymis protein 4(HE4),cancer embryonic antigen(CEA), carbohydrate antigen(CA125,CA19-9,CA153),alpha fetoprotein(AFP) and β-human chorionic gonadotrophin (β-HCG) in ovarian cancer early diagnosis.Methods:Abbott Architect i2000SR was used to detect the levels of preoperative serum tumor markers (n=7) in ovarian cancer group,benign ovarian tumor group and the normal control (each n=60).Results:The levels of serum HE4,CA125, CA199,CEA,CA153,AFP and β-HCG in ovarian cancer group were markedly higher than the benign ovarian tumor group and the control group.There was statistically significant difference ( P<0.05 ).The diagnosis of ovarian cancer tumor markers were high specificity,but sensitivity was not high except HE4 (76.67%) and CA125 (68.33%).With Youden Index,the area under curve of ROC,the HE4 was demonstrated higher specificity ,sensitivity and accuracy.There was also medium diagnostic value of CA 125 ,CA199 and CEA for ovarian cancer.The sensitivity of ovarian cancer diagnosis is raised by combined assay with serum tumor marker ,but the specificity would be reduced accordingly.HE4, CA125, CA199 and CEA combined detection is considered the best.Conclusion:CA153,AFP and β-HCG have lowered diagnosis for ovarian cancer.HE4, CA125, CA199 and CEA combined detection could significantly improve specificity ,sensitivity and accuracy in the early diagnosis of ovarian cancer.

Objective To find the plantar pressure readings which best indicate foot inversion during the stance phase of walking among hemiplegic stroke survivors.Methods Twenty-two hemiplegic stroke survivors who were able to walk without extra aid were recruited as the experimental group, while 17 healthy elderly men of similar age and body weight were selected as the control group.Those in both groups were asked to walk at their preferred speed over a Footscan device which measured medio-lateral pressure ratios, maximum plantar pressures and the contact areas of both feet.The Clinical Spasticity Index (CSI) was used to evaluate the affected feet.Results The average medial forefoot pressure of the affected side in the experimental group was significantly lower than that of the control group, but their average mesopodium and heel pressure was significantly higher.The average pressure applied by the great toe on the uninjured side in the experimental group was significantly smaller than that of the control group, but the average mesopodium and heel pressure of both feet among the hemiplegics were significantly higher than those of the control group.Among the experimental group, the average medial forefoot pressure of the affected foot was significantly greater than that of the healthy foot.The average contact area of the great toe on the affected side was significantly bigger than was observed in the control group.That of the medial forefoot was, however, significantly smaller than in the control group.There was no significant difference in the contact area between the healthy and affected feet in the experimental group, though the maxmium medio-lateral pressure ratios of their full feet and forefeet on the affected side were significantly lower than those in the healthy group.No significant differences in the maxmium medio-lateral pressure ratios of the heel were observed between the two groups, nor of the full feet, forefeet and heels of the affected and unaffected sides in the experimental group.The patients demonstrated consistently reduced joint mobility on both sides during the stance phase, coinciding with increased inversion.A significant negative correlation was found between the maxmium medio-lateral pressure ratios of the full foot and the maximum pressure of the lateral part of forefoot in the experimental group, but there was no significant correlation with contact area or CSI.Conclusions Plantar pressure data can be used to describe the amount of foot inversion in the stance phase of walking with hemiplegic patients after stroke.The maxmium medio-lateral pressure ratios can effectively reflect their foot inversion.