Objective To investigate the molecular mechanism of Klebsiella pneumoniae resistant to imipenem.Methods Anti-microbial susceptibility was evaluated by disk diffusion test,Seven imipenem-resistant strains of Klebsiella pneumoniae were select-ed.And PCR was used to amplify so as to detect eighteen resistant genes.Results Seven imipenem-resistant strains of Klebsiella pneumoniae were more sensitive to aminoglycosides and sulfamethoxazole/trimethoprim.The positive rates of KPC,ant(3′′)-Ⅰ, SHV,CTX-Mand ant(2′′)-Ⅰin these imipenem-resistant strains were high.Conclusion Carbapenem-resistant Klebsiella pneumon-iae isolated from our hospital carries several kinds of resistant genes.Carrying KPC may be the main resistant mechanism of Kleb-siella pneumoniae resistant to carbapenem,but other mechanisms also exist at the same time.

Objective To analyze the relationship between clinical competence of baccalaureate nursing students and its potential related factors,and investigate the results of curriculum reform of 4-year nursing undergraduate education.Methods The records of 263 baccalaureate nursing graduates were retrieved.Variables including age,years of college education,sex,college entrance examination scores,average scores of basic courses,average scores of public courses and average scores of professional courses were collected.Clinical competence was measured by the clinical practice tests at various clinical units.The linear regression analysis was performed to find out the influencing factors of clinical competence.Results The clinical competence was significantly related to sex,average scores of public courses and average scores of professional courses(P

Pig aortic vessels were processed by vacuum freeze-drying and then the aotic vessels were scanned and compared by CT, microscopic and texture analyzer. These processes presented a new method for preserving the vessels. Morphological changes of the vessels were tracked by Micro-CT, and mechanical properties were compared by texture analyzer combining with microscopic observation for structures and tissues. Results showed that the wall of the vessels became thinner by freeze-drying. After rehydration, the membrane structure was generally maintained, and the elastic fibers were more orderly arranged so that they were close to fresh vessels. In the area of mechanical property, the maximum puncture stress and axial tensile stress of rehydrated blood vessels were stronger than that of the fresh, while circumferential tensile stress was weaker than that of the fresh. Finally, analysis also showed that the freeze-dried vessel was basically remained the original morphological structure. The pores in vessel fiber and stratification during drying may be beneficial to the host cell invasion and angiogenesis, so it is expected to be a new effective means to save the blood vessels. Currently, four pigs have been transplanted with the rehydrated vessels, and all of the four have survived for more than 3 weeks.
Animals ; Aorta ; anatomy & histology ; Freeze Drying ; Swine ; anatomy & histology

BACKGROUND:Bone tumors around the Ⅱ section of pelvis are difficult to treat due to complicated anatomic structures.Using computer-aided technique,the excision range and prosthesis preparation can be individualized,which may obtain notable therapeutic efficacy in treating pelvic fractures in the clinic.OBJECTIVE:To discuss the application and the clinic effect of computer-aided technique in bone tumors therapy around the Ⅱsection of pelvis.METHODS:The pelvis model was generated with its CT data by rapid prototyping.Simulated bone resection and reconstruction were performed on the models.Then we designed surgical extension and made hemi-pelvic.Eight cases received resection of pelvic tumor and reconstruction based on computer-aided technique.RESULTS AND CONCLUSION:The resection of tumor and implantation of prosthesis were easily accessible.Two cases relapsed and 1 case loosened at 2 years after operation.According to Harris scoring criteria after total hip replacement,the scores of cases were well.The simulated resection and reconstruction of bone tumors around the Ⅱ section of pelvis based on computer-aided technique makes the operation easy and reconstruction precise,which produces good clinic results and offers a good promise for the application.

Objective To explore the diagnostic value of 18F-FDG PET/CT in primary peritoneal papillary serous carcinoma (PPPSC).Methods Ten postmenopausal female cases of pathologically diagnosed PPPSC from March 2009 to October 2011 were retrospectively reviewed (age range:61-81 years,mean:(69.4±6.2) years).All cases underwent 18F-FDG PET/CT.The CT characteristics and SUVmax of lesions on PET images were analyzed.Serum CA125 levels were measured before or after PET/CT within one week.The patterns of PPPSC on PET/CT were compared with histopathological results.Linear correlation analysis was used to evaluate the correlation between the CA125 and the maximum SUVmax of lesions presented in parietal peritoneum,greater omentum or mesentery.Results The PET/CT uptake pattern of the 10 PPPSC cases was described as floccus,multi-nodular or cake-like in greater omentum (SUVmax =6.32±2.87),and as diffuse or localized nodules,or non-uniform strip-like thickening in 9 parietal peritoneum and 8 mesentery cases (SUVmax =5.96±2.14 and 5.70± 1.69,respectively).The most commonly involved sites were pelvic wall of peritoneum and mesentery of small intestine.All 10 cases had different degrees of ascites,mainly intrapelvic and perihepatic.Hypermetabolic ovarian enlargement (all ＜5 cm) was bilateral in 2 patients and right-sided in 1 patient.Four patients had retroperitoneal lymph node metastasis and others were found with punctate calcifications in metastatic lymph nodes,small pleural effusions,liver metastasis,as well as portal node metastasis.CA125 concentration was elevated in all cases ((51.25±26.40) ×104 U/L),but there was no significant correlation between CA125 and the maximum SUVmax of lesions found in parietal peritoneum,greater omentum or mesentery (r=0.05,P＞0.05).Conclusion 18F-FDG PET/CT could show the positions and metabolic status of PPPSC lesions.It may be an effective imaging modality in the diagnosis and assessment of PPPSC.

To analyze features of the rabies epidemic in China between 2007 and 2011,identify factors influencing the epidemic and to provide a scientific basis for further control and prevention of rabies,Descriptive epidemiological methods and statistical analysis was used on data collected from the National Disease Reporting Information System between 2007 to 2011 and the National Active Surveillance System between 2007 and 2010.Our analysis shows that while the number of human rabies cases decreased year by year,the number of districts reporting cases did not show significant change.The situations in Guangdong,Guangxi,Guizhou and Hunan provinces clearly improved over the period but they remain provinces with high-incidence,and consequently influence the epidemic situation of surrounding provinces and possibly the whole country.Summer and autumn were high-incidence seasons.Farmers,students and pre-school children represent the high-risk populations,and rates of cases in farmers increased,those for students decreased,and pre-school children remained unchanged.Provinces with active surveillance programs reported a total of 2346 individual cases,of which 88.53％ were associated with canines.Postexposure prophylaxis (PEP) of rabies cases was not significantly improved,whereas PEP in post-exposure population was good.In rural regions of China,canine density was reduced somewhat,and the immunization rate increased slightly.Finally we show that while the epidemic decreased 2007 to 2011 in China,cases continued to be diffused in certain regions.Lack of standardization of PEP on rabies cases was the main reason of morbidity.The high density and low immunization of dog in rural areas and the defective situation of PEP are still continuous occurrences in China and remain a cause for concern.

In recent years (2007 to 2011),although the overall number of rabies cases in China has decreased,there is evidence of emerging or re-emerging cases in regions without previous rabies cases or with low incidence of rabies.To investigate the origin and the factors affecting the spread of rabies in China,specimens were collected from 2007 to 2011 from provinces with emerging and re-emerging cases and tested for the presence of the rabies virus.Positive specimens were combined with sequences from GenBank to perform comparisons of homology and functional sites,and to carry out phylogenetic analyses.Out of these regions,five provinces had 9positive specimens from canine and cattle,and 34 canine or human specimens were obtained from previously high-incidence provinces.Complete sequences of G gene were obtained for these samples.Homology of the sequences of these 43 specimens was 87％-100％ at the nucleotide level and 93.7％ -100％ at the amino acid level.These G gene sequences were combined with reference sequence from GenBank and used to construct a phylogenetic tree.The results showed that 43 specimens were all assigned to China clade I and clade Ⅱ,with all specimens from emerging and re-emerging areas placed within clade I.Specimens isolated from Shanxi and Inner Mongolia in 2011 were distinct from previously-isolated local strains and had closer homology to strains from Hebei,Beijing and Tianjin whereas new isolates from Shanghai were tightly clustered with strains isolated in the 1990s.Finally,Shaanxi isolates were clustered with strains from adjacent Sichuan.Our results suggest that the rabies cases in emerging and re-emerging areas in China in the last 5 years are a consequence of the epidemic spreading from of neighboring provinces and regions experiencing a serious epidemic of rabies.

Objective:To investigate whether chemokine like factor (CKLF)-like myelin and lympho-cyte and related proteins for vesicle trafficking and membrane link (MARVEL)transmembrane domain-containing protein 2 (CMTM2)is involved in spermatogenesis in varicocele induced sub-fertility rats and to discuss the possible mechanisms.Methods:Forty male SD rats (body weight:220 -330 g,age:6 -7 weeks)were randomly divided into 4 groups:varicocele for 4 weeks,varicocele for 12 weeks,sham operation for 4 weeks and sham operation for 12 weeks,with 10 rats in each group.These rats were intro-duced by partially ligating left kidney veins for the experimental groups,and the sham surgery groups as controls were executed with exactly the same surgery as in the experimental groups except for the ligation. The rats in control and experimental groups for 4 and 12 weeks were killed after laparotomy at the end of 4 and 12 weeks,respectively,the left testes and epididymis were taken out for counting the sperm,ob-serving the seminiferous tubule change and immunochemistry for CMTM2.The changes included sperm density and motility,the outer diameter and inner diameter change and the changes of epithelium and the CMTM2 expression in immunochemistry.Results:Compared with the control groups,the sperm density [(63.9 ±7.1)×106 /mL vs.(74.3 ±5.0)×106 /mL]and motility[(58.7% ±7.9%)vs.(66.1% ± 4.3%)]were reduced slightly in group of varicoele for 4 weeks,respectively (t =1.432,1.563;P =0.076,0.059,respectively ).Varicocele significantly caused a decrease in sperm concentration [(40.5 ±7.2)×106 /mL vs.(71.1 ±4.5)×106 /mL]and motility [(35.2% ±8.5%)vs.(63.4% ± 4.1%)]at 12 weeks,compared with the related sham groups (t =3.754,3.933;P =0.004,0.002, respectively).Additionally,testis CMTM2 exhibited the same disparity,that is,the CMTM2 protein ex-pression in varicocele group was significantly reduced,with the ratio of sham group to varicocele group at the end of 12 weeks 2.3 ±0.4 (t =1.978;P =0.039).In the evaluation of seminiferous tubules diame-ter,the external [(198.2 ±10.2)μm vs.(255.8 ±12.7)μm,t =2.125,P =0.003]and epithelium diameter [(54.1 ±1.5)μm vs.(75.5 ±4.1)μm,t =2.246,P =0.021]were decreased compared with the sham-related groups and previous varicocele groups.In all the varicocele groups,all types of sperm motility decreased compared with the related sham-operated group (P <0.05).Conclusion:This study suggests varicocele has a detrimental effect on CMTM2 levels and decreases spermatogonia cell number,seminiferous tubules diameter,and sperm indices.CMTM2 is associated with sperm changes in rats with varicocele,and further studies are needed to study the mechanism.

Objective To evaluate the health-related quality of life (HRQOL) for prostate cancer patients receiving androgen deprivation therapy (ADT).Methods We studied 200 patients with prostate cancer who were treated with primary ADT in Peking University People's Hospital from June 2014 to June 2015.The patients'average age was 73.9 years.The mean PSA level was 21.57 ng/ml when they were diagnosed with prostate cancer.Of these 200 patients,79％ (158/200) were localized and seclected ADT therapy due to age,body condition,basic diseases or individual will.21％ (42/200) were locally advanced or metastasic,which accord with the indication of ADT therapy.The scales,including the MOS item short from health survey (SF-36),Functional Assessment of Cancer Therapy-General module (FACT-G),Functional Assessment of Cancer Therapy-Prostate instrument (FACT-P),Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS) were used to evaluate their HRQOL.Results According to results of SF36,the physical health component score and mental health component score was 67.41 ± 16.39 and 64.81 ± 17.51,respectively.They indicated that the overall quality of life of these patients was at an acceptable level.And the average score of all domains exceeded 60 except general health domain,which the score was only 40.03 ± 21.89.When it comes to FACT-P,the sum score,emotional well-being score and prostate cancer component score were 8.15 ± 3.72,12.30 ± 4.04 and 77.41 ± 9.95,respectively,which were less than half of their respective top score.However the physical well-being score was 20.41 ±4.29,which was a relatively satisfactory value.In addition,61％ (121/200) patient selected not at all in item I am able to have and keep an erection.The score of SDS and SAS was 46.76 ± 8.29 and 43.25 ±9.69,respectively.And there were 23.0％ (46/200) and 21.5％ (43/200) patiens exhibited depression and anxiety,respectively.Conclusion In the present study,the prostate cancer patients receiving ADT showed acceptable HRQOL,but some patients sufferd from depression,anxiety and erectile dysfunction.

Objective: To study the expression of transmembrane protein CMTM2 in the testis and sperm of adult males and to approach the potential function of the protein in the male reproductive system.Methods: The expression of CMTM2 in human testis and sperm was confirmed by Western blot.Immunohistochemical staining was used for detecting CMTM2 localization in the testis tissue, TRITC-CMTM2 and FITC-Hoechst double immunofluorescence staining was performed to examine the subcellular localization of CMTM2 in the human sperm before and after acrosome reaction, that is, immunofluorescent staining was used for detecting CMTM2 localization in both the testis and sperm before and after the acrosome reaction.Results: CMTM2 was presented in both human testis and sperm.In the testis, CMTM2 immunoreactive particles were observed mainly in the membrane of the different stages of spermatogenic cells.In the human sperm, its immunoreactivity was restrictively localized to the posterior head where sperm-egg fusion occurred, and the CMTM2 localization was not affected by sperm acrosome reaction.CMTM2 was widely expressed in seminiferous tubules of the human testis, mainly in the cell membranes of spermatogenic cells, which was consistent with the previous reports.The immunofluorescence performed on frozen human testis slides showed similar findings with immunohistochemistry, which gave weight to the localization of CMTM2 in the cell membranes of spermatogenic cells at different stages.TRITC-CMTM2 and FITC-Hoechst double immunofluorescence staining was performed to examine the subcellular localization of CMTM2 in the human sperm before and after acrosome reaction.CMTM2 was localized at the posterior head of sperm before and after acrosome reaction.The localization and expression of CMTM2 were not affected by sperm acrosome reaction.Conclusion: Expression of CMTM2 in the male reproductive system of the adult human exhibits cell-and region-specific patterns, which suggests that they may play an important role in spermatogenesis and sperm-egg fusion.The expression of CMTM2 in the male reproductive system of the adult human exhibits cell-and region-specific patterns, which suggests that they may play an important role in spermatogenesis and sperm-egg fusion.However, it still remains to be further elucidated about the definite role of CMTM2 in male reproductive system and the process of spermatogenesis.And in vitro fertilization experiments are needed to confirm the role of CMTM2 in fertilization in future.