Bacterial resistance to antibiotics is currently a serious health concern.According to the data from the surveil-lance of bacterial resistance in China ( CHINET) ,the isolation rates of gram-negative bacteria have been rising annually. Among the gram-negative organisms, the isolation rate of Carbapenem-resistant enterobacteriaceae, especially extensive drug-resistant strains,has been increasing rapidly.The isolation rate of extensive drug-resistant or pandrug-resistant non-fermenting bacteria,es-pecially Acinetobacter baumanii,is still relatively high.These extensive drug-resistant gram-negative bacteria cause high mortality, which has drawn great attention in clinical settings.On the part of multidrug-assistant gram-positive bacteria,the isolation rate of vancomycin-resistant enterococci remains stable but rates of methicillin-resistant Staphylococcus aureus and coagulase-negative staphylococci are still high.Staphylococcal strains have not yet been found resistant to vancomycin in China.Understanding the epi-demiology of local drug-resistant bacteria facilitates the development of appropriate antibiotic strategies. The mortality of patients with severe infection may be improved by early use of antibiotics and appropriate de-escalation therapy.Rational use of antibiotics and recognition of the influence factors,such as antibiotic-induced endotoxin release,may maximize the efficacy of antibiotics and minimize the adverse reactions.

Objective: To explore the effect of schisandrin B (SchB) on P21 and Caspase-3 expression in cisplatin induced human proximal renal tubular epithelial (HK-2) cells injuried by CDDP in vitro. Methods: HK-2 cells were randomly divided into five groups: control group (untreated), CDDP group (treated with 50 μmol/L CDDP for 24 h), SchB pretreat groups (CDDP + SchB, cells were pretreated with 5, 10, and 20 μmol/L SchB for 2 h, and the rest of the operation was the same as CDDP group). CCK-8 kit was used to detect the cell viability of five groups. Flow cytometry was used to detect the apoptotic rate of five groups. The morphology of cells was observed by inverted microscope. The protein expression of P21 and Caspase-3 was assessed by Western blotting assay. Results: Compared with the control group, the cell viability decreased, and the apoptosis increased, the protein expression of P21 and Caspase-3 was up-regulated in HK-2 cells after treated with 50 μmol/L CDDP. Cell volume was reduced, and the mutual connection disappeared. Compared with the CDDP group, the cell viability increased and the apoptosis was decreased, the expression of Caspase-3 was down-regulated and the expression of P21 was up-regulated in HK-2 cells after pretreated with 5, 10, and 20 μmol/L SchB. Cell morphological damage lightened, the volume slightly decreased, and the mutual connection reduced. Conclusion: SchB has a protective effect on HK-2 cells damage induced by cisplatin. The mechanism may be related to up-regulation of P21 and down-regulation of Caspase-3 expression, and its protective effect is dose dependent.

Objective To explore the curative effect of traditional Chinese herbal packet combined with ST 36 injection therapy on gastrointestinal dysfunction in severe patients. Methods Sixty severe patients with gastrointestinal dysfunction were randomly divided into the control group and treatment group with random digital number, 30 cases in each group. The control group received conventional care and besides conventional care , the treatment group was treated with traditional Chinese herbal packet combined with ST 36 injection. The two groups were compared 7 days after treatment in terms of scores by (acute physiology and chronic health evaluationⅡ, APACHEⅡ) and improvement of gastrointestinal dysfunction. Result After treatment, the APACHE II score and improvement of gastrointestinal dysfunction of the treatment group were significantly higher and better than those of the control group (P<0.05). Conclusion The traditional Chinese herbal packet combined with ST 36 injection can promote the recovery of gastrointestinal dysfunctional in severe patients.

Objective To evaluate the efficacy and safety of radioactive 125 I seed implantation combined with paclitaxel (PTX) for treating senile non‐small cell lung cancer(NSCLC) .Methods The clinical data in 35 patients with NSCLC in our hospi‐tal from June 2013 to August 2014 were retrospectively analyzed ,including 12 cases receiving the lung tumor radioactive 125 I seed implantation therapy(group A) ,10 cases treated with PTX combined with cisplatin (TP scheme)after receiving radioactive 125I seed implantation therapy(group B) and 13 cases only conducted TP scheme(group C) .The 21 d chemotherapy was a evaluation cycle . The adverse reactions were evaluated after 1 cycle and the curative efficacy was evaluated after 2 cycles .Results Thirty‐five cases were followed up for 6 months .The adverse reactions could be evaluated in all the cases .The short‐term efficacy could be evaluated in 34 cases .The group A had no obvious adverse reactions ,the main adverse reactions in the group B and C were bone marrow sup‐pression and digestive tract reactions without statistically significant differences (P> 0 .05) .The effective rates after 4 cycles of chemotherapy in the group A and B were 66 .7% and 80 .0% ,the clinical benefit rates were 83 .3% and 90 .0% respectively ,which were higher than 23 .1% and 53 .8% in the group C respectively ,the differences were statistically significant ( P< 0 .05 ) . Conclusion Radioactive125 I seed implantation therapy and PTX combined with radioactive 125 I seed implantation for treating senile early NSCLC are superior to the simple PTX chemotherapy ,which have high effective rate and benefit rate ,safety ,mini‐invasion and mild adverse reactions ,and can increase the patient′s living quality .

Objective To investigate the biofilm formation,the alginate biosynthetic gene ex- pression and analyze the mucA gene sequence of mucoid Pseudomonas aeruginosa PA17 and nonmu- cold Pseudomonas aeruginosa PA01.Methods The modified plate culture method was used to estab lish the biofilm model in vitro.Semi-quantitative RT-PCR was used to determine the expression level of algD in planktonic condition and during the formation of biofilm.The mucA gene of PA17 and PA01 was amplified and the products were sequenced.Results PA17 biofilm was mature at 6th day, and PA01 biofilm was mature at 3rd day.The structures of the biofilms were both like pellicle.In planktonic condition,the algD expression of PAl7 was higher than PA01;in biofilm formation,the algD expression was maximal when the biofilm was mature.There was a 166～333 deletion mutation and 342A→G in mueA gene of PA17,the mucA gene of PA01 was the same with the sequence of Genbank.Conclusions The mucA gene mutation of PA17 was a new type,which maybe the reason for the little expression difference of algD between PA17 and PA01 during the biofilm formation than it in planctonic condition and the same structure of PA17 and PA01 biofilm.

The treatment effect of primary and metastatic hepatic carcinoma after local intervention?al therapy is closely related to the prognosis of patients. Traditional imaging modalities such as CT, MRI and ultrasound can only provide anatomical information in monitoring treatment response. In recent years, PET/CT has been widely used in monitoring treatment response for tumors. Many studies have compared the effi?cacy of PET/CT with that of traditional imaging modalities in monitoring the response of primary and meta?static hepatic carcinoma after interventional therapy. This review summarizes recent progress in this field.

Objective:To obtain mutA gene of Strepto c occus mutans (Ms),and to express it in E.coli DH5?.Methods: mutA gene was amplified by PCR with specific primers from genome of Ms CH43 strain. After sequencing, the gene segment was inserted into vector pProEX and expressed in E.coli DH5?.The protein expression was induced by ITPG an d the protein products were examined by 180 ml/L SDSPAGE electrophorosis. Results:The length of PCR product was 147 bp and was identical to mu tA gene reported by GenBank.The mutA gene product was expressed in E.col i DH5? with Mr of 5.7?10 3.The maximum mutA protein product amount (20% of the total bacterial protein) was obtained when the A 600 value of DH5? was 1.666,IPTG concerntration 1.0 mmol/L and induction time 6 h.Conclus ion:mutA of Ms CH43 can be cloned and expressed in E.coli DH 5?.

Objective To explore neurobehavioral changes in rats with recurrent seizures and the prevention effect of melatonin.Methods 6-day-old (P6) SD rats were randomly divided into four groups of 24 (n =6):the control group (CONT),melatonin per se group (MEL),recurrent neonatal seizure group (RS) and melatonin administration prior to RS group (RS + MEL).Rats in RS group were subjected to 5 seizures with flurothyl during the first 14 days of life.In RS + MEL group,melatonin was injected at 8:00 before seizures were induced.Neurobehavioral tests including Plane righting experiment,Cliff avoidance test,the grip-strength test and negative geotaxis test were implemented on P24,while open field test on P35.Results (1) Plane righting experiment:the time of plane righting in RS group ((0.33 ± 0.51)s) was significantly shorter than that in the CONT group ((1.17 ± 0.40) s) and RS + MEL group ((0.50 ± 0.54) s) (P ＜ 0.05).(2) Cliff avoidance test:the time of cliff avoidance in RS group ((16.00 ± 6.32) s) was significantly longer than that in CONT group ((4.00 ± 2.60) s)(P ＜ 0.01),while the time of cliff avoidance in RS + MEL group ((7.67 ± 3.26) s) was shorter than that in the RS group (P ＜ 0.05).(3) The grip-strength test:compared with CONT group ((49.50 ± 28.96) s),the time needed to hold on wire in RS group((11.67 ± 7.58)s)was significantly shorter (P ＜ 0.05) and longer in RS+ MEL group ((24.83 ± 6.61) s) (P ＜ 0.05).(4) Negative geotaxis test:the time for rats to turn 180° upward in RS group((7.67 ± 1.36) s) was longer than that in the CONT group ((4.50 ± 2.66) s) and RS + MEL group ((6.17 ± 0.75) s) (P ＜ 0.05).(5) Open field test:the time for rats to begin to run in the RS group ((8.17 ± 3.86) s) was longer than that in the CONT group ((3.00 ± 1.41) s) (P ＜ 0.05).Conclusion The neurobehaviors are damaged following flurothyl-induced recurrent neonatal seizures,and melatonin can reduce the neurobehavioral injury.