Objective The distribution and drug resistance of Klebsiella pneumonia isolated from clinical department were ana‐lyzed in this article .It will provide evidence for the clinical rational medication and the control of nosocomial infections .Methods In this hospital ,892 strains of Klebsiella pneumonia isolated from January 2011 to December 2013 were performed a statistical analy‐sis .Results Among all the samples ,the extended spectrumβ‐lactamases(ESBLs) positive Klebsiella pneumoniae accounted for 40 . 92% .The highest detection rate in the all the clinical department is the ICU with a value of 46 .46% .The highest detection rate in the sample is the sputum with a value of 43 .51% .In addition ,the ESBLs positive strains had a trend of multiple drug resistance . The Klebsiella pneumonia was the most sensitive bacteria to imipenem ,meropenem ,piperacillin/tazobactam and cefoperazone/sul‐bactam ,no matter whether they produced ESBLs or not .Conclusion The resistant rate of ESBLs positive strains is higher than that of ESBLs negative strains .It was recommended to the rational use of antibiotics based on the duration of disease and the products with or without ESBLs .Furthermore ,it will be of great importance to reduce the incidence of multiple drug resistance ,and to con‐trol the hospital infection effectively .

After a description of the basic situation of medical literature retrieval course for foreign undergraduates studying in Sun Yat-sen University, the problems in their teaching contents and teaching methods were pointed out with measures proposed for improving the teaching of their medical literature retrieval course.

Objective To investigate the change in intracranial pressure (ICP) during induction of anesthesia with fentanyl, propofol and succinylcholine in neurosurgical patients by measuring cerebral spinal fluid (CSF) pressure at the level of lumbar spine.Methods Twenty ASA Ⅰ or Ⅱ patients (9 males, 11 females) aged 24-54 yrs scheduled for elective craniotomy for intracranial tumor were included in this study. Lumbar puncture was performed at L2,3 or L3,4 interspace with an epidural needle through which an epidural catheter was placed in the subarachnoid space to allow measurement of lumbar CSF pressure. Anesthesia was induced with fentanyl 2-3 ?g?kg-1 followed by propofol 2 mg?kg-1 and succinylcholine 1.5 mg?kg-1. CSF pressure was recorded before induction of anesthesia (baseline value), at 5 min after intravenous fentanyl injection, 1, 2, and 3 min after propofol injection, during fasciculation of muscle and immediately after intubation.Results CSF pressure was significantly decreased at 1, 2 and 3 min after i.v. propofol and during muscle fasciculation. The CSF pressure was lowest at 3 min after propofol injection. Tracheal intubation did not result in significant increase in CSF pressure as compared with the baseline value before induction. Conclusion Intracranial pressure is decreased during induction of anesthesia with fentanyl, propofol and succinylcholine in neurosurgical patients and the adverse effect of tracheal intubation on ICP is effectively blunted.

Objective To investigate the correlation between PaCO2 and cerebral blood flow (CBF), cerebral metabolism of oxygen (CMRO2), glucose (CMRglu) and lactate (CMRlact) and intracranial pressure during intracranial surgery. Methods Twenty ASA Ⅰ - Ⅱ patients (6 male, 6 female), aged between 26-54yr, weighing (65 ? 11) kg scheduled for elective intracranial surgery were studied. The patients were unpremedicated. Before general anesthesia radial artery was cannulated and a catheter was inserted into internal jugular vein and advanced cranially until jugular bulb. Lumber puncture was performed at L3-4 and a catheter was inserted into subarachnoid space for 3 cm, for pressure monitoring and CSF sampling. Anesthesia was induced with diazepam 10mg, fentanyl 3-4?g?kg-1, propofol 2mg?kg-1 and vecuronium 0.08mg?kg-1 iv. The patients were mechanically ventilated with a mixture of oxygen and argon (O2 : argon = 3 : 1) after tracheal intubation. Anesthesia was maintained with sevoflurane and intermittent iv boluses of vecuronium. Arterial and cerebral venous blood gases, glucose and lactate levels, CBF, ICP and CSF level of lactate were determined before anesthesia when patients were awake(Ⅰ) and during anesthesia when PETCO2 = 40, 30, 20 mm Hg (Ⅱ,Ⅲ,Ⅳ). CBF was measured by modified Kety-Schmidt inert gas saturation technique with argon. CMRO2 and CMRglu were calculated based on the difference in their arterial -cerebral venous blood levels. Results At PETCO2 20mm Hg (Ⅳ) CBF decreased by 57.75% and CMRO2 by 58.70% as compared with the baseline; CMRglu decreased by 46.93% as compared with the baseline. There was no significant change in lactate level, jugular venous blood O2 saturation and pH. ICP decreased from (22.14 ? 7.88)mm Hg( Ⅰ) to (17.57?5.03)mm Hg( Ⅱ ),(13.43?4.89)mm Hg(Ⅲ) and (10.00? 2.31)mm Hg(Ⅳ) and the differences were significant. All measurements were done when MAP and HR were stable. PET CO2 was (10? 2) mm Hg lower than PaCO2 . Conclusions Cerebral blood flow, cerebral oxygen and glucose metabolism and intracranial pressure change with changes in PET CO2 . Cerebral vascular reactivity to CO2 is not impaired by 1.3 MAC sevoflurane. Mild hypocapnia is necessary during neurosurgery.

Objective Intestinal subepithelial myofibroblasts(ISEMFs) exist throughout the gastrointestinal tract. Due to their ability to secrete cytokines, prostaglandins, growth factors, and extracellular matrix proteins, they are thought to play critical roles in inflammation, repair, fibrosis and neoplasia. The goal of this study was to investigate the relationship between ISEMFs and ulcerative colitis by establishing the method of ISEMFs detection from the biopsy specimens. Methods ISEMFs in colon biopsy specimens (15 from active ulcerative colitis patients and 20 from controls) were detected by immunohistochemistry with smooth muscle actin monoclonal antibody. Results ISEMFs existed in a subepithelial location of colon, were located in the basement of epithelial, and were oval or scaphoid in appearance. ISEMFs in active ulcerative colitis (71.3?9.1) were more than those in controls (56.3?6.9) per field of high power ( P

Objective To investigate the feasibility of L-[1- 13 C]phenylalanine breath test to assess liver function and determine the effective parameters of the test for quantitative assessment of liver function in adult. Methods Twelve healthy volunteers served as control group, and 26 liver cirrhotic patients with hepatitis B were divided into three groups, 10 patients in Child-Pugh classification A, 8 in B and 8 in C, An oral dose of 100 mg of nonradiative tracer L-[1- 13 C]phenylalanine were administered to all the subjects. Breath samples were taken before and different intervals within 360 min after administration. 13 CO_2 enrichment was measured by isotope ratio mass spectrometer. Results After the oral administration of L-[1- 13 C] phenylalanine, 13 C excretion reached a peak within 10-30 min. The parameters of 13 CO_2 excretion rate at 30 min ( 13 CO_2ER_ 30 ) , 13 C cumulative excretion of 60 min ( 13 C_ cum60 ), 75 min( 13 C_ cum75 ), 90 min( 13 C_ cum90 ) and 13 CO_2 half excretion time ( t _ 1/2 ) were shown sensitive, which could differentiate significantly the groups( P

Objective To detect the changes of serum integrinβ4 level during both exacerbation and clinical remission of asthmatic patients, and observe the correlation between the changes and balance of Th1/Th2,and to explore the relationship between integrinβ4 and the immune function in asthmatic patients.Methods Thirty?five cases patients who were hospitalized in the Seventh People's Hospital of Shenzhen from May 2013 to June 2015 were collected into this study.Serum interleukin?4(IL?4),interferonγ(IFN?γ),and integrinβ4 were measured with ELISA and western?blotting methods during both exacerbation and remission of asthmatic patients. Then the level of IL?4, IFN?γand integrinβ4 of the two groups were compared. Results The level of serum integrinβ4 protein in the remission stage of asthma was significantly higher than that in the acute attack period, and the difference was statistically significant(0.633±0.032 vs. 0.375±0.107,t=3.31,P<0.01).The level of ser?um IFN?γ in the remission stage of asthma was significantly higher than that in the acute attack period,and the difference was statistically significant((49.3±6.4) g/L vs. (16.7±7.2) g/L,t=3.11,P<0.05),and the level of IL?4 was (25.3±3.6) ng/L and (43.7±11.2) ng/L respectively,the difference between the two groups had sta?tistical significance(t=3.23,P<0.05).The serum level of integrinβ4 and IL?4/IFN?γratio were passively corre?lated(the acute attack period:r=0.749,P=0.05;the remission stage of asthma:r=0.745,P=0.015).Conclu?sion The serum level of integrinβ4 is passively related to IL?4/IFN?γ. Integrinβ4 may play an important role between immune function and the development in airway inflammation of asthmatic patients.

Objective To study the effect of bcl-2 antisense oligodexynucleotides on the apoptosis in human small-cell lung cancer cell line NCI-H69. Methods Cultured cells were divided into 4 groups: antisense oligodexynucleotides(ASODN), sense oligodexynucleotides (SODN), nonsense oligodexynucleotides (NSODN) and control.The different bcl-2 oligodexynucleotides was transfected into corresponding cells using oligofectamine.The expression of bcl-2 was examined by Western blot.The apoptosis rates were measured by flow cytometry (FCM).Results The bcl-2 expression in ASODN group was significantly inhibited compared to the control group, SODN and NSODN groups, but it was not obviously inhibited in SODN and NSODN groups.The apoptosis rate of ASODN group in different concentration was (9.97±1.54) %, (15.28±1.73) % and (21.41±1.85) % respectively, it was significantly higher than that of the control group (F = 7.19-15.48,q = 5.21-7.98, P ＜0.01). Conclusion The bcl-2 ASODN could enhance cell apoptosis rate in small-cell lung cancer by blocking bcl-2 gene effectively.

OBJECTIVE:To evaluate the clinical efficacy of Shuanghuanglian injection in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD),and to observe its effects on the plasma levels of C-reactive protein (CRP),procalcitonin(PCT)and interleukin-6(IL-6). METHODS:A total of 100 AECOPD patients were randomly divided into observation group and control group,with 50 cases in each group. Control group received routine treatment,such as controlled oxygen therapy,intravenous dripping of moxifloxacin,bronchodilator for relieving asthma,mucolytic for eliminating phlegm,nu-tritional support. Observation group was additionally given Shuanghuanglian injection 1 ml/(kg·d)added into 5% Glucose injec-tion 250 ml intravenously,qd,on the basis of control group. Treatment course of 2 groups lasted for 10 d. Clinical efficacies of 2 groups were compared as well as the changes of serum levels of CRP,PCT and IL-6 before and after treatment and the occur-rence of ADR. RESULTS:After treatment,total effective rate of observation group was 96.0%,which was significantly higher than 82.0% of control group,with statistical significance(P<0.05). Before treatment,there was no statistical significance in se-rum levels of CRP,PCT and IL-6 between 2 groups (P>0.05). After treatment,serum levels of CRP,PCT and IL-6 were de-creased significantly in 2 groups,and those of observation group were significantly lower than those of control group,with statis-tical significance (P<0.05). There was no statistical significance in the incidence of ADR between 2 groups (P>0.05). CON-CLUSIONS:Shuanghuanglian injection can effectively improve serum inflammatory factors of AECOPD patients,and shows good clinical efficacy and safety.

Objective To investigate the influence of alprostadil on renal function,oxidative stress,and immune function in early diabetic nephropathy patients.Methods Eighty-six cases of early diabetic nephropathy patients in our hospital during April 2013 to January 2016 were chosen as research subjects,all patients were divided into observation (n =43) and control (n =43) groups according to random data form.Patients in observation group received alprostadil combined with pioglitazone treatment and those in control group received pioglitazone treatment only,both lasted for one month.Before treatment,one month after treatment,renal function indices were detected;serum oxidative stress indices were detected by automatic biochemical analyzer;T lymphocyte subsets in peripheral blood were measured by flow cytometry.Results Before treatment,there were no significant differences in renal function,oxidative stress,immune function between two groups (P ＞ 0.05).One month after treatment,peripheral blood renal function indices such as blood urea nitrogen (BUN),estimated glomerular filtration rate (eGFR),and cystatin C (CysC) levels were lower in observation group than in control group,the level of serum albumin (Alb) was higher in observation group than in control group,the difference was statistically significant (P ＜ 0.05);semm oxidation indices malondialdehyde (MDA),and advanced oxidation protein products (AOPP) were lower in observation group than in control group,human antioxidant indices such as superoxide dismutase (SOD),and total antioxidant capacity (T-AOC) were higher in observation group than in control group,the difference was statistically significant (P ＜ 0.05);peripheral blood CD3 +,CD4 + T lymphocytes and the ratio of CD4 +/CD8 + were higher in observation group than in control group,CD8 +T lymphocyte level was lower in observation group than in control group,the difference was statistically significant (P ＜ 0.05).Conclusions Alprostadil can optimize the renal function and immune function in early diabetic nephropathy patients,reduce the degree of oxidative stress.