Objective To clarify the clinical distribution and antimicrobial resistance characteris-tic of bacterial biofilm during catheter-associated urinary tract infection,and to simulate biofilm "real state" in vivo. Methods Totally 120 patients with catheter-associated urinary tract infections (UTIs) were enrolled in the study. The urine specimens were collected for screening biofilm strains and the corresponding planktonic strains. The biofilm was detected with semi-quantitative detecting method. Antibiotics susceptibility test were performed on the biofilm bacteria to clarify the difference of drug resistance in common MH medium the between biofilm strains and the corresponding planktonic strains,as well as the difference of drug resistance of positive strains of the biofilm between Poloxamer medium and common MH medium. Results Totally 48 strains (48/120,40%) of biofilm bacteria were detected. The antibiotic susceptibility test of planktonic and biofilm bacteria in Mueller-Hinton agar showed no significant difference (P>0.05), while the antibiotic resistance of biofilm bacteria in Muel-ler-Hinton agar and Poloxamer hydrogel was statistically different (P<0.05),and the former was stronger. Conclusion The biofilm bacteria during the urinary tract infection were mainly Staphylococci and Enterococci. The antimicrobial resistance of planktonic and biofilm bacteria have no significant difference in vitro, h is speculated that Poloxamer media may simulate the real living environment of biofilm bacteria and display their "true" drug resistance.

Objective To investigate the association of esp, gelE, ebpA and QS-fsr system and biofilm formation in Enterococcus faecalis. Methods Totally 24 isolates of Enterococcus faecalis were collected from urine and catheter of clinical urine tract infection patients in Third Xiangya Hospital from Oct. 2007 to Jun. 2008, and were divided into biofilm group and non-biofilm group. The luminance ratios of esp, gelE, ebpA and fsrrB of Enterococcus faecalis in biofilm group and non-biofilm group were detected by RT-PCR. And the expression of esp, gelE, ebpA, fsrrB genes in different groups were detected by real-time PCR and were relatively quantitated through 2-△△Ct method. Moreover, the relevancies between that fourgenes and biofilm formation in Enterococcus faecalis were analyzed respectively. Results The expression of esp and ebpA in biofilm group were 298 times and 59 times more than the non-biofilm group. The expression level ofgelE and fsrB in biofilm group were 1/244 and 1/249 times less than the non-biofilm group, and the luminance ratios of esp, gelE, ebpA and fsrB were not significant between the two groups (rank sum was 92,79, 42 and 34 respectively,all P ＞ 0. 05 ). Conclusions The results showed that the biofilm formation in Enterococcus faecalis was promoted by esp and ebpA, and was inhabited by gelE and fsrB, which suggested that the expression of esp, ebpA and gelE genes was regulated by fsr system.

Objective To investigate the effect of Ambroxol on NF?B activation of macrophage in the induced sputum in patients with stable COPD.Methods Induced sputum was taken from 47 stable COPD patients,who were divided into two groups randomly.Macrophages were collected,and NF-?B activation and IL-8 of induced sputum were determined by immunohistochemistry;SOD and MDA were determined synchronously.Results NF-?B activation in macrophage and IL-8 in the treated group were significantly decreased in patients of stable group than those in the controls.Conclusion Ambroxol can decrease NF-?B activation in macrophage in stable COPD patients.

Objective To discuss the role of IL-8 and NF-?B in the airway inflammation of COPD in stable stage.Methods From Mar.2003 to Sep.2005,select 26 COPD patients in stable stage,determine the concentration of IL-8 in the serum of induced sputum,separate the macropolycyte and determine the degree of active expression of NF-?B,the concentration of SOD,MDA and IL-8 in peripheral blood.Lung function(the percent of FEV_1/FEV_1 prospectived value,FEV_1/FVC)of all patients were investigated.Results The concentration of IL-8 in the serum of induced sputum of COPD patients was higher than the normal group obviously(P

Objective To investigate the efficacy of interferon alpha (IFNα) plus adefovir dipivoxil (ADV) and tebivudine (LdT) monotherapy for patients with HBeAg positive chronic hepatitis B (CHB) who have poor response to IFNα treatment.Methods A total of 86 HBeAg positive CHB patients admitted to the Sixth People' s Hospital of Shaoxing during February 2010 and April 2013 were enrolled in the study.All the patients received IFNα monotherapy for 24 weeks and had poor responses.The patients were voluntarily divided into three groups:IFNα monotherapy group (n =21),IFNα plus ADV group (n =30) and LdT monotherapy group (n =35).Chi-square test was used to compare ALT normalization rates,rate of HBV DNA load ＜ 500 copies/mL,HBeAg seroconversion and HBsAg seroconversion rates among three groups.Results After 48 weeks of treatment,the ALT normalization rate in IFNα monotherapy group was 52.6％ (10/19),which was lower than those in IFNα plus ADV group (86.7％,26/30) and LdT monotherapy group (84.8％,28/33) (x2 =6.913 and 6.361,P ＜ 0.05).The rate of HBV DNA load ＜500 copies/mL in IFNα monotherapy group was 26.3％ (5/19),which was lower than those in IFNα plus ADV group (60.0％,18/30) and LdT monotherapy group (54.5％,18/33) (x2 =11.33 and 3.895,P ＜0.05).No HBeAg negative conversion or seroconversion was observed in IFNα monotherapy group,but it was observed in 6 (20.0％,6/30) patients in IFNαt plus ADV group and 7 (21.2％,7/33) patients in LdT monotherapy group (x2 =4.330 and 4.657,P ＜ 0.05).No HBsAg seroconversion was observed in three groups.There were no statistical significant differences in ALT normalization rates,rate of HBV DNA load ＜ 500 copies/mL,HBeAg seroconversion and HBsAg seroconversion rates between IFNαt plus ADV group and LdT monotherapy (x2 =0.042,0019 and 0.064,P ＞ 0.05).Conclusion For patients with HBeAg positive CHB who had poor response to IFNα treatment,IFNα plus ADV therapy and LdT monotherapy have the same efficacy in improvement of both liver function and virological response.

Objective To evaluate the application value of UF-1000i automated urine formed elements analyzer in the diagnosis of urinary tract infection. Methods 150 urine specimens were analyzed using the UF-1000i in parallel with detection of leukocyte, yeast-like fungus, and bacteria. These detection results were collected for evaluation of urinary tract infection and scatter grams were recorded. At the same time, these samples were cultured for bacterial identification, which results were compared with that of the UF-1000i. The clinical diagnose criteria of the UTI was performed as golden standard. As compare with results obtained with UF-1000i, the sensitivity and specificity of UF-1000i for diagnosis of urinary tract infection were evaluated, and the consistency were analyzed among scatter grams, bacterial culture and final diagnosis. Results The statistical results from 146 specimens showed that the positive rate of UF-1000i was 32. 9% (48/146), the positive rate of urine culture is 28. 8% (42/146). There was no significant statistical difference found (χ2 = 1.79 ,P = 0. 18 )and Kappa test showed a considerable consistency (K = 0. 775 6). The UF-1000i detection results showed the sensitivity 76. 0% ( 38/50 ), specificity 89. 6% ( 86/96 ), positive predictive value 79. 2% ( 38/48 ) and negative predictive value 87. 8% ( 86/98 ), respectively. The distribution of coccus and bacilli obtained from the UF-1000i testing was basically in accordance with the results of bacterial culture. Conclusion The "UTI-information" of UF-1000i is very important for the diagnosis of urinary tract infections.

Objective To explore the value of multi-model reconstruction of 16-slice spiral CT in diagnosis of rib fractures.Methods 16-slice spiral CT volumetric scanning was performed in 72 patients with rib fracture proved by clinical,all images were reconstructed in thin slice and transferred into ADW4.1 workstation.Images such as multiplanar reconstruction(MPR),maximum intensity projection(MIP)and volume rendering(VR)were performed,then the reconstructed images of injured ribs were observed and analyzed by two experienced radiologists and compared with radiographs.Results In 72 cases,there were 217 rib fracture and 7 costal cartilage fracture depicted on MSCT.The location and number of fracture and displacement of fracture could be showed clearly on images of multi-model reconstruction.VR images were betten in demonstration of the anatomical structure,MPR images were better to show the minor lesion of rib fracture,MIP was the best imaging method in detecting the costal cartilage fracture,while axial image was the basic CT scanning section.Radiographs revealed 169 rib fractures but no costal cartilage fracture.Conclusion 16-slice spiral CT of multi-model reconstruction is superior to radiography in diagnosis of rib fracture and costal cartilage fracture.But the combinalion of various reconstruction techniques should be acquired.

This paper reports 17 cases of hypomagnesemic convulsiens of the newhorn that were admitted from Se-Ptember 1981 to January 1983. Only 2 patients were breast-fed.Symptoms and signs of hypomagnesemia are indistinguishable from these of hypocalcemia unless the serum magne-sium is determ ined. Serum magnes iumlevels had been determined in 50 normal children. The average value-2 standard deviation=2.17-2?0.34=1.49mEq/L.We defined hypomagnesemia as the serum magnesium lcvels below 1.48mEg/L. The serum magnesium levels of 17 patients varied from 0.65 to 1.46m Eq/L. Of 10 cases serum calcium le-vel6mg/dl.2.5%MgSO_4 was given intraveno-usly by continuous infusion in a dose of 2-4ml/kg every 12 hours. After the convulsions had been controlled a dose of 25% MgSO_4 was given intramuscul-arly in a dose of 0.4ml/kg twice daily Convulsions usually ceased after 1--4doses of MgSO_4, but the serum magne-sium levels did not rise to normal le-vels until 2-6 days. The convulsions could not be controlled by repeated ad-ministrations of calcium gluconate in 5 patients who had both hypomagnes-emja and hypocalcemia. Only after theadministiation of MgSO_4 did the serum calicum levels rise to the normal level and the convulsions cease.Electrocardjograms recorded in 7 patients all were abnormal but 1 case,so we should pay attention to the inf-luence of magnesium upon the heart.

Objective To investigate the serum cystatin C (CysC) level and explore its relationship with cytokines and atherosclerosis (AS) in maintenance hemodialysis (MHD) patients.Methods A total of 110 stable MHD patients undergoing hemodialysis for at least six months and 60 healthy control people were enrolled in the study.Serum levels of CysC and high-sensitivity Creactive protein (hsCRP) were measured by immunoturbidimetry.The serum levels of total homocysteine (tHcy),IL-1β,IL-6 and TNF-α were determined by ELISA.Prevalence of atherosclerosis was detected by carotid ultrasonography.The relationship of CysC level and cardiac geometry incidence in MHD patients was analyzed by Logistic regression model.Results The serum CysC level was significantly higher in MHD patients as compared with healthy controls [(6.19±0.95) mg/L vs (0.76±0.21) mg/L,P＜0.01],and the serum levels of hsCRP,tHcy,IL-1β,IL-6,TNF-α were significantly higher in MHD patients than those in healthy control group (P＜0.05 or P＜0.01).The serum CysC level was higher in MHD patients with carotid artery atherosclerosis compared to patients without carotid artery atherosclerosis (P＜0.05).CysC was positively correlated with hsCRP,tHcy,IL-1β,IL-6,TNF-α respectively (P＜0.05 or P＜O.01),and was positively correlated with carotid intimal medial thickness (IMT) and AS.Besides,a negative correlation was found between the serum CysC level and the serum albumin level (P＜0.05),while CysC was positively correlated with dialysis duration,systolic pressure and iPTH (P ＜0.05).Conclusion Serum CysC level is significantly higher in MHD patients and is correlated with hsCRP,tHcy,IL-1β,IL-6,TNF-α as well as carotid artery atherosclerosis,which indicates that CysC is an independent risk factor of AS in MHD patients.

Objective To investigate the effects of trimetazidine on the oxidative stress in maintenance he-modialysis (MHD) patients. Methods Eighty-six MHD patients and 30 healthy volunteers were recruited in the study. The activity of glutathione peroxidase (GSHPx) was measured by colorimetry and superoxide dismutase (SOD) in serum was measured by hydroxylamine method. The levels of serum malondialdehyde (MDA) were meas-ured by thiobarbituric acid reaction. Serum advanced oxidation protein products (AOPP) levels were measured by enzyme-linked immunosorbent assay (ELISA). All MHD patients were randomly divided into two groups, treatment group (n = 46) and control group (n = 40), who had undergone hemodialysis for at least three months before the study and were in a stable clinic status without signs of infection or disease activity. In the treatment group,20 mg of trimetazidine was taken orally three times each day for twenty-four weeks, when the parameters for oxidative stress were studied. The levels of GSHPx. SOD, MDA and AOPP in serum were measured before and after the treat-ment. Results At the initiation of the investigation, the serum levels of GSHPx [(584.37±215.70) μmol/L, (580.87±309.12) μmol/L vs (769.06±302.46) μmol/L] and SOD [(347.87±82.09) kU/L, (348.16±75.33) kU/L vs (428.34±15.23)kU/L] in the M HD patients were significantly lower than those in the normal eontrol group (P < 0.01), whereas the content of MDA [(4.94±1.32) nmol/L, (4.97±1.61) nmol/L vs (3.56±0.46)nmol/L] and AOPP [(120.95±59.24) μg/L,(121.76±69.12) μg/L vs (47.69±20.15) μg/L] in MHD patients was higher than those in the control group( P < 0.05 and P <0.01, respectively). After treatment for twelve weeks, the scores of GSHPx and SOD were significantly increased in the treatment group compared to that before treatment (P <0.01). However, the contents of the MDA and AOPP decreased. There were significant differences in the levels of GSHPx, SOD,MDA and AOPP between the two groups of MHD patients after the treatment with trim-etazidine. Conclusions Trimetazidine in maintenance hemodialysis patients appears to be associated with an im-provement of oxidative stress.