Objective To evaluate the effects of selected decontamination of the digestive tract(SDD) on intestinal derived endotoxmia,inflammation mediator and clinical outcome in patients of rheumatic heart disease undergoing valve replacement operation with cardiopulmonary bypass(CPB).Methods Thirty patients with CPB were randomly divided into control group(n=15) and treatment group(SDD group,n=15).The patients in control group routinely took preoperative preparation while those in treatment group orally administrated Tobramycin 100 mg,garlicin 40 mg and Lactulose 10ml three times per day in addition to routinely preoperative bowel preparation.The levels of endotoxin,D-lactate,TNF-? and complement 3 were measured at four time points of anesthetic induction,CPB end,2 h and 24 h after CPB.Results The level of D-lactate in the patients of SDD group was significantly lower than that of the control group at time points of anesthetic induction and 2 h after CPB(P0.05).Conclusion The endotoxemia can be induced by CPB.The regime of SDD is an effective way of preventing endotoxemia,but it may not have effect on inflammation medium and clinical outcome.

Objective To study expiration time and the origin of bacteria for the sterile packages of strategic reserve between inland region and littoral under natural environment.Methods We prepared operation dressing package,apparatus package as well as dressing and apparatus mixed package with double- cotton and to be deposited in storage boxes of combat readiness warehouse under natural environment after pulsing vacuum steam sterilization.Three packages of every kind were put in a storage boxes and samples were taken from the packages and underwent bacterial culture at different time-points.Meanwhile,the bacteria strains in combat readiness warehouse' air and in the storage boxes were cultured and performed with homology analysis.Results Expiration time of sterile packages of strategic reserve was 40d in inland region whereas 24d in littoral.The major bacteria were G+ bacilli and G+ staphylococus in sterile packages of strategic reserve,combat readiness warehouse' air and storage boxes in two regions.In inland region,the 16～23SrRNA ITS sequences of bacteria strains in sterile packages shared about 97％～100％ homology with which between the air bacteria strains in combat readiness warehouse and the storage boxes whereas it was about 98％～99％ homology in littoral.Conclusions The storage environment is the most influential factor on expiration time of sterile packages of strategic reserve.The bacteria in sterile packages of strategic reserve came from the air of combat readiness warehouse.To ensure the expiration time of sterile package of strategic reserve,corresponding management methods are important guarantee which can provide new methods about management on strategic reserve.

Objective To investigate the origin of bacteria in sterile packages for war readiness under natural environment in inland region.Methods Genomic DNAs from the Bacillus cereus,Micrococcus luteus and Staphylococcus cohnii ureal in sterile packages for war readiness and from air bacteria strains in war readiness warehouse were extracted,and then used as templates to amplify the 16S rRNA and 23S rRNA ITS(internal transcribed spacer) sequences by PCR.The PCR products were extracted and sequenced,and the sequences homology analysis was performed with BLAST.Results Amplification products of DNA PCR from Bacillus cereus,Micrococcus luteus and Staphylococcus cohnii ureal were about 800,1 200 and 1 000 bp respectively;The 16S rRNA-23S rRNA ITS sequences of bacterial strains in sterile packages shared 98% to 99% homology with those from the air bacteria strains in war readiness warehouse.Conclusion The bacteria in sterile packages for war readiness come from the air in war readiness warehouse under natural environment in inland region.

OBJECTIVE:To study the difference between the hydrophilic and hydrophobic fluoroquinolones(FQNLs)in?ducing resistant Klebsiella pneumoniae(Kpn)in vitro.METHODS:Hydrophilic ciprofloxacin(CIP)and hydrophobic sparfloxacin(SPFX)were used to induce FQNLs resistant mutants from a clinical susceptible isolate Kpn909with stepwise selection method,respectively,The susceptivity of bacteria to was determined by the standard method of two fold agar dilu?tion.RESULTS:The resistance of Kpn909to FQNLs was raised up gradually as FQNLs'concentration increased;Minimum inhibitory concentrations(MICs)of Kpn9098Selected by CIP at2?MIC(0.5mg/L)were16～32times higher than that of Kpn909,and showed resistant to ofloxacin(OFX),lomefloxacin(LMFX)and enofloxacin(ENX)with a MIC of8mg/L,16mg/L and8mg/L.Otherwise,SPFX-selected Kpn with a similar resistant level occurred at the concentration of8?MIC(1mg/L).The maximal selecting concentration of CIP and SPFX were128mg/L and64mg/L,and MIC of5FQNLs to the resistant mutants obtained at which were≥256mg/L and32～128mg/L,respectively.CONCLUSION:Both hydrophilic CIP and hydrophobic SPFX could induce Kpn the cross resistance to others FQNLs,but hydrophobic FQNLs may be superior to hydrophilic FQNLs to delay the resistance occurrence in Kpn.

AIM: To investigate the antagonistic effect of zinc on hepatic ischemia- reperfusion (HIR) injury and the effect of zinc on the expression of adhesion molecules in rat liver to clarify the mechanisms involved. METHODS: After zinc supplementation (5 ?mol/kg bw,po) , the changes in hepatocellular morphology,ALT and AST activities in serum,MDA levels in serum,and expression of ICAM-1,VCAM-1 in liver of the animals subjected to HIR were examined. RESULTS: The results showed that HIR (30 minutes of ischemia followed by 90 minutes of reperfusion) significantly increased ALT, AST activities and MDA levels in serum. The destruction of hepatic structure was observed in HIR rats. In the mean time, the expression of adhesion molecule was enhanced.After zinc administration, ALT and AST activities in serum and MDA levels in serum were all decreased. The structure of hepatocyte was nearly normal.The further experiment showed that adhesion molecule expression was suppressed.CONCLUSION: These results indicate that zinc may protect liver against ischemia-reperfusion injury by inhibiting the production of free radicals and the expression of adhesion molecule.

The curriculum of Communitity Health Nursing has fine operation and practicability.Aiming at this point, the situational teaching method is used in teaching.This method is uniquely excellent in arousing students enthusiasm of learning,improving students' ability to integrate theory with practice, cultivating students' creative thinking and team spirit.The teaching effect has been proved correct in our practice.

OBJECTIVE To investigate the storage time and the origin of bacteria for disinfection package for combat readiness under natural environment in inland and plateau situation.METHODS We prepared double-cotton operation dressing packet,apparatus package,as well as dressing and apparatus mixed packet each with 72 pieces,respectively.Packages were deposited within closed and opened storage boxes under natural environment in depository for combat readiness,respectively after vacuum steam sterilization.Three different kinds of packages each with 3 items were put inside each box.After sterilization,total of 9 items with each 3 from one type of package were taken randomly from each group every time for bacterial culture by different time.At the same time,samples of the air and depot boxes in warehouse for combat readiness were collected and cultured as well as analyzed for bacterial homology.RESULTS In Chongqing,all packages were negative for bacteria on the 40th day after sterilization,while 2 packages were positive for bacteria on the 49th day.In Lhasa,4 packages were positive in opened group on the 106th day after sterilization.On the 122nd day,6 packages were positive in opened group and 1 item was positive in closed group.The dominant bacteria are bacilli and staphylococci both in the air and depot boxes of the warehouse for combat readiness.CONCLUSIONS The storage time for disinfection package under natural environment in different areas correlates closely with the local environmental and climatic situations.The bacteria of the package were confirmed to be from the air.The effective storage time for disinfection package would be prolonged by standardization of the disinfection procedure,and control multiple environmental factors affecting microorganisms.

Objective To survey the antimicrobial resistance of nosocomial Klebsiella Pneumoniae (Kpn) isolates. Methods All the 68 Kpn strains were isolated and collected from nosocomial infections during April 2002 to March 2003. The susceptivity of bacteria and the production of extended spectrum ?-lactamases (ESBLs) were determined by Kirby-Bauer disc diffusion test and phenotypic confirmatory testing, respectively. Results All 68 Kpn strains were 100% susceptible to Menopenem and Imipenem but resistant to 14 other antimicrobials to different degrees. The first five drugs of high resistant rate were ampicillin (100%), amoxycillin/clavulanic acid (79.4%), sulphamethoxazole/trimothoprim (67.6%), cefotaxime (58.8%), gentamycin (47.0%). There were 28 isolates producing ESBLs (41.2%), which showed much higher resistance to ?-lactam, aminoglycosides, quinolones and sulphamethoxazole/trimothoprim than the non-ESBLs-producing strains. Conclusion Nosocomial Kpn isolates were most multidrug resistant, of which ESBLs-producing strains showed a higher resistance and which may involve other resistant mechanisms.

Objective: To study the regulatory effects of Momordica charantia L. saponins on immune function of senile mice. Methods: Female senile Kunming mice (15 months) were divided into senile control group(SC), experiment group 1(E1) and experiment group 2(E2). SC drank tap water, E1 and E2 drank tap water supplemented with 100mg/L and 200mg/L Momordica saponins respectively. After 5 weeks, samples were collected for IL 2, TNF ?, T cell subpopulation, phagocytosis index, thymus and spleen indices. At the same time, splenocyte, peritoneal macrophage, thymocyte obtained from senile mice, were cultured in medium containing 25mg/L and 50mg/L Momordica saponins respectively, and tested for IL 2, TNF ? and apoptosis. Results: There was no change in spleen index, but thymus index increased markedly in E2 group. Phagocytosis index, serum IL 2 level were increased obviously, while there was significant difference between E2 and E1. At the same time, ratio of CD8 + T cell raised significantly in thymus, and ratio CD + 4 CD + 8 T cell declined obviously in both thymus and spleen. Momordica saponins could increase splenocyte to secrete IL 2, enhance peritoneal macrophage to secrete TNF ?, but had no effect on apoptosis of thymocyte. Conclusion: Momordica saponins can improve immune function of senile mice by modulating the ratio of T cell subpopulation.

Objective To compare treatment outcomes and antibiotic related costs of A. baumannii infection treated with imipenem cilastatin and ampicillin sulbactam and to provide evidence for clinical treatment of A. baumannii infection. Methods A prospective investigation was performed on 71 ICU A. baumannii infection patients treated with imipenem cilastatin and ampicillin sulbactam. The treatment outcomes and antibiotic related costs were also analyzed. Results There was no significant difference between the therapeutic efficacy of these two drugs within the same time limit. The antibiotic related costs of the patients treated with ampicillin sulbactam were significantly lower than those with imipenem cilastatin (2 113 Yuan vs 5 789 Yuan , P