Objective To investigate the genetic mutation of the norA gene and its promotor from the wild-type drug-resistance Staphylococeus aureus(S.aureus)strains. Methods A total of 10 antibiotic-resistant S.aureus strains were isolated and screened from the burn wound for the sequencing and analysis of the nora gene and its promoter. Results There isolated 87 S.aureus strains from the burn wound flora,which were completely sensitive to vacomycin,highly sensitive to Quinupristin and Nitrofurantoin,but highly resistant to the other antibiotics,even up to91.7% of MRSA.There found the same point mutation(G→A) located at 1 349 sites of the norA gene coding region in all the S.aureus strains,saying that the amino acid was changed from Gly(glycin)to Asp(agpartic acid) in 291 sites.The resetpine reverse test showed that the MICs value of three antibiotics was lowered at various degrees in all 10strains.Conclusion NorA gene mutation is one of the mechanisms for antibiotic-resistance of S.aureus.

Neomangiferin, a natural C-glucosyl xanthone, has recently received a great deal of attention due to its multiple biological activities. In this study, a rapid and sensitive ultra-high performance liquid chroma-tography tandem mass spectrometry (UHPLC–MS/MS) method for the quantification of neomangiferin in rat plasma was developed. Using chloramphenicol as an internal standard (IS), plasma samples were subjected to a direct protein precipitation process using methanol (containing 0.05% formic acid). Quan-tification was performed by multiple reactions monitoring (MRM) method, with the transitions of the parent ions to the product ions of m/z 583.1-330.9 for NG and m/z 321.1-151.9 for IS. The assay was shown to be linear over the range of 0.2–400 ng/mL, with a lower limit of quantification of 0.2 ng/mL. Mean recovery of neomangiferin in plasma was in the range of 97.76%–101.94%. Relative standard deviations (RSDs) of intra-day and inter-day precision were both o 10%. The accuracy of the method ranged from 94.20%to 108.72%. This method was successfully applied to pharmacokinetic study of neomangiferin after intravenous (2 mg/kg) and intragastric (10 mg/kg) administration for the first time. The oral absolute bioavailability of neomangiferin was estimated to be 0.53%7 0.08%with an elimination half-life (t1/2) value of 2.74 7 0.92 h, indicating its poor absorption and/or strong metabolism in vivo.

AIM: To study the effects of IL-6 and IL-1? on the blood polymorphonuclear-neutrophils(PMN) apoptosis postburn. METHODS: Wistar rats inflicted by 30% total body surface area (TBSA) Ⅲ degree scalding were employed as the model. PMN were isolated by density gradient centrifugation using Percoll-hypaque and labeled with TdT-mediated and dUTP nick end labeling (TUNEL) and analyzed by flow cytometric analysis. The intracellular caspase-3 activation and the serum levels of IL-6 and IL-1? were analyzed by fluorometric immunosorbent enzyme assay and enzyme-linked immunosorbent assay, respectively. RESULTS: The serum IL-6 levels (?g/L) in groups of 3, 6, 12, 24 and 48 h postburn (9 14?1 16, 12 49?1 14, 3 01?0 75, 1 41?0 28 and 1 56?0 43 in turn) and IL-1? (ng/L) in groups of 3, 6, 12 h postburn (90 08?8 39, 320 93?14 48 and 47 84?5 19) were much higher than IL-6 (0 24?0 07) and IL-1? (27 65?4 86) in control group ( P

A total of 226 strains of organisms was isolated from the cultures of the subeschar unburnt tissues of the burn patients admitted to this institute in the period from April 1980 to April 1982. Among the organisms, gram-negative bacilli exceeded gram-positive cocci in number. The frequently seen gram-negative bacilli, in the order of frequency, were Pseudomonas, Serratia, Klebsialla, and E. coli. And the frequently seen gram-positive cocci were Staphylococcus aureus, Staphylococcus albus, Streptococcus fecalis, and Streptococcus hemolyticus.The quantitative culture of the biopsy specimen showed its value in our clinical application. In cases of multiple infections, after the identification and precise count of the bacterial colonies on the cultures were done, the percentage of the various organisms could be obtained and the main pathogen was revealed.It was pointed out that ordinary culture media were only favorable for rapid growth of bacteria but the existence of fungi was usually masked. A. modified method of fungus culture, tissue thread culture, was used for the early diagnosis of fungus infection. 38 specimens were studied simultaneously with three methods. The positive rate for fungus was 8% in ordinary cultures, 26% in his-tologic examinations, and 61% in tissue thread cultures.Anaerobic culture was performed for 102 swab specimens from the burn wounds and a positive rate of 14.7% was obtained. In addition, anaerobic blood culture was performed in 10 cases of severe burns with 2 positive cultures. It is suggested that anaerobic infections should not be neglected in burns.

Objective　To investigate the role of bacterial DNA in systemic inflammatory response syndrome (SIRS). Methods　A total of 100 mice of Kunming species were divided into ten groups: E.coli DNA (30, 20, 10, 5 and 1 mg/kg ), 30 mg/kg of CT DNA, 60Co DNA, DNased DNA, organic residue of DNA extraction and sterile water control. The last two were pre-treated with D-galactoamine (600 mg/kg intra peritoneally). Animals were administratively injected via tail vein. General physical condition and the death rate of mice were observed within 48 h. Results　①Obvious lethal effect of double strand E.coli DNA on mice were observed with a dose-effect correlation, LD50=11.51 mg/kg. ②NO difference in death rate was found in the group of 30 mg/kg E.coli DNA with or without 60Co irradiation (10/10 and 8/10,P>0.05). ③No rats died in the group of DNased DNA, organic residue of DNA extraction and calf thymic DNA (0/10). Conclusion　Bacterial DNA may play an important role in the development of SIRS.

Background and purpose:Bladder cancer radical surgery is dififcult with many perioperative complications, and the learning curve is long. To introduce the clinical application of complete retrograde radical cystectomy and consequent abdominal cavity reconstruction in male bladder cancer, and to provide a standardized surgical procedure with minimum perioperative complications and short learning curve. Methods:From Apr. 2012 to Apr. 2013, 110 cases of male patients with bladder cancer received this procedure in our department, with a median age of 64 (35-83) years;Preoperative characters, surgical parameters, perioperative complications, pathology, long-term complications and short-term prognosis were collected and analyzed. Results:The median number of lymph nodes resected in operation was 12 (8-16);Neurovascular bundles were reserved bilaterally in 65 cases, and unilaterally in 31 cases;The complete procedure including urinary diversion took 4.4 (2.2-6.0) hours, with a median time of opened abdominal cavity of 43.0 (5.0-75.0) minutes;The median blood loss was 140.0 (50.0-600.0) mL, and 4 patients needed transfusion; Median time of abdominal and pelvic drainage was 10.0 (6.0-15.0) days, the median gastrointestinal recovery time was 2.5 (1.0-12.0) days, and the median postoperative hospital stay was 17.0 (10.0-39.0) days;Grade 2 Clavien-Dindo classiifcation (CDC) of surgical complications that required medical intervention were found in 19 cases, CDC grade 3 or above were found in 8 cases;Mild to moderate postoperative ileus happened in 5 cases, all recovered in median 2 (1-4) weeks with supportive treatments;There were no perioperative deaths. All samples were sent to pathological analyses. After a median follow-up of 9 (3-15) months, no complications of or above CDC grade 3 happened, and there were no recurrence. Conclusion:Complete retrograde radical cystectomy in male bladder cancer provided clear anatomical approach, reliable neurovascular bundle preservation, less blood loss, limited abdominal organs disturbance and better surgical exposure; With respect to tumor control, more peritoneal was retained for subsequent abdominal cavity reconstruction. The introduced procedure effectively speeded up gastrointestinal recovery, reduced postoperative complications, especially the incidence of ileus and its severity, and shortened hospital stay. The learning curve of this procedure for urologists was short, and further investigation was warranted.

Infant hair is a good medium to assess the cumulative exposure level of infant in the mother ' s body. Chlorinated persistent organic pollutants were ubiquitous and with the highest volume concentration in the human body. In this experiment, 20 infant hairs were collected from Beijing. The sample was overnight incubated in HCl, extracted with the mixture of hexane and dichloromethane, and cleaned up by a cartridge filled with alumina and acidified silica. The final eluate was concentrated, and 16 kinds of typical chlorinated persistent organic pollutants were detected with gas chromatography_high resolution mass spectrometry ( HRGC_MS). The results showed that the detection limit of the target compounds in sample was 1. 00-2. 50 μg/kg, the recovery of surrogate in all samples was more than 67 . 6%, and the range of recoveries for target compounds in spiked sample was 62. 5%-92. 3%. The positive rate is 100% for hexachlorobenzene,β_HCH and p, pˊ_DDE, 85% for γ_HCH, 50% for PCB28, and 40% for PCB52. The concentrations of Hexachlorobenzene, HCHs, DDTs and PCBs were 5. 48-8. 40 μg/kg, 3. 86-27. 1 μg/kg, 1. 16-18. 3 μg/kg and 2. 20-22. 1 μg/kg, respectively. The average concentrations were 7. 84 μg/kg for hexachlorobenzene, 6. 93 μg/kg for HCHs, 5. 53 μg/kg for DDTs, and 3. 44 μg/kg for PCBs. The method and the analysis results can be used to evaluate the accumulation level and cumulative exposure level of 16 target compounds for fetal in motherˊs body.

BACKGROUND:The laparoscopy is superior to open surgery for being less invasive, inducing mild stress reaction and allowing quick recovery after operation, however the effects of laparoscopy on perioperative serum cytokine levels are controversial, and only a few studies discuss these effects among pediatric patients.OBJECTIVE: To compare the changes in perioperative cytokine levels and their clinical significance in pediatric patients undergoing laparoscopy and open surgery.DESrGN: Non-randomized concurrent controlled observation.SETTTNG: Department of Urology in Xijing Hospital of the Fourth Military Medical University of Chinese PLA.PARTICT PANTS: From May 2004 to December 2006, 135 pediatric patients for elective operation were recruited from Department of Urology in Xijing Hospital of the Fourth Military Medical University of Chinese PLA. Sixty-five patients were scheduled for laparoscopic surgery while the remaining 70 patients for open surgery.METHODS: Serum levels of interleukin-1 beta (IL-1β), IL-6, IL-10 and tumor necrosis factor-alpha (TNF-α) were measured at 24 hours before operation, and 3, 24, 48 hours after operation respectively. Duration of hospitalization time of all the children was also recorded.MAIN OUTCOME MEASURES: Levels of IL-1β, IL-6, IL-10 and TNF-α of all the patients were measured 24 hours preoperatively, and 3, 24, 48 hours postoperatively.RESULTS: All the 135 cases were included for statistical analysis. ①There were no significant perioperative changes in cytokine levels after laparoscopic surgery (P ＞ 0.05). In the open surgery group, IL-1β and IL-6 levels increased significantly at 3 and 24 hours after operation (P ＜ 0.05), and normalized within 48 hours postoperatively. No significant perioperative differences were found in IL-10 and TNF-α levels (P ＞ 0.05). The levels of IL-1β and IL-6 were significantly higher in the open surgery group than in the laparoscopic surgery group (P ＜ 0.05). ②Duration of hospitalization was shorter in the laparoscopic surgery group than in the open surgery group [(3.5±1.0), (7.5+1.5) days, P＜ 0.05].CONCLUSTON: Pediatric patients undergoing laparoscopic surgery had less perioperative changes in cytokine levels and quicker recovery.

Background and purpose:It has been demonstrated that radical prostatectomy for patients with oligometastatic prostate cancer may contribute to improving local control of prostate cancer and overall survival by several retrospective studies. Perioperative complications play an important role in determining whether radical prostatectomy is appropriate for patients with oligometastatic prostate cancer. This study aimed to discuss the recurrence rate and the sever-ity of perioperative complications, and the primary curative effect of radical prostatectomy on oligometastatic prostate can-cer patients.Methods:A total number of 247 patients who received radical prostatectomy were recruited in the study from Jul. 2015 to Jan. 2016, including 25 patients with oligometastatic prostate cancer and 222 patients with localized prostate cancer. Patients with perioperative complications in both groups were graded with the Clavien-Dindo grading system. The proportion of PSA decline and the rates and severity of perioperative complications were analyzed in both groups.Results:The cases of prostate specific antigen (PSA) decline in the oligometastatic group were 21 (84.0%), lower than the localized group with 212 cases (95.5%). There were 6 cases (24.0%) with postoperative complications in the oligometastatic group, including serious complications (Ⅲ or above) 1 case (4.0%), and 49 cases (22.1%) with postoperative complications in the localized group, including serious complications (Ⅲ or above) 7 cases (3.2%). The differences between the groups reached no statistical significance (P>0.05).Conclusion:Radical prostatectomy for patients with oligometastatic prostate cancer could be safe, effective, and appropriate, the risk of perioperative complications should not be one of the limiting factors.

Objective To analyze the follow-up results and clinical characteristics of one case of highly sensitized recipient after combined kidney transplantation and splenic fossa auxiliary heterotopic liver transplantation.Methods This patient was diagnosed as having chronic renal insufficiency in the uremia period 10 years ago,subjected to kidney transplantation 9 years ago,and got renal allograft loss 8 years ago.The recipient was positive for PRA (for class Ⅰ,31％,and for class Ⅱ,63％).Under the general anesthesia,the patient was given combined kidney transplantation and splenic fossa auxiliary heterotopic liver transplantation.The ATG was used for immune induction.Rituximab and plasma exchange were applied to prevent acute rejection.Regular follow-up was done after discharge.Results On the postoperative day (POD) one,ALT was 256 IU/L,AST was 342 IU/L and serum creatinine was 502 μmol/L.On the POD 6,ALT and AST levels were normal and serum creatinine was 141 μmol/L.Serum creatinine increased to 202 μmol/L and the volume of urine reduced on the POD 7.The ultrasound displayed graft size increased slightly,substantial echogenicity enhanced,artery blood flow RI increased to 0.8,suggesting the occurrence of acute rejection.A single dose of Rituximab,intravenous IG,and plasma exchange were given.On the POD 60,serum creatinine was reduced to 131 μmol/L.During a follow-up period of 28 months,imrnunosuppresants were given:Tac + MMF + Pred.FK506 valley concentration was maintained at 6-8 μg/L.The function of the transplanted kidney and liver was normal,and the general conditions were good.Conclusion Combined kidney transplantation and splenic fossa auxiliary heterotopic liver transplantation is safe.Individualized medication and regular follow-up are the important factors for long-term survival of recipients.