Objective To investigate TEM and SHV ESBLs in Klebsiella pneumoniae and Escherichia coli clinical isolates from West China Hospital of Sichuan University and detect resistance of ESBLs-producing isolates. Methods The TEM and SHV ESBLs-encoding gene was amplified by PCR and was sequenced. And the MIC of eight antibiotics against the ESBLs-producing strains were detected by agar dilution. Results All strains were resistant to cefotaxime; eleven strains were resistant to aztreonam; two were resistant to ceftizidime; eleven, five and three were resistant to ciprofloxacin, amikacin and cefoxidine respectively; All strains were susceptible to imipenem. Ten strains of twelve ESBLs-producing strains carried bla SHV-2, two carried bla TEM-19. Conclusions ESBLs producers were mainly resistant to cefotaxime and aztreonam and most of them were multi-drug resistance; Cefotaxime resistance is partially due to production of SHV-2 and TEM-19 in this study.

Objective To investigate the drug-resistance and distribution of 142 strains acinetobacter baumannii.Methods Drug-resistance test of acinetobacter baumannii strains was observed in 13 kinds of antibiotics.The drug sensitivity tests was performed by the method of Kirby-Bauer paper-diffusion with the standard of NCCLS.AmpC enzyme was examined by cefoxitin three dimension test and PCR amplification of ampC structure gene were studied.Results The main sources of specimen were sputum,wound secretion,urine and blood.The respiratory tract was a major site to the development of acinetobacter baumannii.Acinetobacter baumannii strain emerged mostly in the intensive care unites.The drug resistance to cefotaxime,ceftriaxome and aztreonam were high.PCR amplification showed that of 142 acinetobacter baumannii strains,23 strains had ampC structure gene which accounted for 16 2% total strains.The drug resistance of acinetobacter baumannii producing AmpC enzyme were significantly higher than those of non-producing AmpC.The best choice of treatment was imipenem.Conclusions Acinetobacter baumannii have higher multiple-antibiotic resistance,the finding prompting us to project prospective control strategies.

Objective:To observe any improvement in hemiplegic upper limb functioning when transcranial direct current stimulation (tDCS) is combined with robot-assisted upper limb treatment, and analyze the potential mechanism of neural plasticity through diffusion tensor imaging (DTI).Methods:Twenty stroke survivors with hemiplegia were randomly divided into a treatment group and a control group, each of 10, according to a random number table. Both groups were treated with conventional medication and rehabilitation training using an upper limb robot, while the treatment group also received tDCS daily, with the current increasing from 0 to 1mA over 10 seconds, and then decreasing to 0 over twenty minutes. The experiment lasted for 15 days. The upper extremity portion of the Fugl-Meyer rating scale (UE-FMA) and the Wolf Motor Function Rating Scale (WMFT) were used to evaluate motor functioning before and after the treatment. DTI was also conducted for both groups.Results:After the treatment, the average UE-FMA and WMFT scores of the two groups were significantly higher than before the treatment, with the average UE-FMA score of the treatment group (35.32±13.25), significantly higher than that of the control group (21.80±13.93). After the treatment there were significant differences between the groups in their average FA, rFA and FAasy of the posterior limb of the internal capsule, as well as in FA and the CST length of the central anterior gyrus.Conclusion:tDCS combined with robot-assisted upper limb rehabilitation training can significantly improve the motor functioning of hemiplegic upper limbs, possibly due to neuroplasticity mechanisms that promote CST integrity and symmetry changes. tDCS can be an important adjunct therapy in clinical neurorehabilitation.

Objective To develop a HPLC-MS/MS method for the absolute bioavailability study of salidroside in Beagle dogs. Methods Gastrodin was used as internal standard. Plasma samples were treated by protein precipitation and separated by Symmetry RP₁₈ column (100 mm×4.6 mm, 3.5 μm). 0.1% formic acid in water(A) and 0.1% formic acid in acetonitrile: methanol (20 : 80, V/V) (B) were used as the mobile phase for isocratic elution with 35% mobile phase B. The flow rate was 0.4 ml/min. Column temperature was 40 ℃. Injection volume was 2 μl. By electrospray ionization source (ESI) and multi-reaction monitoring (MRM) mode, the MRM ion pairs of salidroside and gastrodin were identified as m/z 299.1→118.9 and m/z 285.1→122.9, separately. Blood samples were collected at different time points after oral or intravenous administration of salidroside. The harvested plasma samples were analyzed by HPLC-MS/MS method to assess the pharmacokinetics and absolute bioavailability of salidroside. Results Excellent linearity(r>0.998 6) was found in the concentration range of 10−10 000 ng/ml for salidroside and the lowest quantitative concentration was 10 ng/ml. The recovery was 89.5%−91.8%. The intra-day precision (RSD) was less than 9.7%, and the inter-day precision (RSD) was less than 7.3%. After a single oral dose of 15 mg/kg or an intravenous injection of 1.5 mg/kg of salidroside, c_max was (9 680±3725) and (9 310±1 645) ng/ml; t_max was (1.25±0.67) and (0.011±0.017) h, AUC_0−t was (20 535.4±5 200.0) and (4 646.7±720.5) ng·h/ml, AUC_0−∞ was (20 607.9±5 266.2) and (4 691.6±715.2) ng·h/ml; t_1/2 was (1.31±0.63) and (0.98±0.13) h, respectively. Conclusion The LC-MS/MS method established in this study was simple, rapid, sensitive and reliable. It meets the regulatory requirements of biological analysis for pharmacokinetic properties of salidroside in Beagle dogs. The absolute bioavailability of salidroside in Beagle dogs is (43.9±11.2)%.

Child ; Chromosomes, Human, Pair 21 ; Core Binding Factor Alpha 2 Subunit ; genetics ; Gene Amplification ; Gene Deletion ; Humans ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; genetics ; Proto-Oncogene Proteins c-ets ; genetics ; Repressor Proteins ; genetics

Hip fractures are among the most common fractures in the elderly, presenting to be a leading cause of disability and mortality. Surgical treatment is currently the main treatment method for hip fractures. The incidence of perioperative malnutrition is increased after hip fractures in the elderly due to the comorbidities, decreased basal metabolic rate, accelerated protein breakdown, weakened anabolism and surgical stress. However, malnutrition not only increases the incidence of postoperative complications, but also leads to increased mortality, indicating an important role of perioperative nursing management of nutrition for the elderly patients with hip fractures. At present, there still lacks scientific guidance and application standards on perioperative nursing management of nutrition for the elderly patients with hip fractures. Therefore, the Orthopedic Nursing Committee of Chinese Nursing Association and the Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Expert consensus on perioperative nursing management of nutrition for elderly patients with hip fractures ( version 2023) according to evidence-based medical evidences and their clinical experiences. Fourteen recommendations were made from aspects of nutrition screening, nutrition assessment, nutrition diagnosis, nutrition intervention and nutrition monitoring to provide guidance for perioperative nursing management of nutrition in elderly patients with hip fractures.