OBJECTIVE To analyze resistance and detect plasmid-mediated AmpC genes in Klebsiella pneumoniae.METHODS The susceptibility of the K.pneumoniae to 13 antibiotics was tested by K-B method.Modified three-dimensional extract test was adopted to detect AmpC lactamases in K.pneumoniae.The genotypes of AmpC lactamases were determined by polymerase chain reaction and sequencing.RESULTS Among the 105 isolates,the rate of extended spectrum ?-lactamases(ESBLs) was 41.90%,the rate of AmpC ?-lactamases was 0.95% strains,and the rate of ESBLs and AmpC ?-lactamases was 2.86%.DNA sequence analysis conformed that AmpC lactamases positive isolates were DHA AmpC gene.The resistance rate to penicillins,cephalosporins,?-lactam/?-lactam inhibitors,monobactams,and fluoroquinolones was very high.The susceptibility rate to imipenem was 100.00%.CONCLUSIONS The plasmid-mediated AmpC gene is present in clinically isolated K.pneumoniae.The resistance can be transferred to homologous or different genera of bacteria.

OBJECTIVE:To observe the effectiveness and safety of azelastine combined with fluticasone in the treatment of allergic rhinitis(AR). METHODS:A total of 135 AR patients were selected from 3 hospitals during Jan. 2015-Jul. 2016, and divided into azelastine group,fluticasone group and drug combination group according to random number table,with 45 cases in each group. On the basis of decongestant Oxymetazoline hydrochloride spray,azelastine group was given Azelastine hydrochloride nasal spray,1 spray each nostril,morning and night;fluticasone group was given Fluticasone propionate nasal spray,1 spray each nostril,morning and night;drug combination was given Azelastine hydrochloride nasal spray combined with Fluticasone propionate nasal spray,with the same usage and dose. Three groups were treated for consecutive 30 d. Total nasal symptom score (TNSS) and total ocular symptom score (TOSS) decline indexes,nasal minimal cross-sectional area (NMCA),total nasal resistance(TNR)and the occurrence of ADR were compared among 3 groups. RESULTS:Some pa-tients were withdrawal from the trial;finally,127 patients were included in full analysis set,and 130 patients were included in safety set. After treatment,TNSS decline index of drug combination group was significantly higher than azelastine group and fluticasone group,with statistical significance(P<0.05). There was no statistical significance in TNSS decline indexes be-tween azelastine group and fluticasone group,as well as TOSS decline indexes among 3 groups(P>0.05). Before treatment, 3 groups suffered from nasal ventilation disorder to different extents,but there was no statistical significance in TNR or NMCA among 3 groups(P>0.05). After treatment,NMCA and TNR at 75,150 Pa of 3 groups were significantly lower than before,and TNR of drug combination group was significantly lower than azelastine group and fluticasone group,with statisti-cal significance(P<0.05). There was no statistical significance in NMCA among 3 groups(P>0.05). There was no statistical significance in the incidence of ADR among 3 groups(P>0.05). CONCLUSIONS:Both azelastine and fluticasone can effec-tively relieve nasal symptom as well as improve nasal ventilation disorder in AR patients;therapeutic efficacy of drug combi-nation is better than single drug,and it doesn't increase the incidence of ADR.

OBJECTIVE To analyze the cause of Acinetobacter baumannii resistance to ?-lactam and the aminoglycoside-modifying antibacterials. METHODS Three-dimensional test was used to analyze and classify the ?-lactamases. Proper primers was used to do PCR and determined by sequencing. RESULTS A. baumannii clinical isolate harbored blaOXA2-23,blaTEM and blaADC genes and aac(3)-Ⅰ,aac(6')-Ⅰb and ant(3″)-Ⅰ aminoglycoside-modifying enzyme genes. CONCLUSIONS An A. baumannii strain which carries TEM,OXA-23,ADC ?-lactams and aac(3)-Ⅰ,aac(6')-Ⅰb,ant(3″)-Ⅰ aminoglycoside-modifying enzyme genes is detected.

Hepatoid adenocarcinoma of the stomach ( HAS) belongs to one of the rare cases in gastric cancer types ,which has extremely high malignant degree and poor prognosis .Lymph node metastasis and liver me-tastasis are common in HAS.In this article,we reported alpha-fetoprotein-high-producing hepatoid adenocar-cinoma of the stomach(HAS),and reviewed the related literature at home and abroad in order to improve clinical physicians understanding of these diseases and treatment experience .

AIM: To develop a method for determining the contents of peoniflorin,ferulaic acid and paeonol in Shi'er Wuji Baifeng Pills(Gallus Domesticus,Radix Astragali,Rhizoma Dioscoreae,Radix Codonopsis,etc.) METHODS: The analytical column was an ODS column.The mobile phase consisted of acetonitrile-0.1% phosphoric acid aqueous solution using a gradient elution.The detection wavelengths of peoniflorin,ferulaic acid and paeonol were at 230,320 and 274 nm,respectively. RESULTS: The calibration curves of peoniflorin,ferulaic acid and paeonol showed good linearity at the ranges of 21.19-211.90,1.01-10.06,10.63-106.30 ?g/mL and the average recoveries were 98.63%,98.35%,99.12%,respectively. CONCLUSION: The method is simple,rapid,reliable and can be used for the drug control.

Objective To analysis the T lymphocyte subsets distribution of patients with myelodysplastic syndrome (MDS)-RA and-RCMD,assess the immune status of MDS patients,and analysis the effects of cyclosporine on T lymphocyte subsets.Methods Using flow cytometry (FCM) on MDS-RA and -RCMD patients and 13 normal controls peripheral blood samples for T lymphocyte subsets,detection of patients with RA and RCMD lymphocyte subsets before and after 6 months of treatment in the application of cyclosporine-based immunosuppressive regimen.Results The MDS group Th cells (CD; CD;),Th/Ts ratio were lower than those in normal control group (t =13.39,3.64,all P ＜ 0.05).Ts cells (CD3+ CD8+) express higher than that in normal control group [(29.07±3.88) ％ vs (21.80±3.63) ％] (t =6.47,P ＜ 0.05).Before and after treatment of Th cells,Th / Ts ratio,Ts cells of T lymphocyte subset were significant difference [(35.72±5.02) ％,(29.07±3.88) ％,(1.89±0.51) ％ vs (38.19±4.98) ％,(26.03±3.03) ％,(1.96±0.35)％] (t =0.39,2.65,3.57,all P ＜ 0.05).Cyclosporine treatment after 6 months of effective and ineffective group of T cell subsets,Th cells (CD3+ CD4+),Th/Ts ratio of T lymphocyte subsets,there was significant difference in Ts cells [(42.79±7.74) ％ vs (36.46±.1.28) ％,(22.14±.3.91) ％ vs (27.51±2.84) ％,(2.40±0.40) ％ vs (2.08±0.11) ％](t =67.65,3.77,3.57,all P ＜ 0.05).Conclusion MDS patients with T-lymphocyte subsets immune disorders lead to immune dysfunction,cyclosporine may improve the imbalance of T lymphocyte subsets of MDS patients.

OBJECTIVE:To investigate clinical efficacy and safety of oral loratadine combined with physiological seawater na-sal irrigation in the treatment of intermittent allergic rhinitis. METHODS:Totally 300 patients with intermittent allergic rhinitis were chosen from the Second Hospital of Hebei Medical University during Jan. 2013-Jun. 2015,and then divided into group A,B,C ac-cording to lottery method,with 100 cases in each group. Group A was given Loratadine tablets 10 mg,po,qd. Group B received nasal irrigation with physiological seawater nasal spray,every morning and evening. Group C was given oral loratadine combined with physiological seawater nasal irrigation. Treatment courses of 3 groups lasted for 28 d. Clinical efficiencies of 3 groups were compared as well as symptom and sign scores,respiration function indexes and inflammatory factor levels before and after treat-ment,and the clinical recurrences were followed up for 12 months. RESULTS:The total response rates of group A,B,C were 80.00%,78.00%,96.00%,respectively,and that of group C was significantly higher than that of group A and B,with statistical significance(P<0.05). Before treatment,there was no statistical significance in symptom and sign scores,respiration function in-dexes and inflammatory factor levels among 3 groups(P>0.05). After treatment,symptom and sign scores,the rates of PEF diur-nal variation,TNF-α,INF-γ and IL-4 in 3 groups were significantly lower than before treatment,and the levels of PEF and IL-12 were significantly higher than before treatment. Above indexes of group C were significantly better than those of group A and B, with statistical significance (P<0.05). Clinical recurrence rates of group A,B,C were 21.00%,23.00%,6.00%,and group C was significantly lower than the group A and B,with statistical significance (P<0.05). There was no statistical significance in above indexes between group A and group B (P>0.05). CONCLUSIONS:Oral loratadine combined with physiological seawater nasal irrigation in treatment of intermittent allergic rhinitis can efficiently relieve the nasal symptoms and signs,improve expiratoryfunction,reduce the inflammatory response levels and be help-ful to reduce the long-term recurrence risk.

Objective To investigate the expression of CD38 and ZAP-70 in chronic lymphocytic leukemia and the relationship between the clinical stages and prognostic significance.Methods Flow cytometry was used to analyze CD38 and ZAP-70 expression in CLL,the patients were divided into high-risk group (Ⅲ,Ⅳ stage) (25 cases) and low-medivm risk group (0,Ⅰ,Ⅱ stage) (17 cases) according to Rai clinical stages.The distribution of CD38 and ZAP-70 expression in Rai clinical stages and the prognostic significance were analyzed.Results Positive expression of CD38 was 47.6 ％ (20/42) in all patients,64.0 ％(16/25) patients in high-risk group and 23.5 ％ (4/17) in low-medium risk group.The distribution of CD38 expression had significant difference between two groups (x2 =6.645,P =0.014).Positive expression of ZAP-70 was 40.5 ％ (17/42) in all patients,60.0 ％ (15/25) patients in high-risk group and 11.8 ％ (2/17) in low-medium risk group.The distribution of ZAP-70 expression had significant difference between two groups (x 2 =9.772,P =0.003).The patients with ZAP-70+ CD38 and ZAP-70+ CD38 were more distribute in high risk campare to the CD38+ ZAP-70- in low-medium risk group (x 2=10.076,9.346,6.005,all P ＜ 0.05).Follow-up 48 months (1-136 months),the progression-free survival of patients with ZAP-70+ CD38+ and ZAP-70 CD38 were respectively for 19.0 and 58.0 months (x2 =11.488,P =0.003).The progression-free survival of ZAP-70+CD38 or ZAP-70 CD38+ were 43.5 and 51.7 months and not statistically significant (x2 =0.075, P =0.784).Conclusion CD38 and ZAP-70 positive expression occurs in large proportion of CLL patients with advanced stages (Rai Ⅲ and Ⅳ stage) and according to the clinical stages the expression of CD38 and ZAP-70 may be predicted.The current findings suggest that both ZAP-70 and CD38 expression should be assessed in patients with CLL for the definition of prognostic subgroups.

OBJECTIVETo establish a HPLC method for determination of 4 components in different varieties of vinegar backed Rhizoma Curcuma.

METHODThe method was established by using an Elite Hypersil ODS2 column (4.6 mm x 250 mm, 5 microm). The mobile phase comprising acetonitrile (A) and water (B) was used to elute the targets in gradient elution mode. Flow rate and detection wavelength were set at 1 mL x min(-1) and 214 nm, respectively. The column temperature was 25 degrees C and the injection volume was 10 microL.

RESULTAll calibration curves showed good linearity with r > 0.999 5. Recoveries measured at three concentrations were in the range of 97.27% - 99.27% with RSD < 3%.

CONCLUSIONThe validated method is simple, reliable, and successfully applied to determine the contents of the selected compounds in vinegar backed Rhizoma Curcuma. The results of the determination showed that contents of the four components in vinegar backed Curcuma wenyujin were relatively high.

China ; Chromatography, High Pressure Liquid ; methods ; Curcuma ; chemistry ; Drugs, Chinese Herbal ; analysis ; Rhizome ; chemistry ; Sesquiterpenes ; analysis ; Sesquiterpenes, Germacrane ; analysis

Objective To observe over-time changes in rat blood flow in the skins of related meridian points during physiological status, the pathological state of ischemic myocardial injury and low or high frequency electroacupuncture intervention and explore the post effect of different frequency electroacupuncture on related meridian points after treating ischemic myocardial injury. Method Fifty male Wister rats were randomized into five groups: blank control, sham operation, model, low frequency electroacupuncture (meridian point A) and high frequency electroacupuncture (meridian point B), 10 rats each. Blood flow in the skins of bilateral points Neiguan (PC6), Ximen (PC4) and Tianquan (PC2), and non-meridian and non-acupoint control points was measured by laser speckle contrast imaging in every group immediately and at 30 and 60 min after the end of three treatments. Statistical analysis was made. Result Blood flow in the skins of bilateral points Neiguan, Ximen and Tianquan was significantly lower in the blank control group than in the model group (P<0.01,P<0.05). Blood flow in the skin of every acupoint increased in varing degrees after low or high frequency electroacupuncture treatment. Blood flow in bilateral points Neiguan, Ximen and Tianquan regions in meridian point group A was closer to that in the blank control group immediately after treatment. Blood flow in three left-side and three right-side acupoint regions in meridian point group B was closer to that in the blank control group at 30 and 60 min, respectively, after treatment. Conclusion The immediate effect of low frequency electroacupuncture on blood flow in acupoint regions is better than high frequency electroacupuncture during intervention in ischemic myocardial injury. The post effect of high frequency electroacupuncture on blood flow in acupoint regions is better than low frequency electroacupuncture during intervention in ischemic myocardial injury.