Objective To analyze the clinical distribution and antimicrobial resistance of Pseudomonas aeruginosa (PA) so as to guide the reasonable clinical use of antibiotics .Methods The results of drug susceptibility testing of PA strains isolated from pa‐tients in the Hongqiao Hospital from Jan .2010 to Dec .2013 and distribution of specimens were retrospectively analyzed .The WHO‐NET5 .5 software was used for data statistic analysis .Results A total of 752 PA strains were isolated and were most isolated from sputum(accounted for 86 .8% ) ,followed with secretions(accounted for 5 .7% ) .The drug resistance rates of PA to imipenem ,mero‐penem and cefoperazone‐sulbactam were 1 .6% ,2 .9% and 1 .9% ,respectively ;while the drug resistance rates to ciprofloxacin ,levo‐floxacin ,amikacin ,gentamicin ,tobramycin ,cefepime and piperacillin‐tazobactam were 11 .3% ,12 .5% ,14 .0% ,16 .5% ,15 .0% , 11 .6% and 14 .1% ,respectively ;the drug resistance rates to other antibiotics were higher than 20 .0% .The drug resistance rate to sulfamethoxazole‐trimethoprim was the highest(81 .4% ) .Conclusion PA may mainly induce respiratory tract infections ,and the drug resistance rates of PA to the commonly used antibiotics are relatively low .The clinicians should reasonably use antibiotics so as to reduce the resistant strains .

Objective To investigate the clinical and imaging features in patients with vertebrobasilar dolichoectasia (VBD) through a comparative study in patients with ischemic stroke with or without VBD.Methods The patients with acute cerebral infarction were divided into either a VBD group or a non-VBD group according to magnetic resonance angiography.The VBD group was further divided into an anterior circulation infarction subgroup and a posterior circulation infarction subgroup.The cardiovascular risk factors,the diameter of basiar artery (BA),bifurcation height,and horizontal displacement were compared in all groups.Results A total of 269 patients with acute cerebral infarction were included,28 had VBD,accounting for 10.41％ of the patients with acute cerebral infarction during the same period.The proportion of male patients (78.6％ vs.66.8％ ;x2 =4.392,P =0.036),age (70.38 ± 10.58 years vs.62.86 ± 12.20 years; t =2.870,P =0.009),and the proportion of hypertension (89.3％ vs.47.7％ ; x2 =17.367,P =0.000) in the VBD group were significantly higher than those in the non-VBD group.The multivariate logistic regression analysis showed that the advanced age (odds ratio [OR] 1.248,95％ confidence interval [CI] 1.137-1.371; P=0.000),hyperglycemia (OR 1.599,95％ CI 1.181-2.164; P =0.002),hypertension (OR 1.251,95％ CI 1.020-1.534; P =0.032) and increased triglyceride level (OR 1.876,95％ CT 1.021-3.445; P =0.043) were the independent risk factors for VBD,while female gender (OR 0.133,95％ CI 0.024-0.735; P =0.021) was the independent protective factor for VBD.Of the 28 cerebral infarction patients with VBD,9 had anterior circulation infarction and 19 had posterior circulation infarction.There were significant differences in BA diameter ([5.40 ± 0.49] cm vs.[6.00 ± 0.77] cm; t =2.046,P =0.041),and the proportions of high score in bifurcation height (x2 =6.768,P =0.037) and horizontal displacement (x2 =5.241,P =0.042) between the 2 groups (all P ＜0.05).The multivafiate logistic regression analysis showed that the BA bifurcation height was an independent risk factor for posterior circulation infarction (OR 1.347,95％ CI 1.069-2.457; P =0.038) in patients with VBD.Conclusions VBD accounted for 10.41％ of the patients with acute cerebral infarction during the same period.Advanced age,hyperglycemia,hypertension and increased triglyceride level were the independent risk factors for VBD.Female gender was the independent protective factors for VBD,and the BA bifurcation height was an independent risk factor for VBD occurring posterior circulation infarction.

Objective To perform a nationwide external quality assessment for detection of Chlamydia trachomatis, and to improve the performance of laboratories in the detection of Chlamydia trachomatis. Methods Totally, 419 quality control samples were sent to tested laboratories, including 76 samples in 2007, 168 samples in 2008 and 175 samples in 2009. The laboratories were required to test the samples and report test results, within stipulated time, to the reference laboratory in National Center for Sexually Transmitted Disease (STD) Control, Chinese Center for Disease Control and Prevention. The reported results were statistically analyzed by the National Center for STD Control, who finally fed back the statistical results to all of the participants. Results The percentage increased from 84.93% in 2007 to 92.14% in 2009 for laboratories showing an 80% or more consistency with the reference laboratory in the detection of Chlamydia trachomatis from quality control samples (qualified), from 47.95% in 2007 to 70% in 2009 for those showing a 100% consistency (excellent), and dereased from 5.48% in 2007 to 0.71% in 2009 for those showing a consistency of lower than 60% (unqualified). The centralabs of provincial CDC and volunteer laboratories exhibited a satisfactory performance for the detection of Chlamydia trachomatis, while the performance of a small number of national STD surveillance sites needed to be increase. Conclusion The external quality assessment reveals a continuous improvement in the capability of detecting Chlamydia trachomatis in STD laboratories at different levels in China.

Objective To evaluate the quality of literatures and the accuracy of ultrasonography in diagnosis of deeply infiltrating endometriosis(DIE).Methods The database of Medline (1966 to 2009), the excerpta medica database (EMBASE, 1980 to 2009), Chinese biological medicine on disc (CBMdisc, 1978 to 2009), China national knowledge infrastructure (CNKI, 1979 to 2009) and VIP for Chinese technology periodical database (VIP, 1989 to 2009) Cochrane library of studies about the diagnosis of ultrasound for DIE were searched and analyzed.Quality assessment of diagnostic accuracy studies (QUADAS) items were used to evaluate the quality of literatures.The sensitivity, specificity, positive likelihood ratio(+ LR), negative likelihood ratio (-LR) ,diagnostic test odds ratio (DOR) for the pooled analysis and heterogeneity test were analyzed for transvaginal ultrasonography(TVUS), transrectal ultrasonography (TRUS) and rectal endoscopic sonography(EUS) by Meta-disc software, and drew the summary receiver operating characteristic (SROC) curves for those without heterogeneity.Results Totally 15 literatures in English were enrolled into this study.The positive rate of 10 items of QUADAS were above 60%, whereas that of the 11th item "Were the reference standard results interpreted without knowledge of the results of the index test" was 46.7% ;none of studies had mentioned the 13th item " Were uninterpretable/intermediate test results reported".All researches had no heterogeneity by explored threshold effect.The results of pooled sensitivity, specificity, + LR, - LR, DOR were 0.925,0.986, 30.036,0.107, 299.25 for TRUS, 0.799,0.944,11.972,0.187, 69.126 for transvaginal ultrasonography (TVUS), and 0.635,0.928,8.022, O.320, 39.606 for EUS, respectively.Area under the curve of EUS was 0.9479, and that of TVUS was 0.9246.Conclusions TRUS,TVUS and EUS all showed optimal value in diagnosis of DIE.The bias identified from the 15 studies might be mainly resulted from reference standard review bias.

Objective:To evaluate the clinical therapeutic effect and mechanism of recombinant human brain natri-uretic peptide (rhBNP,Xinhuosu)in patients with acute heart failure (AHF).Methods:A total of 90 AHF patients were randomly and equally divided into rhBNP group (received intravenous injection of rhBNP based on routine treatment for 3d)and routine treatment group.Left ventricular ejection fraction (LVEF),levels of serum high sen-sitive C reactive protein (hsCRP)and matrix metalloproteinase-9 (MMP-9)were measured and compared between two groups before and after treatment.Results:Compared with before treatment,after treatment,LVEF signifi-cantly rose,levels of hsCRP and MMP-9 significantly reduced in both groups,P <0.05 or <0.01;compared with routine treatment group after treatment,there was significant rise in LVEF [(41.4±12.8)% vs.(51.3±13.9)%], and significant reductions in levels of hsCRP [(8.63±3.57)mg/L vs.(6.67±3.97)mg/L]and MMP-9 [(17.89 ±4.75)mg/L vs.(14.64±4.89)mg/L]in rhBNP group,P <0.05 or <0.01. Conclusion:The rhBNP possesses significant therapeutic effect on acute heart failure,and its mechanism may be related with reducing hsCRP and MMP-9 levels.

Objective To investigate the effect of sarcopenia on the skeletal muscle and cardiac function in elderly patients with chronic heart failure (CHF).Methods Sixty patients with CHF and sarcopenia and 60 sex and age-matched CHF patients without sarcopenia were enrolled from September 2014 to December 2015.The skeletal mass was evaluated by fat-free mass index (FFMI) and muscle function was evaluated by gait speed (GS),hand strength (HS) and the simple physical performance battery (SPPB).The cardiac function was accessed by a 6-min walk distance (6-MWD) and left ventricular ejection fraction (LVEF).Furthermore,the serum inflammation cytokines IL-6,TNF-α,and skeletal muscle biomarker C 1q were measured.Results The CHF patients with sarcopenia had lower values for skeletal muscle mass:FFMI [(17.68±0.74) vs.(18.34±0.54)kg/m2,F=33.696,P＜0.05] and lower muscle function:HS [(17.26±4.20)vs.(28.85±6.43)kg,F=136.54,P＜0.05],GS [(0.65±0.11) vs.(0.90±0.10)m/s,F=-12.922,P＜0.05],SPPB [(6.45±2.07) vs.(7.65± 1.76),t=-3.452,P＜0.05].And the cardiac function decreased significantly in patients with sarcopenia:6-MWD [(253.76 ± 72.62) vs.(340.91 ± 55.78)m,F=54.350,P＜0.05],LVEF [(39.12 ± 7.02)vs.(43.83±5.81)％,t=16.060,P＜0.05].Serum IL-6/TNF-α/C1q levels were significantly elevated:IL-6[(14.12± 1.40) vs.(13.46±1.06) ng/L,F=8.513,P＜0.05],TNF-α [(443.43±28.06) vs.(299.37±21.53)ng/L,t=31.556,P＜0.05],C1q[(578.92±23.63) vs.(504.1 1±41.77)ng/L,F=145.78,P＜0.05].Conclusion The CHF patients with sarcopenia present less skeletal muscle mass,poorer skeletal function and reduced cardiac function,and higher inflammation levels.

Objective To study the effect of rhBNP on serum chemerin and IL-37 levels in acute myocardial infarction (AMI) patients undergoing emergency PCI.Methods Eighty AMI patients who underwent emergency PCI were randomly divided into cortrol group (n =40) and rhBNP treatment group (n=40).The patients in control group were treated with conventional drugs and those in rhBNP treatment group were treated with intravenous rhBNP.Their serum chemerin and IL-37 levels were measured by ELISA.Their LVEDD and LVEF were compared.Results The serum level of chemerin was significantly lower while that of IL-37 was significantly higher in two groups at 72 h and on day 7 after PCI than before PCI (P＜0.05).The serum level of chemerin was significantly lower while that of IL-37 was significantly higher in rhBNP group than in control group at 72 h and on day 7 after PCI (P＜0.05).The LVEDD was significantly shorter while the LVEF was significantly higher in two groups on day 7 and month 1 after PCI than before PCI (P＜0.05).The LVEDD was significantly shorter in rhBNP group than in control group on day 7 and month 1 after PCI (P＜0.05).Conclusion rhBNP can effectively reduce the serum chemerin level,increase the serum IL-37 level,and improve the cardiac function in AMI patients following emergency PCI.The effect of rhBNP is better than that of conventional drugs in AMI patients after emergency PCI.

The importance of gut microbes to human health has gradually attracted attention. With the use of animal models, it has been revealed that maternal microbes during pregnancy could influence their children's health outcomes through shaping their microbial composition and regulating the development of their metabolic and immune system. However, the physiological mechanism of the human body is more complex and is affected by the interaction of multiple factors. The research results obtained from animal models are often inconsistent with human studies. At present, the influence of maternal intestinal microbes during pregnancy on the microbial colonization in their offspring and on a series of children's health outcomes is still unclear. Establishing a sub-cohort to detect the microbiome of the women across pregnancy and of their offspring, and further to integrate with variety of environmental and behavioral exposures can better provide reliable support for the research on the mechanism of children's health and diseases. This paper briefly introduces the research objectives, content, progress, strength and limitations of the sub-cohort study.

OBJECTIVE To explore the self precipitation source of Erhuang powder, determine the content of related components and its efficacy on HeLa cells. METHODS Bifurcation study to identify the main compatibility of precipitating. The self precipitation, supernatant and extract of Erhuang powder were analyzed by UHPLC-Q-Exactive MS. The main compounds in Coptidis Rhizoma and Catechu, catechin, epicatechin, epicberberine, coptisine, berberine and palmatine were selected as controls. A analysis method of UHPLC for self precipitation, supernatant and extract of Erhuang powder was established and the related components were quantitatively determined. The effects of self precipitation, supernatant and extract on HeLa cells were evaluated by MTT method and flow cytometry. RESULTS A slight flocculation precipitate appeared when the decoction of Erhuang powder was mixed in pairs, while a large amount of flocculation appeared when the decoction of Coptidis Rhizoma and Catechu water was mixed. The self precipitation, supernatant and extract samples contained 39 compounds, which were mainly alkaloids and phenolic acids. The contents of catechin and berberine in the 6 index components were mostly, which accounted for 73.56% of the total content of the index components in self precipitation and 61.89% of the total content of the index components in extract. Inhibition effect on HeLa cells: extract ≈ self precipitation > supernatant, and inducing apoptosis: self precipitate ≈ extract, supernatant had no apoptosis-inducing effect. CONCLUSION Coptidis Rhizoma-Catechu is the main compatible formula for precipitation formation. The self precipitation and extracts of Erhuang powder are mainly alkaloids and phenolic acids, among which berberine and catechin are high in content and can be used as representative components. The effect of self-precipitation and extract on HeLa cells was better than that of supernatant. This basically indicates that the self precipitation components and pharmacological effects of Erhuang powder are similar to those of the extract.