Objective To evaluate the effect of 5-aminolevulinic acid-based photodynamic therapy (ALA-PDT) on S.epidermidis biofilms.Methods S.epidermidis was cultured on cover glasses,with or without thepresence of ALA at 50 mmol/L for 16 hours followed by the exposure to different doses (100,200,300 J/cm2) of red light.S.epidermidis receiving neither pretreatment nor irradiation served as the negative control.Subsequently,confocal laser scanning microscopy (CLSM) was used to observe the structure and evaluate the biological activity of S.epidermidis biofilms; colony forming units (CFUs) of S.epidermidis were counted for the evaluation of killing effect of ALA-PDT; scanning electron microscopy (SEM) was used to observe the morphological structure of the biofilms.Results The number of colony forming units per milliliter (CFU/ml) was (210 ± 7.55) × 105,(91 ± 1.53) × 105,(16 ± 1.52) × 105 for S.epidermidis pretreated with ALA followed by irradiation with red light at 100,200 and 300 J/cm2 respectively,significantly different from untreated S.epidermidis ((388 ±8.89) × 105,all P ＜ 0.01) and S.epidermidis irradiated with red light only.Increased ratio of dead to live cells was observed in ALA-pretreated S.epidermidis irradiated with red light at 100,200 and 300 J/cm2compared with untreated S.epidermidis (1.254 ± 0.096,1.301 ± 0.160 and 3.410 ± 1.140 vs.0.358 ± 0.057,all P ＜ 0.01) and S.epidermidis irradiated with red light only.SEM showed that the biofilm structure was loose and obscure in S.epidermidis treated with ALA-PDT,and even disappeared with S.epidermidis distributed in single colonies when the dose of red light was 300 mJ/cm2.Conclusion ALA-PDT shows a potential bactericidal activity against S.epidermidis in biofilms,which can not only reduce biofilm vitality,but also damage biofilm structure.

Objective To observe the effect of 5-aminolevulinic acid-based photodynamic therapy (ALA-PDT) on S.epidermidis planktonic cells,and to determine the optimal concentration and incubation time of ALA.Methods Some S.epidermidis planktonic cells were divided into 3 groups to be incubated with ALA at 50 mmol/L for different durations (3,5,8,12,16,18,20 and 24 hours) at 37 ℃ in dark room (group 1 ),with ALA at various concentrations ( 10,20,30,40 and 50 mmol/L) for 16 hours at 37 °C in dark room (group 2),and with fresh trypticase soya broth (TSB) solution for 24 hours at 37 ℃ in dark room (group 3),respectively.Confocal laser scanning microscopy (CLSM) was used to measure the fluorescence intensity of protoporphyrin Ⅸ (PpⅨ) in bacterial suspensions at different time points.Additionally,some S.epidermidis planktonic cells in group 1 were irradiated with red light at 30,50,70,90 and 100 J/cm2 after incubation with ALA at 50 mmol/L for 16 hours,some in group 2 were irradiated with red light at 100 J/cm2 after incubation with ALA for 16 hours,those cells in group 3 received no irradiation (blank control group),and some S.epidermidis planktonic cells receiving only irradiation and no pretreatment with ALA served as the laser control group; subsequently,the bacterial suspension was inoculated onto trypticase soy agar (TSA) followed by the calculation of colony forming units (CFUs) of S.epidermidis.Results Brick red fluorescence was observed by CLSM in S.epidermidis planktonic cells in group 1 and 2,but not in those in group 3,and the fluorescence intensity was enhanced with the increase in incubation time and concentration of ALA.In detail,the fluorescence intensity was significantly higher in planktonic S.epidermidis cells after 16-,18-,20- and 24-hour incubation than in those after 3-,5-,8- and 12-hour incubation with ALA at 50 mmol/L (all P ＜ 0.05),and higher in those incubated with ALA at 50 mmol/L than in those with ALA lower than 50 mmol/L (all P ＜ 0.05).After irradiation,the number of surviving S.epidermidis planktonic cells declined with the increase in ALA concentration and red light doses,statistically lower in the group 1 and 2 than in the blank control group (both P ＜ 0.05),but similar between the blank control and laser control group (P ＞ 0.05).The growth of planktonic cells was inhibited after incubation with ALA at 50 mmol/L and irradiation with red light at 100 J/cm2.Conclusions ALA-PDT shows a marked inhibitive effect on S.epidermidis planktonic cells,with the optimal working concentration of ALA being 50 mmol/L,incubation time 16 hours,and dose of red light 100 J/cm2.

Background and purpose:Non-small cell lung cancer (NSCLC) patients who have good curative effect on epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) will inevitably acquired drug resistance. It will effect the survival directly. In contrast, few studies have found that EGFR-TKI effectively acquired drug resistance in patients with clinical characteristics. We investigated clinical characteristics of NSCLC patients who experienced acquired drug resistance during geiftinib therapy. Methods:To review the treatment from the beneift of patients with non-small cell lung cancer. All of the data were obtained from Jan. 2007 to Jan. 2014 in Xinjiang tumor hospital. The treatment for failure of acquired drug resistance of clinical manifestations, time to progress (TTP) and post-progression survival (PPS) were retrospectively analyzed. Results:The total collection of 417 patients. Median TTP was 10.2 months (95%CI:9.5-10.9). The TTP of women adenocarcinoma patients who didn’t smoke signiifcantly extended. When acquired drug resistance happened, 63.3%of patients appeared worse symptoms. The progress of the disease is as follows:209 cases (58.4%) from the primary lesion, 137 cases (38.3%) before the transfer, 194 cases (54.2%) of new happened. Patients of epidermal growth factor receptor (EGFR) wild type had more tendencies of symptomatic deterioration and new central nervous system (CNS) transfer than patients of EGFR mutation type. Patients of exon 19 deletion and L858R mutations on the new transfer were different (41.4%vs 6.3%, P=0.02). PPS was 8.9 months (95%CI:7.4-10.4). Smoking history, performance status (PS) score, new CNS lesions and the subsequent chemotherapy is independent factors of PPS. Conclusion:This study suggests that the clinical manifestations of acquired drug resistance according to EGFR mutation status and EGFR mutation genotype may be different. In addition, after the treatment of acquired drug resistance in patients with non-small cell lung cancer, the subsequent clinical beneift from chemotherapy are also associated with PPS.

OBJECTIVE To understand flora distribution and four antifungal drugs′in vitro antifungal activity of deep fungi in nosocomial infection in order to provide help to clinics.METHODS Fungi were cultured and isolated by routine procedure which identified by VITEK microbe automatic system.Drug susceptibility test used Rosco paper disk diffusion and broth dilution method with NCCLS M27-A.RESULTS Totally 156 strains with 9 species of deep fungi that main fungi were Candida albicans,and C.tropicalis with 57.69%,and 31.41%,respectively,were isolated from nosocomial infection.The major isolating rates of clinical infection specimens were from respiratory,cardiovascular surgery,and neurological departments with 26.28%,12.18%,and 9.62%,respectively.The main infection specimens were from respiratory tract and urinary tract with 71.15% and 16.67%,respectively.Drug resistance rates to fluconazole,amphotericin B,itraconazole,and ketoconazole with Rosco paper disk diffusion were 23.08%,2.56%,12.18%,and 17.36%,MIC90 were 64.0,2.0,8.0,and 16.0mg/L,respectively.CONCLUSIONS The main deep fungi are C.albicans and C.tropicalis.Antifungal activity of amphotericin B is the highest than others.The drug resistance rate to fluconazole is more and more higher.Clinics should use antifungal drug rationally in accordance with drug susceptibility test results.

Objective To study the role of Foxp3 + CD4 + CD25 + regulatory T cells(Foxp3 + CD4 + CD25 + Tregs) and Foxp3mRNA in pathogenesis of passive transferred myasthenia gravis(PTMG) by detecting their expression in a PTMG model.Methods Sixteen C57BL/6 young female mice were divided into model group and control group.A PTMG model was established by injecting Ringer's solution containing 1.0 mg/kg mAb35 into abdominal cavity.Mice in control group were injected with Ringer's solution not containing mAb35.Levels of CD4 + CD25 + T cells and Foxp3 + CD4 + CD25 + Tregs in spleen cells were measured by flow cytometry.Expression of Foxp3 mRNA in spleen cells was detected by real-time fluorescent quantitative polymerase chain reaction(RT-FQ-PCR).Serum level of interleukin-2 and interferon-? was detected by ELISA.Results The ratio of CD4 + CD25 + T cells and CD4 + T cells was higher in model group(8.82 ? 0.74)% than in control group(9.89 ? 0.88)%(P

OBJECTIVE To enhance the positive rate of the blood culture in order to make pathogenic diagnosis actually and quickly and conducting usage of antimicrobial agents in clinic.To value the clinical applied circumstance of BacT/Alert 3D automated blood culture system.METHODS The 3728 blood cultures were detected by BacT/Alert 3D automated blood culture system,and bacterial susceptibility test was conducted on all isolates using Kirby-Bauer methods with CLSI standards.To statistically analyze the examined time,the positive rate and variety and drug resistance for all kinds of pathogens.RESULTS The blood culture positive rate was 6.0% in the 3728 blood cultures with 222 strains of bacteria.The false positive rate was 0.2% and the false negative rate was 0.4%.The positive rate of blood culture was 0.89% in 12 hours,2.01% in 18 hours,and 3.51% in 24 hours.Among all the 222 isolates,29.7% were Enterobacteriaceae,the drug resistant rates to amikacin,ceftazidime,ciprofloxacin,and imipenem were 13.6%,36.3%,42.4%,and 3.0%,respectively;20.3% were Staphylococcus,the drug resistant rates to erythromycin,levofloxacin,cefoxitin,and vancomycin were 75.6%,33.3%,68.9%,and 0,respectively;11.7% were Enterococcus,the drug resistant rates to errythromycin,levofloxacin,fosfomycin,and vancomycin were 96.2%,80.8%,23.1%,and 0,respectively;11.3% were non-fermented bacilli,the drug resistant rates to amikacin,ceftazidime,ciprofloxacin,and imipenem were 32.0%,52.0%,32.0%,and 32.0%,respectively;12.6% were fungi.CONCLUSIONS The pathogens in the blood specimens are more wider in distribution and more higher in drug resistance rates than before.BacT/Alert 3D automated blood culture system can be an important tool for the blood culture,it can provide the diagnostic help quickly for the clinic and increase the positive rates in blood culture.It can not only shorten the check-up time,but also be more quick and more exact.

OBJECTIVE To understand the distribution or change and drug resistance of the bacteria flora in nosocomial infection,in order to provide laboratory evidence for controlling nosocomial infection and to indicate clinical antimicrobial agents usage.METHODS All isolates were identified by routine procedure and VITEK microbe automatic system and API identified system.Drug susceptibility test was used K-B paper disk diffusion method in accordance with the CLSI/NCCLS standards.RESULTS There were 11 464 strains of bacteria which were obtained from 2002 to 2006.Sputum,secretion and middle urine were the major specimens.The major bacteria floras were Pseudomonas aeruginosa,Escherichia coli,Acinetobacter,Enterococcus,Staphylococcus and Candida albicans,whose isolating rates were 57.02% in 2002,64.46% in 2003,57.83% in 2004,57.49% in 2005,and 60.73% in 2006.E.coli and Klebsiella pneumoniae produced ESBLs rates were from 39.87% to 61.98% that drug resistance rates to cefoperazone/sulbactam and imipenem were 14.06% and 0.64%.The drug resistance rates of nonferment Gram-negtive bacteria to cefoperazone/sulbactam were below 33.22%,Gram-positive cocci to vancomycin was below 0.34%.CONCLUSIONS Now,the important bacteria flora is nonferment Gram-negative bacteria in nosocomial infection.The P.aeruginosa,E.coli,Acinetobacter baumannii,Enterococcus faecalis,C.albicans,and meticillin-resistant staphylococcus(MRS) were prevalent important bacteria in nosocomial infection.The situation of producing ESBLs in Enterobacteriaceae is very severe.Glycopeptides are the best choice to MRS.To zymogenic bacteria and the nonferment Gram-negtive bacteria that cause severe infection,combining-drug treatment can be chosen according to drug susceptibility test results.

OBJECTIVE: To develop a set of consummated comprehensive application platform that meets the actual demand so as to promote hospital treatment level and pharmaceutical care quality.METHODS: The protocol and standard meeting the international standard was adopted for system design.The currently popular combination tools(Apache+PHP+MySQL) set was developed and an open information resources management system and multi-structured architecture were established.RESULTS & CONCLUSIONS: This system is practical,advanced and safe and it is composed of 5 modules: drug inquiry system,rational drug use system,management on adverse drug reactions,pharmacy administrative management and network management.The system can not only guarantee the compatibility and the expandability of system,but also meet the needs of the development of hospital pharmacy and effectively enhance the rational drug use.

Objective To investigate the distribution and antimicrobial resistance of multidrug‐resistant organisms(MDROs) . Methods The distribution and antimicrobial resistance of MDROs ,isolated from 2010 to 2014 ,were retrospectively analyzed . MDROs were identified according to international consensus .The WHONET5 .6 software was used to analyze data .Results A to‐tal of 5 709 strains of MDROs were isolated in five years ,in which 2 441 strains were Staphylococcus(42 .76% ) ,2 091 strains were non‐fermentive bacterial(36 .63% ) ,737 strains were Enterococcus(12 .90% ) ,440 strains were Enterobacter(7 .71% ) .Of the 5 709 MDROs isolates ,55 .04% were isolated from respiratory tract specimens .The resistant rate of multidrug‐resistant E .coli and K . pneumoniae against cefoperazone/sulbactam ,imipenem and meropenem was less than 30% .The resistance of multidrug‐resistant A . baumanii was higher than 90% ,except to minocycline and cefoperazone/sulbactam ,20 .2% and 50 .6% respectively .The resistant rate of multidrug‐resistant P .aeruginosa was 71 .4% -97 .0% against other antimicrobial agents ,except to polymyxin B .The resist‐ance of multidrug‐resistant E .faecium against the antimicrobials was higher than 90% ,except 13 .8% to minocycline and less than 3% to linezolid ,teicoplanin and vancomycin .Meanwhile ,1 linezolid resistant strain was identified in 1 914 methicillin resistant S .au‐reus(MRSA) strains and all MRSA strains were susceptible to vancomycin and teicoplanin .Conclusion MDROs could be predomi‐nated by A .bauman and MRSA in this hospital .Monitoring and control measures to healthcare‐associated infections should be in‐tensified to prevent the spread of MDROs .

Objective To study clinical efficacy of porcine-derived small intestinal submucosa (Surgisis) in treatment of pelvic organ prolapse (POP).Methods From Mar.2012 to Mar.2013,15 patients with POP at more than Ⅲ of POP quantitation (POP-Q) staging system undergoing pelvic reconstructive surgery with Surgisis in Peking University People's Hospital.The mean age was 59 years old (39-82).The variable site of POP-Q staging systemn was compared between preoperative and postoperative status among those patients.Quality of life questionnaire of pelvic floor impact questionnaire (PFIQ-7),pelvic floor distress inventory short form (PFDI-20) and PISQ-31 were studied to evaluate subjective satisfaction,recurrence and the quality of life's improvement.Results All patients were followed up at mean of 9.9 months (3-15 months),the mean time of surgery was 96 mins (65-120 mins),the mean blood loss was 159 ml (50-500 ml).No infection and erosion was observed on those patients.The rate of subjective satisfaction was 14/15,the recurrence rate of prolapse was 2/15.Scoring system of PFDI-20 was from 87 (56-124) at operative status to 30 (22-48) at postoperative status.PFIQ-20 was from 129 (85-158) at preoperative status to 24 (18-48) at postoperative status.PISQ-31 was from 48 (32-55) at preoperative status to 79 (66-89) at postoperative status,which all reached statistical difference (all P ＜0.05).Total 9 patients obtained satisfactory sexual life.Conclusions The short-term clinical effect of pelvic reconstructive surgery with Surgisis was satisfied,quality of life and sexual life was improved,and less complication were observed.However,long-term clinical effect on patients should be warranted to follow up.