OBJECTIVE To study the correlation between mutations of gyrA and parC genes and ciprofloxacin-(resistant) clinical isolates of Acinetobacter baumannii from Chengdu.METHODS The genes of gyrA and parC DNA in 28 ciprofloxacin-resistant and 2 ciprofloxacin-susceptible isolates of A.baumannii were amplified by PCR and then analyzed by restriction fragment length polymorphism(PCR-RFLP) and DNA sequencing.(RESULTS) Hinf Ⅰ digestion of the gyrA gene products of susceptible isolates(generated) two fragments,but resistant isolates(generated) one fragment.The parC gene products generated 2 fragments.DNA sequencing of 5 resistant isolates revealed mutations in gyrA gene that resulted in amino acid substitutions: Ser83→Leu and Ala88→Thr,especially,Ser83 point mutation accounting for the disappearance of sequence of Hinf Ⅰ.There was not any mutation in(gyrA) of 1 susceptible isolate;the substitution of Ser108→Ile in parC(gene) of 1 susceptible and 1 resistant isolates were identified,the remaining four isolates had more nosense mutations.CONCLUSIONS Compared with parC gene mutations,(gyrA) gene mutations of A.baumannii appears to be the main molecular mechanism responsible for ciprofloxacin resistance.The high-level ciprofloxacin resistance in A.baumannii probably needs a variety of mutations.

Acute Coronary Syndrome ; drug therapy ; Anticoagulants ; therapeutic use ; Humans ; Polysaccharides ; therapeutic use

Objective To study the lipids related indicators ,high-sensitivity C-reactive protein(hs-CRP) ,FIB and D-dimer levels in cerebral infarction patients .Methods 259 cerebral infraction patients(cerebral infraction group) and 210 healthy individuals(con-trol group) were enrolled in the study .Plasma lipids related indicators such as TC ,TG ,HDL-C ,LDL-C ,ApoA1 ,ApoB ,ApoE levels were measured by enzymatic colorimetric assay .Quantitative fluorescence immunoassay was used to determine serum level of hs-CRP .FIB levels were determined by using coagulation method ,and D-dimer levels by using immune turbidimetric method .Results Compared with the control group ,the TG ,LDL-C ,ApoA1 ,ApoE and hs-CRP levels were significantly higher in the cerebral infarc-tion group(P<0 .01) ,however ,the HDL-C level decreased significantly (P<0 .01) .For TC and ApoB levels ,there were no statis-tical differences between the two groups(P>0 .05) .Conclusion Lipids ,inflammation ,coagulation and fibrinolysis are closely relat-ed in the development of cerebral infarction ,and combined detection helps diagnose cerebral infarction .

Objective To investigate the effect of Xuefuzhuyu pill on blood glucose,sex hormone,insulin levels and HOMA-IR index in patients with polycystic ovary syndrome and infertility.Methods 59 patients with polycystic ovary syndrome and infertility from January 2014 to January 2015 in our hospital were selected and randomly divided into experimental group and control group,29 cases in each group,the control group was treated with clomiphene citrate capsules,the patients in the experimental group were given Xuefuzhuyu pill baseed on the treatment in control group,treatment period for three menstrual cycles,after the end of treatment,the levels of serum sex hormone levels,fasting blood glucose,insulin levels,HOMA index,uterine endometrial thickness,ovulation and pregnancy were detected.Results After treatment,compared with control group,in the experimental group,the serum levels of LH and T were significantly lower,and the serum levels of FSH,E2 and P were significantly higher,the difference was statistically significant(P<0.05),the serum anti-Mullerian hormone(AMH)content in the experimental group was significantly lower,the difference was statistically significant(P<0.05),the serum levels of FINS and HOMA-IR were significantly lower in the experimental group,the difference was statistically significant(P<0.05),the endometrial thickness of patients in experimental group was significantly increased,the number of follicles and ovarian volume were significantly decreased,the difference was statistically significant(P<0.05),the ovulation rate and pregnancy rate in the experimental group was higher,the difference was statistically significant(P<0.05).Conclusion Xuefuzhuyu pill can significantly reduce the serum LH,T,FINS,AMH and HOMA-IR levels in patients with polycystic ovary syndrome,which can improve the serum FSH,P,E2 levels,regulate sex hormone secretion,reduce insulin resistance,improve the ovulation rate and pregnancy rate,compared to single use of citric acid clomiphene capsules effect is more ideal.

Objective To examine current use, associated complications, and short-term outcomes in patients with acute myocardial infarction (AMI) requiring intra-aortic balloon pump (IABP) counterpulsation. Methods A single-centre registry was conducted between October 2004 and July 2008. Data were collected from 121 consecutive AMI patients treated with IABP counterpulsation at the 28th Division of Beijing Anzhen Hospital. Results Among 806 patients with AMI, IABP counterpulsation was employed in 121 patients. Placement of an IABP was indicated for hemodynamic support during high-risk catheterization and/or angioplasty (66.9%) and cardiogenic shock (27.3%). Balloon insertions were successful in 98.3% of patients and duration of mean use was 34.2?16.2 hours. No major IABP complications occurred in all the patients. Diagnostic catheterization was performed in all the patients inserted with IABP, and 93.4% underwent coronary revascularization before hospital discharge. The total in-hospital mortality was 13.2% (34.4% in patients with cardiogenic shock) and varied markedly by indication and use of revascularization procedures. Conclusion IABP counterpulsation may be successfully employed for a wide variety of conditions in the AMI setting, providing significant hemodynamic support with rare major complications in a high-risk patient population. IABP counterpulsation may reduce mortality in patients with AMI undergoing reperfusion therapy.

Objective To reveal the hepatitis A vaccine (HepA) coverage among pre-school children in Shandong province before Hepatitis A vaccine was introduced to the EPI and to provide evidence for improving the strategy for hepatitis A control.Methods A cross-section survey was conducted among children aged between 2 and 6 years old in Shandong province in March 2008.The study population was selected by random sampling method and HepA immunization history was obtained by immunization record or recall.Results 78.90% had received one dose of HepA at least.The coverage rate decreased with age and the differences in three age groups were statistically significant (x 2 =11.54,P=0.02).The coverage rates among the boys and girls were 77.67% and 80.30% respectively,the difference was not significantly(x 2 =1.17,P=0.28).The HepA coverage rates among the children living in the eastern areas and in the richer areas were higher than the centrale and western areas and poverty areas,the difference has statistic significance (x 2 =27.25,58.17,P

Objective To make a systematical review of the safety and efifcacy of Etomidate plus Fentanyl-class drugs and Propofol plus Fentanyl-class drugs in older patients undergoing gastroscopy. Methods We searched the Cochrane library, PubMed, Embase, China Biology Medicine (CBM), CNKI, VIP, Wanfang Database for all randomized controlled trials (RCTs) about the efifcacy of Etomidate plus Fentanyl-class drugs(Fentanyl, Sufentanil, remifentanil) in older patients undergoing gastroscopy. The quality of the studies was evaluated by the method recommended by the Jadad scale. Meta-analysis was conducted using the Cochrane Collaboration’s RevMan 5.3 software. Results 11 RCTs involving 1 535 patients were analyzed. Meta-analysis showed that patients in the Etomidate group had a lower heart rate [Weighted Mean Difference (WMD)=2.25, 95%CI(0.93, 3.56), P=0.001] and mean arterial pressure [WMD=9.09, 95%CI (7.60, 10.57), P=0.000] lfuctuation than whose of the Propofol group.The hypoxemia occurrence [O^R=0.46, 95%CI (0.32, 0.65), P=0.000] in Etomidate group is also lower than which of the Propofol group. For side effects aspects, the risk of apnea[O^R=0.26, 95%CI(0.15, 0.48), P=0.000] and injection pain [O^R=0.02, 95%CI (0.01, 0.05), P=0.000] in the Etomidate group is much lower than the Propofol group ,while the myoclonus [O^R=8.14, 95%CI (4.18, 15.87), P=0.000], nausea and vomiting [O^R=3.44, 95%CI (2.03, 5.84), P=0.000] were more incidental than the Propofol group. Conclusion Etomidate plus Fentanyl-class drugs can effectively maintain circulatory system for the old undergoing painless gastroscopy, demonstrated to be a safe and valid anesthesia method.

Combining the experiment teaching innovation in our college,we carried on beneficial quest to the teaching mode of the biochemistry experiment.During the practice of the designing experiment,we not only pay attention to cultivating students' creation ability,but also lay emphasis on cultivation of their autonomy ability.which is very important to improve the students,early scientific research abilities or clinical practice abilities and so on.

It is very important to assess the role of suitable social medical support level in operation and adjustment of social medical insurance system.The social medical support level in Shandong Province was measured and analyzed,the coordination of social medical support level and economic development was emphasized with suggestions put forward for the development of system and optimization of policies.

ObjectiveTo analyze the neurological manifestations of chronic mercury poisoning for the improvement of clinical understanding of this disease.MethodsThe clinical data of 8 cases diagnosed as chronic mercury poisoning admitted in the department of neurology of Xuanwu hospital during the past 5 years were collected and analysed.Results Neurological manifestations of chronic mercury poisoning involved psychological problems,sleep disorders,ataxia,extremities weakness and atrophy,tremor,peripheral neuropathy and paresthesia.ConclusionsThere are various kinds of neurological manifestations of chronic mercury poisoning.Identification of these manifestations in clinical practice and early diagnosis are beneficial for the relief of pains in the patients.