Objective To analyze the clinical distribution and antimicrobial resistance of Acinetobacter baumannii (A.baumannii)from a hospital,so as to guide the rational use of antimicrobial agents and provide scientific basis for the prevention and control of healthcare-associated infection(HAI).Methods Distribution and antimicrobial susceptibility testing results of A.baumannii isolated from patients between January 2011 and December 2013 were analyzed retrospectively.Results A total of 339 A.baumannii isolates were isolated within three years,291 iso-lates (85.84%)were from sputum,followed by urine (n=29,8.55%),secretion(n=12,3.54%)and blood (n=3,0.89%).The main distribution departments were intensive care unit(ICU,n=149,43.95%),department of re-spiratory medicine (n=46,13.57%),department of pediatrics (n =32,9.44%)and oncology (n =22,6.49%). The resistant rate of A.baumannii to tobramycin and imipenem were 11 .11 %-49.47%,the resistant rates to the other antimicrobial agents were relatively high;antimicrobial resistant rate of 2012 and 2013 were obviously lower than 2011 .Conclusion A.baumannii from this hospital are mainly from sputum specimens,and mainly distribute in ICU and department of respiratory medicine,antimicrobial resistant rate is high,but there is a decreasing tenden-cy in recent years.

Objective:To develop and characterize the hydrogel microspheres for embolization.Methods:N-[tris(hydroxymethyl)methyl] acrylamide-gelatin microspheres(TGMs)were prepared by an inverse suspension polymerization approach.Effects of materials on size,water absorption rate and elasticity of the microspheres were investigated.The materials which were included consisted of gelatin in the range of 10.0-100.0 g/L,N-[tris(hydroxymethyl)methyl]acrylamide in the range of 33.3-200 g/L,cross-linking agent N,N'-methylene-bis-acrylamide in the range of 3.3-10.0 g/L,surfactant Span 80 in the range of 0.5-1.8 g/L,and initiator ammonium persulfate in the range of 1.0-5.0 g/L.The appearance of TGMs was observed under microscope.TGMs were analyzed by infrared spectrum(IR).Results:The TGMs were round with smooth surface in view of photograph of microscope.The average diameter of TGMs was increased with the increase of gelatin,monomer or cross-linking agent concentrations but decreased with the increase of surfactant or initiator Concentration.The water adsorption rate of the microspheres was decreased with the increase of gelatin or cross-linking agent concentration but not affected by surfactant concentration.The elasticity of TGMs was increased with the increase of monomer or cross-linking agent concentration,decreased with the increase of gelatin concentration,but not affected by surfactant or initiator concentration.All factors above considered,the final prepared TGMs consisted of 10 g/L gelatin,100.0 g/L monomer,6.7 g/L cross-linking agent,0.9 g/L surfactant,and 3.0 g/L initiator.The average diameter of TGMs obtained was about 700.0 ?m.The water adsorption rate and the elasticity in accordance with the maximum diameter of the microspheres passed through a microcatheter of TGMs were 12.4(g/g),and 1 600.0 ?m,respectively.The results of IR spectra confirmed the polymerization of monomer,resulting in N-[tris(hydroxymethyl)methyl]acrylamide-gelatin microspheres.Conclusion:The developed TGMs seemed to be suitable for clinical embolization according to the surface,average diameter,elastic and hydrophilic property of TGMs.

Objective To observe the effects of hyperbaric oxygen (HBO) on the apoptosis expression of intestinal mucosa during the different periods of ischemia-reperfusion injury in order to elucidate the underlying mechanisms. Method Rats were subjected to ischemia for 60 min by clamping superior mesenteric artery, and then had reperfusion for 60 min by unclamping. Rats were randomly divided into four groups: ischemia-reperfusion group (I/R), pre-emptive HBO or HBO treatment before ischemia (HBO-P) group, HBO treatment during ischemia period (HBO-I) group, and HBO treatment during reperfusion (HBO-R) group. After reperfusion for 60 min, samples of small intestine tissue were taken from the end portion of ileum for detecting the levels of ATP by using colorimetric method and the levels of caspase-3 by using immunochemistry. The levels of TNF-α in intestinal tissue were measured by using enzyme-linked immunosorbent assay method ( ELISA). All values were expressed in Mean ± Standard Deviation (x ± s). The different groups were compared among them with SNK- q test of OneWay analysis of variance (One-Way ANOVA plus SNK). Results The levels of TNF-α in HBO-I group were significantly lower than that in HBO-P group ( P ＜ 0.05), and significantly lower in HBO-P group than those in HBO-R or I/R groups ( P ＜ 0.05), and there was no significant difference in TNF-α between HBO-R and I/R group ( P ＞ 0.05). The levels of caspase-3 were significantly lower in HBO-I group than those in HBO-P group ( P ＜ 0. 05), and also significantly lower in HBO-P group than those in I/R or HBO-R groups ( P ＜ O. 05), and no significant difference caspase-3 was found between HBO-R and I/R groups. The ATP levels were significantly lower in HBO-I group than those in HBO- P group ( P ＜ 0. 05), and also significantly lower in HBO- P group than those in I/R or HBO-R group ( P ＜ 0.05), and no significant difference in ATP level between in HBO-R and I/R group. Conclusions There was a connection between HBO and small intestinal I/R injury as well as mucosal cell apoptosis. And HBO maintained ATP and aerobic metabolism, and inhibited the genesis of TNF-α, and thus in turn prevented intestinal mucosa cell from apoptosis. The best result was obtained when HBO was administered during ischemia period, and there was no effect found when HBO was employed during reperfusion period.

Objective To study the effect of Toll-like receptor 4(TLR4)on expression of IRF-3 and IFN-? during the inflammatory reaction induced by cerebral ischemia reperfusion in mice. Methods After blockade of TLR4 by TLR4 antibody,expression of TLR4,IRF-3 and IFN-? at the protein level in hippocampus was examined by Western blot,respectively. Mice were randomly divided into sham group,ischemia reperfusion group and TLR4 blocking group in different time points (1,2,3 and 4 day). Results In the right cortex,the expression of TLR4,IRF-3 and IFN-? of I group was distinctly higher than that of S and T group(P

Objective To investigate the effects of nursing intervention on the rehabilitation of patients with benign paroxysmal positional vertigo (BPPV).Methods 64 BPPV patients were randomly divided into control group and observation group, with 32 cases in each group.The control group received otorhinolaryngology routine nursing, while the observation group was managed with continuously systemic nursing interventions, including manipulative re-duction, psychological nursing intervention, health education, head nursing, follow -up and family nursing interven-tion.The Hamilton Anxiety Scale (HAMA) and Hamilton Depression Rating Scale (HDRS) were applied to evaluate the intervention effects.Results Cure rate of the observation group was significantly higher than that of the control group, and recurrence rate of the observation group was obviously lower than that of the control group(p <0.05).The anxiety and depression assessment of the observation group was significantly lower than that of the control group, with statistical difference (p <0.05).Conclusion Systemic nursing intervention can effectively improve the rehabilita-tion of patients with BPPV, and reduce recurrence rate.

NG-nitro-D-arginine (D-NNA) produced pressor responses in rats by acting via chiral inversion intoNG-nitro-L-arginine (L-NNA), an inhibitor of nitro oxide synthase. The present investigation aimed to study the roleof the D-amino acid oxidase (DAAO) in chiral inversion of D-NNA and the relationship between DAAO activitieson various D-amino acids and their inversion rate. Benzoate (400 mg/kg) or creatinine (400 mg/kg), two inhibitorsof DAAO, blocked D-NNA-induced pressor responses in rats. Furthermore, the addition of the pure DAAOsignificantly potentiates L-NNA production rate in kidney homogenates by approximately 2-folds. The in vivo andin vitro results suggested that DAAO plays an essential role in the pressor responses elicited by D-NNA.Moreover, crude DAAO solution from the kidney showed marked selection (the maximal ratio of Kcat/Km wasnearly 15 times) on different D-amino acids that exhibited similar chiral inversion rate in vivo, suggesting that otherenzymes, such as transaminase, are also required for the entire process of D-NNA chiral inversion.

Objective To investigate the clinical features of glucose transporter 1 deficiency syndrome(GLUT1-DS) and summarize the characteristics of GLUT1-DS through reviewing related references.Methods The clinical data including manifestation,cerebrospinal fluid (CSF) glucose,electroencephalogram,MRI and gene mutation of a patient with GLUT1-DS was collected and the related literatures were reviewed.Results The patient was a 6 years old boy.The patient,whose seizures occurred at the age of 9 month-old and prolonged to 6 year-old,attacked before breakfast.Physical examination showed microcephaly with head circumference 47.5 cm.Laboratory tests showed that CSF glucose decreased (1.87 mmol/L) and CSF-serum ratio was 0.36.And meantime the MRI was normal and electroencephalogram showed general spike and slow wave complex paroxysm.Mutation of SLC2A1 gene,c.350_385del,was found in the patient.There were 219 cases with GLUT1-DS had been reported and the age of onset was 15.69 months.In 219 patients,159 cases (72％) suffered seizures,105 cases (47％) had motor abnormalities,61 cases (27％) suffered intellectual disability.The CSF glucose values were (1.92±0.31) mmol/L,CSF-serum ratio was 0.36±0.07.SLC2A1 gene mutations were detected in 183 patients(96％)in which missense mutation was the most mutation.Conclusion A wide range of phenotypes of GLUT1-DS include seizures,motor abnormalities,mental retardation.The diagnosis is confirmed when CSF glucose and CSF-serum ratio are continuously decreased which in the absence of meningitis.The SLC2A1 gene should be detected in suspicion of GLUTI-DS patients.Early diagnosis and treatment may improve the prognosis of those GLUTI-DS patients.

Objective To establish normal reference interval for four items of blood coagulation on ACL‐TOP Automatic coagu‐lation analyzer .Methods The fasting anti‐coagulation blood samples were collected from 1 268 inpatients and people conducted physical examination ,all subjects without liver disease ,history of blood disease and coagulation disfunction .The prothrombin time (PT) ,activated partical prothrombin time(APTT) ,thrombin time(TT) and serum levels of fibrinogen(FIB) were determined by u‐sing ACL‐TOP automatic coagulation analyzer which was producted by America IL company .And data of determination results were used to establish the normal reference intervals of indexes in this laboratory .Results The precision and accuracy of this analy‐zer was good .There were differences of normal reference intervals between which established in this laboratory and which provided by the manufacturer .Conclusion Each laboratory should establish its own normal reference interval ,not blindly refer to reference interval provided by regents manual .

Objective To investigate the effect of labor induction of full-term pregnancy use of oxytocin,and the incidence of adverse reactions of mode of delivery of cervical dilatation balloon with pubeisheng.Methods The clinical data of full-term pregnant women who were delivered in our hospital from October 2014 to November 2015 were retrospectively analyzed,According to the induction of labor is divided into the way of pubeisheng group and cervical dilation balloon group.The differences of delivery mode,oxytocin utilization,maternal and neonatal outcomes and adverse reactions were observed between the two groups.Results Cervical dilatation balloon group vaginal delivery rate was 90.38％,higher than that of pubeisheng group(P<0.05); oxytocin use rate of 11.54％,lower than that of pubeisheng group(P<0.05); Cervical dilatation balloon group first,second and third labor time is shorter pubeisheng group(P<0.001); The cervical dilation balloon group bleeding more than pubeisheng group(P<0.001),two groups of infection,urinary retention complication rate had no significant difference.Two groups of neonatal aspiration pneumonia incidence rate had no significant difference after the birth of 1min Apgar score difference,and cervical dilatation balloon group after the birth of 5min Apgar was higher than that of pubeisheng group(P<0.05).Conclusion The application of cervical dilation balloon in the induction of labor in term pregnancy is better,which can significantly improve the rate of vaginal delivery,reduce the use rate of oxytocin and shorten the labor process,and has the value of clinical application.

Objective To investigate the clinical effect and safety of EEG biofeedback therapy combined with mirtazapine in the treatment of depressive disorder.Methods 124 patients with depressive disorder were selected and randomly divided into the observation group and the control group,62 cases in each group.The control group was given mirtazapine treatment,while the observation group was given EEG biofeedback therapy combined with mirtazapine.All the two groups were treated for 8 weeks.Before and 2,4,8 weeks after treatment,the clinical effects in the two groups were evaluated by Hamilton depression scale (HAMD),Montgomerie depression rating scale (MADRS) and the clinical global impression scale (CGI).The side effects scale(TESS) assessment was used to assess the side effects.And the serum norepinephrine (NE),5-hydroxytryptamine (5-HT) and dopamine (DA) levels were measured before and 8 weeks after treatment.Results The total effective rate of the observation group was 87.5％,which was significantly higher than 66.1％ in the control group (x2 =7.213,P ＜ 0.05).In the two groups,2,4,8 weeks after treatment,the HAMD scores were significantly lower than those before treatment (t =9.391,19.349,26.349,5.026,12.610,19.518,all P ＜ 0.05),the M ADRS scores were significantly lower than those before treatment (t =8.646,22.190,33.101,4.986,13.185,25.959,all P ＜ 0.05),and the CGI scores were significantly lower than those before treatment(t =17.471,29.482,42.256,13.136,28.358,35.661,all P ＜ 0.05).In the observation group,after treatment for 2,4,8 weeks,the HAMD scores were significantly lower than those in the control group(t =4.093,4.537,5.655,all P ＜ 0.05),and the MADRS scores were significantly lower than those in the control group (t =3.622,9.740,7.490,all P ＜ 0.05),while the CGI scores were significantly lower than those in the control group(t =8.608,11.024,12.598,all P ＜ 0.05).After treatment,the levels of 5-HT,NE and DA were (148.5 ± 4.9) ng/mL,(60.6 ± 4.2) ng/L and (78.0 ± 4.1) ng/L in the observation group,which were significantly higher than before treatment [(79.8 ± 4.3) ng/mL,(30.3 ± 4.0) ng/L and (43.5 ± 4.0) ng/L,t =82.977,41.134,46.837,all P ＜ 0.05].In the control group after treatment,the levels of 5-HT,NE and DA were (125.4 ± 4.1) ng/mL,(40.2 ± 4.0)ng/L and (50.3 ± 4.3)nig/L,which were significantly higher than those before treatment [(79.2 ± 3.9)ng/mL,(30.5 ±4.1)ng/L and (43.2 ±3.6)ng/L,t =64.287,13.334,9.969,all P ＜0.05],but which those in the observation group increased more significantly (t =28.469,27.695,36.286,all P ＜ 0.05).4 weeks and 8 weeks after treatment,the TESS scores in the observation group were (3.0 ± 1.0) points and (4.3 ± 1.2) points,which in the control group were (2.8 ± 1.2) points and (4.1 ± 1.3) points,there were no significant differences in terms of TESS scores (t =1.150,0.846,all P ＞ 0.05).Conclusion EEG biofeedback therapy combined with mirtazapine in the treatment of depression is better,the adverse reactions is not significantly increased,and it also has higher clinical safety compared with mirtazapine alone.