OBJECTIVE To study the classification of the ?-lactamases produced by Citrobacter freundii.METHODS To detect the ?-lactamases produced by 33 strains of C.freundii with nitrocefin test,a multi-disk test(synergy test and antagonized test) for the inducible AmpC ?-lactamases(IABLs),AmpC ?-lactamases(ABLs) phenotype test,extended-spectrum ?-lactamases(ESBLs) screening test,and carbapenem-hydrolyzing ?-lactamases(CHBLs).RESULTS In the 33 strains,29 strains produced the ?-lactamases(87.9%);the nitrocefin tests of 27 from the 29 strains were positive(81.8%);two strains produced penicillinases,3 strains produced cephalosporinases,5 strains produced broad-spectrum ?-lactamases(BSBLs),11 strains produced ESBLs alone,and 6 strains produced ESBLs+ high-productive ABLs,the rate of ESBLs produced by the 33 strains of C.freundii was 51.5%,and 2 strains produced CHBLs(all produced ESBLs+ metallo-?-lactamase).CONCLUSIONS The rate of ?-lactamases,rate of ESBLs and co-produced rate is very high.There are six kinds of ?-lactamases produced by the 33 strains of C.freundii,mainly BSBLs and ESBLs.

OBJECTIVE To study the classification the ?-lactamases produced by Providencia spp.METHODS To detect the ?-lactamases produced by 19 strains of Providencia spp with nitrocefin test,a multi-disk test(synergy test,antagonized test for the inducible AmpC ?-lactamases(IABLs),AmpC ?-lactamases(ABLs) phenotype test and extended-spectrum ?-lactamases(ESBLs) screening test,carbapenem-hydrolyzing ?-lactamases(CHBLs).RESULTS The nitrocefin tests of all of 19 strains were positive,producing the ?-lactamases(100.0%);eight strains produced broad-spectrum ?-lactamases(BSBLs,42.1%) and ESBLs(42.1%),respectively,one strain produced overexpression of AmpC,3 strains produced CHBLs.CONCLUSIONS The rate of ?-lactamases produced by the 19 strains of Providencia spp is very high,there are three kinds of ?-lactamases,mainly BSBLs and ESBLs.

Objective To calculate and measure the depth and radius of the target vessel in the upper limb venous ultrasound image in order to contribute to automatic venipuncture.Methods Two methods of measuring the radius of veins in an ultrasonic vein cross section image were adopted.One method was to segment the vein based on the threshold selected after evaluation, and then scan the upper and lower edges of the vein to obtain the radius.The other method was based on Otsu method,which was to divide the vein and then morphologically process the binary image.The radius was calculated in a manner similar to the first method.After the radius was obtained, the depth of the vein was corrected in conjunction with the radius.Results The above two methods were tested on 500 upper limb venous ultrasound images.The accuracy rate of the first method was 93.0%, and that of the second method was 99.4%.Conclusion The method based on Otsu and morphological processing is more effective for radius measurement of veins in upper limb venous ultrasound image.

Objective To evaluate the effect of double-plate treatment on grade Ⅱsupination adduction ankle frac? tures with impaction of tibial plafond. Methods A total of 17 patients of gradeⅡsupination adduction ankle fractures with impaction of tibial plafond were treated surgically in our hospital. Anteromedial approach to the medial malleolus was taken to expose the tibial plafond and the vertical medial malleolus fractures. One distal radius plate was placed on the anteromei?dal tibial plafond, and another buttress plate was placed on the medial malleolus. Bone grafting was used to restore the height of the collapsed tibia. Lateral malleolus fractures were treated with reconstruction plate. The fracture union after operation was detected by X-ray examination. American Orthopedic Foot and Ankle Society (AOFAS) ankle hind foot score was used to assess the ankle function. Results Sixteen of 17 patients were followed up postoperatively for a mean period of 2.6 ± 0.9 years. CT cross-sectional study found that the collapsed articular surface of 12 (70.6%) patients was mainly located in the an?teromedial one-fourth area, with the worst at anterior margin. Bony fusion was achieved in all patients after an average peri?od of 2.9±0.5 months. No internal fixation loosening or fracture redisplacement was found by X-ray. The average range of an?kle joint activity was 16.4°±2.8° for dorsiflexion, and was 39.2°±5.3° for plantarflexion. According to AOFAS ankle hindfoot scale, ankle function was excellent in 14 patients and good in 2, with excellence rate of 100%. Conclusion The application of double-plate fixation to treat gradeⅡsupination adduction ankle fractures with impaction of tibial plafond can play a key role in reducing fracture redisplacement and osteoarthritis.

BACKGROUND:Spinal cord ischemia-reperfusion injury is a serious secondary injury of the spinal cord. Multifactor could contribute to the mechanism of this injury, and many therapeutic measures emerge, but the therapeutic effect is not ideal.
OBJECTIVE:To investigate the protective effects and mechanism of hydrogen-rich saline on spinal cord ischemia-reperfusion injury in rabbits.
METHODS:ZIVIN method was adopted to prepare the model of spinal cord ischemia-reperfusion injury. The rabbit models were randomly divided into model group, sham operation group, and hydrogen-rich saline group.
RESULTS AND CONCLUSION:Improved Tarlov scores for the evaluation of motor function were significantly increased in hydrogen-rich saline group compared with the model group at 6, 12, 24, 72 hours after reperfusion (P<0.01). The contents of malondialdehyde were significantly lower (P<0.05), while catalase activity was significantly higher (P<0.05) in hydrogen-rich saline group than that in model group at 72 hours after reperfusion. Hematoxylin-eosin staining revealed that, spinal cord anterior-horn motor neurons maintained intact structure in sham operation group;more necrotic spinal cord anterior-horn motor neurons were found in model group, and granular-vacuolar degeneration occurred in the endochylema. In hydrogen-rich saline group, the structure of spinal cord anterior-horn motor neurons was basical y intact, only a smal amount of spinal cord anterior-horn motor neurons appeared vacuolar degeneration. TUNEL staining showed no apoptotic spinal cord anterior-horn motor neurons in sham operation group. Many inflammatory cel s and apoptotic neurons were found in model group. There were few inflammatory cel s and apoptotic neurons in hydrogen-rich saline group. Hydrogen-rich saline can prevent the apoptosis of spinal cord anterior-horn motor neurons in rabbits with spinal cord ischemia-reperfusion injury, and the underlying mechanism is associated with antioxidative effect.

Objective To explore the clinical and laboratory characteristics of patients with dengue fever(DF)in Guangzhou from July to September in 2006 and to improve the awareness of dengue virus infection for physicians.Methods Clinical data of 277 patients with DF admitted to our hospital in Guangzhou were retrospectively analyzed.Dengue virus was isolated from patients' blood specimens by C6/36 cell culture and typed by reverse transcriptase-polymerase chain reaction(RT-PCR)assay and gene sequencing.Results Age of the 277 patients,148 males and 129 females,averaged 36 years with a standard deviation of 17 years,ranging from 9 months to 78 years.Their most common symptoms included fever(100.0%),skin rash(85.2%),headache(69.3%),myalgia(51.3%),bone soreness (39.0%)and nausea or vomiting(39.4%),and leucopenia and/hromboeytopenia occurred in 75.5% and 62.5% of them,respectively.Elevated alanine aminotransferase(ALT)was found in 59.6%,elevated aspartate aminotransferase(AST)in 81.6%,and hypopotassemia in 53.8% of them.Serum positivity of antibody against dengue virus IgM was 90.6%,which could be detected 3 to 10 days after onset of the illness,with a mean of 6.2 days with a standard deviation of 1.9 days.Cell-cultured virus from 20 patients were identified as typed by RT-PCR and RNA sequence analyses.All patients were clinically classified as typical DF and all of them completely recovered.Conclusions DF during this epidemic in Guangzhou was caused by dengue virus-1,with typical manifestations in all the patients but more damage in the liver.Some patients demonstrated hypopotassemia,but no dengue hemorrhagic fever or dengue shock syndrome was found.All the patients experienced a good prognosis with timely diagnosis and treatment.

BACKGROUND:The residual alveolar ridge in edentulous patients with osteoporosis always presents with a poor shape,which increases the difficulty in complete denture restoration.Until now,there are no predictors for residual alveolar ridge resorption or guidelines on the frequency of denture relines.OBJECTIVE:To investigate the correlation between the frequency of complete denture relines and serum bone turnover markers,osteocalcin (OC) and cross-linked carboxy-terminal telopeptide of type Ⅰ collagen (CTX),in elderly edentulous patients with osteoporosis,in order to provide reference for complete denture repair.METHODS:According to inclusion criteria,50 elderly edentulous patients with osteoporosis who had complete dentures were recruited in the study randomly.The frequency of complete denture relines was surveyed by related questionnaire and medical record,and the serum OC and CTX levels were detected by electrochemiluminescence immunoassay.Related data were analyzed statistically via Pearson correlation analysis.RESULTS AND CONCLUSION:It showed a strong positive correlation between the frequency of complete denture relines and the serum OC level (r=0.517,P ＜ 0.01).No significant correlation between relines frequency and the serum CTX level was observed (r=0.278,P=0.051 ＞ 0.05),but it showed a similar tendency between them.These findings indicate that to detect the levels of serum bone turnover markers may be conducive to evaluating curative effect of complete dentures in elderly edentulous patients with osteoporosis as well as to making subsequent diagnostic and therapeutic strategies.

Objective:To investigate the effect of continuous blood purification (CBP) on inflammatory factors and immune function in patients with sepsis,in order to provide reference for clinical treatment of sepsis.Methods:A total of 76 patients with severe sepsis,who were treated in ICU of Daqing Oilfield General Hospital from June 2014 to December 2016,were selected.The patients were divided into conventional group (n=36) and CBP group (n=40) according to the received treatment method.The patients in the conventional group were treated with targeted therapy and life support,while the patients in the CBP group were treated with CBP on the basis of targeted therapy.The levels of interleukin-6 (IL-6),interleukin-10 (IL-10),tumor necrosis factor-α (TNF-α) and C reactive protein (CRP) of the patients in the two groups were detected and compared before treatment and after 3d of treatment.The CD3+,CD4+,CD8+T cell and the CD4+/CD8+ ratio before treatment and after 3 d of treatment were calculated and compared between the two groups.Results:There was no significant difference in the level of serum inflammatory factors between the two groups before treatment (P＞0.05).The levels of serum inflammatory factors in the two groups were significantly decreased after 3 d of treatment,and the levels of IL-6,TNF-α and CRP in the CBP group were significantly lower than those in the conventional group (P＜0.05).There was no significant difference in immune function indexes between the conventional group and the CBP group before treatment (P＞0.05).After 3d of treatment,CD3+,CD4+ and CD4+/CD8+ ratio were significantly increased in the two groups,and the CD4+ and CD4+/CD8+ ratio of the CBP group were sig-nificantly higher than those of the conventional group (P＜0.05).Conclusion:The application of CBP in the treatment of patients with sep-sis can obviously improve the expression of inflammatory factors of patients,and can improve the immune function and promote the re-covery of immune function.

To investigate the expression of Toll-like receptor (TLR) 2 and 4 mRNA in local tissues of model of oropharyngeal candidiasis in mice and to explore the potential role of TLR2 and TLR4 in earlier period of immune response, a murine model of oropharyngeal candidiasis inoculated by cotton wool balls saturated with Candida albicans was established. Mice were sacrificed at the indicated time points and the oropharyngeal tissues were excised. The expression of TLR2 and TLR4 mRNA was detected by RT-PCR. The results showed that low level of TLR2/4 mRNA could be detected in oropharyngeal tissues, but they were markedly up-regulated 6 h after inoculation, peaking after 12-24 h. Tissue TLR4 mRNA was gradually down-regulated 24-48 h, while TLR2 mRNA levels remained high up to the 72nd h. These data suggested that oropharyngeal infection of Candida albicans could result in up-regulation of TLR2/4 mRNA expression in local tissues, which might play important roles in earlier period of immune response.
Candidiasis/metabolism ; Candidiasis, Oral/*metabolism ; Mouth Mucosa/*metabolism ; Pharyngitis/metabolism ; RNA, Messenger/biosynthesis ; RNA, Messenger/genetics ; Random Allocation ; Toll-Like Receptor 2/*biosynthesis ; Toll-Like Receptor 2/genetics ; Toll-Like Receptor 4/*biosynthesis ; Toll-Like Receptor 4/genetics

ObjectiveTo evaluate the efficacy of self-management to improve the lower urinary tract symptoms (LUTS) and life quality in benign prostatic hyperplasia (BPH) patients.MethodsTwo hundred and twenty-two men were recruited to take αblockers for at least 3 months from March 2008 to September 2009. Participants were randomized to either attend a self-management program in addition to standard care or to standard care alone. Difference of scores of International Prostate Symptom Score (IPSS) and BPH-specific quality of life scale between the two groups was analyzed during enrollment period, the 1st week, the 3rd month and 6th month of therapy.ResultsAll participants were followed up for 6 months.The IPSS scores of the SMI group were 20.5 and 20.5 and the QOL were 50.9 and 50.8 at the 1st week.While the numbers were 19.6 and 19.3 for IPSS and 51.1 and 51.1 for QOL in the control group. There was no statistic difference in the control group.Whereas during the 3rd and 6th month assessment, the scores of IPSS and quality of life of self-management interventional group were statistically significantly lower than those of the control group.ConclusionsSelf-management intervention could reduce the LUTS symptoms and improve quality of life in BPH patients who were taking medicines.