OBJECTIVE:To detect and analyze the drug resistance of the AmpC and the extended-spectrum ?-lactamases(ESBLs)in Escherichia coli(E coli)from urinary infections.METHODS:ESBLs was detected by Phenotypic Confirmatory Test and AmpC was detected by improved three dimensional test.RESULTS:The isolating rates of ESBLs(45 strains),AmpC(8 strains)and AmpC+ESBLs in E.coli(5 strains)were 34.6%,6.2% and 3.8%,respectively.The drug resistance rates of ESBLs and AmpC-producing E.coli was higher than those of the strains without producing ESBLs or AmpC.CONCLUSION:Production of AmpC and ESBLs in ?-lactam antibiotics was the main resistance mechanism against E.coli.Carbopenems should be regarded as the first choice in clinical empirical medication for enzyme-producing strains.

Objective To investigate the effects of peer education on treatment among patients using 131I with thyroid cancer after surgery.Methods A total of 80 patients using 131I therapy after surgery of thyroid can cerhospitalized from June 2014 to May 2016 were enrolled and randomly divided into two groups.The control group were given routine health care including hospitalized treatment,education,and follow-up examination after discharge from hospital,while the experimental group were given peer education,and the intervention was provided from admission to one month after discharge.Distress level,complication rates and knowledge mastering were compared between two groups.Results The differences of distress level,complication rates and knowledge mastering between two groups were statistically significant(P＜0.05).Conclusion Patients using 131I with thyroid cancer after surgery suffer from significant distress.Peer education can greatly reduce patients' distress,complications after 131I treatment,and improve mastering knowledge.

OBJECTIVE:To investigate the characteristics and influential factors of adverse drug reactions(ADRs)of docetax-el in our hospital,and to provide suggestions for clinical rational drug use and individualized administration. METHODS:Medical records of patients receiving anti-tumor chemotherapy were extracted from hospital information system(HIS)of our hospital during Apr. 2014 and Oct. 2015,and Docetaxel related ADR reports were collected and comprehensively analyzed by retrospective classi-fied statistics. RESULTS:Among 417 cases,105 cases of docetaxel related ADR were reported. There were 69 patients aged 50-69 with highest ADR frequency. The ADR incidence of female patients was higher than that of male patients (29.29% vs. 19.66%). The incidence of docetaxel related ADR and arrest of bone marrow increased as the increase of drug dosage;the incidence of breast cancer ADR was the highest (46.03%),followed by lung cancer (37.25%) and gastric cancer (25.00%). The incidence of docetaxel+platinum chemotherapy plan ADR was the highest (35.10%). Main organs/system involved in ADR was hematological system (55.65%). CONCLUSIONS:The individual difference of docetaxal related ADR are great and affected by several factors. Individual physical condition of patients should be taken into consideration as early as possible,which can reduce the incidence of ADR and promote clinical rational drug use.

Objective: To establish a rapid detection method for Salmonella based on the combination of enzymatic recombinase amplification (ERA) and lateral flow chromatography (LF), so as to provide technical support for the on-site detection of Salmonella. Methods: Specific ERA primers and probes were designed based on the highly conserved flagella gene fimY in Salmonella. The primers were screened using capillary electrophoresis, and the probes were designed according to the amplification range of the screened primers. The amplification temperature and time were optimized to establish the amplification method, and the product was detected using LF strips. A standard strain of Salmonella was used to verify the sensitivity, 10 other gut bacteria were used to to verify the specificity and sensitivity, and the nucleic acid of the actual Salmonella strains was amplified to verify the detectability. Results: After screening for Salmonella-specific primers using capillary electrophoresis, the minimum detection concentration was 5 copies/μL under the amplification temperature of 37 ℃ and reaction time of 20 minutes. This method had a positive amplification result for Salmonella nucleic acid, and the amplification results of 10 other gut bacteria were all negative, with good specificity. Conclusion This method provides a possibility for on-site point of care testing of Salmonella infection.

Objective To investigate the correlation between the level of serum cortisol and alexithymia in depressive patients with somatic symptoms.Methods The morning level of serum cortisol was measured with radioimmunoassay in 30 depressive patients with somatic symptoms (somatization group) and 30 depressive patients without somatic symptoms (non-somatization group).The severity of alexithymia was evaluated with Toronto alexithymia Scale(TAS-20).Results (1) The level of serum cortisol in somatization group was significantly higher than that in non-somatization group((533.88±144.10) μmol/L vs (458.27±82.87) μmol/L,P＜0.01).(2) The total TAS score and the factor score of Difficulty in identifying feelings and Difficulty in describing feelings in somatization group were obviously higher than those in non-somatization group,respectively ((67.13 ± 6.96) vs (62.03±7.14),(24.50±3.78) vs (21.63±3.63),(15.30±2.69) vs (13.57±2.03),all P＜0.01).(3) The level of serum cortisol in somatization group was positively correlated with the total score of alexithymia (r=0.596,P＜0.01) and the factor score of Difficulty in identifying feelings, Difficulty in describing feelings, externally oriented thinking,respectively (r=0.391,0.435,0.452,all P＜0.05).(4) The level of serum cortisol in non-somatization group was positively related to the total TAS score (r=0.418,P＜0.05) and the factor score of externally oriented thinking(r=0.489,P＜0.01).Conclusions Compared with depressive patients without somatic symptoms,depressive patients with somatic symptoms had more severe alexithymia,especially in Difficulty in identifying feelings and Difficulty in describing feelings.The severity of alexithymia was positively correlated with the level of serum cortisol.

To express feruloyl esterase A from Aspergillus oryzae in Pichia pastoris expression system and study its hydrolysis function, explore the conditions and effects of purification for ferulic acid extracts by macroporos resin. Using the total RNA from A. oryzae CICC 40186 as the template, we amplified coding sequence AorfaeA encoding a mature feruloyl esterase A (AorFaeA) by RT-PCR technique. Then, the coding sequence AorfaeA was successfully expressed in Pichia pastoris GS115 mediated by an expression plasmid pPIC9K. The purified recombinant AorFaeA (reAorFaeA) showed one single band on SDS-PAGE with an apparent molecular weight of 39.0 kDa. The maximum activity of reAorFaeA to methyl ferulate, measured by high-performance liquid chromatography (HPLC), was 58.35 U/mg. Then, reAorFaeA was used to release ferulic acid from de-starched wheat bran in the presence of xylanase. The purification tests for ferulic acid from the enzymatic hydrolysate were carried out with preselected macroporous resins. The results showed that macroporous resin HPD-300 had much higher adsorption and desorption capacities. Ferulic acid could be quantitatively recovered by 50% of the eluent concentration at a flow speed of 1 mL/min. Under the purification condition, the recovery ratio of ferulic acid was 92%, and the content of ferulic acid was increased from 0.13% in the raw material to 10.55%. This work exploits the breakdown of ferulic acid by recombinant enzymeand provids a good strategy to its "green production".
Aspergillus oryzae ; enzymology ; Carboxylic Ester Hydrolases ; biosynthesis ; genetics ; Cloning, Molecular ; Coumaric Acids ; chemistry ; Electrophoresis, Polyacrylamide Gel ; Hydrolysis ; Molecular Weight ; Pichia ; genetics ; metabolism

Objective:To provide reference for clinical pharmacists participating in the therapy of idiopathic membranous nephrop-athy patients. Methods:The drug use in 3 cases of idiopathic membranous nephropathy participated by clinical pharmacists was ana-lyzed. Results:When idiopathic membranous nephropathy was treated with glucocorticoid combined with tacrolimus, it was necessary to master the drug selection, dose and blood concentration of the drugs, course and time of the treatment and adverse reactions etc. In addition, the effectiveness and safety should be unified. Conclusion:Clinical pharmacists should pay close attention to the rational drug use, compliance of patients and adverse reactions through participating in the therapy of idiopathic membranous nephropathy.

To construct human antibody repertory with phage display technology. Total RNA was extracted from peripheral blood lymphocytes (PBL) of clinical glioma patients and subjected to reverse transcription PCR. Variable region genes(V ? and V H genes) were amplified from the cDNA using nested polymerase chain reaction. V ? gene library was first constructed and attached to the Linker which could specially connect V ? gene and V H gene, then V H gene was cloned into V ? gene library to build ScFv repertoire. Positive colonies were selected randomly and sequenced. The results implied that amplified human V ? gene and V H gene could be derived from PBL of clinical glioma patients. ScFv phage antibody gene repertoire in about 2?10 6 capacity was successfully constructed. The sequencing indicated that the cloned genes encoded variable regions of heavy chains of human antibody and were highly homologous with human kappa heavy chain group III of Kabat's database. Then human antibody repertoire was successfully constructed with phage display technology. The present study can be used as a foundation for succeeding screening of specific antibody against human glioma.

Objective To evaluate the capability of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry ( MALDI-TOF MS) for rapid identification of methicillin-resistant Staphylo-coccus aureus (MRSA) and methicillin-sensitive Staphylococcus aureus (MSSA) strains.Methods Twenty-five MRSA and thirty MSSA isolates were collected from the Second Affiliated Hospital of Zhejiang University School of Medicine as the experiment group .Twelve MRSA and twenty-two MSSA clinical strains were isola-ted as the control .All strains were identified by MALDI-TOF MS and the results were further analyzed by ClinProTools 3.0 software.Results Four algorithms including support vector machine (SVM), genetic al-gorithm ( GA) , supervised neural network ( SNN) and quick classifier ( QC) showed similar results in dis-tinguishing MRSA from MSSA isolates .The sensitivity of GA was 100 .0%and the sensitivities of other algo-rithms were all greater than 95.0%.The specificities of GA, SVM and QC were all greater than 90.0%. The areas under the receiver operating characteristic ( ROC) curves of four characteristic peaks at mass-to-charge ratios (m/z) of 3279, 6485, 6555 and 3299 m/z were all greater than 0.9.The virtual gel view showed that the bands generated by MSSA isolates at 3279 , 6485 and 6555 m/z were obviously deeper in color than those generated by MRSA isolates .However , the bands of MSSA isolates at 3299 m/z were appar-ently lighter in color than those of MRSA isolates .83.3%of MRSA and 90.0%of MSSA isolates from the control group were correctly identified by the GA model .Conclusion MALDI-TOF MS could rapidly and accurately identify MRSA from MSSA isolates under the strictly controlled experimental conditions with the advantages of less time-consuming, high sensitivity and high specificity .The accurate identification of MRSA from MSSA isolates could be applied for the prevention and treatment of MRSA infection .

Objective To evaluate the comprehensive clinical ability of new nurses in hospital of traditional Chinese medicine by the application of obstructive structured clinical examination.Methods New nurses of Nanjing hospital of traditional Chinese medicine (TCM) of the grade 2012 and 2013 were assessed.The examination consisted of four parts including standard patient station,the capacity of the case,the basic nursing skills of medicine and TCM.The scores of the theoretical knowledges and nursing skills were assessed.Results The average score of the nurses was (76.32±6.31)points,complying to the normal distribution;The degree of difficulty of the examination was 0.70-0.85 and the degree of distinguish was 0.28-0.48;The score of the theoretical test was lower than that of nursing skills and there was significant difference between them (P＜0.05).Conclusions The design of the examination is reasonable and the clinical ability of new nurses majored in TCM can be well assessed.