Objective To discuss drug resistance of wound-isolated pseudomonas aeruginosa and its correlation with use of antibiotics in children,for guiding the clinical use of antibiotics.Methods One hundred and forty wounded children admitted from January 2009 and December 2013 were collected in the study.There were 97 males and 43 females,aged (5.4 ± 2.6) years.All were victims of road traffic accidents.Distribution of bacteria isolated from the wound and drug resistance of pseudomonas aeruginosa were detected.Twenty-seven children with pseudomonas aeruginosa infection were divided into imipenem-resistant group (n =7) and non-imipenem resistant group (n =20).Drug resistance and application intensity of antibiotics were compared between the two groups.Results A total of 64 pathogens were isolated from the wound culture.Top five bacteria detected were acinetobacter baumannii,pseudomonas aeruginosa,enterobacter cloacae,escherichia coli and staphylococcus epidermidis.Pseudomonas aeruginosa showed resistance to β-lactam antibiotics,tetracyclines,chloram-phenicol and sulfanilamide.Drug resistance of piperacillin tazobactam (64.7％),meropenem (100％),ceftazidime (64.7％) and piperacillin (76.5％) in imipenem-resistant group were all 40％ higher than that in nonimipenem resistant group (P ＜ 0.05).Imipenem-resistant group versus non-imipenem resistant group revealed no significant differences in drug resistant rate of azactan (76.5％,39.0％),cefepime (70.6％,29.3％) and gentamicin (35.3％,17.1％) (P ＞ 0.05).There was no significant difference in total application intensity of antibiotics between the groups (P ＞ 0.05).Conclusions Wound-isolated pseudomonas aeruginosa in children is multidrug resistant.Thus bacterial monitoring in children with traumatic wounds should be strengthened and antibiotics should be selected rationally to reduce the production of multidrug resistance of pseudomonas aeruginosa.

Objective To establish a HPLC method for determination of geniposide content in Qingkailing Capsule. Methods HPLC with Gracesmart C18 was used and detection wavelength was 238 nm with acetonitrile-water (15∶85) as mobile phase. The flow rate was 1.0 mL/min. Results The standard curve was linear over the range of 0.060 4～0.302 0 ?g (r=0.999 8). The average recovery was 98.73%, and RSD was 1.61%. Conclusion This method is reliable, accurate and suitable for the determination of geniposide in Qingkailing Capsule.

Objective To evaluate different tigecycline susceptibility testing methods for A.baumannii.Methods Thirty carbapenem resistant A.baumannii (CRAB) and 30 carbapenem sensitive A.baumannii (CSAB) isolates were randomly collected from 30 hospitals during January to December in 2010 in China retrospectively.MIC and inhibitory zone diameters for tigecyclinc were determined by the susceptibility testing methods such as broth microdilution (BMD),agar dilution,E test,MIC Test Strip (MTS),Vitek2.Data were analyzed by comparing the results from each method to those produced by the reference BMD method.The effects of two different susceptibility test media (M-H and ISO-Sensitest Agar) on the MIC of tigecycline were also analyzed.Results For CSAB isolates,the MIC50/MIC90 of BMD,agar dilution,E test,MTS and Vitek2 were as follows:0.125/0.25 mg/L,0.125/0.25 mg/L,0.5/1 mg/L,0.125/0.25 mg/L and 0.5/0.5 mg/L.Compared with BMD method,the categorical agreement rates (CA) of each method were ≥90％,and produced no very major errors (VME) by Food and Drug Administration (FDA)/ European Committee on Antimicrobial Susceptibility Testing (EUCAST) breakpoints.For CRAB isolates,the MIC50/MIC90 of BMD,agar dilution,E test,MTS and Vitek2 were as follows:2/4 mg/L,4/4 mg/L,4/4 mg/L,1/2 mg/L and 2/4 mg/L.Compared with BMD method,MTS produced 3.3％ (1/30)/6.7％ (2/30) VME(FDA/EUCAST breakpoints),and no method CA was ≥90％.The CA between disk diffusion and BMD results were higher by using the criteria of Jones than FDA breakpoints,but only 66.7％ (20/30) were observed in CRAB isolates,and produced no VME.The MIC of tigecycline determined using M-H agar were usually higher than those using ISO-sensitest Agar.Conclusions Agar dilution,E test,Vitek 2 and disk diffusion appear not to be a suitable method for routine susceptibility testing of tigecycline for CRAB strains.Tigecycline intermediate or resistant results determined by these methods require confirmation by BMD,and MTS results also need to be interpreted with caution.

The relationship between C936T polymorphism at 3'-untranslated region of vascular endothelial growth factor (VEGF) gene and diabetic nephropathy (DN) was analysed in 194 type 2 diabetic patients. The frequencies of genotype CC and allele C were significantly higher in DN group than those in non-DN group and control group. Allele C and genotype CC of VEGF may be a genetic marker susceptible to DN.

ObjectiveTo evaluate prognostic factors affecting local tumor progression after radiofrequency ablation (RFA) of hepatocellular carcinoma (HCC).MethodsA total of 246 HCC patients (343 lesions) underwent RFA treatment in our department and were enrolled into this study.The average tumor size was 3.7 cm ( range 0.9 ～ 3.7 cm).Regular follow-up with enhanced CT was performed to evalutate the treatment results.Kaplan-Meier model and log-rank test were used in univariate analysis and COX regression model was used in multivariate analysis to identify risk factors for local tumor progression.ResultsThe local tumor progression rate was 11.4％ (39/343 lesions),and the average time from initial RFA to local tumor progression was 12.0 months.Univariate analysis indicated tumor size ( P ＜0.001 ),close to intrahepatic vessels ( P ＜0.001),tumor boundary ( P =0.020),pathological grade( P =0.010) and CEUS before RFA ( P =0.001) as risk factors for local progression.The following factors were identified as independent prognostic factors for local tumor progression by multivariate model:tumor size (P ＜ 0.001),isolated or close to intrahepatic vessels( P ＜0.001) and CEUS before RFA(P =0.018).ConclusionsTumor size,CEUS before RFA and close to intrahepatic vessels are the most important factors for local progression after RFA.Being awaring of possible risk factors for local tumor progression may increase the treatment efficacy and help to promote the use of RFA technique.

OBJECTIVE To investigate the cytotoxic activity of Arca subcrenata Lischke anticancer protein(ASAP)constituents on human myeloid leukemia K562 cells in vitro and analyze its anticancer mechanisms. METHODS ASAP was extracted by low temperature water and ammonium sulfate precipitation. Protein concentration of ASAP was detected by Bradford method. Morphological changes of cultured K562 cells treated with ASAP were observed under the inverted phase-contrast micro?scope. The cell and nucleus changes were analyzed by Giemsa staining. The cytotoxicity of ASAP on K562 cells was detected by MTT assay. Flow cytometry was used to detect apoptosis and cell cycle of K562 cells treated with ASAP. The expression of apoptosis and cell cycle related proteins procaspase 3, caspase 3,P53 and programmed cell death 4(PDCD4)were analyzed by Western blotting. RESULTS ASAP exhibited significant cytotoxic effect on K562 cells in a time- and concentration-dependent manner. The concentration-effect correlation coefficient of ASAP 50,100 and 200 mg · L-1 on K562 cells for 24, 48 and 72 h was 0.851,0.8977 and 0.8997,respectively. Under an optical microscope,K562 cells showed cytomorphosis,or nuclear fragmentation after treatment with ASAP 200 mg · L-1 for 48 h. Flow cytometry analysis and Giemsa staining assay indicated that apoptotic cells increased and G2/M phase cells accumulated significantly with the increase of ASAP concentration. After treatment with ASAP 200 mg · L-1 for 48 h,the early and late apoptosis cell rate increased to(32.8 ± 0.1)%and(31.2 ± 2.2)%vs control group(3.7 ± 1.1)% and (9.9 ± 0.8)%(P<0.01),respectively,and the G2/M phase cells increased to (55.2 ± 1.7)% vs (15.3 ± 0.8)% in control group(P<0.01). After treatment with ASAP 200 mg · L-1 for 0-40 h,the expression of apoptotic protein procaspase 3 was down-regulated and its active form caspase 3 was significantly up-regulated at 32 h,while PDCD4 and P53 protein expression was down-regulated significantly in 0-40 h. CONCLUSION Apoptosis and cell cycle arrest induced in G2/M phase may account for ASAP cytotoxic activity to K562 cells. K562 cell apoptosis induced by ASAP depends on caspase 3 signal pathway. Down-regulated expression of PDCD4 and P53 proteins may be related to K562 cell apoptosis and cell cycle arrest in G2/M phase by ASAP.

AlM: To observe the effects of the coelomic cavity injection of triamcinolone acetonide ( TA) combined with laser photocoagulation on patients with retinal vein occlusion.
METHODS:Fifty-six patients of retinal obstruction with macular edema were accepted from January 2010 to December 2012 in our hospital. All patients received iodized lecithin and Xueshuantong. And, patients with central retinal vein occlusion ( CRVO ) , hemi- central retinal vein occlusion ( hemi-CRVO ) and branch retinal vein occlusion ( BRVO ) treated by TA combined with laser photocoagulation, respectively. Follow-up period was of at least 6mo
RESULTS: After the treatment of 1, 3 and 6mo, the central foveal thickness was reduced significantly ( P<0. 05). After followed up 6-12mo, the total effective rate of CRVO, Hemi-CRVO and BRVO patients was 83% ~95% and all the patients had no significant adverse reactions.
CONCLUSlON:Basing on the traditional treatment, TA combined with laser photocoagulation is more effective in the treatment of retinal vein occlusion and is worthy of clinical usage.

AIM:To investigate the serum antibody of aquaporin 4 ( AQP4 - Ab ) in positive expression rate and the significance in patients with neuritis.
●METHODS: A total of 98 cases ( 128 eyes ) of patients with optic neuritis were studied to detect the patient′s serum AQP4-Ab positive rate of antinuclear antibodies ( ANAs) from Jan. 2012 to Dec. 2015 in ophthalmology center of our hospital. According to the expression of AQP4 - Ab group, the best corrected visual acuity between the two groups, peripapillary nerve fiber layer thickness (pRNFL), the volume of the macula, macular RNFL ( mRNFL ) , macular core layer volume ( mlNL ) measurement were compared.
●RESULTS:Ninety-eight patients (128 eyes) with optic neuritis cases diagnosed through examination revealed AQP4-Ab positive in 22 patients ( 22%) , negative in 76 patients ( 78%) , ANAs positive in 21 patients ( 21%) , negative 77 patients ( 79%) . Optic neuritis patients with serum AQP4 - Ab positive rate and ANAs positive significant correlation ( r = 0. 707, P < 0. 05 ). After examination revealed AQP4-Ab patients and negative-positive patients with best corrected visual acuity difference was not statistically significance (P>0. 05). After inspection found pRNFL, macular volume measured value AQP4 - Ab positive patients were significantly less than the negative patients, the differences were statistically significant (P<0. 05). AQP4-Ab positive patients and negative patients the mRNFL, mlNL measured values were not significantly different (P>0. 05).
●CONCLUSION:AQP4-Ab and ANAs expression in optic neuritis patients is a significant correlation. AQP4-Ab positive patients with optic neuritis pRNFL thinning of macular volume are decreased compared with negative patients.

Objective To study the role of immunoregulation in patients with Recurrent vulvovaginal candidiasis(RVVC) that evaluate the efficacy of application with combining clotrimazole and rhIFN-? therapy.Methods Patients were divided randomly into two groups :treatment group(60) and control group(60). The patients in treatment group were scheduled to receive clotrimazole therapy, 400mg,pv,qd,and add to rhIFN-? 1000000u im,biw; control group only using clotrimazole therapy.Results The curative rate betweet two groups had significant difference (68.33 (41/60) vs. 35.0(21/60). The efficiency rate in control group was significantly higher than treatment group( (56.67(34/60)vs 26.67(16/60)),In treatment group ,the serum levels of IL-18(pg/ml)(before treatment (111.71?18.45),after treatment (189.18?28.17))and TNF-? (pg/ml)(before treatment (52.66?18.75),after treatment (124.25?43.77))were significantly increased (P0.05). Conclusion The application with combining clotrimazole and rhIFN-? can significant ameliorate the curative rate of RVVC,by regulate immune fanction in the patients that were induced the produce of IL-18 and TNF-?. rhIFN-?can improve cell-mediated immunity in patients with RVVC.

Objective To explore the significance of gene mutations of methylenetetrahydrofolate reductase(MTHFR) C677T,cystathionine ?-synthase(CBS)844ins68,T27796C and methionine synthase (MS A2756G) in the development of brain stroke. Methods There were no obvious differences in age and sex among the four groups. The plasma homocysteine (Hcy) levels of 78 patients with cerebral infarction, 26 patients with cerebral hemorrhage, 29 patients with other neurological diseases and 50 healthy control elders were measured by enzyme-linked immunoassay. Moreover,the genotypes of MTHFRC677T, CBS844ins68, CBST27796C and MSA2756G were detected by PCR-RFLP in four groups. Results The mean plasma Hcy levels in cerebral infarction or in cerebral hemorrhage was significantly higher than those in other neurological diseases or in healthy control elders. The prevalences of CBS 844ins68 and MS A2756G in the cohort studies were obviously lower than those in Caucasian populations. The plasma Hcy level in C677T homozygote mutation was higher than that in wild type or heterozygote. However,heterozygote mutation of CBS T27796C gene reduced Hcy concentration. There were no significant differences in the frequencies of MTHFR,CBS and MS mutations among four groups. Conclusions Hcy might be associated with brain stroke. Moreover,the prevalences of gene mutations of CBS 844ins68 and MS A2756G might vary with different ethnic groups or geographic regions. The homozygosity of MTHFR C677T might contribute to the increase of total plasma Hcy, and CBS T27796C gene heterozygote mutation might lower the raised total Hcy. In addition, four gene mutations are consistent with the law of heredity balance.