OBJECTIVE To investigate the tendency of bacterial distribution and drug resistance of pathogens in ICU,then instruct clinical application of antibiotics reasonably.METHODS The identification of bacteria,isolated from patients in ICU from Jan 2005 to Dec 2006,and antibiotic susceptibility by ATB expression were used.RESULTS A total of 1197 pathogens strains were isolated,Gram-negative bacilli,Gram-postive cocci and fungi accounted for 64.2%,19.6% and 15.8%,respectively.The most common pathogens of them were Pseudomonas aeruginosa(22.1%).Except Escherichia coli(40%),the rate of the ESBL-producing strains of Serratia marcescens,Klebsiella pneumoniae,Acinetobacter baumannii and Enterobacter cloacae were higher than 70%.The most common pathogens of Gram-postive cocci were Staphylococcus.Meticillin-resistant strains of Staphylococcus aureus accounted for 93.8%.Mainly pathogenic bacteria were multi-resistant to some antibiotics.There were 189 strains fungi.And all the fungi were sensitive to amphotericin B,fluconazole and ketoconazole.CONCLUSIONS The infection and multi-drug resistance of pathogens are serious in ICU.It′s important and urgent to carry out surveillance of bacterial resistance for appropriately using antibiotics.

OBJECTIVE To investigate the influence on air quality in cleaning room of the supply department when the water/gas blast gun is used to clean endoscope,to give basis for valuable protective procedures. METHODS Bacterial number of the air in the supply department was sampled using flat plate settling process pre-and post-operation. Simultaneously,the air purification effect of the laminar purification equipment was evaluated. RESULTS The air bacterial content before the water/gas blast gun ran was significantly different from that when the gun stopped (P

Objective To investigate the advantages of BLADE technique in MR T2WI/TSE abdomen scanning. Methods 36 cases, which had obvious motion defects with conventional T2WI/TSE axial abdomen scanning because of psychology or disease, performed T2WI/BLADE/TSE scan with the same regions. Then the image quality was compared, and amendment of motion defects was reviewed. The equipment was SIEMENCE 3.0T scanner and phased-array coil. Results Motion defects of all images with T2WI/BLADE/TSE were attenuated with different degree compared with T2WI/TSE. All images with T2WI/BLADE/TSE satisfied the diagnostic demand. Conclusion The BLADE technique in abdomen scanning solves the difficult problem of impossible MR scan with uneven breath and trembling patients because of psychology or disease, and obtains good diagnostic imaging.

Objective To evaluate the nephrotoxicity induced by radiographic contrast media with different osmolality in rats with hypercholesterolemia, and to explore the protective effect of pentoxifylline. Methods Forty-eight healthy SD male rats were randomly divided into normal dietary group (NN, n =8) and high cholesterol supplemented dietary group (H, 4% cholesterol and 1% cholic acid, n=40). At the end of 8th week, the rats with high cholesterol diet were randomly divided into five subgroups (n=8, respectively): high cholesterol diet group(HN), high cholesterol plus iso-osmolar contrast media (iodixanol, IOCM) group (HI), high cholesterol plus low-osmolar contrast media (iohexle, LOCM) group (HL), high cholesterol diet plus high-osmolar contrast media (diatrizoate, HOCM) group (HH) and high cholesterol plus HOCM plus pentoxifylline group (HHP). Forty-eight hours after contrast media injection, the rats were executed and blood samples were prepared to determine total cholesterol, triglyceride, serum creatinine, creatinine clearance(Ccr), fractional excretion of sodium and potassium(FeNa, FeK), and angtension Ⅱ (Ang Ⅱ) levels. The renal injury was assessed by HE staining and TUNEL staining, respectively. The expression of NF-κB protein in the renal tissue was detected by using immunohistocbemical method. Results An increase of cholesterol was observed in all the rats with high cholesterol diet. Scr, FeNa%, FeK% and Ang Ⅱ levels of rats in HH group were obviously higher than those in HL and HI groups respectively. Ccr in HH group [(0.11±0.02) ml·min-1·(100 g)-1] was significantly lower than that in HHP group [(0.43±0.03) ml·min-1·(100 g)-1], HL group [(0.25±0.02) ml·min-1·(100 g)-1] or HI group [(0.27±0.03) ml·min-1,(100 g)-1] (P<0.05). TUNEL staining showed that the pewentage of apoptotic cells in HH group [(89.60±6.40)% ] was higher than that of the other groups [NN (2.40±0.77)%, HN (5.60±1.08)%, HHP (8.91±1.44)%, HL (63.34±11.97)% and HI (61.50±9.40)%]. Immunohistochemistry staining showed that the average gray value of NF-κB positive cells in HH group decreased (P<0.05). There were no significant differences of all indices between HL and HI groups (P0.05). Conclusions Contrast media can cause kidney injuries in the rats with hypercholesterolemia. PTX can protect the renal tissue from nephrotoxicity induced by HOCM in hypercholesterolemia.

Objective To investigate the expression and clinical value of miRNA -22 in gastric cancer tissues.Methods Real -time PCR was used to detect the miRNA -22 expression in gastric cancer tissues and matched adjacent tissues.The correlations of miRNA -22 expression with clinic pathological features were analyzed. Results 87.5%(77 /88)of the gastric tumor tissues showed aberrant down regulation of miRNA -22 compared with adjacent non -tumor tissues (χ2 =69.32,P <0.05).Lower miRNA -22 level was strongly associated with T3 -T4 stage (χ2 =64.38,P <0.05)and lymph node metastasis(χ2 =68.56,P <0.05).The correlation statistical analysis results indicated that there were no significant differencec in sex,age and differentiation grade (all P >0.05 ). Conclusion The lower expression of miRNA -22 is associated with clinic pathological features.

Objective To study the effect of MMP-9 and ZO-1 expressions on the brain edema in rats with hepatic encepha -lopathy.Methods Ninety rats were randomly divided into two groups .In one group, rats were intraperitoneal of D -galactosamine (400mg/kg) with lipopolysaccharide(100μg/kg) to induce hepatic encephalopathy , and then observe the symptom.12 hours later, ammonia, the evans blue(EB)content, the brain water content and the MMP -9 mRNA and the ZO-1 mRNA in the brain tissue was as-sessed by real-time Q-PCR.Results Two hours later the rats in hepatic encephalopathy groups begin to appear the symptom .12 hours later, the ammonia, the EB content, the brain water content and the MMP -9 mRNA content of the hepatic encephalopathy groups was increased significantly[(279.53 ±9.78)μmol /L vs (33.85 ±1.50)μmol/L, (6.71 ±0.50)μg/g vs (3.96 ±0.48)μg/g, (82.14 ±0.30)% vs (76.07 ±0.39)% and 1.4255 ±0.1131 vs 0.8298 ±0.0537, P <0.01],but the ZO-1 mRNA content was decreased (1.0795 ±0.0534 vs 1.4576 ±0.0654, P <0.01).Conclusions Blood brain barrier permeability enhancement and brain edema in hepatic encephalopathy rats, MMP-9 mRNA increase and ZO-1 mRNA decrease may play an important role .

Objective:To identify the pathogenic gene mutations in a family with early onset severe retinal dystrophy (EOSRD).Methods:A retrospective clinical study. One patient and three family members from a Han of EOSRD who were diagnosed at Henan Eye Hospital in August 2018 were included in the study. After the detailed history of the patients was collected, all participants underwent best corrected visual acuity (BCVA), slit-lamp, fundus biomicroscopy with the slit lamp, untra-widefield fundus color photography, spectral-domain optical coherence tomography (SD-OCT) and full-field electroretinography (ff-ERG). The subject’s peripheral venous blood of 5 ml was collected and the whole genome DNA was extracted. A genetic eye disease capture chip containing 441 disease-causing genes was used for targeted capture and enrichment of high-throughput sequencing, and Sanger sequencing was performed for the clear pathogenic mutation sites; the analysis software was used for bioinformatics analysis of the mutation sites.Results:A 6-year-old female proband developed poor night vision in both eyes after 1 year old. The BCVA of both eyes were 0.1. The color of the optic disc was slightly lighter; the diameter of the retinal vessels was slightly reduced, and extensive pigment changes can be seen in the retina outside the vascular arch. SD-OCT examination showed that the outer membrane, ellipsoid zone and chimera zone in the central fovea of both eyes were unclear and intermittent. The visual area outside the fovea was neuroepithelial outer plexiform layer, outer nuclear layer, outer membrane, ellipsoid zone. The chimera zone gradually disappeared, and the thickness of the pigment epithelial layer was not uniform. In ff-ERG examination, the functions of the binocular cone and rod system were severely decreased. The results of genetic testing showed that there were c.921C>A homozygous mutations in the Tubby-like protein (TULP1) gene of the proband, and c.3121C>T and c.3488G>A compound heterozygous mutations in the cyclic nucleotide gated channel beta 1 (CNGB1) gene. Amino acid conservation analysis results showed that the above three mutation sites were highly conserved in multiple species; bioinformatics analysis results showed that TULP1 gene c.921C>A (p.Cys307*) had translation termination in the protein conserved region, CNGB1 gene c.3121C>T (p.Arg1041Trp) and c.3488G>A (p.Gly1163Glu) had amino acid polarity changes in the protein conserved region, which led to major changes in the protein spatial structure.Conclusion:TULP1 gene c.921C>A homozygous mutation, CNGB1 gene c.3121C>T and c.3488G>A compound heterozygous mutation are the mutation sites of this EOSRD family.

Objective To discuss the clinical value of magnetic resonance imaging in the diagnosis of inner ear lesion.Methods 94 patients who took magnetic resonance imaging water imaging were selected as study subjects from February 2014 to October 2016 in Heilongjiang Province Hospital.All the patients had surgical data,CT,MRI water imaging data.Based on the standard data of surgery gold,analyzed the sensitivity,specificity,accuracy,positive predictive value and negative predictive value of CT and MRI in the diagnosis of inner ear lesions,compared the statistical differences between the two methods of examination.Results The sensitivity,specificity,positive predictive value and negative predictive value of MRI water imaging in diagnosis of inner ear werehigher than CT,but the differences were no statistically significant (all P ＞ 0.05).In the case of abnormal vestibular aqueduct (x2 =7.265,P =0.015),cochlear deformity (x2 =5.042,P =0.028),diagnostic accuracy of cochlear fibrosis (x2 =5.492,P =0.027),the differences were statistically significant(all P ＜ O.05).Conclusion MRI water imaging can effectively provide the information of ear canal,eudometrial and other internal organs,can provide a favorable clinical diagnosis,it is worth to promote the application in the clinical work.

OBJECTIVE: To assess the association of cytochrome P450 (CYP450) gene polymorphisms with the occurrence of ischemic stroke (IS). METHODS: From January 2020 to August 2022, 390 IS patients treated at the Zhengzhou Seventh People's Hospital were enrolled as the study group, and 410 healthy individuals undergoing physical examination during the same period were enrolled as the control group. Clinical data of all subjects were collected, which included age, sex, body mass index (BMI), smoking history and results of laboratory tests. Chi-square test and independent sample t test were used for comparing the clinical data. Multivariate logistic regression analysis was used to analyze the non-hereditary independent risk factors for IS. Fasting blood samples of the subjects were collected, and the genotypes of rs4244285, rs4986893, rs12248560 of the CYP2C19 gene and rs776746 of the CYP3A5 gene were determined by Sanger sequencing. The frequency of each genotype was calculated by using SNPStats online software. The association between the genotype and IS under the dominant, recessive and additive models was analyzed. RESULTS: The levels of total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL-C), apolipoprotein B (Apo-B) and homocysteine (Hcy) of the case group were significantly higher than those of the control group, whilst the levels of high density lipoprotein (HDL-C) and Apo-A1 (APO-A1) were significantly lower (P < 0.05). Multivariate Logistic regression analysis showed that TC (95%CI = 1.13-1.92, P = 0.02), LD-C (95%CI = 1.03-2.25, P = 0.03), Apo-A1 (95%CI = 1.05-2.08, P = 0.04), Apo-B (95%CI = 1.7-4.22, P < 0.01) and Hcy (95%CI = 1.12-1.83, P = 0.04) were non-genetic independent risk factors for the occurrence of IS. Analysis of the association between the genetic polymorphisms and the risk of IS showed that the AA genotype at rs4244285 of the CYP2C19 gene, the AG genotype and A allele at rs4986893 of the CYP2C19 gene, and the GG genotype and G allele at rs776746 of the CYP3A5 gene were significantly associated with IS. Under the recessive/additive model, dominant model and dominant/additive model, polymorphisms of the rs4244285, rs4986893 and rs776746 loci were also significantly associated with the IS. CONCLUSION TC, LDL-C, Apo-A1, Apo-B and Hcy can all affect the occurrence of IS, and CYP2C19 and CYP3A5 gene polymorphisms are closely associated with the IS. Above finding has confirmed that the CYP450 gene polymorphisms can increase the risk of IS, which may provide a reference for the clinical diagnosis.
Humans ; Cytochrome P-450 CYP3A/genetics* ; Cytochrome P-450 CYP2C19/genetics* ; Ischemic Stroke ; Cholesterol, LDL/genetics* ; Polymorphism, Single Nucleotide ; Genotype ; Apolipoproteins B/genetics* ; Gene Frequency

Objective:To investigate the effect of Mediterranean diet on blood glucose control and cardiovascular risk factors in patients with type 2 diabetes.Methods:As to December 2021, the PubMed, Cochrance Central Register of Controlled Trials and Cochrance Database, Cochranc Library, Embase, China National Knowledge Infrastructure and Wanfang Medical Network system were searched for clinical randomized controlled trials(RCTs) of Mediterranean diet in patients with type 2 diabetes to conduct Meta-analysis The main observation index were cardiovascular risk factors, and the mean difference and its 95% confidence interval were used to estimate the effect size.Results:There were six RCTs, and 1181 patients met the inclusion criteria and entered the Meta-analysis. Compared with the control group, the intervention group can significantly reduce the level of systolic blood pressure ( MD=-1.20, 95% CI-2.21 to -0.19) and diastolic blood pressure ( MD=-4.17, 95% CI-7.12 to -1.22) in patients with type 2 diabetes mellitus, but there were no significant difference in the level of TC ( MD=2.92, 95% CI-0.84 to-6.67), HDL ( MD=2.33, 95% CI-0.27 to -4.92) and LDL ( MD=-2.34, 95% CI-5.67 to -0.99) between the two groups (all P>0.05). Conclusions:The meta-analysis provided evidence the Mediterranean diet showed the beneficial improvements in blood pressure glycemic control, but the effect of Mediterranean diet on lipid profile was not significant, which needed further verification.