OBJECTIVE To investigate the distribution and drug resistance of pathogenic bacteria in septicemia in order to provide the reference for clinical antimicrobial agents usage.METHODS The blood samples of inpatients were cultured with blood culture apparatus,VITEK-AMS was used to identify the bacteria and conduct drug resistance test and ESBLs produced by Escherichia coli,and Klebsiella were detected by disc diffusion confirmatory test.RESULTS The 221 strains of pathogens that caused septicemia were mainly distributed in ICU,blood department and infection department.The 61 strains of E.coli were isolated,among which ESBLs were detected and accounted for 39.3%(24),26 strains of Klebsiella were isolated,among which ESBLs were detected and accounted for 26.9%(7),ESBLs strains were more resistant than ESBLs negative strains.Thirty two strains of Staphylococcus were isolated,among which MRS were detected and accounted for 62.5%(20).The pathogens showed highly multiple drug-resistance.Vancomycin and imipenem were the highest susceptible for Gram-positive and Gram-negative bacteria,respectively.CONCLUSIONS The pathogens that caused septicemia are mainly distributed in ICU,blood department and infection department.The situation of antibiotic resistance of pathogens is very serious now.Therefore,it is important to prevent the septicemia and to detect enzyme producing strains regularly for reference of reasonable antibiotic use.

OBJECTIVE To study the change and significance of TNF-? and IL-18 in the Acinetobacter baumannii sepsis. METHODS Sixty male SD rats were divided into 6 groups. The first group was normal control group. The second to sixth groups were sepsis groups which were killed at 4h,16h,24h,48h,72h after injecting A. baumannii through intraperitoneal injection to make sepsis model. The level of TNF-? and IL-18 in the serum of rats was measured by enzyme linked immunosorbent assay (ELISA). RESULTS The level of TNF-? in the serum increased markedly in the sepsis groups (P

Objective　To find out the appropriate bedbound period after Coronary Arteriography (CAG) in order to reduce the complications and uncomfort caused by prolonged Bedbound period and affected limb immobilization.Methods　121 cases of CAG patients were randomly divided into the reduced period group (experiment group) and the conventional group (the control group),two ways of nursing and observation respectively.Result　the rate of complication occurred in the experiment group much less than that of in the control group and the bedbound period were different as well.The above items showed statistics significance (P<0.005～0.05).Conclusion　The reduced bedbound period decreases the suffering of CAG patients and provides the reliable clinical evidence for proper nursing approach in this field.

Objective:To investigate the predictive value of acute gastrointestinal injury (AGI) score for the severity of acute pancreatitis (AP), infectious pancreatic necrosis and patients′ death.Methods:Clinical data of 719 patients with AP were collected from the AP database of the National Clinical Research Center for Digestive System Diseases from January 2016 to June 2018. According to the severity of the disease, they were divided into MAP group (506 cases), MSAP group (112 cases) and SAP group (101 cases). AGI, APACHEⅡ, MCTSI and BISAP scores were calcululated in the three groups. Receiver operating characteristic curve (ROC) was drawn and the area under the curve (AUC) was calculated. The predictive value of the above four scoring systems for the hospitalization days, disease severity, infectious pancreatic necrosis and death was analyzed, respectively.Results:There were no cases of infectious pancreatic necrosis or death in the MAP group, but there were 9 cases of infectious pancreatic necrosis and 2 deaths in the MSAP group and 19 cases of infectious pancreatic necrosis and 8 deaths in the SAP group. There was a strong correlation between AGI score and AP patients′ hospitalization days ( r=0.619). AUC of AGI, APACHEⅡ, MCTSI and BISAP score in predicting the AP patients′ severity (MSAP+ SAP) was 0.967 (95% CI 0.951-0.982), 0.769(95% CI 0.720-0.899), 0.842(95% CI 0.809-0.875), 0.862 (95% CI0.832-0.893). AUC for forecasting infectious pancreatic necrosis was 0.803, 0.677, 0.692, 0.724, and the 95% CI was 0.724-0.882, 0.573-0.781, 0.582-0.636, 0.801-0.812. AUC for predicting death in patients with AP were 0.915, 0.597, 0.659, 0.812, and the 95% CI were 0.843-0.986, 0.444-0.751, 0.498-0.698 and 0.882-0.926. AGI score had the highest predictive value, followed by BISAP score, and the correlation between these two scores was the closest. The predictive value of AGI combined with BISAP score for infectious pancreatic necrosis and patient death (AUC were 0.837, 0.942, 95% CI were 0.770-0.903, 0.897-0.987) was better than that of AGI and BISAP score alone. Conclusions:AGI score combined with BISAP score is more effective in predicting the severity of AP, the occurrence of infectious pancreatic necrosis or patient death.

OBJECTIVE To investigate and analyze the bacteria on the nurse mask in ICU ward and its air effects disinfection.METHODS Sixty masks were examined for the bacteria numbers,germiculture and drug resistance.The bacteria numbers on the mask were recorded in 2,4,6 and 8 h with or without air disinfection,and the numbers of air bacteria were also estimated before and after air disinfection 2,4,6 and 8 h.The kinds and drug resistance of bacteria in the sputum of patients were recorded during the examining time.RESULTS The meticillin-resistant Staphylococcus(MRS,90.6%) and the Escherichia coli(ECO,9.4%) were the major bacteria on the mask.The numbers of bacteria on the mask at 2,4,6 and 8 h with air disinfection were 1.2?1.5,3.4 ?2.8,4.2?3.4 and 5.3?3.6 CFU/cm2,respectively.The numbers of bacteria on the air before air disinfection were 1264?314 CFU/m3 and after air disinfection 2,4,6 and 8 h were 917?213,790?176,676?179 and 483?167 CFU/m3,respectively.The numbers of bacteria on the mask and on the ward air were decreased obviously after the air disinfection comparing without disinfection.MRS was found in 26.7% patients sputum,and had the same drug-resistance spectrum as the bacteria on the mask.CONCLUSIONS MRS and ECO may be infected through air,and the effective air disinfection could reduce the numbers of bacteria on the air,and decrease the possibility of intercross infection.

Objective: To observe the impact of cardiac contractility modulation (CCM) on myocardial remodeling in rabbit model of chronic heart failure (CHF) with its possible mechanism. Methods: Rabbit HF model was established by ascending aortic root ligation; the animals were divided into 3 groups: Sham group, the animals received thoracotomy without aortic ligation, HF group and HF+CCM group, the HF animals received CCM treatment for 4 weeks. n=10 in each group. Cardiac function was measured by echocardiography at 12 and 16 weeks in each group respectively; myocardial tissue fibrosis and pathological changes were examined by Masson staining; plasma BNP level was assessed by ELISA; protein expressions of collagen I, collagen II, MMP2,MMP9, TIMP1 and galectin-3 in myocardial tissue were determined by Western blot analysis. Results: ① By echocardiography: with 12 weeks treatment, compared with Sham group, HF group and HF+CCM group had increased LVESD, LVEDD and decreased LVFS, LVEF, all P<0.05; with 16 weeks treatment, compared with HF group, HF+CCM group had improved LVESD, LVEDD, LVEF and LVFS, all P<0.05. ② Pathological changes:compared with Sham group, HF group showed increased collagen content in myocardial tissue, P<0.05; CCM treatment could partially decrease collagen accumulation, P<0.05. ③ After 12 weeks treatment, compared with Sham group, HF group and HF+CCM group presented elevated plasma BNP level, P<0.05; after 16 weeks treatment, compared with HF group, HF+CCM group presented reduced plasma BNP, while it was still higher than that in Sham group, P<0.05. ④ By Western blot analysis: compared with Sham group, HF group demonstrated increased protein expressions of collagen I, collagen II, MMP2, MMP9, TIMP1 and galectin-3 in myocardial tissue; the above indexes were much lower in HF+CCM group while still higher than those in Sham group, all P<0.05. Conclusion: CCM could improve myocardial remodeling in rabbit model of CHF which might be related to down-regulated protein expressions of collagen I, collagen III, MMP2, MMP9, TIMP1 and galectin3 in myocardial tissue.

Objective To explore the correlation between serum cystatin C,lipoprotein associated phospho-lipase A2 (LP-PLA2) and lower limb vascular disease in patients with type 2 diabetes mellitus.Methods From August 2014 to December 2016,a total of 187 type 2 diabetic patients in Weihai Central Hospital were selected. According to the ankle brachial index (ABI),the patients were divided into without lower limb vascular disease group (SDM group,85 cases) and with lower limb vascular disease group (T2DM+LLVD group,102 cases).Meanwhile,82 healthy people were selected as control group.The cystatin C,LP-PLA2,hemoglobin (HbAlc),triglyceride,total cholesterol,high density lipoprotein cholesterol ( HDL-C) and low density lipoprotein cholesterol ( LDL-C) were calculated.Results Compared with the control group [(0.788 ±0.084)mg/L],the cystatin C was significantly high-er in the SDM group[(0.913 ±0.135)mg/L] and the T2DM +LLVD group[(1.114 ±0.225)mg/L],and the difference was statistically significant (t＝5.511,9.121,all P＜0.01).The cystatin C in T2DM+LLVD group was higher than that in the SDM group ( t ＝7.209,P ＜0.01 ).Compared with the control group [( 342.76 ± 33.49)ng/mL],LP-PLA2 was significantly higher in the T2DM+LLVD group[(513.54 ±94.26)ng/mL],and the difference was statistically significant ( t ＝11.428,P＜0.01 ).Compared with the SDM group [( 352.28 ± 67.82)ng/mL],the cystatin C and LP-PLA2 levels were significantly higher that in the T2DM+LLVD group,and the difference was statistically significant (t＝7.209,13.181,all P＜0.01).Conclusion Cystatin C and LP-PLA2 play important roles in type 2 diabetic patients with lower limb vascular disease.Cystatin C and LP -PLA2 may become the forecast indicators in type 2 diabetic patients with lower limb vascular disease.

BACKGROUND:Bone marrow stem cell transplantation can improve heart function and prevent ventricle remodeling.At present,the adult bone marrow stem cells used for transplantation primarily included bone marrow mononuclear cells (BM-MNCs) and mesenchymal stem cells (MSCs),and endothelial progenitor cells.The curative effects and precise mechanisms of transplantation of various bone marrow stem cells remain unknown.OBJECTIVE:To compare the effects of transplantation of autologous BM-MNCs and MSCs via the coronary artery on ventricle remodeling subsequent to acute myocardial infarction (AMI). DESIGN,TIME AND SETTING:Randomized controlled animal experiment performed at the Center for Clinical Research,Hebei Provincial People's Hospital,Electron Microscope Room,Hebei Medical University between March 2005 and December 2006.MATERIALS:Thirty-six male Jizhong pigs,were randomly divided into 4 groups:control group (n = 6),infarct model group (n = 10),BM-MNC group (n = 10),and MSC group (n = 10).METHODS:Porcine autologous BM-MNCs were isolated by gradient density centrifugation,and MSCs were obtained by adherence method.Prior to transplantation,both BM-MNCs and MSCs were colloidal gold labeled.Except the infract model group,pigs in the other 3 groups were developed into AMI models by oppressing the left anterior descending branch with balloon catheter.Ninety minutes after modeling,(6.0±1.3)×107 autologous BM-MNCs and (4.5±2.1)x 107 MSCs were respectively transplanted into pigs in the BM-MNC group and the MSC group via the coronary artery and cultured for 28 days.MAIN OUTCOME MEASURES:Observation of pathological changes of cardiac muscle tissue by light and electron microscope;Examination of cardiac function by ultrasonograph;Detection of the number of blood vessels and apoptotic myocardial cells,and expression of nuclear factor-κB (NF-κB) and troponin Ⅰ and its correlation to cardiac function by immunohistochemistry;Detection of mRNA expression of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) in the cardiac tissue as well as its correlation to cardiac function by reverse transcription-polymerase chain reaction (RT-PCR).RESULTS:In the MSC group,there was proliferation of a great deal of blood vessels as well as growth of abnormal cell masses around the coronary vessels,while the BM-MNC group exhibited the "budding" of many capillary vessels.Prior to transplantation,cardiac function indices were basically similar among each group (F = 1.550,P＞0.05).Twenty-eight days after transplantation,left ventricular ejection fraction was significantly lower in the control,BM-MNC,and MSC groups than in the infarct model group (F = 5.30,P＜0.05),while endocardial fractional shortening was significantly higher (F = 10.67,P＜0.01).Compared with the infarct model group,the number of blood vessels in the infarct zone and infarct border zone was increased in the BM-MNC group (F=29.56-34.87,P＜0.01) and had no apparent change in the MSC group.In the BM-MNC and MSC groups,apoptotic myocardial cells in the infarct zone and infarct border zone were significantly reduced (F=14.31-35.34,P＜0.01 ) and troponin I expression rate was significantly increased (F=19.05,P＜0.01 ),as compared with the infarct model group.In addition,NF-κB positive rate in the infarct border zone was significantly lower in the BM-MNC and MSC groups than in the infarct model group (F=19.05,P＜0.01).VEGF gene expression level in the infarct border zone was significandy higher in the BM-MNC group than in the infarct model group and MSC group (F = 49.41,P＜0.01).bFGF gene expression level in the infarct border zone was significantly higher in the MSC group than in the infarct model and BM-MNC groups (F=4.71,P＜0.01).LVEF was negatively correlated to myocardial cell apoptosis rate and NF-κB level (r=-0.441 1,P＜0.05;r=-0.579 6,P＜0.01 ).LVEF was positively correlated to number of blood vessels,VEGF and bFGF expression (r=0.775,P＜0.01;r=0.565 1,P＜0.05;r=0.573 5,P＜0.05).CONCLUSION:Transplantation of both autologous BM-MNC and MSC via coronary artery can improve the condition of left ventricular remodeling subsequent to myocardial infarction.The improvement of cardiac functions is related to the increase of blood vessels,VEGF and bFGF expression,the decrease of myocardial cell apoptosis and NF-κ B level in cardiac muscle tissues after stem cell transplantation.BM-MNC transplantation better promotes blood vessel proliferation and VEGF expression in the cardiac tissue but produces worse effects on bFGF gene expression than MSC transplantation.

Genetically encoded Ca(2+) indicators (GECI) are important for the measurement of Ca(2+) in vivo. GCaMP2, a widely-used GECI, has recently been iteratively improved. Among the improved variants, GCaMP3 exhibits significantly better fluorescent intensity. In this study, we developed a new GECI called GCaMPJ and determined the crystal structures of GCaMP3 and GCaMPJ. GCaMPJ has a 1.5-fold increase in fluorescence and 1.3-fold increase in calcium affinity over GCaMP3. Upon Ca(2+) binding, GCaMP3 exhibits both monomeric and dimeric forms. The structural superposition of these two forms reveals the role of Arg-376 in improving monomer performance. However, GCaMPJ seldom forms dimers under conditions similar to GCaMP3. St ructural and mutagenesis studies on Tyr-380 confirmed its importance in blocking the cpEGFP β-barrel holes. Our study proposes an efficient tool for mapping Ca(2+) signals in intact organs to facilitate the further improvement of GCaMP sensors.
Calcium ; chemistry ; metabolism ; Calmodulin ; chemistry ; genetics ; metabolism ; Crystallography, X-Ray ; Dimerization ; Green Fluorescent Proteins ; chemistry ; genetics ; metabolism ; Histidine ; chemistry ; genetics ; metabolism ; Hydrogen-Ion Concentration ; Myosin-Light-Chain Kinase ; chemistry ; genetics ; metabolism ; Peptide Fragments ; chemistry ; genetics ; metabolism ; Protein Structure, Tertiary ; Recombinant Fusion Proteins ; biosynthesis ; chemistry ; genetics

Objective To study the effect of cardiac contractility modulation (CCM) on TGFβ1/Smad/CTGF signaling pathway.Methods A rabbit heart failure (HF) model was established by ligating the ascending aortic root.Thirty rabbits were divided into sham operation group (n=10),HF group (n=10) and CCM group (n=10).Myocardial tissue collagen Ⅰ and collagen Ⅲ were analyzed with Sirius red staining,myocardial tissue hydroxyproline level was measured by chromometry,and expressions of TGFβ1,Smad3,Smad7,CTGF were detected by Western blot in 3 groups.Results Collagen Ⅰ,collagen Ⅲ and hydroxyproline content were highcr in HF group than in sham operation group,while collagen Ⅰ,collagen Ⅲ and hydroxyproline conten were lower in CCM group than in sham operation group (0.69±0.05 μg/mg vs 0.98±0.04 μg/mg,P＜0.05).The expression levels of TGFβ1,Smad3,CTGF were higher while those of Smad7 were lower in HF group than in sham operation group (P＜0.05).The expression levels of TGFβ1,Smad3,CTGF were lower while those of Smad7 were higher in CCM group than in HF group (0.49±0.03 vs 0.67±0.04,0.43±0.06 vs 0.59±0.06,0.45±0.08 vs 0.75±0.09,P＜0.05;0.43±0.08vs 0.26±0.04,P＜0.05).Conclusion CCM can improve the myocardial fibrosis in HF rabbits by downregulating the expression of TGFβ1,Smad3,CTGF and upregulating the expression of Smad7.