OBJECTIVE To investigate antimicrobial resistance of Acinetobacter baumannii and detect metallo-?-lactamases (MBLs) in clinical isolates from ICU. METHODS Forty-two strains of A. baumannii were isolated from sputum samples between Jul 2005 and Mar 2007 in Affiliated Hospital of North Sichuan Medical College. Bacteria identification and antimicrobial susceptibility test were performed by VITEK-32 system and K-B disk method. Meanwhile,MBLs were detected by Etest. RESULTS Cefoperazone/sulbactam with low resistance accounted for 2.4%. The resistance to imipenem was 66.7%. The resistance to other antibiotics ranged from 69.4% to 100%. Nine MBLs-producing strains were detected by Etest. CONCLUSIONS Metallo-?-lactamases produced by A. baumannii are one of important mechanisms which caused resistance to imipenem. Cefoperazone/sulbactam and polymyxin can be chosen to treat resistant A. baumannii.

Objective To explore the clinical value of Glucosamine hydrochloride tablets(GH)alone and combination with Xianlinggubao capsules(XLGB)for treatment patients with knee osteoarthritis(KOA).Methods 96 patients with KOA were selected,and were divided into two groups according to the random number method, 48 cases in each group.The control group was treated with GH alone,while the observation group was treated with XL-GB on the basis of the control group.US Western Ontario and McMaster University Osteoarthritis Index (WOMAC) were used to evaluate the symptoms change,including pain,stiffness,physical function scores and total scores before and after treatment.The onset time,knee function (HSS)score at 3 months and 6 months after treatment were recor-ded.CRP and ESR were measured,and the total efficacy was evaluated at the end of treatment.Results The differ-ence of WOMAC score between the two groups was not statistically significant before treatment (P >0.05 ).After treatment,pain,stiffness,physical function scores and total scores were (10.2 ±1.4)points,(3.5 ±1.6)points, (40.5 ±5.0)points and (56.4 ±6.7)points in the observation group,those were (14.8 ±2.6)points,(6.2 ±2.3)points, (52.2 ±6.8)points and (73.3 ±4.5)points in the control group,the differences were statistically significant (t =7.631,4.721,6.791,10.26,all P <0.01).The onset time,HSS score at 3 months and 6 months after treatment in the observation group were (6.0 ±2.2)d,(68.2 ±6.4)points and (84.3 ±6.2)points,while those were (9.8 ± 2.8)d,(58.5 ±3.9)points and (72.8 ±5.4)points in the control group,the differences were statistically significant (t =5.228,6.341,6.852,all P <0.01 ).The improvements of CRP level and ESR in the observation group were more pronounced than those in the control group (t =3.880,2.668,all P <0.05).After treatment,the total effective rate of the observation group was 93.8%(45 /48),while that was 77.1%(37 /48)in the control group,the difference was statistically significant (χ2 =5.352,P <0.05).Conclusion GH combines with XLGB can significantly improve symptoms in patients with KOA,with more rapid recovery of knee function,thus it is a safe and effective therapy.

Objective To observe and compare the effect of different concentration of ropivacaine on elderly patient with bra-chial plexus block under ultrasound-guided ,to assess its effectiveness and security ,so as to determine the optimum dosage of anes-thetic for elderly patients with brachial plexus block .Methods 120 patients undergoing elective surgery of forearm or hand in this hospital from February 2013 to December 2014 were selected as the observation group in this study .These patients were randomly divided into four groups on average ,narcosis was conducted in each group with ultrasound-guided :group A with 30 mL of 0 .250%ropivacaine ,group B with 30 mL of 0 .375% ropivacaine ,group C with 30 mL of 0 .500% ropivacaine ,group D with 30 mL of 0 .750% ropivacaine .The onset time of sensory block ,motor block level ,duration of analgesia and adverse reactions were observed and recorded .Results With the increase of concentration of ropivacaine ,the onset time of narcotize became shorter(P< 0 .05) and duration of analgesia became longer(P < 0 .05) .There were no significant difference in the effects of brachial plexus block (P>0 .05) .There was no complications occurred in four groups after narcosis .Conclusion Concentration of ropivacaine more than 0 .375% can achieve perfect clinical effect on elderly patients with brachial plexus block under guidance of ultrasound .

Objective: To investigate the effects of selenium enriched yeast on antioxidative activities and immune functions in pregnant dairy cows. Methods: Twenty-four healthy Holstein-Friesian dairy cows were used for the experiment. All of them were pregnant as comfirmed by rectal palpation and divided into 4 groups, of which 3 were assigned for test groups(TI, T2, T3) and one served as control (C). Three different selenium (Se) sources namely Se-yeast (Sel Plex50, from Alltech ), mixture of Se compounds (70% Sel Plex 50 + 30% Na selenite ) and Na selenite were respectively supplemented to 3 test groups. Whole feeding experiment lasted for 168 days. During the experiment, the blood GSH-Px activity, serum Se concentration, erythrocyte superoxide dismutase(SOD) activity, malonaldehyde(MDA) level in serum, lymphocyte transformation rate and T cell count were determined. Results: Blood GSH-Px ,serum Se concentration and erythrocyte SOD activity,T1, T2 and T3 were higher (P

Objective To investigate the prevalence of virulence genes(ply, pspA, nanA, lytA, psaA) among Streptococcus pneumoniae recently isolated from clinical patients. Methods The 133 strains were isolated from patients in three teaching hospitals in Chongqing from 2006 to 2008. Polymerase chain reaction was used to screen for virulence genes (ply, pspA, nanA, lytA, psaA). Results The positive rate of lytA, psaA, ply, nanA and pspA in 133 clinical isolates were 94.7%, 85.0%, 82.7%, 84. 2% and 60.2%, respectively. The positive rates of the lytA, psaA, ply, nanA and pspA genes in 87 common serotypes isolates was 100%, 87.4%, 86.2%, 89.7%, 67.8%, respectively. Conclusion The total positive rates of five virulence genes in the 133 clinical strains were high. The positive rates of five genes in the com-mon serotypes isolates were higher than those in the no-common serotypes. These genes are important virulence genes of Streptococcus pneumoniae. They could be candidates for protein vaccine of Streptococcus pneumoniae.

Objective To investigate the application value of procalcitonin(PCT) in fever of the patients with malignant tumor.Methods A total of 254 patients with malignant tumor complicating fever from January to October 2016 were collected and grouped after clearly diagnosing the causes of body temperature increase according to the clinical manifestations,laboratory examination and imaging examination results.The difference of PCT level was compared among various groups.Results Compared with tumor thermal group,the PCT level in the sepsis and non-sepsis groups was significantly increased(P<0.001).Moreover no matter which was bacterial infection,fungal infection or both mixed infection,the PCT level was significantly higher than that in the tumor thermal group;compared with the fungal infection group,the PCT level in the bacterial infection group was increased significantly(P<0.01).The PCT level distribution difference among the tumor thermal group,fungal infection group and bacterial infection group was statistically significant(P<0.01).The critical values of PCT for diagnosing fungal and bacterial infectious fever were 0.575,0.945 ng/mL respectively.The areas under ROC curve were 0.812(95%CI:0.805-0.934);0.951(95%CI:0.917-0.985).Conclusion It is priliminarily considered that PCT can serve as an effective clinical auxiliary diagnostic indicator for differentiating the fever cause in the patients with malignant tumor.

Objective To explore the differences in antimicrobial resistance of bacteria isolated from different samples ,and to guide antibiotic chemotherapy in clinic .Methods The sputum ,blood ,pus and urine specimens were collected from 2009 to 2013 in our hospital for bacterial identification and drug sensitivity tests by using automatic system .The drug resistance rate of Staphylo‐coccus aureus ,Escherichia coli ,Klebsiella pneumoniae isolated from different samples were compared .Results All isolates of E .co‐li ,Klebsiella pneumoniae were sensitive to imipenem ,ertapenem ,piperacillin/tazobactam and amikacin .All isolates of S .aureus were sensitive to vancomycin ,linezolid ,nitrofurantoin ,quinupristin/dalfopristin .The ESBLs positive rate of E .coli(71 .5% )and the MR‐SA detection rate(79 .9% ) of Staphylococcus aureus from sputum samples were significantly higher than that from other samples (P<0 .05) .The ESBLs positive rate(44 .4% ) of Klebsiella pneumoniae isolates from urine was significantly higher than that from other samples(P<0 .05) .Conclusion The same bacteria isolated from different samples have different antimicrobial resistance rates ,so the selection of antibiotics should based on drug sensitivity tests results for the treatment of the same pathogen infection confirmed by bacterial cultures from different samples .

Objective To inquire into the curative effects of combination of laproscopic cholecystomy and laparoscopic transcystic duct common bile duct exploration on cholelithiasis, cholecystolithiasis and cho-ledocholith. Methods The clinical data of 19 cases were retrospectively analyzed from Sep. 2006 to Jan.2009. Results All the operations were performed successfully. The operative time was 60～120 min, the drainage time was 3～5 d, and the postoperative hospitalization time 4～7 days. All of the patients were fol-lowed up from 3 to 6 months. No complications occurred. Conclusion Laparnscopic transcystic biliary duct exploration is safe, feasible and worth generalizing.

Objective To analyze the infection status and variation tendency of chlamydia trachomatis (CT) ,Neisseria gonorrhoe-ae(NG) and ureaplasma urealyticum(UU) in female genital tract in northeast Sichuan province during 2005 -2012 to provide the laboratory basis for their diagnosis and treatment Methods The real-time fluorescent quantitative PCR (RT-PCR) was applied to detect the CT DNA ,NG DNA and UU DNA in 1 386 samples from female genital tract and the detection results were performed the statistical analysis .Results The total positive rate of these 3 kinds of pathogens was 62 .8% (871/1 386) .Among the simple in-fection ,UU had the highest positive rate(48 .0% ,665/1 386);the positive rates of CT and NG were only 2 .2% .In the mixed infec-tion ,the positive rate of CT + UU was highest(6 .5% ,90/1 386) ,while which of UU + NG ,CT + NG and CT+ NG+ UU was 2 .5% (35/1 386) ,0 .4% (5/1 386) and 1 .1% (15/1 386) respectively .In different age groups ,the positive rate in the age <20 years old group was 49 .3% ,while which in the age >20 years old groups were all more than 60% .The positive rate of the CT ,NG and UU pathogens in females was in continuous high level during 2005 -2012 ,and which totally showed an increasing tendency . Conclusion CT and UU are the main pathogens in female genital tract infection in this region ,and the positive rate of genital tract infection in females aged more than 20 years is higher ,the infection rate of these 3 kinds of pathogens demonstrates the increasing trend year by year ,so more attention should be paid to the detection of CT and UU in this group for guiding the clinicians to con-duct the diagnosis and treatment .

Objective To detect the expression of miR-26a/b in the aorta and serum of mice so as to explore the role of miR-26a/b in vascular remodeling of hypertension.Methods C576L/BJ male mice were randomly divided into AngⅡ group and control group.Mini-osmotic pump was implanted subcutaneously into the back of mice, and the model of blood vessel remodeling in mice was established by continuous infusion of AngⅡ(2.0mg/kg·d).The mice in control group were injected with saline.Blood pressure was taken before the intervention and at 3, 5, 7, 10 and 14 days after the intervention.After 2 weeks, the mice were killed, the serum and aorta tissues were collected, and the expression of miR-26a/b was determined by RT-PCR.HE staining, Masson staining and immunohistochemistry were performed to observe changes in vascular morphology, fibrosis and protein expression.Results After the intervention, systolic blood pressure and diastolic blood pressure were significantly higher in AngⅡ group than in control group (P<0.05).HE staining showed that the vessel wall of AngⅡ group was thicker than that of control group.Masson staining showed more blue collagen deposition in the middle of aorta in AngⅡ group but no obvious collagen deposition in control group.RT-PCR showed that the expression of miRNA-26a/b in the serum and aorta of AngⅡ group was significantly lower than in control group (P<0.05).Immunohistochemistry indicated that the expressions of CTGF, collagen Ⅰ and collagen Ⅲ all increased after AngⅡ infusion (P<0.05).Conclusion MiR-26a/b, CTGF, collagen Ⅰ and collagen Ⅲ may be involved in AngⅡ-induced vascular remodeling in hypertension.MiR-26a/b may be a new therapeutic target of vascular remodeling in hypertension.