Objective To understand the drug resistance situation of 84 strains of Acinetobacter Baumannii (ABA) isolated from the lower respiratory tract samples in ICU patients to provide a basis for the rational use of antibacterial drugs in clinic .Methods Eighty-four strains of ABA were retrospectively analyzed .The VITEK2-Compact automatic microbiological analyzer was adopted to conduct the bacterial identification and drug susceptibility test .The software Whonet5 .6 was used for conducting the statistical analysis .Results Eighty-four strains of ABA had strong drug-resistance . The resistance rate of nitrofurantoin was highest (100 .00% ) ,followed by cefotetan (98 .81% ) and aztreonam(80 .95% ) .The resistance rate of beta lactam antibacterial drugs was>75 .00% ,and which to imipenem was 76 .19% .The sensitive rate of 13 kinds of common antibacterial drugs was < 30 .00% . MDR ,XDR and PDR strains were 67 strains ,64 strains and 26 strains respectively ,which accounted for 79 .76% ,76 .19% and 30 . 95% respectively .The non-sensitivity rates of multi-drug resistant strains either to MDR or XDR was >90 .00% in non sensitive rate of common antimicrobial agents .Conclusion ABA is the major pathogen .The laboratory should strengthen the analysis and drug sensitivity monitoring of ABA resistant strains in ICU .At the same time ,ICU should strengthen the disinfection and isolation to avoid the outbreak of nosocomial infections .

?Pathological myopia are often complicated by a series of pathological changes in fundus including foveoschisis, which can lead to visual dysfunction when processing with retinal detachment, macular hole, epiretinal membrane and vitreoretinal traction diseases. According to the current knowledge, the main mechanism of foveoschisisi might be attributed to the impaired macular structure and function caused by a variety of traction on the retinal and retina poor condition. Surgical treatments have been reported to be effective in treating foveoschisis, however, the indications and surgical procedures are still controversial. ln this article, we reviewed the clinical features, diagnosis, treatment strategies and prognosis of pathological myopia foveoschisis.

Objective To establish a high performance liquid chromatography method to detect the concentration of lamotrigine in blood dialysate and investigate in vitro recovery of lamotrigine and the factors.Select the microdialysis conditions that apply to the animal experiment and guide the stability study of in vivo recovery.Methods Positive dialysis and retrodialysis were used for the examination of lamotrigine in vitro recovery and the influencing factors such as flow rate, concentration, temperature and time.Filtered out the best conditions that apply to the in vivo experiment.Used the retrodialysis to determine the in vivo recovery and its stability.Results There was no significant difference between relative recovery and relative loss in the same flow rate.The concentration had no obvious effect on relative recovery.At the same condition,relative recovery decreased with the increase of the flow rate and increased with the temperature.The in vivo recovery had a good stability of 6.5 hours when the flow rate and stabilization time were set at 2μL/min and 1.5 h, respectivily.Conclusion Microdialysis technique can be used for the pharmacokinetic study of lamotrigine.Retrodialysis can be used for the determination of the lamotrigine in vivo recovery.

To study the relation between drug release and the drug status within curcumin-loaded microsphere, SPG (shirasu porous glass) membrane emulsification was used to prepare the curcumin-PLGA (polylactic-co-glycolic acid) microspheres with three levels of drug loading respectively, and the in vitro release was studied with high-performance liquid chromatography (HPLC). The morphology of microspheres was observed with scanning electron microscopy (SEM), and the drug status was studied with X-ray diffraction (XRD), differential scanning calorimetry (DSC) and infrared analysis (IR). The drug loading of microspheres was (5.85 ± 0.21)%, (11.71 ± 0.39)%, (15.41 ± 0.40)%, respectively. No chemical connection was found between curcumin and PLGA. According to the results of XRD, curcumin dispersed in PLGA as amorphous form within the microspheres of the lowest drug loading, while (2.12 ± 0.64)% and (5.66 ± 0.07)% curcumin crystals was detected in the other two kinds of microspheres, respectively, indicating that the drug status was different within three kinds of microspheres. In the data analysis, we found that PLGA had a limited capacity of dissolving curcumin. When the drug loading exceeded the limit, the excess curcumin would exist in the form of crystals in microspheres independently. Meanwhile, this factor contributes to the difference in drug release behavior of the three groups of microspheres.

To study the relation between drug release and the drug status within curcumin-loaded microsphere, SPG (shirasu porous glass) membrane emulsification was used to prepare the curcumin-PLGA (polylactic-co-glycolic acid) microspheres with three levels of drug loading respectively, and the in vitro release was studied with high-performance liquid chromatography (HPLC). The morphology of microspheres was observed with scanning electron microscopy (SEM), and the drug status was studied with X-ray diffraction (XRD), differential scanning calorimetry (DSC) and infrared analysis (IR). The drug loading of microspheres was (5.85 ± 0.21)%, (11.71 ± 0.39)%, (15.41 ± 0.40)%, respectively. No chemical connection was found between curcumin and PLGA. According to the results of XRD, curcumin dispersed in PLGA as amorphous form within the microspheres of the lowest drug loading, while (2.12 ± 0.64)% and (5.66 ± 0.07)% curcumin crystals was detected in the other two kinds of microspheres, respectively, indicating that the drug status was different within three kinds of microspheres. In the data analysis, we found that PLGA had a limited capacity of dissolving curcumin. When the drug loading exceeded the limit, the excess curcumin would exist in the form of crystals in microspheres independently. Meanwhile, this factor contributes to the difference in drug release behavior of the three groups of microspheres.
Calorimetry, Differential Scanning ; Curcumin ; chemistry ; Drug Liberation ; Lactic Acid ; Microscopy, Electron, Scanning ; Microspheres ; Polyglycolic Acid ; X-Ray Diffraction

Objective To prospectively compare MR pulmonary perfusion imaging with quantitative HRCT for the detection of mild chronic obstructive pulmonary disease (COPD) and classification of COPD.Methods Sixty-two consecutive patients with COPD and 17 healthy volunteers underwent pulmonary function test (PFT),HRCT and MR perfusion imaging on the same day.According to the Global Initiative for Chronic Obstructive Lung Disease (GOLD),all COPD patients were classified into 4 stages:stage Ⅰ (n =19),stage Ⅱ (n =17),stage Ⅲ (n =14),stage Ⅳ (n =12).The signal intensity of perfusion defects (SIPD),signal intensity of normal lung perfusion (SInormal) on 3D MR perfusion were obtained through postprocessing and the signal intensity ratio (RSI) was calculated.The total lung volume (TLV) was calculated automatically on HRCT and the total emphysema volume (TEV) was obtained by applying -950 HU thresholds.The TEV/TLV was deduced as emphysema index (EI).Several comparisons were made between the volunteers and COPD patients by one-way ANOVA and Kruskal-Wallis test.Results The RSI,SIPD,PEI,MSI,MSD values of MRI perfusion in volunteers (43.9 ± 7.2,48.2 ± 19.7,31.4,55.7,44.1) were significantly different from those in patients with COPD (18.1 ± 8.1,47.4 ± 20.0,8.6,30.2,22.7) (P ＜ 0.01).The RSI showed a significant difference between stage Ⅰ (24.4 ± 9.8) and stage Ⅲ (15.9 ± 5.3) or Ⅳ (9.2 ± 2.7) and between stage Ⅱ (19.9 ± 3.1) and stage Ⅳ (t =4.05-6.64,P ＜0.01).However,all MRI perfusion parameters between stage Ⅰ and stage Ⅱ,stage Ⅱ and stage Ⅲ,stage Ⅲ and stage Ⅳ were no differences (t =2.00-4.46,P ＞ 0.05).The median of EI in volunteers and stage Ⅰ-Ⅳ COPD patients were 1.2,3.8,8.0,13.7,18.3,and the quartile range were 3.7,7.1,9.2,10.5,7.7,respectively.The EI in volunteers showed significant differences with that of stage Ⅱ-Ⅳ COPD and the EI of stage Ⅳ was different from that of stage Ⅱ or Ⅰ (t =-7.32--1.85,P ＜ 0.01),but there was no significant difference between volunteers and stage Ⅰ COPD (t =-1.99,P ＞ 0.05).Conclusions The RSI of MRI is more sensitive than that of HRCT for assessing mild COPD.The severity of COPD could be reflected by MRI perfusion and HRCT.

Objective:To evaluate the clinical outcomes of implant-retained overdentures.Methods:57 patients treated by implant-retained overdentures were included.Parameters for peri-implant tissue conditions (e.g.peri-implant probing depth,plaque index,bleeding on probing,mucosal hyperplasia,peri-implant marginal bone loss) and prosthetic complications were examined and recorded.The precentage of satisfaction of the patients was assessed using the visual analog scale (VAS).Results:After an average follow-up of (48±11.3) months,the survival rate of the implants was 98.1%,the marginal bone loss was (1.38±0.74) mm.There was no statistically difference among the different attachment groups(bar,magnet and ball) regarding the peri-implant marginal bone loss or bleeding on probing(P>0.05).The peri-implant probing depth and plaque index in patients with magnet and ball attachments were lower than those in patients with bar attachments(P<0.05).The major complications were the upper abutment fracture,prostheses fracture and screw loosening.Most patients were satisfied with their prostheses and there was no statistically significant difference between the attachment types(P>0.05),except that magnet and ball attachments were much easier to clean compared with bar attachments(P<0.05).Conclusion:Implant-retained overdenture is a successful and satisfactory treatment option for patients with edentulous jaw.The patients should been given regular clinical examinations to keep peri-implant tissue health and reduce the complications,especially those with bar attachments.

Objective To study the diagnostic and therapeutic value of 1.4-metre colonoscope for upper jejunum lesions. Methods From 2008 to 2009, patients with suspected upper jejunum lesions, who presented as obscure gastrointestinal bleeding or other digestive symptoms and got no definite diagnosis from gastroscopy and entire digestive tract barium meal, were recruited as experimental group (n = 115) and underwent an examination with 1.4-metre endoscope. The endoscope was inserted into proximal jejunum, biopsy or treatment was performed according to the found lesions. Another 115 patients from 2004 to 2007, who presented with similar situation but were examined with gastroscope, were recruited as control group. Results Descending duodenum was accessed successfully in all cases from 2 groups. Horizontal duodenum was accessed in 112 and 107 cases of experimental group and control, respectively (97. 39% vs. 93.04%, P ＞0. 05), while the ascending part was accessed in 109 and 72 cases, respectively (94.78% vs. 62.61%, P＜0.005), and the proximal jejunum was accessed in 102 and 35 cases, respectively (88.70% vs. 30. 43%, P ＜ 0. 005). A total of 31 (26. 96%) lesions were found in experimental group, which was significantly higher than that in control group (6/115, 5.22%, P ＜0.005). Biopsy or endoscopic management was performed in 20 cases from experimental group, in which 12 occupying lesions were confirmed by pathology and surgery. In control group, 1 case of stromal tumor, 1 adenocarcinma, 1 P-J syndrome and 3 ancylostomiasis at horizontal duodenum were confirmed. Conclusion 1.4-metre endoscope can be inserted deeper than gastroscope, and is of better diagnostic value for bleeding in descending duodenum, especially in upper jejunum.

Objective To investigate the relationship between uncoupling protein 2 (UCP-2) gene promoter -866 G/A polymorphism and Chinese diabetic nephropathy (DN). Methods A total of 182 patients with type 2 diabetic mellitus were selected and divided into DN group (90 cases with DN ) and NCD group (92 cases without DN ). Genomic DNA was detected, and UCP-2 genotype and allele gene frequency was confirmed by polymerase chain reaction-restrictive fragment length polymorphism, then compared.Results The genotype frequency of UCP-2 gene promoter-866 G/A polymorphism was distributed in DN group[GG 14.44%( 13/90),GA 31.11%(28/90),AA 54.44%(49/90)],and distributed in NCD group[GG 29.35% ( 27/92 ), GA 32.61% ( 30/92 ), AA 38.04% ( 35/92 )], and there was significant difference between two groups ( χ2 = 7.28 , P ＜ 0.05 ). There was also significant difference in allele gene frequency between DN group and NCD group[G 45.65% (84/184) vs. 30.00% (54/180),A 54.35% (100/184) vs. 70.00% (126/180)]( χ2 = 9.47, P ＜ 0.05 ). Conclusion There is correlation between the UCP-2 gene promoter-866 G/A polymorphism and Chinese DN, and the incidence of DN with A/A genotype is increased.

Objective To explore the impact of nucleos(t)ide analogue antiviral therapy on anxiety and depression of patients with chronic hepatitis B (CHB),and analyze the related factors.Methods Before nucleos(t)ide analogue antiviral therapy,1 year and 2 years after antiviral therapy,120 CHB patients were investigated with self-rating anxiety scale (SAS) and self-rating depression scale (SDS).The demography data of patients were collected.Serum levels of alanine transaminase (ALT) and hepatitis B virus (HBV) DNA and other biochemical indicators were measured regularly.Results Before nucleos(t)ide analogue antiviral therapy,1 year and 2 years after antiviral therapy,both the mean scores of SAS and SDS became lower gradually (F=12.661 and 22.395,respectively;both P＜0.01).The percentage of patients with SAS and SDS scores more than 50 were 5.8％,4.2％,1.7％ and 13.3％,7.5％,5.0％,respectively.After 2 years of therapy,the anxiety improvement rate of the patients obtained HBV DNA＜1000 copy/mL was 69.0％,while those with HBV DNA≥1000 copy/mL was 22.2％ (x2 =22.325,P＜0.01).Meanwhile,after 2 years of therapy,the depression improvement rate of the patients obtained HBV DNA＜1000 copy/mL was 77.4％,while those with HBV DNA≥1000 copy/mL was 22.2％ (x2 =32.179,P＜0.01).Multiple factors Logistic regression analysis indicated that the odds ratios (OR) of improvement of anxiety and depression in patients with HBV DNA＜1000 copy/mL were 7.751 (95％ CI:3.026-19.853) and 15.069(95％ CI:5.309-42.770),respectively,compared with those with HBV DNA≥1000 copy/mL; and OR of improvement of depression in patients with ALT≤40 U/L waa 4.103 (95％ CI: 1.376 - 12.238).Conclusions Nucleos(t) ide analogue antiviral therapy could improve the anxiety and depression of CHB patients.The HBV DNA negativity is the independent impact factor of improvement of anxiety and depression in CHB the patients.