ObjectiveTo analyze the clinical distribution and antimicrobial resistance profile of Serratia marcescens(S. marcescens), and to provide the scientific evidence supporting clinical diagnosis and treatment.MethodsThe antimicrobial susceptibility test was performed in 104 strains of S. marcescens by agar dilution method. The results were judged according to the criteria recommended by Clinical and Laboratory Standards Institute (CLSI) 2010.The data were analyzed by chi square test. Results The majority of S. marcescens were isolated from sputum specimens,accounting for 59.6％ (62/104). The bacteria were most frequently isolated from department of respiratory (33.7％,35/104),followed by intensive care unit (23.1％,24/104),department of gerontology (16.3％, 17/104). The results of antimicrobial susceptibility test showed that the resistance rates of S.marcescens against ampicillin,gentamicin and cephazolin were high,which were 90.4％,86.5％ and 79.8％,respectively; those against the 3rd generation of cephalosporins were 24.0％-43.3％. No imipenem and meropenem resistant strains were identified. Compared with cefoxitin-resistant strains,the resistance rates of non-cefoxitin resistant strains against piperacillin (82.9％ vs 28.6％),ceftazidime (63.4％ vs 9.5％),aztreonam (68.3％ vs 9.5％),amikacin (68.3％ vs 20.6％),ciprofloxacin (48.8％ vs 19.1％) and chloramphenicol (90.3％ vs 58.7％) were all lower (all P ＜ 0.05 ). Conclusions S. marcescens is one of the most common conditional pathogenic bacteria leading to nosocomial infections,which is resistant to many kinds of antimicrobial agents.The surveillance of antimicrobial resistance in S. marcescens should be strengthened for purpose of preventing the transmission of multidrug resistant strains.

ObjectiveTo investigate the variations and distributions of the plasmid-mediated quinolone resistance genes in clinical isolates of Shigella and their resistance to antimicrobial agents. Methodsqnr, aac(6')-Ib-cr and qepA genes were identified by polymerase chain reaction (PCR) in 137 clinical isolates of Shigella.DNA sequencing of gene-positive strains were analyzed and the conjugation experiment was performed. The minimal inhibitory concentrations (MIC) of Shigella isolates, recipient strains and transconjugants were tested by agar dilution method for quinolones and other antimicrobial agents. The genotype of transconjugants were determined by PCR and sequencing. ResultsFour (2.9％) strains of the 137 Shigella isolates were qnr gene positive, including 3 qnrS2 positive and 1 qnrB4 positive (GenBank accession numbers of the complete sequence were JF261185 and HQ917003, respectively).Furthermore,five (3.6％) aac ( 6')-Ib-cr gene-positive strains (GenBank accession number JF261186 ) and one (0.7％) qepA gene-positive strain were identified in all isolates. The conjugation experiments were successfully carried out in six out of ten PCR-positive isolates. The MIC of transconjugants against quinolones and other antimicrobial agents increased differently compared to recipient strains. Conclusions The plasmid-mediated quinolone resistance genes are lowly prevalent in clinical isolates of Shigella. However, these resistance genes have the characteristic of horizontal transfer, which indicates that more attention should be paid to this phenomenon.

Objective To explore the weight for the training target of Applied nursing undergraduate. And find the degree of importance for the indexes of the target , thus highlighting theApplied training objective characteristics. Methods Developed by Bloom's teaching objectives classification theory and educational objectives theory to refined indexes, using Delphi method to establish the Applied nursing undergraduate training objectives. By the importance assignment from experts on each index, using analytic hierarchy process (AHP) method to construct the judgment matrix. Then calculate the weight of each index weight, and test its logical consistency. Results The weight of theattitudes and valueswas 0.56, andknowledgeandabilitywere 0.22. For the secondary indicators, in the values dimension,professional attitudeandideological qualityhad relatively high weight.Under the knowledge dimension, the professional knowledge had the highest weight; and for the ability dimension,communication skillsandapplicationswere heavily maximum. All the random consistency rates (CR) for the indexes were less than 0.10, so there was no logical confusion. ConclusionsAppliednursing undergraduate talents need to combine theory and practice quickly into clinical work. By weight setting, this study provides basis to further quantify and highlight the Applied nursing undergraduate training features, and provides the basis for the application-oriented undergraduate nursing personnel reforms.

Objective To develop the Applied nursing undergraduate students training framework objective, clear the entry of applied training target for undergraduate nursing students. Methods Through literature review and panel discussions, Delphi expert consultation questionnaires were preliminary designed. 23 experts were issued via email and paper questionnaires, conducted two expert advice and analysis. Results A total of 20 valid questionnaires were recovered after two consultation. The expert advice of good scientific reliability:experts had positive reply, and the authority level was 0.857, Kendall were 0.130-0.293, it showed a good level of coordination (P < 0.05). By two rounds of expert advice, three capacity index target level for Applied nursing undergraduate students training were gotten: attitudes, values and basic literacy; knowledge of the target; the ability. The secondary capacity index for target had 15 items, and the third capacity index had 63 items. Conclusions TheAppliednursing undergraduate students training objectives and targets were refined through Delphi which provide the basis for the Applied nursing undergraduate training model and curriculum reform.

Objective To explore the effects of surface modification of PLGA-[ASP-PEG] scaffold with typeⅠcollagen on the adhesion,proliferation and osteogenic differentiation of rabbit bone marrow stromal cells (BMSCs).Methods After PLGA-[ASP-PEG] materials were modified with typeⅠcollagen chemically,the collagen was coated onto the materials physically.The BMSCs obtained from rabbits were cultured on the modified PLGA-[ ASP-PEG] and on the unmodified PLGA-[ ASP-PEG] as control.The adhesion and proliferation behavior of the cells was analyzed and the expressions of osteogenie marker alkaline phosphatase,osteocalcin,osteopontin,typeⅠcollagen and core binding factor al were also detected.Results X-ray photoelectron spectrometry(XPS) confirmed that TypeⅠcollagen was grafted onto the surface of PLGA-[ASP-PEG] successfully and the collagen content on the materials modified chemically and physically was significantly increased.The abilities of adhesion and proliferation and the expressions of osteogenie makers of the BMSCs were significantly greater than those in the control group(P＜0.05).Conclusion Since Type collagen I can improve the biocompatibility of PLGA- [ASP-PEG] scaffold materials,it can be used as a new way to optimize scaffolds in tissue engineering.

Objective To investigate the feasibility and efficiency of K16GRGDSPC(K16-RGD) for exogenous gene transfer to bone marrow derived stroma cells(BMSCs).Methods The peptide K16-RGD was synthesized by solid-phase batch peptide synthesizer.The K16-RGD was used as vector for transfecting the luciferase into BMSCs and the expression of the luciferase gene was monitored.The influence of chloroquine and polyethyleneimine was observed.The targeted specificity was examined by cell attachment test and transfection inhibitation test.Results The transfection efficiency of K16-RGD vector was lower than that of commercial lipofectamine.But the efficency of K16-RGD was greatly enhanced in the presence of chloroquine and polyethyleneimine.The peptides containing RGD inhibited the BMSCs attachment to the 96-well plates and decreased the transfection efficiency of K16-RGD significantly.Conclusion Peptide K16GRGDSPC is a new kind of targeted-nonviral gene delivery vector,which is easy to be synthesized,high efficiency and low cytotoxicity.

AIM: To investigate the effect of probucol on proliferation of rat vascular smooth muscle cells(VSMC) stimulated by basic fibroblast growth factor (bFGF) and/or hydrogen peroxide(H 2O 2). METHODS: Effects of probucol on VSMC proliferation and DNA synthesis stimulated by bFGF and/or H 2O 2 were observed by means of MTT test, cell number count and [ 3H]-TdR incorporation. RESULTS: ①Probucol significantly inhibited proliferation and DNA synthesis in VSMC stimulated by bFGF and/or H 2O 2, with dosage-dependent manner. Cell number, A value and [ 3H]-TdR incorporation in group probucol+bFGF and group probucol+H 2O 2 were reduced by 40.0%, 39.1%, 45 5% and 46 9%, 45 0%, 39 5%, respectively, compared with group bFGF and group H 2O 2 ( P 0.05). CONCLUSION: Probucol dramatically inhibited proliferation and DNA synthesis in VSMC stimulated by bFGF and/or H 2O 2, but had no inhibitory effect on the cell proliferation prestimulated by bFGF and /or H 2O 2. [

A 23 amino acid, bifunctional integrin-targeted synthetic oligopeptide was evaluated for ex vivo gene delivery to rabbit bone marrow stromal cells (BMSCs). Synthesis of the peptide (K)16GRGDSPC was performed on a solid-phase batch peptide synthesizer. BMSCs were transfected with plasmid DNA coding for luciferase by (K)16GRGDSPC and the transfection efficiency was assayed. The influences of chloroquine and polyethyleneimine on the transfection efficiency were also examined. The target specificity of (K)16GRGDSPC to mediate exogenous gene into BMSCs was analyzed using cell attachment test and gene delivery inhibition test. The results showed that the transfection efficiency of the oligopeptide vector was lower than that of Lipofectamine. But in the presence of endosomal buffer chloroquine or endosomal disrupting agent polyethyleneimine, the transfection efficiency of the vector was greatly enhanced. In addition, RGD-containing peptides inhibited BMSCs' attachment to the 96-well plates pretreated with fibronectin or vitronectin and significantly decreased the transfection efficiency of the oligopeptide vector. These studies demonstrated that oligopeptide (K)16GRGDSPC was an ideal novel targeted non-viral gene delivery vector, which was easy to be synthesized, high efficient and low cytotoxicity. The vector could effectively deliver exogenous gene into rat BMSCs.

OBJECTIVETo study the efficacy of erythropoietinin (EPO) in the treatment of moderate or severe hypoxic-ischemic encephalopathy (HIE) in neonates.

METHODSSeventy neonates with moderate or severe HIE were randomly assigned to two groups: EPO treatment and control (n=35 each). The EPO treatment group included 22 cases of moderate HIE and 13 cases of severe HIE. The control group included 24 cases of moderate HIE and 11 cases of severe HIE. Thirty-five healthy full-term infants served as normal group. The control group received a conventional treatment. Beside the conventional treatment, the EPO treatment group was intravenously injected with EPO of 200 IU/kg•d, 3 times weekly. Routine blood test was performed every 6 days. EPO dose was adjusted based on the results of the routine blood test. The course of EPO treatment was 2 to 4 weeks. Neonatal Behavioral Neurological Assessment (NBNA) was performed at age of 28 days. The infant development test of Child Development Centre of China (CDCC) was performed at ages of 3 months and 6 months.

RESULTSThe percentage of normal NBNA scores in the EPO treatment group was significantly higher than that in the control group at age of 28 days (P<0.05), but was significantly lower than that in the normal group (P<0.01). The CDCC test including physical development index (PDI) and physical development index (MDI) showed the percentage of normal results in the EPO treatment group was significantly higher than in the control group at age of 3 months (P<0.05), but was significantly lower than in the normal group (P<0.01). The CDCC test including PDI and MDI showed that the percentage of normal results in the EPO treatment group was significantly higher than in the control group at age of 6 months. The MDI test results in the EPO treatment group were not significantly different from those in the normal group at age of 6 months, but the percentage of normal results in the PDI test in the EPO treatment group was still significantly lower than that in the normal group (P<0.05).

CONCLUSIONSEPO treatment has neuroprotective effects against moderate or severe HIE and improves long-term behavioral neurological developments in neonates.

Child Development ; Erythropoietin ; therapeutic use ; Female ; Humans ; Hypoxia-Ischemia, Brain ; drug therapy ; psychology ; Infant Behavior ; Infant, Newborn ; Male

OBJECTIVETo present the clinical application of the meshed acellular dermis xenograft with scalp thin split-thickness skin autograft.

METHODSThe meshed acellular dermis xenograft (pigskin) was placed on the granulation or defects after scar resection. Four or five days afterwards, scalp thin split-thickness skin was transplanted. A total of 15 patients with 25 wounds were treated using this technique. The survival rates and quality of the grafts were observed.

RESULTSThe survival rate of the meshed acellular dermis xenograft was (96.40 +/- 2.60)% and the scalp thin split-thickness skin autograft was (97.44 +/- 3.50)%. All grafts showed normal skin-alike color and elastic and smooth texture.

CONCLUSIONThe combined use of meshed acellular dermis xenograft and scalp skin autograft demonstrated an ideal way for the repair of full-thickness skin burn or defects from scar resection. The scalp can provide thin skin graft repeatedly without influence of the hair.

Adolescent ; Adult ; Animals ; Burns ; pathology ; surgery ; Child ; Child, Preschool ; Dermatologic Surgical Procedures ; Dermis ; transplantation ; Female ; Humans ; Male ; Middle Aged ; Skin ; pathology ; Skin Transplantation ; methods ; Swine ; Transplantation, Autologous ; Transplantation, Heterologous ; Wound Healing