OBJECTIVE To investigate the risk factors for nosocomial pneumonia(NP) caused by imipenem-resistant Acinetobacter baumannii(IRAB) and its antimicrobial susceptibility in vitro. METHODS The data of 34 cases of IRAB-NP were analyzed and 68 cases of NP caused by imipenem-susceptible A.baumannii(ISAB) were randomized as control.Antimicrobial susceptibility(MIC) was determined with the method of agar dilution. RESULTS The two independent factors associated with the development of IRAB-NP: previous fluoroquinolone(OR=5.738) and imipenem/meropenem(OR=7.129) use.The drug sensitivity test in vitro showed that these strains were multiresistant to commonly used antibiotics,and only ampicillin/sulbactam and cefoperazone/sulbactam whose resistance rate was less than 30%. CONCLUSIONS Previous imipenem/meropenem and fluoroquinolone use is independent risk factors for IRAB-NP.These strains are high drug resistant.

Objective To investigate the prevalence and risk factors of atherosclerotic renal artery stenosis (ARAS) in patients with ischemic stroke (IS).Methods A total of 596 consecutive patients with ischemic stroke underwent cerebrovascular and renal angiography at our hospital from January 2008 to March 2013.Renal artery stenosis was defined as at least one of renal artery narrowing ≥ 50％ of luminal diameter.Multivariate logistic regression analysis was performed to investigate the association of the clinical variables with ARAS.Results Intracranial arterial stenosis (ICAS) was identified in 203 patients (34.1％),including 108 cases (18.5％) with arteriostenosis ≥ 50％.Extracranial arterial stenosis (ECAS) was identified in 250 patients (41.9％),including 149 cases (25.0％) with arteriostenosis ≥ 50％.The prevalence of ECAS was higher than that of ICAS(x2 =7.86,P ＜ 0.05).ARAS was identified in 77 patients (12.9％),and the prevalence of ARAS in patients with ECAS ≥50％ was higher than that in with ICAS ≥50％ (30.2 ％ vs.18.5％,x2 =4.52,P ＜0.05).Multivariate analysis showed that the age≥ 60 y (OR:2.48,P ＜ 0.05) and ECAS ≥ 50％ (OR:5.37,P ＜ 0.05) were independent risk factors for prevalence of ARAS.Conclusion ARAS is a relatively common finding among patients with ischemic stroke,suggesting that renal angiography should be performed in elderly IS patients,especially for those combined with severe ECAS.

OBJECTIVETo investigate the effect of component I from agkistrodon acutus venomon (AAVC-I) the migration of human umbilical vein endothelial cells (HUVECs), and to elucidate the possible anti-angiogenic mechanism of AAVC-I.

METHODSThe effect of AAVC-I on the migration of HUVECs which was cultivated in vitro and treated with AAVC-1 at four concentrations: 0, 20, 40, 80 microg/ml, was observed by methods of scratch wound-healing and Transwell assay. The expression level of mRNA and protein of P-selectin and intercellular cell adhension molecule-I (ICAM-1) were examined by RT-PCR and Western blot assay.

RESULTSCompared with the blank group, the migration ability of HUVECs in each AAVE-I treated group was reduced in a dose-dependent manner, and the expression level of the mRNA and protein of P-selectin and ICAM-1 were decreased.

CONCLUSIONAAVC-I inhibits the migration of endothelial cell, which is acted by down-regulation of the expression content of mRNA and protein of P-selectin and ICAM-1.

Cell Movement ; drug effects ; Cells, Cultured ; Crotalid Venoms ; pharmacology ; Down-Regulation ; Human Umbilical Vein Endothelial Cells ; drug effects ; Humans ; Intercellular Adhesion Molecule-1 ; metabolism ; P-Selectin ; metabolism ; RNA, Messenger

Objective To investigate the effects of the low-osmolar nonionic contrast media on renal function in elderly patients suffering from ischemic cerebral vascular disease and undergoing angiography.To study the incidence and risk factors for contrast-induced nephropathy (CIN).Methods 276 elderly patients who were going to receive selective cranial angiography and bilateral renal angiography were included.The 0.9 ％ sodium chloride (1 ml · kg-1 · h-1) was administered in all patients 6 hours before and 12 hours after contrast media administration.No patients suffered from obviously congestive heart failure.The levels of serum creatinine (Scr) and serum urea nitrogen (SUN) were measured 3 days before and at day 1,2,6 after the administration of contrast media respectively.Then creatinine clearance rate (Ccr) was calculated.Multivariate predictors of contrastinduced nephropathy were determined by logistic regression.Results Among the 276 patients,CIN occurred in 19 patients (6.9％),among whom 4 patients suffered from severe renal artery stenosis and received percutaneous transluminal renal angioplasty (PTRA) at 1 week after undergoing angiography.The renal function in the other 15 cases with CIN were recovered to baseline 1evel 3 months after the use of contrast media.No patients underwent a maintenance hemodialysis.In the 19 patients with CIN,the levels of SUN and Scr were higher and Ccr was lower at day 1 and 2 after angiography than before the procedure (all P ＜ 0.05),but the parameters were decreased to preoperative level at day 6 after angiography (all P＞0.05).Logistic regression analysis showed that renal dysfunction,diabetes mellitus and severe renal artery stenosis were the major risk factors for contrast-induced nephropathy.Conclusions Low-osmoiar nonionic contrast used in angiography is safe for elderly patients if adequately hydrated with 0.9 ％ sodium chloride.The clinical risk factors for CIN are renal dysfunction,diabetes mellitus and severe renal artery stenosis.

Effects of main environmental factors, such as temperature, pH , metal ions and anions, on expression and activity of bacterial extracellular car bonic anhydrase(CA) were studied, exemplified by a bacterium named GLRT102Ca, wh ich was separated from karst ecosystems of Southwest China. The results showed that the tested strain could express different activity of extracellular carboni c anhydrase within the scope of experimental temperature (10℃~50℃) and pH (5. 5~9.0). The activity of extracellular carbonic anhydrase was higher at tempera ture of 20℃~30℃ and at neutral and alkaline trending condition. Moreover, the expression of activity of extracellular carbonic anhydrase could be generally p romoted at the experimental range of concentration of 4 kinds of metal ions such as Ca2+, Mg2+, Zn2+ and Co2+, along with 8 kinds of ani ons such as SO2-_4, H_2PO-_4, NO-_3, NO-_2, Cl-,Br-, I- and HCO-_3. This research provides a cert ain theoretical basis for further study on the role of microbial CA in karst pro cesses.

The traditional fermentation engineering experiment requires a reform on the experimental con-tents and teaching pattern. According to the production process of industrial enzymes, we set up a two-week comprehensive experiment. The students designed and prepared the experiment by themselves. Moreover, the pattern of self-management was used in the process and the experiment scores included the self-assess-ment and objective assessment. It was proved that the new teaching pattern increased the study interesting of students, inspired their initiative and trained their spirits of team cooperation. The teaching effect was im-proved markedly and good ideas are also put forward to solve the possible problem.

Objective To investigate the relationship between urinary iodine level and thyroid disease.Methods The study used a case-control design.One hundred and nine patients with thyroid disease from the Affiliated Hospital of Shanxi Institute for Endemic Disease Control were selected as case group from 2011 to 2012,and these patients were divided into three groups:Graves's disease (GD) group (n =48),chronic lymphocytic thyroiditis (HT) group(n =34) and thyroid nodules group(n =27).Sixty-two healthy people from the same region were selected as a control group.Urinary iodine was determined using arsenic cerium catalytic spectrophotometry,thyroid autoantibody (TRAb) and thyroid peroxidase antibody (TPOAb) was detected using electrochemiluminescence,while iodine absorption rate was measured using thyroid function analyzer,and thyroid volume was measured using type-B ultrasonic method.The relationship between urinary iodine level and patients with thyroid disease was compared with that of control group.Results Urinary iodine levels of patients with GD,HT,thyroid nodules and control groups were 313.95,375.20,220.20 and 196.50 μg/L,respectively.Urinary iodine levels of patients with GD and HT groups were higher than that of control group(Z =3.238,4.275,all P ＜ 0.0125).Urinary iodine level of patients with HT was higher than that of thyroid nodules(Z =3.762,P ＜ 0.0125).Iodine uptakes of GD,HT,thyroid nodules and control groups were (84.20 ± 16.90)％,(23.51 ± 6.72)％,(28.34 ± 8.02)％ and (29.31 ± 8.41)％; TRAbs of patients with GD,HT,thyroid nodules and control groups were (58.57 ± 20.31)％,(2.54± 1.00)％,(2.98 ± 0.83)％ and (3.01 ± 1.21)％; TPOAbs of patients with GD,HT,thyroid nodules and control groups were (117.03 ± 57.21)％,(251.00 ± 98.20)％,(16.81 ± 9.87)％ and (15.00 ± 7.23)％.Iodine uptake,TRAb and TPOAb of GD group were higher than those of control group(P ＜ 0.05).TPOAb of HT group was higher than that of control group(P ＜ 0.05).Urinary iodine levels of GD group and HT group were positively correlated with TPOAb(correlation coefficient were 0.462,0.478 all P ＜ 0.05).Conclusions Excessive iodine intake is found in patients with GD and HT.Determination of urinary iodine is helpful for individualized iodine supplementation.

Objective To investigate the efficacy and safety of endovascular treatment for subclavian steal syndrome (SSS). Methods During the period from April 2004 to Feb. 2013 at authors’ hospital, a total of 12 patients with SSS, including subclavian artery stenosis (n = 7) and occlusion (n = 5), underwent endovascular treatment. Percutaneous transluminal angioplasty (PTA) was carried out in 4 cases and stent implantation in 8 cases. The clinical data were retrospectively analyzed. Results Technical success rate was 100%(12/12). The diseased side/healthy side blood pressure ratio increased from preoperative (0.46 ± 0.28) to postoperative (0.89 ± 0.32), and the difference was statistically significant (P < 0.05). After the treatment, the clinical symptoms were improved in different degrees in all patients. During the follow - up period lasting for (16.7 ± 7.9) months, restenosis occurred in one case with left SSS thirteen months after PTA, and the condition was improved after stenting angioplasty. Another patient with severe subclavian artery stenosis developed peripheral micro- vascular thrombosis of the diseased limb in 23 days after PTA, which was relieved after medication to improve microcirculation and vasodilation. No severe complications such as stroke occurred. Conclusion For subclavian artery steal syndrome, endovascular management is a minimally invasive, safe and effective treatment. It can significantly relieve the clinical symptoms due to vertebral- basilar artery insufficiency caused by subclavian steal syndrome, and improve limb weakness, low body temperature, etc. Therefore, this technique should be recommended in clinical practice.

Adult ; Aged ; Antineoplastic Agents ; pharmacology ; therapeutic use ; DNA-Binding Proteins ; genetics ; metabolism ; Drug Therapy, Combination ; Endonucleases ; genetics ; metabolism ; Female ; Fluorouracil ; pharmacology ; therapeutic use ; Humans ; Male ; Middle Aged ; Organoplatinum Compounds ; pharmacology ; therapeutic use ; RNA, Messenger ; drug effects ; metabolism ; Statistics as Topic ; Stomach Neoplasms ; drug therapy ; genetics ; metabolism ; Survival Analysis ; Treatment Outcome

Objective To explore the effect of solution-focused approach nursing on the perioperative anxiety and depression of patients with percutaneous renal needle biopsy.Methods Totals of 60 cases who underwent renal biopsy were randomly divided into control group and experimental group with 30 cases each group.Two groups were received regular health education,while the experimental group from 1 day before surgery to 3 days after surgery received the nursing intervention on the solution-focus approach.Before and after surgery,self-rating anxiety scale (SAS),self-rating depression scale (SDS) were used to investigated the patients and compared.Results The incidence of anxiety and depression among all patients was 63.3％ and 66.7％,and no significant difference was found in the score of SAS and before received the percutaneous renal needle biopsy between two groups( P ＞0.05 ).After intervention,the score of SAS and SDS score of experimental group were ( 42.60 ± 6.95 ) and ( 46.80 ± 7.73 ),respectively,and that of control group were ( 50.53 ± 8.63 ),(53.53 ± 10.93 ),and the differences were statistically significant ( P ＜ 0.05 ).Conclusions The intervention solution-focused approach nursing can reduce renal biopsy perioperative patients' degree of anxiety and depression,and improve the quality of nursing.