Cluster Analysis ; Fuzzy Logic ; Humans ; Mathematics ; Medicine, Chinese Traditional

OBJECTIVE To establish a convenient method for detecting plasmid-mediated AmpC beta-lactamases in Enterobacteriaceae lacking chromosomal AmpC beta-lactamases and to investigqte their genotype.METHODS Fifteen isolates of Klebsiella pneumoniae were collected and the diameters of inhibitory zone of cefoxitin in combination with or without cloxacillin were measured separately by standard disc diffusion test.The M3D assay was used as control method.And the activity of AmpC beta-lactamases of all isolates was simultaneously assayed.Multiplex PCR was performed to determine the genotype of AmpC beta-lactamases.RESULTS Among 15 isolates,8 isolates were identified to have plasmid-mediated AmpC beta-lactamases.The sensitivity and specificity of AmpC beta-lactamases phenotypic confirmatory test were 100%.Eight of 15 isolates were identified to be DHA-1 beta-lactamases by multiplex PCR.CONCLUSIONS The new AmpC beta-lactamases phenotypic confirmatory test is a reliable method for detecting plasmidmediated AmpC beta-lactamases in Enterobacteriaceae lacking chromosomal AmpC beta-lactamases.DHA-1 beta-lactamases are the main genotypes of plasmid-mediated AmpC beta-lactamases in Hubei Province of China.

A pepsin modified poly (glycidyl methacrylate-ethyleneglycol dimethacrylate)(poly (GMA-EDMA)) capillary monolith (32 cm ×75 μm,22cm effective lenth)was applied in exploring the interaction between nefo-pam enantiomers and bovine serum albumin (BSA),mode of frontal analysis was selected to measure the binding constant,number of binding sites and the location of binding sites of BSA to both nefopam enantiomers.The opti-mal CEC conditions obtained were a running buffer consisted of 15 mmol /L ammonium acetate at pH 5.5,separa-tion voltage 5.0 kV,detection wavelength 215 nm,injection 10 kV ×6 s,solvent of samples consisted of 50 mmol/L ammonium acetate at pH 7.4.The results indicated that the monolith could provide a satisfactory resolution between the two enantiomers plateaus,BSA in the binding system didn′t disturb the separation or determination of nefopam enantiomers in electrochromatography.The frontal analysis demonstrated that BSA has only one binding site with both enantiomers,the binding constants (K)were 443 L/mol and 527 L/mol,respectively,and the dis-placement experiments indicated that binding site of both isomers to BSA molecule was the Sudlow siteⅡ.

Adenocarcinoma, Papillary ; diagnosis ; metabolism ; Carcinoma, Pancreatic Ductal ; diagnosis ; metabolism ; Cystadenoma, Mucinous ; diagnosis ; metabolism ; Gene Expression Regulation, Neoplastic ; Humans ; Mucins ; classification ; genetics ; metabolism ; Pancreas ; metabolism ; Pancreatic Neoplasms ; diagnosis ; metabolism

Objective To investigate the effects of protein kinase C (PKC) on proliferation, extracelluar matrix synthesis and transcriptional factor SOX9 (SRY-related high mobility group-box gene 9) expression of rat growth plate chondrocytes in vitro. Methods Rat costochondral growth plate chondrocytes (RGC) were isolated and cultured. The 1st serum free cultured passage RGCs were treated with 1, 10 and 100 nmol/L phorbol 12,13-dibutyrate (PDBu), PKC agonist, cell morphology were observed with inverted microscopy, cell proliferation, COLLAGEN and GAG synthesis were detected by isotope incorporation COLLAGEN TYPEⅡ and AGGRECAN mRNA transcription and SOX9 expression were revealed by RT-PCR and Western blot.Results 100 nmol/L PDBu treatment made the cell morphology of serum free cultured RGC closed to serum group and inhibited proliferation but promoted COLLAGEN and AGGRECAN synthesis, 3H-TdR、3H-proline and 35S-sulfate incorporation of 100nmol/L PDBu group were as 83%, 52.6% and 146.5% as those of serum free control(P

Objective To investigate the clinical value of combined general and gynecological laparoscopy.Methods From March 2003 to December 2006,160 patients with abdominal and gynecological diseases were treated with laparoscopy,including laparoscopic cholecystectomy(LC)+ salpingostomy in 20,LC + ovarian cystectomy in 24 cases,LC + hysteromyomectomy in 12,LC + hysteromyomectomy and uterine artery blockage in 7,LC + subtotal hysterectomy in 19,LC + total hysterectomy in 11,LC + treatment of endometriosis in 6,laparoscopic appendectomy(LA)+ salpingostomy in 16,LA + ovarian cystectomy in 22,LA + subtotal hysterectomy and total hysterectomy in 18,decortication of liver cysts + ovarian cystectomy in 4,and laparoscopic hepatectomy + adnexectomy in 1.Results Laparoscopic procedures were completed in all the 160 cases without conversion to open surgery.The operation time ranged from 40 to 220 min(mean,120 min),and postoperative hospital stay ranged from 1 to 6 days(mean,3.4 days).No patient had perioperative complications.Among the 160 cases,143 were followed up for 3 to 24 months(mean,19.5),during which 1 developed vaginal stump hemorrhage 10 days after the operation and was cured by conservative therapy,1 experienced vaginal polypi at the stump 2 months postoperation and underwent polyp resection.Conclusions Combined general and gynecological laparoscopy is a promising method for patients with abdominal diseases complicated with gynecological diseases.It is important for surgeons from different departments to deeply understand the indications of laparoscopy,prepare well before operation,and cooperate closely.

Objective To explore the effect of failure mode and effect analysis (FMEA) on reducing the unplanned extubation rates for patients with severe craniocerebral injury. Methods FMEA model was used to analyze the main reasons of unplanned extubation patients with severe craniocerebral injury, 7 failure modes with higher RPN scores was selected. The nursing intervention for the fixation of the catheter were improved. The control group with 181 cases of patients without FMEA application were given routine care. FMEA group owning 196 cases were given the optimization process. The incidence rate of unplanned extubation of two groups was compared. Results After improvement of the nursing process of patients with severe craniocerebral injury for fixing the catheter, the RPN of 7 failure modes was lowered. Compared with the control group, the total rate of unplanned extubation in FMEA group decreased to 1.1% (9/832), less than 5.1% (40/779) of the control group. The statistical difference was significant (χ2=22.410, P < 0.01) . The rate of UEX in gastric tube, urinary catheter and central venous catheter were 3.1%(6/196), 1.0%(2/196), 0, lower than 8.8%(16/181), 4.9%(9/181), 3.9%(7/181) in the control group. The statistical difference was significant(χ2=5.718, 5.224, 7.724, P < 0.05). No statistical difference in tracheal cannula and drainage tube of head between the two groups was found(P>0.05). Conclusions The FMEA model can be effective in reducing the rate of unplanned extubation .

OBJECTIVE:To observe the efficacy and safety of paroxetine combined with buspirone in the treatment of geriatric depression with anxiety. METHODS:78 patients with geriatric depression with anxiety were randomly divided into control group (39 cases) and observation group (39 cases). Control group received 20-40 mg Paroxetine hydrochloride tablet,within half an hour after breakfast. Observation group additionally received 5-10 mg Buspirone hydrochloride tablet for 3 times. The treatment course for both groups was 8 weeks. Clinical efficacy,HAMD,HAMA and TESS before and after 2,4 and 8 weeks of treatment in 2 groups were observed. RESULTS:The total effective rate in observation group was significantly higher than control group,the difference was statistically significant(P<0.05). HAMD after 4 and 8 weeks,HAMA after 8 weeks in control group,HAMD and HAMA after 2,4 and 8 weeks in observation group were significantly lower than before,and it gradually decreased by time pro-longed,observation group was lower than control group,the differences were statistically significant (P<0.05 or P<0.01). And there was no significant difference in the TESS rating in 2 groups before and after treatment(P>0.05). CONCLUSIONS:The effi-cacy of buspirone combined with paroxetine is superior to paroxetine alone in the treatment of geriatric depression with anxiety, with better safety.

Objective:To develop an HPLC-DAD method for the simultaneous determination of seven alkaloid constitutents, so-phoranholN-oxide, oxymatrine, sophoridine, oxysophocarpine, sophoranol, matrine and sophocarpine in Sophora flavescens Ait. Meth-ods:The chromatographic separation was performed on an Agilent Zorbax C18 column (150 mm × 4. 6 mm, 5μm) with 10 mmol·L-1 NH4Ac(0.1% ammonia, pH=9.0)(A)-acetonitrile-methanol(1 ∶22) containing 20 mmol·L-1NH4Ac(B) as the mobile phase with gradient elution at the flow rate of 1 ml·min-1 . The detection wavelength was set at 220 nm,and the column temperature was maintained at 30 ℃. Results: SophoranholN-oxide, oxymatrine, sophoridine, oxysoph-ocarpine, sophoranol, matrine and sopho-carpine was linear within the range of 0.093-1.860 μg(r =0.999 6) , 0.530-10.600 μg (r =0.999 7), 0.062-1.240 μg (r =0. 999 8), 0. 281-5. 620 μg (r=0. 999 9), 0. 026-0. 520 μg (r=0. 999 8) ,0. 036-0. 720 μg (r=0. 999 7) and 0. 032-0. 640 μg (r=0. 999 6), respectively. The average recovery was 97. 5%, 98. 2%, 99. 0%, 99. 4%, 99. 2%, 98. 2% and 98. 7%, and RSD was 1. 18%, 0. 92%, 1. 43%, 1. 04%, 0. 81%, 0. 43% and 0. 88%(n =6), respectively. Conclusion:The method is convenient, accurate and reproducible in the quality control of multicomponents in Sophora flavescens Ait.

Objective To analysis the effect of compound betamethasone injection combined with radiation on keloid in frontal facial region. Methods 60 cases of keloid patients in zhejiangprovincial people's hospital from January 2014 to January 2016 were selected,all patients were treated with surgery,the patients were randomly divided into observation group and control group,30 cases in each group,radiotherapy was used in the control group,the observation group was treated with local injection of compound betamethasone on the basis of the control group,the therapeutic effects, pain scores, adverse reactions and complications were compared between the two groups. Results The recurrence rate of the observation group was 3.33% which was significantly lower than that of the control group 10%,the improvement rate of the observation group 93.33% was significantly higher than the control group 80%,the difference was statistically significant (P<0.05).one,two and three months after operation,the pain scores in the observation group were significantly lower than those in the control group at the same time point,the difference was statistically significant (P<0.05).The adverse reaction rate was 6.66% (2/30) in the observation group and 23.33% (7/30) in the control group, there was no significant difference between the two groups.The incidences of skin sag, pigmentation, incision delayed union and telangiectasia in the observation group were significantly lower than those in the control group (P<0.05). Conclusion Compound betamethasone injection combined with radiation on the frontal facial keloid patients with significant effect,can significantly reduce the recurrence rate,improve the rate of improvement,reduce pain and complications in patients.