OBJECTIVE:To probe the advantages and disadvantges of soft packing container of hospital－ prepared infusion fluid.METHODS:The hospital－ prepared bottled infusion fluid was compared with soft parking fluid in respect to production costs,quality of preparation and clinical use.RESULTS ＆ CONCLUSION:The soft packing infusion fluid has developing potential,however,at present there exist some problems to be settled.It can not take the place of bottled infusion fluid in the near future.

OBJECTIVE:To establish the chemical identification method of bis muth subcarbonte in weishusan.METH?ODS:The samples were ignited,then bismuth subcarbonate in residue was identified by the identification method of bismuth of identification method of potassium iodide from Chinese Pharmacopenia,with dilute nitric acid as solvent.RESULTS:Bis?muthic salt positive result was found in all dilute nitric acid solvent,this method could eliminate the interference with identi?fication of bismuth subcarbonate from traditional Chinese medicinal components in weishusan,it could also exclude the pseu?do-positive and pseudo-negative reaction,the color was easy to identify.CONCLUSION:This method is simple and stable and therefore applicable to quality control of weishusan.

OBJECTIVE:To probe the advantages and disadvantges of soft packing container of hospital-prepared infusion fluid.METHODS:The hospital-prepared bottled infusion fluid was compared with soft parking fluid in respect to production costs,quality of preparation and clinical use.RESULTS & CONCLUSION:The soft packing infusion fluid has developing potential,however,at present there exist some problems to be settled.It can not take the place of bottled infusion fluid in the near future.

OBJECTIVE:To correct the standard of bismuth content in Weishusan.METHODS:The contents of effective bismuth in Weishusan and other three reference substances were detected by compleximetry.After adjusting the dosage of Weishusan,clinical rank sum test was carried out.RESULTS:The content of bismuth in original formula of Weishusan was rather high,therefore the inventory of bismuth subcarbonate in preparation technic of Weishusan should be reduced to7.0kg.CONCLUSION:The quality standard should be reformulated as bismuth subcarbonate0.1g(?10%)in per gram of Weishusan.

Objective: To establish the detemination method of bismuth subcarbonate in Weishu Powder. Methods: The samples were ignited, then bismuth subcarbonate in residue was determined by compleximetry. Results: The average recovery was 99.36?0.14%(n=9). Conclusion: This method can be used in quality control of Weishu Powder preparation.

Objective To investigate the resistant mechanism of carbapenem-resistant Escherichia coli and its relationship with endogenous infection. Methods Two carbapenem-resistant Escherichia coli strains were isolated from blood and stool of a same patient, respectively. The minimal inhibition concentrations (MIC) of the two isolates against imipenem and meropenem were determined by E-test. The susceptibility against other antimicrobial agents were done by disc diffusion method. Isoelectric focusing electrophoresis (IEF), polymerase chain reaction (PCR) amplification,cloning and sequencing, conjugation, Southern blotting were carried out to analyze the encoding gene of β-lactamases. Homology analysis of the two strains was done by pulsed field gel electrophoresis (PFGE). Results MIC against imipenem and meropenem of the two strains were both≥32 mg/L.Both strains produced KPC-2 (pI 6.7) and SHV-12 (pI 8.2) β-lactamases. blaKPC2gene was located on a 54 kb transferable plasmid. PFGE showed that the two Escherichia coli strains were derived from the same clone. Conclusions The resistance and enzyme digestion map of chromosome DNA of the two Escherichia coli strains are coincident. The Escherichia coli septicemia of this patient is probably an endogenous infection caused by the immigration of Escherichia coli from the gut.

OBJECTIVE To identify the antibiotic resistance,homology and the carbapenemases determinants of imipenem-resistant strains of Acinetobacter baumannii isolated from elderly in the Zhejiang Hospital.METHODS All 142 strains of A.baumannii were isolated from Zhejiang Hospital through Jan 2005 to Jan 2007.K-B method was used to screen imipenem-resistant strains.The MICs of imipenem-resistant strains to 14 antimicrobial agents were determined by agar dilution method.The homology of these isolates was analyzed by pulse-field gel electrophoresis(PFGE).The coding genes of carbapenamases and the gene environments were investigated by PCR,clone,and sequencing.RESULTS Ninety-seven strains of imipenem-resistant A.baumannii were isolated from 142 strains.All of the strains of carbapenem resistant A.baumannii belonged to 4 epidemic PFGE-clones.Ninety carbapenem resistant strains contained OXA-23-like carbapenemase gene and 91 isolates were positive for OXA-51-like gene. OXA-23-like gene of 86 strains was just on the down-stream of insert sequence ISAba1.OXA-51-like gene of 6 strains had an ISAba1 sequence just on the up-stream.CONCLUSIONS All imipenem-resistant strains of A.baumannii are pan-resistant isolates.Clone dissemination is the most important style of strains spread.No OXA-24-like,OXA-58like,IMP-like,and VIM-like gene are detected.OXA-23-like and OXA-51-like gene are the most popular carbapenemases coding genes of these strains in the Zhejiang Hospital.ISAba1 has close relationship with OXA type carbapenemases genes in Zhejiang Hospital.

Objective To investigate the resistance of Pseudomonas aeruginosa and genotyping of the main β-lactamases in China. Methods A total of 645 Pseudomonas aeruginosa isolates were collected from 28 hospitals in 16 cities in China from July 2006 to July 2007. The susceptibilities to 11 kinds of antimicrobial agents were detected by agar dilution or Kirby-Bauer disk diffusion method. The genotypes of β-lactamases including TEM, SHV, CTX-M and OXA of all the strains were detected by polymerase chain reaction (PCR) and sequence analysis. Results The resistance rates of 645 Pseudomonas aeruginosa isolates to antimicrobial agents were high, except those to amikacin and meropenem were lower than 30 %. Two hundred and seventy-five (42. 64 % ) strains were carbapenem and (or) meropenem-nonsusceptible Pseudomonas aeruginosa. Three hundred and sixty-eight (57.05 %) strains were multidrug-resistant Pseudomonas aeruginosa and 20 (3. 10%) strains were pandrug-resistant. The genotyping results of β-lactamases were as follows: 51 stains produced OXA-10 group β-lactamases, 37 were CARB type, 36 were TEM, 35 were PER, 11 were CTX-M, 9 were VEB, 5 were SHV, 24 were metallo-β-lactamases positive and 1 was GES. None of genotypes of plasmidmediated AmpC enzyme and other carbapenemases were detected. CTX-M-13, CTX-M-14,CTX-M-15, CTX-M-3 of extended spetrum β-lactamese were detected in Pseudomonas aeruginosa.Conclusions The situation of Pseudomonas aeruginosa resistances is severe in China. OXA-10 and PSE-1 are the most common genotypes of β-lactamases. The β-lactamases genotyping is different between carbapenem-nonsusceptible and carbapenem-susceptible strains.

PurposeTo investigate the feasibility of using low concentration contrast agent and low tube voltage in the light and moderate weight's abdominal contrast-enhanced CT scan, in order to find an optimal solution to reduce radiation dose and iodine intake.Materials and Methods Forty patients with light weight whose body mass indexes (BMI) were lower than 20 kg/m2 were randomly divided into group A1 (n=20) and group B1 (n=20). Meanwhile, another 40 patients with moderate weight whose BMI ranged from 20 kg/m2 to 25 kg/m2 were randomly divided into group A2 (n=20) and group B2 (n=20). Low concentration contrast agent and low tube voltage (Visipaque 270 mgI/ml, 100 kV) were used in both group A1 and group A2 in abdominal enhanced CT scan. While both group B1 and group B2 used conventional scan solution (Omnipaque 300 mgI/ml, 120 kV) in abdominal enhanced CT scan. Then the contrast noise ratio (CNR), the image quality score and the effective radiation dose (ED) were compared among the four groups.Results The CNR and image quality score at artery phase and portal phase were neither significantly different between group A1 and group B1, nor between group A2 and group B2 (t=-1.539-0.000,P>0.05). The CNR and image quality score of the liver at artery phase in group B1 were signiifcantly higher than those in group A2 and group B2 (P<0.05).Conclusion The solution of using low concentration contrast agent and low tube voltage in contrast enhanced scan can achieve the same high quality abdominal image with reduced iodine intake and radiation, compared with the application of conventional enhanced scan; BMI has rather great impact on image quality score at arterial phase and little impact on that at portal phase. So it is suggested that the protocol of liver contrast-enhanced CT scan may choose reduction of voltage at portal phase so as to reduce radiation.

Objective To investigate the prevalence and dissemination mechanism of 16S rRNA methylase genes in extended-spectrum beta-lactamases(ESBLs)-producing Enterobacteriaceae in China.Methods PCR amplification and DNA sequencing were used for screening and identifing 16S rRNA methylase genes and ESBLs genes.Minimal inhibitory concentrations(MICs)of the antimicrobial agents were detected by Etest.Conjugation and plasmid extract were performed to study dissemination mechanism of 16S rRNA methylase genes and ESBLs genes.Results Only one strain.Klebsiella oxytoca strain ZJ157 was screened as positive for armA gene from 447 ESBLs-producing isolates,which also contained CTX-M-15 and TEM-1 genes.It was resistant to aminoglycesides,ciprofloxacin,and most β-lactams,except carbapenems,polymyxin E and tigecyeline.Resistance to amikacin and β-lactams was transferred to a recipient Escherichia coli 600 by conjugation experiment.arntA.CTX-M-15 and TEM-1 genes were detected in the transconjugant.A plasmid about 55 kb was extracted from Klebsiella oxytoca ZJl57 and the transconjugant.Conclusions A 16S rRNA methylase gene armA was detected in an isolate of Klebsiella oxytoca.armA,CTX-M-15 and TEM-1 genes can be co-transferred in the same plasmid leading to multi-drug resistance.