OBJECTIVE To analyze the multi-drug resistant genes(genes encoding extended-spectrum ?-lactamases,outer membrane protein gene oprD2,aminoglycoside-modifying enzyme genes,sulfonamides and disinfectant-resistance gene and plasmid-mediated quinolone resistance gene) of Pseudomonas aeruginosa clinical strains.METHODS The drug-resistance to 15 antibiotics was detected by the disc agar diffusion(DAD) and microdilution broth method in 32 P.aeruginosa strains isolated from Jun to Dec 2006.Twenty-eight related drug-resistant genes and outer membrane protein gene oprD2 were examined by PCR method.RESULTS The resistance rate of 32 P.aeruginosa strains to amikacin,ceftazidime,ciprofloxacin,cefepime,cefoperazone/sulbactam,imipenem,meropenem,levofloxacin,piperacillin/tazobactam,aztreonam and piperacillin were 9.4%,25%,59.4%,68.7%,68.8%,78.1%,81.1%,81.3%,84.4% and 94.4%,respectively,and that to others antibiotics were 100%.The detective rate of aminoglycoside-modifying enzyme genes(aac(6′)-Ⅱ,aac(3)-Ⅱ,aac(6′)-Ⅰ,aph(3′)-Ⅵ,ant(3″)-Ⅰ and aac(3)-Ⅰ) were 68.8%,62.5%,21.9%,9.4%,9.4% and 6.3%,and the genes encoding extended-spectrum ?-lactamases(blaFOX,blaIMP,blaVIM and blaDHA) were 37.5% 15.6% 6.3% and 9.3%,respectively.Twenty-two(68.8%) of them were detected in oprD2 and 9(28.1%),but positive in qacE?-sul1 gene.CONCLUSIONS The detective rate of aminoglycoside-modifying enzyme genes,extended-spectrum ?-lactamases genes and the loss rate of outer membrane protein gene oprD2 are high in these 32 multi-drug resistant P.aeruginosa clinical strains.

Objective To evaluate results of surgical treatment for patients with acute type A aortic dissection using Sun’s operation and triple-branched stent graft. Methods According to the operation mode, thirty-three patients with type A aortic dissection were divided into Sun’s operation group (n=22) and triple branches aortic arch stent-graft placement op?eration (triple-branched) group (n=11). Preoperative examinations included cardiac ultrasound, aortic CT angiography (CTA), hepatic and renal functions and blood routine test in all patients. Intraoperative monitoring included the index about cardiopulmonary bypass and blood loss. The perioperative hepatic and renal functions and complications were also recorded. Survival and recovery rates were evaluated by follow-up between two groups of patients. Results There were six periopera?tive death in Sun’s group, and three patients died in triple-branched group. In triple-branched group, the intraoperative blood loss was significantly increased than that in Sun’s group [(3 586.4±2 926.8) mL vs. (2 630.5±1 821.2) mL, P<0.05]. Postoperative echocardiographic examinations revealed that the left ventricular size (LVEDd) and the aortic diameter were decreased while the left ventricular ejection fraction (LVEF) was elevated after surgery in Sun’s group [(50.9±6.9) mm vs. (55.0±7.5) mm,(28.2±1.6) mm vs. (48.8±11.0) mm, 0.620±0.031 vs. 0.469±0.104, P<0.05]. Whereas, only the aortic diame?ter was decreased after surgery in triple-branched group [(28.6±3.9) mm vs. (50.9±9.2) mm, P<0.05]. Kaplan-Meier surviv?al curve showed that five-year survival rate of Sun’s group was similar with that of triple-branched group (Log-rank χ2=0.095,P>0.05). At 5 year after operation, there were no significant differences in the recurrence of new aortic dissection, the incidence of cerebral infarction and mortality between Sun’s group and triple-branched group (P>0.05). Conclusion Sun’s operation can significantly decrease patient’s intraoperative blood loss and improve cardiac function. But its survival rate and long term results need advanced observation.

Objective We have revised the Sunnybrook facial nerve grading system which has been widely recog?nized in the world to a Chinese version and verified its credibility and validity. Methods First we translated and edited the Sunnybrook facial nerve grading system using Chinese.Nine doctors, who were selected from different hospitals, then scored twice on the same video of 90 patients with facial nerve palsy using the Chinese version of the Sunnybrook facial nerve grading system and grading standard separately at one month interval. The consistency and the repeatability of the Chinese version of the Sunnybrook facial nerve grading system were evaluated. Results The Cronbach 's alpha value was 0.92 and the average coefficient of repeatability (CR) was 12.72, indicating that the Chinese version of the Sunny?brook facial nerve grading system had a high degree of internal consistency and repeatability. The ICC values on the as?sessment and evaluation for the internal measurement were 0.97 and 0.98, respectively. The scored results were compara?ble between doctors who were not familiar with this disease and those who were very familiar with the disease. The aver?age ICC was 0.97(95%CI:0.95~0.99). Conclusions The Sunnybrook facial nerve grading system has good reliability and consistency and hereby recommend Chinese doctors to use it.

Objective To understand the level of urinary iodine of schoolchildren and salt iodine content of their families in a primary school and to analysis influence between salt iodine content and urinary iodine level in Haimen City,Jiangsu Province.Methods A cross-sectional study was conducted in a primary school of Haimen City in 2012.With the method of stratified cluster sampling,all students aged 9 ～ 12 were extracted in grades 3-5,urine samples and salt samples of their family were collected.Urinary iodine and salt iodine were determined according to Method for Determination of Iodine in Urine by As3+-Ce4+ Catalytic Spectrophotometry (WS/T 107-2006) and Direct Titration of Universal Test method in Salt Industry (GB/T 13025.7-1999).Results Totally,452 students from grades 3-5,including 233 boys and 219 girls were selected by cluster-stratified sampling.The median of children's urinary iodine was 231.90 μg/L,while the median of boys and girls was 235.40 and 222.60 μg/L,respectively.The median of urinary iodine of 9,10,11 and 12 year old students was 253.65,195.70,236.40 and 241.70 μg/L,respectively.The proportion of less than 100 μg/L and ≥300 μg/L was 7.7％ (35/452) and 27.7％ (125/452),respectively.There were no significant differences between different gender and age students.Among the 452 salt samples collected the median of salt iodine was 27.50 mg/kg.The coverage rate of iodized salt,the qualified rate of iodized salt and the intake rate of qualified iodized salt were 98.9％ (447/452),95.1％ (425/447) and 94.0％ (425/452),respectively.After consumptionn of non-iodized salt (＜ 5 mg/kg),unqualified iodized salt(5 ～ ＜ 20 mg/kg or ＞ 50 mg/kg) or qualified iodized salt [(35 ± 15)mg/kg],the median of urinary iodine of children was 177.30,211.95 and 232.90 μg/L,respectively.Correlation analysis showed that there was no relationship between iodine content of salt and urinary iodine level of schoolchildren (r =0.085,P ＞ 0.05).Conclusions Current nutritional level of schoolchildren in Haimen City is higher than the appropriate amount.Household salt iodine content of edible salt does not affect urinary iodine level of the children significantly.

Objective:To assess the effect of combined cognitive rehabilitation training on improving cogni-tive dysfunction in amphetamine-type stimulant dependent patients.Methods:Subjects who met the clinical diagno-sis of ATS dependence by DSM-IV in compulsory isolation detoxification institute were randomly assigned into in-tervention group (n =30 )and control group (n =26 ).Control group received a regular education.Intervention group also received a combined cognitive rehabilitation training besides regular education,including psychological and physical rehabilitation for 24 weeks.The Chinese version of CogState Battery (CSB)was used to assess cogni-tive function at baseline and 24 weeks after the intervention.Results:No significant difference was found on all sub-scales scores of CogState Battery between two groups at baseline.At 24 weeks after the intervention,compared to control group,the intervention group had more improvements in three sub-scale scores,i.e.,One Card LearningTask [(0.06 ±0.12)vs. (-0.03 ±0.14),P<0.05],Two-back Task [(0.12 ±0.15)vs. (0.01 ±0.19),P<0.05]and Continuous Paired Association Learning Task [(-0.46 ±0.35)vs. (-0.15 ±0.49),P<0.05].No difference was found on improvements in the rest 5 sub-scale scores,i.e.,Detection Task,Identification Task,Inter-national Shopping List Task,Groton Maze Learning Task and Social Emotional Cognition Task (P >0.05 ).Conclusion:The combined cognitive rehabilitation training could improve amphetamine-type stimulant dependent patients'visual learning and memory,working memory and spatial working memory,while have no significant im-provement on other cognitive functions.

Objective To explore the effect of theta burst stimulation (TBS) paradigm of repetitive transcranial magnetic stimulation (rT-MS) on executive function in patients with chronic schizophrenia. Methods 60 patients meeting DSM-IV for chronic schizophrenia disor-ders criteria were enrolled. They were randomly divided into TBS group (n=30) and sham intervention group (n=30). They were assessed with digit span performance, space span performance and Wisconsin Card Sorting Test (WCST) before and 4 weeks after intervention. Re-sults After intervention, the forward score of digit span performance, the total score and forward score of space span performance increased (P<0.05), the error selection percentage, the error selection number and the percentage of error number of WCST decreased, the percentage of conceptual level of WCST increased (P<0.05) in the TBS group. However, there was no significant difference in the digit span perfor-mance, space span performance and WSCT in the sham intervention group (P>0.05). There was significant difference in all the items be-tween 2 groups after intervention (P<0.05). Conclusion TBS paradigm of rTMS could improve the executive function in schizophrenic pa-tients.

Objective: To study the effects of capsaicin applied locally to infraorbital nerve on primary afferent nerve inadult rats. Methods:Capsaicin solution (2% ) was directly applied onto one lateral intraorbital nerve, and the contralateralnerve was used as self-control. Both experimental and control infraorbita1 nerves were observed under electron tnicroscope on3, 7, 14, 21, 28, 35 or 42 d after local administration. Substance P(SP)--like immunoreactive positive granules in both lateralnucleus caudalis spinalis nervi trigemini (CNV) were examined by immunohistochemical method. Results: Degenerated un-myelinated fibers in capsaicin-treated nerves were found under electron microscope, and no myelinated fibers changes werefound. The gray scale value of SP-like immunoreactive positive granules in the experimental side was markedly lower thanthat in the control side (P＜0. 01), while no significant difference was observed between different time groups. Conclusion:Local administration of capsaicin can produce selective destruction of unmyelinated fibers in primary afferent nerves, and canreduce the levels of SP in regions of CNV. The results suggest that local administration of capsaicin has potential therapeuticvalue for trigeminal neuralgia.

Objective To compare clinical effect of unipolar versus bipolar radiofrequency ablation in treating atrial fibrillation (AF) in elderly patients and discuss the correlated risk factors.Methods From October 2008 to December 2013,a total of 50 elderly patients with organic heart disease and AF underwent radiofrequency ablation surgery.All patients were divided into 2 groups of unipolar (group A,n=20) and bipolar (group B,n=30 patients) radiofrequency ablations.The variations of electrocardiogram (ECG) and ultrasonic cardiogram (UCG) in patients were collected and the complications and the NYHA class of the patients were recorded at 3,6 and 12 months after surgery.The total 43 elderly patients were divided into sinus group and non-sinus group according to their ECG at 12 months after surgery.Results The recovery rates of sinus rhythm at 3,6 and 12 months after surgery were 73.7％(14/19),66.7％(12/18) and 61.1％ (11/18)respectively in group A and 82.8％(24/29),85.2％(23/27)and 88.0％(22/25) respectively in group B.Two groups of the recovery rate of sinus rhythm had a statistically significant difference between the two groups (P＜0.05) at 12 months after surgery.The complication rate in group A was higher than in group B [55.0％ (11 cases) vs.26.7％ (8 cases),P＜0.05].Preoperative history of AF and left atrial diameter were the influencing factors for the sinus rhythm recovery rates (P＜0.05).Conclusions Bipolar radiofrequency ablation for AF is safe and has less complications and high success rate of restoring sinus rhythm.The patients with long preoperative history of AF and left atrium distension have a low success rate of restoring sinus rhythm with a high recurrence rate.

BACKGROUND: Nano-hydroxyapatite has been widely used as reconstructive and prosthetic material for osseous tissue, owing to its excellent biocompatibility and bioactivity. But, its brittleness is one of the most serious obstacles for its wider applications as load-bearing implants. Therefore, hydroxyapatite/chitosan composites have been widely studied as bone substitute, due to their excellent biocompatibUity and suitable mechanical properties.OBJECTIVE: To review various preparation methods of hydroxya patite/chitosan composites and the development trend in this field.METHODS: Articles were searched in Medline Database (1995-01/2009-03), VIP Database (1995-01/2009-03) and "qinghuatongfang" Database (1995-01/2009-03) with the keywords of "nano-hydroxyapatite, chitosan, preparation, development trend".RESULTS AND CONCLUSION: Total 2 034 related articles were collected, including 1 634 in Chinese and 670 in English. Following excluding earilier published, duplicate, and similar studies, we brought into 37 sub-standard literatures. Hydroxyapatite/chitosan composite in nanometer size, with similar structure as natural bone, has better biological function compared with corresponding micrometer composite. Simultaneously, optimized material composition, structure and technology will obtain more suitable bone substitute in mechanical property compared with natural bone. This paper reviews preparation methods at home and abroad in recent years, with the rapid development of biological materials, hydroxyapatite compositematerials have been wisely used in bone tissue repair and replacement surgery, but its poor mechanical properties limits its clinical application.

AIM: To investigate the effect of single immunoglobin IL-1 receptor related protein (SIGIRR) on damage of alveolar epithelial cells in acute lung injury induced by lipopolysaccharide. METHODS: The acute alveolar epithelial cell injury model was constructed by stimulation of A549 cells with LPS. In order to over-express SIGIRR, the A549 cells were transferred with eukaryotic expression vector containing full length SIGIRR cDNA. The transcriptional activity of NF-κB was measured by dual-luciferase reporter assay system. The concentrations of IL-1β, TNF- α and IL-6 were detected by ELISA. The levels of these inflammatory factors between the transfected cells and untransfected cells were compared. RESULTS: The over-expression of SIGIRR inhibited the transcriptional activity of NF-κB. The increases in IL-1β, TNF-α and IL-6 concentrations in alveolar epithelial cells induced by LPS were observed. CONCLUSION: SIGIRR in alveolar epithelial cells inhibits TLR4 signals triggered by LPS and attenuates the inflammatory reactions in alveolar epithelial cells, which plays a protective role against the acute damage of the alveolar epithelial cells.