Objective:To assess the genetic relationship of clinical isolates of carbapenem-resistant A.baumannii (resistant to both imipenem and meropenem) from January 2007 to March 2008 in Peking University Third Hospital for measures to decrease the isolates; to investigate the characteristics of patients with carbapenem-resistant A. baumannii colonization or infection and to evaluate antibiotic treatment for health care-associated infections caused by carbapenem-resistant A. baumannii. Methods: The medical records of patients with carbapenem-resistant A. baumannii colonization or infection were reviewed. Antibiotic susceptibilities of the isolates were determined by the standardized disk-diffusion method and the clonal relationship of the isolates was analyzed by pulsed-field gel electrophoresis. Results: A total of 49 carbapenem-resistant A. baumannii strains were isolated from the 49 patients hospitalized during the study period and pulsed-field gel electrophoresis typing yielded 7 different patterns. A total of 45 (91.8%)genotyped strains showed clonal relationship. The most frequently identified predisposing factors were intensive care unit stay, invasive procedures, and hypoalbuminemia. Chronic obstructive pulmonary disease (12 cases) and cerebrovascular disease (10 cases) were the most common comorbid conditions.The mortality of patients with carbapenem-resistant A. baumannii infection was 38. 1% (8 of 21 patients), and the acute physiology and chronic health evaluation Ⅱ score, initial antibiotic therapy failure rate and the presence of hypoalbuminemia were significantly increased in the death group. Combination therapy regimens had higher success rates than monotherapy regimens (11/13, 84. 6% vs. 3/17,17.6%). Conclusion: There has been clonal spread of carbapenem-resistant A. baumannii strains among patients in our hospital since 2007. Intensive care unit stay, invasive procedures, hypoalbuminemia, chronic obstructive pulmonary disease and cerebrovascular disease were common in patients with carbapenem-resistant A. baumannii colonization or infection. Antibiotic combination therapy may be effective for carbapenem-resistant A. baumannii infection.

Objective To analyze the antimicrobial resistance of Staphylococcus aureus isolated from clinical samples.Methods Staphylococcus aureus and methicillin-resistance Staphylococcus aureus were collected in the microorganism lab from 2004 to 2008,and the antimicrobial susceptibility test was conducted by disk diffusion technique(K-B method).Results A total of 1521 Staphylococcus aureus were collected in 5 years,of which 890 were MRSA(58.5%).Of all the SAU strains,255 were isolated from emergency room(16.8%),201 from surgery wards(13.2%)and 171 from surgical intensive care unit(SICU)(11.2%).Of all the MASA strains,199 were collected from emergency room(22.4%),148 from SICU(16.6%)and 131 from RICU(14.7%).Most of the MRSA strains(725,81.5%)were isolated from sputum,and the others from wound secretions(62,14.7%),blood(27,3.0%),throat(17,1.9%)and urine(16,1.8%),etc.MASA was resistant to most antibiotocs,but quite sensitive to SMZ.No strains resisted to vancomycin or teicoplanin were found in this study.MASA from all the departments showed a feature of highly resisting to variety antibiotics.Conclusion SAU,especially MASA were increasing in the past 5 years in our hospital.MASA was resistant to 90% of the ? lactan,macrolides and quinolones.No strains resistant to vancomycin or teicoplanin were found yet.It is of great value to monitoring the antimicrobial resistance of SAU and MRSA during the clinical practice.

OBJECTIVE: To investigate the allergens in patients with allergic rhinitis in Yichang, so that to find common allergens of Yichang and to provide statistic basis for a reasonable prevention and treatment to allergic rhinitis. METHOD: 1,979 patients with allergic rhinitis in Yichang were detected for allergens by skin prick test and the distribution of positive rates to inhaled allergens was compared between different genders and ages. RESULT: 1,545 (78.1%) of 1,979 suspected allergic rhinitis patients presented positive reaction. The positive rate in male was significantly higher than in female, and that in juvenile group was significantly higher than in adults. Among positive cases in inhalation group, the most common allergen was flour mite (80.4%), followed by house dust mite (64.9%), cockroach (13.3%) and artemisia pollen (8.2%). CONCLUSION The study shows that the flour mite and house dust mite are the most common inhaled allergens causing allergic rhinitis in Yichang. We should pay more attention to the prevention and treatment for the juvenile patients.
Adolescent ; Adult ; Aged ; Allergens ; immunology ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Rhinitis, Allergic ; diagnosis ; epidemiology ; immunology ; Skin Tests ; Young Adult

Objective To compare the differences of lung pathological changes of acute lung injury in mice in-duced by lipopolysaccharide ( LPS) and graphite particles, and to explore the possible mechanisms of acute lung injury in-duced by fine particles of different origins.Methods 140 male specific-pathogen-free Kunming mice weighing 18-20 g were randomly divided into 7 experimental groups, in addition to the normal control group.The experimental groups were treated by intratracheal instillation of LPS solution or graphite powder suspension in different doses, respectively, to induce acute lung injury in the mice.The mortality of the mice was observed, and pathological changes of the lung tissues were ex-amined by light and transmission electron microscopy.Western blot was used to detect the protein expression of neutrophil elastase ( NE) in lung tissues , and real-time quantitative PCR was used to detect mRNA expression of monocyte chemotac-tic protein-1 ( MCP-1) in the lung tissue .Results Compared with the normal control group, some pathological changes were observed in the lung tissues of the groups L ( LPS) and G ( graphite) .There were numerous macrophages in the lung tissues in the group G mice, and exudate, mainly neutrophils, in the lung tissues of the group L.The NE protein expres-sion in the lung tissue was significantly higher than that of the normal control group ( P<0.05) , and there was also a sig-nificant difference between the groups L and G (P<0.05).The MCP-1 mRNA expression in lung tissues was higher in the control group (P<0.01), and there was also a significant difference between the groups L and G (P<0.01).Conclu-sions Diverse types of particulate matters induce different pathological changes in the lungs, therefore the mechanism may also be different in the inflammatory responses.It means that the lung injuries caused by fine particles of mixed composition may have complex mechanisms.

OBJECTIVE: To study dynamic change and pathophysiology of airway obstruction of the soft palate in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) during wakefulness and natural sleep. METHOD: Sixteen patients who were diagnosed as OSAHS by sleep questionnaires, medical examination and polysomnography were enrolled in this study in Shanghai Tenth People' Hospital from May to December during 2007. All patients were requested to keep awake prior to examination. Sequential midline sagittal images of the upper airway were obtained during awake and asleep state with Cine-MRI and been transmitted to portable computer. Morphologic change of the soft palate, the anterior-posterior pendulum angle of the soft palate, the anteroposterior diameter and the length of soft palate were measured. Statistical analysis was performed with paired t-test. RESULT: During wakefulness: soft palate caused obstruction by floating backwards and widening anteroposterior diameter(distance between hard palate and uvula P > 0.05, included angle of hard palate and segmental vente of uvula P < 0.05, included angle of hard palate and segmental dorsum of uvula P < 0.01, difference of included angle P < 0.01). Main obstruction site was on retropalatal region. During natural sleep: soft palate caused obstruction by lengthening down and widening anteroposterior diameter (distance between hard palate and uvula P < 0.01), included angle of hard palate and segmental vente of uvula P > 0.05, included angle of hard palate and segmental dorsum of uvula P > 0.05, difference of included angle P < 0.01). Main obstruction site was on retroglottal region. CONCLUSION Morphologic change of soft palate in patients with OSAHS is multiple, and level of obstruction is deeper during natural sleep than during wakefulness. Main reason of airway obstruction is distinct during different state. The obstruction of upper airway of patients with OSAHS during wakefulness can't replace that during natural sleep.
Adult ; Airway Obstruction ; Humans ; Magnetic Resonance Imaging, Cine ; Male ; Middle Aged ; Palate, Soft ; pathology ; physiopathology ; Polysomnography ; Sleep Apnea, Obstructive ; pathology ; physiopathology

Our work focuses on the quality control and structural identification of Photocyanine as a cancer therapeutic photosensitizer. Photocyanine is a mixture which contains four ZnPcS2P2 type substituted Phthalocyanine isomers. In order to obtain the single component from Photocyanine, the mixture of four isomers possessing the similar structures and chemical property had been isolated and purified. An HPLC method with a mixture of methanol-acetonitrile-ion-pair buffer as the mobile phase was applied to isolate the four isomers by means of a semi-preparative C18 column. To remove the salts which were mixed in the preparative product, a SPE C18 column was used to separate the salts by elution with water and then the marker component was eluted by methanol. Subsequently, a column of Sephadex LH-20 gel was applied to elute the crudes with methanol to desalination. The purity of the isolated compound was measured by TLC and four different isomers of phthalocyanine were obtained. The chemical structures of them were elucidated by 1H NMR spectra, gCOSY and NOE1D. An HPLC-DAD method was developed for simultaneously determination of four major isomers in Photocyanine with a C18 column (Grace Smart, 150 mm x 4.6 mm ID, 5 microm). The separation was carried out with a gradient program at a flow rate of 1.0 mL x min(-1). The mobile phase was a mixture of acetonitrile and ion-pair buffer (0.01 mol x L(-1) hexadecyl trimethyl ammonium bromide and 0.01 mol x L(-1) potassium dihydrogen phosphate, adjusted the pH value to 6.8 with potassium hydroxide solution). The resolution values of four isomers were 2.5, 1.20, 1.33, and 1.8. Linear regression analysis for four compounds was performed by the external standard method. Four constituents were linear in the concentration range of 0.005 to 10 microg. The values of relative standard deviation (RSD) of intra-day were 0.12%, 0.66%, 0.99%, and 1.21%, respectively. The limits of detection for four compounds were 15 ng, 20 ng, 12 ng, and 25 ng, respectively. This method was simple, accurate and reproducible. The developed method can be successfully applied to analyze isomers in Photocyanine.
Antineoplastic Agents ; analysis ; chemistry ; Chromatography, High Pressure Liquid ; methods ; Indoles ; analysis ; chemistry ; Isomerism ; Molecular Structure ; Organometallic Compounds ; analysis ; chemistry ; Photochemotherapy ; Photosensitizing Agents ; analysis ; chemistry ; Quality Control

The study was aimed to investigate the effects of bortezomib (BTZ) on the expression of ERK, JNK and P38 in daunorubicin (DNR)-resistant K562 cells (K562/DNR) and to clarify the molecular mechanism of BTZ in reversing the drug-resistance in leukemic cells. The K562/DNR cells and the cellular toxicity of BTZ was determined by MTT, then 4 µg/L of BTZ was chosen to do the experiment. The expression of ERK, JNK, p38 and P-gp of K562/DNR cells treated with DNR only or DNR combined with BTZ for 12, 24 and 36 hours was detected by Western blot. The apoptosis rate in each group was assayed by flow cytometry. The results showed that as compared with DNR group, the expression of P-ERK, P-P38 and P-gp was significantly suppressed (p < 0.05) and the expression of P-JNK was significantly enhanced (p < 0.05) in the cells treated with DNR combined with BTZ. There was no change in the expression of total ERK, P38 and JNK. The effect increased with the prolonging of time. Meanwhile, the apoptosis rate in cells treated with DNR combined with BTZ increased compared with DNR only. It is concluded that the BTZ can reverse the drug resistance in K562/DNR cells by MAPK signaling pathway and increase the apoptosis of leukemic cells. The effect shows the characteristics of time-dependent manner.
Apoptosis ; drug effects ; Boronic Acids ; pharmacology ; Bortezomib ; Drug Resistance, Multiple ; drug effects ; Drug Resistance, Neoplasm ; drug effects ; Humans ; K562 Cells ; MAP Kinase Signaling System ; Pyrazines ; pharmacology

Objective To investigate the therapeutic effect and mechanism of Chaizhixiaji Decoction on experimental bile reflux gastritis (BRG) rats.Methods Wistar rats were randomly divided into five groups by random according to weight and sex:control group,model group,Chaizhixiaji Decoction low and high dose groups,and Hydrotalcite Tablets group.Rats were given self-made reflux liquid orally to induce experimental bile reflux gastritis.The diet,stool and urine,hair color and body weight of rats in control group and model group were observed.The histopathological changes of gastric antrum mucosa were observed by naked eyeand light microscope after HE staining.ELISA method was used for detection of serum GAS,PGE2 content in gastric antrum mucosa.Result Compared with control group,rats in model group show thin boicing stool containing red yellow mucus,slow reaction,and body weight decreased significantly (P ＜ 0.05).There were patchy erosions of the gastric antrum with yellow green bile and more yellow mucus of model group in the naked eye.Model control group had a significant rise of inflammatory cells infiltration and intestinal metaplasia,and scores of inflammation and intestinal metaplasia increased significantly (P ＜ 0.01).GAS and PGE2 contents obviously decreased compared with that in control group (P ＜ 0.01).Compare with model group,Chaizhixiaji Decoction of high dosesignificantly improved gastric mucosal tissue damage morphology;reduced the infiltration of inflammatory cells and intestinal metaplasia,which score decreased significantly (P ＜ 0.05,0.01);and increasedlevels of GAS and PGE2 significantly (P ＜ 0.01).Conclusion Chaizhixiaji Decoction has obvious protective effect on gastric mucosa,and its mechanism may be related with the regulation of GAS,PGE2 contents.

Objective The aim of this study was to investigate associations of overall obesity (OO) and abdominal obesity (AO) with brachial-ankle pulse wave velocity (baPWV) among type 2 diabetes(T2DM) patients. Methods A community-based study for T2DM patients was conducted in rural communities in Beijing．Every patient completed a questionnaire to collect demography, lifestyle and diseases history, and underwent physical examinations, baPWV assessments and blood biochemical tests. Multivariate linear regression was used to assess the relationship between obesity index and baPWV. Abnormal baPWV was defined as patients with baPWV≥1,700 cm/s. Logistic regression model was performed to explore the risk of abnormal baPWV after adjusting for poetential confounders step by step. Results A total of 2 048 T2DM patients were recruited. The average age was (59.2±8.3) years and total prevalence of abnormal baPWV was 49.7%. After multivariable adjustment, linear regression showed that there was a negative correlation between body mass index(BMI) and baPWV and a positive correlation between waist-to-hip ratio (WHR) and baPWV. Compared to normal weight group, those with BMI≥28 kg/m2 had lower risk of abnormal baPWV (OR=0.59, 95% CI: 0.44-0.78，P<0.001), but there was an increased risk of 46% among patients with obesity in WHR (OR=1.46, 95% CI:1.07-2.00，P=0.018). Compared to those without OO and AO, patients without OO but with AO had a 1.67-fold increasesd risk of abnormal baPWV (OR=1.67, 95% CI: 1.19-2.35，P=0.003). Conclusions Abdominal obesity is related with arterial stiffnening among T2DM patients, and it is critical to evaluate arterial stiffness of T2DM patients with abdmonal obesity and normal BMI in order to reduce future risk of cardiovascular diseases.

Objective To explore the relationship between sleep duration and different ischemic stroke (IS) subtypes. Methods Participants in the study were recruited from rural communities in Beijing. The survey questionnaires, physical examination and biochemical tests were performed. Sleep duration was categorized into 5 groups, namely ≤5 hours/day, 6 hours/day (5.5-6.5 h/d), 7 hours/day (6.5-7.5 h/d), 8 hours/day (7.5-8.5 h/d) and ≥9 hours/day(≥8.5 h/d). Classification of ischemic stroke was based on Trial of org 10172 in acute stroke treatment(TOAST)classification. Logistic models were used to evaluate the associations between sleep duration and different IS subtypes. Results A total of 6 370 participants were recruited. The average age was (58.34±9.37) years old. Logistic regression analysis showed that after adjusting for age, sex, behavioral lifestyle, socioeconomic status and health status, compared to subjects with 7 hours/day, subjects with sleep duration ≤5 hours/day was significantly associated with increased risk of IS (OR=1.75, 95% CI: 1.42-2.15, P<0.001), large-artery atherosclerosis (OR=1.98, 95% CI:1.46-2.70, P<0.001), small-artery occlusion lacunar (OR=5.73, 95% CI:3.34-9.83, P<0.001) and stroke of undetermined etiology (OR=4.43, 95% CI:1.86-10.53, P=0.001). Subjects with sleep duration 8 hours/day and ≥9 hours/day was only found to be significantly associated with IS and large-artery atherosclerosis (P<0.05). Conclusions Short sleep duration is associated with increased risk of IS, large-artery atherosclerosis, small-artery occlusion lacunar and stroke of undetermined etiology. But long sleep duration is only associated with increased risk of IS and large-artery atherosclerosis.