Risk factors for acquisition of ESBL-producing Escherichia coli and Klebsiella pneumoniae on non-ventilator-associated hospital-acquired pneumonia in a tertiary care hospital in Indonesia

Aims@#This study was aimed to identify the risk factors for the acquisition of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae on non-ventilator hospital-acquired pneumonia (NV-HAP) patients in a tertiary care hospital in Indonesia.@*Methodology and results@#A case-control study was performed between March 31, 2018, and August 31, 2019. Twenty-eight ESBL-producing E. coli and K. pneumoniae isolates and 28 susceptible strains of E. coli and K. pneumoniae obtained from NV-HAP patients were included in this study. Phenotypic screening for ESBL production was performed by the Vitek2 system and subsequently confirmed by double-disk synergy tests. The use of 3rd generation cephalosporin as initial antibiotic therapy for more than three days was the significant risk factor for the acquisition of ESBL-producing E. coli and K. pneumoniae among NV-HAP patients (odds ratio [OR] 41.827; p=0.001). The length of stay of patients with NV-HAP acquiring the ESBL strains was longer than 10 days (OR 17.334; p=0.001).@*Conclusion, significance and impact of study@#The use of 3rd generation cephalosporin as the initial antibiotic for NV-HAP should be restricted to prevent the emergence of ESBL-producing strains. Infection prevention measures are required to control the acquisition of ESBL-producing E. coli and K. pneumoniae in NV-HAP patients.

RADIOACTIVE CEMENT OF PMMA AND HAP-Sm-153, Ho-166, OR RE-188 FOR BONE METASTASIS TREATMENT / CIMENTO RADIOATIVO DE PMMA E HAP-Sm-153, Ho-166 OU RE-188 NO TRATAMENTO DE METÁSTASES ÓSSEAS

ABSTRACT Polymethylmetacrylte (PMMA) is used in the fields of dentistry and biomedicine as a constituent of bone cements. Hydroxyapatite (HAp) is a bioceramic produced naturally in the bones. PMMA and HAp are fundamental constituents in the preparation of bone cements. Bisphosphonates have also been used as radiopharmaceutical in dental implants and nuclear medicine, or as palliative systemic treatment for pain reduction in bone metastasis. Vertebroplasty and kyphoplasty are bone cement-based techniques used in orthopedics, being minimally invasive procedures with low risks of infections, applied in osteoporosis and high-impact fractures. Recently, Núcleo de Radiações Ionizantes da Universidade Federal de Minas Gerais proposed a synthetic composite of M-HAp with a metallic nuclide M. After irradiation, M-HAp was added to PMMA, compounding a radioactive bone cement that can recover bone body stabilization, pasting microfractures and recomposing the anatomy and functionality of the affected parts by the compression of bone metastases, with possible pain reduction through quick radiation-induced decompression. Computational dosimetric models, and the synthesis and characterization of bioceramics that incorporate Re-188, Ho-166, or Sm-153 have demonstrated the benefits of these biometrics as promising alternative therapies, mainly from their ability to maintain the ionization in the bone structure, thereby sparing the spinal cord. This article presents a review on this topic. Level of Evidence V, Expert Opinion.

RESUMO Polymethylmetacrylte (PMMA) é um composto utilizado na indústria e desde os anos 80's também tem sido empregado nas áreas odontológica e biomédica como constituinte de cimentos ósseos. A hydroxyapatite (HAp) é uma biocerâmica produzida naturalmente nos ossos. Esses dois componentes são constituintes fundamentais no preparo de cimentos ósseos. A síntese artificial de HAp pode ser feita pelo método sol-gel. Bifosfanatos tem também sido utilizado na odontologia em implantes dentários e na medicina nuclear, como radiofármaco ou no tratamento paliativo sistêmico de redução de dor das metástasis ósseas com 153 Sm-EDTPM. A Vertebroplastia e Cifoplastia são técnicas empregadas na ortopedia utilizando o cimento ósseo, sendo procedimentos minimamente invasivos de baixo risco de infeções, aplicadas em osteoporose e fraturas de alto impacto. Recentemente, no Grupo de Pesquisa NRI - Nucleo de Radiações Ionizantes/UFMG, foi proposto um compósito de M-HAp com nuclideo metálico M incorporado na matriz, que após ativado é adicionado ao PMMA constituíndo um cimento ósseo radioativo que pode recuperar a estabilização o corpo ósseo, colando microfraturas, recompondo a anatômia e funcionalidade de peças afetadas pela compressão das metástases ósseas com possível redução de dor pela rápida descompressão induzida pela radiação. Modelos dosimétricos computacionais, sintese e caracterização destas biocerâmicas incorporando Re-188, Ho-166 ou Sm-153 tem indicado benefícios radioterapêuticos promissores, podendo se tornar uma alternativa para radioterapias convencionais, principalmente por conter a dose absorvida na estrutura óssea, por exemplo no corpo da vertebra poupando a medula espinhal. O presente artigo apresenta uma revisão sobre o tema. Nível de Evidência V, Opinião do Especialista

Bioactividad y pruebas de hemólisis de compósitos de hidroxiapatita zirconia (HAp/ZrO2-8Y2O3) para implantes óseos / Bioactivity and hemolysis test of hydroxyapatite/zirconia composites (HAp/ZrO2-8Y2O3) for bone implants

Resumen Se presenta la síntesis de compósitos de hidroxiapatita/zirconia (HAp/ZrO2-8Y2O3) por el método de mezclado líquido en base al método de Pechini, cuya innovación radica en la obtención simultánea de ambas fases con distribución uniforme, aunque tiene la limitante de la interacción de los cationes, propiciando la formación de fases secundarias si no se controlan las variables. Los materiales fueron conformados en discos de 1 cm de diámetro y tratados a 1400 °C, para caracterizarse por espectrometría de infrarrojo (FTIR-ATR) y difracción de rayos X (DRX). Las pruebas de bioactividad fueron realizadas mediante el método de inmersión en fluidos fisiológicos simulados durante 21 días y caracterizadas por microscopia electrónica de barrido (MEB) y espectrometría de fotoelectrones emitidos por rayos X (XPS). Las pruebas de hemólisis se basaron en la norma ASTM F 756-00. Después de la inmersión, se observó la presencia de cristales de hidroxiapatita sobre la superficie del compósito, además los análisis de XPS muestran señales de energía para los elementos de calcio y fósforo. En cuanto a las pruebas de hemólisis se observaron grados de citotoxicidad por debajo del 3% con lo cual se infiere que son hemocompatibles, aunque se requieren más estudios de biocompatibilidad para su aplicación biomédica.

Abstract The synthesis of hydroxyapatite/zirconia composites (HAp/ZrO2-8Y2O3) is presented, using the liquid mixing method based on the Pechini method, whose innovation lies in the simultaneous synthesis of both phases with uniform distribution, although it has the limitation of the cations interactions, favoring the formation of secondary phases if the variables are not controlled. The obtained materials were formed into discs of 1 cm in diameter and treated at 1400 °C, and then characterized by infrared spectrometry (FTIR-ATR) and X-ray diffraction (XRD). The bioactivity tests were carried by the immersion method in simulated body fluid for 21 days and characterized by scanning electron microscopy (SEM) and X-ray photoelectron spectrometry (XPS). The hemolysis tests were based on the ASTM F 756-00 standard. After the immersion, the presence of hydroxyapatite crystals on the surface of the composite was observed; in addition, the XPS analyzes show energy signals for the elements of calcium and phosphorus. Regarding the hemolysis tests, degrees of cytotoxicity were observed below 3%, it is inferred that they are hemocompatible, although more biocompatibility studies are required for biomedical application.

Predominant antigenic epitopes on Hap adhesin of nontypeable Haemophilus influenzae and their immunogenicity / 中华微生物学和免疫学杂志

Objective To investigate the distribution and sequence conservation of Hap adhensin encoding gene (hap) in clinical isolates of nontypeable Haemophilus influenzae (NTHi), to screen out and identify the predominant T-and B-cell (T-B) combined antigenic epitopes on Hap protein and to analyze their immunogenicity.Methods Sequence conservation of hap genes in NTHi strains and T-B combined antigenic epitopes were predicted using bioinformatic softwares.PCR was used to amplify the 156 bp segment at 5′-end and the 855 bp segment at 3′-end of hap gene (hap-5′-156 and hap-3′-855) and the amplified products were sequenced.Phage display systems of seven T-B combined antigenic epitopes located on the 55 aa segment at N-terminal and the 285 aa segment at C-terminal of Hap protein (Hap-N52 and Hap-C285) were constructed.Western blot assay and ELISA were performed to detect the antigenicity and immunoreactivity of different T-B combined epitopes displayed by recombinant phage PⅢ protein (rPⅢ).Results Hap protein encoded by the hap gene in NTHi was located on membrane surface.Sequences of the 156 bp segment at 5′-end and the 855 bp segment at 3′-end of hap genes extracted from different NTHi strains were relatively conservative, but many mutations were found in sequences at the middle regions of these hap genes.All of the 56 NTHi strains carried hap-5′-156 and hap-3′-855 segments and shared 92.3％-100％ identities in nucleotide and amino acid sequences of these segements.Hap-N5-24 in the Hap-N52 segment as well as Hap-C4-27, Hap-C28-47, Hap-C114-129, Hap-C150-173, Hap-C200-227 and Hap-C241-267 in the Hap-C285 segment was predicted as the T-B combined antigenic epitope with a higher score and less mutations.Results of Western blot assay and ELISA confirmed that the rPⅢ-displayed Hap-C4-27 and Hap-C150-173 epitopes presented clear hybridization bands with NTHi antisera, and 96.9％ (63/65) and 92.3％ (60/65) of serum samples from children with NTHi infection were positive for antibodies against Hap-C4-27 and Hap-C150-173 epitopes, respectively.Conclusion The gene of hap is widely distributed in clinical isolates of NTHi.Moreover, sequences of the 156 pb segment at 5′-end and the 855 bp segment at 3′-end of hap gene are conservative.Hap-C4-27 and Hap-C150-173 are the predominant T-B combined antigenic epitopes on Hap protein, suggesting that they can be used as epitope candidates for developing multiple antigenic peptide vaccines against NTHi.

SNPs analysis of ABCA4 gene in Han Chinese in Beijing / 实用口腔医学杂志

Objective:To provide the basis of single nucleotide polymorphism(SNPs)for identification and analysis of ABCA4 gene related etiologic studies in Han Chinese in Beijing(CHB).Methods:SNPs of ABCA4 gene were analyzed for minor allele frequencies (MAFs),haplotype frequencies,linkage disequilibrium patterns,and tag SNPs by Haploview program using the HapMap data.Re-sults:129(37.6%)of 343 SNPs were monotonic.95 tagging SNPs were identified in 214 eligible SNPs with 3 haplotype blocks identi-fied.The frequencies of the top 2 haplotypes among each of the 3 haplotype blocks were between 91.1% and 94.0%.Conclusion:SNPs in ABCA4 gene were analyzed by Haploview program.The analysis provides clues for future studies involving this gene.

In vitro and in vivo evaluation of the developed PLGA/HAp/Zein scaffolds for bone-cartilage interface regeneration / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To investigate the effect of electronspun PLGA/HAp/Zein scaffolds on the repair of cartilage defects.</p><p><b>METHODS</b>The PLGA/HAp/Zein composite scaffolds were fabricated by electrospinning method. The physiochemical properties and biocompatibility of the scaffolds were separately characterized by scanning electron microscope (SEM), transmission electron microscope (TEM), and fourier transform infrared spectroscopy (FTIR), human umbilical cord mesenchymal stem cells (hUC-MSCs) culture and animal experiments.</p><p><b>RESULTS</b>The prepared PLGA/HAp/Zein scaffolds showed fibrous structure with homogenous distribution. hUC-MSCs could attach to and grow well on PLGA/HAp/Zein scaffolds, and there was no significant difference between cell proliferation on scaffolds and that without scaffolds (P>0.05). The PLGA/HAp/Zein scaffolds possessed excellent ability to promote in vivo cartilage formation. Moreover, there was a large amount of immature chondrocytes and matrix with cartilage lacuna on PLGA/HAp/Zein scaffolds.</p><p><b>CONCLUSION</b>The data suggest that the PLGA/HAp/Zein scaffolds possess good biocompatibility, which are anticipated to be potentially applied in cartilage tissue engineering and reconstruction.</p>

Tratamiento del tumor de células gigantes con curetaje e injerto con hidroxiapatita porosa coralina HAP-200® / Treatment of the giant cells tumor with curettage and graft of porous coral hydroxyapatite HAP-200®

Se realizó la presentación de un caso con un tumor de células gigantes en el extremo distal del fémur derecho a nivel del cóndilo femoral interno. Se retira quirúrgicamente, previo estudio, donde se confirmó el diagnóstico a través de la biopsia. En dicho proceder se efectuó un raspado extenso de la lesión respetando la superficie articular del cóndilo femoral, rellenando la cavidad con la hidroxiapatita HAP-200 ®, sin necesidad de apoyar dicho acto con una osteosíntesis interna o externa, sólo con una calza de yeso por 6 semanas. El seguimiento del paciente ha sido, hasta la fecha, de 6 años y no se ha reportado ninguna recidiva o metástasis, con una osteointegración positiva del biomaterial, lográndose la curación ósea y una función articular sin restricción.

We presented a case of a giant cells tumor in the distal end of the right thigh at the level of the internal femoral condyle. Previously studied, the tumor was surgically retired, and the diagnosis was established through the biopsy. In that procedure we carried out a lesion extended scrape respecting the join surface of the femoral condyle, filling the cavity with hydroxyapatite HAP-200®, being unnecessary to support it with an internal or external osteosynthesis, only with plaster wedge for 6 weeks. The patient´s follow-up has lasted for 6 years up to day, and no recidivism or metastasis has been reported, with a biomaterial positive osteointegration, achieving the bone healing and a join functioning without restriction.

Prospective study estimating healthcare associated infections in a paediatric hemato-oncology unit of a tertiary care hospital in north India.

Background & objectives: Healthcare associated infections (HAIs) are responsible for morbidity and mortality among immunocompromised and critically ill patients. We undertook this study to estimate the burden of HAIs in the paediatric cancer patients in a tertiary care hospital in north India. Methods: This prospective, observational study, based on active surveillance for a period of 11 months was undertaken in a 4-bedded isolated, cubicle for paediatric cancer patients. Patients who stayed in the cubicle for ≥48 h, were followed prospectively for the development of HAIs. Results: Of the 138 patients, 13 developed 14 episodes of HAIs during the study period. Patient-days calculated were 1273 days. Crude infection rate (CIR) and incidence density (ID) of all HAIs were 9.4/100 patients and 11/1000 patient-days, respectively. Of the 14 episodes of HAIs, seven (50%) were of blood stream infections (HA-BSI), five (36%) of pneumonia (HAP) and two (14%) urinary tract infections (HA-UTI). The CIRs of HA-BSI, HAP and HA-UTI were 5.1, 3.6 and 1.4/100 patients, respectively. The corresponding IDs were 5.5, 3.9 and 1.6/1000 patient-days, respectively. Mean length of stay was significantly higher in patients who developed an HAI [13.8 (range 7-30), median (Interquartile range) 12 (11-14)] vs 7.5 days [range 2-28, median (interquartile range) 7 (5-9); P<0.0001]. Also mortality was significantly higher in patients who developed an HAI [23% (3/13) vs 3% (4/125), P<0.05]. Interpretation & conclusions: The incidence of HAIs in the paediatric cancer patients in the study was 11/1000 patient days, of which HA-BSIs were the commonest. HAIs were associated with an increase in morbidity and mortality amongst this high risk patient population.

Evaluation of BISAP and HAP scoring system in predicting prognosis of acute pancreatitis / 中华胰腺病杂志

Objective To evaluate the bedside index for severity in acute pancreatitis (BISAP) and harmless acute pancreatitis (HAP) scoring system in predicting prognosis of acute pancreatitis (AP).Methods A total of 442 AP patients,who were admitted to The First Affiliated Hospital of Sun Yat-sen University from January 2003 to December 2010,were retrospectively studied.BISAP and HAP scores were evaluated respectively.The value of BISAP and HAP scores in predicting severity,local complications,organ failure and mortality were measured by the area under the curve (AUC) of receiver operator characteristic curve (ROC),and it was compared with that of traditional Ranson's score.Results Among 442 patients,73 patients (16.5％) were diagnosed to have severe acute pancreatitis (SAP).AUC for BISAP score in predicting SAP,local complications,organ failure and mortality were 0.90 (95％ CI:0.86 ～ 0.93),0.82(95％ CI:0.76 ～ 0.89),0.93 (95％ CI:0.89 ～ 0.96),0.93 (95％ CI:0.87 ～ 0.98).There were no statistically significant differences in AUCs of the four prognostic parameters between BISAP and Ranson's score.The specificity,positive predictive value (PPV),and AUC of HAP score in predicting mild AP were 85％,95％ and 0.73 (95％ CI:0.67 ～ 0.79).The risk of dismal prognosis increased when both BISAP and HAP score were abnormal.Conclusions BISAP and Ranson's score have comparable ability in predicting prognosis of patients with AP.However,BISAP score is simpler.HAP score is a simple and accurate method for predicting prognosis of patients with mild AP.Combination of BISAP score with HAP score can better help predict the prognosis of AP patients.

Risk factors and prevention of HAP after surgical excision of esophageal carcinoma in elderly patients / 国际外科学杂志

Objective Explore the risk factors and prevention of HAP after surgical excision of Esophageal carcinoma in elderly Patients.Methods Two hundred and eight elderly patients with HAP after Surgical excision of Esophageal carcinoma from 2009 to 2012 were analyzed.Logistic regression analysis was used to find the related risk factors.Results The incidence of HAP was 25.9％.In several factors Logistic regression analysis,smoking,low lung function,postoperative non-epidural analgesia,injure of recurrent laryngeal nerve and fistula of anastomotic were the risk factors.Conclusions The preoperative evaluation,Intensive monitoring during the postoperative period and reducing the complication after operation can decrease the incidence of HAP.

Obtención de hidroxiapatita sintética por tres métodos diferentes y su caracterización para ser utilizada como sustituto óseo / Synthetic hydroxyapatite obtaining using three different methods and characterization to use it as bone substitute

El método de obtención de la hidroxiapatita (HAp) para ser utilizada como sustituto óseo, debe ofrecer un producto de alta pureza, rendimiento, rapidez y bajo costo, y contar con propiedades como bioactividad, biocompatibilidad, osteoconductividad y unión directa al hueso. En este trabajo se elaboró HAp sintética mediante tres métodos reportados en la literatura de vía sinterización y vía precipitación. El material obtenido se caracterizó por espectrometría de absorción atómica (AAS), espectrometría de absorción molecular (UV-Vis), espectroscopía infrarroja con transformada de Fourier (FTIR), difracción de rayos X (XRD), microscopía electrónica de barrido (SEM) y espectroscopía por dispersión de energía de rayos X (EDX). La ruta de síntesis de HAp por precipitación ofreció mejores resultados, comparados con la muestra estándar comercial y el hueso bovino, obteniéndose un tamaño de grano aproximado de 1 µm, relación molar Ca/P de 1,7, alta pureza y cristalinidad; mientras que los resultados obtenidos por vía sinterización mostraron la presencia de fases amorfas. El método de síntesis por precipitación vía húmeda usando nitratos de calcio y fosfatos, mostró ser práctico y adecuado para realizar la inmovilización de HAp sobre un soporte metálico como silicio, importante para su uso en cirugía reconstructiva en el área odontológica y médica.

The method by which to obtain Hydroxyapatite to be used as bone substitute should offer specific qualities such as, high purity, performance, low cost and has to be the following, bioactive, biocompatible, it has to have osteoconductivity and it has to bond directly to the bone. In this paper, synthetic HAp was prepared using 3 different methods reported in the literature as a route via sintering and precipitation, and subsequently characterized by atomic absorption spectrometry (AAS), molecular absorption spectrometry (UV-Vis), infrared spectroscopy (FTIR), X-ray diffraction (XRD), scanning electron microscopy (SEM) and energy dispersive spectroscopy X-ray (EDX). The route of synthesis of HAp precipitation gives better results, compared to the commercial standard sample and bovine bone, such as grain size which is of about 1 µm, molar ratio Ca/P of 1.7, high purity and crystallinity, while the results obtained via sintering show the presence of amorphous phases. The synthesis method using a wet precipitation of calcium nitrates and phosphates is practical and suitable for the immobilization of HAp on a metal substrate such as silicon, important for the use in dental and medical reconstructive surgery.

Implant with simultaneous bone grafting for replacement of maxillary anterior tooth - A case report.

Successful replacement of the lost teeth by means of tissue-integrated implants represents a major advance in dentistry. The bone quality and amount of bone available in anterior maxilla is often variable and commonly there is a deficiency of bone volume. Currently, however, implants are also being placed in sites with ridge defects of various dimensions. The various reconstruction techniques using bone graft, guided bone regeneration, orthognathic surgery or bone distraction provides the surgical specialist with a wide range of treatment options for placing implants in compromised ridges. Appropriate use of these methods will enable the successful treatment of almost any complicated case with bone deficient jaws. This case reports the step-by-step procedures in a case where the missing maxillary left central incisor was restored by placement of implant simultaneous with the use of bone grafting using Hydroxyapatite for the correction of minor dehiscence in the alveolar ridge.

Aplicación de la hidroxiapatita porosa coralina® HAP-200 con antibióticos en la osteomielitis de la tibia / Application of HAP-200® coralline porous hydroxyapatite with antibiotics in tibia osteomyelitis

A pesar de los tratamientos quirúrgicos actuales y de la aplicación de antibióticos de amplio espectro en pacientes con osteomielitis aguda, tanto a punto de partida de procesos sépticos a distancia o por inoculación directa, existe un porcentaje de pacientes que evolucionan a la cronicidad. La osteomielitis crónica representa aproximadamente el 4,2 por ciento de las secuelas del tratamiento de fracturas expuestas de la tibia, y Staphylococcus aureus es el germen que con mayor frecuencia se aísla. Se presentan dos casos tratados eficazmente mediante curetaje de la lesión y relleno con hidroxiapatita porosa coralina® HAP-200 impregnada con gentamicina, y aplicación de antibiótico sistémico. Se valoró el tipo de lesión, y los aspectos analíticos y radiológicos. El objetivo fue demostrar la utilidad de este biomaterial en la cirugía séptica de la tibia

Despite the current surgical treatment and the applications of wide-spectrum antibiotics in patients presenting with acute osteomyelitis from the at distance first septic processes or by direct inoculation, there is a percentage of patients evolving to chronic stage. Chronic osteomyelitis represent approximately the 4,2 percent of sequalae of tibia exposed fractures and Staphylococcus aureus is the more frequent isolated germ. Two cases are presented effectively treated by curettage of the lesion and filled with HAO-200 ® coralline porous hydroxyapatite impregnated with Gentamicin and a antibiotic systemic application. Type os lesion was assessed as well as the analytical and radiologic features. The aim of present paper was to demonstrate the usefulness of this biomaterial in tibia septic surgery

Malgré les traitements chirurgicaux actuels et l'utilisation des antibiotiques de large spectre d'action chez des patients atteints d'ostéomyélite aigüe (aussi à l'origine des processus infectieux à distance qu'au moyen de l'inoculation directe), il y a un grand nombre de patients évoluant vers la chronicité. L'ostéomyélite chronique représente environ 4,2% des séquelles du traitement des fractures exposées du tibia, et le Staphylococcus aureus est le germe le plus souvent isolé. Deux cas avec un traitement efficace par curetage et remplissage de la lésion avec hydroxyapatite poreuse corallienne HAP-200® imprégnée de gentamycine, et par application d'un antibiotique systémique, sont présentés. On a évalué le type de lesion, et les aspects analytiques et radiologiques. Le but de cette étude a été de démontrer l'efficacité de ce biomatériel dans la chirurgie septique du tibia

Functional study of the different haplotypes cDNA in the coding region of CⅡTA gene / 中华微生物学和免疫学杂志

Objective To study the function of 4 different haplotypes cDNA which are constructed by two non-homonymy single nueleotide polymorphism (SNP) sites C19170G (Leu45Val) and C30799G (Ala500Gly) in the coding region of human CⅡTA gene. Methods HeLa cells were transfeeted with eu-karyotic expression vectors containing four different haplotypes cDNA. C Ⅱ TA mRNA and HLA classⅡanti-gen (HLA-DR, DP, DQ) were respectively detected by RT-PCR and indirect cell immunofluoreseence tech-nique in the untransfected and transfeeted with four eukaryotic expression vectors and empty vectors HeLa cells. The quantity of HLA classⅡ antigen were analyzed by flow eytometry. Results No expression of CⅡTA mRNA and HLA class Ⅱ antigen were observed on original HeLa cells and empty vector transfected cells. CⅡTA mRNA expression was emerged, and the expression of HLA class Ⅱ antigen were observed in the HeLa cells transfected with eukaryotic expression vectors containing four different haplotypes cDNA. And there were not significantly different with the levels of HLA class Ⅱ antigen expression among HeLa cells transfected with eukaryotic expression vectors containing four different haplotypes cDNA ( P > 0.05 ). Con-dusion The SNP of Chinese at the sites C19170G(Leu45Val) and C30799G(Ala500Gly) in the coding site of C Ⅱ TA gene did not influence capability of CⅡTA trans-aetivating HLA class Ⅱgene expression.

Remoción de fenantreno por azolla caroliniana utilizando bioaumentación con microorganismos hidrocarbonoclastas / Phenanthrene dissipation by azolla caroliniana utilizing bioaugmentation with hydrocarbonoclastic microorganisms / Remoção de fenantreno por azolla caroliniana utilizando bioaumentação com microorganismos hidrocarbonoclásticos.

El objetivo de este trabajo fue conocer la capacidad de crecimiento y remoción de fenantreno (FEN) por el helecho Azolla caroliniana, utilizando bioaumentación con microorganismos hidrocarbonoclastas. A. caroliniana fue seleccionada de entre cuatro colectas de Azolla de México, por su tolerancia a concentraciones crecientes de FEN. Posteriormente, A. caroliniana fue expuesta a tres concentraciones de FEN: 20, 40 y 60mg·l-1, e/o inoculada con el complejo microbiano Bacillus stearothermophilus y Oscillatoria sp. (BST+OSC) con tolerancia in vitro a 100mg FEN·l-1 de medio de cultivo. A los 49 días después de la inoculación (DDI), la mayor producción de materia seca se presentó en el tratamiento con 20mg FEN y en el que se aplicó bioaumentación con BST+OSC en presencia de 40mg FEN. Ambos tratamientos superaron en 19,7% al testigo. Los tratamientos con mayor producción de materia seca presentaron mayor actividad nitrogenasa (7-12nmol C2H4·g-1·h-1), mientras que la menor actividad se observó en los tratamientos con 60mg FEN (3-4nmol C2H4·g-1·h-1). La menor remoción de FEN (45%) se observó en A. caroliniana sin BST+OSC con 20mg FEN; en contraste, la mayor remoción (80%) se presentó en A. caroliniana inoculada y/o sin inocular en presencia de 60mg FEN. Este trabajo es uno de los primeros reportes del efecto negativo de FEN sobre el crecimiento de Azolla y su microsimbionte, así como del potencial de remediación de FEN por A. caroliniana mediante el uso de bioaumentación.

The aim of this work was to evaluate the ability of Azolla caroliniana to grow and to dissipate phenanthrene (PHE) by using bioaugmentation with hydrocarbonoclastic microorganisms. A. caroliniana was selected from four Mexican strains based on its tolerance to increasing concentrations of PHE. Afterwards, A. caroliniana was exposed to PHE concentrations of 20, 40 and 60mg·l-1 and/or inoculated with the microbial consortium conformed by Bacillus stearothermophilus and Oscillatoria sp. (BST+OSC), strains previously tested for their tolerance to 100mg PHE·l-1. After 49 days, the higher dry mass production was observed at the treatment with 20mg PHE and at that with BST+OSC in presence of 40mg PHE·l-1; both treatments had 19.7% more dry mass than the control. Treatments with higher dry mass production also had higher nitrogenase activity (7-12nmolC2H4·g-1·h-1), whereas the lowest activity was observed at the treatments with 60mg PHE (3-4nmol C2H4·g-1·h-1). The lowest PHE dissipation (45%) was observed in A. caroliniana without BST+OSC in the presence of 20mg PHE; in contrast, the highest PHE dissipation (80%) was observed with A. caroliniana, either inoculated or not, when in presence of 60mg PHE. This is one of the first reports describing the negative effects of PHE on the growth of Azolla and its microsymbiont, as well as the potential of A. caroliniana for the dissipation of PHE with or without bioaugmentation.

O objetivo deste trabalho foi conhecer a capacidade de crescimento e remoção de fenantreno (FEN) pela Azolla Caroliniana (Azolla caroliniana), utilizando bioaumentação com microorganismos hidrocarbonoclásticas. A. caroliniana foi selecionada de entre quatro coletas de Azolla de México, por sua tolerância a concentrações crescentes de FEN. Posteriormente, A. caroliniana foi exposta a três concentrações de FEN: 20, 40 e 60 mg·l-1, e/ou inoculada com o complexo microbiano Bacillus stearothermophilus e Oscillatoria sp. (BST+OSC) com tolerância in vitro a 100mg FEN·l-1 de meio de cultivo. Aos 49 dias depois da inoculação (DDI), a maior produção de matéria seca apresentou-se no tratamento com 20mg FEN e naquele onde foi aplicada bioaumentação com BST+OSC na presença de 40mg FEN. Ambos tratamentos superaram em 19,7% ao testemunha. Os tratamentos com maior produção de matéria seca apresentaram maior atividade nitrogenase (7-12nmol C2H4·g-1·h-1), enquanto que a menor atividade foi observada nos tratamentos com 60mg FEN (3-4nmol C2H4·g-1·h-1). Observou-se a menor remoção de FEN (45%) em A. caroliniana sem BST+OSC com 20mg FEN; em contraposição, apresentou-se a maior remoção (80%) em A. caroliniana inoculada e/ou sem inocular na presença de 60mg FEN. Este trabalho e um dos primeiros relatórios a respeito do efeito negativo de FEN sobre o crescimento de Azolla e seu microsimbionte, assim como do potencial de remediação de FEN por A. caroliniana mediante o uso de bioaumentação.

Traditional Medicine Seen from the Perspective of Western Medicine during the Late 19th and Early 20th Century in Korea / 의사학

From the 18th century traditional medicine began to be criticised by some of Korean intellectuals who attained the knowledge of Western medicine through the imported books on Western science. In the early 20th century, Western medical doctors in Korea generally had critical attitude toward traditional medicine. Their critical opinions on traditional medicine are typically recognizable in the debate between two camps that occurred in 1930s. However, some exceptional doctors such as Chang Ki-moo and Bang Hap-shin had special interest in traditional medicine despite their education in Western medicine. It was their clinical experience of the limitation of Western medicine which led them to study traditional medicine. Both of them were particularly attracted by the School of Old Prescriptions, which was a school of Japanese traditional medicine. The medical theory of the school was characterized by the simplification of vague and complicated theory of traditional medicine. The school held the theory that all diseases are caused by one poison. Consequently, treatment of all diseases consists in eliminating the poison. He also put forward a theory of one prescription for one disease, and therefore the same remedy should be applied to a disease with the same cause even though it might manifest various symptoms. Given the fact that their theory of diseases is very similar to that of Western medicine, it is understandable that they were attracted to the School of Old Prescriptions. As the doctors trained in Western medicine, they were possibly more familiar with the doctrine of the School of Old Prescriptions than the traditional medicine based on Yin Yang and Five-Phase theory.

Diagnostic and Prognostic Value of C-reactive Protein in Hospital-acquired Pneumonia / 中华医院感染学杂志

OBJECTIVE To assess the diagnostic and prognostic value of C-reactive protein(CRP) levels,body temperature and white blood cell(WBC)count for hospital-acquired pneumonia(HAP).METHODS Temperature,and concentration of CRP and WBC count of the patients were determined daily,and fixed a day for sequential organ failure assessment(SOFA).Then observed the prognosis be cured,stable out of ICU or death.Patients were divided into death and survival groups according to the prognosis and analyzed retrospectively.RESULTS There were four response modes of CRP ratio after antibacterial treatment:fast response,slow response,nonresponse and biphasic response.All patients with fast response and most patients with slow response survived,whereas all patients with nonresponse and biphasic response were died(P

Hospital-acquired Pneumonia:Risk Factors and Antimicrobial-resistant Gram-negative Bacilli in Adult Patients / 中华医院感染学杂志

OBJECTIVE To know the incidence, etiology, risk factors of hospital-acquired pneumonia(HAP). METHODS From Jan 2003 to Dec 2004, 129 cases of HAP were retrospectively studied. Epidemiologic data, etiology , and evolution of pneumonia were recorded. RESULTS The 115 patients with HAP had one or more intrinsic risk factors, mainly malnutrition (albumin values

High Risk Factors of Hospital-acquired Pneumonia for Senile Patients in Department of Neurology / 中华医院感染学杂志

OBJECTIVE To provide more evidence for hospital infection control.METHODS To(analyze) the clinical records of the hospital-acquired pneumonia(HAP) of senile patients in department of(neurology) during Jan 2004 to Dec 2005 retrospectively.RESULTS There were 109 person-times(145 cases) senile(patients) with hospital(infection) during the two years.From them 77 cases were hospital-acquired infection,32 cases were ventilator-(associated) pneumonia(VAP),the infection rate was 22.1%.CONCLUSIONS The infection of HAP in department of neurology may induce by several factors.The key point to control HAP is prospective monitoring hospital(infection) in time,and taking effective measures to prevent the hospital infection on the basis of treatment the(underlying) disease.

Preparation and antimicrobial effects of HAP-Ag / 医疗卫生装备

Based on hydroxyapatite (HAP), a kind of antimicrobial ceramic, i.e. hydroxyapatite loading Ag+ ions (HAP-Ag), is prepared in a wet chemical process with the addition of AgNO3. The X-ray diffraction analysis shows that the HAP-Ag is mainly composed of nitrate-apatite, which is formed by the substitution of Ca2+ with Ag+. The antimicrobial effects of the HAP-Ag and its resistibility against the acrobic Escherichia coli and Staphylococcus aureus are tested respectively through the spread plate method. The results show that HAP-Ag is capable of inhibiting the growths of E.coli and S.aureus.