目的 了解宝鸡市人民医院耐甲氧西林金黄色葡萄球菌的临床分布特点及对抗菌药物的耐药性,为临床合理使用抗生素和医院感染控制提供依据. 方法 回顾性分析该院2012-2015年耐甲氧西林金黄色葡萄球菌(methicillin resistant Staphylococcus aureus,MRSA)的临床分布及耐药性情况.采用VITEK-2 Compact全自动微生物鉴定药敏仪对可疑菌落进行鉴定和药敏检测,使用WHONET 5.6软件分析数据. 结果 2012-2015年共分离出MRSA菌株177株,MRSA菌株检出率为28.0％,男性患者MRSA检出率(33.1％)明显高于女性(21.2％),差异有统计学意义(x2=10.97,P=0.00).MRSA菌株主要源于痰液(占50.2％)和分泌物(占45.7％),二者MRSA菌株检出率分别为35.7％、26.0％;不同科室MR-SA主要以儿科(占33.9％)、皮肤科(占14.7％)为主,各科室MRSA检出率差异有统计学意义(x2=11.202,P=0.011);各年度MRSA检出率差异有统计学意义(x2=14.898,P=0.002),2012年最高(37.2％),2014年最低(20.3％).MASA对青霉素G、苯唑西林完全耐药,对红霉素(89.8％)、克林霉素(74.6％)耐药率较高,尚未发现对利奈唑胺、万古霉素、替考拉宁耐药. 结论 2012-2015年宝鸡市人民医院MRSA检出率28.0％,低于全国平均水平,不同标本、不同科室、不同年度MRSA检出率不同.MRSA对青霉素G、苯唑西林、红霉素、克林霉素常出现耐药.

Objective To understand the clinical distribution and drag resistance of Staphylococcus aureus,and to provide the basis for the rational use of antibiotics and the hospital control of the bacteria.Methods The clinical distribution and drug resistance of 632 strains of staphylococcus aureus from 2012 to 2015 in a hospital were retrospectively analyzed.VITEK-2 was used to identify the suspected colonies and the drug susceptibility of them.The statistics was conducted with WHONET 5.6 and SPSS17.0.Results A total of 6 777 strains of bacteria were isolated in the past 4 years,632 strains of them were Staphylococcus aureus,177 strains of them were Methicillin resistant Staphylococcus aureus,and 455 strains of them were Methicillin sensitive Staphylococcus aureus.The detection rate of Staphylococcus aureus,Methicillin resistant Staphylococcus aureus and Methicillin sensitive Staphylococcus aureus were lower than national average.The resistance rations of Staphylococcus aureus to Penicillin G,Erythromycin and Clindamycin were 94.5％,73.6％ and 60％,respectively,to Oxacillin,Amikacin,Rifampicin,Levofloxacin and Cotrimoxazole were less than 30％,to Linezolid,Vancomycin and Teicoplanin were all 0％.The resistance rations of methicillin resistant Staphylococcus aureus to Penicillin G,Oxacillin,Amikacin,Rifampin,Levofloxacin,Erythromycin and Clindamycin were more than that of Methicillin sensitive Staphylococcus aureus (P＜O.05).Conclusion The control of Staphylococcus aureus in the hospital is better than that in other hospitals,but the resistance ration is high.Multiple drug resistance and high resistance are found IN Methicillin resistant Staphylococcus aureus and Methicillin sensitive Staphylococcus aureus.

Objective:To understand the situation and level of the utilization of network resources and the internet addiction of college students,To explore and analyze the influencing factors of Internet addiction,and to provide scientific basis for the prevention and intervention of college students' internet addiction.Methods:Investigated sites were selected by cluster sampling and 1465 students were divided into three layers according to the grade.General situation questionnaire,Young Internet addiction scale, social support scale,college students' life satisfaction rating scale four scale research.Data using frequency and composition ratio description, chi square test, Logistic regression model for single factor, multi factor analysis.Results:The 1385 subjects of Internet addiction total average score was 32.31±8.76, of which 93 people judged to be addicted to the Internet addiction rate of 6.7%.Multi factor logistics regression analysis, family income, counselors satisfaction, attention transfer, time control ability of the transfer of attention to the greatest contribution to the equation.Conclusion:The independent influencing factors of internet addiction include: family annual income, counselors' work, attention transfer, overall life satisfaction, time control ability.

Objective To explore the expression and clinical significance of microRNA (miR)-155 and miR -222 in plasma of patients with ventricular septal defect(VSD),and to analyze the possible mechanism.Methods A total of 20 children with VSD who received treatment at the Department of Cardiovascular Surgery from August 2012 to June 2013 were enrolled (the VSD group)and 15 patients with fracture (the control group).The plasma miR -155 and miR -222 expression levels were measured by real -time quantitative reverse transcription -polymerase chain reaction (RT -qPCR).The potential target genes of miR -155 and miR -222 were predicted by using 3 current-ly available prediction programs,including TargetScan,mirbase and Miranda,and the signaling pathway of miRNA was predicted by Pathway -express analysis.Results Compared with the control group,the expression levels of miR -155 (P =0.033)and miR -222(P <0.001)in the VSD group decreased significantly;miR -155 and miR -222 predic-ted target genes included 74 and 50,respectively.The Pathway -express analysis indicated that 7 signaling pathways played important roles in the occurrence of fetal VSD,including signaling pathways for heart development,such as:mito-gen -activated protein kinase(MAPK)signaling pathway.Conclusions The expression levels of plasma miR -155 and miR -222 in VSD were significantly decreased.The target genes were related to signaling pathways for heart deve-lopment (MAPK signaling pathway),which indicates that miR -155 and miR -222 may be involved in the pathological process of VSD,and may serve as an independent evaluation indicator for the diagnosis of VSD.

Objective:To characterize the expression of miRNAs that might be involved in the development or reflect the consequences of VSD. Methods:MiRNA microarray analysis and reverse transcription-polymerase chain reaction(RT-PCR)were employed to determine the miRNA expression profile from 3 patients with VSD and 3 VSD-free controls. The expression of eight selected miRNAs(hsa-let-7e-5p,hsa-miR-155-5p,hsa-miR-222-3p,hsa-miR-379-5p,hsa-miR-409-3p,hsa-miR-433,hsa-miR-487b and hsa-miR-498)were then independently validated by RT-PCR of plasma samples from 20 VSD patients and 15 VSD-free controls. A total of 446 target genes were predicted by bioinformatic methods. Results:Thirty - six differentially expressed miRNAs were found in the patients with VSD and the VSD-free controls. Compared with VSD-free controls,expression of 15 miRNAs were up-regulated and 21 miRNAs were down-regulated in the VSD group. The results of the RT-PCR were consistent with those of the microarray analysis. Gene ontology analysis indicated that the top target genes were mainly related to cardiac right ventricle morphogenesis. Additionally,we predicted NOTCH1, HAND1,ZFPM2,and GATA3 as targets of hsa-let-7e-5p,hsa-miR-222-3p and hsa-miR-433. Conclusion:The study has reported for the first time three circulating miRNA profiles for patients with VSD and VSD-free controls and validated these results in a larger group of subjects. These findings may reveal important insights into the pathogenesis of VSD.

目的 通过筛选室间隔缺损(ventricular septal defect,VSD)患者和正常对照组血清差异microRNA (miRNA),应用生物信息学方法预测VSD相关易感基因,为VSD的临床诊断和治疗提供理论依据.方法 于2014年9月-2015年12月,采用miRNA表达谱芯片技术在济南市儿童医院心外科取样并筛选VSD患者和正常对照组血清miRNA差异表达情况,预测调控靶基因,经基因富集分析(gene ontology analysis,GO)和基因通路分析筛选候选基因.结果 通过miRNA芯片技术共获得36个差异表达miRNAs,预测得到靶基因447个,新的VSD易感基因7个.文献挖掘发现这7个基因在心脏发育过程中均起着极其重要的作用.结论 通过生物信息学分析发现差异miRNA调控的7个靶基因可能与VSD密切相关,提示该病的发生是多基因相互作用的结果,为后续深化该病机制研究提供了有效的指导.