RÉSUMÉ
Objective:To study the interaction between Tanreqing injection and commonly used antibiotics against multi-drug resistant Pseudomonas aeruginosa (MDR-PA) and the effect on bacterial efflux pump. Method:Antibiotic susceptibility test was performed with bacteria. Paper diffusion method (Kirby-Bauer, KB) combined with efflux pump inhibitor (50 mg·L-1) was used to measure the diameter of the inhibition zone, and real-time fluorescence quantitative polymerase chain reaction (Real-time PCR) was used to detect gene expression of efflux pump Positive efflux pump strain. KB method was used to observe the changes of Tanreqing (final concentration 3 g·L-1) and antibiotics on the diameter of the zone of inhibition. Strains were co-cultured with Tanreqing and antibiotic sub-inhibitory concentrations for Real-time PCR detection. KB method was used to observe the effect of Tanreqing on the diameter of bacteriostatic ring after the continuous use of efflux pump-positive bacteria. Result:Two MDR-PA efflux pump-positive strains were identified and screened. Tanreqing has synergistic antibacterial effect with aloxicillin, aztreonam, meropenem, ceftazidime, cefoperazone, and Shupushen. In inhibiting the expression levels of bacterial efflux pump genes, the four drugs were compared by the effect: cefoperazone>Tanreqing>ceftazidime>Shupushen. After Tanreqing continued to act on efflux pump-positive strains, it could have a better effect in combination with ceftazidime, cefoperazone, and Shupushen. Conclusion:Tanreqing, ceftazidime, cefoperazone, and Shupushen can reduce the drug resistance of bacteria by down-regulating the expressions of bacterial efflux pump genes, and reducing the clinical dose of antibiotics, and thus play a bacteriostatic effect.
RÉSUMÉ
Objective::To explore the feasibility of the rapid identification system(MALDI-Biotyper System) of microorganisms for rapid identification of Pseudomonas aeruginosa and clinical isolation of Staphylococcus aureus. Method::Identification quality control and clinical isolation were conducted for drug resistance of S. aureus by microbial rapid identification system and broth dilution method. The scores of microbial rapid identification system were compared with the MIC value of broth dilution method. The drug resistance of P. aeruginosa was simultaneously identified to determine the accuracy and applicability of the rapid identification system of microorganisms. Result::The scores of the microbial rapid identification system showed that the score of sensitive quality control strain S. aureus was higher than 2.000, and the that of resistant strain of methicillin-resistant S. aureus(methicillin-resistant S. aureus, MRSA)was between 1.700 and 2.000.The score of clinically isolated S. aureus was between 1.700 and 2.000, which suggested the drug resistance and was consistent with the MIC value of the broth dilution method. At the same time, the systemic identification value of the P. aeruginosa, which is independent of the quality control sensitive strain, was greater than 2.000, showing sensitivity and it was a sensitive strain itself, which was consistent with the results. Conclusion::The microbial rapid identification system scoring method can be used for the rapid identification of the drug resistance of S. aureus and P. aeruginosa.
RÉSUMÉ
Self-directed learning ( SDL) skill is one of the necessary capabilities of an excellent doctor .SDL train-ing has become the important content in the top creative talents training .SDL training has been carried out for 6 years since 2011 by physiology department of Tongji University .Feedback from medical students had been collect-ed, which was used to make modifications and supplementary including direct to learning ( D2L) platform to im-prove SDL.SDL training is proved to be a widely accepted model in medical students and receive good learning out-come.D2L platform is helpful in progressing SDL training .