Objective To evaluate VITEK2 Advanced Expert System (AES) for detection and analysis of clinically important beta-lactam phenotypes.Methods 124 known resistant phenotype strains including Staphylococcus spp, E.coli, Klebsiella spp. and Ent. cloacae were tested by VITEK2 AES. Results The resistant phenotypes for methicillin susceptible, and resistant Staphylococcus spp, producing ESBL E. coli, Klebsiella spp. and Ent. cloacae isolates, and inducible AmpC and hyperproduced AmpC Ent. cloacae isolates can be accurately identified by VITEK2 AES. The most Ent. cloacae strains for both producing ESBLs and hyperproduced AmpC were partially identified.Conclusion VITEK2 AES can be accurately identified most clinically important beta-lactam phenotypes and suggested additional therapeutic correction based on phenotype. Certain problems for Ent. cloacae in the study should be remediable with further work on AES.

Objective: To study therapeutic effects of simvastatin on vascular endothelial cell dysfunction in patients with coronary heart disease (CHD). Methods: According to LDL-C level, a total of 90 CHD patients were divided into simvastatin 20mg group (n=37, LDL-C≥2.5mmol/L), simvastatin 10mg group (n=35, 1.8mmol/L≤LDL-C<2.5mmol/L) and routine treatment group (n=18, LDL-C<1.8mmol/L). Their course of treatment was 8 weeks. Color Doppler ultrasound diagnostic instrument was used to measure flow-mediated dilation of brachial artery (FMD), and nitrate reductase method was used to measure concentration of nitric oxide (NO) in all CHD patients. Serum concentrations of TC, TG, LDL-C and HDL-C were routinely measured. Results: After treatment of eight weeks, compared with before treatment, there were significant decrease in concentrations of TC, TG and LDL-C (P<0.05 all), and significant increase in HDL-C level (P<0.05 all) in simvastatin 20mg and 10mg group, but there were no significant difference in above-mentioned all indexes between simvastatin 20mg and 10mg groups, P>0.05 all; Compared with routine treatment group, there were significant improvement in FMD [(6.01±0.49)% vs. (9.01±0.39)% vs. (9.01±0.47)%，P<0.01 all] and significant increase in serum NO concentration [(38.97±8.89)μmol/L vs. (47.67±10.89) μmol/L vs. (45.61±9.09) μmol/L，P<0.05 all] in simvastatin 20mg and 10mg group; But there were also no significant difference in serum NO and FMD between simvastatin 20mg and 10mg groups, P>0.05 all. Conclusion: Simvastatin can increase NO concentration and improve vascular endothelial cell dysfunction in CHD patients. Its mechanism may be related with lipid-lowering effect, but independent of its lipid-lowering effect

Prosthodontics is an important undergraduate course in stomatology. It's an unprecedented challenge for teachers to give theoretical lectures completely by online teaching methods. After several months of online teaching practice, a complete closed-loop online teaching mode of "pre-class, in-class and after-class" has been formed by using online teaching tools such as Tencent meeting, Superstar learning platform and WeChat. A comprehensive feedback and assessment mechanism has also been established. On the premise of the teaching quality, online teaching has also promoted the exploration and reform of the information-based teaching of prosthodontics course.

Objective To evaluate the clinical effect of endoscopic retrograde biliary drainage (ERBD) and endoscopic naso-biliary drainage (ENBD) on hilar cholangiocarcinoma (HACC).Methods The clinical data of 87 patients with HACC,who underwent ERBD and ENBD form January 2010 to January 2016,were retrospectively analyzed.The incidence of postoperative severe cholangitis,biliary obstruction again within 4 weeks,reduction of total bilirubin and survival time were studied.Results There were significant differences between ERBD group and ENBD group on the incidence of severe cholangitis[29.2％ (14/48) VS 10.3％ (4/39),x2 =4.689,P=0.030] and bile duct obstruction in 4 weeks after operation [47.9％ (23/48) VS 23.1％ (9/39),x2=5.710,P =0.017].The total bilirubin within 2 weeks and 4 weeks postoperatively was significantly reduced compared with that before operation (P＜0.05).There was no statistical difference in descend range of total bilirubin between the two groups.There was significant difference between ERBD group and ENBD group in the median survival time [14 weeks (range,0-60 weeks) VS 34 weeks (range,2-96 weeks),x2 =10.101,P=0.010].Conclusion Compared to ERBD,ENBD has certain advantages on palliative care for HACC.

Objective:To explore the effect of health education based on theory of planned behavior combined with stepped care model on negative emotion, psychological flexibility and quality of life in patients with lung cancer undergoing chemotherapy.Methods:From October 2020 to December 2021, 108 chemotherapy patients who underwent lung cancer surgery in Affiliated Hospital of Weifang Medical College and had anxiety or depression that scores was greater than 7 in any dimension of the Hospital Anxiety and Depression Scale (HADS) were selected as the study subjects. The study subjects were divided into observation group ( n=46) and control group ( n=48) by random digits table method. Routine care was implemented in the control group. The observation group implemented health education based on the theory of planned behavior combined with stepped care model intervention. The HADS scale was used every 4 weeks to assess negative emotion in both groups. In observation, patients with negative emotion relief stop the next stage of nursing intervention, and patients without relief continue the next stage of higher intensity nursing intervention. Results:Before the intervention, there were no significant difference in the scores of negative emotion, psychological flexibility and quality of life between the two groups ( P>0.05). After intervention, the scores of all dimensions of negative emotion and the total score in the observation group were significantly lower than those in the control group, and the differences had statistical significance ( t=4.86, 3.19 and 4.53, all P<0.05). After the intervention the scores of psychological flexibility and quality of life dimensions and the total score in the observation group were higher than those in the control group, the differences had statistical significance (t values were -6.01--2.89, all P<0.05). After the intervention, there was no significant difference in the remission rate of negative emotions between the clinical observation stage of the observation group and the concurrent control group ( P>0.05). The remission rates of guided self-help, problem-solving therapy, psychological or drug therapy and total negative emotions in the observation group were 38.46%(15/39), 33.33%(8/24), 6/16 and 78.26%(36/46), respectively, which were higher than those in the control group, and the differences had statistical significance ( χ2 values were 7.04 - 13.80, all P<0.05). Conclusions:Health education based on the theory of planned behavior combined with stepped care model can effectively alleviate the negative emotions of lung cancer patients undergoing chemotherapy and improve psychological flexibility and quality of life.

OBJECTIVETo analyze horizontal transmission patterns of Streptococcus mutans among caries-active preschool children for early interventions of dental caries.

METHODSPlaque samples obtained from 20 caries-active preschool children between 4 and 5 years of age were cultured under anaerobic conditions for isolating S. mutans, which were identified by morphological and biochemical analyses and PCR using primers homologous to the surface protein glucosyltransferase B (gtfB). The genotypes of the isolated S. mutans strains were determined by arbitrarily primed PCR (AP-PCR).

RESULTSOf the 200 S. mutans isolates obtained, 19 were excluded by biochemical analysis, and the remaining 181 isolates were identified as S. mutans by PCR with primers of gtfB, showing 37 different genotypes as identified by AP-PCR. Six children were found to carry S. mutans of a single genotype, 11 carried 2 genotypes, 2 had 3 genotypes, and 1 had 4 genotypes; 2 children from different classes were found to carry S. mutans of the same single genotype.

CONCLUSIONWe identified 37 genotypes of S. mutans in these caries-active preschool children, among whom horizontal transmissions of the strains were not found.

Child, Preschool ; Dental Caries ; microbiology ; Dental Plaque ; Genotype ; Glucosyltransferases ; Humans ; Polymerase Chain Reaction ; Streptococcal Infections ; transmission ; Streptococcus mutans ; classification

Tu-Xian decoction (TXD), a traditional Chinese medicine (TCM) formula, has been frequently administered to manage diabetic cognitive impairment (DCI). Despite its widespread use, the mechanisms underlying TXD's protective effects on DCI have yet to be fully elucidated. As a significant regulator in neurodegenerative conditions, death-associated protein kinase-1 (DAPK-1) serves as a focus for understanding the action of TXD. This study was designed to whether TXD mediates its beneficial outcomes by inhibiting DAPK-1. To this end, a diabetic model was established using Sprague-Dawley (SD) rats through a high-fat, high-sugar (HFHS) diet regimen, followed by streptozotocin (STZ) injection. The experimental cohort was stratified into six groups: Control, Diabetic, TC-DAPK6, high-dose TXD, medium-dose TXD, and low-dose TXD groups. Following a 12-week treatment period, various assessments-including blood glucose levels, body weight measurements, Morris water maze (MWM) testing for cognitive function, brain magnetic resonance imaging (MRI), and histological analyses using hematoxylin-eosin (H&E), and Nissl staining-were conducted. Protein expression in the hippocampus was quantified through Western blotting analysis. The results revealed that TXD significantly improved spatial learning and memory abilities, and preserved hippocampal structure in diabetic rats. Importantly, TXD administration led to a down-regulation of proteins indicative of neurological damage and suppressed DAPK-1 activity within the hippocampal region. These results underscore TXD's potential in mitigating DCIvia DAPK-1 inhibition, positioning it as a viable therapeutic candidate for addressing this condition. Further investigation into TXD's molecular mechanisms may elucidate new pathways for the treatment of DCI.
Animals ; Rats ; Brain/metabolism* ; Cognitive Dysfunction/drug therapy* ; Diabetes Mellitus, Experimental/metabolism* ; Hippocampus ; Rats, Sprague-Dawley