Objective To analyze the drug resistance genes and homology in nosocomial infection caused by carbapenem‐resistant Acinetobacter baumannii(CRAB) .Methods Forty strains of CRAB were collected and the minimal inhibitory concentration (MIC) was detected by the agar dilution method .The main carbapenemase genes were detected by PCR .The PCR products were performed the DNA sequencing .The enterobacterial repetitive intergenic consensus (ERIC)‐polymerase chain reaction(PCR) was performed to analyze the genotypes and homology of these strains .The plasmid conjugation experiment was carried out to investigate the trans‐mission of resistant genes .Results Forty strains of CRAB maintained the good sensitivity only to polymyxin B (100% ) and cef‐operazone/sulbactam(57 .5% ) .All of them had different degrees of resistance to other drugs .The OXA‐23 and OXA‐51genes were detected by PCR amplified in all of the CRAB strains .The homology analysis showed that the strains could be divided into 4 types according to 80% of cluster similarity coefficient ,the type A1 (19 strains) was the major epidemic strain ,moreover the various de‐partments had cross infection ;the plasmid conjugation experiment failed .Conclusion There is an endemic spread of CRAB in our hospital and its resistant mechanism is mainly related with OXA‐23 gene expression ;in the rational antibiotics use at the same time , the isolation and prevention measures should be done well for avoiding the hospital cross infection .

Objective To investigate anxiety of clinicians in tertiary hospitals,and discuss the fac-tors that influence clinicians'anxiety in order to provide reference for further effective intervention measures. Methods 427 clinicians from various departments in tertiary hospitals selected by cluster sampling method were investigate by self-rating anxiety scale ( SAS) .Statistical software SPSS 17.0 was used to analyze data for multivariate logistic regression analysis of its relevant influencing factors.Results 38.2%of the clini-cians had anxiety symptoms (55.0%was mild anxiety,26.1%was moderate anxiety,18.9%was severe anxi-ety) .Factors like education (χ2=7.3, P=0.03) ,job title (χ2=53.24, P<0.01) ,divisions (χ2=46.46, P<0.01) ,work experience (χ2=9.78, P=0.04) ,work overtime (χ2=4.29, P=0.03) ,worry of medical mal-practice (χ2=9.54, P<0.01),doctor-patient relationship tension (χ2=7.50, P<0.01),fear for personal safety (χ2=10.27, P<0.01) ,job promotion competition (χ2=11.40, P<0.01) ,labor and payment situation (χ2=6.36, P=0.01) ,colleagues'understanding and support (χ2=15.77, P=0.01) ,work environment (χ2=21.85, P<0.01) and leaders'attention (χ2=7.17, P=0.01) had significant differences between anxiety and non-anxiety clinicians.Multivariate logistic regression analysis revealed that factors like divisions ( com-pared with internal medicine,OB&GYNβ=0.98,surgeryβ=0.95,pediatricsβ=0.86,emergencyβ=0.69) , work overtime (β=0.18),fear for personal safety (β=0.86),fear of medical malpractice (β=0.79) and doctor-patient relationship tension (β=0.28) had a negative impact on anxiety,while factors like education ( compared with bachelors,mastersβ=-1.38,doctorsβ=-1.65) ,job title ( compared with primary,intermedi-ateβ=-0.33,highβ=-0.45,advancedβ=-0.59) ,work experience (β=-0.18 ) and work environment (β=-0.32) were protective factors.Conclusion There is a certain degree of anxiety among clinicians in tertiary hospitals,resulting in a heavy psychological burden on them.Active measures should be taken to improve the clinicians'psychological health.

[ ABSTRACT] AIM:To explore the effects of eplerenone on the expression and activity of aortic endothelial nitric oxide synthase ( eNOS) in high salt-induced hypertensive rats .METHODS: Male Wistar rats (4 week old, weighting 50~60 g) were randomly divided into control group , high-salt diet group and eplerenone group .The rats in control group were fed with ordinary rodent animal diet , the rats in high-salt group and eplerenone group were exposed to 5%salt diet for 16 weeks and administrated with the same dosage of saline or eplerenone (40 mg? kg-1? d-1 ) by gavage for 4 weeks, re-spectively.Systolic blood pressure (SBP) was measured by tail-cuff every 2 weeks.The rats were sacrificed after 16 weeks and the thoracic aorta was collected .The aldosterone content in the aorta was measured by ELISA .The protein levels of mineralocorticoid receptor (MR) and eNOS were determined by Western blot.The activitie of constitutive NOS (cNOS) was measured by chemocolorimetry .The protein localization of eNOS , neuronal nitric oxide synthase ( nNOS) and MR was observed by immunohistochemistry .RESULTS: A process of 8-week high-salt diet increased SBP gradually .SBP in the rats exposure to high salt for 16 weeks was significantly higher than that in control group ( P<0.05 ) .After 4 weeks of eplerenone treatment, SBP in the rats was significantly lower than that before treatment (P<0.05).Compared with control group, the aldosterone content in the aorta were significantly increased in high-salt diet group and eplerenone group ( P<0.05), the expression level of MR also increased significantly (P<0.05).Compared with control group, both eNOS pro-tein expression (P<0.05) and cNOS activity in high-salt diet group were significantly decreased (P<0.05).The protein expression of eNOS as well as cNOS activity in aorta increased significantly in eplerenone group compared with high -salt diet group (P<0.05).CONCLUSION:Aldosterone content in aorta of high-salt-induced hypertensive rats increases signifi-cantly .Aldosterone attenuates the protein expression of eNOS and reduces the enzyme activity through the activation of min -eralocorticoid receptor .The selective mineralocorticoid receptor antagonist eplerenone enhances the protein expression of eNOS and its activity , thereby improves eNOS function .

AIM: To investigate the molecular mechanism by which hypoxia affect the endothelial nitric oxide synthase (eNOS) expression in cerebral artery endothelial cells (CAECs). METHODS: Primary cultured porcine CAECs were exposed to hypoxia for 2 h, 6 h, 12 h, 24 h and 48 h. The eNOS mRNA level was determined by RT-PCR. The level of eNOS protein was detected by Western blotting. After specific PKC inhibitors BIM Ⅰ(1 ?mol/L) and G6983 (1 ?mol/L) were added, CAECs were exposed to hypoxia for 24 h. The effect of hypoxia on eNOS mRNA stability was analyzed after actinomycin D was added. RESULTS: After exposure to hypoxia for 2 h, the levels of eNOS mRNA and protein in CAECs were increased. The levels of eNOS mRNA and protein reached peak after 12 h of hypoxia (about 2 5 fold and 2 0 fold, respectively, compared to control), and remained at higher level even after 48 h of hypoxia. Moreover, hypoxia did not change the stability of eNOS mRNA. The specific PKC inhibitors BIM Ⅰ and G6983 attenuated significantly the effects of hypoxia on eNOS gene expression. CONCLUSION: These results suggest that hypoxia may enhance the expression of eNOS gene in CAECs through PKC signaling pathway, which might be one of the mechanisms of cerebral artery dilation and neuroprotection during cerebral hypoxia.

Objective To explore the risk factors of osteoporosis in elderly patients with ischemic stroke by intracranial atherosclerotic stenosis(ICAS). Methods 342 elderly patients(≥ 65 year)with ischemic stroke by ICAS were divided into osteoporosis group and non-osteoporosis group,multivariate unconditional Logistic re-gression analysis was used to analyze the risk factors for elderly patients with ischemic stroke by ICAS. Results Univariate analysis shows that female,unilateral anterior circulation infarct,involvement of vessels of more than two branches,complete paralysis,delayed paralysis,BI index were significantly associated with osteoporosis in el-derly patients with ischemic stroke by ICAS between the two groups(all P < 0.05). Multiple Logistic regression analysis revealed that gender,disease duration,involvement of cerebral circulation,paralysis degree,muscle ten-sion state were independent risk factors for the development of osteoporosis in elderly patients with ischemic stroke by ICAS(OR = 3.459,2.486,4.540,3.819,3.699,P < 0.05). Conclusions Gender,disease duration,in-volvement of cerebral circulation,paralysis degree,muscle tension state are independent risk factors of osteoporo-sis in elderly patients with ischemic stroke by ICAS,provides a theoretical basis for the prevention of osteoporosis in elderly patients with ischemic stroke by ICAS.

Objective:To investigate the uncoupling protein 2 (UCP2) expression and its relations with apoptosis, oxidative stress and mitochondrial division/fusion in HT22 cell model with intracerebral hemorrhage.Methods:HT22 cells cultured in vitro were divided into control group, and groups of 3, 6, 12 and 24 h after modeling; cells in the later 4 groups were given 10 μmol/L hemin for 3, 6, 12 and 24 h, respectively, and cells in the control group were given the same equivalent solvent for 24 h. The apoptosis of HT22 cells in these 5 groups was detected by Annexin V-FITC/propidium iodide Apoptosis Detection Kit. The reactive oxygen species (ROS) expressions in these 5 groups were detected by fluorescence probe method. Western blotting was used to detect the protein expressions of UCP2, apoptosis-related protein cleaved caspase 3, anti-apoptosis protein B cell lymphoma/leukemia2 (bcl2), and mitochondrial division/fusion proteins (Fis1, Drp1, Opa1, and Mfn2). Results:As compared with the control group, groups of 3, 6, 12 and 24 h after modeling had significantly increased apoptosis rate, ROS level, and UCP2, cleaved caspase 3, Fis1 and Drp1 expressions, and statistically decreased bcl2, Opa1, and Mfn2 expressions. Groups of 3, 6, 12 and 24 h after modeling had successively increased apoptosis rate, successively increased ROS levels, and successively increased UCP2, cleaved caspase 3, Fis1 and Drp1 expressions, and successively decreased bcl2, Opa1, and Mfn2 expressions, with significant differences ( P<0.05). Conclusion:UCP2 expresses in HT22 cell model with intracerebral hemorrhage in time-dependent manner, and it has close relations with apoptosis, oxidative stress, and dynamic balance of mitochondrial division/fusion of HT22 cells.

Dental Caries is a kind of chronic oral disease that greatly threaten human being's health. Though dentists and researchers struggled for decades to combat this oral disease, the incidence and prevalence of dental caries remain quite high. Therefore, improving the disease management is a key issue for the whole population and life cycle management of dental caries. So clinical difficulty assessment system of caries prevention and management is established based on dental caries diagnosis and classification. Dentists should perform oral examination and establish dental records at each visit. When treatment plan is made on the base of caries risk assessment and carious lesion activity, we need to work out patient‑centered and personalized treatment planning to regain oral microecological balance, to control caries progression and to restore the structure and function of the carious teeth. And the follow-up visits are made based on personalized caries management. This expert consensus mainly discusses caries risk assessment, caries treatment difficulty assessment and dental caries treatment plan, which are the most important parts of caries management in the whole life cycle.
Consensus ; Dental Care ; Dental Caries/prevention & control* ; Humans ; Prevalence

The dental operative microscope has been widely employed in the field of dentistry, particularly in endodontics and operative dentistry, resulting in significant advancements in the effectiveness of root canal therapy, endodontic surgery, and dental restoration. However, the improper use of this microscope continues to be common in clinical settings, primarily due to operators' insufficient understanding and proficiency in both the features and established operating procedures of this equipment. In October 2019, Professor Jingping Liang, Vice Chairman of the Society of Cariology and Endodontology, Chinese Stomatological Association, organized a consensus meeting with Chinese experts in endodontics and operative dentistry. The objective of this meeting was to establish a standard operation procedure for the dental operative microscope. Subsequently, a consensus was reached and officially issued. Over the span of about four years, the content of this consensus has been further developed and improved through practical experience.
Humans ; Dentistry, Operative ; Consensus ; Endodontics ; Root Canal Therapy ; Dental Care