Objective To investigate the pathogens and their antibiotic resistance profile of hospital and community-acquired spontaneous bacterial peritonitis ( SBP) in patients with liver cirrhosis. Methods Eighty-four cirrhotic patients with SBP were recruited, in which 61 (72. 6% ) were diagnosed as communityacquired SBP and 23 (27.4% ) were diagnosed as hospital-acquired SBP. Bacterial identification and drug susceptibility tests were performed. SPSS 16. 0 was used for statistical analysis. Results There were 68 (81.0%) Gram-negative strains and 16 (19.0%) Gram-positive strains. Escherichia coli and Klebsiella pneumoniae were the top two prevalent strains. In community-acquired group, there were 21 (21/61, 34. 4% ) strains of Escherichia coli and 15 ( 15/61 , 24. 6% ) strains of Klebsiella pneumoniae; while in hospital-acquired group, it was 12 (12/23, 52.2%) strains and 6 (6/23, 26. 1%) strains, respectively. There were no statistical differences in the infection rates of Escherichia coli and Klebsiella pneumoniae between community and hospital-acquired SBP patients (x2 = 2. 21 and 0. 02, P > 0. 05). Drug susceptibility tests showed that Escherichia coli and Klebsiella pneumoniae were 100% sensitive to impenem, and the sensitivity to Piperacillin/Tazobactam was also high. But these strains were highly resistant to Ampicillin and Ampicillin/Sulbactam. All extended spectrum β-lactamases ( ESBLs) positive strains were resistant to cephalosporins, while ESBLs-negative strains were all sensitive to cephalosporins. Conclusions SBP in patients with liver cirrhosis are mainly caused by Gram-negative strains, especially Escherichia coli and Klebsiella pneumoniae. ESBLs-positive strains are highly resistant to cephalosporins, so proper use of right antibacterial agents is important.

Objective: To study the effect of Tianmeng Capsule combined with paroxetine in the treatment of menopausal women with generalized anxiety disorder (GAD) and its mechanism of the reaction with oxidative stress. Methods: Totally 120 cases of menopausal patients with GAD, without the use of estrogen replacement therapy, were randomly divided into control group and observation group of 60 cases, the control group were treated with paroxetine, the observation group were additionally treated with Tianmeng Capsule, then the clinical effects were compared. Results: The Hamilton anxiety scale (HAMA) scores and Pittsburgh sleep quality index scale (PSQI) scores were significantly decreased in two groups and the indexes in the observation group were lower than control group (P < 0.05). The total effective rate in the observation group was significantly better than that of the control group (P < 0.05 ). There were no obvious adverse drug reactions in the two groups. The serum follicle stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E2) levels had no significant difference between two groups after treatment. The serum superoxide dismutase (SOD) levels increased, and malondialdehyde (MDA) levels decreased in the observation group (P < 0.05). Conclusion: It is safe and effective to treat GAD patients with Tianmeng Capsule, which may not improve the level of hormone but related to oxidative stress.

Objective To investigate the correlation between the features of multimodal magnetic resonance imaging (MRI) and the expression of human epidermal growth factor receptor-2 (HER-2) in ductal carcinoma in situ (DCIS). Methods A total of 53 patients with DCIS confirmed by surgery and pathology in Dezhou Second People’s Hospital from September 2018 to June 2021 were analyzed retrospectively. The patients were divided into HER-2 positive group (29 cases) and HER-2 negative group (24 cases). MRI features were compared between the two groups. Results There were significant differences in the internal enhancement characteristics, microvascular sign, and time-intensity curve type between the two groups (P < 0.05). There were no significant differences in lesion morphology, non-mass-like enhancement pattern, and apparent diffusion coefficient value (P > 0.05). The HER-2 positive group showed clumped enhancement (65.5%), type Ⅱ (48.1%) andtype Ⅲ (29.6%) time-intensity curves, and microvascular sign (89.7%). The HER-2 negative group showed clusteredring enhancement (50.0%), type Ⅱ (45.8%) and type I (54.2%) time-intensity curves, and microvascular sign (54.2%). A combination of clumped enhancement, microvascular sign, and type Ⅲ time-intensity curve showed 100% specificity and 100% positive predictive value for the diagnosis of HER-2 positive DCIS. Conclusion Clumped enhancement, microvascular sign, and type Ⅱ or Ⅲ time-intensity curve on MRI can largely reflect the expression of HER-2 in DCIS. The three can be used in combination to improve the diagnostic efficiency of HER-2 positive DCIS.

Objective: To investigate the effects of postoperative analgesia with Dexmedetomidine combined with Sufentanil on pulmonary infection complications and immune function in patients with lung cancer. Methods: A total of 200 patients with lung cancer who underwent radical lung cancer in our hospital from July 2014 to June 2018 were randomly divided into the group A(n=100, receiving Sufentanil analgesia)and group B(n=100, receiving Sufentanil combined with Dexmedetomidine analgesia)according to the random number table method.The analgesic effect, pulmonary complication incidence and immune function were compared between the two groups. Results: The analgesic and sedative effects were better in the group B than in the group A at 4, 8, 12 and 24 hours after surgery, respectively(P<0.05). The visual analogue scale(VAS)and Ramesay score had statistically significant differences between the two groups at 4, 8, 12 and 24 hours after surgery, respectively(VAS: t=4.137, 2.575, 3.869, 12.676 and 9.945, all P<0.05; Ramesay score: t=6.771, 5.647, 16.763, 21.154 and 6.556, all P<0.05). The pulmonary infection, acute lung injury, focal lung infiltration, atelectasis and respiratory failure occurred in 1, 0, 1, 1 and 0 case in the group B and 3, 2, 3, 1 and 1 case in the group A, respectively.The incidence of pulmonary complications was lower in the group B than in the group A(3% or 3/100 vs.10% or 10/100, χ²=4.031, P=0.045). There were no significant difference in the levels of CD3⁺, CD4⁺, CD8⁺ and CD4⁺ /CD8⁺ cells before surgery between the two groups(P>0.05). The levels of CD3⁺, CD4⁺, CD8⁺ and CD4⁺ /CD8⁺ cells were higher in group B than in group A at 1 day after surgery(t=7.419, 7.867, 11.968 and 8.755, P=0.000). Conclusions Postoperative Dexmedetomidine combined with Sufentanil analgesia not only helps to reduce the incidence of pulmonary complications, but also improves the analgesic effect and immune function in patients with lung cancer undergoing radical surgery.

【Objective】 To explore the efficacy of transurethral columnar balloon dilation of prostate (TUCBDP) and transurethral bipolar plasmakinetic resection of prostate (TUPKP) for patients with small volume (≤30 mL) benign prostatic hyperplasia (BPH) and the effects on urinary control and sexual function. 【Methods】 Clinical data of BPH patients who underwent surgical treatment during Jun.2021 and Jan.2022 were reviewed. A total of 95 patients with prostate volume ≤30 mL and regular sexual life were selected as subjects, including 45 patients who received TUCBDP as the TUCBDP group and 50 patients who received TUPKP as the TUPKP group. The patients were followed up for 12 months, and the perioperative data and follow-up results were analyzed. 【Results】 The TUCBDP group had shorter operation time, less intraoperative blood loss, less postoperative hemoglobin loss and sodium concentration loss, shorter bladder irrigation time, lower pain score, shorter urinary tube indwelling time and shorter hospital stay than the TUPKP group (P<0.05). Twelve months after surgery, the International Prostate Symptom score (IPSS), quality of life score (QoL), residual urine volume (PVR) and maximum urine flow rate (Qmax) were significantly improved in both groups (P<0.05). The International Index of Erectile Function-5 (IIEF-5), Erection Hardness Grading Score (EHS), Sexual Function Score in Patients with Premature Ejaculation-5 (CIPE-5) score had no significant differences compared with those before surgery (P>0.05). The TUPKP group had worse ejaculation function score and ejaculation disturbance score after surgery (P<0.05), while the TUCBDP group had no significant change (P>0.05), and the two indexes were superior in the TUCBDP group than in the TUPKP group. The TUCBDP group had significantly lower complication rate than the TUPKP group (P<0.05). 【Conclusion】 TUCBDP is safe and effective in the treatment of small volume (≤30 mL) BPH, less trauma, less biochemical interference, less pain, fewer complications, and shorter course of disease. It has little effect on the ejaculation function and erectile function, and is more suitable for patients requiring retention of sexual function. It has a good application prospect in the treatment of small volume BPH.

BACKGROUND: Ischiofemoral impingement (IFI) syndrome has attracted more and more attention, but there is little report on IFI because of its low incidence. Moreover, its imaging characters have not yet been fully understood.OBJECTIVE: To discuss the MRI diagnostic criteria for IFI, thus understanding the imaging characters of IFI revealed on MRI.METHODS: Sixteen cases (21 hips) of suspected IFI were selected as experimental group, and 25 healthy volunteers as control group. The bilateral ischiofemoral space (IFS, the shortest distance between the ischial tuberosity and lesser trochanter of femur) and quadratus femoris space (QFS, distance between the lesser trochanter of femur and hamstring tendon insertion) were measured on MRI axial image. The signal and morphology of the quadratus femoris were observed. The differences in QFS and IFS were compared between two groups.RESULTS AND CONCLUSION: (1) Among 16 patients, there were 13 females, and 3 males, and 5 female cases of bilateral IFI. (2) In the experimental group, the IFS ((13.65±3.87) mm versus (22.17±5.75) mm) and QFS ((7.15±3.50) mm versus (12.89±3.13) mm) showed significant differences between affected and opposite sides (P < 0.01). (3) In the control group, the IFS ((23.59±6.14) mm versus (23.08±5.82) mm) and QFS ((12.41±3.75) mm versus (13.22±3.84) mm) did not differ significantly between left and right sides (P > 0.05). (4) Compared with the control group, there were significant differences in IFS and QFS of the affected side in the experimental group, and no significant differences in IFS and QFS of the opposite side. (5) In the experimental group, quadratus femoris appeared with deformation, edema and atrophy. (6) To conclude, the incidence of IFI in females is significantly higher than that in males, and bilateral hips are usually affected. MRI diagnostic criteria for IFI are IFS ≤ 11.46 mm, QFS ≤ 5.53 mm of the affected side, and quadratus femoris present edema and deformation, which are more sensitive on axial fat-suppressed MRI imaging.

OBJECTIVE: To explore effection and significance of sunitinib on gefitinib resistance of lung cancer cells. METHODS: Cell proliferation inhibition of 28 gefitinib resistance lung cancer patients tumor tissues extracted with sunitinib treatment were measured using MTT assay. After sunitinib treatment, sensitivity of gefitinib resistance cells were measured by CellTiter-Glo method;The accumulation of Rh-123 in gefitinib resistant cells with sunitinib treatment were measured by FCM method. Accumulation of multi-drug resistance protein (MDR), transcription factors κB(NF-κB)and vascular endothelial growth factor(VEGF) were examined using Western blotting after sunitinib treatment on gefitinib resistance cells. RESULTS: Cell proliferation were inhibited by dose dependent after sunitinib treatment, IC50 is (6.73±1.57) μmol·L-1. Sensitivity of gefitinib resistance cells were significantly increased, and decreased the IC50 of gefitinib for inhibiting resistance cells after 1 and 2 μmol·L-1 sunitinib combine with gefitinib treatment, IC50 of gefitinib is (38.64±1.29) and (20.37±1.75) μmol·L-1 respectively. The accumulation of Rh-123 in gefitinib resistant cells with 1 μmol·L-1 sunitinib treatment were significantly increased(P<0.05), fluorescent density increased by 2.44 times following treatment with 1 μmol·L-1 of sunitinib, accumulation of Rh-123 in gefitinib resistant cells with 2 μmol·L-1 sunitinib treatment is larger significantly increased(P<0.01), fluorescent density increased by 5.64 times following treatment with 2 μmol·L-1 of sunitinib; expression level of MDR, NF-κB and VEGF proteins were significantly reduced after 1 and 2 μmol·L-1 sunitinib treatment. CONCLUSION: Sunitinib is able to reverse the gefitinib resistance, the theoretical foundation is provided for clinical treatment of patients with gefitinib resistance.

Objective: The non-convulsive status epilepticus (NCSE) is easy misdiagnosed due to its complex etiology, clinical manifestations. It is more difficult to diagnose and treat for elderly patients with multiple basic diseases. The purpose of this study is to investigate the clinical characteristics of elderly patients with NCSE, therapy, diagnosis, and the value of long-range video electroencephalography (LV-EEG). Methods: The clinical and electroencephalography (EEG) data of the five elderly patients with NCSE in my hospital were analyzed retrospectively.Results: Five patients showed episodes of abnormal behavior during seizure (5/5). There were 3 patients with previous history of epilepsy after cerebral infarction (3/5), 1 patient diagnosed intracranial infection because of NCSE episodes to consultation (1/5), and 1 case with previous history of epilepsy (1/5). The V-EEG of the 5 patients showed persistent epileptic form discharges during seizure. Intravenous diazepam had good effect to the 5 patients during seizure. Seizure of the 5 cases was controlled acceptably with different antiepileptic drugs according to different epilepsy forms.Conclusions: The abnormal mind and behavior is still main performance in elderly patients with NCSE. The LV-EEG provides reliable foundation for diagnosis of the disease. The rational use of antiepileptic drugs is effective. Intravenous diazepam slow for elderly patients with NCSE is applied as well.

Nasal cancer has not been included in the current list of legal occupational diseases in China. There is also a lack of systematic and in-depth study on the relationship between nasal cancer and occupational exposure factors in China. In September 2018, the department for work and pensions of UK released the latest edition of the "List of diseases covered by industrial injuries disablement benefit", which lists nasal cancer and nasopharyngeal carcinoma associated with wood dust exposure on the UK's occupational disease list. In order to better protect the health of workers, the relationship between occupational wood dust exposure and nasal cancer is reviewed, which provides a reference for further revision and improvement of occupational disease catalogue.

Diquat is a kind of conductive contact-killing herbicides. The damage of central nervous system is relatively common, but the peripheral neuropathy caused by diquat has not been reported yet. In September 2021, we treated a patient with diquat poisoning. During the hospitalization, the patient was diagnosed with peripheral neuropathy. Therapy for peripheral nerve injury was given on the basis of conventional treatment of poisoning. The patient was discharged after his condition was stable. The follow-up showed that the peripheral neuropathy of patient was better than before. According to the condition of this patient, it is suggested that we should not only protect the function of gastrointestinal tract, liver, kidney, and central nervous system early, but should also pay attention to the damage of peripheral nervous system in clinical work. We should intervene earlier to improve the prognosis of patients.
Humans ; Diquat ; Herbicides ; Kidney ; Liver ; Peripheral Nerve Injuries ; Poisoning