OBJECTIVE To investigate the drug-resistance status of Escherichia coli(ECO)from various kinds of specimens to provide the scientific evidence for reasonable use of antibiotics.METHODS ECO strains were isolated and identified according to the National Clinical Laboratory Operation Rules.Drug resistance profile was analyzed by K-B method recommended by CLSI.RESULTS Among 275 ECO strains,50.2%(the most highest isolating rate)were isolated from urine.Detection rate of extended spectrum ?-lactamases(ESBLs)producing ECO was 32.4%(89/275).Except for 100% susceptibility to carbopenems,the drug-resistance to 14 antibiotics in ESBLs producers was higher than in the nonproducers.CONCLUSIONS Laboratory department should think highly of the monitoring of ECO to prevent and control the occurrence and prevalence of the nosocomial infection with ECO.

Objective To compare the anthelmintic effect of albendazole with that of triclabendazole against Fasciola giganti-ca. Methods Two patients infected with Fasciola gigantica were investigated,and one was administered with albendazole orally (200 mg,twice per day for 5 days)and another was administered with triclabendazole[10 mg/(kg?d)for 2 days]. Their total fe-ces were collected daily during the period of whole therapy,and the eggs of the parasite were collected by using the nylon bag method,and incubated at 28℃. Results The parasite eggs were detected from the first patient’s dejecta on the 1st,2nd and 5th day after the end of the treatment,and no miracidiums hatched out as well as no eggs developed during the period of 25 days of the incubation. Meanwhile,her body temperature fluctuated between 37.4℃and 38.3℃,and she still complained bellyache. For the other invalid,the eggs were not detected on the 2nd and 5th day after the end of the treatment. However,the eggs before and dur-ing the treatment developed the miracidiums of Fasciola gigantica on the 13th day after the incubation,but the eggs collected from the 1st day after the termination of the therapy did not develop and no miracidiums hatched out. At the same time,the signs and symptoms of the patient vanished after the 4th day of the end of the therapy. Conclusions Albendazole has no obvious insecticid-al activity on adult Fasciola gigantica in the short term,but may affect the development of eggs. Triclabendazole has the anthelmin-tic effect on the adults as well as eggs of Fasciola gigantica. In addition,triclabendazole has the characteristics of well curative ef-fect,short course of treatment,and no obvious side effects.

Objective To detect the expression of hypoxia-inducible factor 1α (HIF-1α) and bcl-2 ovarian serous carcinoma and their clinical significances. Methods Paraffin specimens including 61 cases of ovarian serous carcinoma and 50 normal ovarian tissues were selected. The expressions of HIF-1α and bcl-2 proteins were detected by immunohistochemical EnVision method and their relationship between them was analyzed. Results The positive rate of HIF-1α and bcl-2 proteins expression in 61 ovarian serous carcinoma was 68.9%and 54.1%, respectively. There was a significant difference between the two groups (χ2=55.381, P< 0.05; χ2= 38.493, P< 0.05). The clinical pathological parameters showed that the positive expression of HIF-1αand bcl-2 proteins were not related with the age (P>0.05). HIF-1αpositive expression was correlated with tumor grades, the state of lymph node metastasis and FIGO stages (χ2=4.931, 25.008, 5.610, P<0.05). Bcl-2 was significantly associated with tumor grades and lymph node metastasis (χ2= 6.956, 33.869, P<0.05), but not with FIGO stages (χ2=3.391, P>0.05). The expression of bcl-2 was positively correlated with HIF-1α in ovarian serous carcinoma (r= 0.304, P= 0.017). Conclusions The expressions of HIF-1α and bcl-2 play a synergic role in the progression of ovarian serous carcinoma. The combined detection of HIF-1αand bcl-2 is effective for patients'prognosis judgment.

Objective To investigate the assessment of multi-detector spiral CT on the cardiac function after bioprosthetic valve replacement with mitral valve preservation.Methods Thirty-five patients suitable for undergoing bioprosthetic mitral valve replacement in our hospital from May 2012 to February 2014 were randomly divided into 2 groups:group A(experimental group,intraoperative preservation of mitral valve and subvalvular structure during,n=16) and group B (control group,without intraoperative preservation of subvalvular structure of mitral valve,n=19).MDCT before operation and on postoperative 10 d was performed for evaluating the left ventricular function.Results In the comparison of preoperative MDCT,the end diastolic velocity(EDV),end systolic velocity(ESV),ejection fraction(EF) and stroke volume(SV) had no statistical difference between the group A and B.In MDCT results on postoperative 10 d,EDV,ESV and EF in the group A were 113.42±9.22)mL,(38.63±3.40)mL and (51.63±4.71) ％,which in the group B were(113.42 ± 9.22) mL,(38.63 ± 3.40) mL and (51.63 ± 4.71) ％ respectively,the difference was statistically significant(P＜0.05),but SV had no statistical difference between the two groups(P＞0.05).Conclusion The bioprosthetic valve replacement with mitral valve preservation is safe and feasible in technology,moreover effectively protects the postoperative left ventricular function.

Objective To investigate the influence of Yishen granule on the expression of type Ⅳ collagen,laminin (LN)and fibroneetin (FN)in diabetic nephropathy (DN) rats.Methods DN model rats were established by unilateral nephrectomy and intraperltoneal injection of STZ.The experimental rats were divided into six groups:normal group,DN model group,Yishen granule groups in low and high dose (8.1 g/kg、16.2 g/kg) and positive control medicine group with lotensin (0.0015 g/kg).After 16 weeks of treatment,kidney tissues were sampled and pathologically observed through Masson trichrome staining.The proteins of type Ⅳ collagen、LN and FN were determined through immunohistochemical methods.Results The type Ⅳ collagen in normal group,DN model group,Yishen granule groups in low and high dose,and positive control medicine group was (1521.22 ± 415.26),(1579.22 ± 343.26),(3402.00 ± 863.39),(2984.30 ± 674.53),(2959.15 ± 561.22),(2918.04±363.96); LN was (1968.04±522.17),(2004.52±417.19),(3299.04±665.78),(3116.89±540.10),(2932.63 ± 528.38),(2815.89 ± 798.58) ; FN was (2614.67 ± 533.82),(2742.63 ± 562.80),(3311.41 ± 529.29),(2993.44±548.66),(2953.30±535.74),(2897.41 ±505.84) respectively.The level of type Ⅳ collagen、LN and FN expression in Yishen granule group obviously decreased as compared with that in DN model group (P＜0.05).The mesangial cells,basement membrane thickening and endocapillary proliferation in glomerular filtration membrane were significantly alleviated in Yishen granule group.The pathology of kidney was obviously modulated by Yishen granule.Conclusion Yishen granule can significantly inhibits the expression of type Ⅳ collagen、LN and FN in DN rats,which may be the mechanisms for Yishen granule in protecting the DN rat's kidney.

Objective:To compare total percutaneous access using preclose technique with femoral ar-tery cut-down in endovascular aneurysm repair (EVAR)and assess the safety and feasibility of preclose technique.Methods:In the study,81 cases undergoing EVAR from Dec.2011 to Nov.2014 in Peking University People’s Hospital were retrospectively reviewed.Preoperative CT angiography (CTA)showed presence of infrarenal abdominal aortic aneurysm or descending aortic aneurysm in all the cases.The maximum diameter of aneurysm >4.5 cm met the indications for surgical treatment.The conditions of bi-lateral femoral artery and iliac artery CTA showed were good,and there was no moderate or severe steno-sis,nor was there any severe calcification in anterior wall of femoral artery.Not only were the cases fit for percutaneous endovascular aortic aneurysm repair (PEVAR),but also feasible with open endovascular aneurysm repair (OEVAR).According to the intention of the patients about the surgical incision,the ca-ses were divided into group PEVAR and group OEVAR.The data of the general situation,operation time,blood loss,technical success rate,length of hospital stay after procedure and wound complications were analyzed statistically.Results:In the study,44 cases (78 incisions)were enrolled in group PEVAR and 37 cases (65 incisions)in group OEVAR.There was no significant difference between the two groups in age,gender,body mass index (BMI),accompanying diseases,average number of stents and outer diameter of stent delivery system.Average operation time of group PEVAR was less than that of group OEVAR [(119.1 ±102.0)min vs.(163.6 ±61.9)min,P =0.025].The blood loss in group PEVAR was less than that in group OEVAR [(64.7 ±97.0)mL vs.(98.6 ±88.3)mL],but there was no significant difference (P =0.106).There was no difference in the technical success rate (94.9% vs. 95.4%,P =1.000).The average length of hospital stay after procedure was significantly shorter in group PEVAR [(7.8 ±2.8)d vs.(12.3 ±7.2)d,P <0.001].There were 2 cases with subcutaneous hematoma of wound in group PEVAR and 7 cases of wound complications that occurred in group OEVAR including 3 cases with lymphatic leakage,3 cases with lower limb ischemia and 1 case with subcutaneous hematoma.The analysis showed that PEVAR could reduce the wound complications (2.6%vs.10.8%), but there was no significant difference between the two groups (P =0.079).Conclusion:Using preclose technique in EVAR is safe and effective.It can shorten the operation time and length of hospital stay after procedure.

To investigate the effects of 2-(4-methoxycarbonyl-2-tetradecyloxyphenyl)carbamoylbenzoic acid (CX09040) on protecting pancreatic β cells, the β cell dysfunction model mice were induced by injection of alloxan into the caudal vein of ICR mice, and were treated with compound CX09040. Liraglutide was used as the positive control drug. The amount and the size of islets observed in pathological sections were calculated to evaluate the β cell mass; the glucose stimulated insulin secretion (GSIS) test was applied to estimate the β cell secretary function; the oral glucose tolerance test (OGTT) was taken to observe the glucose metabolism in mice; the expressions of protein in pancreas were detected by Western blotting. The effects on the target protein tyrosine phosphatase 1B (PTP1B) were assessed by the PTP1B activities of both recombinant protein and the intracellular enzyme, and by the PTP1B expression in the pancreas of mice, separately. As the results, with the treatment of CX09040 in alloxan-induced β cell dysfunction mice, the islet amount (P<0.05) and size (P<0.05) increased significantly, the changes of serum insulin in GSIS (P<0.01) and the values of acute insulin response (AIR, P<0.01) were enhanced, compared to those in model group; the impaired glucose tolerance was also ameliorated by CX09040 with the decrease of the values of area under curve (AUC, P<0.01). The activation of the signaling pathways related to β cell proliferation was enhanced by increasing the levels of p-Akt/Akt (P<0.01), p-FoxO1/FoxOl (P<0.001) and PDX-1 (P<0.01). The effects of CX09040 on PTP1B were observed by inhibiting the recombinant hPTP1B activity with IC50 value of 2.78x 10(-7) mol.L-1, reducing the intracellular PTP1B activity of 72.8% (P<0.001), suppressing the PTP1B expression (P<0.001) and up-regulating p-IRβ/IRβ (P<0.01) in pancreas of the β cell dysfunction mice, separately. In conclusion, compound CX09040 showed significant protection effects against the dysfunction of β cell of mice by enlarging the pancreatic β cell mass and increasing the glucose-induced insulin secretion; its major mechanism may be the inhibition on target PTP1B and the succedent up-regulation of β cell proliferation.

ThisstudywasaimedtoobservetheinhibitoryeffectsofQi-Zhu (QZ)granulesonearlyproteinuria in diabetic nephropathy rats with syndrome of qi-yin deficiency and phlegm blocking collaterals. A total of 44 rats were randomly divided into the blank group, model group, Huang-Kui capsule group, QZ granules group. The rat model of diabetic nephropathy with syndrome of qi-yin deficiency and phlegm blocking collaterals was induced by the combination of unilateral renal artery ligation, diet of high-calorie and high cholesterol, and intraperitoneal injection of low-dose streptozotocin. The medication was given for 8 weeks. The concentrations of protein and creatinine in urine were observed on the 4th week. The blood glucose, blood lipids, liver function and renal pathological changes were observed at the end of the experiment. The results showed that compared with the model group, QZ granules can obvious suppress early proteinuria in diabetic nephropathy, promote creatinine excretion, regulate blood lipid metabolism, protect liver function and improve renal pathological changes. It was concluded that QZ granules had independent inhibition effect on early proteinuria in diabetic nephropathy rats with syndrome of qi-yin deficiency and phlegm blocking collaterals. The effect was independent of lowing blood glucose. It represented the corresponding relation between the syndrome and efficacy in Chinese herb compounds.

Objective:To establish and validate a prognosis prediction model of gall bladder cancer after surgery based on the albumin-bilirubin (ALBI) grade.Methods:The clinicopathological data of 161 patients with gallbladder cancer undergoing radical surgery in the First Hospital of Jiaxing between March 2011 to January 2020 were retrospectively analyzed, including 44 males and 117 females, aged (65±9) years old. The patients were grouped by the levels of ALBI score. The survival data were obtained through telephone or outpatient review. The Kaplan-Meier method was used to draw the survival curve. Multivariate analysis was performed using the Cox regression analysis model. The time-dependent receiver operating characteristic (ROC) curve was plotted to compare the prognostic value of the scoring system. A nomogram based on ALBI grade was established and its predictive performance was evaluated.Results:The 1, 3, 5 years overall survival (OS) rates of patients with gallbladder cancer were 76.7%, 52.5%, and 41.9%, respectively. The time-dependent ROC curves revealed that the area under the curve (AUC) values of ALBI grade were 0.659, 0.597 and 0.599 for 1, 2 and 3 years, showing a good prognostic performance. Multivariate regression analysis showed that poorer tumor differentiation ( HR=2.890, 95% CI: 1.816-4.600, P<0.001), TNM Ⅲ/Ⅳ stage ( HR=2.832, 95% CI: 1.781-4.503, P<0.001), ALBI grade 2 ( HR=1.595, 95% CI: 1.017-2.500, P=0.042), and ALBI grade 3 ( HR=3.938, 95% CI: 1.375-11.278, P=0.011) were independent risk factors for OS. The nomogram established with the independent risk factors such as ALBI grade showed a good predictive value for OS. The ROC curve results showed that the AUC values for 1, 3 and 5 years were 0.796, 0.806 and 0.799, respectively. The calibration plots and clinical decision curve analysis (DCA) showed the clinical feasibility of this nomogram. Conclusion:The nomogram model based on ALBI grading has a good predictive value for gallbladder cancer after surgery, which could guide the prognosis and individualized treatment decision-making.

Objective:To investigate the factors affecting prognosis of pancreatic cancer patients with carbohydrate antigen 19-9 (CA19-9) negative before surgery.Methods:Retrospectively analyzed the clinic pathological data of 158 patients with pancreatic cancer who underwent radical surgery between November 2011 and August 2022, including 84 males, and 74 females, aged (65±9) years old. Patients were divided into two groups according to CA 19-9 levels over a threshold of 37 U/ml. Patients with CA19-9 levels ≤37 U/ml were included in the CA19-9 negative group ( n=34), while patients with CA19-9 levels >37 U/ml were included in the CA19-9 positive group ( n=124). We performed a comparison between the two groups regarding demographic and clinical data, tumor staging, lymphovascular and nerve invasion and so on. Survival data were extracted from outpatient or telephone records during follow-up. The Kaplan-Meier method was used to draw the survival curve, and the survival rate was compared by log-rank test. Multivariate analysis was performed using the Cox regression analysis model. Results:CA19-9 expression was associated with tumor location and nerve invasion (both P<0.001). There was no significant difference in cumulative survival rate ( χ2=0.07, P=0.787) and progression-free survival rate ( χ2=0.13, P=0.721) between two groups. Multivariate analysis showed that lymphovascular invasion ( HR=5.962, 95% CI: 2.189-16.239, P<0.001) was a prognostic factor for overall survival in the CA19-9 negative group. Age ≤60 years old ( HR=0.306, 95% CI: 0.118-0.796, P=0.015) and lymphovascular invasion ( HR=3.096, 95% CI: 1.232-7.780, P=0.016) were prognostic factors for progression-free survival. Conclusion:Age ≤60 years old and lymphovascular invasion are the influencing factors of poor prognosis in pancreatic cancer patients with CA19-9 negative.