Objective To investigate the clinical effect of prenatal B ultrasound in the diagnosis of fetal hydronephrosis.Methods 105 pregnant women with advanced hydronephrosis in the Department of Ultrasound of our hospital were selected as the research subjects from November 2013 to September 2015.Grignon classification was performed according to the first B ultrasound results,including 2 cases of level Ⅴ,3 cases of level Ⅳ,6 cases of level Ⅲ,30 cases of level Ⅱ and 64 cases of level Ⅰ.The hydronephrosis was reexamined by ultrasonography within the postnatal 24h.Meanwhile,the B ultrasound reexamination was performed in the postnatal 1,3,6 and 12 months.The change of hydronephrosis was observed.Results Among 105 cases of fetal hydronephrosis,64 cases of kidneys at level Ⅰ were improved in the postnatal 6 months,including 46 cases during 1 month and 16 cases during 3 months;30 cases of kidneys at level Ⅱ were improved during 6 months,including 24 cases during 3 months;6 cases of kidneys at level Ⅲ were progressing;Among 3 cases,2 cases of hydronephrosis at level Ⅳ underwent the surgery and 1 case was progressing;2 cases of hydronephrosis at level Ⅴ underwent the surgery.98 cases of hydronephrosis were physiological (93.33％).2 cases of hydronephrosis progression at level Ⅲ required to follow up.MRU examination suggested no surgical indication at present;1 case belonged to the hydronephrosis progression at level Ⅳ.The family members asked to be reviewed.Conclusion The fetal hydronephrosis can be classified accurately through the prenatal B ultrasound examination.The prenatal B ultrasound examination is the best method for the diagnosis and prognosis of fetal hydronephrosis.

OBJECTIVE: To ensure legal,rational and safe use of anesthetic drugs.METHODS: Based on the related laws and regulations as well as the actuality,the regulatory regime on the use of anesthetic drugs was set and enforced.RESULTS: The regulations about the use of anesthetic drugs were able to be implemented satisfactorily,and the regulatory regime has changed the abstract management connotation into rapid process.CONCLUSION: It's operative and efficient to adopt flow management on the use of anesthetic drugs.

Objectives To investigate the clinical significance of dual energy spectral CT (DESCT) in quantitatively differentiating peripheral lung cancers from pulmonary inflammatory masses.Methods Sixty patients with 35 lung cancers and 25 inflammatory masses underwent DESCT to get arterial phase (AP) images and venous phase (VP) images.Iodine concentrations in the central and peripheral zone of the masses were measured and normalized to the aorta as normalised iodine concentration (NIC).The difference of NIC between central and peripheral zone of the masses (dNIC) was calculated.The spectral attenuation curve was obtained automatically and the slope of curve (λHU) was also calculated in the two groups.The quantitative parameters was presented as M (Q1,Q3),and Wilcoxon signed rank test was used to compare above two independent samples.Receiver operating characteristic (ROC) curves were generated to calculate the sensitivity and specificity.Results NICs in the central zone of peripheral lung cancers were significantly lower than that of inflammatory masses:mean NICs were 0.03 (0,0.05) versus 0.12 (0.07,0.20) in AP,and 0.14 (0.12,0.19) versus 0.30 (0.21,0.57) in VP (Z=-4.14,-3.70,respectively,P＜0.01).While the dNIC values of lung cancers were significantly higher than that of inflammatory masses:dNIC values were 0.08 (0.05,0.11) versus 0.04 (-0.02,0.08) in AP,and 0.23 (0.17,0.34)versus 0.07 (-0.04,0.08) in VP(Z=-2.56,-4.00,respectively,P＜0.05).Mean λHU values of lung cancers were also lower than inflammatory masses:1.03 (0.67,1.67)versus 2.75 (1.61,3.19) in AP,and 1.58 (1.30,2.17) versus 3.25 (2.37,4.54) in VP (Z=-3.90,-4.42 respectively,P＜0.01).According to ROC curves,cutoff value of λHU =2.11 in VP had the highest sensitivity (89％) and specificity (91％) in differentiating peripheral lung cancers from inflammatory masses.Conclusions Contrast-enhanced dual energy spectral CT imaging with some quantitative parameters such as normalised iodine concentration,dNIC,and the slope of spectral attenuation curves may be a promising new method for differentiating peripheral lung cancers from inflammatory masses.

With increasing use of carbapenem antibiotics , carbapenems-resistant gram-negative bacteria are spreading, and carbapenemase-producing is the main mechanism of carbapenems resistance . Rapid and accurate identification of carbapenemase and its type is of great importance to timely and effective treatment and control of infections .Chromogenic /Fluorogenic culture media, modified Hodge test and double disk synergy test are traditional methods for carbapenemase detection , but all are time-consuming. Biochemical method is more time efficient and with high sensitivity and specificity , but cannot be used to identify subtypes.Now matrix-assisted laser desorption ionization -time-of-flight mass spectrometry (MALDI-TOF MS) has been successfully applied in the identification of species , subtypes and detection of drug -resistant genes.And among various carbapenemase gene detection techniques , next generation sequencing (NGS) can also be used for the detection of integrons , transposons and plasmids, which is important in both epidemiology and resistant mechanism studies .This article reviews the advantages and disadvantages of various methods for phenotype and gene detection of carbapenemase .

Objective To systematically review the cardioprotection induced by sevoflurane postconditioning in the patients undergoing cardiac surgery with cardiopulmonary bypass.Methods Databases including Pubmed,EMBase,Web of Science,Cochrane Library,CBM,WangFang Data,CNKI and VIP were searched by a computer from the date of database establishment up to February 2019 and there was no limitation for language.The randomized control trials involving the cardioprotection induced by sevoflurane postconditioning in the patients undergoing cardiac surgery with cardiopulmonary bypass were collected.Evaluation indexes included:incidence of perioperative cardiac events,duration of intensive care unit stay,plasma concentrations of cardiac troponin I and creatine kinase-MB at 6 and 24 h after aortic opening,plasma concentrations of interleukin-6 at 2,12 and 24 h after aortic opening and percentage of spontaneous recovery of heart beat.Meta-analysis was conducted using the RevMan 5.3 and Stata 12.0 softwares.Results Seventeen randomized controlled trials involving 763 patients were included in our meta-analysis.Compared with control group,the incidence of reperfusion arrhythmia was decreased,the plasma concentrations of cardiac troponin I and creatine kinase-MB at 6 and 24 h after aortic opening and interleukin-6 at 2,12,and 24 h after aortic opening were decreased,the percentage of spontaneous recovery of heart beat was increased (P＜0.05 or 0.01),and no significant change was found in duration of intensive care unit stay in sevoflurane postconditioning group (P ＞ 0.05).Conclusion Sevoflurane postconditioning can produce cardioprotection in the patients undergoing cardiac surgery with cardiopulmonary bypass.

Objective To explore the molecular mechanism of Xiaojin Pills in the treatment of breast cancer using an integrated network pharmacology and experimental verification.Methods The chemical components and potential targets of Xiaojin Pills were obtained from TCMSP,TCM-ID,ETCM and SwissTargetPrediction databases.Breast cancer related targets were collected from GeneCards,OMIM and KEGG databases.The overlapped targets were imported into STRING database to analysis a protein-protein interaction(PPI).The key targets of PPI networks were screened based on node topology parameter values through Cytoscape 3.8.0.DAVID database was used to analyze the GO and KEGG pathway enrichment to build drug-chemical components-key targets-signaling pathway network.The breast cancer cell lines MDA-MB-231 and SK-BR-3 were used to study the effects of Xiaojin Pills extract on cell apoptosis,migration and invasion,and to verify the key pathway obtained by enrichment analysis.Results Totally 181 chemical components in Xiaojin Pills were obtained,including quercetin,myricetin,pinocembrin and β-sitosterol.615 potential targets were identified for the anti-breast cancer effects of Xiaojin Pills.After overlapping,170 key targets against breast cancer were identified based on the topological analysis,which included SRC,ERK1/2,AKT1,EGFR,etc.KEGG analysis enriched pathways including pathways in cancer,MAPK signaling pathway,endocrine resistance,PI3K-AKT signaling pathway,EGFR tyrosine kinase inhibitor resistance,apoptosis,and HIF-1 signaling pathway,which may play important roles in the therapeutic effects of Xiaojin Pills against breast cancer.GO enrichment was involved in protein phosphorylation,inflammatory response,negative regulation of apoptosis,and positive regulation of ERK1 and ERK2 cascades.Cell experiments showed that Xiaojin Pills further induced mitochondria-dependent apoptosis by inhibiting the activation of MAPK and PI3K-AKT pathways.At the same time,the expressions of ZO-1 and β-catenin increased,and the epithelial-mesenchymal transformation process was reversed to inhibit the metastasis of breast cancer cells.Conclusion The key targets and signaling pathways of Xiaojin Pills in the treatment of breast cancer are studied through network pharmacology combined with in vitro experiments,which provided a basis for further study of its pharmacodynamic material basis,mechanism of action and clinical application.

Objective To analyze the epidemiological characteristics of hepatitis B in Guangzhou from 2006 to 2018. Methods The data were retrieved from the National Infectious Disease Surveillance Information Report Management System. Descriptive methods were used to analyze and summarize the results. Chi-square test was used for statistical analysis of classification data, and Joinpoint software was used to analyze the annual change percentage and trend. Results A total of 292 674 cases of hepatitis B were reported in Guangzhou from 2006 to 2018, and the annual average reported incidence was 182.2 per 100,000. Chronic hepatitis B was the main type, accounting for 89.9%. The incidence rate of males (241.6 / 105) was higher than that of females (117.9 / 105), with a ratio of 2.0:1. During the period from 2006-2018, the reported incidence of hepatitis B in Guangzhou first increased, reached the highest in 2008, and then decreased year by year. There was no significant difference in the number of HBV cases among different months. The average onset age of hepatitis B reported in Guangzhou was 39.3 years old, and the average onset age increased year by year from 2006 to 2018. Conclusion The incidence rate of hepatitis B in Guangzhou has decreased since 2008, but it was still higher than the national average incidence rate. The hepatitis B infection in Guangzhou remains a big issue. It is suggested to further strengthen the prevention and control of hepatitis B in adults by maintaining a national immunization program for children, thereby reducing the epidemiological level of hepatitis B in Guangzhou.