Objective To realize the distribution and change in antimicrobial resistance of common pathogens causing acute lower respiratory tract infection (LRTI)in children,and provide evidence for rational use of antimicrobial agents. Methods Data about pathogens from children with LRTI in a hospital between January 2011 and December 2013 were ana-lyzed statistically.Results Of 934 isoalted pathogenic strains,728 (77.94%)were gram-negative bacteria,the major were Klebsiella pneumoniae (n =278),Escherichia coli (n =216),Enterobacter cloacae (n =85 ),and Pseudomonas aeruginosa (n=63).The isolation rate of gram-positive bacteria was 20.87%(n=195),the major were Staphylococcus aureus (n=132)and Streptococcus pneumoniae (n=49).Antimicrobial susceptibility testing results revealed that sensitive rate of gram-negative bacteria to imipenem,meropenem,and amikacin were all 100.00%,to ceftazidime/clavulanic acid and piperacillin/tazobactam were relatively low,to cephalosporins increased year by year.Sensitive rates of the main gram-positive bacteria to vancomycin were both 100.00%, to erythromycin and clindamycin were relatively low. Conclusion The major pathogenic bacteria causing LRTI in pediatric department are gram-negative bacteria,antimicrobial resistance rates increased year by year,management of antimicrobial use in children should be strengthened to prevent the occurrence of multidrug-resistant organism infection.

Objective To explore the application of lentil lectin‐reactive alpha‐fetoprotein ratio (AFP‐L3% ) applied in the dif‐ferential diagnosis between hepatitis B infection of primary liver cancer and benign liver disease .Methods We included 108 cases of chronic HBV infection ,including 50 cases of primary liver cancer ,42 cases of cirrhosis ,16 cases of chronic hepatitis .Chemilumines‐cence detection was used to detect alpha‐fetoprotein (AFP) and AFP‐L3 content ,AFP‐L3 and the ratio of AFP (AFP‐L3% ) was calculated .Results AFP≥400 ng/mL as primary liver cancer diagnostic threshold ,the sensitivity and specificity were 36% ,84% , when used AFP‐L3% ≥ 10% as primary liver cancer diagnostic threshold ,the sensitivity and specificity were 62% ,83% . Conclusion AFP‐L3% is a better clinical indicator to distinguish between primary liver cancer and benign liver disease .AFP‐L3%can be used as a clinical indicator to differential diagnosis between HBV infection of primary liver cancer and benign liver disease .

BACKGROUND:Pain is the main clinical manifestation for ankylosing spondylitis. At present, nonsteroid anti-inflammatory drugs are oral y taken, but the effects are limited and toxic and side effects are more. Thus, there is no effective scheme for treatment of pain induced by ankylosing spondylitis.
OBJECTIVE:To investigate the correlation between postoperative joint pain al eviation and al ogeneic blood transfusion, and the mechanisms.
METHODS:We retrospectively analyzed clinical data of 88 ankylosing spondylitis patients combined with kyphosis who received only one section of osteotomy surgery merging hip joint pain. We compared the visual analog scale score of hip joint and detected the variation of leucocytes, lymphocytes and immunoglobulin concentrations before and after the operation in the groups of fresh al ogeneic whole blood transfusion, autologous whole blood transfusion, and mixed transfusion of al ogeneic and autologous whole blood. Flow cytometry was used to analyze the number and ratio of peripheral blood Th17 cells and Treg cells which were both highly associated with autoimmune diseases.
RESULTS AND CONCLUSION:The symptom of hip arthralgia obviously improved in both groups transfused by fresh al ogeneic whole blood or al ogeneic-autologous mixed whole blood. However, no obvious variation was detected in leucocytes, lymphocytes and immunoglobin concentration. However, flow cytometry results indicated that Th17/Treg proportion associated with autoimmune diseases was increased remarkably in peripheral blood of ankylosing spondylitis patients. Results suggested that al ogeneic whole blood transfusion can al eviate patients’ joint pain by correcting the imbalance of Th17/Treg which may improve their immune state.

Objective The aim of this study was to investigate the effect and mechanism of pterostilbene on apoptosis and glycolysis of ovarian cancer SKOV3 cells. Methods SKOV3 cells were treated with 0,25,50,100 and 150 μmol/L of pterostilbene for 24,48 and 72 hours. The proliferation of SKOV3 cells was measured by CCK. The effect of pterostilbene on apoptosis of SKOV3 cells was determined by flow cytometry. The glucose consumption and lactate production were detected by glucose oxidase assay and chemical colorimetry. The expression of signal transducer and activator of transcription 3 ( STAT3 ), phosphorylated STAT3 ( p -STAT3) and hexokinase 2 ( HK2) proteins was detected by Western blot. The expression of glucose transporter 1 ( GLUT1) and M2 pyruvate kinase(PKM2)mRNA was detected by qRT-PCR. Results Pterostilbene inhibited the proliferation of SKOV3 cells in a time- and dose-dependent manner. According to CCK-8 results,100 μmol/L of pterostilbene was selected as the follow-up ex-perimental group and 0 μmol/L as a control group. Pterostilbene could significantly promote the apoptosis of SKOV3 cells in a dose-dependent manner. The higher the concentration,the more obvious apoptosis effect,the difference was statistically significant ( P <0. 05). In addition,the levels of glucose consumption and lactate production in the 100 μmol/L group were significantly lower than those in the 0 μmol/L group(P<0. 01). The expression of p-STAT3 and HK2 protein in the 100 μmol/L group was also significant-ly lower than those in the 0 μmol/L group(P<0. 001). The expression of GLUT1and PKM2 mRNA in the 100 μmol/L group was also significantly decreased than those in the 0 μmol/L group(P<0. 01). Conclusion Pterostilbene can inhibit the proliferation of SK-OV3 cells and promote apoptosis,and may inhibit the glycolysis of ovarian cancer through a STAT3/HK2 pathway.

By analyzing and comparing the IVD product classification supervision system in the EU's new IVDR, old IVDD and related guidance documents, concepts of related regulatory reforms were analyzed and explored, to provide references for industrial personnel to understand and master the new EU IVD classification system, and for China's ongoing classification management reform.
European Union ; Industry ; Reagent Kits, Diagnostic

Objective:To explore the chest drainage effect of use different diameter thoracic drainage tube after biportal thoracoscopic radical resection for lung cancer.Methods:300 patients with lung cancer who received biportal thoracoscopic radical resection were divided into group A and group B from January 2018 to September 2020. Group A: 150 patients with single 28# thoracic drainage tube after surgery. Group B: 150 patients with single 20# thoracic drainage tube and a negative pressure drainage ball after surgery. The postoperative drainage volume, drainage time, postoperative pain, postoperative thoracic puncture, hospital stay and total hospital expenses were compared.Results:No significant difference between the two groups in terms of sex, age, postoperative pathological type and resection range. There no significant difference between the two groups in total drainage volume [(1 010.31±525.29)ml vs.(985.35±403.93)ml] and total drainage time [(5.69±2.55)days vs.(5.42±1.94)days]. The difference of different diameter thoracic drainage tube used [(5.69±2.55)days vs.(2.88±0.64)days] was statistically significant. There were significant differences between two groups in terms of hospital stay[(12.64±2.89)days vs.(11.25±1.62)days] and total hospital expenses[(62 899.00±1 588.82) yuan vs.(64 327.00±3 587.04)yuan]. No significant differences on the postoperative first day, second day and third day in VAS pain scores. However, on the postoperative fifth day, the difference was statistically significant. In addition, the rate of group A postoperative thoracic puncture was 10%, group B was 0, the comparison was statistically significant.Conclusion:Using a single thin thoracic drainage tube and plus a negative pressure drainage ball after biportal thoracoscopic radical resection for lung cancer will not cause pain increase, shorten hospital stay days, control the rate of postoperative thoracic puncture and then reduce patients total hospital expenses.

Bone defects caused by different causes such as trauma, severe bone infection and other factors are common in clinic and difficult to treat. Usually, bone substitutes are required for repair. Current bone grafting materials used clinically include autologous bones, allogeneic bones, xenografts, and synthetic materials, etc. Other than autologous bones, the major hurdles of rest bone grafts have various degrees of poor biological activity and lack of active ingredients to provide osteogenic impetus. Bone marrow contains various components such as stem cells and bioactive factors, which are contributive to osteogenesis. In response, the technique of bone marrow enrichment, based on the efficient utilization of components within bone marrow, has been risen, aiming to extract osteogenic cells and factors from bone marrow of patients and incorporate them into 3D scaffolds for fabricating bone grafts with high osteoinductivity. However, the scientific guidance and application specification are lacked with regard to the clinical scope, approach, safety and effectiveness. In this context, under the organization of Chinese Orthopedic Association, the Expert consensus for the clinical application of autologous bone marrow enrichment technique for bone repair ( version 2023) is formulated based on the evidence-based medicine. The consensus covers the topics of the characteristics, range of application, safety and application notes of the technique of autologous bone marrow enrichment and proposes corresponding recommendations, hoping to provide better guidance for clinical practice of the technique.

Objective     To explore the correlation between the imaging features of peripheral ground-glass pulmonary nodules and the invasion degree of lung adenocarcinoma, and the high risk factors for infiltrating lung adenocarcinoma under thin-slice CT, which provides some reference for clinicians to plan the surgical methods of pulmonary nodules before operation and to better communicate with patients, and assists in building a clinical predictive model for invasive adenocarcinoma. Methods    Clinical data of the patients with peripheral ground-glass pulmonary nodules (diameter≤3 cm) in thin-slice chest CT in the First Affiliated Hospital of Soochow University from January 2019 to January 2020 were continuously collected. All patients underwent thin-slice CT scan and thoracoscopic surgery in our center. According to the pathological examination results, they were divided into two groups: an adenocarcinoma lesions before infiltration group, and an invasive lung adenocarcinoma group. The thin-slice CT imaging parameters of pulmonary nodules were collected. The nodular diameter, mean CT value, consolidation tumor ratio (CTR), nodular shape, vacuolar sign, bronchial air sign, lobulation sign, burr sign, lesion boundary, pleural depression sign, vascular cluster sign and other clinical data were collected. Univariate and multivariate analyses were conducted to analyze the independent risk factors for the infiltrating lung adenocarcinoma, and to analyze the threshold value and efficacy of each factor for the identification of infiltrating lung adenocarcinoma. Results     Finally 190 patients were enrolled. There were 110 patients in the adenocarcinoma lesions before infiltration group, including 21 males and 89 females with a mean age of 53.57±10.90 years, and 80 patients in the invasive lung adenocarcinoma group, including 31 males and 49 females with a mean age of 56.45±11.30 years. There was a statistical difference in the mean CT value, nodular diameter, CTR, gender, smoking, nodular type, nodular shape, vacuolar sign, lobulation sign, burr sign, lesion boundary, pleural depression sign, vascular cluster sign between the two groups (P<0.05). However, there was no statistical difference between the two groups in age (P=0.081), lesion site (P=0.675), and bronchial air sign (P=0.051). Multiple logistic regression analysis showed that nodular diameter, mean CT value, CTR and lobulation sign were independent risk factors for differentiating preinvasive adenocarcinoma from invasive adenocarcinoma. At the same time, the threshold value was calculated by Youden index, indicating that the CTR was 0.45, the nodal diameter was 10.5 mm and the mean CT value was –452 Hu. Conclusion     In the peripheral ground-glass pulmonary nodules, according to the patient's CT imaging features, such as mixed ground-glass nodules, irregular shapes, vacuoles, short burrs, clear boundaries, pleural indentations, and vascular clusters, have a certain reference value in the discrimination of the invasion degree of ground-glass pulmonary nodules. At the same time, it is found in this research that peripheral ground-glass pulmonary nodules with diameter greater than 10.5 mm, CT value greater than –452 Hu, CTR greater than 0.45 and lobulation sign are more likely to be infiltrating lung adenocarcinoma.

OBJECTIVETo evaluate the clinical outcomes of total en-bloc spondylectomy (TES) in recurrence spinal tumor.

METHODSThe study was a retrospective study of recurrence spinal tumor from January 2010 to October 2013. A total of 6 patients with recurrent spinal tumor underwent TES procedures, with 5 cases located in thoracic spine and 1 case located in L1. There were 3 male and 3 female patients, with a mean age of 33.2 years. Pathological diagnosis included giant cell tumor of bone in 3 cases, breast cancer, lung cancer and nasopharyngeal carcinoma with 1 case in each. The operation time, bleeding loss, resected segments, cutting edge, spinal cord function and complications was evaluated.

RESULTSSingle segment resected in 1 case, 2 segments resected in 2 cases and 3 segments resected in 3 cases. The average operation time was 8.9 hours (7.5 to 12.0 hours). The average blood loss was 3 116 ml (2 500 to 4 500 ml). The average follow-up period was 23.2 months (12 to 47 months) without recurrence. There was no spinal cord injury during operation. The neurologic function was significantly improved in 2 cases (American Spinal Injury Association (ASIA) grade C to grade D), unchanged in 1 cases (ASIA grade B) and no deteriorated case in 3 cases (ASIA grade E). There was no perioperative deaths case. Complications included 2 cases pleural rupture, 1 case dural tear and 1 case massive haemothorax. No peri-operation death case.

CONCLUSIONSome of the recurrent spinal tumors are still suitable for en-bloc resection and TES procedure with the extent of its applicability under strict control.

Adult ; Female ; Humans ; Lung Neoplasms ; Male ; Neoplasm Recurrence, Local ; Retrospective Studies ; Spinal Cord Neoplasms ; Spinal Neoplasms ; surgery ; Spine