OBJECTIVE The antimicrobial activity in vitro of mezlocillin／sulbactam(MLBT),piperacillin／tazobactam(Tazocillin,TZXL),mezlocillin(MLXL) and ticarcillin／clavulanic acid(Timentin TMT) against 179 clinical isolates was studied.METHODS MICs were determined by agar dilution method.RESULTS The antimicrobial activity in vitro of MLBT against clinical bacteria was 1-2 times higher than that of MLXL.In vitro,MLBT has higher susceptibility than MLXL against Escherichia coli which have higher rate producing β-lactamase,such as Enterobacter species,Acinetobacter species,et al.,and has higher susceptibility than TMT against Enterobacter and other G- bacillus(P＜0.01).MLBT and TZXL have similar antibacterial spectrum and activity susceptible rate.MIC50 of TZXL was 1-2 times lower than that of the MLBT,but there were no siginficant differences. CONCLUSIONS The antimicrobial spectrum and antimicrobial activity in vitro of MLBT were similar to that of TZXL.

[ ABSTRACT] AIM:In this study, we aim to obtain the induced pluripotent stem cells ( iPSCs) from the patients with sporadic Alzheimer disease ( AD) .METHODS:Three typical Alzheimer’ s patients were chosen, and the epithelial cells were isolated from their urine.We reprogrammed these cells into induced pluripotent stem cells by transfection of 4 factors (Oct4, Sox2, Klf4 and SV40LT) with the technique of electro-transfection.After getting these iPSCs, we continue to differentiate them into neural cells by a specific method—dual inhibition of Smad signaling.RESULTS: The primary cells from 3 AD patients were successfully reprogrammed to iPSCs, and these patients-derived iPSCs were differentiated into neural cells.There was no significant difference, during iPSCs reprogramming and neural differentiation, between cells from AD patients and normal people.CONCLUSION: The urine cells from AD patients were able to transfer to iPSCs, functional neurons and neurogliocytes.

Objective To evaluate balloon angioplasty and stenting of the hepatic veins for the treatment of Budd-Chiari syndrome with long segmental inferior vena cava (IVC).Methods The hepatic veins were evaluated by colour Doppler,CT or MR.Epidiaphragmatic inferior vena cavography was performed to locate the stenused opening of the hepatic veins,in case of membrane occlusion of the hepatic veins,a puncture was attempted with Rups100 needle and then balloon dilation of the hepatic veins and stents implantation was carried out.Results In 40 cases of long segmental inferior vena cava ( IVC ) occlusive Budd-Chiari syndrome,membranous obstruction of the hepatic veins was found in 5 cases and short-segmental occlusion in 24 cases.28 cases were successfully treated with balloon dilation and stents implantation,including percutaneous transluminal angioplasty(PTA) of hepatic vein in 5 cases,and stent implantation in 23 cases,puncture procedure was failed in 1 case.Postoperative follow-up was made in 26 cases from 6 to 62 months ( mean,24.0 ± 1.3 months ).Symptoms recurred in 6 cases.Hepatic vein restenosis or occlusion were observed using color Doppler ultrasound in 6 cases.Conclusions Most lesions in hepatic veins were membranous obstruction or short-segmental occlusion among patients with long-segmental occlusion of IVC.Balloon angioplasty and stenting of hepatic veins for long segmental IVC occlusive Budd-Chiari syndrome through jugular vein can relieve hepatic venous obstruction and relieve portal hypertension.

Moxibustion,which is simple for manipulation and effective,has always been a very important way for external treatment.Acupuncture and moxibustion were complementary to each other sincc ancient times.but modem people usually only pay attention to acupuncture and neglect the usage of moxibustion.In this paper the importance of moxibustion is expounded briefly.

OBJECTIVETo investigate the cytogenetic differences between children and adults with acute lymphoblastic leukemia (ALL) using eight-probe fluorescence in situ hybridization and karyotype analysis.

METHODSEight-probe (MYC, P16, E2A, TEL/AML1, BCR/ABL , MLL , IGH, and hyperdiploidy) fluorescence in situ hybridization and karyotype analysis were performed for 86 adults and 39 children with acute lymphoblastic leukemia.

RESULTSEight-probe fluorescence in situ hybridization showed significant differences in the positivity rate of TEL/AML1, BCR/ABL, and hyperdiploidy between adult patients and children with ALL. By karyotype analysis, the positivity rate of t(9;22) and hyperdiploidy differed significantly between the children and adult patients (P<0.05).

CONCLUSIONAdults and children with ALL have different expression profiles of the fusion genes. Eight-probe fluorescence in situ hybridization is time-saving, accurate and efficient in detecting common genetic abnormalities in ALL patients, and can be well complementary to karyotype analysis in clinical diagnosis of ALL.

Adolescent ; Adult ; Child ; Child, Preschool ; Cytogenetics ; Female ; Humans ; In Situ Hybridization, Fluorescence ; methods ; Infant ; Karyotype ; Karyotyping ; Male ; Middle Aged ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; diagnosis ; genetics ; Young Adult

Objective To evaluate the safety of Propofol combined with Fentanyl in intravenous anesthesia for endoscopic retrograde cholangiopancreatography(ERCP)in elderly patients.Methods The clinical data of 63 elderly patients aged ≥80 years with common bile duct stones who underwent ERCP in digestive endoscopy center of our hospital were retrospectively analyzed.All the patients were divided into Propofol combined with Fentanyl anesthesia group(group A,n =41)and midazolam combined with Fentanyl anesthesia group(group B,n=22).The changes of blood pressure,heart rate and blood oxygen saturation(SpO2),and postoperative complications were compared between the two groups.Results The incidence of hypotension was higher in Propofol combined with Fentanyl anesthesia group than in midazolam combined with Fentanyl anesthesia group(24.4 ％ vs.0.0％,x2=4.683,P =0.030),but the incidence of SpO2 ＜ 90 ％ in midazolam combined with fentanyl anesthesia group was significantly increased(22.7％ vs.0.0％,x2 =7.250,P =0.007).There was no statistically significant difference in the incidence of anesthesia-related complications (39.0％ vs.36.4％,x2 =0.043,P =0.836) and postoperative complications (4.9 ％ vs.4.5 ％,x2 =0.003,P =0.953) between the two groups.Conclusions For elderly patients with common bile duct stones,intravenous anesthesia with Propofol and Fentanyl during ERCP is safe,and blood pressure changes need to be closely monitored.

Objective: The study aimed to explore the recommended treatment for toxicosis of botulism toxin type A. Methods: From January 2016 to August 2017, 8 patients with toxicosis of botulism toxin type A were hospitalized in Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine. All patients were female, 21-33 years of age, with an average age of 26.4 years. All patients showed progressive myasthenia and abnormal electromyography. The clinical manifestations and treatment outcomes of 8 patients in antitoxin group or non-antitoxin group were retrospectively analyzed. Five patients treated in plastic and reconstructive surgery department were included in the antitoxin group. They received skin test before injection, followed by intramuscular injection of 10 000-20 000 U antitoxins once a day for 2-3 days. Three patients treated in neurology department were included in the non-antitoxin group. They received only intravenous drip of neurotrophic drugs. After treatment, the improvement of clinical symptoms such as myasthenia and blepharoptosis was observed, and the electromyogram was followed up. Results: The symptoms of myasthenia of the 5 patients in antitoxin treatment group were significantly improved, and the electromyogram signal returned to normal. However, for the 3 patients in non-antitoxin group, the symptoms of myasthenia did not significantly improve, and their electromyogram signal did not return to normal, even after 5 days′continuous treatment. Conclusions To regulate the cosmetic medical market is the key to prevent the accident of toxicosis of botulism toxin type A. It is necessary to make a definite diagnosis and medical intervene in time for the toxicosis. Antitoxin has a better curative effect, but further research is needed, to verify its safety and effectiveness.

Objective:To analyze the case fatality rate of HIV/AIDS cases and influencing factors in Jingzhou.Methods:The data were retrieved from HIV/AIDS Comprehensive Response Information System and the cases diagnosed with HIV/AIDS in Jingzhou during 1996-2021 and aged 15 years or older were selected for the study. The death curve was drawn with Kaplan-Meier method, and Cox proportional-hazards model was used to identify influencing factors for death.Results:A total of 3 304 HIV/AIDS cases were followed up for 16 091.5 person-years, and 893 cases died, with a case fatality rate of 5.5/100 person-years. The cumulative case fatality rates of 1, 5 and 10 years were 15.4%, 25.0% and 34.6% respectively, the cumulative case fatality rates of 1, 5 and 10 years were 6.9%, 14.4% and 23.7% in the cases with access to antiretroviral therapy (ART), and 68.0%, 90.1% and 98.7% in the cases without access to ART. The results of Cox proportional hazards regression model showed that the risk for death was higher in those without access to ART than in those with access to ART (a HR=9.85, 95% CI: 8.19-11.85). The risk factors for death in those with access to ART included being men (a HR=1.64, 95% CI: 1.29-2.08), age ≥60 years old at diagnosis (a HR=3.52, 95% CI: 2.38-5.20), being infected by injecting drug use/others (a HR=2.38, 95% CI:1.30-4.34), being detected by medical institution (a HR=1.53, 95% CI: 1.11-2.11), CD4 +T lymphocytes(CD4) counts <50 cells/μl (a HR=2.58, 95% CI: 1.87-3.58). The protective factor for death was high education level (high school and technical secondary school: a HR=0.64,95% CI:0.46-0.90; college and above: a HR=0.42, 95% CI: 0.24-0.73). The risk factors for HIV/AIDS death in those without access to ART included older age at diagnosis (30-44 years old: a HR=2.32, 95% CI: 1.40-3.84; 45-59 years old:a HR=2.61, 95% CI: 1.59-4.27; ≥60 years old: a HR=3.31, 95% CI: 2.01-5.47), lower CD4 counts (<50 cells/μl: a HR=10.47, 95% CI: 6.47-16.56; 50-199 cells/μl: a HR=2.31, 95% CI: 1.08-4.94; 200-349 cells/μl: a HR=2.35, 95% CI: 1.46-3.79). Conclusions:The case fatality rate of HIV/AIDS was relatively high in Jingzhou from 1996 to 2021, the first CD4 counts, ART and age at diagnosis were the major factors affecting HIV/AIDS death, "Expanding testing" and "prompt treatment upon diagnosis" should be continued and enhanced to improve the efficacy of ART and HIV/AIDS case survival.

Objective:To investigate the feasibility and advantages of unilateral primary hyperparathyroidism (PHPT) treated by transthyretal interosseous muscle approach surgery.Methods:Clinical data of 7 patients with unilateral PHPT treated by interstitial sternocleidomastoid muscle approach from Jan. 2021 to Feb. 2022 in the thyroid surgery of China-Japan Union Hospital of Jilin University were retrospectively analyzed, including preoperative blood calcium concentration, operation time, incision length, intraoperative parathyroid hormone (PTH) , blood calcium concentration and PTH value in the first month after surgery, abnormal sensation of the skin in the anterior cervical area, etc. The feasibility and advantages of interstitial sternocleidomastoid muscle approach surgery for unilateral PHPT were analyzed.Results:All 7 patients with unilateral PHPT were operated successfully. The PTH was 17.2-63.3 pg/ml on recheck 1 month after surgery, which were all within the normal range. The time from skin opening to resection of the diseased parathyroid gland was 20-35 min, and the length of the surgical incision was 3-4 cm. all patients were given intravenous and oral calcium therapy after surgery, and the blood calcium and PTH levels were within the normal range at 3-12 months of follow-up; the incision recovered well, and there was no significant sensory and functional abnormalities in the anterior neck area.Conclusion:The treatment of unilateral PHPT through the sternocleidomastoid interosseous approach can ensure the safety and efficacy of the operation while better protecting the sensory and motor functions of the anterior cervical region and improving the aesthetics of the surgical incision.