Objective To establish human colon carcinoma LoVo/Adr cell line with multidrug resistance (MDR) and to study its MDR mechanism. Methods MDR cell line (LoVo/Adr) was induced by stepwise selection on exposure to increasing doses of adriamycin (ADR). The MDR of LoVo/Adr was detected by MTT assay and the distribution of its cell cycle was detected by flow cytometry. The expression of MDR related genes, including mdr1, MRP, GST ? and TopoⅡ was measured by RT PCR and the level of P gp was detected by immunohistochemistry. Results Compared with parental cells, the resistance line had a slower growth rate and longer doubling time. It was larger and mixed with giant cells in different sizes and the number of cells in S phase decreased while that in G1, G2 phase increased. The LoVo/Adr cell line showed 61 fold, 14 fold, 3 fold, 9 fold and 1 fold higher resistance to ADR, VCR, MMC, CTX and 5 FU respectively than its parental cell line. It was also cross resistant to VCR, MMC and CTX, but not to 5 FU. The parental LoVo cells showed no mdr1 expression and the level of mdr1 mRNA expression increased gradually according to the concentration of ADR in resistant cell lines, and the level of GST ? mRNA was only increased significantly in the induced initial stage, although the parental LoVo cells expressed a low level of GST ?. MRP mRNA expression was not detected in both parental cell line and resistant cell lines. The level of Topo ⅡmRNA remained stable. Conclusions LoVo/Adr cell line offers a model with a typical MDR phenotype for the study of MDR in human colon cancer. Its drug resistance was mediated by mdr1 and GST ?, not MRP and TopoⅡ.

Objective:To study the differences of ventilation function in patients between chronic right heart failure secondary to pulmonary arterial hypertension and chronic whole heart failure secondary to left heart diseases.
Methods:A total of 102 patients with clinical stable chronic heart failure (CHF) were studied. The patients were divided into 2 groups:Whole heart failure (WHF) group, n=41 and Right heart failure (RHF) group, n=61. The ventilation function test at rest and cardiopulmonary exercise test (CPX) were conducted and compared between 2 groups.
Results: The rest ventilation function was similar between 2 groups. For CPX examination, compared with WHF group, RHF group had the lower peak minute ventilation (VE), higher anaerobic threshold and peak minute ventilation/CO2 production (VE/VCO2), higher peak dead space volume/tidal volume (VD/VT), all P<0.05.
Conclusion:At exercise condition, RHF patients had decreased ventilation function and ventilation index due to severe abnormality of ventilation/perfusion (V/Q).

Objective To investigate whether the colonoscopy skills could be retained after the endoscopy simulator training,and to find evidence for curriculum design.Methods A total of 14 trainees received virtual reality simulator colonoscopy training and took a standardized VR colonoscopy test at the end of training and at 6 months later without practice during the time period.Results Scores drastically decreased at 6 months after training when compared to those right after the training.Although there was no difference in safety or accuracy,there was significant difference in the residual air volume,intestinal loop and procedure time.Conclusion Some skills acquired by using the Endoscopy Simulator can be retained,but other skills may be lost,which requires more practice.

OBJECTIVETo analyze the epidemiological characteristics and the bacterial pathogen composition of pneumonia among children under 5 years old in Ningbo.

METHODSIn 2013 February-April, we selected pediatric ward in three hospitals according to stratified cluster random sampling, and from which we collected all 57 556 hospitalized cases in January 2009-December 2012 period of children under 5 years old. A total of 16 740 medical records and bacterial spectrum records of pneumonia or bronchial pneumonia cases among children under 5 years old were described to calculate the proportions of children pneumonia or bronchial pneumonia hospitalized cases accounted for hospitalized children over the same period(referred to as proportions of pneumonia incidence), the detection rate of bacterial pathogens, proportions of bacterial spectrum, and to analyze the characteristics and bacterial pathogen composition of pneumonia among children under 5 years.

RESULTSThe proportions of children pneumonia in 2009-2012 were 26.16% (2 882/11 017), 31.23% (4 004/12 819), 29.35% (4 898/16 689) and 29.10% (4 956/17 031)(Z = 3.13, P < 0.01), and were in a downward trend by the increasing of age(Z = -113.74, P < 0.01). The proportions of children pneumonia of 0-5 age group were 50.71% (6 756/13 318), 26.60% (3 159/11 877), 24.17% (2 574 /10 648), 22.36% (2 509 /11 223) and 16.63% (1 745 /10 490). The proportions of children pneumonia with different season were 26.90% (3 725/13 850), 26.51% (3 788/14 287), 29.59% (4 442/15 011) and 33.21% (4 785 /14 408) (χ² = 198.77, P < 0.01). The proportions of severe children pneumonia of 0-5 age group were 1.10% (74/6 753), 0.47% (15/3 159), 0.19% (5 /2 574),0.08% (2 /2 509) and 0.06% (1 /1 745), with a downward trend by the age(F = 57.62, P < 0.01). The detection rate of Klebsiella pneumoniae, Haemophilus influenzae,Acinetobacter baumannii, Escherichia coli, Staphylococcus aureus, and Streptococcus pneumoniae was 19.3% (540/2 805), 16.4% (460/2 805), 13.6% (381/2 805), 11.9% (335/2 805), 11.5% (323/2 805) and 6.8% (192/2 805).

CONCLUSIONIn 2009-2012, the proportions of children pneumonia under 5 year old constituted a relatively high proportion in Ningbo city. Children under 1 year old were the major suffering group of pneumonia and severe pneumonia, which should be the key prevention group. The major bacterial pathogens of children's pneumonia in Ningbo are gram-negative bacteria.

Acinetobacter baumannii ; Child ; Epidemics ; Escherichia coli ; Gram-Negative Bacteria ; Haemophilus influenzae ; Humans ; Incidence ; Infant ; Klebsiella pneumoniae ; Pneumonia ; Staphylococcus aureus ; Streptococcus pneumoniae

Objective:To construct and validate a predictive model for the risk of excessive blood loss in pa-tients with ruptured tubal pregnancy,and to provide a basis and tool for the assessment of changes in the condi-tion of patients with ruptured tubal pregnancy.Methods:Clinical data of inpatients with ruptured tubal pregnancy from January 2014 to July 2021 were retrospectively analyzed,who underwent surgical treatment in the Depart-ment of Gynecology,Dongguan Maternal and Child Health Hospital.The pelvic blood volume was categorized into excessive blood loss and non-excessive blood loss groups based on whether the amount of pelvic blood was found to be≥750 ml intraoperatively.Factors influencing the occurrence of excessive blood loss were screened and modeled by univariate analysis,Lasso regression,and multi-factor Logistic stepwise regression.The area un-der the subject working characteristic curve(AUC)was used to evaluate the discrimination of the predictive mod-el,the model's consistency was evaluated by calibration curve and goodness-of-fit test,and the clinical utility of the model was evaluated and validated by the decision analysis curve.Finally,column line plots were drawn.Results:①A total of 386 patients with ruptured tubal pregnancy were included,of whom 124(32.12%)had blood loss≥750 ml.②The optimal predictors for predicting concomitant blood loss in patients with ruptured tubal preg-nancy were screened,including:days of abdominal pain,dizziness,pallor,fatigue,the maximum diameter of para-metrial mass,human chorionic gonadotropin(β-hCG),and hemoglobin(Hb)and the model and the column line graphswere constructed accordingly.③The prediction model AUC was 0.827(95%CI 0.781-0.873);the cut-off value was 0.391,at which point the specificity and sensitivity were 68.55%and 84.35%,respectively,and the AUC validated within the model by resampling was 0.804.Clinical decision curves showed that the threshold probability intervals for the maximum net benefit values ranged from 8.5%-97%,respectively.Conclusions:The constructed prediction model was validated to suggest good discriminatory efficacy and degree of consistency.As a tool,it has clinical application value in predicting the risk of hemorrhage in patients with ruptured tubal pregnan-cy.It can help to determine the occurrence of adverse events such as hemorrhagic shock at an early stage and improve the success rate of rescue treatment.

Objective To analyze the epidemiological characteristics and the bacterial pathogen composition of pneumonia among children under 5 years old in Ningbo.Methods In 2013 February-April, we selected pediatric ward in three hospitals according to stratified cluster random sampling,and from which we collected all 57 556 hospitalized cases in January 2009-December 2012 period of children under 5 years old.A total of 16 740 medical records and bacterial spectrum records of pneumonia or bronchial pneumonia cases among children under 5 years old were described to calculate the proportions of children pneumonia or bronchial pneumonia hospitalized cases accounted for hospitalized children over the same period( referred to as proportions of pneumonia incidence), the detection rate of bacterial pathogens, proportions of bacterial spectrum, and to analyze the characteristics and bacterial pathogen composition of pneumonia among children under 5 years.Results The proportions of children pneumonia in 2009-2012 were 26.16%( 2 882/11 017),31.23%(4 004/12 819),29.35%(4 898/16 689) and 29.10%(4 956/17 031)(Z=3.13,P<0.01),and were in a downward trend by the increasing of age(Z=-113.74,P<0.01).The proportions of children pneumonia of 0-5 age group were 50.71%(6 756/13 318),26.60%(3 159/11 877),24.17%(2 574 /10 648),22.36%(2 509 /11 223) and 16.63%(1 745 /10 490).The proportions of children pneumonia with different season were 26.90%(3 725/13 850),26.51%(3 788/14 287),29.59%(4 442/15 011) and 33.21%( 4 785 /14 408 ) (χ2 =198.77, P <0.01 ) .The proportions of severe children pneumonia of 0-5 age group were 1.10%(74/6 753),0.47%(15/3 159),0.19%(5 /2 574),0.08%(2 /2 509) and 0.06%(1 /1 745),with a downward trend by the age(F=57.62,P<0.01).The detection rate of Klebsiella pneumoniae, Haemophilus influenzae, Acinetobacter baumannii, Escherichia coli, Staphylococcus aureus,and Streptococcus pneumoniae was 19.3%(540/2 805),16.4%(460/2 805),13.6%(381/2 805), 11.9%(335/2 805),11.5%(323/2 805) and 6.8%(192/2 805).Conclusion In 2009-2012,the proportions of children pneumonia under 5 year old constituted a relatively high proportion in Ningbo city.Children under 1 year old were the major suffering group of pneumonia and severe pneumonia, which should be the key prevention group.The major bacterial pathogens of children′s pneumonia in Ningbo are gram-negative bacteria.

Objective To analyze the epidemiological characteristics and the bacterial pathogen composition of pneumonia among children under 5 years old in Ningbo.Methods In 2013 February-April, we selected pediatric ward in three hospitals according to stratified cluster random sampling,and from which we collected all 57 556 hospitalized cases in January 2009-December 2012 period of children under 5 years old.A total of 16 740 medical records and bacterial spectrum records of pneumonia or bronchial pneumonia cases among children under 5 years old were described to calculate the proportions of children pneumonia or bronchial pneumonia hospitalized cases accounted for hospitalized children over the same period( referred to as proportions of pneumonia incidence), the detection rate of bacterial pathogens, proportions of bacterial spectrum, and to analyze the characteristics and bacterial pathogen composition of pneumonia among children under 5 years.Results The proportions of children pneumonia in 2009-2012 were 26.16%( 2 882/11 017),31.23%(4 004/12 819),29.35%(4 898/16 689) and 29.10%(4 956/17 031)(Z=3.13,P<0.01),and were in a downward trend by the increasing of age(Z=-113.74,P<0.01).The proportions of children pneumonia of 0-5 age group were 50.71%(6 756/13 318),26.60%(3 159/11 877),24.17%(2 574 /10 648),22.36%(2 509 /11 223) and 16.63%(1 745 /10 490).The proportions of children pneumonia with different season were 26.90%(3 725/13 850),26.51%(3 788/14 287),29.59%(4 442/15 011) and 33.21%( 4 785 /14 408 ) (χ2 =198.77, P <0.01 ) .The proportions of severe children pneumonia of 0-5 age group were 1.10%(74/6 753),0.47%(15/3 159),0.19%(5 /2 574),0.08%(2 /2 509) and 0.06%(1 /1 745),with a downward trend by the age(F=57.62,P<0.01).The detection rate of Klebsiella pneumoniae, Haemophilus influenzae, Acinetobacter baumannii, Escherichia coli, Staphylococcus aureus,and Streptococcus pneumoniae was 19.3%(540/2 805),16.4%(460/2 805),13.6%(381/2 805), 11.9%(335/2 805),11.5%(323/2 805) and 6.8%(192/2 805).Conclusion In 2009-2012,the proportions of children pneumonia under 5 year old constituted a relatively high proportion in Ningbo city.Children under 1 year old were the major suffering group of pneumonia and severe pneumonia, which should be the key prevention group.The major bacterial pathogens of children′s pneumonia in Ningbo are gram-negative bacteria.

In this study,the current status for breast diseases in a region with high-incidence of cervical cancer were epidemiologically investigated.From March to August,2009,17618 women,from Wufeng area of Hubei province,China,were recruited to screen breast diseases by using breast infrared diagnostic apparatus.Other diagnostic methods,such as B-mode ultrasound,X-ray mammography,needle biopsy and pathological examination were,if necessary,used to further confirm the diagnosis.The screening showed that 5990 of 17618 cases (34.00％) had breast diseases,5843 (33.16％) had mammary gland hyperplasia,48 (0.27％) had breast fibroadenoma,ll (0.06％) had breast carcinoma,and 88 (0.50％) had other breast diseases.The peak morbidity of breast cancer was found in the women aged 50-0 ages.The morbidity of breast cancer was significantly increased in women elder than or equal to 50 years old (n=8,0.157％) in comparison with that in the subjects younger than 50 years old (n=3,0.024％) (u=2.327,P＜0.05).It was shown that the occurrence of breast diseases was concentrated in women aged 20-40 years,while the total morbidity reached its peak at the age of 30 years and then decreased sharply after age of 40.Compared with the patients elder than or equal to 40 years old (n=3289,27.46％),the morbidity rate of breast diseases was significantly increased in women less than 40 years old (2648 cases,47.18％; P＜0.001).However,there was no significant difference in the morbidity of breast diseases between the age group of 20-29 years and that of 30-39 years (P=0.453),and both of them were high.There was no significant association between the morbidity of breast diseases and cervical cancer.Since the morbidity of breast diseases was higher among young women,more attention should be paid to the screening of breast diseases among young women for early diagnosis.