32,16,16.Combined with azithromycin were8,16,16,8.MEM,CAZ,CIP combined with AMK were 1,4,8.AMK combined with CIP were 4.Conclusion Compared with sole,MEM,CAZ,CIP combined with azithromycin can reduce the MPC and SI of antibiotics alone to pseudomonas aeruginosa and restrain the drug-resistant mutants.But the capacity of preventing mutants arise were weaker than combined with AMK.AMK combined with azithromycin can't reduce the SI.But when combined with CIP,the SI of AMK were reduced greatly.

OBJECTIVE To study whether the ciprofloxacin(CIP)combined with amikacin(AMK)will decrease the drug-resistant mutants of Escherichia coli(ECO)in vitro.METHODS The MIC of CIP and AMK alone was determined by agar plates dilution method,and the combined MIC by checkerboard method.The mutant prevention concentration(MPC)both alone and combined was determined by the method of agar plates dilution method,and then the value of selectiveity index(SI)(MPC/MIC)would be acquired.RESULTS The SI of two antibiotics separatedly were 16(CIP)and 32(AMK).When two antibiotics combined,if the concentration of AMK and CIP reached 2MIC could restrain the mutants.After these two antibiotics combined,the value of SI(MPCcombined/MICcombined)came to be 8(0.008/0.001)and 8(2.0/0.25).CONCLUSIONS Compared with alone,CIP and AMK combined can decrease the MPC and SI to ECO,and have the more effect to AMK.In this way,we can reduce the drug-resistant mutants.

Objective To understand the level of vitamin A (VA)in children in Beijing city.Methods 292 children aged from 0~14 years old visited the health clinic from November 2012 to March 2013 in Beijing city were surveyed by a question-naire,and medical history,physical examination,a blood sample was collected from each child,and serum VA was measured with reversed-phase high-performance liquid chromatography(HPLC).Results ①The mean serum VA concentration for the 292 children was (1.09 ± 0.29)μmol/L.②There were 5.8% (17/292)of children affected with subclinical VAD (SVAD),and 38.0% (107/292)had suspected SVAD (SSVAD).③Multivariate logistic regression analysis showed that parents were unware of health implications of VA,low VA intake and recurrent respiratory infection were associated with SVAD or SSVAD.Conclusion Low VA status remains a nutritional problem in children in Beij ing city.Multiple factors need to be considered together for them,such as parents were unware of health implications of VA,low VA intake and re-current respiratory infection.

Objective:To explore the electro-clinical characteristics of Jeavons syndrome complicated with non-convulsive status epilepticus (NCSE).Methods:Three patients of Jeavons syndrome complicated with NCSE during electroencephalogram (EEG) monitoring in the EEG Monitoring Center, Department of Neurology, Xijing Hospital in 2018 were studied and followed up.Results:Among the three patients, there are two female patients, one male patient, aged 12 to 24 years. Generalized spike-wave discharges and impaired consciousness were recorded during video-EEG monitoring, which lasted for 8 minutes to 6.5 hours and evolved in generalized tonic clonic seizure (GTCS), and did not recur after receiving correct anti-epileptic drugs.Conclusion:NCSE can also occur in Jeavons syndrome, and NCSE in patients with Jeavons syndrome ends with GTCS, suggesting that early detection and timely termination of NCSE in patients with Jeavons syndrome may avoid the occurrence of GTCS.

Objective To investigate the effects of 6-minutes of walking exercise (6-MWE) on the exercise tolerance and left ventricular diastolic function (LVDF) of heart failure patients with a normal ejection fraction (HFNEFs).Methods Ninety grade Ⅱ or Ⅲ HFNEFs of the New York heart association (NYHA) were randomly divided into an exercise training group and a control group with 45 cases in each.The control group was treated with routine drugs.The exercise training group was treated with the same drugs plus 6-MWE.Before and after the sixmonth period of treatment,plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) levels were determined,each subject's left atrial volume index (LAVI) was measured with a color ultrasonic cardiogram (UCG),and their 6-minute walk distance (6-MWD) was measured.Results Plasma NT-proBNP levels and 6-MWD improved significantly comparing with before treatment in both groups.The average 6-MWD,LAVI and plasma NT-proBNP level all improved significantly more in the experimental group.Conclusion 6-MWE can significantly improve the exercise tolerance and LVDF of HFNEFs,and improve their quality of life.Walking can be helpful in delaying the development of HFNEF.

A simple, rapid and sensitive method based on an ultra-performance liquid chromatography–tandem mass spectrometry(UPLC–MS/MS)has been developed and validated for the determination of pimavanserin in rat plasma.The analyte was extracted by protein precipitation with methanol and separated on an ACQUITY BEH C18column(100 mm×2.1 mm,1.7μm;Waters,USA),with an isocratic elution of acetonitrile-water containing 10 mM ammonium acetate (70:30, v/v), at a flow rate of 0.2 mL/min for 2.5 min. The analyte and clarithromycin (the internal standard) were detected and quantified in positive ion mode using multiple reaction monitoring transitions at m/z 428.2 → 223.0 for pimavanserin and m/z 748.5 → 589.5 for clarithromycin. Relative coefficient (r) for the calibration curve was more than 0.9980. The intra-day and inter-day precisions(relative standard deviation,RSD%)were less than 13.3% and 10.5%,respectively,and the accuracy(relative error,RE%)was within ± 11.5%.The analytical method was successfully applied to a routine pharmacokinetic study of pimavanserin in rats after oral administration at the dose of 10 mg/kg.

Objective:To study the learning curve in laparoscopic left lateral hepatic sectionectomy.Methods:The clinical data of 62 consecutive patients who underwent left lateral hepatic sectionectomy by a single operator from February 2015 to May 2022 in General Hospital of Northern Theater Command were retrospectively analyzed. There were 22 males and 40 females, with mean ±s.d. of (50.7±11.7) years. The learning curve was depicted and evaluated by using the cumulative summation test. The general information, operation and postoperative indicators of the growth level group and the master level group were compared.Results:The average operation time of the 62 consecutive subjects was (172.9±70.1) minutes. Intraoperative blood loss was 100 (50, 200) ml. Two patients were converted to open hepatectomy. Clavien-Dindo grade I postoperative complications occurred in 20 patients (32.3%), with grade Ⅱ in 1 patient (1.6%) and grade Ⅲb in another patient (1.6%). The learning curve reached its highest point on the 20th patient by using the cumulative summation test. The study subjects were then assigned into the growth level group (patient 1-20) and the master level group (patient 21-62). The master level group had a significantly wider spread of patient age [(52.9±11.0) years vs (46.1±11.9) years], decreased operation time [(146.8±55.6) min vs (227.9±66.7) min], shortened drainage tube removal time [4(3, 5) d vs 6(4, 7) d] and decreased postoperative hospital stay [5(5, 7) d vs 6.5(4, 9) d] (all P<0.05) when compared with the growth level group. Conclusion:Left lateral hepatic sectionectomy was safe and feasible, and a single operator went through a learning curve of 20 patients before he/she could master the operation more proficiently.