OBJECTIVE:To study the enterococcal distribution in clinical samples and their drug resistance to commonly use antibiotic and provide the guidance for rational administration.METHODS : Adopting paper diffusion method to observe the drug resistance of enterococci isolated from clinical samples in our hospital and analyzing their distribution in the samples.RESULTS :Enterococcus faecalis accounts for 44.1% in 227 strains and Enterococcus faecium accounts for 37.9%,the other kinds of enterococci were rare.There was no statistical difference between drug resistance of Enterococcus faecium and that of enterococcus faecalis. Vancomycin was the most potent antimicrobial.Penicillin,ampicillin,and nitrofurantion showed good antibacterial activity against enterococcus faecalis. Enterococcus faecium displayed high-level resistance against antibiotics in addition to glycopeptides.CONCLUSION:Doctor should pay attention to the drug resistance about clinically common pathogenic bacterium. Continual surveillance of resistance rate of enterococcus is important to direct the treatment of enterococcus infections.

Objective:To explore high-risk factors of respiratory distress syndrome (RDS) and to compare the clinical efficacy of calf pulmonary surfactant (PS) combined with budesonide suspension and poractant alfa injection in the treatment of RDS in premature infants.Methods:A retrospective analysis was conducted. Preterm infants who were born in the obstetrics department of Liaocheng People's Hospital and admitted to the neonatal intensive care unit (NICU) within 24 hours from July 2016 to July 2020 were enrolled. The clinical data of these patients including perinatal conditions, clinical features, therapeutic regimens of PS and outcomes were collected and analyzed. According to the diagnostic criteria of neonatal respiratory distress syndrome (NRDS), premature infants were divided into NRDS group and non-NRDS group. First, the clinical data of the two groups were compared to analyze the related factors of NRDS. Then the related factors of NRDS were confirmed by Logistic regression analysis. In addition, according to the trapeutic regimens of PS, the children were divided into calf PS combined with budesonide suspension group and poractant alfa injection group, and the efficacy of the two PS was compared.Results:① A total of 1 690 preterm infants were included, including 297 preterm infants were diagnosed with NRDS which accounted for 17.6% of live preterm infants. There were significant differences in gender, gestational age (GA), birth parity, birth weight (BW), asphyxia of newborn, caesarean section, premature rupture of membrane, placental abruption, gestational diabetes and father's smoking addiction (maternal exposure to smoke during pregnancy) between NRDS group and non-NRDS group (male: 71.0% vs. 59.0%; GA: < 28 weeks was 4.1% vs. 0.1%, 28 weeks ≤ GA < 34 weeks was 70.0% vs. 29.9%, 34 weeks ≤ GA < 37 weeks was 25.9% vs.70.0%; birth parity: 2 (1, 3) vs. 2 (1, 3); BW: < 1 000 g was 4.1% vs. 0.4%, 1 000 g ≤ BW < 1 500 g was 31.3% vs. 6.5%, 1 500 g ≤ BW < 2 500 g was 51.5% vs. 58.9%, 2 500 g ≤ BW < 4 000 g was 12.8% vs. 33.1%, BW≥4 000 g was 0.3% vs. 1.1%; asphyxia of newborn: 50.8% vs. 14.6%; caesarean section: 71.7% vs. 65.0%; premature rupture of membrane: 66.7% vs. 42.2%; premature rupture of fetal membranes: 11.4% vs. 5.2%; gestational diabetes: 12.1% vs. 7.0%; father's smoking addiction: 80.8% vs. 71.5%, all P < 0.05), but there was no significant difference in prenatal use of dexamethasone (DEX) between NRDS group and non-NRDS group (80.1% vs. 84.1%, P > 0.05). Binary multivariate Logistic regression analysis showed that GA, gender, cesarean section, premature rupture of membranes, gestational diabetes, father's smoking addiction and neonatal asphyxia were the risk factors of RDS [odds ratio ( OR) and 95% confidence interval (95% CI) were 0.621 (0.557-0.693), 2.043 (1.478-2.825), 1.365 (1.036-1.797), 0.697 (0.506-0.961), 3.223 (1.906-5.449), 1.836 (1.261-2.673), 3.596 (2.622-4.933), all P < 0.05]. ② A total of 160 patients diagnosed with grade Ⅲ/Ⅳ NRDS were included to analyze the efficacy of PS. Among them, 42 cases were treated with calf PS combined with budesonide suspension, and 118 cases were treated with poractant alfa injection. Compared with the poractant alfa injection group, the total oxygen consumption time of the calf PS group was shorter [days: 9.0 (5.0, 19.0) vs. 13.0 (6.0, 26.0)], the hospitalization expenses were lower [ten thousand Yuan: 3.46 (2.88, 5.18) vs. 4.58 (3.08, 6.06)], and the incidence of bronchopulmonary dysplasia (BPD) was lower (11.9% vs. 28.8%), with statistically significant differences (all P < 0.05). Conclusions:In addition to GA, gender, cesarean section, premature rupture of membranes, gestational diabetes, and neonatal asphyxia, the father's smoking addiction (maternal smoke exposure during pregnancy) is an important risk factor of RDS in premature infants. The efficacy of prenatal use of DEX for prevention of RDS in preterm infants is affected by many factors, such as prenatal smoke exposure, timing of use, multiple fetuses, etc. Calf PS combined with budesonide suspension is better than poractant alfa injection in reducing the incidence of BPD.

In daily medical work, it is common to carry out bedside ultrasound guided puncture surgery, which is easy to miss and inconvenient to operate when transporting medical devices. The department of emergency of the First Hospital of Jiaxing designed a kind of mobile ultrasound guided puncture vehicle, and obtained the National Utility Model Patent of China (ZL 2020 2 0100473.X). The utility model includes a car body, a work table, an ultrasonic machine, a storage cell and a material basket. The side of the car body is provided with an opening, and both sides of the opening surface are provided with a turnover mechanism, and the rotation axis of the turnover plate is horizontally arranged. The utility model can facilitate the operation of puncture bags, disinfection articles, monitors, oxygen bottles and other medical equipment, and can expand the use area of the operating platform, increase the storage function and store more. This device has good practical value.

Tracking changes in the number and function of T cells is of great value to clinical diagnosis and evaluation of the efficacy of allergen immunotherapy. This review summarizes research progress in detection methods for allergen-specific T cells and their application, such as carboxyfluorescein succinimidyl ester dilution assay, enzyme-linked immunospot assay, intracellular cytokine staining assay and microarray immunosensors, providing references for selecting and developing appropriate detection methods in clinical practice.

The main factor is the number of patients, which predicted by least square method to reduce the deviation. The like equipments located nearby are also considered and the Shared Coefficient is proposed.

Tryptophan is the essential amino acid in the growth of cell.Indoleamine 2,3-dioxygenase is the rate-limiting enzyme in the catabolism of tryptophan along the kynurenine pathway.Indoleamine 2,3-dioxygenase enzyme mainly promotes tryptophan consumption of local micro-environment,causing tryptophan lack,thus inhibiting proliferation and activation of T cell.Tryptophan-derived catabolites suppress allogeneic T-cell proliferation (kynurenine,3-hydroxykynurenine,and 3-hydroxyanthranilate).Indoleamine 2,3-dioxygenase dendritic cells may interact with regulatory T cells forming an immunomodulatory network to promote immune tolerance induction.Though the immune regulation mechanism of the indoleamine 2,3-dioxygenase-initiated L-tryptophan in transplantation remains unclear,Numerous researches indicate that its role of tolerance induction in transplantation will be significant.

Objective To evaluate the effects of blood perfusion(HP)combined with hemodialysis(HD)on micro inflammation and malnutrition status in patients with maintenance of hemodialysis(MHD). Methods Eighty MHD patients admitted to blood purification center of Wuhan Puai Hospital in Hubei Province were enrolled and randomly divided into two groups. Pure HD group underwent conventional HD for 4 hours,3 times a week,and based on the weekly HD series,the HD+HP group took additionally HP once a week,the therapeutic course in both groups being consecutive 12 weeks. Blood was collected before and after treatment for detection of interleukin-6. (IL-6) and tumor necrosis factor-α(TNF-α) levels by enzyme-linked immunosorbent assay (ELISA), and the serum high sensitivity C-reactive protein (hs-CRP) and homocysteine (Hcy) levels were determined with electrochemiluminescence immunoassay,and the changes in nutritional indexes of hemoglobin(Hb),total protein(TP), albumin(Alb),transferrin(TRF)were observed. Results Compared with the indexes before treatment,in HD+HP group,hs-CRP(ng/L:5.65±2.21 vs. 13.91±2.10),IL-6(ng/L:50.10±6.65 vs. 101.22±21.32),TNF-α(ng/L:80.21±9.41 vs. 197.64±25.47),Hcy(μmol/L:13.31±2.21 vs. 40.96±9.42)were significantly decreased (all P<0.05),and Hb(g/L:106.65±22.21 vs. 92.01±12.10),TP(g/L:62.10±22.65 vs. 51.22±11.32),Alb (g/L:38.21±6.41 vs. 30.84±5.47),TRF(μg/L:196.31±22.21 vs. 161.96±15.42)were significantly increased (all P<0.05);but the above parameters in HD group did not change significantly(all P>0.05). There were statistical significant differences in above indexes after treatment between HD+HP group and HD group〔hs-CRP (ng/L):5.65±2.21 vs. 13.22±1.10,IL-6(ng/L):50.10±6.65 vs. 100.32±25.24,TNF-α(ng/L):80.21±9.41 vs. 196.87±24.54,Hcy(μmol/L):13.31±2.21 vs. 37.23±8.33,Hb(g/L):106.65±22.21 vs. 94.22±13.10,TP (g/L):62.10±22.65 vs. 51.32±12.32,Alb(g/L):38.21±6.41 vs. 32.87±4.54,TRF(μg/L):196.31±22.21 vs. 162.23±15.33,all P<0.05〕. Conclusion HP combined with HD in the treatment of MHD can improve the micro inflammation and malnutrition state in patients with MHD.

Objective To detect the expression of Survivin ,PTEN and to discuss the correlations between them and the clinico-pathological characteristic of rectal carcinoma ,evaluate their effects on the development of rectal carcinoma .Methods SP immuno-histochemical was used to detect the expression level of Survivin and PTEN in 72 rectal carcinoma samples ,and randomly selected 20 cases of normal paraneoplastic tissues as control group .Results The positive rate of Survivin and PTEN in normal paraneoplas-tic tissues were 0 and 85 .0% respectively ;The positive rate in rectal carcinoma samples were 61 .1% and 41 .7% respectively .Posi-tive expressions of Survivin and PTEN did not had no correlation with gender ,age ,but correlated with differentiation ,dukes staging and lymph node metastasis .PTEN expression was negatively correlated with Survivin expression in rectal carcinoma .Conclusion The low expression of Survivin and high expression of PTEN might promote tumor genesis and progression of rectal carcinoma , which could be used to judge the rectal cancer clinical staging and pathologic grading .

Multidrug-resistant (MDR) bacterial infections, especially those caused by Gram-negative pathogens, have emerged to be one of the world's greatest health threats. However, not only have recent decades shown a steady decline in the number of approved antimicrobial agents but a disappointing discovery also void. The development of novel antibiotics to treat MDR Gram-negative bacteria has been stagnated over the last half century. Though few compounds have shown activities in vitro, in animal models or even in clinical studies, the global antibiotic pipeline is not encouraging. There are a plethora of unexpected challenges that may arise and cannot always be solved to cause promising drugs to fail. This review intends to summarize recent research and development activities to meet the inevitable challenge in restricting the proliferation of MDR Gram-negative bacteria, with focus on compounds that have entered into clinical development stage. In addition to new analogues of existing antibiotic molecules, attention is also directed to alternative strategies to develop antibacterial agents with novel mechanisms of action.

Effective loading and site-specific delivery of growth factors to regulate the cell growth on scaffold is one of the key issues of tissue engineering. Polymeric nanoparticle is one of the candidate carriers for carrying growth factors. This article attempts to introduce the biological characteristics of growth factors commonly used in tissue engineering, polymer materials for carrying the growth factors and the preparation of the nanoparticles and delivery systems. The advantages and disadvantages of different preparations are also discussed to facilitate the selection of the appropriate methods and materials. Relevant research progress and application potentials are discussed ss well.