OBJECTIVE To study the classification and distribution of the ?-lactamases produced by Escherichia coli in diabetic patients.METHODS To detect the ?-lactamases produced by E.coli in diabetic patients with a multi-disk synergy test.RESULTS Forty-nine strains of 60 strains in our study produced the ?-lactamases with total positive rate of 81.67%,From them 5 strains were producing penicillinases,17 strains producing BSBLs(28.33%),and 27 strains were producing ESBLs(45.00%),no carbapenem-hydrolyzing ?-lactamases were detected.In 27 strains producing ESBLs,the sensitivities to the ceftazidime,aztreonam and cefotaxime were similar.CONCLUSIONS The types of ?-lactamases produced by E.coli in diabetic patients are mainly BSBLs and ESBLs,without carbapenem-hydrolyzing ?-lactamases;the sensitivities to the ceftazidime,aztreonam and cefotaxime are similar.

Objective: To investigate the level of maternal and infant health literacy and its influencing factors among rural pregnant and lying-in women in Guian New Area, Guiyang City, so as to provide insights into maternal and infant health education. Methods: All pregnant and lying-in women included in health management in township hospitals of Guian New Area from October to December 2021 were selected using a stratified cluster random sampling method. Participants' basic features, maternal and infant health literacy and health education needs were collected using electronic questionnaires, and factors affecting maternal and infant health literacy were identified among pregnant and lying-in women using unconditioned multivariable logistic regression model. Results: A total of 918 valid questionnaires were recovered, and the participants included 325 pregnant women (35.40%), 823 married women (89.65%), 466 women with an educational level of junior high school and below (50.76%), 847 rural household registration (92.27%), 695 women with monthly family income of 3 200 Yuan and less (75.71%), and 267 women with maternal and infant health literacy (29.08%). Multivariable logistic regression analysis identified pluripara (OR=3.418, 95%CI: 1.689-6.919), educational level (diploma, OR=2.901, 95%CI: 1.230-6.842; bachelor and above, OR=6.282, 95%CI: 2.548-15.489), household monthly income per capita (3 201-5 000 Yuan, OR=2.373, 95%CI: 1.499-3.757; 5 001 Yuan and more, OR=7.752, 95%CI: 3.072-19.558), a disease history (OR=3.045, 95%CI: 1.175-5.406), use of maternal and child health manuals (OR=1.881, 95%CI: 1.345-2.632) and emphasizing health education (OR=1.735, 95%CI: 1.122-2.463) as factors promoting for the level of maternal and infant health literacy. In addition, pregnant and lying-in women's major maternal and infant health education needs included infant growth and development knowledge (745 women, 81.15%), management of common infant diseases (719 women, 78.32%), daily infant nursing (651 women, 70.92%) and infant nutrition and feeding (646 women, 70.37%). Conclusions The level of maternal and infant health literacy is low among rural pregnant and lying-in women in Guian New Area, and there is a high demand for health education. High attention should be paid to rural pregnant and lying-in women with a low educational level, low incomes, and primipara.

Objective To perform a spatial analysis of myocardium uhrastructure and the activity of mitochondrial succinate dehydrogenase in sub-acute Keshan disease. Methods Myocardium samples were collected from the cases with sub-acute Keshan disease and non-myocarditis(control), and their ultrastructure was observed under electron microscope. The density of mitochondrion volume and cristal membrane and its volume were measured by a point-counting method, while mitochondrion volume was estimated by water displacement method, succinate dehydrogenase activity of mitochondrion by iron-copper method in sub-acute Keshan disease and non-myocarditis cases. Results The volume ratio of mitochondrion to the cell on myoeardium [(47.79±6.20)%], the area ratio of mitochondrion to sarcoplasm [(55.06±6.50) %], mitochondrion to myofibrils [(1.43±0,41)%], mitochondrion section area[(0.78±0.15)μm2], and ratio of the lesion of cristal membrane area to the matrix area and mitochondrion volume[(67.14±13.96)%, (44.62±13.44)%]in sub-acute Keshan disease group were obviously higher than those in control [(33.20±7.62)%, (38.07±9.43)%, (0.71±0.33)%, (0.44±0.07)μm2, (14.11± 12.51)%, (9.34±11.28)%; t = 3.75,7.93,6.61,36.40,52.65,37.51, all P < 0.05]. The volume ratio of myofibrils to cell[(34.52±5.12)%]and the area ratio of cristae mitochondria to matrix[(32.43±14.42)%]in sub-acute Keshan disease group was obviously less than those in control [(48.51±4.30)%, (86.04±12.37)%; t = 9.85, 53.46, both P < 0.05)]. Succinate dehydrogenase activity was negative in sub-acute Keshan disease group. Conclusions Myocardium ultrastructure changes in sub-acute Keshan disease including the increase of volume and areas of mitochondria and the damage of the cristal membrane in mitochondria. Succinate dehydrogenase activity is decreased or even disappeared.

Objective To evaluate the effect of arsenic trioxide (As2 O3 ) on the proliferation of human renal carcinoma cell line 786-O ,and to explore the changes of the PI3K-Akt signaling pathway .Methods Human renal cancer cells 786-O was cultured in 96-well plates ,and divided into the control group (n= 45 holes) and the experimental group (n= 45 holes) .After stimulation by 1 μM As2 O3 and saline ,the cells in 15 holes were collected at 0 ,12 ,and 24 h .BrdU assay was performed to quantify DNA synthesis to evaluate the cells proliferation ,the quantitative PCR was used to measure PI3K and Akt relative mRNA expression ,and Western blot was used to quantify the relative expression levels of of intracellular PI 3K and Akt .Results After 12 ,24 h of As2 O3 stimula-tion ,the amount of DNA synthesis in the observation group was gradually lower than that of the DNA synthesis at 0 h(P<0 .05) and significantly lower than that of the control group at 12 h and 24 h(P<0 .05) .At 0 ,12 ,24 h ,the relative expression level of in-tracellular PI3K and Akt mRNA and protein in the observation group had no significant difference (P>0 .05) ,and the relative ex-pression levels of PI3K and Akt mRNA and protein in the control group were increased as the proliferation was gradually increased . Conclusion As2 O3 inhibits human renal carcinoma cell line 786-O proliferation through inhibiting the PI3K-Akt transduction path-way ,and has potential clinical value for the treatment of kidney cancer .

Urinary tract infection complicated with urinary tract calculi( lithangiuria)is one of the most common diseases causing serious urinary sepsis and septic shock. Recent studies show that the accurate diagnosis,rational use of antibiotics and timely treatment of complications are the key to treatment success. In this article,the latest progress and the treatment strategies for urinary tract infections complicated with lithangiuria are explored.

As a kind of source wide,low inherent immnunogenicity multipotent stromal cells,mesenchymal stem cells (MSCs) have been used to cell-based therapeutic researches of immunodeficient deseases or other severe clinical disorders.Despite low levels of engraftment in the injured lung,numerous preclinical trials indicate that mesenchymal stem cells can promote damaged tissue repair constructed by secreting paracrine factors to regulate the host immunity,inhibit inflammation and restore epithelial integrity.Acute lung injury(ALI) is a serious organ dysfunction occurred earliest and the most commonly affected organ.Currently there is no effective medicine therapy and the mortality remains high.Researches demonstrate MSCs can reduce alveolar edema,improve lung function and reduce motality.So understanding of the mechanism will be conductive to the MSCs from experimental stage into clinical application.This issue will put a brief overview pointed on the mechanism of mesenchymal stem cells in repairing the injured lung.

Meshless methods are recently developed numerical methods which require only node informa- tion. This paper introduces the basic principles and history of meshless methods, the principles and implementation of the moving least square method taking Galerkin method as an example. Finite points mixed method (FPMM) and its application in solving electrocardiogram(ECG) forward problem is also introduced. Foreground and problems need to be solved concerning the application of meshless methods in the study of ECG forward problem are discussed.

The study is to investigate the pharmacokinetics of S-1 capsule (tegafur, gimeracil and potassium oxonate capsule) in patients with advanced gastric cancer after single and multiple oral administration. Twelve patients with advanced gastric cancer were recruited to the study. The dose of S-1 for each patient was determined according to his/her body surface area (BSA). The dose for single administration was 60 mg every subject. The dose for multiple administration for one subject was as follows: 100 mg x d(-1) or 120 mg x d(-1), 28-days consecutive oral administration. The pharmacokinetic parameters of tegafur, 5-fluorouracil, gimeracil, potassium oxonate and uracil after single oral administration were as follows: (2,207 +/- 545), (220.0 +/- 68.2), (374.9 +/- 103.0), (110.5 +/- 100.8) and (831.1 +/- 199.9) ng x mL(-1) for Cmax; (11.8 +/- 3.8), (4.4 +/- 3.3), (7.8 +/- 5.1), (3.1 +/- 0.9) and (8.8 +/- 4.1) h for t1/2, respectively. After six days oral administration, the average steady state plasma concentrations (Cav) of tegafur, 5-fluorouracil, gimeracil, potassium oxonate and uracil were (2,425 +/- 1,172), (73.88 +/- 18.88), (162.6 +/- 70.8), (36.89 +/- 29.35) and (435.3 +/- 141.0) ng x mL(-1), respectively, and the degree of fluctuation (DF) were (1.0 +/- 0.2), (2.5 +/- 0.4), (3.1 +/- 0.8), (2.4 +/- 0.8) and (1.5 +/- 0.3), respectively. The cumulative urine excretion percentage of tegafur, 5-fluorouracil, gimeracil and potassium oxonate in urine within 48 h were (4.2 +/- 2.8) %, (4.7 +/- 1.6) %, (18.5 +/- 6.0) % and (1.7 +/- 1.2) %, repectively, after single oral administration of S-1. The results exhibited that tegafur had some drug accumulation observed, and gimeracil, potassium oxonate, 5-fluorouracil and uracil had no drug accumulation observed.

We enrolled 60 patients with American Association of Anesthesiologists grade Ⅰ - Ⅱ undergoing unilateral total knee arthroplasty. All patients received combined epidural and spinal anesthesia,and a nerve stimulator was used to guide placement of a femoral nerve catheter. Patients were divided into three groups according to the catheter location on X-ray : psoas muscle group ( n = 18 ), iliacus muscle group (n = 19) and local group (n =23). Visual analog scale (VAS) pain scores were recorded at rest and with movement at 4, 24 and 48 h postoperatively and sensory blockade of the femoral, obturator and lateral femoral cutaneous nerves was recorded at 24 h.There were no significant differences in femoral nerve blockade among the three groups. Obturator nerve blockade was significantly better in the psoas muscle group than in the iliacus muscle and local groups, and was also better in the local group than in the iliacus muscle group. There was no significant difference in lateral femoral cutaneous nerve blockade between the psoas muscle and iliacus muscle groups, but there was better blockade in both these groups than in the local group. At 4 h postoperatively, VAS pain scores at rest were significantly lower in the psoas muscle group than in the iliacus muscle and local groups, but there were no significant differences in VAS pain scores with movement among the three groups. At 24 and 48 h postoperatively, VAS scores at rest and with movement were significantly lower in the psoas muscle group than in the iliacus muscle and local groups.

BACKGROUND:Many internal fixations,such as dynamic hip screw,Gamma screw,proximal femoral nail,angle steel plate,as well as locking proximac femoral plate,are utilized in treating intertrochanteric fractures,especially the dynamic hip screw However,the failure rate is gradually increased.OBJECTIVE:To explore the application and clinical efficacy of total hip replacement for the treatment of elderly intertrochanteric fracture fixation after failure of dynamic hip screw.METHODS:A total of four cases with intertrochanteric fractures were treated by total hip replacement after failure of dynamic hip screw fixation was selected.According to Evans typing,one case were type Ⅱ,two cases were type Ⅲ A,and one case was typeⅢB.Internal fixation displacement could be found at half to 1 year after dynamic hip screw fixation.Because of bone disunion,coxa adducta and pain,the patients could not walk.Sequentially,total hip replacement was performed with 45°abduct angle and10°-15°anteversion angle The clinical efficacy was evaluated by Harris scoring criteria.RESULTS AND CONCLUSION:All the cases were operated smoothly,with 1.5-2 hour operation duration and 400-600 mL blood loss.No case appeared allergic response to bone cement.By 3-12 months follow-up,4 successful operative cases do not appear prosthesis loosening,subsidence and are satisfied with well hip function.The average Harris score were 81 points.The results revealed that application of total hip replacement after the failure of DHS in elderly intertrochanteric fracture fixation,which shortened the time patients stay in bed to reduce complications and improved the hip joint function.