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 .

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.

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.

Objective To investigate the clinical value of radiotherapy combined with xeloda monotherapy in the treatment of elderly patients with rectal cancer.Methods 80 elderly patients with rectal cancer were retrospectively collected.The patients were assigned into study group (n=43) or control group (n=37) according to the treatment way.The study group adopted radiotherapy combined with xeloda,while the control group only treated with radiotherapy.The main indicators included major clinical outcomes (3-year survival rate,recurrence rate,progression free survival),and postoperative health related quality of life and major complications of the two groups were observed.Results Compared with the control group,the 3-year recurrence rate of the study group decreased significantly (25.58% vs.48.65%,x2=4.579,P=0.032);the progression free survival was significantly prolonged [(42.58±7.63)months vs.(34.95±6.30)months,t=7.495,P=0.000];the quality of health related life after 1 year increased significantly [(75.50±8.11) vs.(69.76±9.58),t=3.295,P=0.002].There were no significant differences in postoperative major complications (granulocyte reduction,diarrhea,nausea,vomiting,hand foot syndrome and sensory neuropathy) and 3-year survival rate between the two groups (all P>0.05).ConclusionRadiotherapy combined with xeloda chemotherapy helps improve progression free survival and recurrence rate in elderly patients with rectal cancer.

Objective To study the drug resistance situation of Mycobacterium tuberculosis strains isolated from the patients with HIV/AIDS complicating tuberculosis (TB).Methods One hundred and ninety-six inpatients with AIDS complicating TB in our hospital from January 2012 to December 2015 were collected.The drug resistance situation of Mycobacterium tuberculosis strains cultured from sputum/tissue fluid/fiber liquid and pathological tissue submitted samples in the patients with AIDS complicating active TB was analyzed.The BACTEC MGIT960 systems was adopted to perform the bacterial identification.The drug sensitivity test was conducted by using 960 culture testing system.Results One hundred and ninety-six strains of Mycobacterium tuberculosis were cultured,the total drug resistance rate of Mycobacterium tuberculosis was 26.02％.These cases were divided into the ＞100/μL and ≤100/μL groups according to different CD4+ T cells count.The drug resistance situation of Mycobacterium tuberculosis to 4 kinds of first line anti-TB drugs were compared between these two groups.The comparison results found that the resistance rate of Mycobacterium tuberculosis strains to the first line anti-TB drugs had no statistical difference between the two groups (P＞0.05).The resistance rates of first line anti-TB drugs from high to low were isoniazid,rifampicin,streptomycin and ethambutol.The drug resistance rate of Mycobacterium tuberculosis strains to 5 types of drug resistant TB had no statistical difference(P＞0.05).Conclusion The drug resistance rate in the initial patients with HIV complicating TB is consistent with the average initial drugresistance level of TB patients in our country.The TB drug resistance rate in the patients with HIV complicating TB has no correlation with CD4+ T cells count.

Growth of tumor need new blood vessel to meet the demand for adequate oxygen and nutri -ents.Inhibiting the formation of blood vessel can inhibit growth of tumor .In all of the endogenous angiogenesis in-hibitors deriving from the type IV collagen .Study of tumstatin is the most widely .Tumstatin can inhibit endothelial proliferation and induce the apoptosis of endothelial cell .This article reviews the research status of the tumstatin .

Objective To observe the change rules of expressions of IL-1β, IL-4, IFN-γ and TGF-β1 in serum and colon tissue in rats with ulcerative colitis of spleen-kidney yang deficiency type; To explore the action in the progress of ulcerative colitis of spleen-kidney yang deficiency type.MethodsComposite method was used to establish rat models with ulcerative colitis of spleen-kidney yang deficiency type. 75 Wistar rats were randomly divided into blank group, model 3 d group, model 7 d group and model 21 d group. ELISA was used to test the levels of IL-1β, IL-4, IFN-γ and TGF-β1 in serum and colon tissue.Results Compared with the blank group, contents of IL-1β and IFN-γ in model group increased significantly (P<0.05,P<0.01), and the contents of IL-4 and TGF-β1 content decreased (P<0.05,P<0.01),especially in the model 7 d group (P<0.01).ConclusionThe pro-inflammatory factor IL-1β, IFN-γ and anti-inflammatory factor IL-4 and TGF-β1 play an important role in rats with ulcerative colitis of spleen-kidney yang deficiency type.