OBJECTIVE:To study the change of antibacterial resistance spectra of3non-fermental G - bacteria in our hospital during recent4years,so as to guide the rational use of antibacterial.METHODS:Pseudomonas aeruginosa,acineto?bacter baumanii,stenotrophomonas maltophilia were isolated from clinical samples in our hospital from July2001to June2005,the susceptibility of these isolates were tested by Kirby-Bauer agar diffusion method,data were analyzed by WHONET5.RESULTS:598strains of P.aeruginosa,281strains of A.baumanii and209strains of S.maltophilia were obtained during4years.Now the resistance rates of ceftazidime,amikacin,cefoperazone/sulbactam and imipenem to P.aeruginosa were lower than30%;A.baumanii were sensitive to imipenem,the other antibiotic resistance rates were more than50%;The antibiotic resistance rate of S.maltophilia to ofloxacin and trimethoprim/sulfamethoxazole was relatively low?er.CONCLUSIONS:The antibiotic resistance rates of non-fermental G - bacteria are high and display multiple-resistant.It's important to monitor the antibiotic resistance periodically to guide clinical antibiotics use.

Objective To investigate the comprehensive prevention strategy in the prevention of oral mucositis (OM) during allogeneic hematopoietic stem cell transplantation (HSCT). Methods A total of 721 patients who received HSCT from January 2010 to December 2011 at the Institute of Hematology, Peking University were enrolled. All the patients received the comprehensive prevention strategy of OM. Results A total of 315 patients (43.7 percents) suffered from OM during HSCT, the median time from HSCT to OM occurrence was 5 days. There were 173 (54.9 percents), 91(28.9 percents), 37(11.7 percents), and 14(4.4 percents) patients suffered from gradeⅠ,Ⅱ,Ⅲ, and IV OM, respectively. Tongue OM was most common. A total of 111 patients suffered from multiple OM (≥2 locations). Multiplicity showed that duration of agranulocytosis≥15 days was the only independent risk factor of OM in HSCT [ hazard ratio (HR) value 1.5, P<0.05 ]. Neutrophil engraftment time≥12 days was significantly associated with prolonged OM (≥8 days) (HR=2.1, P<0.05). Patient age ≥20 was independent risk factor for occurrance of grade Ⅲ-Ⅳ OM (HR=2.7, P<0.05). Conclusions Comprehensive prevention strategy can overcome the risk factors of OM and prevent the occurrence of OM during HSCT.

Objective To evaluate the diagnostic yield and safety of transbronchial lung biopsy (TBLB) under virtual bronchoscopic navigation (Direct Path), endobronchial ultrasonography with a guide sheath (GS) and rapid on-site evaluation using an ultrathin bronchoscopy (UNRE) for bacterial infection located in the peripheral third of the lung field. Methods Ninety-seven patients with bacterial infection, which located in the peripheral third of the lung field on CT images, were ran-domly assigned to UNRE (n=49) or non-UNRE (NUNRE, n=48) groups, who were treated in General Hospital of Tianjin Medical University between April 1, 2014 and March 31, 2015. The TBLB guided by UNRE was performed in two groups. The diagnostic yield, safety and complication rate were compared between two groups. Moreover, the differences of autofluo-rescence intensity of alveolar macrophage in alveolar lavage fluid were compared between two groups of patients. Results The diagnostic yield was significantly higher in UNRE group than that of NUNRE group (81.6% vs 56.2%, χ2=7.313, P <0.01). The diagnostic yield was higher in UNRE group with bronchus sign compared to that of NUNRE. All patients had a mild bleeding at the time of biopsy. There were no hemoptysis, pneumothorax or other serious complications. The autofluores-cence intensity of alveolar macrophage was different in different levels of infection in patients. Conclusion The procedure of UNRE has higher diagnostic rate and fewer complications. The careful selection of suitable cases can further improve the diagnostic accuracy. The autofluorescence intensity of alveolar macrophage in alveolar lavage fluid indicates the severity of infection in patients.

Objective To investigate the expression of Semaphorin3B (SEMA3B) in hepatocellular carcinoma (HCC) and reveal its clinical significance.Methods Immunohistochemistry and Western blotting were performed to examine the expression of SEMA3B protein in 56 hepatocellular carcinoma samples,matched perineoplastic tissues and 14 normal liver samples.Microvessel density (MVD) was determined by counting CD34-positive endothelial cells.Statistical methods were performed to analyse the relationships between the expression of SEMA3B and clinicopathologic factors.Results The rate of the SEMA3B-positive in HCC tissues was 42.9％ and significantly lower than that in normal liver tissues and non-cancerous adjacent liver tissues(78.6％ and 85.7％,respectively)(P＜0.05).MVD in SEMA3B-positive HCC tissus was lower than that in SEMA3B-negative HCC tissus (P＜0.05).The expression of SEMA3B was closely related to tumor nodular number,tumor size,tumor capsulation and CLIP score (P＜0.05 for all).The recurrence and metastasis rate in SEMA3B-positive group was lower than that in the negative group(P＜0.05),and the survival rate in positive group was higher than that in the negative(P＜0.05).Conclusion The expression of SE-MA3B was decreased in HCC tissues,and its expression was closely associated with tumor progression,angiogenesis and prognosis,indicating that it might seve as a predictor of prognosis and a possible novel target of antiangiogenic therapy for patients with HCC.

Objective To assess the clinical efficacy of acupuncture at the sphenopalatine ganglion for the treatment of patients with moderate to severe allergic rhinitis.Methods 42 cases of moderate to severe allergic rhinitis patients in Otorhinolaryngology clinic of Tongren Hospital between August 2012 to November 2013 were randomized into a treatment group and a control group. The treatment group was treated by acupuncturing sphenopalatine ganglion, once per week, altogether 4 times. The control group was treated by acupuncturingFengchi(GB20),Baihui(GV20),Yingxiang(GV29),Shangxing(GV23),Taiyang(EX-HN5), Quchi(LI11) andZusanli (ST36) was used in the control group, 3 times per week for 4 weeks. The changes of the Total Nasal Symptoms Score (TNSS) and the Total Non-Nasal Symptom Score (TNNSS) were evaluated before and after treatment. The Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) was used to evaluate the quality of life.Results One week after treatment, the scores of TNSS, TNNSS and RQLQ in both groups were significantly improved than before the treatment (treatment group: 5.0[4.0, 6.0]vs. 9.0[7.0, 10.0], 1.0[1.0, 1.5]vs. 3.0[3.0, 3.0], 44.0[35.5, 50.0]vs. 60.0[53.5,75.0]; control group: 6.0[5.5, 8.0]vs. 10.0[8.5, 10.1], 2.0[2.0, 3.0]vs. 3.00[3.0, 3.0], 50.0[45.5, 58.0]vs.43.0[27.0, 48.0]; allP<0.01); the scores of TNSS, TNNSS and RQLQ 1 week after treatment in the treatment group were significantly improved than those in the control group. The scores of TNSS(2.0[1.0, 3.0]vs. 3.0[2.0, 4.5]), TNNSS(1.0[0.0, 1.0]vs.2.0[2.0, 3.0]) and RQLQ(24.0[19.0, 29.0]vs. 43.0[27.0, 48.5])4 week after treatment in the treatment group were significantly improved than those in the control group(allP<0.01).Conclusions Acupuncture at the sphenopalatine ganglion could relieve the symptoms and improve the quality of life in patients with moderate to severe allergic rhinitis, and show more rapid and persistent therapeutic effect. It may be superior to the common acupuncture.

Objective To investigate the expression of T cell immunoglobulin-and mucin-domaincontaining molecule-3 (Tim-3) in peripheral CD8 +T cells and its significance in patients with chronic hepatitis B (CHB).Methods Fifty-eight CHB patients and 16 healthy controls were enrolled.Tim-3 expression in CDs + T cells was detected by flow cytometry,and quantities of IFNγ-producing HBV-specific cytotoxic T lymphocytes (CTLs) in HLA-A2 positive subjects were detected by enzyme-linked immunosorbent spot (ELISPOT) test before and after the blockade of Tim-3/Tim-3L pathway.Paired t test was performed to compare the quantities of CTLs before and after the blockade,and nonparametric Spearman correlation analysis was performed to explore the correlation in quantitive data.Results Tim-3 expression in CHB patients was (14.2 ± 8.98 )％,which was higher than that of healthy controls (4.80 ± 2.92)％,and the difference was of statistical significance (x2 =92.48,P ＜ 0.05 ) Tim-3 expressions in 16 severe CHB patients and 42 mild CHB patients were ( 19.54 ± 10.95) ％ and (9.58 ± 7.30) ％,respectively,and the difference was statistically significant (x2 =77.24,P ＜ 0.05 ). Before the blockade of Tim-3/Tim-3L pathway,IFNγ-producing HBV-specific CTLs were 7.27 ± 3.14,and it increased to 19.62 ± 4.97 after the blockade ( t =2.95,P ＜ 0.05 ).Conclusion The upregulation of Tim-3 on peripheral CD8 + T cells may inhibit HBV-specific CTLs,and the blockade of Tim-3 pathway can enhance the proliferation of IFNγ-producing HBV-specific CTLs,thus can enhance antiviral effect.

The mutual influence of lead and cadmium ions on “in-situ” bismuth film coated glassy carbon electrode was demonstrated using different concentration target ions by changing ratio between Pb2+ and Cd2+. It is found that the presence of coexisting ions can have an influence on the detection of target ions. Especially for the detection of Cd2+, the existence of Pb2+ can be beneficial for the deposition of Cd due to the more positive deposition potentials. And the analytical performances of Cd2+and Pb2+ were obtained. The detection limit is 0. 5 μg/L towards Pb2+ with a linear range from 1-80 μg/L using 60 s deposition time. The resulting calibration plots of Cd2+ are linear over the range from 1-25 and 30-200 μg/L with the detection limit of 1 μg/L using 120 s deposition time. The bismuth film was finally employed to determine the Pb2+and Cd2+in real sample with good satisfied results.

Objective To study phylogenies, epidemiology and genetic environment of CTX-M type of ESBLs produced by Escherichia coli and Klebsiella pneumoniae isolated from nine hospitals in Guangzhou. Methods The phylogenies of CTX-M type of ESBLs were analyzed by PCR Genetic environment of CTX-M-15 encoding gene (bla_(CTX-M-15)) were investigated by conjugation test and plasmid analysis. The clonal relationship of strains producing CTX-M-15 was determined by enterobacterial repetitive intergenic consensus PCR (ERIC-PCR). Results A total of 361 ESBLs-producing isolates of Escherichia coli and Klebsiella pneumoniae were collected. 67.3% of ESBLs strains were detected to produce CTX-M-type ESBLs, and the commonest genotypes in Escherichia coli and Klebsiella pneumoniae were CTX-M-14 (35.4% and 28.3%), CTX-M-15(21.5% and 26.1%) EBIC-PCR products of all CTX-M-15-producing strains show 39 strains of Escherichia coli were classified into 27 genotypes while 43 strains of Klebsiella pneumoniae were divided into 30 genotypes. Furthermore, the genotypes of CTX-M-55, CTX-M-19, CTX-M-27, with ceftazidime-hydrelyzing activity, were detected in this study. The great majority of bla_(CTX-M-15) genes were found to locate on a 65 000 bp-conjugative plasmid, and there was no blaTEM-1, bla_(OXA-1), blaDSA-1 or aac (6')-Ib-cr gene coexisted on the plasmid, ISEcp1-like insertion sequences, relative to mobilization of bla_(CTX-M-15) gene, were detected in all bla_(CTX-M-15) positive strains, and the distances between the end of ISEcp1-like insertion sequences and the start cedon of bla_(CTX-M-15) were equal, with 48 base pairs. Conclusion CTX-M-14 is still the most common genotype of ESBLs in Guangzhou, but high prevalence of CTX-M-15 ESBLs hydrolyzing ceftazidime already appears in south China.

Visual object recognition in humans and nonhuman primates is achieved by the ventral visual pathway (ventral occipital-temporal cortex, VOTC), which shows a well-documented object domain structure. An on-going question is what type of information is processed in the higher-order VOTC that underlies such observations, with recent evidence suggesting effects of certain visual features. Combining computational vision models, fMRI experiment using a parametric-modulation approach, and natural image statistics of common objects, we depicted the neural distribution of a comprehensive set of visual features in the VOTC, identifying voxel sensitivities with specific feature sets across geometry/shape, Fourier power, and color. The visual feature combination pattern in the VOTC is significantly explained by their relationships to different types of response-action computation (fight-or-flight, navigation, and manipulation), as derived from behavioral ratings and natural image statistics. These results offer a comprehensive visual feature map in the VOTC and a plausible theoretical explanation as a mapping onto different types of downstream response-action systems.

Objective:To compare the clinical effects of endoscopic thyroidectomy with different approaches on patients with thyroid cancer.Methods:A prospective study was conducted on 96 patients with thyroid cancer who underwent complete endoscopic thyroidectomy (CET) by the same experienced surgical team in the Head and Neck Surgery Department of Shanxi Cancer Hospital from Jan. 2020 to Jan. 2023. The patients were randomly divided into a trans-subclavian approach group of 48 cases and a transoral vestibular access group of 48 cases using a random number table method. The trans-subclavian approach group underwent CET via the subclavian approach, while the transoral vestibular access group underwent CET via the oral vestibular approach. The surgical and postoperative rehabilitation conditions, complications, and cosmetic satisfaction scores were compared between the two groups. The immune indicators (T lymphocyte subsets (CD3 +, CD4 +), CD4 +/CD8 +), serum soluble interleukin 2 receptor (SIL-2R), tissue kallikrein 11 (KLK11), midkine (MK) levels were measured before surgery. At 1 d, 3 d, and 7 d postoperatively, neck function was assessed using the visual analog scale (VAS), neck injury index, and dysphagia index. Results:The operation time of the transoral vestibular access group and the Trans-subclavian approach group were (117.58±10.87) min and (101.84±11.35) min, respectively ( P<0.001), and the hospitalization time was (4.31±0.86) d and (5.12±0.91) d, respectively ( P<0.001). The drainage volume was (65.13±12.49) mL and (78.65±15.32) mL, respectively ( P<0.001). At 1, 3, and 7 days after surgery, the CD3 + levels in the transoral vestibular access group and the trans-subclavian approach group were (41.53±3.86) % and (38.29±3.51) %, respectively ( P<0.001), (46.21±4.35) % and (42.81±4.06) %, respectively ( P=0.001), and (48.23±4.47) % and (45.10±4.23) %, respectively ( P<0.001). The CD4 + levels were (33.27±3.90) % and (30.18±3.45) %, respectively ( P<0.001), (36.28±4.15) % and (33.46±3.87) %, respectively ( P=0.001), and (38.69±4.22) % and (35.17±4.10) %, respectively ( P<0.001). The CD4 +/CD8 + levels were (1.31±0.22) and (1.16±0.21), respectively ( P=0.001), (1.40±0.23) and (1.20±0.22), respectively ( P<0.001), and (1.58±0.24) and (1.45±0.25), respectively ( P=0.011). There was no significant difference in the levels of serum SIL-2R, KLK11, MK, VAS scores, cervical injury index, or swallowing dysfunction index between the transoral vestibular access group and the trans-subclavian approach group on postoperative day 1, 3, and 7 ( P>0.05). The incidence of complications in the transoral vestibular access group and the trans-subclavian approach group was 8.33% (4/48) and 22.92% (11/48), respectively ( P=0.049), and the cosmetic satisfaction rate was 95.83% (46/48) and 81.25% (39/48), respectively ( P=0.025) . Conclusions:Both the transoral vestibular approach and the subclavian approach for CET treatment of thyroid cancer can cause damage to cervical function. The former can reduce immune function damage, help with early postoperative recovery, and improve safety and patient satisfaction with cosmetic appearance, but it can prolong the operation time.