Objective To analyse the DNA heterogeneity of 20 clinical isolates of Acinetobacteria using infrequet-restriction-site PCR (IRS-PCR ).Methods Strain-specific electrophoretic patterns from PCR products by amplifying DNA sequences flanking infrequent restriction of 20 strains of Acinetobacter were compared with the results of genotype with RAPD as well as the results of biotyping.Results Among the 20 bacteria, ten can be recognized as Acinetobacter haemolytius with biotyping, seven as Acinetobacter lwoffi, while the other 3 bacteria can not be recognized. Acinetobacter haemolytius isolates were divided into 5 gene types with IRS-PCR, isolates of Acinetobacter lwoffi were divided into 4 gene types, meanwhile, the last three bactria were divided into 2 gene types. With RAPD technique, Acinetobacter haemolytius, Acinetobacter lwoffi and the other 3 bacteria were divided into 6 gene types, 4 types, and 2 types by prime 1, respectively, the amplifying results of primer 2 divided Acinetobacter haemolytius into 9 gene types, the Acinetobacter lwoffi ,5 types and the other 3 bacteria,2 types. Conclusion IRS-PCR can be used for typing Acinetobacter and is more aceurate than biotyping. It has the same recogniton abili ty as RAPD while is of better stability and repeatability, so this method is capable of clinical application.

Objective:To explore the effect of enhanced recovery after surgery(ERAS)-based multidisciplinary collaboration model on shortening the time of forbidden eating before receiving surgery, provide the basis for the selection of the preoperative diet prohibition scheme.Methods:From January 2017 to February 2019, a total of 384 patients who received the operation in Qingdao Municipal Hospital were analyzed retrospectively. The patients who under the traditional preoperative diet prohibition scheme were taken as the control group(156 cases) while those who under the multidisciplinary cooperation mode nursing under the concept of eras were taken as the experimental group(228 cases). The experimental group formulated the perioperative diet prohibition process according to the guidelines of eras, and the experimental group carried out the perioperative diet management for the patients according to the procedure. The difference between the two groups in the time of fasting, hunger, thirst incidence, insulin resistance, temporary stop will be observed and compared.Results:The time of fasting was (4.01±1.55) h in the experimental group and (10.12±1.57) h in the control group,there was significant difference between the two groups( t value was -1.65, P < 0.01). The incidences of thirst,hunger were 13.2%(30/228), 11.8%(27/228) in the experimental group and 89.7%(140/156), 87.2%(136/156) in the control group, there were significant differences between the two groups(χ 2 values were 220.20, 215.20, P < 0.01). The levels of insulin resistance on the first and third day after operation were 1.85 ± 0.43,1.52±0.61 in the experimental group and 1.99±0.51, 1.67±0.49 in the control group, the differences were statistically significant ( t values were -2.90, -2.56, P < 0.05).The temporary stop rate was 1.75%(4/228) in the experimental group and 7.69%(12/156) in the control group, the difference was statistically significant( χ2 value was 8.19, P<0.01). Conclusions:The ERAS-based multidisciplinary collaboration model can effectively shorten the preoperative fasting time, reduce the level of insulin resistance, reduce the incidence of hunger and thirst, and improve the rate of temporary stop and adjustment.

OBJECTIVE:To optimize the ultrasonic extraction technology of salidroside in Rhodiola rosea. METHODS:With the content of salidroside as the index,L16(45)orthogonal test was designed to observe the effects of 4 factors including the mass fraction of ethanol,solid-liquid ratio,extraction time and ultrasonic power on the content of salidroside in R. rosea extraction solu-tion. By using Matlab 6.5 software,mathematical simulation of ultrasonic extraction process of salidroside was made with the data of orthogonal test. Multiple regression analysis method was adopted to optimize the ultrasonic extraction technology of salidroside, and then the extraction result of optimal technology and that of traditional heating reflux technology were compared. RESULTS:The optimal extraction technology of salidroside was as follows as ethanol mass fraction of 77%,solid-liquid ratio of 1∶34 (g∶ml),extraction time of 34 min,ultrasonic power of 237 W(ultrasonic frequency of 40 kHz). Under the above-mentioned condi-tions,the content of salidroside was up to 0.982 4%,close to the predicted value of 0.989 4%. Compared to heating reflux meth-od,the ultrasonic method has similar content of salidroside but extraction time was shortened by 62.2%. CONCLUSIONS:The ul-trasonic extraction method for extracting the salidroside in R. rosea is simple,requires shorter time,and giving rise to higher extrac-tion rate.

ObjectiveTo explore the best time for replacing the long-term indwelling catheter in patients with silicone catheter.MethodsDomestic literature were retrieved and analyzed using Cochrane systematic review,and the meta-analysis of randomized controlled trials was conducted in accordance with inclusion criteria and exclusion criteria so as to look into the most suitable time for replacing the indwelling catheter for patients with silicone catheter at clinical trials.The replacement frequency for the catheters of different size together with the relevant infections in urinary tract infection and relative risk(RR)were used as values for effectiveness of interventions.ResultsA total of 11 literature were retrieved. Meta-analysis results suggested that the RR values of urinary tract infections when the catheters were replaced once every two weeks vs. every four weeks,and once every three weeks vs. every four weeks were 0.51[95% CI(0.40,0.66),P <0.001],0.79[95% CI(0.58,1.08),P = 0.14],respectively.The urinary infection rate of replacing a silicone cathether every 2 weeks was higher than that of every 4 weeks,but there was no difference between that of every 3 weeks and 4 weeks.Conclusion According to the nature of silicone catheter material as well as the clinical indexes, it is most reliable to replace a silicone catheter every four weeks to reach a best clinical outcome.

Hepatobiliary and pancreatic diseases are common comorbidities of inflammatory bowel disease (IBD), and the presence of such diseases may affect the diagnosis, treatment, and prognosis of IBD and has certain value in identifying the cause of IBD. This article elaborates on the epidemiology of IBD with hepatobiliary and pancreatic diseases, so as to provide new insights for understanding the pathogenesis of IBD and formulating effective clinical treatment regimens.

Objective To explore the attitude toward medication compliance among patients with chronic heart failure. Methods Totals of 8 chronic heart failure patients and 5 medical staffs had been selected to have a in-depth interview for the investigation of medication compliance and current belief of medication taking. Results The behavior of medication incompliance was various for chronic heart failure patients, mainly including the behavior of suspending medication by themselves and adjusting medication dose. The medication compliance had a close relationship with the belief of medication taking. Drug-related convictions included awareness the importance of medicine, efficacy perception, fear of side effects, convenience and accessibility of taking medicine. Conclusions The improvement of patient′s medication compliance requires personal belief of medication taking. We understands the think of medication taking, implements individuals and targeted nursing intervention, so as to improve medication compliance.

Objective:To investigate the application value of establishing the differential diagnosis model of pulmonary tuberculosis using routine laboratory data.Methods:The retrospective study was conducted. The routine laboratory data of newly diagnosed patients with pulmonary tuberculosis and other pulmonary diseases in Beijng Jishuitan Hospital and Beijing Hepingli Hospital from May 2015 to November 2021were collected. According to the random numbers showed in the computer, all the 11516 patients were divided into training dataset and test dataset with a ratio of 9∶1. Four machine learning algorithms, Support Vector Machine, Random Forest, K-Nearest Neighbor and Logistic Regression, were used to build models and select features. The diagnostic accuracy of each model was verified by using the 10-fold cross-validation method and the performance of each model was evaluated by using the receptor operator of characteristic (ROC) curve.Results:Random Forest was selected as the optimal machine learning algorithm to build the best feature model in the study. According to importance scale of factors, the differential diagnosis model of pulmonary tuberculosis consisting of 37 non-specific test indexes. In the validation set and test set the accuracy and area under curve (AUC) of the models were 0.747 and 0.736, the sensitivity, specificity and accuracy were 68.03% and 68.75%, 70.91% and 67.90%, 70.30% and 68.12%, respectively.Conclusion:A key tool in the differential diagnosis model of pulmonary tuberculosis was established by routine laboratory data in combination with machine learning. The results of this study need to be further verified by more data from medical institutions.

Objective To investigate the expression of lncRNA SNHG8 in placenta accrete(PA)and its effect on trophoblast invasion and migration.Methods qRT-PCR was used to detect the expression of lncRNA SNHG8 in placenta tissue of 30 cases in PA group and 30 cases in control group,and the correlation between lncRNA SNHG8 expression and prenatal ultrasound score of 30 cases in PA group was analyzed.Transwell and scratch assay were used to detect the effect of lncRNA SNHG8 interference on the invasion and migration of human chorionic trophoblast cells(HTR8/SVneo cells),and western blot was used to detect the expression of MMP-2 and MMP-9.The downstream targets of lncRNA SNHG8 were predicted by StarBase software,and the expression of lncRNA SNHG8 was detected in placental tissues of the two groups.Dual luciferase reporter assay was used to detect the targeting relationship between lncRNA SNHG8 and miR-542-3p.Results Compared with that of the control group,the expression of lncRNA SNHG8 was up-regulated in the placenta tissue of the PA group(P<0.05),and it was positively correlated with prenatal ultrasound score.Interference with lncRNA SNHG8 inhibited the invasion and migration of trophoblast cells(P<0.05);the protein expression of MMP-9 and MMP-2 also decreased signifi-cantly(P<0.05).Biological prediction indicates that miR-542-3p had a binding site with lncRNA SNHG8,and miR-542-3p expression was down-regulated in PA placental tissue(P<0.05).Dual luciferase reporter assay confirmed that lncRNA SNHG8 could target miR-542-3p.Compared with si-SNHG8+inhibitor-NC,co-transfection of si-SNHG8 and miR-542-3p inhibitor enhanced the invasion and migration ability of trophoblast cells(P<0.05).Conclusion lncRNA SNHG8 is highly expressed in PA and is related to the severity of PA.LncRNA SNHG8 promotes the invasion and migration of trophoblast by regulating the level of miR-542-3p.The study suggests that lncRNA SNHG8 plays an important role in the invasion and migration of PA trophoblast cells,which is expected to be a clinical diagnostic biomarker and therapeutic target.

Among the staff of Beijing Chao-Yang Hospital, Capital Medical University, who received the inactivated SARS-CoV-2 vaccine on January 30 in 2021, 28 recipients were selected for this research. Samples for nucleic acid tests were collected from the surface of the recipients′ both hands before and after vaccination. The hemostatic stickers used after the inoculation were also collected for nucleic acid tests. The nucleic acid tests of the samples collected from the surface of both hands of the 28 recipients before vaccination were all negative. After vaccination, the nucleic acid tests of the samples collected from the surface of both hands of recipients were positive in 3 cases, and suspicious in 8 cases, with a positive rate of 10.7%. A total of 25 hemostatic stickers used were collected, 24 of them had positive nucleic acid tests, and the rest one had suspicious nucleic acid test result, with a positive rate of 96%. The hemostatic stickers used after the inoculation have the risk of nucleic acid contamination.

Lung cancer accounts for the highest proportion of cancer deaths in the world and poses a great threat to human health.About 30％to 40％of non-small cell lung cancer(NSCLC)is caused by point mutations,exon insertion and exon deletion of the epidermal growth factor receptor(EGFR).In addition to the common exon 19 deletion mutation and exon 21 L858R mutation,exon 18 G719X mutation,exon 21 L861Qmutation and exon 20 S768I mutation are the most important rare mutations.At present,the diagnostic methods for major rare mutations are mainly next-generation sequenc-ing(NGS),digital polymerase chain reaction(dPCR),droplet digital PCR(ddPCR),etc.Regarding the targeted therapy of G719X/L861Q/S768I mutant NSCLC,the first generation EGFR-tyrosine kinase inhibitors(TKIs)have poor efficacy,while the second and third generation EGFR-TKIs have similar efficacy.The novel third generation EGFR-TKIs and combina-tion therapy show a good therapeutic prospect.This article summarized the progress in the diagnosis and targeted therapy of G719X/L861Q/S768I mutant NSCLC,so as to provide reference for subsequent clinical drug use and research.