OBJECTIVE To analyze the pathogenic distribution and antimicrobial resistance in our hospital in 2006 and provide the rational information to use antibiotics reasonably.METHODS Flora cultivation and isolation were operated with the methods described by the National Clinical Laboratory Operational Regulations.Flora was identified with the VITEK32 automatic identifier,and bacteria-susceptibility test was operated with Kirby-Bauer method.RESULTS Totally 967 strains of pathogenic bacteria were isolated;they comprised 326 strains of Gram-positive bacteria,541 strains of Gram-negative bacteria and 100 strains of fungi.The main Gram-positive microorganisms included Staphylococcus aureus and Enterococcus faecalis,et al.The main Gram-negative microorganisms included Escherichia coli,Klebsiella pneumoniae,Acinetobacter baumannii,Stenotrophomonas maltophilia and Pseudomonas aerugiinosa,et al.Specimen samples mainly isolated from sputum(43.85%),urine(22.34%),and secretion(10.03%).G+ microorganisms were sensitive to nitrofurantoin and vancomycin.G-microorganisms except A.baumannii and S.maltophilia were sensitive to cefoxitin,piperacillin/tazobactam,imipenem,and amikacin;the average resistant rates of A.baumannii and S.maltophilia to antibiotics were 68.20% and 64.43%,respectively.CONCLUSIONS The severe degree of bacterial multi-drug resistance is increasing,it is urgent to carry out surveillance of bacterial resistance for reasonabe use of antibiotics and decreasing the morbidity rate and the fatality rate.

The application of tooth whitening technology in oral clinical diagnosis and treatment is becoming increasing widespread. Non-invasive tooth whitening based on bleaching technology has become the choice of many patients with tooth discoloration because of its unique advantage of not destroying the hard tissue of the tooth. The whitening effects differ according to the causes and degrees of tooth discoloration The effect of bleaching on tetracycline teeth is not as good as that of fluorosis teeth. The bleaching effect of hydrogen peroxide bleaching agents is similar to that of urea peroxide bleaching agents with the same concentration of hydrogen peroxide. The addition of non-peroxide agents such as bromelain to peroxide bleaching agents can improve the whitening effect on teeth. The whitening effect of a high-concentration bleaching agent can be achieved by using a low-concentration bleaching agent for a prolonged the working time. The effect of pH on tooth whitening is still controversial; the combination of lasers and traditional peroxide bleaching agents can effectively improve the whitening effect of teeth. The combination of enamel micro-grinding and peroxide tooth bleaching agents can improve the whitening effect in cases of dental fluorosis. This review analyzes the causes of tooth staining, the properties of bleaching agents, the application of laser microgrinding and the changes in tooth tissue after bleaching to discuss the influencing factors of the non-invasive tooth whitening effect mainly based on bleaching techniques.

This study was designed to determine the effect of backpack loading on the gait pattern and corresponding compensatory strategy, which is important to the balance control of biped robot and military training. Five healthy subjects were instructed to walk at their preferred speed on level pathway taking three different loads i.e. 6 kg, 12 kg and 25 kg, on their backs. The results showed that the gait pattern was apparently influenced, and the dominant effects were found to be the flexion of hip, knee joints and pitch angle of torso. The stride speed decreased apparently with loading on their backs, but the stride length showed less changes. Besides, the responses to taking loads might be influenced by the strength of body. An apparent multi-joints coordination motor mode was employed to compensate the influences of loading, however, their contributions are different; hip, knee joints and torso pitch made dominant contributions to the compensation while ankle joints made minor. The anterior pitch of upper torso could be employed to adjust the overall center of mass while loading on their backs, the larger the magnitude of loading on their backs, the larger the anterior pitch angle of torso. After the heel touched the ground, the flexion of hip and knee joints were effective for the shock absorption, which means that the stiffness of hip and knee joints can be used to absorb the shock and avoid the trauma of each joints.
Adult ; Ankle Joint ; physiology ; Back ; physiology ; Gait ; physiology ; Hip Joint ; physiology ; Humans ; Knee Joint ; physiology ; Male ; Weight-Bearing ; physiology

A lean management practice had been in place in Taizhou Enze Medical Center during the COVID-19 epidemic period, featuring the " principle-system-tool" theory of the Shingo model, in an effort to build a new model of COVID-19 prevention and control. The center upheld such five principles of lean management as overall planning, total involvement, system collaboration, concern with process and continuous improvement, and people-oriented practice. Under such principles, the center set up five supportive systems of lean management tools, namely risk identification, rapid screening, homogeneous treatment, customized follow-up and employee care. Integrated use of multiple tools of lean management, had improved the hospital′s crisis response ability, achieving desirable outcomes in stages in combating COVID-19 epidemic.

Objective To investigate the clinical manifestations,imaging features and prognosis of mixed liver cancer.Methods The clinical and pathological data of 26 patients with combined hepatocellular carcinoma and cholangiocarcinoma (cHCC-CC) pathologically diagnosed after liver resection were retrospectively analyzed,and the relevant factors affecting the prognosis were statistically analyzed.Results Of the 26 cHCC-CC patients,19 were on background of chronic viral hepatitis,including 17 chronic viral hepatitis B and 2 chronic viral hepatitis C.There were 18 cases having AFP≥20ng/ml,9 cases were with carbohydrate antigen 199 (CA199) ≥ 37U/ml,and 5 cases with carcinoembryonic antigen (CEA) ≥5ng/ml.The 1-,3-,and 5-year postoperative survival rates were 68.8％,34.4％,and 17.4％.Multivariate analysis showed that serum CA199≥37U/ ml(x2 =5.687,P =0.019) was an independent risk factor for patients' survival.Conclusion Most cHCC-CC is found in association with chronic viral hepatitis.Serum CA199 ≥37U/ml is an independent risk factor affecting patients survival.

Objective:To investigate whether SKA1 is a key molecule regulating malignant proliferation of liver cancer, and further explore its mechanism to provide molecular theoretical basis for subsequent targeted therapy.Methods:The data of liver cancer from TCGA database were analyzed by bioinformatics technology. The expression of SKA1 in liver cancer was analyzed. At the same time, we also analyzed the relationship between the expression of SKA1 and the prognosis of patients with liver cancer. The hepatoma cell line overexpressing SKA1 was constructed by liposome-mediated cell transfection technique, and the effect of SKA1 on the proliferation of hepatoma cells was further tested by CCK-8 and plate cloning assay. At the same time, we found that E2F1 is also highly expressed in liver cancer, using bioinformatics technology to analyze the correlation between SKA1 and E2F1 expression, further detecting the binding site of E2F1 in the SKA1 promoter region, and using dual luciferase technology to detect E2F1 against SKA1. Transcriptional activation.Results:KA1 was highly expressed in liver cancer tissues, and the overall survival rate of liver cancer patients with high SKA1 expression was 49.8%, lower than that of patients with low SKA1 expression, showing a negative correlation. E2F1 is also highly expressed in liver cancer tissues, and the survival time of patients with liver cancer with high E2F1 expression is significantly lower than that in the low expression group, which was negatively correlated with poor prognosis. SKA1 overexpression could increase the proliferation ability of liver cancer cells by nearly 50%. SKA1 is regulated by the E2F1 transcription factor, and the E2F1 transcription factor is combined with the SKA1 promoter to transcriptionally activate the expression of SKA1 in liver cancer cells.Conclusion:E2F1 transcriptional activation of SKA1 promotes proliferation of hepatoma cells, leading to poor prognosis in patients with liver cancer

Objective:To detect gene mutations in a pedigree with dominant dystrophic epidermolysis bullosa (DDEB) .Methods:A 20-year-old male proband presented with repeated blisters, ulceration, pigmentation, scars on the limbs, and deformation of the nails/toenails after birth. There were 5 patients in the 3-generation family, and they all presented with typical skin lesions. Peripheral blood samples were obtained from 14 members of the pedigree (including the 5 patients) and 100 unrelated healthy controls. Whole-exome sequencing was performed in the proband to identify relevant mutation sites, which were then confirmed in the family by Sanger sequencing.Results:Genetic testing indicated that the proband and the other 4 patients all carried a missense mutation (c.7885G>A) in exon 107 of the COL7A1 gene, resulting in the substitution of glycine by arginine at amino acid position 2629 (p.G2629R). The mutation was identified neither in the 9 healthy relatives nor in the 100 unrelated healthy controls. The mutation co-segregated with DDEB in the family, and was not included in databases such as Pubmed, HGMD or ClinVar, suggesting it was a novel missense mutation. The amino acid encoded by this mutation may alter the structure of type Ⅶ collagen, thereby affecting its function.Conclusion:A novel missense mutation was identified in exon 107 of the COL7A1 gene in the family with DDEB, expanding the spectrum of mutations in the COL7A1 gene.

Objective:To assess the effectiveness of a 6-month Ba Duan Jin exercise program in improving the balance of community-dwelling older adults.Methods:A two arms, parallel-group, cluster randomized controlled trial was conducted in 1 028 community residents aged 60-80 years in 40 communities in 5 provinces of China. Participants in the intervention group (20 communities, 523 people) received Ba Duan Jin exercise 5 days/week, 1 hour/day for 6 months, and three times of falls prevention health education, and the control group (20 communities, 505 people) received falls prevention health education same as the intervention group. The Berg balance scale (BBS) score was the leading outcome indicator, and the secondary outcome indicators included the length of time of standing on one foot (with eyes open and closed), standing in a tandem stance (with eyes open and closed), the closed circle test, and the timed up to test.Results:A total of 1 028 participants were included in the final analysis, including 731 women (71.11%) and 297 men (28.89%), and the age was (69.87±5.67) years. After the 3-month intervention, compared with the baseline data, the BBS score of the intervention group was significantly higher than the control group by 3.05 (95% CI: 2.23-3.88) points ( P<0.001). After the 6-month intervention, compared with the baseline data, the BBS score of the intervention group was significantly higher than the control group by 4.70 (95% CI: 4.03-5.37) points ( P<0.001). Ba Duan Jin showed significant improvement ( P<0.05) in all secondary outcomes after 6 months of exercise in the intervention group compared with the control group. Conclusions:This study showed that Ba Duan Jin exercise can improve balance in community-dwelling older adults aged 60-80. The longer the exercise time, the better the improvement.

Objective: To investigate the clinicopathological and radiological features of benign fibro-osseous lesion (BFOL). Methods: Sixty-five cases of craniofacial BFOL, eight cases of peripheral ossifying fibroma (POF) and one case of low-grade central osteosarcoma diagnosed at Sichuan Provincial People′s Hospital between January 2010 and March 2019 were collected. The clinicopathologic features, hematoxylin-eosin and immunohistochemical (IHC) staining and radiographic features were analyzed. MDM2 gene amplification was detected by FISH in difficult borderline cases. Results: This cohort of BFOLs included 50 cases of fibrous dysplasia (FD), 12 cases of ossifying fibroma (OF), and three cases of juvenile psammomatoid ossifying fibroma (JPOF). The average ages of patients with FD,OF and JPOF were 31.7, 39.2 and 26.0 years respectively. The male to female ratio was 1.0∶1.8.The average age of POF was 47.0 years, with male to female ratio of 1∶7. Patient of low-grade central osteosarcoma was a 48-year-old man. Twenty-seven cases of FD were located in the jaw, and 23 cases were in other craniofacial bones. Nine cases of OF were located in the jaw, and three cases were in the nasal cavity. Two cases of JPOF were in the nasal sinus, and one was in the jaw. All POF were located in the gingiva, and low-grade central osteosarcoma was located in the mandible. The imaging features of FD were luffa-like or ground-glass like signal shadows with poorly defined borders with expansion. OF had clear borders or sclerosing margins. Both JOF and low-grade central osteosarcoma were expansile intraosseously and with focally invasive nodular masses with ground-glass like signal shadows; and POF showed soft tissue mass with bone formation. Histological features of BFOLs showed mixed fibrous and irregular osteoid lesions. FD had no clear relationship with the host bone and no osteoblasts surrounded the bone trabeculae. Osteoblasts rimming was found in OF, and the boundaries of the host bone were clear. JPOF and low-grade central osteosarcoma infiltrated the host bone focally, and the latter showed mild cellular atypia. MDM2 amplification was detected in low-grade central osteosarcoma. Conclusions BFOLs are a group of fibro-osseous lesions with similar morphology in the head and neck and face, but their clinical features and prognosis are different; and their imaging and histological characteristics are also slightly different. Attentions should be given to the combination of clinical, imaging and pathologic features of BFOLs, especially the differential diagnosis between BFOLs and low-grade central osteosarcoma. Molecular detection could be used to assist the diagnosis in difficult cases.