OBJECTIVE To detect AmpC ?-lactamases from isolates of extended spectrum ?-lactamases(ESBLs) positive Escherichia coli and Klebsiella pneumoniae,which were isolated from four hospitals in Hangzhou from 2005 to 2006,and to analyze the antimicrobial activity of clinically commonly used antibiotics in vitro.METHODS Amount of 324 ESBLs positive isolates including E.coli and K.pneumoniae were collected from Zhejiang Provincial People′s Hospital;1st Affiliated Hospital of Zhejiang University;2nd Affiliated Hospital of Zhejiang University and Hangzhou Traditional Chinese Medicine Hospital perspectivly.AmpC ?-lactamase was identified by disc screening testing and three dimensional test,and the genotypes of AmpC ?-lactamase were also determined by multiplex polymerase chain reaction(Multi-PCR).Minimal inhibitory concentrations(MICs) of ten clinically commonly used antibiotics were determined by agar dilution for AmpC ?-lactamases positive isolates,and the data were analyzed by WHONET 5.3.RESULTS AmpC ?-lactamase phenotype test revealed that 76 AmpC ?-lactamase positive isolates(23.5%) were identified among 324 ESBLs positive isolates of E.coli and K.pneumoniae from four hospitals in Huzhou.69.7% Of the AmpC ?-lactamase phenotype positive isolates were positively amplified by Multi-PCR.The value of MIC50 for carbapenem was lower 0.25 ?g/ml.We also found four carbapenem-resistant strains in this study.CONCLUSIONS We found that the incidence rate of AmpC ?-lactamase is high among the ESBLs producing E.coli and K.pneumoniae strains in Hangzhou.Carbapenem antibiotics have higher antimicrobial activity than other tested antibiotics.

AIM To investigate the cardiovascular activity of new compound V03(CPU228) derived from dofetilide. METHODS Arrhythmias was induced by the occlusion and reperfusion of left anterior descending coronary artery. The effects of CPU228 and dofetilide on QT interval and inducing Tdp were compared in anesthetized rabbits during stimulation with methoxamine. The contractions of thoracic aortic rings induced by KCl (rat) and Phe (guinea pig) in Ca 2+-free and calcium recovered K-H solution was studied to determinate the activity of CPU228 on intracellular calcium mobilization and calcium entry. RESULTS ① CPU228 suppressed the maximal arrhythmia scores, decreased the AUC of arrhythmia score( reduced the duration of VF and VT significantly). PU228 is more potent than dofetilide.②The potency of CPU228 of inducing Tdp is significantly weaker than that of dofetilide.③There were significantly inhibitions of CPU228 on the contractions of aortic rings induced by KCl and Phe in Ca 2+-free solution and dofetilide only had a inhibition on the former. CPU228 inhibited contractions of aortic ring by adding calcium which influx via L-type calcium channel while dofetilide had no effects on these. CONCLUSION CPU228 has stronger inhibition on coronary occlusion and reperfusion arrhythmia and lower potency of inducing Tdp than dofetilide. All the results suggest that CPU228 is a nonselective I Kr-blocker combined with a blockade on the L-type Ca 2+ channel and?adrenergic receptor.

Objective To systematically evaluate the efficacy and safety of posterior short segment and long segment pedicle screw internal fixation in the treatment of thoracolumbar burst fracture. Methods By searching the database, including PubMed, EMBASE, the Cochrane Central Register of Controlled Trials, a comprehensive study was carried out to make a comparison between the posterior short segment and the long segment pedicle screws internal fixation in treatment of thoracolumbar burst fracture, and Meta analysis was performed. Results A total of 14 related studies and 658 patients were enrolled in the study, including 320 patients in short segment group and 338 cases in long segment group, and Meta analysis was performed. The results suggested that there was no significant difference between the short segment group and the long segment group in terms of the deformity angle of the injured vertebra measured after operation and at the last follow?up, and sagittal index at the last follow?up ( MD=-0. 22,95%CI -2. 73,2. 28,P=0. 86;MD=-0. 28,95%CI -2. 23,1. 67, P=0. 78;MD=0. 47, 95%CI -3. 45, 4. 39, P=0. 81 ) . Besides, both groups had no statistical difference in post?operative COBB angle,anterior vertebral height and compression rate of injured vertebrae ( MD=0. 21,95%CI -0. 65,1. 06,P=0. 64; MD=-0. 46,95%CI -1. 40,0. 49,P=0. 34; MD=0. 47,95%CI -2. 28, 3. 21, P= 0. 74 ) , while the differences in COBB angle, anterior vertebral height, compression rate, correction loss were statistically significant at the last follow?up (MD=5. 11,95%CI 2. 81,7. 40,P<0. 0001;MD=-11. 89,95%CI-15. 28,-8. 50,P<0. 00001;MD=6. 46,95%CI 3. 85,9. 07,P<0. 00001) . There was no significant difference in VAS scores and the ODI scores between the two groups at the last follow?up ( MD =0. 01,95%CI -0. 15,0. 17,P=0. 9; MD=-0. 47,95%CI -2. 68,1. 74,P=0. 86),while the two groups showed statistically significant difference in fixation failure ( RR = 0. 08, 95%CI 0. 01, 0. 15, P = 0. 02 ) . Conclusion Posterior long segment pedicle screw internal fixation is more effective in treating thoracolumbar burst fracture than short segment surgery. It can reduce the COBB angle,restore the anterior height of the injured vertebra,and decrease the anterior vertebral pressure.

Objective To explore the effects of perinatal infection on retinopathy of prematurity (ROP).Methods A retrospective cohort study was performed to analyzed the clinical data of 238 preterm infants at gestational age ≤32 weeks who were delivered in Guangdong Women and Children Hospital from November 2014 to October 2015 and ROP screening examinations.Observation was not terminated until they were 45 weeks of corrected gestational age.Mild ROP was defined as having stage 1 or stage 2 ROP in zone Ⅱ or Ⅲ without additional disease,and severe ROP was defined as stage 3 or higher,any ROP in zone Ⅰ,prethreshold/threshold,with additional disease,and aggressive posterior retinopathy of prematurity (AP-ROP).Medical records of eligible preterm infants were retrospectively reviewed and analyzed.Occurrences of ROP,severe ROP,and clinically significant ROP requiring surgical treatment were assessed.Results The mean gestational age of the cohort was (30.10 ± 1.34) weeks (25.29-32.00 weeks) and the mean birth weight was (1 373 ± 272) g(720 ～2 330 g).ROP was diagnosed in 76 of 238 infants (31.9％),including 39 cases with mild ROP (16.4％) and 37 cases with severe ROP (15.5％).Surgical treatment was performed on 22 infants (9.2％).In the patients with ROP,the time to develop ROP from birth was (35.16 ± 14.26) d and the mean time of its most serious stage was (44.62 ± 18.99) d.In 22 patients with ROP who required surgical treatment,the time of surgical treatment was (50.27 ± 17.24) d.In univariate analysis,maternal perinatal infection disease was found to be associated with ROP occurrence (x2 =7.891,P =0.005) and ROP progression requiring surgical treatment (x2 =4.494,P =0.034).Small gestational age,low birth weight and long-term oxygen therapy were found to be asso ciated with ROP occurrence and severe ROP (gestational age:t =-5.803,P ＜ 0.001;t =-5.290,P ＜ 0.001;t =-4.150,P ＜ 0.001;birth weight:t =-4.942,P ＜ 0.001;t =-4.058,P ＜ 0.001;t =-3.126,P =0.002;the duration of oxygen therapy:t =2.351,P =0.020;t =2.473,P =0.018).Apgar scores ≤ 7 at 1 min and 5 min were found to be associated with severe ROP (x2 =4.803,P =0.028).Neonatal sepsis and neonatal fungal infection were found to be associated with ROP occurrence (x2 =6.071,P =0.014;x2 =4.070,P =0.044).Neonatal fungal infection was also found to be associated with severe ROP (x2 =5.479,P =0.019).Multivariate regression analysis indicated that maternal perinatal infection disease was associated with an increased risk of ROP and ROP progression requiring surgical treatment (OR =2.837,P =0.023;OR =4.087,P =0.012).Maternal preeclampsia was also associated with an increased risk of ROP (OR =2.506,P =0.040).Gestational age was an important risk factor for the development of ROP.The smaller the gestational age was,the higher the rate of occurring ROP and severe ROP (OR =0.518,0.508,0.520,all P ＜ 0.001).Conclusions Both fetal and neonatal exposure to infection appear to contribute to the increase of ROP risk in the preterm infants at gestational age ≤ 32 weeks.Maternal perinatal infection disease and maternal preeclampsia were independently associated with ROP occurrence and ROP progression in the preterm infants at gestational age ≤32 weeks.

Objective To find the safe vertical displacement for minimal infusion rate change of syringe pumps as the theoretical guidance for moving pumps. Methods The infusion volume within 1 minute after none and vertically moving 15, 25, 35, 50 cm of the pumps (microinfusion pump WZ-50C、WZ-50C2、BRAUN perfusor compact) at 10 ml/min were weighted and compared by the electronic balance. Results Significant differences of the infusion rate were detected. The difference of average infusion volume within 1 minute after vertically moving 15, 25, 35, 50 cm and non-movement were 0.004 (minimal),0.017, 0.033, 0.046ml. The lowest infusion curve of 15cm displacement stretches slightly above the horizontal plane until the inflexion in the section graph, leading to steeper in accordance with the increasing vertical displacement of the pumps,which implied the following drastic increase in infusion rate. Conclusions The minimal infusion change is obtained at 15cm, thus becomes the safe displacement height and the inflexion point of further soaring changes.

BACKGROUND: Hyaluronan-methylcellulose hydrogel cannot only be conjugated with short peptide sequences and growth factors to achieve sustained release, but also has a role in blocking dural defects and reducing inflammation. It is an ideal biomaterial for the treatment of spinal cord injury. OBJECTIVE: To investigate the effect of neurotrophin-3 modified hyaluronan-methylcellulose (HAMC-NT-3) hydrogel on the recovery of neurological function in rats with spinal cord injury. METHODS: Fifty-four female Sprague-Dawley rats (provided by the Experimental Animal Center of the Academy of Military Medical Sciences in China) were randomly divided into three groups (n=18 per group) . The sham group only underwent T10 laminectomy. In the model group and the experimental group, an aneurysm clip was used to establish spinal cord injury models after T10 laminectomy. The experimental group was locally injected with HAMC-NT-3 hydrogel. The Basso Beattie Bresnahan function scoring was performed at 1 day, 1, 2, 3, 4, 5, 6, 7, and 8 weeks after surgery. The inclined plane test was performed at 4, 6 and 8 weeks after surgery to evaluate the recovery of hindlimb motor function. ELISA was used to detect the concentrations of inflammatory factors in the spinal cord at 1 week after surgery. Immunohistochemical staining was used to observe the area of syringomyelia, glial fibrillary acidic protein expression and nerve regeneration at 8 weeks after surgery. RESULTS AND CONCLUSION: (1) The Basso Beattie Bresnahan scores of the model group and the experimental group were lower than those of the sham group at various time points after surgery (P < 0.05) . The Basso Beattie Bresnahan scores of the experimental group were higher than those of the model group at 4-8 weeks after surgery (P < 0.05) . (2) In the inclined plane test, the maximum inclined angles of the model group and the experimental group at each time point after surgery were lower than that of the sham group (P < 0.05) . The maximum inclined angles of the experimental group at 6 and 8 weeks after surgery were higher than those of the sham group (P < 0.05) . (3) The concentrations of tumor necrosis factor-α, interleukin-1β, interleukin-6 and interleukin-10 in the experimental group and the model group were higher than those in the sham group (P < 0.05) . The concentrations of tumor necrosis factor-α, interleukin-1β and interleukin-6 in the experimental group were lower than those in the model group (P < 0.05) . The concentration of interleukin-10 in the experimental group was higher than that in the model group (P < 0.05) . (4) Immunohistochemical staining showed that the expression levels of glial fibrillary acidic protein in the experimental group and the model group were higher than those in the sham group, while the expression of glial fibrillary acidic protein in the experimental group was lower than that in the model group. The area of syringomyelia in the experimental group was smaller than that in the model group (P < 0.05) . These results indicate that local injection of HAMC-NT-3 hydrogel can effectively inhibit inflammation as well as astrocyte activation and proliferation, reduce fibrous scar formation, and promote the protection of nerve tissue and the recovery of hindlimb motor function after spinal cord injury.

Objective To preliminarily investigate the role of Vitamin C in cecal ligation and puncture-induced septic brain injury.Methods Male specific pathogen free (SPF) Sprague-Dawley male rats were randomly assigned into control group,sham operation group,sepsis group and sepsis therapy group.The rats in sepsis group were prepared by cecal ligation and puncture.The rats in sepsis therapy group were injected sodium ascorbate through the tail vein 3 h after the cecal ligation and punature procedure.The animals in other groups were subjected only to subcutaneous bolus injection of 9 g/L saline only.Animals were evaluated by neurologic reflex scores before sacrifice and brain tissues were quickly removed at the indicated time points.Reactive oxygen species (ROS),superoxide dismutase (SOD),malondialdehyde (MDA),nitric oxide (NO),inducible nitric oxide synthase (iNOS) and catalase (CAT) were determined by using enzyme assay kits.Hematoxylin-eosin (HE) staining was used to observe morphological changes in brain tissues.Results The survival rate of the sepsis group (30％ at 7th day) was significantly lower than that of the control group (100％ at 7th day)and sham operation group(100％ at 7th day).The survival rate of the sepsis therapy group (45％ at 7th day)was significantly higher than that of the sepsis group(P ＜ O.05).The neurological reflex assessment began to decrease at 6 h in sepsis group and reached the lowest at 24 h (6.00 ± 0.53).The sepsis therapy group (7.62 ± 0.52) was significantly higher (P ＜ 0.05) than the sepsis group and began to recover at 72 h (8.63 ±0.52).ROS,SOD,MDA,NO and iNOS in the sepsis group and the sepsis therapy group reached a peak at 24 h,which decreased at 72 h.The value in sepsis therapy group was significantly decreased than that in the sepsis group,and the difference was statistically significant(P ＜0.05).CAT changed in the opposition.The SOD/CAT in sepsis group was the highest 24 h after the operation,while the ratio in sepsis therapy group was significantly improved.SOD/CAT and MDA were positively correlated(r =0.968,P ＜ 0.05).HE staining showed significant damage to the brain tissue structure in the sepsis group,however some improvement was observed in the sepsis therapy group.Conclusion Vitamin C can significantly improve the survival rate and encephalopathy prognosis in the cecal ligation and puncture SD rat models.The mechanism may be related to the reduction of oxidative stress.

AIM: To compare the efficacy of intravitreal injection of ranibizumab(IVR)and intravitreal injection of conbercept(IVC)in children with retinopathy of prematurity(ROP).METHODS: Retrospective study. A total of 1 100 eyes with ROP treated with intravitreal anti-VEGF at our hospital from January 2015 to June 2023 were included. According to the different therapeutic drugs, the children were divided into two groups: IVR group and IVC group. According to the degree of ROP, the patients were divided into three groups: aggressive ROP(A-ROP), Zone Ⅰ type 1 ROP and Zone Ⅱ type 1 ROP. The reactivation and retreatment between the two groups were compared after propensity score matching(PSM)analysis, and they were followed-up for at least 3 mo after surgery.RESULTS: In Zone Ⅱ type 1 ROP, there was a statistically significant difference in the rates of reactivation and retreatment between the IVR and IVC groups(P<0.05); however, in A-ROP and Zone I type 1 ROP, there were no statistically significant differences in the rates of reactivation and retreatment between the two groups(P>0.05). The risk of reactivation and retreatment of Zone I type 1 ROP was higher than the Zone II type 1 ROP. Furthermore, the use of drugs and corrected gestational age of first treatment were influencing factors of lesion recurrence and retreatment.CONCLUSION: There is a significant difference in the initial cure effect between the two drugs in Zone II type 1 ROP, with the reactivation and retreatment rates of the IVC group being much lower than those of the IVR group.