Objective To monitor and analyze the distribution of pathogenic bacteria from CSF and its drug resistance change in Yangzhou area during 2011-2015 ,so as to provide the latest evidence for clinical rational use of antibacterial drugs .Methods The VITEK 2 automatic microbiological instrument was applied to identify bacteria and conduct the drug susceptibility test .The distri‐bution and drug susceptibility situation of isolated pathogenic bacteria were analyzed by using the WHONET 5 .6 software . Results In 2074 CSF bacterial culture from 2011 to 2015 ,74 strains(3 .57% ) of pathogenic bacteria were isolated ,in which the top three were Acinetobacter baumanni(21/74 ,28 .38% ) ,Klebsiella pneumonia (13/74 ,17 .57% )and Staphylococcus epidermis(12/74 , 16 .22% ) .The resistance rate of acinetobacter baumanni toantibacterial drugs was extremely serious ,showing muti‐drug or pan‐drug resistant phenomena .Conclusion Regular monitoring and analyzing the species and change of drug resistance in pathogenic bacteria isolated from CSF have an important significance to guide clinic to rationally use antibacterial drugs .

Objective To investigate the effect of total saponins of panax notoginseng(PNS)on the production of collagen Ⅰ,Ⅲ and TGF-?1 in rats with experimental fibrosis.Methods Experimental fibrosis model was copied by intracutaneous injection of BSA and rats feeding on diet rich in lipid.From the 1st day after BSA injection,SPN(60 or 30 mg/kg)or Colchicine were given intracutaneously once a day for 42 days.All animals were sacrificed on the 43rd day.Their hepatic function was evaluated by determining the levels of ALT,AST,ALB in serum.The progression of hepatic fibrosis was confirmed by pathological analysis.Then type collagenⅠ,Ⅲ and TGF-?1 were observed with immunohistochemical method.Results The BSA injection significantly elevated the levels of ALT and AST,while SPN treatment significantly down-regulated them.But the level of ALB was opposite to that of ALT or AST in SPN treatment group.The positive staining of the collagenⅠ,Ⅲ and TGF-?1 was stronger in hepatic fibrosis model group than in SPN treatment group.The contents of the collagen were identical to the immunohistochemical results.Conclusion SPN has the protective effect against liver fibrosis.

Objective To investigate the effect of a selective cyclooxygenase-2 inhibitor on tumor metastasis,tumor angiogenesis,and vascular endothelial growth factor(VEGF)of orthotopic implanted human gastric carcinoma in non.obesity diabetes(NOD)severe combined immune deficiency(SCID)mice.Methods Human gastric cancer SGC-7901 tissues were orthotopically implanted into the stomach of the NOD SCID mice.Forty mice were randomly divided into two groups which received either intravenous injections of 0.9% Nacl solution (0.9% NaCL solution group)or 50mg/kg.d Nimesulide(Nimesulide group)twice weekly for two weeks.Mice were sacrificed in the 5th week after implantation.Tissues from stomach and other organs were obtained for histopathologieal evaluation.The intratumoral microvessel density(MVD)and VEGF protein expression in tumor were evaluated by immunochemical method.Results The tumor metastasis rates were 18/20 in 0.9% Nacl solution group and 5/20 in Nimesulide group(P＜0.05).MVD was 9.5±2.9 in 0.9% NaCl solution group and 3.9±2.1 in Nimesulide group(P＜0.01).VEGF protein expression was 90% in 0.9%NaCl solution group and 25% in Nimesulide group(P＜0.01).Conclusions Nimesulide can inhibit the metastasis or gastric cancer through inhibiting tumor VEGF expression and tumor angiogenesis with no obvious anticoagulant activity.

Objective: To construct a nursing care service index system for postoperative ostomy patients with colorectal cancer based on Omaha system, which is used to guide nursing practice. Methods: Using the Omaha system as the conceptual framework, using literature search method, expert group discussion, Delphi expert correspondence method, screening indicators to establish a system of postoperative care services for patients with colorectal cancer. Results: The two rounds of expert letters asked that the effective recovery rate of the volume was 100%(28/28). The coefficient of expert authority of the two rounds of letters was 0.88 and 0.89 respectively, and the coordination coefficients of the expert opinions were 0.476 and 0.501 respectively. The finalized indicator system for care services includes 4 first-level indicators, 13 secondary indicators, and 61 third-level indicators. Conclusion The results of this study are scientific and reliable, and the formation of postoperative ostomy patients with colorectal cancerThe indicator system can provide a reference for clinical practice.

Objective To investigate the effect and underlying mechanism of radioactive 125I seed implantation on the angiogenesis of transplanted human lung adenocarcinoma in nude mice.Methods An animal model of transplantd human lung adenocarcinoma was established by subcutaneous implanting A549 cells into nude mice.Twenty four tumor-bearing nude mice were randomly divided into 4 groups with different irradiation doses of blank control (without any treatment) and 0 MBq,22.2 MBq,29.6 MBq and by embedding radioactive 125I seeds with an 18 G implant needle.Tumor volumes were measured every 4 days until all mice were terminated 30 d later and the tumor growth curve was drawn.The microvessel density (MVD) in the tumor tissue was detected by immunohistochemistry S-P assay.The mRNA and protein levels of VEGF and HIF-1α of each group were detected by RT-PCR and Western blot,respectively.Results After embedding of 125I seeds,the tumor volumes of 22.2 MBq group (886 ± 97) and 29.6 MBq group (590 ± 107) were significantly smaller than those of control group (2 297 ± 149) at 54 d after administration (q =14.117,17.075,P ＜ 0.05),but there were no significant differences among 0 MBq group and control group,22.2 MBq and 29.6 MBq groups (P ＞ 0.05).The immunohistochemical CD34-positive staining demonstrated that MVD in 22.2 MBq group (522 ± 119) and 29.6 MBq group (491 ± 121) were decreased significantly compared with control group (922 ± 260) (q =4.826,5.197,P ＜0.05),but there were no significant differences among 0 MBq and control groups,22.2 MBq and 29.6 MBq groups(P ＞0.05).The mRNA expressions of VEGF and HIF-1α in 22.2 MBq group (0.279±0.0659,0.370 ±0.0857) and 29.6 MBq group (0.215 ±0.0620,0.278 ±0.0651) were significantly lower than those in the control group (q VEGFmRNA =18.881,17.211,q HIF-1αmRNA =15.376,14.733,P ＜0.05),but there were no significant differences among 0 MBq and control groups,22.2 MBq and 29.6 MBq groups(P ＞0.05).At the same time,the expression levels of VEGF and HIF-1α protein after 125I seed implantation were also obviously decreased in 22.2 MBq and 29.6 MBq groups (qvEGr =5.848,6.263,q HIF-1α =6.560,7.576,P ＜ 0.05),and no significant difference between 0 MBq and control groups(P ＞ 0.05) and between 22.2 MBq and 29.6 MBq groups (P ＞ 0.05).Conclusions Interstitial implantation with 125I seeds may potently inhibit angiogenesis in human lung adenocarcinoma xenografts of nude mice.

Objective To survey the resistance profile of clinical isolates to antibiotics across the hospitals in Dongguan,Guangdong Province during 2015.Methods Kirby-Bauer method or automated system was used to test the susceptibility of clinical isolates to selected antimicrobial agents.Results were analyzed according to CLSI 2015 breakpoints.The susceptibility data were analyzed using WHONET 5.6 software.Results A total of 29 665 strains of microorganisms were isolated,of which gram positive cocci accounted for 32.1％ (9 509/29 665) and gram negative bacilli accounted for 67.9％ (20 156/29 665),respectively.The prevalence of methicillinresistant Staphylococcus was 23.3％ (705/3 024) in S.aureus and 43.6％ (1 054/2 419) in coagulase-negative Staphylococcus.No vancomycin-resistant staphylococcal strain was found.ESBLs-producing strains accounted for 36.4％ (2 554/7 020) in E.coli and 24.5％(792/3 227) in Klebsiella isolates.The prevalence of carbapenem-resistant Enterobacteriaceae was 0.2％ (30/13 077).The prevalence of carbapenem-resistant Pseudomonas aeruginosa (CRPA) and carbapenem-resistant Acinetobacter baumannii (CRAB) was 16.0％ (500/3 116) and 53.9％ (827/1 533),respectively.The prevalence of penicillin-resistant S.pneumoniae (PRSP) strains was 10.1％ (142/1 404).Beta-lactamase was produced in 30.6％ (276/902) of the H.influenzae strains.The prevalence of vancomycin-resistant Enterococcus (VRE) strains was 0.7％ (10/1 441).Conclusions Periodic surveillance of antimicrobial resistance is valuable for rational antimicrobial therapy,formulation of treatment guidelines and infection control and prevention measures,as well as preventing the spread of drug-resistant strains.

BACKGROUNDLung cancer with intramedullary spinal cord metastasis(ISCM) is a rare event,which showes poor response to treatment.Its optimum treatment remains controversial.The objective of this study is to investigate the clinical features,diagnosis and treatment of lung cancer with ISCM.

METHODSThe diagnosis and treatment of two cases of lung cancer with ISCM in 2005 were reported retrospectively and some related literatures were reviewed.

RESULTSThe diseases of the two cases progressed fast,and their responses to treatment were poor.

CONCLUSIONSThe clinical feature of lung cancer with ISCM is untypical.Magnetic resonance imaging is now considered the most important method for diagnosis of ISCM.Radiotherapy is the major treatment.Its prognosis is still poor.

Background and Purpose:Prostate cancer is one of the most common cancers and the second leading cause of cancer-related death in Europan and North American males.The incidence of prostate cancer has also been increasing during the past few decades in China.It is widely accepted that this heterogeneity,which results from the tumor progression driven largely by genomic instability(genetic and/or epigenetic alterations)of tumor cells in primary tumor,endows specific populations of tumor cells with the unique character needed for invasion,migration,and metastasis colony formation in other organs and only these subpopulations possessing thost character can survive the potentially destructive journey from the primary tumor to the sites of metastases.The purpose of the present study was to explore the genes associated with invasion and metastasis of human prostate cancer cell line PC-3M in nude mice.Methods:After PC-3M cells were inoculated into orthotopic site(prostate) in a male nude mouse for two months,tumor cells were isolated from the primary tumor and lymph node metastasis,separately.Cell invasion and adhesion ability in vitro were first compared between two cells.Then metastasis-related genes differentially expressed between them were analyzed by utilizing cDNA microarray technique.Results:The in vitro cell invasion and adhesion potential of tumor cells from lymph node metastasis was significantly higher than those from primary tumor by 2.5 fold and 1.5 fold,respectively.Metastasis-related genes differentially expressed between those two sublines were identified,all of them were up-regulated in the tumor cells from lymph node metastasis and could be categorilized: 1.genes encoding cellular matrix-degrading proteolytic enzyme including cathepsin and MMP.2.genes encoding transcription factors.3.genes related to heterotypic adhesion of tumor cells.4.genes encoding cell surface receptors.Conclusions:There are significant differences in invasion and adhesion potential between cells from primary tumor and those from lymph node metastasis.Some differentially expressed molecules might be playing pivotal roles in promoting tumor cells to migrate from primary tumors to distant metastases,which may be helpful to elucidate the possible mechanism of metastasis in prostate cancer.

Objective: To develop a model incorporating radiomic features and clinical factors to accurately predict acute ischemic stroke (AIS) outcomes. Materials and Methods: Data from 522 AIS patients (382 male [73.2%]; mean age ± standard deviation, 58.9 ± 11.5 years) were randomly divided into the training (n = 311) and validation cohorts (n = 211). According to the modified Rankin Scale (mRS) at 6 months after hospital discharge, prognosis was dichotomized into good (mRS ≤ 2) and poor (mRS > 2); 1310 radiomics features were extracted from diffusion-weighted imaging and apparent diffusion coefficient maps. The minimum redundancy maximum relevance algorithm and the least absolute shrinkage and selection operator logistic regression method were implemented to select the features and establish a radiomics model. Univariable and multivariable logistic regression analyses were performed to identify the clinical factors and construct a clinical model. Ultimately, a multivariable logistic regression analysis incorporating independent clinical factors and radiomics score was implemented to establish the final combined prediction model using a backward step-down selection procedure, and a clinical-radiomics nomogram was developed. The models were evaluated using calibration, receiver operating characteristic (ROC), and decision curve analyses. Results: Age, sex, stroke history, diabetes, baseline mRS, baseline National Institutes of Health Stroke Scale score, and radiomics score were independent predictors of AIS outcomes. The area under the ROC curve of the clinical-radiomics model was 0.868 (95% confidence interval, 0.825–0.910) in the training cohort and 0.890 (0.844–0.936) in the validation cohort, which was significantly larger than that of the clinical or radiomics models. The clinical radiomics nomogram was well calibrated (p > 0.05). The decision curve analysis indicated its clinical usefulness. Conclusion The clinical-radiomics model outperformed individual clinical or radiomics models and achieved satisfactory performance in predicting AIS outcomes.

Objective:To investigate the value of radiomics based on three-dimensional high resolution MR vessel wall imaging (3D HRMR-VWI) for identifying culprit plaques in symptomatic patients with middle cerebral atherosclerosis.Methods:The clinical and imaging features of 117 patients (139 middle cerebral artery plaques) with cerebrovascular diseases in Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from October 2018 to October 2020 were respectively reviewed. Stratified random sampling was used to divide 139 plaques into training set (97 plaques) and validation set (42 plaque) at the ratio of 7∶3. The plaques were divided into 69 culprit plaques and 70 non-culprit plaques based on plaque MR features and clinical symptoms. The clinical and imaging characteristics of culprit plaques and non-culprit plaques were compared by independent sample t-test, Mann-Whitney U test and χ 2 test, and factors with significant difference between two groups in univariate analysis were further analyzed by multivariate logistic regression to find out the independent predictors of culprit plaques. Radiomics features were extracted, screened and radiomics model was constructed using pre-and post-contrast 3D HRMR-VWI based on the training set. The combined model was constructed by combining the independent predictors and radiomics model. Receiver operating characteristic curve and area under curve (AUC) were used to evaluate the efficacy of each model, and DeLong test was used to compare the efficacy of different models. Results:Significant difference was found in intraplaque hemorrhage, lumen area of stenosis, stenosis diameter, stenosis rate, plaque burden and enhancement rate between culprit and non-culprit plaques (all P<0.05). Multivariate logistic regression analysis confirmed that only intraplaque hemorrhage was the independent predictor for culprit plaques (OR=7.045,95%CI 1.402-35.397, P=0.018). In the validation set, the AUC of the pre-contrast 3D HRMR-VWI model was lower than that of the post-contrast 3D HRMR-VWI model ( Z=-2.01, P=0.044). The AUC of pre+post-contrast 3D HRMR-VWI model was not significantly different from that of post-contrast 3D HRMR-VWI model ( Z=0.79, P=0.427). The AUC showed no significant difference between combined model and pre+post-contrast 3D HRMR-VWI model ( Z=-0.59, P>0.05). The combined model showed the best performance in predicting culprit plaques of middle cerebral artery (AUC=0.939), with the sensitivity, specificity and accuracy of 95.24%, 76.19% and 85.71%. Conclusion:Radiomics based on 3D HRMR-VWI has potential values in identifying culprit plaques in symptomatic patients with middle cerebral atherosclerosis.