Objective Study the effect of hysteroscopic surgery in treatment of small mass of caesarean scar pregnancy(CSP).Methods From January 2000 to January 2013,61 cases lesions ≤2.5 cm diameter of endogenous CSP undergoing treatment in Luohe Central Hospital were studied retrospectively.According to different treatment,they were divided into 21 cases in hysteroscopic surgery group,23 cases in methotrexate + operation group and 17 cases in bilateral uterine artery embolism + curettage group.Intraoperative blood loss,operative time,hospitalization time after treatment and β-hCG to normal time were compared among those three groups.Results The surgical blood loss,hospitalization time after treatment,β-hCG to normal time were (49.8 ± 6.2) ml,(3.5 ± 0.8) days,(21.2 ± 2.4) days in hysteroscopic group,(87.0 ±30.5) ml,(12.5 ± 1.0) days,(29.6 ±2.2) days in methotrexate + operation group,the difference was statistically significant (P ＜ 0.05).The operation time were (33 ± 4) minutes in hysteroscopic surgery group and (35 ± 6) minutes in methotrexate + operation group,which did not reached significant difference (P ＞ 0.05).Length of hospital stay after treatment of hysteroscopic surgery group is less than the bilateral uterine artery embolism + curettage group significantly (P ＜ 0.05).Operation time,surgical bleeding and β-hCG to normal time had no obvious difference between hysteroscopic surgery and in bilateral uterine artery embolism + curettage group (P ＞ 0.05).Conclusion Hysteroscopy surgery in treatment of small mass endogenous CSP is effective,shorter hospitalization time,quick recovery.

Objective To construct a new molecular biological method for the analysis of microbial species in lower respiratory tract infections based on 16S rRNA gene by denaturing high-performance liquid chromatograph(DHPLC).Methods The universal primer set was analyzed basing on the highly conserved regions of 16S rRNA gene.DNA amplicons of lower respiratory tract were analyzed by DHPLC to generate peak profiles respectively.The incorporation of 40-bpGC clamp into the amplification primet was essential to effectively discriminate genetic differences identification.Results The primers could only amplify bacterial 16S rRNA.Bacterial of amplicons which incorporation of a 40-bpGC clamp were effectively discriminated genetic differences in DHPLC.The results of clinical isolares identification showed 100%according with the traditional method.Conclusion DHPLC has not only high accuracy,but also is a convenient,rapid and high-through technique for the discrimination bacteria.It has potential value in the detection of lower respiratory pathogenic bacteria.

Objective To investigate the therapeutic effect of Saccharomyces boulardii on antibiotics associated diarrhea (AAD)in infant pneumonia.Methods 302 hospitalized infant patients (1 month-3 years) with pneumonia but without gastroenteric disease were selected , and antibiotics were administrated intravenously at least 5 continuous days for each patient .Patients were all giv-en antibiotics and randomly divided into three groups:control group with no Saccharomyces boulardii administration ( group A, 60 ca-ses);Saccharomyces boulardii were applied as addition on the occurrence of diarrhea (group B, 92 cases), and Saccharomyces boular-dii and antibiotics were co-administrated (group C, 150 cases).Incidences of AAD in all groups were carefully examined and differ-ences of therapeutic effect between groups were compared and analyzed .Results The incidence of AAD in Group C was significantly lower than that in other groups .In term of diarrhea severity, no significant difference was observed in all groups (P>0.05).Howev-er, duration of diarrhea showed significant different between groups (P<0.001):group A with the longest duration and group C with the shortest .The results indicated that the total efficiency of anti-diarrhea in group C was significantly higher than that in control group (P<0.05).However, group B presented no significant difference compared with neither control group nor group C in term of therapeu -tic effect on diarrhea .Conclusion Administration of Saccharomyces boulardii Sachets could shorten the duration of diarrhea on the oc-currence of AAD in infant pneumonia .According to our results , Saccharomyces boulardii was effective in both preventing the develop-ment of AAD and shortening duration of diarrhea , and therefore improved therapeutic effect on ADD .

ObjectiveTo investigate the correlation between genetic polymorphism of heat shock proteins 70 (HSP70) and susceptibility to occupational noise-induced hearing loss (ONIHL). Methods A total of 229 ONIHL workers were selected as the case group and 229 healthy workers with similar age, years of noise exposure, and noise exposure levels were selected as the control group using the case-control study method. Occupational health examinations were conducted on both groups, and peripheral blood of individuals was collected for DNA extraction. The genotypes of three single nucleotide polymorphisms of the HSP70 were detected using the MassArray system. Results The allele frequency distribution of HSP70 rs2227956, rs1043618, and rs1061581 in the control group was in Hardy-Weinberg equilibrium (all P>0.05). The genotype and allele frequency distribution of rs2227956 was significantly different between the two groups (all P<0.05), while no significant difference was found for rs1043618 and rs1061581 (all P>0.05). After adjusting for age, years of noise exposure, individual noise exposure level, smoking, and drinking, individuals with AG and AG+GG genotypes of rs2227956 had a higher risk of ONIHL than those with AA genotype (all P<0.05). The risk of ONIHL was higher in individuals with G allele of rs2227956 than in those with A allele (P<0.05). No correlation was found between rs1043618 and rs1061581 polymorphisms and the risk of ONIHL (all P>0.05). Conclusion The rs2227956 polymorphism of the HSP70 gene is correlated with susceptibility to ONIHL in noise-exposed workers, and the G allele is a risk factor for ONIHL in this population.

Objective:To investigate the clinical efficacy of Bacille Calmette-Guerin polysaccharide nucleic acid combined with montelukast in the treatment of bronchial asthma and its effect on lung function and serum inflammatory factor level.Methods:Eighty patients with bronchial asthma who met inclusion criteria and received treatment in The First People's Hospital of Huzhou from January 2019 to December 2020 were included in this study. They were randomly assigned to undergo either routine systematic treatment and oral montelukast (control group, n = 40) or routine systematic treatment, oral montelukast, and intramuscular injection of Bacille Calmette-Guerin polysaccharide nucleic acid in combination (combined group, n = 40). The changes in serum inflammatory factors and pulmonary function after treatment relative to before treatment, clinical efficacy and adverse reactions were compared between the two groups. Results:Total response rate in the control and combined groups was 80.00% (32/40) and 95.00% (38/40) respectively. Total response rate in the combined group was significantly higher than that in the control group ( χ2 = 4.11, P = 0.043). There were no significant differences in peak expiratory flow rate, forced expiratory volume in 1 second, maximum voluntary ventilation, forced vital capacity, airway resistance and forced expiratory volume in 1 second/forced vital capacity between the two groups before treatment (all P > 0.05). In the combined group, peak expiratory flow rate, forced expiratory volume in 1 second,forced expiratory volume in 1 second/forced vital capacity, maximum voluntary ventilation and forced vital capacity were significantly increased, and airway resistance was significantly decreased after treatment compared with before treatment ( t = -4.81, -5.09, -7.39, -4.12, -7.14, 5.17, all P < 0.001). After treatment, clinical efficacy in the combined group was superior to that in the control group. Before treatment, there were no significant differences in the St George's Respiratory Questionnaire score and Asthma Control Test score between the two groups (both P > 0.05). After treatment, St George's Respiratory Questionnaire score in the combined group was significantly decreased, while Asthma Control Test score was significantly increased compared with before treatment ( t = 9.19, -3.44, both P < 0.001). Before treatment, there were no significant differences in serum interleukin-4, interleukin-5, and interferon-γ levels between the two groups (all P > 0.05). After treatment, serum levels of interleukin-4, interleukin-5, and interferon-γ in the combined group were significantly lower than those in the control group ( t = 6.95, 4.72, -11.24, all P < 0.001). No drugs-related adverse reactions were found in each group during the treatment period. Conclusion:Bacille Calmette-Guerin polysaccharide nucleic acid combined with montelukast is highly effective on bronchial asthma. The combined therapy can improve quality of life and lung function, decrease serum inflammatory factor levels, and is safe.

Objective To evaluate the influences of susceptibility interpretation of Escherichia coli,Klebsiella pneumonia and Proteus mirabilis in China mainland according to the old and new ceftazidime,cefotaxime and ceftriaxone breakpoints in CLSI M100-S20 and CLSI M100-S19. Methods First, We analyzed the antibacterial susceptibility results of the three bacteria by agar dilution method in the SEANIR surveillance item, which were collected from 15 national hospitals between the year of 2005 and 2007 and excluded the AmpC enzyme positive isolates according to the PGR-DNA sequencing method and/or the antibacterial susceptibility phenotype. ESBL phenotype was confirmed by the CLSI phenotypic confirmatory test. Antibacterial susceptibility of the total 2733 Escherichia coli, Klebsiella pneumonia, Proteus mirabilis isolates was retrospectively analyzed by WHONET 5. 4 software according to the breakpoints of the CLSI M100-S19 (S19) and CLSI M100-S20 (S20). Second, 207 isolates of Peking Union Medical College Hospital with the results of both agar dilution method and disk diffusion method were performed by recurrent analysis. Then we observed the inter-method agreement through the scatter diagram according to the breakpoints of S19 and S20. Results First, as to the ESBL positive Escherichia coli, Klebsiella pneumonia and Proteus mirabili.s, the resistant rate of cefotaxime increased from 65.2% , 55.5%, 14. 6% under S19 (64 μg/ml) to 99. 7%, 96. 2% , 93. 8% under S20 (4 μg/ml). The susceptibility rates decreased from 6. 0%, 11.5%, 33.3% under S19 (8 μg/ml) to 0%, 0. 2%, 0% under S20 ( 1 μg/ml). Ceftriaxone had the same trend as cefotaxime. Though ceftazidime was more active than cefotaxime and ceftriaxone, as to the ESBL positive Escherichia coli and Klebsiella pneumonia, the resistant rates slightly increased from 30. 3%,43. 2% under S19 (32 μg/ml) to42.0%, 56. 0% under S20 (16 μg/ml). The susceptibility rates slightly decreased from 58. 1%, 44. 1% under S19 (8 μg/ml) to 44. 7%, 28.0% under S20 (4 μg/ml). Second,as to the ESBL negative Escherichia coli, Klebsiella pneumonia and Proteus mirabilis, all the susceptibility rates of ceftazidime, cefotaxime and ceftriaxone were between 99. 2%-100. 0%, the resistant rate were between 0%-0. 4%. Third, the S20 MIC breakpoints had a good correspondence with the ESBL phenotype.Fourth, according to the recurrent analysis of MIC testing and disk dilution method, r value was 0. 67,0. 79, 0. 77 for ceftazidime, cefotaxime and ceftriaxone, respectively, and all P value were under 0. 01. The intermethod rates of S19 and S20 were both acceptable. Conclusions If the cefotaxime and ceftriaxone S20 new breakpoints were used, the concordance of antibacterial susceptibility results and ESBL phenotype would increase greatly. The clinician could select proper antibiotics according to the antibacterial susceptibility results and clinical symptoms. It is no longer necessary to edit results for cephalosporins, aztreonam, or penicillins from susceptible to resistant. However, until laboratories implement the new interpretive criteria,ESBL testing should be performed as described in Supplemental Table 2A-S1. The relationship between the new breakpoints of ceftazidime and clinical outcomes need to be further evaluated.

Endothelial cell injury is a major contributor to cardiovascular diseases.The 2,3,5,4’-Tetrahydroxystilbene-2-O-β-D-Glucoside (TSG) contributes to alleviate human umbilical vein endothelial cells (HUVECs) injury through mechanisms still know a little. This study aims to clarify the TSG effects on gene expression (mRNA and microRNA) related to oxidative stress and endoplasmic reticulum stress induced by H2O2 in HUVECs. We found that TSG significantly reduced the death rate of cells and increased intracellular superoxide dismutase activity. At qRT-PCR, experimental data showed that TSG significantly counteracted the expressions of miR-9-5p, miR-16, miR-21, miR-29b, miR-145-5p, and miR-204-5p. Besides, TSG prevented the expression of ATF6 and CHOP increasing. In contrast, TSG promoted the expression of E2F1. In conclusion, our results point to the obvious protective effect of TSG on HUVECs injury induced by H2O2, and the mechanism may through miR16/ATF6/ E2F1 signaling pathway.

Endothelial cell injury is a major contributor to cardiovascular diseases.The 2,3,5,4’-Tetrahydroxystilbene-2-O-β-D-Glucoside (TSG) contributes to alleviate human umbilical vein endothelial cells (HUVECs) injury through mechanisms still know a little. This study aims to clarify the TSG effects on gene expression (mRNA and microRNA) related to oxidative stress and endoplasmic reticulum stress induced by H2O2 in HUVECs. We found that TSG significantly reduced the death rate of cells and increased intracellular superoxide dismutase activity. At qRT-PCR, experimental data showed that TSG significantly counteracted the expressions of miR-9-5p, miR-16, miR-21, miR-29b, miR-145-5p, and miR-204-5p. Besides, TSG prevented the expression of ATF6 and CHOP increasing. In contrast, TSG promoted the expression of E2F1. In conclusion, our results point to the obvious protective effect of TSG on HUVECs injury induced by H2O2, and the mechanism may through miR16/ATF6/ E2F1 signaling pathway.

OBJECTIVE To investigate the antimicrobial resistance of hospital-and community-acquired pathogens collected from 10 teaching hospitals located at different areas in China in 2006.METHODS According to the study protocol,the strains of Streptococcus pneumoniae,meticillin-susceptible Staphylococcus aureus(MSSA),Escherichia coli and Klebsiella pneumoniae were collected and sent to the central lab for reidentification and susceptibility testing.The minimal inhibitory concentrations(MICs) of antimicrobial agents against Str.pneumoniae were determined by Etest method and MICs of antimicrobial agents against S.aureus,E.coli and K.pneumoniae strains were determined by agar dilution method.WHONET5.4 software was used to analyze the data.RESULTS Among 353 Str.pneumoniae strains,74.2% were penicillin-susceptible(PSSP),9.6% were penicillin-intermediate(PISP) and 16.2% were penicillin-resistant(PRSP).Strains from different hospitals showed different sensitivity to penicillin.Among ?-lactam antibiotics,cefuroxime showed the lowest susceptibility rate of 0%(for PRSP) to 76.7%(for PSSP).The susceptibility rate to ceftriaxone and amoxicillin-clavulanic acid was 98.1% and 98.9% in PSSP group,61.8% and 64.7% in PISP group,and 15.8% and 10.5% in PRSP group.The ESBLs rate was 56.2% among 267 Escherichia strains and 42.7% among 206 K.pneumoniae strains.For ESBLs-producing strains,the susceptibility rates to cefotaxime and ceftriaxone were low and the rate to ceftazidime was relatively high among ?-lactam antibiotics.73.4% MSSA strains produced ?-lactamase.?-Lactam antibiotics tested showed high susceptibility against MSSA strains.The susceptibility rate was 98.9-100%.The susceptibility rate to ciprofloxacin and levofloxacin was 80.8% and 88.1%,separately.CONCLUSIONS Fluoroquinolones show high susceptibility against Str.pneumoniae.Ceftriaxone and amoxicillin-clavulanic acid have relatively high susceptibility among ?-lactams.For MSSA and non-ESBLs-producing E.coli and K.pneumoniae strains,?-lactams show high susceptibility.For ESBLs-producing E.coli and K.pneumoniae strains,the susceptibility rates to cefotaxime and ceftriaxone are low and that to ceftazidime,cefepime and cefoperazone-sulbactam are relatively high.

Objective To investigate antimicrobial resistance among Streptococcus pneumoniae clinically isolated from 14 teaching hospitals located at different areas in China in 2005-2008 and to give logical guidance for clinical empirical therapy.Methods A total of 1 317 non-repetitive S.pneumoniae isolates in 14 teaching hospitals from 2005-2008 were collected and sent to the central lab for reidentification and susceptibility testing, including 271 isolates collected in 2005, 391 isolates collected in 2006, 363 isolates collected in 2007 and 292 isolates collected in 2008. Most of the isolates were from community-acquired respiratory tract infections, which were isolated from outpatient or emergency department patients with respiratory tract infections or those patients with respiratory tract infections within ≤48 hours hospitalization.The districts where the organisms were isolated include North China, Northeast China, South China, Central and Northwest China and East China.The patients included adults, teenagers and children.The minimum inhibitory concentrations (MICs) or inhibitory zone diameter of 17 antimicrobial agents were determined by Etest method, agar dilution method or disk diffusion method.WHONET5.5 software was used to analyze susceptibility rate, intermediate rate, resistance rate, MIC50 and MIC90.Results Linezolid (100%) and fluoroquinolones (95.2%-99.7%) showed excellent activities against S.pneumoniae.Among β-lactams, amoxicillin-clavulanic acid remained high activities (73.8%-92.1%),followed by penicillin, ceftriaxone and cefepime with year-over-year decrease in activities.The activities of three second-generation cephalosporins were low (36.3%-38.4% in 2008).The activities of erythromycin, azithromycin, clindamycin, trimethoprim/sulfamethoxazole and tetracycline against S.pneumoniae were poor and decreased year over year.The incidence of penicillin non-susceptible S.pneumoniae (PNSP) was increasing especially for PISP (from 4.4% in 2005 to 20.2% in 2008).The incidence of PNSP in North China was low (6.0%), while this value were high in central China and East China (30.1% and 38.7%, separately).The incidence of PNSP in adults (15.7%) was obviously lower than that in children(≤5 years:33.0%) and teenagers (6-17 years:38.2%).Conclusions linezolid and fluoroquinolones showed excellent in vitro activity against S.pneumoniae, followed by penicillin and cephalosporins with year-over-year decrease of activity. Clinicians should pay more attention when using those antimicrobial agents with poor activity against S.pneumoniae, which include macrolides, clindamycin, trimethoprim/sulfamethoxazole and tetracycline.