Matrix assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF MS) is an emerging tool for detecting microorganisms. It can be used not only for rapid identification of microorganisms, but also for the research of resistance mechanisms. Producing β-lactamase is the main mechanism for resistance of β-lactam antibiotics in Gram-negative bacilli. Currently using MALDI-TOF MS for rapid detection of bacterialβ-lactamase has been widely reported, including detection of β-lactam hydrolysis activity of β-lactamase, direct detection of β-lactamase molecule, peptide and relevant proteins, and detection of the single nucleotide polymorphisms (SNPs) of β-lactamase gene. This paper reviews current application of MALDI-TOF MS to the detection of β-lactamase based on the latest research findings.

BACKGROUND:The eradication therapy of glioma is the major problem, and anti-angiogenesis therapy is a potential treatment of glioma.
OBJECTIVE:To confirm the inhibiting effect of endostatin on angiogenesis in vitro, and to lay the foundation in inhibiting the growth of tumor by endostatin in the future.
METHODS:Endostatin mRNA was extracted from the liver of Wistar rats by Trizol and endostatin cDNA was synthesized by RT-PCR. Endostatin cDNA and pcDNA3 were connected and pcDNA3-Endo recombined plasmid was constructed successful y. The recombinant pcDNA3-Endo was transfected into bone marrow mesenchymal stem cells by Lipofectamine. The expression of endostatin was identified by RT-PCR and western blot analysis. Endostatin proteinum activity was detected by ECV-304 cellproliferation inhibition experiment using MTT assay. The in vitro experiments were divided into four groups:recombinant plasmid group, vector plasmid group, liposome control group and blank control group.
RESULTS AND CONCLUSION:PcDNA3-Endo eukaryon expression plasmid was constructed successful y. Endostatin gene can be transcribed and expressed effectively in vitro by pcDNA3-Endo plasmid. The growth of ECV-304 cellwas inhibited obviously by pcDNA3-Endo. The growth of vascular endothelial cells can be inhibited obviously by endostatin gene.

Objective To investigate the effect of atorvastatin calcium combined with sitagliptin phosphate on β2-microglobulin (β2-MG ) in peripheral blood and serum uric acid ( UA) levels in patients with type 2 diabetes.Methods A total of 78 patients with type 2 diabetes in endocrinology department from Hangzhou Xiasha Hospital were collected and randomly divided into the control group and the experimental group, with 39 cases in each group.The two groups of patients were treated by conventional treatment, life intervention, the control group were treated by metformin hydrochloride sustained-release tablet and sitagliptin phosphate, the experimental group were treated on the basis of control group with atorvastatin calcium.Both groups were treated for 3 cycles, one cycle for 7 days.The clinical curative effect,β2-MG in peripheral blood and urine, serum UA levels and adverse reactions were compared between two groups after treatment.Results After treatment, compared with control group, the clinical total effective rate in experimental group was higher (P<0.05).The serum IgG,β2-MG, urineβ2-MG and UAlb, serum UA levels were lower in two groups post-treatment compared with pre-treatment(P<0.05).Compared with control group, serum IgG, β2-MG, urine β2-MG and UAlb, serum UA levels were lower (P<0.05).There was no significant difference between two groups.Conclusion The atorvastatin calcium combined with sitagliptin phosphate has a significant efficacy in the treatment of patients with type 2 diabetes, it could down-regulate β2-MG in peripheral blood and urine and serum UA levels, improve immunity and prevent patients from cardiovascular complications.

Objective To explore the influence of percutaneous gastrostomy-jejunostomy ( PEG-J) on the nutritional status and prognosis of critically ill patients in ICU .Methods Totally 58 patients who received me-chanical ventilation in the ICU of Changshu No .1 People's Hospital from January 2013 to December 2015 were di-vided into two groups according to random number table:treatment group ( n=28, enteral nutrition by establis-hing PEG-J tube in 120 hours after excluding contraindications );and control group ( n=30, nasogastric tube as the way of giving enteral nutrition and if delayed gastric emptying happened , nasogastric tube would be replaced by nasointestinal tube).The incidence of ventilation-associated pneumonia (VAP) within 28 days, duration of ICU stay, and duration of mechanical ventilation were compared between these two groups .Results The inci-dence of 28-day VAP (7.14%vs.26.67%, P=0.049), duration of ICU stay [ (13.6 ±5.9) d vs.(16.8 ± 4.4) d, P=0.024], duration of mechanical ventilation [ (8.1 ±5.0) d vs.(10.7 ±4.5) d, P=0.041] were significantly lower or shorter in treatment group than in control group .Conclusions The use of PEG-J tube for enteral nutrition in critically ill patients is reliable and safe .It also helps to reduce VAP .

Objective To investigate the prognosis and recurrent factors of primary retroperitoneal liposarcoma (PRPLS).Methods The retrospective case-control study was conducted.The clinicopathological data of 51 patients with PRPLS who were admitted to the Southwest Hospital of the Third Military Medical University from January 2005 and March 2015 were collected.Observation indicators:(1) follow-up institution.(2) Analysis of prognostic factors:gender,age,tumor diameter,combined organs resection,pathological type,cancer risk and local recurrence.(3) Analysis of recurrent risk factors:gender,age,tumor diameter,combined organs resection,pathological type and cancer risk.(4) Stratified analysis:the independent risk factors of recurrence were done by the stratified analysis.(5) Correlation between cancer risk and tumor diameter or number of organs invaded.(6) Correlation between adjacent organ invasion and tumor diameter.Follow-up using outpatient examination and telephone interview was performed to detect the survival of patients and tumor recurrence up to October 2015.The survival rate and curve were respectively calculated and drawn by KaplanMeier method.The univariate analysis and survival analysis were done using the Log-rank test.The multivariate analysis was done by the COX regression model.The correlation analysis was done using the Pearson test.Results (1) Follow-up institution:51 patients were followed up for 3-114 months,with a median time of 43 months.The 3-year survival rate of 51 patients was 70.6％.Twenty-two patients had the first local recurrence,with a recurrent time of 3-60 months and a median time of 29 months.(2)Analysis of prognostic factors:the results of univariate analysis showed that tumor diameter,combined organs resection,pathological type,cancer risk and local recurrence were the related factors affecting prognosis of patients with PRPLS (x2 =5.926,4.936,17.856,17.279,14.568,P ＜ 0.05).The results of multivariate analysis showed that combined organs resection,pathological type and cancer risk were the independent factors affecting prognosis of patients with PRPLS [OR =0.538,0.645,9.620,95％ confidence interval (CI):0.238-0.997,0.458-1.058,1.692-18.714,P ＜ 0.05].(3) Analysis of recurrent risk factors:the results of univariate analysis showed that pathological type and cancer risk were the related factors affecting recurrence of patients with PRPLS (x2 =12.375,12.364,P ＜ 0.05).The results of multivariate analysis showed that cancer risk was an independent factor affecting recurrence of patients with PRPLS (OR =6.234,95％ CI:1.419-27.377,P ＜ 0.05).(4) Stratified analysis:the 3-year survival rates of 11 patients with low risk of recurrence of PRPLS and with high risk of recurrence of PRPLS were 63.6％ and 9.1％,respectively,with a statistically significant difference (x2 =12.364,P ＜ 0.05).(5)Correlation between cancer risk and tumor diameter or number of organs invaded.Tumor diameter and number of organs invaded were respectively (17 ±8)cm,1 ± 1 in 33 patients with low risk of PRPLS and (19 ±5)cm,2 ± 1 in 18 patients with high risk of PRPLS,with no statistically significant difference in tumor diameter (r =0.222,P ＞ 0.05) and with a statistically significant difference in number of organs invaded (r =0.666,P ＜ 0.05).(6)Correlation between adjacent organ invasion and tumor diameter.Tumor diameter was (16 ± 8) cm in 19 patients without adjacent organ invasion and (19 ± 7)cm in 32 patients with adjacent organ invasion,respectively,showing no statistically significant difference (r =0.225,P ＞ 0.05).Conclusions The combined organs resection,pathological type and cancer risk are independent factors affecting prognosis of patients with PRPLS,and cancer risk is an independent factor affecting recurrence of patients with PRPLS.The prognosis of patients with low risk of PRPLS is better than that with high risk of PRPLS.The organ invaded is much likely to occur in patients with high risk of PRPLS.

Objective:To explore the correlation between hypersomnia and anhedonia in patients with major depressive disorder.Methods:From November 2018 to May 2019, patients hospitalized with major depressive disorder who met the ICD-10 diagnostic criteria were selected.According to the Epworth Sleepiness Scale (ESS), 46 patients were divided into daytime sleepiness group with ESS ≥ 7, and 171 patients were divided into non-sleepiness group with ESS < 7.The Chinese Revised Social Anhedonia Scale (RSAS) and the Chinese Revised Physical Anhedonia Scale (RPAS) were used to evaluate the patients' anhedonia symptoms.Two-way ANOVA and Pearson correlation analysis were used for data processing.Results:(1)There was no interaction between the hypersomnia and gender on the score of physical anhedonia ( F=0.274, P=0.601). The main effect analysis showed that there was significant difference in the influence of gender on physical anhedonia ( F=10.948, P<0.05). (2)There was interaction between the hypersomnia and age on the score of physical anhedonia ( F=4.396, P=0.013). Further simple effect analysis showed that the score of physical anhedonia in 40-49 age(21.54±12.37) was lower than that in 50-64 age(34.13±12.53) in daytime sleepiness group( P<0.05). (3) There was interaction between hypersomnia and sitting and lying on the score of social anhedonia ( F=4.247, P=0.041). Further simple effect analysis showed that the score of social anhedonia in patients with sitting and lying time less than 2 hours (13.71±5.18) was lower than that in patients with sitting and lying time more than 2 hours (19.75±6.39) in daytime sleepiness group( P<0.05). (4)Pearson correlation analysis showed that the total sleepiness score of depression patients was positively correlated with the social anhedonia score ( r=0.206, P<0.01). After adjusting for gender, age and sitting and lying time, the total sleepiness score was still positively correlated with the social anhedonia score( r=0.225, P<0.01). Conclusion:Hypersomnia may be associated with anhedonia in patients with major depressive disorder.

Objective To research the resilience and influencing factors of the plateau soldiers.Methods Resilience Scale for Adult (RSA),Symptom Checklist (SCL-90),Eysenck Personality Questionnaire (EPQ) and General Self-Efficacy Scale (GSES) was used in this study to 756 plateau soldiers.Results ①The high resilience has been found in plateau soldiers (2.78 ± 0.47 ).There were significantly differences in three education levels of the plateau soldiers in planned of future (F =3.261,P =0.039 ),family cohesion (F =6.428,P =0.002 ),structure style(F=4.135,P=0.016) and RSA scores(F=4.162,P=0.016),and college ＞ senior high school ＞ junior high school.②Compared to the lower group in the RSA,the higher group scored significantly higher in extraversion ( t =13.004,P =0.000) and self-efficacy ( t =12.956,P =0.000 ),while lower in SCL-90 ( t =10.308,P =0.000) and neuroticism( t =11.297,P =0.000).③Resilience had significantly positive relation with self-efficacy ( r =0.48 ) and extraversion ( r =0.46 ),and negative relation with neuroticism ( r =- 0.42 ) andSCL-90( r =-0.41 ).The self-efficacy extraversion and neuroticism have nice predictive ability (42％).Conclusion The Resilience of plateau soldiers are good condition,self-efficacy,extraversion,and neuroticism are important influencing factors for plateau soldiers.

Objective To prepare a sustained-delivery of paclitaxel-loaded thermosensitive hydrogel for the treatment of breast cancer by ultrasound-guided intratumoral injection,and probe the antitumor effect and mechanism of the new method. Methods Paclitaxel-loaded thermosensitive hydrogel was prepared. A total of 40 rats bearing subcutaneous breast tumor were randomized into 4 groups. Each group of rats were administered ultrasound-guided intratumoral injection of different agents as follows: salin, thermosensitive hydrogel, paclitaxel injection and paclitaxel-loaded thermosensitive hydrogel. The tumor nodules were scanned by high frequence ultrasound. The rats were sacrificed on the 14th day,and then the tumors were stripped to calculate the growth inhibitory rate. Histological examinations were undergone and RT-PCR was performed for the detection of bcl-2 and bax expression. Results Greater decrease in average tumor weight was found in paclitaxel-gel group [(16. 04 ± 2. 82)g], compared with that in paclitaxel group [(27.45 ±5.13)g, P ＜0. 05],and tumor growth inhibitory rate in the group was 62.77 %. In this group, blood flow signals reduction was detected on ultrasound and extensive necrosis was found in histological examination. In addition,down-regulation in bcl-2 mRNA expression and up-regulation in bax were found. Conclusions Ultrasound-guided percutaneous intratumoral injection of paclitaxel-loaded thermosensitive hydrogel may provide an effective method for breast tumor ablation therapy. The mechanism may be related to the inhibition of proliferation and induction of apoptosis.

Objective To investigate the hemodynamic changes of protosystemic collaterals before and after endoscopic treatment in patients with gastroesophageal varices using 64-row multidetector computed tomograghy portal venography (MDCTPV) so as to evaluate the efficacy of endoscopic treatment in patients with or without para-esoghageal varices and with or without nonvarices portosystemic collaterals before treatment. Methods Twenty-six patients with gastroesophageal varices, who underwent endoscopic variceal ligation (EVL) for esophageal varices and endoscopic N-butyl-2-cyanoacrylate injection (EBC) for gastric varices between Jan.2007 and Dec. 2009, were enrolled. Sixty four-row MDCT was used to examine the changes of portosystemic collaterals 1 week before and 12 months after endoscopic treatment. The reconstructed images of portosystemic collaterals before and after endoscopic treatment were evaluated. Results Excellent quality of portosystemic collateral vessels on CTPV were obtained in all patients. The mean diameter of left gastric vein decreased from (6.7±1.9) mm to (5.0±1.9) mm after endoscopic treatment,with significant difference (P＜ 0.05). There was no significant difference in outcomes between patients with or without para-esoghageal varices (80% vs 72.7%, P＞0.05) and patients with or without non-varices portosystemic collaterals (82.4% vs 66.7% ,P＞0.05). Conclusions Sixty fourrow MDCTPV may provide important information for option of endoscopic treatment and prognosis.

Aim To investigate the effects of berberine combined with bone marrow mesenchymal stem cells ( BM-MSCs) on the energy metabolism of human um-bilical vein endothelial cells ( HUVECs ) under the condition of high glucose. Methods ①The state of cell reproduction and cell proliferating activity were de-termined by MTT assay. ②The cell cycle was detected by flow cytometry ( FCM ) . ③DNA damage of cells was measured by comet tail assay. ④The contents of ATP, ADP and AMP were determined by high perform-ance liquid chromatography ( HPLC ) and the level of energy charge ( EC) was calculated. ⑤The expression of CCR and COX mRNA was detected by reverse tran-scription-polymerase chain reaction ( RT-PCR) . ⑥The expressions of COX and CCR were detected by Western blot. Results ①The proliferating activity of HUVECs declined apparently and the proliferation decreased af-ter high glucose intervention. Meanwhile, the quantity of cells during S +G2 dropped dramatically and there was certain degree of damage to DNA. The berberine and BM-MSCs respectively improved the proliferating activity and the proliferation in different degrees, in-creased the quantity of cells during S+G2 and promo-ted the repair of DNA ( P <0 . 01 ) , and so did the combination of the two, with a better effect than each of them alone. ②After high glucose intervention and the damage caused, the content of both ATP and ADP of HUVECs was reduced, and EC level also declined significantly, while the content of AMP increased. The berberine and BM-MSCs respectively up-regulated the content of ATP and ADP ( P<0. 01 ) , and so did the combination of the two, with a better effect than each of them alone. ③After high glucose intervention and the damage caused, the expression of COX, CCR mR-NA and protein decreased obviously. Yet, all of the three gained a dramatic increase when the berberine, BM-MSCs or the combination of the two were added ( P<0. 01 or P <0. 05 ) , among which the combination worked more effectively. Conclusions The berber-ine, BM-MSCs and the joint use of the two could im-prove the energy metabolism of HUVECs, which had been damaged by high glucose, probably because the berberine and BM-MSCs could up-regulate the expres-sion of COX, CCR mRNA and protein, which leads to the hydrolyzation of glucose oxide and thus the im-provement of blood environment and the enhancement of glucose's supply and intake of HUVECs. Then, here comes the final result: the improvement of the energy metabolism of damaged vascular endothelial cells by high glucose.