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 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 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 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 related factors of the rescue soldiers. Methods Resilience Scale for Adults( RSA ), Self-report Symptom Checklist 90 (SCL-90), Eysenck Personality Questionnaire(EPQ) and Coping Style Questionnaire were applied in this survey to 1401 rescue soldiers. Results ①The soldiers' resilience score was (2.49±0.57) ,significantly lower than college students( t= 16.619, P=0. 000).The rescue soldiers with the year in army above 3 were significantly higher than that below 2 years in social competence( t=2.581, P=0.01 ) ,social resources( t=2. 158, P=0.031 ) ,structured style( t=3.254, P=0.001 ) and RSA scores(t=2.455, P=0.014). There exist significantly differences in various education level of the rescue soldiers in perception of self(t=3.732, P=0.024), planned of future ( t = 9.324, P = 0.000 ) , social competence ( t = 8. 838, P = 0.000 ), social resources ( t = 13. 660, P = 0. 000 ) and RSA scores (t=9.805, P=0.000) , 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=16. 204, P=0.000) and positive coping( t = - 18. 171, P=0.000), while lower in SCL-90 (t=8.461, P=0.000) and neuroticism (t=8.833, P=0.000 ).③Resilience have the obvious positive correlation with the education ( r= 0. 116 ), extraversion ( r= 0. 463 ) and positive coping(r=0.500) ,and negative correlation with the neuroticism(r=-0.251 ) and SCL-90( r= -0.260). It can be assumed that positive coping,extraversion and neuroticism had good predictive ability(35.9％) to resilience. Conclusion The rescue soldiers have low resilience than college students, positive coping, extraversion, and neuroticism are important psychological factors for rescue soldiers.

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.

BACKGROUND:The smal intestinal submucosa has good biocompatibility and biodegradability, and also contains a variety of growth factors that can significantly promote celladhesion, proliferation and differentiation. Currently, the smal intestinal submucosa has been widely used in bone and cartilage, blood vessels, skin, bladder, smooth muscle and pancreatic tissue repair, showing good performance as a tissue-engineered cellscaffold.
OBJECTIVE:To investigate the in vitro feasibility of tissue engineered periosteum constructed by porcine smal intestinal submucosa and osteoblasts differentiated from bone marrow mesenchymal stem cells.
METHODS:Bone marrow mesenchymal stem cells were harvested from 2-week-old healthy New Zealand rabbits by using adherent method, and then cells were cultured, induced, differentiated and identified in vitro. Fol owing induced differentiation and identification, the bone marrow mesenchymal stem cells were compounded with porcine smal intestinal submucosa to fabricate tissue engineered periosteum. The adhesion, growth, and proliferation of cells on the materials were observed.
RESULTS AND CONCLUSION:At 5 days after inoculation, the cells receiving osteogenic induction could quickly adhere and proliferate on the surface of porcine smal intestinal submucosa and be interconnected;at 10 days, the desmosomes formed among the cells, cellprocesses from osteoblasts were visible and attached to the smal intestine submucosa;at 15 days, cellproliferation and secretion of matrix appeared, and multi-layer membrane-like structure formed on the surface of the smal intestine submucosa. These findings indicate that after osteogenic induction, the bone marrow mesenchymal stem cells can be combined with porcine smal intestinal submucosa to construct a tissue engineered periosteum, which is hoped to be an ideal scaffold for tissue engineering.

Aim To observe the analgesic effect of oxymatrine(OMT)and its mechanism.Methods A peripheral mononeuropathy was produced in adult mice by placing loosely constrictive ligatures around the common sciatic nerve.The antinociceptive effects of the OMT were assessed in mechanical allodynia and cold allodynia tests.The CAMKII inhibitor KN-93 and AIP were adopted to investigate the influence of OMT on the analgesic effect and analyze its analgesic mecha-nisms.Western blot was used to evaluate the expres-sions of tCaMKII and pCaMKII protein.Results The intraperitoneal administration of OMT (1 60,80 mg· kg -1 )increased the paw withdrawal threshold in the
mechanical allodynia test (P <0.05 ),OMT (1 60, 80,40 mg·kg -1 ,ip)remarkably decreased the paw lifts in the cold allodynia test (P <0.05).Ith KN-93 (1 .25 μg/site),AIP (0.02 μg/site)significantly en-hanced the analgesic effect of OMT (35 mg·kg -1 ) (P <0.01 ).Protein expression of pCaMKII was de-creased by OMT(1 60 mg·kg -1 ).Conclusion OMT has significant protective effects on chronic constriction injury(CCI)in mice,and the effective mechanism of OMT inhibits the expression of CaMKII receptor.