Objective To investigate the antibiotic resistance and molecular epidemiology character of ?-lactamase producers among clinical isolates of Citrobacter freundii.Methods Four strains of Citrobacter freundii were detected by K-B susceptibility method and three-dimensional test.The ?-lactamase gene was identified by polymerase chain reaction(PCR) and sequencing.Results The No.29 strain of Citrobacter friundii was multiple-drug-resistant and proved to produce CMY,DHA type AmpC,TEM and SHV type of extended-spectrum ?-lactamases(ESBLs).The sequencing of corresponding DNA revealed 97% identities of the CMY-2 amino acid sequence.It was a new type of cephalosporinase.Conclusion A novel strain of Citrobacter friundii with CMY type AmpC,DHA type AmpC,TEM and SHV type ESBLs has been found in southern China and it is multiple-drug-resistant.

Objective To investigate if there is a synergism of kansui root and low molecular weight heparin(LMWH) in combined treatment of SAP in rats.Methods SD rats were randomly divided into 5 groups:Sham group(A group),severe acute pancreatitis group(B group),kansui root treatment group(C group),LMWH treatment group(D group),combined treatment group(E group).The serum TNF-?,IL-6 level and the ratio of TXB2/6-keto-PGF1? in pancreatic tissue,and the histological examination were evaluated.Results The values of TNF-??IL-6 and the ratio of TXB2/6-keto-PGF1? in C,D,E group were significantly lower than those in B group at the time point of 6,12,24h.But there were no significant differences in C,D,E group at all the time points.The histological examination showed that the pancreas was normal in group A;the pathological changes were milder in C,D,E group than that in B group.Conclusions Combined treatment of kansui root and LMWH was effective in SAP,but there was no synergism,and also no side effects.

Objective:To determine initial concentrations of ozonated water under different temperatures,attenuation rules ofozonated water under the room temperature (25 ℃),and to inspect the effects ofozonated water under different concentrations on common microorganisms.Methods:The online test method and the plate cultivation method were employed to check the concentrations and killing rates on common microorganisms of ozonated water produced by HZ-2601 B Ozone Water Generating Instrument.Results:The initial concentrations of ozonated water at 20,25,30,35,and 40 ℃ were 4.38,4.26,3.12,2.76,and 1.31 mg/L,respectively.The ozonated water was rapidly attenuated at first 10 min.The concentration ofozonated water still remained at 1.06 mg/L and 0.37 mg/L at 25 and 30 ℃ after 30 min.The average killing rates for Pseudornonas aeruginosa,Escherichia coli,Staphylococcus aureus,methicillin-resistant Staphylococcus aureus,and Candida albicans in 1.0 mg/L ozonated water for 1 min were 99％,100％,100％,100％,and 100％,respectively.The average killing rates of Escherichia coli,Staphylococcus aureus,methicillin-resistant Staphylococcus aureus,Pseudomonas aeruginosa,and Candida albicans in 0.3 mg/L ozonated water for 1 min were 100％,100％,100％,95％,and 92％,respectively.Conclusion:The initial concentrations of ozonated water produced by HZ-2601 B Ozone Water Generating Instrument decrease with the increase of temperature.Ozonated water under 20-30 ℃ has good sterilization effect on common microorganisms.

Objective:To observe the clinical efficacy and safety of topical ozone therapy for patients with herpes zoster by reflectance confocal microscopy (RCM).Methods:A total of 60 patients with herpes zoster were divided into a control group and an ozone treatment group (n=30).In the control group,patients took oral valacyclovir tablets or granules (0.3 g per day,three times a day) and they were subjected to local weak laser irradiation treatment plustopical 2％ mupirocin ointment twice a day.In the ozone group,the treatment is same as the control group except mupirocin ointment was replaced with topical ozone treatment (hydrotherapy every day plus ozonated oil twice a day).The clinical symptoms,discoid cell and adverse reactions were observed and taken records at day 0,3,7 and 14.Statistical analysis was performed to compare the clinical efficacy between the 2 groups.Results:On the seventh day of treatment,the discoid cells of the ozone group disappeared,and the difference between the control group and the ozone group was statistically significant (P＜0.05).The difference of decreased percentage of pain scores at each time point between the 2 groups was statistically significant (P＜0.05).The clinical efficacy was 100％ in the ozone group and 86.7％ in the control group,with significant difference between the 2 groups (P＜0.05).Conclusion:Topical ozone therapy in patients with herpes zoster is helpful in relieving pain,shortening the course as well as improving the clinical efficacy without obvious adverse reactions.It is worth to be popularized.

Objective:To verify the effect of ozone on Staphylococcus aureus (S.aureus) colonization in patients with atopic dermatitis (AD) and its correlation with the patient's status.Methods:A total of 12 patients with moderate or severe AD,aged from 6 to 65 years,were recruited from outpatient of the Third Xiangya Hospital.The treatment sides were showered with ozonated water and smeared with ozonated oil for 7 days (twice a day),while the control sides were washed with warm running water and smeared with base oil.At different time points,the severity scoring ofatopic dermatitis (SCORAD) scores,sleep and pruritus scores were assessed and compared between the two sides.Meanwhile,plate cultivation was used to quantitatively detect the changes ofS.aureus colonization in skin lesions.Results:After 7 days treatment,erythema and pimples were decreased in the treatment sides.The clear skin texture,smooth skin,improved skin lesions were also observed by dermoscopic examination.The results of reflectance confocal microscopy (RCM) demonstrated that the parakeratosis was improved,the structures were clearer,and the inflammatory cells infiltration was reduced after ozone treatment for 7 days.After ozone treatment for 3 and 7 days,the S.aureus colonization in the treatment sides decreased by (75.55±21.81)％ and (97.24±2.64)％ respectively.Compared to that of control sides,the percentage of S.aureus colony after ozone treatment for 7 days decreased significantly (P＜0.01).After ozone treatment for 7 days,the SCORAD scores,sleep and pruritus scores were significantly decreased (all P＜0.01).There was a linear correlation between the decreasing percentage of S.aureus colony and the declining percentage of SCORAD scores in AD patients.Conclusion:Topical ozone therapy can effectively reduce S.aureus colony in skin lesions and alleviate the severity of AD patients with moderate to severe degree.

Objective:To evaluate the clinical efficacy and safety of the innovative topical ozone therapy for infantile atopic dermatitis.Methods:Sixty children with atopic dermatitis were divided into a treatment group and a control group.The treatment group was showered with ozonated water (3-5 times a week) and smeared with ozonated oil (twice a day),while the control group was washed with warm running water and smeared with base oil,adding moisturizer if necessary.The treatment course was 2 weeks.Efficacy and side effect were evaluated.Results:The skin exudation was reduced and erosion was healing after 3-5 days topical ozone therapy for infantile atopic dermatitis.The effective rates were 80.0％ and 20.0％ in the treatment group and control group for 1 week,and 89.6％ and 30.7％ for 2 weeks,respectively,with significant difference between the 2 groups (P＜0.001).Conclusion:Innovative treatment of infantile atopic dermatitis with topical ozone application is safe and effective,which is worth popularizing in clinic.

[Objective]To explore the clinical characteristics of neurobrucellosis in Kashi,Xinjiang Uygur Autono-mous Region,thus improve the diagnosis and treatment.[Methods]A retrospective analysis was conducted on the clinical data of 18 cases of neurobrucellosis who were admitted to the First People's Hospital of Kashi Prefecture between Decem-ber 2019 and January 2024.[Results]The study included 9 males and 9 females,with a median age of 36 years(range:17-54.5).A clear epidemiological history was found in all the 18 brucllosis patients,12 of whom presented with meningo-encephalitis,5 meningitis,and 1 encephalitis.Two comorbided with spinal meningitis,2 osteoarthritis and 1 epididymitis.Most frequently reported clinical symptoms were headache,fever and fatigue.The prevalence rates of brucellosis by rose bengal plate agglutination test(RBPT)and serum agglutination test(SAT)were 11/12 and 8/9,respectively.Two of 10 patients had positive blood cultures,four of 16 had positive cerebrospinal fluid(CSF)cultures and five of five were detect-ed to be positive by next-generation sequencing(NGS)for pathogens in CSF.CSF showed exudative changes and elevated number of leukocytes,with predominance of single nucleated cells.All patients were treated with the combined use of two to four from the drugs like doxycycline,rifampicin,ceftriaxone,cefixime,minocycline,levofloxacin and sulfanilamide.Most patients had a favorable prognosis.[Conclusions]Neurobrucellosis should be considered in all patients with central nervous system manifestations from endemic areas.If there are exudative changes in CSF,differential diagnoses can be made by serological testing,blood culture,CSF culture and NGS.NGS could significantly increase the accuracy for neuro-brucellosis diagnosis.

Non-small cell lung cancer is the main cause of cancer death in the world, and its incidence is increasing year by year, seriously endangering human health. Early non-small cell lung cancer is generally difficult to be detected based on symptoms and signs. Therefore, accurate pathological diagnosis and accurate prediction of prognosis are crucial for formulating the best treatment plan for non-small cell lung cancer patients and improving their survival. The application of artificial intelligence in the diagnosis and treatment of non-small cell lung cancer has shown good performance and great potential effect. This paper introduces the research progress of artificial intelligence in predicting the classification, staging, genomics and prognosis of non-small cell lung cancer.

Objective To discuss the main pathological types and imaging characteristics of pulmonary nodules that are highly suspected to be malignant in clinical practice but are pathologically confirmed to be benign. Methods A retrospective analysis was performed on the clinical data of patients with pulmonary nodules who were initially highly suspected of malignancy but were subsequently pathologically confirmed to be benign. These patients were treated at the First Affiliated Hospital of Xiamen University from December 2020 to April 2023. Based on the outcomes of preoperative discussions, the patients were categorized into a benign group and a suspicious malignancy group. The clinical data and imaging characteristics of both groups were compared. Results A total of 232 patients were included in the study, comprising 112 males and 120 females, with a mean age of (50.7±12.0) years. Among these, 127 patients were classified into the benign group, while 105 patients were categorized into the suspicious malignancy group. No statistically significant differences were observed between the two groups regarding age, gender, symptoms, smoking history, or tumor history (P>0.05). However, significant differences were noted in nodule density, CT values, margins, shapes, and malignant signs (P＜0.05). Further analysis revealed that in the suspicious malignancy group, solid nodules were predominantly characterized by collagen nodules and fibrous tissue hyperplasia (33.3%), followed by tuberculosis (20.4%) and fungal infections (18.5%). In contrast, non-solid nodules were primarily composed of collagen nodules and fibrous tissue hyperplasia (41.2%) and atypical adenomatous hyperplasia (17.7%). Conclusion Benign pulmonary nodules that are suspected to be malignant are pathologically characterized by the presence of collagen nodules, fibrous tissue hyperplasia, tuberculosis, atypical adenomatous hyperplasia, and fungal infections. Radiologically, these nodules typically present as non-solid lesions and may exhibit features suggestive of malignancy, including spiculation, lobulation, cavitation, and pleural retraction.

Objective To explore the value of preoperative detection of soluble fragments of cytokeratin-19 (CYFRA21-1), carcinoembryonic antigen (CEA), and postoperative detection of nuclear proliferation associated antigen Ki67 in prognostic evaluation of non-small cell lung cancer patients. Methods The clinicopathological data and follow-up results of patients with non-small cell lung cancer treated in the Department of Thoracic Surgery of the First Affiliated Hospital of Xiamen University in 2017 were collected. CYFRA21-1>3.39 ng/mL was defined as positive, and CEA>5 ng/mL was defined as positive. The receiver operating characteristic curve (ROC curve) of Ki67 expression level was drawn. The maximum area under the curve (AUC) was the cutoff value of Ki67 expression level, and the Ki67 expression level greater than its cutoff value was defined as positive. Cox regression analysis was used to determine the independent risk factors for poor prognosis in patients with non-small cell lung cancer. Results Finally 248 patients were collected, including 125 males and 123 females, with a median age of 61 years (ranging from 30 to 81 years) at the time of surgery. Univariate analysis showed that positive CYFRA21-1, high expression of Ki67, positive CEA, age≥60 years at operation, distant metastasis, lymph node metastasis, maximum tumor diameter>3 cm, and TNM stage Ⅲ were associated with poor prognosis in patients with non-small cell lung cancer. When combined detection of preoperative tumor markers and postoperative Ki67, the prognosis of all negative patients was the best, and that of all positive patients was the worst. Cox regression analysis showed that positive CEA+positive CYFRA21-1+high expression of Ki67 was an independent risk factor for poor prognosis in patients with non-small cell lung cancer (P<0.05). Conclusion The combined detection of preoperative serum CYFRA21-1, CEA, and postoperative Ki67 has important value in evaluating the prognosis of non-small cell lung cancer patients.