Objective:To study the effect of cervical canal mucosa dng excision on cervical columnar eversion in Loop electrosurgical excision procedure(LEEP).Methods:A prospective randomized control trail was performed in 125 cervical intraepithelial neoplasia(CIN)patients.Cervix and cervical canal were conically excised with triangle electrode in 62 patients in the control group;in the study group,a small ring electrode was put into the cervical canal and the cervical canal mucosa was excised about 0.5～0.8cm,after excision as the control group.Follow-up was performed postoperatively in 1,3,6 months respectively.The operation time,the bleeding volume,the rate of cervical columnar eversion and cervical adhesion or stenosis were compared between the two groups.Results:The rate of cervical columnar eversion in the study group (1/63,1.59%)was lower than that in the control group(9/62,14.52%).There was significantly statistical difference between them(P=0.008).There was no statistical differences between them in the operation time,the bleeding volume,and the rate of cervical adhesion or stenosis (P>0.05).Conclusions:The cervical canal mucosa ring excision in LEEP can effectively prevent postoperative cervical columnar eversion.

OBJECTIVE:To observe analgesic effect and safety of ketorolac tromethamine combined with butorphanol tartrate in the treatment of acute pain after fracture surgery. METHODS:76 acute pain patients after fracture surgery were selected and ran-domly divided into control group and observation group,with 38 cases in each group. Control group was given Ketorolac trometh-amine injection 30 mg,ivgtt,and then 2 ml/h,0.5 mg/kg,ivgtt;observation group was additionally given butorphanol tartrate 10 mg,ivgtt,on the basis of control group. Pain degree was evaluated with VAS before and 10 min,1,2,4 and 6 h after treatment, and the occurrence of ADR was observed in 2 groups. RESULTS:10 min,1,2,4 and 6 h after treatment,VAS score of 2 groups were significantly lower than before,with statistical significance(P<0.05);6 h after treatment,VAS score of observation group was significantly higher than that of control group,with statistical significance (P<0.05);there was no statistical significance in VAS score between 2 groups 10 min,1,2 and 4 h after treatment (P>0.05). The incidence of ADR in observation group (5.26%)was significantly lower than in control group(21.05%),with statistical significance(P<0.05). CONCLUSIONS:Com-pared with ketorolac tromethamine alone,ketorolac tromethamine combined with butorphanol tartrate shows shorter analgesia dura-tion,similar therapeutic efficacy,and lower incidence of ADR.

Objective To evaluate the efficacy of Marvelon on treatment of adenomyosis.Methods A total of 42 women with adenomyosis were recruited in the study.They were given Marvelon on the first day of menstruation,1 piece,qd,continouly for 21 days.With an alternation of seven days a new cycle begins.There are 6 cycles in total.We observe their degree of dysmenorrheal,menstrual blood volume(MBV) ,hemoglobin and the volume of uterus before and after Marvelon used.Results After 6 months,the dysmenorrheal remitted obviously,the score decline from (8.51±1.73 ) to (0.62±0.70) ,P <0.01.The MBV reduced and hemoglobin rise distinctly ,before treatment Hb is (104.71±12.09) while (112.00±8.57)after therapy,P <0.01.After treatment the volume of uterus shrinks a little, but not significant(P > 0.05).Conclusion Marvelon is an effective drug in treatment of adenomyosis in the near future,and is cheap,convcnieat.

BACKGROUND:Fetal bovine serum based media used for expanding and cryopreserving human mesenchymal stem cells raise safety concerns in the clinical setting. OBJECTIVE:To investigate the feasibility of human umbilical cord blood plasma as a replacement for fetal bovine serum in culture and cryopreservation of human mesenchymal stem cells derived from umbilical cord. METHODS:Umbilical cord blood units were suitable for this research if they fulfil ed the donor selection criteria of the Guangzhou Cord Blood Bank strictly. Cord blood plasma was ready to use after col ected from the plasma reduction during the suitable cord blood units processing and pooling. Umbilical cord mesenchymal stem cells were harvested from the umbilical cord tissue of health ful-term newborns after delivery by enzyme digestion and were cultured in the presence of Dulbecco’s modified Eagle’s medium/Ham’s nutrient mixture F-12 containing either fetal bovine serum or pooled cord blood plasma. Morphology, proliferation, immunophenotype detected by flow cytometry and differentiation toward adipogenic and osteogenic lineages were utilized for investigating the effect of media on umbilical cord mesenchymal stem cells after 3-5 passages. Then cells were cryopreserved in media containing 10%dimethyl sulfoxide, 20%fetal bovine serum or 20%pooled cord blood plasma for at least 6 months. Viability, adhesion, proliferation, immunophenotype and osteogenic differentiation of the cells were assessed after thawing. RESULTS AND CONCLUSION:The morphology (spindle-shaped and plastic-adherent), phenotype and differentiation potential (osteogenic and adipogenic) were almost indistinguishable between cells cultured in fetal bovine serum or cord blood plasma medium, while cells grown in cord blood plasma medium demonstrated significantly higher proliferation rates than those in medium containing fetal bovine serum. After thawing, the cells maintained their adherence to the culture surface and differentiation potential to osteoblasts, but cells from cord blood plasma cryopreservation medium showed significantly better plastic attachment and produced greater cellnumbers than fetal bovine serum for the first three post-thaw passages. The results demonstrate that cord blood plasma can sever as an effective substitute to fetal bovine serum for growth, maintenance and differentiation of umbilical cord mesenchymal stem cells, and thus it wil be a safe choice for clinical-scale production of human mesenchymal stem cells.

Objective:To study the dynamic expression of Nogo-A in hippocampus of rats after carbon monoxide poisoning,and to explore the effect and influence of Nogo-A in the damage to nervous system after carbon monoxide poisoning.Methods:Thirty male SD rats were randomly divided into NC group(n=6),CO group(n=6),CO-24 h group(n=6),CO-48 h group(n=6),CO-7d group(n=6).The method of injection CO gas was used to establish the carbon monoxide poisoning model.Then immunohistochemical (IHC) and Western blot (WB) techniques were used to observe dynamic expression of Nogo-A in hippocampus of rats at several time intervals after carbon monoxide poisoning and to analyze its change law.Results:IHC results showed that the average optical density value of expression of Nogo-A in NC group,CO group,CO-24 h group,CO-48h group and CO-7d group were 0.0928± 0.0038,0.01172± 0.0042,0.1452± 0.0056,0.1271 ± 0.0057,0.1088± 0.0055.WB results showed that the expression of Nogo-A in hippocampus after carbon monoxide poisoning was significantly higher than that in NC group(P＜0.05),and reached the highest level at 24 h,then had a gradual recovery after 24h.The expression of Nogo-A decreased obviously,but still higher than that of NC group by day 7 (P＜0.05).Conclusions:In this study,the increase of expression of Nogo-A was associated with carbon monoxide poisoning.The expression of Nogo-A reached the highest level at 24h,then had a gradual recovery after 24 h.

Objective To investigate the situation of pulmonary tuberculosis among the in-school students and to provide the data for improvement of pulmonary tuberculosis control and prevention.Methods All the pulmonary tuberculosis cases of in-school student's registration cards registered during 2008 in Hefei antituberculosis station were analyzed,and the PPD and X ray were used for disease screening.Results There were 168 student patients with pulmonary tuberculosis,physical examination was the main way to find patients.The positive of mycobacterium tuberculosis examination in tuberculosis patients was highest in junior high school.The results of PPD test showed the rate of strongly positive in close contactors was 13.8%,and four new patients were diagnosed.Conclusions Study shows the pulmonary tuberculosis epidemiological and prevention condition among students sub-population are still serious,so stricter control measures should be improved in the future.

Objective:To analyze the relationship between virulent phenotypes and the expression of antigens.Methods:The authors observed virulent phenotypes of different Shigella and its mutant by Congo red test(Pcr),contacting hemolysis test (CHT),invading HeLa cells test(Inv) and keratoconjunctivits test(Ser) and analyzed genetic background of the virulence of Shigella.Took the convalescent sera of monkeys infected with Shigella flexneri 2a to analyze the virulence associated antigens of different Shigella and enteroinvasive E.coli2 by BA immunoblot methods.Results:All virulent Shigella strains have a 120～140 MegaDalton(MD) plasmid and are Pcr(+),CHT(+),Inv(+),Ser(+).While all virulent Shigella strains are negative.All virulent strains contain four invasive plasmid antigens(IpaA?B?C?D),while nor do virulent strains.The virulence of Shigella is related not only with Ipas,but also with LPS antigen.Conclusion:The virulence of Shigella is associate with biology phenotypes of Shigella.Only with common expression of the two antigens(Ipas and LPS),the bacteria express the virulence.

Abstract： Objective　To analyze the characteristics and corresponding drug resistance of pathogenic bacterial spectrum in eight major infection sites of hospitalized patients, and to provide epidemiological data for the rational selection of antibiotics in clinical practice. Methods　A total of 396 bacterial strains isolated from clinical specimens of hospitalized patients in member institutions of the Hainan Provincial Bacterial Resistance Monitoring Network from September 1, 2020, to September 30, 2022, were included in this study. Data were screened and filtered from the database of MH120 Microbial Identification and Drug Sensitivity Analysis System based on the technical scheme of the National Bacterial Drug Resistance Surveillance Network and Science and Technology Basic Resources Investigation Project research plan in 2020. The testing data were integrated, summarized, and analyzed using EXCEL and WHONET 5.6 software, and statistical analysis was conducted using SPSS 26.0 software. Results　Among of 396 strains of bacteria, 78 (19.7%) were isolated from respiratory tract specimens, 74 (18.7%) from urinary tract specimens, 72 (18.2%) from blood specimens, 54 (13.6%) from abdominal cavity specimens, 48 (12.1%) from skin and soft tissue specimens 48 strains (12.1%), 30 (7.6%) from reproductive tract specimens, 22 (5.6%) from central nervous system specimens, 18 (4.5%) from digestive tract specimens. Gram-negative bacteria accounted for 69.4% of the isolates, while gram-positive bacteria accounted for 30.6%. The top five gram-negative bacteria isolated were Klebsiella pneumoniae (14.9%), Escherichia coli (14.4%), Pseudomonas aeruginosa (10.4%), Acinetobacter baumannii (5.3%), and Salmonella species (4.5%). The top five gram-positive bacteria were Staphylococcus aureus (11.1%), Streptococcus agalactis (7.8%), Enterococcus faecalis (3.0%), Enterococcus faecium (2.8%), and Streptococcus suis (1.8%). Respiratory failure and bloodstream infection were independent influencing factors of treatment response (P<0.01). The resistance rate of Escherichia coli to ampicillin was 81.4%, and the resistance rate of Staphylococcus aureus to gentamicin and levofloxacin were both below 7%. Conclusions　The pathogen spectra vary with different infection sites of patients, and rational selection of antibiotics based on drug susceptibility testing is crucial to shorten the treatment time of patients and avoid the unnecessary emergence of drug-resistant strains caused by drug abuse.

Abstract: Objective　To identify the species of Mycobacteroides abscessus complex (MABC) in patients with pulmonary infection from the Second Affiliated Hospital of Hainan Medical University, and to investigate the species types, drug sensitivity and population distribution of MABC in pulmonary infection in Hainan. Methods　Respiratory tract specimens were collected from suspected tuberculosis patients who visited the Second Affiliated Hospital of Hainan Medical University from January 2014 to December 2021 and cultured for Mycobacterium isolation. Non-tuberculous mycobacteria (NTM) strains were preliminarily identified by p-nitrobenzoic acid/thiophen-2-carbohydrazide (PNB/TCH) medium and DNA microarray chip, and then MABC and its subspecies were identified by hsp65 and rpoB gene sequencing. In vitro antimicrobial susceptibility test was performed by broth microdilution method. Results　A total of 3 025 respiratory specimens from suspected pulmonary tuberculosis patients were collected during the study period. Among the 123 patients with identified MABC isolates, 124 MABC strains were isolated and identified, including 74 strains of Mycobacteroides abscessus subsp. abscessus, 38 strains of Mycobacteroides abscessus subsp. massiliense and 12 strains of Mycobacteroides abscessus subsp. bolletii. Among them, 118 patients had single MABC subspecies infection, one patient had mixed infection with two MABC subspecies, two patients had mixed infection with MABC and other NTM, and two cases had mixed infection with MABC and M.tuberculosis. There were more female patients than male patients with a ratio of 1:0.64, and those aged 50 and above amounted to 76.42% (94/123, 95%CI: 67.93%-83.61%). There was no significant difference in age distribution between male and female patients (Z=-0.944, P=0.347). The drug susceptibility results showed that all MABC strains were sensitive to Tigecycline (TGC), with a resistance rate of 0.81% (1/124) to Amikacin (AK), and resistance rates of 6.45% (8/124), 32.26% (40/124), and 74.19% (92/124) to Cefoxitin (FOX), Linezolid (LZD), and Imipenem (IPM), respectively. For Clarithromycin (CLR), MABC showed induced resistance , and there was a statistically significant difference in the CLR (14D) resistance rates among the three subspecies (χ2=66.335, P<0.001). The resistance rates to Tobramycin (TOB), Doxycycline (DOX), Moxifloxacin (MFX), Ciprofoxacin (CIP), Trimethoprim/Sulfamethoxazole (TMP-SMX), and Amoxicillin/Clavulanic acid (AMC) were high, all >80%. Conclusion　 In Hainan Province, pulmonary infections with MABC are mainly caused by Mycobacteroides abscessus subsp. Abscessus, which show high rates of inducible resistance to CLR. Timely and accurate identification of MABC to subspecies and drug susceptibility testing are of significant important for clinical decision-making.