Objective To investigate the distribution and antimicrobial resistance of bacteria isolates from intensive care units(ICUs) in Shandong Province.Methods Antimicrobial susceptibility data about clinical strains isolated from ICUs of 101 hospitals and general wards(non-ICUs) of 106 hospitals in Shandong Province in 2014 were analyzed statistically.Results A total of 24 458 strains of bacteria were isolated, of which gram-negative and gram-positive bacteria accounted for 80.37% and 19.63% respectively.The top five pathogens in ICUs were Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Escherichia coli, and Staphylococcus aureus.Resistance rates of Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, and Serratia marcescens obtained from ICUs to carbapenems, piperacillin/tazobactam, cefoperazone/sulbactam, and amikacin were all higher than those from non-ICUs(all P<0.01).Resistance rates of Acinetobacter baumannii, Pseudomonas aeruginosa, and Staphylococcus spp.from ICUs were all higher than those from non-ICUs(P<0.05).Resistance rates of Acinetobacter baumannii isolated from ICUs to imipenem and meropenem were 78.0% and 79.0% respectively;while Pseudomonas aeruginosa were 25.5% and 21.6% respectively, resistance rates to other antimicrobial agents were all <30.0%.Isolation rate of methicillin-resistant Staphylococcus aureus from ICUs was higher than that from non-ICUs(39.7% vs 26.0%, P<0.05).Conclusion Antimicrobial resistance of bacteria isolated from ICUs is serious, rational use of antimicrobial agents should be guided according to the results of antimicrobial susceptibility testing result, so as to prevent the spread of drug-resistant bacteria.

Objective To investigate the effect of nitric oxide(NO)on the prostatic proliferation/apoptosis in rat models. Methods Twenty adult male rats were randomly divided into 3 groups.Group 1 were normal controls (n=6);group 2 (n=7) and group 3 (n=7) were treated with subcutaneous injection of nitric oxide synthase (NOS) inhibitor-L-NG-Nitroarginine methyl ester (L-NAME) 50mg/kg and 100mg/kg, bid, respectively.The weight of the prostate was measured after 2 weeks and morphological changes were examined with light microscope.Detection of ki-67 and TUNEL in prostatic epithelial cells were undertaken so as to assess the proliferation and apoptosis index.The protein and mRNA expression of NOS were analyzed by means of immunohistochemistry and RT-PCR. Results The prostate weight of 3 groups was not significantly different.Compared with group 1, remarkable atrophy of prostatic epithelial cells,marked decrease in proliferation rate of epithelial and interstitial cells, and significant increase in apoptosis rate of epithelial cells were noted in group 2 and group 3 (P

Objective:To investigate the efficacy of early minimally invasive catheterization continuous abdominal lavage and drainage in treatment of severe acute pancreatitis (SAP) .Methods:170 SAP patients admitted to Quzhou People’s Hospital from Jan. 2016 to Jun. 2020 were divided into the observation group and the control group, with 85 cases in each group, according to the random number table method. The control group received comprehensive medical treatment, while the observation group received early minimally invasive catheterization continuous abdominal lavage and drainage intervention based on the control group. The efficacy and complications after 1 week of treatment were evaluated. Besides, the intra-abdominal pressure (IAP) and acute physiology and chronic health II (APACHEII) were scored, liver and lung function indexes [oxygenation indexes, oxygen partial pressure (PaO 2) , aspartate aminotransferase (AST) , alanine aminotransferase (ALT) ], and inflammation indexes [C-reactive protein (CRP) , tumor necrosis factor-α (TNF-α) , macrophage inflammatory protein-1α (MIP-1α) ] were measured before and 1 week after the treatment. Results:The total effective rate of the treatment in the observation group was 91.77%, which was significantly higher than 77.65% in the control group ( P<0.05) . The level of IAP, APACHEII score, AST, ALT, CRP, TNF-α, MIP-1α of the two groups after 1 week of treatment decreased significantly compared with those before treatment, while the oxygenation index and PaO 2 increased significantly. The levels of IAP, APACHEII score, AST, ALT, CRP, TNF-α, and MIP-1α in the observation group were lower than those in the control group after 1 week of treatment, while the oxygenation index and PaO 2 in the observation group were higher than those in the control group, with statistically significant difference ( P<0.05) . The incidence rates of multiple organ dysfunction syndrome (MODS) , sepsis and systemic inflammatory response syndrome (SIRS) in the observation group were: 8.24%, 11.76% and 15.29%, significantly lower than 21.18%, 29.41% and 30.59% in the control group ( P<0.05) . Conclusion:Early minimally invasive catheterization continuous abdominal lavage and drainage in treatment of SAP is safe and effective, which can significantly inhibit pro-inflammatory factors, and protect liver and lung function.

Objective To explore the possibities of routine disinfection for prosthetic sockets. Methods From June to August, 2016, 19 lower limbs prosthesis wearers wiped their prosthetic socket surfaces and sprayed the stump socks with a compound of quaternary ammoni-um salt every night for three weeks. Meanwhile, field investigation and sampling were carried out weekly. Staphylococcus aureus, Pseudo-monas aeruginosa, Escherichia Coli and Candida albicans were isolated and identified, and colony counting was carried out. Results After disinfection, the number of bacteria on the prosthetic socket reduced 1.8-3.0 log, and the number of fungi reduced 1.6-1.9 log. One strain of Staphylococcus aureus and one strain of Escherichia Coli were isolated before disinfection and one strain of Pseudomonas aeruginosa was isolated after disinfection. Eczema and itching symptoms relieved or disappeared and deodorant effect was distinguished after continuous disinfection. Conclusion Disinfection on prosthetic sockets with compound of quaternary ammonium salt may control the microbial contam-ination and odor, reduce the incidence of eczema and other skin diseases.

Objective To explore the clinical features,efficacy and prognosis of different treatments for children with achalasia of cardia(AC).Methods In this retrospective study,the clinical features,laboratory examination and treatment of 36 children with AC who had been admitted to Department of Gastroenterology,Beijing Children's Hospital,Capital Medical University from August 2006 to September 2015 were reviewed,and the efficacy and prognosis of different treatments were compared.The symptoms of the children were graded using the AC clinical symptom score(Eckardt score),and the Eckardt score ≤ 3 scores was defined as the effective treatment.SPSS 19.0 statistical software was used to analyze the data,and P<0.05 for the difference was statistically significant.Results Thirty-six children with AC included 24 boys and 12 girls.Ages ranged from 1.4 to 15.5 years old,with a mean age of(10.0±3.4)years old.Course of disease ranged from 1 month to 9 years,with a mean course of 0.5(0.2,3.0)years.In the 36 children,33 cases(91.7％)had vomiting,23 cases(63.9％)had dysphagia,16 cases(44.4％)had weight loss,and 9 cases(25.0％)had chest pain.The effective rates of treatment in surgical treatment group and drug treatment group were 100.0％(13/13 cases)and 71.4％(5/7 cases),respectively in 3 months,and there was no significant difference between the 2 groups(P=0.111).The effective rates of treatment were 100.0％(13/13 cases)and 50.0％(3/6 cases),respectively in 6 months,and the difference was statistically significant between the 2 groups(P=0.021).Within 12 months,there was no recurrence in surgical treatment group and the effective rate was 100.0％.Children in drug treatment group had 1 case who stopped taking medicine,while the other children received surgical treatment in other hospitals due to poor drug treatment.Conclusions Drug and surgical treatment of AC both have good short-term effect,however,the medium and long-term efficacy of surgical treatment is higher than that of drug treatment in children.Symptomatic relief is more stable,and symptom is not easy to relapse for the children with surgical treatment.

Varied TCM constitutions in the patient of acute cerebral infarction were classifyed by using HLA - DQAl allehc gene to analyze hereditary susceptibility of constitution types and relation among constitution, syndrome and treatment. PCR-SSP technique was used for classification of Yin - deficiency Yang - deficiency, Qi - deficiency, phlegm - dampness and blood stasis constitution in 103 cases of acute cerebral infarction and HLA - DQAl allelic gene was used for gent classification in 99 cases of nomal constituion. Results indicated that HLA -DQA * 0501 gene type in Yin -deficiency constitution was significant higher than that of normal constitution CP

Objective:To investigate the role of extracellular signal-regulated kinase 1/2(ERK1/2)signal pathway in the pathogenesis of stress-induced gastric ulcer.Methods:Animal model of stress-induced gastric ulcer was established in rats with water-immersion restraint(WIR)stress.The mucosal activation of ERK1/2 was observed before and 5,15 and 30 min,and 1, 2 and 3.5 h after WIR stress.Some animals were also treated with an intravenous injection of PD98059(1 mg/kg),a specific ERK1/2 inhibitor,1 h prior to WIR stress.Expression of total ERK1/2 and caspase-3 were detected by Western blot analysis; ERK1/2 activity was measured by kinase activity assay using myelin basic protein as a specific substrate.DNA-binding activities of the transcription factors activator protein-1(AP-1)and nuclear factor-?B(NF-?B)were determined by electrophoretic mobility shift assays(EMSA).Mucosal TNF-?and IL-1?mRNA expression was analyzed by Northern blot analysis.The degrees of the gastric mucosal lesions were expressed as ulcer index(UI)and pathological evaluation.Apoptosis in the gastric mucosa was examined by an in situ TdT-mediated dUTP nick-end labeling(TUNEL)method.Results:Activated ERK1/2 was very weakly expressed in the gastric mucosa of normal rats.ERK1/2 was rapidly activated in the gastric mucosa of rats 15 min after WIR stress and the activity reached the maximal after 3.5 h.Pretreatment with PD98059 significantly inhibited ERK1/2 activation,decreased AP-1 and NF-?B activities and TNF-?and IL-1?mRNA expression,and obviously relieved gastric mucosal lesions,accompanied by caspase-3 activation and increased apoptosis.Conclusion:The present results indicate that ERK1/2 activation plays an important role in the development of stress-induced gastric ulcer.

Objective:To evaluate the clinical efficacy and safety of Infliximab (IFX) in pediatric Crohn′s disease (CD).Methods:The efficacy of IFX therapy in 30 patients suffering from active CD who were not completely improved with traditional medicine and enteral nutrition or had intolerance to the medicine in Beijing Children′s Hospital Affiliated to Capital Medical University from December 2014 to December 2019 were retrospectively analyzed.Pediatric Crohn′s Disease Activity Index (PCDAI), blood biochemistry indices, mucosal healing, nutritional status, and adverse reactions were compared and evaluated.Results:Thirty active CD cases, with 18 males and 12 females, were enrolled, and the average age was (8.63±4.76) years old.Three cases who didn′t complete 3 times of IFX injection and 1 case who lost to be followed up were excluded.A total of 26 cases of CD in active period were enrolled in this study on efficacy.The clinical remission and response rate of 26 cases were 61.5% and 84.6%, respectively, at 14-week of IFX therapy.The clinical remission and response rate of 21 cases were 71.4% and 85.7%, respectively, at 30-week.The clinical remission and response rate of 15 cases were 86.7% and 93.3%, respectively, at 54-week.At week 14 th, PCDAI score [(9.56±8.05) scores vs.(29.02±10.86) scores] decreased compared with before treatment ( t=7.339, P<0.05). The levels of erythrocyte sedimentation rate [(15.54±10.26) mm/1 h vs.(33.77±21.30) mm/1 h] and C-reactive protein [(4.79±12.94 ) mg/L vs.(16.33±23.43) mg/L] were obviously decreased, and the hemoglobin [(126.27±16.51) g/L vs.(110.58±16.45) g/L], hematocrit [(37.03±3.95)% vs.(33.52±4.32)%], and albumin levels [(42.30±3.03) g/L vs.(37.13±5.68) g/L] were remarkably increased compared with those before treatment ( t=3.932, 1.993, -3.398, -3.060, -4.009, all P<0.05). Height for age Z score and body mass index Z score were increased after IFX treatment, without statistically significant differences (all P>0.05). Conclusions:IFX therapy had good clinical efficacy in controlling inflammatorys and inducing clinical remission in pediatric CD.

Objective: To investigate the clinical value of modified glaucoma combined with cataract surgery in the treatment of chronic angle closure glaucoma with cataract. Methods: From May 2012 to August 2017, 350 patients with chronic angle closure glaucoma complicated with cataract in the Second Hospital of Shaoxing were studied.According to the difference of treatment methods, they were divided into two groups, with 175 cases in each group.The control group was treated with trabeculectomy, the observation group was treated with modified glaucoma combined with cataract surgery.The intraocular pressure (IOP), visual acuity were observed. Results: The IOP values of the observation group were (22.50±1.48)mmHg, (18.77±2.38)mmHg, (14.21±0.93)mmHg at 3 d, one month and three months after operation, which were significantly lower than those of the control group [(28.91±2.05)mmHg, (23.28±2.49)mmHg, (17.75±1.16)mmHg], the differences were statistically significant(t=33.54, 17.32, 31.50, all P<0.05). Three months after operation, the depth of central anterior chamber in the observation group was (3.21±0.51)mm, which was obviously higher than that in the control group [(2.90±0.77)mm], the difference was statistically significant (t=4.44, P<0.05). The visual acuity index of the observation group was better than that of the control group (P<0.05). There was no statistically significant difference in the incidence of adverse events between the two groups (1.14% vs.4.00%, χ²=2.85, P>0.05). Conclusion The modified glaucoma combined with cataract surgery is effective in the treatment of chronic angle closure glaucoma with cataract, and can significantly improve the IOP and visual acuity.And the safety is high.

Objective To establish embryonic stem cells (ESC) that can express green fluorescent protein (CFP) and differentiate them into neurons. It would provide tagging neurons for clinical transplantation to cure neural system diseases. Methods ESC (R1) was transfeeted with a plasmid containing the GFP by electroporation. A transgeuic cell line was obtained after selection with G418. The ESCs were characterized by AKP staining. Monolayer differentiation method was used to induce neural differentiation derived from GFP-ESC and immunofluorescence method was used to identify Tuj1 positive cells. Results There was no significant difference(X2=3.14,P0.05) in transfect rates between liposome and electroporation (65% vs 79%). The AKP staining of GFP-ESC was positive. GFP-ESC could be differentiated into neural cells. Conclusions These results show that ESC expressing GFP has been estabhshed, which can be differemiated into neurons.