Objective To study drug resistance of carbapenem-resistant Klebsiella pneumonia ( CRKP) in neonates hospitalized in the neonatal unit , and to identify the risk factors for CRKP colonization in neonates .Methods Totally 108 neonates with Klebsiella pneumonia colonization admitted in Department of Neonates , the Second Hospital of Tianjin Medical University during January 2012 and June 2014 were enrolled in the study , including 23 cases with CRKP colonization ( case group ) and 85 cases with carbapenem-sensitive Klebsiella pneumonia (CSKP) colonization (control group).Chi-square test and fisher exact test were used to compare the differences in resistance to 21 antibiotics between CRKP and CSKP . Univariate analysis and Logistic regression analysis were performed to identify the risk factors for CRKP colonization in neonates .Results All of the CRKP strains were resistant to penicillins , cephalosporins and SMZco, and 95.7% and 87.0% of the CRKP strains were resistant to meropenem and imipenem , respectively.All of the CRKP strains were susceptible to amikacin , gentamicin, ciprofloxacin and tetracycline, but were highly resistant to the rest 16 antibiotics compared with CSKP strains (all P<0.05). Univariate analysis showed that 14 factors were associated with CRKP colonization: exposure to cefoxitin (χ2 =20.053, P<0.01), sputum suction (χ2 =15.817, P<0.01), gastrointestinal decompression (χ2 =10.731, P<0.01), nasogastric feeding (χ2 =15.146, P<0.01), invasive procedure (χ2 =22.572, P<0.01), birth weight (χ2 =6.026, P<0.05), frequency of sampling for CRKP/CSKP (χ2 =18.577, P<0.01), hypertension of pregnancy (χ2 =8.698, P<0.01), premature birth (χ2 =4.904, P<0.05), prenatal hospitalization experience (χ2 =8.396, P<0.01), adequacy for gestational age (χ2 =7.295, P<0.05), gestational age (χ2 =7.294, P<0.05), rupture of membranes (χ2 =9.397, P<0.01), length of hospitalization (χ2 =14.649, P<0.01) and admission to the neonatal intensive care unit (NICU) (OR=11.050, P<0.01).Multivariate Logistic regression analysis showed that hypertension of pregnancy (OR=9.718, P<0.01), rupture of membranes ( <24 h) (OR=6.640, P<0.01) and admission to NICU ( OR=4.119, P<0.05) were independent risk factors for CRKP colonization .Conclusions CRKP strains are highly resistant to most antibiotics .Preventing hypertension of pregnancy and rupture of membranes , and monitoring bacterial resistance in NICU may help to reduce the occurrence of CRKP colonization and dissemination .

Objective To explore the characteristics of selective attention function in patients with silent cerebral in-farction (SCI) and depression, the relationship between depression, selective attention and cognitive dysfunction. Methods Eighty-two patients with SCI and 82 normal subjects were selected and evaluated by using Hamilton Depression Rating Scale (HAMD), Montreal cognitive assessment (MoCA) and Stroop color-word test (CWT). Patients with SCI were further classified into depression subgroup and no-depression subgroup based on the score of HAMD. Results The score of MoCA was lower in SCI group (23.11 ± 5.41) and was much lower in depression subgroup (20.31 ± 5.44) compared with control group (28.70 ± 2.18) (all P<0.01). Compared with control group, the reaction times of card A, B, C and Stroop interference effects (SIE) were prolonged in SCI group. The reaction time of card A, B, C and SIE were (33.25±14.10);(42.45±15.18);(104.68 ± 25.08) and (62.24 ± 21.53) in depression subgroup, respectively. The error counts of card B, C and SIE were in-creased (P<0.05) in SCI group. The error counts of card B,C and SIE were (3.59±2.14), (15.67±7.20) and (12.08±6.46) in depression subgroup, respectively. The scores of MoCA were negatively correlated with the reaction time and error counts of SIE (r=-0.429,r=-0.500,all P<0.01).The location of infarction was correlated with the score of HAMD and error counts of SIE to some degree: both of the scores were higher in patients with left infarction compared with right infarction and were higher in patients with cortex infarction compared with subcortex infarction. Conclusion The present study revealed that patients with SCI and depression have selective attention deficit which is closely correlated with the level of cognitive function.

BACKGROUND:Oversize stress of a dental implant and its surrounding tissue is the main factor to affect the
long-term use of dental implants. So, the reasonable and precise design of implant shape is one of the important methods of prolonging the life span of dental implants.
OBJECTIVE:To make the optimal analysis and design of the diameters of connector screw and central screw of the adjustable-angle dental implant invented in the earlier stage.
METHODS: The finite element analysis model of the edentulous mandible with adjustable-angle dental implant was established by software Pro/E 5.0, Mimics 10.0 and ANSYS Workbench 14.5. The maximum equivalent
stress of dental implant-edentulous mandibular model was analyzed.
RESULTS AND CONCLUSION:The maximum equivalent stress of dental implant-edentulous mandibular model

The temporary function replacement and intensive support play a pivotal role in the treatment of patients with acute or chronic end-stage organ failure. The hemodialysis and peritoneal dialysis have become routine techniques in the management of acute or chronic renal failure. But for the complexity of hepatic function, e.g. metabolism, biosynthesis and biotransformation for endogenous or exogenous substrates, the simulation or partial replacement of hepatic function is a great dream of bionic technologists. With the development of cell biology and biomedical material, the combination of biomaterial and the hepatocyte cultured ex vivo could provide a range of human liver-specific functions. The combination of biomaterial and viable cell was called hybrid or bioartificial liver support system (BALSS). It is a chimera of biomaterials and hepatocytes. The bionic technologists study the cell and its culture in vitro, which is the main component of BASLL. Many types of BALSS were translated into the early clinical stage. In this overview, we review the hepatocyte culture and the design of different bioreactors. It includes the immune obstacles in xeno-hemoperfusion and how to assess pre-clinical and clinical effectiveness.
Bioreactors ; Cells, Cultured ; Hepatocytes ; cytology ; Humans ; Liver, Artificial

In the conventional treatments of type I diabetes, there are various problems. As a new adequate treatment of diabetes, cell replacement therapy of diabetes has been applied and given research priority. We have investigated the applications of cell transplantation in the treatment of diabetes and have retrieved the relevant articles on cells transplantation for the treatment of diabetes. In this paper, we review the history, development, merits and demerits of cell transplantation and the recent advances in pancreatic islet transplantation research. The latest progress in the induction of stem cell to differentiate into the insulin-producing cells was also introduced.
Animals ; Diabetes Mellitus, Type 1 ; surgery ; therapy ; Humans ; Insulin-Secreting Cells ; cytology ; Islets of Langerhans Transplantation ; methods ; Stem Cell Transplantation

Objective:To evaluate the effects of rocuronium on limb ischemia-reperfusion injury in the patients undergoing total knee arthroplasty.Methods:Ninety patients of both sexes, aged 50-80 yr, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, with body mass index<30 kg/cm 2, scheduled for elective unilateral knee arthroplasty under general anesthesia combined with femoral nerve block from January 2019 to October 2019, were divided into 3 groups ( n=30 each) using a random number table method: normal saline group (group S), rocuronium 0.6 mg/kg group (group RL) and rocuronium 1.2 mg/kg group (group RH). Anesthesia was induced by intravenous injection of midazolam, etomidate, sufentanil and rocuronium 0.6 mg/kg (group RL) or 1.2 mg/kg (group RH) or equal volume of normal saline (group S). Mechanical ventilation was performed after placement of laryngeal mask to maintain P ETCO 2 35-45 mmHg.Femoral nerve block was performed under ultrasound guidance.Anesthesia was maintained by inhaling 1% sevoflurane and intravenous infusion of propofol and remifentanil to maintain entropy index at 40-60 during operation.Patient-controlled intravenous analgesia was performed with sufentanil after surgery to maintain visual analogue scale score ≤ 4 points.When visual analogue scale score was > 4, flurbiprofen axetil 100 mg was intravenously injected.The vastus medialis muscle at the edge of the incision was obtained at 60 min after inflation to determine the expression of dystrophin by immunohistochemistry.Arterial blood samples were collected immediately after inflation of the tourniquet, at 60 min after inflation, and at 5 and 30 min after deflation for determination of the serum malondialdehyde (MDA) concentrations by the thiobarbituric acid method.The effective pressing times of the analgesic pump and consumption of sufentanil and flurbiprofen axetil were recorded within 48 h after operation.The occurrence of responses to tourniquet and residual muscle relaxation during recovery from anesthesia, the first postoperative off-bed time and postoperative length of hospital stay were recorded.The thigh girth was measured before operation and at 24 and 48 h after operation, and the difference after and before operation was calculated.The range of motion of knees of the operated limb and tourniquet-related complications in the early postoperative period (3 days) and in the long-term postoperative period (3 months) were recorded. Results:Compared with group S, the expression of dystrophin in skeletal muscle was significantly up-regulated, the concentration of serum MDA was decreased at 30 min after deflation, and the difference in thigh girth at 24 and 48 h after operation was decreased in group RH, and the range of motion of knees was significantly increased at 3 days and 3 months after operation, and the first postoperative off-bed time was shortened in group RH and group RL ( P<0.05). Compared with group RL, the range of motion of knees was significantly increased at 3 days and 3 months after operation, and the first postoperative off-bed time was shortened in group RH ( P<0.05). There was no significant difference in the incidence of responses to tourniquet, postoperative length of hospital stay, effective pressing times of the analgesic pump, postoperative consumption of sufentanil and flurbiprofen axetil, and the incidence of tourniquet-related complications in the early and long-term postoperative periods among the three groups ( P>0.05). No residual muscle relaxation was found during recovery from anesthesia in three groups. Conclusion:Rocuronium 1.2 mg/kg can reduce limb ischemia-reperfusion injury in the patients undergoing total knee arthroplasty.

Objective:To explore whether autophagy is involved in dysfunction of vascular endothelial induced by sodium arsenite (NaAsO 2). Methods:Human primary umbilical vein endothelial cells were isolated and cultured. The cells were treated with different levels of NaAsO 2 [0 (control)), 2, 5, 10, 20, 30, 50 μmol/L] for 24 h, and cell viability was determined using CCK8. According to the results of CCK8, the levels of arsenite used in subsequent experiments were determined, intracellular nitric oxide (NO) content (incubated by NaAsO 2 for 4 h) was detected by flow cytometry, LC3 levels (incubated by NaAsO 2 for 0, 6, 12 and 24 h) was detected using Western blotting, and autophagosome (incubated by NaAsO 2 for 12 h) was observed by electron microscope. At the same time, human primary umbilical vein endothelial cells were pretreated with 0.1 mmol/L 3-MA (autophagy inhibitor) for 2 h, and induced by 30 μmol/L NaAsO 2, and the above detection indicators were compared with those of the 30 μmol/L NaAsO 2 group. Results:Human primary umbilical vein endothelial cells were successfully isolated and cultured. Compared with the control group [cell viability: (99.97 ± 5.33)%, NO content: 42 048.34 ± 789.61], the cell viability [(73.00 ± 0.86)%] and NO content (23 353.97 ± 971.85) of 30 μmol/L NaAsO 2 group were remarkably lower, and the differences were statistically significant ( P < 0.01). Incubated with 30 μmol/L NaAsO 2 at different time points 6, 12, 24 h, LC3Ⅱ levels (5.782 ± 2.789, 9.692 ± 2.222, 5.573 ± 2.941) were significantly elevated than those of control group (1.000 ± 0.383, P < 0.05), and the LC3 Ⅱ level was the highest at 12 h. After treatment with 30 μmol/L NaAsO 2 for 12 h, the number of autophagosome in cells observed under electron microscope was significantly higher than that of the control group. Compared with 30 μmol/L NaAsO 2 group [cell viability: (68.78 ± 1.55)%, LC3 Ⅱ level: 5.680 ± 0.545, NO content: 13 025.78 ± 962.61], cell viability [ (79.54 ± 4.99) %] in 3-MA+ NaAsO 2 group was increased, the LC3Ⅱ level (3.956 ± 0.398) was decreased, and the differences were statistically significant ( P < 0.05); intracellular NO content (13 988.51 ± 1 671.07) increased, whereas the difference was not statistically significant ( P > 0.05). Conclusion:Autophagy is involved in the vascular endothelial dysfunction induced by arsenic.

Objective To explore the role of pigment epithelium-derived factor (PEDF) in vascular endothelial cells dysfunction induced by sodium arsenite (NaAsO2).Methods Human umbilical vein endothelial cells (EA.Hy926 cells) were treated with different levels of NaAsO2 [0 (control),1,2,5,10,20,50 μmol/L] for 24 hours.The cell viability was determined using CCK8.Colorimetric assay was used to detect the activity of inducible nitric oxide synthase (iNOS) in culture supematants,PEDF content in the supematant of EA.Hy926 cells was detected by enzyme-linked immunosorbent assay (ELISA),and nitric oxide (NO) content in cells was detected by flow cytometry.Results Compared with the control group [(101.08 ± 3.22)％],the cell viability of 20 μ mol/L group [(80.69 ± 7.95)％] and 50 μmol/L group [(69.87 ± 10.54)％] decreased significantly,and the differences were statistically significant (P ＜ 0.05).The activity of iNOS increased significantly in 10,20,50 μmol/L groups [(829.1 ± 68.2),(772.3 ± 37.1),(874.6 ± 43.5) U/L],respectively,in comparison with that of the control group [(397.5 ± 43.5) U/L] in the cell culture supematant (P ＜ 0.01).Similarly,PEDF levels in the groups of 10,20,50 μmol/L [(12.06 ± 0.55),(11.97 ± 0.39) and (13.89 ± 0.26) mg/L respectively] were higher than that of the control group [(10.70 ± 0.35) mg/L,P ＜ 0.01],and the highest content of PEDF was found in 50 μmol/L group.The NO level in 50 μmol/L group (11 558.99 ± 397.43) was significantly lower than that of the control group (14 131.49± 262.61,P ＜ 0.01).Conclusion PEDF is involved in the vascular endothelial cells dysfunction induced by arsenic.

OBJECTIVE： To provide reference for clinical treatment of precancerous lesions of gastric cancer. METHODS： A total of 685 patients with precancerous lesions of gastric cancer were selected from our hospital during Jan.-Dec. 2018. Totally 455 patients in treatment group received individualized TCM therapy according to syndrome differentiation， 7 days as a course， 4 courses in total； another 230 patients in control group received Folic acid tablets， 5 mg， tid， for 2 months. The changes of pepsinogen ratio （PGⅠ/PGⅡ）， gastrin-17 （G-17） and Helicobacter pylori （Hp）before and after treatment， and the occurrence of ADR were compared between 2 groups. RESULTS： After treatment， total response rate of treatment group was 90.3％， which was significantly higher than 68.6％ of control group. PGⅠ/PGⅡ of treatment group were increased significantly， which was significantly higher than control group； G-17 levels of 2 groups were decreased significantly （P＜0.05）； there was no statistical significance in Hp level between 2 groups before and after treatment （P＞0.05）. There was no statistical significance in the incidence of ADR between 2 groups（P＞0.05）. CONCLUSIONS： Chinese medicine syndrome differentiation individual therapy can significantly delay the development of precancerous lesions of gastric cancer， and has good safety.