Objective To analyze clinical common pathogenic bacteria distribution of neonatal sepsis and antimicrobial resistance ,in order to provide theoretical basis for clinical rational use of antibiotics .Methods 342 cases of neonatal sepsis were selected as the research objects ,through the case control study ,specimens were collected retro-spectively the clinical data and blood culture ,to understand the pathogenic bacteria children with neonatal septicemia culture,To understand the pathogenic bacteria in children with neonatal septicemia culture .Distribution and drug resistance of pathogenic bacteria were analyzed .Results 342 cases of neonatal septicemia infection rate was 5.4%, among the 136 cases of preterm infants with sepsis ,infection rate is 10.9%,206 cases of full-term infants with sep-sis,infection rate was 4.0%, Septicemia in premature infants infection than full -term sepsis (χ2 =88.07, P <0.01);No significant difference of septicemia in premature infants and full -term infants septicemia pathogen strain distribution(P>0.05).Coagulase negative Staphylococcus aureus and Staphylococcus aureus resistant to penicillin , drug resistance rates were 97.1% and 87.5%,secondly to erythromycin resistance ,respectively were 86.9% and 75.0%;Three kinds of common gram negative bacteria were sensitive toimipenem ,resistance to ampicillin and cefazo-lin,drug resistance rate was 100.0%,the second was piperacillin ,cefepime,cefotaxime and ceftazidime .Conclusion Neonatal septicemia of gram positive bacteria mainly coagulase negative Staphylococcus aureus and Staphylococcus aureus,gram negative bacteria mainly in grams of Klebsiella pneumoniae , Escherichia coli and Escherichia coli . Common pathogenic bacteria with drug resistance .Clinical treatment of neonatal sepsis should be rational use of anti -biotics,to strengthen the monitoring of drug resistance .

With food containing konjac flour, a 45-day-long feeding trial on 110 old people suffering from hyperlipidemia was conducted to observe the effect of konjac food on lipid metabolism of human beings.The konjac flour was from Amorphophallus konjac, a kind of traditional food, with trace protein and very low energy, but rich in dietary fibre composed mainly of gluco-mannan.The results obtained were as follows;1.After having konjac flour 5g/day as a supplement of their regular meal for 45 days, concentration of TG, TC and LDLC in the serum of the experimental subjects decreased significantly (P

Seventy two diabetic subjects type Ⅱ were given konjac food for 65 days.The data analysed by multiple F-test indicated that the fasting blood glucosc(FBG), 2-h postprandial blood glucose (PBG) at the 30th and 65th day after consuming the food were significantly reduced (P = 0.001, P200mg%) decreased on the average by 51.8 and 84.6 mg% respectively, those with FBG-O 150-200 mg% by 24.1 and 68.7mg%, and those with FBG-0200 mg%).It could be concluded that konjac food was very useful in both prevention and treatment of hyperglycemia.

Objective To construct an eukaryotic expression vector pEGFP-N1-CKB and establish a stably transfected NCI-H520 cell line.Methods Human CKB gene was amplified by PCR with human CKB cDNA library as the template and the fragment was combined with plasmid pEGFP-N1.The recombinant expression vector,pEGFP-N1-CKB,was transfected to NCI-H520 using Lipofectamin.The stably transfected cell line was established after G418 selection and the expression level of CKB gene before and after transfection was detected by Western blot.Results After identification by restriction enzyme digestion and sequencing,the eukaryotic expression vector,pEGFP-N1-CKB,was successfully constructed.The expression level of CKB in NCI-H520 transfected by pEGFP-N1-CKB was significantly higher than that in control.CKB gene had a stable transfection in NCI-H520 cells.Conclusions An eukaryotic plasmid encoding CKB (pEGFP-N1-CKB) has been constructed and a cell line expressed CKB stably has been successfully prepared.

Objective To investigate the diagnostic value of narrow-band imaging for flat bladder lesions.Methods Forty-nine patients with flat bladder lesions diagnosed by white light cystoscopy + narrow-band imaging followed by transurethral resection were included.The diagnostic value of narrow-band imaging was evaluated based on postoperative pathological results.Results A total of 59 flat lesions were identified,in which 8 were normal urothelium,3 were chronic inflammation,1 was papillary urothelial neoplasm of low malignant potential,1 were mild dysplasia,1 was moderate dysplasia,1 were severe dysplasia,3 were carcinoma in situ,16 were low-grade papillary urothelial carcinoma,16 were high-grade papillary urothelial carcinoma,and 8 were invasive papillary urothelial carcinoma.For narrow-band imaging,the sensitivity was 86.7 ％ (39/45),specificity was 57.1％ (8/14),diagnostic accuracy was 79.7 ％ (47/ 59),false-positive rate was 42.9％ (6/14),positive predictive value was 86.7％ (39/45),negative predictive value was 57.1％ (8/14),area under ROC curve was 0.719.Among these lesions,the sensitivity and specificity for postoperative recurrent lesions were 100％ (3/3) and 40％ (2/5),respectively,and those for erythematous patch-like lesions were 90％ (9/10) and 100％ (4/4),respectively.Conclusion Narrow-band imaging can improve the detection rate for flat bladder tumor lesions,and reduce the risk for missed diagnosis under white light cystoscopy,especially for otherwise indistinguishable erythematous patch-like lesions.

Objective To perform an exploratory investigation on confocal laser endomicroscopy (CLE) in the diagnosis of malignant bladder tumour.Methods From June 10 to July 11,2017,6 male bladder cancer patients underwent white light cystoscopy (WLC) + CLE examination,aging 64-86 years (median 72 years).All patients received TURBT on suspected lesions.WLC and CLE imaging results were recorded and validated by pathologic specimens.Results Lesions confirmed by histopathology were 3 low grade non-invasive papillary urothelial carcinomas,1 high grade non-invasive papillary urothelial carcinoma,1 low grade invasive urothelial carcinoma,1 high grade invasive urothelial carcinoma,1 carcinoma in situ (CIS),1 high grade dysplasia,1 cystitis glandularis,1 chronic inflammation,and 1 scar tissue.For CLE images in the normal urothelium,three layers of cells with different presentation were observed,namely,the superficial umbrella cells,the intermediate cells smaller in size and uniformly shaped,and the capillary network in the lamina propria.For non-invasive urothelial carcinoma,tumour cells appeared as papillary lesions growing from fibrovascular cores,with low grade cells appearing monomorphic and more cohesively arranged,and high grade cells relatively pleomorphic,more disorganised and with tortuous blood vessels in the fibrovascular core.For invasive urothelial carcinoma,tumour cells invaded the lamina propria,with uniform appearances,poor cohesion and indistinct cellular borders,and high grade ones were more pleomorphic.CIS and inflammation both appeared as erythematous patch-like flat lesions under WLC and sometimes difficult to differentiate.Under CLE,the former appeared as dysplastic and disorganised cells with indistinct cellular borders,with intact lamina propria,and inflammatory cells were discovered as infiltrative clusters in the lamina propria that were uniformly shaped and loosely connected.Dysplasia appeared somewhat similar compared with CIS under WLC,but with lower cellular irregularity as confirmed with pathology.Cellular appearance and structure in scar tissue was similar to that in the normal urothelium,but superficial umbrella cells were more likely absent,with thinner cell layers,and inflammatory infiltration was sometimes discovered in the lamina propria.Conclusions CLE provides real-time cellular imaging of the urothelium,and shows promising potential for clinical diagnosis,especially in differentiating fiat urothelial lesions.Large prospective studies are required for further validation.

Organoids are novel in vitro models that can effectively simulate the complexities of tumor microenvironments.Compared to tra-ditional preclinical models,organoids retain most of the histological and molecular properties of the primary tumor;therefore,they are more useful for studying tumor heterogeneity,underlying functional pathways,and immune microenvironments as well as for research on biomarker discovery,drug screening,and individual chemotherapy.Furthermore,current limitations,challenges such as low modeling suc-cess rates,high costs,and lack of standardization are expected to be overcome by continued innovations in bioengineering technologies and interdisciplinary integration.This article reviews the advantages,establishment processes,and prospects and challenges associated with the clinical application of organoids in bladder cancer.

BACKGROUND:Glucocorticoids can inhibit the expression of hub genes in the parathyroid hormone type Ⅰ receptor(PTH1R)/protein kinase A(PKA)signaling axis and interfere with the osteogenic and angiogenic differentiation of bone marrow mesenchymal stem cells,leading to the disruption of blood supply in bone and bone tissue structures.Previous studies of the research team showed that Gubitongxiao granules can induce blood vessel formation and inhibit osteoblast apoptosis,which has a certain effect on the prevention and treatment of steroid-induced femoral head necrosis. OBJECTIVE:To observe the therapeutic effect of Gubitongxiao granules in a mouse model of steroid-induced femoral head necrosis,and to explore its mechanism from the PTH1R/PKA signaling axis. METHODS:An animal model of steroid-induced necrosis of the femoral head was established by intraperitoneal injection of lipopolysaccharide and gluteal muscle injection of prednisolone acetate.After identification by nuclear magnetic resonance method,60 mice that were successfully modeled were divided into model group,Gubitongxiao granule group and Tongluo Shenggu capsule group,with 20 mice in each group.Another 12 normal mice were used as control group.The corresponding groups were intragastrically given the corresponding drugs for 12 weeks,and then the samples were taken under anesthesia.Histomorphology of femoral head samples was observed by hematoxylin-eosin staining.Enzyme-linked immunosorbent assay was used to detect the serum levels of bone alkaline phosphatase,type Ⅰ amino-terminal extension peptide,parathyroid hormone,osteocalcin and alkaline phosphatase.Western blot and RT-qPCR were used to detect PTH1R,PKA,myocyte enhancer factor 2,sclerostin and guanylate-binding protein activity-stimulating peptide at protein and gene expression levels,respectively. RESULTS AND CONCLUSION:Gubitongxiao granules may reduce the serum PTH level in mice,inhibit the activation of the PTH1R/PKA signal axis,further up-regulate the protein expressions of sclerostin and myocyte enhancer factor 2,and increase the levels of bone alkaline phosphatase,type Ⅰ amino-terminal extension peptide,osteocalcin and alkaline phosphatase in mice,thus improving femoral head necrosis,which is comparable to the intervention effect of Tongluo Shenggu capsules.It is speculated that Gubitongxiao granules may prevent and treating hormonal femoral head necrosis by regulating the PTH1R/PKA signaling axis.

Objective:To compare the short and medium-term effects of arthroscopic surgery versus intra-articular injections for rotator cuff tears with concomitant shoulder stiffness in elderly patients.Methods:We performed a retrospectively study that included 116 patients with rotator cuff tears combined with shoulder stiffness between January 2015 and June 2017, with 56 patients receiving arthroscopic surgery (the surgery group)and 60 patients given intra-articular injections (the control group). The visual analogue scale (VAS)score, range of motion (ROM), American Shoulder and Elbow Surgeons (ASES)score, University of California Los Angeles (UCLA)score were recorded before treatment and 3, 6 and 12 months after treatment.Results:Compared with pre-treatment, VAS scores were lower and ROM, ASES and UCLA scores were higher in both groups after treatment ( P<0.05). At 3 months after treatment, VAS scores were higher and ASES and UCLA scores were lower in the surgery group than in the control group ( P<0.05), while there was no significant difference in ROM between the two groups ( P>0.05). At 6 and 12 months after treatment, VAS scores were lower, ROM was larger, and ASES and UCLA scores were higher in the surgery group than in the control group ( P<0.05). Conclusions:In patients with rotator cuff tears combined with shoulder stiffness, both arthroscopic surgery and intra-articular injections can alleviate pain and improve ROM and shoulder joint function.After 6 months of treatment, greater improvement is achieved in patients undergoing arthroscopic surgery than in patients receiving intra-articular injections.