OBJECTIVE To investigate the incidence rate of Pseudomonas aeruginosa whose ceftazidime resistance was induced by imipenem and the relationship of excretion pump with sensibility of imipenem and ceftazidime.METHODS The sensibility to 15 antibacterials and ceftazidime resistance induced by imipenem were detected by slip diffusion method,detect these bacteriumas′s MIC to Imipenem and Ceftazidime before and after excretion pump inhibitor hydroxide radical cyanogen chlorine phenylhydrazone(CCCP) were added by agar dilution,detect Ceftazidime′s MIC value which were added different concentration imipenem by agar dilution.RESULTS From 325 strains 116 strains(35.7%) were imipenem induced ceftazidime-resistant drug fast,from them 80.2% were imipenem-resistant and ceftazidime-sensitive,19.8% were imipenem and ceftazidime both sensitive.Sensibility to imipenem and ceftazidime was no marked change before and after CCCP added,MIC value of ceftazidime was step up 4-12 times by imipenem.CONCLUSIONS The incidence rate of ceftazidime-resistant P.aeruginosa induced by imipenem is high,clinical microbiological laboratory should evolve D-test to guide clinician use antibacterials more reasonable.

Objective To evaluate the diagnostic value of gray-scale ultrasonography (GSU) combined with contrast-enhanced ultrasonography (CEUS) and real-time elastography imaging (EI) in solid thyroid nodules.Methods A total of 124 solid nodules were collected from Xuanwu Hospital of Capital Medical University from September 2011 to November 2014, including 49 benign nodules and 75 malignant nodules conifrmed by surgical pathology. The data of multimodal imaging were retrospectively analyzed and compared with the pathological results. The parameters among the groups were compared byχ2 test. Four diagnostic models including the statistically signiifcant independent variables were established accord to different combinations of routine ultrasound examination. The binary Logistic regression equation using the pathological results as the dependent variable Y and the ultrasound features of thyroid nodules as independent variableX was established for calculating the area under the receiver operator curve (ROC) and multiple regression analysis furthermore.Results There were statistically significant differences in aspect ratio, margin condition, echo type, CEUS features, elastic imaging score and elastic strain rate of benign and malignant thyroid nodules(χ2=13.966, 7.106, 24.215, 17.250 and 27.158,P<0.05).The four Logistic regression models were statistically signiifcant (χ2=5.37, 5.37, 8.155, 8.155, allP<0.05). By using modelⅠ,Ⅱ,Ⅲ andⅣ, the diagnostic sensitivity, speciifcity and accuracy of malignant nodules were (73.8%, 75.9%, 79.7%, 83.3%), (67.5%, 70.7%, 85.2%, 86.7%), and (71.8%, 74.2% 81.8%, 84.4%) respectively. The area under the ROC of logistic equation predicted values were (0.778, 0.809, 0.875 and 0.898, allP<0.01). Multivariate categorical analysis showed that aspect ratio, margin condition and the elastic strain rate ratio (χ2=13.73, 7.541 and 11.461, allP<0.05) of thyroid nodules were effective diagnostic indicators. Conclusions Our study indicated that CEUS and EI could be helpful modality for GSU to improve the diagnostic accuracy of thyroid nodules. The combined application of multi mode ultrasound examination has a high diagnostic value.

Objective To explore the peripheral blood microRNA (miRNA) expression of patients with gastric cancer,and to establish specific peripheral blood miRNA expression profile of gastric cancer,which would provide the evidencc for investigating the role of miRNA in the genesis and development of gastric cancer and looking for new molecular markers of gastric cancer.MethodsA total of 6 gastric cancer patients and 6 healthy volunteers were selected.The totat RNA of peripheral blood was extracted for miRNA expression profile examination and hioinformation analysis. The results of microarray were verified by real-time PCR. The online miRNA target gene pr(e)diction software was used to predict and screen miRNA differentially expressed target genes. Results Compared with control group,there were 54 differentially expressed miRNA in gastric cancer group,of which the expression of 35 miRNA (miRNA-504,mi RNA-183,miRNA- 938,miRNA-1285,miRNA- 576-3p,miRNA-663,etc) were up-regulated and 19 miRNA (miRNA-433,miRNA-193b,miRNA-329,miRNA 409-3p,miRNA 154,el(e)) were down-regulated.The results of real-time PCR indicated that there was a good consistency between PCR verificd results and microarray results in 2 up-regulated miRNA (miRNA 504 and miRNA-183) and 2 down-regulated miRNA (miRNA-443 and miRNA- 193b).ConclusionThere is specific peripheral blood miRNA expression profile of patients with gastric cancer,and these differentially cxpressed miRNA will likely become new diagnostic biomarkers of gastric cancer.

Gasdermin E is closely related to neoplasms, which is involved in the occurrence and development of neoplasms through gene methylation, gene mutation or other ways. Pyroptosis mediated by gasdermin E is involved in drug therapy of various neoplasms, which provides a new theoretical basis for drug therapy of neoplasms. The study of gasdermin E aims to deepen the understanding of neoplasms and provide a new perspective for the prevention and treatment of neoplasms.

Pyroptosis is a type of programmed cell death distincted from apoptosis and necrosis, which is accompanied by the lysis of cell membranes and the release of cell contents. Pyroptosis occurs as mediated by Gasdermin protein family and is dependent on the activity of caspase. GSDME is one of the most important members of the Gasdermin protein superfamily. GSDME-mediated pyroptosis relies on the activity of caspase-3. In recent years, with further research on pyroptosis, the mechanism of GSDME-induced pyroptosis is becoming clear. Numerous studies have shown that GSDME-mediated pyroptosis plays an important role in the occurrence and development of tumors, as well as chemotherapy resistance. However, GSDME-mediated pyroptosis has no specificity and can induce pyroptosis of normal cells in the body while inducing tumor cell pyroptosis, thus causing different degrees of damage to various organs of the body. Further study on the mechanism of GSDME-induced pyroptosis, the role of GSDME in malignant tumors and the adverse reactions of chemotherapy can provide new ideas for tumor monitoring, treatment and prognosis judgment.

Objective:To investigate the efficacy and safety of atorvastatin combined with indobufen in the treatment of elderly patients with diabetic kidney disease (DKD) complicated with large atheromatous ischemic stroke (LAA-IS) during convalescence.Methods:The clinical data of 102 elderly patients with DKD complicated with LAA-IS during convalescence from September 2018 to April 2022 in Baoding Second Central Hospital were retrospectively analyzed. Among them, 51 patients were treated with atorvastatin combined with indobufen (observation group), 51 patients were treated with atorvastatin combined with aspirin (control group), and both groups were treated continuously for 6 months. The prethrombotic state indexes, neurological function and quality of daily life, carotid artery ultrasound indexes, renal fibrosis indexes before treatment and after treatment were compared between two group. The prethrombotic state indexes included arachidonic acid (AA) and adenosine diphosphate (ADP) induction platelet aggregation rate, fibrinogen (FIB), protein C; the National Institutes of Health Stroke Scale (NIHSS) was used to evaluate the neurological function, and the modified Barthel index (MBI) was used to evaluate the quality of daily life; carotid artery ultrasound indexes included carotid artery intima-media thickness (IMT) and maximum plaque area; the renal fibrosis indexes included transforming growth factor-β 1 (TGF-β 1), matrix metalloproteinase-9 (MMP-9), hyaluronic acid and platelet derived growth factor-BB (PDGF-BB). The adverse reactions were recorded. Results:There were no statistical differences in the all indexes before treatment between two groups ( P>0.05). In two groups, compared before treatment, the AA induction platelet aggregation rate, ADP induction platelet aggregation rate, FIB, NIHSS score, IMT and maximum plaque area after treatment were significantly lower, the protein C and MBI score were significantly higher, and there were statistical differences ( P<0.01); but there were no statistical differences after treatment between two groups ( P>0.05). The TGF-β 1, MMP-9, hyaluronic acid and PDGF-BB after treatment in two groups were significantly lower than before treatment, and the indexes in observation group were significantly lower than those in control group: (39.46 ± 6.89) μg/L vs. (45.04 ± 8.20) μg/L, (278.46 ± 49.39) μg/L vs. (327.30 ± 57.28) μg/L, (102.37 ± 20.62) μg/L vs. (116.84 ± 24.97) μg/L vs. (25.26 ± 4.45) μg/L vs. (28.13 ± 5.08) μg/L, with statistically significant differences( P<0.01). The incidence of adverse reactions in observation group was significantly lower than that in control group: 7.84% (4/51) vs. 23.53% (12/51), and there was statistical difference ( P<0.05). Conclusions:Compared with atorvastatin combined with aspirin, atorvastatin combined with indobufen in elderly patients with DKD complicated with LAA-IS during convalescence has the same effect in improving the related indicators of prethrombotic state, reducing neurological function deficit, improving the ability of daily living, and reversing carotid atherosclerosis. However, atorvastatin combined with indobufen can further protect renal function with higher safety.

Background: The incidence rate and mortality of colorectal cancer (CRC) in China are increasing, and the age of onset is tending to be younger. Aims: To analyze the results of colonoscopy in patients positive for CRC screening, and to explore the significance of a CRC screening protocol that combines risk assessment questionnaire with fecal occult blood test (FOBT) in early diagnosis of colorectal neoplasms. Methods: Individuals who were positive for the first stage of screening (questionnaire + FOBT) in a community CRC screening program in Shanghai Huangpu District from May 2013 to October 2019 and then received the second stage of screening (colonoscopy) in Ruijin Hospital Luwan Branch were enrolled consecutively. Biopsy or polypectomy specimens were taken for pathological examination if any lesions were found endoscopically. Patients who underwent colonoscopy due to changes in bowel habits in the same period were served as controls. The detection rates of colorectal neoplasms in these two groups and the disease characteristics in the screening positive group were analyzed. Results: The screening positive group included 1 329 residents positive for the first stage of screening. The overall detection rate of colorectal lesions was 63.3%, and the detection rates of CRC, colorectal polyps and adenomatous polyps were 2.6% (34 cases), 60.7% (807 cases) and 35.2% (468 cases), respectively. While in control group (n=22 438), the rates were 43.6%, 1.8%, 41.5%, and 21.6%, respectively, all were significantly lower than those in screening positive group (all P<0.05). In screening positive group, the overall detection rate of colorectal lesions was higher in male than in female (73.7% vs. 54.2%, P<0.05) and increased with aging (P<0.05). Most of the CRC cases were in 60-79 years old age group with no gender difference. All CRC and most of the adenomas with dysplasia were greater than or equal to 1 cm in diameter, while most of the adenomas without dysplasia, hyperplastic polyps and inflammatory polyps were less than 1 cm in diameter. Conclusions: The community CRC screening program practiced in China can increase the detection rates of CRC and precancerous lesions effectively.