Objective To investigate the action of integron-mediated multidrug resistance in clinical multi-resistant Pseudomonas aeruginosa in Huaibei area.Methods The antibiotic susceptibility of 13 different antibiotics of 36 multi-drug resistant P.aeruginosa was tested by K-B.The three-dimensional method was taken to differentiate the various beta-lactamases.The integron was determined by PCR with integron-specific primer.Results The positive rate of integron detection in multi-resistant Pseudomonas aeruginosa was 86.1%.Two kinds of integron with different length were found,i.e.1 000 bp and 2 000 bp.PSE-1,aadA2,aadB,aac(6)-II and CARB-8 were the resistance-related gene cassette in the integrons.Conclusions Integron may enroll in multiple resistance of multi-resistant Pseudomonas aeruginosa.

OBJECTIVE To investigate the genes associated with the drug-resistance to ?-lactam antibiotics in Pseudomonas aeruginosa(PAE) isolated from clinical patients in Huaibei,Anhui Province.METHODS Antibiotic sensitivity test was performed by VITEK-AMS.The three-dimensional method was taken to differentiate various beta-lactamases.The ?-lactamases and the outer membrane protein D2(oprD2) genes were detected by polymerase chain reaction(PCR) in 36 PAE strains.RESULTS In 36 PAE strains,the positive rates of genes of TEM,DHA,CTX-Ge and CARB were 77.8%,69.2%,27.8% and 25.0%,respectively,that of the OXA-1,OXA-10,VIM-2 and IMP-1 were 16.7%,16.7%,13.9% and 2.8%,respectively.The rate of lacking oprD2 gene was 58.3%,and none possessed VEB,SHV,GES,PER,GIM and SPM-2 genes.CONCLUSIONS P.aeruginosa carries various beta-lactamase genes in clinical patients of Huaibei,and the deletion ratio of oprD2 gene is higher.

Objective To investigate the genotypes of aminoglycoside-modifying enzymes (AMEs) produced by Pseudomonas aeruginosa isolated from Huaibei Miner's General Hospital.Methods Minimum inhibitory concentration of 36 strains of P. aeruginosa to 3 aminoglycoside antibiotics was determined. AME genes were amplified by polymerase chain reaction (PCR). Results The P. aeruginosa isolates were resistant to multiple antibiotics. Most (62.2% to 81.1%) were resistant to aminoglycosides. And 27 strain (75.0%) carried one or more types of AME genes, including ant(3″)-Ⅰ (63.9%), aac(6')-Ⅱ (58.3%), aac(6')-Ⅰ (50.0%), aac(3)-Ⅱ (38.9%) and ant(2″)-Ⅰ (36.1%). The aac(3)-Ⅰ, aac(3)-Ⅲ, aac(3)-Ⅳ, aph(3')-Ⅳ genes were not identified.Conclusions The study indicates that the P. aeruginosa isolates in Huaibei are multi-resistant to aminoglycoside antibiotics. The prevalence of AMEs-positive strains is high.

Objective To evaluate the value of the application of ultrasonic elastography and ultrasound contrast imaging on thyroid microcarcinoma(TMC). Methods The in-patients with thyroid lesions admitted in the Second People's Hospital of Foshan City from January 2013 to April 2014 were enrolled. Two-dimensional ultrasonography was used to screen the 162 solid thyroid nodules with a diameter ≤10 mm;they were examined by ultrasonic elastography and ultrasound contrast imaging respectively,and the result of pathological examination was regarded as the golden standard to compare the sensitivity and specificity between ultrasonic elastography and ultrasound contrast imaging for the diagnosis of TMC. Results The pathological results showed there were benign nodules 118 and malignant nodules 44 in number. The sensitivity,specificity,incidence of accuracy,positive predictive value and negative predictive value of the diagnosis of TMC by ultrasonic elasticity imaging,ultrasound imaging,and elasticity imaging combined with ultrasound imaging were much higher than those by two-dimensional ultrasonography〔sensitivity:88.64%(39/44),90.91%(40/44),95.45%(42/44)vs. 81.82%(36/44);specificity:91.53%(108/118),92.37%(109/118),95.76%(113/118)vs. 85.59%(101/118);accuracy:90.74%(147/162), 91.97%(149/162),93.26%(151/162)vs. 84.56(137/162);positive predictive value:79.59%(39/49),81.63%(40/49),83.67%(41/49)vs. 67.92%(36/53);negative predictive value:95.58%(108/113),96.46%(109/113), 97.35%(110/113)vs. 92.66%(101/109),all P<0.05〕. Conclusion For the diagnosis of TMC,both ultrasonic elastography and ultrasound contrast imaging have rather high value,and when they are combined together to be applied for the diagnosis,the result is the best.

OBJECTIVETo evaluate the impact of preoperative platelet-lymphocyte ratio (PLR) on the prognosis in patients with operable colorectal cancer.

METHODSThe clinical data of 140 patients with operable colorectal cancer were analyzed retrospectively. According to preoperative PLR, the patients were divided into low PLR group (PLR<250) and high PLR group (PLR≥250). The overall 5-year survival rates and the clinicopathological factors in the two groups were analyzed using univariate analysis and COX regression model.

RESULTSThe patients with a high PLR had a significantly lower overall 5-year survival rate than those with a low PLR (71.4% vs 51.5%, P=0.045). Univariate analyses identified tumor location, the depth of tumor invasion, lymph nodes metastasis, TMN stage, and PLR as significant risk factors for reduced overall 5-year survival. In COX regression model, a high PLR was identified as an independent risk factor for poorer prognosis in patients with resectable colorectal cancer (RR: 2.213; 95%CI: 1.007-4.863, P=0.0048).

CONCLUSIONPreoperative PLR can be a clinically significant factor for assessment of prognosis of resectable colorectal cancer.

Adult ; Aged ; Blood Platelets ; cytology ; Colorectal Neoplasms ; diagnosis ; mortality ; Female ; Humans ; Lymphocyte Count ; Lymphocytes ; cytology ; Male ; Middle Aged ; Platelet Count ; Prognosis ; Retrospective Studies ; Survival Rate

Objective:To explore the method and experience of augmentation mammoplasty with autologous fat transplantation assisted by external expander.Methods:From January 2013 to December 2020, 352 female patients (698 breasts, 346 bilateral and 6 unilateral), aged from 18 to 55 years, with an average age of 41.5 years, were admitted to the Department of Cosmetic Surgery, Beijing Jingmei Medical Cosmetology Clinic. From 1-28 days before surgery, autologous fat transplantation was performed after wearing the dilator, and postoperative wearing of the dilator lasted from 1 to 24 months, with an average of 3.5 months.Results:The volume of fat transplantation per breast ranged from 150 ml to 460 ml, with an average of 320 ml. No obvious postoperative complications such as fat liquefaction, infection, intramammary induration and fat embolism were observed, and the postoperative appearance was lasting. The postoperative follow-up was conducted from 6 months to 7 years, and patient postoperative satisfaction rate reached 84.9% and doctors＇ satisfaction after surgery reached 82.1%.Conclusions:Augmentation mammoplasty with autologous fat transplantation assisted by external expander can effectively improve the appearance of breast morphology and contour defects and increase the survival rate of fat transplantation, which is worthy of clinical application.

Objective:To explore the module of the construction and application of medical first-aid at the door of the space capsule and the air evacuation.Methods:According to the purpose, principle, and method set by the module, it was divided into two sub-modules: medical first-aid at the door of the space capsule and the air evacuation. During the comprehensive first-aid training, independent training and combined training were carried out respectively according to different mission stages of launch and recovery and different recovery terrain. Meanwhile, research was performed to ensure that medical carrying equipment was lightweight, modular, and portable, and the efficiency of modularization construction was tested in the comprehensive training.Results:The module of medical first-aid at the door of the space capsule and the air evacuation obviously shortened the rescuing time during the comprehensive training, the saving effect was remarkable, and the overall saving efficiency was significantly improved.Conclusions:The module of medical first-aid at the door of the space capsule and the air evacuation meet the requirements that the emergency support system of aerospace medicine should function on an immediate basis, ensuring accurate treatment and air evacuation without any delay, so that to achieve the aim of aerospace medicare.

Objective:To study the application of scenario simulation teaching combined with modular training in nursing education of medical rescue in manned space flight.Methods:Twenty nurses from the medical rescue team of Strategic Support Force Characteristic Medical Center were selected as the research objects. The research objects were randomly divided into the scenario simulation combined with practical training group (practical training group, n=10) and traditional teaching group (control group, n=10). Scenario simulation teaching combined with modular training and traditional teaching were used to carry out nursing training. After the training, theoretical assessment, operation assessment and satisfaction survey were organized. Results:The scenario simulation teaching combined with modular training group was significantly better than the traditional training group in theory assessment, operation assessment and satisfaction survey of nursing staff (all P<0.05). Conclusions:Scenario simulation teaching combined with modular training has obvious teaching effect, which can improve the ability and quality of nursing staff, and help to complete the manned space medical rescue mission efficiently.

Objective:To review the characteristics and coping strategies of the rescue and landing medical support mission of Shenzhou-14 manned spacecraft.Methods:The characteristics of rescue and landing medical support mission of Shenzhou-14 manned spacecraft was analyzed, and the coping strategies and experience were discussed.Results:(1) The characteristics of rescue and landing medical support mission of Shenzhou-14 manned spacecraft included: long time in space station and high-intensity space missions; high-density space medical support mission in short term; special environmental factors in severe cold night; complex terrain of landing site; and the young medical support team. (2) The main coping strategies of rescue and landing medical support mission of Shenzhou-14 manned spacecraft included: strengthened the organization and leadership and improved the training model; reinforcement learning the medical treatment plan and strengthened the medical rescue skills training; optimized the carrying equipment and added the heat preservation and lighting measures; improved the medical rescue process and perfected the emergency plan; emphasized on the scientific research as important as mission; and strengthened the physical exercise and cold resistance exercise.Conclusions:The characteristics and coping strategies of rescue and landing medical support mission of Shenzhou-14 manned spacecraft are summarized to provide the experience for space medical rescue and offer the support for China's manned space industry.

IntroductionTo validate the effect of ethylene oxide sterilization of disposable electronic analgesia infusion pumps and determine the residual amount. MethodsAccording to ISO 11135：2014 Sterilization of Healthcare Products⁃Ethylene Oxide⁃Requirements for the Development， Validation and Routine Control of Sterilization Process for Medical Devices， qualification of physical cycle performance and microbial cycle performance were conducted on disposable electronic analgesia infusion pumps， and sterilization effect was then validated by using sterility test. According to ISO 10993⁃7：2008 Biological Evaluation of Medical Devices—Part 7： ethylene oxide sterilization residuals， the residual amount of ethylene oxide were further measured. ResultsThe sterilization effect fulfilled the requirements under the physical conditions of 38.0‒45.4 ℃ and 46%‒81% humidity. When the temperature was lower than 35 ℃ and the humidity was higher than 71%， the bacterial tablets remained fully activated after the sterilization with ethylene oxide. The shortest survival time without biological indicator after exposure to ethylene oxide was 8h. Furthermore， the residual amount of ethylene oxide after the sterilization was lower than the minimum detection limit. ConclusionAll tested products are sterilized. Sterilization equipment and sterilization process fulfilled the requirements of ISO 11135：2014. Additionally， the sterilization residual amount conforms to the limit values of ISO 10993⁃7：2008.