Objective To study the Genotype of local clinical isolates of Enterobacteriaceae producing extended spectrum ? lactamases. Methods K B test, conjugative transfer test, plasmid profile analysis, PCR, PCR RFLP, and DNA sequencing were used to detect the phenotype and genotype of 33 isolates of Enterobacteriaceae producing ESBLs. Results Eighty five percent of 33 isolates was resistant to cefotaxime which was obviously higher than that to ceftazidime. blaCTX M ESBLs was detected in 28 isolates by PCR, blaTEM DNA in 24 isolates, and blaSHV DNA in 9 isolates. Mutation of E104K was only identified in one TEM ? lactamase produced by EC98A7 by PCR RFLP. No substitution of G238S occurred in 9 SHV ? lactamases. DNA sequencing and DNA alignment showed the blaCTX M DNA fragments from 4 clinical isolates of EC98A7,EB56,CFR78 and, KP9941 belonged to CTX M type 1, with highest identity to blaCTX M 3 or blaCTX M 12 respectively. Conclusions CTX M ESBLs is carried in 85% isolates of Enterobacteriaceae producing ESBLs in this city. Most of the isolates carry 2 or more ? lactamases. E. coli EC98A7 produces two ESBLs, a TEM ESBL and a CTX M ESBL.

construction of a comprehensive,multifunctional and theory supported operation system is the organization basis on which occupation burnout can be scientifically and effectively interfered.Interference to occupation burnout is divided into nine subsystems by "participation" dimension which consists of organization,family and individual,and by "functional" matrix dimension which consists of the first grade prevention(development interfere),the second grade prevention(symptom interfere) and the third grade prevention(burnout interfere).Among these subsystems there exist factors of different target,content,mode and method etc.Their operation and interrelation form a complete working system via which an organization interferes occupation burnout.Promote the hospital management more scientificly and hominizaiton's in human resource.

Objective To explore the influence on the expression of elF4E and heparanase by antisense oligodeoxyribonucleotides (ASODN) transfection in human bladder carcinoma BIU-87 cells.Methods After transfecting the 2.5,5.O,7.5 μg/ml eIF4E ASODN into BIU-87 cells,at 24 h,48 h and 72 h,a cell control group (no transfection),a blank control group (empty liposomes) and a non-sense control group (transfected with non-sense ASODN) were established.The expression of eIF4E,HPA and mRNA were detected by in situ hybridration.The expression of eIF4 and HPA protein were detected by immunocytochemistry.SPSS 13.0 statistical software was used for statistical analysis.Results The expression quantity of eIF4E protein and mRNA were lower in the experimental groups ( protein:2.5 μg/ml ASODN treated 24 h,48 h,72 h were:3.55 ±0.52,3.52 ±0.51,3.22.±0.44 respectively; 5.0 μg/ml group:3.43 ±0.47,3.41 ± 0.46,3.19 ± 0.41 respectively ; 7.5 μg/ml group:2.36 ± 039,2.33 ± 0.37,2.05 ± 0.30 respectively.mRNA:2.5 μg/ml treated 24 h,48 h,72 h were:3.19 ±0.41,3.13 ±0.39,2.90 ±0.38 respectively ; 5.0 μg/ml group:3.07 ± 0.39,2.94 ± 038,2.27 ± 0.37 respectively ; 7.5 μg/ml group:2.22 ± 037,2.06 ± 0.30,1.95 ± 0.29 respectively.All data were less than those in the control groups (P ＜0.05).The expression quantity of HPA protein and mRNA were lower in experimental groups (protein:2.5 μg/ml ASODN treated 24 h,48 h,72 h were:4.44 ±0.55,4.40 ±0.54,3.99 ±0.52 respectively; 5.0 μg/ml group:4.41 ±0.55,4.21 ±0.53,3.77 ±0.50 respectively; 7.5 μg/ml group:4.02 ±0.52,3.98 ±0.52,2.32 ±0.37 respectively.mRNA:2.5 μg/ml treated 24 h,48 h,72 h were:4.12 ±0.51,3.75 ± 0.50,3.63 ± 0.45 respectively ; 5.0 μg/ml group:4.00 ± 0.51,3.71 ± 0.50,3.54 ± 0.44respectively ; 7.5 μg/ml group:3.87 ± 0.52,3.61 ± 0.49,2.08 ± 0.30 respectively).All data were less than in control groups ( P ＜ 0.05 ).There was a positive correlation on expression of HPA protein and eIF4E protein by inhibitory effect of eIF-4E ASODN (protein r=9.23,mRNA r=9.59,P ＜0.01).Conclusion eIF-4E ASODN might be used to inhibit the expression of eIF-4E gene and HPA gene in bladder cancer BIU-87 cells.

Objective To study effectiveness of System intervention to occupation burnout of medical staff.Methods Specimens were classified as interventional group and control group by 1:1 partnership rule.Systemic intervention,which came from organization,family and individual,was only applied to interventional group.The objective was to establish requirement and resource mechanism,continually increase response resource,and improve matching state of individual & job.It allowed full play to the first grade prevention(development intervention),the second grade prevention(symptom intervention)and the third grade prevention(burnout intervention).It determined effectiveness of intervention via indexes of occupation burnout,mental health and satisfaction within group or internal groups.Results Before systemic intervention,there was no significant difference between intervention group and control group(P＞0.05).After systemic intervention,the scores of burnout(emotion exhaustion(17.54±9.97)vs(14.30±11.87),P＜0.01;depersonalization(5.29±5.01)vs(4.63±5.65),P＜0.05;low personal accomplishment(6.47±4.89),(5.61±5.10),P＜0.01),check list-90(SCL-90),personal satisfaction in intervention group showed apparent difference compared with that in control group.But there was no significant difference in control group before and after intervention.Conclusion On the whole systemic intervention to health care staff obtains obvious achievement,effectively reduces emotional exhaustion,obsessive symptom and terror emotion,and enhances individual satisfaction.

Objeetive:To observe the effect of acupuncture-moxibustion on TNF-a,sTNFR-Ⅰand sTNFR-Ⅱ in rats with Crohn's disease(CD).Method:The models of CD rats induced by TNBS were randomized into model group.herbal cake-partitioned moxibustion group and electroacupuncture group as well as a normal control group.The histopathological changes of colon mucus membrane were observed with HE staining and the contents Of TNF-a.sTNFR-Ⅰand sTNFR-Ⅱ were detected with ELISA method.Results:When compared with the normal group,the TNF-a level in CD rats was substantially elevated and the sTNFR-Ⅰ and sTNFR-Ⅱ showed no marked changes.After herbal cake-partitioned moxibustion and electroacupuncture treatment,the TNF-a level in CD rats was substantially reduced and sTNFRL-Ⅰ and sTNFR-Ⅱ showed no marked changes.The inflammatory lesions and abnormal structures of CD rats were significantly improved after herbal cake-partitioned moxibustion and electric stimulation.Conclusion:Herbal cake-partitioned moxibustion and electroacupuncture Can both remarkably reduce the TNF-a level in blood serum.and this might be one ofthe action mechanisms in the treatment of CD.

There are multitudes of web resources that are quite useful for the microbial scientific research community. Here, we provide a brief introduction on some of the most notable microbial web resources and an evaluation of them based upon our own user experience.

Objective To evaluate the value of localization diagnosis of 1H-magnetic resonance spectroscopy (MRS) in the patients with structural MRI-negative temporal lobe epilepsy (TLE) based on the results of localization diagnosis of electroencephalogram (EEG) in patients with TLE without lesion.Methods Thirty-three patients with MRI-negative TLE and 33 age-and sex-matched healthy control subjects underwent MRS and took the side localized by scalp/video EEG as standard,to evaluate the value of N-acetyl-L-aspartic acid (NAA)/creatine (Cr),NAA/(Cr + choline (Cho)) in the localization diagnosis of TLE.Results There was no significant difference in NAA/Cr,Cho/Cr and NAA/(Cr + Cho) in bilateral hippocampi of 33 healthy controls,and the mean values of them in bilateral hippocampi were regarded as normal values.The NAA/Cr and NAA/(Cr + Cho) ratios were significantly decreased in both sides of the hippocampi ipsilateral and contralateral to the seizure side.Taking NAA/Cr and NAA/(Cr +Cho) as an index to localize respectively and comparing with the localization diagnosis of EEG,spectral anomalies were found in 28 cases and 29 cases respectively,and the abnormal rate reached 85％ and 88％.The localization diagnosis of 17 and 18 cases was consistent with the EEG,the rate being 52％ and 55％ respectively,but 12％ (4/33) and 18％ (6/33) were opposite.There were 36％ (12/33) and 27％ (9/33) cases who could not be localized.The localization diagnosis results by NAA/Cr and NAA/(Cr +Cho) were not significantly different.Conclusions The existence of mirror-image foci may be the main reason of the failure of localization diagnosis.1H-MRS has higher value for localization of TLE foci,and combining 1H-MRS with other techniques can further improve the accuracy and reliability of localizing the epileptic foci in patients with TLE.Compared with EEG in the diagnosis of TLE,there are no significant differences in the localization diagnosis of TLE by NAA/Cr and NAA/(Cr + Cho),which can all be the standard indices of localization diagnosis.

Objective To discuss the value of dynamic contrast-enhanced MRI (DCE-MRI)in differential diagnosis of high-grade gliomas (HGG)and metastasis.Methods 27 cases of HGG and 46 cases of metastasis were enrolled.All patients took contrast MRI and DCE-MRI before operation.Using the pharmacokinetic model of Extended Tofts Linear to quantitative analyze the data,volume transfer constant (Ktrans ),extracellular extravascular volume fraction (Ve )and blood plasma fraction (Vp )of the lesion's solid components and perilesional edam were obtained.Ktrans value,Ve value and Vp value were compared to judge whether there were significant differences between the two kinds of tumors.Results The values of the Ktrans ,Ve and Vp in parenchyma of HGG and metastasis were not statistically significant (P >0.05).The values of Ktrans and Ve in peritumoral edema of HGG were significantly higher than that of metastasis (P <0.05);Vp values in the peritumoral edema of HGG were lower than that of metastasis,but the difference was not statistically significant (P >0.05). Conclusion DCE-MRI can effectively distinguish HGG from metastasis through quantitative analysis of the perilesional edema.

Objective To investigate the prevention effects of antithrombotic pressure pump combined with graduated compression stockings (GCS) on incidence of postoperative lower extremity deep venous thrombosis (LEDVT) in breast cancer patients. Methods A total of 363 cases of breast cancer patients after operation were divided into routine care group (124 cases) according to the method of random number table, pressure group (127 cases) and combined treatment group (112 cases). The routine care group received conventional LEDVT ankle pump exercises. The pressure group used GCS besides the routine intervention. The combined group received GCS and antithrombotic pressure pump besides the routine intervention. Then the levels of thrombosis markers, D-dimers,platelets, and incidences of LEDVT were examined in the three groups. Results Before operation, no significant differences between the levels of prothrombin time (PT), activated partial prothrombin time (APTT), thrombin time (TT), fibrinogen, plasma D-dimer and platelets (P>0.05). After operation, the levels of PT, APTT, TT, fibrinogen, plasma D-dimer and platelets in three groups were (10.22 ± 0.76) s, (27.24 ± 3.68) s, (14.60 ± 0.88) s, (2.94 ± 0.59) mg/L, (0.31 ± 0.21) mg/L, (288.48 ± 71.29) × 109/L, (10.73 ± 0.79) s, (27.35 ± 2.54) s, (14.71± 1.76) s, (4.12±1.09) mg/L, (0.46±0.38) mg/L, (284.26±70.98) ×109/L and (11.11±0.64) s、(28.52± 2.74) s, (14.33± 1.02) s, (4.42±1.20) mg/L, (0.35±0.33) mg/L, (258.79±62.35) ×109/L, respectively. There was significant difference among these groups (F=5.71-87.31, P<0.01). The differences on PT, APTT, fibrinogen and D-dimers between combined treatment group and routine care group were statistically significant (P<0.05). The differences on PT, fibrinogen and platelets between combined treatment group and pressure group were statistically significant (P<0.05). The differences on PT, APTT, fibrinogen and D-dimers between routine care group and pressure group were statistically significant (P<0.05). Through one months of follow-up, the incidence of LEDVT in routine care group, pressure group and combined treatment group were 12.10％(15/124),3.15％(4/127),0.89％(1/112), respectively. There was significant difference among these groups (χ2=16.279,P<0.01). Conclusions The application of antithrombotic pressure pump combined with GCS significantly improves the postoperative hypercoagulable states in breast cancer patients. The combined treatment reduces the incidence of LEDVT without bleeding risk. Therefore, antithrombotic pressure pump combined with GCS is recommended for clinical use in the postoperative breast cancer patients.

Objective:To investigate the effects of a novel retrograde tibial nail (RTN) in the treatment of distal tibial fractures.Methods:A retrospective study was conducted in the 11 patients with distal tibial fracture who had been admitted to Department of Traumatic Orthopedics, The Second Affiliated Hospital, Hengyang Medical School from July 2020 to July 2021. There were 5 male and 6 females, aged from 18 to 70 years (average 54.7 years). By the AO/OTA classification, there were 7 extra-articular distal fractures (3 cases of type 43-A1, 3 cases of type 43-A2 and one type 43-A3) and 4 intra-articular fractures (2 cases of type 43-C1 and 2 cases of type 43-C2); by the Gustilo classification, there were 7 closed fractures and 4 open fractures (2 cases of type I and 2 cases of type Ⅱ). All fractures were fixated with a novel RTN. Deformities like distal tibial varus and valgus as well as fracture-related complications were observed after operation while the curative effects evaluated by the ankle-hindfoot score of the American Orthopaedic Foot and Ankle Society (AOFAS).Results:This cohort was followed up for an average of 7.4 months (from 5 to 12 months). All patients obtained clinical union and recovered daily life and work. Radiographic evaluation showed no distal tibial varus or valgus. There were no such complications as postoperative infection, exposure of bone and internal fixation, compartment syndrome, or neurovascular lesion. According to the ankle-hindfoot score of AOFAS, 7 cases were excellent and 4 cases good.Conclusion:This novel retrograde tibial nail may result in good efficacy in the treatment of distal tibial fracture, but its advantages still need further verification.