Abstract: To report the diagnosis and treatment of Mucor infection in two cases of renal transplantation, and to provide reference for diagnosis and treatment of Mucor infection. Case 1, a male patient, who underwent allogeneic kidney transplantation due to increased creatinine for more than 8 years. The renal function had partially recovered 25 days after the operation, but then the patient suddenly got worse epigastric pain. Pathogen culture, smear microscopy, mass spectrometry identification and next-generation metagenomic sequencing (mNGS) were performed on the peritoneal drainage, with the result pointing to Rhizopus microsporus. The patient's condition improved after antifungal treatment using amphotericin B lipid complex (ABLC) and was discharged. Case 2, a male patient with hypertension and increased creatinine for more than 7 years was admitted to the hospital. After allograft kidney transplantation, tissue culture smear and histopathological examination suggested Mucor infection. The patient then underwent a "hand muscle debridement surgery + closed negative pressure drainage (VSD)" procedure, and amphotericin B was given postoperative treatment against Mucor infection and debridement. Subsequent retesting with mNGS showed no signs of Mucor infection. In the course of treatment, two patients developed abdominal pain after treatment with tegacycline, which was immediately diagnosed as pancreatitis and recovered after withdrawal. Both patients being male, with one case associated with hypertension. After initially guiding the diagnosis with traditional smear tests, final confirmation was done using histopathological examination, mNGS and mass spectrometry. One case was infected by Rhizopus microspora, and the other was infected by Rhizopus oryzae and Cunninghamia microbicans. The causes leading to Mucor infection in patients post renal transplantation varied greatly. Early diagnosis is the key to treatment of patients with Mucor infection after renal transplantation. Treatment with amphoteric B and its liposome is an effective means to improve mucormycosis patients after renal transplantation. The use of amphotericin B lipid complex treatment proved to be an effective treatment method for patients with Mucor infection after renal transplantation.

Objective To investigated the absorbed dose response of Al2O3 dosimeter in water phantom irradiated by 60Co γ spectrum source. Methods The EGSnre simulation program code DOSRZnrc was used to calculate the absorbed dose of the Al2O3 dosimeter and that of the equivalent volume of water in the corresponding position, as well as the absorbed dose conversion factor, irradiated by 60Co photon beams in a water phantom. Simulations were done for a eylindrieal geometry dosimeter (diameter 0.4 cm and height 0.1 cm) and the dosimeter was placed at the centre of the water phantom at different depths. Results The average absorbed dose conversion factor is 1.143 ± 0.006 and changes little with the depth of the dosimeter in the water phantom, and the deviation is less than 1.0 %. Conclusion The absorbed dose response of Al2O3 dosimeter irradiated by 60Co γ spectrum source is steady and is independent on the depth of the dosimeter in water phantom in this research.

[ABSTRACT]AIM:Toinvestigatetheeffectofsilencingisocitratedehydrogenase2(IDH-2)genebysmallinter-fering RNA (siRNA) on the biological characteristics of human small cell lung cancer cell line NCI -H446.METHODS:IDH-2 expression was knocked down in human small cell lung cancer cell line NCI -H446 by siRNA-IDH-2.The expression level of IDH-2 was determined by real-time PCR and Western blotting .The cell proliferation was measured by CCK-8 as-say , the protein expression of MAPK p 42 was detected by Western blotting , and the cell cycle was analyzed by flow cytome-try.The migration was observed using Transwell cell migration system .BALB/c nude mice were subcutaneously injected on the back with NCI-H446 cells transfected with siRNA-IDH-2/negative control siRNA or non-transfected cells to study the tumor growth .RESULTS:siRNA-IDH-2 remarkably down-regulated the expression of IDH-2 and MAPK p42 in the NCI-H446 cells.siRNA-IDH-2 inhibited both the proliferation and migration abilities of NCI-H446 cells, and the cell cycle was arrested in S phase as compared with negative control group .Additionally, the volume of xenograft tumors in siRNA-IDH-2 group was significantly decreased as compared with control group .CONCLUSION:siRNA-IDH-2 down-regulates the expres-sion of IDH-2 in NCI-H446 cells, reduces the cell migration efficiency and inhibits the tumor growth in vitro and in vivo.

Objective The beam data is compared with those obtained from Monte Carlo (MC)simulation and measurement to investigate their feasibility and reliability for X-ray small fields.MethodsThe beam data,including the total scatter factor (Scp),percentage depth dose (PDD) was acquired byneasurement and calculation with the field size ranging from 0.5 cm × 0.5 cm to 10 cm x 10 cm.The resultswere compared and analyzed.Results All the data is most consistent for the fields size of ≥3.5 cmx 3.5cm,but they are obvious different for the fields size of ≤ 3.0 cm × 3.0 cm.The measurements seem toreliable using the chambers of CC04 and CC13 for the fields size of ≥2.0 cm x 2.0 cm.Conclusions It isdemonstrated that the accurate measurements and calculations of Scp and PDD can be obtained for the fieldssize of ≥2.0 cm ×2.0 cm,but they needed morc rcscarchcs for thc smaller fields.

Objective To explore the association between maternal age and perinatal outcomes.Methods Totally,3 151 women with advanced maternal age and 6 098 women younger than 35 years old who delivered in Beijing Obstetrics and Gynecology Hospital in 2016 were recruited.Their clinic characteristics and perinatal outcomes were collected to divide into 3 groups based on delivery age,Group 1 (aged 35-39 years,2 683 cases),Group 2 (aged ≥40 years,366 cases) and the control group (aged＜35 years,6 098 cases).The association between maternal age and adverse perinatal outcomes were analyzed,including hypertensive disorder complicating pregnancy,gestational diabetes mellitus (GDM),preterm birth and postpartum hemorrhage.Results The rate of cesarean section history (27.39％,33.61％,5.53％) or previous myomectomy history (2.80％,5.46％,0.72％) were compared between the advanced maternal age groups and the control group,and the differences were statistically significant (P＜0.05).The percentage of prepregnancy overweight and obesity (29.67％,27.05％,18.47％),complicated with myoma (14.83％,19.95％,5.64％) were compared among the three groups,and the differences were statistically significant (P＜ 0.05).The percentage of pregnancy through assisted reproductive technology (9.84％,15.03％,3.12％) also had statistically significant differences (P＜0.05).The incidence of fetal chromosomal abnormalities (1.23％,3.01％,0.36％) and fetal malformations (1.94％,4.37％,0.48％) increased with the maternal age,with statistically significant differences (P＜0.01).The mobidity of hypertensive disorders (9.84％,13.11％,9.23％),pregestational diabetes mellitus (1.83％,2.19％,0.72％),gestational diabetes mellitus (22.70％,28.42％,14.87％),premature rupture of membranes (25.57％,19.40％,31.42％),placenta previa (2.05％,2.46％,0.92％),preterm birth(8.35％,11.20％,5.51％),postpartum hemorrhage (25.11％,18.31％,20.27％)and forceps delivery (5.42％,2.33％,5.71％) were compared,and the differences were statistically significant (P＜0.05).The cesarean section rate in primipara (45.42％,75.74％,21.33％) and multipara (51.46％,61.54％,30.95％) had statistically significant difference (P＜0.05).The proportion of macrosomia (10.80％,8.85％,7.96％) and neonates transferred into neonatal ICU (9.63％,11.48％,5.21％) in term neonates had statistically significant difference (P＜0.05).Conclusions Women with advanced maternal age increase after new family planning policy put into effect,so do the risk of adverse perinatal outcomes.Attention and interventions should be made to cope with the occurrence of adverse perinatal outcomes.

Objective To explore the effect of TGF-β microbubble targeting on the treatment of skeletal muscle injury in rats.MethodsEighty SD rats of 2 months old were randomly divided into experimental group(including TGF-β microbubble),pure drug group,microbubble group(exclusive drug) and control group,20 SD rats in each group.Four groups accepted ultrasonic transmission with consistent time and frequency.The contraction stress and stress relaxation of injured gastrocnemius muscle were measured,the changes of injured gastrocnemius muscle were observed by light microscope and electron microscope.Results There was no statistically significant difference in contraction stress of gastrocnemius muscle among all groups at 1,5,9 days after injury(P>0.05).And at 14 days,the contraction stress of gastrocnemius muscle of the experimental group and the pure drug group were obviously higher than those of the rest two groups,the differences were significant(P<0.05).The difference of gastrocnemius muscle contraction stress was statistically significant between the experimental group and the pure drug group(P<0.05).For the stress relaxation of gastrocnemius muscle,the experimental group was lower than the other three groups at 1 day after injury,the differences were significant(P<0.05).Light microscopy showed the number of muscle fiber in the experimental group increased obviously at 9 days after injury.There was no scarring at 14 days after injury.Electron microscope showed mitochondria and sarcoplasmic reticulum increased in the experimental group,and the new muscle cells and satellite cells were significantly more than those of the rest three groups.Conclusion TGF-β cell targeted therapy can obviously improve the shrinkage stress of skeletal muscle in rats after injury and recover the stress decay,which can obviously promote the injury repair and regeneration of skeletal muscle,and reduce scar formation at the same time.

OBJECTIVE: To investigate the stability of 0.5% glutaraldehyde solution. METHODS: Classic constant temperature accelerated test method and sample observation method were applied with the content of glutaraldehyde as index. The content of glutaraldehyde was determined by titration which was determined by titration. RESULTS: The content change of 0.5% glutaraldehyde solution was in line with the first order kinetics, and the results of both methods were similar. The validity duration of 0.5% glutaraldehyde solution was 85.7 days at room temperature (25 ℃). CONCLUSION: 0.5% glutaraldehyde solution should be used up as soon as possible and the perfect time is less than 2 week.

OBJECTIVE:To ensure children's medication safety and to promote rational drug use.METHODS:33001ou_ t-patient transfusion prescriptions of12days in2004in our hospital were randomly sampled,in which,the irrational pre?scriptions were classified and analyzed statistically based on clinical pharmacological knowledge and literatures.RESULT:Of the total prescriptions investigated,60.56%of which were about the combined use of drugs;1354(4.10%of the total)involved irrational drug use like repeat drug application,improper combination of drugs,and improper application.CONCLUSION:To reduce the incidence of adverse drug reactions,clinicians should be provided with timely feedbacks on medication information.

Abstract： Objective　To analyze the characteristics and corresponding drug resistance of pathogenic bacterial spectrum in eight major infection sites of hospitalized patients, and to provide epidemiological data for the rational selection of antibiotics in clinical practice. Methods　A total of 396 bacterial strains isolated from clinical specimens of hospitalized patients in member institutions of the Hainan Provincial Bacterial Resistance Monitoring Network from September 1, 2020, to September 30, 2022, were included in this study. Data were screened and filtered from the database of MH120 Microbial Identification and Drug Sensitivity Analysis System based on the technical scheme of the National Bacterial Drug Resistance Surveillance Network and Science and Technology Basic Resources Investigation Project research plan in 2020. The testing data were integrated, summarized, and analyzed using EXCEL and WHONET 5.6 software, and statistical analysis was conducted using SPSS 26.0 software. Results　Among of 396 strains of bacteria, 78 (19.7%) were isolated from respiratory tract specimens, 74 (18.7%) from urinary tract specimens, 72 (18.2%) from blood specimens, 54 (13.6%) from abdominal cavity specimens, 48 (12.1%) from skin and soft tissue specimens 48 strains (12.1%), 30 (7.6%) from reproductive tract specimens, 22 (5.6%) from central nervous system specimens, 18 (4.5%) from digestive tract specimens. Gram-negative bacteria accounted for 69.4% of the isolates, while gram-positive bacteria accounted for 30.6%. The top five gram-negative bacteria isolated were Klebsiella pneumoniae (14.9%), Escherichia coli (14.4%), Pseudomonas aeruginosa (10.4%), Acinetobacter baumannii (5.3%), and Salmonella species (4.5%). The top five gram-positive bacteria were Staphylococcus aureus (11.1%), Streptococcus agalactis (7.8%), Enterococcus faecalis (3.0%), Enterococcus faecium (2.8%), and Streptococcus suis (1.8%). Respiratory failure and bloodstream infection were independent influencing factors of treatment response (P<0.01). The resistance rate of Escherichia coli to ampicillin was 81.4%, and the resistance rate of Staphylococcus aureus to gentamicin and levofloxacin were both below 7%. Conclusions　The pathogen spectra vary with different infection sites of patients, and rational selection of antibiotics based on drug susceptibility testing is crucial to shorten the treatment time of patients and avoid the unnecessary emergence of drug-resistant strains caused by drug abuse.

Objective To study the diagnosis and treatment for distractive extension injuries of the cervical vertebrae.Method From 2000 to 2005.the clinical and image data of fifty-six patients in the Second Affiliated Hospital of Zhejiang University College of Medicine with distractive extension injuries of the cervical vertebrae were studied and treated with anterior discectomy or subtotal vertebrectomy in the second affiliated Hospital of zhejiang university collegeof medicine,bone grafting and internal fixation with plate.Results The follow-up period was six to seventeen months in fourty-eight patients.The neurological recovery was found after operation in five of nine case with complete spinal cord injuries and thirteen patient had complete recovery.Neck pain completely disappeared in 6 patients with oboslete injury and neurological recovery was improved in 4 patients.Condusions MRI examination is the essential approach to diagnoze distractive extension injuries of the cervical vertebran,and early operation,including anterior discectomy,bone graftillg and internal fixiation with plate,is a best choice of surgical interrention to achieve cervical stabilization and neurological improvement.