Objective To explore the prevalence of 11 efflux pumps in isolates of multidrugresistant Escherichia coli(MDR-ECO). Methods Efflux pumps emrB, emrD , emrE, mdfA, sugE, mdtl,tehA, oqxA, qacE△1, qacE and smr-2 were detected by polymerase chain reaction(PCR)in 20 MDR-ECOs isolated from clinical samples. Results Efflux pumps emrB, emrD, emrE, mdfA, sugE, mdtI, qacE △1, tehA and oqxA were detected, and 8 efflux pumps were found in the same strain. Conclusion Multidrug- resistance in Escherichia coli may be related with efflux pumps.

Objective To investigate the correlation between acquired drug resistance-related genes and mobile genetic elements from pandrug-resistant Acinetobacter baumannii. Methods Fifty-three horizontal transfer drug resistance-related genes ( β-lactamases,aminoglycoside and quinolones resistance related) and 12 mobile genetic elements (including zygosity plasmid,transposon,insertion sequence and integron) were detected by polymerase chain reaction (PCR) in 20 clinical isolates of pandrug-resistant Acinetobacter baumannii.Index cluster analysis was performed to explore the correlation.Results In 20 strains of pandrug-resistant Acinetobacter baumannii,there were 3 types of β-lactamases related genes (TEM-1,ADC-30,OXA-23 ),4 types of aminoglycoside modifying enzyme genes [ aac (3)-Ⅰ,aac(6′)-Ⅰ b,ant( 3″)-Ⅰ and aph( 3′)-Ⅰ ],and 5 kinds of mobile genetic elements ( int Ⅰ 1,tnpU,tnp513,IS26 and ISAba1 ). Index cluster analysis showed high correlations between resistance genes [TEM-1,ADC-30,aac( 6′)-Ⅰ b,ant( 3″)-Ⅰ,abeB,qacE Δ1] and mobile genetic elements ( int Ⅰ 1,tnpU,tnp513,IS26,ISAba1 ).Conclusion Clinical isolated pandrug-resistant Acinetobacter baumannii carries several acquired drug resistance-related genes and mobile genetic elements,and there may be a close association between them.

Objective:To investigate the therapeutic effect of Wenxin granule combined with sotalol on patients with arrhythmia and its influence on the levels of plasma angiotensin Ⅱ(Ang Ⅱ), C-reactive protein (CRP) and NT-proBNP.Methods:From January 2018 to October 2019, 162 patients with arrhythmia admitted to Taizhou Central Hospital were divided into observation group (81 cases) and control group (81 cases) according to the random digital table method.The control group was treated with sotalol, and the observation group was treated with Wenxin granule on the basis of the control group.The course of treatment in both two groups was 2 months.The changes of cardiac function, Ang Ⅱ, CRP and NT-proBNP levels, as well as adverse reactions were compared before and after treatment.Results:The total effective rate of the observation group (92.59%, 75/81) was higher than that of the control group (77.78%, 63/81) (χ 2=7.044, P<0.05). After treatment, the LVEDD [(53.18±3.09)mm] and LVESD [(52.19±2.35)mm] in the observation group were lower than those in the control group [(58.97±2.73)mm and (57.79±2.65)mm], while the SV [(76.93±3.67)mL] and LVEF [(53.90±2.64)%] in the observation group were higher than those in the control group [(71.35±2.87)mL and (46.75±2.18)%], the differences were statistically significant ( t=12.638, 14.230, 10.779, 18.795, all P<0.05). The plasma AngⅡ [(96.52±12.16)ng/L], CRP [(4.30±0.69)mg/L] and NT-proBNP [(394.25±47.15)ng/L] in the observation group were lower than those in the control group [(135.42±23.15)ng/L, (6.27±0.78)mg/L and (565.29±56.72)ng/L] ( t=13.389, 17.025, 20.870, all P<0.05). The incidence of adverse reactions in the observation group (11.11%) was lower than that in the control group (30.86%) (χ 2=9.529, P<0.05). Conclusion:Wenxin granule combined with sotalol is effective in the treatment of arrhythmia, which can reduce the plasma levels of Ang Ⅱ, CRP and NT-proBNP, improve the heart function and has no obvious adverse reactions.

Objective:To explore the practical value of general anesthesia with non-intubated spontaneous breathing in uniportal thoracoscopic surgery in elderly patients.Methods:Clinical data of 86 elderly patients undergone uniportal thoracoscopy surgery during hospitalization at our hospital between March 2020 and December 2021 were retrospectively reviewed and analyzed.Based on the anesthesia intubation method, they were divided into a non-intubated spontaneous breathing video-assisted thoracic surgery group(NI-VATS group)and a one-lung ventilation video-assisted thoracic surgery group(OLV-VATS group), with 43 cases in each group.Data were compared on the inflammatory indexes, preparation time for anesthesia, time to awakening after anesthesia, intraoperative lung collapse score, mediastinal flutter score, time to postoperative feeding, digestive tract complications, sore throat, postoperative pulmonary atelectasis, and hospitalization time.Results:Compared with the OLV-VATS group, the NI-VATS group had a shorter anesthesia preparation time [(19.8±2.6)min vs.(32.3±4.5)min, t=-15.77, P<0.001]and a shorter time to awakening [(6.8±2.1)min vs.(11.9±2.9)min, t=-9.485, P<0.001], slightly poorer operating field during surgery, an unfavorable lung collapse score [(2.5±0.7) vs.(1.8±0.7) t=4.704, P<0.001], worse mediastinal flutter [(2.1±0.6) vs.(1.3±0.5), t=6.514, P<0.001]. Lower procalcitonin(PCT)[(0.189±0.130)μg/L vs.(0.264±0.123)μg/L, t=-2.744, P=0.007), a shorter time to postoperative feeding [(3.4±1.0)h vs.(5.5±1.0)h, t=-9.55, P<0.001], and lower rates of digestive tract reactions(4.7% vs.20.9%, χ2=5.108, P=0.024)and throat pain(4.7% vs.23.3%, χ2=6.198, P=0.013), and a shorter length of hospital stay [(3.8±0.3)d vs.(4.9±0.8)d, t=-7.266, P<0.001]. Conclusions:For the elderly patients undergoing uniportal thoracoscopic surgery, non-intubated spontaneous breathing may somewhat obstruct the operating field, but it can shorten the time of anesthesia and the time to awakening, does not increase complications from anesthesia and surgery, favors rapid postoperative recovery for patients and therefore should be promoted.