Objective To investigate the characteristics of strains of AmpC β-lactamase(AmpC enzyme)production in Dathogenic bacteria in blood stream and clinical presentations of the cases, and study the related ampC and ampD genes.Methods One hundred and eighty-one strains of gram negative bacillus in blood stream were collected,Cefoxitin screening test and three-dimensional test were performed for screening of strains of AmpC enzyme,production and those of AmpC enzyme hyperproduction retrospective analysis was condected in the strains with positive results.ampC and ampD gene PCR ampliftcation, sequencing and sequence analysis of positive strains were performed, and gene homology of ampC positive strains was analysed bv Rep-PCR. Results Among 181 strains in blood stream,strains of AmpC enzyme production were detected in 39 isolates by Cefoxitin screening test,with the detection rate of 21.5%(39/181).The detection rate of strains of AmpC enzyme hyperproduction by three-dimensional test was 43.6%(17/39).PCR revealed that the positive rates for ampC and ampD genes were 41%(16/39)and 56.4%(22/39),respectively.The ampC gene sequencing of 16 positive strains indicated that the homology was 98%to 100%by comparison with the GenBank,while the ampD gene sequencing of 2 strains of Enterobacter cloacae demonstrated that the suspected gene mutations existed in the carboxy-terminal of ampD gene. Conclusion The prevalence of drug-resistant pathogenic bacteria in blood stream in this study is due to nosocomial infection.The mutation of ampC gene is rare in the pathogenic bacteria in blood stream with production of AmpC enzyme,while the rate of gene mutation in Enterobacter cloacae is higher, and the deletion and amino acid substitutions in the carboxy-terminal of ampD is highly relevant to the depressed expression of AmpC enzyme.

Ginsenoside is the main component of antitumor effects of traditional Chinese medicine (TCM) Ginseng. Clinical pharmacological studies have shown that Ginsenoside Rb1 can inhibit P-gp which can lead to efflux of drugs, enhance the sensitivity of cells to drugs, reduce the multidrug resistance of the tumor cell, and maintain the immune function of the body to tumor cells. Ginsenoside Rg3 can impact tumor cell protein expression, play a role in cell division, induce tumor cell apoptosis and inhibit tumor growth of blood vessels. Ginsenoside Rh2 may play an antitumor effect by inhibiting tumor cell proliferation and metastasis, inducing tumor cell apoptosis. This article ex-plained the antitumor effects and mechanism of Ginsenoside Rb1, Rg3, Rh2 in order to provide theoretical evidences for the clinical development and application.

Objective To investigate the expression of sex hormone receptor (SHR) in meningioma and its relationships to the origin of tumor central artery.Methods The expressions of sex hormone receptors, including progesterone receptor (PR), androgen receptor (AR) and estrogen receptor (ER) in 43 cases with meningioma were detected by immunohistochemically streptavidin-peroxidase (SP) method. These data combined with the characteristics of digital subtraction angiography (DSA) were analyzed.Results The expression of ER in meningioma was not related to the origin of tumor central artery. The positive expression rates of PR and AR in external carotid artery (ECA) original group (26.9%,23.1%) were significantly lower than those in internal carotid artery (ICA) original group (88.9%,77.8%) and ECA combined with ICA group (87.5%,87.5%) (all P

Objective To investigate the changes of brain angiography in patients with virus encephalitis.Methods Examining 5 patients with herpes simplex virus encephalitis and 2 patients with Epstein-Barr(EB)virus encephalitis by digital subtractiona angiography(DSA)system and compares the results with control group(including 10 headache patients).Results The results of DSA of virus encephalitis patients were all abnormal,the outcome was accelerating blood circle like irritation.The average of the whole time of brain artery and vein circle was 6.71 seconds,while the results of DSA examination of the control group were all normal,the whole time of brain circle was 10.25 seconds.There was significant difference between the two groups(P

OBJECTIVE: To draw the attention of our country and the concerned party on the shortage of certain drugs. METHODS: Based on the drug shortage condition in our hospital in recent years, we analyzed the reasons for drug shortage, put forward the solution and summarized the clinically indispensable categories. RESULTS & CONCLUSIONS: We should draw experiences from US by solving shortage problem of certain drugs through the co-efforts of government, manufactures and medical institutions to satisfy patients' needs of disease prevention and treatment.

An artificial liver support system (ALSS) is a body circulatory system aims to blood purification, which consists of plasma exchange, hemodialysis, hemoperfusion, in combination with hemodiafiltration. The clinical application of non-biological artificial liver, especially plasma exchange technology, can solve the problem such as hyperbilirubinemia, endotoxemia, toxic substance accumulation and disorder of amino acid metabolism, which would save patients’ lives. ALSS can significantly improve the general physical condition, reduce operative risk, as well as relieve physiologic derangement after liver transplantation. Therefore, artificial liver serves as a bridge for liver transplantation. This paper analyzes the characteristics of ALSS, explores the methods of ALSS application in perioperative period of liver transplantation, and discusses its developing orientation.

Objective To investigate characteristics of deceleration capacity (DC) and Tp-e/QT value in different age groups of patients with diabetic autonomic neuropathy, and to analyze their influencing factors. Methods A total of 487 subjects were enrolled in this study, and divided into three groups:patients with diabetic autonomic neuropathy (DM+CAN group,n=287), normal glucose tolerance patients with diabetic autonomic neuropathy (CAN group,n=130) and healthy controls (NC group,n=150).Then the DM+CAN group were further divided into three subgroups according to age tertiles:the lowest tertile group (35.0~47.2 years old,n=91),the middle tertile group (47.3~59.6 years old,n=116)and the highest tertile group (59.7~72.0 years old,n=80).All subjects were underwent 24-hour dynamic electrocardiogram recordings.DC and Tp-e/QT values were calculated,and then the correlation between DC and Tp-e/QT with other indicators was analyzed. Results The levels of WC,SBP,BMI,FPG,HbA1c,FIns and HOMA-IR were higher in DM+CAN group than in CAN group and in NC group (P<0.05 or P<0.01).DC increased and Tp-e/QT decreased from DM+CAN group,CAN group to NC group,and the pairwise comparisons were statistically significant (P<0.05 or P<0.01).DM duration,WC,FPG,FIns,HbA1c,HOMA-IR,hypertension and CHD ratio were higher in the highest tertile group and middle tertile group than in the lowest tertile group (P<0.05 or P<0.01).DM duration and FIns were higher in the highest tertile group than in middle tertile group (P<0.05 or P<0.01).RHR and AHR were lower in the highest tertile group than in the lowest tertile group (P<0.05),and there were no statistical significant difference between the middle tertile group and the lowest tertile group (P>0.05).DC increased [(2.90±0.47) vs (4.22±0.41) vs (4.97±0.35) ms],and the Tp-e/QT decreased [(0.23±0.05) vs (0.18±0.03) vs (0.12±0.02)] from the highest tertile group to the lowest tertile group,(P<0.05 or P<0.01),and the pairwise comparisons were statistically significant (P<0.05 or P<0.01).Multiple stepwise regression analysis showed that age,DM duration,WC,FPG,HbA1c,complicated with hypertension and coronary heart disease (CHD) were risk factors for DC and Tp-e/QT values (P<0.05). Conclusion Together with the increased age,DC level is reduced and Tp-e/QT value increased in patients with diabetic autonomic neuropathy.Dynamic electrocardiogram should be considered in patients with advanced age,long DM duration,high level of WC,FPG,HbA1c,and complicated with hypertension and CHD,in order to prevent the occurrence of cardiovascular events effectively.

The setting up of morphologic experimental centre has brougt experimental methods and means to a higher level. However, it is worth considering how to share the resource furthest,and how to exert experimental technicians’ efforts. This article intends to discuss those problems.

[Objective]To investigate the influence of the two different methods on the runtime of capsule endoscope in the small bowel.[Method]There were 31 patients who accepted the examination of capsule endoscope.Among these patients,we used pro- kinetic agents or gastroscope for 12 cases with capsule endoscope staying in the stomach for more than 60 minutes.We analyzed the influence on runtime of capsule endoscope in the small bowel with the two methods above and that of the 19 untreated cases. [Result]In the control group,15 cases completed the examination on the whole small bowel,with the average runtime 234.4?70.3min,and 4 of them failed.In medicine group,5 cases completed the examination with the average runtime 121.8?103.7min. 7 cases with the help of gastroscope all completed the examination on small bowel and its average runtime was 275.3?81.8min. [Conclusion]Taking prokinetic agents tends to have more influence on the runtime of capsule endoscope in the small bowel,but it has disadvantages over the observation of small bowel diseases;Help of gastroscope takes less effect on the runtime of capsule en- doscope in the small bowel,while it loses the advantage of no traumas and sufferings.

Objective:To explore the rehabilitation effect and safety of laparoscopic herniorrhaphy through different approaches in the treatment of inguinal hernia.Methods:The clinical data of 132 patients with inguinal hernia in Shushan Branch of Hefei First People′s Hospital from January 2018 to May 2020 were retrospectively analyzed. Laparoscopic herniorrhaphy was performed in all patients. The 46 patients who were treated with transabdominal preperitoneal patch (TAPP) repair were included in TAPP group, while another 86 patients who were treated with totally extraperitoneal patch implantation (TEP) were included in TEP group. The surgery-related indexes, influencing indexes of pneumoperitoneum on pathophysiology, inflammation indexes, pain score and postoperative complications were compared between 2 groups.Results:There were no significant differences in intraoperative blood loss, recovery time of gastrointestinal function, hospitalization time and non-surgery cost between 2 groups ( P>0.05). The operation time, leaving bed time and surgery cost in TEP group were significantly lower than those in TAPP group: (45.08 ± 4.92) min vs. (51.03 ± 5.62) min, (20.93 ± 2.64) h vs. (22.98 ± 2.01) h and (6 887 ± 603) yuan vs. (8 276 ± 813) yuan, and there were statistical differences ( P<0.01). Before pneumoperitoneum, at 10 min after pneumoperitoneum and after extubation, there were no significant differences in levels of total carbon dioxide (TCO 2), partial pressure of carbon dioxide (PaCO 2), partial pressure of oxygen (PaO 2) and bicarbonate radical between 2 groups ( P>0.05). Before and after surgery, there were no significant differences in interleukin (IL)-6, IL-10 and C-reactive protein (CRP) between 2 groups ( P>0.05). At 1, 3 and 7 d after surgery, there were no significant differences in visual analogue scale (VAS) between 2 groups ( P>0.05). There was no significant difference in the total incidence of complications between 2 groups ( P>0.05). Conclusions:Both TAPP and TEP are safe and effective in the treatment of inguinal hernia. The surgical cost of TEP is relatively lower, and operation time and leaving bed time are shorter. The choices of clinical surgical methods should base on surgeons′ experience and individualized features of patients.