Objective To compare the resistance of metallo-β-lactamase -producting Pseudomonas aeruginosa between burn ward and other wards, so as to provide basis for reasonable use of antimicrobial agents. Methods BD Phoenix-100 bacteria identification and drug sensitivity analyzer was used to detect Pseudomonas aeruginosa and its susceptibility, and disc synergy method was used for the screening of metallo-v-lactamase -producting Pseudomonas aeruginosa. Results Of 68 strains of Pseudomonas aeruginosa, 9 strains (13.2%) were metallo-β-lactamase (MBL) positive. Among the 9metallo-β-lactamase positive strains, 7 strains were from the burn ward and 2 strains from other wards. The resistance rate of the MBL-producing strains to ceftazidime, cefotaxime, imipenem, ciprofloxacin, amikacin, gentamicin, piperacillin and aztreonam was respectively 100.0%, 100. 0%, 88.9%, 66.7%, 88.9%, 100,0%, 100.0%, and 88.9%, obviously higher than that of non-MBL-pro-ducing Pseudomonas aeruginosa. Conclusion The rate of MBL-producing Pseudomonas aeruginosa is obviously higher in burn ward than that in other wards. The resistance of MBL-producing Pseudomonas aeruginosa is high against commonly used antimicrobial agents. Clinical use of antibiotics should he based on the antimicrobial susceptibility test results.

Objective To investigate the effect of early low-glucocorticoid on hemodynamics and prognosis in the patients with septic shock.Methods Sixty patients with septic shock failing in active fluid resuscitation and vasoactive drugs in our hospital from June 2013 to August 2015 were selected and divided into the control group,early-hormone group and late-hormone group.MAP,HR,PO2/FIO2 and serum lactic acid levels were monitored in all selected patients before treatment and at 12,24,48 h after treatment.Apache Ⅱ,SOFA scores were assessed before treatment and on 1,3,7 d after treatment.The ventilation time,ICU stay time,hospital stay time and intravenous use time of vasoactive agents(VDNT) were recorded.Results The Apache Ⅱ scores and SOFA scores on 3,7 d after treatment in the early-hormone group were significantly decreased compared with the late-hormone group and control group (P＜0.05).MAP and HR at 24,48 h after treatment in the early-hormone group were significantly improved compared with the late-hormone group and control group (P＜0.05).The level of serum lactic acid at 12,24 h after treatment in the early-hormone group and late-hormone group were obviously lower than that in the control group,the levels of serum lactic acid at 12,24 h after treatment in the early-hormone group were obviously lower than those in the late-hormone group (P＜ 0.05).PO2/FIO2 at 12 h after treatment in the early-hormone group and late-hormone group were obviously better than that in the control group,and PO2/FIO2 at 12 h after treatment in the early-hormone group was obviously better than that in the late-hormone group(P＜0.05).The ventilation time,ICU stay time,hospital stay time and VDUT in the early-hormone group were significantly shortened compared with the late-hormone group and control group.The ventilation times,ICU stay time and VDUT in the latehormone group were significantly shortened compared with the control group (P＜0.05).Conclusion Early using low-dose glucocorticoid may restore hemodynamics more quickly,protects the organ function and improves the prognosis in the patients with septic shock.

Objective This article introduced the concrete methods and benefits of promoting and holding competition of acupuncture and moxibustion in TCM universities or colleges. A regular skill competition will not only stimulate students' passion for TCM study and expand teaching methods, but also serve as a effective way to enhance practical skills of students.

0.05). CONCLUSION: Serum Cys C is significantly increased in ARF and correlated well with the severity of ARF. Serum Cys C can be one of the detectable markers of ARF, but it is independent of the mortality and does not predict the prognosis of these patients.

Objective To review the diagnosis and treatment of squamous cell carcinoma of renal pelvis. Methods The clinical data from October 1991 to May 2009 of eight cases of squamous cell carcinoma of renal pelvis were reviewed and analyzed retrospectively. The symptoms of the patients were hematuria (eight cases), pain (seven cases) and abdominal mass (one case). All patients underwent B-ultrasound and IVU examination and four cases underwent CT scan. Three cases were diagnosed as having a tumor before surgery. Five cases were diagnosed as renal calculus, two of the five cases were diagnosed by intraoperative frozen section. Radical nephroureterectomy were performed in four cases, nephrectomy in three cases and palliative resection in one case. Results Histological classification revealed that six cases were moderately differentiated, one case was well differentiated and one case was poorly differentiated. Two cases had stage pT1/pT2 and six cases had stage pT3/pT4. 2 cases had regional lymph nodes metastasis. Seven cases were followed-up. All patients died of tumor recurrence or metastasis. The median tumor specific survive time was six months (range from two months to 42 months). Conclusions Squamous cell carcinoma of renal pelvis is often occurs concurrently with urolithiasis which could lead to difficulty in diagnose before operation. As the most of the patients were diagnosed with advanced stage disease, squamous cell carcinoma of renal pelvis tended to early recurrence and metastasis and the prognosis was very poor.

Objective To observe the influence of spinal cord injury (SCI) in hypothalamus AMP-activated protein kinase (AMPK) expression,and explore the mechanism of SCI-induced type 2 diabetes or insulin resistance.Methods Eighteen SD rats were randomly divided into model group,High Fat/High Sucrose/High Cholesterol Diet group and SCI group (n=6).The animals in the model group and High Fat/High Sucrose/High Cholesterol Diet group underwent a T10 laminectomy without weight-drop injury,and SCI models were induced by MASCIS Impactor method.Blood glucose and glucose tolerance tests were performed before experiment and 8 weeks after the experiment.At 8 weeks,the levels of serum inflammatory factors,tumor necrosis factor (TNF)-α,interleukin (IL)-1β,and IL-6,were observed by ELISA;Western blotting was used to detect the expression of phosphorylated (p) -AMPK in the hypothalamus.Results Blood glucose levels in the rats of High Fat/High Sucrose/High Cholesterol Diet group and SCI group were significantly higher than that in the model group (P＜0.05).Blood glucose levels 15 and 60 min after SCI in rats of SCI group were significantly higher than those in the model group (P＜0.05);Blood glucose levels 15,30,60 and 120 min after SCI in rats of High Fat/High Sucrose/High Cholesterol Diet group were significantly higher than those in the model group (P＜0.05).As compared with those in the model group,the expression of p-AMPK in the hypothalamus were significantly decreased,and the TNF-α,IL-1β and IL-6 levels were statistically increased in rats of High Fat/High Sucrose/High Cholesterol Diet group and SCI group (P＜0.05).Conclusion SCI could inhibit AMPK expression in the hypothalamus,activate inflammatory signaling pathway and enhance chronic systemic inflammation,and therefore,insulin resistance is induced.

Objective To investigate the effect of Jin's 3-needling therapy on executive function and spatial learning and memory abilities and their mechanism in frontal lobe injury rats. Methods Thirty-two male Sprague-Dawley rats were randomly divided into sham-operated group, Jin's 3-needling group, model group and medoba treatment group (n=8). The rats in the sham-operated group only underwent craniotomy to remove the bone flap and no impact was performed on the frontal lobe; the frontal lobe injury models of model group, Jin's 3-needling group and medoba treatment group were established by eCCI-6.3 device; rats in the Jin's 3-needling group were treated with Jin's 3-needling therapy, and rats in the madopa treatment group were given 2 mL of madopa suspension by perfusion once daily. The behavior of rats in each group was evaluated by GO/NO GO task and Morris water maze test, and apoptosis of cells was detected by TUNEL, dopamine receptor D1 (DRD1) expression was determined by immunohistochemistry, and the content of dopamine in frontal tissues was analyzed by high performance liquid chromatography. Results The accuracy rate of GO/NO GO task in Jin's 3 needling group was significantly higher than that in madopa treatment group (P<0.05); and that in madopa treatment group was significantly higher than that in model group (P<0.05). On the 3rd and 4th d of place navigation test, the escape latency in the Jin's 3 needling group and madopa treatment group was significantly decreased as compared with that in the model group (P<0.05); the escape latency in the Jin's 3 needling group was significantly decreased as compared with that in the madopa treatment group (P<0.05). In spatial probe test, the number of times of crossing the platform in the Jin's 3 needling group and madopa treatment group was significantly larger as compared with that in the model group (P<0.05). As compared with those in the model group, the number of apoptotic neurons in the frontal lobes was significantly larger, the content of dopamine in the frontal lobes and the DRD1 expression were significantly increased in the madopa treatment group and Jin's 3-needling group (P<0.05); the number of apoptotic neurons in the Jin's 3 needling group was significantly smaller as compared with that in the madopa treatment group (P<0.05); the content of dopamine in the frontal lobes and the DRD1 expression in the Jin's 3 needling group were significantly increased as compared with those in the madopa treatment group (P<0.05). Conclusion Jin's 3-needling therapy can effectively improve the executive function and spatial learning and memory abilities of frontal lobe damaged rats, and their mechanism may be related to decreased apoptosis of frontal tissue cells and increased dopamine content and increased DRD1 expression.

Objective:To investigate the value of number of negative lymph nodes (NLNs) in predicting the prognosis of patients with esophageal cancer after neoadjuvant therapy and the construction of nomogram prodiction model.Methods:The retrospective cohort study was conducted. The clinicopathological data of 1 924 patients with esophageal cancer after neoadjuvant therapy uploaded to the Surveillance, Epidemiology, and End Results Database of the National Cancer Institute from 2004 to 2015 were collected. There were 1 624 males and 300 females, aged 63 (range, 23?85)years. All 1 924 patients were randomly divided into the training dataset of 1 348 cases and the validation dataset of 576 cases with a ratio of 7:3 based on random number method in the R software (3.6.2 version). The training dataset was used to constructed the nomogram predic-tion model, and the validation dataset was used to validate the performance of the nomogrram prediction model. The optimal cutoff values of number of NLNs and number of examined lymph nodes (ELNs) were 8, 14 and 10, 14, respectively, determined by the X-tile software (3.6.1 version), and then data of NLNs and ELNs were converted into classification variables. Observation indicators: (1) clinicopathological characteristics of patients in the training dataset and the validation dataset; (2) survival of patients in the training dataset and the validation dataset; (3) prognostic factors analysis of patients in the training dataset; (4) survival of patients in subgroup of the training dataset; (5) prognostic factors analysis in subgroup of the training dataset; (6) construction of nomogram prediction model and calibration curve. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were represented as M(range), and comparison between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test. The Kaplan-Meier method was used to draw survival curve and Log-Rank test was used for survival analysis. The COX proportional hazard model was used for univariate and multivariate analyses. Based on the results of multivariate analysis, the nomogram prediction model was constructed. The prediction efficacy of nomogram prediction model was evaluated using the area under curve (AUC) of the receiver operating characteristic curve and the Harrell′s c index. Errors of the nomogram prediction model in predicting survival of patients for the training dataset and the validation dataset were evaluated using the calibration curve. Results:(1) Clinicopathological characteristics of patients in the training dataset and the validation dataset. There was no significant difference in clinicopatholo-gical characteristics between the 1 348 patients of the training dataset and the 576 patients of the validation dataset ( P>0.05). (2) Survival of patients in the training dataset and the validation dataset. All 1 924 patients were followed up for 50(range, 3?140)months, with 3-year and 5-year cumulative survival rate as 59.4% and 49.5%, respectively. The 3-year cumulative survival rate of patients with number of NLNs as <8, 8?14 and >14 in the training dataset was 46.7%, 62.0% and 66.0%, respectively, and the 5-year cumulative survival rate was 38.1%, 52.1% and 59.7%, respectively. There was a significant difference in the survival of these patients in the training dataset ( χ2=33.70, P<0.05). The 3-year cumulative survival rate of patients with number of NLNs as <8, 8?14 and >14 in the validation dataset was 51.1%, 54.9% and 71.2%, respectively, and the 5-year cumulative survival rate was 39.3%, 42.5% and 55.7%, respectively. There was a significant difference in the survival of these patients in the validation dataset ( χ2=14.49, P<0.05). The 3-year cumulative survival rate of patients with number of ELNs as <10, 10?14 and >14 in the training dataset was 53.9%, 60.0% and 62.7%, respectively, and the 5-year cumulative survival rate was 44.7%, 49.1% and 56.9%, respectively. There was a significant difference in the survival of these patients in the training dataset ( χ2=9.88, P<0.05). The 3-year cumulative survival rate of patients with number of ELNs as <10, 10?14 and >14 in the validation dataset was 56.2%, 47.9% and 69.3%, respectively, and the 5-year cumula-tive survival rate was 44.9%, 38.4% and 51.9%, respectively. There was a significant difference in the survival of these patients in the validation dataset ( χ2=9.30, P<0.05). (3) Prognostic factors analysis of patients in the training dataset. Results of multivariate analysis showed that gender, neoadjuvant pathological (yp) T staging, ypN staging (stage N1, stage N2, stage N3) and number of NLNs (8?14, >14) were independent influencing factors for the prognosis of patients with esophageal cancer after neoadjuvant therapy ( hazard ratio=0.65, 1.44, 1.96, 2.41, 4.12, 0.69, 0.56, 95% confidence interval as 0.49?0.87, 1.17?1.78, 1.59?2.42, 1.84?3.14, 2.89?5.88, 0.56?0.86, 0.45?0.70, P<0.05). (4) Survival of patients in subgroup of the training dataset. Of the patients with NLNs in the training dataset, the 3-year cumulative survival rate of patients with number of NLNs as <8, 8?14 and >14 was 61.1%, 71.6% and 76.8%, respectively, and the 5-year cumulative survival rate was 50.7%, 59.9% and 70.1%, respectively. There was a significant difference in the survival of these patients in the training dataset ( χ2=12.66, P<0.05). Of the patients with positive lymph nodes in the training dataset, the 3-year cumulative survival rate of patients with number of NLNs as <8, 8?14 and >14 was 26.1%, 42.9% and 44.7%, respectively, and the 5-year cumulative survival rate was 20.0%, 36.5% and 39.3%, respectively. There was a significant difference in the survival of these patients in the training dataset ( χ2=20.39, P<0.05). (5) Prognostic factors analysis in subgroup of the training dataset. Results of multivariate analysis in patients with NLNs in the training dataset showed that gender, ypT staging and number of NLNs (>14) were independent influencing factors for the prognosis of patients with esophageal cancer after neoadju-vant therapy ( hazard ratio=0.67, 1.44, 0.56, 95% confidence interval as 0.47?0.96, 1.09?1.90, 0.41?0.77, P<0.05). Results of multi-variate analysis in patients with positive lymph nodes in the training dataset showed that race as others, histological grade as G2, ypN staging as stage N3 and number of NLNs (8?14, >14) were independent influencing factors for the prognosis of patients with esophageal cancer after neoadjuvant therapy ( hazard ratio=2.73, 0.70, 2.08, 0.63, 0.59, 95% confidence interval as 1.43?5.21, 0.54?0.91, 1.44?3.02, 0.46?0.87, 0.44?0.78, P<0.05). (6) Construction of nomogram prediction model and calibration curve. Based on the multivariate analysis of prognosis in patients of the training dataset ,the nomogram prediction model for the prognosis of patients with esophageal cancer after neoadju-vant treatment was constructed based on the indicators of gender, ypT staging, ypN staging and number of NLNs. The AUC of nomogram prediction model in predicting the 3-, 5-year cumulative survival rate of patients in the training dataset and the validation dataset was 0.70, 0. 70 and 0.71, 0.71, respectively. The Harrell′s c index of nomogram prediction model of patients in the training dataset and the validation dataset was 0.66 and 0.63, respectively. Results of calibration curve showed that the predicted value of the nomogram prediction model of patients in the training dataset and the validation dataset was in good agreement with the actual observed value. Conclusion:The number of NLNs is an independent influencing factor for the prognosis of esophageal cancer patients after neoadjuvant therapy, and the nomogram prediction model based on number of NLNs can predict the prognosis of esophageal cancer patients after neoadjuvant therapy.