Objective To investigate the situation of drug resistance and nosocomial infection of multi-drug resistant bacteria (MDR),guidance for clinical rational use of antibiotics.Methods A total of 1521 strains of MDR was isolated from January 2015 to December in Beijing Tongren Hospital,using matrixassisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) identification of bacteria,VITEK-2 Compact and Kirby Bauer (KB) method for drug sensitivity test.Results In 1 521 strains of MDR,Acinetobacter Baumanii were 589 strains (38.7％),nosocomial infection rate were 16.6％;350 strains of Escherichia coli (23.0％),nosocomial infection rate were 9.0％;249 strains of Staphylococcus aureus (16.4％),nosocomial infection rate were 2.7％;171 strains of Klebsiella pneumoniae (11.2％),nosocomial infection rate were 14.3％;150 strains of pseudomonas aeruginosa (9.9％),nosocomial infection rate were 64.7％;12 strains of Enterococcus faecium (0.8％),nosocomial infection rate were 16.7％.MDR Acinetobacter Baumanii,MDR Pseudomonas aeruginosa,extended-spectrumβ-lactamase (ESBL) + Escherichia coli and ESBL + Klebsiella pneumoniae resistance rate to Imipenem were 100％,91.5％,0.6％ and 55.6％.Conclusions MDR pseudomonas aeruginosa (MDR-PAE),MDR acinetobacter baumanii (MDR-AB) and ESBL + Klebsiella pneumoniae were highly resistant,and the nosocomial infection rate were higher.

Bilingual teaching is a new measure to enhance the quality of education in universities and to meet the requirement for a WTO member.Conducting bilingual teaching in medical schools is to aim at cultivating high-quality doctors and improving Chinese medical science.This article interprets the concept and goal of bilingual teaching and analyzes the history and mode of bilingual teaching in China.The methods of conducting medical bilingual teaching,the construction of the teaching resource and the evaluation of the curriculum have also been discussed.

The article sums up the thinking and methods of the top-quality courses of Pediatrics constructed by the pediatric bed-sided teaching(PBL courses) and clinical training.The aim of the courses is to combine gradually lecture,question,discussion and practice,encourage active discussion,emphasize clinical ability and establish a new teaching method of pediatrics.

Pediatrics is a medical discipline,studying children health,growth and development,health care and disease prevention.To ignite medical students' interest in pediatrics,cultivate their creativity and ability in clinical practice,since February 2004,Pediatric Department in Children's Hospital of Fudan University has implemented the teaching pattern that combines traditional teaching practice with problem based learning(PBL) in students of seven-year medical training program,which has received positive feedback and wide approval from the students.

Facing a transformation of society and new problems of health care system in the twenty-first century,traditional medical modals have many challenges.The new modes of modern medicine have been formed.The medical education reform must adapt new medical modes to cultivate high quality medical talents.And at the same time the course of pediatrics should be constantly innovated to construct the first class teaching staff,first-rank teaching contents,teaching methods,teaching material and teaching administration.

Because of the unsatisfactory treatment options for breast cancer (BC), there is a need to develop novel therapeutic approaches for this malignancy. One such strategy is chemotherapy using non-toxic dietary substances and botanical products. Studies have shown that Panduratin A (PA) possesses many health benefits, including anti-inflammatory, anti-bacterial, anti-oxidant and anti-cancer activities. In the present study, we provide evidence that PA treatment of MCF-7 BC cells resulted in a time- and dose-dependent inhibition of cell growth with an IC50 of 15 µM and no to little effect on normal human MCF-10A breast cells. To define the mechanism of these anti-proliferative effects of PA, we determined its effect critical molecular events known to regulate the cell cycle and apoptotic machinery. Immunofluorescence and flow cytometric analysis of Annexin V-FITC staining provided evidence for the induction of apoptosis. PA treatment of BC cells resulted in increased activity/expression of mitochondrial cytochrome C, caspases 7, 8 and 9 with a significant increase in the Bax:Bcl-2 ratio, suggesting the involvement of a mitochondrial-dependent apoptotic pathway. Furthermore, cell cycle analysis using flow cytometry showed that PA treatment of cells resulted in G0/G1 arrest in a dose-dependent manner. Immunoblot analysis data revealed that, in MCF-7 cell lines, PA treatment resulted in the dose-dependent (i) induction of p21WAF1/Cip1 and p27Kip1, (ii) downregulation of Cyclin dependent kinase (CDK) 4 and (iii) decrease in cyclin D1. These findings suggest that PA may be an effective therapeutic agent against BC.
Apoptosis* ; Breast Neoplasms* ; Breast* ; Caspases ; Cell Cycle Checkpoints* ; Cell Cycle* ; Cell Proliferation* ; Cyclin D1 ; Cyclins ; Cytochromes c ; Down-Regulation ; Drug Therapy ; Flow Cytometry ; Fluorescent Antibody Technique ; Humans ; Inhibitory Concentration 50 ; Insurance Benefits ; MCF-7 Cells ; Phosphotransferases

Objective:To observe the effect of NGF on the expression of BMP-2 in rabbit model and explore the molecular mechanism of NGF which might promote the healing of mandibular fracture with nerve injury. Method:The 48 New-Zealand white rabbits were randomly divided into the experimental group (mandibular fracture+to cut off the nerve bundle+NGF by GS), the control group (mandibular fracture+to cut off the nerve bundle+NS by GS), the blank group (mandibular fracture+to cut off the nerve bundle) and the full-set group (mandibular fracture+retains the nerve bundle). After 2 weeks, 4 weeks, 6 weeks and 8 weeks, 3 rabbits were sacrificed in each group for HE staining and RT-PCR, respectively. Result:HE staining showed the osteogenesis phenomenon: the experimental group was clearer than control group, the full-set group was clearer than the blank group and the control group is similarly to the blank group. RT-PCR results revealed that there was a statistically significance in the early stage. The expression of BMP-2 peaked in 2 weeks and decreased later with time. Conclusion:The local application of NGF can prompt BMP-2 expression in the early stages of the mandibular fracture with partial nerve injury healing and this may be one of the molecular mechanisms.

Objective:To explore the predictive value of Red Blood Cell Distribution Width (RDW) in predicting the prognosis of patients with Extracorporeal Membrane Oxygenation (ECMO).Methods:The clinical data of patients undergoing ECMO admitted to Intensive Care Unit of Sichuan Provincial People’s Hospital from January 2015 to January 2020 were retrospectively analyzed. Patients were divided into the survival group and death group according to the prognosis during ICU hospitalization. The patients' basic data , acute physiology and chronic health score system Ⅱ (APACHE Ⅱ), RDW and activated partial thromboplastin time (APTT) at 72 hours after treatment with ECMO were compared between the two groups. Univariate and Logistic regression multivariate analyses were used to analyze the prognostic factors of patients with ECMO, predictive models and death warning scores were established. The receiver operating characteristic (ROC) curve was plotted to evaluate the diagnostic efficacy of RDW and death warning scores for the prognosis of patients with ECMO.Results:A total of 71 patients with ECMO who met the inclusion criteria were included, including 38 patients in the death group and 33 patients in the survival group. The age, APACHE-Ⅱscore, 72 h RDW and 72 h APTT in the death group were higher than those in the survival group. Respectively, the hospitalization time of ICU in the death group was significantly lower than that in the survival group ( P< 0.05). Logistic regression analysis showed that APACHE-Ⅱscore ( OR=1.117, P=0.047)、72 h RDW( OR=1.102, P=0.029) and 72 h APTT ( OR=1.049, P=0.029) were independent risk factors for death in patients with ECMO. ROC curve analysis showed that the area under ROC curve (AUC) of the APACHE-Ⅱ, score 、72 h RDW and 72 h APTT were 0.691, 0.691 and 0.632( P<0.05), Respectively, the combined AUC was 0.764, the sensitivity was 0.526, and the specificity was 0.909. The death warning score of patients with ECMO was established according to the Predictive model , which is less than 2 points with low risk of death and more than 2 points with high risk of death. The area under the ROC curve of death warning score is 0.8, the sensitivity is 0.607 and the specificity is 0.923. Conclusions:The RDW at 72 hours after treatment with ECMO has a good value in predicting the prognosis of patients with ECMO. Besides, a greater predictive value for the prognosis of patients with ECMO by combining 72 hours RDW, 72 hours APTT with APACHE-Ⅱscore than that of any separate indicator.

OBJECTIVE To study in vitro inhibitory effects of realgar nanoparticles on breast cancer stem cells. METHODS Human breast cancer MCF- 7 parent cells were selected as subjects and cultured by serum-free culture to obtain breast cancer stem cells. Using adriamycin （1 mg/L）as positive control ，same concentration of water-processed realgar as reference ，the effects of realgar nanoparticles on the proliferation of MCF- 7 parent cells and stem cells were detected by CCK- 8 method. The effects of realgar nanoparticles on the formation of mammosphere ，the ability of differentiation ，migration and invasion ，the proportion of CD44+/CD24－ subgroup in breast cancer stem cells were detected by mammosphere formation and differentiation experiment ， scratch experiment ，Transwell invasion experiment and flow cytometry. Western blot assay was used to detect the expression of proteins related to epithelial mesenchymal transformation pathway （E-cadherin and vimentin ） in breast cancer stem cells. RESULTS The survival rates of MCF- 7 parent cells and stem cells （except for breast cancer stem cells in both 1 mg/mL groups ）in 1，5，10，40，60，80 mg/L groups of water-processed realgar and realgar nanoparticles were significantly lower than blank control group（P＜0.01）. The number of mammosphere （＞20 stem cells ）in 1，2.5，5，10 mg/L groups of water-processed realgar and realgar nanoparticles was significantly lower than blank control group （P＜0.01）；the volume of mammosphere decreased and the differentiated adherent cells decreased ；the healing rate of wound ，relative invasion rate （except for water-processed realgar 1 mg/L group）and the proportion of CD 44+/CD24－ subgroup were significantly lower than blank control group （P＜0.01）. The expressions of E-cadherin in 2.5，10 mg/L groups of water-processed realgar and realgar nanoparticles was significantly higher than blank control group ，and the expressions of vimentin was significantly lower than those in blank control group （P＜0.01）. The above effects of realgar nanoparticles were generally better than those of water-processed realgar with the same mass concentration （P＜ 0.01）. CONCLUSIONS Compared with water-processed realgar with the same mass concentration ，realgar nanoparti cles can significantly inhibit the proliferation of breast cancer stem cells， the formulation and differential ability of mammo- sphere，and reduce the proportion of CD 44+/CD24－ subgroup. The effect may be associated with the inhibition of migration and invasion of breast cancer stem cells by inhibiting the expression of proteins related to epithelial mesenchymal transformation pathway.

ObjectiveTo investigate a suspected outbreak of carbapenem-resistant Acinetobacter baumannii （CRAB） nosocomial infection in an intensive care unit （ICU） and provide scientific evidence for prevention and control of multi-drug resistant nosocomial infection. MethodsClinical and epidemiological data of 4 patients with CRAB infection were retrospectively investigated in the ICU of Renji Hospital in November 2021. Environmental hygiene monitoring and multilocus sequence typing （MLST） were conducted and intervention measures were taken. ResultsA total of 4 cases with CRAB infection were identified， among which 1 case was determined to be community-acquired and3 cases were hospital-acquired. The isolated strains shared the same drug resistance， and were all classified into ST368 type. In the surface and hand samples （n=40）， 2 CRAB strains were detected in the air filter beside the bed of the first case， with a detection rate of 5%. After adopting comprehensive prevention and control strategies， including environmental cleaning and disinfection， hand hygiene， staff management and training， and supervision， no similar case with CRAB infection was found. ConclusionThis suspected outbreak of CRAB nosocomial infection may be induced by inadequate environmental cleaning and disinfection， and inadequate implementation of hand hygiene. Timely identification， investigation， and targeted measures remain crucial to effective control of possible nosocomial infection.