Electromagnetic Fields ; adverse effects ; Humans ; Mutagenicity Tests

The cultivation of medical talents is the main goal of medical postgraduate training. Zunyi Medical University innovates many aspects of postgraduate education, including student sources, spirit of scientific research, curriculum setting, assessment mechanism and quality control, etc. It fo-cuses on cultivating students' practical and innovative abilities through developing professional-typed education, constructing excellent courses, and boosting students' core competitiveness.

Objective To understand antimicrobial resistance of Enterobacteriaceae strains and distribution charac-teristics of carbapenemase-resistant Enterobacteriaceae(CRE)in Xijing Hospital in 2015,so as to provide basis for rational use of antimicrobial agents in clinic. Methods Specimens from infected inpatients and outpatients in Xijing Hospital in January-December 2015 were performed pathogenic culture,isolation and identification. Antimicrobial susceptibility testing was performed with Kirby-Bauer method,carbapenemase confirmatory test was conducted with modified Hodge test,antimicrobial resistance of Enterobacteriaceae was statistically analyzed. Results A total of 4166 pathogenic strains were isolated in 2015,1554 (37.30% )of which were Enterobacteriaceae strains,the top 5 isolated pathogens were Escherichiacoli(E. coli),Klebsiella pneumoniae(K. pneumoniae),Enterobactercloacae (E. cloacae),Proteusmirabilis,and Enterobacteraerogenes. Of 787 E. coli strains,581(73.82% )were extend-ed-spectrumβ-lactamases(ESBLs)-producing strains;of 367 K. pneumoniae strains,182 (49.59% )were ESBLs-producing strains. E. coli and K. pneumoniae had the highest resistance rates to cefazolin,which were 93.14% and 78.48% respectively. A total of 81 (5.21% )CRE were detected,K. pneumoniae,E. cloacae,and E. coli were 41 ,27,and 13 strains respectively;strains were mainly isolated from patients in departments of neurosurgery(n=42),gastroenterology(n= 9),and neurology(n= 8). 1.02% (8/787)of E. coli and 3.27% (12/367)of K. pneu-moniae were multidrug-resistant. Conclusion Enterobacteriaceae accounted for a higher proportion of pathogenic bacteria causing HAI,the detection rate of ESBLs-producing strains remains high,the isolation rate of carbapenem-resistant Enterobacteriaceae is higher than that of last year,especially K. pneumoniae.

Recent studies have demonstrated that hyperhomocysteinemia is an independent risk factor for stroke,which may cause vascular endothelial injury by multiple mechanisms,destroy blood coagulation and fibrinolytic systems,and influence on lipid metabolism.Methylenetetra hydrofolate reductase(MTHFR)is a key enzyme of homocysteine metabolic pathway in the human body.If it is insufficient or its activity decreases,it will directly result in the accumula tion of homocysteine in the human body,and callse hyperhomocysteinemia.Although a number of studies have found that MTHFR gene mutation is the main cause of MTHFR insufficient and its activity decrease,the correlation between MTHFR gene mutation and ischemic cerebral vascular disease is quite controversial now.This article reviews the relationship between MTHFR gene polymorphisms and ischemic stroke.

Objective To evaluate the efficacy of zoledronic acid combined with radiotherapy for metastatic bone tumours. Methods Eighty patients with metastatic bone tumour by meta were randomly derided into two groups study group(n=40), and the eantrol group (n=40). The study group received 4 mg zoledronic acid infusion for 15 minutes combined with radiotherapy (DT 30Gy/10f/2w) ,control group was only treated with radiotherapy. The primary effective parameters were pain scores, quality of life, KPS scores and pain relief rates. The vital signs, bi-ochemical and hematological parameters were determined. Results The overall response rates of study group and control group were 97.5% and 72.5% ,respectively(P<0.05). The overall response rate of movement capacity im-provement was 87.5 % in the study group and 65.0% in the control group(P<0.05). There was statistical signifi-cance of QOL and KPS in two groups (P<0.01). An adverse event of mild systemic skeletal pain was recorded after pamidronate infusion and completely reversed after 8 hours. Conclusion Zoledronic acid combined with radiothera-py is effective and safe for treating malignant tumour with mestastatic bone tumours. It is a better way to treat meta-static bone tumors at present.

Objective To observe the effect of high-dose leucovorin(LV)plus 5-fluorouracil(5-Fu)for 48hours infusion in combination with cisplatin(DDP)in treatment of advanced esophageal cancer.Methods Pathological diagnosis of esophageal cancer 60 cases were randomly divided into treatment group of 30 patients,using DDP 25mg/m2 intravenous infusion 30 minutes,d1～3,LV 200mg/m2 intravenous infusion 2 hours,5-Fu 0.5 intravenous injection 10 minutes,and 5-Fu 2.5/m2,continuous infusion with the infusion pump for 48 hours every 21 days,2 cycles of assessment of efficacy.Control group of 30 patients,using DDP 25mg/m2 intravenous infusion 30 minutes,d1～3,LV 60mg/m2 intravenously two hours,d1～5,5-Fu 500mg/m2 intravenously 8 hours every 21 days,2 cycles of assessment of efficacy.Results Short-term effect,treatment group,complete remission(CR)1 patient and partial remission(PR)15 cases,stable(SD)9 cases,progress(PD)5 cases,the total effective rate of CR + PR53.3％(16/30).Control group,PR 11 patients,SD 11 cases,PD 8 cases,no cases of PR,the total effective rate 36.7 ％(11/30).Nausea,vomiting,oral mucositis,bone marrow suppression,diarrhea and hair loss were the main adverse reactions.Two groups are able to withstand,without any Ⅳ toxicities,myelosuppression was significant in control group than the treatment group.Conclusion High-dose LV + 5-Fu 48 hours infusion combined platinum-term efficacy in treatment of advanced esophageal cancer compared with conventional DF program is good,less adverse reactions,should further expand the study.

Cell Physiological Phenomena ; Electromagnetic Fields

Objective To study the relationship between serum fibrosis parameters levels and chronic viral hepatitis B patients.Methods Radioimmunoassay and chemiluminescence were used to test the levels of hyaluronic acid(HA),collagen type Ⅳ(Ⅳ-C),laminin(LN) and procollagen type Ⅲ(PC Ⅲ) in 146 cases of chronic hepatitis B and 40 of normal controls,and the relationship with clinical parameters of liver function were analyzed.Results The levels of HA,Ⅳ-C,LN,PC Ⅲ in chronic hepatitis B patients were higher than those of normal control group (P ＜0.05 or P ＜ 0.01),there were statistical differen in different course of disease (P ＜ 0.05 or P ＜ 0.01) ; The levels of serum Ⅳ-C and PCⅢ had positive correlation with plasma PT,the same to HA with TBil and PCⅢ with ALT;The levels of HA,Ⅳ-C and LN had negative correlation with Alb,the same to LN with CHE.Conclusion The levels of HA,Ⅳ-C,LN and PC Ⅲ in chronic hepatitis B patients may reflect the situations of hepatic fibrosis and the degrees of liver function damage.

Anhedonia, or markedly diminished interest or pleas-ure, is a hallmark symptom of depression.As a psychopathological symptom, anhedonia was first noted in the early 19th century.The neurobiological mechanisms that underline anhedonia and its role in diagnosing depression disorder or evaluating antidepressant response have long been aroused attention for nearly a century.Consequently, there are many measuring methods established in both the animal study and human research, which would be reviewed in the present study.

OBJECTIVE To study the clinical effect of preventing and treating sterile phlebitis(abacterial phlebitis,SP) by infrared irradiation after peripherally inserted central catheterization(PICC).METHODS Totally 122 inpatients from the Zhejiang Provincial People′s Hospital were divided into two groups randomly,the control group and the experimental group.The control group was only treated with usual care after PICC,while the experimental group with both infrared irradiation and usual care.The incidence rate of SP and its correlation factor were compared between the two groups.RESULTS None in the experimental group got SP.Nevertheless,the control group got a 21.9%incidence rate.The development of SP mostly own to impassable intubation or repeating intubation.CONCLUSIONS For those patients with impassable intubation or repeating intubation during PICC operation,infrared irradiation shows greatly helpful and can obviously prevent the SP and diminish patients′ fee.