OBJECTIVE:To investigate the distribution and drug resistance of Acinetobacter baumannii in our hospital,and provide reference for rational use of antibiotics. METHODS:Clinical specimen of inpatients in our hospital from Jan. 2012 to Dec. 2015 was collected,the identification of strains and drug sensitivity test were performed by the VITEK-2 microorganism analyzer;use rate of antibiotics and detection of multidrug-resistant and pandrug-resistant A. baumannii for inpatients in our hospital were an-alyzed,and their correlation was detected by Pearson correlation analysis. RESULTS:Totally 2 468 strains of A. baumannii were isolated in our hospital during 2012-2015,mainly derived from sputum samples (88.2%),distributed in respiratory medicine de-partment(47.0%)and ICU(13.1%);A. baumannii showed totally high drug resistance to common antibiotics,and only sensitive to tigecycline. Totally 386(79.3%),434(61.6%),358(53.4%)and 291(48.0%)strains multidrug-resistant A. baumannii were detected every year in our hospital;and pandrug-resistant A. baumannii were 336(69.0%),385(54.7%),331(49.3%)and 256 (42.2%) strains,respectively. There was a positive correlation between the percentage of multidrug-resistant and pandrug-resistant A. baumannii in total strains and use rate of antibiotics (r=0.987、0.981,P<0.05). CONCLUSIONS:A. baumannii has emerged as an important pathogen in hospital acquired infections,which mainly caused respiratory system infection;the drug resistance situ-ation is not optimistic,tigecycline can be used as one of the best choice for treatment of A. baumannii infections;our hospital should continue to control the use of antibiotics to decrease the emerging of drug resistance strains.

Objective:To investigate the expression of human epidermal growth factor receptor 4 (HER4) and metastasis-related protein (MMP-9) in human esophageal carcinoma tissues, and their relationship with clinicopathological features of the disease. Methods:Immunohistochemical Envision technique was applied to detect the expressions of HER4 and MMP-9 in 45 specimens of esophageal carcinoma tissues, paracancerous tissues and normal tissues. Statistical method was used to analyze the association of the positivity of HER4 with clinical pathological index and MMP-9 expression.Results:The positive rates of HER4 expression were 73.3%, 33.3%, and 2.2% in 45 specimens of esophageal carcinoma tissues, paracancerous tissues, and normal tissues, respectively. The expression of HER4 was correlated with TNM stage and lymph node metastasis (P<0.01), but not correlated with histological grade (P>0.05). The expression of MMP-9 correlated with T stage, invasion depth, TNM stage, and lymph node metastasis (P<0.05). Conclusion:The expression of HER4 is apparently different in esophageal carcinoma tissues, paracancerous tissues, and normal tissues. Its positive expression in esophageal carcinoma tissues is correlated with TNM stage and lymph node metastasis. The expression of MMP-9 in esophageal carcinoma tissues is correlated with the T stage, TNM staging, and lymph node metastasis. The positive expression of HER4 in esophageal carcinoma tissues is associated with the expressions of MMP-9.

Objective To compare the safety and efficacy of carotid artery stenting (CAS) and carotid endarterectomy(CEA) for the treatment of carotid stenosis. Methods The electronic databases (PubMed, EMbase, Cochrane Central Register of Controlled Trials, CNKI, VIP and Wanfang) were searched in order to retrieve randomized controlled trials (RCTs) about comparing CAS and CEA for the treatment of carotid stenosis. Cochrane collaboration's RevMan 5.0.24 were used for analyzing data. Results Twelve RCTs totalling 6903 patients (3460 patients were randomized to CAS and 3443 randomized to CEA) with symptomatic or asymptomatic stenosis were included in the meta-analysis. There were significantly higher 30-day relative risks after CAS than after CEA for death or any stroke [RR=1.64, 95%CI (1.33-2.03), P＜0.00001] and for stroke [RR=1.70, 95%CI (1.34-2.14), P＜0.00001]. The relative risks of myocardial infarction [RR=0.62, 95%CI (0.39-0.97), P=0.04] and cranial neuropathy [RR=0.07, 95%CI (0.03-0.16), P＜0.00001] was significantly less after CAS than after CEA. The relative risks of death [RR=1.27, 95%CI (0.82-1.96), P=0.29] or disabling stroke within 30 days [RR=1.33, 95%CI (0.78-2.28), P=0.29] and any stroke or death at 1 year after the procedures [RR=0.96, 95%CI (0.63-1.46), P=0.84] did not differ significantly between CAS and CEA operation. Conclusions CEA remains the first choice for treatment of carotid stenosis for patients with low surgery risk. For patients with high surgery risk and unsuitable for surgery, CAS has more advantages. It is reasonable to view CAS and CEA as complementary rather than competing modes of therapy.

Objective To explore the life quality of postoperative patients after a hypertensive cerebral hem-orrhage in the basal ganglia and the factors influencing it, so as to provide evidence for improving the life quality of such patients. Methods A total of 128 patients were studied retrospectively. Their gender, age, occupation, mari-tal status, education level, place of residence and family size were tabulated, as well as whether or not they were liv-ing with their children, smoking or drinking alcohol. Their household income was recorded along with their clinical condition during surgery ( midline shift, blood loss, operative time, whether a hernia occurred, consciousness, and whether bleeding broke into the ventricles. The SF-36 health measurement scale was used to evaluate the patients′life quality, and the factors influencing it were analyzed. Results Univariate analysis showed that: ( 1) Their physio-logical functioning ( PF) and global health ( GH) were mainly affected by age, marital status, family size, midline shift, quantity of cerebral hemorrhage, occurrence of herniation, consciousness and whether the hemorrhage broke in-to the ventricles. (2) Their physiological role (RP) was influenced by marital status, education background, household monthly income, midline shift, consciousness and whether the hemorrhage broke into the ventricles. (3) Pain (BP) was mainly affected by marital status and family size. (4) Social functioning (SF) was closely related to marital status, family size, consciousness and whether hemorrhage broke into the ventricles. (5) Their mental health (MH) was main-ly affected by the amount of bleeding, whether they were living with their children, the operation′s duration and whether the hemorrhage broke into the ventricles. (6) Their emotions (RE) were influenced by their consciousness and whether bleeding broke into the ventricles. (7) Their vitality (VT) was affected by their marital status, smoking, consciousness and whether the bleeding broke into the ventricles. Multivariate analysis showed that whether the hemorrhage broke into the ventricles was the most influential factor. Family size was also influential. Conclusions Age, number of family members, whether they are living with their children, and whether hemorrhage broke into the ventricles are all influen-tial in predicting the life quality of survivors of hypertensive cerebral hemorrhage in the basal ganglia.

ObjectiveTo explore the new rehabilitation model of medication combined with education of cerebral palsy.MethodsThe cross-professionals were organized to assess and observe 126 children with cerebral palsy. Then, individual education plan (IEP) combined with medication, family, feeding was made and performed.ResultsAfter educational rehabilitation, the children with cerebral palsy got improvement in intellection, social adaptation, communion aspiration, thinking and etc. They became more cooperated in medical rehabilitation.ConclusionInterdisciplinary cooperation, IEP, participation of parents are the conditions for success of medical rehabilitation combined with education.

Objective To purify native and recombinant heparin-binding hemagglutinin(HBHA)protein,and investigate the activity of HBHA polyclonal antibody against aggregation of Bacillus CalmetteGuerin(BCG)induced by HBHA.Methods After growing BCG to the stationary phase in the 7H9 liquid medium,the native HBHA protein(nHBHA)was obtained by CL-6B column chromatography.At the same time,the HBHA gene fragment was cloned and expressed by transforming Escherichia coli BL-21.Then the polyclonal antibody against rHBHA was prepared by immunizing rabbit.Different comcentration of the HBHA protein was added to the BCG liquid medium,and the aggregation of the BCG was observed.Then,add the HBHA protein that incubated with anti-HBHA antibodies to the BCG culture medium and observe the aggregation of BCG.Results The purity of native HBHA was 99% and the concentration was 1.016 mg/ml.The expressed product contained 36% of total somtic protein.After purified,the purity of the recombinant HBHA protein was 97.1% and the concentration was 10.98 mg/ml.Both the rHBHA and nHBHA could induce the aggregation of BCG.When then concentration of nHBHA is 0.2μg/ml,BCG could be induced to aggregate,while the rHBHA concentration is 2μg/ml could induce the aggregation.Both aggregations could be suppressed by the polyclonal antibody against rHBHA.Conclusions The native and recombinant HBHA are successfully obtained.It is proved that the rHBHA could induce the aggregation of BCG similar as nHBHA,and polyclonal antibody against rHBHA could also suppress the activity of nHBHA.It suggested that rHBHA could be further used in clinical diagnosis and vaccination.

Objective To establish a accurate and rapid method of loop-mediated isothermal amplification(LAMP) for detecting Legionella Pneumophila(LP) .Methods The strains of LP ,Staphylococcus aureus ,Pseudomonas aeruginosa ,Escherichia coli ,Enterobacter sakazakii ,Listeria monocytogenes ,Salmonella typhimurium ,shigella flexneri and Vibrio parahaemolyticus were selected . According to six special domains of toxicity-related mip gene on LP ,the LAMP primers(mip-1 ,mip-2 ,mip-3) were designed by using the Primer Explorer Version 4 .0 .The genomic DNA was extracted for conducting LAMP .Then its specificity ,lowest detectable limit and stability were evaluated .Results The screened primer mip-3 appeared the peak after amplification for about 10 min in the LAMP reaction system for detecting LP ,moreover the peak value was higher ;while the strains of non-LP had no amplification reaction ;the LAMP detection limit could reach 100 fg/μL .The primer mip-3 appeared the peak almost at the same time in 20 times of duplicated detection ,and its stability was good .Conclusion The established LAMP detection method has the advantages of strong specificity and high stability ,can rapidly and accurately detect LP and has large prospect of promotion and application .

Objective: To evaluate the effectiveness for the construction of "mosquito-free village" in Xuejia Village, Pujiang County, Zhejiang Province, so as to provide the guidance for the construction of "mosquito-free village" in other rural areas. Methods: Density of adult mosquitoes in Xuejia Village was investigated using light trap method and density of larval mosquitoes was investigated using larval straw method from April to November each year. Totally 30 households of villagers were randomly selected, and their awareness rates of mosquito control knowledge, mosquito control behavior forming rates and satisfaction rates were surveyed through questionnaires. Investment during construction (from August 2016 to December 2018) and maintenance period (from 2019 to 2023) of "mosquito-free village" were investigated through data review and interviews. Long-term effects of "mosquito-free village" construction in Xuejia Village were evaluated in terms of mosquito density from 2016 to 2023, effectiveness of health education for villagers, satisfaction and investment. Results: Compared with the year 2016, the densities of adult and larval mosquitoes in Xuejia Village were significantly decreased from 2017 to 2023. The average monthly density of adult mosquitoes in 2023 decreased by 98.34%, and the average monthly 100 household index of larval mosquitoes decreased by 98.45% compared to 2016. The average monthly density of adult mosquitoes from 2019 to 2023 was less than or equal to one mosquito per light trap in a night, and the average monthly 100 household index of larval mosquitoes was less than or equal to five places per 100 households. The awareness rate of mosquito control knowledge was 93.33%, the behavior forming rate was 86.67%, and the satisfaction rate was 90.00%. By December 2023, the total investment during construction and maintenance period was 450 thousand Yuan, with an average annual investment of 60.7 thousand Yuan and average annual investment of 206.61 Yuan per household. The average annual investment during maintenance period was 36.2 thousand Yuan, and the average annual investment per household was 109.70 Yuan. Conclusion The mosquito density, effectiveness of health education for villagers and satisfaction of "mosquito-free village" in Xuejia Village all meet the evaluation criteria of "mosquito-free village", and the investment is reasonable, making it suitable for promotion to other rural areas.

Objective To evaluate the effect of sevoflurane anesthesia on cognitive impairment in rats with traumatic brain injury. Methods One hundred and and twenty healthy male Wistar rats, aged 2-3 months, weighing 190-220 g, were assigned into 4 groups ( n=30 each) using a random number table method: control group ( group C) , traumatic brain injury group ( group T) , sevoflurane anesthesia group ( group S) , and traumatic brain injury plus sevoflurane anesthesia group ( group T+S) . A 40 g hammer was freely dropped onto the left parietal bone window from a height of 20 cm to establish the traumatic brain inju-ry model in T and T+S groups. Twelve days later, S and T+S groups inhaled 3％ sevoflurane for 3 h, and C and T groups inhaled pure oxygen for 3 h. On 1 day before anesthesia and 3 and 7 days after anesthesia, 10 rats in each group were randomly selected for performing Morris water maze test. Rats were sacrificed af-ter the end of Morris water maze test, and the hippocampal tissues were obtained for determination of the apoptosis rate of hippocampal neurons, cytoplasmic calcium concentration [Ca2+]i (by flow cytometry), expression of glucose-regulated protein 78 ( GRP78) and CCAAT∕enhancer-binding protein homologous pro-tein ( CHOP ) ( by immunohistochemistry ) , and expression of caspase-3 and caspase-12 ( by Western blot) . Results Compared with group C, the escape latency was significantly prolonged, the number of crossing platform was decreased, the apoptosis rate of hippocampal neurons and [ Ca2+] i were increased, and the expression of caspase-3, caspase-12, GRP78 and CHOP in hippocampal tissues was up-regulated in S, T and T+S groups ( P<0. 05) . Compared with T and S groups, the escape latency was significantly prolonged, the number of crossing platform was decreased, the apoptosis rate of hippocampal neurons and [ Ca2+] i were increased, and the expression of caspase-3, caspase-12, GRP78 and CHOP in hippocampal tissues was up-regulated in group T+S ( P<0. 05 ) . Conclusion Sevoflurane anesthesia can accentuate cognitive impairment in rats with traumatic brain injury, and the mechanism may be related to aggravating the degree of endoplasmic reticulum stress-induced calcium overload and increasing the apoptosis rate of hip-pocampal neurons.

Objective To evaluate the application value of polarized light dermoscopy in the diagnosis of vitiligo and differential diagnosis between vitiligo and other common hypopigmented diseases.Methods Dermoscopic images of lesions of 235 patients with confirmed vitiligo (130 with active vitiligo and 105 with stable vitiligo) were collected from the database in the Department of Dermatology,Xijing Hospital from January 2018 to July 2018,and retrospectively analyzed.Meanwhile,dermoscopic images of amelanotic nevus (151 cases),pityriasis alba (113 cases) and idiopathic guttate hypomelanosis (54 cases) were compared with the dermoscopic images of vitiligo.Chi-square test was used for comparison of rates among groups.Results The prevalence of perifollicular pigmentation,reticular pigmentation,starburst,Tapioca sago and micro-Koebner phenomenon was significantly higher in the patients with active vitiligo than in those with stable vitiligo (x2 =36.5,151.2,13.0,14.9,8.4 respectively,all P ＜ 0.05).The prevalence of perifollicular pigmentation,perilesional hyperpigmentation,perifollicular telangiectasia,leukotrichia was significantly higher in patients with stable vitiligo than in those with active vitiligo (x2 =91.2,166.0,54.3,41.1 respectively,all P ＜ 0.05).The prevalence of residual perifollicular pigmentation was significantly higher in patients with active (89.2％,116/130) or stable vitiligo (54.3％,57/105) than in those with amelanotic nevus (20.5％,31/151,P ＜ 0.05),pityriasis alba (12.4％,15/113,P ＜ 0.05)or idiopathic guttate hypomelanosis (9.3％,5/54,P ＜ 0.05).Conclusion Residual perifollicular pigmentation could serve as an important feature for distinguishing vitiligo from achromic nevus,pityriasis alba and idiopathic guttate hypomelanosis,and polarized light dermoscopy shows good value in the differential diagnosis between vitiligo and some hypopigmented diseases.