@@

Abstract: Objective　To analyze the genotype of carbapenemase resistance genes and their genetic homology in multidrug-resistant Acinetobacter baumannii, and to provide a theoretical basis for guiding the rational use of antibiotics and controlling the prevalence of nosocomial infections. Methods A total of 83 multidrug-resistant Acinetobacter baumannii isolated from patients in the intensive care unit (ICU) and environmental specimens in the Sixth People's Hospital of Nantong from July 2020 to December 2021 were collected. The bacteria were identified and subjected to drug sensitivity tests using the BioMérieux DL96-Ⅱ automatic bacterial identification susceptibility system. The carbapenemase-related drug resistance gene types were detected using the polymerase chain reaction (PCR) method, and clones were analyzed by pulsed field gel electrophoresis (PFGE). Results The types of 83 ICU Acinetobacter baumannii specimens include sputum (43 strains), broncholavage fluid (20 strains), and surfaces of objects such as ventilators (20 strains). The resistance rates of all strains to imipenem, tetracycline, gentamicin, amikacin and ciprofloxacin were 100%, 32.5%, 38.6%, 41.0% and 77.1% respecitively, while the resistance rates to others such as ticarcillin and clavulanate were greater than 95%. All strains carried were detected to carry OXA-23 and OXA-51 genes, while OXA-24, OXA-58, IMP-1, VIM, IMP-4, SIM and NDM-1 resistance genes were all negative. PFGE homology analysis confirmed that 83 strains of Acinetobacter baumannii, with counts of 12, 18, 12, 13, 10, 6, 7, 5 respectively, mainly A, B, C, D, E clones, the rest were sporadic clones. Conclusions The carbapenem resistant Acinetobacter baumannii isolated from our ICU are widely drug-resistant to commonly used antimicrobial drugs, with B clone strain being the major prevalent strain. Carrying OXA-23 and OXA-51 genes may be an important reason for the resistance of Acinetobacter baumannii to carbapenem antibiotics in our ICU. Rational use of antimicrobial drugs, enhanced monitoring of bacterial resistance, and effective control of the generation and further spread of drug-resistant strains should be emphasized.

BACKGROUND:As propofol has a neuroprotective effect, and umbilical cord blood mesenchymal stem cel s have a high differentiation potential, their combination wil have a better therapeutic effect on cerebral ischemia-reperfusion injury. OBJECTIVE:To study the effect of propofol pretreatment combined with umbilical blood mesenchymal stem cel transplantation on cerebral ischemia-reperfusion injury in rats. METHODS:Sixty-three Sprague-Dawley rats were randomized into model, propofol, and combined group (n=21 per group). Rat models of cerebral ischemia-reperfusion injury were made using ligation of the middle cerebral artery occlusion in the three groups. Rats in the combined group were given 100 mg/kg propofol injection at 1 day before injury and injection of umbilical blood mesenchymal stem cel s via the tail vein (0.5 mL, 2×109/L). RESULTS AND CONCLUSION:Compared with the model group, the neurological function was improved significantly in the propofol and combined group, especial y in the latter one, presenting with a remarkable mitigation in brain injury and an increased level of survivn mRNA in the rat hippocampus. The content of serum malondialdehyde was lower but the activity of superoxide dismutase was higher in the combined group compared with the propofol group. These findings indicate that propofol pretreatment combined with umbilical blood mesenchymal stem cel transplantation has better therapeutic effects than propofol pretreamtnet alone for improving cerebral ischemia-reperfusion injury in rats.

Objective To assess the clinical outcomes about the visual qulitity of toric implantable contact lens ( TICL) implantation for high myopia with astigmatism. Methods Fifty-two eyes of 27 patients that underwent TICL implantation were examined. Uncorrected visual acuity( UCVA) ,best corrected visual acuity( BCVA) ,refraction,contrast sensitivity ( CS) with and without glare were evaluated before and after the treatment. Results Significant improvement in UCVA and BCVA were found at 1 month and 6 months after treatment (P<0. 05). The refraction at 1 month ( -0. 56 ± 0. 42)D and 6 months ( -0. 58 ± 0. 22)D after treatment were of no significant difference (P>0. 05), and the astigmatism at 1 month ( -0. 35 ± 0. 60)D and 6 months ( -0. 31 ± 0. 42)D after treatment were of no significant difference either (P>0. 05). The CS with and without glare were all significantly better than results before operation for 6. 0,12. 0 and 18. 0 cycles/degree (P<0. 05),but there were no significant difference between 1 month and 6 months after treatment (P>0. 05). No significant difference were found preoperatively,1 month after treatment and 6 months after treatment in terms of CS with and without glare (P>0. 05). The satisfaction of this investigation was 100%. Conclusion The TICL performed well in correcting high myopia with astigmatism,and it is a good surgical option for the treatment.

Vascular endothelial growth factor,hypoxia inducible factor,interleukin,angiopoietin-like protein,integrin and epithelial mesenchymal transition can provide nutritional support and favorable environment for the growth,invasion and metastasis of cancer cells.Researches about mechanisms of the angiogenesis in esophageal squamous cell carcinoma may provide more ideas and potential targets for the anti-angiogenesis targeted therapy.

Objective:To explore the influence of different blood glucose level at hospitalization on no-reflow and prognosis in patients with acute myocardial infarction (AMI),but without diabetes after emergency percutaneous coronary intervention (PCI).Methods:A total of 678 non-diabetic AMI patients undergoing PCI were selected.Ac-cording to blood glucose level at hospitalization,patients were divided into normal group (n=312),blood glucose level higher group (higher group ,n=201)and blood glucose level extremely high group (extremely high group,n=165).Clinical characteristics,no-reflow after PCI and incidence of cardiovascular events within 30d after PCI were compared among three groups.Results:Compared with normal group and higher group,there were significant rise in age,percentages of >1 location of myocardial infarction and Killip's ≥ class II,white blood cell count instant af-ter hospitalization,peak value of creatine kinase (CK)and CK-isoenzyme (CK-MB)in extremely high group,P <0.01 all;Compared with normal group,the age,peak value of CK and CK-MB significantly rose in higher group (P<0.01 all).Along with blood glucose rose,incidence rate of no-reflow significantly increased (17.0% vs.38.8%vs.49.7%),left ventricular ejection fraction (LVEF)on 30d after PCI gradually reduced [(68.6± 5.7)% vs. (62.2±6.4)% vs.(55.6±6.9)%]in above-mentioned 3 groups in turn,there was significant difference between any two groups,P <0.05 or <0.01.Conclusion:Stress hyperglycemia possesses great influence on no-reflow and prognosis in non-diabetic AMI patients after PCI.

Aim To investigate the effect of resveratrol (Res)on septic mice and LPS-insulted H9c2 cells,as well as its involved mechanisms.Methods By use of a mouse cecal ligation and puncture-induced septic model (CLP),the survival of septic mice was evalua-ted after resveratrol treatments.H9c2 cells were insul-ted by LPS and then treated with resveratrol,the mR-NA expressions of TNF-α,SIRT1 and other class III HDAC members were detected using RT-PCR and real-time PCR,Finally,the protein levels of nuclear p65, an important subunit of NF-κB,were measured in H9c2 cells using Western blot assay,to reveal the effect of resveratrol on LPS-induced nuclear transloca-tion of NF-κB.Results Compared with the control septic animals,intraperitoneal injection of resveratrol (1 or 5 mg·kg -1 ·d -1 )significantly increased the survival of septic mice.Furthermore,resveratrol signif-icantly increased mRNA expressions of SIRT1,SIRT2, SIRT6 and SIRT7 in LPS-insulted H9c2 cells.Res-veratrol also remarkably inhibited LPS-induced nuclear translocation of NF-κB.Conclusion An appropriate dose of resveratrol protects septic mouse hearts from the injury induced by LPS through the activation of SIRT family members and the inhibition of NF-κB pathway.

3T3-L1 adipocytes transfected with TSH receptor (TSHR) shRNA were incubated with bovine TSH.The concentration of tumor necrosis factor (TNF)-α in culture medium was measured by enzyme linked immunosorbent asssy.Protein level of insulin receptor substrate 1 (IRS-1) was quantified by Western blotting.Tyrosine phosphorylation of IRS-1 was measured by immunoprecipitation.The results showed that 1 mIU/ml TSH significantly sitmulated TNF-α release in 3T3-L1 adipocytes [(341.85 ± 12.00 vs 522.67 ± 36.22) ng/L,P＜0.01],along with the decreases in IRS-1 protein expression and its tyrosine phosphorylation (P＜ 0.01).These effects disappeared when TSHR expression was down-regulated with RNA interference in 3T3-L1 adipocytes.In addition,WP9QY,a TNF-α antagonist,blocked TSH-decreased IRS-1 expresssion.These results suggest that TSH downregulates IRS-1 protein expression and its tyrosine phosphorylation through stimulating production of TNF-α,and thus contributes to the development of insulin resistance.

Objective To explore the relationship between vascular lesions and benign paroxysmal positional vertigo in the elderly.Methods 74 patients aged 60 years and over with benign paroxysmal positional vertigo in Huanhu Hospital and 80 subjects without vertigo history in the medical examination center of the same hospital were randomly divided into the case group and the control group,respectively.The carotid intima-media thickness (CIMT) and plaque in the carotid artery were detected using high-resolution color duplex ultrasound for evaluating large vascular lesions.At the same time,T1WI,T2WI and diffusion weighted imaging (DWI) were performed with high-field 3.0 T MRI scanner as the detection index of small vascular lesions to compare the difference in severity of lacunar infarction,leukoaraiosis and micro hemorrhage between the two groups.Both indexes were used together to compare the overall difference in the intracranial and extracranial vascular lesions between the two groups.Results Between the case group and the control group,there were significant differences in the CIMT [(0.96±0.21) mm vs.(0.84±0.26) mm,t=3.136,P＜0.05],the detection rate of plaque (89.2％ vs.72.5％,x2 =5.803,P＜0.05),the number of lacunar infarction [(3.48± 1.67) vs.(2.34± 2.06),t=1.994,P＜0.05] and the score of white matter [(4.77±2.15) vs.(3.95±2.04),t=2.430,P＜0.05].There was no significant difference in the positive detection rate of the cerebral microbleeds in the case group and control group (22.9％ vs.17.5％,x2=0.4264,P＞0.05).Conclusions There is a relationship between the benign paroxysmal positional vertigo and intracranial or extracranial vascular lesions in the elderly.Vascular factor may play an important role in the pathogenesis of benign paroxysmal positional vertigo.Not only the atherosclerosis of large and small arteries but also the microcirculation disturbance may be partly attributed to the benign paroxysmal positional vertigo in the elderly.

Objective To test thyroid-stimulating hormone (TSH) suppress GLUT4 expression and translocation by stimulating TNF-α secretion in 3T3-L1 adipocytes via a cAMP-PKA pathway.Methods 3T3-L1 preadipocytes were induced to differentiate into adipocytes.The adipocytes were treated with bovine TSH,Forskolin,H89 and Rapamycin,respectively.The concentration of TNF-α in the cell culture medium was measured by ELISA.The level of GLUT4 mRNA in adipocytes was assessed by real time polymerase chain reaction.Protein levels of GLUT4 in total cell lysates and plasma membrane lysates were quantified by Western blotting.Results Incubating 3T3-L1 adipocytes with TSH markedly increased the concentration of TNF-α in medium in a time-and dosedependent manner (P ＜ 0.05); meanwhile,the levels of GLUT4 mRNA and total and plasma membrane GLUT4 protein were decreased in a dose-dependent manner (P＜0.05 or ＜0.01).H89 and rapamycin could block the above effects respectively (326.7±43.2 vs.341.9±12.0,P＞0.05).However,there was no statistical difference in the TNF-α levels between stimulation with 1 μmmol/L forskolin versus 0.04 μmmol/L bovine TSH (481.9± 28.4 vs.522.7± 36.2,P＞0.05).Conclusions TSH can down-regulate GLUT4 expression and translocation in 3T3-L1 adipocytes by stimulating TNF-α secretion through a cAMP-PKA pathway.