OBJECTIVE:To study the effects of combined use of cefoperazone/sulbactam(CFS),meropenem(MRP)with le-vofloxacin (LVX) on mutant prevention concentration for Acinetobacter baumannii so as to provide a experimental foundation for preventing bacterial drug resistance. METHODS:In the test,there were groups of single use of CFS,MRP and LVX,and groups of combined use of CFS+LVX and MRP+LVX. Double dilution agar method was used to respectively detect minimal inhibitory con-centration (MIC) for standard Acinetobacter baumannii strains ATCC 19606 and 36 clinically isolated strains in all groups,and then the index of fraction inhibitory concentration(FIC)was calculated. Agar dilution method on plates was employed to detect mu-tant prevention concentration (MPC) for Acinetobacter baumannii in all groups,and then corresponding selection index (SI) was calculated. RESULTS:After combined use of CFS or MRP with LVX,synergistic effect accounted for 55%(20/36)and 50%(18/36). For standard strain ATCC 19606,after combined use of CFS+LVX and MRP+LVX,MPC reduced from 32.0 and 4.0 mg/L to 1.8 and 0.8 mg/L;For 36 clinically isolated strains,after combined use of CFS+LVX and MRP+LVX,MPC reduced from 8.0-32.0 and 1.0-2.0 mg/L to 0.25-1.0 and 0.25-0.5 mg/L. SI were all obviously reduced after combination. CONCLUSIONS:The combina-tion of CFS or MRP with LVX can reduce MPC for Acinetobacter baumannii more significantly than the single use,and narrow mu-tant selection window.

Aim To study the change of mutant pre- vention concentration (MPC) in carbapenem-resistant Acinetobacter baumannii (CRAB) treated with moxi- floxacin ( MFX ) and/ or cefoperazone/ sulbactam (CFS) in vitro, and provide a theoretical support for preventing the bacterial resistance. Methods To cal- culate the fractional inhibitory concentration (FIC) in- dex, the minimum inhibitory concentration (MIC) of 20 clinical isolates of CRAB treated with MFX and/ or CFS was determined by checkerboard microdilution as- say. In addition, to calculate the selection index (SI), the MPC of 20 clinical isolates of CRAB treated with MFX and/ or CFS was determined by agar plate di- lution assay. Results Our study showed that there was synergistic/ addictive action, rather than antago- nism action against clinical isolates of CRAB when treated with MFX + CFS. The SI of the 20 isolates trea- ted with MFX or CFS alone was 4 ~128 and 8 ~64 re- spectively, but reduced to 1 ~8 and 4 ~16 when trea- ted with MFX + CFS, which decreased by 2 ~16 and 2 ~4 times respectively compared with the single treat- ment. Conclusion These results suggest that the combination treatment of MFX + CFS against clinical isolates of CRAB might lower the MPC of the isolates treated with MFX/ CFS alone, narrow the mutant selec- tion window, and prevent the generation of drug - re- sistant mutants.

Objective To observe the effects of exercise on serum adiponectin and adiponectin receptor (AdipoR) level in skeletal muscle of insulin-resistant rats. Methods A total of 30 healthy male rats were randomly divided into a control group ( NC, n = 8) and a high-fat group ( HF, n = 22), fed with normal chow and high fat diet, respectively. Eighteen weeks later, the high-fat group was randomly divided into a high-fat diet control group (HC, n = 10) and an exercise group (HE, n = 12). The HC and HE group were continually fed with high fat diet, while the HE group was administered with swimming training for 6 weeks in addition at the same time. After 24 weeks, the insulin sensitivity index was calculated, and serum adiponectin level was detected by using ELISA. The expressions of AdipoR mRNA in skeletal muscle were detected with real-time fluorescence quantitative polymerase chain reaction (PCR). Results After 18 weeks, compared to NC group, the insulin sensitivity index of HF group decreased significantly. It suggested that insulin resistance appeared in HF group. Twenty-four weeks later, compared to NC group, the ISI of HC group was significantly decreased, meanwhile the level of serum adiponectin, expression of AdipoR1 and AdipoR2 mRNA in skeletal muscle of HC group were 71.9% , 59.9% and 69.2% of those of the NC group, respectively; compared to HC group, the ISI was increased significantly by exercise, meanwhile the expression of AdipoR1 mRNA in skeletal muscle was significantly increased by 1.33 times, however the level of serum adiponectin and the expression of AdipoR2 mRNA in skeletal muscle were not altered in HE group. Conclusion Six weeks of exercise improves insulin sensitivity through increasing the expression of AdipoRI mRNA in skeletal muscle.

Objective To compare the toxicity and anti-inflammatory effect of total saponins from Panax japonicus by different extraction technology. Methods The total saponins of sample 1, sample 2, sample 3, sample 4, sample 5 and sample 6 was prepared respectively by different process, and RAW264.7 cells were treated with the samples of different concentration. Then cells morphology was observed under microscope, thiazolyl blue (MTT) method was used to detect cell activity, the nitric oxide (NO) release of RAW264.7 cells was detected with NO kit. Results The cell toxicity of different samples from low to high was as follows:sample 4sample 5>sample 2>sample 6>sample 1>sample 3. Conclusion Among these six different kinds of extraction process of total saponins from Panax japonicus, the total saponins extract by foam fractionation has not only the minimal toxicity, but also the best primary anti-inflammatory effect.

Objective To evaluate the correlation of ADC values on 3.0 T MR with the pathological grades in pT1b clear cell renal cell carcinoma(CCRCC).Methods Conventional MR images,ADC values and Fuhrman pathological grading of pT1b CCRCC were performed in 30 patients.Grade Ⅰ and Ⅱ were defined as low-grade group; grade Ⅲ and IV were defined as high-grade group.The differences of ADC values among four different pathologic grades were compared with a one-way analysis of variance. The comparison of ADC values of two different grade groups was performed with t test,and the ROC curve was performed to evaluate the diagnostic efficacy of ADC value. Correlation between pathological gradings and ADC values was assessed with Spearman rank correlation analysis. Results ( 1 ) The mean ADC value of grading Ⅰ ( 10 patients ), Ⅱ ( 8 patients ),Ⅲ ( 7 patients ),IV ( 5 patients ) was ( 0.94 ± 0.11 ) ×10-3 mm2/s,(0.82 ±0.13) × 10-3 mm2/s,(0.68 ±0.09) × 10-3 mm2/s,(0.59 ±0.03) × 10-3 mm2/s,respectively.Significant differences of ADC values among the four grades were present (F =16.422,P =0.000 ).( 2 ) The mean ADC value of the low-grade group was significantly higher than that of the high-grade group(t =5.738,P =0.000).Sensitivity and specificity of diagnosing the low-grade group was 88.9％ and 83.3％ respectively.There was a negative correlation between pathological grading and ADC value ( r =-0.807,P ＜ 0.05). Conclusions The ADC values of pT1b CCRCC have close correlation with pathological gradings.They can be used to predict the degree of tumor malignancy preoperatively and guide surgical planning.

Objective:To observe the clinical effect of four-point fixation in patients with posterior chamber intraocular lens dislocation.Methods:A retrospective case series study was adopted.Sixteen patients (16 eyes) with posterior chamber intraocular lens dislocation who underwent suture suspension techniques with four-point fixation in Changzhou No.2 people's Hospital from January 2015 to January 2018 were enrolled.Postoperative effects were observed during follow-up, ranging from 6 to 13 months.The preoperative and 6-month postoperative uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), corneal endothelium cell count and astigmatism were measured and the differences were compared, and the relationships between total astigmatism and corneal astigmatism or intraocular lens induced astigmatism were analyzed, and the postoperative position of intraocular lens and complications were observed.This study adhered to the Declaration of Helsinki.The study protocol was approved by an Ethics Committee of Changzhou No.2 People's Hospital (No.2015-C-012-01).Written informed consent was obtained from each patient before surgery.Results:The mean preoperative UCVA (LogMAR) and BCVA (LogMAR) were 1.09±0.24 and 0.48±0.20, respectively, which were significantly improved to 0.30±0.12 and 0.26±0.13 at 6 months after operation, respectively.And the differences were statistically significant ( t=11.782, 3.795; both at P<0.01).The preoperative and 6-month postoperative corneal endothelium cell count were (2 270±360)/mm 2 and (2 032±327)/mm 2, respectively, and the difference was not significant ( t=1.921, P=0.074).The 6-month postoperative mean total astigmatism, corneal astigmatism and intraocular lens induced astigmatism were (-1.47±0.82)D, (-1.34±0.61)D and (-0.22±0.35)D, respectively.There was a highly positive correlation between total astigmatism and corneal astigmatism ( r=0.885, P<0.05), but there was no significant correlation between total astigmatism and intraocular lens induced astigmatism ( r=-0.432, P=0.095).No dislocation, deviation or torsion of intraocular lens were observed during the follow-up.Varying degree of symptoms of iridocyclitis were observed during early stage after operation, which disappeared after treatment.There were two cases of high intraocular pressure, which were normal after treatment.No retinal detachment, choroidal detachment, expulsive suprachoroidal hemorrhage, endophthalmitis, corneal endothelial decompensation or other complications occurred during and after operation. Conclusions:There is a stable position of intraocular lens, good visual acuity and few complications after four-point fixation with suture and suspension, which is a feasible method to treat dislocated intraocular lens.

Objective To establish the method and cardiovascular imaging in mice using ultrasound biomicroscopy(UBM) with anatomical confirmation by magnetic resonance (MR) imaging, and to evaluate the feasibility and value of UBM in mice cardiovascular imaging.Methods The mouse thoracic anatomy was elucidated using Signo 3.0T MR imaging on 2 healthy C57BL/6 adult male mice.The structures and flow of mice heart and great vessels in 16 healthy C57BL/6 adult male mice were showed and analyzed by Visualsonics Vevo 770 UBM through several acoustic windows, including left parasternal, right parasternal, apical regions, and suprasternalis.The systolic and diastolic function of mice heart were also evaluated.ResultsAnatomic characteristic of mice could be displayed by MR imaging.The heart was mostly located in left thoracic cavity.The angle between long axis of the heart and the midline of the chest was about 45 degrees.Left atrium,left ventricle, mitral valve and right ventricle were located on the left side of the midline of the chest.Aortic valve orifice, ascending aorta,right atrium and tricuspid valve were located on the right side of the midline of the chest.Left heart long axis view,left ventricular short axis view,ascending aorta long axis view,long axis view of aortic arch, aortic short axis view, right ventricular inflow tract long axis view, pulmonary artery long axis view and so on were obtained clearly using UBM.The structures of heart and great vessels were displayed and the cardiovascular parameters could be measured accurately,including left atrium,left ventricle,aorta and aortic arch,interventricular septum,right atrium, right ventricle, pulmonary artery, innominate artery, right internal carotid artery and the velocity in each valve orifices from Doppler flow spectrum.No significant difference was found in the measurements between different age groups.Conclusions The cardiovascular structures and hemodynamics could be displayed by UBM in mice when appropriate acoustic windows and sections were selected.This novel imaging protocol provides us a non-invasive way to follow atherosclerosis in genes knockout mice.

Perfluorinated compounds (PFCs), a group of persistent organic pollutants, have been widely detected in environmental media and posed great threat to human health. The researches on environmental pollution and health concern of PFCs are the hotspot areas. Because PFCs contain lots of homologs and isomers which are detected at trace levels (ng/g or μg/L) in environment, advanced and reliable analytical methods for determination of PFCs in environment are urgently needed. At present, studies on analytical methods of trace PFCs in environmental samples have been widely carried out in China and abroad. However, systematic review on the sample pretreatment, analytical method, and matrix effect of PFCs determination in complex environmental matrixes is relatively scarce. Therefore, this paper reviews the pretreatment methods, martix effects, and detection techniques (especailly isomers) of PFCs in environment samples (water, sediment/sluge, soil and plant). We hope that this review may provide valuable reference for the enviromental researches on PFCs.

Objective To explore the comprehensive approach and efficacy of secondary unilateral cleft rhinoplasty by using autologous costal cartilage grafts.Methods Secondary rhinoplasty was performed in 28 patients with unilateral cleft-lip nasal deformity.The costal cartilage was harvested through a mini-invasive incision.Septal deviation was corrected,and nasal tip framework was reconstructed with the autologous costal cartilage through direct transcolumellar incision.Diced cartilage fragments were used to augment the depressed alar base.Nasolabial muscles were repositioned to restore the balance of muscular tension system.Results The appearance of the nasal deformity was greatly improved in all the 28 cases postoperatively by follow-up from 3 to 12 months.Increased stability and symmetry of the nasal tip,along with the improvement of nasal breathing function was achieved and sustained effectively.Conclusions Definitive secondary unilateral cleft rhinoplasty using autologous costal cartilage grafts provides good aesthetic and functional results.

Objective: To understand the correlation between ambient ozone (O₃) and premature birth in Taiyuan. Methods: The data of O₃ daily average concentrations and maximum concentration of 8 hours, PM_2.5 daily average concentrations, meteorological factors (including the average temperature and relative humidity) and daily premature birth numbers during 2013-2015 were collected in Taiyuan from China National Environmental Monitoring Center and China Meteorological Administration. The models were developed by using generalized linear model. The gender of the premature birth was analyzed by subgroup analysis. Sensitive analysis were used to estimate the model stability. Results: Ambient O₃ daily average concentrations and maximum concentration of 8 hours in Taiyuan of 2013 to 2015 were 45.35 μg/m³ and 71.33 μg/m³ respectively. In single pollutant model, the effects of different window exposures on premature birth were different. The RR of preterm birth about an increase of 10 μg/m³ of O₃ (lag 3 weeks, lag 4 weeks) were 1.090 (95%CI: 1.042-1.139), 1.095 (95%CI: 1.032-1.163) respectively. According to the infant gender subgroup analysis, male infants were more likely to be affected by ambient O₃. The average daily of O₃ concentration increased by 10 μg/m³, and the RR for male infants and female infant were 1.013 (95%CI: 0.997-1.029), 0.996 (95%CI: 0.983-1.010) respectively. By comparing the daily average concentration of O₃ with the maximum daily concentration of O₃ for 8 hours as an indicator of exposure, it was found that the daily average concentration of O₃ was more sensitive. The RR of preterm birth about an increase of 10 μg/m³ of average daily of O₃ concentration and the maximum daily concentration of O₃ for 8 hours. were 1.006 (95%CI: 0.994-1.017) and 0.997 (95%CI: 0.988-1.005) respectively. As for sensitive analysis, when O₃ introduced PM_2.5 or change the degree of model variables, the association of premature birth was still constant. Conclusion Prenatal exposure to O₃ may increase the risk of premature birth, with different window exposures premature births have different risks and this risk is more pronounced in male infants.