Objective Malrotation of intestine with midgut volvulus is a special disease in newbo-rns.It is important of early diagnosis to avoid the risk of intestinal infarct and necrosis.We intended to ex-plore the value of early ultrasonographic diagnosis in malrotation of intestine with midgut volvulus,comparing with upper gastrointestinal imaging.Methods Ultrasonographic features and upper gastrointestinal imaging of 48surgically confirmed malrotation of intestine with midgut volvulus between January 2011and December 2014were retrospectively analyzed.Results All patients were comfirmed by operaion.The rotational degree of midgut volvulus were 90to 720°.In 43of 48patients (89.58%)of malrotation of intestine with midgut volvulus were diagnosed by ultrasonography.The typical ultrasonographic features were called “whirlpool sign”,which was the superior mesenteric vein and the mesentery around the superior mesenteric artery.In 35 of 48(72.92%)patients with malrotation were confirmed by the upper gastrointestinal imaging.The typical sign of the upper gastrointestinal imaging was the helical form of the distal duodenum and proximal jejunum located at middle abdomen.Compared with upper gastrointestinal radiographic examination,ultrasonographic examination had more sensitivity in diagnosis of malrotation of intestine with midgut volvulus (P﹤0.05). Conclusion Ultrasonographic examination have more sensitivity in diagnosis.Noninvasiveness,absence of X-rays,and low costs could make ultrasonographic examination a useful screening test in patients with sus-pected malrotation of intestine with midgut volvulus.“Whirlpool sign”could be considered a specific ultra-sonographic sign in diagnosis of midgut volvulus,which could provide reference for the clinical treatment of malrotation of intestine with midgut volvulus.

Anidulafungin is an effective antifungal medicine, which can inhibit activities of candida in vitro and in vivo. Echinocandin B (ECB) is the key precursor of Anidulafungin, thus the price and market prospect of Anidulafungin is directly due to the fermentation titer of ECB. In this study, Aspergillus nidulans was used for ECB fermentation, and the influence of adding microparticles on ECB fermentation was studied, such as talcum powder, Al2O3, and glass beads. The particle size and concentration were the key factors for mycelium morphology and ECB production, and ECB production could reach 1 262.9 mg/L and 1 344.1 mg/L by adding talcum powder of 20 g/L (d50 = 14.2 μm) and 7 glass beads (6 mm), an increase by 33.2% and 41.7%, respectively. The results indicated that the mycelium morphology of filamentous microorganisms and the product yield of fermentation could be improved by adding microparticles remarkably, and it provide an important method for the fermentative optimization of filamentous microorganisms.
Antifungal Agents ; metabolism ; Aspergillus nidulans ; metabolism ; Echinocandins ; biosynthesis ; Fermentation ; Fungal Proteins ; biosynthesis ; Industrial Microbiology ; methods

Objectives This study was conducted to detect and analyze the presence of plasmidmediated quinolone resistance (PMQR) determinants [qnr,aac-(6′)-Ib-cr and qepA] among clinical isolates of Citrobacter freundii strains isolated from patients in Anhui,China,and to understand the susceptibility of PMQR positive strains to commonly used antimicrobial agents.Methods During the year 2009,31 Citrobacter strains were collected from the First Affiliated Hospital of Anhui Medical University.Polymerase chain reaction (PCR) was used to detect PMQR genes.Amplicons were purified,sequenced and compared with data from the GenBank.Conjugation experiments were conducted to determine whether the qnr-carrying plasmids were self-transferable.The susceptibility of the positive isolates and transconjugants were tested by agar dilution method according to Clinical and Laboratory Standards Institute (CLSI) guidelines.The minimum inhibitory concentrations (MIC) of ciprofloxacin and levofloxacin were determined by E-test strips.Results Among the 31 Citrobacter strains,the qnr genes were detected in 8 isolates (25.8％),among which,6 carried qnrB.Aac-(6′)-Ib-cr and qepA were not identified in these isolates.The qnr genes were transferred from four clinical isolates to their transconjugants.Sequence analysis identified one novel qnrB variant (qnrB24).The resistant rate of qnr-positive clinical isolates to quinolone was 87.5 ％.Most of them were also resistant to various other antibiotics,including cefotaxime (75.0 ％),amikacin (7.5 ％),ceftazidime (62.5 ％),cefapime (37.5 ％),and gentamycin (87.5 ％).All qnr positive strains were susceptible to imipenem.MIC of all transconjugants showed reduced susceptibility to fluoroquinolones,with MIC increased by 10-23 folds.Conclusions Our study shows that qnr gene has occurred in Citrobacter freundii isolates from Anhui Province,China.QnrB is most prevalent in these isolates.Most qnr positive isolates are resistant to commonly used antimicrobial agents.

This paper analyzed the articles from the journal of Chinese Medical Ethics published for 30 years. The results showed that the development of medical ethics in China can be divided into four stages, the incubation period, the slow growth period, the rapid growth period and the stable period;regional distribution was affected by economic development, and the development of medical ethics was also relatively backward in areas where econom-ic development was relatively backward;the number of columns was increasing year by year, the classification tend to be refined, the proportion of each column was fluctuating with the change of the social hotspot, and in recent years, the doctor -patient relationship and medical management and system construction had received more and more attention;and the paper cooperation degree need to be improved, the number of quotations and cited quota-tions steadily improved, and the quality of the paper was improved. Therefore, the government should strengthen policy guidance and standardize the development of medical ethics; the academic level should focus on regional differences and promote academic communication and disciplinary development; and on the individual level, the new medical ethics problem should be concerned, and the research on the hotspots of medical ethics should be car-ried out.

Objective To explore the effect of Exosomes isolated from the A549 lung cancer cells on the proliferation of these cells and their ho?mologous tumor cells,HCC827,and the role of the PI3K/Akt and SRC signaling pathways in this process. Methods Exosomes were isolated from the supernatant after density gradient centrifugation of A549 cells. The Exosomes morphology was observed by transmission electron microscopy. The expression of the Exosome?specific proteins was analyzed using Western blotting. Cell proliferation was investigated using the MTT assay. Re?sults The A549?derived Exosomes were 30?100 nm in diameter and had a bilayer membrane.Western blotting showed that CD9 was detected in these Exosomes. The isolated Exosomes promoted the proliferation of the A549 and the HCC827 cells in a dose?and time?dependent manner,ac?companied by the activation of Akt and SRC. Conclusion Exosomes isolated from A549 cells promote the proliferation of the secreting cells and the homologous tumor cells in a dose?and time?dependent manner. The mechanism may be related to the activation of Akt and SRC.

Objective To investigate the effect of Exosomes derived from lung cancer cells on the migration of secretory cells and homologous tumor cells and to explore the role of PI3K/Akt and SRC signaling pathways in this process.Methods Exosomes were isolated from the supematant post density gradient centrifugation of A549,lung cancer cells.Morphology of the Exosomes was studied using transmission electron microscopy.Protein expression was analyzed using Western blotting.Cell migration was analyzed by a transwell assay.Results The double-membrane-bound Exosomes appeared as discal-shaped structures,30-100 nm in diameter.Western blotting showed that CD9 was abundant in the Exosomes.The Exosomes promoted the migration of A549 cells and their homologous tumor cells,HCC827 in a dose-dependent manner,accompanied by the activation of Akt and SRC.Conclusion The Exosomes derived from A549 (lung cancer) cells promote the migration of the secreting cells and the homologous tumor cells.The mechanism may be correlated with the activation of Akt and SRC.

Objective To investigate the status of anxiety, depression and family function in infertile patients in day-care wards , and to explore the effects of continuing nursing on their negative emotions and family adaptability. Methods A total of 50 infertile women patients who were treated in day-care ward from February to August 2017 were selected in this study using systematic sampling. The participants were randomly divided into the intervention group (n=24) and the control group (n=26). The control group was given routine education and general psychological care at discharge. In contrast, the intervention group received continuous nursing after discharge which including establishing follow-up files, conducting group psychotherapy, and health education through the internet. Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), and Family Assessment Device (FAD) were used for the assessment before and two months after the discharging. The spontaneous ovulation rate and natural pregnancy rate were compared between two groups. Results There were no significant difference in HAMA scores between the two groups (P> 0.05). The HAMD score in the intervention group was significantly lower compared with the control group after two months of intervention (P< 0.01). After the intervention, the scores of communication skills, role positioning skills and behavior control dimensions regarding the family function in the intervention group were significantly lower than those in the control group (P<0.05). Moreover, the spontaneous ovulation and natural pregnancy rate in both groups increased but had no significant difference between two groups (P>0.05). Conclusions The continuing nursing has a good clinical effect on improving the depression and family function of infertile patients in the day-care ward. It is an extended service based on humanistic care and is worth developing in the day-care ward.

Objective To investigate the effect of microRNA-1183 on proliferation and metastasis on gastric cancer cells and to explore the role of microRNA-1183 and CBL-B signaling pathways in this process. Methods MGC803 cells were transfected with a microRNA-1183 mimic. Real-time PCR detected the expression of microRNA-1183 in gastric cancer cell line MGC803. MTT detected the proliferative effect of microRNA-1183 on MGC803 gastric cancer cells. A Transwell assay detected the effect of microRNA-1183 on the metastasis of MGC803 gastric cancer cells. A dual luciferase reporter assay detected the binding ability between microRNA-1183 and CBL-B. The expression of the protein was tested by Western blotting. Results MTT assay results showed that microRNA-1183 promoted the proliferation of MGC803 cells. Transwell assay results revealed that microRNA-1183 promoted the metastasis of MGC803 cells. The results of BLAST contrast analysis show that CBL-B is one of the target genes of microRNA-1183. Western blotting analysis showed that the mimic microRNA-1183 inhibited the expression of CBL-B. A dual luciferase reporter assay showed that CBL-B was the target gene of microRNA-1183. A CBL-B knockdown promoted the proliferation and metastasis of MGC803 cells. microRNA-1183 promoted the proliferation and metastasis of MGC803 cells by inhibiting the expression of CBL-B. Conclusion microRNA-1183 can inhibit the proliferation and metastasis of gastric cancer cell lines by inhibiting the expression of CBL-B.

Objective:To explore the relationship between proactive personality, resilience and achievement motivation of military cadets, and to explore the mediating role of resilience between proactive personality and achievement motivation, as well as the moderating effect of cadets’leading ability on this mediating role.Methods:In this study, 109 military cadets were measured with proactive personality scale, Connor-Davidson resilience scale (CD-RISC) and achievement motivation scale. SPSS 26.0 was used for descriptive statistical analysis and correlation analysis.Results:①There was a significant correlation among the total scores of proactive personality, resilience and achievement motivation ( Ps<0.01). ②Proactive personality could significantly predict the level of achievement motivation ( a=0.454, P<0.001), and resilience could significantly predict the level of achievement motivation ( b=0.231, P=0.019). ③Resilience significantly mediated the relationship between proactive personality and achievement motivation ( c′=0.3, P=0.003). ④Cadets' leading ability moderated the effect of resilience on achievement motivation (index=0.338, 95% CI: 0.057 to 0.881). The mediating effect of resilience between proactive personality and achievement motivation was significant for cadets' leaders (Effect=0.381, 95% CI: 0.085 to 1.005), but not significant for other students (Effect=0.043, 95% CI: -0.069 to 0.252). Conclusion:The proactive personality of military cadets can affect the level of achievement motivation through psychological resilience, which is also moderated by cadre identity, suggesting that military education should improve the level of achievement motivation in many ways.

Objective:To analyze the clinicopathological features of intraabdominal bronchogenic cyst.Methods:The clinical data of 8 patients with intraabdominal bronchogenic cyst admitted in 3 Grade-A tertiary hospitals in Yunnan province between 2014 and 2023 were retrospectively analyzed. The clinical and pathological features, diagnosis, treatment and prognosis of intraabdominal bronchogenic cyst were reviewed.Results:There were 1 male and 7 females with an mean age of 45±12 years (21-65 years). Two patients presented with abdominal pain and 5 asymptomatic patients were found during physical examination. The cysts were located in retroperitoneum in 4 cases, located between the pancreas tail, spleen and the posterior wall of the stomach in 2 cases, located in the posterior wall of the stomach in 1 case, and located close to left adrenal gland in 1 case. Two patients had elevated tumor markers, while tumor markers in the remaining 6 cases were normal. Seven cases underwent laparoscopic complete cyst resection and 1 case had open surgical resection. The wall of most cysts were lined with respiratory epithelium and composed of goblet cells or pseudostratified ciliated columnar epithelium. The wall of cysts was composed of fibrous connective tissue or smooth muscle bundles, and the cavity contained serous mucous glands. Two cases showed cartilage tissue and one showed the infiltration of large number of inflammatory cells. The mean follow-up time was 31±32 months (range 5-107 months), and no recurrence or metastasis was found during the follow-up.Conclusions:Abdominal bronchogenic cyst is often found in adulthood, and most cases are symptomatic and found during physical examination. The diagnosis mainly depends on pathological examination, and tumor markers are not specific for its diagnosis. Surgery is the best way for treatment.