Acinetobacter baumannii, a glucose-nonfermentative gram-negative coccobacillus, is an important pathogen isolated in nosocomial infections, and the clinical detection rate has been increasing in recent years. Acinetobacter baumannii attracts widespread attention due to strong viability, broad resistance spectrum and high rate of drug resistance. The resistance mechanisms include the production of β-lactamases, alterations in penicillin-binding proteins, decreased outer membrane permeability and overexpression of active efflux pumps. The mechanisms of Acinetobacter baumannii resistance to β-lactarn antibiotics, especially those of the outer membrane porin and active efflux system are reviewed in this paper.

Objective To summarize the clinical features of diabetic ketoacidosis (DKA) in children with newly diagnosed type 1 diabetes mellitus(T1DM),and to explore the predictors of DKA by analyzing these factors in order to achieve early recognition.Methods In this retrospective study,200 children with newly-onset T1DM from January 2009 to December 2012 in Shengjing Hospital of China Medical University were chosen.These patients were divided into DKA group and non-DKA group.Clinical data including age,gender,health insurance,body shape,infection history,family history of diabetes,type of residence,income,duration of history,C peptide,glycosylated hemoglobin,blood lipids,thyroid tests,diabetes antibodies etc were collected.Results Among 200 cases of newly diagnosed T1DM,107 children had DKA,93 children had non-DKA,and the incidence of DKA was 53.5％.In the group of DKA,39 cases (36.5％) were male,68 cases were female,while in the group of non-DKA 45 cases (48.4％) were male,48 cases were female.In the group of DKA,children ranged in age from 16 months to 13 years old,and the average age was (6.53 ±3.55) years old.In the non-DKA group,children ranged in age from 1 to 14 years old,and the average age was (7.05 ± 3.55)years old.In the group of DKA,43 cases (40.2％) didn't have health insurance,while in the non-DKA group,28 cases (30.1％) didn't have medical insurance.In the DKA group,30 cases (28％) had a family history of diabetes,while in the non-DKA group,27 cases (29％) had a family history of diabetes.In the group of DKA,the duration was (30.24 ± 76.50)days,while in the group of non-DKA,the duration was (33.38 ± 49.30) days.The glycosylated hemoglobin in the DKA group was (12.38 ± 2.66)％,in the non-DKA group was (12.48 ± 2.24) ％.There were no significantly differences of the above factors between the 2 groups (all P ＞ 0.05).In the group of DKA,35 cases(32.7％) were thin,66 cases(61.7％) were of normal size,and 6 cases(5.6％) were fat.In the group of non-DKA,9 cases(9.3％) were thin,76 cases (78.6％) were of normal size,and 8 cases(12.1％) were fat.In the group of DKA,33 cases (30.8％) had infection history,77 cases (72％) lived in rural areas,and the average of C peptide was (0.25 ± 0.22) μg/L.In the group of non-DKA,17 cases (18.3％) had infection history,52 cases(55.9％) in rural areas,and the average of C peptide was (0.36 ± 0.21) μg/L.There were significant differences of the above factors between the 2 groups (all P ＜ 0.05).Conclusions Children with newly diagnosed T1DM who is thin,rural resident,and has lower C peptide level is more susceptible to DKA.More attention should be paid to the children with newly diagnosed T1DM who have above characteristics.

Objective: To investigate the effect of Celastrus orbiculatus extracts (COE) on xenograft tumor growth of HepA1-6 hepatoma in mice, and to explore its possible mechanism. Methods: HepA1-6 hepatoma model was established in mice, and then these mice were randomly divided into blank control group, solvent control group (1% DMSO), negative control group (0.9% NaCl solution), positive control group (cisplatin), and low-, medium- and high-dose COE groups (10, 20 and 40 mg/kg, respectively). The body weight, tumor growth inhibitory rate, liver index, spleen index and thymus gland index were calculated, and the expression levels of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) as well as microvessel density (MVD) were detected by immunohistochemistry. The apoptosis rate was determined by TUNEL assay. Results: COE could significantly inhibit the tumor growth, increase the apoptosis rate, and down-regulate the expression levels of VEGF, bFGF and MVD of HepA1-6 hepatoma in the liver of mice, as compared with the negative control group (P < 0.05). There was no statistically significant differences in liver index, spleen index, thymus gland index and body weight between COE-treated groups and the negative control group (P > 0.05). Conclusion: COE can inhibit the xenograft tumor growth of HepA1-6 hepatoma in mice. This effect may be associated with the enhancement of apoptosis and the inhibition of angiogenesis in tumors. Copyright© 2011 by TUMOR.

Objective: To investigate the effects of oxymatrine(OM) on the apoptosis of human hepatoma HepG2 cells and its possible mechanisms. Methods: HepG2 cells were treated with different concentrations of OM. The proliferation inhibition was measured by MTT assay and the apoptosis of HepG2 cells were examined by Hochest staining method. Flow cytometry was used to analyze the cell cycle distribution and apoptosis rate. The expression of caspase-3, Bcl-2, Bcl-xL and Bax proteins was assayed by Western blotting assay. Results: OM inhibited HepG2 cells growth in a time- and dose-dependent manner. After treatment with OM for 24 hours, some cells appeared typical apoptotic characteristics and the apoptosis rate was increased. Treatment with OM also increased caspase-3 activity and Bax expression in HepG2 cells, and decreased the expression levels of Bcl-2 and Bcl-xL. Conclusion: OM can induce HepG2 cell apoptosis, which may be related to the down-regulation of PI3K/Akt signal pathway, suppression of Bcl-2 and Bcl-xL activity, and activation of caspase-3.

BACKGROUND:Mechanical factors play an important role in wound healing and scar formation. Finite element model is established to stimulate, analyze and optimize different sutures, which has become a hotspot to guide surgies accurately. OBJECTIVE:To analyze the stress distribution of different simple interrupted suturing directions on the skin wound by establishing the skin finite element model, and to provide basic data for the study of scar formation. METHODS:Porcine back skin uniaxial tensile test was performed to provide reference for the mechanical properties of human skin. Orthotropic skin wound model was established using ABAQUS to calculate the stress distribution on the wound in different suturing directions. RESULTS AND CONCLUSION:The anisotropic mechanical properties of skin wound influenced the suture stress significantly. The elastic modulus along the Langer’s line was larger than that in the vertical direction. The stress increased orderly in the Langer’s line direction, the Langer’s line deflected 30°, bias Langer’s line 45° and vertical Langer’s line. These results suggest that the clinical incision should be made along the Langer’s line direction. Additional y, the cut at an angle with Langer’s line can also reduce the stress of suture.

Antigens, CD34 ; metabolism ; Hemangioendothelioma, Epithelioid ; metabolism ; pathology ; surgery ; Hepatectomy ; methods ; Humans ; Liver Neoplasms ; metabolism ; pathology ; surgery ; Male ; Middle Aged ; Vascular Endothelial Growth Factor A ; metabolism ; von Willebrand Factor ; metabolism

Acupuncture Points ; Acupuncture, Ear ; instrumentation ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Spinal Nerve Roots ; physiopathology ; Spondylosis ; physiopathology ; therapy ; Young Adult

Objective To investigate the efficacy and safety of laparoscopic repair in children with congenital esophageal hiatal hernia. Methods From September 2001 to December 2008,seven children with congenital esophageal hiatal hernia,including 4 boys and 3 girls,were treated by laparoscopic repair and Nissen's fundoplication in our hospital. One of them received laparoscopic pyloroplasty in the meanwhile because of delayed gastric emptying (confirmed by preoperative gastrointestinal angiography); one child underwent laparoscopic high ligation due to right oblique inguinal hernia; spleneolus was found in one patient,no further treatment was carried out. Results The procedures were completed in all of the patients without conversion to open surgery. The mean operation time was 94.2 min (75-150 min) in this series,and the average blood loss was 5 ml (2-10 ml). No patient received blood transfusion after the surgery. The children began to intake milk or regular diet in 24-48 hours after the operation. They were discharged from hospital in a mean of 4.5 days (ranged from 3 to 7 days). Then,the children were followed up for 6 to 20 months (mean,12.6 months). One of the patients suffered from vomiting on the 10th day after the operation,1 patient showed recurrence in 1 year postoperation and then was cured by a second operation. The other five patients were healthy during the follow-up. Conclusions Laparoscopic repair of congenital esophageal hiatal hernia is a safe,effective,and minimally invasive procedure. It is feasible for patients complicated with other diseases. The indications for the surgery must be strictly selected.

In view of the status of "emphasis on medical treatment,neglecting education,lack of teaching positivity and low teaching management level" in teaching hospital at present,MBO was applied in the incentive mechanism of clinical teachers as a means,which aroused the teachers' positivity effectively,ensured the teaching quality,improved the teaching level of management and achieved significant results. It also made our medical activities,teaching and researching develop harmoniously.

Carcinoma, Small Cell ; metabolism ; pathology ; Diagnosis, Differential ; Gastrointestinal Stromal Tumors ; metabolism ; pathology ; Humans ; Mastocytosis ; metabolism ; pathology ; Melanoma ; metabolism ; pathology ; Neuroblastoma ; metabolism ; pathology ; Proto-Oncogene Proteins c-kit ; biosynthesis ; Seminoma ; metabolism ; pathology