Bariatric and metabolic surgery has been in China for more than 30 years, which has developed rapidly. However, it can be predicted that there will be many opportunities and challenges in the future development of bariatric and metabolic surgery, including the replacement of classic surgical methods, the guarantee of surgical safety, the brave exploration of new surgical methods, the decisive abandonment of bad surgical methods, the implementation of surgical standardization, and the breakthrough of basic and clinical research all mean more efforts. With the continuous rise of the incidence rate of metabolic syndrome and the continuous improvement of people′s health needs, these opportunities and challenges are particularly significant. Bariatric and metabolic surgery will also play a crucial role in overcoming obesity and metabolic diseases.

Circulating cell-free nucleic acids are defined as extracellular DNAs or RNAs in blood with physiological or pathological origins. Previous studies showed that the concentration of cell-free nucleic acids in the blood of cancer patients is significantly higher than in healthy people. Further studies showed that the genetic and epigenetic alterations of circulating cell-free nucleic acids are relevant to cancer development and progression, including mutation, hypermethylation, loss of heterozygosity, change of integrity, and abnormal expression of microRNAs. Detection of circulating cell-free nucleic acids shows promising potential in cancer screening, diagnosis, personalized treatment, and prognosis.

The laboratory accreditation plan is an effective way to realize the standardization of medical laboratories.The test method validation is required by ISO 15189 guideline and CAP checklists.However,after CBC analyzers and coagulation analyzers are repaired,no solution for the validation is put forward.

Bone Diseases ; complications ; pathology ; Bone Diseases, Infectious ; complications ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; complications ; microbiology ; Male ; Middle Aged ; Necrosis ; Osteomyelitis ; complications

To detect and phylogeneticaly analyze arenavirus carried by wild rodents in Ningbo ,China ,two pairs of degener‐ate‐primers were designed to amplify the S and L gene of arenavirus ,and then RT‐PCR was applied to detect arenavirus carried by rodents which captured from Ningbo port area .All 73 rodents samples were detected ,of which 12 Rattus norvegicus were positive ,an arenavirus virus strain named DX1401 were separated .The S gene amplified products of DX1401 was about 413 bp ,and the L gene was 1 204 bp .The phylogenetic analysis of S segments showed that DX1401 strain was in one branch of phylogenetic tree with Mobala virus strain ACAR3080 .The genetic distance to Mobala virus strain ACAR3080 was the closest , with the value of 0 .467 ;the phylogenetic analysis of L segments showed that DX1401 strain were in one group of phylogenetic tree with Lassa virus strain Josiah ,NL ,Z148 ,Bamba‐R114 ,Soromba‐R ,Nig08‐A37 ,Nig08‐A47 ,Mobala virus strain ACAR3080 ,Morogoro virus strain 13017/2004 ,Mopeia virus strain Mozambique ,and AN 21366‐BNI .The genetic distance to Mobala virus strain ACAR3080 was the closest ,with the value of 6 .953 .In conclusion ,the study confirmed the existence of arenavirus popular in wild rodents in Ningbo ,China .

Objective To study the effect of Sildenafil in the treatment of hypoxemia after operation of cyanotic congenital heart disease.Methods A total of 34 cases with hypoxemia after operation of cyanotic congenital heart disease were collected between January 2009 to January 2015.They took Sildenafil with the dosage of 0.3-0.5 mg/kg every 6 hour.The change of heart rate (HR),systolic blood pressure (SBP),central venous pressure (CVP),pulmonary artery pressure (PAP),arterial partial pressure of oxygen [pa (O2)],arterial partial pressure of carbon dioxide [Pa (CO2)],oxygenation index [pa (O2)/FiO2],peak airway pressure (Ppeak),positive inotropic drug score (PIDS) and the lower bound of liver were observed at 4 time points,including before taking the medicine,after taking the medicine for 1 hour,after taking the medicine 1 day and after the ventilator was removed.Based on the data,the therapeutic effects of Sildenafil were studied.Results All 34 cases were cured.At the time point of 1 hour after taking Sildenafil,PAP,CVP and Ppeak decreased significantly,but pa (O2) and pa (O2)/FiO2 increased significantly (P ＜ 0.05).At the time point of 1 day after taking Sildinafil,SBP increased steadily,but PAP and CVP continued to get lower,and PIDS decreased significantly,while the liver lower bound was significantly reduced (P ＜ 0.05).At the time point of removing the ventilator,pa (O2) reached to (144.12 ± 26.25) mmHg,and hypoxemia was corrected,but PAP was reduced to (37.47 ± 3.77) mmHg,PIDS decreased to (17.56-± 1.94) scores,and heart failure was corrected.Compared with the previous 3 time points,there were statistically significant differences (P ＜ 0.05).Conclusion Sildenafil can highly selectively decrease pulmonary vascular resistance and obviously promote the correction of hypoxemia after operation of cyanotic congenital heart disease.

Risk management is derived from industry.In recent years,risk management is introduced by many medical laboratories their process management abroad.However,the concept of risk management is still very new for laboratories in China.Therefore,the establishment of the project for risk detection,classification,correction,prevention and supervision could help medical laboratories improve their service quality.

Objective To learn drug resistance of bacteria isolated from a hospital of Chengdu from 2012 to 2013 .Methods From 2012 to 2013 ,39 732 clinical specimens were collected ,ATB Express half‐automatic bacteria identification system were used to identify the bacteria ,and paper diffusion(K‐B) method was used to do drug sensitive test ,results were judged according to Clini‐cal and Laboratory Standards Institute 2012 standard interpretation ,Whonet5 .6 was used to do statistical analysis .Results In the bacteria isolated from this hospital in 2012 and 2013 ,gram‐positive bacteria accounted for 27 .7% and 37 .4% respectively ,gram negative bacteria accounted for 72 .3% and 62 .6% .The top five pathogenic bacteria were E .coli(16 .3% ,20 .3% ) ,Pseudomonas aeruginosa(11 .5% ,11 .7% ) ,Staphylococcus aureus (11 .3% ,11 .4% ) ,Acinetobacter baumannii(10 .6% ,9 .3% ) ,Klebsiella pneu‐moniae(14 .7% ,12 .0% ) .The detection rates of Methicillin‐Resistant Staphylococcus(MRSA) were 56 .2% ,47 .7% .The positive rates of producing extended spectrum βlactamases(ESBLs) of E .coli and Klebsiella pneumonia accounted for 41 .0% ,32 .2% and 21 .0% ,10 .8% ,which were high sensitive to carbon penicillium alkene antibiotics and amikacin .Susceptibility monitoring results showed that the drug resistance of Acinetobacter baumannii was rising ,and the drug resistant of Pseudomonas aeruginosa to most antibiotic were decline .Conclusion The top five bacteria isolated from this hospital in 2012 and 2013 are given priority to gram‐negative bacteria ,in addition to the drug resistant trend of Acinetobacter baumannii increased slightly ,the drug resistant of other four common bacteria were decline .Clinical attention should focus on positive ESBLs ,E .coli ,Klebsiella pneumoniae ,MRSA and M ulti‐resistant bacteria .

Aim Toinvestigatetheroleofbrain-de-rived neurotrophic factor(BDNF)-tyrosine receptor ki-nase B (trkB ) signaling pathway in the therapeutic effects of ketamine on diabetic neuropathic pain.Meth-ods Forty-eightWistarrats,aged3months,weighing 200~250 g,were equally randomized into 4 groups(n=12 ):control group (C group ), saline group (S group),ketamine group (K group)and ketamine +ANA-12 group (KA group ).Rats in S,K and KA groups were intraperitoneally injected with a single of streptozotocin(STZ)65 mg·kg-1 to construct diabetic neuropathic pain model.After twenty-eight days,rats in S,K and KA groups were intraperitoneally injected with saline, ketamine 10 mg·kg-1 and ketamine 10 mg·kg-1 +ANA-12 0. 5 mg·kg-1 for consecutive 7 days, respectively. On the 8th day, mechanical withdrawal threshold(MWT)of rats was measured.Af-ter that,the rats were immediately sacrificed,and dor-sal ganglion of lumbar spine and prefrontal cortex (PFC)were harvested for measuring BDNF,p-trkB/trkB,synaptophysin and spine density by Western blot andglogistaining.Results ComparedwithCgroup, rats in S group significantly decreased MWT,BDNF, p-trkB/trkB,synaptophysin and spine density in dorsal ganglion and PFC (P <0. 05 ).Compared with S group,rats in K group showed a significant increase of MWT,BDNF,p-trkB/trkB,synaptophysin and spine density in the all observed regions(P<0. 05 ).On the contrary,rats in KA group showed a significant de-crease of MWT and BDNF,p-trkB/trkB,synaptophys-in and spine density as compared with K group in all regions(P<0. 05 ).Furthermore,BDNF was positive-ly correlated with spine density in all regions (P <0.05).Conclusion BDNF-trkBsignalingpathway mediates ketamine-induced therapeutic effects in dia-betic neuropathic pain.

Objective To understand the drug-resistance of MRSA patients in neurosurgery intensive care unit,raise the prevention of MRSA and provide doctors the basis for controlling it. Methods The 5 year(20012005) MRSA patients were tested by Kirby-Bauer in neurosurgery intensive care unit of a third-tier general hospital in Shanghai. Statistic and analysis the drug-resistance of the patients. Results The rates of 121 MRSA drug-resistance to penicillin G,erythromycin, ciprofloxacin, amikacin and the cephalosporins are 92.3 % to 100 %, totally senaitire to teicoplanin and vancomycin and lower drug-resistance to rifampin,netilmicin and fosfomycin, but it rapidly raised from 10.0 % (2001 ) to 95.2 % (2005) to sulfamethoxazole. Conclusion It is time to take care of the drug-resistance of MRSA. Prevention and use antibiotics properly are the important ways to decrease the hospital infection and to improve the quality of recovered.