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.

Objective To investigate the effect and mechanism of low-dose remifentanil(RF)on systemic artery tension of baby rabbit with septic shock.Methods Thirty-six systemic artery strips were prepared from 12 baby rabbits and randomly divided into 6 groups:control group,lipopoly-saccharide(LPS)group,RF group,LPS + RF group,NG-nitro-L-arginine(L-NNA)pretreated group,LPS + L-NNA pretreated group.Each group had six rings(n =6).The effect of low-dose RF on the systemic artery tension of baby rabbit with septic shock was observed with isolated vascular ring technique.The change was also obversed after L-NNA pretreatment.Results In control group:the relaxant rates after low-dose RF at the time point of 5 min,10 min,20 min were(18.48±3.96)％,(23.63±4.42)％,(28.33±3.73)％(P＜0.05),compared with NS group.After pretreatment with L-NNA,RF-related relaxant rates of systemic arteries decreased significantly to(8.15 ± 1.01)％,(13.08 ± 1.46)％,(18.54 ±2.94)％(P ＜ 0.05).In LPS group,low dose RF(4 μg/L)did not bring out any response to systemic arteries(P ＞0.05).The tension was not affected with pretreatment of L-NNA(P ＞ 0.05).Conclusion These results suggest that low dose RF has relaxant effect on systemic arteries of baby rabbits,and NO may be involved.Low dose RF has no relaxant effect on LPS-pretreated systemic arteries of baby rabbits,and it has no association with NO.

Objective: To understand the suicidal ideation among migrant construction male workers in Pudong New Area, Shanghai, and analyze the influence factors based on social cognitive theory. Methods: Surveys were carried out among 1 850 migrant construction male workers from 3 randomly chosen construction sites using cluster random sampling. Univariate and multivariate Logistic regressions analysis were used to explore the association between suicidal ideation and its related factors such as negative psychology, negative cognition and high-risk behavior. Results: Among the total 1 580 respondents completed the survey, 126 (8.0%) reported having suicidal ideation. In the univariate Logistic regression analysis, drug abuse, alcohol abuse, depression, generalized anxiety and loneliness were risk factors for suicidal ideation, while perceived social support was a protective factor. Five of the six variables, alcohol abuse (ORm=2.15, 95%CI 1.42-3.24), depression (ORm=2.47, 95%CI 1.17-5.21), generalized anxiety (ORm=2.24, 95%CI 1.50- 3.35), loneliness (ORm=2.09, 95%CI 1.28-3.40) and perceived social support (ORm=1.84, 95%CI 1.20-2.83) were selected by the multivariate Logistic regression analysis. Conclusion: Suicidal ideation among migrant construction male workers in Pudong New Area, Shanghai occurs under the influence of negative psychology, negative cognition and high-risk behavior. For the crowds, family and society should be actively promoted and mental health interventions should be strengthened, which could effectively prevent suicide ideation.

Objective To investigate the value of immunophenotypes in pathologic diagnosis of follicular lymphoma (FL) and the differential diagnosis between neoplastic follicle (NF) and reactive hyperplastic follicle (RHF).Methods 50 cases of FL and 10 cases of RHF as control were studied by clinical data, the expressions of CD20, bcl-2, CD3, CD10, bcl-6, CD21 and Ki-67 were detected by EnVision immunohistochemical method for the immunphenotypical pattern of FL and RHF.Results Among 50 FL cases , there were 24 male cases and 26 female cases, with median age of 50 years old (10-80 years old), including 32 cases (64 ％) involved predominantly neck lymph nodes.The histologic grades were 1-2 in 16 cases (32 ％) and ≥3 in 34 cases (68 ％).CD20, CD10 and bcl-6 were positive in NF tissues of FL, with irregular forms of NF and loss of the mantle area without clear demarcation, and infiltrating to NF, irregular shape and no clear perimeter.The bcl-2 was positive in all of grade 1-2 NF, and it was positive in 68 ％ (23/34) cases and was partial or total negative in 32 ％ (11/34) cases in grade≥3 NF.Those were poorly demarcated contours.The Ki-67 proliferative index of NF were ＜30 ％ in grade 1-2, and ＞30 ％ in grade ≥ 3, with the highest to 90 ％.In FL, the CD21 staining result showed follicular dendritic cells (FDC) network were synchronized with NF, and in some cases of grade ≥ 3, the FDC network were ruptured.In RHF, the CD20 was positive for round or oval nodules with clear demarcation.The CD10, bcl-6 and CD21 were positive and bcl-2 was negative in all germinal center without invasive immunophenotype.The Ki-67 index was high in germinal center, and sometimes polarity may be seen.Conclusion The immunophenotypical differences between FL and RHF include invasive characteristics, loss of follicular mantle area and germinal center pattern in the NF, while the normal follicular immunophenotype in the RHF.

This article introduces the independent experiment and social investigation activities in the course of medication analy- sis set up for strengthening students' comprehensive abilities.These activities create a good study atmosphere for enhancing stu- dents' ability to do research and their humanistic qualities.

Background Treatment of corneal ulceration by transplanting drug-loaded amniotic membrane has been used widespreadly abroad,however,seldom study is found in China up to now.Objective This study was to explore the sustained release property and the efficacy of the drug-loaded amniotic membrane.Methods The bacteriostatic area of amniotic membrane fragments immersed with different concentrations (5,20,30 g/L) of levofloxacin for different time points (5,15,30,60 minutes) was evaluated by in vitro test.Bacterial corneal ulceration models were established in 20 rabbits by injected 0.7 MCF staphylococcus aureus suspension (0.1 ml) into the central corneal stroma to form the cloudy area of 4.0-6.0 mm.Then the rabbits were randomized into two groups.Regular amniotic membrane transplantation was performed laterally and 0.5％ levofloxacin drops was topically administered after operation in the amnion+levofloxacin drops group,and drug-loading amnion transplantation was used in the drug-loading amnion group.Aqueous humor of 0.1 ml was collected in 30 minutes,1 hour,2,3.5,5.5 hours after levofloxacin was administered and 1 day,3,7,10,14,21 days after operation for the detect of levofloxacin level with high-performance liquid chromatography.The corneal symptom was scored based on McNeill's criteria in 1 week,2 weeks and 4 weeks and the ulceration area was assessed under the slit lamp in the first week.The pathological examination was carried out in the fourth week after surgery.Results The mean bacteriostatic area was bigger with the increase of levofloxacin concentration,and bacteriostatic area in amnion immersed for 15 minutes was bigger than that of 5 minutes (P＜0.01).The levofloxacin concentration of aqueous humor after transplantation was decreased by extending the time,and that in 30 minutes and 5.5 hours after operation was (0.873±0.264) mg/L and (0.106±0.027) mg/L,respectively,in the amnion+levofloxacin drops group,and that in day 1,3,7 after surgery in the drug-loading amnion group was higher than at 30 minutes in the amnion+levofloxacin drops group,showing all significant differences (all P =0.00).In the first,second and fourth week after operation,the corneal symptom score was 1.7±0.6,1.3±0.5,0.2±0.4 in the drug-loading amnion group and 2.2±0.8,2.0±0.6,1.5±0.8 in the amnion+ levofloxacin drops group,with the significant differences among the different groups and time points (Fgroup =9.49,P =0.01 ;Ftime =22.96,P=0.01).The corneal ulceration area was (1.6±0.6) mm2 in the drug-loading amnion group and (3.2±0.8) mm2 in the amnion+levofloxacin drops group 1 week after operation,showing a significant difference between them (t =3.98,P =0.00).Histopathological revealed that the various layers of cornea tissue appeared irregular arrangement in the amnion + levofloxacin drops group 4 weeks after operation with 1-2 layers of new squamous epithelium.Disorder hypothallus structure,more inflammatory cells and residual vascular cavity were visible.However,new squamous epithelium of 4-5 layers was seen in the drug-loading amnion group,and inflammatory cells and residual vascular cavity were less than the amnion+levofloxacin drops group 4 weeks after operation.Conclusions Levofloxacin-loaded amniotic membrane can sustained release levofloxacin and maintain an effective drug concentration in aqueous humor,which improves the treating efficacy for staphylococcus aureus corneal ulceration.

A double-molecular beacons (DMB) based assay was developed for porcine circovirus 2(PCV2) detection. Two single-stranded DNA molecular beacons which could specifically hybridize with PCV2 genome DNA respectively in different sequence were designed according to the characteristics of the PCV2 genome sequences. The fluorescence signal was amplified 80 times by DMB, which was 2-4 times higher than that of single molecular beacon. Under the optimal conditions of 10 mmol/L MgCl2 , 20 mmol/L Tris-HCl (pH=8. 0), 40 ℃ and 30 min incubation time of DNA with DMB, the enlargement factor was increased linearly with DNA concentration over the range from 2 nmol/L to 200 nmol/L, with a detection limit of 1 nmol/L. The method was applied to detect PCV2 in genome of 18 swine fever samples and 8 PCV2 positive cases were found, which were confirmed by PCR method.

Abstract?AIM:To study the Influence and outcomes of eye healthcare information teaching for the visual development of children under“combination of medicine and education” in kindergartens.?METHODS:The children(5-6 years old) were randomly selected from 6 kindergartens in Nanjing, 3 in Yuhua District as the experimental group, and the other 3 in Jianye District as the control group.A one-year follow-up was conducted to evaluate the difference of visual development, including the rate of low vision, rate of referral caused by refractive abnormality, rate of astigmatism, the average of the equivalent spherical lens and the rate of lacking physiological hypermetropia, between the experimental group and the control group children.?RESULTS:One school year later,the rate of low vision, rate of referral caused by refractive abnormality and the rate of astigmatism, were significantly lower (P<0.05)in the experimental group under the mode of“combination of medicine and education”, which were also lower than those before experiment(P<0.05).The average of the equivalent spherical lens of experimental group increased and the rate of lacking physiological hypermetropia decreased significantly, compared with the control group ( P <0.05 ) and with those before experiment(P<0.05).?CONCLUSION:Using “combination of medicine and education” eye health care model,is good for children's visual development,so as to reduce the rate of low vision and delay the occurrence of myopia.

OBJECTIVETo observe the clinical effects of two different circumcision procedures with the Shang Ring and compare their advantages and disadvantages.

METHODSA total of 527 adult males with phimosis or redundant prepuce underwent Shang Ring circumcision by conventional outward replacement (n = 254) and inward placement (n = 273), respectively. We observed the in-ring nocturnal pain, complications, ring-removal pain, degree of edema, recovery time, and patients' satisfaction after surgery, and compared them between the two groups.

RESULTSCompared with the conventional outward placement (5.9%) of the Shang Ring, the inward placement method showed the advantages of mild in-ring nocturnal pain, a low complication rate, significantly reduced ring-removal pain, and mild edema, but exhibited longer healing time.

CONCLUSIONIn Shang Ring circumcision for phimosis and redundant prepuce in adult males, each of the outward and inward placement methods has advantages and disadvantages of its own, but the latter is more advantageous and feasible.

Adult ; Circumcision, Male ; adverse effects ; instrumentation ; Edema ; etiology ; Foreskin ; abnormalities ; surgery ; Humans ; Male ; Pain, Postoperative ; Patient Satisfaction ; Penile Diseases ; etiology ; Penis ; abnormalities ; surgery ; Phimosis ; surgery ; Prostheses and Implants ; Wound Healing

Objective To study the diagnostic and predictive values of amino-terminal pro-B-type natriuretic peptide (NT-proBNP) in patients presenting acute dyspnea. Method A total of 533 patients with dyspnea were studied. According to the clinical characteristics and echocardiographic findings, the patients were divided into two groups, namely acute congestive heart failure group (ACHF) and non-ACHF group. NT-proBNP levels were assayed in all patients in order to evaluate the diagnostic value, and predictive value in patients of ACHF group by following up study to know the clinical destination of patients to be cardiac death or re-admission into hospital. Results There were 272 ACHF patients and 261 non-ACHF patients, and the levels of NT-proBNT were significantly different between two groups ( 2683.4±86.9) pg/mL vs. (238.6+8.7) pg/mL, P＜0.01) . A total of 220 patients were followed for 158 ±32. 8 days. The level of NT-proBNT in myocardium of patients in re-admission group was 2683 + 86. 9 pg/mL and in death group was 3283.4 + 105.7 pg/mL which both were higher than that in patients without cardiac events ( 1123. 5 + 72. 1 pg/mL) ( P ＜0. 01 ) . By using multivariate Cox analysis, log NT-proBNT was ( r = 0. 987, P = 0. 002), and atrial fibrillation (r = 0. 876, P = 0. 005 ) and ventriculat tachycardia ( r=0. 891, P =0. 005) were the valid predictors of cardiac events. Conclusions Routine determination of NT-proBNT in Emergency Department should be useful for quickly sorting patients with acute dyspnea. The NT-proBNT could be used as a good prognostic indicator of ACHF. In addition, log NT-proBNT and atrial fibrillation, ventricular tachycardia were the independent risk factors of cardiac events.