Objective To investigate antibiotics resistant characteristics and carbapenemases genotype of Acinetobacter baumannii in Intensive Care Unit (ICU),so as to provide theoretical basis for clinical prevention and treatment.Methods Retrospective study was made on 90 non-duplicated clinical isolates of Acinetobacter baumannii,which were collected From January 2013 to January 2014 in three tertiary hospitals of Qingdao.All strains were identified by VITEK2 automated microbiology analyzer;K-B method was used to do drug susceptibility test;polymerase chain reaction (PCR) was used to amplify the OXA-23,OXA-24,OXA-51,OXA-58,KPC-2,VIM,IMP genes,and the positive products of genes were sequenced;the chi-square test was used to compare the difference of the resistance rates.Results The detection rate of multi-drug resistant A.baumannii (MDRAB)and Pan-drug resistant A.baumannii (PDRAB)was 61.11% (55/90) and 17.78% (16/90).In the 32 strains of imipenem-resistant Acinetobacter baumannii,the resistant rates to Cefoperazone/sulbactam,Polymyxin B was lower,while the resistant rates to other drugs tested were more than 85%.The difference of the resistance rates to 9 drugs between imipenem resistant group and Imipenem sensitive group were statistically significant (P≤0.05).PCR result showed: 32 strains detected OXA-51 gene,28 strains detected OXA-23 gene,and 3 strains detected VIM gene,the detection rates of which were 100%,87.50% and 9.38% respectively.All strains were not detected OXA-24,OXA-58,KPC-2 and IMP genes.The sequenced results were absolutely homology with the corresponding genes in genbank.Conclusions The resistance of A.baumannii in ICU is serious in this region,especially imipenem-resistant A.baumannii,which were nearly no-sensitive to most of the drugs commonly used in clinical.The gene existence of carbapenemase and carbapenemase producing is one of the main resistance mechanism of Acinetobacter baumannii to carbapenem antibiotics.OXA-23 was the major genotypes in this region.

Objective To explore the effect of mesenteric lymphatic ligation on liver injury induced by severe acute pancreatitis. Methods 54 SD rats are randomly divided into sham-operation group (A), severe acute pancreatitis group (B) and severe acute pancreatitis and ligation group (C). Liver tissues were collected from each rat in 6, 12, and 24 h after ligation. Pathological changes in liver tissues were observed by haematoxylin and eosin staining. Levels of serum glutamic-pyruvic transaminase and glutamic oxalacetic transaminase were detected. Levels of TNF-α and IL-1 in liver homogenate were examined by enzyme linked immunosorbent assay. Results Under light microscopic examination, neutrophils and inflammatory exudate in hepatic lobule was increased as time prolonged in group B. Inflammation was reduced in group C as compared with group B.Levels of serum glutamic-pyruvic transaminase and glutamic oxalacetic transaminase were more significantly increased in groups B and C than in group A (P<0.05);while they were more significantly decreased in group C than in group B. Levels of TNF-αand IL-1 in liver homogenate were significantly increased in group B as compared with group A (P < 0.05); whereas they were more significantly decreased in group C than in group B at 24 h (P < 0.05). Conclusions Mesenteric lymphatic ligation can reduce liver injury in severe acute pancreatitis. Mesenteric lymphatic fluids may play an important role in severe acute pancreatitis.

Objective To investigate the effect of interfering Hiwi gene on the apoptosis of MDA-MB-231 cells. Methods The mRNA and protein expression of Hiwi mRNA and its target protein were analyzed by qRT-PCR and Western Blot after transfection. MDA-MB-231 cells were divided into 6 groups according to the experimental design. Interference effects were screened as siRNA interference group (Hiwi10330 group), and then divided into 3 groups according to the experimental design: interference group, negative control group/NC, blank control group/Blank. The cell apoptosis rate was detected by flow cytometry after transfection. Results The expression of mRNA in the interference group was significantly lower than that in the siRNA group (P < 0.05), the expression of target protein of Hiwi gene was also significantly inhibited (P < 0.05). The apoptosis rate of MDA-MB-231 cells was significantly higher than that of NC and Blank groups (P<0.05). Conclusion The apoptosis rate of breast cancer cells MDA-MB-231 was significantly increased after siRNA targeting hiwi gene silencing.

Objective:To investigate the clinical effect of the transverse rectus abdominismuscle (TRAM) on reconstruction of the breast.Methods:The clinical data of 23 patients receiving TRAM breast reconstruction in our department from Jan. 2018 to Dec. 2019 were retrospectively analyzed.Results:The operation time of 23 patients ranged from 240 to 360 mins, andthe average time was about 300 mins. Intraoperative bleeding was about 120 to 200 ml, with an average of 170 ml. All the flaps survived successfully, but 2 cases were complicated with local fat necrosis. The postoperative period was between 6 and 12 months. No local tumor recurrence or metastasis was found inall patients during postoperative follow-up, and the breast shape was maintained in good condition.Conclusion:TRAM can make up for the regret of breast loss caused by breast cancer in female patients. It can bring confidence in life and work to female patients, and the technology is safe and reliable, which is worthy of promotion.

OBJECTIVETo investigate the role of miR-181c in glycolysis of cancer-associated fibroblasts (CAFs) and explore the mechanism.

METHODSHuman lung CAFs and normal fibroblasts (NFs), isolated from fresh human lung adenocarcinoma tissue specimens by primary culture of tissue explants, were transfected with a miR -181c mimics, a miR-181c inhibitor, a siRNA siRNA-HK2 or the vector HK2-vector via Lipofectamine(TM) 2000. Quantitative real-time PCR was used to analyze the changes in miR-125b expression in the transfected cells; hexokinase-2 (HK2) protein expression in the cells was detected using Western blotting, and the cellular glucose uptake was assessed with 2-NBDG. Lactate production in the cells was examined and expression of HK2 mRNA was detected with dual luciferase reporter gene assay.

RESULTSNo obvious difference was found in the cell morphology between CAFs and NFs. Compared with the NFs, the CAFs showed obviously increased glucose uptake, lactate production and HK2 protein expression with decreased expressions of the miR-181 family (P<0.05). Transfection with the miR-181 inhibito- rsignificantly increased glucose uptake, lactate production and HK2 protein expression in the NFs. In CAFs, transfection with the miR-181 mimics caused significantly lowered glucose uptake, lactate production and HK2 protein expression of. Knockdown of endogenous HK2 by siRNA abolished miR-181 mimics-mediated decrease of glucose uptake and lactate production in CAFs, while transfection with miR-181 mimics suppressed HK2 overexpression-induced enhancement of glucose uptake and lactate production in NFs.

CONCLUSIONTransfection with miR-181 mimics can suppress glycolysis in CAFs by inhibiting HK2 expression.

4-Chloro-7-nitrobenzofurazan ; analogs & derivatives ; Adenocarcinoma ; pathology ; Deoxyglucose ; analogs & derivatives ; Fibroblasts ; drug effects ; Glycolysis ; Hexokinase ; antagonists & inhibitors ; Humans ; Lung Neoplasms ; pathology ; MicroRNAs ; pharmacology ; RNA, Messenger ; RNA, Small Interfering ; Real-Time Polymerase Chain Reaction ; Transfection ; Tumor Cells, Cultured

Objective To analyze the clinical manifestations of pulmonary fungal disease in patients with different pathogen infection and different immune states. Methods A retrospective analysis was carried out with the clinical data of 78 patients with pulmonary fungal disease who were treated in Fujian Provincial Hospital from June 2012 to June 2016. Results The identified pathogens included Cryptococcus (78.2％, 61/78), Aspergillus(17.9％, 14/78), Talaromyces marneffei, Mucor, and Trichosporon asahii (one each). Cryptococcus was mostly found in healthy individuals without underlying disease and Aspergillus largely infected those with underlying disease. Diabetes mellitus was the most common underlying disease. Pulmonary fungal infection was confirmed by pneumonectomy (41.0％, 32/78), CT-guided percutaneous transthoracic biopsy (43.6％, 34/78), transbronchial lung biopsy (14.1％, 11/78), or blood culture (1.3％, 1/78). Pulmonary cryptococcosis was often asymptomatic (47.5％, 29/61). Hemoptysis was only found in the patients with underlying disease. The patients with pulmonary aspergillosis showed higher prevalence of hemoptysis (57.1％, 8/14) than the patients with other pulmonary fungal diseases. Bronchoscopy usually gave negative finding in case of pulmonary cryptococcosis (77.8％, 14/18). Inflammatory exudation was the primary finding of pulmonary aspergillosis (6/10). Intraluminal necrosis and neoplasia were only found in the aspergillosis patients with underlying disease. The primary imaging findings in pulmonary cryptococcosis was nodule or mass (78.7％, 48/61). Halo sign and crescent sign were rarely found in pulmonary aspergillosis. Of the 78 patients, 45 (57.7％) patients received pharmacological therapy alone, 15 (19.2％) surgical treatment alone, and 18 (23.1％) received drugs in combination with surgery. Six patients died, 25 lost to follow-up, and 47 with stable disease. Conclusions The clinical characteristics of pulmonary fungal disease vary with the pathogen and the immune states of patients. Clinical symptoms and immune status of patients should be taken into account when making diagnosis of pulmonary fungal disease for the purpose to speculate the probable fungal pathogen and choose the most appropriate diagnostic tool.

Purpose: This study aims to explore whether neoadjuvant chemotherapy with immunotherapy (NACI) leads to different tumor shrinkage patterns, based on magnetic resonance imaging (MRI), compared to neoadjuvant chemotherapy (NAC) alone in patients with triple-negative breast cancer (TNBC). Additionally, the study investigates the relationship between tumor shrinkage patterns and treatment efficacy was investigated. Methods: This retrospective study included patients with TNBC patients receiving NAC or NACI from January 2019 until July 2021 at our center. Pre- and post-treatment MRI results were obtained for each patient, and tumor shrinkage patterns were classified into three categories as follows: 1) concentric shrinkage (CS); 2) diffuse decrease; and 3) no change.Tumor shrinkage patterns were compared between the NAC and NACI groups, and the relevance of the patterns to treatment efficacy was assessed. Results: Of the 99 patients, 65 received NAC and 34 received NACI. The CS pattern was observed in 53% and 20% of patients in the NAC and NACI groups, respectively. Diffuse decrease pattern was observed in 36% and 68% of patients in the NAC and NACI groups. The association between the treatment regimens (NAC and NACI) and tumor shrinkage patterns was statistically significant (p = 0.004). The postoperative pathological complete response (pCR) rate was 45% and 82% in the NAC and NACI groups (p < 0.001), respectively. In the NACI group, 17% of patients with the CS pattern and 56% of those with the diffuse decrease pattern achieved pCR (p = 0.903). All tumor shrinkage patterns were associated with achieved a high pCR rate in the NACI group. Conclusion Our study demonstrates that the diffuse decrease pattern of tumor shrinkage is more common following NACI than that following NAC. Furthermore, our findings suggest that all tumor shrinkage patterns are associated with a high pCR rate in patients with TNBC treated with NACI.

Essential palatal tremor is relatively rare in clinical practice, which manifests involuntary and rhythmic contraction of soft-palate along with auditory click. The cause is unknown and there is no specific treatment at present. This article reports a female patient with essential palatine tremor, who presented with involuntarily beating of soft palate, disappeared during sleep, had sensory tricks, and gradually developed mental and psychological problems such as anxiety disorders. After treatment with integrated traditional Chinese and Western medicine, the symptoms improved. The clinical features of the case were analyzed, relevant literature was reviewed, and the possible etiology and characteristics of the disease were explored, so as to provide reference for clinical diagnosis and treatment.

Objective:To investigate the correlation between triglyceride-glucose (TyG) index and high on-treatment platelet reactivity (HTPR) during clopidogrel treatment in patients with ischemic stroke.Methods:Patients with ischemic stroke who received maintenance dose of clopidogrel (75 mg/d) in the Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine from January 2017 to March 2021 were retrospectively included. The highest quartile (Q4) of the TyG index was defined as insulin resistance. Platelet reactivity was assessed by thromboelastogram and clopidogrel HTPR was defined as the clot strength induced by adenosine diphosphate (MA ADP) >47 mm. Multivariate regression model was used to analyze the independent correlation between TyG index and platelet reactivity. Results:A total of 83 patients were included. The TyG index showed a linear correlation with MA ADP. The patients were divided into 4 groups according to the quartile of TyG index. The incidence of clopidogrel HTPR increased significantly with the increase of the quartile of the TyG index ( Ptrend=0.017). Multivariate analysis showed that there was a significant independent correlation between insulin resistance and clopidogrel HTPR (odds ratio 4.597, 95% confidence interval 1.285-16.446; P=0.019). Conclusions:In patients with ischemic stroke treated with clopidogrel, the incidence of clopidogrel HTPR gradually increases with the increase of the quartile of the TyG index. The insulin resistance assessed by the TyG index is independently associated with clopidogrel HTPR.

Objective:To investigate the feasibility of the surgical mode of immediate implant-based breast reconstruction (IIBR) with silicone implants under subcutaneous tissue directly after the total mastectomy in breast cancer.Methods:Data of 53 patients who underwent (skin-sparing mastectomy, SSM) or (nipple-areola-complex-sparing mastectomy, NSM) combined with IIBR in Department of Breast Surgery, Maoming People’s Hospital were retrospectively analyzed. Patients were divided into two groups, 31 cases with the silicone implant placed in different anatomical locations of the chest wall, including subcutaneous tissue, and 22 cases with subpectoral space implantation followed NSM or SSM. The two groups were compared in terms of the short-term and long-term complications, as well as the aesthetic outcome. Within 12 months the local recurrence rate was collected to evaluate the treatment safety of the two groups preserving the thickness of subcutaneous adipose after NSM or SSM.Results:There was no nipple-areola-complex (NAC) or skin flap for both groups, and the time of removing the drainage tube had no significant difference ( P>0.05) . There was no significant difference between the two groups in terms of the short-term complications within 6 months (repeated local infection and unknown effusion occurrence) , the long-term complications after 6 months (local skin with wrinkles sign, prosthesis displacement, and grade III-IV capsular contracture ( P>0.05) . However, the subcutaneous tissue implant group were superior ( P<0.05) in cosmetic outcome because of the breast had better symmetry. What’s more, no local tumor recurrence occurred in either group within 12 months. Conclusions:IIBR of subcutaneous tissue implantation (without patches) is an economical, novel, safe, and effective surgical mode for breast reconstruction, and the key to this operation mode depends on quality control of surgical procedures and the thickness of skin flap ≥ 1cm covering silicone implants. However, due to the cases enrolled in this study is not enough and short follow-up time, further clinical studies are still needed.