Objective To evaluate the synergy effect of Meropenem and Sulbactam combination against Meropenem-resistant and Meropenem-susceptible A.baumannii in vitro and optimize combination ratio of Meropenem and Sulbactam to achieve best synergy effect.Methods Evaluating the synergy effect of Meropenem and Sulbaetam combination through microdilution checkerboard method against Meropenemresistant and Meropenem-susceptible A.baumannii,isolated from inpatients of Chinese hospitals.Assessing the synergy effect of combination in different ratios of Meropenem to Sulbactam.Results The checkerboard method with the combination of Meropenem and Sulbactam demonstrated 25.0％ ( 10/40 ) synergism,67.5％ (28/40) partial synergism,7.5％ (3/40) additive,no indifference and antagonism in Meropenemsusceptible isolates,and 27.5％ (11/40) synergism,40.0％ (16/40) partial synergism,25.0％(10/40) additive,no indifference and antagonism in Meropenem-resistant isolates.Eleven Meropenemresistant isolates which showed synergism in synergy test were tested for MICs of combination of Meropenem and Sulbactam,using ratios of 4∶ 1,2∶ 1,1∶1 and 1∶2,and the MIC90 were 64∶ 16,64∶ 32,32∶32,32∶64 μg/ml,respectively.Conclusions Meropenem and Sulbactam combination show synergism or partial synergism against most A.baumannii isolates.The optimal ration of combination for clinical use may be 1∶ 1.

Objective To analyze the causes of blood deficiency in the process of voluntary blood donation and to adopt targeted control measures,so as to effectively reduce blood scrapping and to better ensure theclinical blood use of the hospital.Methods The data of blood collection from January 2014 to December 2016 and the various reasons of insufficient blood collection were summarized;and according to these data as the object of study,the targeted measures were taken to observe the effect.Results According to the the reasons for the lack of blood collection,the targeted measures,such as organizing staff training,strengthening communication with blood donors and so on,were taken.After the implementation of these measures,the phenomenon of insufficient blood collection from 2014 to 2016 showed declining trend,withthe proportion decreased from 0.29％ to 0.20％.Conclusion To strengthen the staff staining in order to improve them vein collection technology,to publicize further,to communicate with blood donors effectively and improve the blood donation services,to ease the feelings of blood donors and to create a warm,harmonious and orderly blood donation atmosphere;all of these should be helpful for reducing the occurrence of insufficient blood collection.

Objective To analyze the specific activity of radionuclides based on laboratory intercomparison.Methods Intercomparison of the measurements of radioanuclides 232Th,40K and 137Cs in soil samples,organized by National Institute for Radiological Protection,China CDC,was conducted using HPGe γ-spectrometry and the method of relative comparison and efficiency curve,respectively.Results The relative deviations were all less than 5％compared to the reference values in the conditions of both relative comparison method and efficiency curve method used,respectively.The relative deviations to the reference values were less than 4％for the relative comparison method.Conclusions Both the relative comparison method and the efficiency curve method can be used to measure the activity of radionuclides in the intercomparison samples,and the latter is superior to the former.

Objective:To investigate the two-dimensional ultrasound ,color Doppler ultrasound and ultrasonic elastography fea-tures of breast phylloides tumors .Methods :Sixteen cases of breast phylloides tumors proved by pathology were retrospectively analyzed .Results:In all cases ,there was a single tumor .Postoperative pathological results proved benign ,borderline and ma-lignant breast phylloides tumor in 8 ,4 and 4 cases ,respectively ;and the mean diameters of them were 30 mm ,41 mm and 38 mm ,respectively .Twelve lesions were lobulated and 4 oval in 16 tumers .The tumor margins were circumscribed in all cases , and 2 malignant lesions had incomplete capsules .Intramural clefts and high echo separations were found in 12 lesions .All le-sions had posterior enhancement .Grade II-III blood flow were seen in 7 benign lesions ,3 borderline lesions and 4 malignant le-sions .In ultrasontic elastography fifteen lesions had horizontal red/yellow stripes ,8 lesions had more than ten red/yellow stripes ,2 borderline lesions and 2 malignant lesions had a mosaic pattern of red and green in the centre and blue “ring sign”in the periphery .There were 7 ,3 ,2 lesions scored as 1 ,and 1 ,1 ,2 lesions scored as 3 on ultrasonic elastography for benign , borderline and malignant phylloides tumors ,respectively .Conclusions:The breast phylloides tumors mostly present as lobulated , well circumscribed ,intramural cleft ,high echo separations ,posterior enhancement and abundant blood flow on ultrasound . Many horizontal red/yellow stripes are typical appearance of breast phylloides tumors on elastography .Incomplete capsule , scored as 3 on elastography or blue“ring sign” in the periphery suggest borderline and malignancy phylloides tumors .

Objective :To investigate ultrasonographic features of neuroendocrine carcinoma of breast . Methods :The ultrasonographic features of twenty-nine patients with neuroendocrine carcinoma of breast confirmed by pathology were retrospectively analyzed .Among them ,twenty-five cases were invasive neuroendocrine carcinomas while the other four cases were neuroendocrine carcinomas in situ .Results :Twenty-six lesions were hypoechoic while the other three were isoechoic . Twenty-three lesions were heterogeneous while the other 6 were homogeneous .The shape was irregular in twenty-three masses and regular in 6 masses . Microcalcification was found in 11 masses while hyperechoic halo was found in 1 mass . Hypervascular ,isovascular ,hypovascular and avascular images were found in 15 ,9 ,3 ,and 2 masses ,respectively .Eight masses were examined by ultrasound elastography .According to elastography score ,1 ,3 ,and 4 points were found in 1 ,2 , and 5 masses , respectively . The accuracy rate of ultrasonographic diagnosis for breast mass was 97% (28/29 ) . And the accuracy rate of ultrasonographic diagnosis for ipsilateral axillary lymph node metastases was 75% (9/12 ) .Conclusions :Features such as heterogeneous echo ,irregular shape ,microcalcification inside mass ,hypervascular image and high score on elastography are frequent for neuroendocrine carcinoma of breast .The combined application of gray-scale ultrasound ,color Doppler ultrasound and ultrasound elastography may be conducive to the differential diagnosis of lesion .

Objective :To investigate the imaging features of metaplastic breast carcinoma by grayscale ultrasound , color Doppler ultrasound and ultrasound elastography .Methods :Imaging data of metaplastic breast carcinoma of twenty cases proved by pathology were retrospectively analyzed .Results :There were eighteen masses with hypoecho and 2 masses with medium echo .Ten masses showed heterogeneous echo and the other ten showed homogeneous echo .The shape was irregular in 13 masses ,oval in 4 masses and microlobulated in 3 masses .The margin was circumscribed in 15 masses and indistinct in 5 masses .Microcalcifications were found in 6 masses .Echo free space was found in 9 masses .There were 18 cases with posterior acoustic enhancement , one case with invariable posterior echo and one case with posterior attenuation . Hypervascular , isovascular ,and avascular masses were found in 14 ,4 ,and 2 cases ,respectively .The mean resistance index was 0 .77 .Four masses were examined by ultrasound elastography .One mass was scored as 3 and 3 masses were scored as 4 .The accuracy rate of ultrasonic diagnosis for breast mass was 85% (17/20) .And the accuracy rate of ultrasonic diagnosis for ipsilateral axillary lymph nodes was 75% (3/4) .Conclusions :Irregular shape ,posterior acoustic enhancement ,cystic spaces ,microcalcifications , hypervascular mass and high elastography score are the most frequent ultrasonic features for metaplastic breast carcinoma .The combination application of grayscale ultrasound ,color Doppler ultrasound and ultrasound elastography may be conducive to the etiologic diagnosis of lesion .

Objective To investigate the prevalence of vitiligo in China through a multi-center and larse-population epidemiological survey.Methods A community-based survey was conducted in 6 cities from 6 provinces.Cluster sampling method was used.Subjects were required to fulfill the self-report questionnaires and received physical examination by dermatologists.EpiData and SPSS11.5 were utilized for statistical analysis. Results Totally,19 974 patients participated in this study,and 17 345 valid questionnaires were retrieved with a return rate of 86.84%.Of them,122 were found to have vitiligo.The prevalence and standardized prevalence of vitiligo was 0.70% and 0.56% in all patients,0.95% (75) and 0.69% in male patients and 0.50% (47) and O.45% in female patients.respectively.A significant elevation was observed in the prevalence of vitiligo in males than in females (P<0.01).The prevalence of vitiligo was increased with age and peaked in patients aging from 60 to 69 years and those over 70 years.The age at onset of vitiligo varied from 0 to 19 years in 21.85% of these patients,from 20 to 49 years in 47.05%.The most connnon type was focal vitiligo,which accounted for 36.06%,while the rarest type wag segmental type (2.46%).The pesitivity rate of family history of vitiligo was 9.84% in patients and 1.31% in community population (P<0.01).About 31.97% of the patients complained of negative influence of vitiligo on quality of life.Conclusions The standardized prevalence of vitiligo is 0.56%in 6 provinces from China.Males seem to have a higher prevalence of vifiligo than females.

Objective:To investigate the differences in applicability of both the portable high-purity germanium (HPGe) γ spectrometer and the portable lanthanum bromide (LaBr) γ spectrometer for measuring thyroid 131I activity and internal exposure monitoring for radiation workers. Method:Both DETECTIVE-DX100-KT portable HPGe γ spectrometer and InSpector 1000 portable LaBr γ spectrometer were used to measure the 131I content in thyroid of radiation workers for comparison of the measuring result, minimum detectable activity (MDA) and corresponding annual committed effective doses between two types of spectrometers. Results:The detection rate of 131I in thyroid of radiation workers was 67.7% for HPGe γ spectrometer and 26.2% for LaBr γ spectrometer, respectively. The MDA was 12.26-14.74 Bq (measuring time: 3-5 min) for HPGe γ spectrometer and 56.56-80.37 Bq for LaBr γ spectrometer (measuring time: 2-4 min). The annual committed effective dose corresponding to MDA was 0.07-0.08 mSv (3-5 min) for HPGe and 0.31-0.45 mSv (2-4 min) for LaBr, respectively, in the case of using chronic continuous intake mode and 7 d monitoring period. Conclusions:The minimum detectable activity (MDA) of the two types of portable spectrometers could meet the requirements specified in GBZ 129-2016 Specifications for individual monitoring of occupational internal exposure for thyroid monitoring equipment. The two types of spectrometers could be used for routine monitoring of internal contamination. The difference between the monitoring result of LaBr γ and HPGe γ spectrometers might be due to such factors as large uncertainty in short measuring time and low activity concentrations, incomplete identical of distance between probe and neck, probe angle setting, different response of equipment to the environment, background deduction method.

Objective:To investigate the role of miRNA-4298/PADI4/p53 signal axis in mediating 4f-induced apoptosis of leukemia cells.Methods:The cell growth density was observed under inverted microscope and the proliferation of leukemia cells was detected by CCK-8 counting assay. The expression of PADI4 and P53 at mRNA level was detected by qRT-PCR. Cell cycle and apoptosis were measured with flow cytometry. The expression of PADI4, P53, Bcl-2, Bax, caspase-3 and caspase-9 at protein level was detected by Western blot. Differential miRNA and mRNA expression profiles was detected by next generation sequencing. Databases such as TargetScan were used to predict the potential upstream and downstream genes of PADI4. A luciferase reporter assay was used to detect the 3′UTR of PADI4 targeted by miRNA-4298. Cell transfection assay was used to detect the effect siRNA, PADI4 vector, miRNA mimics and miRNA inhibitor in interference and rescue.Results:Nuclear factor erythroid 2-related factor 2 (Nrf2) inhibitor 4f could inhibit the proliferation of THP-1, K562 and U937 cells, and induce the apoptosis of these leukemia cells. It downregulated the expression of PADI4 mainly through the binding activity of miRNA-4298 to miRNA sponges, which resulted in the proliferation inhibition and apoptosis of leukemia cells. The inhibited proliferation and apoptosis of leukemia cells by 4f were associated with the increase of P53 expression after the decrease of PADI4 expression. The PADI4-dependent upregulation of P53 led to the ratio inversion of downstream Bcl-2/Bax, which activated caspase-3 or caspase-9 to induce the apoptosis of leukemia cells.Conclusions:The apoptosis of leukemia cells induced by Nrf2 inhibitor 4f was mainly associated with the miRNA-4298/PADI4/p53 axis, suggesting that it might be a novel signaling pathway for targeted therapy.

Background::There is a need for effective and safe therapies for psoriasis that provide sustained benefits. The aim of this study was to assess the efficacy and safety of tildrakizumab, an anti-interleukin-23p19 monoclonal antibody, for treating moderate-to-severe plaque psoriasis in Chinese patients.Methods::In this multi-center, double-blind, phase III trial, patients with moderate-to-severe plaque psoriasis were enrolled and randomly assigned (1:1) to receive subcutaneous tildrakizumab 100 mg or placebo at weeks 0 and 4. Patients initially assigned to placebo were switched to receive tildrakizumab at weeks 12, 16, and every 12 weeks thereafter. Patients in the tildrakizumab group continued with tildrakizumab at week 16, and every 12 weeks until week 52. The primary endpoint was the Psoriasis Area and Severity Index (PASI 75) response rate at week 12.Results::At week 12, tildrakizumab demonstrated significantly higher PASI 75 response rates (66.4% [73/110] vs. 12.7% [14/110]; difference, 51.4% [95% confidence interval (CI), 40.72, 62.13]; P <0.001) and Physician’s Global Assessment (60.9% [67/110] vs. 10.0% [11/110]; difference, 49.1% [95% CI, 38.64, 59.62]; P <0.001) compared to placebo. PASI 75 response continued to improve over time in both tildrakizumab and placebo-switching to tildrakizumab groups, reaching maximal efficacy after 28 weeks (86.8% [92/106] vs. 82.4% [89/108]) and maintained up to 52 weeks (91.3% [95/104] vs. 87.4% [90/103]). Most treatment-emergent adverse events were mild and not related to tildrakizumab. Conclusion::Tildrakizumab demonstrated durable efficacy through week 52 and was well tolerated in Chinese patients with moderate-to-severe plaque psoriasis.Trial registration::ClinicalTrials.gov, NCT05108766.