Phages also known as bacteria viruses, are recognized as the most abundant and diverse microbes. This diversity is adapting to the selective pressures such as the prevalence of the phage resistance mechanisms of bacteria. Phages invade and lyse bacterial through six steps (adsorption, injection, replication, transcription translation, assemble, release). Bacteria evolve to many anti-phage mechanisms to avoid phage infection and lysis. This paper focus on a variety of anti-phage mechanisms of bacteria.
Bacteria ; genetics ; virology ; Bacterial Physiological Phenomena ; Bacteriophages ; genetics ; physiology ; DNA Replication ; Evolution, Molecular ; Virus Attachment

Objectives To develop Z-scores reference ranges for kidney in normal fetuses from the measurements of gestational age (GA),biparietal diameter (BPD) or femur length (FL) using two-dimension ultrasound.Methods A retrospective cross-sectional study of 403 singleton normal fetuses was performed.The gestation age range was from 18 to 40 weeks.Fetal biologic parameters included GA and BPD and FL based on menstrual age.Left kidney length and left kidney width of normal fetus were measured.Normal Z-score ranges were developed for leftkidney length or left kidney width using GA,BPD and FL as independent variables.Results Linear regression model was the best description of the data in each case and correlation between left kidney length or left kidney width and independent variables were excellent (r=0.8761,0.8818,0.8797,0.8604,0.8723,0.8643).All P values were less than 0.01.The equations were as follows,Y=0.094 22 + 0.1088X,Y=0.132 57 + 0.4349X,Y=0.6664 + 0.491 05X,Y=0.060 58X-0.051 98,Y=0.262 19X-0.197 55,Y=0.294 02X + 0.136 19.Heteroscedasticity of standard deviation (s) with increasing independent variables also could be modeled with a simple linear (r=0.925,0.934,0.915,0.908,0.914,0.922),All P values were less than 0.01.The equations were as follows,Y=0.025 + 0.005 58X,Y=0.097 09 + 0.010 45X,Y=0.046 17 + 0.025 65X,Y=0.001 13 + 0.002 24X,Y=0.003 67 + 0.011 55X,Y=0.005 07 + 0.015 89X.Then we got Z-scores based on the equation,Z-score=(actual measurement data of left kidney length or left kidney width-predictive data of left kidney length or left kidney width) predictive s.Conclusions Normal reference ranges and Z-scores for fetal left kidney length and left kidney width had been provided.These normative data may be useful tools for assessment of fetal kidney length and kidney width,especially had potential applications in malformations of fetal kidney.

Objective To observe the near-term impact of the second natural delivery on the structure of a female pelvic floor by ultrasonography. Methods Selected fifty second-natural-delivery women and fifty first-natural-delivery women from Tongde Hospital of Zhejiang Province between October, 2016 and October, 2017 undertook pelvic ultrasonnography (42 days postpartum). Pelvic ultrasonography was used to determine all mothers' bladder neck descent, bladder posterior angle, bladder neck tilt angle, bladder neck rotation angle, and the area of pelvic diaphragm hiatus when performing the Valsalva maneuver. Besides, pelvic ultrasonography was used to determine the extent of mothers' internal-urethral-of-orifice funneling, perineal hyperactivity, uterine prolapse and rectal bulge. The paired t test was applied between groups to compare the bladder neck descent, bladder posterior angle, bladder neck tilt angle, bladder neck rotation angle and the area of pelvic diaphragm hiatus of the second-natural-delivery mothers with those of the first-natural- delivery mothers. The χ2test was also applied to examine the degree of mothers' uterine prolapse, rectal bulge and internal-urethral-of-orifice funneling, as well as their perineal hyperactivity rate. Results The bladder neck descent, bladder posterior angle, bladder neck tilt angle, bladder neck rotation angle and the area of pelvic diaphragm hiatus of the second-natural-delivery mothers were all wider than those of the first-natural-delivery mothers [(29.37±5.32) mm vs (22.63±6.35) mm, (148.8±14.97)° vs (141.2±15.20)°, (73.69±16.03)° vs (69.8±15.25)°, (44.41±19.27)° vs (40.0±17.52)°, (21.47±5.19) cm2vs (19.15±4.10) cm2], and differences were statistically significant (t=5.761, P ＜0.001; t=2.519, P=0.001; t=2.476, P=0.001;t=3.123, P=0.001; t=2.481, P＜0.001). The degree of the second-natural-delivery mothers'uterine prolapse and internal-urethral-of-orifice funneling as well as their perineal hyperactivity rate were all higher than those of the first-natural-delivery mothers [46.0% (23/50) vs 20.0% (10/50), 12.0% (6/50) vs 6.0% (3/50), 20.0% (10/50) vs 6.0% (3/50)], and differences were statistically significant ( χ2=7.644, P=0.006; χ2=3.342, P=0.043; χ2=4.332, P=0.037). The differences in the incidence rate of rectal bulge between the two groups were of no statistical significance [4.0% (2/50) vs 2.0% (1/50), χ2=1.197, P=1.000]. Conclusions The pelvic ultrasonogram showed that the near-term impacts of the second natural-delivery on women's pelvic floor were more obvious than those of the first natural delivery. What's more, pelvic floor ultrasound has been proved to be a reliable basis for the diagnosis and screening of dysfunctional diseases of pelvic floor.

Objective:To study the intraoperative surgical factors which influenced non-immediate postoperative tracheal extubation (IPTE) after liver transplantation.Methods:The clinical data of all liver transplant recipients operated at the Qilu Hospital of Shandong University from January 2011 to July 2019 were reviewed. Patients who returned to a surgical ward with a tracheal cannula or who underwent re-intubation within 48 hours after IPTE because of hypoxemia were assigned to the cannula-preserving group (non-IPTE). The remaining liver recipients were assigned to the control group (IPTE). Univariate and multivariate logistic regression analysis were used to analyze the risk factors influencing IPTE.Results:Of 70 patients enrolled into this study, there were 30 patients in the cannula-preserving group (with 25 males, 5 females, and age of 51.8±7.3). And 40 patients in the control group (with 35 males, 5 females, and age of 48.4±9.6). Univariate logistic regression analysis showed anhepatic phase >45 min, blood loss >800 ml and intraoperative hypothermia were related with non-IPTE after liver transplantation(all P<0.05). Multivariate logistic regression analysis revealed anhepatic phase >45 min ( OR=3.972, 95% CI: 1.193-13.220, P=0.025) and intraoperative hypothermia ( OR=23.682, 95% CI: 2.434-230.438, P=0.006) increased the risk of unsuccessful IPTE. Conclusion:A long anhepatic phase and intraoperative hypothermia were surgical risk factors affecting non-IPTE after liver transplantation. Surgeons should avoid patients having hypothermia and a prolong anhepatic phase during liver transplantation.

Objective:To analyze the operational efficiency and its changes of traditional Chinese medicine(TCM)hospitals in Guangdong province,and to provide empirical evidence for improving the operational efficiency of TCM hospitals in Guangdong Province.Methods:The three-stage DEA model was used to conduct a static analysis of the operating efficiency of TCM hospitals in Guangdong Province in 2022,and the Malmquist index was used to conduct a dynamic analysis of the changes in the operating efficiency of TCM hospitals in Guangdong Province from 2018 to 2022.Results:After eliminating the influences of environmental variables and random interference,the average values of comprehensive efficiency,pure technical efficiency and average scale efficiency of the TCM hospitals in Guangdong Province in 2022 were 0.970,0.982 and 0.988,respectively.From 2018 to 2022,the total factor productivity index of Guangdong's TCM Hospitals was 1.008.Conclusion:The overall operation efficiency of TCM hospitals in Guangdong is high,but there are obvious regional differences.Further improvement of operation efficiency is mainly restricted by pure technical efficiency.Operational efficiency needs to be further improved through measures such as coordinating the layout of resources in various places,improving the external environment,sounding the internal management system of hospitals,and fine-tuning operational management.

Objective:To analyze the operational efficiency and its changes of traditional Chinese medicine(TCM)hospitals in Guangdong province,and to provide empirical evidence for improving the operational efficiency of TCM hospitals in Guangdong Province.Methods:The three-stage DEA model was used to conduct a static analysis of the operating efficiency of TCM hospitals in Guangdong Province in 2022,and the Malmquist index was used to conduct a dynamic analysis of the changes in the operating efficiency of TCM hospitals in Guangdong Province from 2018 to 2022.Results:After eliminating the influences of environmental variables and random interference,the average values of comprehensive efficiency,pure technical efficiency and average scale efficiency of the TCM hospitals in Guangdong Province in 2022 were 0.970,0.982 and 0.988,respectively.From 2018 to 2022,the total factor productivity index of Guangdong's TCM Hospitals was 1.008.Conclusion:The overall operation efficiency of TCM hospitals in Guangdong is high,but there are obvious regional differences.Further improvement of operation efficiency is mainly restricted by pure technical efficiency.Operational efficiency needs to be further improved through measures such as coordinating the layout of resources in various places,improving the external environment,sounding the internal management system of hospitals,and fine-tuning operational management.

Objective:To analyze the operational efficiency and its changes of traditional Chinese medicine(TCM)hospitals in Guangdong province,and to provide empirical evidence for improving the operational efficiency of TCM hospitals in Guangdong Province.Methods:The three-stage DEA model was used to conduct a static analysis of the operating efficiency of TCM hospitals in Guangdong Province in 2022,and the Malmquist index was used to conduct a dynamic analysis of the changes in the operating efficiency of TCM hospitals in Guangdong Province from 2018 to 2022.Results:After eliminating the influences of environmental variables and random interference,the average values of comprehensive efficiency,pure technical efficiency and average scale efficiency of the TCM hospitals in Guangdong Province in 2022 were 0.970,0.982 and 0.988,respectively.From 2018 to 2022,the total factor productivity index of Guangdong's TCM Hospitals was 1.008.Conclusion:The overall operation efficiency of TCM hospitals in Guangdong is high,but there are obvious regional differences.Further improvement of operation efficiency is mainly restricted by pure technical efficiency.Operational efficiency needs to be further improved through measures such as coordinating the layout of resources in various places,improving the external environment,sounding the internal management system of hospitals,and fine-tuning operational management.

Objective:To analyze the operational efficiency and its changes of traditional Chinese medicine(TCM)hospitals in Guangdong province,and to provide empirical evidence for improving the operational efficiency of TCM hospitals in Guangdong Province.Methods:The three-stage DEA model was used to conduct a static analysis of the operating efficiency of TCM hospitals in Guangdong Province in 2022,and the Malmquist index was used to conduct a dynamic analysis of the changes in the operating efficiency of TCM hospitals in Guangdong Province from 2018 to 2022.Results:After eliminating the influences of environmental variables and random interference,the average values of comprehensive efficiency,pure technical efficiency and average scale efficiency of the TCM hospitals in Guangdong Province in 2022 were 0.970,0.982 and 0.988,respectively.From 2018 to 2022,the total factor productivity index of Guangdong's TCM Hospitals was 1.008.Conclusion:The overall operation efficiency of TCM hospitals in Guangdong is high,but there are obvious regional differences.Further improvement of operation efficiency is mainly restricted by pure technical efficiency.Operational efficiency needs to be further improved through measures such as coordinating the layout of resources in various places,improving the external environment,sounding the internal management system of hospitals,and fine-tuning operational management.

Objective:To analyze the operational efficiency and its changes of traditional Chinese medicine(TCM)hospitals in Guangdong province,and to provide empirical evidence for improving the operational efficiency of TCM hospitals in Guangdong Province.Methods:The three-stage DEA model was used to conduct a static analysis of the operating efficiency of TCM hospitals in Guangdong Province in 2022,and the Malmquist index was used to conduct a dynamic analysis of the changes in the operating efficiency of TCM hospitals in Guangdong Province from 2018 to 2022.Results:After eliminating the influences of environmental variables and random interference,the average values of comprehensive efficiency,pure technical efficiency and average scale efficiency of the TCM hospitals in Guangdong Province in 2022 were 0.970,0.982 and 0.988,respectively.From 2018 to 2022,the total factor productivity index of Guangdong's TCM Hospitals was 1.008.Conclusion:The overall operation efficiency of TCM hospitals in Guangdong is high,but there are obvious regional differences.Further improvement of operation efficiency is mainly restricted by pure technical efficiency.Operational efficiency needs to be further improved through measures such as coordinating the layout of resources in various places,improving the external environment,sounding the internal management system of hospitals,and fine-tuning operational management.

Objective:To analyze the operational efficiency and its changes of traditional Chinese medicine(TCM)hospitals in Guangdong province,and to provide empirical evidence for improving the operational efficiency of TCM hospitals in Guangdong Province.Methods:The three-stage DEA model was used to conduct a static analysis of the operating efficiency of TCM hospitals in Guangdong Province in 2022,and the Malmquist index was used to conduct a dynamic analysis of the changes in the operating efficiency of TCM hospitals in Guangdong Province from 2018 to 2022.Results:After eliminating the influences of environmental variables and random interference,the average values of comprehensive efficiency,pure technical efficiency and average scale efficiency of the TCM hospitals in Guangdong Province in 2022 were 0.970,0.982 and 0.988,respectively.From 2018 to 2022,the total factor productivity index of Guangdong's TCM Hospitals was 1.008.Conclusion:The overall operation efficiency of TCM hospitals in Guangdong is high,but there are obvious regional differences.Further improvement of operation efficiency is mainly restricted by pure technical efficiency.Operational efficiency needs to be further improved through measures such as coordinating the layout of resources in various places,improving the external environment,sounding the internal management system of hospitals,and fine-tuning operational management.