To explore the in vitro and in vivo synergistic effect of paclitaxel in combination with co-listin against MDREscherichia coli(E.coli)and the corresponding mechanism of synergism,we measured the MICs of PTX alone and combination of PTX+antimicrobial drugs on E.coli and Staphylococcus aureus(S.aureus)by broth microdilution method.Then,checkerboard method was used to determine the FICI of PTX+COL combination,and the antibacterial synergies of PTX and COL was further explored through analyzing the membrane permeability and efflux pump ac-tivity.The MICs results showed that the MIC values of PTX alone against E.coli(G5,E25)and S.aureus S238 were＞1 024 mg/L and 512 mg/L,respectively.Meanwhile,we found that the anti-bacterial activity of COL against E.coli could be significantly enhanced(MIC decreased by 4 to 8 times)when used in combination with PTX.The checkerboard test showed that the FICI values of PTX combined with COL for E.coli(G5,E25)were 0.31 and 0.29,respectively,indicating a synergistic antibacterial effect on these strains.The FICI values of PTX combined with COL for E.coli G21,S.aureus(S237 and S238)were 0.51,0.75 and 0.53,respectively,indicating additive effects on these strains.In the mouse abdominal infection model,the combination group could ex-tremely significantly reduce the bacterial burden of E.coli in abdominal compared to the COL or PTX alone group(P＜0.001).The analysis of membrane permeability and efflux pump activity showed that PTX combined with COL significantly increased the inner and outer membrane per-meability of E.coli(G5 and E25),and markedly inhibited the efflux pumping activity of E.coli,when compared that of PTX and COL alone(P＜0.01).The above results indicated that the com-bination of PTX and COL could exert a synergistic in vivo and in vitro antibacterial effect on COL-resistant E.coli through increasing bacterial membrane permeability and inhibiting efflux pump activity.This study provides the theoretical foundation for the development of a novel combi-nation regimen for the treatment of MDR E.coli infection.

Objective To investigate the clinical,imaging,and pathological manifestations of myofibroma in children.Methods The data of 31 patients with myofibroma confirmed by pathology were analyzed retrospectively,and the imaging features were observed.Results Among the 31 cases,28 cases were treated with subcutaneous painless mass.There were 28 cases of single lesions and 3 cases of multiple lesions.There were 5 cases with calcification,13 cases with cystic degeneration,and 12 cases with capsules.The enhanced scan showed mild to moderate progressive enhancement in 8 cases,obvious uniform/uneven enhancement in 11 cases(obvious peripheral enhancement in 5 cases),and no obvious enhancement in 2 cases.Among them,26 cases were subcutaneous type,mainly manifested as subcutane-ous round mass,with uniform or uneven density/signal,and the enhancement was mainly mild to moderate progressive enhancement or obvious enhancement.There were 3 cases of intraosseous type,mainly manifested as expansive bone destruction,without periosteal reaction and sclerotic edge,with uniform density/signal and obvious enhancement.There were 2 cases of visceral type,mainly with obvious uneven mass enhancement.Conclusion The imaging findings of myofibroma are characteristic,especially the subcutaneous and intraosseous types,which are highly consistent with pathology.Preoperative imaging examination can clearly show the size,number,enhancement and visceral involvement of the lesions.

To explore the in vitro and in vivo synergistic effect of paclitaxel in combination with co-listin against MDREscherichia coli(E.coli)and the corresponding mechanism of synergism,we measured the MICs of PTX alone and combination of PTX+antimicrobial drugs on E.coli and Staphylococcus aureus(S.aureus)by broth microdilution method.Then,checkerboard method was used to determine the FICI of PTX+COL combination,and the antibacterial synergies of PTX and COL was further explored through analyzing the membrane permeability and efflux pump ac-tivity.The MICs results showed that the MIC values of PTX alone against E.coli(G5,E25)and S.aureus S238 were＞1 024 mg/L and 512 mg/L,respectively.Meanwhile,we found that the anti-bacterial activity of COL against E.coli could be significantly enhanced(MIC decreased by 4 to 8 times)when used in combination with PTX.The checkerboard test showed that the FICI values of PTX combined with COL for E.coli(G5,E25)were 0.31 and 0.29,respectively,indicating a synergistic antibacterial effect on these strains.The FICI values of PTX combined with COL for E.coli G21,S.aureus(S237 and S238)were 0.51,0.75 and 0.53,respectively,indicating additive effects on these strains.In the mouse abdominal infection model,the combination group could ex-tremely significantly reduce the bacterial burden of E.coli in abdominal compared to the COL or PTX alone group(P＜0.001).The analysis of membrane permeability and efflux pump activity showed that PTX combined with COL significantly increased the inner and outer membrane per-meability of E.coli(G5 and E25),and markedly inhibited the efflux pumping activity of E.coli,when compared that of PTX and COL alone(P＜0.01).The above results indicated that the com-bination of PTX and COL could exert a synergistic in vivo and in vitro antibacterial effect on COL-resistant E.coli through increasing bacterial membrane permeability and inhibiting efflux pump activity.This study provides the theoretical foundation for the development of a novel combi-nation regimen for the treatment of MDR E.coli infection.

Objective To investigate the clinical,imaging,and pathological manifestations of myofibroma in children.Methods The data of 31 patients with myofibroma confirmed by pathology were analyzed retrospectively,and the imaging features were observed.Results Among the 31 cases,28 cases were treated with subcutaneous painless mass.There were 28 cases of single lesions and 3 cases of multiple lesions.There were 5 cases with calcification,13 cases with cystic degeneration,and 12 cases with capsules.The enhanced scan showed mild to moderate progressive enhancement in 8 cases,obvious uniform/uneven enhancement in 11 cases(obvious peripheral enhancement in 5 cases),and no obvious enhancement in 2 cases.Among them,26 cases were subcutaneous type,mainly manifested as subcutane-ous round mass,with uniform or uneven density/signal,and the enhancement was mainly mild to moderate progressive enhancement or obvious enhancement.There were 3 cases of intraosseous type,mainly manifested as expansive bone destruction,without periosteal reaction and sclerotic edge,with uniform density/signal and obvious enhancement.There were 2 cases of visceral type,mainly with obvious uneven mass enhancement.Conclusion The imaging findings of myofibroma are characteristic,especially the subcutaneous and intraosseous types,which are highly consistent with pathology.Preoperative imaging examination can clearly show the size,number,enhancement and visceral involvement of the lesions.

During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.

Objective: To study the effect of the modified preparation method with root canal flushing of different solutions on the anti-fracture properties of mechanical nickel-titanium filings. Methods: A transparent resin model of root canal was established. ProTaper Universal (PTU F1) instrument was used to prepare the root canals. The number of prepared root canals by each PTU F1 with the various solutions(n = 20) was recorded and compared among groups. Results: 6. 13 ± 3. 52 root canals were prepared in distilled water group, 6. 25 ± 1. 76 in 0. 9％saline group, 6. 27 ± 2. 07 of 0. 2％ chlorhexidine group, 6. 88 ± 3. 21 in 1％ sodium hypochlorite group, 4. 31 ± 2. 34 in 5％ sodium hypochlorite group and 3. 26 ± 2. 08 in dry drilling group. The number between each 2 of distilled water, 0. 9％saline group, 0. 2％chlorhexidine group and 1％ sodium hypochlorite group, and the number between 5％ sodium hypochlorite group and dry drilling group was not statistically significant(P＞ 0. 05). The number of prepared root canals in the first 4 groups was more than that in the latter 2 groups(P＜ 0. 05). Conclusion: Distilled water, 0. 9％ saline, 0. 2％ chlorhexidine or 1％ sodium hypochlorite for root canal irrigation can improve mechanical nickel-titanium instrument for fatigue resistance in root canal preparation, but 5％ sodium hypochlorite and dry drilling can not.

The distribution and prevalence of low pathogenic avian influenza virus in major live poultry wholesale markets around the Dongting Lake region ,China were investigated in our study to propose prevention and control measures on low pathogenic avian flu in the area of live poultry wholesale market .The samples were injected to SPF chicken embryos by allanto-ic cavity ,and then the allantoic fluid were harvested and used for hemagglutination (HA) .If it was positive by HA ,subtypes of the virus would be determined by hemagglutination inhibition (HI) and RT-PCT .We isolated 627 low pathogenic avian in-fluenza viruses in major live poultry wholesale market around Dongting Lake region systematically in winter and spring during 2009-2011 ,and the total separation rate was 22 .2% .The duck swab separation rate of low pathogenic avian influenza was the highest ,which was 24 .6% ,and the following was chicken swab that reached 21 .5% ,and the goose swab separation rate was 11% .We isolated 6 HA subtypes including H3 ,H4 ,H6 ,H9 ,H10 ,and H11 in every live poultry wholesale market ,and the separation rate of H9 ,H6 and H4 subtypes was relatively high ,which could reach 11% ,6 .3% and 3 .4% ,respectively . Those results indicated that recessive infection of low pathogenic avian influenza virus was serious in live poultry wholesale mar-ket around the Dongting Lake area ,and it was a great threat to the occurrence of avian flu .

Objective To develop electrically evoked auditory brainstem response(EABR) modules of REZ-Ⅰ domestic cochlear implant device,and testify the reliability and validity of the modules.Methods Postoperative EABR were recorded in guinea pigs by using the self-designed EABR module.Results EABR waves were recorded in all 15 ears of 9 guinea pigs with normal hearing.The threshold was (159.00 ±50.21) current level (CL) and e Ⅲ wave latency was (2.36 ± 0.46)ms of 100 μs pulse width stimulation; for 150 μs pulse width stimulation,the threshold was (131.44 ± 49.25)CL and e Ⅲ wave latency was (2.59 ± 0.46) ms ; for 200 μs pulse width stimulation,the threshold was (119.63 ± 52.56) CL and e Ⅲ wave latency was (2.62 ± 0.44) ms.Conclusion According the preliminary results of the study,the reliability and stability of the EABR modules of domestic cochlear implant device can meet the demands of EABR recording.