Objective To analyze the pathogenic bacteria and drug resistance of peritoneal dialysis-associated peritonitis(PDAP),and provide a clinical reference for the rational use of antibiotics.Methods The demographic data of PDAP patients admitted to the peritoneal dialysis(PD)Center of the First Affiliated Hospital of Soochow University from July 1,2015 to December 30,2021 were collected,and the pathogens,drug resistance and prognosis were retrospectively analyzed.Results A total of 150 episodes of PDAP occurred in 92 patients.The positive rate of PD fluid culture was 61.33％,including 65 cases(70.65％)of Gram-positive(G+)bacteria,mainly Staphylococcus and Streptococcus.Gram-negative(G-)bacteria were in 16 cases(17.39％),mainly Escherichia coli and Enterobacter cloacae.There were 11 cases(11.96％)of multiple infections,including 5 cases of combined fungal infection.From 2016 to 2021,the incidence of G+bacteria-related PDAP decreased from 14 to 8 cases.G+strains were resistant to methicillin(35.00％),and were sensitive to linezolid(100.00％),teicoplanin(100.00％)and rifampicin(100.00％).The sensitivity rate to vancomycin was 98.59％.G-strains were sensitive to ceftazidime(86.36％),ceftizoxime(88.89％)and amikacin(100.00％).The MIC of vancomycin against Staphylococcus showed an upward trend in 2019-2021.The overall cure rate of PDAP was 81.33％in patients who responded to antibiotic treatment,and the cure rate of G+bacteria was higher than that of multiple infections(89.23％vs.36.36％,P＜0.01).The outcome of patients with multiple infections,especially those with concurrent fungal infection was poor.Conclusion The incidence of PDAP in the PD center has shown a decreasing trend in recent years.G+bacteria are still the main pathogenic bacteria causing PDAP,and they are highly resistant to methicillin,so vancomycin should be used as empirical therapy.For G-bacteria,cefotaxime and amikacin can be chosen as empirical therapy.There is a drift in the MIC values of vancomycin against Staphylococcus in the study period,so it is necessary to monitor the MIC of vancomycin against Staphylococcus and its changing trend.

Objective:To evaluate the safety and efficacy of the domestic robotic surgical system for general surgery.Methods:A prospective single-center, single-arm exploratory study was conducted at Gansu Provincial People's Hospital from Jun 2022 to Oct 2023, enrolling 54 patients undergoing general surgery using domestically produced Toumai? Endoscopic Surgical Robotic System. The primary study endpoint was surgical success rate, and the secondary study endpoints were intraoperative bleeding, operative time, complications, system performance, hospitalization days.Results:In this study, robotic surgery was successfully completed in 52 patients, and in 2 patients undergoing thyroid operation it was converted to open surgery due to bleeding, with a success rate of 96%, no organ injury or death during surgery, and no system failure. The types of surgery included cholecystectomy, radical gastric cancer resection, radical colorectal cancer resection, inguinal hernia repair, partial hepatectomy, total thyroidectomy and choledocho-jejunal anastomosis.Conclusion:The study provides preliminary evidence of the safety and efficacy of the Toumai? Endoscopic Surgical Robotic System for the treatment of general surgical diseases.

Hepatogenous diabetes (HD) is a common complication of end-stage liver disease, and many studies have confirmed its adverse effect on prognosis. In recent ten years, a great number of studies have been conducted on the pathogenesis of HD and some progress has been made. This article reviews the research advances in the pathogenesis of HD, in order to provide a reference for the diagnosis and treatment of HD by clinicians.

Both diabetes mellitus and liver cirrhosis have high incidence rate and mortality rate around the world, and in recent ten years, scholars in China and globally have conducted many studies on the association between diabetes mellitus and liver cirrhosis. This article systematically reviews the advances in the basic and clinical research on the influence of diabetes mellitus on liver cirrhosis and its complications and summarizes possible mechanisms. The results show that diabetes mellitus can accelerate the process of liver fibrosis, increase the risk of complications and progression to liver cancer in patients with liver cirrhosis, and reduce their survival rate.

Glycosylation is one of the most important post-translational modification in protein biosynthesis. Immunoglobulin glycosylation can exert anti-inflammatory or pro-inflammatory activity by regulating antibody stability and affecting its interaction with different FcγRs. In recent years, a large number of studies have confirmed that abnormal glycosylation of immunoglobulin plays a key role in the pathogenesis of autoimmune diseases. Its products, such as sugar chain structure or/and glycosylated proteins, can be detected by lectin microarray and other technologies, are expected to become new serum markers of autoimmune diseases. It has a broad application prospect in disease diagnosis, condition monitoring, prognosis evaluation and treatment.

Objective To compare the level of Annexin Ⅱ in patients with systemic lupus erythematosus(SLE),diabetic nephropathy(DN),chronic glomerulonephritis and normal controls,and explorle the significance of the annexin Ⅱ in SLE.Methods Thirty-five cases of patients with SLE,ten cases of patients with DN,ten cases of patients with chronic glomerulonephritis were enrolled in this study,twenty cases of healthy controls were also enrolled.Circulating annexin Ⅱ in white blood cells was detected bv flow cytometry.Student's t test,variance analysis and Lineat correlation analysis were used for statistial analysis.Resuits Compared with healthy controls,the level of annexin Ⅱ in white blood cells in SLE patients (7.1±2.9)%and DN patients(8.0±3.7)%were significantly lower than that of the healthy controls(P<0.01,p<0.05).In the SLE group,the level of annexin Ⅱ of patients who had more active disease(SLEDAI≥9)decreased more thall those with less active disease(SLEDAI<9),(P<0.05).A positive correlation was found between annexin Ⅱ and serum albumin level(r:0.439,P<0.01),but negative correlation was found between annexin and urine protein/urine creatinine(r=-0.382,P<0.05),SLEDAI(r=-0.417,P<0.05),D-dimer(r=-0.336.p＜0.05) levels.Conclusion The level of annexin Ⅱ is decreased in patients with SLE,so it can renectthe abnormality of coagulation and fibrinolytic systems,and it may be used as a good indicator for prothrombotic status in SLE patients.It can be helpful to evaluatethe activity of the disease and the therapeutic efficacy.

OBJECTIVETo investigate the expression of anaphylatoxin receptor C5aR (CD88) in synoviocytes from patients with rheumatoid arthritis (RA) and osteoarthritis (OA).

METHODSThe expression of C5aR was assessed in synoviocytes isolated from 27 RA and 12 OA patients using reverse transcription-polymerase chain reactions (RT-PCR), flow cytometry, and immunofluorescence analysis. The effects of C5a on the release of tumor necrosis factor alpha (TNF alpha) from synoviocytes were assayed using enzyme-linked immunosorbent assays (ELISA).

RESULTSC5aR mRNA was detected in 24 of 27 samples from RA patients, and 10 of 12 samples from OA patients. Flow cytometric analysis and immunofluorescence study demonstrated the cell surface expression of C5aR in a significant proportion of synoviocytes from both RA and OA patients, and the level of C5aR expression in synoviocytes was significantly correlated with joint swelling, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) in RA patients. Finally, interaction of C5aR with its ligand C5a was shown to enhance lipopolysaccharide (LPS)-induced TNF alpha release from synoviocytes.

CONCLUSIONSThe expression of C5aR in synoviocytes from inflammatory joint diseases and also the induction of TNF alpha release in activated synoviocytes by the interaction of C5a and C5aR suggest that the C5a/C5aR system may play an important role in joint inflammation process.

Adult ; Aged ; Arthritis, Rheumatoid ; metabolism ; Cells, Cultured ; Female ; Humans ; Male ; Middle Aged ; Osteoarthritis ; metabolism ; Receptor, Anaphylatoxin C5a ; analysis ; Synovial Membrane ; chemistry ; cytology

Aim To evaluate neuroprotective effects of stearic acid on primarily cultured hippocampal neurons and to study the mechanism of neuroprotection afforded by stearic acid.Methods Primarily cultured hippocampal neurons were insulted by OGD(oxygen-glucose deprivation),H_2O_2,glutamate and NaN_3;MTT assay was utilized to evaluate cell viability;Inhibitors of PPAR?and PI-3K signal pathway were used to study mechanisms of neuroprotection of stearic acid.Results Compared with control neurons,A_(570) in MTT assay were increased significantly by stearic acid in hippocampal neurons insulted by OGD(oxygen-glucose deprivation),H_2O_2 and glutamate(P

AIM: To investigate the effect of intraventricular pressure change by volume overload (VOL) on expression of proto-oncogene c- fos ,c- jun ,c- myc and egr-1 . METHODS: Left ventricular systolic pressure(LVSP) and left ventricular end diastolic pressure (LVEDP) of rat with VOL induced by aortacaval fistula operation and rats of control group were measured at 30 min, 1, 4, 6, 12 and 48 h after the operation,these mRNAs at the foregoing time points were measured by slot bloting method and quantified with densitometry. RESULTS: Be compared with the control group, VOL rats LVSP decreased ( P 0.05) after the operation.The proto-oncogene expression signals were not detected in the control,negative controls and VOL rats at 30 min after the operation. The c- fos, c- jun and egr-1 mRNA signals appeared earlier,at 1 h, and c- myc mRNA increased later at 4 h.All reached peak value at 4 h and then declined gradually.The c- fos mRNA were not detected at 48 h. The c- myc ,c- 0jun and egr-1 mRNA persisted throught the entire observation period from 1 h to 48 h. CONCLUSIONS: During VOL early phase the overload have effect on expression of the proto-oncogene mRNA,c- fos, c- jun and egr-1 mRNA appear earlier, c- myc later, egr -1,c- jun and c- myc persist longer period, but the expressions do not strengthen with the ventricule wall load increase.This sequential induction pattern may reflect the time course regularity of the proto-oncogenes expression induced by VOL,and indicate the proto-oncogenes expression initiate while the heart load accumulate some extent and duration and the load magnitude may not play a critical role.

0 05), but there were no relationship between collagen type Ⅰ/Ⅲ ratios in IZ and +P'max or - P'max in IZ.CONCLUSION: Collagen deposition in IZ after myocardial infarction was of benefit to improvement of systolic function. Collagen deposition in NIZ was harmful to systolic and diastolic function.