Objective To analyze the correlation between the drug resistance rate of common pathogens in blood culture of inpatients from the First Hospital Affiliated to Hebei North University from 2019 to 2021 and the frequency of antimicrobial drug use (DDDs). Methods Strains isolated from positive blood cultures of inpatients from 2019 to 2021 were collected, and data on antimicrobial drug use in patients with positive blood cultures during the same period were also collected. WHONET 5.6 software and Pearson correlation analysis were used to explore the correlation between pathogenic bacterial resistance rate and antimicrobial DDDs. Results A total of 916 samples tested positive in blood cultures from 2019 to 2021. Among the top antimicrobial drugs in DDDs, the DDDs of cefazolin, cefuroxime, and ceftazidime all showed an upward trend year by year (the increase from 2019 to 2021 was 38.8%, 228.3%, and 87.1%, respectively). A total of 739 pathogenic bacteria strains were isolated from positive blood culture samples from 2019 to 2021, and the top five pathogenic bacteria were Escherichia coli, Klebsiella pneumoniae, Staphylococcus epidermidis, Staphylococcus aureus, and Pseudomonas aeruginosa, accounting for 37.2%, 16.1%, 8.1%, 7.4%, and 6.5%, respectively. The drug resistance rates of Escherichia coli to cefazolin, ceftazidime, cefotaxime, and polymyxin B were positively correlated with their DDDs (r=0.961, 0.907, 0.988, 0.997, P < 0.05). The drug resistance rates of Klebsiella pneumoniae to piperacillin, cefazolin, cefotaxime, cefepime, aztreonam, imipenem, meropenem, levofloxacin, and polymyxin B were positively correlated with their DDDs (r=0.766, 0.772, 0.838, 0.667, 0.734, 0.821, 0.904, 0.980, 0.997, P < 0.05). The drug resistance rate of Pseudomonas aeruginosa to gentamicin was positively correlated with their DDDs (r=0.878, P < 0.05). The drug resistance rate of Acinetobacter baumannii to moxifloxacin was positively correlated with its DDDs (r=0.856, P < 0.05). However, there was no correlation between the drug resistance rates of Staphylococcus aureus and Staphylococcus epidermidis to most commonly used antimicrobial drugs and antimicrobial DDDs (P>0.05). Conclusion The pathogenic bacteria causing bloodstream infections in inpatients at the First Hospital Affiliated to Hebei North University from 2019 to 2021 are complex and diverse (mainly Gram-negative bacteria). The overall drug resistance rate of pathogenic bacteria shows an upward trend, and there is a correlation between the drug resistance rates of most pathogenic bacteria and antimicrobial DDDs.

Objective:To analyze the value of dual energy CT parameters combined with serum procollagen Ⅰ N-terminal propeptide (PⅠNP) and beta C-terminal cross-linked telopeptide of type Ⅰ collagen (β-CTX) in differential diagnosis of spinal bone metastasis from lung cancer and myeloma.Methods:The clinical data of 54 patients with spinal bone metastasis from lung cancer and 50 patients with myeloma in Jincheng People′s Hospital from October 2019 to March 2021 were analyzed retrospectively. All patients were examined by dual energy CT on the day of admission, and the CT values at the energy levels of 40 to 80 keV (energy interval of 10 keV) were recorded. The serum PⅠNP and β-CTX levels were detected by chemiluminescent assay before treatment. The pathological examination results were taken as gold standard, and the CT values at the energy levels of 40 to 80 keV by dual energy CT and serum PⅠNP and β-CTX levels were compared between 2 groups. Receiver operating characteristic (ROC) curve was used to analyze the differential diagnosis value of the CT values at the energy levels of 40 to 80 keV, serum PⅠNP and β-CTX levels alone and combination.Results:The CT values at the energy levels of 40 to 80 keV by dual energy CT and serum PⅠNP and β-CTX levels in patients with spinal bone metastasis from lung cancer were significantly higher than those in patients with myeloma: 79.86 (61.20, 116.32) HU vs. 58.29 (46.92, 64.03) HU, 64.48 (50.27, 90.08) HU vs. 45.78 (38.59, 56.75) HU, 57.35 (43.31, 78.04) HU vs. 43.62 (36.91, 54.06) HU, 52.05 (42.98, 75.79) HU vs. 41.26 (32.84, 51.76) HU, 45.52 (38.55, 63.59) HU vs. 36.68 (28.72, 49.83) HU, 66.35 (31.15, 81.97) μg/L vs. 31.38 (27.76, 34.50) μg/L and 0.61 (0.48, 0.67) μg/L vs. 0.49 (0.47, 0.52) μg/L, and there were statistical differences ( P<0.05 or <0.01). ROC curve analysis result showed that the sensitivity of the combination of the CT values at the energy levels of 40 to 80 keV by dual energy CT was higher than those alone (83.33% vs. 59.26%, 61.11%, 62.96%, 64.81% and 66.67), the area under the curve (AUC) was also higher than those alone (0.882 vs. 0.798, 0.811, 0.817, 0.801 and 0.773), and there were statistical differences ( P<0.01 or <0.05); the sensitivity of the combination of serum PⅠNP and β-CTX levels was higher than those alone (81.48% vs. 57.41% and 62.96%), the AUC was higher than those alone (0.829 vs. 0.753 and 0.729), and there were statistical differences ( P<0.01 or <0.05); the sensitivity of all indexes combined in the differential diagnosis of spinal bone metastasis from lung cancer and myeloma was higher than those of the combination of the CT values at the energy levels of 40 to 80 keV by dual energy CT, the combination of serum PⅠNP and β-CTX levels (98.15% vs. 83.33% and 81.48%), the same as AUC (0.976 vs. 0.882 and 0.829), and there were statistical differences ( P<0.01); there were no significant differences in the specificity of each index alone and combination ( P>0.05). Conclusions:Compared with myeloma, the CT values at the energy levels of 40 to 80 keV by dual energy CT, serum PⅠNP and β-CTX levels in patients with spinal bone metastasis from lung cancer are increased, and the combination of the above indexes has ideal value in differential diagnosis of the two diseases.

Alpha-7 nicotinic acetylcholine receptors (α7 nAChRs) are expressed in the central nervous system (CNS) and are thought to play a role in a wide variety of psychiatric and neurological disorders. Activation of α7 nAChR leads to an anti-inflammatory effect, which may show beneficial effects in those central nervous system disorders. In the present article, we summarize information on receptor distribution and expression, and review the effects of α7 nAChR on the CN disorders (e.g., Alzheimer's disease, Parkinson's disease, and stroke), which may provide a new idea for the development of the treatment of CNS diseases.

Objective To analyze the distribution characteristics and risk factors of extended stay over 30 days at tertiary comprehensive hospitals, and explore methods of shortening average length of stay(LOS).Methods Homepage of all inpatients discharged from October 2014 to October 2015 of 31 tertiary comprehensive hospitals in Shanxi province were collected.39 234 cases of these inpatients stayed over 30 days and their case information was complete.A generalized linear model was used for risk factors analysis.Results With the extension of LOS, most of the inpatients with extended stay were found during their 30th-40th days, accounting for 50.21% of all and constituting the highest daily costs as well.The ratio of inpatients decreases with their LOS, and its distribution presents a positive skew in entirety.Distribution of inpatients over 30 days identified urban employees under medical insurance accounting for the highest ratio among all payment categories,and those from the department of orthopedics for the highest ratio among all departments, while those of diseases from injury and poisoning accounting for the highest ratio among all disease categories.The findings indicated ten important factors for extended stay, namely gender, medical payment category, ICD, inter-department transfer, nosocomial infection, and clinical pathway.Conclusions To strengthen management of specific departments and inpatients, focus on key process of medical quality, and accelerate medical insurance payment reform can effectively control extended stay.

Objective To study formation of ammonion-magnesium phosphate crystals in urine with bacteria growing and provide guidance for cilinical prevention of urinary calculi.Methods Bacterial culturefluid of Escherichia coli,Proteus mirabilis,Pseudomonas aeruginosa,Klevsiella pneumoniae,Enterococcus in urine was examined directly under the ultrahigh sensitive microscpcope system for ammonion-magnesium phosphate crystasl.The number of ammonion-magnesium phosphate crystasl was measured when the 24th and the 48th hour.Results Ammonion-magnesium phosphate crystasl were observed from the culture fluid without ammonion magnesium phosphate crystasl.The rate of male formation was higher than that of female.Ammonion-magnesium phosphate crystals in culture fluid of Proteus mirabilis was the highest,Pseudomonasaeruginosa was the second,the third was Klebsiella pneumoniae,and there was formed 1 case in 2 ml culturefluid of enterococcus,and 2 cases of formation in 5 ml culturefluid of Escherichia coli.The crystals formed were the most unformed feather crystals,followed by cubic and square cylinders,an d the envelope like crystals were the least.Conclusion Bacteria with urease play a significant role in ammonion-magnesium phosphate crystasl formed,Proteus mirabilis is the main pathlogen.

Objective To investigate the protection effect of cyclosporine A on spatial memory following chronic cerebral hypoperfusion in rats and its possible mechanism.Me,ods Sixty SD rats were randomly divided into sham operation,vehicle,low-dose cyclosporine A,medium-dose cyclosporine A,and high-dose cyclosporine A groups.A chronic cerebral hypoperfusion model was prepared by permanent bilateral ligation of bilateral common carotid arteries.From 46 days after modeling,olive oil 1 ml/d was used for intragastric administration in the sham-operation group and the vehicle group.Cyclosporine A 3 mg/kg,6 mg/kg,and 12 mg/kg were administrated intragastrically in the low-dose,medium-dose and high-dose cyclosporine A groups,respectively,once a day for 14 days.The spatial memory was assessed using Morris water maze test.Reverse transcriptase polymerase chain reaction (RT-PCR) was used to detect the expression of NADPH oxidase 4 (NOX4) mRNA in the cerebral cortex.Immunohistochemical staining and Western blot were used to detect the expression of NOX4 protein in the cerebral cortex.Results The Morris water maze test showed that the escape latencies in all cyclosporine A groups were significantly shorter than the vehicle group (all P ＜0.05).Immunohistochemical staining showed that the percentages of the NOX4-positive cells in the sham-operation,vehicle,low-dose,medium-dose,and high-dose cyclosporine A groups were4.43％ ±0.37％,37.44％ ±4.76％,18.05％ ±2.91％,12.51％ ±3.4％,and 11.06％ ±1.74％,respectively (F =262.021,P ＜ 0.001),the vehicle group was significantly higher than the sham-operation group (P ＜ 0.01),and all cyclosporine A groups were significantly less than the vehicle group (all P ＜ 0.01).RT-PCR showed that the expression levels of NOX4 mRNA in cerebral cortex in the sham-operation,vehicle,low-dose,medium-dose,and high-dose cyclosporine A groups were 0.36 ± 0.03,1.04 ± 0.04,0.58 ± 0.02,0.49 ± 0.01,and 0.40 ± 0.02,respectively (F =1 324.941,P ＜ 0.001),all cyclosporine A groups were significantly lower than the vehicle group (all P ＜ 0.01).Western blot showed that the expression levels of NOX4 protein in cerebral cortex in the sham-operation,vehicle,low-dose,medium-dose,and high-dose cyclosporine A groups were 0.02 ± 0.01,0.27 ± 0.04,0.09 ± 0.02,0.06 ± 0.02,and 0.06 ± 0.01,respectively (F =222.692,P ＜ 0.001),all cyclosporine A groups was significantly lower than the vehicle group (all P＜0.01).Conclusion Cyclosporine A may improve spatial memory following chronic cerebral hypoperfusion in rats by down-regulation of NOX4.

Prostate cancer tissue is composed of both cancer cells and host cells. The milieu of host components that compose the tumor is termed the tumor microenvironment (TME). Host cells can be those derived from the tissue in which the tumor originates (e.g., fibroblasts and endothelial cells) or those recruited, through chemotactic or other factors,to the tumor (e.g., circulating immune cells). Some immune cells are key players in the TME and represent a large proportion of non-tumor cells found within the tumor. Immune cells can have both anti-tumor and pro-tumor activity.In addition, crosstalk between prostate cancer cells and immune cells affects immune cell functions. In this review,we focus on immune cells and cytokines that contribute to tumor progression. We discuss T-regulatory and T helper 17 cells and macrophages as key modulators in prostate cancer progression. In addition, we discuss the roles of interleukin-6 and receptor activator of nuclear factor kappa-B ligand in modulating prostate cancer progression. This review highlights the concept that immune cells and cytokines offer a potentially promising target for prostate cancer therapy.

Objective To investigate the relationship of TCM constitution and syndrome elements based on patients with hyperhomocysteinemia. Methods A survey was conducted among 1316 patients with diabetes, coronary disease, hypertension and cerebral infarction. Totally 326 patients with hyperhomocysteinemia were incorporated in diagnostic data and their constitutions were determined. At the same time, syndrome elements identification method for syndrome elements was applied for judgment, and consistency of the constitution and syndrome elements was analyzed. Results The survey showed that prevalence rate of population with hyperhomocysteinemia was 24.77%;there were 6 cases with mild nature, and 320 cases with biased constitution;phlegm dampness, blood stasis, qi deficiency of constitutions 110 cases, 73 cases and 59 cases, respectively;blood stasis, phlegm, qi deficiency, and dampness were the main syndrome elements of hyperhomocysteinemia, of 100 cases, 98 cases, 73 cases and 59 cases, respectively;the consistency of phlegm dampness constitution and syndromes of phlegm was the most obvious (Kappa=0.89, P<0.05). Conclusion Phlegm dampness, blood stasis, and qi deficiency were the most common constitutions of hyperhomocysteinemia;blood stasis, phlegm, qi deficiency and dampness were the main syndrome elements of hyperhomocysteinemia patients. The two results were consistent, and the consistency of phlegm syndrome and phlegm dampness constitution was the most obvious.

Objective To analyse the distribution of pathogenic isolates and their durg resistance from inpatient in department of orthopedics from Jan.2008 to Dec.2012 and promote rational use of antibiotics.Methods All the clinical isolates were analyzed ret-rospectivily.Results of 1044 isolates,Gram-negative bacteria accounted for 54.12% (151/279 ),the most common pathogens of which were Escherichia coli,Enterobacter cloacae,and Pseudomonas aeruginosa.Gram-postive bacteria accounted for 41.58%(116/279),Staphylococcus aureus were the most common type.Fungi isolates accounted for 3.94%.The drug sensitive test showed that the resistance of different bacteria to the same antibiotic was different.The same kind of bacteria showed different drug resistance to different antibiotics.The most effective drugs for Enterobactericaeae infection treatment was Imipenem.Pseudomonas aeruginosa was sensitive to all the antibiotics exept for ciprofloxacin,to which the drug resistance was was 80%.The drug-resistance rate of Staphylococcus aureus to erythromycin,SMZ-TMP and clindanmycin were all higher than 50%,while to the rest antibiotic was low.Conclusion The bacteria that caused the infection in patients were widely distributed in the department of orthopedics,antibi-otics should be properly chosen according to the results of microbial culture and antimicrobial susceptibility test.

Objective To investigate antimicrobial resistance and pathogen in hebei antibacterial resistance investigation net in 2012.Methods Antimicrobial susceptibility test was detected by Kirby-Bauer method or broth dilution test.Results were analyzed according to CLSI 2010 breakpoints.WHONET 5.5 software was used to analyze the data.Results A total of 10 504 clinical isolates were collected in 2012,of which gram negative bacilli and gram positive cocci accounted for 76.2%, 23.8%,respectively.The most common pathogen in gram-negative rod was E.coli,K.pneumoniae,P.aeruginosa, A.baumanii and E.cloacae respectively.The most common pathogen in gram-positive cocci was S.aureus,E.facium,E-.faecalis,S.pneumoniae and S.epidermidis.ESBL rate of E.coli and K.pneumoniae was 66.5 and 46.7%.The resistant rate of E.coli,K.pneumoniae,E.cloacae to imipenem was 0.1%,0.5%,8.9% and to meropenem was 0.1%,0.6%,4.2%, respectively.P.aeruginosa was resistant to imipenem and meropenem were 38.9% and 32.3%.A.baumanii was resistant to imipenem and meropenem were 5 6.5% and 5 9.7%.Methicillin-resistant strains accounted for an average of 5 7.5% in S.aureus and 87.3% in coagulase negative staphylococcus.Staphylococcus was still susceptible to minocycline and chloram-phenicol.No staphylococcal strains were found resistant to vancomycin,linezolid.But a few coagulase negative staphylococcal strains were resistant to teicoplanin.Conclusion Surveillance of antimicrobial agents played an important role in controlling hospital infection.