Objective:To investigate the therapeutic effects of photodynamic therapy (PDT) on a rat model of ulcerative colitis (UC) induced by Escherichia coli. Methods:Each rat was administered 1 ml of 1×10 9 enteric invasive E. coli to establish an UC model. Thirty-six Sprague Dawley rats were randomly divided into control, model, low-dose LD 4-PDT, medium-dose LD 4-PDT, high-dose LD 4-PDT (60, 120, 240 μg/kg), and levofloxacin (LEV) (100 mg/kg) groups, with six rats in each group. The UC model was established in all groups except the control group, which received 0.9% sodium chloride injection once. The first day of E. coli administration was recorded as day 0, and treatment was initiated on day 7 with LD 4 enema, levofloxacin gavage, and alternating enema/gavage for a total of four times. After a 30-minute exposure to each dose, the colon was irradiated using a 650 nm laser PDT system with an energy density of 25 J/cm 2, while the LEV group was not irradiated. The levels of body mass, colon length, intestinal pathological tissue, inflammatory factors interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), malondialdehyde (MDA), oxidative stress factors myeloperoxidase (MPO), glutathione (GSH), and superoxide dismutase (SOD) were compared among all groups. Results:The body mass and colon length of the model group were lower than those of the control group. The body mass and colon length of the low, medium, and high -dose LD 4-PDT groups and LEV group were higher than those of the model group. Compared to the control group, the model group exhibited more epithelial cell loss, multiple ulcers, infiltration of inflammatory cells into the mucosa and submucosa, and decreased goblet cells. In contrast, the surface mucosa of colon tissue recovered, goblet cells increased, and ulcer healing was good in the low, medium, and high-dose LD 4-PDT groups and LEV group compared to the model group. Compared to the control group, the levels of TNF-α, IL-6, and MPO inflammatory factors were significantly increased in the model group ( all P < 0.001). Compared to the model group, the levels of TNF-α, IL-6, and MPO inflammatory factors in colon tissue from the low, medium, and high -dose LD 4-PDT groups and LEV group were significantly decreased ( P < 0.05, P < 0.001). Compared to the control group, MDA levels were increased, while GSH and SOD levels were decreased in the model group. In contrast, MDA levels in the low, medium, and high-dose LD 4-PDT groups were decreased ( P < 0.05, P < 0.001), while GSH and SOD levels were increased compared to the model group. Conclusions:Low-dose LD 4-PDT promotes the healing of colon mucosa, alleviates inflammation, regulates oxidative stress, and improves symptoms of UC.

Objective:To investigate the effects of abdominal Tuina(Chinese therapeutic massage)on behavioral function,5-hydroxytryptamine 1A receptor(5-HT1AR),and synapsin-1(Syn1)in neonatal rats with hypoxic-ischemic brain injuries(HIBI). Methods:Forty healthy neonatal rats,born of 5 specific pathogen-free healthy pregnant rats,were randomly divided into a group for modeling(n=28)and a sham operation group(n=12)on the 7th day of birth.In the group for modeling,24 neonatal rats with HIBI successfully established by the Rice method were randomly divided into a model group(n=12)and an abdominal Tuina group(n=12).The abdominal Tuina group was given abdominal Tuina for 28 d from 24 h after modeling,and the other groups were put under the same conditions but without any treatments.Rats in each group were subjected to suspension tests on the 7th,14th,21st,and 28th days of intervention.After the intervention,the rat hippocampal tissue was collected and stained with hematoxylin-eosin to observe the pathological changes in the rat hippocampal CA1 region.The 5-HT1AR expression in rat hippocampal CA1 region was detected by immune-histochemistry.The Syn1 expression in rat hippocampus was measured by Western blotting method. Results:The cells were disordered,and edema and necrosis appeared in the hippocampal CA1 region of the model group.Cell arrangement was clear,and edema was improved obviously in the hippocampal CA1 region of the abdominal Tuina group.Compared with the sham operation group,the suspension test scores,the number of 5-HT1AR positive cells,and Syn1 protein expression in the hippocampus decreased significantly in the model group after 21 d and 28 d of interventions(P<0.05).Compared with the model group,the suspension test scores,the number of 5-HT1AR positive cells,and Syn1 protein expression increased significantly in the abdominal Tuina group after 21 d and 28 d of interventions(P<0.05). Conclusion:Abdominal Tuina improves the behavioral function of upper limbs and up-regulates the expression levels of 5-HT1AR and Syn1 in the hippocampus of neonatal HIBI rats.

Objective:To explore the currents status of central vascular access devices (CVADs) in children's medical center in China and to provide a reference for the standardized use of CVADs and specialized nursing as well as a basis for pediatric intravenous therapy management.Methods:Totally 31 hospitals of Futang Research Center of Pediatric Development, children's hospitals of the medical treatment alliance as well as women and children care centers and general hospitals with pediatric departments were selected by convenient sampling from July 23rd to 31st, 2018. All the pediatric patients using CVADs were investigated with the Central Vascular Access Device Questionnaire which was designed by the research group, and the incidence of complications was also observed. Totally 1 333 questionnaires were collected, among which 1 288 were valid, accounting for an effective recovery rate of 96.62%.Results:There were 22 ClassⅢ and 9 ClassⅡ hospitals among the 31 hospitals. Among the 1 288 pediatric patients who used CVADs, 860 used peripherally inserted central catheters (PICC) , accounting for 66.77%; 342 used central venous catheters (CVC) , accounting for 26.55%; 77 used implantable venous access port (PORT) , accounting for 5.98%; and 9 used umbilical venous catheters, accounting for 0.70%. CVADs were mainly used in the Departments of Hematological Neoplasms, ICU, Intensive Care Unit Pediatric Surgery, Vasculocardiology and Neonatals. PICC, CVC and PORT were mainly applied to upper extremities (90.00%, 74 cases) , jugular vein (73.39%, 251 cases) and the breast (96.10%, 74 cases) respectively. In the maintenance of CVADs, there was the problem of co-existing dressings.Conclusions:CVADs have been widely used in pediatric patients, and the choice of CVADs is relatively standardized. However, the maintenance of the catheters, the use of dressings, the selection of infusion connectors and the control of related complications still need to be strengthened. It is recommended that nursing professionals and nursing managers should further strengthen their knowledge about the placement and maintenance of CVADs, and intensify their management and supervision in accordance with international and national guidelines and standards for intravenous infusion therapy to further reduce the incidence of vascular access complications in pediatric patients.

Objective:To compare the caries experience and the kinds of dental treatment between children with autism spectrum disorders (ASD) and children without systemic disease who were all treated under general anesthesia.Methods:Totally 103 children with ASD who received dental treatments under general anesthesia in 13 professional dental hospitals around China from April to November 2016 were included in the present study. A group of 97 children without systemic disease, according to the age, gender and application propensity score matching method, were chosen as controls, who received dental treatments under general anesthesia between January 2015 to November 2018 in the same hospitals as the children with ASD. Decay missing filling tooth (DMFT/dmft, DMFT for permanent teeth and dmft for primary teeth) indices of two groups of children and the contents of the dental treatments under general anesthesia were analyzed.Results:No significant difference of DMFT/dmft index ［ M( Q25, Q75)］ was found between children with ASD group ［0 (0, 3)/11(8, 14)］ and control group ［0 (0, 3)/9(7, 13)］ ( P>0.05). The average number of dental treatments under general anesthesia and the average number of endodontic treatment in children with ASD were 13 (11, 15) and 3 (2, 6) teeth respectively, while those in the control group were 12 (9, 14) and 2 (1, 4) teeth respectively, the differences were statistically significant ( P<0.01, P<0.05). Conclusions:No significant difference was found between children with ASD and the normal controls who receive dental treatments under general anesthesia in DMFT/dmft index, but the treatment needs of children with ASD is relatively higher, and their tooth decay is relatively severer.

OBJECTIVETo investigate the drug resistance, β-lactamase-encoding genes and protoporphyrin ferrochelatase-encoding genes of, and to explore its structure and pathogenic function.

METHODSThe strain was isolated by plate streaking method and identified by automatic bacteria detection system and 16S RNA gene PCR. Microdilution method was applied for drug susceptibility test. β-lactamases, extended spectrum β-lactamases (ESBL) and carbapenemases were detected using nitrocefin-disk, Kirby-Bauer disk, and Hodge test, respectively. Five β-lactamase-encoding genes and protoporphyrin ferrochelatase-encoding gene of the isolate were amplified by PCR for sequencing. Bioinformatic softwares were used to analyze the structure and function of the product of protoporphyrin ferrochelatase-encoding gene.

RESULTSA strain belonging towas isolated. This isolate was sensitive to cefepime, ciprofloxacin, ofloxacin and tigecycline, but resistant to five penicillins, four cephalosporins and two carbapenems antibiotics. The isolate produced β-lactamases but did not produce ESBL and carbapenemases. The isolate had five distinct β-lactamase-encoding genes and protoporphyrin ferrochelatase-encoding gene. The product of protoporphyrin ferrochelatase-encoding gene contained two functional domains of protoporphyrin ferrochelatase belonging to type Ⅱ chelatase superfamily that presented the most closely genetic relationship with the protoporphyrin ferrochelatase of.

CONCLUSIONSThe isolate ofhas a higher resistance to β-lactam antibiotics and its β-lactamase-encoding genes are different with the common bacterial β-lactamase-encoding genes. Protoporphyrin ferrochelatase may act as an important virulence factor of.

Objective To explore the clinical characteristics and outcomes of patients with atrial fibrillation (AF) and repeated emergency department (ED) visits.Methods Patients with AF were examined and analyzed retrospectively.Data were collected from consecutive patients from resuscitation room in the Department of Emergency of a large-scale general teaching hospital,from January 1,2011 to December 31,2015.The patients were verified by electrocardiographic examination and/or monitoring.The main outcomes were length of resuscitation room stay and outcome scales (defined as death,transfer to intensive units,to ordinary wards,or direct discharge).Results 908 patients were enrolled in the study with a mean age of 70.3 ± 12.8 years,and 494(54.4％) were female.There were 262(28.9％) cases visited ED for more than one time,and 646(71.1％) visited ED without repetition.Compared with the patients without repeated visit,patients with repeated visits were older (73.0 ± 9.8 years versus 69.2 ± 13.6 years,t=4.705,P＜0.001),and had a larger proportion of patients with CHADS2-VASc score greater or equals to 2(70.6％ versus 60.2％,x2 =8.660,P=0.003),whereas those patients had a shorter stay in the resuscitation room (13.6 ± 27.1h versus 27.0 ± 89.7h,t=3.370,P=0.001),and a higher percentage of directly discharge (73.3％ versus 61.9％,x2=10.607,P=0.001).In multiple logistic regression analysis,a higher CHADS2-VASc score and a lower quartile of the resuscitation room stay were independently predictive factors of repeated ED visits.Conclusion Patients with AF and repeated ED visits would have relatively complex condition and more comorbidities.High CHADS2-VASc score and short ED stay are independently predictive factors for repeated ED visits.

Objective To investigate the correlation between the indications,findings,interventions of fibrobronchoscopy(FB) in neonates and their correlative diseases with neonatal FB results and clinical data.Methods Retrospective case series of 243 consecutive patients of 28 days old or younger were investigated underwent FB for the first time from January 2010 to December 2014,at a tertiary care hospital.The common indications for FB and detection rate of respiratory tract diseases were collected.If the findings of FB had significant associations with premature birth and other diseases were analyzed.Associations between interventions and basic illnesses were also analyzed.Results Of the 243 patients undergoing 275 procedures of FB,201 cases were boys(73.1％).The age of FB was (13.34 ± 9.76) days and the weight was (3.08 ± 0.68) kg.Forty-five cases were premature infants (16.4％).A total of 254 procedures were found to have congenital diseases (92.4％),and 177 cases of them had congenital heart diseases (CHD) (64.4％).Common indications for FB were dyspnea(140 cases,50.9％),tachypnea(82 cases,29.8％),and stridor(71 cases,25.8％).A total of 188 upper airway lesions were found and the most common findings were laryngomalacia(56 cases,20.4％) and vocal cord paralysis(bilateral/unilateral,50 cases,18.2％).A total of 315 lower airway lesions were found and the most common findings were airway mucosal inflammation (98 cases,35.6％),trachea and main bronchial stenosis (73 cases,26.5 ％).A total of 21 cases (7.6％) underwent supraglottoplasty during or after FB,while 17 cases (6.2％) underwent tracheal dilation and 10 cases (3.6％) underwent tracheotomy.Compared with non-CHD neonates,neonates with CHD were statistically significantly less likely to have congenital lesions statistically,such as laryngomalacia(15.8％ vs.28.6％,P =0.012),bilateral vocal cord lesions(6.2％ vs.21.4％,P =0.000) and congenital laryngeal dysplasia(0 vs.7.1％,P =0.001).The tracheotomy(0 vs.10.2％,P =0.000) and supraglottoplasty(2.3％ vs.17.3％,P =0.000) were more rare.Nevertheless,they were more likely to have secondary lesions such as the left main bronchial stenosis caused by extrinsic compression (23.7％ vs.1.0％,P =0.000),abnormal bronchial anatomy(9.6％ vs.2.0％,P =0.018),left vocal cord paralysis(9.0％ vs.1.0％,P =0.008) and airway mucosal inflammation(41.8％ vs.24.5％,P =0.004).The tracheostenosis and main broncial stenosis (37.3％ vs.7.1％,P =0.000) with long-term intubation(78.5％ vs.58.2％,P =0.000) were more common.There was no significant difference between term neonates and premature infants in the detection rate of respiratory tract diseases (P ＞ 0.05),tracheotomy (0 vs.4.3 ％,P =0.322),supraglottoplasty (13.3 ％ vs.6.5 ％,P =0.205) or long-term i ntubation (80.0％ vs.69.6％,P =0.157).Complications caused by procedure were rare and mild.Conclusions FB can detect whether the neonates with dyspnea,tachypnea and stridor have laryngomalacia,vocal cord paralysis,airway mucous edema,tracheal and main bronchial stenosis and other signs,and FB may play an important role in diagnosis,treatment and prognosis evaluation of neonatal respiratory diseases.

Objective To investigate the clinic effect of tunnel technique on endoscopic submucosal dissection(ESD)for massive colorectal laterally spreading tumor(LST). Methods A retrospective study was conducted on the data of patients with colorectal large area LST(the shortest diameter>4 cm) undergoing ESD by tunnel technique from January 2015 to June 2016 in Digestive Endoscopy Center of Jiangsu Province Hospital of Traditional Chinese Medicine. The size of resected specimens, operation time, complications, pathology results, the number of en bloc resection and curative resection were analyzed. Results A total of 14 cases were collected, including 7 males and 7 females. The longest diameters of resected specimens were from 4.0 to 7.0 cm with mean size of 5.18 ± 0.49 cm. The operation times were from 40 to 120 min with mean time of 63.57±12.95 min. Intraoperative perforation occurred in 2 cases but no delayed perforation and bleeding occurred. Postoperative pathology showed 1 patient with adenoma hyperplasia with crypt abscess,3 patients with low grade intraepithelial neoplasia,6 patients with high grade intraepithelial neophasia,1 patient with carcinoma in situ, 1 patient with carcinoma in M3, and 2 patients with carcinoma in SM1. The number of cases who received en bloc resection, complete resection, and curative resection were 13, 13, and 13, respectively. Conclusion ESD by tunnel technique is safe and effective in the treatment of colorectal large area LST,which is worth popularizing in clinics.

Bacterial extracellular metalloproteases ( BEMPs) are a large group of metal ion-contai-ning proteases. All BEMPs identified so far are endopeptidase or endoprotease. BEMPs can be classified into nine metalloprotease families based on the sequences and structures of enzymatic molecules. Double-valence zinc ion ( Zn2+) is necessarily required by catalytic centers of most BEMPs. The main function of BEMPs in non-pathogenic heterotrophic bacteria is to hydrolyze environmental proteins and polypeptides to provide vari-ous amino acids as nutrients. However, BEMPs of pathogenic bacteria, serving as important virulence fac-tors, help the pathogens invade into hosts and spread in hosts. In recent years, the roles and mechanism of BEMPs in bacterial pathogenesis have attracted great attention. Here, we make a brief review about the structures and types as well as the functions and pathogenic roles of BEMPs.

Objective To explore the impact of atrial fibrillation (AF) recognized at primary diagnosis on clinical features and outcomes of patients with AF in emergency service.Methods Data were collected from consecutive patients admitted in resuscitation room in the Department of Emergency (ED) of a major comprehensive teaching hospital,from January 1,2011 through December 31,2015.Patients were checked by electrocardiogram examination and / or monitored in resuscitation room after admission,and were divided into patients with AF recognized at a primary diagnosis and those with AF judged by alternative primary diagnoses in ED.The main criteria of prognosis were the length of resuscitation room stay,number of repeated ED visits,and outcome scale (such as death,transferred to intensive units,transferred to general wards,or direct discharge).Non-paired student t test,x2,and circular distribution analysis were performed using SPSS 10.0 and EXCEL 2007 software.Results A total of 929 patients with mean age of (70.3 ± 12.7) years,and 502 (54.0％) female were enrolled.There were 122 cases with AF not recognized at primary diagnosis but by an alternative primary diagnosis (non-primary group,NPG),and 807 cases with AF recognized at primary diagnosis (primary group,PG).Compared with the PG,the patients were older [(76.9 ±9.3) vs.(68.7 ± 14.4),P ＜0.01],had more comorbidities [(1.75 ± 1.26) vs.(0.08±0.39),P＜0.01],higher APACHE Ⅱ scores [(17.89±8.19) vs.(8.64±4.15),P＜ 0.01],longer resuscitation room stay (P ＜ 0.01),higher mortality (11.5％ vs.0.2％,OR =52.176,95％ CI:11.698-232.710,x2 =78.928,P ＜ 0.01) and a higher percentage of transferring to intensive careunit (14.8％ vs.5.1％,OR=3.234,95％CI:1.791-5.838,x2 =16.674,P＜0.01) in NPG.There were no significant difference in number of repeated-visits in ED between the PG and the NPG.Conclusion Patients with AF in the ED judged by alternative primary diagnosis are older and have more comorbidities,higher mortality and higher probability to be transferred to intensive care unit than patients with AF directly recognized by a primary diagnosis.This cohort of patients with special characteristics should be meticulously cared for and be distinguished from the patients with AF crystal clear at a primary diagnosis.Future studies are needed to examine the specific impact of AF on outcomes in the setting of primarydiagnoses in ED.