Multidrug resistant organism refers to bacteria that are insensitive to three or more antibiotics commonly used in clinic, including Pseudomonas aeruginosa, Acinetobacter Baumannii and Klebsiella pneumoniae, etc. MDRO infection is a major factor affecting the survival rate after lung transplantation (LTx), accounting for 30% of the causes of death in the first year after transplantation. Antibiotic treatment has low specificity and is prone to drug resistance. The development of new drugs has a long cycle and high cost, with significant limitations. Phage has high specificity for bacteria, which can proliferate in large quantities in the infected lesion and co-evolve with bacteria during the action process. Phage also have a good killing effect on MDRO, which is expected to make up for the deficiencies of existing antibiotic therapy. This article reviews the development background and mechanism of action of phage therapy, and summarizes its application status and early clinical trial results in the field of LTx, in order to providing new thinking paths for clinical work.

Objective:To evaluate the clinical feasibility, safety, and advantages of small lateral cervical incision for parathyroid exploration and resection.Methods:A total of 31 consecutive patients who underwent parathyroidectomy with a small lateral cervical incision, in the Department of Endocrinology and Breast Surgery of the First Affiliated Hospital of Chongqing Medical University from Apr. to Nov. 2021, including 11 males and 20 females, aged (49.32±13.79) years, ranging from 28 to 86 years, were selected to make retrospective statistical analysis of the surgical time, hospital stay, intraoperative blood loss, postoperative drainage and postoperative complications of the patients. All patients were injected with carbon nanoparticles suspension injection guided by color ultrasound to locate the enlarged parathyroid gland before surgery. EXCEL 2019 software was used for statistical analysis.Results:Thirty-one patients underwent parathyroidectomy through a small lateral cervical incision. Primary hyperparathyroidism was performed in 19 cases (including 2 cases with bilateral small lateral cervical incision, 2 cases with unilateral excision of thyroid mass combined with parathyroidectomy, 1 case with resection of huge parathyroid adenoma, and 1 case with local anesthesia) . Twelve patients with secondary hyperparathyroidism underwent total parathyroidectomy through bilateral small lateral cervical incision and forearm autogenous parathyroid transplantation (including bilateral thyroid mass resection combined with bilateral total parathyroidectomy and forearm autogenous parathyroid transplantation in 2 cases, local anesthesia and cervical plexus nerve block in 2 cases, and ectopic parathyroid gland in thyroid in 1 case) . Among them, the average operative time of patients with primary hyperparathyroidism was (54.74±27.71 & 74.14±31.73) min, the average intraoperative blood loss was (8.11±5.05 & 14.43±10.94) ml, the average postoperative drainage was (14.37±24.64 & 26.36±32.87) ml, the average postoperative parathyroid hormone was (11.59±16.46 & 26.65±56.38) pg/ml, the average hospital stay was (10.00±5.09 & 10.96±4.55) d, and the postoperative complication rate was (3.2% & 0%) .Conclusions:Parathyroid gland exploration and resection through small lateral cervical incision is a safe and effective surgical method and can also complete thyroid exploration and parathyroidectomy at the same time. Appropriate anesthesia should be selected after a full assessment of the patient’s basic condition.

Objective:To figure out the structure and relevant data measurements of zygomatic ligament by cadaver anatomy and review of previous studies.Methods:From July 2018 to January 2020, the zygomatic areas of 20 Chinese frozen fresh cadaver hemifaces were dissected in the Department of Anatomy, Health Science Center of Hangzhou Normal University. Then the structures of zygomatic ligaments were shown. The characters of the ligament and the relationship with adjacent tissue were described and measured. And 16 previous studies were reviewed to get a comprehensive description about the characters of zygomatic ligaments.Results:Zygomatic ligaments were even and dense fibrous tissue structures distributed vertically between the skin and the subcutaneous tissue. Under the SMAS plane, the ligaments divided into two bundles. The origin of major bundle located beyond the origin of the zygomatic major muscle on the periosteum, and the origin of minor bundle located between the origin of the zygomatic minor and major muscle.Conclusions:The anatomy of the zygomatic ligament has a regular pattern, and its anatomical data has certain directive significance for clinical application.

Objective: To evaluate the effect of the Thyroid Imaging Report and Data System proposed by American Radiological Society (ACR-TIRADS) for differential diagnosis in thyroid nodules, and compare ACR-TIRADS to the TIRADS proposed by Kwak et al.(K-TIRADS) and the ultrasound-based risk stratification system evaluated by American Thyroid Association (ATA-Risk Stratification). Methods: The clinical data of 1 760 patients with 1 912 thyroid nodules from 8 hospitals in Jiangsu province were retrospectively analysed. All of them were categorized based on ultrasound-based risk stratification systems. The ROC curve was established to assess and compare the diagnostic value of the systems. Results: The area under the ROC curve (AUC) of ACR-TIRADS was 0.830, with high sensitivity and negative predictive value (86.9% and 87.5%, respectively), and relatively low specificity and positive predictive value (64.1% and 62.9%, respectively). The sensitivity and specificity of K-TIRADS were up to 84.9% and 76.1%, respectively. The AUC of ATA-Risk Stratification was 0.852, with relatively high specificity (83.4%), and low sensitivity (79.4%). There were significant differences in the AUC among the three ultrasound-based risk stratification systems, of which K-TIRADS was the highest (P<0.001). There was no significant difference in sensitivity of ACR-TIRADS and K-TIRADS (P=0.137), but significantly higher than that of ATA-Risk Stratification (P<0.001). There were significant differences in the specificity among the three systems, of which ATA-Risk Stratification was the highest (P<0.001). In addition, there were 109 nodules (5.7%) couldn′t be classified based on ATA-Risk Stratification, with high malignancy rate of 31.2%. Conclusions The diagnostic efficiency of ACR-TIRADS is good, but lower than K-TIRADS and ATA-Risk Stratification. ACR-TIRADS has the highest sensitivity, and ATA-Risk Stratification has the highest specificity, while the overall diagnostic efficiency of K-TIRADS is the best.

Objective To investigate the effects of ropivacaine on proliferation,apoptosis and cell cycle of MDA-MB-231 Cells. Methods The cultured MDA-MB-231 cells were treated with different concentrations of ropivacaine. The proliferation of MDA-MB-231 cells was detected by MTT method. Cell apoptosis and cell cycle were detected by Annexin V-FITC/PI and flow cytometry. Results After ropivacaine administration,MDA-MB-231 cells proliferation inhibition ratio increased significantly.Annexin V-FITC/PI and flow cytometry showed ropiva-caine had no significant effects on cell apoptosis and cell cycle.Conclusion Ropivacaine can inhibit the prolifera-tion of MDA-MB-231 cells,but can′t induce apoptosis and block cell cycle.

To compare the diagnostic value between the thyroid imaging reporting and data system ( TIRADS) and ultrasound ( US ) patterns of 2015 American Thyroid Association ( ATA ) guidelines in the differentiation of benign and malignant thyroid nodules. 639 patients in Jiangsu province who were scheduled for ultrasound-guided fine-needle aspiration biopsy or thyroidectomy were recruited for the retrospective study. All of them were categorized based on TIRADS and ultrasound patterns of ATA ( 2015 ) guidelines. The receiver operating characteristic curve was established to assess and compare the diagnostic value of the two models. Results:( 1 ) 639 patients with 847 thyroid nodules were included in this study, 510 females and 129 males. The mean age was (46. 77 ±12.98)yearsold. (2)818nodulescouldbeclassifiedaccordingtoTIRADS. ThemalignancyratesofTIRADS2,3, 4A, 4B, 5 were 0, 15. 9%, 49. 1%, 78. 8% ,and 100%, respectively. (3) Ultrasound patterns of ATA could be assigned to 793 nodules. The malignancy rates of nodules with very low, low, intermediate, high suspicion for malignancy were 6. 2%, 10. 3%, 24. 9% and 70. 1%, respectively. (4) Ultrasound patterns of ATA had higher specificity (77. 9%) compared to TIRADS. The sensitivity and area under curve of ultrasound patterns of ATA were lower than those of TIRADS, though, not significant. Ultrasound patterns of ATA(2015) guidelines may yield higher specificity in the differential diagnosis of benign and malignant thyroid nodules, while TIRADS classification may offer a relatively higher sensitivity and area under curve.

Objective To explore the expression of cadherin (Cad) genes in patients with chronic myeloid leukemia (CML),and to elucidate the significance of Cad genes in the development of CML.Methods E-Cad and N-Cad gene expression levels in bone marrow mononuclear cells (BM-MNC) from 48 CML patients (29 in chronic phase,19 in progressive phase) were detected by real time quantitative polymerase chain reaction (qRT-PCR).Results Gene expression of E-Cad and N-Cad was detectable in CML BM-MNC.E-Cad gene expression level was lower in progressive CML than that in chronic CML (0.20 ± 0.35 vs 1.19 ± 0.87,P ＜ 0.01),while N-Cad was highly expressed in progressive CML than in chronic CML (0.89 ± 0.45 vs 0.57 ± 0.47,P ＜ 0.05).E-Cad gene expression level was negatively corrclatcd with thc pcrccntagc of peripheral blood progenitor cells (r =-0.705,P ＜ 0.01).Conclusion E-Cad and N-Cad gene expression correlates with the progression of CML,and might be used as an evaluation index for disease development.

Objective To explore the effects of diethylenetriamine/nitric oxide (DETA/NO)on capillary spasm and early brain injury (EBI)after subarachnoid hemorrhage (SAH)in rats.Methods Sixty-nine male Sprague-dawley rats were randomized into three groups:sham group,SAH group and DETA/NO group.SAH model was established by wearing out the willis ring with thread and then Garcia neurological score was observed in the general animals.The expressions of alpha smooth muscle actin (αSMA)and PDGFRβwere detected by dual immunofluorescence staining;nitric oxide kit was used for detecting brain tissue NO concentration.Changes in the hemoglobin-stimulated capillaries were observed in rat slices.Results Three days after surgery,neurological deficit score was remarkably improved in DETA/NO group compared with that in SAH group (P<0 .0 5 ). Immunofluorescence results showed that the expressions of peri-capillaryαSMA and PDGFRβwere significantly increased after SAH (P<0.05 ),and that DETA/NO could down-regulate the expressions (P<0.05 ).NO concentration was greatly reduced about 3 hours after SAH and then gradually increased;DETA/NO could maintain the concentration of NO at an early stage (P<0 .0 5 ).The capillary contraction was observed in slices perfused with hemoglobin;DETA/NO could alleviate capillary spasm.Conclusion DETA/NO can alleviate the severity of capillary spasm and EBI after SAH in rats.

OBJECTIVETo explore arsenic accumulation and toxicity mechanism following long-term use of realgar and provide scientific basis for safety use of realgar in clinic.

METHODThe realgar which was used in the study contains 90% insoluble asenic sulfide (As2S2) and 1.696 mg x kg(-1) soluble arsenic. Two separate experiments were performed: 1) Twenty-eight fasting SD rats were orally given a single dose of realgar at the dose of 0.8 g x kg(-1) and the other four rats were given ultra-filtrated water served as control group. Blood, hearts, livers, kidneys, lungs and brains of four rats were taken out at 0.5, 1, 2, 4, 8, 16, 36 h respectively after treatment. Asenic quantity of each organ or blood sample was measured. 2) Forty SD rats were randomly divided into four groups: control group and realgar 0.02, 0.08, 0.16 g x kg(-1) groups, each group containing 5 females and 5 males. The rats were intra-gastrically treated with realgar once a day for successively 90 days, while the control group was given ultra-filtrated water. Asenic amount in blood, liver, kidney and brain of each rat was measured in fasting rats at 16 h after last dosing.

RESULTAsenic amount of blood, liver, kidney, heart, lung and brain increased after single dosing of realgar at dose of 0.16 g x kg(-1), with the order from high to low blood > kidney > lung > liver > heart > brain. Asenic amount was much higher in blood than that in other organs. The feature of asenic distribution in blood following realgar administration may be the basis for its use for leukemia Ninety-day oral treatment of realgar led to significant accumulation of asenic in blood, kidney, liver and brain. The highest asenic accumulation times was found in kidney followed by liver, which was assumed to be associated with nephrotoxicity and hepatotoxicity of realgar. The highest amount of asenic was observed in blood after 90 day's administration of realgar, and the amount of asenic in organs was in the order of blood > kidney > liver > brain.

CONCLUSIONAsenic can be absorbed and extensively distributed in various organs or tissesses after realgar administration in rats. Long-term use of realgar caused high asenic accumulation in various tissueses, including blood, kidney, liver, and brain. The nephrotoxicity and hepatotoxicity of realgar could be associated with the asenic accumulation in relative organs. Blood is the target of the most highest distribution and accamulation of asenic after realgar treatment, that could be associated with the efficacy of realgar on the treatment of leakemia.

Animals ; Arsenic ; analysis ; chemistry ; pharmacokinetics ; toxicity ; Arsenicals ; administration & dosage ; adverse effects ; chemistry ; Female ; Male ; Rats ; Rats, Sprague-Dawley ; Solubility ; Sulfides ; administration & dosage ; adverse effects ; chemistry ; Time Factors