Objective To investigate the detection rate,epidemiology and resistance mechanism of methicil-lin-resistant Staphylococcus aureus(MRSA)in a hospital in recent 5 years.Methods A total of 762 strains of non repetitive Staphylococcus aureus detected from 2016 to 2020 in a hospital were collected retrospectively.Methicillin-sensitive Staphylococcus aureus(MSSA)was 392 strains(MSSA group)and 370 strains caused by MRSA(MRSA group),and 95 strains of MRSA isolated in 2020 were further used for resistance mechanism.Staphylococcus aureus was identified and tested for drug sensitivity by Vitek 2 automatic microbial system.Molecular epidemiological typing was determined by multilocus sequence typing.The biofilm formation was performed by crystal violet staining.PCR amplification was used to detect drug resistance genes,virulence genes and biofilm related genes,and logistic regression analysis was used to investigate the independent risk factors of its occurrence.Results The detection rate of MRSA in past five years was 48.56％,mainly was from pus samples and secretion samples(38.38％,33.51％respectively).MRSA was found in the general sur-gery(18.65％)and otorhinolaryngology(12.70％).ST88 was the most common multilocus sequence typing(37.89％),and followed by ST951(24.21％).Moderate biofilm formation was the most common,accounting for 74.73％.Multivariate regression analysis showed that compared with MSSA group,hypoproteinemia,en-docrine system diseases,wound infection and history of antibiotic use within six months were the independent risk factors for infection in MRSA group.Compared with the control group,hospital transfer,wound infection and tumor were independent risk factors for infection in MRSA group(P＜0.05).Conclusion The detection rate of MRSA in a hospital is high,and the carrying rate of various drug-resistant genes is high.The hospital should pay attention to the prevalence of MRSA and related risk factors,so as to prevent it early.

Objective To explore the effect of improved total cavity endoscopy on lung function,postoperative feeding and complications in patients with chronic lung disease of esophageal cancer.Methods 120 esophageal cancer patients with chronic lung disease admitted to our hospital from September 2022 to June 2023 were randomly divided into two groups.The observation group consisted of 60 patients who underwent improved total cavity endoscopy assisted esophageal cancer resection,while the control group consisted of 60 patients who underwent traditional open surgery.The perioperative related indexes,lung function indexes[forced expiratory volume in the first second(FEV1),forced vital capacity(FVC),maximum ventilation volume(MVV)],inflammatory level[interleukin-6(IL-6),interleukin-8(IL-8),tumor necrosis factor(TNF-α)]were compared between the two groups.Results The blood loss,operation time,number of lymph node dissection and drainage time in the observation group were(329.51±78.84)ml,(175.47±10.41)min,(29.67±17.86)pieces per case and(3.14±0.98)d respectively.In the control group,the intraoperative blood loss,operation time,number of lymph node dissection and drainage time were(372.31±99.23)ml,(148.54±10.68)min,(28.36±18.15)pieces and(6.37±1.23)d,respectively,there was statistical significance between the two groups(P＜0.05).The FEV,,FVC and MVV of the observation group were(1.88±0.53)L,(2.33±0.46)L and(32.59±11.84)L,respectively.Two weeks after operation,the control group was(1.37±0.31)L,(1.75±0.38)L and(23.68±9.41)L respectively,there was statistical significance between the two groups(P＜0.05).The inflammatory factors IL-6,IL-8 and TNF-α in the observation group were(2.17±1.62)ng/ml,(2.09±1.52)ng/ml and(1.32±0.57)ng/ml,respectively.The control group were(3.06±1.52)ng/ml,(2.75±1.29)ng/ml and(1.73±0.75)ng/ml respectively,there was statistical significance between the two groups(P＜0.05).The incidence of postoperative complications in the observation group and the control group were 6.67％and 20.00％respectively,and patients in the observation group ate earlier than those in the control group(P＜0.05).Conclusion Compared with the traditional open surgery,the improved total laparoscopic surgery has the advantages of less trauma,simpler operation,less damage to lung function,significantly lower incidence of postoperative complications,and shorter postoperative eating time.

Objective:To investigate the microstructural abnormalities of the white matter in first-episode medication-free patients with schizophrenia (FESZ) based on inter-voxel diffusivity metric local diffusion homogeneity (LDH) and traditional intra-voxel diffusivity metric.Methods:A total of 56 FESZ patients admitted to our hospital from January 2020 to December 2021 were selected as research subjects, and 64 healthy volunteers recruited during the same period were selected as healthy controls. All subjects accepted magnetic resonance diffusion tensor imaging, and the LDH, anisotropy fraction (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD) were obtained by FSL and PANDA software. Tract-based spatial statistics (TBSS) method was employed to analyze and compare the differences in the diffusivity metrics of white matter fibers between the two groups. For white matter fiber tracts with significant inter-group differences, receiver operating characteristic(ROC) curve was used to evaluate the diagnostic value of each diffusivity metric in FESZ, and Spearman partial correlation was used to analyze the relation between each diffusivity metric and positive and negative symptom scale (PANSS) scores.Results:As compared with that in the heathy control group, LDH in partial voxel clusters in bilateral anterior thalamic radiation of the FESZ group was statistically increased ( P<0.05, FWE correction). As compared with that in the heathy control group, the mean LDH in the tracts of interest (TOI) of the right inferior longitudinal fasciculus and the right uncinate fasciculus in the FESZ group was significantly increased ( P<0.05, FDR correction). In the above 4 fasciculi, ROC analysis showed that LDH had diagnostic efficacy ( P<0.05), and the diagnostic efficacy of LDH was the highest when the fasciculi structures were combined (AUC=0.733, P<0.001). LDH in white matter fiber tracts with significant inter-group differences had no statistical correlation with PANSS scores ( P>0.05). No voxel clusters or TOIs enjoyed statistical differences between groups were noted in the FA, MD, AD and RD parameter maps ( P>0.05). Conclusion:The inter-voxel diffusivity metric LDH can detect the compensatory changes of white matter microstructure in FESZ patients that could not be detected by traditional intra-voxel diffusivity metric.

Objective:To investigate the abnormal dynamic characteristics of brain functional connectivity in patients with neuropsychiatric systemic lupus erythematosus (NPSLE) and its correlation with clinical indicators by using dynamic functional connectivity (dFC) analysis based on independent component analysis (ICA).Methods:The clinical and imaging data of female NPSLE patients diagnosed in the First Affiliated Hospital of Zhengzhou University from July 2018 to September 2019 were prospectively collected. The levels of complement C3, C4, CH50, glucocorticoid prednisone dosage, systemic lupus erythematosus disease activity index (SLEDAI) score and Systemic Lupus International Collaborating Clinics (SLICC)/American College of Rheumatology (ACR) damage index (SDI) score were recorded. Age and sex matched healthy controls (HC) were enrolled at the same time. All subjects underwent resting state functional MRI (rs-fMRI). The spatial group independent component analysis was performed on MRI data using GIFT software, and 29 independent components (IC) were selected as internal connectivity network; five functional connectivity states and three dFC indexes (fraction time, mean dwell time, number of transitions) were obtained by using sliding time window technology. Two independent sample t test was used to calculate the difference of functional connectivity in different states. Mann-Whitney U test was used to calculate the difference of dFC indexes between groups. Spearman correlation analysis was used to calculate the correlation between dFC index and clinical data in NPSLE group. Results:A total of 45 NPSLE patients and 35 HC patients were enrolled. There was no significant difference in age and education level between the two groups ( t=-0.327, -0.460, P>0.05). Compared with HC group, NPSLE group had higher fraction time and longer mean dwell time ( Z=-2.496, -2.462, P<0.05); in state3 strong connection, compared with HC group, functional connectivity (FC) between posterior cerebellar lobe (IC39) and basal ganglia (IC10) was enhanced ( t=-5.201, P<0.05); FC was found decreased between posterior cerebellar lobe (IC39) and temporal lobe (IC5), temporal lobe (IC7), superior parietal lobe (IC65) ( t=4.212, 5.572, 4.415, P<0.05), as well as between paracentral lobular region (IC12) and posterior cingulate gyrus (IC15) ( t=3.893, P<0.05) in NPSLE group. The SDI score of NPSLE patients was negatively correlated with the fraction time and mean dwell time of state1 and state3 strong connection state ( P<0.05), and the SLEDAI score was negatively correlated with the fraction time and mean dwell time of state1 and state2 ( P<0.05). The SDI and SLEDAI scores were positively correlated with the fraction time and mean dwell time of state4 weak connection state, respectively ( P<0.05). The levels of serum complement C3, C4 and CH50 in NPSLE patients were positively correlated with the number of transitions ( r=0.428, 0.354, 0.385, P<0.05), and the dosage of prednisone was negatively correlated with the number of transitions ( r=-0.466, P<0.05). The validation analysis results showed the experimental results could be effectively repeated. Conclusion:The dFC analysis method based on ICA can effectively identify the alterations of brain functional connectivity on a shorter time scale, which may provide a new perspective for further exploration of the neuroimaging mechanism of cognitive impairment in NPSLE.

Chronic excess alcohol intake triggers the formation of enterogenic endotoxemia. TLR4 ligand localization activates nuclear transcription factor NF-κB by inducing the up-regulation of NLRP3 inflammasome and the biologically inactive IL-1β and IL-18 precursors to form initiation of pro-inflammatory signals. Under the influence of ethanol, the damaged hepatocyte release uric acid, and adenosine triphosphate and induces NLRP3 inflammasome assembly and functional activation in Kupffer cells to promote the release of inflammatory mediators, such as interleukin-1β and interleukin-18, that cascade mediates inflammation and drive alcoholic liver disease from steatosis to inflammation and fibrosis. The NLRP3 inflammasome acts as a ligand-sensing element and plays an important role in mediating the immune and inflammatory response in the course of alcoholic liver disease. Thus, exploring the activation mechanism of NLRP3 inflammasome and its pathogenic role may provide a new idea in the clinical treatment of alcoholic liver disease.

Objective: To analyze the silver content, homogeneity, and cytotoxicity of silver-containing products. Methods: (1) Five kinds of silver-containing products A, B, C, D, and E were purchased from the market, and products A, B, C, and D are liquid or gel form while product E was dressing form. The silver content of each product and the homogeneity of product E were determined by flame method. The sample number was 3. (2) Human hepatocellular carcinoma cell line (HepG2) was selected as the evaluation model. Four silver-containing products A, B, C, and D were diluted with high-glucose dulbecco′s modified eagle medium (DMEM) at multiple ratios of 1∶100, 1∶200, 1∶400, and 1∶800, and then they were used for cell culture. Cells cultured with high-glucose DMEM and high-glucose DMEM containing 20 μg/mL silver nitrate were used as blank control and positive control, respectively. The cell viability was determined by methyl thiazolyl tetrazolium assay, and each sample number was 5. (3) Four mass concentrations of 0.031 3, 0.062 5, 0.125 0, and 0.250 0 μg/mL were prepared from silver-containing product A, and then they were used to culture HepG2 cell. Cells cultured with high-glucose DMEM containing fetal calf serum and 294 μg/mL potassium dichromate were used as positive control, while those containing fetal calf serum were used as blank control. Hoechst 33258 staining method was used to detect apoptosis rate of cells. The tail moment, tail length, and the percentage of DNA in the tail of cells were observed by comet assay to evaluate DNA damage. The sample numbers were all 3. Data were processed with one-way analysis of variance and least significant difference-t test. Results: The silver content of products A, B, C, and D was (256.5±1.5) μg/mL, (271.5±1.3) μg/mL, (652.4±2.6) μg/g , (330.0±2.1) μg/g, which was in accordance with labelled amount. The silver content of product E was (0.158±0.013) mg/g, and the silver content of each piece of product E was (0.125±0.017) mg/g, showing good uniformity of product E. (2) Compared with the rate of blank control, the cell survival rates of product A at the dilution ratio of 1∶100, product B at the dilution ratio of 1∶100, and product C at the dilution ratio of 1∶100 and 1∶200 were significantly reduced (t=35.506, 8.914, 37.594, 30.693, P<0.01). Compared with the rate of positive control, the cell survival rates of product A at the dilution ratio of 1∶200, 1∶400, and 1∶800, product C at the dilution ratio of 1∶400 and 1∶800, products B and D at each dilution ratio were increased significantly (t=27.537, 18.262, 18.709, 26.333, 41.762, 15.776, 19.759, 20.443, 15.715, 26.792, 24.963, 31.803, 30.537, P<0.01). (3) The apoptosis rates of cells treated by 0.250 0 μg/mL product A and positive control were (6.1±0.4)% and (62.2±3.9)% respectively, which were significantly higher than the apoptosis rate of blank control [(3.3±0.7)%, t=13.327, 30.475, P<0.05]. The apoptosis rates of cells treated by 0.031 3, 0.062 5, 0.125 0 μg/mL product A were (2.9±0.4)%, (3.1±0.4)%, and (4.2±0.9)% respectively, which were close to the apoptosis rate of blank control (t=1.181, 0.133, 1.097, P>0.05). (4) The tail moment, tail length, and tail DNA percentage of cells cultured with 0.125 0 and 0.250 0 μg/mL product A were significantly higher than those cultured with blank control (t=29.026, 51.194, 21.851, 36.138, 24.721, 50.455, P<0.05 or P<0.01). However, the tail moment, tail length, and tail DNA percentage of cells cultured with 0.031 3 and 0.062 5 μg/mL product A were close to those cultured with blank control (t=5.878, 3.429, 2.779, 1.960, 1.328, 7.763, P>0.05). Conclusions The silver content of silver-containing products meets the requirements of the labeling. The concentration of product C is higher than that of other products, leading to a greater possibility of decreasing the survival rate of HepG2 cells. It is suggested that the products A and B should be taken as reference in the concentration setting of silver ion products. The product solution with higher concentration may have higher risk of damage to cell DNA. Therefore, it is not recommended to upregulate silver content of relevant products blindly in order to achieve better antibacterial effect.

Objective Molecular biological methods were used to classify and analyze the isolated Brucella strains,and to understand the geographical distribution characteristics,genetic types and regional distribution characteristics of Brucella in Qinghai Province.Methods Molecular biology typing of species of isolated Brucella strains in Qinghai was studied using Multiple Locus Variable-number tandem repeat Analysis (MLVA) technology.The classification results were described by geographical information system (GIS).Results There were 3 species Brucella melitensis,Brucella abortus,and Brucella suis among the 65 strains of Brucella in Qinghai.Brucella melitensis was the dominant species.The genotypes of MLVA were 42,43,47,28,36,112 and 6.The geographical distribution features showed that the 42 belonged to the evolutionary branches of A and B,which was widely distributed.The 43 of the C evolutionary branch and 47 of the E evolution branch were mainly in the hinterland of the Qinghai-Tibet Plateau.When searching in the Brucella2012 MLVA database,none of the genotypes obtained in this study were identical to those in the database.Conclusions The MLVA genotypes of Brucella are varied in Qinghai Tibet Plateau.They are widely distributed,completely different from those in other areas,and different genetic variations are found in different places.

Objective To investigate the effects of glutathione protected gold nanoclusters (GSH-Au NCs) on HeLa cytotoxity.Methods Fluorescence intensity were measured on GSH-Au NCs containing medium treated cells using fluorescence spectrophotometer at different time points.GSH-Au NCs uptake by HeLa cells at 1,2,6,12 and 24 h were investigated through fluorescent spectrophotometer.In vivo tumor uptake was also investigated on BALB/c tumor-bearing mice through inductively coupled plasma mass spectrometry (ICP-MS) at 24 h after intraperitoneal injection of 0.2 ml GSH-Au NCs (3 mmol/L) and distilled water (control group) respectively.The cytotoxicity of GSH-Au NCs at different doses (0.003-0.3 mmol/L) was tested at 24 and 48 h using MTT assay after interaction with HeLa cells.Results The uptake efficiency of GSH-Au NCs by HeLa cells kept increasing and reached maximum of 73.13％ at 24 h.The results of tumor-bearing mice indicated that the tumor tissue had higher uptake efficiency after 24 h (320±15) ng/g than that of control group (intraperitoneal injection of distilled water),and the difference was stastically significant (P＜0.05).HeLa cells were treated with different concentrations of GSH-Au NCs for 24 h,and GSHAu NCs had a slight effect on cell viability.With the increase of GSH-Au NCs dose,the inhibition effects on growth of HeLa cells enhanced.The cell activity of HeLa cells treated with 0.3 mmol/L GSH-Au NCs for 24 h reduced to 86％compared with that of control group (the concentration of GSH-Au NCs was 0) (P＜0.05),while there was no significant difference between the survival rate of different concentrations of GSH-Au NCs group and the control group for 48 h.Conclusions GSH-Au NCs have neglectable cytotoxity on HeLa cells even though both in vitro and in vivo uptake are high.GSH-Au NCs are suitable for biomedical application such as imaging,drug loading and targeted drug delivery.

Objective To investigate parenteral nutrition and enteral nutrition therapy for esophageal cancer patients nutritional status improvement.Methods Totally 63 patients with esophageal cancer were chosen,preoperative Nutritional Risk Screening 2002 (NRS2002) nutritional screening through joint after parenteral nutrition and enteral nutrition therapy.Patients with intestinal tolerability and complications after surgery on days 1 and 7 days nutrition indicators were observed,including total serum protein,albumin,prealbumin,hemoglobin,and lymphocyte count.Results Preoperative risk malnutrition occurred in 39 patients.Compared to patients on day 1 after the first 7 days,serum levels had no significant difference in total protein.Albumin,prealbumin,hemoglobin,and lymphocyte counts were significantly different statistical significance (P ＜ 0.05).Conclusions NRS2002 for nutritional screening patients at risk of malnutrition can be determined,and the combined parenteral and enteral nutrition therapies can improve nutritional status of patients with esophageal cancer.

Objective To investigate the effects of different dose of tranexamic acid in fibrinolysis during liver transplantation. Methods Sixty ASA Ⅱ~ Ⅳ liver transplant recipients, were randomly, double-blind assigned to one of 3 groups (n = 20): group control (group C), group tranexamic acid 1 (group T1) and group tranexamic acid 2 (group T2). The patients in group C received a loading dose of normal saline 10 mL, then continued infuse normal saline at 20 mL/h until neohepatic phase 120 min, while in other two groups, patients received a loading dose of tranexamic acid 1 g, totally 10 mL, followed by continuous infusion at 10 mg/(kg·h) in group T1 or 20 mg/(kg·h) in group T2 until neohepatic phase 120 min. Prothrombin time, fibrinogen, fibrin degradation product and D-dimers were measured before operation (T0), 120 min after the skin incision (T1), nonhepatic phase 30 min (T2), neohepatic phase 120 min (T3). Blood loss, fresh frozen plasma dosage, fibrinogen dosage and thromboembolic events were recorded. Results The plasma concentration of fibrin degradation product and plasma concentration of D-dimers were different in the 3 groups, group T2< group T1 0.05). Conclusions Continuous infusion of tranexamic acid can inhibit fibrinolysis during liver transplantation. No adverse event of thrombosis was detected. Larger dose of tranexamic acid can reduce blood loss and fresh frozen plasma transfusion.