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Objective:To explore the effects of non-suicidal self-injury on suicidal ideation in adolescents with depressive disorder, and the mediating role of rumination and depression between them.Methods:A sample of 397 depressive disorder adolescents were recruited to complete the adolescent non-suicidal self-injury behaviour questionnaire, ruminative responses scale (RRS), self-rating depression scale (SDS), and Beck scale for suicide ideation-Chinese version(BSI-CV). All data processing and analysis were performed using SPSS 23.0.The mediating effect was tested by correlation analysis and Bootstrap analysis.Results:The non-suicidal self-injury score was (29.192±11.281), the rumination score was (65.036±12.284), the depression score was (75.770±11.278), and the suicidal ideation score was (40.681±11.626). Non-suicidal self-injury was significantly and positively correlated with suicidal ideation( r=0.403, P<0.01), rumination and depression( r=0.332, 0.470, both P<0.01). Rumination was significantly and positively correlated with depression and suicidal ideation( r=0.549, 0.181, both P<0.05). Depression was significantly and positively correlated with suicidal ideation( r=0.313, P<0.01). The direct effect value of non-suicidal self-injury on suicidal ideation was 0.341(95% CI=0.238-0.444), the indirect effect of non-suicidal self-injury on suicidal ideation through two pathways, the separate mediating effect value of depression was 0.057(95% CI=0.077-0.114), and the chain mediating effect value of rumination and depression was 0.026(95% CI=0.004-0.057). Conclusion:Non-suicidal self-injury can directly affect suicidal ideation of depressive disorder adolescents and indirectly through rumination and depression.
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With the continuous progress of tumor treatment methods in recent years, more and more emerging antitumor drugs have been approved to market and put into clinical use. In addition, some treatments that are in clinical trials such as gene therapy are also continuously making new breakthroughs. In this review, we mainly give a brief introduction to the novel antineoplastic therapies that have been clinically used in recent years, as well as the ones with remarkable efficacy and are expected to be approved for marketing.
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PiggyBac is a transposable DNA element originally discovered in the cabbage looper moth (Trichoplusia ni). The T. ni piggyBac transposon can introduce exogenous fragments into a genome, constructing a transgenic organism. Nevertheless, the comprehensive analysis of endogenous piggyBac-like elements (PLEs) is important before using piggyBac, because they may influence the genetic stability of transgenic lines. Herein, we conducted a genome-wide analysis of PLEs in the brown planthopper (BPH) Nilaparvata lugens (Stål) (Hemiptera: Delphacidae), and identified a total of 28 PLE sequences. All N. lugens piggyBac-like elements (NlPLEs) were present as multiple copies in the genome of BPH. Among the identified NlPLEs, NlPLE25 had the highest copy number and it was distributed on five chromosomes. The full length of NlPLE25 consisted of terminal inverted repeats and sub-terminal inverted repeats at both terminals, as well as a single open reading frame transposase encoding 546 amino acids. Furthermore, NlPLE25 transposase caused precise excision and transposition in cultured insect cells and also restored the original TTAA target sequence after excision. A cross-recognition between the NlPLE25 transposon and the piggyBac transposon was also revealed in this study. These findings provide useful information for the construction of transgenic insect lines.
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Animals , Amino Acid Sequence , Animals, Genetically Modified , DNA Transposable Elements/genetics , Hemiptera/genetics , Transposases/geneticsABSTRACT
In recent years, antiangiogenic drugs based on VEGF and VEGFRs signaling pathway have been widely used in the treatment of malignant tumors. Apatinib is an orally bioavailable small-molecule antiangiogenic agent and can specifically inhibit the tyrosine kinase activity of VEGFR, thereby inhibiting tumor angiogenesis. Apatinib is the first-level recommendation of third-line treatment of gastric cancer in CSCO Guidelines for the Diagnosis and Treatment of Gastric Cancer published in 2018. Apatinib has been proved to be effective and safe in gastric, lung and breast cancers. In addition, the drug shows great potential in the treatment of a variety of solid tumors. This article reviews the recent progress on the mechanism, clinical efficacy, related efficacy predictors of apatinib and its combination with other antitumor drugs.
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Objective:To explore the effects of early fortified amino acid nutrition on nutritional indicators, development and immune function of premature infants.Methods:From January 2017 to December 2018, 150 premature infants hospitalized in the neonatal intensive care unit of the Second Hospital of Shanxi Medical University were selected. Using random number table method, the children were randomly divided into group A, group B and group C, with 50 cases in each group. Group A was given a total intravenous nutrition strategy within 24 h of birth, group B was given a total intravenous strategy within 48 h of birth, and group C was given a total intravenous strategy within 72 h of birth. The children in the three groups were observed in the hospital until discharged. The levels of liver function, nutritional indicators and immune function were detected in the three groups.Results:The levels of body mass increase rate, head circumference increase rate and body length increase rate in group A were higher than those in group B and group C [22.73 ± 2.02) g/(kg·d) vs. (19.90 ± 1.89) and (17.60 ± 2.01) g/(kg·d), (0.76 ± 0.17) cm/week vs. (0.69 ± 0.18) and (0.60 ± 0.15) cm/week,(1.21 ± 0.20) cm/week vs. (1.02 ± 0.24) and (0.89 ± 0.22) cm/week], and there were significant differences ( P<0.05). After treatment, the levels of alanine aminotransferase, aspartate aminotransferase in three groups had no significant differences ( P>0.05). After treatment, the levels of total albumin and albumin in group A were higher than those in group B and group C [(49.92 ± 3.30) g/L vs. (45.03 ± 2.94) and (42.03 ± 3.00) g/L, (33.10 ± 2.02) g/L vs. (29.89 ± 1.95) and (25.59 ± 2.00) g/L], and there were significant differences( P<0.05). After treatment, the levels of CD 3+ and CD 4+ in group A were higher than those in group B and group C [(68.80 ± 4.01)% vs. (59.02 ± 3.20)% and (55.03 ± 3.10)%,(43.31 ± 2.09)% vs. (38.82 ± 2.06)% and (34.40 ± 2.11)%], the level of CD 8+ in group A was lower than that in group B and group C [(23.30 ± 2.80)% vs. (28.89 ± 2.91)% and (34.40 ± 2.05)%], and there were significant differences ( P<0.05). Conclusions:Early fortified amino acid nutrition can significantly improve the nutritional status and immune function of premature infants, and contribute to their growth and development.
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Objective To: explore the clinical value of one-stop procedure in DSA hybrid operating room for treatment of ruptured intracranial complex aneurysms combined with cerebral hematomas. Methods: Eleven patients within 72 h after onset of ruptured intracranial complex aneurysms combined with cerebral hematomas without cerebral hernia underwent one-stop procedure in DSA hybrid operating room. Intraoperative DSA was used to evaluate whether the aneurysm involved the parent artery. The aneurysms were treated with intracranial aneurysm isolation combined with extra-intracranial bypass under the guidance of DSA or temporary balloon occlusion assisted shape clipping. And the hematomas were removal appropriately. Intraoperative situation of hybrid surgery was monitored in real time. Intraoperative and postoperative complications were recorded. The patients were followed up after discharge. CTA examinations were performed 6 months after operation. Glasgow outcome score (GOS) was used to evaluate the efficacy when patients were discharged and the last follow-up. When the scores were equal or greater than 4, the discharge was considered as effective treatment. Results: Superficial tempora1 artery (STA)-middle cerebral artery (MCA) bypass were performed in 5 patients smoothly. Intraoperative DSA revealed that the bridge vessel was unobstructed, and the aneurysms were isolated in one stage. Six patients were treated with shape clipping. Mistakenly clipping of perforator vessels occurred in 3 patients, and incomplete clipping occurred in 1 patient. The clamping effect was satisfactory after adjusting the positions of aneurysm clips. There were 2 cases of focal infarction and 1 case of epilepsy after operation. The proportion of patients responded well to treatment was both 81.82% (9/11) when discharged and the last follow-up, respectively. No recurrence, stenosis of anastomotic nor parental artery was detected among 11 patients 6 month after operation. Conclusion: Patients with complex aneurysms associated with intracranial hematomas impossible treated with single surgical clipping or endovascular intervention can be cured with one-stop procedure in DSA hybrid operating room with relatively satisfied results.
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Liver fibrosis is a common pathological response in chronic liver injury. In the pathological process of hepatic injury, signaling pathways associated with hepatic fibrosis, which mediates the repair, proliferation and fibrosis of the liver secrete different cytokines. In these pathways, transforming growth factor beta (TGFβ) and signal transducer and activator of transcription 3 (STAT3) play key roles in the proliferation and activation of hepatic stellate cells (HSCs) and promote epithelial mesenchymal transition. In addition, it is also involved in the process of proliferation and transformation of collagen and extracellular matrix molecules into myofibroblasts. TGFβ and STAT3 molecular-related signaling pathways mediate the loss of epithelial phenotype and gene expression in mature epithelial cells, transforming them into mesenchymal cells, and producing anti-apoptosis to hepatocytes and promoting the proliferation of HSCs. However, the mechanisms by which STAT3 and TGFβ molecules are involved in the development and progression of liver fibrosis are not sound distinct. In this review, we attempt to know the mechanisms and interactions of TGFβ and STAT3 molecules that mediate potential liver fibrosis, and promote their role in promoting HSCs production and epithelial mesenchymal transition.
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Objective To explore the clinical significance of centralized surveillance of hydatidiform mole.Methods From Feb.2013 to Feb.2017 all patients with hydatidiform mole,who underwent suction curettage and were confirmed by histopathology in Dalian Maternal and Child Health Care Hospital,were registered centrally for serum hCG monitoring and treatment if necessary.Prophylactic chemotherapy was not administered regardless of risk factors for malignant transformation of hydatidiform mole.The risk factors included age of over 40 years,excessive uterine enlargement for presumed gestational age,a serum hCG level greater than 5 00 000 U/L,large theca lutein ovarian cysts (＞6 cm),and a history of previous hydatidiform mole.The centralized surveillance of hydatidiform mole was based on the central pathology review,team cooperation and service improvement.Their treatments and outcomes were analyzed retrospectively.Results A total of 407 women of hydatidiform mole were registered with histopathology confirmation,including 70 high-risk hydatidiform moles.The follow-up rate was 97.5％ (397/407).The incidence of post-mole neoplasia was 8.1％ (32/397),which was diagnosed in 22.9％ (16/70) of high-risk and in 4.9％ (16/327) of low-risk hydatidiform moles,showed statistically significant difference between high-risk and low-risk groups (x2=25.108,P＜0.01).Thirty-two patients with post-mole neoplasia were all at low risk of International Federation of Gynecology and Obstetrics (FIGO) score (range,0-6) and received complete remission with chemotherapy alone in 31 of them except one treated by hysterectomy.The primary cure rate of single-agent chemotherapy was 60.0％ (18/30).Patients with low-risk or high-risk post-mole neoplasia were both 16.There were no significant differences between the two groups in interval that was end of antecedent pregnancy to start of treatment,the serum level of hCG before treatment,clinical stage or risk factor score (all P＞0.05).Conclusions The risk of malignant transformation is increased in high-risk hydatidiform mole,however,the high risk factor itself does not affect the prognosis in patients with timely diagnosis and treatment of post-mole neoplasia.Therefore,prophylactic chemotherapy is not recommended to high-risk hydatidiform mole patients.Centralized surveillance of hydatidiform mole is practical in a local hospital of China and could greatly improve the prognosis of post-mole neoplasia.
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Objective To evaluate the therapeutic effect of bone marrow mesenchymal stem cell (MSC) infusion transplantation via renal artery and via caudal vein in treating chronic kidney disease (CKD) in rats,and to compare the expressions of aquaporin1 (AQP1) and aquaporin2 (AQP2) between the two transplantation routes.Methods A total of 50 male SD rats were selected for this experiment.Two experimental rats were used to make preparation of bone marrow MSC.CKD model was established with infusion of adriamycin via caudal vein in 36 rats.The 36 CKD models were randomly divided into adriamycininduced renal failure model control group (A-C group,n=12),MSC transplantation through the right renal artery group (M-A group,n=12) and MSC transplantation through the caudal vein group (M-V group,n=12).The remaining 12 male SD rats were used as the blank control group (N group).One week after the last bone marrow MSC transplantation,the 24 h urine volume,24 h urinary protein content,serum sodium content and serum albumin level were measured,and AQP1 and AQP2 expressions in the kidney tissue were determined by immunohistochemistry.Results Compared with A-C group,the serum albumin level and 24h urine volume in both M-V group and M-A group were significantly increased (P＜0.05),while 24h urinary protein content and serum sodium content were remarkably decreased (P＜0.05).The 24h urinary protein content in the M-A group was obviously lower than that in the M-V group (P＜0.05).The AQP1 and AQP2 expressions in the kidney tissue in both M-V group and M-A group were strikingly lower than those in the A-C group (P＜ 0.05),but no statistically significant differences in AQP1 and AQP2 expressions existed between the M-V group and the M-A group (P＞0.05).Conclusion MSC transplantation can increase serum albumin,and lower urinary protein,serum sodium and the expressions of AQP1 and AQP2 in renal parenchymal cells,which has the effect on repairing renal injury of adriamycin-induced CKD rats.For a given period of time,the clinical curative effect of MSC transplantation via renal artery is better than that of MSC transplantation via peripheral vein,but the difference in curative effect between the two MSC transplantation pathways has no obvious correlation with AQP1 and AQP2 expressions.
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Objective To collect the demographic,lifestyle and clinical factors of patients with cerebrovascular disease,and analyze the vascular cognitive impairment(VCI) factors and set up high-risk factors model.methods 505 patients with cerebrovascular disease hospitalization in department of geriatrics and neurology in hospital from October 2014 to October 2016 were enrolled.According to the questionaire survey data of demographics,lifestyle and clinical factors,the patients were divided into training set (421 cases) and test set (84 cases),and training set were divided into the non-VCI set (225 cases) and VCI set (196 cases).Analyzed the influence factors of VCI in patients with cerebrovascular disease by decision tree algorithm,and compared it with the Logistic regression analysis and chi-square and established the decision tree model for risk factors of VCI.Result sAccording to the VCI decision tree model,cross validation model recognition accuracy was 73.63%,while test set prediction accuracy was 73.81%.Alcoholism,hobbies,education level,tea drinking,diabetes,hypertension,diet,age,sleep and physical exercise were classification of node variables,while drinking was the root.The probability of VCI had significant difference (P<0.05) in the crowds with different risk factors.According to Result s of Logistic regression analysis,education level,drinking,exercise and diabetes were independent risk factors for VCI,while the model prediction accuracy was 66.98%,and test set prediction accuracy was 53.57%.According to the ROC curve of the decision tree model and the Logistic regression model,the decision tree model AUC was 0.737 (95%CI 0.688 to 0.786),and the Logistic regression model AUC was 0.664 (95%CI 0.612 to 0.717).Conclusion It is suggested that the decision tree model might be superior to logistic regression model in the prediction accuracy for VCI of patients with cerebrovascular disease.The alcoholism,diabetes,high blood pressure,high fat diet and insomnia are risk factors of VCI,while hobbies,high level of education,physical exercise and drinking tea can be the protective factors of the VCI.
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Objective To identify the median effective volume (EV50) of 0.3 ％ ropivacaine in the old patients with femoral intertrochanteric fracture undergoing ultrasound-guided fascia iliaca compartment block (FICB).Methods Thirty-nine patients,18 males and 21 females,aged 65-98 years old,ASA physical status Ⅱ or Ⅲ,scheduled for femoral intertrochanteric fracture surgery were sequentially received ultrasound-guided FICB.Patients were sequentially given a pre-set volume of 0.3％ ropivacaine according to our pilot study.A sign of "+" was marked if the patient was positive to FICB and totally pain-free 30 min after block,and the next patient would be assigned to a lower volume of ropivacaine.Otherwise,a sign of was marked if the patient was negative to FICB that was partially or not pain-reliefed 30 min after block,and the next patient would be assigned to a larger volume of ropivacaine.The trial was terminated when 7 inflection points appeared.The EV50 of 0.3％ ropivacaine with 95％ confidence interval (CI) was calculated according to sequential method.Results Twenty (51.3％) in a total of 39 patients received a successful ultrasound-guided FICB.The EV50 and 95 ％ CI of 0.3 ％ ropivacaine using ultrasound-guided FICB in old patients with femoral intertrochanteric fracture was 25.37 ml (95％CI 22.06-29.19 ml).Conclusion The EV50 of 0.3％ ropivacaine using ultrasound-guided FICB in the old patients with femoral intertrochanteric fracture is 25.37 ml.
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Objective To explore the applicable conditions for using urine uranium monitoring data to assess personal internal doses with a view to providing references for the occupational health management and the urine uranium monitoring in nuclear industry sector.Methods The urine uranium levels were calculated, through simulation calculation set at 1 mSv effective dose arising from either acute or chronic ingestion of uranium compounds.The results were compared with the monitoring values of workers without occupational exposure history.The feasibility of urine uranium monitoring for dose assessment of internal radiation exposure was discussed.Results For special monitoring of acute ingestion, liquid fluorimetry can meet monitoring requirements of Type F uranium compound, Type M low enriched uranium and Type S naturally occurring uranium.For routine monitoring, only Type F low enriched uranium and Type M naturally occurring uranium can be detected at shorter monitoring intervals, But it was not suitable for Type S uranium compounds.Conclusions Background levels and detection limits should be considered when urine uranium is measured for the purpose of assessment or control of exposure to uranium and the interpretation of the results.
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Objective To investigate the characteristics of intestinal flora in infants with different feeding patterns.Methods Sixty-two cases of health infants(30-120 d)were divided into 4 groups according to their feeding patterns:breast feeding,imported powder milk feeding,domestic powder milk feeding and mixed feeding.Samples of their fresh feces in each group were collected and divided into sections equally:the bifidobacteria were isolated in anaerobic box and the number was counted for one section;for the other section,total DNA of intestinal flora was extracted and enterobacterial repetitive intergenic consensus (ERIC) fingerprints were amplified with the method of ERIC-PCR.After that,the specific bands observed in different groups were cloned and sequenced and alignmented.Results The colonies of bifidobacteria were more in breast feeding and mixed feeding groups[(9.10 ± 1.33) cfu/g;(8.62 ± 1.35) cfu/g]than those in domestic powder milk feeding and imported powder milk feeding groups[(7.62 ± 1.22) cfu/g;(7.32 ± 0.80) cfu/g,t =3.23,P ＜ 0.05];while there was no significant difference between breast feeding and mixed feeding groups,and between 2 powder milk feeding groups.Two specific bands were found from the ERIC fingerprints (A:1 100 bp mainly in breast feeding,domestic powder milk feeding and mixed feeding groups;B:1 000 bp mainly in imported powder milk feeding group).Sequencing and analysis of Basic Local Alignment Search Tool showed that homologous bacteria of A and B fragments were bifidobacterium longum.The encoding protein of A fragments might be related to the enzymes of carbohydrate metabolism,and B fragments were related to the enzymes of protein metabolism.Conclusions The colonies of bifidobacteria in intestinal tract are more in breast feeding and mixed feeding infants than those in formula feeding groups.The distribution of intestinal flora in domestic powder milk feeding infants is more similar to that of the breast feeding infants.
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Objective To establish a methamphetamine-dependent model in zebrabfish.Methods On the basis of conditioned place preference (CPP) in drug-dependent experiment,place preference box for zebrafishes was designed.According to the natural characteristics of zebrafishes,their preference side and non-preferred side were determined.After intraperitoneal injection of methamphetamine,zebrafishes were placed in non-preferred side(drug box).After intraperitoneal injection of normal saline,zebrafishes were placed in preference side (non-drug box).CPP training was five days and then the methamphetamine-induced place preference in zebrafish were observed.Results After five days training,the staying time of zebrafishes of control group in drug box was not significantly lengthened to compared with before training(.( 287.5 ± 80.18 ) s,(276.3 ± 85.04) s),P＞ 0.05 ).The staying time of zebrafishes of model group in drug box was markedly extended after training.In comparison with before training or control group,the significant differences were observed ( (465.5 ± 113.49 ) s,( 247.9 ±95.62)s,(276.3 ±85.04)s,P＜0.01).Conclusion Methamphetamine can induce conditioned place preference in zebrafishes.The CPP model in zebrafish established in this study can be used as a new animal model in drug dependence.
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Based on their inherent relationship,some independent and verifying experiments of medical immunology were intergrated into a series of comprehensive and open experiments,which was embodied in the preparations of antiserum.so as to set up a new experiment teaching system emphasizing the training of student comprehensive capability.Achievements in training students'scientific research capacity,innovative motivation and practical working ability have been obtained and the results could provide valuable experience for innovation and reform of medical immunology experiment teaching model and method.
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Objective To compare the efficacy of the emergency ESWL within 24 hours after the onset of renal colic and elective ESWL at 5 - 7 days after the onset of renal colic in the treatment for ureteral stones.Method From January 2008 to October 2009, 365 patients in the Second Hospital of Nanchang, with ureteral stones were admitted to our department for renal colic. They underwent emergency ESWL or elective ESWL with HK. ESWL- 108 energy electromagnetic shock wave lithotripter. Success rate of fragmentation, stone-free rate after 2 weeks of operation, pain recurrence rate, and complications were evaluated. The data were analyzed using SPSS 15.0. Results The success rate of fragmentation and the stone-free rate after 2 weeks of emergency ESWL were 96.76% and96.21%, respectively, which were higher than those (88.33% and 87.22%, respectively) of elective ESWL ( P ＜ 0. 05). The postoperative pain recurrence rate of emergency ESWL ( 4.32 % ) was lower than that (9.44%) of elective ESWL ( P ＜0.05). There was no difference of total complications between emergency ESWL (3.24%) and elective ESWL (2.78%) group (P ＞0.05). Conclusions Emergency ESWL is superior to selective ESWL and is the safe and effective method for the management of ureteral stones.
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BACKGROUND:Knee osteoarthritis and rheumatoid arthritis are common arthritis in the knee.In late stage of arthritis,severe deformation and activity obstacle are found,which require total knee replacement.The total knee replacement not only can significantly relieve symptom,but also correct deformation and improve joint function.OBJECTIVE:To summarize classification of knee joint,techniques of knee replacement surgery and complications following replacement.METHODS:We retrieved Vip Database (http://www.cqvip.com) for titles and abstracts with the key words of "knee replacement,prosthesis,complication".Articles concerning clinical application of knee prosthesis were included.Articles in the same field that published recently or in authorized journals were included.A total of 20 literatures were included for review according to inclusion criteria.RESULTS AND CONCLUSION:Various artificial total knee prostheses were used in different patients in accordance with patients' condition,joint limitation degree,fixation method and meniscus function.Indication of different knee prostheses depends on bone and soft tissue of the knee,and quality and status of knee ligament,joint deformation and destruction degree of articular cartilage are responsible for the choice of prosthesis.Thrombosis of deep veins of the lower limb,pulmonary embolism,infection surrounding the prosthesis and prosthesis loose are common complications in joint replacement.
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In this study,a standard strain of HSV-1(strain SM44)was used to investigate the antiviral activity of the recombinant Cyanovirin-N(CV-N)against Herpes simplex virus type 1(HSV-1)in vitro and in vivo.Cytopathic effect(CPE)and MTT assays were used to evaluate the effect of CV-N on HSV-1 in Vero cells.The number of copies of HSV-DNA was detected by real-time fluorescence quantitative PCR(FQ-PCR).The results showed that CV-N had a low cytotoxicity on Vero cells with a CC50 of 359.03±0.56 μg/mL,and that it could not directly inactivate HSV-1 infectivity.CV-N not only reduced the CPE of HSV-1 when added before or after viral infection,with a 50% inhibitory concentration(IC50)with 2.26 and 30.16μg/mL respectively,but it also decreased the copies of HSV-1 DNA in infected host cells.The encephalitis model for HSV-1 infection was conducted in Kunming mice,and treated with three dosages of CV-N(0.5,5 & 10 mg/kg)which was administered intraperitoneally at 2h,3d,5d,7d post infection.The duration for the appearance of symptoms of encephalitis and the survival days were recorded and brain tissue samples were obtained for pathological examination(HEstaining).Compared with the untreated control group,in the 5mg/kg CV-N and 10mg/kg CV-N treated groups,the mice suffered light symptoms and the number of survival days were more than 9d and 14d respectively.HE staining also showed that in 5mg/kg CV-N and 10mg/kg CV-N treated groups,the brain cells did not show visible changes,except for a slight inflammation.Our results demonstrated that CV-N has pronounced antiviral activity against HSV-1 both in vitro and in vivo,and it would be a promising new candidate for anti-HSV therapeutics.
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OBJECTIVE To investigate the drug-resistance of Enterobacter cloacae(ECL) and its carrying rate of gene encoding aminoglycosides modifying enzymes(AMEs).METHODS Totally 132 clinically isolated ECL strains were identified with VITEK-32.Their drug susceptibility was tested with K-B disc diffusion.The presence of ESBLs and AmpC was tested with three dimensional test.The genes encoding AMEs were detected with PCR and confirmed by sequence.RESULTS All strains of ECL were susceptible to IMP and MER.The resistance rate to AMK,LVX,FEP,CFS and CIP was 21.2%,35.6%,37.9%,46.2% and 48.5%,respectively with gradually increasing.Their resistance rate to other antibiotics ranged from 50.0% to 87.7%.Among 132 strains of ECL,45 strains producing ESBLs,accounted for 34.1%,27 strains producing AmpC,accounted for 20.5%,11 strains producing ESBLs and AmpC,accounted for 8.3% and 49 strains producing neither ESBLs nor AmpC,accounted for 37.1%.Seven strains without positive detection of ESBLs were resistant to CTX and CAZ,but carried the genes of resistance to TEM and SHV.The detection rate of genes encoding AMEs was about 62.1%,among which subtypes of aac(6′)-Ⅰb dominated with detection rate of 51.5%.Meanwhile the detection rate of subtype aac(3)-Ⅰ,aac(3)-Ⅱ,aac(6′)-Ⅱ,ant(3″)-Ⅰ,ant(2″)-Ⅰ and aph(3′)-Ⅵ was 15.9%,12.9%,18.9%,37.1%,6.8% and 9.8%,respectively.The detection rate of carrying more than two types of AMEs was about 89.0%.There were 5 strains of presenting phenotypic resistance without detection of genes encoding AMEs.CONCLUSIONS The clinically isolated ECL strains are not only severe resistant to drug and but also multi-drug resistant.The carrying rate of genes encoding ESBLs,AmpC and AMEs is higher than estimated which is the leading cause of resistance to antibiotics.
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The external wrapping of intracranial aneurysm is the definitive treatment of choice for surgical clipping or endovascular occlusion, yet there may exist considerable difficulties and risks because so far neither ideal wrapping techniques nor ideal wrapping materials have been obtained. An encapsulated aneurysm clip with biomembrane graft across the vessels is introduced in this article. By clipping the neck and wrapping the sack of aneurysm simultaneously, this clip successfully solves the problems of unreasonable encapsulated materials and techniques; it has been proved to be an effective method for treating intracranial refractory aneurysms.