NDM-1 and IMP-4-producing isolates highlight that active surveillance is necessary to prevent the further spread of the bacteria. Multilocus sequence typing (MLST) showed that two KPC-producing isolates assigned to ST93, two isolates carrying NDM-1 assigned to ST1120. Moreover, the MEGA analysis showed that ST93, ST256, and ST1120 have homology, showing that CREL in our area has a potential spread risk. Conclusions These findings indicating that CREL clonal dissemination may occurred in this region and should be taken seriously concern. Our study highlights an urgent need to monitor these isolates to prevent their further spread.Background Benign anastomotic esophageal stricture after surgical resection frequently occurs and requires endoscopic balloon dilation (EBD) or incision to maintain patency because of the significant recurrence rate. Our study was designed to evaluate the effectiveness and safety of endoscopic incision and selective cutting (EISC) as primary treatment on 5 patients for benign anastomotic esophageal stricture. Methods Five patients with benign stricture of the esophageal anastomosis after radical resection for esophageal cancer underwent EISC in our center between April, 2018 and January, 2019. The effectiveness and safety of the procedure were observed during at least 12 months follow-up. Results The EISC was successfully performed in all 5 patients. The diameters of the anastomoses were increased from 1-3 preoperatively to 14-18 mm (mean 15.6 mm) intraoperatively (P less then 0.05). The duration of the operation ranged from 30-55 min (mean 42.8 min). During at least 12 months follow-up observations, all patients resumed eating solid meals and had no recurrence of dysphagia. Conclusions EISC as primary treatment is a safe and effective treatment for benign anastomotic esophageal stricture.Background Nursing quality is an integral part of health care quality and one of key performance indicators (KPIs) for health care management. The Plan-Do-Check-Act (PDCA) cycle is a management tool for continuous improvement of a business's products or processes. It can be applied to standardize nursing management and thus improve the nursing quality and increase the survival rate of patients. This study assessed the value of the PDCA cycle in standardizing nursing management in an intensive care unit (ICU) for patients with severe coronavirus disease 2019 (COVID-19). Methods The status quo of the ICU was analyzed, and the relevant issues and countermeasures were proposed. The PDCA cycle was applied to standardize the nursing management in the ICU. Results Nine measures were proposed and applied to improve the management of the COVID-19 ICU defining the clean or contaminated areas, use of self-designed shoe storage cabinets, defining staff roles and responsibilities, establishing the staffing structure, staff training, placing items at fixed locations, improving shift handover, use of bulletin boards for listing key points, and use of reserved drugs cabinets. The virus contamination awareness, professional skills, awareness of duties and responsibilities, and quality and performance of nursing were remarkably improved 2 weeks after the implementation of the above countermeasures. Conclusions The PDCA cycle helps to standardize nursing management in COVID-19 ICU by developing and applying effective nursing management approaches.Background Observation indexes used to evaluate the effect of dexrazoxane-anthracycline combinations in breast cancer often only take into account the clinical symptoms, or left ventricular ejection fraction (LVEF), biomarkers [such as creatine kinase MB (CK-MB), brain natriuretic peptide (BNP) and cardiac troponin T (cTnT)], or tumor recurrence rate, improvement of autonomic nerve function or economic benefits. This study aimed to evaluate the effect of dexrazoxane on the changes of mechanical properties of right ventricular myocardium in patients who underwent pirarubicin chemotherapy with three-dimensional speckle-tracking imaging (3D-STI). Methods A total of 64 breast cancer post-operation patients who received pirarubicin chemotherapy were randomly divided into two groups the experimental group (with dexrazoxane added) and the control group (without dexrazoxane). The mechanical properties of the right ventricular myocardium were monitored by 3D-STI before and after chemotherapy. The levels of serum hypersensitive troponin I (hs-cTnI) and N-terminal B-type pro-natriuretic peptide (NT-proBNP) as well as conventional echocardiographic parameters were also measured. Results After chemotherapy, right ventricular global longitudinal strain (RVGLS) and right ventricular global area strain (RVGAS) were significantly reduced in both groups (P less then 0.05). There was a significant difference between the two groups (P less then 0.05). Conclusions Dexrazoxane can alleviate the toxicity of pirarubicin in the right ventricular myocardium. 3D-STI is a potential new method for early and accurate evaluation of the mechanical properties and functional changes of the right ventricular myocardium.Background Although labor pain is treated clinically by the administration of local anesthetics alone or with opioids in the epidural or spinal spaces, however, the mechanisms of labor pain mechanisms have not been fully elucidated during to the lack of animal models, and the side effects of drugs still existed. Spinal microglia can be activated or mobilized under several pain states, and we want to explore the activation of spinal microglia is involved in the acute uterine cervical distension rats or not. Methods (I) The electromyographic (EMG) response to uterine cervical distension (UCD) was observed. Twenty-four Sprague-Dawley rats were randomly divided into three groups standard group, sham group, and UCD group (n=8). EMG response to UCD was recorded at 30, 60 and 120 min after distension, respectively. The activation of microglia in the spinal cord at UCD 60 min was seen. Grouping following the first part (n=4), four rats were executed perfusion after distension of 60 min, the T12 to L2 spinal cord segmoup, and the UCD group were no statistical significance (P>0.05).  https://www.selleckchem.com/products/carfilzomib-pr-171.html  After UCD, the EMG of the UCD group were increased at 30, 60, 120 min. Compared with fundamental values (P0.05). Conclusions The activation of spinal microglia is involved in the formation of acute visceral pain induced by uterine cervical distension, Electrical acupuncturing Hegu, and Sanyinjiao alleviate pain, and the possible mechanism is inhibiting the activation of spinal microglia in the acute uterine cervical distension rats.