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Objectives:To investigate the genetic characteristics of the blaNDM-1-carrying plasmid of the multidrug resistant Enterobacter hormaechei subsp. hoffmannii clinical isolate C37, and constructing a phylogenetic tree of the 66 publicly available genomes of the Enterobacter hormaechei subsp. hoffmannii to explore its global epidemic situation. Methods:Carbapenem-resistant Enterobacter cloacae complex (CRECC) strains isolated from the First Affiliated Hospital of Sun Yat-sen University from August 2014 to August 2021 were collected. Matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS) and 16S rDNA Sanger sequencing were used for species identification. Micro broth dilution method was used for antibacterial susceptibility test. The polymerase chain reaction (PCR) was used to detect the β-lactamase resistance gene and plasmid-mediated quinolone resistance (PMQR) gene carried by the C37 strain. The conjugation experiment was used to confirm the conjugative metastasis of the resistance genes in C37 strain. Whole genome of the C37 strain was sequenced. Core genome was extracted and the phylogenetic analysis of 66 publicly available Enterobacter hormaechei subsp. hoffmannii was performed. Results:Enterobacter hormaechei subsp. hoffmannii C37 strain is resistant to third-generation cephalosporins, carbapenems, aminoglycosides and quinolones, and carries blaACT-5, blaNDM-1, qnrA1, aac(6′)-Ib-cr, oqxAB, fosA, dfrA15 and other resistance genes, as well as IncX3, IncX4, IncFIB and IncFII plasmids. Multilocus sequence typing (MLST) analysis showed that C37 strain belongs to the ST78 type of Enterobacter cloacae complex (ECC). Conclusions:ST78 type Enterobacter hormaechei subsp. hoffmannii is closely related to the spread of carbapenem resistance genes. It is a potential high-risk clone to spread carbapenem resistance genes. The prevalence and trends of ST78 type Enterobacter hormaechei subsp. Hoffmannii should be monitored.
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Objective To investigate the effect of levosimendan on cardiac function and prognosis in elderly patients with septic myocardial contractility impairment.Methods A prospective,randomized,controlled study was conducted.The elderly patients with septic myocardial contractility impairment who were admitted to Intensive Care Unit in Zhejiang Hospital were consecutively enrolled from January 2017 to September 2017.The key inclusive criterion was left ventricular ejection fraction (LVEF) ≤ 50％ after fluid resuscitation.A total of 30 patients were randomly assigned to levosimendan group (n=15) and dobutamine group (n=15).Based onconventional treatment,intravenous dobutamine (5 μg per kilogram of body weight per minute) or levosimendan (0.2 μg per kilogram of body weight per minute)were continuously administrated for 24 hours in two groups.At 0 h,24 h,48 h,72 h after injection,the following parameters or values were recorded including serum lactic acid (Lac),and echocardiographic parameters such as LVEF,stroke volume (SV).The time of mechanical ventilation,length of stay in ICU and 28-day mortality were compared in two groups.Results Compared with dobutamine group,blood Lac at 24 h [(1.97±1.10)mmol/L vs.(2.73 ± 2.06) mmol/L,P=0.002] decreased significantlyin levosimendan group.LVEF and SV were significantly higher in levosimendan group at 24 h [LVEF:(47.93±5.01)％ vs.(45.60±5.47)％,P=0.004;SV:(47.73 ± 14.01) ml vs.(44.80±16.89) ml,P=0.035;respectively],48 h [LVEF:(51.07 ± 5.05)％ vs.(46.73 ± 6.34)％,P=0.004;SV:(49.87 ± 14.15) ml vs.(45.07± 16.94) ml,P=0.005;respectively] and 72 h [LVEF:(53.20±5.92)％ vs.(47.70±6.71)％,P=0.002;SV:(51.27±14.98) ml vs.(45.73±17.34) ml,P=0.010].The time of mechanical ventilation,length of stay in ICU and 28-day mortality were comparable between two groups (P＞0.05).Conclusions Levosimendan improves cardiac systolic function and tissue perfusion in elderly patients with septic myocardial contractility impairment.However,cardiac diastolic function,liver and kidney function are not further improved by levosimendan compare with dubutamine.Time of mechanical ventilation,length of stay in ICU and 28-day mortality in two groups are similar.
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Objective To examine the practice and value of comprehensive geriatric assessment(CGA)in geriatric care by conducting comprehensive evaluation of hospitalized elderly patients.Methods CGA was carried out in 91 hospitalized patients at our hospital from July 2015 to October 2015.Patients aged 65-75(6 cases),76-85(38 cases)and ＞85-99 years(47 cases)were assigned into three Groups.The incidence of geriatric syndromes ineach age group was calculated,and characteristics of geriatric syndromes among the patients were analyzed.ResultsFrailty had the highest incidence among all age groups 69(64.8％).In Group 65-75 years old,pain was mostfrequently reported 2(33.3％);in Group 76-85 years old,the three most frequent syndromes were frailty,dementiaand falls;in Group 85-99 years old,frailty,polypharracy and rnalnutrition occurred most often.Up to 37.4％％ of the patients showed coexistence of 3-4 common geriatric syndromes,and only 14.2％ of the patients had none Conclusions Frailty,dementia,falls,polypharrnacy,and malnutrition are the most common geriatric syndromes in hospitalized elderly patients.Coexistence of multiple geriatric syndromes is common among these patients.
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Sepsis is defined as a host imbalance of response induced by infection leading to life-threatening organ dysfunction, and septic shock is the most severe form of sepsis resulting from systemic circulatory and metabolic abnormalities, having high mortality rate. During septic shock stage, there are myocardial injury and myocardial inhibition, and after septic shock combined with cardiac injury, the mortality will be increased significantly. Levosimendan can improve cardiac function, hemodynamics, microcirculation, tissue oxygen metabolism, organ functions, etc in patients with septic shock. Now the effects of levosimendan on internal organ functions and hemodynamics in treatment of patients with septic shock are reviewed.
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Objective To investigate the effect of escitalopram combined neuro-linguistic programming treatment(NLP) on cognitive function in patients with somatoform disorders.Methods 120 cases with somatoform disorders were randomly divided into the escitalopram monotherapy group and escitalopram with NLP combined group,with 60 cases in each group for six weeks.At baseline and after six weeks for treatment,it was respectively assessed that the efficacy using Symptom Checklist 90 and Global Assessment Function,and cognitive function using the Raven Standard Progressive Matrices Test,digit span and digit symbol tests in Adult Wechsler Intelligence Test,while event related potentials P300 were detected.60 cases normal healthy adults as controls.Results Compared with the control group,the Raven scores,digit span,digit symbol scores were lower (P ＜0.01),N1,P3 latent periods were longer (P ＜ 0.01 or ＜ 0.05),N1N2,N2P2,P2P3 amplitudes were less(P =0.00) in patients with somatoform disorders.After treatment,Raven scores(91.25 ± 14.87,95.60 ± 19.95),digit span scores (11.98 ± 1.89,10.90 ± 2.76),digit symbol scores (11.71 ± 2.89,11.92 ± 2.90),N2P2 amplitudes ((11.32 ± 6.67) μV,(13.39 ± 9.31) μV),P2P3 amplitudes ((9.04 ± 6.14) μV,(9.51 ± 7.17) μV) increased,N2 latent periods ((240.60 ± 41.41) ms,(238.31 ± 41.47) ms) prolonged,N1 latent periods shortened (P ＜ 0.05 or 0.01) in the monotherapy group and the combined group.The digit span,P2 latent periods,N1N2,N2P2,P2P3 amplitudes had statistically significant differences between monotherapy group and combined group after treatment(P ＜ 0.05 or 0.01).Conclusion Both escitalopram monotherapy and escitalopram combined NLP have improved cognitive function in patients with somatoform disorders,but combined therapy has more prominent advantage.
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This study was designed to label rat bone marrow mesenchymal stem cells (rBMSCs) with humanized renillar green fluorescent protein (hrGFP) for exploring the detectable effects of hrGFP on the construction of tissue-engineered bone in vitro. The hrGFP expression plasmid was packed into lentivirus by 293FT cells and transduced into rat BMSCs. After transduction, 81.3% rBMSCs successfully expressed green fluorescence. The hrGFP-rBMSCs were statically loaded on Bioglass-Collagen-Hyaluronic Acid-Phosphatidylserine (BG-COL-HYA-PS) scaffold in complete L-DMEM medium or osteogenic medium for 14 days. At 6h, a number of cells expressing green fluorescence can be observed by fluorescent microscopy. At day 7 and 14 after co-culture, the number of cells on the scaffold gradually increased. After 14 days for osteogenic induction, the hrGFP-rBMSCs and the interior of scaffold can be detected the expression of type I collagen. The results demonstrate that hrGFP labelling technique can detect visualizedly and effectively cell adhesion, proliferation and osteogenic differentiation in the construction of tissue-engineered bone in vitro.
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Animals , Humans , Rats , Bone Marrow Cells , Cell Biology , Cell Culture Techniques , Cells, Cultured , Green Fluorescent Proteins , Genetics , Metabolism , Mesenchymal Stem Cells , Cell Biology , Metabolism , Osteogenesis , Staining and Labeling , Methods , Tissue Engineering , Methods , Tissue ScaffoldsABSTRACT
Objective To measure the operative length of the radioactive source with RL_HZJ18 afterloading machine.Methods The ways of direct measurement and treatment plan are both collected to measure.Results Both of the ways can measure the operative length,and the error of length can be accurate to 1mm.Conclusion The way is simple,practical,good maneuverability,it is worth the trial and promotion.