Genotyping Characteristics of Human Fecal Escherichia coli and Their Association with Multidrug Resistance in Miyun District, Beijing / 生物医学与环境科学（英文）

OBJECTIVE@#To explore the genotyping characteristics of human fecal Escherichia coli( E. coli) and the relationships between antibiotic resistance genes (ARGs) and multidrug resistance (MDR) of E. coli in Miyun District, Beijing, an area with high incidence of infectious diarrheal cases but no related data.@*METHODS@#Over a period of 3 years, 94 E. coli strains were isolated from fecal samples collected from Miyun District Hospital, a surveillance hospital of the National Pathogen Identification Network. The antibiotic susceptibility of the isolates was determined by the broth microdilution method. ARGs, multilocus sequence typing (MLST), and polymorphism trees were analyzed using whole-genome sequencing data (WGS).@*RESULTS@#This study revealed that 68.09% of the isolates had MDR, prevalent and distributed in different clades, with a relatively high rate and low pathogenicity. There was no difference in MDR between the diarrheal (49/70) and healthy groups (15/24).@*CONCLUSION@#We developed a random forest (RF) prediction model of TEM.1 + baeR + mphA + mphB + QnrS1 + AAC.3-IId to identify MDR status, highlighting its potential for early resistance identification. The causes of MDR are likely mobile units transmitting the ARGs. In the future, we will continue to strengthen the monitoring of ARGs and MDR, and increase the number of strains to further verify the accuracy of the MDR markers.

Effectiveness and Safety of a Novel Approach for Management of Patients with Potential Difficult Mask Ventilation and Tracheal Intubation: A Multi-center Randomized Trial / 中华医学杂志(英文版)

<p><b>Background:</b>Patients with potential difficult mask ventilation (DV) and difficult intubation (DI) are often managed with awake intubation, which can be stressful for patients and anesthesiologists. This prospective randomized study evaluated a new approach, fast difficult airway evaluation (FDAE). We hypothesized that the FDAE approach would reduce the need for awake intubation.</p><p><b>Methods:</b>After obtaining informed consent, 302 patients with potential DV/DI undergoing elective surgeries were randomly assigned to the FDAE group (Group E) and the control group (Group C). In Group E, patients were gradually sedated, and adequacy of manual mask ventilation during spontaneous breathing was assessed at various sedation levels. Awake intubation was applied in those with inadequate mask ventilation. In Group C, DI was evaluated under local anesthesia. However, the care team could intubate under general anesthesia if the vocal cords were visible. The primary outcome was the rate of awake intubations in both groups and the induction efficiency assessed by the induction time. The secondary outcome was the incidence of serious complications.</p><p><b>Results</b>The rate of awake intubation was significantly lower in Group E than that in Group C (5.81% vs. 36.05%, χ = 42.3, P < 0.001). The induction time was much shorter in Group E than in Group C (11.85 ± 4.82 min vs. 18.71 ± 7.85 min, t = 5.39, P < 0.001). There was no significant difference in the incidence of intubation related complications between the two groups. Patients in Group E had a much lower incidence of recall (9.68% vs. 44.90%, χ = 47.68, P < 0.001) of the induction process and higher satisfaction levels than patients in Group C (t = 15.36, P < 0.001).</p><p><b>Conclusions</b>The FDAE significantly reduces the need for awake intubation and improves the efficiency of the intubation process without comprising safety in patients with potential difficult mask ventilation and DI.</p><p><b>Trial Registration:</b>No. ChiCTR-TRC-11001418; http://www.gctr.org/cn/proj/show.aspx?proj=1562.</p>

Relationship between the early incidence of postoperative complications and renal pelvic pressure during mini-mally invasive percutaneous nephrolithotomy / 局解手术学杂志

Objective To evaluate the relationship between the early incidence of postoperative complications and renal pelvic pressure during minimally invasive percutaneous nephrolithotomy. Methods 133 renal calculi patients were monitored during MPCNL. Then the patients were separated into two groups according to the renal pelvic pressure,and the postoperative fever,the perirenal fluid and impairment of renal function were analyzed. Results The average body temperature was higher in high pelvic pressure group than that in low pelvic pressure group from the first day to the fourth day after operation(P<0. 05). The urinary protein of all patients raised obviously after the op-eration while it decreased gradually afterward. The urinary protein of the high pelvic pressure group was much higher than that of the low pel-vic pressure group in same day with a significant difference (P<0. 05). The incidence of perirenal fluid was much higher in high pelvic pres-sure group than that in low pelvic pressure group (P<0. 05). Conclusion The incidence of early postoperative complications was related to renal pelvic pressure during MPCNL.

Chemical constituents from stems of Glycosmis pentaphylla / 中草药

Objective: To study the chemical constituents in the stems of Glycosmis pentaphylla. Methods: The constituents were isolated and purified by silica gel and preparative HPLC, and their structures were elucidated by means of physicochemical properties and spectroscopic analyses. Results: Nine compounds were isolated from the n-butanol-soluble fraction of 95% ethanol extract from the stems of G. pentaphylla, and identified as methyl 2-hydroxybenzoate 2-O-β-D-apiofuranosyl-(1→2)-O-β-D-glucopyranoside (1), inosine (2), 4-methoxy-8-(O-β-D-glucopyranosyloxy)-2(1H)-quinolinone (3), threo-guaiacyl-glycerol-8-O-4'-sinapyl ether 7-O-β-D-glucopyranoside (4), vitexin (5), ethyl-O-β-D-glucopyranoside (6), 2-propyl-O-β-D-glucopyranoside (7), threo-guaiacyl glycerol (8), and erythro-guaiacyl glycerol (9). Conclusion: Compound 1 is a new phenolic glycoside named glycopentosine A, and compounds 2-4 and 6-9 are isolated from the plants of Glycosmis Correa for the first time.

Impact of weight gain following smoking cessation on one-year outcome after drug-eluting stent implantation / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Weight gain following smoking cessation increases cardiovascular risk, but its effects on prognosis after percutaneous coronary intervention (PCI) remain unclear. This study aimed to investigate the relationship between weight gain post smoking cessation and one-year clinical outcome in patients who underwent PCI with drug-eluting stent (DES).</p><p><b>METHODS</b>A total of 895 consecutive male smoking patients were divided into quitters (n = 437) and continuers (n = 458) according to their smoking status after PCI. Weight gain, major adverse cardiac events (MACE, including cardiac deaths, myocardial infarction and revascularization), and recurrent angina were recorded during follow-up for one year.</p><p><b>RESULTS</b>Average weight gain in quitters was more than that in continuers (1.5 kg vs. -0.03 kg, P < 0.001). Weight was unchanged or increased by more than 1.5 kg in 78.17% of continuers, while 50.57% of quitters had a weight gain of less than 1.5 kg. Compared with continuers, MACE in quitters was significantly reduced after PCI (6.12% vs. 4.81%, P = 0.049), especially recurrent angina (13.97% in continuers vs. 9.84% in quitters, P = 0.027). After adjusting for weight gain and other factors, smoking cessation was independently associated with a lower risk of MACE and recurrent angina (OR = 0.73, P = 0.035). However, weight gain > 1.5 kg (OR = 1.55, P = 0.026) could curtail the benefits from smoking cessation.</p><p><b>CONCLUSIONS</b>Weight gain may reduce the benefits of smoking cessation after PCI with DES implantation. Thus, although smoking cessation is recommended after PCI, weight control should also be highly encouraged for these patients.</p>

Qualitative and quantitative analysis of fluoxetine hydrochloride by 19F NMR / 药学学报

The chemical shift of fluoxetine hydrochloride appears at delta 14.15 in 19F NMR analysis. The delta moved upfield slightly from 14.158 to 14.145 when the concentration of solution became diluted from 2.00 to 0.05 mmol x L(-1). Spiking test was suggested to confirm the existence of the compound for qualitative analysis. 19F NMR detection sensitivity test illustrated that a concentration of 17 mg in 1 L water could be detected while the sample was scanned 500 times with optimum parameters. In quantitative analysis, standard curve of concentration versus fluorine signal intensity was proposed to determine the amount of fluoxetine. Long capillary tube containing trifluoroacetic acid was used as internal standard for the integration measurements and straight line was obtained with good fitting. Direct additions of trifluoroethanol to fluoxetine solutions gave a poorer standard curve.

Effect of Multimodal Therapeutic Measures on Severe Knee Osteoarthritis in the Old / 中国康复理论与实践

@#Objective To observe clinical efficacy of intra-articular injection of sodium hyaluronate(SH) and betamethasone accompanied with Bulleyaconitin A or diclofenac sodium administration for severe knee osteoarthritis(KOA).Methods60 patients with severe KOA from 580 subjects with KOA were selected as observational subjects in the experiment. All patients were treated by intra-articular injection of sodium hyaluronate 2.5 ml and betamethasone administration once a week for five consecutive weeks as a therapeutic course, betamethasone only once. Bulleyaconitin A group was accompanied with Bulleyaconitin A 0.4 mg, t.i.d, p.o.; diclofenac sodium group was accompanied with diclofenac sodium 75 mg, b.i.d, p.o. According to knee joint comprehensive score table (Tegner rating systems), the function comprehensive scores for all the patients pre-treatment and post-treatment knee joints were assessed.ResultsThe function comprehensive scores improved significantly after treatment in two groups(P＜0.001). The side effects in Bulleyaconitin A group decreased significantly than in diclofenac sodium group(P＜0.01).ConclusionThe intra-articular injection of SH and betamethasone accompanied with Bulleyaconitin A administration was an effective and less side-effect therapeutic measure for the treatment of knee osteoarthritis, especially for the old patients with severe knee osteoarthritis.

The clinical characteristics of primary biliary cirrhosis in China: a systematic review / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To summarize the clinical features, diagnosis and treatment of patients with primary biliary cirrhosis (PBC) in China.</p><p><b>METHODS</b>Systematic analysis of clinical characteristics by searching the Chinese literatures.</p><p><b>RESULTS</b>From 1955 to 2007, 2740 PBC patients were reported in 103 papers (duplicated reports were deleted). The detailed information of 985 patients from 16 papers were collected. Female : male was 6.82:1. The age range was 42 to 56.2-year-old. The time from onset to diagnosis was 12 to 98.4 months. The most common symptoms were fatigue (72.40%), jaundice (67.41%), anorexia (68.58%) and pruritus (45.60%). 20% patients were asymptomatic at onset. The most frequent physical signs were splenomegaly (57.53%), hepatomegaly (43.56%) and ascites (18.45%). Serum alkaline phosphatase (ALP) and gamma glutamyl transpeptidase (GGT) levels were markedly elevated in most of these patients. The immunological marks of AMA and M2 were positive in 88.98% and 82.65% patients, respectively. The most common comorbidity were Sjögren syndrome (9.14%), rheumatoid arthritis (3.95%) and diabetes type II (2.54%). Of the 507 patients treated with ursodeoxycholic acid (UDCA), 345 patients got complete or partial clinical biochemical response. The common complications were gastrointestinal bleeding (41.67%) and liver failure (41.67%). Liver transplantation was the only effective way for the treatment of the end-stage liver disease.</p><p><b>CONCLUSION</b>The clinical feature of primary biliary cirrhosis in China was similar to the overseas literatures. Further research should focus on epidemic investigation, early diagnosis, long term follow up of asymptomatic patients, immunological mechanism and the efficacy of liver transplantation.</p>

Comprehensive Therapy for Herpes Zoster in Renal Transplantation Recipients: 12 Cases Report / 中国康复理论与实践

@#Objective To explore the therapy for herpes zoster (HZ) after renal transplantation. Methods 12 renal transplantation recipients with herpes zoster were treated with acyclovir, ultraviolet rays and nerve block. The pain was assessed with visual analogue scale (VAS). Results The scores of VAS decreased from 9.3 to 2.1 after treatment (P<0.01). The total effective rate was 100%. Conclusion Acyclovir combined with ultraviolet rays and nerve block is a more safe and effective therapy for the herpes zoster in renal transplantation recipients.

Effect of angong niuhuang pill as an adjuvant treatment on moderate or severe neonatal hypoxic-ischemic Encephalopathy / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To evaluate the clinical efficacy and safety of angong niuhuang pill (ANP) as an adjuvant treatment on moderate or severe neonatal hypoxic-ischemic encephalopathy (NHIE).</p><p><b>METHODS</b>Thirty-nine neonates with NHIE in the control group were treated with conventional treatment, and 58 in the treated group were administered orally ANP additionally, and relative indexes were observed.</p><p><b>RESULTS</b>The improvement of aspects such as recovery of consciousness, muscular tension, and primitive reflex and disappearance of convulsion, in the treated group was better than that in the control group (P < 0.01).</p><p><b>CONCLUSION</b>ANP as an adjuvant treatment has a definite effect on NHIE, it can promote the recovery of patients, decrease the occurrence of sequelae and with high safety, therefore, is a drug feasible for clinical application.</p>

Clinical Significance of Monitoring Indexes of Oxygen Exchange in Neonatal Respiratory Distress Syndrome / 实用儿科临床杂志

0.05).Conclusion Indexes of oxygen function may become criteria of early diagnosing NRDS,observing effect of treatment and guidance of ventilation weaning.