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Objective:To investigate the antibiotics resistance of patients with Helicobacter pylori ( H. pylori) infection of different age in Ningxia. Methods:From July to December 2021, a total of 1 040 patients with H. pylori infection confirmed by 14C-urea breath test who had no history of H. pylori treatment and underwent gastroscopy were selected from the H. pylori special outpatient clinics from Ningxia Hui Autonomous Region People′s Hospital, Ningxia Hospital of Integrated Traditional Chinese and Western Medicine, Yuanzhou District People′s Hospital of Guyuan, Wuzhong People′s Hospital, the Second People′s Hospital of Shizuishan, People′s Hospital of Zhongwei, Yinchuan First People′s Hospital. Gastric mucosa specimens were obtained under gastroscopy and cultured for H. pylori in vitro. Harvested H. pylori were detected for H. pylori drug resistance phenotype. Kirby-Bauer disk diffusion method was used to detect antibiotic sensitivity. Previous use of antibiotics of patients were recorded. The characteristics of primary drug resistance of people≤44, 45 to 59, and ≥60 years old were analyzed. Chi-square test was used for statistical analysis. Results:A total of 538 H. pylori strains were obtained from 1 040 gastric mucosa specimens cultured in vitro, with a positive rate of 51.7%. A total of 187 patients could provide information on history of antibiotics usage. The primary drug resistance rates of metronidazole, clarithromycin and levofloxacin were high, which were 95.5% (514/538), 44.6% (240/538) and 45.4% (244/538), respectively; however drug resistance of amoxicillin, furazolidone and tetracycline were not found. The double drug resistance rate was 36.4% (196/538), mainly resistant to metronidazole and clarithromycin or metronidazole and levofloxacin, the drug resistance rates were 17.8% (96/538), 18.2% (98/538), respecitively. The triple drug resistance rate was 25.5% (137/538), all of the strains were metronidazole, clarithromycin and levofloxacin resistant strains. The primary drug resistance rates to levofloxacin and clarithromycin in patients with H. pylori infection who had previous history of quinolones and macrolides were 60.9% (28/46) and 63.4% (83/131), respectively; which were higher than those of patients who had not used corresponding drugs (41.8%, 59/141 and 39.3%, 22/56), and the differences were statistically significant ( χ2=5.05 and 9.23, P=0.023, 0.002). The drug resistance rates of metronidazole of ≤44, 45 to 59, and ≥60 years old group were 94.2% (163/173), 95.5% (231/242) and 97.6% (120/123), respectively, and the differences were not significant ( P>0.05). The single drug resistance rates of levofloxacin of ≤44, 45 to 59, and ≥60 years old group were 34.7% (60/173), 48.3% (117/242) and 54.5% (67/123), respectively, and the differences were statistically significant ( χ2=12.95, P=0.002). The levofloxacin resistance rate of ≤44 years old group was lower than that of 45 to 59, and ≥60 years old group, and the differences were statistically significant ( χ2=7.70 and 11.49, P=0.006, 0.001). The single drug resistance rates of clarithromycin of ≤44, 45 to 59, and ≥60 years old group were 36.4% (63/173), 50.4% (122/242) and 44.7% (55/123), respectively, and the differences were statistically significant ( χ2=8.00, P=0.018). The clarithromycin resistance rate of ≤44 years old group was lower than 45 to 59 years old group, and the difference was statistically significant ( χ2=8.00, P=0.005). Dual drug resistance rates of levofloxacin and clarithromycin of ≤44, 45 to 59 and ≥60 years old group were 49.7%(86/173), 70.2%(170/242), 45.5%(56/123), and the difference was statistically significant( χ2=27.63, P<0.001). The resistance rate of clarithromycin and levofloxacin in 45 to 59 years old group was higher than that in ≤44 and ≥60 years old group, and the difference was statistically significant ( χ2=18.00 and 21.13, both P<0.001). Conclusions:Primary drug resistance rates to metronidazole, levofloxacin and clarithromycin are high in patients with H. pylori infection of different ages in Ningxia. Individualized eradication therapy guided by drug resistance test is recommended.
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Objective:To compare and study coronary artery lesions characteristics of patients with non -ST -seg‐ment elevation acute myocardial infarction (NSTEMI) .Methods :A total of 66 patients diagnosed as acute NSTEMI were enrolled as NSTEMI group ,meanwhile 74 patients with unstable angina pectoris (UAP) were regarded as UAP group and 76 patients with acute ST -segment elevation myocardial infarction (STEMI ) were regarded as STEMI group .All patients received coronary angiography (CAG) and optical coherence tomography (OCT) examination . Coronary artery lesions characteristics were compared among three groups .Results:Pairwise comparison showed , that occlusion lesion (33.3% ) and serious stenosis (70% ~94% ) lesion (34.8% ) in NSTEMI group were signifi‐cantly more than those of UAP group (14.9% ,8.1% ) respectively;the occlusion lesion and serious stenosis lesion of STEMI group were no significant difference compared with those of STEMI group , P>0.05 all;type C lesion 43.9% of NSTEMI group was significantly more than that of UAP group (27.0% ) and of STEMI group (31.6% ) respectively ( P 0.05). Conclusion :Serious stenosis lesion ,type C lesion and vulnerable plaque of NSTEMI group are significantly more than those of UAP group ;in NSTEMI group , type C lesion is significantly more than ,and occlusion lesion occlusion le‐sion significantly less than that of STEMI group .
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Objective To investigate drug resistance and clinical efficacy of second-line anti-tuberculosis drugs in patients with multidrug-resistant pulmonary tuberculosis.Methods A total of 183 multi-drug resistant pulmonary tuberculosis (MDR-PTB) patients received standard anti-tuberculosis treatment in Zhejiang Provincial Center for Diagnosis and Treatment of Tuberculosis during March 2011 and March 2013.Patients were divided into four groups according to the results of first-line anti-tuberculosis drugs susceptibility test:group A (n =30) resistant to isoniazid (H) and rifamipicin (R) ; group B (n =28) resistant to HR and ethambutol (E) ; group C (n =53) resistant to HR and streptomycin (S) ; groups D (n =72) resistant to HRES.Drug susceptibility tests of second-line drugs kanamycin (Km),protionamide (Pto),paraaminosalicylic acid (PAS) and levofloxacin (Lfx) were performed.Negative conversion rates of mycobacterium tuberculosis in sputum culture were also observed and compared among different groups with x2 test.Results Among 183 MDR-PTB patients,49 cases (26.8％) were resistant to Lfx,which was significantly higher than that of Km (8.7％,n =16),Pto (13.1％,n =24) and PAS (6.6％,n=12) (x2 =37.983,P＜0.05).The resistant rate to Lfx in group D was 45.8％ (33/72),which was higher than that in group A (2/30,6.7％),group B (6/28,21.4％) and group C (8/53,15.1％) (x2 =14.413,5.047 and 13.087,P ＜0.05).The occurrence of pre-extensively drug resistance (Pre-XDR) in group D was 34.7％ (25/72),which was higher than that in group A (3/30,10.0％) and group C (9/53,17.0％) (x2 =6.499 and 4.852,P ＜ 0.05).Among 157 MDR-PTB patients who received standard anti-tuberculosis treatment for one year,the negative conversion rate of mycobacterium tuberculosis in sputum culture was 87.3％ (137/157).The negative conversion rate in group D was lower than that in other groups,but the difference was not of statistical significance (x2 =1.899,P ＞ 0.05).Conclusions The efficacies of second-line anti-tuberculosis drugs vary among MDR-TB patients resistant to different firstline anti-tuberculosis drugs.The sensitivity tests results of the first-line drugs may serve as reference for MDR chemotherapy regimen in lack of test results of second-line drugs.
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AIM: To determine the evolutionary pattern of parenchymal cell apoptosis in multiple organs early after intestinal ischemia-reperfusion(I/R) and its induction mechanisms and the role of apoptosis in triggering SIRS/MODS. METHODS: An I/R model was reproduced by clipping and releasing the superior mesenteric artery in rats and mice. Flow cytometry, electron microscope, DNA agarose gel electrophoresis, TUNEL method, fluorescent and Gomori's silver-HE staining were used to detect apoptosis. Distribution features of apoptotic parenchymal cells in multiple organs were observed. Immunohistochemical staining of HSP 70 and Bcl-2 were performd to study the induction mechanisms of apoptosis.RESULTS and CONCLUSION: 1. Damage of the liver, lung, gut and kidney was appeared in early phase of I/R. The percentages of apoptosis in parenchyma organs increased progressively. The percentages of cell necrosis increased with the prolonged I/R duration. 2. Percentages of apoptosis were much higher near the central veins of liver lobules, in the outer medulla of the kidney, and the antimescenteric border of intestinal mucosal epithelium because of ischemia. 3. The expression of HSP 70 increased and Bcl-2 reduced in the areas mentioned above because of hypoperfusion. 4. Apoptosis of I/R hepatocytes, splenocytes and thymocytes was obviously increased after Kupffer cell blockage with GdCl3, showing the functional state of Kupffer cells may play an important role in SIRS/MODS.
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The role of oxygen free radicals in multiple system organ failure (MSOF) was studied in rats produced by reticuloendothelial system blockade in addition to hemorrhagic shock. In MSOF animals blood reduced glutathione (GSH) elevated to 4.17?0.38 mg/g Hb at day 2, compared with baseline 2.67?0.09. Plasma glutathione peroxidase declined to 1.22?0.27 U/ml?min at day 1, and gradually increased at day 2 and day 3, but still lower than baseline 3.08?0.20. Blood superoxide dismutase (SOD) level was 182.6?27.1 at day 1, lower than baseline 249.5?72.4 ?g/g Hb. Plasma malondialdehyde (MDA) increased twice the normal level of 6.54?31 nmol/ml. Correlation analysis showed that lung index, plasma GPT and creatinine negatively correlated with the level of lung and liver homogenate SOD and kidney homogenate GSH, respectively.Results indicate that there are significant changes in the levels of blood and tissue antioxidants and lipid peroxides during MSOF. Organ failure appears to be correlated with the decrease in tissue antioxidation capacity.
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Complement-induced polymorphonuclearcytes (PMN) aggregate in microvasculature of vital organs, produce microemboli, and block microcirculation blood flow. Activated PMN release oxygen free radicals, prostaglandins and proteases, in turn, damage endothelial and parenchyma cells. This is an important factor in pathogenesis of multiple system organ failure. We have found that Sinomeuine and Sodium Ferulate prevented PMN aggregation induced by activated complement. Adding the drugs into PMN suspension treated with cytochalasin B, the zymosan activated plasma, PMN aggregation was prevented. The changes of light transmission were smaller than those of control without drugs recorded with platelet aggregometer. The 50% of PMN aggregation inhibition with Sinomeuine was 0.76mg/ml (1.gmmol/L), and 0.82mg/ml (3.8mmol/L) with Sodium Ferulate.
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Complement activation induces polymorphonucleal neutrophilic leukocyte (PMN) aggregation in circulation causing microvascular occlusion. The activated PMNs release lysosome enzymes which damage the tissue. It might take an important part in shock and multiple organ failure. We pre-treated rat PMNs with sinomeuine, which was extracted and purified from the stem of Sinomeuium acufum Rehd et Wils. It was found to inhibit the morphological changes and lysosome enzymes release in PMNs activated with zymosanactivated plasma. With administration of sinomeuine PMNs remained a spherical shape, no apparent ruffling or cytoplasmic projection and less aggregation. Elastase and Nacetyl-?-D-glucosaminidase content in PMNs supernatant increased less.