Distribution and drug resistance of pathogenic bacteria for infection after liver transplantation / 临床肝胆病杂志

Objective To investigate the distribution and drug resistance of pathogenic bacteria for infection after liver transplantation, and to provide a scientific basis for the rational clinical application of antibiotics. Methods The pathogenic bacteria isolated from the specimens of 904 patients with infection after liver transplantation in The Affiliated Hospital of Qingdao University from March 2014 to December 2021 were analyzed in terms of distribution and drug resistance. WHONET 5.6 software was used to perform a statistical analysis of strains and bacterial resistance rate, and Excel was used to analyze the sources of specimens, composition ratios, and distribution of pathogenic bacteria. Results A total of 2 208 non-repetitive pathogenic bacteria were isolated, mainly from the specimens of respiratory tract (31.25%), bile (22.28%), ascites (13.18%), blood (8.38%), and drainage fluid (4.62%). The top 10 pathogenic bacteria were Klebsiella pneumoniae subspecies (10.69%), Enterococcus faecium (10.42%), Escherichia coli (8.24%), Pseudomonas aeruginosa (8.24%), Staphylococcus epidermidis (8.06%), Acinetobacter baumannii (7.93%), Stenotrophomonas maltophilia (6.61%), Enterobacter cloacae (3.22%), Staphylococcus haemolyticus (3.08%), and Staphylococcus aureus (2.94%), accounting for 69.43% of the total pathogenic bacteria. Pseudomonas aeruginosa, Stenotrophomonas maltophilia, Klebsiella pneumoniae subspecies, and Acinetobacter baumannii were the main pathogenic bacteria isolated from respiratory tract specimens; Enterococcus faecium was the main pathogenic bacterium isolated from bile, ascites, and drainage fluid specimens; Escherichia coli , Staphylococcus epidermidis , and Klebsiella pneumoniae subspecies were the main pathogenic bacteria isolated from blood specimens. Drug sensitivity data showed that Enterobacterales bacteria had a relatively high resistance rate to cephalosporins and fluoroquinolones and a resistance rate of 50% to macrolides, fluoroquinolones, sulfonamides, and lincomycin, and a small part of these strains were resistant to linezolid and quinupristin/dalfopristin (< 3%), with no Staphylococcus epidermidis strains resistant to tigecycline and vancomycin. A total of 287 drug-resistant strains were monitored, accounting for 13%, among which there were 128 carbapenem-resistant Acinetobacter baumannii strains, 88 carbapenem-resistant Pseudomonas aeruginosa strains, 26 carbapenem-resistant Klebsiella pneumoniae subspecies strains, 11 carbapenem-resistant Escherichia coli strains, 23 methicillin-resistant Staphylococcus aureus strains, and 11 vancomycin-resistant Enterococcus strains. The carbapenem-resistant Klebsiella pneumoniae subspecies strains mainly produced serine carbapenemase, and the carbapenem-resistant Escherichia coli strains mainly produced metal β-lactamase. Conclusion Gram-negative bacteria are the main pathogenic bacteria for infection after liver transplantation, and there are differences in the distribution of pathogenic bacteria between different types of specimens. The resistance rate of some strains tend to increase, and therefore, it is necessary to strengthen the management of nosocomial infection and antibiotics.

The effect of fat mass and obesity associated proteins mediated mRNA m6A modification on animal fat deposition and its application prospects / 生物工程学报

In the process of animal fat deposition, the proliferation and differentiation of pre-adipocytes and the change of lipid droplet content in adipocytes are regulated by a series of transcription factors and signal pathways. Although researchers have conducted in-depth studies on the transcriptional regulation mechanisms of adipogenesis, there are relatively few reports on post-transcriptional modification on mRNA levels. The modification of mRNA m6A regulated by methyltransferase, demethylase and methylation reading protein is a dynamic and reversible process, which is closely related to fat deposition in animals. Fat mass and obesity associated proteins (FTO) act as RNA demethylases that affect the expression of modified genes and play a key role in fat deposition. This article summarized the mechanism of FTO-mediated demethylation of mRNA m6A in the process of animal fat deposition, suggesting that FTO may become a target for effective treatment of obesity. Moreover, this review summarized the development of FTO inhibitors in recent years.

Major routes for orphan drugs to be incorporated into the reimbursement system of UK and the enlightenment to China / 中国药科大学学报

@#In order to provide enlightening experience for the establishment of reasonable and diversified orphan drugs into the reimbursement system in China, the official websites of the National Institute for Health and Care Excellence(NICE)and the National Health Service(NHS)in the UK were inspected, collecting and summarizing the relevant documents, on the inclusion of orphan drugs into the reimbursement system. Relevant literatures were analyzed with theoretical studies on the accessibility of medicines for patients with rare diseases. In the NHS system, the inclusion of orphan drugs into the reimbursement system in the UK can be achieved mainly through seven routes, with three routes that are evaluated by NICE(MTA, STA and HST)and four are directly managed by the NHS(specialized commissioning, CDF, IFRs, CtE). Through the analysis of the inclusion of orphan drugs into the reimbursement system and the various problems in the UK, we have found some enlightening experience for the establishment of the reimbursement system for orphan drugs in China.

Analysis of MRI findings in HIV patients with secondary toxoplasmosis encephalitis / 实用放射学杂志

Objective To investigate the MRI manifestations of secondary toxoplasmosis encephalitis in HIV patients and summarize the characteristics of MRI changes.Methods MRI images of 3 5 HIV patients with secondary toxoplasmosis encephalitis were analyzed retrospectively.Results Of 35 patients,27 showed multiple lesions and 8 showed single lesion.Lesions mainly involved the brain gray matter j unction or basal ganglia.MRI showed lamellar,nodular or round lesions,which showed low signal on T1WI,and slightly higher and unevenly high signal on T2WI.Irregular liquid signal or nodular slightly lower signal was showed on T2WI in 14 cases,and short T1signal was showed in 15 cases.Circular lesions could be seen"cattle eye"in 18 cases.For 11 cases of enhanced scan of a single lesion,a ring enhancement was displayed,and coexistence of patchy,nodular and annular enhancement were showed in multiple lesions,in which parts of the multi-circular enhancemens were clustered.Conclusion MRI manifestations of HIV patients with secondary toxoplasmosis encephalitis show primarily multiple lesions on the gray matter j unction or basal ganglia.The lesions show high signal on T1WI and"cattle eye"on T2WI,and existence of flaky,nodular and ring enhanced lesion or clustered enhancement are showed on enhanced imaging,which is of a certain specificity.

Research and establishment of antibiotics differentiated indexes in clinical appli-cation of cardiothoracic surgery in our hospital / 药学实践杂志

Objective To formulate the clinical application specification of antibiotics ,make a deference index of antibac-terial drugs in chest department according to the investigation about the antibiotics′utility situation in chest department in 2014 and provide a theoretic foundation for the clinical doctor to promote the clinical rational drug use .Methods The antibiotics′ap-plication information of 300 cases inpatients in the chest department of a hospital in 2014 were researched and analyzed through retrospection ,regarding with the relevant regulations and related clinical practice guidelines ,the clinical application specifica-tion of antibiotics was formulated and the analysis ,calculation ,statistics to the actual and theoretical value of the rate and inten-sity of antibiotics′application ,the application rate of the prophylactic antibiotics of type I incision on the inpatients in the chest department had been done .The differentiation index of them were establish .Results The rates of the actual antibiotics′appli-cation and the prophylactic antibiotics of type I incision respectively were 72 .7% and 92 .6% ,while the intensity of antibiotics′application was 61.2 DDDs/(100 persons · d ) . The deference indexes of them were developed 69 .3% , 63 .0% and 49.3 DDDs/(100 persons · d) .Conclusions There′re still much irrational places in the use of antibiotics in chest department of the hospital .It′s essential to strengthen supervision in order to promote the rational use of antibiotics in clinical practice .

Protection against apoptosis of islet cells:a combination of Caspase and Cocktail protease inhibitors / 中国组织工程研究

BACKGROUND:Currently, there are few reports on the effects of Caspase inhibitors combined with Cocktail protease inhibitors on isolation and purification of islet cel s. OBJECTIVE:To explore the effects of Caspase inhibitors and Cocktail protease as protectors on islet cel s during isolation and purification process. METHODS:New-born pigs were selected to separate, purify and culture the islet cel s, and after 24 hours of culture, the specimens were divided into three groups:blank control group, experimental group A (Caspase inhibitors and Cocktail protease were added only during digestion process), and experimental group B (Caspase inhibitors and Cocktail protease were added both during digestion and culture processes). AO-EB staining was used to qualitatively observe cel morphology and apoptosis. Flow cytometry was employed to quantitatively detect cel viability and apoptosis. RESULTS AND CONCLUSION:Percentages ofβcel s were 66.91%in blank control group, 84.58%in the experimental group A, and 87.15%in the experimental group B. The proportions of living cel s, apoptotic cel s and dead cel s were 56.52%, 16.15%, 21.25%in the blank control group, 62.27%, 14.66%, 14.47%in the experimental group A, and 73.09%, 6.83%, 10.28%in the experimental group B, respectively. These findings indicate that in the process of digestion and culture in vitro, Caspase inhibitors and Cocktail protease inhibitors can both obviously decrease the loss of cel s, and increase the percentage of islet beta cel s.

Risk factors for the formation of aberrant artery collaterals in the uterus with scar in pregnancy womenunderwent cesarean / 中南大学学报(医学版)

OBJECTIVE@#To evaluate the prevalence and risk factors for the formation of aberrant artery collaterals in the uterus during uterine artery embolization (UAE).
@*METHODS@#The data of 144 women with scar in the uterus due to cesarean were retrospectively analyzed. They underwent UAE in the period of 2009-2014 and were divided into two groups according to a standard with or without the aberrant artery collaterals in the uterus. The risk factors were analyzed.
@*RESULTS@#Aberrant artery collaterals were found in thirty-four patients. According to multiple logistic regression analysis, the presence of placenta previa (RR=78.556, 95% CI: 2.869-2 150.651, P=0.010), pelvic inflammatory disease (RR=6.633, 95% CI: 1.595-27.592, P=0.009), pregnancy complications (RR=7.264, 95% CI: 1.622-32.531, P=0.010), abortions (RR=18.381, 95% CI: 1.683-200.752, P=0.017) and uterine fibroids or adenomyosis (RR=12.580, 95% CI: 1.004-157.550, P=0.050) were the factors for the presence of aberrant artery collaterals.
@*CONCLUSION@#Aberrant artery collaterals were more frequent in patients with pelvic inflammatory disease, pregnancy complications, abortions and uterine fibroids or adenomyosis.

Outcome of kidney transplantation between controlled cardiac death and brain death donors: a meta-analysis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Our goal was to evaluate the outcomes of kidney transplants from controlled cardiac death donors compared with brain death donors by conducting a meta-analysis of cohort studies.</p><p><b>METHODS</b>The PubMed database and EMBASE were searched from January 1980 to July 2013 to identify studies that met pre-stated inclusion criteria. Reference lists of retrieved articles were also reviewed. Two authors independently extracted information on the designs of the studies, the characteristics of the study participants, and outcome assessments.</p><p><b>RESULTS</b>Nine cohort studies involving 84 398 participants were included in this meta-analysis; 3 014 received kidneys from controlled cardiac death donors and 80 684 from brain death donors. Warm ischemia time was significantly longer for the controlled cardiac death donor group. The incidence of delayed graft function was 2.74 times (P < 0.001) greater in the controlled cardiac death donor group. The results are in favor of the brain death donor group on short-term patient and graft survival while this difference became nonsignificant at mid-term and long term. Sensitivity analysis yielded similar results. No evidence of publication bias was observed.</p><p><b>CONCLUSION</b>This meta-analysis of retrospective cohort studies suggests that the outcome after controlled cardiac death donors is comparable with that obtained using kidneys from brain death donors.</p>