ABSTRACT
Objective@#o investigate the features of pathogenic bacteria for community-acquired bloodstream infection due to Gram-negative bacilli in patients with liver cirrhosis and optimal therapeutic strategy.@*Methods@#A retrospective analysis was performed for the clinical data of patients with liver cirrhosis who were admitted to 302 Hospital of PLA due to community-acquired bloodstream infection from January 2010 to December 2015, and a statistical analysis was performed for their clinical features, pathogenic bacteria, and results of drug sensitivity test. The Pearson chi-square test was used for comparison of rates, and the Wilcoxon rank sum test was used for comparison of ranked data.@*Results@#A total of 240 patients (including 178 male patients) with liver cirrhosis caused by various reasons were enrolled, with a mean age of 51.7 ± 11.1 years, an overall clinical remission rate of 80.42%, and an ineffective/mortality rate of 19.58%. The patients who used sensitive antibiotics within 12 hours after the onset of community-acquired bloodstream infection achieved a significantly higher improvement rate than those who used such drugs at more than 12 hours after onset (88.2% vs 58.1%, P < 0.001). The improvement rate achieved by the application of sensitive antibiotics at more than 12 hours after onset decreased with the increase in the Child-Pugh grade (P < 0.05). A total of 245 strains of Gram-negative bacilli were isolated, among which the six most common ones were 135 strains of Escherichia coli (55.1%), 62 strains of Klebsiella pneumoniae (25.3%), 16 strains of Aeromonas (6.5%), 4 strains of non-typhoidal Salmonella (1.6%), 3 strains of Enterobacter cloacae (1.2%), and 2 strains of Acinetobacter baumannii (0.8%). These Gram-negative bacilli had the highest sensitivity to meropenem (98.5%), followed by imipenem (97.9%), amikacin (97.5%), piperacillin/tazobactam (94.7%), cefmetazole (93.7%), and cefoperazone/sulbactam (93%). Different bacteria had different sensitivities to antibiotics.@*Conclusion@#Once community-acquired bloodstream infection occurs in patients with liver cirrhosis, highly sensitive antibiotics should be used as early as possible. Cefoperazone/sulbactam, piperacillin/tazobactam, imipenem, and meropenem can be used as first-line empirical antibiotics, and drug combination should be considered when necessary.
ABSTRACT
Objective To investigate the clinical characteristics of patients infected with human adenovirus type 7 and to provide guidance for early diagnosis and timely control of the outbreak.Methods A total of 301 patients infected with the human adenoviruses who were quarantined in hospital from December 2012 to February 2013 were observed.Epidemiological questionnaires were used to collect data of clinical features of the disease including symptoms,signs,images and laboratory tests.To confirm infection,real time polymerase chain reaction was performed using patients' swabs to detect viral nucleotide.Results Most cases happened in December to the next February.Totally 277 cases of the 301 patients were male,and only 24 cases were female.Mean age was (19.1±1.9) years old,range 15 to 29 years old.Identifiable epidemiologic links were seen between patients.The most common symptoms were fever (100.0％),cough (70.4％),expectoration (48.2％),and sore throat (47.8％).In addition,some patients presented with headache,dizziness,chills,fatigue.The most common signs were pharyngeal congestion (62.5％),enlargement of tonsils (56.5％) and lymphatic follicular hyperplasia (26.6％).Some patients' tonsil was covered with white secretions.Lung images were abnormal in 75 cases,which were presented with mild pneumonia with or without surrounding exudative lesions and pleural effusion in lung images.Laboratory tests showed that the number of white blood cells in the peripheral blood in most of the patients (99.0 ％) was elevated or normal.The proportions of neutrophils (54.2％) and monocytes (80.7％) and the level of C-reactive protein (42.2％) increased,while the proportion of lymphocytes reduced (67.1％).The average course of disease was (6.6±2.9) d.With the treatment of intravenous ribavirin and reduning,all patients were cured.Conclusions Human adenovirus type 7 is quite contagious and may cause epidemic outbreak,especially in winter.The majority exhibits mild symptoms of upper respiratory tract infection with short duration,including fever,cough,expectoration and sore throat.Through timely and active treatment,all patients have a good prognosis.
ABSTRACT
Objective To investigate the inhibition of lymphoid enhancer factor-1 (LEF-1) expression in human malignant melanoma cell line A375 by RNA interference method. Methods Sense and antisense oligonucleotides with hairpin structures, targeted specifically at LEF-1 mRNA, were designed, synthesized, then linked to the expression vector psilencer3.1-H1 neo after annealing. After identification, the re-combinant psilencer3.1-H1/LEF-1 siRNA was used to transfect the cultured A375 cells by a liposome-medi-ated method. The cells expressing the recombinant RNA was detected by G418 screening. The mRNA and protein levels were detected by RT-PCR, Western blotting and immunocytochemistry, respectively. Results The expression vector psilencer3.1-H1/LEF-1 siRNA was successfully constructed, and its stable expression in cell clones was achieved. The mRNA and protein levels of LEF-1 were both down-regulated in the trans-fected cells. Conclusion The recombinant of psilencer3.1-HI/LEF-1 siRNA can inhibit the mRNA and protein expression of LEF-1 in A375 cells.