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In this study, we aimed to (1) identify white matter (WM) deficits underlying the consciousness level in patients with disorders of consciousness (DOCs) using diffusion tensor imaging (DTI), and (2) evaluate the relationship between DTI metrics and clinical measures of the consciousness level in DOC patients. With a cohort of 8 comatose, 8 unresponsive wakefulness syndrome/vegetative state, and 14 minimally conscious state patients and 25 patient controls, we performed group comparisons of the DTI metrics in 48 core WM regions of interest (ROIs), and examined the clinical relevance using correlation analysis. We identified multiple abnormal WM ROIs in DOC patients compared with normal controls, and the DTI metrics in these ROIs were significantly correlated with clinical measures of the consciousness level. Therefore, our findings suggested that multiple WM tracts are involved in the impaired consciousness levels in DOC patients and demonstrated the clinical relevance of DTI for DOC patients.
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Adult , Female , Humans , Male , Middle Aged , Brain Stem , Diagnostic Imaging , Consciousness , Physiology , Consciousness Disorders , Diagnostic Imaging , Pathology , Diffusion Tensor Imaging , Methods , Image Processing, Computer-Assisted , Methods , White Matter , PathologyABSTRACT
Objective To investigate the antimicrobial resistance profile of the clinical isolates collected from selected hospitals across China. Methods Twenty-nine general hospitals and five children's hospitals were involved in this program. Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems. Results were interpreted according to CLSI 2017 breakpoints. Results A total of 190 610 clinical isolates were collected from January to December 2017, of which gram negative organisms accounted for 70.8％ (134 951/190 610) and gram positive cocci 29.2％ (55 649/190 610). The prevalence of methicillin-resistant strains was 35.3％ in S. aureus (MRSA) and 80.3％ in coagulase negative Staphylococcus (MRCNS) on average. MR strains showed much higher resistance rates to most of the other antimicrobial agents than MS strains. However, 91.6％ of MRSA strains were still susceptible to trimethoprim-sulfamethoxazole, while 86.2％ of MRCNS strains were susceptible to rifampin. No staphylococcal strains were found resistant to vancomycin. E. faecalis strains showed much lower resistance rates to most of the drugs tested (except chloramphenicol) than E. faecium. Vancomycin-resistant Enterococcus (VRE) was identified in both E. faecalis and E. faecium. The identified VRE strains were mainly vanA, vanB or vanM type based on phenotype or genotype. The proportion of PSSP or PRSP strains in the non-meningitis S.pneumoniae strains isolated from children decreased but the proportion of PISP strains increased when compared to the data of 2016. Enterobacteriaceae strains were still highly susceptible to carbapenems. Overall, less than 10％ of these strains (excluding Klebsiella spp.) were resistant to carbapenems. The prevalence of imipenem-resistant K. pneumoniae increased from 3.0％ in 2005 to 20.9％ in 2017, and meropenem-resistant K. pneumoniae increased from 2.9％ in 2005 to 24.0％ in 2017, more than 8-fold increase. About 66.7％ and 69.3％ of Acinetobacter (A. baumannii accounts for 91.5％) strains were resistant to imipenem and meropenem, respectively. Compared with the data of year 2016, P. aeruginosa strains showed decreasing resistance rate to carbapenems. Conclusions Bacterial resistance is still on the rise. It is necessary to strengthen hospital infection control and stewardship of antimicrobial agents. The communication between laboratorians and clinicians should be further improved in addition to surveillance of bacterial resistance.
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Objective@#To evaluate the ability of matrix-assisted laser desorption/ionization-time of flight mass spectrometry(MALDI-TOF MS) in the homology analysis of Carbapenems-resistant klebsiella pneumonia.@*Methods@#Twenty-one non-duplicated strains of Carbapenems-resistant klebsiella pneumoniae were isolated from Shandong Provincial Hospital affiliated to Shandong University during April 2011 and October 2013 in this study. Twenty isolates were from neonatal unit and one from cardiac surgery. The homology analysis of Carbapenems-resistant klebsiella pneumoniae was performed with pulsed-field gel electrophoresis (PFGE), multilocus sequence typing (MLST) and MALDI-TOF MS respectively.@*Results@#The result of PFGE was consistent with MLST. The twenty-one CRKPN strains were divided into three groups by MALDI-TOF MS according to their relationship, 18 of them belonged to II group, and the homology was higher than 75%. From the analysis of protein mass spectra of 18 strains, the protein peaks were roughly the same. Thus, it was concluded that their relationship was close, and the results were basically consistent with the results of PFGE and MLST. The H13 strain with low homology (<60%) was different from the above strains, especially in the molecular weight 4365, 5381 and 6289.The PFGE analysis showed that the homology between H13 and other strains was 61%, and the MLST classification result was ST54.@*Conclusions@#MALDI-TOF MS can be used to identify CRKPN accurately and analyze its homology analysis more conveniently than other methods in clinical laboratory. MALDI-TOF MS has the potential to be used as an easy and rapid epidemiology typing tool for nosocomial infection investigation caused by drug-resistant bacteria.(Chin J Lab Med, 2018, 41: 589-595)
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Objective To investigate the antibiotic resistance of clinical isolates in Shandong Provincial Hospital during 2016.Method The antimicrobial susceptibility of isolates was tested by using VITEK 2-Compact system or disk diffusion method.All the data were analyzed by WHONET 5.6 software according to CLSI 2016 breakpoints.Results A total of 4 810 non-duplicate clinical strains were collected during 2016,of which gram-negative bacilli and gram-positive cocci accounted for 70.2％ and 29.8％,respectively.The most common specimen source was respiratory tract (38.1％),followed by skin and soft tissue (21.1％) and urine (17.5％).Escherichia coli was the most frequently isolated bacteria,followed by Staphylococcus aureus,Pseudomonas aeruginosa,Klebsiella and Enterococcus,accounting for 24.3％,10.2％,9.9％,9.8％ and 9.6％,respectively.The prevalence of ESBLs-positive E.coli and K.pneumoniae was 55.0％ and 37.9％,respectively.Carbapenem-resistant E.coli and K.pneumoniae accounted for 1.6％ and 4.2％,respectively.The percentage of P aeruginosa resistant to imipenem and meropenem was 24.3％ and 21.9％,respectively.More than 40％ of the A.baumannii strains were resistant to all the antibiotics tested except minocycline (33.2％).The prevalence of beta-lactamase positive strains was 70.1％ in H.influenzae and 97.5％ in M.catarrhalis.The prevalence of methicillin-resistant S.aureus (MRSA) was 31.4％.No staphylococcal strains were found resistant to vancomycin,teicoplanin or linezolid.E.faecium strains showed higher resistance rate to most antibiotics tested than E.faecalis.One strain of E.faecium was resistant to both vancomycin and teicoplanin.A total of 191 strains of S.pneumoniae were isolated,of which 143 (74.9％) isolates were from pediatric wards.None of the non-meningitis strains was resistant to penicillin.Other hemolytic Streptococcus strains were sensitive to penicillin,cephalosporins and vancomycin.Conclusions Bacterial resistance is still on rise.We should pay more attention to strengthening antimicrobial resistance surveillance and improving rational use of antimicrobial agents.
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Objective To compare the difference of three methods testing the antibiotic susceptibility of mucoid Pseudomonas aeruginosa in order to provide accurate and reliable antibiotic susceptibility result for clinic.Methods A total of 630 mucoid Pseudomonas aeruginosa were collected from Linyi People′s Hospital during January 2015 to December 2016.They mainly come from respiratory medicine and the most common specimen source was sputum.All specimens were examined in 2 h.The strains isolated from the same patient were discarded.Antibiotic susceptibility was tested by the automatic microorganism analyzer VITEK2 compact, E-test, which was reference method, and K-B disk.The results of three methods were analyzed and compared by χ2 test.Results The result of E-test showed that antibiotic sensitivity of 630 mucoid Pseudomonas aeruginosa was above 52.7% except for Cefepime (39.2%).The result of K-B disk was compared with E-test, the antibiotic sensitivity of mucoid Pseudomonas aeruginosa to imipenem (72.4% vs 52.7%) and amikacin (48.6% vs 71.1%)had significant difference (χ2=8.283 7 and 10.533 8, P<0.05).The result of VITEK2 compact showed that the antibiotic susceptibility of mucoid Pseudomonas aeruginosa to imipenem(70.8% vs 52.7%), cefepime(60.8% vs 39.2%), gentamicin (87.6% vs 74.1%)and levofloxacin(81.3% vs 65.4%) was significant higher than the result of E-test (χ2=6.935 2,9.331 2,5.885 6 and 6.466 5, P<0.05).For tobramycin, piperacillin/tazobactam and ciprofloxacin, the result of three methods is more consistent.Compared to VITEK2 compact, the consistency between K-B disk and E-test was higher.The rate of very major error and major error were between 0.0%-4.8% (Amikacin 12.2%) and minor error was 4.6%-20.3%.Conclusions The drug sensitivity of mucoid Pseudomonas aeruginosa is different between various methods.The result of K-B disk and E-test using blood MH is more reliable than VITEK2 compact.
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Objective To investigate the antimicrobial resistant and transmission mechanisms of carbapenem-resistant K.pneumonia (CR-KP) infection of newborns.Methods A retrospective study was conducted on totally 37 non-repetitive CR-KP which were isolated from patients hospitalized between April 2011 and October 2013.Resistance genes were identified by PCR and sequencing.Plasmid was analyzed by pulsed-field gel electrophoresis (PFGE).Conjugation experiments were performed to determine the transferability of beta-lactamase.Multilocus sequence typing (MLST) was used to determine the genotypes and homology of these isolates.Out-membrane proteins were examined by PCR and sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE).Results Thirty-seven CR-KP isolates were tested.The resistant rates of imipenem, meropenem, ertapenem were 89.2％ (33/37), 83.8％ (31/37) ,97.3％ (36/ 37), respectively.All the 37 CR-KP exhibited 100％ (37/37) sensitivity to tigecycline, colistin, levofloxacin and amikacin, while resistance to most of the other antibiotics.By PCR, 67.6％ (25/37) isolates were blaNDM-1 positive, 35.1％ (13/37) isolates were blaIMP-4 positive and 2.7％ (1/37) isolate were blaIMP-8 positive, including two isolates carrying both blaNDM-1 and blaIMP-4.PFGE results showed that the isolates carried 2-4 plasmids and both blaNDM-1 and blaIMP-4 were transferable by plasmids.MLST assigned them to sequence type (ST) 20, ST17, ST54, ST705, ST290,which showed that there were infectious outbreaks caused by NDM-1-producing and IMP-4-producing respectively among newborns.SDS-PAGE result indicated that there was no absence of outer membrane proteins OmpK35 and OmpK36.Conclusions The main resistant mechanisms of CR-KP causing infection in newborns were those the isolates carried carbapenemase of blaNDM-1 or blaIMP-4 and the K.pneumonia with two kinds of carbapemenase were detected.
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Objective To investigate the mechanisms of Pinacidil prec onditioning protection of hemorrhagic shock rats. Methods The rats were divided into 3 groups: a normal group ( n=10), a control group (n=40) and a preconditioning group (n=40). Pinacidil preconditio ning was processed 24 h before making the hemorrhagic shock model. The cPLA 2 expression in myocardium was observed at different time points with western blot; Pinacidil preconditioning was processed 24, 48 and 72 h before making th e hemorrhagic shock model to observe hsp70 expression in myocardium and liver tissue with western blot. Results Pinacidil preconditioning could increase hsp70 expres sion and decrease cPLA2 expression. Conclusions Pinacidil preconditioning protects "shock cell" by inducing hsp70 overexpression and inhibiting cPLA2 expression, which is re sponsible for protecting myocardial and liver tissues of the hemorrhagic shock rats.
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Objective:To explore the relationship between DRD2 - 141C Ins/Del polymorphism and heroin craving. Methods:380 heroin addicts who were under abstinence were given the cue- elicited heroin craving experiment. And then we detected the polymorphism of DRD2- 141CIns/Del for them by using PCR- RFLP. We compared the relationship between genotypes of DRD2- 141CIns/Del and heroin craving before and after cue exposure. Results:No significant differ- ence has been found between heroin craving before and after cue- exposure in three genotypes of DRD2- 141CIns/Del. Conclusion:D2 receptor gene - 141CIns/Del polymorphisms may have no association with the susceptibility of heroin crav- ing.
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Object To study the effects of SINI TANG (SNT) on the rat aortic rings pre-contracted by high K + and phenylephrine (Phe). Methods The effects of SNT on the aortic rings in the presence of 60 mmol/L KCl and Phe (1?10 -9 -1?10 -4 mmol/L) were observed and t heir me chanisms were studied after treatment with Propranolol (Pro, 3?10 -6 mmol/ L) and Bay K8644 (BK, 1?10 -5 mmol/L) as tool drugs. Results SNT inhibited the contraction induced by cumulative Phe and decreased the maximum tension (T max ); Pro couldn't influe nce the effects of SNT. SNT attenuated the amplitude of contractile effect of hi gh K +; BK couldn't reverse the effects of SNT. Conclusion SNT can shift the dose-response curve to the right and decrease the T max . It shows that SNT is a kind of noncompe titive antagonism. SNT decreases the effect of high K + against contraction of the artery. BK, a L-type Ca 2+ channels activator, couldn't recover the inhibition induced by SNT. The results suggest that SNT inhibit ? 1 recep tor, while calcium channel may not be involved in attenuating the effect of SNT on high K +-induced contraction.