Molecular typing and drug resistance of Methicillin-resistant Staphylococcus aureus isolated from hospital environment / 上海预防医学

[Objective] To investigate the prevalence, drug resistance and molecular characteristics of MRSA in hospital environment, so as to provide basis for prevention and control of nosocomial MRSA infection. [Methods]Specimens from Dec 2014 to May 2015 were collected from a tertiary hospital in Jing'an District of Shanghai and MRSA strains isolated from hospital environment and characterized by antimicrobial susceptibility testing and pulsed-field gel electrophoresis (PFGE). [Results]From 316 specimens were detected 46 MRSA strains with contamination rate being 14.6％ (46/316). And 22 (7.0％) were detected to be carriers of MRSA on the surfaces of ICU environment. MRSA had higher resistant rate to cefuroxime, levofloxacin, ciprofloxacin, Ampicillin/sulbactam, erythrocin, gentamycin than MSSA, and the difference was statistically significant (P<0.01). A total of 8 PFGE patterns were identified among the 14 MRSA isolates, which were mostly similar from one clone. [Conclusion] MRSA strains isolated from ICU in this hospital are multi-resistant to β-lactam antibiotics, quinolones and macrolides. There is clonal pollution in the environment. It is necessary to decrease the contamination rates between patients and environment, health care workers and environment, also it is worthwhile to increase the disinfection rate of environment.

Changes in plasma angiotensin II and circadian rhythm of blood pressure in hypertensive patients with sleep apnea syndrome before and after treatment / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To explore the changes in plasma angiotensin II (Ang II) and circadian rhythm of blood pressure among hypertensive patients with sleep apnea syndrome (SAS) before and after continuous positive airway pressure (CPAP) or surgical treatment.</p><p><b>METHODS</b>A total of 180 essential hypertension patients were enrolled in our study. The determination of plasma Ang II concentration, ambulatory blood pressure (ABP), and polysomnography (PSG) monitoring were performed before and 3 months after CPAP or surgical treatment.</p><p><b>RESULTS</b>Patients were classified into three groups by their apnea-hypopnea index (AHI): essential hypertension group (EH group, n = 72; AHI< 5), essential hypertension with mild SAS group (EH+mild SAS group, n = 60, 5 ≤ AHI < 20), and essential hypertension with moderate and severe SAS group (EH + moderate-severe SAS group, n = 48, AHI ≥ 20). The concentrations of plasma Ang2 in the above three groups were 13.42 ± 3.27, 16.17 ± 3.82, and 18.73 ± 4.05 ng/mL respectively before treatment, and Ang2 concentration in EH patients combined with SAS was significantly higher than that in EH group (all P < 0.05). After treatment the values in the latter two groups significantly decreased to 14.67 ± 2.56 and 15.03 ± 3.41 ng/mL respectively (P < 0.05). The incidence of non-dipper blood pressure curve in EH patients was 31.9%, and those in hypertensive patients with mild SAS and moderate-severe SAS were 51.7% and 58.3%, respectively before treatment. The incidence of non-dipper blood pressure curve in the EH patients with mild SAS was significantly higher than that of patients with EH alone (P < 0.05). After CPAP treatment or surgery, the incidence of non-dipper blood pressure curve in the two SAS groups was significantly decreased to 38.3% and 39.6%, respectively (P < 0.05).</p><p><b>CONCLUSIONS</b>Ang II might play a role in blood pressure variability in patients with obstructive SAS. CPAP or surgical treatment can improve blood pressure disorder and decrease plasma Ang II level in patients with obstructive SAS.</p>

Expression of osteopontin and VEGF in acute leukemia and their relationship with angiogenesis / 中国实验血液学杂志

The aim of this study was to investigate the expression of osteopontin (OPN) and vascular endothelial growth factor (VEGF) in acute leukemia (AL) and its significance in the angiogenesis and progress of AL. Serum levels of OPN and VEGF in 25 de novo patients, 19 complete remitted (CR) patients, 14 unremitted patients, and 11 relapsed patients with AL were measured by enzyme-linked immunosorbent assay (ELISA), and compared with those in normal controls. The results showed that the serum levels of OPN and VEGF in de novo, unremitted, relapsed patients were significantly higher than those in normal controls and CR patients (p < 0.01). Compared with de novo AL patients group, the serum levels of OPN and VEGF in CR patients decreased significantly, but showed no significant difference from those in normal controls (p > 0.05). The expression of OPN and VEGF in acute leukemia was positively correlated with occurrence and development of AL. It is concluded that the expressions of OPN and VEGF are closely related with AL occurrence and development, the OPN may regulate VEGF expression and promote angiogenesis in acute leukemia. Preventing expressions of OPN may seem as targets for leukemia therapy in the future.

Circadian blood pressure variability and plasma neopterin level before and after surgery for obstructive sleep apnea syndrome / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the change of circadian blood pressure variability (BPV) and plasma neopterin before and after surgery (uvulopalatopharyngoplasty) for patients with obstructive sleep apnea syndrome (OSAS).</p><p><b>METHODS</b>A total of 382 OSAS patients underwent uvulopalatopharyngoplasty were divided into three groups based on polysomnography (PSG) results: mild OSAS (n = 206), moderate OSAS (n = 108) and severe OSAS (n = 68). Plasma neopterin, 24-hour ambulatory blood pressure monitoring (ABPM), PSG were measured before and 3 months after surgery.</p><p><b>RESULTS</b>Plasma neopterin increased in proportion to severity of OSAS before surgery (15.08 nmol/L, 27.68 nmol/L and 37.32 nmol/L in patients with mild to severe OSAS) which were significantly reduced post surgery (9.92 ng/ml, 15.07 ng/ml and 18.54 ng/ml, all P < 0.05 vs. pre-surgery). The incidence of non-dipper curve in three OSAS groups were 50.2%, 72.7% and 86.5%, respectively before surgery and the values decreased to 34.8%, 48.2% and 49.2% after surgery (all P < 0.05 vs. pre-surgery). Relevance analysis indicates that D-value of nocturnal and diurnal blood pressure was negatively correlated with plasma neopterin.</p><p><b>CONCLUSION</b>Our findings indicated that plasma neopterin and the incidence of non-dipper could reliably reflect OSAS severity and could thus be used to evaluate the surgery efficacy. Plasma neopterin might be an important player in the pathophysiology of OSAS via modulating blood pressure variability.</p>