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Objective:To investigate the drug resistance of Yersinia pestis to 11 kinds of antibiotics in the natural foci of plague in Inner Mongolia Autonomous Region, and to provide a theoretical basis for scientifically and effectively selecting antibiotics for treatment of the plague. Methods:A total of 137 strains of Yersinia pestis isolated from the natural foci of plague in Inner Mongolia Autonomous Region at different times, regions, hosts and vectors were collected. According to Clinical and Laboratory Standard Institute (CLSI), the agar plate dilution method was used to determine the minimum inhibitory concentration (MIC) of the 11 kinds of antibiotics against 137 strains of Yersinia pestis, including ofloxacin, ciprofloxacin, kanamycin, streptomycin, ceftriaxone, ampicillin, chloramphenicol, spectinomycin, cefuroxime, tetracycline and sulfamethoxazole-trimethoprim. The MIC 50 and MIC 90 (the minimum concentration of drug which could inhibit 50% and 90% of bacterial growth) were calculated, and their sensitivity was determined according to CLSI standards. Results:Among 137 strains of Yersinia pestis tested, no strains of Yersinia pestis had single or multiple resistance to ofloxacin, ciprofloxacin, kanamycin, streptomycin, ceftriaxone, ampicillin, chloramphenicol, spectinomycin, cefuroxime, tetracycline and sulfamethoxazole-trimethoprim. According to CLSI standards, 137 strains of Yersinia pestis were all sensitive to the 11 kinds of antibiotics; among them, ofloxacin, ciprofloxacin, ceftriaxone and sulfamethoxazole-trimethoprim had higher antibacterial activity, with MIC 90 < 0.250 μg/ ml; the antibacterial activity of spectinomycin was the lowest, with MIC 90 of 16.000 μg/ml. Conclusions:The Yersinia pestis isolated from the natural foci of plague in Inner Mongolia Autonomous Region is not found to have single or multiple resistance to the 11 kinds of antibiotics. Continuous drug resistance monitoring of Yersinia pestis should be carried out to provide a basis for clinical medication.
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Objective:To understand the spatial distribution of small mammals in the areas of natural focus disease in Qinghai Province, and to identify captured small mammals at the molecular level using mitochondrial cytochrome C oxidase subunit I (COI) gene as molecular marker.Methods:In 2009 - 2016, the distribution of regional spatial, elevation distribution and ecological environment type of captured small mammals were analyzed in 16 cities (counties) of 6 prefectures in Qinghai Province. The partial COI gene fragment sequence (about 650 bp in length) was obtained by PCR amplification, which was further analyzed through homology comparison, genetic distance and phylogenetic analysis.Results:Totally 1 631 small mammals were captured that had belonged to 30 species of 21 genera, 7 families, 3 orders. Among them there were 926 rodent animals that had belonged to 25 species of 19 genera, 5 families, accounting for 56.78%. There was the largest number in Golmud (313 animals), the highest distribution of small mammals was found at the elevation of 2 800 - < 3 000 m (532 animals), the largest number of small mammals was found in the sandy grassland (612 animals). COI genes of 292 small mammals were successfully amplified, and the homology was consistent with the target sequence. The results showed that the intraspecific genetic distance ranged from 0.01% to 2.90%, interspecific genetic distance ranged from 4.00% to 12.00%, intergenus genetic distance was 13.00% - 21.00% and interfamily genetic distance was 22.00% - 25.00%. The interspecific genetic distance was significantly greater than the intraspecific genetic distance. Neighbor-Joining tree showed that the same species were clustered into a single branch with high support form a total of 20, with a confidence level of 98% to 100%.Conclusions:The spatial distribution of small mammals is influenced by geographical factors such as region, elevation and ecological environment in Qinghai Province. Molecular identification can make up for the shortcomings in morphological identification.
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Objective In order to acquaint with the prevalence of Tibetan sheep plague in this area, we conducted a serum epidemiological investigation of Tibetan sheep plague in Qinghai Province. Methods Indirect hemagglutination assay (IHA) and colloidal gold immunochromatography (GICA) were applied to test serum samples of Tibetan sheep and whole blood samples from jugular vein of Tibetan sheep were collected in 8 Prefectures of Qinghai Province from 2013 to 2016. Results A total of 86 positive Tibetan sheep serum samples with plague F1 antibody were detected by both methods, and the positive rate was 0.68％ (86/12710), the samples collected in Xinghai County Hainan Prefecture had the highest positive rate, which was 5.20％ (27/519). The Haixi Prefecture and Yushu Prefecture were historical epidemic areas, the positive rates were 0.65％(15/2313) and 0.26％(6/2293), respectively. Hainan Prefecture, Guoluo Prefacture and Huangnan Prefecture were newly confirmed epidemic areas, the positive rates were 1.61％ (28/1741), 1.01％ (15/1481), and 1.44％(19/1316), respectively. The antibody titers were 1:20 to 1:5120, the samples collected in Maqin County Guoluo Prefecture had the highest titer, namely 1 :5120. Conclusions In Qinghai Province, Tibetan sheep plague is endemic, and there are outbreaks in some regions. So we have to enhance the Tibetan sheep plague monitoring especially in Marmot plague epidemic area.
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Objective To make up the limitations of traditional morphological classification methods,we identified vector fleas by DNA barcoding in Qinghai Province.Methods The mt DNA cytochrome c oxidase subunit Ⅰ (CO Ⅰ) gene was amplified by PCR from 36 muscle tissues of fleas in 3 states,2 cities and 5 counties of Qinghai Province,and the obtained CO Ⅰ gene fragments were sequenced and aligned.The intra-and inter-species genetic distances were calculated with Mega 6 software using K2-P model and a phylogenetic tree was constructed with neighbor-joining (NJ) method.Results Totally 36 CO Ⅰ gene sequences of 2 superfamilies,4 genera and 6 kinds of vector fleas were measured,the average genetic distance was 0.119,and the intraspecific distance was 0.002-0.027,the interspecific distance was 0.039-0.207,and the interspecific genetic distance was significantly greater than the intraspecific genetic distance.NJ tree showed the same species had formed a single line with high support rate and interspecific branch was clear.Conclusion DNA barcoding is suitable for identification of vector fleas in Qinghai Province,may make up the limitations of traditional morphological classification methods.
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Objective To investigate the MRI features of malignant mesothelioma(MM).Methods MRI data of 18 cases of MM confirmed by pathology were analyzed retrospectively.1 5 cases were malignant pleural mesothelioma,and 3 cases malignant peritone-um mesothelioma.MRI scans were performed in all cases,including MRI plain scan,MRI enhancement and diffusion weighted ima-ging(DWI).We evaluated the location,shape,size,signal,enhancement mode,dispersion characteristics,invasions of surrounding tissues and concomitant changes of MM.Results Among the 15 cases of malignant pleural mesothelioma,14 cases were diffuse type, 1 case was localized type,and 3 cases of malignant peritoneum mesothelioma were all diffuse types.10 of 14 diffuse malignant pleural mesothelioma had a thickening pleural of more than 3 cm,the average thickness was (5.3±3.8)cm,in which soft tissue mass was showed in 6 cases.2 of 3 diffuse malignant peritoneum mesotheliom had a thickening peritoneal of more than 3 cm with soft tissue mass.On T1 WI images,slightly low signal were showed in 7 cases,and equal signal in 1 1 cases.On T2 fat suppression sequence,low signal were showed in 4 cases,slightly high signal in 10 cases and high signal in 4 cases.On DWI,18 cases of MM lesions all showed high signal.On enhanced scan,continuous enhancement were showed in 1 8 cases of MM and the enhancement was the most obvious at 180 s.8 cases with lymph node enlargement (8/18).The diseased lateral thoracic profile was significantly narrowed in 11 cases with malignant pleural mesothelioma,of which 7 cases with chest wall invasion.Conclusion The MRI features of MM have certain char-acteristics,and MRI examination will help to make accurate diagnosis before treatment.
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We have evaluated the plague epidemic situation in the Three Rivers Source Region,Qinghai Province in recent 20 years to provide the basis for revising the plague prevention countermeasures.We have analyzed the time distribution and the plague epidemic situation between animals and human beings during twenty years in the Three Rivers Source Region,Qinghai Province by describing epidemiology.The animal plague in the natural source of Marmot plague was extremely serious in the Three Rivers Source Region during the past 20 years.It mainly distributes in Yushu State and Tanggula County,Germu City and the serious season ran through the whole period of marmot camp ground activities and the peak was between June and August.Human plague epidemic took place between May and October each year and reached its peak between July and September.The peak covered about 41.67％ at most.It mainly endemic distributes in Nangqian and Xinghai Country.During the past 20 years,we have totally found 14 human plague epidemics in the Three Rivers Source Region,among which 48 cases took place and there were deaths of 17 cases.The fatality rate was 35.42％.The lung type was the majority among 48 cases,which startde with the glandular type.During the past 20 years the plague epidemic has been active and the animal plague epidemic broke out continuously in the Three Rivers Source Region,Qinghai Province.The variety of animals and insects infected the plague epidemic was increasing.The human plague epidemics is most serious with high fatality rate,but it is on the decline as a whole.
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Objective To understand the epidemic trend of Tibetan sheep plague in Guoluo Prefecture,Qinghai Province,we detected the plague F1 antibody in Tibetan sheep serum in this area.Methods Indirect hemagglutination test (IHA) and colloidal gold immunochromatography (GICA) were applied to test serum samples of Tibetan sheep which were separated from 5 ml whole blood drew from jugular vein in Maqin County,Maduo County,Gande County,Banma County,Jiuzhi County and Dari County in 2014 and 2015.Results We collected 1 481 serum samples,566 from Maqin County,315 from Maduo County,150 from Gande County,150 from Banma County,150 from Jiuzhi County and 150 from Dari County.Totally 14 serum samples showed F1 antibody positive,the positive rate was 0.95％ (14/1 481),and they were all from Maqin County.Conclusions This area has the prevalence of Tibetan sheep plague.Therefore,the monitoring work of Tibetan sheep plague should be strengthened.
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Objective To explore the function of the regional medical image network consultation system in propelling the quality control of regional medical image.Methods Based on the regional medical image network con-sultation system,the unified standard of quality control was implemented to reach the integrated management of the imaging quality control in region.The imaging specialists checked the quality of image and report in real time.In addi-tion,the specialists and inspectors monthly examined the quality of image and report.Subsequently,the unqualified causes were analyzed and the improvement measures were used.Finally,the quality of image and report were continu-ously improved.Results After the homogeneity management was applied for one year,the rates of remaking photos and returning the report were significantly decreased from 10% to 2%,and 12% to 4% respectively.Additionally,the rates of good image and report were significantly increased from 83% to 98%,and 89% to 100% respectively.The objective of good rate ≥90% was excellently achieved.Conclusion Based on the regional medical image network consultation system,the management in quality control of the networking hospitals has been uniform,and the technique of examination and the report format have been consistent.The standardability and accuracy of image examination have been realized.
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<p><b>OBJECTIVE</b>To identify the epidemiology and etiology characteristics of Tibetan sheep plague in Qinghai plateau.</p><p><b>METHODS</b>The background materials of Qinghai Tibetan sheep plague found during 1975 to 2009 were summarized, the regional, time and interpersonal distribution, infection routes, ecological factors for the spread were used to analyze; followed by choosing 14 Yersinia pestis strains isolated from such sheep for biochemical test, toxicity test, virulence factors identification, plasmid analysis, and DFR genotype.</p><p><b>RESULTS</b>From 1975 to 2009, 14 Yersinia pestis strains were isolated from Tibetan sheep in Qinghai province. Tibetan sheep, as the infection source, had caused 10 cases of human plague, 25 plague patients, and 13 cases of death. All of the initial cases were infected due to eating Tibetan sheep died of plague; followed by cases due to contact of plague patients, while all the initial cases were bubonic plague. Cases of bubonic plague developed into secondary pneumonic plague and septicemia plague were most popular and with high mortality. Most of the Tibetan sheep plague and human plague occurred in Gannan ecological zone in southern Gansu province, which was closely related to its unique ecological and geographical landscape. Tibetan sheep plague coincided with human plague caused by Tibetan sheep, especially noteworthy was that November (a time for marmots to start their dormancy) witnesses the number of Yersinia pestis strains isolated from Tibetan sheep and human plague cases caused by Tibetan sheep. This constituted the underlying cause that the epidemic time of Tibetan sheep plague lags obviously behind that of the Marmot plague. It was confirmed in the study that all the 14 strains were of Qinghai-Tibet Plateau ecotype, with virulence factors evaluation and toxicity test demonstrating strains as velogenic. As found in the (Different Region) DFR genotyping, the strains isolated from Yushu county and Zhiduo county were genomovar 5, the two strain isolated from Nangqian county were genomovar 5 and genomovar 7, while those isolated Delingha region were genomovar 8.</p><p><b>CONCLUSION</b>Tibetan sheep were vulnerable to plague infection, hence causing human plague as the infectious source. The Yersinia pestis strains isolated from Tibetan sheep plague carried pathogen characteristics of Qinghai-Tibet plateau plague, developing many new characteristics of such plague.</p>