Single-center analysis of pathogenic bacteria distribution and drug resistance in renal transplantation patients during perioperative period / 中华器官移植杂志

Objective:To explore the distribution of pathogenic bacteria during perioperative period of kidney transplantation(KT)patients and examine drug resistance of major clinical pathogens to commonly used antibiotics to provide references for empirical medication of pathogenic bacteria infection after KT.Methods:From January 1, 2020 to June 30, 2021, 251 patients undergoing deceased donation KT on kidney transplant ward were selected.Clinical samples were collected and distribution and drug resistance of pathogenic bacteria examined for analyzing the incidence of possible donor-derived infections and predicting prognoses.Results:The detection rate of pathogens was 12.18%(367/3 014). A total of 225 non-repetitive strains were isolated.Gram-positive bacteria, Gram-negative bacteria and fungi accounted for 48.89%(110/225), 43.11%(97/225)and 8.00%(18/225). The proportion of lavage fluid in all isolated bacteria was 49.78%(112/225). And Staphylococcus epidermidis and Klebsiella pneumoniae predominated.Drainage fluid accounted for 24.88%(56/225)and Pseudomonas putida and Staphylococcus haemolyticus predominated.Urine accounted for 18.67%(42/225)with a dominance of Enterococcus faecium; blood accounted for 6.22%(14/225)with a dominance of S. epidermidis.All detected pathogens showed varying degrees of resistance.The resistance rates of E. faecium to ampicillin, vancomycin and linezolid were 93.33%(28/30), 6.45%(2/31)and 38.71%(12/31). The resistance rates of K. pneumoniae and Acinetobacter baumannii to carbapenems were 71.43%(20/28)and 80.00%(12/15). The incidence of possible donor-derived infection was 3.59%(9/251)and there was no mortality.Conclusions:The detection rate of pathogenic bacteria is high in KT patients during perioperative period.There is a diverse distribution of isolates of different specimen types and all detected pathogens show varying degrees of drug resistance.Clinicians should regularly analyze the distribution characteristics and causes of drug-resistant bacteria.And antibiotics should be optimized according to the results of drug sensitivity.

Short-term effect of double bundle reconstruction of posterior cruciate ligament with total internal short tendon technique / 中国骨伤

OBJECTIVE@#To explore the method and curative effect of double bundle reconstruction of posterior cruciate ligament with total internal short tendon technique.@*METHODS@#From October 2010 to June 2018, 50 patients with simple posterior cruciate ligament rupture were admitted, including 35 males and 15 females, ranging in age from 20 to 45 years old, 16 with acute injury and 34 with old injury. The posterior cruciate ligament (PCL) was reconstructed by double bundle technique with the whole internal short tendon. The two ends of the transplanted ligament were fixed by titanium plate suspended with adjustable loop. The Lysholm knee score and IKDC score were used to evaluate the clinical effects.@*RESULTS@#All the 50 patients were followed up, and the duration ranged from 6 to 60 months, with a mean of (28.84±9.52) months. At the latest follow up, the knee joint activity returned to normal range. The median value of Lysholm knee score was 54 before operation and 100 after operation. According to the IKDC score, there were 0 case of grade A, 0 case of grade B, 20 cases of grade C and 30 cases of grade D before operation;29 cases of grade A, 19 cases of grade B, 1 case of grade C and 1 case of grade D after operation;the difference was statistically significant (<0.01).@*CONCLUSION@#Arthroscopic double bundle reconstruction of posterior cruciate ligament with short internal tendon is safe and reliable, with less tendon transplantation, more stable fixation, and more bone reserve, which is beneficial for healing and renovation. The short term effect is positive.

Mycophenolic Acid Synergizing with Lipopolysaccharide to Induce Interleukin-1β Release via Activation of Caspase-1 / 中华医学杂志(英文版)

<p><b>Background</b>The previous study showed that mycophenolic acid (MPA) synergizing with lipopolysaccharide (LPS) promoted interleukin (IL)-1β release, but the mechanism is unclear. This study aimed to investigate the mechanism of MPA synergizing with LPS to induce IL-1β release.</p><p><b>Methods</b>Undiluted human blood cells, THP-1 human myeloid leukemia mononuclear cells (THP-1) cells, or monocytes were stimulated with LPS and treated with or without MPA, and the supernatant IL-1β was detected by enzyme-linked immunosorbent assay. The mRNA levels of IL-1β were detected by real-time quantitative polymerase chain reaction. The intracellular protein levels of nuclear factor kappa B (NF-κB) phospho-p65 (p-p65), precursor interleukin-1β (pro-IL-1β), NOD-like receptor pyrin domain containing-3 (NLRP3), and cysteine aspartic acid-specific protease-1 (caspase-1) p20 in THP-1 cell were measured by Western blot.</p><p><b>Results</b>The MPA alone failed to induce IL-1β, whereas MPA synergized with LPS to increase IL-1β in a dose-dependent manner (685.00 ± 20.00 pg/ml in LPS + 5 μmol/L MPA group, P = 0.035; 742.00 ± 31.58 pg/ml in LPS + 25 μmol/L MPA group, P = 0.017; 1000.00 ± 65.59 pg/ml in LPS + 75 μmol/L MPA group, P = 0.024; versus 408.00 ± 35.50 pg/ml in LPS group). MPA alone has no effect on the IL-1β mRNA expression, LPS induced the expression of IL-1β mRNA 2761 fold, and LPS + MPA increased the IL-1β expression 3018 fold, which had the same effect with LPS group (P = 0.834). MPA did not affect the intracellular NF-κB p-p65 and pro-IL-1β protein levels but activated NLRP3 inflammasome. Ac-YVAD-cmk blocked the activation of caspase-1 and subsequently attenuated IL-1β secretion (181.00 ± 45.24 pg/ml in LPS + MPA + YVAD group vs. 588.00 ± 41.99 pg/ml in LPS + MPA group, P = 0.014).</p><p><b>Conclusions</b>Taken together, MPA synergized with LPS to induce IL-1β release via the activation of caspase-1, rather than the enhanced production of pro-IL-1β. These findings suggested that patients immunosuppressed with mycophenolate mofetil may have overly activated caspase-1 during infection, which might contribute to a more sensitive host defense response to invading germs.</p>

Construction and identification of mouse Krüppel-like factor 4 recombinant lentiviral expression vector and its effect on proliferation of RAW264.7 cells / 天津医药

Objective To construct and identify a lentiviral vector carrying mouse Krüppel-like factor 4 (KLF4) gene, and establish RAW264.7 cell line of peritoneal macrophages that over-expressed KLF4. Methods KLF4 gene was cloned using the measure of polymerase chain reaction (PCR). Then the recombinant transfer vector pLVX-KLF4 (pLVX-KLF4-mCMV-ZsGreen-PGK-Puro) was constructed. The pLVX-KLF4 was confirmed through PCR, restriction enzyme digestion and sequencing. The correct recombinant transfer vector together with its two helper virus vectors (psPAX2 and pMD2.G) were cotransfected into the 293T cells by Lipofectamine? 3000. The supernatant of 293T was harvested to infect RAW264.7 cells. Flow cytometry (FCM) was used to test the viral titer of the expression level of green fluorescent protein. The expression of KLF4 mRNA in RAW264.7 cells was measured by real-time PCR. Results The restriction enzyme digestion, PCR and sequencing confirmed that the transfer lentiviral vector pLVX-KLF4 was constructed successfully. KLF4 mRNA was over-expressed in Lenti-KLF4 transfected RAW264.7 cells than that of wild type RAW264.7 cells (P<0.05). In transfected RAW264.7 cells, KLF4 mRNA was over-expressed (P<0.05). The recombinant lentivirus of KLF4(Lenti-KLF4)titer was 2.05×108 TU/mL measured by FCM.The flow cytometry results showed that the S phase fraction was prolonged and G0/G1 was arrested in the over-expressed KLF4 of RAW264.7 cells. The EdU showed that the up-regulated expression of KLF4 gene stimulated the proliferation of RAW264.7 cells. Conclusion The recombinant lentiviral vector, which can effectively express KLF4 mRNA, has been successfully constructed. The up-regulated KLF4 gene may increase the proliferation of RAW264.7 cells.

Application of Sigma Management in Quality Control of Blood Cell for Occupational Health Examination / 现代检验医学杂志

Objective To evaluate the performance of the main indicators in the blood analysis of an occupational health exam ination agency by Sigma verification of performance chart and guide quality improvement.Methods Collected blood testing laboratory internal quality control (IQC) data in October 2016 and 2016 second national external quality assessment (EQA) results of the blood analysis laboratory in the agency.Regarded the accumulated coefficient of variability as the estimation value of imprecision.Used the percentage difference in EQA results as the estimation value of bias (％) of the laboratory.The total allowable error in health industry standard WS/T406-2012 was adopted as the quality specification (％).Sigma verification of performance chart of the main eight projects in the blood analysis were drawn with professional software.Results The sigma value of WBC reached σ≥6 level,as the first-class performance,and the sigma values of HGB in the 4≤σ ＜5 level,test performance was good.The sigma value of Hct,HCV and MCHC all were in the 3≤σ＜4 level,as the critical level,and the sigma values of RBC,platelet and MCH in the 2≤σ＜3 level,as poor performance.Conclusion Sigma verifica tion of performance chart could reflect the level of the laboratory testing performance on different test items of blood count,promote the quality improvement.

Clinical analysis on adverse reactions of anti-TB drugs and evaluation on curative effect of leucopenia / 重庆医学

Objective To statistically summarize the adverse reactions of anti-TB drugs treatment,to analyze the influencing factors of leucopenia and to compare the effect of Qijiao Shengbai Capsule and Leucogen Tablet in the treatment of leucopenia.Methods The adverse reactions in 840 TB patients diagnosed from September 2014 to November 2015 were statistically analyzed.The influencing factors of leucopenia were analyzed.Finally,the effect of Qijiao Shengbai Capsule(n=480) and Leucogen Tablets (n=360) for treating leucopenia.Results Clinicians paid less attention to routine blood monitoring (39.4 ％).Among adverse reactions,the damage of liver function had the highest incidence rate(abnormal liver enzymes 27.0％,increased bile acid 8.2％),followed by leukopenia [25.4％,mainly degree Ⅰ (16.9％)];female patients(P=0.000) and complicating liver damage(P=0.010) might be the risk factors of leukopenia.After treatment by two kinds of drug,white blood cells count was increased,the difference was statistically significant(P=0.000).Conclusion The occurrence rate of leucopenia is higher,females and liver function damage are easier to appear,so more attention should be paid to monitoring the blood routine in return visit.The two kinds of drug for treating leucopenia induced by anti-TB drugs have definite effect and could be used in clinic.

Analysis of the newly tuberculosis and investigation the awareness on the prevention and treatment from tuberculosis patients in a comprehensive hospital of Chongqing / 重庆医学

Objective To learn the various clinic characteristics of newly T tuberculosis (TB) patients ,investigating the preven-tion and treatment knowledge of TB patients ,in an effort to provide scientific evidence for targeted prevention and control meas-ures .Methods Retrospectively analyzing the common demographic characteristics of 648 newly and 434 old TB patients from Sep-tember 2011 to September 2012 ,diagnostic information ,the awareness on the prevention and treantment ,drug use situation and so on .Results Among these patients ,most of them were males(60 .2% ) ,the middle age and the young were the majority (77 .8% ) , the disease areas were mainly rural ones (61 .6% ) ,and manual workers (65 .4% ) ,secondary pulmonary TB was in the majority (72 .8% ) ,40 .0% (52/130) of the patients with TB pleuritis were accompanied by pulmonary TB .TB patients usually combined with pneumonoconiosis(8 .0% ) ,diabetes(3 .6% ) ,asthma(4 .3% ) and some other fundamental diseases .The old TB patients had more prevention and treatment knowledge about TB than those newly patients (P<0 .05) .The major source of newly patients about the knowledge were mainly from their relatives and friends (30 .3% ) ,whereas the old patients from teaching of medical care (36 .9% ) .The main reasons for irregular usage of medicine came from the lack of knowledge about the course period of treatment (45 .3% ) ,and the disappearing of TB symptoms (30 .8% ) .Conclusion In the less developed rural areas ,the young and middle aged males who mainly done physical work were the majority patients .These newly patients have little prevention and treatment knowledge about TB .Comprehensive hospitals played an important role in transmission of TB knowledge .In the process of educa-tion ,we should pay special attention on the following less known but essential points :mode of transmission ,protective measures , course period of treatment ,monitoring side effect ,giving out free medicine ,and the prognosis of TB .

Advance on mechanisms of metformin′s anti-lung-cancer activity / 医学研究生学报

Diabetes and lung cancer are common diseases worldwide , which have a serious impact on human health .Recently epidemiologic research has found that diabetes , which may enhance the incidence of lung cancer , is one of the risk factors of lung canc-er.The metformin, a first-line drug for treatment of type 2 diabetes, can decrease the incidence of lung cancer and may have an anti-lung-cancer bioactivity ,but its mechanisms are unclear .To make a further study of the mechanisms is expected to reduce the morbidity and is possible to help us find a new therapeutic target .The aim of this article is to review the potential mechanism of the metformin′s anti-lung-cancer activity .

Liposomal paclitaxel in combination with cisplatin as a first line of chemotherapy in treatment of advanced NSCLC with regional lymph node metastasis:A randomized controlled trial / 中国癌症杂志

Background and purpose: Regional lymph node metastasis was significantly associated with the prognosis of patients with non-small cell lung cancer (NSCLC). This study was designed to compare paclitaxel liposome plus cisplatin (LP) with gemcitabine and cisplatin (GP) in patients with regional lymph node metastasis of advanced NSCLC as a ifrst-line treatment. Methods:A total of 55 patients were randomly assigned to receive either liposomal paclitaxel (175 mg/m2) and cisplatin (75 mg/m2) or gemcitabine (1 000 mg/m2) and cisplatin (75 mg/m2) every 3 weeks. Results:Objective response rate (ORR) of lung primary foci was 37.9%in the LP arm and 30.8%in the GP arm (P>0.05) and the disease control rate (DCR) was 91.3%and 80.8%respectively (P>0.05);ORR of regional metastasis lymph node was higher in the LP arm (44.8%vs 15.4%, P0.05). Conclusion: Liposomal paclitaxel plus cisplatin is superior to gemcitabine plus cisplatin with less toxicity and better tolerated, it deserves further research and clinic application for patients with regional lymph node metastasis of advanced NSCLC.