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Objective To explore the risk factors of clopidogrel resistance (CR) in the elderly patients with atherosclerotic cardiovascular disease and to provide evidence for the antiplatelet therapy. Methods A total of 223 elderly patients (≥80 years old) with atherosclerotic cardiovascular disease treated in the Department of Geriatrics in the Peking University People's Hospital from January 18,2013 to November 30,2019 and meeting the inclusion criteria were enrolled in this study.The clinical data and laboratory test results were collected,including clinical disease,drug use,physical examination,complete blood cell analysis,biochemical indicators,and thromboelastogram (TEG).The rate of platelet inhibition induced by adenosine diphosphate was calculated according to the TEG.We assigned the patients into a CR group (n=84) and a control group (n=139) to analyze the incidence and influence factors of CR in the elderly patients with atherosclerotic cardiovascular disease. Results The incidence of CR was 37.7% in the elderly patients with atherosclerotic cardiovascular disease.The CR group had lower hemoglobin (t=3.533,P=0.001) and higher hypertension prevalence rate (χ2=6.581,P=0.006),proportion of multiple drugs (χ2=3.332,P=0.048),body mass index (BMI) (t=-2.181,P=0.030),total cholesterol (t=-2.264,P=0.025),triglycerides (Z=-2.937,P=0.003),low-density lipoprotein cholesterol (LDL-C) (t=-2.347,P=0.020),and proportion of women (χ2=5.562,P=0.014) than the control group.The results of multivariate Logistic regression showed that hemoglobin (OR=0.962,P<0.001),BMI (OR=1.154,P=0.003),and LDL-C (OR=1.688,P=0.018) were the factors influencing CR in the elderly patients with atherosclerotic cardiovascular disease. Conclusion Hemoglobin,BMI,and LDL-C may be independent factors associated with the occurrence of CR in the elderly patients with atherosclerotic cardiovascular disease.
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Aged , Aged, 80 and over , Female , Humans , Atherosclerosis , Cardiovascular Diseases , Cholesterol, LDL , Clopidogrel/therapeutic use , Risk FactorsABSTRACT
The ethyl acetate part of the alcoholic extract of Cordia dichotoma fruits was purified by a combination of normal-phase silica gel column chromatography, Sephadex LH-20 gel column chromatography and semi-preparative HPLC, and the structure was identified by modern spectroscopic techniques (UV, IR, MS, NMR). A total of 10 compounds were isolated and identified as cordilide (1), (S)-2-hydroxy-3-(4′-hydroxyphenyl) propanoic acid (2), vanillic acid (3), p-coumaric acid (4), 3-hydroxy-1-(4-hydroxy-3-methoxyphenyl)propan-1-one (5), benzoic acid (6), p-hydroxypropiophenone (7), p-hydroxyacetophenone (8), 5′-methoxyevofolin B (9) and vanillin (10). Among them, compound 1 is a pair of new phenylpropanoid enantiomers, and compounds 3, 6, 8 and 9 were isolated for the first time from the genus.
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Objective:To investigate the predictive value of MRI radiomics model in assessing the early response to concurrent chemoradiotherapy for locally advanced cervical squamous cell carcinoma.Methods:A total of 367 patients with pathologically proven locally advanced cervical squamous cell carcinoma (International Federation of Gynecology and Obstetrics stage ⅡB-ⅣA) in Liaoning Cancer Hospital & Institute from January 2013 to June 2019 were retrospectively collected. The patients were unable to undergo surgery and received complete concurrent chemoradiotherapy. Pelvic plain MRI, DWI and dynamic contrast-enhanced MRI were performed within 2 weeks before treatment and at the end of the 4th week of treatment. Patients were divided into complete response (CR) group ( n=247) and non-CR group ( n=120) according to response evaluation criteria in solid tumors 1.1. The patients were divided into a training set ( n=256) and a validation set (n=111) via a randomized split method at a ratio of 7∶3. Two radiologists drew the region of interest on the DWI, T 2WI and contrast-enhanced T 1WI (delayed phase) images before treatment to form the volume of interest finally. Totally 1 906 radiomics features were extracted from 3 single sequence images, respectively. Feature correlation analysis and tree model were used for feature selection. Three classifier learning algorithms, namely logistic regression (LR), support vector machine and random forest, were used for machine learning and the best classifier was selected. Based on the best classifier, 3 single sequence radiomics models were built, and a multi-sequence combined model was obtained by multivariate LR analysis. The differences in the area under the receiver operating characteristic curve (AUC) of the 3 single sequence models and the multi-sequence combined model were compared by DeLong test. The clinical application value of the multi-sequence combined model was evaluated by decision analysis curve. Results:In the training set and validation set, the LR classifier model had the best performance. Based on the LR classifier, AUCs of DWI, T 2WI, contrast-enhanced T 1WI and combined sequences in the training set were 0.77, 0.74, 0.79 and 0.86, respectively, and AUCs in the validation set were 0.71, 0.66, 0.75 and 0.77, respectively. In the training set, the AUC of multi-sequence combined model was higher than those of DWI, T 2WI and contrast-enhanced T 1WI sequence models, and the differences were statistically significant ( Z=3.01, 3.56, 2.83; P=0.003, 0.001, 0.005). In the validation set, the AUC of multi-sequence combined model and T 2WI model had significant difference ( Z=2.46, P=0.015). The decision analysis curve showed that when the threshold probability was in the range of 0.44 to 0.88, the multi-sequence combined model yielded a net benefit. Conclusion:Based on the LR classifier, the combined model built by radiomics features of multi-sequence MRI images has predictive value for assessing the early response of concurrent chemoradiotherapy for locally advanced cervical squamous cell carcinoma.
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Silica gel column chromatography, reversed phase C18 column chromatography, Sephadex LH-20 gel column chromatography, high performance liquid chromatography and medium performance semi preparative liquid chromatography were performed to separate and purify the chemical constituents of Hypericum lagarocladum N. Robson. Spectroscopic methods such as MS and NMR combined with physicochemical properties were applied in identifying the structures of the isolated compounds. A total of 11 compounds were isolated and identified as hyperlagarone A (1), hyperpatulone E (2), hyperbeanol G (3), uralione D (4), tomoeone F (5), pyramidatone A (6), tomoeone A (7), tomoeone B (8), hyperbeanol C (9), hyperbeanol A (10), and hypercohone G (11), respectively. Compound 1 is a new polycyclic polyprenylated acylphloroglucinol derivative, and compounds 2-11 are isolated from this plant for the first time. 11 compounds were tested for glucose uptake in L6 cells, and the results showed that compounds 7 and 8 had significant effect on glucose uptake.
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This retrospective study demonstrates the clinical outcomes of patients with nonmosaic Klinefelter's syndrome (KS) who underwent preimplantation genetic testing (PGT) with frozen-thawed testicular spermatozoa. Microdissection testicular sperm extraction (micro-TESE) was performed for sperm retrieval. Next-generation sequencing (NGS) was conducted for embryo analysis. A total of 18 couples aged ≤35 years were included, and 22 oocyte retrieval cycles were completed. Euploidy was detected in 29 of 45 (64.4%) embryos. Additionally, the numbers of aneuploid and mosaic embryos detected were 8 (17.8%) and 8 (17.8%), respectively, regardless of a lack of sex chromosome abnormalities. Finally, 13 couples with euploid embryos completed 14 frozen embryo transfer (FET) cycles. Ten couples had clinical pregnancies, and 6 of them had already delivered 5 healthy babies and 1 monozygotic twin. There were also 4 ongoing pregnancies and 2 biochemical pregnancies, but no early pregnancy loss was reported. Based on our results, we speculate that for KS patients, when sperm can be obtained by micro-TESE, the cryopreservation strategy makes the ovarian stimulation procedure more favorable for female partners. The paternal genetic risk of sex chromosome abnormalities in their offspring is extremely low in men with KS. In addition to PGT, the intracytoplasmic sperm injection (ICSI) procedure is comparably effective but more economical for young nonmosaic KS couples. ICSI should be offered as an option for such couples, but monitoring by prenatal genetic diagnosis is recommended.
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Adult , Female , Humans , Pregnancy , High-Throughput Nucleotide Sequencing/methods , Klinefelter Syndrome/therapy , Outcome Assessment, Health Care/statistics & numerical data , Ovulation Induction/statistics & numerical data , Retrospective Studies , Sperm Injections, Intracytoplasmic/methodsABSTRACT
Alcoholic hepatitis (AH) is a severe alcohol-associated liver disease with a mortality rate as high as 40%. A recent study reveals that the exotoxin (cytolysin)-secreting gut bacterium Enterococcus faecalis is a critical factor for AH, which can be eliminated by bacteriophages, and therefore, the use of bacteriophages for the treatment of AH provide a new treatment option for AH. This article introduces this pioneering study and the knowledge of bacteriophages and cytolysin, so as to provide a theoretical basis for the clinical research on AH.
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Background@#As a large, prospective, multicenter study-based prognostic score for hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF), the Chinese group on the study of severe hepatitis B-acute-on-chronic liver failure score (COSSH-ACLFs), has been approved by some foreign scholars; however, its predictive value needs to be verified. This study investigated the predictive value of COSSH-ACLFs for short-term prognosis in Chinese patients with HBV-ACLF.@*Methods@#This retrospective cohort study included 751 patients with HBV-ACLF admitted to the Fifth Medical Center of Chinese PLA General Hospital between January 2011 and December 2014. Spearman method was used to assess the correlation of COSSHACLFs with classical scores. Different COX multivariate regression models were used to confirm the relationship between COSSHACLFs and short-term prognosis in patients with HBV-ACLF, and stratified analysis was used to further verify the stability of this relationship. We compared the predictive powers of COSSH-ACLFs and other classical scores using area under the receiver operating characteristic curve (AUROC) and Z-test.@*Results@#A total of 975 patients with HBV-ACLF were screened, and 751 were analyzed (623 male and 128 female). COSSH-ACLFs was the highest in patients with end-stage ACLF, followed by those with middle- and early-stage ACLF (H = 211.8, P < 0.001). In the fully adjusted model, COX multivariate regression analysis revealed that COSSH-ACLFs (as a continuous variable) was independently and positively correlated with mortality risk in patients with HBV-ACLF at 28 days (hazard ratio [HR]: 1.37 [1.22, 1.53], P < 0.001) and 90 days (HR: 1.43 [1.29, 1.58], P < 0.001). The same trend could be observed in the crude model and minimally adjusted model. The AUROCs of COSSH-ACLFs for 28-day and 90-day prognoses in patients with HBV-ACLF were 0.807 and 0.792, respectively, indicating a stronger predictive accuracy than those of classic models.@*Conclusions@#COSSH-ACLFs, with a superior predictive accuracy compared with other classical scores, can strongly predict shortterm prognosis in Chinese patients with HBV-ACLF.
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BACKGROUND@#As a large, prospective, multicenter study-based prognostic score for hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF), the Chinese group on the study of severe hepatitis B-acute-on-chronic liver failure score (COSSH-ACLFs), has been approved by some foreign scholars; however, its predictive value needs to be verified. This study investigated the predictive value of COSSH-ACLFs for short-term prognosis in Chinese patients with HBV-ACLF.@*METHODS@#This retrospective cohort study included 751 patients with HBV-ACLF admitted to the Fifth Medical Center of Chinese PLA General Hospital between January 2011 and December 2014. Spearman method was used to assess the correlation of COSSH-ACLFs with classical scores. Different COX multivariate regression models were used to confirm the relationship between COSSH-ACLFs and short-term prognosis in patients with HBV-ACLF, and stratified analysis was used to further verify the stability of this relationship. We compared the predictive powers of COSSH-ACLFs and other classical scores using area under the receiver operating characteristic curve (AUROC) and Z-test.@*RESULTS@#A total of 975 patients with HBV-ACLF were screened, and 751 were analyzed (623 male and 128 female). COSSH-ACLFs was the highest in patients with end-stage ACLF, followed by those with middle- and early-stage ACLF (H = 211.8, P < 0.001). In the fully adjusted model, COX multivariate regression analysis revealed that COSSH-ACLFs (as a continuous variable) was independently and positively correlated with mortality risk in patients with HBV-ACLF at 28 days (hazard ratio [HR]: 1.37 [1.22, 1.53], P < 0.001) and 90 days (HR: 1.43 [1.29, 1.58], P < 0.001). The same trend could be observed in the crude model and minimally adjusted model. The AUROCs of COSSH-ACLFs for 28-day and 90-day prognoses in patients with HBV-ACLF were 0.807 and 0.792, respectively, indicating a stronger predictive accuracy than those of classic models.@*CONCLUSIONS@#COSSH-ACLFs, with a superior predictive accuracy compared with other classical scores, can strongly predict short-term prognosis in Chinese patients with HBV-ACLF.
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Objective To observe the effect of varying intensities of water-jet force on autologous fat graft viability.Methods Lipoaspirate was taken from 12 female patients undergoing waterjet assisted abdominal liposuction at our department.According to the intensity of water-jet force,the experimental group was divided into four subgroups:R1 (pressure,30 bar),R2 (pressure,50 bar),R3 (pressure,70 bar) and R4 (pressure,90 bar).Hand-held suction was taken as the control group C.Adipose tissue was filtered with cotton cushion and centrifuged at low speed,and the composition ratio of water and fat tissue from each group was observed.Calcein-AM/Hoechst 33342 staining was used to detect the viability of adipocytes.Results Fat aspirates was divided into four layers:oil layer,pure fat tissue,liquid and bottom sediment.Oil ratios of R1,R2,R3,R4 and C were (8.9 ± 2.3) ％,(9.6±2.1)％,(10.3±1.3)％,(14.2±1.6)％ and (9.5±1.8)％,respectively.There was no statistically significant difference between R1,R2,R3 and C (P＞0.05).Statistically significant difference was found between R4 and other groups (P＜0.001).Viability of adipocytes from R1,R2,R3,R4 and C groups were (88.1±2.8)％,(89.9±1.9)％,(84.8±2.3)％,(78.0±1.7)％ and (91.1±2.9)％ respectively.There was no statistically significant difference between R1,R2 and C (P＞ 0.05).Statistically significant difference was found between R3,R4 and C (P ＜ 0.05).Conclusions Viability of fat graft harvested under lower intensity of water-jet force (R1,R2) is higher than that harvested under higher intensity of water-jet force (R3,R4).
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Objective@#To investigate the epidemiological characteristics and the causes of two outbreaks of upper respiratory tract infection in our city.@*Methods@#The epidemiological investigation was carried out on the outbreaks and the pharyngeal swabs were collected to do the pathophysiologic examination by using real-time PCR. Hexon gene of adenovirus was amplified by PCR. Then the positive products were sequenced and BLAST searching was done in GenBank.@*Results@#The clinical symptoms of the two cases were high fever, sore throat and cough, etc, while the main signs were pharyngeal congestion and tonsil swelling; 32 students of a class in Yunxing primary school had respiratory infection related symptoms, of which the incidence rate was 55%; while 12 of 38 students in a class of Fangcun primary school were infected. All these students were on school in the same class, and the incidence was aggregate without proliferation. The duration of the disease was about 5 days and the prognosis was good, no death occurred. The positive result of real-time PCR showed adenovirus. BLAST search analysis on hexon gene showed AdV14.@*Conclusions@#According to epidemiological investigation and laboratory test results, the cause of these two outbreaks of upper respiratory tract infection was adenovirus type 14.
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Objective To optimize the lateral position of the operation,to improve the comfort of the lateral decubitus patients, to expose the incision adequately, and to improve the nursing quality of lateral decubitus surgery. Methods A total of 60 cases of thoracic surgery patients with lateral decubitus were divided into the control group and the test group according to the random number table method, 30 cases each. The control group used traditional lateral decubitus placement method, experimental group through the method and fixed on the traditional method of placing lateral limbs was improved, used in thoracic surgery especially in thoracoscopic surgery. The effect was compared between two groups. Results The time between the experimental group and the control group was respectively (5.6 ± 0.7), (9.0 ± 0.5) min, and the difference between the two groups was statistically significant (t = 26.944, P <0.01). In the two groups, the muscle soreness of 24 – 48 h after operation was 1 and 12 cases, and 2 groups were statistically significant(χ2=13.35,P<0.01).The postoperative satisfaction of the two groups of surgeons, anesthesiologists and nurses was statistically significant (Z =- 2.573, P < 0.01). Conclusions The modified lateral application in thoracic surgery is superior than the traditional lateral position, lateral position display method of time and labor saving, energy saving, expand the operation field,improve patient comfort,reduce costs,and improve the safety of nursing quality in operation room.
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Objective To evaluate the value of calcium-based quantitative spectral CT imaging in differential diagnosis of benign and malignant thyroid nodules.Methods Totally 82 patients with 98 thyroid nodules confirmed by pathology underwent unenhanced and dual-phase enhanced spectral CT scans before operation.Thyroid nodules were divided into malignant group (61 nodules) and benign group (37 nodules),according to histopathologic results.Besides,contralateral normal thyroid tissue of 50 patients was selected as normal group.The calcium concentration of malignant,benign and normal group in non-enhanced scanning was analysed.The optimal threshold to predict malignancy and the corresponding diagnostic sensitivity and specificity were obtained by ROC curve.Results The calcium concentrations for malignant, benign and normal group in non-enhanced scanning were (5.52±2.72) mg/cm3, (10.72±4.68) mg/cm3 and (24.66±7.58) mg/cm3 respectively.There were significant differences statistically in any two groups (P<0.001).For malignant thyroid nodules, the best diagnostic threshold of calcium concentration was 6.065 mg/cm3,and the diagnostic sensitivity and specificity were 65.6% and 91.9% respectively.Conclusion Spectral CT imaging can quantitatively assess the calcium concentration of thyroid nodules,which provides promising quantitative approach for distinguishing malignant thyroid nodules from benign nodules.
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Infertility is a common disease in women of childbearing age and is also a refractory disease. Anovulatory dysfunction is one of the main causes of female infertility, and the incidence of anovulatory infertility has been increasing year by year. Traditional Chinese medicine has unique advantages and definite curative effect on the treatment of this disease. Kidney deficiency is the basic pathogenesis and blood stasis is an important factor that has been through. Flexible of tonifying the kidney and promoting blood circulation treatment of anovulatory infertility in clinic, has achieved remarkable curative effect. Kidney deficiency and blood stasis is a common form of gynecological disease. After years of clinical practice, we also found that patients with anovulatory infertility were more common with kidney deficiency and blood stasis. The kidneys and blood are not isolated from each other, but interact and influence each other. Kidney deficiency and blood stasis interact as both cause and effect, they have very close relationship. To achieve the purpose of urinary Tiangui, Chongren, ovulation and pregnancy miscarriage by tonifying the kidney and promoting blood circulation.
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In order to analyze Professor Ma Kun's medication in treating anovulatory infertility, her prescriptions for treating anovulatory infertility in 2012-2015 were collected. The medication features and the regularity of prescriptions were mined by using traditional Chinese medicine inheritance support system, association rules, complex system entropy clustering and other mining methods. Finally, a total of 684 prescriptions and 300 kinds of herbs were screened out, with a total frequency of 11 156 times; And 68 core combinations and 8 new prescriptions were mined. The top three frequently used herbs by effect were respectively tonic herb, blood circulation promoting herb, and Qi-circulation promoting herb. The top three tastes were sweetness, bitterness and pungent flavor. The results showed 28 herbs with a high frequency of ≥100.The top 10 frequently used herbs were respectively Angelica Sinensis Radix, Cyperi Rhizoma, Chuanxiong Rhizome, Paeoniae Radix Rubra, Cyathulae Radix, Taxilli Herba, Cuscutae Semen, Codonopsis Radix, Ligustri Lucidi Fructus, Paeoniae Albaand Paeoniae Radix Alba. The association rules analysis showed commonly used herbal pairs, including Rehmanniae Radix Preparata-Chuanxiong Rhizome, Rehmanniae Radix Preparata-Angelica Sinensis Radix, Cuscutae Semen-Dipsaci Radix. In conclusion, Professor Ma has treated anovulatory infertility by nourishing the kidney and activating blood throughout the treatment course, and attached the importance to the relationship between Qi and blood and there gulation of liver, spleen and kidney in treating anovulatory infertility.
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To systematically evaluate the efficacy and safety of Bushen Huoxue ricipe in treating patients suffering from diminished ovarian reserve. Databases such as CNKI, WanFang, VIP, CBM, PubMed, EMbase and Cochrane Library were searched on randomized controlled trial/quasi-randomized controlled trial about Bushen Huoxue ricipe in treating patients suffering from diminished ovarian reserve form the inception of the study until June 2017. The studies were screened according to inclusion and exclusion criteria. Risk of bias evaluation tools were adopted to conduct quality evaluation. Meta-analysis on outcome indicator was performed by RevMan Version 5.3 Software. Due to the different Bushen Huoxue recipe (observation group) and the different Western medicine(control group) of all included studies, the effect size was combined by the random effect model after the subgroup analysis or sensitivity analysis was performed. Eventually 11 trials were included, including 733 cases of patients. Results of Meta-analysis indicated that, Bushen Huoxue recipe had advantages over Western medicine on lowering FSH, increasing AMH and AFC, enhancing the Chinese medicine symptom curative effect; Bushen Huoxue recipe had no advantages over Western medicine on increasing E2; the advantages of Bushen Huoxue recipe were not clear on reducing FSH/LH and increasing total effective rate because of the different outcomes to compared with the different Western medicine; no serious adverse reaction appering from Bushen Huoxue recipe was reported in the including researches. Bushen Huoxue recipe has the clinical curative effect and high safety suffering from diminished ovarian reserve. However, limited by the poor quantity of studies, these conclusions remain to be examined by more center, more sample and high-quality studies.
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Objective To analyse the significance of proto oncogene protein in oral squamous cell carcinoma and oral leukoplakia.Methods 40 patients who were diagnosed with oral leukoplakia (OLK),40 patients who were diagnosed with oral squamous cell carcinoma(OSCC),and at the same time, 40 healthy volunteers as control group were collected.the lesions and normal oral mucosa were taken as samples, left supernatant after grinding, MDM2 protein, p53 protein and Ki-67 protein were detected by ELISA in three groups,and analyse the correlation between three groups.Results Among three groups,MDM2, p53 expression:OSCC group>OLK group>control group (POLK group>control group (P<0.05).MDM2, p53, Ki-67 expression had a positive correlation in OSCC group and OLK group (P<0.05), but there was no obvious correlation in control group.Conclusion When oral leukoplakia developes into oral squamous cell carcinoma, MDM2, p53, Ki-67 shows high expression, and there is a positive correlation between MDM2, p53, Ki-67.
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Objective To investigate changes of coagulation function in patients with high altitude polycythemia (HAPC) .Meth‐ods Activated partial thromboplastin time (APTT) ,prothrombin time (PT) ,thrombin time (TT) and fibrinogen (Fbg) were de‐tected and compared between 69 patients with HAPC and 60 healthy subjects (controls) .Results Fbg ,APTT and TT levels in pa‐tients with HAPC were higher than controls (P0 .05) .Dynamic obser‐vation indicated that comprehensive therapy could these recover coagulation function .Conclusion Hemorrhage and coagulation process in patients with HAPC could be very complicated ,including physiological adaptation and the process of physiology evolving into pathology .
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Objective To analyse the suspected hereditary non-polyposis colorectal cancer (HNPCC) in mismatch repair protein (MMR) expression of hMLH1 and hMSH2. Methods Immunohistochemical staining method was used for the detection of hMLH1 and hMSH2 protein expression in 193 cases suspected HNPCC patients, the deletion of MMR proteins was identified as highly suspected HNPCC cases. Results Of the 193 patients with suspected HNPCC hMLH1/hMSH2 abnormal expression rate was 29.02%; ≤30 years old was 40%, 31 ~ 40 years old was 28.05%, 41 ~ 50 years old was 28.71%,3 suspected HNPCC showed the deletion of hMLH1/hMSH2 protein expression at the same time ,; In the right colon , the left half colon and rectal anomaly detection rates were 40.74%, 32.65%and 18.89%; hMLH1/hMSH2 deletion was 46.15%with family history. Conclusions The deletion of MMR protein is closely related to age,site and family history in suspected HNPCC, and the deletion of hMLH1 is an important factor to induce early-set colorectal cancer. The deletion of hMLH1/hMSH2 at the same time indicates that hMLH1/hMSH2 genes may play important role in the incidence of HNPCC.
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Group B Streptococcus (GBS) is responsible for two distinct clinical syndromes in the newborn period categorised as either early- or late-onset GBS disease. Maternal GBS colonization of gastrointestinal tract or vaginal is the major risk factor for GBS diseases. There are two main strategies for identifying women at risk of giving birth to a GBS-infected infant: universal screening strategy and risk-based assessment. In the United States and other countries, the implementation of maternal intrapartum antibiotic prophylaxis policies has significantly reduced the incidence of early-onset neonatal GBS disease, but has little effect on the incidence of late-onset GBS disease. Penicillin is the first choice for antibiotic prophylaxis treatment. GBS strains which are isolated from pregnant women who are allergic to penicillin should undergo antibiotic susceptibility testing. Antibiotic prophylaxis measures have some disadvantages, so researchers should actively develop other precautions to prevent GBS infection.
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Female , Humans , Infant, Newborn , Pregnancy , Antibiotic Prophylaxis , Infectious Disease Transmission, Vertical , Pregnancy Complications, Infectious , Streptococcal Infections , Streptococcus agalactiaeABSTRACT
To understand the genetic diversity and drug resistance status of Mycobacterium tuberculosis (M. tuberculosis) circulating in Xuzhou of China, the spacer-oligonucleotide typing (Spoligotyping) and multi-loci VNTRs (variable number tandem repeats) analysis (MLVA) were utilized for the genotyping of the isolates. Drug susceptibility test (DST) was performed by the proportion method on the Lowenstein-Jensen (L-J) medium using isoniazid, rifampicin, ethambutol, and streptomycin. By Spoligotyping, 287 M. tuberculosis isolates were differentiated into 14 clusters. Then with 15-loci MLVA, these strains could be divided into 32 clusters, 228 genotypes. Of 15 VNTRs, 6 loci had the highly discriminatory powers, 6 loci presented moderate discrimination and 3 loci demonstrated less polymorphism. The DST results showed that 46 strains were resistant to at least one first-line anti-tuberculosis agent. There was a difference in the isoniazid resistance between Beijing and non-Beijing genotype strains. We concluded that the combination of Spoligotyping and 15 VNTR loci as the genotyping in our study was applicable for this region, the drug resistant isolates were identified, and the Beijing family was the most prevalent genotype in the rural counties of Xuzhou.