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Background The incidence of Legionnaires' disease is increasing globally and artificial water environment is becoming a common source of outbreaks. Molecular typing techniques can help prevent and control Legionella. Objective To understand the molecular epidemiological characteristics of Legionella pneumophila in artificial water environment of Shanghai hospitals, and provide a scientific basis for the prevention and control of Legionnaires' disease. Methods Water samples were collected from artificial water environment in 14 hospitals from May to October each year from 2019 to 2020 in Shanghai. A total of 984 water samples were collected from 8 Grade-A tertiary hospitals and 6 non-Grade-A tertiary hospitals, including 312 samples of cooling water, 72 samples of chilled water, and 600 samples of tap water. The water samples were isolated and serotyped for Legionella pneumophila and preserved, and the positive rate of Legionella pneumophila in the samples was used as an indicator of contamination. The preserved strains were resuscitated and 81 surviving strains were obtained for pulsed field gel electrophoresis (PFGE) typing analysis. Results A total of 124 Legionella pneumophila positive water samples were detected, with a positive rate of 12.60%. The positive rate was higher in the Grade-A tertiary hospitals (16.54%, 87/526) than in the non-Grade-A tertiary hospitals (8.08%, 37/458) (χ2=15.91, P<0.001). The positive rate of cooling water (23.40%) was the highest among different types of water samples, and the difference was statistically significant (χ2=61.19, P<0.001). The difference in positive rate of tap water was statistically significant among different hospital departments (χ2=11.37, P<0.05). The positive rate in 2019 (15.06%) was higher than that in 2020 (9.84%) (χ2=6.23, P<0.05). From May to October, August had the highest annual average positive rate (16.46%) and October had the lowest (8.54%), but the difference in positive rates among months was not statistically significant (χ2=5.39, P=0.37). The difference in positive rate among districts was statistically significant (χ2=24.88, P<0.001). A total of 131 strains of Legionella pneumophila were isolated, with serotype 1 (80.15%, 105/131) predominating. Among the 81 surviving strains of Legionella pneumophila subjected to PFGE typing, the band-based similarity coefficients ranged from 41.30% to 100%. Among the 29 PFGE band types (S1-S29) recorded, each band type included 1-10 strains, and S28 was the dominant band type. Four clusters (I-IV) of PFGE band types were identified, accounting for 66.67% (54/81) of all strains and containing 13 band types. Conclusion Legionella pneumophila contamination is present in the artificial water environment of hospitals in Shanghai from 2019 to 2020, and the contamination in tap water deserves attention. The detected serotype of Legionella pneumophila is predominantly type 1, and PFGE typing reveals the presence of genetic polymorphism. Therefore, the monitoring and control of Legionella pneumophila in hospital artificial water environment should be strengthened.
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Objective:To investigate epidemiological characteristics of arsenic poisoning-related skin lesions in an arsenic tailing area in Hunan Province.Methods:A cross-sectional study was conducted. From October 2016 to January 2017, all residents aged over 18 years (except pregnant women) were enrolled from 3 villages in Baiyun Town, Shimen County, Hunan Province by using a cluster-sampling method. Demographic information was collected through a face-to-face questionnaire interview. All residents received skin examination performed by professional dermatologists, and blood, urine, and hair samples were collected for the measurement of arsenic levels. Non-conditional logistic regression analysis was performed to analyze factors associated with arsenic poisoning-related skin lesions.Results:A total of 1 092 eligible residents in the arsenic tailing area were recruited in this study, and 756 (69.2%, 95% CI: 66.5%, 72.0%) presented with arsenic poisoning-related skin lesions, including hyperkeratosis, hypo- or hyper-pigmentation. The median ( Q1, Q3) arsenic levels were 0.31 (0.14, 0.74) μg/g in hair samples ( n = 1 079), 0.84 (0.67, 1.10) μg/L in blood samples ( n =1 091), and 60.31 (41.71, 91.52) μg/L in urine samples ( n =1 092). Multivariable analysis showed that the occurrence of arsenic poisoning-related skin lesions was associated with age, residential location, and occupational arsenic exposure history, but was not associated with gender, ethnicity, education levels, migration history, arsenic levels in hair, blood, or urine. Compared with the group aged 18 - 39 years, the group aged 40 - 59 years and the group aged over 60 years showed significantly higher risks of arsenic poisoning-related skin lesions (adjusted OR = 11.34, 95% CI: 5.98, 21.50, P < 0.001; adjusted OR = 71.82, 95% CI: 35.81, 144.05, P < 0.001, respectively). Compared with the residents in the Wangyangqiao village, residents in the Heshan village and Huangchang village showed significantly higher risks of arsenic poisoning-related skin lesions (adjusted OR = 2.89, 95% CI: 2.05, 4.08, P < 0.001; adjusted OR = 4.13, 95% CI: 1.94, 8.78, P < 0.001, respectively). The risk of arsenic poisoning-related skin lesions was significantly higher in residents with occupational exposure history than in those without (adjusted OR = 1.99, 95% CI: 1.04, 3.83, P = 0.039) . Conclusion:Nearly 70% of the residents presented with arsenic poisoning-related skin lesions in an arsenic tailing area in Hunan Province, and the duration and previous degree of arsenic exposure were associated with the risk of arsenic poisoning-related skin lesions.
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Total hip arthroplasty (THA) has been one of the most successful orthopaedic surgery in the last 50 years, with an excellent survival rate of more than 20 years. However, hip instability, impingement, dislocation, and liner wear remain common causes of THA failure and revision after THA. To minimize the risk of postoperative complications, abnormal spine-pelvic-hip mobility and its impact on THA outcomes have received increasing attention. According to the concept, the patient's pelvic mobility should be fully considered when making preoperative plans for THA. Individualized anteversion and inclination angles should be set according to the patient's sagittal balance and pelvic mobility to reduce the incidence of postoperative adverse events and prolong the life of the prosthesis. In the literature, recent studies have shown that patient aging, postural changes in daily life, high body mass index (BMI), and different surgical approaches and positions can impact spinopelvic mobility. Because changes in pelvic mobility translate into changes in acetabular orientation, excessive intraoperative or postoperative changes in pelvic mobility may result in poor intraoperative prosthesis orientation, postoperative impingement, dislocation, and accelerated liner wear, ultimately shortening the life of the prosthesis. Therefore, it is vital to evaluate and measure spinopelvic mobility preoperatively, investigate the factors that influence intraoperative pelvic mobility changes and the use of assisted positioning devices for accurate cup placement, and observe postoperative changes in pelvic mobility and the resulting adverse outcomes. This review takes the current literature on the spine-pelvic-hip interrelationship as a starting point and presents studies on the factors influencing spinopelvic mobility and the strategies for perioperative management of THA.
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Objective:To analyze potential roles of mechanical stress in the formation of plantar melanoma.Methods:A retrospective analysis was conducted on 129 cases of plantar melanoma in Xiangya Hospital, Central South University between 2014 and 2021, and the distribution and clinical characteristics of plantar melanoma were analyzed. The goodness-of-fit test was used to compare the distribution of plantar melanoma between weight-bearing areas (the toes, forefoot, lateral midfoot, heel) and non-weight-bearing areas of the foot (the arch) , while t test, Fisher′s exact test and Wilcoxon rank sum test were used to analyze differences in clinicopathological characteristics of plantar melanoma between weight-bearing areas and non-weight-bearing areas of the foot. Results:Among the 129 patients with plantar melanoma, 66 (51.2%) were males and 63 (48.8%) were females, and their age at onset was 60.6 ± 13.1 years. Plantar melanoma mostly occurred on the heel (65 lesions, 1.31 lesions per square centimeter) , followed by the forefoot (31 lesions, 0.41 lesions per square centimeter) , the bottom of the toes (15 lesions, 0.43 lesions per square centimeter) , lateral midfoot (11 lesions, 0.38 lesions per square centimeter) and the arch of foot (7 lesions, 0.16 lesions per square centimeter) . The goodness-of-fit test showed that melanoma was more prone to occur in the weight-bearing areas than in the non-weight-bearing areas ( χ2 = 66.59, P < 0.001) ; compared with the arch of foot, a higher incidence density was observed in the heel and forefoot ( χ2 = 38.29, 5.23, P < 0.001, = 0.022, respectively) . There were no significant differences in the gender ratio, age and occupation of patients, prevalence rates of left/right foot involvement, Breslow thickness, ulceration status, Clark grades, lymph node metastasis rate, and stages between melanomas in the weight-bearing areas and those in non-weight-bearing areas (all P > 0.05) . Conclusion:Plantar melanoma was more prone to occur in the weight-bearing areas than in the non-weight-bearing areas, suggesting that mechanical stress may be related to the occurrence and development of melanoma.
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OBJECTIVES@#Psoriasis is a chronic inflammatory skin disease that affects adults and children. The most common subtype is psoriasis vulgaris. This article analyzes the characteristics and clinical features of children with psoriasis vulgaris to strengthen the understanding, treatment, and management for children with psoriasis.@*METHODS@#A total of 208 children with psoriasis vulgaris, who were first admitted to the Department of Dermatology, Xiangya Hospital, Central South University from October 2012 to December 2018, were retrospectively analyzed. Their clinical characteristics, results of laboratory examination, treatment options and efficacy were summarized.@*RESULTS@#The age of the 208 children with psoriasis vulgaris was (11.19±3.97) years old, the peak incidence was 12 years old, the disease duration was (27.46±31.30) months, and the male-female ratio was 1∶0.96. The most common site of the first attack was the scalp (37.98%), followed by the trunk (26.44%) and the limbs (22.12%). The causes leading to exacerbation were more common in infections and diets. There were 33 patients (15.87%) with a family history of psoriasis, showing the higher score of Psoriasis Area and Severity Index (PASI) and the higher Dermatological Quality of Life Index (DLQI) (both <0.05). In all patients, 29 cases (13.94%) were overweight, 19 cases (9.14%) were obese, and the rate of overweight and obesity in children with psoriasis vulgaris was higher than that of normal children in China. In the laboratory test, the serum levels of 25-hydroxyvitamin D (25-OH-VD) were decreased in most patients (47.5%), and the serum 25-OH-VD levels were found to be moderately negatively correlated with PASI score (<0.05). The score of DLQI in the patient was 5.56±3.57, the score of PASI was 7.25±6.83, and they were positively correlated (=0.409, <0.001). In most patients (72.11%), the severity of the disease was mild to moderate. Their treatment was often dominated by topical drugs and Chinese patent medicine (65.67%). Retinoids showed a good effect on children. Cyclosporine and methotrexate were effective in more severe cases.@*CONCLUSIONS@#Children with psoriasis vulgaris are mainly caused by infection and diet. Patients with family history have more serious illness, lower quality of life, and are more likely to have metabolic abnormalities such as overweight and obesity. The serum 25-OH-VD levels in children with psoriasis vulgaris are negatively correlated with the score of PASI.
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Adolescent , Adult , Child , Female , Humans , Male , China , Epidemiology , Pediatric Obesity , Psoriasis , Epidemiology , Quality of Life , Retrospective Studies , Severity of Illness IndexABSTRACT
Nail diseases have similar clinical manifestations with a variety of causes. Dermoscopy, a non-invasive examination tool, can be used to rapidly and comprehensively evaluate changes of diseased nails at the early stage by observing nail cuticles, nail folds, nail plates, etc. It can be applied for diagnosis and treatment of nail diseases or evaluation of surgical performance. To improve clinicians′ understanding of nail diseases, the authors summarize dermoscopic manifestations of common nail diseases based on dermoscopic manifestations of definitely diagnosed nail diseases in Department of Dermatology, Xiangya Hospital, Central South University from June 2017 to February 2019.
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Objective@#To understand the epidemiological and pathogenic characteristics of hospitalized severe acute respiratory infections (SARI) in Shanghai, China.@*Methods@#From 2015 to 2017, one Tertiary hospital and one Secondary hospital were chosen as the surveillance sites. Two respiratory tract specimens per case were collected from SARI cases aged 15 years and older. One specimen was tested for 22 respiratory pathogens by RT-PCR, and the other specimen was cultured for 6 respiratory bacteria.@*Results@#A total of 287 SARI cases were enrolled for sampling and lab testing. 70.73% of the cases were aged 60 years and older, with 41.46% (119/287) were positive for at least one pathogen. Influenza virus was the predominant pathogen, accounting for 17.77% (51/287) of all SARI cases. Human rhinovirus/Enterovirus and Coronavirus were both accounting for 7.32% (21/287), followed by Mycoplasma pneumoniae (5.57%, 16/287). The positive rates of parainfluenza virus, bocavirus, adenovirus, respiratory syncytial virus and human metapneumo virus were all less than 5%. Bacterial strains were identified in seven SARI cases, including Klebsiella pneumoniae (3 strains), Staphylococcus aureus (2 strains), Streptococcus pneumoniae (1 strain) and Pseudomonas aeruginosa (1 strain). Two or Three pathogens were co-detected from 40 cases, accounting for 33.61% of 119 positive cases. The most common co-detected pathogens were influenza virus and Mycoplasma pneumoniae (10 cases). Influenza cases peaked in winter-spring and summer. Mycoplasma pneumoniae peaked in winter-spring season and overlapped with influenza. The positive rates of pathogens were not significantly different between different age groups.@*Conclusions@#Various respiratory pathogens can be detected from SARI cases aged 15 years and older. Influenza virus was the predominant pathogen and the co-detection of influenza virus with Mycoplasma pneumoniae the most common one.
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Objective To evaluate the clinical efficacy of lymphoplasma exchange (LPE) for the treatment of severe refractory immune-related skin diseases.Methods From May 2013 to October 2015,8 patients with toxic epidermal necrolysis,drug-induced hypersensitivity syndrome (DIHS),pemphigus vulgaris,pemphigoid or paraneoplastic pemphigus were enrolled from Department of Dermatology,Xiangya Hospital,Central South University,who showed no response to conventional therapy or presented with multiple organ dysfunction.After the treatment with LPE,the efficacy was evaluated,and adverse reactions were observed.Results After one session of LPE therapy,6 patients received marked improvement,and were cured at last.In 1 patient with pemphigus vulgaris who was resistant to the treatment with high doses of glucocorticoids and immunosuppressive agents,the rashes regressed during the treatment with LPE,but recurred after the end of treatment.One patient with bullous pemphigoid presented with eruptive blisters on the next day after the treatment with LPE,which were considered as allergic reactions to allogeneic plasma.There were no obvious differences in white blood cell count,lymphocyte count,neutrophil count and blood platelet count in the peripheral blood of 8 patients before and after the treatment with LPE.During the follow-up of 3-5 years,all of the patients were recovered without recurrence,except 1 patient with bullous pemphigoid who died of disseminated tuberculosis after 1 year.Conclusion LPE is effective for the treatment of severe immune-related skin diseases,but attention should be paid to potential transfusion reaction and allergic reactions.
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A 23-year-old male patient developed vesicles on the scrotum 5 years prior to this presentation.Then,vesicles gradually affected the whole scrotum,whick easily ruptured due to friction.Physical examination showed diffuse millet-sized vesicles on the scrotum with milky white fluids,and exudates with chyle-like appearance.Histopathological examination revealed proliferating and dilated lymphatic vessels with different sizes of lumens in the dermis.Immunohistochemical study showed positive staining for D2-40 and CD31.The patient was diagnosed with scrotal lymphangioma,and received photodynamic therapy with aminolevulinic acid.After the treatment,the number of vesicles markedly decreased,and no obvious exudates were observed.During 1 year of follow up,no scars or other complications occurred,and no obvious relapse was found.
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Objective To observe the preventive effect of Hirudoid (MPS) ointment on psoriasislike dermatitis in mice and explore its mechanism.Metbods 21 Balb/C mice were randomly divided into three groups:blank control group,positive control group (imiquimod group) and treatment group (imiquimod + Hirudoid group).The blank control group was treated with imiquimod matrix.The positive control group was treated with 5％ imiquimod cream to induce psoriatic dermatitis in mice's back.The treatment group was treated with 5％ imiquimod cream in the morning and Hirudoid cream in the afternoon.The changes of skin erythema,scales,infiltration severity and skin histopathology in the experimental area of mice back and serum levels of interleukin (IL)-17A and protein expression of tumor necrosis factor-α (TNF-α)in the three groups of mice were observed.Results The clinical and pathological findings of skin lesions in the positive control group showed that 5％ imiquimod cream successfully induced psoriasis-like dermatitis in mice.The appearance and pathological feature of skin lesions in the blank control group were almost close to normal skin.The degree of erythema,infiltration and scales in the back of the treatment group was significantly less than that in the positive control group,and the degree of microscopic inflammation in the treatment group was also lighter than that in the positive control group;The serum levels of IL-17A and TNF-α in the treatment group and the blank control group were significantly lower than that of the positive control group,with statistically significant difference (P ＜ 0.05).Conclusions Hirudoid can significantly reduce imiquimod-induced psoriasis-like dermatitis by inhibiting the expression of IL-17A and TNF-α.
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Objective To evaluate the diagnostic value of Fite staining in leprosy histopathology.Methods Between 2013 and 2017,13 patients diagnosed with leprosy or suspected leprosy (high suspicion of leprosy based on clinical manifestations and hematoxylin-eosin staining,but negative acid-fast staining) in our department,were enrolled into this study.The histopathological sections were subjected to Fite staining,and the results were compared with those of acid-fast staining,so as to assess the value of Fite staining in the diagnosis of leprosy.Results Six patients with positive acid-fast staining still showed positive Fite staining.Among 7 patients with suspected leprosy and negative acid-fast staining,6 patients showed positive Fite staining with varying numbers of Mycobacterium leprae,and 1 showed negative Fite staining.Conclusion Fite staining can increase the detection rate of Mycobacterium leprae.
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This study was aimed to evaluate the applicability of common Chinese word segmentation software used in the literature study of traditional Chinese medicine (TCM) text,in order to put forward ideas on developing specialized TCM text word segmentation software.By means of installing and operating Chinese word segmentation software,the text segmentation experiment was conducted on TCM text samples.Aspects,such Chinese word segmentation accuracy,speed,maneuverability,reliability,extendibility,portability and other characteristics,were compared among different Chinese word segmentation software.The results showed that there were differences on the accuracy,speed,maneuverability,reliability,extendibility,portability among different Chinese word segmentation software.It was difficult to achieve best performance on different aspects by single software.Through the comparison of different Chinese word segmentation software,the Pan-Gu Segment software showed the best performance on accuracy,with good maneuverability,and high word segmentation efficiency,which was the most suitable for word segmentation in TCM text.It was concluded that developing specialized TCM text segmentation software may be the best solution to meet the requirement of text segmentation in TCM literature study.Basic studies should be strengthened from aspects,such as the construction of standard TCM copus,the completion of TCM dictionary base,the introduction,optimization and innovation of word segmentation algorithm,as well as the development of word segmentation software for TCM text.
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Objective To discuss the epidemiological situation of Streptococcus pyogens infection and drug sensitivity results in children in Meilong area in Shanghai,China,and provided scientific pathogen information for clinic infection control and treatment.Methods This was a retrospective study.The group A Streptococcus pyogens strains which were isolated from a total of 1 069 throat swab samples of pediatrics patients between May 2014 and April 2015,the strains were used the method of molecular biology for emm type and MLST and PFGE,part of the strains were used the Kirby-Bauer method for drug sensitivity test.To analyze the infection characteristics,epidemic tendency and drug sensitivity of GAS in different seasons and different age groups.Results A total of 274 S.pyogens strains were detected,the positive rate was 25.63％,the main types of emm were emm1(38.83％)and emm12(52.75％),the others were 8.42％.The main types of MLST were ST-28,ST-36,ST-49.emm types were closely related with MLST and PFGE clust.Among them,emm1/ST28,emm12/ST36,emm75/ST49 were related to each other,the same emm types were mostly the same cluster of PFGE.During this study,the patients were 3-13 years old,and the high infection age were 6-11 years old.The prevalent infection time were May 2014 and June 2014 and between Novemer 2014 to January 2015 and April 2015.The sensitivity rate of beta-lactamase drugs such as penicillin and ampicillin and levofloxacin,vancomycin and linezolid were 100％,the resistance rate of clindamycin and erythromycin and tetracycline were more than 95％.Conclusion The most popular genotype of GAS was emm12,the main age of infected patients were 6-11 years old,and the epidemic season were winter-spring and early summer in Meilong area,Shanghai,China,and beta-lactamase drugs were the first choice for GAS infection.
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Objective:To explore the clinical characteristics of various types of severe drug eruption and common sensitized drugs,and to provide clinical references for reducing the incidence of severe drug eruption.Methods:The clinical data regarding 126 cases of severe drug eruption were analyzed retrospectively from June 2009 to May 2017 in Xiangya Hospital,Central South University.Results:In the 126 cases of severe drug eruption,the distribution of men and women ratio was 1∶1.38.The length of stay was (12.7±9.8) d.The most common type was Steven-Johnson syndrome;the most dangerous type was drug-induced bullosa epidermolysis,The most common sensitized drug category in these patients was antibiotics;the most common single sensitizing drug was carbamazepine,following by allopurinol.Conclusion:Severe drug eruption occurs mostly in young and middle-aged people.Steven-Johnson syndrome is the most common type;drug hypersensitive syndrome has the longest length of hospital course.Mortality rate of drug-induced bullosa epidermolysis is the highest.Timely stop using of allergens,early using glucocorticoids,and timely combination of non-glucocorticoids treatment (such as intravenous immunogloblin,plasma exchange and hemodialysis),can improve the efficacy and reduce the complications and mortality.
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OBJECTIVE@#To explore the characteristics of health seeking behaviors and relevant factors among the outpatients with psoriasis in a general hospital, and to provide scientific evidence to modify the inappropriate health seeking behaviors for psoriasis patients and improve the therapeutic effect. @*METHODS@#Using cross-sectional study design, a dermatological clinic in a general hospital was selected for this study. Two hundred psoriasis outpatients from 1st April to 30th September in 2014 were enrolled. A series of questionnaires were used to collect information regarding the social-demographic characteristics, health seeking behaviors, knowledge on psoriasis, and depressive and anxious symptoms. @*RESULTS@#Among 200 psoriasis outpatients, 141 patients (70.5%) experienced transfer treatment. One hundred and eighty-two patients (91.0%) went to formal hospitals in county for treatment when symptoms were firstly displayed; the other 18 patients (9.0%) went to village or community clinics, or the private clinics. Over 50% patients chose municipal hospital and 35.0% patients went to provincial hospital for medical treatment among the 182 patients. Ninety-one percent of the patients made decision for the first treatment after consulting with their spouses or relatives. According to the definition of the appropriate health seeking behavior in this study, 50 patients (25%) had inappropriate health seeking behaviors. Logistic regression analysis showed inappropriate health seeking behaviors correlated with the family whose income was less than 3 000 yuan per person per month (OR=2.232, 95%CI 1.086 to 4.585), patients who made the decision for the treatment with no discussion with other people when the symptoms appeared (OR=3.016, 95%CI 1.023 to 8.893), and the high score of the International Psoriasis Severity Index (OR=1.043, 95%CI 1.001 to 1.088). @*CONCLUSION@#The dermatological practitioner should pay more attention to the factors, such as social-demographical characteristics, especially the low level of family income and their treatment experience. It is necessary for the general hospital to conduct health education for psoriasis outpatients to promote their appropriate health seeking behaviors.
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Humans , Anxiety , Cross-Sectional Studies , Health Behavior , Hospitals, General , Outpatients , Psoriasis , Surveys and QuestionnairesABSTRACT
[ ABSTRACT] AIM:To investigate the inhibitory effect of Am80 on neointima hyperplasia in carotid arteries after balloon injury and to observe the interaction between Krüppel-like factor 4 (KLF4) and retinoic acid receptorα(RARα). METHODS:Neointima hyperplasia in carotid arteries was observed by hemotoxylin and eosin staining.The expression of KLF4 and cyclin D1 was examined by immunostaining and Western blotting analysis.To detect the interaction between KLF4 and RARαin the vascular tissue, the injured arteries were harvested, and the protein extracts were prepared and subjected to co-immunoprecipitation assay.RESULTS:Compared with injured group, Am80 significantly reduced neointi-mal hyperplasia and the thickness ratio of intima to media.Am80 not only up-regulated KLF4 or RARαexpression in caro-tid arteries, but also increased the interaction between KLF4 and RARαat tissue levels.CONCLUSION:Am80 inhibits neointima hyperplasia in carotid arteries after balloon injury by promoting the interaction between KLF4 and RARα.
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Objective Toinvestigate the molecular characteristics including antibiotic resistance,strain type,serotype,virulence,biofilm formation of Streptococcus pneumoniae isolated from Shanghai adult patients.Methods A total of 37 non-repetitive S.pneumoniae isolates causing community acquired and hospital acquired infections of adults were collected from Shanghai Huashan Hospital from January 2011 to December 2013.The inhibitory zone diameter or minimum inhibitory concentrations (MICs) of 9 antimicrobial agents (penicillin,vancomycin,erythromycin,clindamycin,levofloxacin,cefprozi,ceftriaxone,cefotaxime and linezolid) were determined by Kirby-bauer (K-B) method or Etest method;Serotypes were tested by polymerase chain reaction (PCR) and S.pneumoniae antisera agglutination;Genomic characteristics of different serotype strains were determined by pulsed field gel electrophoresis (PFGE)method;Multilocus sequence types (MLST) was used for strain type;Semi quantitative biofilm formation test was used for the biological membrane formation.Ten main pneumococcal virulence genes (cbpA,pspA,cps2A,lytA,nana,pavA,piaA,ply,psaA and spxB) were detected by PCR and gel electrophoresis.Statistical analysis was performed using Stata software and association statistics were tested using Fisher's exact test.Results The most frequent serotypes were 19F (13.5％),23 F (13.5％),14 (10.8％),19A (10.8％).The penicillin resistance rate was 64.9％.Serotypes 19 F,19A and 23 F were significantly associated with penicillin resistance (x2 =5.89,P =0.015) and the isolates belonged to these serotypes were all multi-drug resistant (MDR).ST81 and ST271 showed high resistance rates to several antibiotics including penicillin (x2 =4.57,P =0.033).Biofilm formation was significantly associated with serotypes 19A (x2 =5.55,P =0.018) and strain type ST320 (x2 =4.33,P =0.037),but not associated with penicillin resistance (x2 =0.16,P =0.686).Virulence gene lytA,pavA,ply,psaA,spxB were found in all isolates.Conclusions Penicillin resistance rate of S.pneumoniae in adult is rising.Specific serotype,epidemic clone and antibiotic resistance are closely related,and can provide the basis for the infection control.The virulence factors such as PspA will be the new targets for vaccine development to reduce S.pneumoniae infection in the future.
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AIM:To discover the effect of MCPH1 on the DNA damage induced by ionizing radiation in esoph-ageal cancer cells.METHODS:ECA109 cancer cells were radiated at dose of 8 Gy.The nuclear foci of relevant factors were detected 1 h after irradiation in the ECA109 cells after silence of MDC1 gene.A cell line was established that was sta-ble low expression of MCPH1.The nuclear foci induced by ionizing radiation after silence of MCPH1 were determined.RE-SULTS:The MCPH1 gene silenced ECA109 cell line was successfully constructed.A strong relationship between MDC1, MCPH1 andγ-H2AX was observed 1 h after 8 Gy irradiation.Silence of MDC1 did not affect the nuclear foci formation ofγ-H2AX and MCPH1.The nuclear foci of MDC1 but notγ-H2AX significantly reduced after silencing of MCPH1.CON-CLUSION:MCPH1 is located in the downstream of H2AX and upstream formation of MDC1, and regulates the nuclear fo-ci formation of MDC1 during DNA damage response.
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Objective To investigate and compare the molecular epidemiological characteristics of Streptococcus pyogenes isolates from Shanghai adult and pediatric patients in terms of antimicrobial susceptibility ,clone type ,emm type ,biofilm formation and virulence for better infection control and treatment .Methods Thirty‐nine nonduplicate clinical isolates of S . pyogenes from adult and pediatric patients were analyzed by determining the susceptibility to antimicrobial agents by Kirby‐Bauer method;clonal typing by multilocus sequence typing ( MLST ); genotyping by emm gene sequence analysis ,which encoding M protein;genomic characteristics of different emm type strains by pulsed field gel electrophoresis (PFGE );and biofilm formation by semi‐quantitative biofilm formation test . Twenty main virulence genes of S .pyogenes ,including 12 superantigen genes and 8 other key genes were detected by PCR and gel electrophoresis . Results A total of 39 nonduplicate S .pyogenes isolates were analyzed .The most common genotype was emm 12‐ST36 (64 .1% ) and emm 1‐ST28 (17 .9% ) .Isolates from adult and pediatric patients had the same dominant genotype , emm 12‐ST36 . The isolates from children showed significantly higher resistance rate to erythromycin and clindamycin than those from adult patients (P<0 .000 1) .Particular emm type and clone type were frequently identified in the same PFGE cluster .Statistical analysis showed that biofilm formation was significantly associated with emm type 1 (P=0 .005) and erythromycin/clindamycin resistance (P=0 .000 3) .The strains from children showed higher biofilm formation than those from adult patients (P<0 .000 1) .We found that virulence genes speA ,speJ and spd3 were significantly associated with emm type 1 (P<0 .000 1 ,P=0 .005 5 ,P<0 .000 1) ,while speI and sic were significantly associated with emm type 12 (both P<0 .000 1) .We also found that the prevalence of speC ,speH ,ssa , smeZ ,and sdaD genes was significantly different between emm type 12 and emm type 1 (P= 0 .023 8 , P< 0 .000 1 , P<0.0001,P= 0.0003,and P= 0.0068,respectively).TheprevalenceofvirulencegenesspeH,smeZandsdaDwas significantly different between the emm type 12 strains from children and those from adults (all P< 0 .000 1) .Conclusions There is a strong agreement between emm type ,clone type ,virulence genes and the clusters defined by PFGE profiling of S . pyogenes .S .pyogenes isolates from adult and pediatric patients are different in terms of antibiotic resistance and biofilm formation .Certain emm type is significantly associated with antibiotic resistance and virulence ,which is useful for infection control .Dominant virulence genes may be the potential target for developing new vaccine to reduce S .pyogenes infection in the future .
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Two patients who developed typical skin eruptions 24 hours after consumption of shiitake mushrooms are reported.Case 1:a 56-year-old woman suddenly developed widespread itching eruptions one day after intake of shiitake mushrooms.On examination,there were erythematous and edematous linear streaks (flagellate erythema) over the neck,trunk and limbs.Case 2:a 60-year-old man presented with edematous flagellate erythema over the trunk and limbs for four days.He reported intake of shiitake mushroom several days prior to the presentation.Pathological examination revealed focal parakeratosis,intracellular and intercellular edema in the prickle cell layer,severe edema of papillary dermis,evident widening of interfibrous spaces,dilation and congestion of capillaries in the superficial dermis with a mixed perivascular infiltrate of massive lymphocytes and sparse neutrophils.Both patients were diagnosed with shiitake dermatitis,and treated with prednisone and antihistamines.The lesions subsided after 3 and 4 days of treatment in patient 1 and 2 respectively.