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Forkhead box A1 (FOXA1) is expressed in various organs,including breast,liver,pancreas,bladder,prostate,colon,ovary,lung and esophagus.The FOXA1 expression is associated with the growth and carcinogenesis of these organs.It is recently demonstrated FOXA1 plays a significant role in different biological processes including cell proliferation,differentiation,devolopment,carcinogenesis and the process of epithelial-mesenchymal transition (EMT) etc.Its expression is positively correlated with ER and PR expression,and it is demonstrate to be one of the most important favorate prognostic factors of breast cancer.
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<p><b>OBJECTIVE</b>To explore the distribution and antibiotic resistance of pathogens in lesions of diabetic foot osteomyelitis (DFO) and analyze the risk factors causing osteomyelitis.</p><p><b>METHODS</b>A total of 372 patients with diabetic foot infections hospitalized between January 2011 and December 2014, including 203 with osteomyelitis (OM group) and 169 without osteomyelitis (non-OM group), were examined for the distribution and antibiotic resistance profile of the pathogens in the wounds. Logistic regression analysis was used to analyze the risk factors causing osteomyelitis.</p><p><b>RESULTS</b>Gram-negative bacteria were the predominant pathogens (53.7%) in the infected wounds in OM group, whereas Gram-positive bacteria were the most frequently found (56.7%) in non-OM group (P=0.001). Among the Gram-positive bacteria, Staphylococcus was the dominating flora (35.1%). The resistance rate to oxacillin and cefoxitin of the isolated bacteria in OM group (64.9% and 68.5%, respectively) was significantly higher than that in non-OM group (29.2% and 32.6%, respectively; P<0.05). Among the gram-negative bacteria, Enterobacteriaceae was the dominating flora (62.4%), with a higher resistance rate to Cefepime and Aztreonam in OM group (30.1% and 38.6%, respectively) than in non-OM group (15.1% and 22.2%, respectively; P<0.05). Logistic regression analysis indicated that the infection by multi-drug resistant bacteria and an wounds area >4 cm(2) were the risk factors for osteomyelitis in patients with diabetic foot infections (P<0.05).</p><p><b>CONCLUSION</b>In addition to an empirical anti-infection therapy, clinicians should choose specific antibiotics against Gram-negative bacteria according to the microbial spectrum and antibiotic resistance of pathogens in patients with DFO; patients with diabetic foot infections by multi-drug resistant bacteria and those with a wound area exceeding 4 cm(2) are exposed to an increased risk of osteomyelitis.</p>
Subject(s)
Humans , Anti-Bacterial Agents , Cephalosporins , Diabetic Foot , Microbiology , Drug Resistance, Multiple, Bacterial , Gram-Negative Bacteria , Classification , Gram-Positive Bacteria , Classification , Osteomyelitis , Microbiology , Risk Factors , Wound Infection , MicrobiologyABSTRACT
Objective To evaluate the oxacillin disk screening test for screening Streptococcus pneumoniae by the penicillin Etest method.Methods 96 clinically isolated non-meningitis strains of Streptococcus pneumoniae were collected.The sensitivity and spe-cificity of the oxacillin disc screening test was evaluated by the penicillin Etest method as a standard method for detecting the peni-cillin susceptibility.Results Among 96 non-meningitis strains of Streptococcus pneumoniae,the penicillin-susceptible Streptococcus pneumoniae(PSSP)strains detected by the penicillin Etest method accounted for 96.9%(93/96),the penicillin intermediate Strep-tococcus pneumoniae(PISP)strains accounted for 3.1%(3/96)and no penicillin resistant Streptococcus pneumoniae(PRSP)strain was found.But 16 PSSP strains were detected by the oxacillin disc screening test with the sensitivity of 17.2% and the specificity of 100.0%,respectively.The difference between the oxacillin disc screening test and the penicillin Etest method was statistically sig-nificant(χ2 =77,P <0.01 ).Conclusion The oxacillin disc screening test has the low sensitivity for preliminarily screening non-meningitis strains of Streptococcus pneumoniae.Most of Streptococcus pneumoniae must be detected by the minimum inhibitory concentration(MIC)methods such as the penicillin Etest method.
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<p><b>OBJECTIVE</b>To assess the predictive value of Neuropad test on occurrence of diabetic foot ulceration (DFU) among type 2 diabetic patients.</p><p><b>METHODS</b>We divided 725 cases of type 2 diabetic patients into the high-risk and the non-high-risk groups of DFU based on the results of vibration perception thresholds(VPT) examination, which was widely used as a criteria for predicting DFU. Receiver operating characteristic (ROC) analysis was used to compare the effectiveness of Neuropad with 10 g Semmes-Weinstein monofilament (10 g SWMF) testing in predicting the risk of DFU.</p><p><b>RESULTS</b>Among 725 patients of type 2 diabetes, 6.1% were at a high risk of DFU. Compared to non-high-risk group, patients in high-risk group had older age, longer diabetes duration, higher values of complete colour change time (CCC time) of Neuropad and higher abnormal rate of 10 g SWMF (P<0.01). CCC time of Neuropad was shown to be better in predicting the risk of DFU than 10 g SWMF, and the area under the ROC curve was about 0.8, and the best cut-off value was 22.25 min.</p><p><b>CONCLUSION</b>Neuropad is an effective means for predicting of the risk of DFU, and can be used to prevent diabetic foot ulceration.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Diabetic Foot , Diagnosis , Neurologic Examination , Methods , Predictive Value of Tests , Risk AssessmentABSTRACT
OBJECTIVE To strengthen the management of earthquake victims with nosocomial infection,in order to prevent and control the multidrug-resistance transmission,and the nosocomial infection outbreak. METHODS All 77 earthquake victims were under real-time monitoring. RESULTS Of 77 cases,53 were infected (69.74%). From 83 samples,83 pathogenic bacteria were isolated. The Gram-positive cocci were 19 (meticillin-resistant Staphylococcus aureus 3,Meticillin-resistant S. epidermidis 7),58 were Gram-negative bacilli (Acinetobacter baumannii 21,multi-drug resistant strains 10,ESBLs positive Escherichia coli 10,Pseudomonas aeruginosa 9) and the fungi were 6 strains,The resistance rates of Gram-positive cocci to penicillin,ampicillin/sulbactam and cefazolin were 89.47%,68.42% and 89.47%; the resistance rates of Gram-negative bacillis to imipenem,cefoperazone/sulbactam,piperacillin/tazobactam,azithromycin,tobramycin,and cefoxitin were 37.93%,60.34%,48.83%,98.28%,98.28% and 70.69%,respectively. CONCLUSIONS Under the situation of higher infection rate and a serious drug resistance in earthquake area,there are no multidrug-resistance transmissionm and the spread of nosocomiol infection outbreak happened in hospital due to strictly enforced prevention meassures and access real-time monitoring and management,
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Objective We aimed to describe the application value of continuous glucose monitoring system in patients with advanced gestational diabetes mellitus (GDM). Methods Pregant women in the medium and late pregant phases (24～35 weeks) underwent GDM screen test from January 2006 to April 2007. They first received 50 g glucose challenge test and 100g OGTT was performed 3 days later when the blood glucose was higher than or equal to 7.8mmol/L. According to the diagnostic criteria from American Diabetes Mellitus (ADA) 47 women were diagnosed to possess GDM and they were further divided into the test group (25 cases) and the control group (22 cases). The test group received 72 hours continuous glucose monitoring (CGMS). The control group adopted peripheral blood glucose monitoring using blood from the fingertip, 7 times per day. Results There were no records of consciousness hypoglycemic symptoms and hypoglycemia during monitoring. The CGMS data suggested that the record of the percent of high blood glucose was (17.5±3.1)%, percent of low blood glucose was (2.4±0.9)%, which were higher than those of the control group, which were (14.3±2.2)% and 0. Conclusions We recommend pregant women with GDM to undergo CGMS while using peripheral blood glucose monitoring with blood from the fingertip. It could systemicly evaluate the real control condition of blood glucose and ensure the safety of both mothers and babies.
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OBJECTIVE To study penicillin resistance in Staphylococcus aureus and the activity of ?-lactamase.METHODS The strains of S.aureus both sensitive and resistant to penicillin were inoculated into the media with penicillin and then incubated in 37 ℃.The number of the bacteria and the activities of ?-lactamase,were determined respectively at varying times.RESULTS In the media with 64 ?g/ml penicillin,the number of the sensitive strain decreased gradually in 24 h of culturing.The number of the resistant strains decreased at first 6 h and then the number increased in subsequent 24 h.The activity of penicillin did not be changed in the media with the sensitive strain.The activitiy of penicillin was decreased obviously with the resistant stains.In the media without penicillin,the ?-lactamase activities of the resistant stains were stable until 24 h of culturing,while the ?-lactamase activities were increased gradually in the media with penicillin.CONCLUSIONS The growth of early stage of S.aureus can be inhibited obviously by penicillin.?-Lactamase would be induced largely in resistant S.aureus.
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0.05).Compared to cultivation whose positive rate was 33.33%,the rates were obvious higher(P