Genetic factors related to the widespread dissemination of ST11 extensively drug-resistant carbapenemase-producing Klebsiella pneumoniae strains within hospital / 中华医学杂志(英文版)

BACKGROUND@#Carbapenemase-producing Klebsiella pneumoniae (CP-Kp) poses distinct clinical challenges due to extensively drug resistant (XDR) phenotype, and sequence type (ST) 11 is the most dominant blaKPC-2-bearing CP-Kp clone in China. The purpose of this current retrospective study was to explore the genetic factors associated with the success of XDR CP-Kp ST11 strains circulated in the intensive care unit (ICU) of a Chinese tertiary hospital.@*METHODS@#Six ST11 XDR CP-Kp strains were identified between May and December 2014 and validated by minimum inhibitory concentration examination, polymerase chain reaction, and pyrosequencing. The six ST11 XDR CP-Kp, as well as three multi-drug resistant (MDR) and four susceptible strains, were sequenced using single-molecule real-time method. Comprehensively structural and functional analysis based on comparative genomics was performed to identify genomic characteristics of the XDR ST11 CP-Kp strains.@*RESULTS@#We found that ST11 XDR blaKPC-2-bearing CP-Kp strains isolated from inpatients spread in the ICU of the hospital. Functionally, genes associated with information storage and processing of the ST11 XDR CP-Kp strains were more abundant than those of MDR and susceptible strains, especially genes correlative with mobile genetic elements (MGEs) such as transposons and prophages. Structurally, eleven large-scale genetic regions taken for the unique genome in these ST11 XDR CP-Kp strains were identified as MGEs including transposons, integrons, prophages, genomic islands, and integrative and conjugative elements. Three of them were located on plasmids and eight on chromosomes; five of them were with antimicrobial resistance genes and eight with adaptation associated genes. Notably, a new blaKPC-2-bearing ΔΔTn1721-blaKPC-2 transposon, probably transposed and truncated from ΔTn1721-blaKPC-2 by IS903D and ISKpn8, was identified in all six ST11 XDR CP-Kp strains.@*CONCLUSION@#Our findings suggested that together with clonal spread, MGEs identified uniquely in the ST11 XDR CP-Kp strains might contribute to their formidable adaptability, which facilitated their widespread dissemination in hospital.

Therapeutic observation on tuina at head and abdomen for headache due to phlegm turbidity / 针灸推拿医学（英文版）

Objective: To observe the clinical efficacy of tuina at head and abdomen for headache due to phlegm turbidity. Methods:A total of 56 patients with headache due to phlegm turbidity were randomized into a tuina group and a Chinese medicine group by the random number table, with 28 cases in each group. The tuina group was treated mainly with tuina at the head and abdomen, while the Chinese medicine group was treated with oral administration of Ban Xia Bai Zhu Tian Ma Tang(Pinellia, Atractylodes Macrocephala and GastrodiaDecoction). The course of treatment was 30 d. The scores of headache index, traditional Chinese medicine syndrome scale, and the therapeutic efficacy were observed. Results:There were 2 dropouts in each group during treatment. The total effective rate was 92.3％ in the tuina group, significantly higher than 76.9％ in the Chinese medicine group (P<0.05). The scores of headache index and traditional Chinese medicine syndrome scale in both groups decreased after treatment (bothP<0.05), and scores in the tuina group were lower than those in the Chinese medicine group (bothP<0.05). Conclusion:Tuina mainly at head and abdomen is effective in treating headache due to phlegm turbidity, and has a better effect than Ban Xia Bai Zhu Tian Ma Tang (Pinellia, Atractylodes Macrocephala and GastrodiaDecoction).

Effects of silencing Rce1 in vitro on the invasion and migration of tongue carcinoma / 华西口腔医学杂志

OBJECTIVE@#This study aimed to explore the influence of Rce1 on invasion and migration of tongue squamous cell carcinoma cells by silencing the Rce1 gene with RNA interference.@*METHODS@#The tongue squamous cell carcinoma Cal-27 and SCC-4 cells were cultured in vitro. The small interfering RNA (siRNA) of the Rce1 gene was designed, and the Rcel gene expression was silenced vialiposome transfection. According to the siRNA transfected by liposome, the experimental group was divided into three groups, namely, Rce1-siRNA-1, Rce1-siRNA-2, and Rce1-siRNA-3 groups. Negative control group was transfected by siCON, and the blank control group was untransfected by siRNA. The Rce1, RhoA, and K-Ras gene expression levels in each group were analyzed by real-time quantitative polymerase chain reaction. The Rce1, RhoA, K-Ras, MMP-2, and MMP-9 protein expression levels were analyzed by Western blot. The invasiveness of tongue cancer cell Cal-27 and SCC-4 were determined by Transwell invasion assay, and cell migration assay was performed by cell scratch assay.@*RESULTS@#Real-time quantitative polymerase chain reaction and Western blot results showed that compared with the negative and blank control groups, the Rce1 gene and protein expression levels in three experimental groups decreased (P0.05). Meanwhile, the MMP-2 and MMP-9 expression levels decreased (P<0.05). Transwell invasion assay results showed that the total number of cells in the PET film of the experimental groups was significantly decreased compared with the control group (P<0.05). The cell scratch test showed that the cell closure time of the scratch in the interference group was significantly longer than those in the control and blank groups (P<0.05).@*CONCLUSIONS@#Silencing Rce1 in vitro can effectively downregulate its expression in tongue squamous cell carcinoma cells Cal-27 and SCC-4 and reduce the migration and invasion abilities of these cells.

Nutrition in Chinese-Korean Children and Adolescents / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To study the nutrition habits among Chinese-Korean children and adolescents in Yanbian Autonomous Prefecture, Jilin, China.</p><p><b>METHODS</b>Data were obtained from the Chinese National Survey on Students' Constitution and Health in 1995, 2000, 2005, and 2010 for Chinese-Korean children and adolescents aged 7-18 years. The number of the subjects included was 4789, 4704, 5875, and 5315, respectively.</p><p><b>RESULTS</b>The rate of the occurrence of stunting showed a declining trend from 1995 to 2010 (for boys: urban, 6.3%; rural, 12.7% in 1995 and 3.5% for both in 2010. For girls: urban, 7.8%; rural, 13.4% in 1995 and 4.2% and 5.5%, respectively, in 2010). Although the ratio of wasting did not show significant differences between the urban and rural children and adolescents in 1995, 2000, 2005, and 2010 respectively, the ratio of occurrence of overweight or obesity increased (for boys: urban, 7.3% and 1.3% in 1995, 17.6% and 12.9% in 2010; rural, 7.0% and 1.3% in 1995, 14.6% and 12.8% in 2010, respectively. For girls: urban, 8.1% and 1.0% in 1995, 17.3% and 8.6% in 2010; rural 5.7% and 0.7% in 1995, 16.4% and 7.4% in 2010, respectively).</p><p><b>CONCLUSION</b>The ratio of malnutrition in children and adolescents in Chinese-Korean areas declined from 1995 to 2010, and the distinction in malnutrition between the urban and rural areas was negligible in 2010. Further, the ratio of overweight and obesity increased over this period.</p>

Clinical significance of serum myocardial enzymes and CSF LDH detection in adults with intracranial infection / 中国医师杂志

Objective To investigate the changes and clinical significance of serum lactate dehydrogenase (LDH),creatine kinase (CK),glutamate pyruvate transaminase (AST),and cerebrospinal fluid lactate dehydrogenase (CSF LDH) in adult patients with acute central nervous system infection.Methods The levels of myocardial enzymes (AST,LDH,and CK) in serum of 96 adult patients with acute intracranial infection in 7days and 39 healthy people were measured by Beckman automatic biochemical analyzer and enzyme rate assay,and CSF LDH level in 96 patients were measured simultaneously.Results (1) The serum myocardial enzymes (LDH,CK,and AST) of intracranial infection group (47 cases with viral encephalitis,30 cases with tuberculous meningitis,and 19 cases with purulent encephalitis) were significantly higher than those of normal control group (P ＜0.01).(2)The myocardial enzymes (LDH,and AST ) of patients with cerebral functional disorder were significantly higher than those of patients with normal cerebral function (P ＜0.05).(3)The levels of serum AST,LDH,and CK in the virus encephalitis group,serum AST and LDH in the purulent encephalitis group,and serum LDH in the tuberculous meningitis group were significantly higher than those in the control group (P ＜ 0.01).The CSF LDH level in the viral meningitis group was prominently lower than that in the tuberculous encephalitis group and purulent encephalitis group,respectively (P ＜0.01).(4) No correlations were found between CSF LDH and serum myocardial enzymes (P ＞0.05).Conclusions (1)There is significant change in the levels of serum LDH,CK,AST,and CSF LDH of adult patients with acute intracranial infection,especially in infected patients with cerebral functional disorder,and the change of LDH is the most obvious.(2)The levels of serum myocardial enzymes and CSF LDH are helpful to the differential diagnosis of intracranial infection in early stage,and judging the severity of the illness.

Serum levels of matrix metalloproteinase 9 and 19 in the patients with pneumoconiosis / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To measure peripheral serum levels of matrix metalloproteinase 9 (MMP9) and matrix metalloproteinase 19 (MMP19) in patients with pneumoconiosis, and to investigate their feasibility as potential biomarkers for pneumoconiosis.</p><p><b>METHODS</b>Ninety-eight male patients with pneumoconiosis (49 patients in phase I, 36 patients in phase II, and 13 patients in phase III) were enrolled as subjects, which included 41 patients with silicosis and 57 patients with coal workers' pneumoconiosis. Ninety-eight healthy male physical examinees were used as controls. A fasting blood sample (3 ml) was collected from the peripheral venous blood of each patient or control, and the serum was separated from the blood sample. The expression levels of MMP9 and MMP19 in serum were measured by enzyme-linked immunosorbent assay.</p><p><b>RESULTS</b>Serum levels of MMP9 and MMP19 in patients with silicosis or coal workers' pneumoconiosis were significantly lower than those in the control group (P < 0.05). Serum levels of MMP19 in patients with silicosis were significantly higher than those in patients with coal workers' pneumoconiosis (P < 0.05). Serum levels of MMP19 in patients exposed to dust for less than 7 years were significantly higher than those in patients exposed to dust for more than 20 years (P < 0.05). There were no significant differences in serum levels of MMP9 and MMP19 between patients with different levels of pulmonary function impairment (P > 0.05). Serum expression levels of MMP9 and MMP19 were positively correlated with each other in both patients with pneumoconiosis and those in the control group (P < 0.05). The serum expression level of MMP9 was negatively correlated with the stage of pneumoconiosis (P < 0.05).</p><p><b>CONCLUSION</b>Serum MMP9 and MMP19 may be used as potential biomarkers for pneumoconiosis.</p>

Performance evaluation of the Beckman Coulter ACT-5DIFF AL automated hematology analyzer / 中国医师杂志

Objective To evaluate the performance of the Beckman Coulter ACT-5DIFF AL automated hematology analyzer and to verify whether it meets the clinical requirement.Methods The residual contamination rate,accuracy,precision,uncertainty,measurement range,reference interval,and sample injection pattern of detecting system were evaluated.Results The residual contamination of each parameter was less than or equal to 0.18％.According to room between qualitative evaluation results,compared to the target value,bias ranged from 0.32％ to 2.29％.Different concentrations of laboratory variation coefficient (namely precision) of each parameter ranged from 0.35％ to 4.46％,and both of which were less than a third of the CLIA'88 ability verification analysis quality requirements.The expanded uncertainty of each parameter was Uwhite blood cell (WBC) low =7.4％,UWBC high =3.8％,Ured blood cell (RBC) low =3.4 ％,U RBC high =2.8 ％,Uhemoglobin (HGB) low =3.9 ％,UHGB high =2.2 ％,Uplatelet (PLT) low =9.8 ％,UPLT high =7.6％,UMCV low =2.6％,and UMCV high =2.5％.Analysis had a wide measuring range:WBC (0.2 ～ 137.3) × 109/L,RBC(0.72 ～ 7.66) × 1012/L,HGB (20 ～ 231)g/L,PLT(25 ～983) × 109/L,and hematocrit (HCT) (6.1 ～68.0)％.All of them had a linear relationship,and the correlation coefficient of linear regression was close to 1.0.The reference interval quoted was suitable.Both of the automatic and the hand sample injection pattern had no significantly difference in result detection.Five categories of WBC were verified up to standard.Conclusions Under the circumstance of indoor quality control approved,each performance indicator approximately reached the laboratory quality requirements,and it also met the clinical requirements.

Beneficial effects of reciprocating gait orthosis on bladder and bowel functions in paraplegia patients / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the beneficial effects of application of a self-designed reciprocating gait orthosis (RGO) combined with comprehensive rehabilitation training on bladder and bowel function in paraplegic patients sustaining spinal cord injuries (SCI).</p><p><b>METHODS</b>Twelve paraplegic patients with complete spinal cord injury at the levels between T(4) and L(1) received the RGO with a comprehensive rehabilitation exercise program carried out before and after fixing. Cold water and colon excretion tests were performed before and 3 months after application of the RGO, and the bladder volume, residue bladder volume, and bladder and bowel pressures were measured in these patients.</p><p><b>RESULTS</b>The 12 paraplegic patients all showed positive results in cold water test before and after RGO application. Before RGO application, 11 of these patients were positive for urine bacteria and only 1 patient was still positive 3 months after the application. The bladder volume and bowel pressure of the patients were significantly increased (P<0.05), while the residue volume and pressure of the bladder were significantly reduced 3 months after RGO application (P<0.05).</p><p><b>CONCLUSION</b>RGO combined with comprehensive rehabilitation training can effectively improve the bladder and bowel function and the quality of life of patients with complete spinal cord injury, suggesting much clinical value for its extensive application.</p>