Clinical factors associated with composition of lung microbiota and important taxa predicting clinical prognosis in patients with severe community-acquired pneumonia / 医学前沿

Few studies have described the key features and prognostic roles of lung microbiota in patients with severe community-acquired pneumonia (SCAP). We prospectively enrolled consecutive SCAP patients admitted to ICU. Bronchoscopy was performed at bedside within 48 h of ICU admission, and 16S rRNA gene sequencing was applied to the collected bronchoalveolar lavage fluid. The primary outcome was clinical improvements defined as a decrease of 2 categories and above on a 7-category ordinal scale within 14 days following bronchoscopy. Sixty-seven patients were included. Multivariable permutational multivariate analysis of variance found that positive bacteria lab test results had the strongest independent association with lung microbiota (R2 = 0.033; P = 0.018), followed by acute kidney injury (AKI; R2 = 0.032; P = 0.011) and plasma MIP-1β level (R2 = 0.027; P = 0.044). Random forest identified that the families Prevotellaceae, Moraxellaceae, and Staphylococcaceae were the biomarkers related to the positive bacteria lab test results. Multivariable Cox regression showed that the increase in α-diversity and the abundance of the families Prevotellaceae and Actinomycetaceae were associated with clinical improvements. The positive bacteria lab test results, AKI, and plasma MIP-1β level were associated with patients' lung microbiota composition on ICU admission. The families Prevotellaceae and Actinomycetaceae on admission predicted clinical improvements.

An analysis of work-related musculoskeletal disorders and ergonomic loads in male welders in shipbuilding industry / 中华劳动卫生职业病杂志

Objective@#To investigate the prevalence of work-related musculoskeletal disorders (WMSDs) in male welders in different work areas of shipbuilding industry based on their operational working position and body position characteristics and to analyze the operational positions and ergonomic loads.@*Methods@#In February 2017, 412 male welders from the hull and block work areas of a large ship factory were selected by stratified sampling. The prevalence and effects of WMSDs within a year were investigated using the Nordic Musculoskeletal Disorders Questionnaire, and a rapid exposure checklist was used to obtain the ergonomic load index by comprehensive scoring; the exposure-response relationship between the ergonomic loads and WMSDs symptoms of subjects in the hull and block work areas was evaluated.@*Results@#Among the male welders working in the hull work area of shipbuilding industry, WMSDs occurred more commonly in the neck, lower back/waist, and legs, accounting for 53.16% (126/237) , 51.90% (123/237) , and 41.77% (99/237) , respectively; among those working in the block work area, WMSDs occurred more commonly in the lower back/waist, wrist, and legs, accounting for 52.57% (92/175) , 49.14% (86/175) , and 45.14% (79/175) , respectively. There were significant differences in the distribution of cases of pain within the last 7 days and one month, pain lasting more than one month, or absence from work due to pain within a year in the four positions between the two work areas (P<0.05). In the hull work area, high and extremely high exposure levels were mainly seen in the neck, lower back/waist, and legs, accounting for 76.79%(182/237), 69.20%(164/237), and 59.49%(141/237), respectively; in the block work area, high and extremely high exposure levels were mainly seen in the lower back/waist, wrist, and legs, accounting for 77.71%(136/175), 50.29% (88/175), and 46.29% (81/175), respectively. The detection rates of WMSDs in these four positions significantly increased as the exposure levels rose (P<0.01).@*Conclusion@#The WMSDs of male welders working in the hull and block work areas of shipbuilding industry occurs more commonly in the lower back/waist and legs. The risk of WMSDs symptoms increases with the rise of ergonomic load.

Differential expression analysis of circRNA in peripheral blood of tuberculosis patients in Xinjiang / 临床检验杂志

Objective@#To find the differential expression profiles of circRNA in whole blood and predict its target genes in blood of patients with tuberculosis in Xinjiang, and explore the relationship between circRNA and the development of tuberculosis. @*Methods@#The circRNAs expression in peripheral blood from 3 pulmonary tuberculosis patients and 3 healthy individuals were tested by using circRNA microarray assay. The whole blood from 43 patients with tuberculosis, 40 healthy individuals and 43 patients with pneumonia were collected to verify the results by real-time quantitative PCR system. The possibility of differentially expressed circRNA target genes were predicted by circRNA target gene prediction database. @*Results@#In the results of microarray assay 835 circRNAs were found to be expressed differentially in whole blood between the tuberculosis patients and healthy controls of Xinjiang area, of which 249 circRNAs were up-regulated and 586 circRNAs were down-regulated in the patients. The expressions of four significantly different circRNA were verified by real time quantitative PCR and the results showed that hsa_circ_0008276, hsa_circ_0003452, hsa_circ_0001846 and hsa_circ_0090508 were down-regulated (P＜0.05), and hsa_circ_0090508 was the more specific than the other three circRNAs. The results of circRNA target genes prediction suggested that has-miR-1294, has-miR-604, has-miR-616, has-miR-663b and has-miR-486-3p may be the potential target genes of hsa_circ_0090508. @*Conclusion@#The differentially expressed circRNA hsa_circ_0090508 was significantly downregulated in the patients with tuberculosis and may affect the regulation mechanism of tuberculosis through target genes.

Analysis of pathogen spectrum and antimicrobial resistance of clinical common organisms from twelve teaching hospitals in 2016 / 中华检验医学杂志

Objective To investigate the spectrum and antimicrobial resistance of major pathogens causing nosocomial infections in China, 2016. Methods Non-duplicated nosocomial cases as well as pathogens causing bloodstream infections ( BSI) , hospital-acquired pneumonia ( HAP) and intra-abdominal infections ( IAI ) from 12 teaching hospitals across China were collected. The minimum inhibitory concentrations (MICs) of important clinical common strains were determined by agar dilution method or broth microdilution method. The CLSI M100-S27 criteria was used for interpretation. Data were analyzed by using WHONET-5. 6 software. Results A total of 2060 cases were collected, including 894 cases from BSI, 630 cases from HAP and 536 cases from IAI. The MICs of 1896 important clinical common strains were determined. Escherichia coli and Klebsiella pneumoniae were the most prevalent pathogens causing BSI and IAI, while Acinetobacter baumanii and Pseudomonas aeruginosa were dominated in HAP. All Staphylococcus aureus were susceptible to tigecycline, linezolid, daptomycin and glycopeptides. Methicillin-resistant S. aureus accounted for 44. 4％ ( 75/169 ) of all the S. aureus. The rate of methicillin-resistant coagulase-negative staphylococci was 80. 9％ ( 72/89 ) . No Enterococcus strains were found resistant to tigecycline, linezolid or daptomycin. Vacomycin resistant enterococcus was found in Enterococcus faecium, accounting for 1. 8％ ( 2/111 ) of all E. faecium strains. Tigecycline, meropenem, amikacin, imipenem, and polymyxin B exhibited high potency against Enterobacteriaceae and the susceptibility rates were 96. 6％(865/895), 94. 3％ (859/911), 94. 2％ (858/911), 94. 1％ (857/911), and 91. 6％ (820/895), respectively. The prevalence of extended-spectrum β-lactamase was 58. 4％ ( 263/450 ) in E. coli and 28. 6％ ( 84/294 ) in K. pneumonia. The rate of carbapenem resistant K. pneumonia and E. coli was 15. 3％ ( 45/294 ) and 1. 8％ ( 8/450 ) , respectively. The percentage of polymyxin B resistant K. pneumonia and E. coli was 4. 1％ ( 12/294 ) and 4. 4％ ( 20/450 ) , respectively. The rate of tigecycline resistant K. pneumonia and E. coli was 2. 4％ ( 7/294 ) and 0. 2％ ( 1/450 ) , respectively. A. baumanii showed low susceptibility to the antimicrobial agents except tigecycline ( 91. 4％, 235/257 ) and polymyxin B (100％, 257/257). The rate of carbapenem resistant A. baumanii was 80. 5％ (207/257). The rate of carbapenem resistant P. aeruginosa was 31. 7％ ( 59/186 ) . Polymyxin B and amikacin demonstrated high antibacterial activity against P. aeruginosa with susceptility rate of 100％ ( 186/186 ) and 90. 9％ ( 169/186), respectively. Conclusions Nosocomial pathogens showed high susceptibilities against tigecycline and polymyxin B. Antimicrobial resistance in A. baumannii is a serious problem. The prevalence of carbapenem-resistant Enterobacteriaceae and polymyxin B resistant Enterobacteriaceae has increased, which should be monitored continuously in China.

Current prevalence and prevention of work-related musculoskeletal disorders among physicians for internal medical examination in tertiary hospitals in a city of China / 中华劳动卫生职业病杂志

Objective@#To investigate the current prevalence and prevention of work-related musculoskeletal disorders (WMSDs) among physicians for internal medical examination, and to provide a theoretical basis for the prevention and treatment of WMSDs in physicians for internal medical examination.@*Methods@#In February 2017, 326 physicians for internal medical examination were randomly selected from 5 general tertiary hospitals and 2 specialized tertiary hospitals in a city of China. A questionnaire was designed according to the Nordic Musculoskeletal Questionnaire and the occupational features of doctors in China to investigate the prevalence of musculoskeletal pain over the past year, the cognitive attitude to WMSDs, the knowledge of WMSDs prevention, and ways to get the knowledge of WMSDs prevention.@*Results@#In the tertiary hospitals of this city, the symptoms of WMSDs were mainly seen in the wrist (75.78%) , neck (67.19%) , and lower back (58.59%) among male physicians, and in the wrist (73.74%) , lower back (70.95%) , and upper back (60.89%) among female physicians. Compared with the female physicians, the male physicians had a significantly increased detection rate of symptoms of WMSDs in the neck (P<0.05) and significantly reduced detection rates of symptoms of WMSDs in the upper and lower back (P<0.05). There were significant differences between the detection rates of symptoms of WMSDs in the neck, wrist, and lower back within the past 12 months, 7 days, and >1 month (P<0.01). The rates of knowledge of the severity and prevention of WMSDs were significantly different between the physicians with different working years and professional titles (P<0.01) .@*Conclusion@#Among the physicians for internal medical examination in the tertiary hospitals of this city, WMSDs are mostly seen in the wrist, neck, and waist, and the knowledge of WMSDs prevention varies with different working years and professional titles.

Clinical and molecular characteristics of bloodstream infection caused by K. pneumonia / 中华检验医学杂志

Objective To investigate the clinical features and molecular characteristics of bacteremia caused by K. pneumoniae and study on the differences between classical and hypervirulent K. pneumonia( hvKP) . Methods The clinical features of 70 cases of K. pneumoniae bacteremia collected from Beijing Chaoyang Hospital from 2008 to 2012 were retrospectively analyzed. The patients were identified according to the records from the Clinical Microbiology Department. Patients′ data were obtained from medical records. The molecular characteristics of the K. pneumoniae strains were also studied using PCR, multilocus sequence typing and pulsed field gel electrophoresis( PFGE) methods. Data were analyzed using the statistical package SPSS for windows version 17. 0. For categorical data, different groups were compared using the Chi-square test to analyze the quantitative variables. P≤0. 05 was considered to be statistically significant. All susceptibility data were analyzed using Whonet, version 5. 6. Results The hvKP was identified from 31. 4% of the patients with K. pneumoniae bacteremia, which displayed 4 serotypes ( K1, K2, K20, and K57). About 40. 9% (9/22) hypervirulent strains were isolated from patients without underlying diseases, while 95. 8% (46/48) of the classic K. pneumoniae infections were found in patients with the presence of one or more underlying diseases. More hvKP positive patients (95. 5%, 21/22) had community-acquired infections compared with classical K. pneumonia (cKP) infected patients (35. 4%, 17/48). There was a significant difference between these two groups (χ2 =21. 912,P emerging hvKP was prevalent in patients with severe community-acquired infections in healthy individuals. Two ESBLs-producing hvKP strains were identified. Drug resistance had a rising trend, which called for more attention in clinical settings.

Comparison of the effects of Ginkgo biloba extract and minocycline hydrochlovide on periodontitis / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To compare the clinical effect of Ginkgo biloba extract gel (Ginkgo biloba extract,EGB) and minocycline hydrochloride (Periocline) on periodontitis and their inhibition on putative periodontal pathogens.</p><p><b>METHODS</b>Thirty patients with moderate-to-severe periodontitis were selected. The patients were divided into an experimental group and a positive control group (minocycline hydrochloride). Supragingival and subgingival scaling were performed on all patients. Subgingival plaque samples were collected before treatment, 1 week, 2 months and 4 months after treatment. The four major periodontal pathogens Porphyromonas gingivalis (Pg), Bacteroides forsythus (Bf), Prevotella intermedia (Pi), Treponema denticola (Td) were detected by polymerase chain reaction. Clinical indexes plaque index (PLI), bleeding index (BI) and probing depth (PD), attachment loss (AL) were examined before treatment, 3 months and 6 months after treatment. The results were statistically analyzed.</p><p><b>RESULTS</b>The detection rates of the 4 periodontal pathogens were Td (83.3%), Tf (95.0%), Pi (80.0%), Pg (81.7% ) in experimental group and Td (83.3%), Tf (95.0%), Pi (80.0%), Pg (81.7%) in control group before treatment. The detection rates in experimental group were not significantly different with those in control group after treatment, except for the detection rate of Pg 1 week after treatment (P < 0.01, the detection of Pg was 56.7% in experimental group and 53.3% in control group 1 week after treatment). The PLI and BI were not significantly different between experimental group and control group after treatment (P > 0.05). The difference was statistically significant at 6 months after treatment [(3.5 ± 0.5) mm for experimental group and (3.2 ± 0.4) mm for control group, P = 0.00]. The mean of AL decreased with time. The difference was statistically significant at 6 months after treatment [ (4.5 ± 0.4) mm for experimental group and (4.3 ± 0.4) mm for control group at 6 months, P = 0.01].</p><p><b>CONCLUSIONS</b>The inhibition effects of EGB and minocycline hydrochloride were comparable for major periodontal pathogens within short term.</p>

The genotype and epidemiological feature of the Enterobacteriaceae carrying carbapenemase in China / 中华内科杂志

Objective To analyze the genotype and molecular epidemiology of carbapenem-resistant Enterobacteriaceae.Method A total of 201 carbapenem-resistant Enterobacteriaceae were isolated from 14hospitals in 11 cities.The MICs of 14 antimicrobial drugs were detected using agar dilution method.Phenotypes of carbapenemases were screened using modified Hodge test and ethylene diamine tetraacetic acid (EDTA) test.Drug resistance genes were screened using PCR method.The strains carrying carbapenem resistance genes were confirmed by conjugation test.Homology analysis was carried out using pulsed-field gel electro-phoresis (PFGE) method and the epidemiological correlation is analyzed based on the Multilocus Sequence Typing (MLST) method in order to study the molecular epidemiology of carbapenem-resistant Enterobacteriaceae.Results Fifty-three strains among 201 carbapenem-insensitive Enterobacteriaceae were detected positive carbapenem-resistant genes,among which included 33 Klebsiella pneumoniae,9 Citrobacter freundii,6 Escherichia coli and 5 Enterobacter cloacae.Among the 53 strains,43 were from Beijing,6 strains from Hangzhou,3 strains from Nanjing and one from Fuzhou.Resistance genes-harboring plasmids were successfully transferred from 28 of 53 strains to Escherichia coli EC600.The PFGE spectmm showed that 33 Klebsiella pneumoniae were classified into three types,9 Citrobacterfreundii classified into four types,5 Enterobacter cloacae classified into four types,while 6 Escherichia coli were the same type.Based on the results of MLST test,29 Klebsiella pneumoniae strains producing KPC-2 type carbapenemase were all ST11,while among the four Klebsiella pneumonia carrying IMP-4 carbapenem resistant gene,three strains were ST876,one was ST147.Conclusions Carbapenem-resistant genes were detected only in hospitals from Beijing,Hangzhou,Nanjing and Fuzhou,and type KPC-2 was the most common,followed by IMP-4 and IMP-8.High homology of resistant strains could be related to horizontal transfer of carbapenemase genes,which should cause great concern.

In vitro susceptibility of commonly used antibiotics on community-acquired uncomplicated urinary tract infection pathogens in Beijing / 中华泌尿外科杂志

Objective To investigate the distribution and susceptibility patterns of common uropathogens causing community-acquired urinary tract infection (UTI) in Beijing.MethodsA total of 300non-duplicate isolates were randomly collected from 3 hospitals in Beijing between Jan,1 2010 and Mar,312011.Minimal inhibitory concentrations (MICs) were determined by the broth microdilution methods,which were performed and interpreted according to the guidelines established by the Clinical and Laboratory Standards Institute (CLSI).A panel of 8 antimicrobial agents were tested:amikacin,cefaclor,cefepime,cefoperazone/sulbactam,ciprofloxacin,levofloxacin,gentamicin and nitrofurantoin. Fosfomycin trometamol MICs were determined by the agar-dilution method in cation-adjusted MH agar supplemented with glucose 6-phosphate at a concentration of 25 mg/L as detailed in the guidelines issued by 2010 CLSI. All the Escherichia coli,Klebsiella pneumoniae and Proteus mirabilis strains were screened and confirmed by double-disk synergy test for extended-spectrum β-lactamase (ESBLs).Results Among the organisms cultured,E.coli wasthepredominantpathogen(65.0％ ), followedby Enterococcus(11.7％ ),Staphylococcus( 6.3％ ), Klebsiella pneumoniae( 5. 3％ ), Proteus mirabilis( 4. 7％ ), and Pseudomonas aeruginosa (3.0％).Lower susceptibility rates to ciprofloxacin and levofloxacin (31.4％ -47.4％ ) were observed among all the stains.Amikacin,cefoperazone/sulbactam,nitrofurantoin and fosfomycin trometamol were the most active drugs (92.1％,92.1％,88.4％ and 87.9％ susceptible strains,respectively) among the Gram-negative strains.Isolates of Staphylococcus were highly sensitive to amikacin ( 100.0％ ),cefoperazone/sulbactam (94.7％),nitrofurantoin ( 100.0％ ).Higher susceptibility rates to nitrofurantoin (91.4％) and fosfomycin trometamol (90.0％) were observed in Enterococcus.ESBLs-producing strains accounted for 52.3％ (102/195) in E.coli,43.8％ (7/16) in K.pneumoniae and 14.3％(2/14) in P.mirabilis,respectively.ConclusionsResistance is most common to ciprofloxacin and levofloxacin of all the stains.Currently,the most appropriate agents for the empirical management of uncomplicated UTI seems to be amikacin,cefoperazone/sulbactam,nitrofurantoin and fosfomycin trometamol.

The impact of imipenem-resistant Acinetobacter baumannii infection on clinical outcomes and medical care costs / 中华传染病杂志

ObjectiveTo investigate the impact of antimicrobial resistance on clinical outcomes and medical care costs among patients with imipenem-resistant Acinetobacter baumannii (IRAB) nosocomial infection.MethodsA retrospective matched case-control study was performed to compare the differences of clinical outcomes and medical care costs between patients with IRAB infection and patients with imipenem-susceptive Acinetobacter baumannii (ISAB) infection in a tertiary care university teaching hospital in China from January 2007 to June 2009.Cases were matched to controls with ratio of 1:1 on the basis of age,sex,severity of underlying diseases,source of infection,duration of hospitalization period and length of hospital stay before onset of infection.The measurement data between groups were compared by t test and rank test.The numeration data between groups were compared by x2 test. Multiple analysis was performed by Logistic regression.ResultsThe total mortality rate of IRAB infection patients was significantly higher than that of ISAB infection patients (39.1％ vs 20.3 ％ ; x2 =11.728,P＜0.01).Among 138 pairs of patients in IRAB group and ISAB group,there were 72 matched case-control pairs survived,which were significantly different in length of total hospital stay (28.5 days vs 23.0 days; x2 =2.886,P＜0.01) and intensive care unit (ICU) stay (14.5 days vs 0 day; x2 =4.844,P＜0.01).For all the 138 case-control pairs,everyday total hospitalization cost and everyday antibiotic therapy cost in IRAB cases were both higher than ISAB controls (RMB 3652 yuan vs RMB 2092 yuan; Z=3.792,P＜0.01 and RMB 555 yuan vs RMB 338 yuan; Z=4.209,P＜0.01).ConclusionIRAB infection can increase the mortality rate,lengthen hospital stay and elevate the medical costs notably.

Epidemiological investigation of community-acquired methicillin resistant Staphylococcus aureus infection from 4 hospitals in Beijing / 中华检验医学杂志

ObjectiveTo investigate the prevalence,antibiotic characteristics as well as molecular background of community-associated methicillin-sensitive Staphylococcus aureus (CA-MRSA) from patients with skin and sofi tissue infections from 4 different hospitals in Beijing.MethodsFive hundred and one patients were enrolled from 4 hospitals prospectively.Patients with skin and soft tissue infections and no risk factors for healthcare-associated acquisition were included.Sample from the infection sites were collected for culture.Case report form was filled out for each patient.Antibiotic susceptibility test and molecular analysis was performed for each Staphylococcus aureus isolate.ResultsTotally 164 Staphylococcus aureus isolates were cultured from the patients with skin and soft tissue infections.Of them 5 isolates were CA-MRSA.These 5 CA-MRSA isolates harbored SCCmec Ⅰ, SCCmec Ⅲ, SCCmec Ⅳ,SCCmec Ⅴ and untypable,respectively.CA-MRSA was highly resistant to β-lactamase,levofloxacin,erythromycin and clindamycin,but susceptible to vancomycin,teicoplanin,linezolid,daptomycin,and trimethoprim/sulfamethoxazole.Prevalence of PVL in community-associated methicillin sensitive Staphylococcus aureus(CA-MSSA) and CA-MRSA were 41.9％ and 2/5.Other toxins expressed similarly between them.Combined with multilocus sequence typing (MLST) and spa typing,the major clones of CA-MSSA were ST398-t034,ST7-t796,ST398-t571,ST1t127,and ST188-t189,while in CA-MRSA were ST239-t037-SCCmec Ⅰ,ST239-t632-SCCmecⅢ,ST59-t437-SCCmecV,ST8-t008-SCCmecⅣ,and ST6-t701-NT.ConclusionsThe low prevalence of CA-MRSA in Beijing and complexity of the genetic background in CA-MRSA were observed.Clone spread is not found among CA-MRSAisolates.CA-MRSAexhibithigher resistancecomparedwithmethicillinsensitive Staphylococcus aureus (MSSA).Rational drug use scheme is called in the clinical practice to prevent development of high level resistance.

Antimicrobial resistance surveillance among nosocomial pathogens in 13 teaching hospitals in China in 2009 / 中华检验医学杂志

Objective To investigate distribution and antimicrobial resistance among nosocomial pathogens from 13 teaching hospitals in China in 2009. Methods Non-repetitive pathogens from nosocomial BSI, HAP and IAI were collected and sent to the central lab for MIC determination by agar dilution method.WHONET5.6 software was used to analyze the data. Results A total of 2 502 clinical isolates were collected. The top three pathogens of BSI were Escherichia coli [27. 1% (285/1 052 )] , coagulase-negutive staphylococcus [12. 6% ( 133/1 052)] and Klebsiella pneumoniae [10. 8% ( 114/1 052)]. The top three pathogens of HAP were Acinetobacter baumannii [28. 8% (226/785)], Pseudomonas aeruginosa [16. 1% (126/785)] and Klebsiella pneumoniae [14.6% (115/785 )] . The top three pathogens of IAI were Escherichia coli[31.0% ( 206/665 )], Klebsiella pneumonia [11.3% ( 75/665 )] and Enterococcus faecium [10. 8% (72/665)]. Against Escherichia coil and Klebsiella spp. , the antimicrobial agents with higher than 80% susceptibility rate included imipenem and meropenem (98. 1%-100% ), tigecycline (95.3%-100% ), piperacillin-tazobactam ( 88.6% -97. 1% ) and amikacin ( 88. 3% -92. 5% ). Against Enterobacter spp. , Citrobacter spp. and Serratia spp. , the susceptibility rates of tigecycline were 93.5% -100% whereas the value of imipenem and meropenem were 92.9% -100%. Other antimicrobial agents with high activity included amikacin ( 85.2% -96. 7% ), pipcracillin-tazobactam ( 82.4% -96.4% ), cefepime ( 79. 6% -96. 7% ) and cefoperazonc-sulbactam (78. 7%-90. 0% ). Polymyxin B showed the highest susceptibility rateagainst Pseudomonas aeruginosa ( 100% ), followed by amikacin ( 81.9% ) and piperacillin-tazobactam (80.1% ). Polymyxin B also showed the highest susceptibility rate against Acinetobacter baumannii (98. 8% ), followed by tigecycline (90. 1% ) and minocycline (72. 0% ). The incidence of carbapenemresistant Acinetobacter baumannii was 60. 1%. The MRSA rate was 60. 2% and the MRSCoN rate was 84. 2%. All Staphylococcus strains were susceptible to tigecycline, vancomycin, teicoplanin and linezolid except for one isolate of Staphylococcus haemolysis with intermediate to teicoplanin. Two Enterococcus faecalis isolates which were intermediate to linezolid and one Enterococcus faecium isolate which was resistant to vancomycin and teicoplanin was found in this surveillance, while the MICs of tigecycline against these three isolates were 0. 032-0. 064 μg/ml. Conclusions Tigecycline, carbapenems, piperacillin-tazobactam,amikacin and cefepime remain relatively high activity against nosocomial Enterobacteriaceae. Pseudomonas aeruginosa exhibite high susceptibility to polymyxin B, while Acinetobacter baumanni shows high susceptibility to polymyxin B and tigecycline. Tigecycline, vancomycin, teicoplanin and linezolid remain high activity against nosocomial gram-positive cocci.

Application of Table Tennis for Mentally Retarded Children / 中国康复理论与实践

@#Table tennis as an exercise can meet the basic principles for mentally retarded children rehabilitation. Some empirical data showed that it is effective on varying degrees of mentally retardation. In addition, it is valuable in some other aspect, such as politics, economy, culture, and education.

An antimicrobial resistance surveillance of gram-positive cocci isolated from 12 teaching hospitals in China in 2009 / 中华内科杂志

Objective To investigate antimicrobial resistance among gram-positive cocci in China in 2009. Methods From June to December 2009, 1169 consecutive and non-repetitive gram-positive cocci were collected from 12 teaching hospitals at 9 cities. The minimal inhibitory concentration (MIC) of antibacterial agents was determined by agar dilution method. Results The prevalences of methicillinresistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase-negative Staphylococci (MRCoNS) were 45.3% (211/466) and 89. 5% (214/239), respectively. The isolation rate of MRSA was 33. 3%-68. 1% from different samples. All Staphylococci isolates were susceptible to vacomycin, teicoplanin and linezolid. Five point five percent (7/128) E. faecium strains were resistant to vacomycin. All E.faecalis strains were susceptible to vacomycin. About 99. 1% (108/109) of E. faecalis and E. faecium were susceptible to linezoild. The prevalence of penicillin-intermediate Streptococcus pneumoniae (PISP) was 21.6% (48/222). Only 1 (0. 5%, 1/222) Streptococcus pneumoniae strain was resistant to penicillin.Teicoplanin, vancomycin, linezolid and tigecycline were the most active agents against Streptococcus pneumoniae (susceptible rate 100% ). Conclusions The high prevalence of methicillin-resistance is among Staphylococcus strains. Different samples show a different MRSA prevalence. Teicoplanin, vancomycin and linezolid show very high activity to Staphylococci,E. faecalis, E. faecium and Streptococcus pneumoniae.

Stroke and heart rate variability / 国际脑血管病杂志

Heart rate variability (HRV) is a non-invasive index for quantitative evaluation of cardiac autonomic nervous function, its analysis methods mainly include linear time domain analysis, frequency domain analysis, and nonlinear analysis. This article review the relationship between stroke lesion type, lesion location, degree of neurological deficit, duration and HRV, as well as the possible mechanism and intervention measures of stroke caused HRV.

Continuous surveillance of antimicrobial resistance among gram-positive coccus from 1999 to 2006 at Beijing Chaoyang Hospital / 中华微生物学和免疫学杂志

Objective To investigate the change of antimicrobial resistance among gram-positive cocci from 1999 to 2006 in Beijing Chaoyang Hospital. Methods Antimicrobial susceptibility test was car-ried out by MIC method, data were analyzed by WHONET 5.3 software. Results A total of 6192 clinical isolates were collected. The top four pathogens were Staphylococcus coagulase-negative, Staphylococcus au-reus, Enterococcus faecalis and Enterococcus faecium. The prevalence of methicillin-resistant S. aureas and coagulase-negative were identified in 88.4% and 86.9%, respectively. The resistance rates of S. aureus to penicillin G and ampicillin were more than 90.0% during 1999-2006. Neither strains of S. aureus nor strains of coagulase-negative Staphylococcus were found resistant to vancomycin. Vancomyein-resistant Enterococci (VRE) strains were firstly isolated in 2003, thirteen vancomycin-resistant E.faecalis isolates were identified as VanB genotype by PCR and sequencing. The VanA gene was confirmed by PCR and sequencing in seven-teen vancomycin-resistant E.faecium, vancomycin-resistance E.faecium rate increased sharply. The most ac-tive antibiotics against E. faecalis were vancomycin, ampicillin, penicillin with the susceptible rates of 98.7%, 95.7% and 85.6%, however, the susceptibility rate of E. faecalis to penicillin decreased from 94.3%-84.6%. The resistance rates of E.faecalis to clindamycin was 99.0%. The resistance rates of E. faecium to erythromycin and clindamycin were more than 95.0%. The resistance rates of E.faecium to ampi-cillin, penicillin, ciprofloxacin were more than 90.0%. The most active antibiotics against E. faecium was vancomycin. The susceptibility rate of E.faecium to tetracycline increased from 27.8% to 82.6%. Conclu-sion Vancomycin remains highly active against gram-positive cocci. A total of 30 Enterococci isolates were found resistant to vancomycin.

Clinical and electrophysiological analysis of limb-girdle muscular dystrophy:A geneological report / 中华物理医学与康复杂志

Objective To analyze the clinical and electrophysiological features of one geneology with limbgirdle muscular dystrophy(LGMD). Methods Twenty-seven members of one family with limb-girdle muscular dystrophy(LGMD)were investigated.Fourteen of them were examined with electromyography(EMG)and their motor conduction velocities(MCV)and sensory conduction velocities(SCV)were measured.Among them,10 had no clinical manifestations,while 4 demonstrated symptoms and signs of LGMD. Results Three of the 4 patients had suffered from LGMD when young.They demonstrated the typical clinical features,including the progressive muscle weakness in the upper and lower extremities,positive Gower signs,duck gait,muscle atrophy distributed tO the proximal extremity,and no gastrocnemius hypertrophy.One subject presented atypical characteristics.The MCVs and SCVs of the 4 patients were normal,but neuropathic manifestations were found in the EMGS of 3 of them.and mixed neuropathic and myopathic manifestations were found in the EMG of the other.Conclusion LGMD patients in the same family can vary in their clinical characteristics.The longer the duration,the more severe the clinical features.Electrophysiological examination can reveal normal MCV and SCV but abnormal elctromyography.

Effect of astragalus parenteral solution on cytokines and angiotensin Ⅱ in patients with congestive heart failure / 中国组织工程研究

BACKGROUND: Brain ischemia-reperfusion (IR) injury is closely connected with the activity of Kinesin. Previous research believes that reduced activity of Kinesin, a mierotubule based motor protein, is an early mark for nerve cell death induced by brain ischemia. Erigeron breviscapus can prevent brain IR-induced proteinase C activation, reduce calcium overload, and reduce ischemic infarctional volume, thus attenuating brain IR injury. However, it still remains less reported at present whether the neuroprotective role of erigeron breviscapus is related to Kinesin activity.OBJECTIVE: To observe the effect of erigeron breviscapus on the activity of Kinesin, a microtubule based motor protein, in hippocampal pyramidal cells during brain IR.DESIGN: Randomized controlled study.SETTING: Anesthesia Department, Affiliated Hospital of Jining Medical College; Anesthesiology Key Laboratory, Affiliated Hospital of Xuzhou Medical College.MATERIALS: This experiment was carried out in the Anesthesiology Key Laboratory, the Affiliated Hospital of Xuzhou Medical College, between February and August 1999. Totally 35 male gerbils were included.METHODS: Gerbils were randomized into sham-operation group (n=5), ischemia-reperfusion control group (n=15) and erigeron breviscapus group (n=15), the latter two of which were further divided into three subgroups according to reperfusion time, namely reperfusion group Ⅰ (reperfusion of 6 hours), reperfusion group Ⅱ (reperfusion of 48 hours) and reperfusion group Ⅲ (reperfusion of 96 hours) with 5 in each subgroup. Gerbils in IR group and erigeron breviscapus group were subjected to IR model preparation before experiment by brain arterial occlusion for 10 minutes, while gerbils in sham-operation group had only bilateral common carotid artery isolated without occlusion. Gerbils in erigeron breviscapus group were pretreated 15 minutes before ischemic inducement with intraperitoneal injection of breviscapine (its effective component is erigeron breviscapus) at a dosage of 45 mg/kg, which was replaced with the same volume of isometric normal saline in sham-operation group and IR group. IHC staining was used to detect hippocampus microtubule based motor protein-Kinesin activity with the assistance of computer imaging analysis technology. MAIN OUTCOME MEASURES: Activity and changes of Kinesin of animals in each group.RESULTS: Totally 35 animals were enrolled in this experiment and all entered the result analysis with no one lost during the experiment. In hippocampal CA1 region, Kinesin activity in IR group was found to descend to 58%, 38% and 12% respectively of that in sham-operation group at IR 6 hours, 48 and 96 hours (P < 0.01). In erigeron breviscapus group at IR 6 hours, 48 hours and 96 hours it was 81%, 61% and 21% of that in shamoperation group, and was obviously higher than that in IR control group (P < 0.05). However, the changes of Kinesin activity were not obviously different in hippocampal CA2, CA3 and CA4 regions.CONCLUSION: Erigeron breviscapus can exert brain-protecting function by reducing hippocampal CA1 Kinesin activity during brain IR injury.

Studies of WT1 gene expression in leukemia patients / 中华血液学杂志

<p><b>OBJECTIVE</b>To explore the expression of WT1 gene in leukemia patients and its clinical implications.</p><p><b>METHODS</b>Expression of WT1 mRNA was detected in two leukemia cell lines (K562 and HL-60), 49 acute leukemia (AL) patients, 33 chronic myeloid leukemia (CML) patients and 25 healthy subjects by reverse trans-criptase-nested polymerase chain reaction (RT-Nested PCR).</p><p><b>RESULTS</b>WT1 gene was expressed in all subtype of AL including K562 and HL-60 cell lines, 21/29 newly diagnosed and relapsed AL patients, 1/20 complete remission (CR) AL patients, 15/18 CML blastic crisis patients, 1/5 CML patients in accelerated phase, and 1/10 CML patients in chronic phase. WT1 gene was undetectable in 25 healthy subjects. The expression level of WT1 gene was related to the prognosis of AL, patients with relative level >/= 1.0 had lower CR rates and disease-free survival. For CML patients, WT1 gene expression was associated with the clinical phase, it increased with disease progressed.</p><p><b>CONCLUSION</b>WT1 gene expression is associated with pathogenesis of leukemia. It is a prognostic factor and a marker for the detection of minimal residual disease in AL and may used as an indicator for diagnosing CML blastic crisis.</p>

Effect of Stent Implantation on the Expression of PCNA and Cyclin E and Apoptosis in Rabbit Vascular Smooth Muscle Cells / 中山大学学报(医学科学版)

【Objective】To evaluate the impact of stent implantation on proliferation and apoptosis in media vascular smooth muscle cells and to explore the mechanism of restenosis after stent implantation.【Methods】Fifty male New Zealand rabbits were randomized into balloon group and stent group.Control group were set up.The materials were harvested on 3,7,14,28 and 56 day after operation and the following investigation were carried out.① Assessing the expression of proliferating cell nuclear antigen (PCNA) and Cyclin E of media smooth muscle cells with immunohistochemistry;② Analyzing apoptosis of media smooth muscle cells by TUNEL technique.【Results】The expressions of PCNA,Cyclin E and apoptosis in stent and balloon groups were markedly increased compared to control groups.① Stent group induced significant increased expression of PCNA and Cyclin E in the media smooth muscle cells compared to balloon group.On day 7,the positive rates of PCNA and Cyclin E were 24.36±0.55% vs 18.74±1.09% (P<0.01) and 22.65±1.00% vs 17.68±1.10% (P<0.01) respectively;② Stent group induced much more significant apoptosis than balloon group.The highest rate of apoptosis appeared on day 7:12.46±1.13% vs 5.54±0.53% (P<0.01);③By calculating the ratio of positive rates of PCNA to apoptosis and Cyclin E to apoptosis respectively,the ratio of balloongroup was higher than that of stent group.【Conclusion】Stent group induces augmented proliferation and much more significant apoptosis of media smooth muscle cells compared to balloon group.It shows that the severity of restenosis is relieved after stent implantation.