Co-existence of blaOXA-23 and blaVIM in carbapenem-resistant Acinetobacter baumannii isolates belonging to global complex 2 in a Chinese teaching hospital / 中华医学杂志(英文版)

BACKGROUND@#Carbapenem-resistant Acinetobacter baumannii (CRAB) have been a challenging concern of health-care associated infections. The aim of the current study was to investigate the molecular epidemiology and clonal dissemination of CRAB isolates in a Chinese teaching hospital.@*METHODS@#Non-duplicate clinical A. baumannii isolates were collected from inpatients, and we measured the minimal inhibitory concentrations to determine antimicrobial susceptibility. Polymerase chain reaction (PCR) and sequencing were performed to detect carbapenem-resistance genes and occurrence of transposons among CRAB isolates. Moreover, the genetic diversity among isolates and clonal dissemination were determined by repetitive element PCR-mediated DNA fingerprinting (rep-PCR) and multilocus sequence typing (MLST).@*RESULTS@#A total of 67 CRAB isolates displayed resistance to most of the antibiotics tested in this study, except tigecycline. We detected blaOXA-23, blaOXA-51, blaOXA-58, and blaVIM genes in 94.0%, 100.0%, 1.5%, and 80.6% of the CRAB isolates, respectively. Nevertheless, 74.6% of the CRAB isolates co-harbored the blaOXA-23 and blaVIM. Only one type of transposons was detected: Tn2008 (79.1%, 53/67). Although 12 distinctive types (A-L) were determined (primarily A type) ST195 was the most prevalent sequence type (ST). ST368, ST210, ST90, ST829, and ST136 were also detected, and all belonged to clonal complex 208 (CC208) and global complex 2 (GC2).@*CONCLUSION@#The blaOXA-23 and blaVIM genes contributed to the resistance among CRAB isolates collected in our study. Notably, most of the CRAB strains co-harbored blaOXA-23 and blaVIM genes, as well as Tn2008, which could contribute to clonal dissemination. The prevalence of such organisms may underlie hospital acquired infections.

Co-existence of blaOXA-23 and blaVIM in carbapenem-resistant Acinetobacter baumannii isolates belonging to global complex 2 in a Chinese teaching hospital / 中华医学杂志(英文版)

Background:@#Carbapenem-resistant Acinetobacter baumannii (CRAB) have been a challenging concern of health-care associated infections. The aim of the current study was to investigate the molecular epidemiology and clonal dissemination of CRAB isolates in a Chinese teaching hospital.@*Methods:@#Non-duplicate clinical A. baumannii isolates were collected from inpatients, and we measured the minimal inhibitory concentrations to determine antimicrobial susceptibility. Polymerase chain reaction (PCR) and sequencing were performed to detect carbapenem-resistance genes and occurrence of transposons among CRAB isolates. Moreover, the genetic diversity among isolates and clonal dissemination were determined by repetitive element PCR-mediated DNA fingerprinting (rep-PCR) and multilocus sequence typing (MLST).@*Results:@#A total of 67 CRAB isolates displayed resistance to most of the antibiotics tested in this study, except tigecycline. We detected blaOXA-23, blaOXA-51, blaOXA-58, and blaVIM genes in 94.0%, 100.0%, 1.5%, and 80.6% of the CRAB isolates, respectively. Nevertheless, 74.6% of the CRAB isolates co-harbored the blaOXA-23 and blaVIM. Only one type of transposons was detected: Tn2008 (79.1%, 53/67). Although 12 distinctive types (A-L) were determined (primarily A type) ST195 was the most prevalent sequence type (ST). ST368, ST210, ST90, ST829, and ST136 were also detected, and all belonged to clonal complex 208 (CC208) and global complex 2 (GC2).@*Conclusion:@#The blaOXA-23 and blaVIM genes contributed to the resistance among CRAB isolates collected in our study. Notably, most of the CRAB strains co-harbored blaOXA-23 and blaVIM genes, as well as Tn2008, which could contribute to clonal dissemination. The prevalence of such organisms may underlie hospital acquired infections.

Comparison of antimicrobial resistance of Pseudomonas aeruginosa from intensive care units and general wards in a hospital in 2016 / 中国感染控制杂志

Objective To investigate the distribution and antimicrobial resistance of Pseudomonas aeruginosa (P.aeruginosa) from intensive care units(ICUs) and general wards of a hospital,and provide scientific basis for rational use of antimicrobial agents in clinic.Methods Identification and antimicrobial susceptibility testing of clinically isolated bacteria in this hospital in 2016 were performed by VITEK 2 Compact automatic microbial analysis system,difference in antimicrobial resistance of P.aeruginosa between ICUs and general wards was compared.Results The tested specimens were mainly sputum in both ICUs and general wards,accounting for 78.7％ and 66.5％ respectively.There was no significant difference in the isolation rate of P.aeruginosa between ICUs and general wards (11.7％ vs 11.0％,P＞0.05).P.aeruginosa isolated from ICUs had the highest resistance rate to aztreonam (73.8％),resistance rates to piperacillin/tazobactam,cefoperazone/sulbactam,ceftazidime,imipenem,and meropenem were all up to more than 50％;P.aeruginosa detected in general wards had the highest resistance rate to aztreonam(59.6 ％),followed by piperacillin/tazobactam and imipenem,accounting for 48.0 ％ and 44.3 ％ respectively;resistance rates of P.aeruginosa isolated from ICUs to 12 kinds of antimicrobial agents were all higher thanthose of general wards(P＜0.05).Conclusion Resistance rate of P.aeruginosa from ICUs is higher than that in general wards,which should be paid attention,antimicrobial agents should be selected for clinical treatment of infection according to the results of antimicrobial susceptibility testing result.

Effect of 5-HT7 receptor agonist on pyramidal neurons in the medial frontal cortex in a rat model of Parkinson's disease / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the activity of pyramidal neurons in the medial prefrontal cortex (mPFC) of normal and 6-OHDA-lesioned rats and the responses of the neurons to 5-hydroxytryptamine-7 (5-HT(7)) receptor stimulation.</p><p><b>METHODS</b>The changes in spontaneous firing of the pyramidal neurons in the mPFC in response to 5-HT(7) receptor stimulation were observed by extracellular recording in normal and 6-OHDA-lesioned rats.</p><p><b>RESULTS</b>Both systemic and local administration of 5-HT(7) receptor agonist AS 19 resulted in 3 response patterns (excitation, inhibition and no change) of the pyramidal neurons in the mPFC of normal and 6-OHDA-lesioned rats. In normal rats, the predominant response of the pyramidal neurons to AS 19 stimulation was excitatory, and the inhibitory effect of systemically administered AS 19 was reversed by GABAA receptor antagonist picrotoxinin. In the lesioned rats, systemic administration of AS 19 also increased the mean firing rate of the pyramidal neurons, but the cumulative dose for producing excitation was higher than that in normal rats. Systemic administration of AS 19 produced an inhibitory effect in the lesioned rats, which was partially reversed by picrotoxinin. Local administration of AS 19 at the same dose did not change the ?ring rate of the neurons in the lesioned rats.</p><p><b>CONCLUSION</b>The activity of mPFC pyramidal neurons is directly or indirectly regulated by 5-HT7 receptor, and degeneration of the nigrostriatal pathway leads to decreased response of these neurons to AS 19.</p>

An Outbreak of Infections Caused by a Klebsiella pneumoniae ST11 Clone Coproducing Klebsiella pneumoniae Carbapenemase-2 and RmtB in a Chinese Teaching Hospital / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae bacteria, which cause serious disease outbreaks worldwide, was rarely detected in Xiangya Hospital, prior to an outbreak that occurred from August 4, 2014, to March 17, 2015. The aim of this study was to analyze the epidemiology and molecular characteristics of the K. pneumoniae strains isolated during the outbreak.</p><p><b>METHODS</b>Nonduplicate carbapenem-resistant K. pneumoniae isolates were screened for blaKPC-2and multiple other resistance determinants using polymerase chain reaction. Subsequent studies included pulsed-field gel electrophoresis (PFGE), multilocus sequence typing, analysis of plasmids, and genetic organization of blaKPC-2locus.</p><p><b>RESULTS</b>Seventeen blaKPC-2-positive K. pneumoniae were identified. A wide range of resistant determinants was detected. Most isolates (88.2%) coharbored blaKPC-2and rmtB in addition to other resistance genes, including blaSHV-1, blaTEM-1, and aac(3)-IIa. The blaKPC-2and rmtB genes were located on the conjugative IncFIB-type plasmid. Genetic organization of blaKPC-2locusin most strains was consistent with that of the plasmid pKP048. Four types (A1, A2, A3, and B) were detected by PFGE, and Type A1, an ST11, was the predominant PFGE type. A novel K. pneumoniae sequence type (ST1883) related to ST11 was discovered.</p><p><b>CONCLUSIONS</b>These isolates in our study appeared to be clonal and ST11 K. pneumoniae was the predominant clone attributed to the outbreak. Coharbing of blaKPC-2and rmtB, which were located on a transferable plasmid, in clinical K. pneumoniae isolates may lead to the emergence of a new pattern of drug resistance.</p>

Effect of sodium nitrite on phosphorylation of cytoskeletal proteins and spatial learning and memory in rats / 生理学报

The present study was aimed to explore the effect of sodium nitrite on cytoskeletal protein phosphorylation and spatial learning and memory in rats. Rats were served with drinking water containing sodium nitrite (100 mg/kg) for 60 days, then, the ability of spatial learning and memory of the rats was measured by Morris water maze. Phosphorylation level of tau and neurofilament, and the expression of protein phosphatase 2A (PP2A) catalytic subunit in the hippocampus were detected by immunohistochemistry and Western blot. In comparison with the rats served with normal tap water, the rats served with sodium nitrite water showed significantly longer latency to find the hidden platform in Morris water maze (P < 0.05), elevated phosphorylation level of tau and neurofilament, and decreased expression of PP2A catalytic subunit (P < 0.05). These results indicated that administration of sodium nitrite could impair the spatial learning and memory of the rats, and the hyperphosphorylation of cytoskeletal proteins and the down-regulation of PP2A might be underlying mechanisms for the impairment.

Predictive value for long term cardiac events by admission B-type natriuretic peptide and pulmonary capillary wedge pressure in patients with chronic heart failure / 中华心血管病杂志

<p><b>OBJECTIVE</b>To evaluate the predictive value of admission plasma B-type natriuretic peptide (BNP) and pulmonary capillary wedge pressure (PCWP) for long term cardiovascular events in patients with chronic heart failure (CHF).</p><p><b>METHODS</b>A total of 134 patients [70 males and 64 females, mean age (71.28 +/- 8.22) years] with CHF were included in this study. PCWP was measured with a Swan-Ganz catheterization and plasma BNP level was determined by a rapid immunofluorescence assay (Triage, Biosite, USA) in all patients on admission day. Left ventricular end diastolic diameter (LVEDD) and cardiothoracic ratio (CRT) were measured within 24 hours before or after catheterization. All CHF patients received conventional therapy and the rates of cardiac death and rehospitalization were used as end points during 3-year follow up.</p><p><b>RESULTS</b>(1) LVEDD, CRT, PCWP and BNP were increased in patients with cardiac events compared with patients without cardiac events (P < 0.01). (2) Multivariant logistic analysis showed that PCWP (OR = 1.423, 95% CI 1.163 - 1.741) and BNP (OR = 1.005, 95% CI 1.002 - 1.007) were the independent factors for cardiac events. (3) The area under the receiver operating curve (ROC) of BNP and PCWP to predict cardiac death was 0.846 (95% CI 0.771 - 0.922) and 0.762 (95% CI 0.666 - 0.875), respectively. The sensitivity was 76.5% and the specificity was 75.2% with BNP cutoff point of 720.5 ng/L, and the sensitivity was 68.1% and the specificity was 76.2% with PCWP cutoff point of 19.5 mm Hg (1 mm Hg = 0.133 kPa) for predicting cardiac deaths. (4) The survival rate of patients with BNP < or = 702.5 ng/L and PCWP < or = 19.5 mm Hg were significantly higher than that in patients with BNP > 702.5 ng/L (OR = 4.383, 95% CI 1.407 - 13.650) and PCWP > 19.5 mm Hg (OR = 2.843, 95% CI 1.013 - 8.854).</p><p><b>CONCLUSION</b>Both plasma BNP and PCWP on admission day are independent predictors for long term cardiac events in patients with CHF.</p>

Flavones from flowers of Sesamum indicum / 中国中药杂志

<p><b>OBJECTIVE</b>To investigate the chemical constituents from flowers of Sesamum indicum.</p><p><b>METHOD</b>Column chromatography with silica gel, C18 and Sephadex LH -20 as packing materials was used to separate the chemical constituents, and the structures were determined by chemical and spectroscopic methods.</p><p><b>RESULT</b>Six flavones were isolated and elucidated as apigenin (1), ladanetin (2), ladanetin-6-O-beta-D-glucoside (3), apigenin-7-O-glucuronic acid (4), pedalitin (5), and pedalitin-6-O-glucoside (6).</p><p><b>CONCLUSION</b>All of the compounds were isolated from this plant for the first time.</p>

Chemical constituents from flos Sesamum indicum L / 药学学报

Sesame (Sesamum indicum L. ) belongs to Pedaliaceae, and its dry flowers have been used to cure alopecia, frostbite and constipation as a Traditional Chinese Medicine. Interestingly, the Flos Sesamum indicum L. was usually used to cure verruca vulgaris and verruca plana in folk of China, and showed a pleasant result. Previous chemical investigations of this plant mainly concentrate on its seeds, showed the presence of proteins and fat oils, herein we make a systematic chemical research on the dry flowers of this plant. Column chromatography including silica gel, C18 and Sephadex LH-20 were used to separate the chemical constituents and the structures were determined by chemical and spectroscopic methods. Ten compounds were isolated from the 95% ethanol extract of the plant and elucidated as latifonin (1), momor-cerebroside (2), soya-cerebroside II (3), 1-O-beta-D-glucopyranosyl-(2S, 3S, 4R, 5E,9Z)-2-N-(2'-hydroxytetracosanoyl) 1,3,4-trihydroxy-5,9-octadienine (4), 1-O-beta-D-glucopyranosyl-(2S, 3S, 4R, 8Z)-2-N-(2' R) 2'-hydroxytetracosanoyl) 3,4-dihydroxy-8-octadene (5), (2S, 1" S) -aurantiamide acetate (6), benzyl alcohol-O-(2'-O-beta-D-xylopyranosyl, 3'-O-beta-D-glucopyranoside)-beta-D-glucopyranoside (7), beta-sitosterol (8), daucosterol (9) and D-galacititol (10). Among them, 4 is a new compound, and others were isolated from the flowers of the plant for the first time. Compounds 2 to 4 belong to cerebroside, which is rare to be found in land plants and was proved to possess many bioactivities.

Correlation between B-natriuretic peptide and hemodynamics in patients with decompensated heart failure and clinical significance / 中华心血管病杂志

<p><b>OBJECTIVE</b>To determine the correlation between the serum level of B-natriuretic peptide (BNP) and hemodynamic variables and to evaluate the diagnostic value of BNP in patients with decompensated heart failure (HF).</p><p><b>METHODS</b>BNP levels (TRIAGE BIOSITE Diagnostics, San Diego, USA) were obtained by a rapid immunofluorescence assay in 117 patients with dyspnea including cardiogenic group (75 patients) and lung disease (42 patients). Hemodynamic parameters of 53 patients [male 28, female 25, mean age (71.6 +/- 9.8) years] with HF were determined and left ventricular end-diastolic diameter (LVEDD) of all patients were measured by echocardiogram.</p><p><b>RESULTS</b>Pulmonary capillary wedge pressure (PCWP, mm Hg), mean pulmonary arterial pressure (MPAP, mm Hg), right atrial pressure (RAP, mm Hg) and BNP (ng/L) levels according to New York Heart Association (NYHA) class were: 16.10 +/- 3.50, 22.50 +/- 4.68, 3.11 +/- 1.90, 271.25 +/- 159.29 in NYHA class II, respectively; 21.50 +/- 4.42, 28.60 +/- 9.35, 8.95 +/- 3.86, 619.58 +/- 237.48 in NYHA class III; 29.28 +/- 8.61, 36.50 +/- 12.32, 15.27 +/- 4.96, 1519.28 +/- 618.62 in NYHA class IV (P < 0.01-0.05), respectively. PCWP, MPAP, RAP and plasma BNP levels were directly proportional to cardiac function. The plasma BNP levels had also significant positive correlations with PCWP, MPAP, RAP, (r = 0.59, 0.50, 0.32, P < 0.05-0.01). BNP level [(918.48 +/- 453.25) ng/L] of the group with LVEDD (n = 24) > or = 60 mm was much higher than that of the group with LVEDD (n = 29) < 60 mm [(298.58 +/- 167.51) ng/L]. However, the latter was significantly higher than that in pulmonary dyspnea group with a normal left and right ventricular end-diastolic diameter [(35.4 +/- 26.4) ng/L, P < 0.01]. There was a great difference of BNP between cardiogenic dyspnea group [(761.30 +/- 480.47) ng/L]and lung dyspnea group [(35.4 +/- 26.4) ng/L], P < 0.01.</p><p><b>CONCLUSIONS</b>The plasma BNP levels had significant positive correlations with PCWP, MPAP, RAP. BNP is a cardiac neurohormone secreted from cardiac ventricles as a response to ventricular volume expansion and pressure overload. Rapid testing BNP should be of help to differentiate pulmonary dyspnea from cardiac etiologies.</p>

Studies on the constituents in rhizome of Homalomena occuta / 中国中药杂志

<p><b>OBJECTIVE</b>Bio-active constituents were expected to abstain from Homalomena occuta.</p><p><b>METHODS</b>Extracts from the plant with 95% alcohol were distributed by several solvents and isolated via column chromatography on silica and Saphadex 20-LH gel.</p><p><b>RESULTS</b>Thirteen compounds were isolated from this plant. Among them seven natural products were identified via spectral methods as beta-stigmastol(H1) beta-D-Glucopyranoside(3)- stigmast-5-en-3-yl(H2); oplodiol(1); oplopanone(2); homalomenol(3); bullatantriol(4); 1 beta, 4 beta, 7 alpha-trihydroxyeudesmane(5).</p><p><b>CONCLUSION</b>All these compounds were isolated from this plant for the first time.</p>