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Objective:To study the clinical features and drug resistance profile of neonatal sepsis caused by different species of Klebsiella.Methods:From January 2009 to December 2018, cryopreserved Klebsiella strains from blood culture of neonatal sepsis cases in NICU of our hospital were reactivated. Molecular identification and antimicrobial susceptibility tests were performed. Clinical features, laboratory tests, drug resistance profile and prognosis of these patients were analyzed retrospectively.Results:A total of 29 strains of Klebsiella were reactivated. Molecular identification assigned 22 cases (75.9%) into Klebsiella pneumoniae (Kpn) group and 7 cases (24.1%) into Klebsiella quasipneumoniae (Kqu) group. Gestational age and birth weight of Kpn group were higher than Kqu group [(33.1±3.2) weeks vs. (30.6±0.9) weeks, (1 847±677) g vs. (1 416±121) g] ( P<0.05). Abdominal distension was more common in Kqu group than Kpn group [42.9% (3/7) vs. 4.5% (1/22), P<0.05]. No significant differences existed in the laboratory tests including white blood cell count, platelet count, hypersensitive C-reactive protein and procalcitonin between the two groups ( P>0.05). Kpn was 100.0% sensitive to Cefazolin-Tazobactam and Amikacinto and less sensitive to Imipenem and Cefperazone-Sulbactam, Meropenem and Ertapenem. Kqu was generally more sensitive than Kpn and the sensitivity of Kqu to Imipenem was 100.0%. No significant differences existed of the prognosis between the two groups ( P>0.05). Conclusions:Kpn is the main pathogen of neonatal Klebsiella sepsis. Kqu sepsis is more common in neonates with smaller gestational age and lower birth weight. Abdominal distention is common presenting symptom in Kpn sepsis and sensitive antibiotics should be used early.
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Objective:To explore the clinical manifestation, efficacy and treatment strategies in patients with severe warm autoimmune hemolytic anemia (w-AIHA).Methods:A total of 21 patients with w-AIHA who were hospitalized in Children′s Hospital of Capital Institute of Pediatrics from June 2007 to March 2019 were included, and the clinical characteristics, treatment strategies and responses were retrospectively analyzed.Results:A total of 21 children with severe w-AIHA had an average age of 8.0 (2.5, 20.0) months and a follow-up time of 33.0 (18.5, 110.0) months.In 10 (47.6%) cases, the hemoglobin levels were lower than 30 g/L.Evans′ syndrome was diagnosed in five(23.8%) cases.Five (23.8%) cases were secondary cases.Nine (42.8%) cases had a previous infection history and two cases were pollen-induced.Five (23.8%) cases had hemolytic crisis.A total of 12 (57.1%) cases had cross-matching difficulty.Eight (38.1%) cases were admitted to the ICU, and five (23.8%) cases had shock.All children received corticosteroids and intravenous immunoglobulin, 16 (76.2%) cases were treated with second-line regimens (cyclophosphamide and rituximab, etc.), 15 cases had complete response, three cases had partial response and three cases had no response and died.Conclusion:Infection is an important predisposing factor in children with severe w-AIHA, and secondary cases have a higher proportion, mainly caused by immunodeficiency disease.Patients tend to have a high incidence of hemolytic crisis and have difficulty in matching and transfusion.Therefore, transfusion is the key for successful rescue.It is suggested that children with severe w-AIHA require ICU admission for early monitoring and rituximab should be applied in advance to ensure successful transfusion.
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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.
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Objective To investigate the antimicrobial resistance profile of the clinical isolates collected from selected hospitals across China. Methods Twenty-nine general hospitals and five children's hospitals were involved in this program. Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems. Results were interpreted according to CLSI 2017 breakpoints. Results A total of 190 610 clinical isolates were collected from January to December 2017, of which gram negative organisms accounted for 70.8％ (134 951/190 610) and gram positive cocci 29.2％ (55 649/190 610). The prevalence of methicillin-resistant strains was 35.3％ in S. aureus (MRSA) and 80.3％ in coagulase negative Staphylococcus (MRCNS) on average. MR strains showed much higher resistance rates to most of the other antimicrobial agents than MS strains. However, 91.6％ of MRSA strains were still susceptible to trimethoprim-sulfamethoxazole, while 86.2％ of MRCNS strains were susceptible to rifampin. No staphylococcal strains were found resistant to vancomycin. E. faecalis strains showed much lower resistance rates to most of the drugs tested (except chloramphenicol) than E. faecium. Vancomycin-resistant Enterococcus (VRE) was identified in both E. faecalis and E. faecium. The identified VRE strains were mainly vanA, vanB or vanM type based on phenotype or genotype. The proportion of PSSP or PRSP strains in the non-meningitis S.pneumoniae strains isolated from children decreased but the proportion of PISP strains increased when compared to the data of 2016. Enterobacteriaceae strains were still highly susceptible to carbapenems. Overall, less than 10％ of these strains (excluding Klebsiella spp.) were resistant to carbapenems. The prevalence of imipenem-resistant K. pneumoniae increased from 3.0％ in 2005 to 20.9％ in 2017, and meropenem-resistant K. pneumoniae increased from 2.9％ in 2005 to 24.0％ in 2017, more than 8-fold increase. About 66.7％ and 69.3％ of Acinetobacter (A. baumannii accounts for 91.5％) strains were resistant to imipenem and meropenem, respectively. Compared with the data of year 2016, P. aeruginosa strains showed decreasing resistance rate to carbapenems. Conclusions Bacterial resistance is still on the rise. It is necessary to strengthen hospital infection control and stewardship of antimicrobial agents. The communication between laboratorians and clinicians should be further improved in addition to surveillance of bacterial resistance.
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Objective To explore the effect of micro-lecture-CPT teaching method (case,problem and team-based learning,CPT) used in pathology teaching.Methods 236 medical imaging undergraduates from Grade 2015 were selected and divided into two groups equally.The experimental group (118 people) used the micro-lecture-CPT teaching method,and the control group (118 people) used the traditional teaching method.The students in the experimental group used the interactive platform on the internet to share the resource in combination with pathological theory and experiment,including curriculum,microlecture,multimedia courseware,clinical case and the related questions before class.In class,the questions were discussed in groups based on "student centered,teacher guide".Questionnaire survey and test scores were used to collect data and analyze the differences between the two groups.SPSS 13.0 was applied to processing the data.Measurement data were expressed as mean plus or minus standard deviation,and t test was used in the comparison between groups.Results The average score of basic theoretical examination in the experimental group was lower than that of the traditional teaching group [(57.86-± 2.32) vs.(58.23 ±2.06)];While the case score and experimental score in the experimental group were significantly higher than those of the traditional teaching group [(11.27 ± 1.24) vs.(7.40 ± 0.90);(18.04 ± 0.87) vs.(14.75 ± 0.93)].And the differences were statistically significant (P＜0.05).Questionnaire survey demonstrated that the experimental group students' evaluation on the learning of micro-lecture-CPT teaching was higher than the control group's evaluation on traditional teaching in the aspects of improving students' learning interest,promoting autonomous learning and problem solving skills,cultivating clinical thinking ability and team cooperation spirit.Conclusion Micro-lecture-CPT teaching method conforms to the trend of modem teaching reform and achieves good effect in pathology teaching,so it is worth recommending and popularizing.
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Objective To systematically evaluate the value of chemiluminescence assay for detecting human immunodeficien-cy virus(HIV) antibodies as a HIV preliminary screening method .Methods The Chinese and English studies on chemilumines-cence assay for detecting HIV antibodies published by the databases of WanFang ,VIP ,CNKI ,CBM ,Pubmed and Web of Science were collected by computer retrieval and manual retrieval .The retrieval time limit was from the database establish to November 2016 .Two reviewers independently screened the literature ,extracted the data and assessed the methodological quality of included studies .Then the meta-analysis was performed by using Meta-disc1 .4 and Stata12 .0 software .Results A total of 8 studies invol-ving 26168 patients were included .The meta-analysis results showed that the pooled sensitivity of chemiluminescence assay for de-tecting HIV antibodies was 100% (95% CI:1 .00-1 .00) ,the pooled specificity was 100% (95% CI:0 .99-1 .00) ,the pooled posi-tive likelihood ratio was 237 .79(95% CI:80 .50-702 .42) ,the pooled negative likelihood ratio was 0 .00(95% CI:0 .00-0 .02) ,the diagnostic odds ratio(OR) was 48911 .05(95% CI:8257 .50-289711 .20) ,and the area under the curve(AUC) was 0 .9994(SE=0 .0002) .Conclusion Chemiluminescence assay can serve as a HIV preliminary screening method for promotion and application in clinic .
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Objective To explore the influence of Rapamycin (RAPA) on apoptosis of acute lymphoblastic leukemia EU-4 cells induced by Methotrexate (MTX).Methods EU-4 cells were pretreated 0.5 h with 5 pμg/L,10 μg/L,25 μg/L,50 μg/L and 100 μg/L RAPA.RAPA untreated group was set up as control group.The cells were collected and the expression of LC-3 was assayed by using Western blot.The apoptosis of EU-4 cells was detected by using flow cytometry (FCM).The effects of different concentrations of RAPA pretreatment on autophagy and apoptosis of EU-4 cells were observed,and the pretreatment concentration of RAPA was determined.EU-4 cells were divided into RAPA pretreatment group and untreated group.The cells were treated with 0.05 μmol/L,0.10 pμmol/L and 0.20 μmol/L MTX for 24 h,respectively.The apoptotic rate was detected by using FCM.Western blot was performed to test the expression of LC-3 protein,while the absorbance(A562) was measured by using microplate reader,and the protein concentration in the sample was calculated according to the standard curve.Results The apoptotic rates of EU-4 cells in the control group and the different concentrations of PAPA pretreatment group showed that the control group,5 μg/L,10 μg/L,25 μg/L,50 μg/L and 100 μg/L RAPA were (7.51 ±0.32)％,(7.33 ±0.41)％,(7.71 ± 0.51) ％,(7.63 ± 0.38) ％,(7.80 ± 0.43) ％ and (16.66 ± 0.87) ％,respectively.The apoptotic rates of EU-4 cells in the 5 μg/L,10 μg/L,25 μg/L and 50 μg/L PAPA pretreatment group had no significant difference from those in the control group(t =0.427,-0.417,-0.297,-3.561,all P ＞ 0.05).The apoptotic rate of EU-4 cells in 100 μg/L PAPA pretreatment group was significantly higher than that in control group,and the difference was significant (t =-28.815,P ＜ 0.01).Combined with the results of Western blot and FCM,50 μg/L was used as the pretreatment of PAPA.The apoptosis rates of EU-4 cells in PAPA pretreatment group were (50.23 ± 2.11) ％,(66.88 ± 2.89) ％ and (73.11 ± 2.67) ％ after treated with 0.05 μmol/L,0.10 μmol/L and 0.20 μmol/L MTX for 24 h,respectively.The apoptotic rates of EU-4 cells in PAPA unpretreatment group were (22.53 ± 1.67) ％,(42.82 ± 2.26) ％ and (53.22 ± 1.93)％ after treated with 0.05 μmol/L,0.10 μmol/L and 0.20 μmol/L MTX for 24 h,respectively.The apoptotic rates of EU-4 cells in RAPA pretreatment group were significantly higher than those in untreated group in the same concentration of MTX treatment after 24 h,and the differences were significant(t =12.693,66.148,14.429;all P ＜ 0.01).Conclusion With RAPA pretreatment,relative low dose MTX can induce a great deal of acute lymphoblastic leukemia EU-4 cells apoptosis.
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Objective Study the effect of Shuxuetong combined with Shenmai injection on serum CPR, SOD and MDA levels in elderly patients with acute myocardial infarction after PCI, and to analyze the main adverse cardiovascular events. Methods Chose 88 patients with PCI from June 2015 to June 2016 in our hospital, they were randomly divided into observation group and control group, 44 cases in each group. The control group was given conventional drug therapy before PCI. On the basis of this, the observation group was treated with Shuxuetong combined with Shenmai intravenous injection before PCI. The treatment of the two groups continued to one week after PCI. Compared the levels of serum malondialdehyde (MDA), superoxide dismutase (SOD) and hypersensitive C-reactive protein (hs-CRP) between the two groups before and after PCI, and compared the levels of coagulation factor, dynamic electrocardiogram, Left ventricular ejection fraction (LVEF) and myocardial infarct size, and compared the incidence of arrhythmia and major adverse cardiovascular events after PCI. Results The levels of serum MDA and hs-CRP in the observation group were significantly lower than those in the control group (P<0.05), the level of SOD was significantly higher than the control group (P<0.05); The level of coagulation factor in the observation group was significantly higher than that in the control group (P<0.05). The myocardial infarct size, the number of ischemic attacks, the decrease of ST segment and the descending time of ST segment were significantly lower than those of the control group (P<0.01). The incidence of MACE was significantly lower in the observation group than in the control group (P<0.05). Conclusion Conventional treatment combined with Shuxuetong combined with Shenmai injection can effectively prevent ischemia-reperfusion injury in elderly patients with AMI, improve cardiac function and reduce the main adverse cardiovascular events after PCI, which reflects the combination of traditional Chinese and western medicine Advantages, worthy of clinical use.
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Objective To evaluate the significance of cytometric beads array(CBA)in the detection of Th1/Th2/Th17 cytokine in patients with pulmonary tuberculosis.Methods The levels of 7 cytokines (IL-2,IL-4,IL-6,IL-10,TNF,IFN-γ and IL-17A) were detected by CBA according to the instruction of BD CBA Human Th1/Th2/Th17 Cytokine Kit(BD Biosciences,USA)in the serum of 98 patients with tuberculosis(38 sputum-smear positive and 60 sputum-smear negative)and 79 healthy individuals.Then analyze the relationship and differences among these groups.Results Except IL-17A,the level of IL-2,IL-4,IL-6,IL-10,TNF,IFN-γwas higher in the patients group than control group;As to IL-2,IL-4,IL-10 and IFN-γ,the sputum-smear positive group had a higher level than control group,but the sputum-smear positive group had no difference with sputum-smear negative group.Com-pared with sputum-smear negative group,the sputum-smear positive group have a higher level of IL-6 and TNF.Conclusion IL-6 and TNF can be used to monitor the prognosis of tuberculosis.Meanwhile,CBA is sensitive,could detect several cytokines once with less sample consumption and time,thus could be applied for the monitor of tuberculosis progress.
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Objective To investigate the susceptibility profile of clinical isolates collected from hospitals across China.Methods Twenty-six general hospitals and four children's hospitals were involved in this program.Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems.Results were analyzed according to CLSI 2016 breakpoints.Results A total of 153 059 clinical isolates were collected from Junuary to December 2016,of which gram-negative organisms and gram-positive cocci accounted for 71.6％ and 28.4％,respectively.The overall prevalence of methicillin-resistant strains was 38.4％ in S.aureus (MRSA) and 77.6％ in coagulase negative staphylococcus (MRCNS),respectively.The resistance rates of methicillin-resistant strains to most of other antimicrobial agents were much higher than those of methicillin-susceptible strains.However,92.3％ of the MRSA strains were still sensitive to trimethoprim-sulfamethoxazole,while 86.5％ of the MRCNS strains were susceptible to rifampin.No staphylococcal strains were found resistant to vancomycin or teicoplanin.The resistance rates of E.faecalis strains to most drugs tested (except chloramphenicol) were much lower than those of E.faecium.A few strains of both species were resistant to vancomycin.Vancomycin resistant E.faecalis and E.faecium strains were mainly VanA,VanB or VanM type based on their phenotype or genotype.Regarding the non-meningitis S.pneumoniae strains,the prevalence of PSSP or PISP strains isolated from children was higher than that isolated in 2015,but the prevalence of PRSP strains decreased.However,the prevalence of PISP and PRSP strains isolated from adults was lower than that isolated in 2015.The prevalence of ESBLs-producing strains was 45.2％ in E.coli,25.2％ in Klebsiella spp.(K.pneumoniae and K.oxytoca) and 16.5％ in Proteus mirabilis isolates on average.ESBLs-producing Enterobacteriaceae strains were more resistant than non-ESBLs-producing strains in terms of antibiotic resistance rate.The strains of Enterobacteriaceae were still highly susceptible to carbapenems.Overall,less than 10％ of these strains were resistant to carbapenems.About 68.6％ and 71.4％ ofAcinetobacter spp.(A.baumannii accounts for 90.6％) strains were resistant to imipenem and meropenem,respectively.The prevalence of extensively-drug resistant strains in P.aeruginosa was higher than that in 2015.Conclusions Bacterial resistance to commonly used antibiotics is still on the rise.It is necessary to strengthen hospital infection control and management of clinical use of antimicrobial agents,and maintain good practice in surveillance of bacterial resistance.
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Objective To investigate the genotyping characteristics of Han and Uygur patients with hepatitis C virus(HCV) in Urumqi and other area of Xinjiang ,and provide information for diagnosis and treatment .Methods Totally 380 samples of Han and Uygur patients virus load were detected by real - time PCR ,with the load greater than 1 × 103 copies/mL ,HCV genotyping was carried out by PCR - reverse dot blot hybridization .Results A total of 355 samples(93 .4% ) was genotyped successful .Type 1b of Han and Uygun were 59 .91% ,69 .92% ,type 2a were 30 .17% ,12 .20% ,type 3a were 5 .60% ,8 .13% and type 3b were 3 .88% , 8 .94% .In Urumqi and other areas ,significant difference of patient distribution ,male and female were found between Han and Uygur patients(all P 0 .05) .Conclusion HCV genotyping of Uygur and Han patients in Xinjiang is different with the majority areas in China ,type 1b and 2a are the main infectious virus in Han ,and type 1b is the main infectious virus in Uygur ,followed by type 2a ,3a ,3b .
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Objective To evaluate the changing pattern of antibiotic resistance inKlebsiella strains isolated from the patients in 19 hospitals across China based on the data from CHINET Antimicrobial Resistance Surveillance Program during the period from 2005 through 2014.Methods Kirby-Bauer disk diffusion and automated susceptibility testing methods were used to test the susceptibility ofKlebsiella isolates to the commonly used antibiotics. The results were interpreted according to the criteria of the Clinical and Laboratory Standards Institute (CLSI) Performance Standards for Antimicrobial Susceptibility Testing (CLSI-2014).Results A total of 61 406Klebsiella strains were identified between 2005 and 2014, includingK. pneumoniae (56 281 strains), K. oxytoca(4 779),Klebsiella pneumoniae subsp.Ozaenae (300) and otherKlebsiella species (46). Most (89.0%, 54 664/61 406) of theKlebsiella strains were isolated from inpatients, and 60.0% (36 835/61 406) were from respiratory tract speciems. About 16.7% (10 248/61 406) of the strains were isolated from pediatric patients aged 0-17 years and 83.3% (51 158/61 406) from adult patients. The prevalence ofKlebsiella spp. increased with time from 10.1% in 2005 to 14.3% in 2014. Based on the surveillance data during the 10-year period, we found a marked increase of resistance to imipenem (2.9% to 10.5%) and meropenem (2.8% to 13.4%) inKlebsiella spp. The prevalence of ESBLs-producing isolates inK. pneumoniae andK. oxytoca decreased from 39.0% in 2005 to 30.1% in 2014. The resistance to amikacin, ceftazidime, ciprolfoxacin, pipracillin-tazobactam and cefoperazone-sulbactam was on decline. The resistance rate to cefotaxime remained high about 49.5%. Carbapenem resistantance was identiifed in 5 796 (9.4%) of the isolates, including 5 492 strains ofK. pneumoniae and 280 strains ofK. oxytoca. Overall, 4 740 (7.8%) strains were identiifed as extensively-drug resistant (XDR), including 4 520 strains ofK. pneumoniae and 202 strains ofK. oxytoca. The carbapenem-resistant strains showed high (>60%) resistance rate to majority of the antimicrobial agents tested, but relatively low resistance to tigecycline (16.8%), amikacin (54.4%), and trimethoprim-sulfamethoxazole (55.5%).Conclusions During the 10-year period from 2005 through 2014, carbapenem resistance amongKlebsiella isolates has increased dramatically in the hospitals across China. The level of resistance to other antibiotics remains stable.
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Objective To investigate the distribution and antibiotic resistance proifle of clinicalEnterobacter isolates using the data from CHINET during the period from 2005 through 2014.Methods A total of 20 558 clinical strains ofEnterobacter spp. were collected from 2005 to 2014 in CHINET Antimicrobial Resistance Surveillance Program. Antimicrobial susceptibility testing was performed with Kirby-Bauer or minimum inhibitory concentration method. The results were analyzed according to CLSI 2014 breakpoints.ResultsEnterobacter cloacae andEnterobacter aerogenes accounted for 71.1% (14 617/20558) and 20.1% (4 129/20 558) of all theEnterobacterisolates, respectively. The proportion ofEnterobacter spp. increased with time from 3.5% in 2005 to 4.3% in 2014. The main source of the isolates was respiratory tract, accounting for 55.2% (11 358/20 558). More than 90% of theEnterobacterisolates were resistant to cefazolin and cefoxitin, but less than 30% of the strains were resistant to cefepime, piperacillin-tazobactam, cefoperazone-sulbactam, amikacin, gentamicin, ciprolfoxacin, meropenem, imipenem and ertapenem. TheEnterobacterisolates showed a trend of declining resistance to most antibiotics except ertapenem and meropenem. The resistance proifle ofEnterobacterisolates varied with departments where they were isolated. The strains from ICU and Department of Surgery were relatively more resistant to antibiotics. The prevalence of multi-drug resistant (MDR) strains was decreasing, but the prevalence of carbapenem-resistantEnterobacter (CRE, resistant to any of imipenem, meropenem or ertapenem) was increasing. The MDR and CRE strains were primarily isolated from ICU and Department of Surgery. At least 30% of the MDREnterobacter strains were resistant to any of the antimicrobial agents tested except meropenem, imipenem and ertapenem and at least 35% of the CRE strains were resistant to any of the antimicrobial agents tested except amikacin and ciprolfoxacin.Conclusions TheEnterobacter isolates in CHINET Antimicrobial Resistance Surveillance Program showed decreasing resistance to most of the antimicrobial agents tested since 2011, but the prevalence of CRE strains increased progressively. Effective measures should be carried out to prevent the spread of CRE strains in hospitals.
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Objective To understand the changing resistance proifle ofProteus,Serratia,Citrobacter,Morganella andProvidencia in hospitals across China according to the data from CHINET Antimicrobial Resistance Surveillance Program 2005-2014.Methods Antimicrobial susceptibility was tested by using Kirby-Bauer method or automatic minimum inhibitory concentration determination according to a uniifed protocol.Results A total of 21 663 clinical isolates were collected from January 2005 to December 2014. The proportion ofProteus andSerratia isolates increased with time from 1.41% in 2005 to 2.09% in 2014, and from 0.99% in 2005 to 1.28% in 2014 among all the isolates. No change was found for the proportion ofCitrobacter,Morganella, orProvidencia. Less than 10% of theProteus isolates were resistant to cefoperazone-sulbactam, piperacillin-tazobactam, ceftazidime, cefoxitin, amikacin and tigecycline. Less than 10% of theSerratia isolates were resistant to cefoperazone-sulbactam, piperacillin-tazobactam, amikacin and tigecycline. Less than 20% of theCitrobacter isolates were resistant to cefoperazone-sulbactam, piperacillin-tazobactam, cefepime, amikacin and tigecycline. Less than 10% of theMorganella isolates were resistant to cefoperazone-sulbactam, piperacillin-tazobactam, cefepime, amikacin and tigecycline. Less than 20% of theProvidencia isolates were resistant to cefoperazone-sulbactam, piperacillin-tazobactam, cefepime, cefoxitin and tigecycline.Conclusions The antibiotic resistance ofProteus,Serratia, Citrobacter,Morganella andProvidencia isolates in hospitals across China is growing during the period from 2005 to 2014. Strengthening infection control and rational antibiotic use are effective to slow the growth of drug resistance.
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Objective To investigate the distribution and changing resistance proifle ofSalmonella isolates in hospitals across China during the period from January 2005 to December 2014.Methods Seventeen general hospitals and two children’s hospitals were involved in this program. Antimicrobial susceptibility testing was carried out by means of a unified protocol using Kirby-Bauer method or MIC determination. The results were analyzed according to CLSI 2014 breakpoints.Results The proportion ofSalmonella isolates increased with time from 0.2% in 2005 to 0.7% in 2014. A total of 3 478Salmonella strains were collected from 19 hospitals. The proportion ofSalmonella typhimurium andSalmonella enteritidis was 27.4% and 24.4%, respectively. During the 10-year period, theSalmonella strains showed highest resistance rate to ampicillin (33.3%-64.8%), but low resistance to cefoperazone-sulbactam (0-5.3%) and ciprofloxacin (2.4%-14.3%).S. typhimurium showed higher resistance rate thanS. typhi,S. paratyphi andS. enteritidis. About 76.8% and 50.5% ofS. typhimurium were resistant to ampicillin and trimethoprim-sulfamethoxazole. The average prevalence of multi-drug resistantSalmonellawas 3.9% in the ten-year period, the highest (7.5%) was in 2005, the lowest (1.5%) in 2013.Conclusions During the period from 2004 to 2015, majority of theSalmonella isolates in hospitals across China wasS. typhimurium andS. enteritidis. Ampicillin and trimethoprim-sulfamethoxazole are no longer appropriate for empirical treatment ofS. typhimurium infection due to high resistance rate.Salmonella isolates are relatively more susceptible to third-generation cephalosporins and quinolones. Ongoing monitoring is necessary to identify multi-drug resistant strains ofSalmonella.
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Objective To analyze the resistance proifle of bacterial strains isolated from geriatric patients in 17 hospitals across China from 2005 to 2014.Methods A total of 17 representative general hospitals were involved in this program. Bacterial susceptibility testing was carried out by means of a uniifed protocol using Kirby-Bauer method and MIC determination. The results were analyzed according to CLSI 2014 breakpoints.Results The proportion of the strains isolated from geriatric patients among all the clinical isolates increased with time from 30.0% in 2005 to 32.7% in 2014. A total of 159 888 clinical isolates were collected from geriatric patient during the period from 2005 to 2014, about 33.1% of the whole patient population. Gram negative organisms and gram positive cocci accounted for 77.1% (123 229/159 888) and 22.9% (36 659/159 888), respectively. Majority (92.8%, 148 376/159 888) of the isolates were from inpatients and more than half (55.2%, 88 201/159 888) of the isolates were from sputum or other respiratory tract specimens. Methicillin-resistant strains inS. aureus (MRSA) and coagulase negativeStaphylococcus (MRCNS) accounted for an average of 67.1% and 75.9%, respectively. The resistance rates of methicillin-resistant strains to β-lactams and other antimicrobial agents were much higher than those of methicillin-susceptible strains. No staphylococcal strains were found resistant to vancomycin, teicoplanin or linezolid. Some strains ofE. faecalis (0.4%) andE. faecium (4.6%) were resistant to vancomycin, which was higher than average national level (0.3%, 3.2%). Vancomycin-resistant strains ofE. faecalisandE. faecium were mainly VanA type and VanB type based on their phenotype. The prevalence of penicillin-susceptibleS. pneumoniae strains was 78.2%, slightly lower than the 95.0% in Chinese adults in year 2014. The prevalence of ESBLs-producing strains was 67.5% inE. coli, 40.4% inKlebsiella (K. pneumoniae andK. oxytoca) and 34.3% inProteus mirabilis isolates on average. The strains ofEnterobacteriaceae were still highly susceptible to carbapenems (<10% resistant), followed by amikacin and the beta-lactam and beta-lactamase inhibitor combinations. Overall, 35.9% and 33.0% of theP. aeruginosa strains were resistant to imipenem and meropenem. More than 50% of theA. baumannii strains were resistant to imipenem and meropenem. The prevalence of extensively drug-resistant (XDR)P. aeruginosa (4.0%-1.8%) was higher than the average national level (2.1%-1.6%). The prevalence of XDR A. baumannii (19.2%-15.5%) and XDREnterobacteriaceae (0.1%-1.0%) was lower than the average national level (21.4%-19.7% and 0.3%-3.2%).Conclusions The proportion of clinical isolates from geriatric patients is different from average national level at the same period. The isolates from geriatric patients are more likely from inpatients, respiratory tract specimens and more likely non-fermentative gram-negative bacilli compared to average national level. The proportion of fastidious bacteria andEnterobacteriaceae species is generally lower than average national level. MRSA, VRE, ESBLs-producing strains and XDRP. aeruginosa are more prevalent in geriatric patients than in general Chinese patient population. This study suggests that surveillance of antimicrobial resistance for the clinical isolates from geriatric patients is very important for rational antimicrobial therapy.
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Virtual reality is a technology to simulate the real world by computer, with 3 characteristics of immersion, interaction and imagination. It is a new method applied to gait rehabilitation after stroke. This article briefly introduced the characteristics of virtual reality, and the value for rehabilitation in stroke patients. The recent development of the studies on virtual reality in gait rehabilitation for stroke was summarized, mainly included the advantages of virtual reality technology, virtual reality hardware devices applied to the gait rehabilitation, and its therapeutic effect.
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Objective To analyze the positive rate of autoantibodies in Xinjiang Uygur patients with different types of auto‐immune liver disease and its diagnostic value .Methods Fifty‐one Uygur outpatients and inpatients with of autoimmune liver disease in our hospital from October 2012 to October 2014 were selected ,including 20 cases of autoimmune hepatitis (AIH ,AIH group) and 31 cases of primary biliary cirrhosis (PBC ,PBC group) .The indirect immunofluorescence and Western blotting were used to detect the serum biochemical indexes and autoantobodies ,and the comparative analysis was performed .Results The levels of various bio‐chemical indexes in the two groups were increased ,in which ALT ,γ‐GT ,ALP and IgM levels had statistical difference between the two groups(P<0 .05) .The positive rates of ANA ,SMA ,LKM‐1 antibody ,LC‐1 antibody ,SDLA/LP antibody and AMA in the AIH group were 65 .0% ,40 .0% ,10 .0% ,5 .0% ,10 .0% and 5 .0% respectively ;the positive rates of ANA ,AMA and M2 subtype (AMA‐M2) in the PBC group were 61 .3% ,100 .0% and 96 .8% respectively .Conclusion The autoantibodies spectrum in Xinjiang Uygur patients with autoimmune liver diseases has certain characteristics .The autoantibodies spectrum detection has an important significance for the diagnosis ,classification and differential diagnosis of autoimmune liver diseases .
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Objective To understand the situation of nosocomial infections, the distribution of important pathogens of affected patients and the uses of antibacterial drugs.Methods The cross-sectional survey was ap-plied.Before the survey, the investigators were trained by the professionals of the department of hospital infection management.Medical records were reviewed one by one, checked with bedside physical examination.Results In this survey, 283 inpatients were investigated, with an actual check rate of 100%.Two inpatients were affected with nosocomial infection with the prevalence rate of 0.71%.There were two cases of infections (0.71%).Conclusion Investigation of the prevalence rate of nosocomial infection was an important means to monitor the hospital infection, which can monitor specifically, minimize the incidence of nosocomial infection and ensure medical safety by obtaining the information of the departments with high-risk nosocomial infection, the main infectious sites and pathogens.
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Post competency is a kind of necessary ability for professional working.In order to train the students' excellent professional skills,we have conducted exploration and reform in post competency oriented experiment teaching,through reforming experimental courses,changing teaching methods and means of examination,constructing the laboratory etc.,so that we have built a new professional training model in pathological diagnosis and technology specialty experimental teaching.The experimental teaching reform results have improved the experimental teaching quality and the talents capability.