Expert Consensus on Polymyxin Antimicrobial Susceptibility Testing and Clinical Interpretation / 中国医学科学杂志(英文版)

The polymyxins are important antimicrobial agents against antibiotic-resistant gram-negative bacilli. In 2020, the Clinical and Laboratory Standards Institute modified the clinical breakpoints for polymyxin susceptibility test by eliminating the "susceptible" interpretive category, only reporting intermediate (≤2 mg/L) and resistant (≥4 mg/L). However, the European Committee on Antimicrobial Susceptibility Testing recommended the use of clinical breakpoints of ≤2 mg/L as susceptible and >2 mg/L as resistant. The first-line laboratorians and clinicians in China have been perplexed by the inconsistence of international polymyxin clinical breakpoints and discouraged by the difficulty of conducting polymyxin susceptibility testing. Therefore, it is urgently needed to make it clear for the laboratorians in China to know how to accurately carry out polymyxin susceptibility testing and standardize the interpretation of susceptibility testing results. To this end, the experts from relevant fields were convened to formulate this consensus statement on the testing and clinical interpretation of polymyxin susceptibility. Relevant recommendations are proposed accordingly for laboratorians and clinicians to streamline their daily work.

Gemifloxacin for the treatment of community-acquired pneumonia and acute exacerbation of chronic bronchitis: a meta-analysis of randomized controlled trials / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Gemifloxacin is a fluoroquinolone antibiotic with broad spectrum of antibacterial activity. The aim of the study was to evaluate the comparative effectiveness and safety of gemifloxacin for the treatment of patients with community-acquired pneumonia (CAP) or acute exacerbation of chronic bronchitis (AECB).</p><p><b>METHODS</b>We performed a meta-analysis of randomized controlled trials (RCTs) comparing gemifloxacin with other approved antibiotics. The PubMed, EMBASE, Chinese Biomedical Literature Database and the Cochrane Central Register of Controlled Trials were searched, with no language restrictions.</p><p><b>RESULTS</b>Ten RCTs, comparing gemifloxacin with other quinolones (in 5 RCTs) and β-lactams and/or macrolides (in 5 RCTs), involving 3940 patients, were included in this meta-analysis. Overall, the treatment success was higher for gemifloxacin when compared with other antibiotics (odds ratio 1.39, 95% confidence interval 1.15 - 1.68 in intention-to-treat patients, and 1.33, 1.02 - 1.73 in clinically evaluable patients). There was no significant difference between the compared antibiotics regarding microbiological success (1.19, 0.84 - 1.68) or all-cause mortality (0.82, 0.41 - 1.63). The total drug related adverse events were similar for gemifloxacin when compared with other quinolones (0.89, 0.56 - 1.41), while lower when compared with β-lactams and/or macrolides (0.71, 0.57 - 0.89). In subgroup analyses, administration of gemifloxacin was associated with fewer cases of diarrhoea and more rashes compared with other antibiotics (0.66, 0.48 - 0.91, and 2.36, 1.18 - 4.74, respectively).</p><p><b>CONCLUSIONS</b>The available evidence suggests that gemifloxacin 320 mg oral daily is equivalent or superior to other approved antibiotics in effectiveness and safety for CAP and AECB. The development of rash represents potential limitation of gemifloxacin.</p>

Activity of ciprofloxacin and azithromycin on biofilms produced in vitro by Haemophilus influenzae / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>It is recognized that Haemophilus influenzae isolated from patients with otitis media forms biofilms both in vitro and in vivo, suggesting that biofilm formation in vivo might play an important role in the pathogenesis and chronicity of otitis media, but the effect of antibiotics on biofilm has not been well studied. We investigated the impact of ciprofloxacin and azithromycin on bacterial biofilms formed by Haemophilus influenzae in vitro in this study.</p><p><b>METHODS</b>Eleven strains of Haemophilus influenzae were isolated from sputum specimens collected from patients with acute exacerbation of chronic obstructive pulmonary diseases. Formation of bacterial biofilm was examined by crystal violet assay and a scanning electron microscope. Alterations of biofilms were measured under varying concentrations of azithromycin and ciprofloxacin.</p><p><b>RESULTS</b>Striking differences were observed among strains with regard to the ability to form biofilm. Typical membrane-like structure formed by bacterial cells and extracellular matrix was detected. Initial biofilm synthesis was inhibited by azithromycin and ciprofloxacin at concentrations higher than two-fold minimal inhibitory concentration. Disruption of mature biofilms could be achieved at relatively higher concentration, and ciprofloxacin displayed more powerful activity.</p><p><b>CONCLUSIONS</b>Haemophilus influenzae is capable of forming biofilm in vitro. Sufficient dosage might control early formation of biofilms. Ciprofloxacin exerts better effects on breakdown of biofilm than azithromycin at conventional concentration in clinics.</p>

Comparison of lung function measurement values with two different apparatus / 中国医疗器械杂志

This paper introduces a random measurement analysis of, lung function measurement values with two different apparatus. in 41 patients. It shows that the differences are not statistically significant (P>0.05) between two apparatus measurement values except DLCO, FEF25, FEF75 in the group of normal ventilation, FVC in the group of abnormal ventilation. The two groups are both correlated closely (r> 0.9) except MMF(r=0.7725, RV r=0.808) in the normal group of ventilation, and FEF75 (r=0.58) in the abnormal group of ventilation (p<0.001). The two apparatus with different measuring theories have a good correlation.

The immunity effects of quorum sensing in the pulmonary infection in rats due to pseudomonas aeruginosa / 中华急诊医学杂志

Objective To investigate the immunity effects of quorum sensing in the pulmonary infection in rats due to Pseudomonas aeruginosa.Method(1)300 healthy,clean Sprague-Dawley rats were divided into 3 groups randomly:two different Pseudomonas aeruginosa(the wide-type Pseudomonas aeruginosa PAO1 and its double mutant PAO-JP2,in which the quorum sensing systems were defective,embedded in minute seaweed algiante beads which was made by an ejection set with an acuminate hole were inoculated to Sprague-Dawley rats to establish animal model of chronic pulmonary infection.The control group were dealed with the same methods using the sterile brine instead.(2)The levels of antibody IgG,IgM,IgG1,IgG2a to Pseudomonas aeruginosa in sera and cytokines including interferon-?(IFN-?),Interleukin-4(IL-4)in lung homogenate was measured at 3,7,14,28 days after infection.Results(1)The mortality in the PAO1-JP2-infected group(11.0%)was significantly lower than that of the PAO1-infected group(29.7%)and the control group(4.21%).(2) Compared with the PAO-JP2 group,during the early stages of infection(3 days after infection),the IFN-?level in lung homogenates was significantly higher;during the middle stages of infection(7 days after infection),the levels of IFN-?and IL-4 of PAO1-infected rats were significantly higher;In the later stages of infection(14 to 28 days after infection),levles of IFN-?,IgG2a were lower,while levels of IL-4,IgG,IgG1 were higher persistantly in PAO1-infected rats.Conclusions Quorum sensing system play an important role in pathogenesis and immunity effects of pseudomonas aeruginosa infection via modulating the expression of virulence factors and interfering with the immune system of hosts.

Effect of iipopclysaccharide on ENaC expression in the lung of rats with acute lung injured / 中华急诊医学杂志

Objective To study the effect of lipopolysaccharide(LPS)on the endo-pulmonary natrium channel(ENaC)expression in the lung of rats with acute lung injured.Method Sixteen rats were randomly divided into normal control group and LPS-group.Rats of normal control group and LPS-group were killed at 6 hours after intravenous injection of normal saline(8 ml/kg)or LPS(8 mg/kg).The extent of lung injury was assessed by arterial blood gas analysis and histological examination.At the same time,?-ENaC protein and???- ENaC mRNA expression in the lung tissue were analyzed by immunohistochemistry and RT-PCR.Results PaO_2 in LPS-group was noticeably lower than in normal control group(P

Correlation between the expression of PCDGF in serum and the chemotherapeutic sensitivity in NSCLC / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the expression of PC cell-derived growth factor (PCDGF) in the serum of non-small cell lung cancer (NSCLC) patients and healthy adults, and it's correlation with chemotherapeutic sensitivity.</p><p><b>METHODS</b>The venous blood samples of 44 advanced NSCLC patients and 30 healthy adults were collected, and PCDGF mono-antibody was used for detection in the experiment. A part of specimens were randomly selected for Western-blot, and all specimens were eventually examined by ELISA. Chemotherapeutic response of these patients was recorded in order to analyze the correlation between PCDGF expression level and chemotherapeutic sensitivity.</p><p><b>RESULTS</b>Western blot results indicated that there was PCDGF expression both in NSCLC patients and healthy adults, and the expressing intensity of PCDGF in NSCLC patients was higher than that in healthy adults. The result of ELISA showed PCDGF expression in the patients whoever was chemoresistant or chemosensitive was significantly higher than that in healthy adults (P < 0.01), However, in chemoresistant patients, it was significantly higher than that in chemosensitive with a borderline statistical difference (P < 0.05).</p><p><b>CONCLUSION</b>PC cell-derived growth factor is found to be not only expressed in healthy adult but also in NSCLC patient at a high level in the serum, which may indicate metastasis and active proliferation in NSCLC. The intensity of PCDGF expression may be correlated with chemotherapy response and the high level expressing of PCDGF may indicate resistant to platinum-based chemotherapeutic regimen.</p>

Expression of serum breast drug-resistance protein in predicting chemosensitivity of NSCLC / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate expression of serum breast cancer resistance protein (BCRP) in non-small cell lung cancer patient (NSCLC) and healthy adult, and its correlation with chemosensitivity as one passible value of BCRP in clinical application.</p><p><b>METHODS</b>Venous blood specimens of 44 advanced NSCLC patients and 30 healthy adults were collected. Antibody of BCRP was used to detect its expression in the experiment. Part of venous specimens were randomly selected for Western-blot, and all specimens were examined by ELISA at last. Chemotherapy response of these patients was observed in order to analyze the correlation between BCRP expression level and chemosensitivity.</p><p><b>RESULTS</b>Western blot result showed that BCRP expression can be detected both in NSCLC patient and normal adult. The expression level in NSCLC patients detected by ELISA was significantly higher than that in the healthy adults (P = 0.00); which was also significantly higher in chemo-resistant patients than that in the chemosensitive (P = 0.02) and the healthy adults (P = 0.00); however, BCRP expression in chemo-sensitive patients was not significantly different from that in the healthy adults (P = 0.08).</p><p><b>CONCLUSION</b>Breast cancer resistance protein (BCRP) is found to be expressed at high level in the serum of NSCLC patient, the intensity of BCRP expression may be correlated with chemotherapy resistance in NSCLC, and the high level expressing of BCRP may indicate resistance to the platinum-based chemotherapy regimen. Detection of serum BCRP may someday become a useful bio-marker in predicting chemosensitivity of NSCLC.</p>

Study on the dynamics of IgG antibody in 311 patients with severe acute respiratory syndrome / 中华流行病学杂志

<p><b>OBJECTIVE</b>To detect the level and dynamic change of severe acute respiratory syndrome (SARS)-coronavirus-specific IgG antibody in conavalescent SARS patients, and to provide information for prevention and vaccine development.</p><p><b>METHODS</b>IgG antibody against coronavirus was detected by ELISA in the blood of 311 convalescent SARS patients for every 2 - 4 weeks. Stata 7.0 statistics software was used to analyse the results.</p><p><b>RESULTS</b>IgG antibody was detected positive on each testing of all the convalescent patients and its peak appeared 35 days after recovery. IgG antibody level showed a 35.8% decrease within one year.</p><p><b>CONCLUSION</b>Data showed that all the SARS convalescent patients had generated high level of specific IgG antibody against coronavirus in the early stage of recovery, but the antibody level declined along with the progress of convalescence, suggesting that the detection of the IgG antibody should go on until it disappeared.</p>

Inspiration from diffuse panbronchiolitis / 中国医学科学院学报

Diffuse panbronchiolitis is a new respiratory tract disease and was initially found in Japan. Strong association between race-dependent antigens and diffuse panbronchiolitis suggests a genetic predisposition to the disease. 14-member ring and 15-member ring macrolides have been proved to have significant therapeutical effect on diffuse panbronchiolitis. The discovery of diffuse panbronchiolitis and the advent of macrolide therapy for this disease suggests that clinicians should pay more attention to racial difference of some diseases and never overlook any accidental phenomenon in clinical practice.