Antimicrobial resistance profile of clinical isolates in hospitals across China: report from the CHINET Surveillance Program, 2017 / 中国感染与化疗杂志

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.

Comparison of effect of different treatment methods in the prevention of persistent ectopic pregnancy after laparoscopic tubal pregnancy conservative operation / 中国基层医药

Objective To compare the effect of different treatment methods in the prevention of persistent ectopic pregnancy after laparoscopic tubal pregnancy conservative operation, to provide reference to women's clinical treatment planning needs of choice.Methods 204 patients underwent laparoscopic tubal pregnancy conservative surgery were selected.According to perioperative preventive postoperative persistent ectopic pregnancy in different ways, they were divided into four groups.After the removal of the gestational sac, the methotrexate injected into the fallopian tube was established as A group(48 cases);methotrexate combined with mifepristone on the prevention of persistent ectopic pregnancy after laparoscopic cyst removal was established as B group(56 cases);simultaneous removal of corpus luteum in laparoscopic cyst removal surgery was established as C group(51 cases);after removal of the bursa, methotrexate injected into the fallopian tube in laparoscopic cyst removal surgery was established as D group(48 cases).The operation indicators of four groups (operation time and intraoperative bleeding volume),blood beta-HCG(β-HCG) changes of 1st,3rd,6th and 12th day after surgery, ectopic pregnancy rate continued after surgery, postoperative follow-up of 2 years were compared.Of the four groups, the normal pregnancy again time after operation, the comprehensive evaluation of different treatment methods for the effect of ectopic pregnancy in the prevention of laparoscopic tubal pregnancy conservative surgery were compared.Results Of the four groups, the age, reproductive status, menopause, preoperative 1st day bleeding, tubal rupture cases, tubal mass diameter, gestational sac in the fallopian tube in position, bloodβ-HCG levels, operation methods had no statistically significant differences(all P<0.05).Comparison of four groups of operation indicators, the operation time in B group was significantly shorter than that in the other three groups(F=5.305,P=0.037).The amount of bleeding in C group and D group was similar, which was significantly higher than that of A group and C group(F=7.483,P=0.005).The β-HCG levels of D group of 1st,3rd,6th and 12th day were significantly lower than those of the other three groups(all P<0.05), which of B group at different time were significantly higher than those of the other three groups(all P<0.05).The persistent ectopic pregnancy rate of D group was significantly lower than that of the other three groups(2.08% vs 14.58%,14.29%,11.54%,x2=7.406,P=0.040),and the normal pregnancy again rate of D group was significantly higher than that of A,B and C groups(58.33% vs 32.14%,37.50%,38.46%,x2=5.349,P=0.022).Conclusion The laparoscopic removal of tubal pregnancy sac at the same time, to the fallopian tube injection of methotrexate, enucleation of corpus luteum, although increases operation time and bleeding volume, but can significantly reduce the harm to women of childbearing age of persistent ectopic pregnancy, and it has high clinical value.

Role of tyrosine kinase receptor RON in tumor growth and metastasis:research progress / 中国药理学与毒理学杂志

Recepteur d′origine Nantais(RON),a tyrosine kinase receptor ,is a growth factor receptor belonging to the proto-oncogene met family and has been proved to display abnormal expres?sion in many types of tumors. The RON receptor is activated by binding to the ligand macrophage stim?ulating protein,overexpression of the receptor,variants of the proto-oncogene and by point mutations of the kinase region. The downstream transduction of RON by mitogen-activated protein kinases and phosphoinositide3-kinase signaling pathways can help regulate the proliferation,apoptosis,migration and invasion of tumor cells. A better understanding of the mechanisms and related signaling pathways of RON activation in tumor progress and development will provide more information for the RON-based target therapy.

The effect of hyaluronic acid on conception rate of ectopic patients who underwent laparoscopic surgery treatment / 中国基层医药

Objective To observe the clinical effect of hyaluronic acid on conception rate of ectopic pregnancy patients who received conservative tubal operation under laparoscopy.Methods 100 patients with ectopic pregnancy received conservative tubal operation under laparoscopy treatment were selected.Hyaluronic acid was used in 50 cases (the treatment group),unused anti blocking preparations for the control group in 50 cases.Then patients were followed up on the tubal patency,and observed pregnancy after 1 year.Results The rate of tubal patency after menstrual clean was 84％ in the treatment group,which was significantly higher than 60％ in the control group(x2 =7.155,P ＜ 0.05).In the treatment group,40 cases were intrauterine pregnancy,4 cases were ectopic pregnancy,6 cases were infertility.The rate of intrauterine pregnancy after 1 year was 80％ in the treatment group,which was significantly higher than 56％ in the control group(x2 =6.65,P ＜ 0.05).Conclusion Hyaluronic acid is effective in preventing tubal adhesion in the ectopic pregnancy patients who received laparoscopic conservative surgery,and can improve the postoperative tubal patency rate and conception rate.

Clinical study on the surgical treatment pelvic organ prolapse in 60 elder women / 中国基层医药

Objective To compare the clinical effects of the traditional operation and the new patch technique for the elderly women with pelvic organ prolapse.Methods 60 elderly women with pelvic organ prolapse patients were randomly divided into the traditional group and the modern group with 30 cases.The traditional group was treated with traditional surgery.The madern group was treated by new patch repair.Compare of the operation time,operative blood loss,catheter duration,hospital stay,postoperative recovery and 3 years recurrence rate in two groups.Results The catheter duration and hospital stay of the mederm group were significantly shorter than those of the traditional group (t =8.9471,14.2584,P ＜ 0.05).The postoperative recovery of the new group was better than the traditional group (x2 =5.9341,P ＜ 0.05).The 3 years recurrence rate of the mederm group was significantly lower than those of the traditional group (x2 =4.7059,P ＜ 0.05).The operation time of the mederm group was longer than those of the traditional group (t =4.4631,P ＜ 0.05) and the operative blood loss was more than the traditional group (t =2.0318,P ＜ 0.05).Conclusion The effect of the new patchin the treatment of elderly women with pelvic organ prolapse is better than the traditional surgery.

Efficacy of Wearing Gloves to Protect Laboratory Staffs from Hepatitis B Virus (HBV) Infected Via Hands / 中华医院感染学杂志

OBJECTIVE To survey hepatitis B virus(HBV) contamination on hands of laboratory staffs and to evaluate the protection efficacy against HBV infection by wearing gloves.METHODS Samples from used gloves and gloves-protected hands were carried out according to the methods stipulated in the Technical Guidelines for Disinfection.All samples were divided into 3 groups:gloves worn for 1h,gloves worn for 3h and gloves-protected hands,each group had 202 cases.To detect HBsAg and HBV DNA by microparticle enzyme immunoassay(MEIA) and fluorescence quantitative polymerase chain reaction(FQ-PCR),respectively.RESULTS HBsAg polluted rates of gloves worn for 1h,gloves worn for 3h and gloves-protected hands were 22.77%,34.65% and 2.48%,respectively;HBV DNA polluted rates of gloves worn for 1h,gloves worn for 3h and gloves-protected hands were 27.72%,41.58% and 2.48%,respectively.The HBsAg and HBV DNA polluted rates of gloves worn for 3h were higher than those of gloves worn for 1h,the difference was significant between them(P