Distribution and Drug Sensitivity Analysis of Pathogenic Bacteria Isolated from Patients in Hematology Department / 中国实验血液学杂志

OBJECTIVE@#To investigate the distribution and drug sensitivity of pathogenic bacteria isolated from patients in hematology department, in order to provide evidence for rational use of antibiotics in clinic.@*METHODS@#The distribution of pathogenic bacteria and drug sensitivity data of patients in the hematology department of The First Affiliated Hospital of Nanjing Medical University from 2015 to 2020 were retrospectively analyzed, and the pathogens isolated from different specimen types were compared.@*RESULTS@#A total of 2 029 strains of pathogenic bacteria were isolated from 1 501 patients in the hematology department from 2015 to 2020, and 62.2% of which were Gram-negative bacilli, mainly Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Stenotrophomonas maltophilia and Acinetobacter baumannii. Gram-positive coccus accounted for 18.8%, mainly Coagulase-negative staphylococcus (CoNS) and Staphylococcus aureus. Fungi (17.4%) were mainly candida. The 2 029 strains were mainly isolated from respiratory tract (35.1%), blood (31.8%) and urine (19.2%) specimens. Gram-negative bacilli were the main pathogenic bacteria in different specimen types (>60%). K. pneumoniae, S. maltophilia and A. baumannii were the most common pathogens in respiratory specimens, E. coli, CoNS, K. pneumoniae and P. aeruginosa were common in blood samples, and E. coli and Enterococcus were most common in urine samples. Enterobacteriaceae had the highest susceptibility to amikacin and carbapenems (>90.0%), followed by piperacillin/tazobactam. P. aeruginosa strains had high sensitivity to antibiotics except aztreonam (<50.0%). The susceptibility of A. baumannii to multiple antibiotics was less than 70.0%. The antimicrobial resistance rates of E. coli and K. pneumoniae in respiratory tract specimens were higher than those in blood specimens and urine specimens.@*CONCLUSION@#Gram-negative bacilli are the main pathogenic bacteria isolated from patients in hematology department. The distribution of pathogens is different in different types of specimens, and the sensitivity of each strain to antibiotics is different. The rational use of antibiotics should be based on different parts of infection to prevent the occurrence of drug resistance.

Epidemiological characteristics and treatment outcome analysis of 229 patients with hydrofluoric acid burns in hands / 中华烧伤杂志

Objective: To explore the epidemiological characteristics and treatment outcomes of patients with hydrofluoric acid burns in hands. Methods: A retrospective observational study was conducted. The medical records of 229 patients with hydrofluoric acid burns in hands who were admitted to Zhejiang Quhua Hospital from January 2008 to December 2020 and met the inclusion criteria were collected. The following statistical data of patients were collected, including gender, age, type of affiliated enterprise, hydrofluoric acid mass fraction, injury site, total burn area, prehospital time, length of hospital stay, length of wound healing, whether hypocalcemia and hypomagnesemia occurred or not on admission, whether surgery intervention was performed or not, and whether scar sequelae occurred or not. Single factor and multivariate logistic regression analysis were used to screen out the risk factors impacting surgery intervention and scar sequelae of all the patients and patients whose hydrofluoric acid mass fraction was known. Single factor and multivariate linear regression analysis were used to screen out the risk factors impacting the length of wound healing of all the patients and patients whose hydrofluoric acid mass fraction was known. Results: The 229 patients included 206 males and 23 females, with the majority aged 30 to 50 years (139 patients). The type of affiliated enterprise of majority patients was non-fluorine chemical enterprise. The hydrofluoric acid mass fraction was known in only 91 patients, mainly medium. The majority injury site was in the middle and end of finger. The total burn area was below or equal to 1% total body surface area. The prehospital time was 19 (9, 29) h. The length of hospital stay was 2 (1, 7) d. The length of wound healing was 12 (8, 18) d. The proportions of hypocalcemia and hypomagnesemia were 0.9% (2/229) and 1.3% (3/229) on admission, respectively. Thirty-six patients had surgeries and 83 patients had scar sequelae. In 229 patients, single factor logistic regression analysis showed that both type of affiliated enterprise and prehospital time were the factors impacting surgery intervention (with odds ratio values of 7.86 and 51.35, respectively, 95% confidence intervals of 1.83-33.76 and 11.89-221.78, respectively, P<0.01) and scar sequelae of patients (with odds ratio values of 3.62 and 27.40, respectively, 95% confidence intervals of 1.76-7.43 and 13.25-56.68, respectively, P<0.01); multivariate logistic regression analysis showed that prehospital time was the independent risks factor impacting surgery intervention and scar sequelae of patients (with odds ratio values of 43.00 and 24.55, respectively, 95% confidence intervals of 9.89-187.03 and 11.78-51.16, respectively, P<0.01); single factor linear regression analysis showed that both type of affiliated enterprise and prehospital time were the factors impacting the length of wound healing of patients (with β values of 6.16 and 12.83, respectively, 95% confidence intervals of 3.38-8.93 and 10.72-14.93, respectively, P<0.01); multivariate linear regression analysis showed that both type of affiliated enterprise and prehospital time were the independent risk factors impacting the length of wound healing of patients (with β values of 2.81 and 12.16, respectively, 95% confidence intervals of 0.50-5.13 and 10.00-14.31, respectively, P<0.05 or P<0.01). In 91 patients whose hydrofluoric acid mass fraction was known, single factor logistic regression analysis showed that type of affiliated enterprise, hydrofluoric acid mass fraction (low and high), and prehospital time were all the factors impacting surgery intervention of patients (with odds ratio values of 9.10, 11.25, 10.69, and 0.04, respectively, 95% confidence intervals of 1.15-72.25, 1.39-90.93, 1.32-86.59, and 0.01-0.19, respectively, P<0.05 or P<0.01), type of affiliated enterprise, hydrofluoric acid mass fraction, and prehospital time were all the factors impacting scar sequelae of patients (with odds ratio values of 0.32, 0.21, and 36.80, respectively, 95% confidence intervals of 0.11-0.92, 0.06-0.73, and 11.03-122.79, respectively, P<0.05 or P<0.01); multivariate logistic regression analysis showed that both hydrofluoric acid mass fraction and prehospital time were the independent risk factors impacting surgery intervention of patients (with odds ratio values of 11.51 and 0.04, respectively, 95% confidence intervals of 1.22-108.26 and 0.01-0.25, respectively, P<0.05 or P<0.01), prehospital time was the independent risk factor impacting scar sequelae of patients (odds ratio=37.71, with 95% confidence interval of 9.97-142.69, P<0.01); single factor linear regression analysis showed that type of affiliated enterprise, hydrofluoric acid mass fraction (low and high), and prehospital time were all the factors impacting the length of wound healing of patients (with β values of 7.12, -5.63, -9.74, and 13.50, respectively, 95% confidence intervals of 2.43-11.81, -10.59--0.68, -14.78--4.70, and 10.14-16.86, respectively, P<0.05 or P<0.01); multivariate linear regression analysis showed that both hydrofluoric acid mass fraction and prehospital time were the independent risk factors impacting the length of wound healing of patients (with β values of -5.84 and 0.09, respectively, 95% confidence intervals of -10.59--1.08 and 0.05-0.12, respectively, P<0.05 or P<0.01). Conclusions: The majority of patients with hydrofluoric acid burns in hands are young and middle-aged males. Type of affiliated enterprise, hydrofluoric acid mass fraction and prehospital time are the risk factors that affect the treatment outcomes of patients with hydrofluoric acid burns in hands.

Innovation and exploration of diversified teaching patterns for Biochemical Reaction Engineering under the new engineering education background / 生物工程学报

Biochemical Reaction Engineering is a professional discipline with emphasis on both theory and practice. It is the core course in the curriculum provision for students majoring in bioengineering and plays an important role in the cultivation of professional talents. However, there are so much theory knowledge, such as formulas and deduction, that students showed poor efficiency in their study. Herein, to cater the objective command of innovative talents under new education background, and to improve the practical teaching efficiency and the students' enthusiasm as well as the practical innovation capability, the teaching team innovated and explored the teaching pattern, the teaching method as well as the teaching technologies. The teaching efficiency has been remarkably improved by introducing the virtual simulate technology, the micro-lecture, the case teaching pattern attempts and the scientific platform, which can be used as reference by other peers.

Identification of New Psychoactive Tryptamines 4-OH-MET and 4-AcO-DMT Using High Resolution Mass Spectrometry and Nuclear Magnetic Resonance Spectroscopy / 法医学杂志

Objective To detect the uncontrolled new psychoactive tryptamines involved in drug-related cases with high resolution mass spectrometry and nuclear magnetic resonance spectroscopy. Methods White and brown powder obtained in actual cases were extracted and analyzed by gas chromatography-quadrupole time-of-flight mass spectrometry （GC-QTOF-MS）, ultra-high performance liquid chromatography-linear ion trap quadrupole-orbitrap mass spectrometry （UPLC-LTQ-Orbitrap MS） and 1H-nuclear magnetic resonance spectroscopy （1H-NMR）. Results After detection by GC-QTOF-MS, the components of white powder showed main characteristic fragment ion peaks at m/z 218.141 0 （molecular ion peak）, 72.080 6 （base peak）, etc. After detection by UPLC-LTQ-Orbitrap MS, its protonated molecular ion was m/z 219.149 4. The main ions in the secondary mass spectrum under the collision-induced dissociation （CID） mode were m/z 160.076 3 and 72.080 8. After detection by GC-QTOF-MS, the components of brown powder showed main characteristic fragment ion peaks at m/z 246.135 7 （molecular ion peak）, 58.065 1 （base peak）, etc. After detection by UPLC-LTQ-Orbitrap MS, its protonated molecular ion was m/z 247.145 0. The main ions in the secondary mass spectrum under CID mode were m/z 202.087 1, 160.076 3 and 134.060 5. NIST 17 library retrieval and 1H-NMR confirmed that the white powder and brown powder contained new psychoactive tryptamines 4-OH-MET and 4-AcO-DMT, respectively. Conclusion GC-QTOF-MS, UPLC-LTQ-Orbitrap MS and 1H-NMR can be used together to identify unknown new psychoactive substances.

Prognosis factors analysis of patients with malignant solitary pulmonary nodules / 北京大学学报(医学版)

OBJECTIVE@#To explore the prognosis factors that influence the postoperative survival rate in patients with malignant solitary pulmonary nodules and to provide a reference for the prognosis risk stratification of early lung cancer patients.@*METHODS@#In this study, we retrospectively reviewed 172 patients who were admitted to Peking University First Hospital from April 2006 to December 2013. All cases were radiologically defined as solitary pulmonary nodule and were pathologically confirmed to be stage Ia non-small cell lung cancer after surgical procedure. The patients' clinical and follow-up data were summarized and analyzed. The relevance between survival time and factors that may affect patients' prognosis was evaluated, which included gender, age, clinical symptoms, smoking history, comorbidity index, tumor biomarkers, nodule type, type of surgery, nodule location, nodule histopathological type, nodule size, histopathological differentiation grade, proliferating cell nuclear antigen Ki-67 expression level and epidermal growth factor receptor (EGFR) gene mutation. Kaplan-Meier survival analysis, Cox univariant and multivariant regression analysis were conducted to evaluate the factors affecting prognosis.@*RESULTS@#The 3-year overall survival rate of the atients with malignant solitary pulmonary nodules was 93.6%, and the 5-year overall survival rate was 89.8%. KaplanMeier survival analysis and Cox univariant regression analysis showed that the overall survival rate of the male patients was significantly lower than that of the female patients. In addition, the elderly patients with histopathology characterized as high Ki-67 proliferation index were also associated with the worse overall survival (P<0.05). Cox multivariant regression analysis demonstrated that age more than 65 years as well as the high Ki-67 expression level were independent risk factors for overall survival in patients with malignant solitary pulmonary nodules (age: P=0.023, HR=3.531, 95%CI 1.190-10.472; Ki-67: P=0.004, HR=1.021, 95%CI 1.007-1.035).@*CONCLUSION@#For patients with malignant solitary pulmonary nodules, with pathological defined as stage Ia non-small cell lung cancer, age, gender and Ki-67 expression levels might be important prognostic factors. Comprehensive consideration of Ki-67 proliferation index and clinical pathological features may help to stratify the prognosis more accurately and guide the selection of appropriate therapeutic strategies, which needs to be verified by multi-center studies.

Observation on the Efficacy of Acupuncture plus Intradermal Needle in Treating Mild-to-moderate Post-stroke Depression / 上海针灸杂志

Objective To observe the clinical efficacy of acupuncture plus intradermal needle in treating mild-to-moderate post-stroke depression (PSD). Method Ninty patients with mild-to-moderate PSD were randomized into group A, B and C, with 30 cases in each group. All the groups were intervened by selecting Baihui (GV20), Shenting (GV24) and Yintang (GV29). Group A received acupuncture plus intradermal needle; group B, intradermal needle alone; group C, acupuncture plus sham acupuncture. Hamilton depression rating scale (HDRS) score and Barthel index (BI) score in the three groups were observed before and at the end of the treatment, and the clinical efficacies of the three groups were compared. Result The HDRS score and BI score showed a significant change after the treatment in the three groups (P<0.01). After the treatment, the HDRS score and BI score in the group A and group B was significantly different from those in group C (P<0.05). The total effective rate was 90.0％ in group A versus 86.7％in group B, and 73.3％ in group C; there was a statistically significant difference between group C and group A or B (P<0.01, P<0.05). Conclusion Both acupuncture plus intradermal needle and intradermal needle alone are effective approaches in treating mild-to-moderate PSD. The treatment efficacy of these two methods is similar.

Clinical analysis of pulmonary cryptococcosis in non-human immunodeficiency virus infection patients / 北京大学学报(医学版)

OBJECTIVE@#To improve the understanding of the clinical features of pulmonary cryptococcosis in non-human immunodeficiency virus (non-HIV) infection patients and reduce delay in diagnosis, or misdiagnosis.@*METHODS@#The clinical features, imaging characteristics, laboratory examinations, treatment and prognosis of 34 cases of pulmonary cryptococcosis were retrospectively analyzed. The data were collected from Peking University First Hospital from June 1997 to June 2016.@*RESULTS@#There were 34 cases diagnosed with pulmonary cryptococcosis, including 22 males and 12 females, aged from 20 to 75 years [average: (50.1±15.0) years]. There were 16 cases with host factors and (or) underlying diseases named immunocompromised group. In the study, 67.6% patients had clinical symptoms while 32.4% patients had no symptoms. The most common symptoms included cough, fever, chest pain, shortness of breath, and hemoptysis in sequence. Common chest imaging findings were patchy infiltrates, consolidation, single or multiple nodular or masses shadows. Among the 20 cases with cryptococcal capsular polysaccharide antigen detection, 19 were positive. Eleven cases underwent routine cerebrospinal fluid examination, and 3 cases complicated with central nervous system cryptococcal infection. At first visit, 24 cases were misdiagnosed, among which, 11 cases were misdiagnosed as lung cancer. The diagnosis of 15 cases was proved by percutaneous lung biopsy and 11 were confirmed by surgery, while 8 were diagnosed clinically. Then 11 cases were treated by surgical resection, and in median 4 years' followp, there was 1 case of recurrence. And 23 cases were treated with antifungal therapy, and in median 8 years' follow-up, 3 cases lost to the follow-up and 1 case of recurrence. Compared with normal immune group, immunocompromised patients had higher ages (P=0.017), more crackles (P=0.006) and more percentage of increase of peripheral white blood cells or neutrophils (P=0.003), but no significant difference in symptoms, imaging characteristics or hospitalization time.@*CONCLUSION@#There were no specific clinical symptoms and signs for pulmonary cryptococcosis in non-HIV patients. Diagnosis of pulmonary cryptococcosis depends on pathology. Percutaneous lung biopsy was mostly recommended for clinical highly suspected patients. Cryptoeoccal capsular polysaccharide antigen detection had a high sensitivity for the clinical diagnosis. Antifungal drug therapy was the major treatment, and the prognosis of the most patients was good.

Distribution and antibiotic resistance of 532 bacterial panthogens in blood culture in a hematology de-partment / 中华微生物学和免疫学杂志

Objective To analyze the distribution and antibiotic resistance of bacterial pathogens in blood culture in the Department of Hematology of the First Affiliated Hospital of Nanjing Medical Universi-ty from 2013 to 2017. Methods BACTEC FX automatic blood culture instrument was used for blood cul-ture. VITEK-2 Compact automatic microbial identification and drug susceptibility system was used for bacte-rial identification, drug sensitivity testing and fungal identification. K-B and ATB FUNGUS 3 methods were used for Streptococcus and fungi susceptibility testing, respectively. WHONET5. 6 software was used for sta-tistical analysis. Results The positive results of blood culture accounted for 7. 6% during 2013 to 2017 and the top five isolated pathogenic bacteria were Escherichia coli (20. 9% ), Klebsiella pneumoniae (18. 0% ), coagulase negative Staphylococcus (12. 4% ), Pseudomonas aeruginosa (11. 5% ) and Enterobacter cloacae (3. 6% ). Carbapenems (94. 4% ) were the most active antibiotics against Enterobacteriaceae. Pseudo-monas aeruginosa strains were sensitive to all antibacterial dugs except aztreonam. Acinetobacter baumannii strains had a lower sensitivity to almost all antibacterial dugs. Vancomycin, linezolid and teicoplanin were active antimicrobial agents against gram-positive cocci. Conclusion Patients with hematological diseases are more susceptible to nosocomial infection, which should be paid more attention to in clinical and laborato-ry practice. Rational antimicrobial therapy is an effective way for control of antimicrobial resistance.

Clinical application evaluation of Xpert detection system of Clostridium difficile / 临床检验杂志

Objective To evaluate the clinical application value of Xpert detection system of Clostridium difficile (C.difficile).Methods A total of 43 stool specimens from the patients with diarrhea were collected,and C.difficile in stool specimens were detected by the Xpert detection system,the toxigenic culture method,and the toxin detection method which detected the toxin of C.difficile by VⅥDAS automatic analyzer after anaerobic culture,respectively.The analytic performance of Xpert detection system was evaluted based on the toxigenic culture method as the gold standard.Meanwhile,the consistency of the results from different detection methods was compared.The ribotype 027 strain (ATCC BAA-1870) simulating the stool specimen was further used to verify the Xpert detection system.Results Based on the gold standard of the toxigenic culture method,the sensitivity,specificity,positive predictive value and negative predictive value of the Xpert detection system were 90.9％,93.8％,83.3％ and 96.8％,respectively.The Kappa values for the consistency between the Xpert detection system and the toxigenic culture method or the toxin detection method were 0.822 (P ＜ 0.05) and 0.419 (P ＜ 0.05),respectively.Moreover,the ribotype 027 strain simulating the stool specimen was verified by the Xpert detection system successfully.Conclusion The Xpert detection system may rapidly and accurately detect the C.difficile in stool specimens,especially the ribotype 027 strain with high toxicity.

Performance verification of diluted thrombin time assay for detecting Dabigatran level in plasma / 临床检验杂志

Objective To evaluate the performance of diluted thrombin time (dTT) assay for detecting Dabigatran levels and observe whether this assay may meet the requirements of clinical laboratory.Methods According to EP15-A2,EP6-A,EP7-A and C-24 documents of the Clinical and Laboratory Standards Institute (CLSI),the precision,trueness,analytical measurement range,carryover rate and anti-biological interference of dTT assay were evaluated and the stability of specimen for dTT assay was observed.Results Both the within-day and between-day coefficient of variation (CV) of dTT assay for detecting Dabigatran levels were consistent with manufacturer's stated CV.Compared with target values of Dabigatran,the relative bias of 3 levels of proficiency test materials from College of American Pathologists (CAP) were less than 10％.The results meet linear verification when Dabigatran concentration was between 30.92 and 249.13 ng/mL.The carryover rate was-0.84％.There was no interference for Dabigatran levels by dTT assay for detecting Dabigatran when Hb≤3 g/L,triglyceride≤873 mg/dL,heparin≤2.2 IU/mL and FDP≤29 mg/L.The results of stability showed that plasma specimens for dTT could not be stored at room temperature more than 4 hours,at 4 ℃ more than 4 days,at-20 ℃ exceed 1 month,while at-80℃ the plasma specimens could be stored at least 6 months for dTT assay.Conclusion The precision,trueness,analytical measurement range,carryover rate,anti-biological interference of dTT assay may meet the requirement of clinical laboratory.The stability of the specimen can fulfill the clinical requirements.

Percutaneous mechanical thrombectomy with subsequent iliac vein stent implantation accomplished by single-procedure for acute deep venous thrombosis of lower extremity: preliminary results in 12 cases / 介入放射学杂志

Objective To evaluate the feasibility,safety and effectiveness of percutaneous mechanical thrombectomy (PMT) and iliac vein stent implantation which are accomplished by single-procedure in treating acute deep venous thrombosis (DVT) of lower extremity.Methods During the period from December 2014 to January 2016,a total of 12 patients with acute DVT of lower extremity,including 3 males and 9 females with a mean age of (50.42±16.21) years old,were admitted to authors' hospital to receive treatment.Clinically,all patients presented with left leg swelling and pain.Central type of DVT was seen in 3 patients and mixed type of DVT was found in 9 patients.Preoperative placement of inferior vena cava filter was employed in all patients,which was retrieved after the treatment.PMT by using Angio Jet thrombus removal catheter,balloon angioplasty,and iliac vein stent implantation were successively carried out during the same procedure.When residual thrombus was identified on checkup angiography the catheter sheath would be reserved,and the thrombolytic therapy would be adopted.The patients were followed up at outpatient clinic at one,3,6 and 12 months after the treatment,and reexamination of color ultrasound and/or lower limb venography was used to assess the blood flow in the deep veins and in the stents.Results The combination of several therapies was accomplished in a single procedure,the technical success rate was 100％.The used time for the operation was 60-110 minutes,with a mean of (96.25±14.32) minutes.The used time for thrombus aspiration was 51-280 seconds,with a mean of (199.92±74.89) seconds.Thrombus clearance rate of grade Ⅲ was obtained in 10 patients,and thrombus clearance rate of grade Ⅱ was seen in 2 patients;the clinical symptoms were improved in all patients.Except some patients complained of different degrees of pain during the performance of balloon dilatation of left common iliac vein,no serious complications such as pulmonary embolism,severe hemorrhage,etc.occurred.The patients were followed up for (5.58±2.75) months;color ultrasound and/or lower limb venography performed in 11 patients showed that the blood flow in deep veins and iliac vein stents was unobstructed,and relapse of DVT was observed in one patient with cerebral astrocytoma.Conclusion For the treatment of DVT of lower extremity,PMT combined with iliac vein stent implantation that is accomplished by single-procedure is safe and feasible,its preliminary clinical results are satisfactory.

Effects of betaine on formation and dispersion of Pseudomonas aeruginosa biofilm and its drug-resistance / 临床检验杂志

Objective To investigate the effects of betaine on the formation and dispersion of biofilm of Pseudomonas aeruginosa and its drug-resistance.Methods A total of 20 strains of Pseudomonas aeruginosa were obtained from clinical inpatients.The biofilm formation abilities of the Pseudomonas aeruginosa were evaluated by violet staining,and the effects of betaine on the formation and dispersion of biofilm were studied.The minimum inhibitory concentration (MIC) values of Pseudomonas aeruginosa on ciprofloxacin were compared with the controls when biofilm was formed and inhibited.Results Biofilm was formed in all the 20 strains of Pseudomonas aeruginosa in 24 hours with absorbance (A590 nm) (1.90 ± 0.66).Betaine significantly inhibited biofilm formation of Pseudomonasaeruginosa in 24 hours compared with control group(t =4.36,P ＜ 0.01) and the maximum inhibition reached in 48 hours with absorbance(A590 nm) (1.12 ±0.60).The maximum dispersion of betaine on mature biofilm of Pseudomonas aeruginosa reached in 24 hours.The MIC range of ciprofloxacin to the 20 strains of Pseudomonas aeruginosa was 0.03 to 4 μg/mL with 0.25 μg/mL of MIC50 and 2 μg/mL of MIC90.After the biofilm was inhibited by belaine,the MIC of ciprofloxacin to Pseudomonas aeruginosa did not changed.The MIC of ciprofloxacin to biofilm-formed Pseudomonas aeruginosa was more than 16 μg/mL.Conclusion Betaine could effectively inhibit the formation of biofilm and disperse the mature biofilm of Pseudomonas aeruginosa,which may provide more choices for the treatment of clinical infection.The germicidal efficacy of ciprofloxacin has no changed on the biofilm-formed bacteria when inhibition of betaine was involved.

Inhibitory and dispersive effects of betaine on formation of Staphylococcus aureus biofilm / 临床检验杂志

Objective To observe the formation of Staphylococcus aureus biofilm and the inhibitory and dispersive effects of betaine on the biofilm.Methods The inhibitory and dispersive effects of 0.1％ betaine on the biofilm from 20 strains of Staphylococcus aureus were examined by crystal violet assay.Results All the 20 strains of Staphylococcus aureus formed biofilm.The biofilm of methicillinsensitive Staphylococcus aureus (MSSA) was formed in 24 hours with peak value of absorbance (A590 nm) (1.99 ± 0.53).The biofilm of methicillin-resistant Staphylococcus atureus(MRSA) was formed in 48 hours with peak value of absorbance(A590 nm) (1.13 ±0.47).After adding betaine,the absorbance(A590 nm) of MSSA biofilm fell down to(1.74 ± 0.61) in 24 hours,while the absorbance(A590 nm) of MRSA biofilm fell down to(0.40 ± 0.12) in 48 hours,which was significantly reduced compared with the controls (t =2.43,5.84,P ＜ 0.05 respectively).When adding betaine after the biofilm formed,the absorbancies (A590 nm) of both MSSA and MRSA showed no significant difference compared with the controls (P ＞ 0.05).Conclusion Betaine could inhibit biofilm formation of Staphylococcus aureus at concentration of 0.1％,but it could not disperse the mature biofilm of Staphylococcus aureus.

Results analysis of blood infectious indicators in 331 968 outpatients and inpatients / 国际检验医学杂志

Objective To analyze the results of detection of infectious indicators of patients from the first affiliated hospital of Nanjing Medical University in recent 5 years ,and to provide a scientific basis for the control and prevention of infectious diseases . Methods The patients with clinical data from January 2010 to April 2014 were retrospectively analyzed ,then the infectious indica‐tors of all the subjects were detected and analyzed .Results HIV positive rate was between 0 .043% to 0 .061% ,positive rate of HCV was between 1 .07 to 1 .41% ,positive rate of TP was between 2 .01% to 2 .17% .HBsAg positive rate in 2010 was 8 .36% ,the positive rate was 7 .81% in 2014 .HBsAb positive rate in 2010 was 35 .36% ,positive rate was 50 .96% in 2014 .Conclusion Effec‐tively cut off the route of transmission could prevent the further spread of infectious disease .

MicroRNA-3666 regulates expression of phosphatase and tensin homo-logue deleted on chromosome ten in leukemic cells / 中国病理生理杂志

AIM:To explore the regulatory effect of microRNA-3666 (miR-3666) on the expression of its tar-get gene phosphatase and tensin homologue deleted on chromosome ten (PTEN) in leukemic cells.METHODS: miR-3666 expression levels in normal peripheral blood mononuclear cells and leukemic cells were determined by quantitative real-time PCR.miR-3666 targeting PTEN 3'-untranslated region (3'UTR) was predicted by TargetScan software .3'UTR of PTEN was inserted in the dual luciferase reporter vector psiCHECK 2.The reporter activity was evaluated by the Dual-Lu-ciferase Reporter Assay System after the luciferase promoter vector and miRNA were co -transfected into HEK293T cell line. K562 cells were transfected with synthetic miR-3666 inhibitor ( anti-miR-3666) or a synthetic control miRNA ( anti-miR-C) .The expression of PTEN protein in the above transfected K 562 cells was determined by Western blotting .RESULTS:miR-3666 was up-regulated in the human leukemic cell lines and primary leukemic cells compared to normal peripheral blood mononuclear cells .The results of dual luciferase assays validated PTEN as a specific target gene of miR-3666.Inhi-bition of miR-3666 resulted in an up-regulation of PTEN protein expression in the K 562 cells.CONCLUSION:miR-3666 is over-expressed in leukemic cells .The abnormal over-expression of miR-3666 may play a key role in leukemia due to the down-regulation of PTEN .

Cement Embolus Trapped in the Inferior Vena Cava Filter during Percutaneous Vertebroplasty

A 58-year-old female patient, diagnosed with adenocarcinoma of the lung, underwent percutaneous vertebroplasty at the L4 vertebral body due to painful spinal metastases. Because of deep venous thrombosis of the left femoral and iliac veins, an inferior vena cava filter had been placed before vertebroplasty. Bone cement migrated into the venous bloodstream and then was being trapped within the previously placed filter. This case illustrates that caval filter could capture the bone cement and prevent it from migrating to the pulmonary circulation.

Treatment strategies and indications for interventional management of pseudoaneurysms / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Pseudoaneurysms (PAs) are common vascular abnormalities predominantly arising from a disruption in the integrity of the arterial wall. The potential complications of PAs are usually unpredictable and carry high rates of morbidity and mortality. This paper presents our experience with various treatment strategies for PAs.</p><p><b>METHODS</b>Fifty-four patients with 55 PAs were diagnosed by non-invasive imaging examination. The etiology of PAs included trauma (33/55), infection (5/55), iatrogenic (6/55), and idiopathic (11/55). Different procedures including ultrasound (US)-guided compression, endovascular treatment, and surgery were performed depending on the location of PAs, size of the sac and neck, and characteristics of the donor artery. The methods of endovascular treatment included embolization of parent artery, the PA sac, or implantation of a stent-graft. Follow-up was performed using US or CT and ranged from 1 day to 24 months (average 16.7 months).</p><p><b>RESULTS</b>In all 54 patients, 3 patients with superficial PAs were treated by US-guided compression, while 44 patients with 45 PAs located in the head and neck (n = 20), viscera (n = 10) or extremities (n = 15) were treated by endovascular treatment. Nine patients with PAs located in the head and neck (n = 2) or extremities (n = 7) were treated by surgery. Among them, one patient underwent endovascular treatment combined with surgery and 1 was treated by surgery after unsuccessful US-guided compression. In the 3 patients treated with US-guided compression, 2 were successfully treated while the remaining patient required additional surgery. Primary technical success of endovascular management was 97.7% (43/44) and the cure rate was 95.5% (42/44). In the surgery group, 4 patients recovered well, 1 patient was cured by endovascular treatment combined with surgery, 2 cases underwent amputation, 1 patient died of multi-organ failure and 1 patient was paralysed.</p><p><b>CONCLUSIONS</b>Minimally invasive interventional techniques are established treatment methods for PA with favorable success rates and minimal morbidity. The therapeutic options should be tailored to the location, size and rupture risk of PA, condition of the donor artery and existing comorbidity.</p>

Cerebral lipiodol embolism following transcatheter arterial chemoembolization for hepatocellular carcinoma: a report of two cases and literature review / 中华医学杂志(英文版)

Cerebral lipiodol embolism (CLE) is an extremely rare complication of transcatheter arterial chemoembolization for hepatocellular carcinoma. To our knowledge, only 11 cases have been previously reported. We recently encountered two cases of CLE in our clinical work. Reviewing the 11 cases in the literature and the two cases in our report indicates that large dose lipiodol infusion and absence of particulate embolization should be avoided. The presence of a right-to-left shunt and inferior phrenic artery injection seems to increase the risk of CLE. More caution should be taken in these situations.

Value of multi-detector row CT and magnetic resonance imaging in the diagnosis of retinal detachment / 南方医科大学学报

<p><b>OBJECTIVE</b>To summarize multi-detector row CT (MDCT) and magnetic resonance imaging (MRI) features of retinal detachment and evaluate the diagnostic value of these two imaging modalities.</p><p><b>METHODS</b>The MDCT and MRI manifestations were reviewed in 45 cases (47 eyes) of retinal detachment, among which 16 cases (17 eyes) were examined by MDCT and 29 cases (30 eyes) by MRI. Thirty-two cases (33 eyes) were confirmed by operation, and the other 13 cases (14 eyes) were confirmed based on the clinical findings.</p><p><b>RESULTS</b>MDCT and MRI displayed signs of fluid retention between the detached retina and the posterior wall of the eyeball in the cases. Among all these cases, 21 eyes showed simple retinal detachment and 26 had also other pathologies (hemorrhage in 20 eyes and calcification in 6 eyes). Choroidal osteoma was identified in 3 eyes and melanoma of choroid in 5 eyes.</p><p><b>CONCLUSION</b>MDCT is sensitive in detecting calcification in the eyes and MRI with a minimal risk of radiation, and shows advantages in displaying hemorrhage and confined retinal detachment. Both MDCT and MR have high clinical value in the diagnosis of retinal detachment, and their choice depends on the individual condition of the patients.</p>