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Objective To analyze the changing antibiotic resistance profile of the Klebsiella pneumoniae strains isolated from blood cultures during the last 9 years in our hospital for rational use of antibiotics. Methods Antibiotic resistance of the K. pneumoniae strains isolated from blood cultures from 2009 to 2017 was retrospectively analyzed. Medical records of the corresponding inpatients were reviewed and analyzed. Results A total of 6 917 bacterial strains were isolated from blood cultures between 2009 and 2017, of which 311 strains (4.5％) were Klebsiella pneumoniae. Complete antimicrobial susceptibility data were available for 298 of the 311 strains. The K. pneumoniae strains isolated from blood cultures showed increasing resistance rate to the antimicrobial agents in the nine-year period. The resistance rates to piperacillin-tazobactam, cefotetan, amikacin, carbapenem antibiotics increased from 0 to 48.6％. The prevalence of CRKP increased from 0 in 2009 to 48.7％ in 2017. The inpatients with K. pneumoniae isolate from blood cultures were mainly found in general surgery, cardio-thoracic surgery department, emergency room, and pediatrics surgery department. Significant difference was found between CRKP-associated inpatients and non-CRKPassociated inpatients in the time to detection of K. pneumoniae, exposure to antimicrobial agents, invasive procedure, length of hospital stay, and prognosis (P＜0.001). Conclusions The antibiotic resistance profile of the K. pneumoniae strains isolated from blood cultures showed a rising tendency during the period from 2009 to 2017. Clinical microbiology laboratory should pay more attention to strengthening antibiotic resistance surveillance. Clinicians should reduce the use of invasive procedures and use appropriate antimicrobial agents to prevent the emergence of antibiotic-resistant strains.
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Objective To investigate the CT features of nodular or mass-like type pulmonary cryptococcosis(PC). Methods A total of 52 cases with nodular or mass-like type PC confirmed by pathological examinations at Fuzhou Pulmonary Hospital of Fujian from January 2008 to December 2012 were studied. Each patient underwent a breath-hold MSCT scan and contrast enhanced CT was performed in 19 patients. The data including lesion size, number, distribution, density, performance of enhanced CT scan and accompanying signs were analyzed. Each CT accompanying sign was compared between nodular lesions and mass-like lesions using χ2 test,continuous correction χ2 test or Fisher exact test. Results Of all the 52 patients, pulmonary cryptococcosis was consisted single nodules/masses (21 cases) and multiple of nodules/masses (31 cases). There were total 206 lesions with 172 nodules and 34 masses. The lesions were mainly found in lower lobe(73.3%, 151/206)and outer zone or subpleura(87.4%, 180/206)of lung. Plain CT scan showed the densities of most lesions were solid and uniform(74.7%, 154/206). A total of 95 lesions were detected in the 19 patients with contrast enhanced CT, in which 61 lesions (64.2%) showed homogeneous enhancement and 86 lesions (90.5%) showed moderate enhancement. Nodular or mass-like lesions accompanied by many CT signs including halo sign (59.2%, 122/206), air bronchogram (32.0%, 66/206), pulmonary cavity or vocule sign (15.0%, 31/206), lobulation sign (25.2%, 52/206), spicule sign (13.1%, 27/206), pleural indentation(7.8%, 16/206) and vascular cluster (1.9%, 4/206). Compared with mass-like lesions, lobulation sign was more frequently observed in nodular lesions(χ2=13.750, P=0.001), whereas air bronchogram and pulmonary cavity orvocule sign were less frequently observed(χ2=19.957, P=0.001; χ2=5.295, P=0.021, respectively). No significant statistically differences were detected in other CT signs between them (P>0.05). Conclusions PC lesions usually occur in right lung, lower lobe and close to the pleura. Halo sign and air bronchogram are the characteristic findings of CT manifestations in nodular or mass-like type PC.
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0.05), hinted that the tenocyte's function was not disturbed. The DNA index of cells of TDBM group was 0.96, 10.1% higher than the control group, indicating that the tenocytes grow and proliferate faster when being combine cultured on TDBM. Non malproliferation of tenocytes were founded, and lots of collagen formed among TDBM fibers within 2 months in vitro culture. Conclusion TDBM show good biocompatibility combined with tenocytes because of more similarity of surface and component with tendon. It could be promising extracellular matrix scaffold for cell transplantation in tendon tissue engineering.