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ObjectiveTo summarize the modeling elements， evaluation indicators， characteristics， and drawbacks of the animal models of diabetic nephropathy， and thus provide guidance for the standardized modeling and rational application of these models. MethodThe articles about the animal experiments of diabetic nephropathy published in the last decade were retrieved from China National Knowledge Infrastructure， Wanfang Data， and PubMed. The data of animal species， sex， modeling techniques， modeling criteria， and evaluation indicators were analyzed in Excel. ResultA total of 287 publications were included in this study. Male SD rats were mainly used for the modeling of diabetic nephropathy. The animal models of type 1 diabetes were mainly established by intraperitoneal injection of streptozotocin （STZ） at 60-69 mg·kg-1 once or 50 mg·kg-1 for 5 continuous days， and those of type 2 diabetes by intraperitoneal injection of STZ at 30-39 mg·kg-1 once or 30 mg·kg-1 for 2 continuous days combined with 4 weeks of high-fat and high-sugar diet. Blood glucose and 24-hour urine protein were mainly used to determine whether the modeling was successful. The evaluation indicators of the animal models mainly included basic indicators， glucose and lipid metabolism indicators， and renal function indicators. ConclusionAnimal models are commonly used in the research on diabetic nephropathy， while there is no unified standards for the preparation or evaluation of the animal models. Moreover， Chinese medicine is rarely considered in the modeling. Through literature review and data analysis， this paper summarizes the modeling elements and standards， key evaluation indicators， characteristics， and shortcomings， aiming to build the animal models of diabetic nephropathy with a high success rate and with the characteristics in line with the clinical pathogenesis and syndromes.
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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 investigate the resistance of Staphylococcus aureus (S.aureus) to vancomycin and linezolid in Sichuan Province, and provide reference for clinical anti-infection treatment.Methods S.aureus and methicillin-resistant S.aureus(MRSA) from 71 hospitals in Sichuan Province in 2011-2015 were collected, minimum inhibitory concentration(MIC) values of vancomycin and linezolid against S.aureus and MRSA in each year were calculated.Results A total of 51 976 strains of S.aureus were collected in 5 years, 14 361 of which were MRSA, isolation rate of MRSA decreased from 36.02％ in 2011 to 25.56％ in 2015, which showed a downward trend (x2=160.72,P<0.05).From 2011 to 2015, MIC50 of vancomycin against S.aureus were 1, 0.5, 0.5, 1, and 1μg/mL respectively,MIC90 increased from 1μg/mL to 2μg/mL;the mean MIC50 of linezolid was 2μg/mL,MIC90 increased from 2μg/mL to 4μg/mL.Change in MIC50 and MIC90 of vancomycin against MRSA in 2011-2015 were obvious, which increased from 0.5, 1μg/mL to 2μg/mL respectively;the mean MIC50 of linezolid was 2μg/mL,MIC90 increased from 2μg/mL to 4μg/mL.Conclusion The isolates rate of MRSA had a decreasing trend,but there is a upward trend of MIC50 and MIC90 of vancomycin and linezolid against MRSA, bacterial resistance surveillance needs to be strengthened to provide evidence for rational clinical antimicrobial therapy.
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Objective To observe the effects of 19 kinds of traditional Chinese medicine (TCM) aqueous extracts in vitro on the standard and clinical strains of propionibacterium acnes.Methods We collected lesion contents of acne vulgaris patients and conducted anaerobic cultivation of propionibacterium acnes at 35 ℃ for forty-eight hours.After tested by oxygen resistance experiment,Gram staining microscopy,catalytic test,nitrate test and sugar fermentation experiment,ANI anaerobic identification card,and VITEK fully-automatic microbe instrument,the strains were identified as propionibacterium acnes.We used AGAR dilution method to test the MIC values of various TCM aqueous extracts.Results The MIC values of Cortex phellodendri,Scutellaria baicalensis,and Rhiubarb were 25 mg/ml,respectively;the MIC values of Sophora flavescens and Honeysuckle were 50 mg/ml;the MIC values of Forsythia was 100 mg/ml.13 kinds of TCM aqueous extract did not produce bacteriostasis at the highest concentration of 200 mg/ml including Belvedere fruit,Chinese bulbul,Hedyotis diffusa,Houttuynia cordata,Purslane,Yerbadetajo herb,Radix isatidis,Lithospermum erythrorhizon,Folium isatidis,Taraxacum,Semen plantaginis,Angelica dahurica,and Fructus cnidii.Conclusions Aqueous extracts of Cortex phellodendri,Scutellaria baicalensis,Rhubarb,Sophora flavescens,Honeysuckle and Forsythia have good inhibitory effects in vitro on Propionibacterium acnes.
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Objective To investigate the incidences, risk factors, genotypes and epidemiology of community-acquired blood stream infection caused by extended spectrum β-lactamases (ESBLs)-producing Escherichia coli and Klebsiella pneumonia strains and to analyze the sensitivity of those ESBLs producing strains to commonly used antibiotics. Methods Forty-two patients who were diagnosed with community-ac-quired blood stream infection caused by Escherichia coli or Klebsiella pneumonia strains in Sichuan Provincial People′s Hospital were recruited in this study. Disc diffusion method was used for the phenotypic confirmato-ry test of ESBLs. Agar dilution method was performed to measure the antimicrobial susceptibility of the ESBLs-producing strains to 13 clinically commonly used antibiotics. Genotypes of the ESBLs-producing strains were identified by polymerase chain reaction (PCR). Multilocus sequence typing (MLST) was used to analyze the epidemiology of ESBLs-producing strains. Logistic regression analysis was performed to analyze the risk factors for community-acquired blood stream infection. Results The ESBLs-producing Escherichia coli strains accounted for 56. 3% (18 / 32) and the ESBLs-producing Klebsiella pneumoniae strains accounted for 20% (2 / 10). All of the 20 ESBLs-producing strains were sensitive to imipenem, meropenem, ertapen-em, nitrofurantoin and moxalactam. The ESBLs-producing strains sensitive to amikacin, piperacillin-tazobactam and fosfomycin accounted for 95% , 90% and 85% , respectively. Drug resistance rates of the 20 strains to cefotaxime, levofloxacin, ciprofloxacin and cefepime were relatively high accounting for 100% , 80% , 80% and 75% , respectively. Among the 20 ESBLs-producing strains, 7 strains only carried the CTM gene, while the other 13 strains were all positive for two genotypes of ESBLs, mainly identified as TEM+CTM-M-14 and TEM+CTM-15 genotypes. The 18 Escherichia coli strains were classified into 10 ST types, most of which were ST131 type, followed by ST10 and ST38 types. This study indicated that malignant tumor might be a possible risk factor. Conclusion The prevalence of community-acquired blood stream infection caused by ESBLs-producing Escherichia coli strains was becoming increasingly serious. Malignant tumor might be the risk factor associated with the producing of ESBLs in Escherichia coli and Klebsiella pneumonia strains. TEM+CTX-M-14 was the predominant genotype of ESBLs-producing strains and the prevalent clone was ST131 type. Carbapenems and enzyme inhibitor compounds were ideal drugs for the treatment of commu-nity-acquired blood stream infection caused by ESBLs-producing Escherichia coli and Klebsiella pneumonia strains. This study was limited by the small sample size. Therefore, it is necessary to conduct further resear-ches based on a large number of samples.