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Alzheimer's disease （AD） is a neurodegenerative disease associated with aging and age-related cognitive decline. It is characterized by insidious onset and progressive development， and has become a major global health and socioeconomic issue. The exact mechanisms underlying AD have not been fully elucidated， and various hypotheses have been proposed by researchers based on different etiologies， including the amyloid β （Aβ） cascade hypothesis， Tau protein hyperphosphorylation hypothesis， mitochondrial dysfunction and oxidative stress hypothesis， and neurotransmitter hypothesis. Therefore， there is an urgent need for comprehensive interventions targeting multiple pathways， links， and targets. Based on traditional Chinese medicine （TCM） theory and modern research findings， kidney-tonifying and anti-aging Chinese medicines have unique advantages of toxicity reduction， long-lasting effects， and treating both the root cause and the symptoms. They have been shown to counteract immune-inflammatory responses， clear reactive oxygen species， exhibit antioxidant properties， inhibit abnormal aggregation of Aβ and Tau proteins， reduce neuronal apoptosis， regulate central neurotransmitters， and modulate gut microbiota in AD. In recent years， stem cell therapy has been explored for the treatment of AD through two strategies： endogenous activation and exogenous transplantation， thereby replenishing and replacing damaged neurons. However， factors such as blood-brain barrier permeability， targeted delivery to the affected area， immune rejection， and cell survival rate can affect the efficacy of stem cell transplantation. Therefore， combining stem cell therapy with medication and other methods can further enhance the effectiveness of stem cell transplantation. Kidney-tonifying and anti-aging Chinese medicines can activate dormant neural stem cells（NSCs） in the body， promote neuroregeneration， and facilitate tissue and organ repair and reconstruction in AD. The combined treatment of these Chinese medicines and stem cell transplantation has shown more significant efficacy compared to either treatment alone. This combination therapy provides a new integration point for the modernization of TCM and offers new ideas and approaches for the prevention and treatment of AD， as well as improving the effectiveness of stem cell transplantation.
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Stroke is one of the major diseases threatening human health， with ischemic stroke accounting for about 70%. Ischemic stroke is characterized by complex pathological mechanism and high incidence， mobility and mortality. At present， the effective clinical treatment measures for ischemic stroke are limited， and it is urgent to develop new and effective treatment measures to improve the prognosis of patients. In recent years， bone marrow mesenchymal stem cells （BMSCs） transplantation has shown great therapeutic potential for a variety of diseases， including ischemic stroke， and has become a new research hotspot. However， due to the low homing and survival rate of BMSCs in human body after transplantation， their clinical effect on ischemic stroke needs to be further improved. With the characteristics of multi-components， multi-channels and multi-targets， Chinese medicine displays desirable curative effect on ischemic stroke， which has been widely concerned. Both Chinese medicine and BMSCs transplantation have good overall brain protection， and their combined effect on ischemic stroke is significantly better than that of single application. The mechanisms include improving the transplantation efficiency of BMSCs， promoting angiogenesis， enhancing neuroplasticity， ameliorating neuroinflammation， enhancing neuroprotection， and regulating the blood-brain barrier and exosomes. The combination of Chinese medicine and modern cutting-edge cell therapy reflects the advantages of integrative medicine， providing a new model and idea for preventing and treating ischemic stroke and improving the efficacy of BMSCs transplantation.
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Objective To investigate the bacterial distribution and antibiotic resistance profile in Tongling People's Hospital during 2016.Methods All the clinically isolated bacterial strains in Tongling People's Hospital during 2016 were identified and tested for their susceptibility to antimicrobial agents.The results were analyzed with WHONET 5.6 software.Results A total of 2 949 strains of bacteria were collected,including 2 134 strains of gram-negative bacteria and 815 strains of gram-positive bacteria.The top five gram-negative bacteria were E.coli,4.baumannii,K.pneumoniae,P.aeruginosa and Enterobacter.The top five gram positive bacteria were coagulase-negative Staphylococcus,S.aureus,E.faecalis,E.faecium and Streptococcus.The prevalence of ESBLs-producing strains was 42.3％ in E.coli and 31.1％ in K.pneumoniae,The prevalence of carbapenem-resistant strains was 1.2％ (8/640) in E.coli isolates and 29.4％ (108/367) in K.pneumoniae isolates.Majority (94.3％) ofA.baumannii strains were susceptible to tigecycline.However,74.3％ and 74.9％ of these strains were resistant to imipenem and meropenem,respectively.Most P aeruginosa strains (78.2％) were resistant to piperacillin,but about 70％ were susceptible to carbapenem antibiotics.The prevalence of methicillin-resistant strains was 32.0％ (74/231) in S.aureus and 65.6％ (170/259) in coagulase-negative Staphylococcus.No staphylococcal strains were found resistant to teicoplanin or vancomycin.No enterococcal isolates were resistant to teicoplanin or linezolid.Conclusions The number of bacterial isolates in this hospital is increasing year by year.The prevalence of multidrug-resistant bacteria is also on rise,especially the pandrug-resistant Enterobacteriaceae and A.baumannii.It is urgently required to strengthen the control of hospital infections.
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Objective To investigate the value of low-dose coronary artery imaging with flash dual-energy CT.Methods In total of 240 patients suspected with coronary heart disease were performed dual-energy CCTA(DE-CCTA)and were divided into four groups according to the A tube electric current and the methods of reconstruction,including group A(conventional group:180 mAs+FBP)and low-dose groups(including group B,C,D:1 50 mAs,120 mAs,90 mAs +SAFIRE,respectively).The mean of CT value, image noise,SNR,CNR,image quality and radiation dosage were compared among the four groups.Among the patients,52 cases with coronary artery stenosis which were diagnosised by DE-CCTA were also confirmed by CAG,and the consistency of these two methods in the diagnosis of coronary artery stenosis were compared.Results The scores of all image quality were more than 3 points and were statistically significant among the four groups(P 0.05), while the image noise,SNR,CNR and the radiation dosage were statistically significant (P <0.05)among the four groups.The ED of group D was lower 55.62% than group A.DE-CCTA and CAG in the diagnosis of coronary artery stenosis had satisfactory consistency (Kappa=0.84,P<0.05).Conclusion Low-dose coronary artery DE-CCTA not only have none affect of image quality and diagnostic accuracy, but also can significantly reduce the radiation dosage.
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Purpose Dual-energy coronary artery CT angiography (CTA) is a very promising one-stop examine, but the radiation dose is too high to hinder the development of the technology. The aim of this article is to explore the feasibility of low tube current combined with sonogram-affirmed iterative reconstruction (SAFIRE) technology in dual energy coronary artery CTA scan. Materials and Methods One hundred and twenty patients were randomly divided into four groups according to the tube current of A ball:conventional group (180 mAs) and low-dose groups (150 mAs, 120 mAs, 90 mAs). The SAFIRE 3 reconstruction method was used in the low-dose groups. The differences of mean CT values, image noise, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), image quality score and effective dose (ED) of the four groups were compared. Results The coronary artery segment display and the mean CT value of the four groups showed no statistic difference (P>0.05), while the image quality score, noise, SNR, and CNR showed statistic difference (P0.05). The ED was (5.50±1.47) mSv, (4.55±1.16) mSv, (3.41±0.77) mSv and (2.44±0.67) mSv, respectively for the four groups, and there was statistical difference (P<0.05). ED of 90 mAs group decreased 55.62% than that of 180 mAs group. Conclusion Coronary artery CTA using 90 mAs combined with SAFIRE can significantly reduce the radiation dose without losing image quality, thus it has a good prospect of clinical application.
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Objective To investigate the bacterial resistance profile of clinical isolates collected in Tongling area . Methods Antimicrobial susceptibility test was conducted by Kirby‐Bauer method . All the data were analyzed with WHONET 5 .6 software .Results A total of 3 419 clinical isolates were collected during 2013 ,of which gram negative organisms and gram positive organisms accounted for 75 .9% and 24 .1% .MRSA accounted for 41 .3% of S .aureus and MRCNS accounted for 73 .5% of coagulase negative Staphylococcus ,respectively .MRSA showed higher resistance to gentamicin ,ciprofloxacin , erythromycin and rifampicin . No vancomycin‐ or teicoplanin‐resistant strains of Staphylococcus spp . were found . No vancomycin‐or teicoplanin‐resistant strains of E . f aecalis and E . f aecium were found .About 51 .6% of E .coli isolates and 42 .8% of K . pneumoniae isolates produced extended‐spectrum β‐lactamases (ESBLs ) . The prevalence of imipenem‐ or meropenem‐resistant strains of K . pneumoniae increased significantly .The percentage of P . aeruginosa strains resistant to amikacin ,piperacillin‐tazobactam ,ciprofloxacin ,cefepime and cefoperazone‐sulbactam was lower than 20 .0% .The percentage of A .baumannii strains resistant to cefoperazone‐sulbactam , minocycline and amikacin w as 34 .7% ,57 .0% and 58 .3% , respectively . More than 68 .0 % of A . baumannii strains were resistant to any of the other antibiotics tested . Conclusions The antibiotic resistance is growing in clinical bacterial isolates .The spread of carbapenem‐resistant strains of K . pneumoniae in some departments poses a serious threat to clinical practice .We should pay more attention to resistance surveillance and rational use of antibiotics .
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Objective To investigate the antimicrobial resistance of clinical isolates in Tongling People′s Hospital during 2013. Methods A total of 2 281 nonduplicate clinical isolates were collected.Kirby-Bauer disc diffusion method was employed to study the antimicrobial susceptibility.The data were analyzed with WHONET 5.6 software according to CLSI 2012 breakpoints. Results The top 5 most frequently isolated microorganisms were E.coli (479,21.0%),K.pneumoniae (360,15.8%),A. baumannii (271,11.9%),P .aeruginosa (240,10.5%),S.aureus (171,7.5%).Gram negative and gram positive microorganisms accounted for 76.5% and 23.5%,respectively.The prevalence of methicillin-resistant strains in S.aureus (MRSA)and coagulase negative Staphylococcus (MRCNS)was 38.6% and 73.1%,respectively.The resistance rates of MR strains to beta-lactams and other antimicrobial agents were much higher than those of MS strains.No staphylococcal strain was found resistant to vancomycin or teicoplanin.E.faecalis showed relatively lower resistance to penicillin,ampicillin and nitrofurantoin.E.faecium strains were more resistant than E.faecalis to most of the antibiotics tested.Approximately 50.5% of E.coli and 44.5% of Klebsiella isolates produced extended-spectrum beta-lactamases (ESBLs).The ESBLs-respectively.And 29.8% and 23.4% of the P .aeruginosa strains were resistant to imipenem and meropenem.Nearly all (94.0%)P .aeruginosa isolates were susceptible to amikacin.Conclusions There appears a trend of increasing resistance in the clinical bacterial isolates in this hospital,especially the carbapenem-resistant Enterobacteriaceae,which is of great concern.It is mandatory to take effective antibiotic policy and infection control measures.
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Objective To investigate the bacterial resistance of clinical isolates collected in Tongling area. Methods Antimicrobial susceptibility test was conducted by Kirby-Bauer method.All the data were analyzed with WHONET 5.5 software.Results A total of 3 092 clinical isolates were collected during 2012,of which gram negative organisms and gram positive organisms accounted for 76.3% (2 359/3 092)and 23.7% (773/3 092),respectively.MRSA and MRCNS accounted for 50.9% of S.aureus and 73.0% of coagulase negative Staphylococcus,respectively.MRSA and MRCNS showed higher resistance to gentamicin,ciprofloxacin and erythromycin.No vancomycin-or teicoplanin-resistant strains of Staphylococcus spp.were found.No vancomycin-or teicoplanin-resistant strains of E.faecalis were found.Some E.faecium strains were resistant to vancomycin and teicoplanin.About 52.1% of E.coli isolates and 42.1% of Klebsiella isolates produced extended-spectrumβ-lactamases (ESBLs).Imipenem-or meropenem-resistant strains of K. pneumoniae were found. The percentage of P.aeruginosa strains resistant to amikacin, cefoperazone-sulbactam and cefepime was 3.4%,14.0% and 17.7%,respectively.More than 70% of Acinetobacter spp. strains were resistant to all the antibiotics tested except minocycline and cefoperazone-sulbactam,to which 42.1%and 4.4% of the strains were resistant.Conclusions The antibiotic resistance of clinical bacterial isolates is growing. The spread of multi-drug or pan-drug resistant strains in a specific region poses a serious threat to clinical practice.We should pay more attention to resistance surveillance and the rational use of antibiotics.
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Objective To investigate the bacterial resistance of clinical isolates collected in Tongling area during 2011.Methods Antimicrobial susceptibility testing was conducted by Kirby-Bauer method.All the data were analyzed by WHONET 5.5 soft-ware.Results A total of 2 690 clinical isolates were collected during 2011,of which gram negative organisms and gram positive organisms accounted for 74.2% and 25.8%,respectively.MRSA and MRCNS accounted for 45.1% of S.aureus and 71.6%of coagulase negative Staphylococcus,respectively.MRSA and MRCNS showed higher resistance to gentamicin,ciprofloxacin and erythromycin than the corresponding methicillin-susceptible strains.No vancomycin- or teicoplanin-resistant strain of Staphylococcus spp.was identified.The resistance rate to penicillin,nitrofurantoin and fosfomycin was low in E.faecalis.No ampicillin-,vancomycin-or teicoplanin-resistant strains were found.For E.faecium,some strains were resistant to vancomy-cin and teicoplanin.About 46.6% of E.coli isolates and 27.7% of Klebsiella isolates produced extended-spectrumβ-lactamas-es (ESBLs).No imipenem-or meropenem-resistant isolate was found.The percentage of P .aeruginosa strains resistant to imipenem,meropenem and amikacin were 29.5%,36.9%and 2.3%, respectively. More than 60.0% of the Acinetobacter strains were resistant to all the antibiotics test-ed except minocycline and cefoperazone-sulbactam,to which 26.4% and 12.5% of the strains were resistant.Conclusions No glycopeptides-resistant isolate was found in gram positive organisms except E.faecium.The resistance rate of Enter-obacteriaceae isolates was lower to imipenem,meropenem, cefoperazone-sulbactam,piperacillin-tazobactam and amika-cin.The prevalence of resistant strains is still increasing,es-pecially carbapenem-resistant P .aeruginosa and carbapenem-resistant A.baumannii.It is mandatory to take effective antibiot-ic policy and infection control measures.
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OBJECTIVE To investigate the drug-resistant rates of clinical Acinetobacter baumannii strains isolated from our hospital and to understand the integrons distribution carried by A.baumannii.To identify the type of the integrons and analyze the correlation between integron and drug resistance in A.baumannii clinical isolates. METHODS Collected clinical isolates and the drug-sensitivity tests were completed by the method of KB.Amplified integrase were tested by PCR and identified the integron category.Correlation between integron in A.baumannii and drug resistance was analyzed.The open reading frame(ORF) of integron were amplified and observed the polymorphism of integron,Part of amplified products were sequenced. RESULTS Apart from imipenem and cefoperazone /sulbactam,the drug-resistant rate of 85 A.baumannii clinical isolates to else 15 kinds of antibacterials surpassed 30.0%.67.1% A.baumannii clinical isolates carried the integrons,and confirmed all of them belonged to integron Ⅰ after identification,but integrons Ⅱ and Ⅲ were not found.The drug-resistant rates of A.baumannii with integron to 14 kinds of antibacterials were higher than those of A.baumannii without integron.The length of amplified products in variable region of ORF of integron varied from 0.15 to 2.5 kb.The sequencing results confirmed the integron carried multidrug-resistant gene code. CONCLUSIONS Drug-resistant rate of A.baumannii clinical isolates in our hospital is higher and the majority of them are multidrug-resistant strains.The drug-resistant rates of A.baumannii with integron to 14 kinds of antibacterial are higher.The multidrug-resistant A.baumannii is associated with integrons.
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OBJECTIVE To investigate the resistance rates of Gram negative bacilli and the distribution of ?-lactamases in hospital infections(HI) or community acquired infections(CAI) in Tongling.METHODS Antimicrobial(susceptibility)(test) was done on 356 strains of Gram negative bacilli isolated in Tongling from Oct 2003 to Sep 2004 by Kirby-Bauer method.The detection of ESBLs and AmpC ?-lactamases was performed by three-dimensional test,MBL by the double-disk synergy test.RESULTS Among total 356 strains of Gram negative bacilli,267 were with HI(53.9%) isolated from sputum of patients,89(34.8%) were(isolated) from CAI patients and urine.The antimicrobial susceptibility rates of Gram negative bacilli from CAI patients was significantly higher than that from HI patients,for Acinetobacter baumannii they were 1.5 to 3.0,for(Pseudomonas aeruginosa) were 1.2 to 1.6.No strains of Escherichia coli and Klebsiella pneumoniae were found resistant to imipenem.Among 356 Gram negative bacilli,77 strains hyperproducing ESBLs and AmpC ?-lactamases,the detection rate was 21.6%, 69 strains were isolated from HI patients,and 8 strains were from CAI patients.From strains resistant to imipenem had 13 strains detected MBL,the detection rate was 52.0%.All of them were isolated from HI patients.CONCLUSIONS The resistance of Gram negative(bacilli) is a serious problem in Tongling.The antimicrobial(susceptibility) rates of Gram negative bacilli from CAI patients are significantly higher than those from HI patients.Gram negative bacilli produce all kinds of(?-lactamases,) such as ESBLs,AmpC(?-lactamases) and MBL.
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OBJECTIVE To study the resistance of Acinetobacter baumannii in our hospital and the relation with ADC ?-lactmases.METHODS Antibiotic susceptibility testing was determined by K-B methods to 115 A.baumannii strains,and three dimensional extract testing was performed to detect the ADC ?-lactmases-producing strains,blaADC gene was detected by PCR methods,and the MIC of ceftazidime,et al were determined in the presence of cloxacillin(500 mg/L) in 30 A.baumannii strains detected.RESULTS The resistance to imipenem and cefoperazone/sulbactam was below 10.4%,to other antibiotic resistance was over 54%;the multiresistance strains were 59%.ADC ?-lactmases and blaADC genes were all positive and the MIC of ceftazidime,et al except cefepime was decreased over eight-fold in the presence of cloxacillin for multiresistant A.baumannii,but not for non-multiresistant A.baumannii.CONCLUSIONS The resistance of A.baumannii is very serious in our hospital,ADC ?-lactmases-producing strains are related markedly with the multiresistance of A.baumannii.
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OBJECTIVE To investigate the pathogenic causes of community-acquired pneumonia(CAP) in adult patients in Tongling.METHODS A prospective study was performed on 260 consecutive adult patients with CAP in Tongling city during last three years.Bacteria culture of sputum and serological tests in paired serum samples were detected.RESULTS Of 260 patients with etiological evaluation,128(49.2%) patients had an identifiable etiology,63(24.2%) had positive outcome from sputum cultured,atypical pathogens were detected from 75(28.8%)patients.Pathogens identified in 128 patients were:Mycoplasma pneumoniae(35.4%),Chlamydia pneumoniae(17.7%) and Streptococcus pneumoniae(13.6%).6.5% All patients had mixed infection.The resistance rate of S.pneumoniae to penicillin and erythromycin was 5 and 50%,respectively.CONCLUSIONS Atypical pathogens have important role in CAP,of which M.pneumoniae is the most common pathogen.S.pneumoniae and K.pneumoniae are the commonly encountered bacteria for CAP in Tongling.