Molecular characteristics and drug resistance of non-O1non-O139 Vibrio cholerae in Zhongshan City, Guangdong Province / 中国热带医学

@#Abstract: Objective　To investigate the molecular characteristics and drug resistance of non-O1/non-O139 Vibrio cholerae in Zhongshan City, and to provide laboratory basis for cholera prevention and control. Methods　The strains of non-O1/non-O139 Vibrio cholerae isolated from sporadic patients and aquatic products from 2015 to 2021 in Zhongshan city were collected. The identification and cluster analysis of the strains were analyzed by matrix assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF-MS), the ctxA virulence gene of strains were detected by real-time fluorescence quantitative PCR, the cluster analysis of the strains was analyzed by pulsed-field gel electrophoresis (PFGE), and the drug resistance of the strains were analyzed by microbroth dilution method. Results　From 2015 to 2021, 33 strains of non-O1/non-O139 Vibrio cholerae were isolated from Zhongshan City, including 28 strains from sporadic patients and 5 strains from aquatic products. Through MALDI-TOF-MS identification, 33 strains of non-O1/non-O139 Vibrio cholera can be identified to the level of species, and the identification results were all Vibrio cholerae. Among 33 non-O1/non-O139 Vibrio cholerae strains, 1 strain carried the ctxA virulence gene. The drug-resistant strains accounted for 69.7% (23/33), and the multidrug resistant strains accounted for 18.2% (6/33). A total of 7 kinds of drug resistance spectrum were produced, including 3 kinds of multidrug resistant spectrum, and showed drug resistance to 8 antibiotics, among which the resistance rates to streptomycin, cefazolin and compound sulfamethoxazole were above 30%. The 33 strains of non-O1/non-O139 Vibrio cholerae were divided into 32 PFGE fingerprints with a similarity ranging from 61.7% to 100%. MALDI-TOF-MS cluster analysis divided 33 non-O1/non-O139 Vibrio cholerae strains into two clusters. Conclusions The results of molecular typing of non-O1/non-O139 Vibrio cholerae in Zhongshan City presented diversity, and no significant correlation was found between PFGE and MALDI-TOF-MS cluster analysis. The strains demonstrated various degrees of resistance to certain antibiotics, and there were multidrug-resistant and toxigenic strains. Therefore, it is necessary to alert to the harmfulness of non-O1/non-O139 Vibrio cholerae and enhance monitoring.

Research on the establishment of standard limits for perfluorooctanoic acid and perfluorooctane sulfonate in the "Standards for Drinking Water Quality（GB5749-2022）"in China / 中华预防医学杂志

Perfluorinated compounds, especially Perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS), are widely detected in water environments in China. Considering the potential health risks of drinking water exposure routes, PFOA and PFOS have been added to the water quality reference index of the newly issued "Standards for Drinking Water Quality (GB5749-2022)", with limit values of 40 and 80 ng/L, respectively. This study analyzed and discussed the relevant technical contents for determining the limits of the hygiene standard, including the environmental existence level and exposure status of PFOA and PFOS, health effects, derivation of safety reference values, and determination of hygiene standard limits. It also proposed prospects for the future direction of formulating drinking water standards.

A Meta-analysis of the prognosis influence of anastomotic leak after surgery in patients with colorectal cancer / 中国医师进修杂志

Objective To study the local recurrence,distant recurrence and survival rate of anastomotic leak after surgery in patients with colorectal cancer.Methods Chinese and English related studies published from January 1970 to June 2011 were searched in PubMed/Medline,Excerpta medica database (EMBASE),Springger,Google scholar,China national knowledge infrastructure (CNKI),China biomedical literature database (CBM),Wanfang data.All controlled trials related to anastomotic leak after surgery in patients with colorectal cancer were retrieved.Outcomes were evaluated including local recurrence,distant recurrence and survival rate,then Mate-analysis was performed using RevMan 5.0 software provided by the Cochrane network.Results Fifteen studies were included,including a total of 18 225 patients.There were 1 425 patients with anastomotic leak and 16 800 patients without anastomotic leak.The patients with anastomotic leak were compared with patients without anastomotic leak.The OR value of local recurrence was 2.47 (95％ CI 1.72-3.55,P ＜ 0.01),the OR value of distant recurrence was 1.18 (95％ CI 0.98-1.43,P =0.08),and the OR value of 5-year survival rate was 1.68 (95％ CI 1.36-2.07,P ＜ 0.01).Conclusions Anastomotic leak after surgery is a bad prognosis factor in patients with colorectal cancer.It can increase the local recurrence rate,and decrease survival rate.

The effect of preoperative anemia, low albumin, low body mass index in the prognosis of advanced gastric cancer / 中国医师进修杂志

Objective To investigate the relationship between preoperative anemia,low albumin,low body mass index and the prognosis of advanced gastric cancer.Methods Three hundred and seventeen patients diagnosed with advanced gastric cancer as well as complete clinical pathology data from January 2006 to January 2008 were retrospectively analyzed.The clinical pathologic factors including age,gender,tumor size,type of Borrmann,hemoglobin,serum albumin,body mass index,type of histology,blood vessels and lymphatic invasion,infiltration depth,lymph nodes metastasis.The single factor and multiple factors were analyzed.Results Tumor size,type of Borrmann,hemoglobin,serum albumin,body mass index,type of histology,blood vessels and lymphatic invasion,infiltration depth and lymph node metastasis were identified as influencing factors of the prognosis,while independent factors associated with the prognosis of gastric cancer were serum albumin (OR =1.546,95％ CI:1.069-2.237),infiltration depth (OR =1.933,95％ CI:1.182-3.162) and lymph nodes metastasis (OR =1.586,95％ CI:1.358-1.853).Conclusion Anemia and low body mass index are the influence factors but not the independent factors in the prognosis of gastric cancer,while low albumin concentration is the independent factor in the prognosis of gastric cancer.

Meta-analysis on comparison of long-term complications and quality of life between two digestive tract reconstruction techniques following total gastrectomy / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To compare the incidence of postoperative long-term complications and quality of life between two digestive tract reconstruction techniques after total gastrectomy in order to provide evidence for clinical practice.</p><p><b>METHODS</b>A systematic literature search was carried out to obtain studies of randomized controlled trials (RCTs) of reconstruction techniques including jejunal interposition and Roux-en-Y. Data extracted from RCTs for meta-analysis were independently assessed by two reviewers. A meta-analysis was performed by RevMan5.0 software.</p><p><b>RESULTS</b>A total of 1628 gastric cancer cases undergoing total gastrectomy from 10 RCTs were eligible for inclusion, among whom 728 received jejunal interposition reconstruction and 954 Roux-en-Y anastomosis. As compared with Roux-en-Y anastomosis, jejunal interposition reconstruction significantly decreased the incidence of dumping syndrome (OR=0.19, 95%CI:0.11-0.34, P<0.01), increased the prognostic nutritional index (WMD=6.02, 95%CI:1.82-10.22, P<0.01), and improved the body weight postoperatively (WMD=-2.45, 95%CI:-3.81--1.71, P<0.01). Meanwhile, jejunal interposition reconstruction did not prolong operative time and hospital stay (both P>0.05).</p><p><b>CONCLUSION</b>Jejunal interposition has better efficacy than Roux-en-Y in dumping syndrome and quality of life, and is a reasonable and effective digestive tract reconstruction for long-term survival of gastric cancer patients.</p>

Comparisons of multiple characteristics between young and old lung cancer patients / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Risk factors that contribute to younger patients with lung cancer are still relatively unknown. The aim of this study was to compare the clinical characteristics, histological types, stages at diagnosis, treatment modalities and survival rates between young and old patients with lung cancer.</p><p><b>METHODS</b>The study was designed as a retrospective review of all lung cancer patients admitted to the Third Affiliated Hospital of Harbin Medical University from 1998 to 2008. Survival analyses using univariate and multivariate approaches were performed to compare the survival rates between different age groups and to discover potential prognostic factors.</p><p><b>RESULTS</b>This research included 3320 patients with primary lung cancer, of whom 626 (18.8%) were 45 years old or younger at the time of diagnosis. The percentage of smokers and the male to female ratios between the young and old patient groups were 51.27% vs. 70.6% (P < 0.001) and 1.99 vs. 2.13 (P = 0.4801), respectively. The young patient group had a higher incidence of adenocarcinoma and fewer surgeries. The 1-year, 3-year and 5-year survival rates in the young patient group were generally lower than those of the old patient group, with significant differences (P = 0.0232). The clinical stage of the tumor was a prognostic factor for both non-small cell lung cancer patients (P < 0.0001) and small cell lung cancer patients (P = 0.0002). Symptoms, diagnostic method, histology, smoking, treatment modality and body mass index were shown to have significant relationships with the survival of lung cancer patients (P < 0.05).</p><p><b>CONCLUSIONS</b>Patients with lung cancer who are younger than 45 years old might have a significantly poorer prognosis than that of older patients. Symptoms, diagnosis method, histology, smoking, treatment modality and body mass index can be independent prognostic factors for lung cancer.</p>

Microsurgery via modified far-lateral approach for giant dumbbell-shaped jugular foramen tumors / 癌症

<p><b>BACKGROUND AND OBJECTIVE</b>During the resection of jugular foramen tumors via the basic far lateral approach, the jugular foramen tumor area as well as its adjacent structures, especially the intracranial part, can be better exposed, which avoids stripping of the petrous part of temporal bone and displacement of facial nerve, and protects the patient's hearing from damage. However, when applied in tumors developed from ventral to the brain stem and middle fossa, with extracranial tumors, this surgical approach seems to be inadequate and limited. This study was to explore the microsurgical technique and clinical value for treating giant dumbbell-shaped tumors at jugular foramen (JF) via a modified far lateral approach.</p><p><b>METHODS</b>A retrospective analysis was performed in 16 patients with huge dumbbell-shaped tumors at JF which were removed through the modified far lateral approach (suboccipital transjugular-jugular tubercle-jugular process) between January 2001 and December 2008. The process of operation, and pre-and postoperative clinical data were included in the analysis.</p><p><b>RESULTS</b>Gross total tumor removal was achieved in 14 cases, subtotal removal in 1 case, and partial removal in 1 case. Follow-up examinations in most patients demonstrated that the patient with an obvious preoperative deficit had a good recovery. During the follow-up from three months to seven years, 10 (76.9%) cases with lower cranial nerve involvement showed obvious improvement of symptom after operation, 8 (80.0%) cases with facial palsy obtained various degrees of alleviation, and 7 (77.8%) cases with hearing impairment at different levels restored hearing. Two patients developed new lower cranial nerve palsies after operation, and underwent functional rehabilitation in the three-month follow-up.</p><p><b>CONCLUSIONS</b>Modified far lateral approach is helpful for removing the huge tumors at JF, especially for tumors extending to the petroclival region ventral part of pontomedullary junction. It has a higher rate of total resection, preoperative cranial nerve function impairment is expected to restore, and also has the advantage of protecting the facial nerve, labyrinth and vertebral artery structure from unnecessary damage.</p>

Preparation and in vitro biocompatibility of xenogenic(porcine)acellular dermal matrix / 中国组织工程研究

BACKGROUND: Human allogenic acellular dermal matrix, as a kind of permanent dermal scaffold, has widely used in the fields of burn wound reparation and aesthetic medicine. However, it is limited due to insufficient resources. OBJECTIVE: To prepare porcine acellular dermal matrix (PADM) dermal matrix, in addition, to estimate its in vitro biocompatibility. DESIGN, TIME AND SETTING: An in vitro cytology contrast experiment. The Experiment was performed at the laboratory of Biomaterials and Pharmacy Technology Institute, China Institute for Radiation Protection between August 2007 and June 2008. MATERIALS: The experiment pigs were supplied by experimental animal center of China Institute for Radiation Protection. Human fibroblasts were obtained from prepuce tissues of healthy children who underwent circumcision at the Shanxi Provincial General Hospital, Chinese People's Armed Police Forces. METHODS: The PADM was prepared from porcine skin by removing epidermis with a hypertonic salt solution and excluding cellular components in dermis with sodium dodecyl sulfate, and trypsin in hypersonic conditions. Human fibroblasts were cultured in vitro, and the biocompatibility of PADM was estimated with MTT method and contact method. MAIN OUTCOME MEASURES: ①Histological morphology of PADM. ②In vitro biocompatibility of PADM. RESULTS: The prepared PADM was a kind of matrix with normal structure and organization of collagen without epidermis and any cellular components in the dermis. The extraction of the porcine acellular dermal matrix had no effect on proliferation of the cultured human fibroblast. The cultured human fibroblasts could attach and proliferate on PADM. CONCLUSION: The PADM effectively removed epidermis and all cellular components with excellent biocompatibility can be obtained by this preparation method.

Establishment of genotyping method for human platelet antigens of HPA-15 system by PCR-SSP / 中国实验血液学杂志

This study was aimed to establish the reliable genotyping method of human platelet antigens of HPA-15 system by PCR-SSP and to use this assay in the further HPA genotyping of volunteer platelet donors. 3 sequence-specific primers recommended by the 11th Platelet Genotyping and Serology Workshop on behalf of International Society of Blood Transfusion (ISBT) were synthesized. The concentration of each primer pair, the concentration of Mg(2+) and the PCR conditions were adjusted to optimize the conditions so that HPA-15 system could be specific amplified. The accuracy and reliability of the developed assay was evaluated and confirmed by typing the coded DNA samples provided by the 11th Platelet Genotyping and Serology Workshop. As a parallel control, a total of 50 volunteer platelet donors in Shenzhen were genotyped by both our assay and the G&T commercial kit at HPA-15 system. 10 coded samples distributed by the 11th Platelet Genotyping and Serology Workshop were genotyped by established PCR-SSP method. The results showed that a concordance rate of 100% was observed between the results obtained by established PCR-SSP method and the results provided by ISBT report. The HPA gene frequencies observed in 50 randomly-selected platelet donors in Shenzhen were 0.5100 and 0.4900 for HPA-15a and HPA-15b respectively. In conclusion, PCR-SSP assay established in our study provides a simple, rapid and accurate method for HPA-15 system genotyping, which assay is suitable for routine clinical HPA genotyping and shows a broad prospect in its further applications.

Prevention of post-laminoplasty adhesion and restenosis using allogeneic freeze-drying radiation sterilization bone sheet:Imaging evaluation / 中国组织工程研究

BACKGROUND: To discuss the feasibility of allogeneic freeze-drying radiation sterilization bone sheet applying in the prevention of post-laminectomy adhesion as an ideal biological material for filling and repairing bone defect. OBJECTIVE: To observe the preventive effect of allogeneic freeze-drying radiation sterilization bone sheet on the postlaminectomy adhesion and restenosis.DESIGN: Follow-up survey on cases.SETTINGS: Department of Orthopedics, Union Hospital, Tongji Medical School of Huazhong University of Science and Technology; Shanxi Medical Tissues of China Institute for Radiation Protection PARTICIPANTS: From March 2003 to June 2005, 58 patients with segmental lumbar spinal stenosis (LSS) were selected from Department of Orthopedics, Union Hospital, Tongji Medical School of Huazhong University of Science and Technology, including 34 males and 24 females, aged 30-78 years, including 25 cases of simple LSS and 33 combined LSS; and including 36 cases in L4-5 and 33 cases in L5, S1 segments. All the patients were similar in age, gender and healthy conditions.METHODS: The segmental whole laminectomies were performed in 58 patients with prolapse of lumbar intervertebral or LSS, and allogeneic freeze-drying radiation sterilization bone sheet in "H" shape was used to cover the vertebral laminae. According to the follow-up standard of lumbar spine operation recommended by the Orthopaedics Branch of Chinese Medical Association, all patients were followed up to evaluate their clinical symptoms, absorption of implanted bone as well as CT and MRI presentations.MAIN OUTCOME MEASURES: Improvements of clinical symptoms;Absorption of bone sheet in lumbar spinal canal.RESULTS: Totally 58 LSS patients were involved in the result analysis.In postoperative 0.5-year follow-up period, 17 of 21 patients showed excellent curative effects while other 4 patients showed fine effects. In postoperative 1-year follow-up period for 23 patients, CT and MRI results demonstrated that the spinal canal had been extended obviously. There was no tilt or displacement of the femoral sheet or compression of the spinal cord. As for 14 patients who were followed up for 1.5 years, CT results displayed that there was no rejective reaction observed in this study. The edgeof the allograft was inosculated with connective lamina of vertebra, and the shape of lumber spinal was good.CONCLUSION: Allogeneic freeze-drying radiation sterilization bone sheet is an ideal dressing material for epidural laminoplasty. The imaging results of patients in postoperative 1.5-year follow-up indicate that it can effectively reduce the post-laminectomy adhesion formation and prevent recurrence of post-laminectomy spinal restenosis, so as to apply on the segmental vertebral plate dressing.

Presurgical evaluation and surgical treatment of medically refractory epilepsy: a report of 162 cases / 中华外科杂志

<p><b>OBJECTIVES</b>To study presurgical evaluation and surgical treatment of medically refractory epilepsy.</p><p><b>METHODS</b>One hundred and sixty-two cases of refractory epilepsy were analysed by their clinical manifestation, neuroradiology and neuroelectrophysiology. Different operative techniques were performed to all the 162 cases according to those analyses.</p><p><b>RESULTS</b>Total effective rate of the surgical treatment was 87.7% and most patients have better life than preoperation.</p><p><b>CONCLUSION</b>Surgical treatment with accurate preoperative location of the epileptogenic zone and suitable operative techniques is an effective method in the treatment of refractory epilepsy.</p>