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AIM: To investigate drug resistance of Acinetobacter baumannii strains isolated in the hospital from 2018 to 2019, and explore plasmid-mediated delivery of quinolones resistance genes (PMQR) in Acinetobacter baumannii, to provide references for the clinical therapy of infections and to analysis the genetic mechanisms of resistance by aid of molecular methods. METHODS: Bacteria were identified by VITEK-2 compact System, the results of antibiotics susceptibility test was determined by using microdilution method MIC. We amplified genes of qnrA, B, C, D, S, aac(6')-Ib and qepA on plasmid by PCR, and PCR products of each resistant gene for sequencing analysis were random selected. We analyzed the results of antibiotics susceptibility of 152 clinical isolates based on WHONET 5.6 software. RESULTS: In the past two years, 152 strains of Acinetobacter baumannii have been detected from clinical specimens. The antibiotics resistance rate of Acinetobacter baumannii isolates was an increasing trend year by year. PCR indicated that some strains of Acinetobacter baumannii have products of aac(6')-Ib and qnrB gene, 29.6%(45/152) strains carrying aac(6')-Ib and 1.3%(2/152) strains carrying qnrB; there were no products of qnrA, C, D, S and qepA genes on plasmid. CONCLUSION: The current drug-resistance rate among Acinetobacter baumannii strains in Hefei to common antibiotics is high, and PMQR carrying rate is low.
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INTRODUCTION@#Flexible bronchoscopic intubation (FBI) is an important technique in managing an anticipated difficult airway, yet it is rarely performed and has a steep learning curve. We aim to evaluate if the integration of virtual reality gaming application into routine FBI training for emergency department doctors would be more effective than traditional teaching methods.@*METHODS@#We conducted a randomised controlled trial to compare self-directed learning using the mobile application, Airway Ex* in the intervention group versus the control group without use of the mobile application. All participants underwent conventional didactic teaching and low-fidelity simulation with trainer's demonstration and hands-on practice on a manikin for FBI. Participants randomised to the intervention arm received an additional 30 minutes of self-directed learning using Airway Ex, preloaded on electronic devices while the control arm did not. The primary outcome was time taken to successful intubation.@*RESULTS@#Forty-five physicians (20 junior and 25 senior physicians) were enrolled, with male predominance (57.8%, 26/45). There was no difference in time taken to successful intubation (median 48 seconds [interquartile range, IQR 41-69] versus 44 seconds [IQR 37-60], P=0.23) between the control and intervention groups, respectively. However, the intervention group received better ratings (median 4 [IQR 4-5]) for the quality of scope manipulation skills compared to control (median 4 [IQR 3-4], adjusted P=0.03). This difference remains significant among junior physicians in stratified analysis.@*CONCLUSION@#Incorporating virtual reality with traditional teaching methods allows learners to be trained on FBI safely without compromising patient care. Junior physicians appear to benefit more compared to senior physicians.
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Objective To analyse the expression of alpha-fetoprotein variant-L3(AFP-L3)and glypican-3(GPC-3)in primary he-patic carcinoma(PHC)with different concentration of alpha-fetoprotein (AFP),so as to provide references for the diagnosis of PHC.Methods 240 cases of outpatients,inpatients and individuals on physical examination were selected as subjects and serum levels of AFP-L3 and GPC-3 were detected.All of the subjects were divided into negative group(0≤AFP<20 ng/mL),low concen-tration group(20≤AFP<400 ng/mL)and high concentration group(AFP≥400 ng/mL)according to the serum levels of AFP.Ser-um levels of AFP-L3 and GPC-3 were compared among the three groups.And the sensitivity,specificity and accuracy of single de-tection of AFP-L3 or GPC-3 and those of combined detection of AFP-L3 and GPC-3 were compared as well.Results The serum levels of AFP-L3 and GPC-3 in the low concentration group and high concentration group were both higher than those in the nega-tive group,and those in the high concentration group were also higher than those in the low concentration group,had statistically significant differences(P < 0.05 ).The sensitivity,specificity and accuracy of combined detection of AFP-L3 and GPC-3 were 84.4%,95.9% and 93.8% respectively,which were higher than those of single detection of AFP-L3 or GPC-3.Conclusion Com-bined detection of AFP-L3 and GPC-3 could improve the sensitivity,specificity and accuracy for diagnosis of PHC,which has clinical significance for the diagnosis of PHC.
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Objective To investigate the change characteristics of serum ferritin(SF)and parathormone (PTH)levels in differ-ent stages of chronic kidney disease(CKD)and their correlation with serum beta 2-microglobulin(β2-MG).Methods The levels of serum PTH,SF andβ2-MG in different stages of CKD were detected and the detection results were compared with those in the con-trol group.The correlation between serum SF and PTH withβ2-MG in each stage of CKD was analyzed.Results The level of ser-um PTH,SF andβ2-MG in the compensation group had no statistical difference compared with the control group (P >0.05),while which had statistical differences among the decompensation group,renal failure group and uremia group (P <0.05)The correlation analysis showed that serum PTH was positively correlated with serumβ2-MG in 145 cases(r=0.92,P <0.05),and the serum SF level was also positively correlated with serumβ2-MG level(r=0.92,P <0.05).Conclusion Detecting serum PTH,SF andβ2-MG levels possesses the important clinical significance for understanding CKD condition and prognosis.
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Objectives To explore the correlation between the population characteristics of sero-reactivity with quantitative antibody based-IHA and the transmission parameters,such as epidemic situation,transmission status or infection trend in population.Methods The residents in one endemic administrative village were simultaneously examined by Kato-Katz technique for parasitological stool examination,as well as by immuno-diagnostic technique IHA for detection of IgG antibody against soluble egg antigen for two consecutive years.The results of examination were analyzed and compared on the diagnostic parameters of IHA,the correlation of the changes of positive rates and antibody levels of IHA with the changes of infection trend in population and the distribution of antibody levels between 'the true negative' and 'the true positive'.Results When Kato-Katz technique based on 2 stool samples,each read in 3 thick smears,was used as the reference,the overall sensitivity of IHA was high (from 77.27% to 85.48%) with a relatively poor specificity of lower than 60%,the negative predict value (NPV) was excellent of higher than 94%.The specificity of IHA decreased with the increase of the age in different age-groups of population,showing the highest among the younger less than 15 years old.The distribution trends of positive rates of antibody in different age groups by IHA showed similar to that of egg positive rate detected by Kato-Katz although the positive rates of IHA were higher than these by Kato-Katz,which showed that a higher false positive (from 41.90% to 44.56%) and a certain false negative (from 14.52% to 22.73%)existed in IHA.The positive rate of antibody decreased slowly among the individuals with S.japonicum infection,who received treatment.There was an overlap in the distribution of antibody levels between ' the true negative' and ' the true positive'.Conclusions Under the current schistosomiasis epidemic situation in China,IHA is valuable in the epidemiologic surveys.It should be of further deliberation applying IHA as the screening approaches for identification of target individuals for treatment or determination of the infection rate in community and IHA needs to be combined with the parasitological examination.