Programmed cell death induced by Klebsiella pneumoniae infection / 中华微生物学和免疫学杂志

Klebsiella pneumoniae can cause a variety of infectious diseases, especially in immunocompromised population. The emergence of multidrug-resistant hypervirulent Klebsiella pneumoniae has greatly limited the choice of treatment for Klebsiella pneumoniae infection, and the exploration of new treatment strategies is imminent. In the process of infection, there is a complex interaction between the programmed cell death of host cells and the invasion of Klebsiella pneumoniae. This paper mainly reviewed the research progress in several mechanisms of programmed cell death such as pyroptosis, apoptosis, necroptosis and autophagy caused by Klebsiella pneumoniae.

Analysis of risk factors of hyperpyrexia suffered by post neurosurgical patients after removal of drainage tube / 中华危重病急救医学

Objective:To analyze the risk factors of hyperthermia after removal of drainage tubes in patients after neurosurgery.Methods:The clinical data of 146 patients after neurosurgery with indwelling drainage tubes admitted to the department of critical care medicine of Pecking University Third Hospital from January 2019 to July 2021 were analyzed retrospectively. The patients were divided into hyperthermia group (body temperature≥39 ℃) and non-hyperthermia group (body temperature < 39 ℃) according to whether their body temperatures within 24 hours after removal of drainage tubes. General clinical data and outcomes of the two groups were collected, and different tendentious scores were matched with the hyperthermia group and non-hyperthermia group based on Glasgow coma score (GCS), respectively. After such matching, the clinical baseline characteristics [age, gender, admission diagnosis, major complications, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) at admission, GCS], number of days of drainage tubes retention, location of drainage tubes, microbial culture results before removal of drainage tubes, white blood cell (WBC) and neutrophil ratio (NEU%) before and after removal of drainage tubes as well as clinical outcomes of the cohort patients were analyzed. The primarily outcome was in-hospital mortality, and then the length of intensive care unit (ICU) stay.Results:A total of 146 patients after neurosurgery were included, 28 of which developed hyperthermia after removal of drainage tubes. The GCS scores at admission in the hyperthermia group were significantly lower than that in the non-hyperthermia group, while the proportion of hypertension and diabetes in the hyperthermia group was significantly higher than that in the non-hyperthermia group. Based on GCS scores, the two groups, each of which included 28 patients, were matched with tendentious scores, and there was no significant difference in gender, age, GCS scores and the proportion of hypertension and diabetes between the two groups. The main disease for patients upon admission was cerebral hemorrhage (53.6%, 30/56). The proportion of indwelling ventricular drainage tube retention in the hyperthermia group was significantly higher than that in the non-hyperthermia group [32.1% (9/28) vs. 7.1% (2/28), P < 0.05], but there was no significant difference in the location of other drainage tubes between the two groups. The proportion of lumbar puncture in the hyperthermia group was also significantly higher than that in the non-hyperthermia group [25.0% (7/28) vs. 0 (0/28), P < 0.05]. Compared with the non-hyperthermia group, WBC [×10 9/L: 13.0 (9.5, 15.2) vs. 11.5 (8.8, 13.3)] of 1 day before removal of drainage tubes, NEU% [0.892 (0.826, 0.922) vs. 0.843 (0.809, 0.909)] after removal of drainage tubes and positive rate of drainage-fluid culture or drainage-tube-tip culture [7.1% (2/28) vs. 0% (0/28)] in the hyperthermia group increased, but there were not significant differences. There was no significant difference in the proportion of pulmonary, urinary system and blood flow infection before removal of drainage tubes in the two groups. In terms of primary outcomes, compared with the non-hyperthermia group, the length of ICU stay [days: 17.0 (8.0, 32.3) vs. 8.5 (1.0, 16.8), P < 0.05] in the hyperthermia group was significantly prolonged, and the in-hospital mortality [35.7% (10/28) vs. 10.7% (3/28), P < 0.05] in the hyperthermia group was obviously increased. The positive rate of carbapenem-resistant bacteria culture [32.1% (9/28) vs. 3.6% (1/28), P < 0.05] in the hyperthermia group during hospitalization was significantly higher than that in the non-hyperthermia group. Conclusions:Hyperthermia after removal of drainage tubes for patients after neurosurgery can significantly prolong the length of ICU stay and increase the in-hospital mortality, which may be related to the secondary infection caused by indwelling intracranial drainage tubes and the intracranial spread of bacteria caused by removal of drainage tubes, as well as the intracranial multidrug-resistant bacterial infection caused by the drainage tubes.

Efficacy observation of tigecycline in the treatment of 107 patients with infection due to granulocytopenia / 中华血液学杂志

<p><b>OBJECTIVE</b>To observe the curative effect and side effect of tigecycline in the treatment of patients with infection caused by granulocytopenia.</p><p><b>METHODS</b>The clinical data of 107 patients who were treated with tigecycline for infection due to granulocytopenia were retrospectively reviewed. The tigecycline was administered by intravenously (30-60 min drip infusion)as the initial dose of 100 mg and maintenance does of 50 mg, every 12h. The whole treatment course kept for 5-7 d when the body temperature was normal and then the step-down treatment or discontinuation of the drug was adopted.</p><p><b>RESULTS</b>A total of 104 strains of bacteria were isolated from 107 cases of hospitalized patient, including 60 multi-drug resistant strains (MDR) and 2 extensively-drug resistant strains (XDR). The total effective rate of tigecycline treatment was 62.6%, including 30 cases with tigecycline alone (63.3% of the effective rate), 21 cases with tigecycline as initial treatment followed by combination with other antibiotics (61.9% of the effective rate), and 56 cases with tigecycline in combination with other antibiotics from the beginning of the treatment (62.5% of the effective rate). There was no statistical significant difference between the 3 treatment groups (P=0.994). Among the 39 patients with MDR strains, 22 patients' temperature was controlled , 9 patients died, and 8 patients' temperature remained uncontrolled. The clinical effective rate of these patients was 56.4%. The median onset time of tigecycline treatment was 3 days. The adverse drug reactions of nausea (11.2% ) and vomiting (8.4% )were tolerable.</p><p><b>CONCLUSION</b>Tigecycline is effective in treatment of resistant bacteria infection in patients with granulocytopenia. The side effects of tigecycline were few, safe and generally well tolerated.</p>

Research progress of epidemiology and clinical characteristics of pertussis / 中华实用儿科临床杂志

Pertussis is an severe infectious respiratory disease that continues to be a serious public health problem,which is caused by Bordetella Pertussis.Because it's highly infectivity,it is still an important etiological factor associated with persistent cough in adults and adolescents.With the introduction of mass vaccination in 1974,there has been a dramatic decrease in the morbidity and mortality.However,in recent years,increasing numbers of pertussis are reported in adolescents and adults in many countries where with high vaccination coverage.The thesis summarize and discuss the progress of pertussis cpidemiology and clinical characteristics.

Effects of Bacillus preparations on immunity and antioxidant activities in grass carp (Ctenopharyngodon idellus).

This experiment was conducted to study the effects of Bacillus preparations on immunity and antioxidant activities in grass carp. A total of 315 grass carp, with similar initial weight (average weight of fish 45 g), were randomly divided into three groups with three replicates. The control group was fed the basal diet without Bacillus; treatment group 1 was added Bacillus preparation no. 1 with 1 × 10(8) cfu/m(3) per 7 days in culture water and also fed the basal diet; treatment group 2 was fed the basal diet mixed with 0.5 % Bacillus preparation no. 2, and the culture water was added 1 × 10(8) cfu/m(3) Bacillus preparation no. 1 per 7 days. After 4 weeks of culture, 12 grass carp from each replicate were taken randomly for the determination of immune response and oxidization resistance indices. The results showed that compared with control, the level of globulin and IgM of treatment group 2 was significantly increased (P < 0.05), which was also significantly higher (P < 0.05) than that of group 1. For the non-specific immunity index, compared with control, the lysozyme activity and complement (C3) content of treatment group 1 significantly increased (P < 0.05), and the level of myeloperoxidase and C3 of treatment group 2 was significantly higher (P < 0.05) than that of control, which was also significantly higher (P < 0.05) than that of group 1. In the serum, compared with the control, the level of total antioxidant activity (T-AOC), antisuperoxide anion free radical (ASAFR) and glutathione (GSH) of two treatment groups was significantly increased (P < 0.05); GSH content of treatment group 2 was significantly (P < 0.05) higher than that of treatment group 1 and control. There was no significant difference between T-AOC and ASAFR among the two treatment groups; no significant effect was found on glutathione peroxidase (GSH-Px) and maleic dialdehyde (MDA) among the three groups. In the liver, T-AOC, SOD, ASAFR, GSH-Px and GSH from two treatment groups were significantly higher (P < 0.05) than those of control; T-AOC, SOD and catalase from treatment group 2 were significantly higher (P < 0.05) than those of treatment group 1; and MDA of two treatment groups was significantly decreased (P < 0.05) as compared with the control. The results indicate that Bacillus preparations added into water can increase serum immunoglobulin levels and most of non-specific immune parameters content and enhance the antioxidant ability of grass carp, while adding Bacillus preparation into the water and feed is much better.

Protective effects of asiaticoside on sepsis-induced acute kidney injury in mice / 中国中药杂志

<p><b>OBJECTIVE</b>The present study is to investigate the protective effects of asiaticoside on sepsis-induced acute kidney injury in mice.</p><p><b>METHOD</b>With the sepsis induced by cecal ligation and puncture (CLP), forty eight kunming mice were randomly divided into four groups as sham operated, CLP treated, CLP + asiaticoside 15, 45 mg x kg(-1) groups. General conditions and the amount of dead rate of mice were observed. The BUN and Cr levels were observed by the kits. IL-6 in serum was assayed by enzyme-linked immunosorbent assay (ELISA). Kidney tissues were harvested for determination of iNOS expression by Western blotting analysis. The pathologic changes were observed under electron microscope via hematoxylin-eosin (HE) stain.</p><p><b>RESULT</b>Compared with CLP group, the death rate, the levels of BUN, Cr, IL-6, and iNOS protein expression of asiaticoside groups were significantly reduced. The pathologic changes in kidney tissues induced by sepsis were significantly attenuated dose-dependently by asiaticoside under electron microscope.</p><p><b>CONCLUSION</b>Asiaticoside has protective effects against sepsis-induced acute kidney injury, which were probably associated with the inhibition of IL-6 in serum and iNOS protein in kidney tissues.</p>