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Objective:To investigate the distribution characteristics of urinary tract pathogens in patients with community-acquired urinary tract infection and their sensitivity to nenoxacin and levofloxacin.Methods:This prospective, multicenter clinical trial included patients with community-acquired urinary tract infection who were admitted to urological clinics at 9 clinical research centers from November 2021 to August 2022.Inclusion criteria: Patients aged 18-70 years with community-acquired acute uncomplicated cystitis(AUC), recurrent acute episodes of urinary tract infection(rUTI), and non-febrile complicated urinary tract infection(cUTI) with signs of urinary tract irritation and abnormal elevation of routine white blood cells in urine. Exclusion criteria: ①Patients who received effective antimicrobial therapy within 72 h before enrollment and lasted for more than 24 h. ②Fever (>37.3℃) or symptoms of upper urinary tract infection such as low back pain, tapping pain in the kidney area, etc. ③Indwelling urinary catheter. At the first visit, clean midstream urine samples were taken for bacterial culture, and the distribution characteristics of urinary pathogens of different types of urinary tract infections were analyzed. Extended spectrum β-lactamases (ESBLs) were measured for Gram-negative bacteria. The susceptibility of nenoxacin and levofloxacin to urinary tract pathogens was determined by disk diffusion method. Drug resistance rate, sensitivity rate were analyzed between different disease groups.Results:There were 404 enrolled patients from 9 hospitals, including 364 (90.1%) females and 40 (9.9%) males. A total of 177 strains of pathogenic bacteria were isolated, among which the highest proportion of Escherichia coli was 66.1% (117/177).Klebsiella pneumoniae was followed by 6.8% (12/177) and Streptococcus agalactis 5.1% (9/177). The bacterial spectrum distribution of AUC and rUTI were similar, and the proportions of Escherichia coli were 70.6% (85/119) and 65.9% (29/44), respectively. However, the proportions of Escherichia coli isolated from cUTI patients were only 28.6% (4/14) and Enterococcus faecalis 7.1%(1/14). The overall detection rate of ESBLs in Gram-negative bacteria was 30.9%(43/139). The sensitivity rate of nenoxacin was 74.6%(91/122), and the resistance rate was 25.4%(31/122). The overall sensitivity rate of levofloxacin was 44.9%(70/156) and the resistance rate was 36.5%(57/156). The rate of resistance of urinary tract pathogens to levofloxacin was 48.2% (27/56) in patients with previous urinary tract infection history, and 30.0% (30/100) in patients with no previous urinary tract infection history, the difference was statistically significant( P=0.023).The sensitivity rate of Gram-negative bacteria to nenofloxacin was 70.7% (65/92) and that to levofloxacin was 50.0% (46/92, P<0.001). The sensitivity of Gram-positive bacteria to nenofloxacin was 80.0% (16/20), and that to levofloxacin was 70.0% (14/20, P=0.009). Conclusions:The bacterial profile of out-patient community acquired urinary tract infection varies greatly according to different diseases. The proportion of Escherichia coli in AUC and rUTI patients is higher than that in cUTI. The detection rate of ESBLs in Gram-negative bacteria was lower than the domestic average.Patients with a history of urinary tract infection had a high risk of treatment failure with levofloxacin. The sensitivity of common urinary tract pathogens to nenofloxacin was higher than levofloxacin.
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Background/Aims@#We performed a systematic review and meta-analysis evaluating the symptomatic response rate to antibiotics in patients with small intestinal bacterial overgrowth (SIBO). Similarly, we performed a meta-analysis on the symptomatic response to antibiotics in irritable bowel syndrome (IBS) patients with and without SIBO. @*Methods@#MEDLINE, EMBASE, Web of Science, and Cochrane databases were searched from inception to March 2021. Randomized controlled trials and prospective studies reporting dichotomous outcomes were included. @*Results@#There were 6 studies included in the first meta-analysis comparing the efficacy of antibiotics to placebo or no antibiotic. This included 196 patients, of whom 101 received antibiotics and 95 received placebo or no antibiotics. Significantly more patients improved with antibiotics (relative risk [95% CI] = 2.46 [1.33-4.55], P = 0.004). There were 4 studies included in the analysis comparing symptomatic response rates in IBS patients with or without SIBO with 266 IBS patients, of whom 172 had SIBO and 94 did not. The pooled response rate for symptomatic response was 51.2% in the SIBO group vs 23.4% in the no SIBO group, respectively. Significantly more IBS patients with SIBO responded to antibiotics compared to those without SIBO (relative risk [95% CI] = 2.07 [1.40-3.08], P = 0.0003). @*Conclusions@#Antibiotics appear to be efficacious in treating SIBO, although small sample sizes and poor data quality limit this interpretation. Symptomatic response rates also appear to be higher in IBS patients with SIBO. This may be the first example of precision medicine in IBS as opposed to our current empiric treatment approach. Large-multicenter studies are needed to verify the results.
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Menopausal syndromes are mostly based on kidney deficiency， which could be expalined that kidney governing essence storage and controlling innateness， so when the kidney water was deficient and the liver fail to nourish， then led to liver depression and transform into fire； deficiency of the kidney， loss of warmth of the spleen， and inability to transport and transform the water and dampness will easily lead to phlegm and fire； the decline of the kidney yin and loss of water and fire will easily cause the exuberance of heart fire. Therefore， clinical symptoms of hot flashes， insomnia， and palpitations are common due to phlegm， depressions， and fire. Based on this， at the beginning of the treatment， we should treat the symptoms firstly by resolving phlegm， relieving depression and clearing fire， and commonly use Huanglian Wendan Decoction （黄连温胆汤）， Yigan Powder （抑肝散）， Chaihu plus Longgu Muli Decoction （柴胡加龙骨牡蛎汤）， and Qingxin Zishen Decoction （清心滋肾饮）， etc. After improving the symptoms of hot flashes and sweating， irritability， dreaming and frightening， then we should give the prescriptions to tonify kidney yang and nourish kidney yin， in order to eliminate the pathogens and reinforce healthy qi， and to treat both the manifestations and the root cause， so that the symptoms of the patients can be better alleviated.
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ObjectiveThe mean hospitalization time and outcome among patients with coronavirus disease 2019 (COVID-19) was estimated with the purpose of providing evidence for decision-making in medical institutions and governments in epidemic areas. MethodThe data of COVID-19 patients in china were collected from the websites of provincial and municipal health commissions. The mean hospitalization time and mortality in the mild or severe patients and the mean time from severe to mild illness were calculated by Gaussian mixture modeling. ResultsThe mean hospitalization time among mild patients in Hubei province, other areas except Hubei province, and the national areas was 20.71{+/-} 9.30, 16.86 {+/-} 8.24, and 19.34 {+/-} 9.29 days, respectively. The mean transition time from severe to mild group in the above three areas were 15.00, 17.00, and 14.99 days, respectively. The death rate of mild and severe patients in Hubei province and the national areas were 1.10% and 18.14%, and 1.10% and 17.70%, respectively. Among those patients who died of COVID-19, the mean time from severe transition to death in Hubei province and the national areas was 6.22 {+/-} 5.12 and 6.35 {+/-} 5.27 days, respectively. ConclusionThere were regional differences in the average length of stay between Hubei province and other regions, which may be related to different medical configurations. For those severe patients who died of COVID-19, the average time from hospitalization to death was about one week, and proper and effective treatments in the first week were critical.
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Objective To analyze the characteristics of nerve damage in diabetic peripheral neuropathy by ultrasound and neuroelectrophysiological techniques and provide a basis for early diagnosis and treatment of diabetic peripheral neuropathy. Methods From January 2016 to May 2018, 225 patients with type 2 diabetes admitted to the hospital were divided into DPN group (110 cases) and non-diabetic peripheral neuropathy (NDPN) group (115 cases),and 120 healthy volunteers were as controls. Ultrasound and nerve conduction velocity(NCV) were used to analyze the characteristics of nerve damage in diabetic peripheral neuropathy(DPN). Results Among the three study groups, the sensory nerves conduction velocity and motor nerves conduction velocity of the ulnar nerve, median nerve, and common peroneal nerve were significantly reduced in the DPN group. But in the same group,the ulnar nerve, median nerve, and common peroneal nerve cross-sectional area (CSA) was significantly increased [(8.68 ± 1.89) mm2 vs. (6.79 ± 1.69) and (5.82 ± 1.57) mm2, (10.59 ± 1.82) mm2 vs. (7.98 ± 1.97) and (7.25 ± 1.71) mm2, (21.24 ± 2.53 )mm2 vs. (16.54 ± 2.49) and (15.40 ± 2.20) mm2]. In the measurement of sensory nerve conduction velocity, the abnormalities of ulnar nerve, median nerve and common peroneal nerve were significantly higher than thoseof motor nerve [34.54%(38/110) vs. 18.18%(20/110), 36.36% (40/110)vs. 20.90% (23/110), 52.72% (58/110) vs. 20.00% (22/110)]. In ultrasound and SCV, the proportion of ulnar nerve and median nerve injury was higher in patients aged 45 years or older or patients over 10 years of course (P<0.05). The proportion of median nerve injury was higher in patients with larger MAGE (P < 0.05). In the abnormal performance of ultrasound: the proportion of abnormal ulnar nerve, median nerve and common peroneal nerve in patients with large MAGE was significantly higher than that in patients with small MAGE (P<0.05); the results of ultrasound measurement of CSA showed that the ulnar nerve, median nerve and common peroneal nerve thickening were more obvious in patients with MAGE>4 mmol/L. Conclusions DPN affects sensory nerves first, and the proportion of injury is significantly higher than that of motor nerves; lower limb nerves are more susceptible to damage, compared with upper limb nerves; patients aged 45 years or older or patients with course over 10 years have a higher proportion of ulnar nerve and median nerve damage; patients with larger MAGE (>4 mmol/L) have a higher proportion of median nerve damage. The characteristics above can provide an effective basis for the prevention, diagnosis and treatment of DPN.
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(Hp) is widely disseminated in human, and Hp infection causes various gastrointestinal diseases, including gastric cancer. Different genotypes of Hp may cause different diseases, so the genotyping is important for clinical and basic research of Hp. This article introduces the methods for Hp genotyping, including multilocus sequence typing, pulsed-field gel electrophoresis, random amplified polymorphic DNA, amplified fragment length polymorphism, and whole-genome sequencing. By reviewing the application of these techniques in Hp genotyping and comparing their advantages and disadvantages, the article provides a theoretical basis for research into the pathogenesis, antibiotic resistance, and epidemiology of Hp infection.
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Humans , Amplified Fragment Length Polymorphism Analysis , Genotype , Helicobacter Infections , Microbiology , Pathology , Helicobacter pylori , Genetics , Polymerase Chain Reaction , ResearchABSTRACT
In this study, BRL 3A cells were treated with different Cd concentrations (0, 10, 20, and 40 µmol/L) for 12 h and preincubated with or without N-acetyl-L-cysteine (NAC) (2 mmol/L) for 30 min, and cells were treated with Cd (0 and 20 µmol/L), pretreated with p38 inhibitor (SB203580), JNK (c-Jun NH2-terminal kinases) inhibitor (SP600125), and extracellular signal-regulated kinase (ERK) inhibitor (U0126) for 30 min, and then treated with 20 µmol/L Cd for 12 h. Cd decreased cell viability, SOD, and GSH-Px activity in a concentration-dependent manner. Increased MDA level, ROS generation, nuclear condensation, shrinkage, and fragmentation in cell morphology were inhibited by NAC. Cd-induced apoptosis was attenuated by pretreatment with SB203580, SP600125, and U0126. The results of western blot showed that NAC preincubation affected Cd-activated MAPK pathways, p38 and ERK phosphorylation. Cd treatment elevated the mRNA levels of Bax and decreased the mRNA levels of Bcl-2, respectively. The same effect was found in their protein expression levels. These results suggest that oxidative stress and MAPK pathways participate in Cd-induced apoptosis and that the balance between pro- and antiapoptotic genes (Bax and Bcl-2) is important in Cd-induced apoptosis.
Subject(s)
Apoptosis/drug effects , Cadmium/toxicity , Mitogen-Activated Protein Kinases/metabolism , Oxidative Stress/drug effects , Acetylcysteine/pharmacology , Animals , Anthracenes/pharmacology , Butadienes/pharmacology , Cell Line , Extracellular Signal-Regulated MAP Kinases/antagonists & inhibitors , Extracellular Signal-Regulated MAP Kinases/metabolism , Glutathione Peroxidase/metabolism , Imidazoles/pharmacology , JNK Mitogen-Activated Protein Kinases/antagonists & inhibitors , JNK Mitogen-Activated Protein Kinases/metabolism , Malondialdehyde/metabolism , Nitriles/pharmacology , Phosphorylation , Protein Kinase Inhibitors/pharmacology , Pyridines/pharmacology , Rats , Reactive Oxygen Species/metabolism , Signal Transduction/drug effects , Superoxide Dismutase/metabolism , p38 Mitogen-Activated Protein Kinases/antagonists & inhibitors , p38 Mitogen-Activated Protein Kinases/metabolismABSTRACT
Objective To evaluate the safety and efficacy of percutaneous nephrolithotomy (PCNL) with B ultrasound-guided renal access in the lateral decubitus flank position for complex renal calculi. Methods From June 2004 to August 2009, 650 patients with renal stones≥20 mm underwent PCNL with B ultrasound-guided renal access in the lateral decubitus flank position. 512 men and 138 women,with a mean age of 38 years(range 11 - 78 years)and a mean stone size of 31 mm(range 20 - 58 mm). Results Successful access was achieved in 650 patients (100%). Minimally PCNL and PCNL were performed in 493 and 157 patients. Complete stone clearance rate was 86. 6% (563/ 650). The mean operative time was 72 min(range 35 - 145 min), and the mean hospital stay was 18d (range 9 - 32 d). There were no visceral injuries. Conclusions PCNL with B ultrasound-guided renal access in the lateral decubitus flank position is safe and convenient, and prevents harmful effects of radiation for the surgeon, the surgical team, and the patient.
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Summary: To study the effect of Trastuzumab in combination with IFN α-2b on HER2 and MRP1 of ACHN in vitro, ACHN cell line of RCC was cultured by employing cell culture. The tetrazolium-based colorimetric assay was used to evaluate the growth-inhibiting effect of Trastuzumab with IFN α-2b. SP method was utilized to determine the expression of HER2 and MRP1 of the cells. Our results showed that Trastuzumab had inhibitory effect on the growth of renal tumor cells and reversing effect on the multi-drug-resistance (MDR) in RCC in a time- and dose-dependent manner. Treated with Trastuzumab with or without IFN α-2b, the expression of HER2 and MRP1 genes of RCC was decreased significantly (P<0.05). It was concluded that Trastuzumab with IFN α-2b could inhibit the proliferation of RCC and the expression of HER2 and MRP1 of ACHN and to some extent, reverse the MDR of the tumor cells.
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Objective: To study the influences of Trastuzumab and IL-2 on human epidermal growth factor receptor-2 (HER2), multidrug resistance-associated protein1 (MRP1) of ACHN in vitro . Methods: ACHN cell line of RCC were cultured by cell culture technique. The tetrazolium-based colorimetric assay was used to evaluate the growth inhibitory effects of trastuzumab and IL-2. S-P method was used to determine the expression of HER2, MRP1 of the cells. Results: Trastuzumab showed the inhibitory effects on growth and multi-drug resistance in RCC from 40 ?g/L or 24 h in time-effective and dose-dependent manner. After treatment with Trastuzumab and/or IL-2, the expression of HER2, MRP1 genes of RCC was decreased significantly( P