Development of SPQC sensor based on the specific recognition of TAL-effectors for locus-specific detection of 6-methyladenine in DNA.

N6-methyladenosine (6mA) plays a pivotal role in diverse biological processes, including cancer, bacterial toxin secretion, and bacterial drug resistance. However, to date there has not been a selective, sensitive, and simple method for quantitative detection of 6mA at single base resolution. Herein, we present a series piezoelectric quartz crystal (SPQC) sensor based on the specific recognition of transcription-activator-like effectors (TALEs) for locus-specific detection of 6mA. Detection sensitivity is enhanced through the use of a hybridization chain reaction (HCR) in conjunction with silver staining. The limit of detection (LOD) of the sensor was 0.63 pM and can distinguish single base mismatches. We demonstrate the applicability of the sensor platform by quantitating 6mA DNA at a specific site in biological matrix. The SPQC sensor presented herein offers a promising platform for in-depth study of cancer, bacterial toxin secretion, and bacterial drug resistance.

PIAS1 upregulation confers protection against Cerulein-induced acute pancreatitis via FTO downregulation by enhancing sumoylation of Foxa2.

OBJECTIVE: This research discussed the specific mechanism by which PIAS1 affects acute pancreatitis (AP). METHODS: PIAS1, Foxa2, and FTO expression was assessed in Cerulein-induced AR42J cells and mice. Loss- and gain-of-function assays and Cerulein induction were conducted in AR42J cells and mice for analysis. The relationship among PIAS1, Foxa2, and FTO was tested. Cell experiments run in triplicate, and eight mice for each animal group. RESULTS: Cerulein-induced AP cells and mice had low PIAS1 and Foxa2 and high FTO. Cerulein induced pancreatic injury in mice and inflammation and oxidative stress in pancreatic tissues, which could be reversed by PIAS1 or Foxa2 upregulation or FTO downregulation. PIAS1 elevated SUMO modification of Foxa2 to repress FTO transcription. FTO upregulation neutralized the ameliorative effects of PIAS1 or Foxa2 upregulation on Cerulein-induced AR42J cell injury, inflammation, and oxidative stress. CONCLUSION: PIAS1 upregulation diminished FTO transcription by increasing Foxa2 SUMO modification, thereby ameliorating Cerulein-induced AP.

Multiple myeloma patients undergoing chemotherapy: Which symptom clusters impact quality of life?

AIMS AND OBJECTIVES: To identify symptom clusters and examine their association with health-related quality of life. BACKGROUND: Multiple myeloma patients undergoing chemotherapy suffer from disease symptoms and adverse effects during the course of the disease. However, single symptom management has little effect, and symptom management for these patients remains challenging. Symptom clusters open a new perspective and provide important clues for symptom management. DESIGN: A cross-sectional study. METHOD: Participants were invited to complete the Chinese version of the Memorial Symptom Assessment Scale and Quality of Life Questionnaire-core 30. Appropriate indicators were used for descriptive statistics. Principal component analysis was used to identify symptom clusters. Associations between symptom clusters and quality of life were examined with Pearson correlation coefficients, Pearson correlation matrix and multiple linear regression. This study was reported following the STROBE checklist. RESULTS: A total of 177 participants were recruited from seven hospitals in this study. We identified self-image disorder, psychological, gastrointestinal, neurological, somatic and pain symptom clusters in multiple myeloma patients with chemotherapy. Approximately 97.65% of patients suffer from multiple symptom clusters. The pain, psychological and gastrointestinal symptom clusters have negatively influence on health-related quality of life. The strongest association was found with the pain symptom cluster. CONCLUSION: Most of multiple myeloma patients suffer from multiple symptom clusters. When improving the multiple myeloma patients' health-related quality of life, the clinical staff should prioritise relieving the pain symptom cluster. RELEVANCE TO CLINICAL PRACTICE: When multiple myeloma patients undergoing chemotherapy suffer from multiple symptom clusters, nurses should prioritise relieving the pain symptom cluster to improve their health-related quality of life. When drawing up and providing interventions, nurses should focus on the correlation among symptoms rather than single symptom. By relieving one symptom in a given cluster, other symptoms within the same symptom cluster may also be relieved.

The core symptom in multiple myeloma patients undergoing chemotherapy: a network analysis.

BACKGROUND: During chemotherapy for multiple myeloma, symptoms include those related to the disease, as well as adverse effects of the treatment. Few studies have explored the relationships between these symptoms. Network analysis could identify the core symptom in the symptom network. OBJECTIVE: The aim of this study was to explore the core symptom in multiple myeloma patients undergoing chemotherapy. METHODS: This was a cross-sectional study in which sequential sampling was used to recruit 177 participants from Hunan, China. Demographic and clinical characteristics were surveyed using a self-developed instrument. The symptoms of chemotherapy-treated multiple myeloma, including pain, fatigue, worry, nausea, and vomiting, were measured using a questionnaire with good reliability and validity. The mean ± SD, frequency, and percentages were used as descriptive statistics. Network analysis was used to estimate the correlation between symptoms. RESULTS: The results showed that 70% of multiple myeloma patients using chemotherapy exhibited pain. In the network analysis, worrying was the dominant symptom, and the strongest relationship was between nausea and vomiting in chemotherapy-treated multiple myeloma patients' symptoms. CONCLUSION: Worrying is the core symptom of multiple myeloma patients. Interventions could be most effective if there is a symptom management focus on worrying when providing care to chemotherapy-treated multiple myeloma patients. Nausea combined with vomiting could be better managed, which would decrease the cost of health care. Understanding the relationship between the symptoms of multiple myeloma patients undergoing chemotherapy is beneficial for precise symptom management. IMPLICATIONS FOR PRACTICE: Nurses and health care teams should be a priority to intervene in the worrying for chemotherapy-treated multiple myeloma patients to maximize the effectiveness of an intervention. Except, nausea and vomiting should be managed together in a clinical setting.

Development of an MSPQC Nucleic Acid Sensor Based on CRISPR/Cas9 for the Detection of Mycobacterium tuberculosis.

Accurate and rapid detection of nucleic acid plays a vital role in the clinical treatment of tuberculosis caused by Mycobacterium tuberculosis (M.TB). However, false-negative and false-positive results caused by base mismatches could affect the detection accuracy. Inspired by the unique property of CRISPR/Cas9, we proposed a new MSPQC M.TB sensor based on the CRISPR/Cas9 system, which can distinguish single-base mismatches in 10 bases from the protospacer adjacent motif (PAM) region. In the proposed sensor, single-stranded DNA on Au interdigital electrodes was used as a capture probe for the target and an initiator for hybridization chain reaction (HCR). HCR was used to generate long double-stranded DNA (dsDNA), which could span the Au interdigital electrodes. CRISPR/Cas9 was used as recognition components to recognize capture/target dsDNA. When the target existed, the capture probe hybridized with the target to form dsDNA, which could be recognized and cut by CRISPR/Cas9. Thus, the DNA connection between electrodes was cut off and resulted in the MSPQC response. When no target existed, the capture probe remained single-stranded and could not be recognized and cut by CRISPR/Cas9. Therefore, DNA connection between electrodes was reserved. Moreover, silver staining technology was utilized to improve the sensitivity of detection. M.TB was detected by the proposed sensor using specific sequence fragments of 16S rRNA of M.TB as the target. The detection time was down to 2.3 h. The limit of detection (LOD) was 30 CFU/mL.

The anti-inflammatory mechanism of SAHA in acute pancreatitis through HDAC5/SLIT2/Akt/ß-catenin axis.

Acute pancreatitis (AP) is widely recognized to be an inflammation-related disease, in which HDAC was upregulated. The anti-inflammatory role of suberoylanilide hydroxamic acid (SAHA), a HDAC inhibitor, has been documented. In this context, this research was implemented to figure out whether SAHA manipulated inflammation in AP. Subsequent to induction of AP mouse model, HDAC5 expression was detected. The binding of HDAC5 and SLIT2 was detected by Co-Immunoprecipitation and Chromatin immunoprecipitation assays. SAHA treatment and gain- and loss-of-function approaches were used in AP mice and lipopolysaccharide (LPS)-induced pancreatic acinar cells. In mice, biochemical methods were implemented to measure activities of pancreatic lipase, trypsin, myeloperoxidase (MPO) and pancreatic edema, TUNEL staining to determine pancreatic cell apoptosis, and flow cytometry to assess the total number of leukocytes and neutrophils in pancreas. In pancreatic acinar cells, CCK-8 was performed to evaluate cell viability. HDAC5 exhibited overexpression in AP mice. Mechanical analysis showed that HDAC5 facilitated SLIT2 deacetylation to downregulate SLIT2, thus activating Akt/ß-catenin pathway in pancreatic acinar cells. SAHA treatment, HDAC5 silencing or SLIT2 overexpression diminished inflammation in AP in vivo and in vitro. SAHA treatment, HDAC5 silencing or SLIT2 overexpression reduced activities of pancreatic lipase, trypsin, MPO, pancreatic edema and cell apoptosis in AP mice as well as elevated viability of LPS-induced pancreatic acinar cells. SAHA might exert anti-inflammatory effects in AP mice via HDAC5/SLIT2/Akt/ß-catenin axis.

Platelet membrane-camouflaged silver metal-organic framework drug system against infections caused by methicillin-resistant Staphylococcus aureus.

BACKGROUND: Due to the intelligent survival strategy and self-preservation of methicillin-resistant Staphylococcus aureus (MRSA), many antibiotics are ineffective in treating MRSA infections. Nano-drug delivery systems have emerged as a new method to overcome this barrier. The aim of this study was to construct a novel nano-drug delivery system for the treatment of MRSA infection, and to evaluate the therapeutic effect and biotoxicity of this system. We prepared a nano silver metal-organic framework using 2-methylimidazole as ligand and silver nitrate as ion provider. Vancomycin (Vanc) was loaded with Ag-MOF, and nano-sized platelet vesicles were prepared to encapsulate Ag-MOF-Vanc, thus forming the novel platelet membrane-camouflaged nanoparticles PLT@Ag-MOF-Vanc. RESULTS: The synthesized Ag-MOF particles had uniform size and shape of radiating corona. The mean nanoparticle size and zeta potential of PLT@Ag-MOF-Vanc were 148 nm and - 25.6 mV, respectively. The encapsulation efficiency (EE) and loading efficiency (LE) of vancomycin were 81.0 and 64.7 %, respectively. PLT@Ag-MOF-Vanc was shown to be a pH-responsive nano-drug delivery system with good biocompatibility. Ag-MOF had a good inhibitory effect on the growth of three common clinical strains (Escherichia coli, Pseudomonas aeruginosa, and S. aureus). PLT@Ag-MOF-Vanc showed better antibacterial activity against common clinical strains in vitro than free vancomycin. PLT@Ag-MOF-Vanc killed MRSA through multiple approaches, including interfering with the metabolism of bacteria, catalyzing reactive oxygen species production, destroying the integrity of cell membrane, and inhibiting biofilm formation. Due to the encapsulation of the platelet membrane, PLT@Ag-MOF-Vanc can bind to the surface of the MRSA bacteria and the sites of MRSA infection. PLT@Ag-MOF-Vanc had a good anti-infective effect in mouse MRSA pneumonia model, which was significantly superior to free vancomycin, and has no obvious toxicity. CONCLUSIONS: PLT@Ag-MOF-Vanc is a novel effective targeted drug delivery system, which is expected to be used safely in anti-infective therapy of MRSA.

Undergraduate nursing students' participation in pre-hospital first aid practice with ambulances in China: A qualitative study.

OBJECTIVES: The aim of this study is to understand the feelings and experiences of nursing undergraduates who participate in pre-hospital first aid and to explore the training programme of pre-hospital first aid for nursing undergraduates. The main objective is to provide a reference for the reform of pre-hospital first aid teaching in undergraduate colleges. METHODS: Semi-structured interviews were conducted with 16 nursing undergraduates who had participated in pre-hospital first aid in an ambulance from a teaching hospital in Hunan, China. The interview data were transcribed, and Colaizzi's seven-step method was used for subject analysis. RESULTS: The experiences of undergraduate nursing interns can be summarized into five themes: helplessness and fear of death, uncertainty of unknown events, satisfaction with self-improvement, need for professional competence, and the perception of a gap in pre-hospital emergency resources. CONCLUSIONS: Nursing colleges and teaching hospitals should pay attention to death education and pre-hospital first aid training. Teachers should be able to apply situational teaching methods to pre-hospital first-aid teaching and should focus on cultivating the comprehensive abilities of nursing students. At the same time, schools and teaching hospitals should also strengthen the cultivation of professional identity during pre-hospital first aid practice to reduce the rate of nursing personnel turnover. It's very important to supplement and retain professional nurses for the pre-hospital first aid.

Mortality predictors in recipients developing acute respiratory distress syndrome due to pneumonia after kidney transplantation.

BACKGROUND: The aim of the present study was to investigate the risk factors related to hospital mortality due to infection in kidney recipients with ARDS meeting the Berlin definition. METHODS: Univariate and multivariate logistic regression analysis were used to confirm the independent risk factors related to infection-associated mortality. RESULTS: From January 2001 to August 2014, a total of 94 recipients with acute respiratory dress syndrome (ARDS) caused by pneumonia following kidney transplantation were enrolled in the present study. The most common type of infection was bacterial (52/94; 55.3%), viral (25/94; 26.6%), and polymicrobial (14/94; 14.9%). The most common ARDS was diagnosed within 6 months after transplantation (76/94; 80.9%). There were 39 deaths in these recipients (39/94; 41.5%). Eleven (11.7%) patients had mild, 47 (50.0%) moderate, and 36 (38.3%) severe ARDS; mortality was 27.3, 27.7, and 63.9%, respectively. The independent predictors of infection-related mortality were serum creatinine level >1.5 mg/dL at ARDS onset (OR 3.5 (95%CI 1.2-10.1), p = 0.018) and severe ARDS (OR 3.6 (95%CI 1.4-9.7), p = 0.009) in the multivariate analysis. CONCLUSION: Infection-related mortality in kidney transplant patients with ARDS was associated with high serum creatinine level and severe ARDS.

Predictors of Mortality in Abdominal Organ Transplant Recipients with Pseudomonas aeruginosa Infections.

BACKGROUND: Pseudomonas aeruginosa infection remains a common life-threatening complication after abdominal organ transplantation. The objective of the present study was to determine epidemiology and predictors of mortality in abdominal organ transplant recipients with P. aeruginosa infections. MATERIAL AND METHODS: A retrospective, double-center study was performed over a 12-year study period. The epidemiology of P. aeruginosa infections was investigated and the univariate and multivariate analyses were performed to identify the independent risk factors for crude and infection-related 30-day mortality in abdominal organ transplant recipients with P. aeruginosa infections. RESULTS: In this study, 60 episodes of P. aeruginosa infection occurring in 54 abdominal organ transplant recipients were enrolled. Postoperative P. aeruginosa infection occurred in 54 (2.8%) of 1935 abdominal organ transplant recipients. Most episodes of P. aeruginosa infections were nosocomial (75.9%, n=41). Among those 54 patients, 30 (55.6%) developed pulmonary infection and 13 (24.1%) developed bacteremia. In 25 of the 54 (46.3%) patients, P. aeruginosa isolates were multidrug resistant. There were 6 (11.1%) cases of septic shock, 18 (33.3%) infection-related deaths, and 21 (38.9%) crude 30-day deaths. Septic shock (odds ratio (OR)=13.46, 95% confidence interval (CI)=1.43-126.38, P=0.023) was identified as an independent risk factor for infection-related 30-day mortality. The risk factors independently associated with crude 30-day mortality included P. aeruginosa or concomitant bacteremia (OR=6.79, 95% CI=1.82-25.39, P=0.004) and a serum creatinine level of ≥1.5 mg/dL (OR=4.62, 95% CI=1.11-19.16, P=0.035). CONCLUSIONS: The morbidity and mortality rates of P. aeruginosa infections were appreciable in abdominal organ transplant recipients. P. aeruginosa or concomitant bacteremia and an elevated serum creatinine level were associated with higher crude mortality, and septic shock independently predicted higher infection-related mortality.

Predictors of shock and mortality in solid organ transplant recipients with bacteremia caused by non-lactose-fermenting gram-negative bacilli.

BACKGROUND: More data on bacteremia due to non-lactose fermenting gram-negative bacilli (NLF GNB) in solid organ transplant (SOT) recipients are needed. We aimed to investigate the epidemiology, microbiology, and risk factors for mortality and septic shock due to NLF GNB bacteremia in SOT recipients. METHODS: We performed a retrospective, double-center study over a 12-year study period. The risk factors for mortality and septic shock in SOT recipients with NLF GNB bacteremia were assessed with multivariate logistic regression analysis. RESULTS: A total of 230 episodes of bloodstream infections (BSIs) occurred in 159 SOT recipients. Fifty episodes of NLF GNB bacteremia were detected in 47 SOT recipients, with a predominance of Acinetobacter baumanii (27 isolates, 54.0%). The antibiotic resistance rate of all NLF GNB to 10 of 12 antibiotics investigated was more than 50%. The independent risk factors associated with septic shock were platelet count < 50 000/mm(3) (odds ratio (OR) = 14.41, 95% confidence interval (CI) = 2.64-78.71, p = 0.002) and late-onset bacteremia (time of onset more than 2 months post-transplant) (OR = 10.87, 95% CI = 1.79-65.89, p = 0.009). Lung focus (OR = 32.91, 95% CI = 2.56-423.18, p = 0.007) and septic shock (OR = 70.38, 95% CI = 4.21-1176.21, p = 0.003) were risk factors for bacteremia-related mortality. CONCLUSIONS: The drug resistance of the pathogens and the morbidity and mortality rates of NLF GNB bacteremia were high in SOT recipients. For septic shock, associated risk factors were thrombocytopenia and late-onset bacteremia. The risk factors significantly associated with mortality were lung focus and septic shock.

Predictors of mortality in solid-organ transplant recipients with infections caused by Acinetobacter baumannii.

Acinetobacter baumannii can cause a serious infection in solid-organ transplant (SOT) recipients, and more data on A. baumannii infection is needed. We sought to investigate the epidemiology and distribution of A. baumannii isolates in SOT recipients. We also investigated the risk factors for overall in-hospital mortality and infection-related 30-day mortality using multivariate logistic regression analysis. A double-center retrospective study of SOT recipients who were infected with A. baumannii between January 2003 and January 2015 was conducted. A total of 71 individuals developed 93 episodes of A. baumannii infection, with a mean age of 44.5 years (44.5±11.9 years). Ninety percent of recipients had nosocomial origin A. baumannii infection, with the bloodstream as the most common site of infection (32.4%). Septic shock developed in 23.9% (17 of 71) of all recipients with A. baumannii infection. Morbidity and mortality rates of A. baumannii infections were high in SOT recipients. The incidence rate of A. baumannii infection in SOT recipients was 3.9% (71 of 1,821). Overall in-hospital mortality and infection-related 30-day mortality were 53.5% (38 of 71) and 40.8% (29 of 71), respectively. Risk factors independently associated with overall in-hospital mortality were mechanical ventilation at onset of A. baumannii infection (odds ratio [OR] 6.29, 95% confidence interval [CI] 1.48-26.85; P=0.013), liver or liver-kidney transplantation (OR 15.33, 95% CI 1.82-129.18; P=0.012), and late-onset A. baumannii infection (OR 7.61, 95% CI 1.07-54.36; P=0.043). A platelet count <50,000/mm(3) (OR 12.76, 95% CI 1.28-126.81; P=0.030) and mechanical ventilation at onset of A. baumannii infection (OR 189.98, 95% CI 13.23-2,728.81; P<0.001) were identified as independent risk factors for infection-related 30-day mortality. In conclusion, the morbidity and mortality rates of A. baumannii infections were high in SOT recipients. Mechanical ventilation at onset of A. baumannii infection was associated with higher overall in-hospital mortality and infection-related mortality. For overall in-hospital mortality, liver or liver-kidney transplantation and late-onset A. baumannii infection, and for infection-related mortality, thrombocytopenia were also risk factors, respectively.

Staphylococcus aureus bacteremias following liver transplantation: a clinical analysis of 20 cases.

BACKGROUND: To describe the incidence, clinical characteristics, and outcomes of Staphylococcus aureus bacteremia after liver transplantation and investigate the drug resistance of S. aureus to frequently used antibiotics to provide evidence for clinical prevention and therapy. MATERIALS AND METHODS: In a double-center retrospective study, blood cultures positive for S. aureus were obtained from January 1, 2001 to December 31, 2014. The BACTEC 9120 blood culture system and the Vitek-2 system were used to process blood samples and identify species, respectively. We also collected these patients' data to confirm clinical and laboratory characteristics. RESULTS: Twenty of 275 (7.3%) liver recipients developed S. aureus bacteremia during the study period. The median time to the onset of S. aureus bacteremias was 6 days after liver transplantation and all episodes of bacteremias were early onset. The lung was the most common source of primary infection, followed by the intra-abdominal/biliary tract. A total of nine (45%) liver recipients died due to S. aureus bacteremias. Of these 20 S. aureus cases, 80% were methicillin-resistant. S. aureus was highly resistant to erythromycin and penicillin (resistance rate >90%). No S. aureus resistant to glycopeptides and oxazolidone antibiotics was observed. There were seven (35%) liver recipients with an inappropriate antibiotic therapy. Between the periods of 2001-2007 and 2008-2014, the distribution of methicillin-resistant S. aureus was not significantly different (P=1.000). Pneumonia as a predominant primary source, a high body temperature, abnormal blood pressure, and decreased platelets, which occurred in the early period after liver transplantation, as well as high morbidity and mortality, were the main characteristics of S. aureus bacteremias. CONCLUSION: S. aureus led to severe bacteremias in liver recipients, with high morbidity and mortality, and the majority of them comprised methicillin-resistant S. aureus.

Distribution and resistance of pathogens in liver transplant recipients with Acinetobacter baumannii infection.

BACKGROUND: Drug-resistant Acinetobacter baumannii has become a major problem in liver transplant recipients. The aim of this study was to investigate the clinical presentation, distribution, and drug susceptibility characteristics in liver recipients with A. baumannii infection. METHODS: We retrospectively investigated 17 liver recipients who developed A. baumannii infection between January 1, 2007 and December 31, 2014. The distribution of A. baumannii and drug susceptibility characteristics were reviewed. RESULTS: Infectious complications due to A. baumannii appeared in 17 liver recipients, with a total of 24 episodes. Approximately 63% (15/24) of A. baumannii infections occurred within 2 weeks after transplantation. The most common source of infection was multiple culture-positive sites (35.3%, n=6), followed by the intra-abdominal/biliary tract (23.5%, n=4) and lung (23.5%, n=4). Eight patients (47.1%) had a body temperature of 38°C or higher at the onset of A. baumannii infection. Nine, seven, and 12 recipients had a serum creatinine level of >1.5 mg/dL, a white blood cell count of >15,000/mm(3), and a platelet count of <50,000/mm(3), respectively. There were five (29.4%) cases of septic shock and eight (47.1%) deaths. The rate of antibiotic resistance of A. baumannii to ten of 12 antibiotics investigated was more than 60%. Among the 24 infections caused by A. baumannii, 75% were carbapenem-resistant. The rods were relatively sensitive to tigecycline and cefoperazone-sulbactam. CONCLUSION: The clinical manifestations of A. baumannii infection included a high body temperature, a decreased platelet count, an elevated white blood cell count, and onset in the early period after transplantation as well as high mortality. The antibiotic resistance rate of A. baumannii was extremely high. Prevention measures and combination antibiotic therapy are needed to improve the outcomes of liver recipients with A. baumannii infections.

The epidemiology and distribution of pathogens and risk factors for mortality in liver transplant recipients with Gram negative bacteremia.

BACKGROUND/AIMS: More data on the epidemiology and distribution of pathogens and the risk factors for mortality in liver transplant recipients with Gram negative bacteremia are needed. METHODs: Among a cohort of 228 liver transplant recipients, we identified 35 patients with initial episodes of Gram negative bacteremia after operation. The association between the risk factors and Gram negative bacteremia related mortality was assessed. RESULTS: Forty-seven episodes of Gram negative bacteremia occurred in 15.4% of liver transplant recipients. The mean age for these 35 patients was 46.1 years. Among patients with Gram negative bacteremia, 51.4% had an intra-abdominal/biliary source of infection and Escherichia coli was the most common microorganism. There were 18 deaths with a mortality rate of 51.4%. Multivariate logistic regression showed that the independent risk factors for mortality are serum albumin level < 3.0 mg/ dL (odds ratio[OR] = 17.6, 95% confidence interval[CI] = 1.4-224.6, P = 0.027) and septic shock (OR = 37.5, 95% CI = 3.6-386.7, P = 0.002). CONCLUSIONS: The risk factors significantly associated with increased mortality due to Gram negative bacteremia in liver transplant recipients are decreased serum albumin level and septic shock.

Mannose-binding lectin-2 and ficolin-2 gene polymorphisms and clinical risk factors for acute rejection in kidney transplantation.

INTRODUCTION: There is growing evidence that the lectin pathway is significantly associated with acute rejection. Rare studies associated both gene polymorphisms of MBL2 and FCN2 with acute rejection after kidney transplantation. The aim of the present study was to investigate the role of the lectin gene profile and clinical risk factors such as PRA level on acute rejection in kidney transplant recipients. METHODS: We prospectively analyzed 157 kidney transplant recipients with and without acute rejection. A total of 6 well-known functional single-nucleotide polymorphisms in the MBL2 gene and 5 in the FCN2 gene of the recipients were determined by gene sequencing. MBL2 and FCN2 genotypic variants were analyzed for association with the incidence of acute rejection within the first year after kidney transplantation. RESULTS: After adjusting for variables of P<0.2, we found the differences in the incidence of acute rejection were only according to panel-reactive antibodies (odds ratios (OR) = 6.468, 95% confidence intervals (CI)= 2.017-20.740, P = 0.002) and the HH genotypes of MBL2 promoter -550 (OR = 2.448, 95%CI = 1.026-5.839, P = 0.044). CONCLUSION: Panel-reactive antibodies and the HH genotypes of MBL2 promoter -550 have significant impacts on the risk of developing acute rejection after kidney transplantation.

The distribution and resistance of pathogens causing blood stream infections following liver transplantation: a clinical analysis of 69 patients.

BACKGROUND/AIMS: To study the distribution and drug resistance of pathogens causing blood stream infections (BSIs) and provide the evidence for clinical therapy after liver transplantation. METHODOLOGY: Blood samples were processed by the BACTEC 9120 blood culture system. Species identification was performed using the Vitek-2 system. The drug susceptibility of pathogens was performed using the ATB FUNGUS 3 system. RESULTS: One hundred and twenty six episodes of BSIs occurred in 69 patients between January 31, 2003 and January 31, 2014. The gram-positive bacteria emerged as major pathogens and constituted 48.4% of all pathogens (61/126). The most common bacilli were Enterobacter spp and Enterococcus spp followed by S. aureus. The gram-negative bacteria were relatively sensitive to carbapenems and the gram-positive bacteria were relatively sensitive to glycopeptides and oxazolidone antibiotics. The drug resistance of fungi to amphotericin B, flucytosine, voriconazole and caspofungin was not found. CONCLUSION: In liver transplantation, gram-positive bacteria caused BSls more frequently than gram-negative bacteria. The resistance rate of bacteria to antibiotics was high while the rate was low in fungi.