OBJECTIVETo observe the effects of Shensu II Recipe on the renal function, mesangial extracellular matrix (ECM) accumulation, the expressions of transforming growth factor-beta1, (TGF-beta1), and plasminogen activator inhibitor-1 (PAI-1) in the focal segmental glomerulosclerosis (FSGS) rats.

METHODSFSGS SD rat model was induced by injecting adriamycin. They were randomly divided into the model group, the Western medicine group, and the Chinese medicine group according to body weight. Besides, another 12 rats was taken as the blank control group. Of them, benazepril (0.33 mg/100 g) was given to rats in the Western medicine group by gastrogavage, while Shensu II Recipe (3.5 g/100 g) was given to rats in the Chinese medicine group by gastrogavage. Normal saline was given to rats in the control group and the model group by gastrogavage. Six rats died during the experiment process, among which, one in the control group, two in the model group, one in the Western medicine group, and two in the Chinese medicine group. The changes of 24 h urinary protein (24 hU, pyrogallol red method), blood urea nitrogen (BUN, urease method), serum creatinine (SCr, enzymatic assay of creatinine), serum total protein (TP, biuret colorimetry), serum albumin (ALB, bromocresol green colormetry) were detected. The pathomorphological changes of the glomerulus were observed. Fibronection (FN), collagen IV (Col IV), glomerulus sclerosis index (GSI), ECM/glomerulus area (GA), expressions of TGF-beta1, and PAI-1 were determined by semi-quantitative analysis.

RESULTSAt the end of the 12th week, improvement was shown in the Chinese medicine group (24 hU: 38.55 +/- 2.49 mg; BUN:10.87 +/- 1.78 mmol/L; SCr: 51.70 +/- 1.50 micromol/L; TP: 68.28 +/- 2.31 g/L; and ALB: 42.43 +/- 1.95 g/L). The pathomorphological observation showed that the development of glomerulosclerosis (GS) was significantly slowed down. Semi-quantitative analysis showed significant difference when compared with the model group (GSI: 1.68 +/- 0.33 grade; ECM/GA: 7.11% +/- 2.46%; FN: 4.15% +/- 1.55%; Col IV:1.47% +/- 0.48%; TGF-beta1:19.70% +/- 5.05%; PAI-1: 22.57% +/- 10.65%) ( P < 0.05, P < 0.01).

CONCLUSIONShensu II Recipe could postpone the development of GS in FSGS rats possibly through inhibiting the expressions of TGF-beta1 and PAI-1, hindering the over-accumulation of mesangial matrix.

Animals ; Disease Models, Animal ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Extracellular Matrix ; drug effects ; Glomerular Mesangium ; drug effects ; Glomerulosclerosis, Focal Segmental ; drug therapy ; metabolism ; Male ; Plasminogen Activator Inhibitor 1 ; metabolism ; Rats ; Rats, Sprague-Dawley ; Transforming Growth Factor beta1 ; metabolism

Objective To investigate the protective roles of Epigallocatechin gallate (EGCG) on liver ischemia reperfusion injury (IRI) in rats.Methods 30 healthy male SD rats were selected and equally and randomly divided into 3 groups.Sham group,IRI group and IRI-EGCG group were established to construct 70％ liver IRI rat model.Drinking water with 0.4 mg/ml EGCG was administered for 2 weeks before the experiment in IRI-EGCG group.HE staining was performed to evaluate the injury.Transaminases in serum were investigated to assess liver injury.p-p85 and p-AKT was detected by Western-blot assay.qPCR was carried out to study the mRNA expression of TNF-α,IL-6 and IL-1β in liver tissue.The secretion of TNF-α,IL-6 and IL-1 β in serum was examined with ELISA assay.Results EGCG pretreatment reduced ASTand ALT in serum [AST:(550.0 ±66.5) IU/L vs.(220.0 ±63.5) IU/L;ALT:(376.0 ± 25.7) IU/L vs.(158.0 ± 33.1) IU/L,all P ＜ 0.05] and mitigated liver tissue damage.p-p85 and p-AKT increased due to liver IRI,and IRI-EGCG group showed higher expression of p85 and AKT.The proinflammatory cytokines of TNF-α,IL-6 and IL-1 β exhibited a relatively lower mRNA expression in IRI-EGCG group comparing with IRI group.IRI-EGCG group also revealed a decreased secretion of TNF-α,IL-6 and IL-1β in serum [TNF-α:(398.0±33.4) ng/Lvs.(211.0±23.6) ng/L;IL-6:(341.0±27.3) ng/L vs.(187.0±19.6) ng/L;IL-1β:(486.0±43.7) ng/L vs.(352.0±31.5) ng/L;allP＜0.05].Conclusion EGCG pretreatment can enhance IRI-induced activation of PI3K/AKT signaling and reduce the release of proinflammatory cytokines to exert liver protective effects.

Objective To retrospectively evaluate the relevant factors for hepatitis B virus-associated glomerulonephritis (HBV-GN).Methods A total of 86 patients with pathologyproven HBV-GN and 135 HBV carriers with non-HBV-GN were included in this retrospective casecontrol study.Logistic regression analysis was used to detect the relevant factors for HBV-GN.Results On univariate analysis,the factors associated with HBV-GN were as follows: male (OR 2.79,95%CI 1.48-5.25,P=0.001),HBeAg positivity (OR 2.60,95%CI 1.49-4.53,P=0.001),HBV replication (OR 3.63,95%CI 1.80-7.33,P＜0.01),liver cirrhosis (OR 4.58,95%CI 1.41-14.91,P=0.011),and elevated alanine aminotransferase (ALT) (OR 2.53,95%CI 1.42-4.51,P=0.002).On multivariate analysis,the associations remained significant for male (OR 2.21,95%CI 1.12-4.33,P=0.022),HBV replication (OR 2.77,95%CI 1.28-5.97,P=0.01),liver cirrhosis (0R 4.55,95%CI 1.29-16.10,P=0.019) and elevated ALT (OR 1.96,95%CI 1.04-3.69,P=0.037).Compared with HBV-associated IgA nephritis (HBV-IgAN) in multivariate model,HBV-associated membranous nephropathy (HBV-MN) or membranoproliferative glomerulonephritis (HBV-MPGN) was significantly associated with male (OR 6.51,95%CI 1.76-24.11,P=0.005) and HBV replication (OR 7.22,95%CI 1.68-30.97,P=0.008).Conclusions Male,HBV replication,liver cirrhosis and elevated ALT may be predictive factors for HBV-GN.Compared with HBV-IgAN,HBV-MN or HBV-MPGN is significantly associated with male and HBV replication.

Animals ; Gene Expression Profiling ; Hepatocytes ; MicroRNAs ; Oligonucleotide Array Sequence Analysis ; Rats

Abstract: Objective　To analyze the characteristics of bloodstream infection of Listeria monocytogenes and provide basis for the diagnosis and treatment of the disease. Methods　We retrospectively analyzed the cases of Listeria monomyrhosi bloodstream infection in Peking Union Medical College Hospital (PUMCH) from April 2012 to April 2022. The age, sex, onset time, underlying disease, symptoms, diagnosis, treatment and prognosis of the patients were analyzed, as well as the changes of white blood cells (WBC), neutrophils, lymphocytes, and C-reactive protein (CRP) before and after anti-infection treatment. Results　Fifty cases of Listeria monocytogenes bloodstream infection confirmed by blood culture were involved. The age of patients ranged from 0 to 82 (43.7±20.0) years old, among whom 20.0% were over 60 years old. The onset time of patients was the highest in spring (44.0%), followed by winter (24.0%), and relatively fewer in summer and autumn (14.0%-18.0%). The median diagnosis time was 3 days (1-60 days). After the etiological diagnosis, 45 patients (90.0%) had underlying diseases or pregnancy status, and 45 patients were adjusted to the target antibacterial treatment mainly with carbapenems (48.9%) and penicillins (44.4%). The level of WBC, neutrophils, lymphocytes, monocytes, and CRP after treatment were significantly lower than those pre-treatments (P<0.05). Among all patients, 36 cases (72.0%) were treated according to the Antimicrobial Treatment Guidelines for Fever Sanford, of which 26 cases (72.2%) were discharged from the hospital, two cases died, one case was transferred to other hospitals, and 7 cases had a poor prognosis. Conclusions　Autoimmune diseases, tumor diseases, pregnant patients are susceptible to Listeria monocytogenes infection. Penicillins are the first choice for effective empiric therapy. For the patients allergic to penicillins, trimethoprim/sulfamethoxazole or meropenem could be used.

OBJECTIVEDiscussing the natural history and the influencing factors of HIV infection among former commercial blood and plasma donors engaged in unsafe blood donation practices in China.

METHODSUsing ambispective cohort study, with data obtained from ten counties (districts) from six provinces in the National AIDS Control Demonstration Area. HIV/AIDS cases were found and confirmed prior to July 24, 2006 being former commercial blood. Plasma donors were selected and data regarding infection, incidence, death, and influencing factors was collected. Analysis was performed using SPSS 12.0 statistical analysis software.

RESULTS(1) In 7551 cases of HIV infection, there were 6533 typical progressors (86.52%, 4757 cases of AIDS), 108 rapid progressors (1.43%), 910 long-term non-progressors (12.05%) with 4865 cases progressed to AIDS (64.43%). The median incubation period for HIV progression to AIDS was nine years (95% CI:8.96-9.04). (2) According to data, from a total of 1157 AIDS cases without ARV therapy (23.78% of total AIDS cases), there were 283 confirmed AIDS-related deaths, of which the median survival time was 6 months (95% CI:4-7) and the two and three year fatality rates were 95% and 99%, respectively. (3) The duration of HIV incubation period was irrespective to gender and age at the time of HIV infection (P > 0.05). Length of survival for untreated AIDS showed correlation to gender (P < 0.05) but no correlation with culture, marital status or age at the time of diagnosis of AIDS (P > 0.05).

CONCLUSIONCompared with the UNAIDS theory regarding slow disease progressors among adults, our study showed a longer AIDS incubation period and shorter outlook for untreated survival, but a similar incubation period for other routes of HIV infection.

Acquired Immunodeficiency Syndrome ; epidemiology ; mortality ; Adolescent ; Adult ; Aged ; Blood Donors ; statistics & numerical data ; China ; Female ; HIV Infections ; epidemiology ; mortality ; Humans ; Infectious Disease Incubation Period ; Male ; Middle Aged ; Young Adult

Objective To investigate the antimicrobial resistance of bacteria isolated from clinical samples in Peking Union Medical College Hospital in 2013 .Methods A total of 7236 nonduplicate clinical isolates were collected from January 1 to December 31 , 2013 .Disk diffusion test ( Kirby-Bauer method ) and automated sys-tems were employed to test the antimicrobial resistance of these isolates .The data were analyzed using WHONET 5.6 software and judged according to the Clinical and Laboratory Standards Institute guideline 2013 .Results Of the 7236 nonduplicate clinical isolates , Gram-negative and Gram-positive bacteria accounted for 71.1%(5147) and 28.9%(2089), respectively.Methicillin-resistant Staphalococcus aureus (MRSA) accounted for 34.9%(244/700) and methicillin-resistant coagulase-negative Staphylococcus (MRCNS) accounted for 67.2% (123/183 ) of Staphalococcus aureus isolates .No staphylococcus strains resistant to vancomycin , teicoplanin , or linezol-id were detected .A few strains of Enterococcus faecium were found resistant to vancomycin and teicoplanin .No linezolid-resistant enterococcus strains were found .Extended spectrum β-lactamases ( ESBLs )-producing strains accounted for 49.5%(698/1410), 25.4% (235/925) and 22.6% (30/133) in Escherichia coli, Klebsiella species ( K.pneumoniae and K.oxytoca) and Proteus mirabilis, respectively .The Enterobacteriaceae strains were still highly sensitive to carbapenems , with only 1.5%-2.3%resistant to carbapenems .The resistance rates of Pseudomonas aeruginosa to imipenem and meropenem were 19.4% and 15.6%, respectively .The resistance rates of Acinetobacter baumannii to these two antimicrobials were 70.9% and 72.0%, respectively .The preva-lence of pan-resistant strains in Acinetobacter baumannii was 42.9% ( 306/714 ) .Conclusions Antimicrobial resistance is still a serious problem , especially pan-resistant Acinetobacter baumannii strains.It is mandatory to take effective measures controlling nosocomial infection and ensuring rational antimicrobial use .

Objective To investigate the distribution and antimicrobial resistance of clinical isolates from surgery wards in Peking Union Medical College Hospital ( PUMCH ) .Methods A total of 3084 non-duplicate clinical isolates were collected from PUMCH surgery wards during the period from January 1, 2012 to December 31, 2013.Disc diffusion test (Kirby-Bauer method) and automated systems were employed to detect the antimicrobial resistance of these isolates .The data were analyzed by WHONET 5.6 software according to Clinical and Laboratory Standards Institute 2013 breakpoints.Results Of the 3084 clinical isolates, the 10 most common bacteria isolated were:A.baumannii (14.1%), E.coli (12.4%), P.aeruginosa (12.4%), K.pneumonia (11.8%), S.aureus (8.9%), E.faecalis (5.4%), coagulase-negative staphylococcus (5.3%), E.cloacae (3.7%), S.maltophilia (3.6%) and E.faecium ( 3.2%) , in which gram-negative bacteria accounted for 71.6% ( 2208 isolates ) and gram-positive accounted for 28.4%(876 isolates).In S.aureus and coagulase-negative staphylococcus, methicil-lin-resistant strains ( MRSA and MRCNS ) accounted for 42.7%(117/274) and 77.3%(119/154) , respectively . The resistance rates of methicillin-resistance strains to β-lactams and other antimicrobial agents were much higher than those of methicillin-susceptive strains including methicillin-susceptible Staphylococcus aureus ( MSSA ) and methicillin-susceptible coagulase-negative Staphylococcus (MSCNS).In addition, 80.3% of MRSA strains were still susceptible to trimethoprim-sulfamethoxazole , while 95.0%of MRCNS strains were susceptible to rifampin .No staphylococcal strains were found resistant to vancomycin , teicoplanin, or linezolid.The drug resistance rates of E.faecalis strains to most antimicrobials tested were much lower than those of E.faecium, except for the resistance rate to chloramphenicol , which was only 4.3%in E.faecium.One strain of E.faecalis and 5 strains of E.faecium were found resistant to vancomycin .No linezolid-resistant strains were found in enterococcal isolates .Extended spectrum β-lactamases ( ESBLs )-producing strains accounted for 56.7% ( 217/383 ) , 23.8% ( 97/408 ) , and 22.8%(13/57) in E.coli, Klebsiella species (K.pneumoniae and K.oxytoca), and P.mirabilis, respectively. The drug resistance rates of ESBLs-producing strains were higher than the corresponding non-ESBLs-producing strains.Enterobacteriaceae strains were still highly susceptible to carbapenems , the overall resistance rates being 1.6%-3.3%.A few pan-resistant strains of K.pneumoniae ( 0.8%, 3/363 ) were identified .The resistance rates of P.aeruginosa to imipenem and meropenem were 19.5%and 15.0%, respectively , while the resistance rate to amikacin was the lowest ( 8.6%) .The resistance rates of A.baumannii to imipenem and meropenem were 74.1%and 74.0%, respectively , compared with the lowest resistance rates to cefoperazone-sulbactam (51.5%) and minocycline (28.9%) .The prevalence of pan-resistant strains in A.baumannii and P.aeruginosa were 44.3%(193/436) and 0.8%(3/381), respectively.Conclusion Regular surveillance of bacterial resistance could pro-vide practical guidance of rational selection of antimicrobial agents for clinicians .

Objective To investigate the antimicrobial resistance of clinical bacterial isolates in Peking Union Medical College Hospital( PUMCH)in 2015. Methods A total of 5746 non-duplicate clinical isolates from January 1 to December 31 2015 were collected. Disc diffusion test( Kirby-Bauer method)and automated systems were employed to detect the antimicrobial resistance. The data were analyzed by WHONET 5. 6 software according to 2015 edition of antimicrobial susceptibility testing standards issued by The Clinical and Laboratory Standards Institute( CLSI)of the United States. Results Of the 5746 clinical isolates,the 10 most common bacteria were:Escherichia coli ( 19. 4%), Pseudomonas aeruginosa ( 11. 3%), Klebsiella pneumoniae (10. 9%),Staphylococcus aureus(9. 8%),Acinetobacter baumannii(9. 6%),Enterococcus faecalis(6. 5%), Streptococcus agalactiae(5. 1%),Enterococcus faecium(4. 6%),coagulase-negative Staphylococcus(2. 7%), and Enterobacter cloacae ( 2. 5%). Gram-negative bacilli and gram-positive cocci accounted for 67. 5% and 32. 5%,respectively. Among Staphylococcus aureus and Staphylococcus isolates,methicillin-resistant Staphyloc-cus aureus( MRSA)and methicillin-resistant coagulase-negative Staphylococcus( MRCNS)accounted for 22. 9%and 77. 6%,respectively. The resistance rates of MRSA and MRCNS strains toβ-lactams and other antimicrobial agents were much higher than those in methicillin-susceptible Staphylococcus aureus( MSSA)and methicillin-sus-ceptible coagulase-negatible Staphylococcus( MSCNS)strains. 88. 8% of MRSA strains were still susceptible to trimethoprim-sulfamethoxazole,while 81. 7% of MRCNS strains were susceptible to rifampin. No staphylococcal strain resistant to vancomycin,teicoplanin,or linezolid was detected. The resistance rate of E. faecalis strains to most of the antimicrobial agents tested( except Chloramphenicol)was much lower than that of E. faecium,while some strains resistant to vancomycin were found in both species. No linezolid-resistant Enterococcus strains was found. 90. 8% of β-hemolytic streptococcus strains were susceptible to penicillin. Extended-spectrum β-lacta-mase( ESBL)-producing strains accounted for 52. 3%( 582/1112 ),28. 9%( 200/692 ),and 26. 2%( 27/103)in E. coli,Klebsiella spp(K. pneumoniae and K. oxytoca),and P. mirabilis,respectively. Enterbacteriace-ae strains were still highly susceptible to carbapenems,with an overall resistance rate of ≤4. 3%. A few exten-sively-resistant strains of K. pneumoniae ( 3. 0%,19/630 ) were identified. About 76. 5% and 74. 8% of A. baumannii were resistant to imipenem and meropenem,while the resistant rates to cefoperazone-sulbactam (49. 8%)and minocycline(21. 8%)were the lowest. The resistance rates of P. aeruginosa to imipenem and meropenem were 16. 6% and 11. 9%,respectively,while the resistant rate(5. 2%)to amikacin was the lowest. The prevalence of extensively-resistant strains in A. baumannii and P. aeruginosa were 20. 8%( 115/553 )and 1. 8%(12/650),respectively. Conclusions Antibiotic resistance may still pose a serious threat to clinical practice. Rational use of antibiotics should be required to prevent the spread of antimicrobial resistant strains.

Objective To investigate the antimicrobial susceptibilities of nosocomial multi-drug resistant Acinetobacter baumannii ( MDR-AB) and multi-drug resistant Pseudomonas aeruginosa ( MDR-PA) isolates. Methods MDR-AB and MDR-PA isolates were collected between August 2011 and July 2012 from 27 hospitals in China.All isolates were collected from high quality samples with definite infection diagnoses , whilst isolates from sputum and screen samples were strictly excluded .Minimum inhibitory concentrations ( MICs) of 12 com-monly used antimicrobial agents were tested by broth microdilution method in a microbiology laboratory .CLSI clinical breakpoints ( CBPs) of pre-and post-revision were applied and compared in determination of MDR .Re-sults A total of 664 MDR-AB and 268 MDR-PA isolates were collected .Pan-drug resistant ( PDR) was detec-ted in four Pseudomonas aeruginosa but not in Acinetobacter baumannii.The majority of isolates were collected from ICUs and surgical wards .Colistin and tigecycline were the most active agents against MDR-AB (96.8%and 72.6% susceptible , respectively ) , while no other drug exhibited activity of >55%susceptible .Only 72.4%of MDR-PA isolates remained susceptible to colistin , but amikacin was more active to MDR-PA ( 64.2%) than MDR-AB (16.7%).By applying revised CBPs , the susceptibility of MDR-AB isolates to imipenem and mero-penem decreased by 1.3% and 0.6%, respectively , whereas the susceptibility of MDR-PA to these two drugs decreased by 5.5%and 8.6%, respectively .The carbapenems susceptible rate of isolates collected from ICUs was lower than surgical and other wards .Isolates collected from different geographic regions showed varied resist -ant profiles .Conclusions Colistin and tigecycline are the most active drugs against MDR-AB, while colistin and amikacin have comparably good performance to MDR-PA.