OBJECTIVE To study the disinfectant resistance of multi-drug resistant Escherichia coli strains isolated clinically,and to find out the efficacy of disinfectants commonly used in killing multi-drug resistant E.coli strains.METHODS Minimal inhibitory concentration(MIC) and suspension quantitative germicidal test were used.Compared with standard strains,strains of multi-drug resistant E.coli isolated clinically were determined the resistance to four kinds of disinfectants including benzalkonium bromide etc.RESULTS A higher MIC of benzalkonium bromide compared with standard strains was observed in 61.9% of all 21 multi-drug resistant E.coli strains,and as for povidone iodine and NaClO,the ratio was 71.4% and 14.3%,respectively.All multi-drug resistant E.coli strains had the same MICs of peroxyacetic acid with standard strains.The above-mentioned 4 disinfectants commonly used at the routine concentrations killed 100% of the resistant strains of E.coli within 5 minutes.CONCLUSIONS The resistance to benzalkonium bromide and povidone iodine of multi-drug resistant E.coli isolated clinically is higher than standard strains;and 4 kinds of disinfectants commonly used are effective for multi-drug resistant E.coli strains isolated clinically.

Objective To investigate the effects of hemin on the quantity and apoptosis of human umbilical cord blood-derived late endothelial progenitor cells (EPCs) in vitro.Methods Mononuclear cells were isolated from human cord blood by density gradient centrifugation and were induced to differentiate to late EPCs in vitro.The second to third generation of attached late EPCs in good state were randomly plated for 24 h under different concentrations(0, 5, 10, 15 and 20 μmol/L)of hemin.Cell viability and proliferation were measured with typan blue staining and cell counting kit-8, respectively.Cell adhesion was analyzed by adhesive assay, and cell apoptosis was detected by flow cytometry.Results Compared to control group, hemin promoted viability of late EPCsat lower concentrations(5and 10μmol/L).Meanwhile, proliferation and adhesion were also improved and apoptosis was inhibited when the concentrations of hemin were 5,10, or 15 μ mol/L.All these effects were most prominent when hemin concentration was 10 μmoL/L, while the effects above were reversed when hemin concentration was moderated to 20 μmol/L.In addition, hemin showed a time-dependent manner in promoting cell proliferation and adhesion, and inhibiting apoptosis.That effects were most obvious at 24 h.Conclusions Lower concentration of herin augments the quantity and adhesion of late EPCs, inhibits cell apoptosis, while higher concentration present the reversed effects.

Objective To investigate the effects of aerobic exercise on cardiorespiratory function in patients with obstructive sleep apnea/hypopnea syndrome (OSAHS).Methods A total of 84 patients with OSAHS were randomly divided into a control group and an aerobic exercise group (42 in each group).The control group was given only training in the activities of daily living (ADL).The acrobic exercise group was given ADL training combined with aerobic exercise training.The regime was maintained for 16 weeks.Each patient's VO2max,maximum heart rate (HRmax),exercise time to exhaustion,6-minute walking distance and quality of life (QOL) were evaluated before and after treatment.Results VO2max,HRmax,VO2max/HRmax,maximum exercise time,6-min walking distance and QOL all increased significantly more in the aerobic exercise group compared with the control group.Conclusion Aerobic exercise training can significantly improve cardiorespiratory function in patients with OSAHS.

Objective To intestate the effect of different doses of atorvastatin on early neurological deterioration and short-term outcomes in patients with acute ischemic stroke.Methods The patients with acute ischemic stroke were enrolled prospectively.They were randomly assigned to either a standard therapy group (atorvastatin 20 mg/d) or an intensive treatment group (atorvastatin 40 mg/d).The primary outcomes were early neurological deterioration within 1 week of treatment and the good outcome of evaluation at 1 month after treatment (the modified Rankin Scale score 0-2); the secondary outcomes were the National Institutes of Health Stroke Scale (NIHSS) score and adverse events at 1 month.Results A total of 125 patients with acute ischemic stroke were enrolled,including 62 in the standard therapy group and 63 in the intensive treatment group.The incidence of early neurological deterioration at 1 week after treatment in the standard therapy group was significantly higher than that in the intensive treatment group (16.13％ vs.4.76％;x2=4.333,P=0.038); the proportion of good outcome in the standard therapy group was significantly lower than that in the intensive treatment group at 1 month after treatment (53.23％ vs.71.43％ ;x2 =4.413,P=0.036).During the treatment,no significant liver damage,muscle toxicity and other adverse events of causing atorvastatin reduction or withdrawal occurred in the patients of both groups.Conclusions Using high-dose atorvastatin in the acute phase of ischemic stroke may decrease the incidence of early neurological deterioration compared with the conventional dose,and improve short-term clinical outcomes.

The clinical features and lung CT findings of 174 heart failure patients,including 85 cases with normal left ventricular ejection fraction (LVEF) and 89 cases with reduced LVEF were reviewed.Patients with normal LVEF had a higher proportion of hypertension,diabetes and obesity than patients with normal LVEF; and cough and dyspnea were more common.The lung CT findings in patients with normal LVEF were frequently presented as interstitial lung edema,increased pulmonary texture,subpleural line,Kerley lines and diffuse ground-glass opacity.Patients with reduced LVEF had a higher proportion of coronary heart disease and clinical manifestations of acute left heart failure,and central alveolar edema presented in lung CT images.Results suggest that heart failure patients with normal LVEF usually have longer clinical history and occult symptoms,and have a different lung CT imaging features from those in heart failure patients with reduced LVEF.

OBJECTIVETo observe the serological features of hepatitis G virus (HGV or GBV) in selected population of Shaanxi, Qinghai and Xinjiang Provinces (region).

METHODSEnzyme-linked immunosorbent assay (ELISA) was used to determine IgG antibody against GBV (anti-GBV IgG) in serum specimens of 1469 individuals from the 3 provinces (region).

RESULTSThe positivity rate of serum GBV-IgG antibody in ethnic minorities (4.11% in Tibetan, 5.36% in Mongolian, 4.55% in Uigur, 4.00% in Hui population) was slightly higher than that in Han population (1.36%-1.73%), but the differences were not significant (P>0.05). The positivity rate of serum GBV-IgG antibody in drug abusers (11.30%, 34/301) was remarkably higher than that of the normal population (2.44%,18/736) (P<0.01). The positivity rate of serum GBV-IgG antibody in blood donors was 1.02%-7.68%.

CONCLUSIONSThe positivity rates of serum GBV-IgG antibody among ethnic groups in the 3 provinces (region) had no significant differences; blood-borne transmission seemed to be an important transmission route of GBV, therefore supervision of blood donors and drug abusers should be intensified.

Antibodies, Viral ; blood ; Blood Donors ; China ; epidemiology ; Enzyme-Linked Immunosorbent Assay ; Flaviviridae Infections ; epidemiology ; transmission ; GB virus C ; immunology ; Hepatitis, Viral, Human ; epidemiology ; transmission ; Humans ; Immunoglobulin G ; blood ; Seroepidemiologic Studies ; Substance-Related Disorders ; virology

Objective To investigate the predictive value of serum lipoprotein (a) (Lp [a]) levels for short-term functional outcomes in elderly patients with acute ischemic stroke and type 2 diabetes mellitus.Methods Elderly patients with acute ischemic stroke and type 2 diabetes mellitus admitted to Nanjing First Hospital from June 2016 to December 2016 were enrolled retrospectively.The modified Rankin scale was used to assess the outcomes at 90 d after onset;0-2 was defined as good outcome and ＞2 were defined as poor outcome.Multivariate logistic regression analysis was used to determine independent risk factors for poor outcomes,and the receiver operator characteristic (ROC) curve analysis was used to evaluate the predictive value of serum Lp(a) levels for poor outcomes.Results A total of 231 patients were enrolled,with an average age of 69.7 years and males accounting for 65.4％.The median serum Lp(a) was 166 mg/L (interquartile range 78-331 mg/L).At 90 d after onset,140 patients (60.6％) had good outcomes and 91 (39.4％) had poor outcomes.After adjustment for other confounding variables,multivariate logistic regression analysis showed that elevated serum Lp(a) (referenced to the lowest quartile,the 3rd quartile:odds ratio[OR]2.899,95％ confidence interval[CI] 1.154-7.285,P =0.024;the 4th quartile:OR 3.334,95％ CI 1.329-8.361,P =0.010),the baseline National Institute of Health Stroke Scale score (OR 1.224,95％ CI 1.143-1.310;P＜ 0.001),and complicated with coronary heart disease (OR 2.504,95％ CI 1.196-5.243;P =0.015) were the independent risk factors for poor outcomes.ROC curve analysis showed that the area under the curve of serum Lp(a) level in predicting the poor outcome was 0.775 (95％ CI 0.696-0.854;P=0.04).The optimal cut-off value was 119 mg/L,the sensitivity was 71.15％,the specificity was 75.90％,the positive predictive value was 38.52％,and the negative predictive value was 61.48％.Conclusion Serum Lp(a) level has certain predictive value for the short-term poor outcomes in elderly patients with acute ischemic stroke and type 2 diabetes mellitus.

Objective:To investigate the predictive values of serum hypersensitive C-reactive protein (hs-CRP) and lipoprotein-associated phospholipase A 2 (Lp-PLA 2) for early neurological deterioration (END) and parenchymal hematoma (PH)-type 2 hemorrhagic transformation (HT) after intravenous thrombolysis in patients with acute ischemic stroke. Methods:Patients with acute ischemic stroke treated with intravenous thrombolysis in the Department of Neurology, Nanjing First Hospital, Nanjing Medical University from January 2018 to January 2021 were enrolled retrospectively. END was defined as an increase of ≥4 in the National Institutes of Health Stroke Scale (NIHSS) score at 24 h after thrombolysis compared with the baseline. PH-2 type HT was defined as parenchymal hematoma with obvious space occupying effect or hemorrhage at the distant site of infarct. Multivariate logistic regression analysis was used to determine the independent influencing factors of END and PH-2 type HT. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of hs-CRP and Lp-PLA 2 levels for END and PH-2 type HT. Results:A total of 804 patients with acute ischemic stroke treated with intravenous thrombolysis were included, of which 63 (7.8%) developed END within 24 h after intravenous thrombolysis; 41 (5.1%) developed HT, of which 38 were PH-2 type HT. Univariate analysis showed that the levels of serum hs-CRP and Lp-PLA 2 in the END group were significantly higher than those in the non-END group (all P<0.05), and the levels of serum hs-CRP and Lp-PLA 2 in the PH-2 HT group were significantly higher than those in the non-PH-2 HT group ( P<0.05). Multivariate logistic analysis showed that hs-CRP (odds ratio [ OR] 1.017, 95% confidence interval [ CI] 1.001-1.034; P=0.043) and Lp-PLA 2 ( OR 1.002, 95% CI 1.000-1.003; P=0.020) were the independent risk factors for END after intravenous thrombolysis. In addition, hs-CRP ( OR 1.019, 95% CI 1.002-1.036; P=0.027) and Lp-PLA 2 ( OR 1.002, 95% CI 1.000-1.003; P=0.018) were also the independent risk factors for PH-2 HT after intravenous thrombolysis. The ROC curve analysis showed that the areas under the curve of hs-CRP and Lp-PLA 2 for predicting END were 0.675 (95% CI 0.609-0.741; P<0.001) and 0.606 (95% CI 0.528-0.683; P=0.005) respectively, and the areas under the curve for predicting PH-2 HT were 0.641 (95% CI 0.545-0.737; P=0.003) and 0.600 (95% CI 0.500-0.699; P= 0.051) respectively. Conclusion:Higher baseline serum hs-CRP and Lp-PLA 2 are the independent predictors of END and PH-2 type HT after intravenous thrombolysis in patients with acute ischemic stroke.

Objective:To investigate the predictive value of inflammatory markers for the risk of stroke-associated infection (SAI) in patients with anterior circulation large vessel occlusive stroke who received endovascular therapy.Methods:Patients with anterior circulation large vessel occlusive stroke received endovascular treatment in Nanjing First Hospital, Nanjing Medical University from 2016 to 2020 were retrospectively enrolled. The clinical data of SAI group and non-SAI group were compared. Multivariate logistic regression analysis was used to screen the independent influencing factors of SAI, and then the predictive nomogram was established according to these influencing factors to verify its clinical application efficiency. Results:A total of 409 patients were enrolled during the study. Their age was 71.3±11.7 years, and 250 were male (61.1%). The median baseline Naitonal Institutes of Health Stroke Scale (NIHSS) score was 16. One hundred and nineteen patients (29.1%) received intravenous thrombolysis, 376 (91.9%) were successfully recanalized after endovascular therapy, and 293 (71.6%) developed SAI. Univariate analysis showed that age, atrial fibrillation ratio, NIHSS score at admission, fasting blood glucose, triglyceride, high sensitivity C reactive protein (hs-CRP), leukocyte count, neutrophil count, neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) were significantly higher than those in the non-SAI group (all P<0.05). Multivariate logistic regression analysis showed that age, NIHSS score at admission, fasting blood glucose, hs-CRP, leukocyte count, neutrophil count and NLR were the independent influencing factors of SAI ( P<0.05). Receiver operating characteristics curve analysis showed that the predictive value of multiple inflammatory markers (hs-CRP, leukocyte count, neutrophil count and NLR) for SAI was significantly better than that of the single inflammatory marker ( P<0.01). The area under the curve was 0.782 (95% confidence interval 0.719-0.846), and the predictive sensitivity and specificity were 80.6% and 64.5% respectively. Decision curve analysis showed that compared with the traditional indicators, the predictive nomogram based on inflammation related indicators (hs-CRP, leukocyte count and NLR) had a higher net profitability for predicting SAI. Conclusion:The hs-CRP, leukocyte count and NLR can be used to predict the risks of SAI in patients with acute ischemic stroke receiving endovascular therapy.

Objective:To discuss the clinical curative effect of the treatment of bundling bone fragment with figure-of-eight suture through double bone tunnels in the chronic bong mallet finger.Methods:A retrospective analysis was performed on patients with chronic bong mallet fingers who underwent surgery in the Department of Hand and Foot Microsurgery of Nanjing Jiangbei Hospital from May 2021 to February 2023. During the procedure, made into transverse double bone tunnels on the base of the distal phalanx with 0. 8 mm Kirschner wire, bundling bone fragment with figure-of-eight suture through double bone tunnels, then fixed with Kirschner wire elastic compression. Removal of the Kirschner wire 3 weeks after the procedure, the active flexion and extension range of the joints of the affected finger and the corresponding finger were measured at the last follow-up, then the range of motion (ROM) of the distal interphalangeal joint (DIPJ) and total action movement (TAM) of the fingers (affected and healthy finger) were recorded. The curative effects were evaluated according to the TAM system of the American Association of Hand Surgeons, including 4 grades: excellent, good, fair, and poor. SPSS 13. 0 software was used for statistical analysis of the data, and the measurement data conforming to normal distribution were expressed as Mean ± SD. The ROM of DIPJ and TAM of the affected finger were compared with the corresponding healthy finger 6 months after surgery by a paired sample t test. P<0. 05 indicates that the difference is statistically significant. Results:A total of 30 patients (30 digits) were enrolled, including 19 males and 11 females, and the age ranged from 18 to 62 years old, with an average age of 31 years old. The time from injury to operation was 24 to 65 days (mean of 35 days) . According to Wehbe and Schneider classification, there were 8 cases of type Ⅰa, 6 cases of type Ⅰb, 7 cases of type Ⅱa, 5 cases of type Ⅱb, 2 cases of type Ⅲa and 2 cases of type Ⅲb. All incisions healed well, the intraoperative blood loss was minimal, with no infection. All 30 cases were followed up for 6 to 7 months. All fractures were well aligned and healed, malformed fingers were completely corrected, and no needle tunnel infection or needle breakage were observed. At the last follow-up, the differences of the ROM of the DIPJ [ (30. 2±3. 5) °vs. (30. 4±3. 3) °, t=2. 57, P=0. 463] and the TAM [ (235. 3± 3. 6) ° vs. (237. 7± 4. 2) °, t=1. 78, P= 0. 247 ] between the affected and healthy fingers were not statistically significant. Finger function assessment: 27 cases were excellent, and 3 cases were good, and the excellent and good rate was 100%. Conclusion:Satisfactory therapeutic outcome for the treatment of chronic bong mallet finger deformity can be achieved by bundling bone fragment with figure-of-eight suture through double bone tunnels. It is an effective and practical method.