OBJECTIVE To study the prevalence of aac(6′)-Ⅰb with its subtypes,one kind of gene for aminoglycoside-modifying enzymes in Escherichia coli.METHODS DNA sequences were analyzed in those strains with aac(6′)-Ⅰb,compared to its family marked in NCBI.Thus,its subtypes were determined.RESULTS Four strains were classical on genotype,the other one with aac(6′)-Ⅰb-Cr,and the last one with a new subtype among the 6 strains of E.coli with aac(6′)-Ⅰb.CONCLUSIONS There exist at least 3 subtypes of aac(6′)-Ⅰb,one kind of gene for aminoglycoside-modifying enzymes in local strains of E.coli.Among those subtypes,the classical type is the main,accompanied by aac(6′)-Ⅰb-Cr and its new subtype.

OBJECTIVE To investigate drug resistance of Escherichia coli,especially the prevalence of the genes for TEM and SHV type ?-lactams in ESBLs-producing E.coli. METHODS A total of 2277 strains of E.coli collected in our hospital from Jan 2006 to Nov 2008 were analyzed for drug resistance to 21 kinds of antibiotics such as aminoglycoside,?-lactams and quinolones using VITEK-32 GNS-145 or GNS-448 card following GNI + for identification.PCR methods were used to analyze TEM and SHV type ?-lactams genes in 36 strains of E.coli with ESBLs so as to study their prevalence. RESULTS From them 1025 strains of E.coli were found positive for ESBLs,with a positive rate of 45.0%.Drug resistance rates were 83.0%,74.0%,52.0%,52.0%,29.1%,27.8%,16.5%,47.0%,31.0%,54.5%,53.0%,56.8%,10.0%,53.9%,38.5%,5.0%,4.0%,5.0% and 5.0%,respectively,for ampicillin,ampicillin/sulbactam,cefazolin,cefuroxime,aztreonam,cefepime,ceftazidime,ceftriaxone,cefotaxime,ciprofloxacin,levofloxacin,gentamicin,amikacin,tobramycin,Co-trimoxazole,nitrofurantoin,piperacillin /tazobactam,cefoperazone/sulbactam and cefoxitin.None was found resistant to imipenem or meropenem.Twenty-five and 14 strains of E.coli were found positive for TEM and SHV genes,respectively(69.4% and 38.9%). CONCLUSIONS Drug resistance of E.coli is severe.The local E.coli with ESBLs shows high positive rates of TEM and SHV genes,which play an important role in its severe drug resistance.

Objective To investigate drug resistance,especially the resistance to aminoglycoside and the prevalence of the genes for aminoglycoside-modifying enzymes in Escherichia coli producing ESBLs.Methods VITEK-32 GNI+ cards and K-B methods were used to identify E.coli and detect the resistance to 18 kinds of antibiotics such as aminoglycoside and ?-lactams respectively in E.coli isolated from our hospital from January to December,2006.PCR method was used to detect the genes for aminoglycoside-modifying enzymes such as aac(3)-Ⅰ,aac(3)-Ⅱ,aac(6')-Ⅰb,aac(6')-Ⅱ,ant(3″)-Ⅰ and ant(2″)-Ⅰ in those 17 strains producing ESBLs.Results Resistance rates were 100.0%,100.0%,41.6%,100.0%,69.5%,30.5%,98.2%,81.0%,81.0%,79.6%,79.2%,34.8%,15.4%,7.1%,7.9%,5.4% and 81.0% for ampicillin,ampicillin/sulbactam,aztreonam,cefazolin,cefepime,ceftazidime,ceftriaxone,ciprofloxacin,levofloxacin,gentamicin,tobramycin,amikacin,cifoxitin,nitrofurantoin,piperacillin/tazobactam,cefoperazone/sulbactam and co-trimoxazole respectively in E.coli producing ESBLs.No drug-resistant strain imepenem was found.Positive rate was 46.4% for ESBLs.Resistance rates were 52.9%(9/17),100.0%(17/17) and 100%(17/17) for amikacin,gentamycin and tobmycin respectively in those 17 strains producing ESBLs.The most genotype for aminoglycoside-modifying enzymes was aac(3)-Ⅱ(94.1%),the second was aac(6')-Ⅰb(35.3%).The positive rates of aac(3″)-Ⅰ and ant(2″)-Ⅰ were 11.8% and 5.9% respectively.of them,one strain was resistant to aminoglycoside on phenotype,but no genes mentioned above was detected.4strains were classical on genotype,one with aac(6')-Ⅰb-Cr,the other one with a new subtype among the 6 strains of E.coli with aac(6')-Ⅰb.Conclusions Drug resistance in E.coli is rather serious.Typically,E.coli producing ESBLs shows multi-drug resistance.Positive rate for aac(3)-Ⅱ takes the first place,followed by aac(6')-Ⅰb among the genes for aminoglycoside-modifying enzymes.Aac(3″)-Ⅰand ant(2″)-Ⅰ show both lower positive rates.Aac(3)-Ⅰ and aac(6')-Ⅱ were not found.There exist at least 3 sub-types of aac(6')-Ⅰb,one kind of gene for aminoglycoside-modifying enzymes in strains of E.coli.Among those sub-types,the classical type is the main,accompanied by aac(6')-Ⅰb-Cr and its new sub-type.

Objective To explore the expression difference of cytokines related to nuclear factor kappa B (NF-κB) signaling pathway among different traditional Chinese medicine (TCM) syndromes in the patients with diabetic nephropathy (DN).Methods Serum tumor necrosis factor-α (TNF-α),interleukin-1 (IL-1),interleukin-6 (IL-6) and interleukin-8 (IL-8) in 146 patients with DN and 62 individuals undergoing healthy physical examination in the control group were measured.Results The levels of serum TNF-α,IL-1,IL-6 and IL-8 in various DN groups were significantly higher than those in the control group (P＜0.05).The levels of serum TNF-α,IL-1,IL-6 and IL-8 were significantly different among groups of different TCM syndromes (P＜0.05).With the progression of DN,all cytokines levels showed a gradually increasing trend,moreover the increased extents and time were different in different TCM syndrome types of DN.Conclusion The levels of serum TNF-α,IL-1,IL-6 and IL-8 related to NF-κB signaling pathway are correlated with different TCM syndromes types and may play a role in the occurrence and progression of different TCM syndrome types of DN.

Objective To compare and evaluate the performance and applications of three assays in preliminary screening of dengue infections.Methods This study was designed as a retrospective study.Clinical data were obtained from 2 137 borderline cases from September to October in 2014 and 2015.Markers of dengue infections of serum samples were detected by NS1 antigen captured ELISA, dengue NS1 detect rapid test and dengue IgM detect rapid test, respectively.Chi square test was used to compare the preliminary screening value of these 3 methods.Forty-eight diagnosed patients were also examined in the 1st-3rd day, 4th-5th day, 6th-7th days and 14th day after infection to access the sensitivities and specificities of three assays.Results Nine hundred and fifty-seven ( 57.2%) cases in 2014 and 48 ( 10.4%) cases in 2015 were diagnosed to be Dengue fever of 2 137 borderline cases.The overall sensitivity of NS1-ELISA was superior to NS1 and IgM rapid detect test (χ2 =40.865,P<0.001;χ2 =151.383,P<0.001).No significant differences were found in specificity between three assays(χ2 =0.661,P=0.416;χ2 =0.548,P=0.459; χ2 =2.397,P=0.122).The NS1 detecting assays were sensitive in 7 days after infection, but the sensitivity of IgM detecting assay increased over time.Conclusions NS1 detecting assays had good sensitivities and specificities, which can be used as an important method in preliminary screening of dengue infection.ELISA or rapid test can be selected according to epidemic situation.

Objective To assess the prognosis of patients with bladder neck (BN) involvement in radical prostatectomy specimens and compare it with patients with seminal vesicle invasion (SVI).Methods From January 2002 to December 2008,42 patients with prostate carcinoma who underwent radical prostatectomy were analyzed retrospectively.The mean age was 70.3 years (range 59-78 years).The patients were divided into two groups according to 2002 TNM system:pT4a group (bladder neck invasion) with 17 cases and pT3b group (unilateral or bilateral seminal vesicle invasion)with 25 cases.Postoperative outpatients were followed-up on a regular basis,two consecutive postoperative serums PSA greater than 0.2 μg/L defined as a biochemical recurrence.The postoperative follow-up to the time of biochemical recurrence or follow up to the deadline without biochemical recurrence were defined as biochemical recurrence free survival time.Results All patients were followed up for 50-122 months.The patients with BN involvement 17.6％ (3/17) had biochemical recurrence,whereas seminal vesicle invasion 24.0％ (6/25),there was no statistical significance between the two groups (P＞0.05).Conclusions Postoperative adjuvant therapies can improve the biochemical recurrence free survival.In this study,the prognosis of pT4a and pT3b group is similar.A conceivable down-staging of BN involvement in the TNM staging system should be considered.

ObjectiveTo observe the clinical characteristic and treatment response of the Gleason 5 + 5 prostate cancer and to summarize the prognostic factor of such patients. MethodsFrom January 2005 to May 2010,21 cases of Gleason 5 + 5 prostate cancer were enrolled in this study.The average age was 73 years and the pre-treatment PSA was 60.8 ng/ml.Six of the 21 cases had a PSA level ≤20 ng/ml.The maximal androgen deprivation therapy (ADT) in the form of castration and Casodex or fluctamide was carried out once the diagnosis was made.Bone metastasis was revealed in 16 cases.PSA levels were tested at the 4th month and then every 3 months after the castration.The observation endpoint was 6 months.Extracorporeal beam irradiation or the systemic chemotherapy was carried out if the PSA did not drop to a normal range after 6 months. ResultsIn the study group with initial PSA ＞ 20 ng/ml,the PSA did not drop to normal range in 5 cases; of which 4 had bone metastasis.With systemic chemotherapy,3 cases died within 1 year.Another case,with localized disease,received an extracorporeal beam irradiation and died within 1 year due to progression of the tumor.Among the remaining 10 cases sensitive to total androgen blockage,7 survived through the end of the study period.One case had PSA recurrence in month seven after the initial therapy and died at month 19.One case had PSA recurrence at month 22 and died at month 36.The patient had his PSA augmented at month 24 after total androgen blockage and the patient passed away 4 months later.Of the 6 cases who had an initial PSA ≤20 ng/ml 4 died within one year. ConclusionsGleason 5 +5 prostate cancer is relatively resistant to ADT with a worse prognosis,especially for the cases with a nadir PSA ＞4 ng/ml after 6 months’ ADT.The patients who had an initial PSA ≤20 ng/ml might have an unsatisfactory clinical outcome.

ObjectiveTo evaluate the clinical effecacy and safety of transurethral enucleation of submucosal bladder leiomyoma.MethodsAnalyze retrospectively the clinical data of 6 patients (2 male,4 female) of submucosal bladder leiomyoma. The mean age was 59 years (range 32- 78). The clinical manifestations included dysuresia in 3 cases, irritative bladder in 1 case, gross hematuria in 1 caes, and no clinical symptoms in 1 case. The mean course was 23 months (range 1 week-4 years). All the bladder tumors were indicated by ultrasonography, CT scan and cystoscopy, while 4 cases of bladder filling defects were showed by intravenous urogram. Before the tranaurethral enucleation of the bladder tumor, a deep needle biopsy and pathological examination were carried out to confirm the diagnosis of bladder leiomyoma. For the relatively small lateral leiomyomas, holium laser enucleation was carried out, while for the big ones, resectoscope enucleation was used to remove the mass. Biopsys were performed after complete removal of the tumor.ResultsTransurethral enucleation of 6 cases of submucosal bladder tumors were successful without any postoperative complication. All patients regained normal urination, and lower urinary tract irritation was relieved obviously and hematuria disappeared. No tumor recurrence or metastasis was found during the follow-up of 4 to 158 months.ConclusionsCystoscopy and transurethral biopsy are the most important methods for the diagnosis of submucosal bladder leiomyoma. The transurethral enucleation is a feasible and safe surgical technique for such patients with excellent results.

Cardiovascular diseases (CVDs) and metabolic disorders are major components of noncommunicable diseases, causing an enormous health and economic burden worldwide. There are common risk factors and developmental mechanisms among them, indicating the far-reaching significance in exploring the corresponding therapeutic targets. MST1/2 kinases are well-established proapoptotic effectors that also bidirectionally regulate autophagic activity. Recent studies have demonstrated that MST1/2 influence the outcome of cardiovascular and metabolic diseases by regulating immune inflammation. In addition, drug development against them is in full swing. In this review, we mainly describe the roles and mechanisms of MST1/2 in apoptosis and autophagy in cardiovascular and metabolic events as well as emphasis on the existing evidence for their involvement in immune inflammation. Moreover, we summarize the latest progress of pharmacotherapy targeting MST1/2 and propose a new mode of drug combination therapy, which may be beneficial to seek more effective strategies to prevent and treat CVDs and metabolic disorders.

Objective To investigate the distribution and antimicrobial resistance profiles of the common pathogens isolated from urine from 2015 to 2021 in the CHINET Antimicrobial Resistance Surveillance Program.Methods The bacterial strains were isolated from urine and identified routinely in 51 hospitals across China in the CHINET Antimicrobial Resistance Surveillance Program from 2015 to 2021.Antimicrobial susceptibility was determined by Kirby-Bauer method,automatic microbiological analysis system and E-test according to the unified protocol.Results A total of 261 893 nonduplicate strains were isolated from urine specimen from 2015 to 2021,of which gram-positive bacteria accounted for 23.8％(62 219/261 893),and gram-negative bacteria 76.2％(199 674/261 893).The most common species were E.coli(46.7％),E.faecium(10.4％),K.pneumoniae(9.8％),E.faecalis(8.7％),P.mirabilis(3.5％),P.aeruginosa(3.4％),SS.agalactiae(2.6％),and E.cloacae(2.1％).The strains were more frequently isolated from inpatients versus outpatients and emergency patients,from females versus males,and from adults versus children.The prevalence of ESBLs-producing strains in E.coli,K.pneumoniae and P.mirabilis was 53.2％,52.8％and 37.0％,respectively.The prevalence of carbapenem-resistant strains in E.coli,K.pneumoniae,P.aeruginosa and A.baumannii was 1.7％,18.5％,16.4％,and 40.3％,respectively.Lower than 10％of the E.faecalis isolates were resistant to ampicillin,nitrofurantoin,linezolid,vancomycin,teicoplanin and fosfomycin.More than 90％of the E.faecium isolates were ressitant to ampicillin,levofloxacin and erythromycin.The percentage of strains resistant to vancomycin,linezolid or teicoplanin was＜2％.The E.coli,K.pneumoniae,P.aeruginosa and A.baumannii strains isolated from ICU inpatients showed significantly higher resistance rates than the corresponding strains isolated from outpatients and non-ICU inpatients.Conclusions E.coli,Enterococcus and K.pneumoniae are the most common pathogens in urinary tract infection.The bacterial species and antimicrobial resistance of urinary isolates vary with different populations.More attention should be paid to antimicrobial resistance surveillance and reduce the irrational use of antimicrobial agents.