Objective To investigate the action of integron-mediated multidrug resistance in clinical multi-resistant Pseudomonas aeruginosa in Huaibei area.Methods The antibiotic susceptibility of 13 different antibiotics of 36 multi-drug resistant P.aeruginosa was tested by K-B.The three-dimensional method was taken to differentiate the various beta-lactamases.The integron was determined by PCR with integron-specific primer.Results The positive rate of integron detection in multi-resistant Pseudomonas aeruginosa was 86.1%.Two kinds of integron with different length were found,i.e.1 000 bp and 2 000 bp.PSE-1,aadA2,aadB,aac(6)-II and CARB-8 were the resistance-related gene cassette in the integrons.Conclusions Integron may enroll in multiple resistance of multi-resistant Pseudomonas aeruginosa.

Hepatitis E ; immunology ; prevention & control ; Humans ; Viral Hepatitis Vaccines

OBJECTIVETo analyse the cases of platelet transfusion refractoriness after received HLA-matched unrelated donor hematopoietic stem cell transplantation, to analyze and identify the phenotype and genotype of CD36 in both the patient and stem cell donor, as well as the characteristic of antibody induced platelet transfusion refractoriness, and to analyse the efficacy of matched CD36-deficiency platelets transfusions.

METHODSThe CD36 expression on platelet and monocyte was analyzed by flow cytometry (FCM) in both patient and donor. Polymerase chain reaction sequence-based typing (PCR-SBT) was used to analyze the exons sequence of CD36 and HPA. Fast monoclonal antibody-specific immobilization of platelet antigen (F-MAIPA) and FCM were used to identify platelet antibodies in the patient. Short tandem repeat polymerase chain reaction (STR-PCR) was applied to monitor engraftment evidence. The platelet level was monitored. CD36- deficiency donor's platelets were selected from CD36- deficiency donor blood bank.

RESULTSThe donor was CD36 positive and the patient was typed I CD36 deficiency. The anti-CD36 antibody was identified in patient's serum (after transplantation), while the HLA and HPA-related antibodies were excluded. Sequence analysis of CD36 exon in the patient showed Exon 6 -1G>C(Change in splicing site) homozygote, which was a novel CD36 mutation. STR, HPA and CD36 of the patient (complete chimerism) were conversed to that of donor gene types on day 18 after allo-HSCT. The positive CD36 expression on platelet and monocyte in the patient was observed on day 96 after allo-HSCT. The patient showed the platelet transfusion refractoriness which was significantly improved after platelets transfusions from CD36 deficiency donors.

CONCLUSIONStem cell transplants resulted in anti-CD36 and caused platelet transfusion refractoriness, that was first reported in China. To ensure the efficacy of platelet transfusion, the CD36-deficiency patient should receive CD36 deficiency platelets for transfusion.

Antigens, Human Platelet ; Blood Platelet Disorders ; Blood Platelets ; CD36 Antigens ; China ; Humans ; Platelet Transfusion ; Thrombocytopenia

OBJECTIVESTo investigate the different effects of closed suction drainage and non-drainage for total knee arthroplasty(TKA) and to provide reference information for the choice of clinical treatment.

METHODSRandomized controlled trials (RCTs) of closed suction drainage versus non-drainage for TKA were collected from the Cochrane Library, PubMed, EMBase, Springer, CBM, CNKI, VIP and WANFANG database. Methodological quality of the RCTs was independently assessed using the Consolidated Standards of Reporting Trials (CONSORT) checklist. Data analysis was performed by RevMan Version 5.1.6 based on the methods recommended by the Cochrane Collaboration.

RESULTSTwenty-one RCTs without bias were finally enrolled, and 1920 enrolled knees were identified into drainage group (979 knees) and non-drainage group (941 knees). A lower incidence of soft tissue ecchymosis was demonstrated in the closed suction drainage group (OR = 0.30, 95%CI: 0.24 - 0.49); however, compared with the non-drainage group, more loss of blood (MD = 320.03, 95%CI: 235.31 - 404.76) and more need of homologous blood transfusion (OR = 1.83, 95%CI: 1.26 - 3.29) were found in the closed suction drainage group. In addition, there were no significant differences of postoperative infection (OR = 0.53, 95%CI: 0.22 - 1.32), deep venous thrombosis (OR = 1.00, 95%CI: 0.46 - 2.18), and the joint range of motion (MD = -0.04, 95%CI: -1.11 - 1.02) between the two groups.

CONCLUSIONBased on the current evidence, no obvious advantage is demonstrated for closed suction drainage, in comparison with non-drainage for TKA.

Arthroplasty, Replacement, Knee ; Drainage ; statistics & numerical data ; Humans ; Postoperative Complications ; epidemiology ; Randomized Controlled Trials as Topic ; Range of Motion, Articular ; Venous Thrombosis ; epidemiology

Adolescent ; Adult ; Aged ; Female ; Humans ; Liver ; physiopathology ; Liver Function Tests ; Male ; Middle Aged ; Severe Acute Respiratory Syndrome ; immunology ; physiopathology ; T-Lymphocyte Subsets ; immunology

Objective To investigate the effects of female sex hormones in cow's milk on metabolism of blood lipid in young male rats.Methods Forty-eight male Sprague-Dawley rats aged 21 days old were assigned randomly to 4 groups,each containing 12 rats,and fed with quantitative milk from postpartum cow,milk from pregnant cow,commercial whole milk and artificial milk,respectively.Serum total cholesterol (TC),triacylglyeriol(TG),high-density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C) and urinary creatinine (Cr) were determined with automatic biochemical analyzer.Serum progesterone(P4)and urinary free estriol(UFE3) were determined with immunochemiluminometric assays after all rats were killed at 53 days old.SPSS 13.0 software was used to analyze the data.Results Total estradiol and P4 were 1 189.66 pmol/L,833.98 pmol/L,588.17 pmol/L,286.48 pmol/L and 9.76 nmol/L,10.18 nmol/L,2.83 nmol/L,0.92 nmol/L in milk from pregnant cow,commercial whole milk,milk from postpartum cow and artificial milk groups,respectively.Serum TC were respectively(1.78?0.29) mmol/L,(1.94?0.20) mmol/L,(2.10?0.28) mmol/L and (2.11?0.22) mmol/L in pregnant milk,commercial whole milk,postpartum milk and artificial milk groups,and TC in pregnant milk group was lower than that in postpartum milk group or artificial milk group(P0.05).Conclusion Milk from pregnant cow may reduce serum TC in young male SD rats,which may be related to the conjoined effect of estradiol and P4.

With the universal two-child policy implementation, the birth rate increased, posing challenges to pediatrician allocation. Based on the birth rate, we calculated pediatrician demands and gaps during the period from 2016 to 2020 by the method of health service demand. The results showed that except Beijing and Shanghai, the ped-iatrician supply and demand ratios are less than 0 . 80 and additional numbers of pediatricians ranging from 191 981 to 198 287 are needed to meet the service demands. We recommend increasing the number of pediatricians taking both national supply-demand ratios and gaps by rationally using reasonable enrolment quota and improving the treatment and other reasonable ways to increase pediatricians. In addition, we should enhance information disclosure and guid-ance, and improve the hierarchical hospital visit system to alleviate the pressure of big cities.

With the universal two-child policy implementation, the birth rate increased, posing challenges to the maternity beds resource allocation. Based on the birth rate and the method of health service demand, we calculat-ed the maternity beds demands and gaps during the period from 2016 to 2020 . Results showed that numbers between 73 478 and 99 004 of maternity beds are needed annually and mainly allocated to eastern and central areas as well. In addition, the maternity beds of different delivery institutions should be adjusted and the hierarchical diagnosis system should be improved in order to alleviate the pressure of the obstestric acceepts in big cities like Beijing and Shanghai.

Objective To establish and evaluate two protocols for the noninvasive visualization and assessment of coronary artery bypass graft (CABG) patency on electron beam tomography (EBT).Methods Two hundred and fourteen consecutive patients who underwent coronary artery bypass graft surgery were scanned using both EBT angiography with 3-dimensional reconstruction and EBT flow study with time-density-curve analysis.Results There were 589 CABGs evaluated in this study (10 grafts were excluded because of artifacts). Among them, 133 (98.5％) of 135 arterial grafts were patent, and 345 (77.7％) of 444 saphenous-vein grafts were patent. Within 5 years or between 5 and 10 years after operation, arterial graft patency exceeded venous graft patency (P ＜ 0.001 ). Three-dimensional EBT angiography achieved higher sensitivity, specificity and accuracy (97.7％, 94.1％ and 96.7％, respectively) than did EBT flow study (88.4％, 82.4％ and 85.2％, respectively) for evaluating occlusion or patency of CABG. The intra-graft flow of patent arterial and venous grafts were 4.9 ± 2.2 mi · min-1 · g-1 and 6.9 ± 2.8 mi · min-1 · g-1,respectively (P＜0.001).Conclusion The combination of EBT three-dimensional reconstruction and flow study can be more effective in the assessment of CABG anatomy and quantification of patent CABG blood flow.

Objective To investigate the morbility status of functional dyspepsia and functional enteropathy of the nurse in emergency department and to find the regularity.Methods The nurses in emergency department of the First Hospital Affiliated to China Medical University and Shengjing Hospital were investigated with digestive symptoms questionnaire and other relative mental scales (nurse's working stressor scale, working burn-out scale, Pittsburg sleep quality index, clinical mental health symptom checklist).Results The morbility and frequency of digestive symptoms of the nurse in emergency department were higher than that of the nurse in outpatient department (P＜0.05 ).In the nurses in emergency department, 72 cases were troubled by functional dyspepsia and functional enteropathy (47.37%), while in the nurses in outpatient department the morbility was 34.65%(P＜0.001 ).The subtypes of functional dyspepsia and enteropathy in two groups were different: FD, functional constipation and IBS were common in the nurses in emergency department; FD, FD with entero-symptom and functional abdominal distention were common in the nurses in outpatient department.The scores of nurse's working stressor scale, working burn-out scale, Pittsburg sleep quality index, clinical mental health symptom checklist in the nurses in emergency department were higher than that of the nurses in outpatient department (P＜0.05).Conclusions There is tendency of functional dyspepsia and enteropathy in the nurses in emergency department, which is possibly related with the nurse's negative emotion, dormancy disorder, tired work, and tension.