OBJECTIVE To investigate the drug resistance of Escherichia coli in biliary tract infection and genotype of ESBLs.METHODS Antimicrobial susceptibility test was performed using Kirby-Bauer method.The genotypes of ESBLs were detected by PCR.RESULTS The detection rate of ESBLs producing bacteria was 32.4%(23 strains),and the drug-sensitivity test indicated that E.coli was sensitive to imipenem,meropenem and cefoperazone/subactam,but these ESBLs producing strains were resistant to other antimicrobial agents.ESBLs were identified as TEM type in 16 strains,SHV type in 4 strains,CTX-M type in 12 strains and OXA type in 5 strains.CONCLUSIONS ESBLs-producing E.coli in biliary tract infections show strous resistance.TEM and CTX-M are the most common ESBLs genotypes.

Objective To improve short-and mid-term surgical outcomes ofter the tricuspid ring annuloplasty,and to provide theoretic basis for strategy making among patients with tricuspid regurgitation secondary to left-sided heart diseases.Methods Tricuspid regurgitation secondary to left-sided heart diseases ( including mitral valve diseases and aortic valve diseases) were treated by using tricuspid ring annuloplasty techniques.Patients'age averaged (47.3 ± 12.0) years old,there were a total of 84 female patients(53.2％ ).The average systolic pulmonary pressure was (53.4 ± 19.8) mm Hg.From August 2002 to December 2007,a total of 158 consecutive patients underwent tricuspid ring annuloplasty in Fuwai Cardiovascular disease Hospital.Among this group of patients,there were 66 mild tricuspid regurgitation(41.8％ ),54 moderate(34.2％ ),and 38 severe tricuspid regurgitation(24.0％ ).The average age was (47.3 ± 12.0) years old and female accounted for 53.2％ of the whole cohort.The indications for the tricuspid ring annuloplasty included:moderate to severe tricuspid regurgitation or moderate to severe pulmonary hypertension ( systolic pulmonary hypertension ＞40 mm Hg).In the current study,the ring annuloplasty techniques were modified in the following aspects:selection of undersized ring and partial fixation of tricuspid septal segment.In all the patients,we chose Cosgrove-Edwards ring for tricuspid annuloplasty.The surgical outcomes were evaluated through multivariate regression and Cox analysis.Results Compared with moderate and severe tricuspid regurgitation groups,mild regurgitation group had the smallest ring diameter,mild group ( 38.2 ± 4.9 ) mm,moderate group(47.0 ± 11.6 ) mm,severe group(44.5 ± 8.9) mm,P ＜0.001.No significant differences were noted in terms of ejection fraction among three groups (0.59 ± 0.08,0.59 ± 0.06 and 0.58 ± 0.09,P =0.73 ).Compared with mild and moderate tricuspid regurgitation groups,severe regurgitation group had the highest systolic pulmonary pressure.The diameter reduction was most significant in severe regurgitation group,diameter reduction in mild,moderate and severe regurgitation groups were ( 12.4 ±5.6) mm,(20.8 ± 11.5 ) mm,( 18.6 ± 8.3 ) mm,respectively,P ＜ 0.00 1.An in-hospital death occurred in moderate regurgitation group.157 patients discharged alive.The median follow-up time was 49.1 months.During follow up,three moderate to severe regurgitation occurred,among which one was in moderate regurgitation group,two in severe regurgitation group ( P =0.06).There were three deaths in mild regurgitation group,two in moderate regurgitation group,and four in severe regurgitation group.No significant differences were found in terms of mid-term morality,P =0.10.Conclusion For patients with tricuspid regurgitation secondary to left-sided heart diseases,the mid-term outcomes of modified Cosgrove-Edwards ring annuloplasty were satisfactory.The taking home messages include:positive recommendation for patients with pulmonary hypertension to accept tricuspid annuloplasty,use of undersized ring,and partial fixation of septal segment.

OBJECTIVE To analyze the resistance feature and the distribution of Enterococcus species isolated from bile specimens.METHODS Totally 715 samples of bile in intra-operation were cultured,and the drug resistances were tested.RESULTS From them 511 strains in 469 cases were detected out(65.6%),among whith 156 were Enterococcus strains and 159 were strains of Escherichia coli.The mixed infection with two kinds of germs was found in 35 cases.The results of drug susceptibility showed the resistant rates of Enterococcus faecalis to penicillin and high concentration gentamicin were lower than those of E.faecium.None of E.faecalis,and E.faecium resisted to vancomycin.CONCLUSIONS The detective rate of the Enterococcus is high in bile samples.The results reveal a different resistance to common antibiotics,but a high sensistivity to vancomycin and teicoplanin.The result of antibiotic susceptibility testing guides rational use of antibacterial agents.

Objective To evaluate the situation of blood concentration detection in Zunyi city by the way of analyzing the practice of blood concentration detection for the past 4 years .Methods The bood samples of 194 928 persons who were voluntary blood donators since full implementation of centralized blood test from February 2011 to December 2014 were analysed .Results The unqualified rates of the 5 detection indicators from the seven blood center banks were closed to the centre blood station ,which was rang from 3 .15% to 4 .85% ,the total unqualified rate was 3 .72% and no significant difference was found(P> 0 .05) .Since the concentration of blood detection ,blood donators in the 7 blood center blood banks increased year by year .Conclusion Blood concen-tration detection improves the blood test quality in this single region ,and promotes the development of blood donation career .

OBJECTIVETo investigate the effect of high-intensity focused ultrasound (HIFU) on tumor metastasis in mouse model bearing melanoma xenograft.

METHODSMice bearing murine melanoma B16-F10 cell xenograft were randomized for sham-HIFU or HIFU exposure when the tumors grew to a maximum diameter of 7-10 mm, and the tumor size was measured every 3 days. The cumulative survival rate of the mice and tumor metastasis rate were calculated, and the circulating melanoma cells were detected using qRT-PCR. At 14 days after HIFU treatment, B16-F10 cells were retransplanted via the tail vein and the pulmonary metastatic nodules were counted.

RESULTSThe median survival time of the mice was 19.00 days (95% CI 17.14-20.86 days) in the sham group and 26.00 days (95%CI 24.76-27.25 days) in HIFU group. The cumulative survival rate in the HIFU group was significantly higher than that in sham-HIFU group (P<0.01), and the tumor size was significantly smaller in HIFU group at 20, 23, and 26 days after HIFU treatment (P<0.05). Compared with the sham-HIFU group, HIFU group had significantly lower levels of MAGE-A3, MART1 and PAX3 at 7 days after HIFU (P<0.05) with still lower MAGE-A3 level at 14 days (P<0.05). HIFU group showed a significantly smaller number of pulmonary metastatic nodules following tumor cell retransplantation than in sham-HIFU group (P<0.01) with a metastasis inhibition rate of 42.4%.

CONCLUSIONHIFU treatment can inhibit tumor metastasis in melanoma-bearing mice possibly by reducing tumor cell detachment from the primary tumor site and suppressing colonization of the circulating melanoma cells.

Animals ; High-Intensity Focused Ultrasound Ablation ; Melanoma, Experimental ; therapy ; Mice ; Mice, Inbred C57BL ; Neoplasm Metastasis ; prevention & control ; Survival Rate

Objective:To investigate the relationship between intramuscular adipose tissue index (IATI) calculated from computed tomography images at transverse process of the first lumbar and all-cause mortality in maintenance dialysis patients, and to provide a reference for improving the prognosis in these patients.Methods:It was a multicenter retrospective cohort study. The clinical data of patients who received maintenance hemodialysis or peritoneal dialysis treatment from January 1, 2017 to December 31, 2019 in 4 grade Ⅲ hospitals including Zhongda Hospital Affiliated to Southeast University, Taizhou People's Hospital Affiliated to Nanjing Medical University, Affiliated Hospital of Yangzhou University, and the Third Affiliated Hospital of Soochow University were retrospectively collected. IATI was calculated by low attenuation muscle (LAM) density/skeletal muscle density. The receiver-operating characteristic curve was used to determine the optimal cut-off value of IATI, and the patients were divided into high IATI group and low IATI group according to the optimal cut-off value. The differences of baseline clinical data and measurement parameters of the first lumbar level between the two groups were compared. The follow-up ended on December 23, 2022. The endpoint event was defined as all-cause mortality within 3 years. Kaplan-Meier survival curve and log-rank test were used to analyze the survival rates and the differences between the two groups. Multivariate Cox regression analysis models were used to analyze the association between IATI and the risk of all-cause mortality in maintenance dialysis patients. Multivariate logistic regression analysis model was used to analyze the influencing factors of high IATI.Results:A total of 478 patients were eligibly recruited in this study, with age of (53.55±13.19) years old and 319 (66.7%) males, including 365 (76.4%) hemodialysis patients and 113 (23.6%) peritoneal dialysis patients. There were 376 (78.7%) patients in low IATI (<0.42) group and 102 (21.3%) patients in high IATI (≥0.42) group. The proportion of age ≥ 60 years old ( χ2=24.746, P<0.001), proportion of diabetes mellitus ( χ2=5.570, P=0.018), fasting blood glucose ( t=-2.145, P=0.032), LAM density ( t=-3.735, P<0.001), LAM index ( t=-7.072, P<0.001), and LAM area/skeletal muscle area ratio ( Z=-9.630, P<0.001) in high IATI group were all higher than those in low IATI group, while proportion of males ( χ2=11.116, P<0.001), serum albumin ( Z=2.708, P=0.007) and skeletal muscle density ( t=12.380, P<0.001) were lower than those in low IATI group. Kaplan-Meier survival analysis showed that the 3-years overall survival rate of low IATI group was significantly higher than that in high IATI group (Log-rank χ2=19.188, P<0.001). Multivariate Cox regression analysis showed that IATI<0.42 [<0.42/≥0.42, HR(95% CI): 0.50 (0.31-0.83), P=0.007] was an independent protective factor of all-cause mortality, and age ≥60 years old [ HR (95% CI): 2.61 (1.60-4.23), P<0.001], diabetes mellitus [ HR (95% CI): 1.71 (1.06-2.78), P=0.029] and high blood neutrophil/lymphocyte ratio [ HR (95% CI): 1.04 (1.00-1.07), P=0.049] were the independent risk factors of all-cause mortality in maintenance dialysis patients. Stepwise Cox regression analysis showed that IATI<0.42 was still an independent protective factor of all-cause mortality in maintenance dialysis patients [<0.42/≥0.42, HR (95% CI): 0.45 (0.27-0.76), P=0.003]. Multivariate logistic regression analysis showed that low skeletal muscle density [ OR (95% CI): 0.84 (0.81-0.88), P<0.001] and high serum triglyceride [ OR (95% CI): 1.39 (1.07-1.82), P=0.015] were the independent influencing factors of IATI≥0.42. Conclusion:IATI<0.42 of the first lumbar level is an independent protective factor of all-cause mortality in maintenance dialysis patients. Localized myosteatosis within high-quality skeletal muscle may reduce the risk of all-cause mortality in these patients.