1.Implementation of active screening for preventing and controlling the spread of multidrug-resistant organisms in intensive care unit
Chinese Journal of Infection Control 2016;15(6):401-404
Objective To implement active screening measures for patients in intensive care unit (ICU),early de-tect patients with multidrug-resistant organism (MDRO)colonization,implement contact isolation measures,pre-vent and control MDRO cross transmission.Methods The nasal and rectal swabs of 240 patients who were admit-ted to ICU from September 2012 to May 2013 were performed bacterial culture,patients with colonization of methi-cillin-resistant Staphylococcus aureus (MRSA),extended-spectrum β-lactamases (ESBLs)-producing Escherichia coli ,and ESBLs-producing Klebsiella pneumoniae were conducted contact isolation.Clinically isolated MDROs from ICU patients in September 2011-August 2012 (before active screening)and September 2012-August 2013 (after active screening)were collected and performed antimicrobial resistance analysis.Results Of 240 patients, nasal swabs screening test showed that there were 56(23.33%)patients who were colonized with MRSA,including 22(39.29%)were colonized at the admission to ICU and 34(60.71%)during the ICU stay.Rectal swabs screening test showed that there were 105(43.75%)patients who were colonized with ESBLs-producing Escherichia coli and Klebsiella pneumoniae ,72(68.57%)were colonized at the admission to ICU,and 33(31.43%)were colonized dur-ing the period of ICU stay.The incidence density of MDROs before and after implementing active screening were 28.56‰ and 13.71‰ respectively,difference was significant (P < 0.05;RR,2.08 [95%CI ,1.582 - 2.743]). Conclusion MDRO colonization rate is high among ICU inpatients,implementation of comprehensive prevention and control measures against MDROs based on active screening can reduce the spread of MDROs in ICU.
2.Clinical observation for the treatment of malignant tumor by Kanglaite injection combined low power ultrasonic cavitation
Journal of International Oncology 2015;42(9):641-643
Objective To investigate the clinical curative effect and security of Kanglaite injection in combination with low power ultrasound microbubble agents (cavitation) in the treatment of vascular embolization therapy.Methods Thirty-eight patients with abdominal malignant tumor,in accordance with the random number table,were divided into two groups:treatment group (Kanglaite combined with ultrasonic cavitation,21 cases) and control group (Kanglaite,17 cases).Intravenous drip with Kanglaite injection for 21 days,200 ml per day.Ultrasonic cavitation therapy treatment for three weeks,5 days a week and once a day.Tumors size,Karnofsky score,grade of the degree of pain and blood biochemical indicator detection were measyred before and after treatment.Results There was no complete remission,4 cases with partial remission,10 cases with stable disease in the treatment group,and the clinical benefit rate was 66.7% (14/21).There was no complete remission,1 case with partial remission,3 cases with stable diseasein in control group,and the clinical benefit rate was 23.5% (4/17).The treatment group was better than control group in clinical benefit rate (66.7% ∶ 23.5%),pain improvement (76.2% ∶ 41.2%),Karnofsky score [(66.67 ± 5.77) ∶ (82.86 ± 6.44);(64.12 ±5.07) ∶ (69.41 ±6.59)],and one year survival rate (57.1% ∶23.5%) (x2 =7.012,P =0.008;x2 =4.821,P=0.028;t=4.575,P<0.001;x2 =4.354,P=0.037).Conclusion Kanglaite injection in combination with cavitation shows higher clinical efficient,tolerated adverse recations,and significant improvement of quality of life.
3.Distribution of Serotypes and Antimicrobial Patterns of group B streptococcus Strains Isolated in Beijing
Adong SHEN ; Yinzhi ZHU ; Yonghong YANG
Chinese Journal of Perinatal Medicine 2000;0(04):-
Objective To obtain information on the distribution of serotypes and antimicrobial agents susceptibilities to group B streptococcus(GBS) strains. Methods Bacterial isolates of GBS were obtained from vaginal and cervical tract of pregnant and nonpregnant women in Beijing Tian Tan Hospital. A total of 76 GBS strains were identified finally by Coagglutination. Serotyping was determinted by Standard Lancefield method. Susceptibility to test agents was assessed by determining the mininum inhibitory concentrations (MICs) with agar dilution method that was established by the National Committee for Clinical Laboratory Standards (NCCLS). Results Seven serotypes were identified among 76 GBS strains isolates. Type II(33%), III(23%) and Ia(16%) were the predominantly serotypes in pregnant and nonpregnant women. MICs of penicillin G and anpicillin were≤0.06 ?g/ml; MICs of cephazolin,cefuroxime, cefoperozone were 0.006~0.03 ?g/ml; MICs of erythromycin was 0.003~0.03 ?g/ml;MICs of gentamycin was 1~32 ?g/ml,MICs of amikacin was 4~≥64 ?g/ml,nearly 12.8% and 40.4% the strains were resistant to gentamycin and amikacin,respectively. Conclusion Our study provide useful epidemiologic data for preparation of GBS type specific vaccines which can prevent GBS infections and antimicrobial agents susceptibility patterns in China. Routine reports on GBS susceptibolities by clinical laboratories and continuous surveillance for changes in the susceptibility is of considerable clinical importance.
4.The study on drug resistance and ermB gene of Enterococci isolated from animal and human
Ling WANG ; Yaoling MA ; Yonghong WANG ; Ping Lü ; Xiwei XU ; Jinghui ZHEN ; Yonghong YANG ; Xuzhuang SHEN
Chinese Journal of Microbiology and Immunology 2008;28(8):733-738
Objective To obtain better insights into transmission dynamics of macrolide resistance genes between human and animal Enterococcus strains.Methods The antimicrobial susceptibility to 8 anti-bioties of 52 Enterococci isolated from animal and 55 Enterococci isolated from human was determined.PCR was used to detect the macrolide resistance genes ermB and mefA,tetracycline resistance genes tetM,and the integrase gene int of Tnl545 of the total 107 strains.Forty-nine ermB positive strains were chosen to be se-quenced.Filter mating experiments were taken.Results The resistance rate to erythromycin were 89.09% and 80.77%for isolates from human and animal:and resistance rate to tetracycline were 80.00%and 67.3l%for isolates from human and animal.respectively.All isolated Enterococci strains were found sensi-tive to vancomycin ermB was detected in 61.82% human Enterococci and 53.85% porcine ones.Identical er-mB gene sequences were found in animal and human Enterococci.Transfer of the ermB gene from porcine E.faecalis to human E.feacalis was successful.and the transfer frequency is 1.2×10-5.Conclusion En-terococci have a high resistance rate to erythromycin and some other antibio tics,especially in pediatric iso-lates:but still very sensitive to glycopeptide.ermB was the predominant genes for macrolide and tetracy-cline.Identical ermB gene sequences were present in animal and human Enterococci and that transfer of the ermB gene from porcine E.faecalis to human E.faecalis and vice versa is possible.but probably occurs at a low frequency.
5.Epidemiological survey of hepatitis B virus serologic markers among university freshmen in Beijing
Yonghong WANG ; Chunping XU ; Xiaofeng SHEN ; Haihong LI
Chinese Journal of General Practitioners 2015;14(2):139-142
To analyze the test results of five serum markers of hepatitis B virus (HBV) among university freshmen from 2007 to 2012.Among a total of 10 827 freshmen,there were 5 021 freshmen from 2007 to 2009 with all five serum markers.The overall ratio of HBsAg positive was 4.5%,4.8%,4.8% and 4.0% for each year.And it had no statistically significant difference.The overall ratio of single-HBsAb positive was 34.8%,37.4%,29.0% and 37.9% for each year and the figure of 2008 was lower than those of 2007 and 2009 (P < 0.01).The overall ratio of five markers all negative were 58.3%,55.4%,63.9% and 55.8% for each year and the figure of 2008 was higher than those of 2007 and 2009 (P < 0.01).And 34.5% of HBsAg positive freshmen were HBsAg(+),HBeAg (+),HBcAb (+) and 44.2% HBsAg(+),HBeAb(+),HBcAb(+).The prevalence ratio of HBsAg for males was higher than that for females (5.1% vs.3.2%,P <0.01).Among 5 806 freshmen tested during 2010-2012,522(9.0%) had a serum level of alanine transaminase (ALT) > 40 U/L,including HBsAg positive (n =12),single anti-HBs positive (n =213) and five negatives (n =288).Approximate 50% university freshmen have no anti-HBs indicating a low level of immunity.And the students should acquire the knowledge of hepatitis B,improve the ratio of vaccination,strengthen the monitoring and prevent its spread through concerted measures.
6.The relationship between penicillin-binding protein genes restriction polymorphism and penicillin susceptibility in Streptococcus pneumoniae
Kaihu YAO ; Yuejuan TONG ; Sangjie YU ; Xuzhuang SHEN ; Yonghong YANG
Chinese Journal of Laboratory Medicine 2003;0(12):-
Objective To indicate the restriction profiles of pbps in Streptococcus pneumoniae(S.pneumoniae), and relationship between pbps profiles and the penicillin MIC.Methods The E-test MIC method was used to determinate penicillin susceptibility of 132 S.pneumoniae strains consisting of 69 penicillin susceptible S.pneumoniae (PSSP) strains and 63 nonsusceptible S.pneumoniae (PNSP) strains. Furthermore, we compared these strains by detecting restriction fragment length polymorphism (RFLP) of the PBPs genes pbp1a, pbp2b and pbp2x.Results The RFLP results showed that 9 genotypes were founded for pbp1a, in which 2 were detected from PSSP and some PNSP strains. The other 7 ones were founded mainly in the PNSP with penicillin MIC≥0.25 ?g/ml. Ten genotypes were founded for pbp2b, in which 3 were detected from PSSP and some PNSP strains. The other 7 ones, similar with pbp1a, were founded mainly in the PNSP with penicillin MIC≥0.25 ?g/ml. Thirty-one restrictive patterns were founded for pbp2x. Seventeen patternss from them were detected in PSSP, and 13 ones were founded only in PSSP. The other 14 patterns all were covered PNSP strains. A total of 47 patterns were found according to the three pbps types. Twenty-three patterns from them were detected in PSSP, and 17 ones were founded only in PSSP. The other 24 patterns all were detected in PNSP.Conclusions Results of the study are consistent with the concept that mutations in PBP1a, PBP2b and PBP2x play an important role in the development of resistance to ?-lactam antibiotics by S.pneumoniae. In the meantime, the profiles of pbps can predict penicillin susceptibility.
7.Identification of Coagulase-Negative Staphylococci by 16S~23SrDNA Internal Transcribed Spacer PCR
Yi LI ; Xuzhuang SHEN ; Jianhui DI ; Yonghong YANG
Chinese Journal of Laboratory Medicine 2003;0(09):-
Objective To develop a molecular method to type coagulase-negative staphylococci(CNS) using 16S~23S internal transcribed spacer-PCR(ITS-PCR)Methods ITS-PCR was performed to identify six control strains and a collection of 171 clinical strains, identified as CNS by AutoScan-4 System The API Staph system also tested the discrepant strainsResults A total of 11 CNS species from control strains and clinical ones confirmed by the API Staph system were resolved by their unique ITS-PCR patterns These results constructed the primary database of CNS in the laboratory They were obtained with Staphylococcusepidermidis, Shaemolyticus, Shominis, Ssaprophyticus, Sxylosus, Swarneri, Scapitis, Scohhni subspurealyticum,S sciuri, Sauricular, Ssimulans Only S sciuri showed intraspecific polymorphism on its ITS-PCR pattern 9357%(160/171) clinical isolates can be identified by this ITS-PCR data base and the accuracy is 9375%(150/160) The coincidence of the API Staph system and ITS-PCR was better than that of AutoScan-4 system results There is at lest 936%(16/171) CNS results from AutoScan-4 system are falseConclusion ITS-PCR is verified as a valuable, easy to perform, rapid, high reliable and low cost molecular typing method for coagulase negative staphylococci
8.Antibacterial agents resistance and typing of ?-lactamases in moraxella catarrhalis
Yan WANG ; Meihe ZHANG ; Xuzhuang SHEN ; Lin YUAN ; Yonghong YANG
Chinese Journal of Laboratory Medicine 2000;0(06):-
Objective To distinguish BRO ?-lactamase by use of restriction endonuclease analysis and investigate antibacterial agents resistance of Moraxella catarrhalis(M. Catarrhalis) with different BRO ?-lactamases .Methods Nasopharyngeal swabs of children with respiratory tract infections from the outpatient department of Beijing Children's Hospital were cultured for isolating M.Catarrhalis. BSAC(british society for antimicrobial chemotherapy) agar diffusion test was used to determine antibacterial agents resistance of M.Catarrhalis.Nitrocefin disk was used to detect ?-lactamase. Restriction endonuclease analysis was used to distinguish BRO ?-lactamases . Antibacterial agents resistance of M. Catarrhalis with different bro genes was compared.Results (1)95.0% of the 80 strains were beta-lactamase positive. MIC 90 of ampicillin was 32 ?g/ml and MIC 90 of cefuroxime,cefaclor and cefotaxime were 4 ?g/ml,8?g/ml and 1?g/ml respectively,MIC 90 of tetracycline was 16?g/ml. Among the antibacterial agents,ciprofloxacin was the most sensintive agent.(2)Among 80 strains,6(7.5%) Strains were bro negative,55(68.8%) were bro-1 positive,19(23.8%)were bro-2 positive。Except 2 strains,the results of ?-lactamases were same as the results of nitrocefin disk and restriction endonuclease analysis.(3)Compared with bro-2 positive strains,the MIC value of ampicillin and cefaclor for bro-1 positive strains were higher.Conclusions Antibacterial agents resistance of M. Catarrhalis to ampicillin was sierous in China. It should be strengthened to monitor antibacterial agents resistance of M.Catarrhalis. Restriction endonuclease analysis can play an important role on characterizing bro genes,evaluating antibacterial agents resistance of Moraxella Catarrhalis to ?-lactam and investigating molecular epideminology
9.Mechanism of polypeptide extracts of Eupolyphaga sinensis Walker against oxidative aging in mice
Chonggao GU ; Yonghong ZHANG ; Ruoyu BAI ; Meijie TIAN ; Hong SHEN
Acta Laboratorium Animalis Scientia Sinica 2014;(6):66-74
Objective The purpose of this study was to investigate the mechanism of action of polypeptide extracts of Eupolyphaga sinensis Walker ( ESW) against oxidative aging.Methods Mice were intraperitoneally injected D-galac-tose for consecutive 20 days to establish an aging mouse model.The model mice were administered with different doses of ESW polypeptide (0, 40, 80, 160 mg/kg/d).The normal activity, movement and anti-stress ability of the mice were ob-served.The activity of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-PX) in blood and different tissues and the content of glutathione ( GSH) and malondialdehyde ( MDA) of the aging mice were assessed by xanthin oxidase activity measurement and spectrophotometry, respectively.The expression of nuclear factor erythroid 2-re-lated factor 2 (Nrf2) in Caco-2 cells was detected by immunofluorescence.Results Comparing the control and polypep-tide groups, there were significant decreases of body weight gain, organ indexes, anti-stress ability and activity capacity, the activity of SOD, CAT, GSH-PX and the content of GSH, and an increase of the content of MDA in blood and different tissues in the aging mice.With the increasing dose of polypeptide extracts of ESW, the body weight gain, organ indexes of the liver, spleen and kidney were significantly increased, the static and dynamic exercise time was prolonged in the poly-peptide group, and their abilities of hypoxia tolerance and heat tolerance were close to that of normal controls.The SOD, CAT, GSH-PX activity and GSH level in blood and different tissues were significantly increased, but MDA content de-creased.The expression of Nrf2 in Caco-2 cell nuclei was significantly increased in the polypeptide group, close to that of the positive control group.Conclusions The results of our study show that polypeptide extracts of ESW improve the anti-stress and antioxidative capacity in D-galactose-induced mouse models of oxidative aging by initiating Nrf2-ARE antioxidant signaling pathway, therefore, delay the oxidative aging in mice.
10.Effects of mesenchymal stem cell transplantatiOn on cardiac function and structure and eIectrophysiology in rabbits with dilated cardiomyopathy
Gengsheng YU ; Xing SHEN ; Jie TIAN ; Yonghong BAI ; Jing ZHU ; Guanxin LIU ; Yuan CHEN
Chinese Journal of Tissue Engineering Research 2008;12(34):6776-6780
BACKGROUND: The study of cell transplantation to repair injured cardiac muscle and improve cardiac function of dilated cardiomyopathy (DCM) has become a hotspot in recent years. However, the effect of cardiac electrophysiology following transplantation is still unknown.OBJECTIVE: To explore the influence of ailogenic implanted mesenchymal stem cells (MSCs) on cardiac function, structure and electrophysiology of rabbits with DCM.DESIGN, TIME AND SETTING: Randomized controlled animal trial was performed at Electrophysiology Laboratory of Institute of Pediatrics, Chongqing Medical University between January 2004 and May 2006.MATERIALS: Forty-three New Zealand whiterabbits, weighing 3.0-3.5 kg, irrespective of gender, were selected. Adriamycin was produced by Haizheng Medical Products Company of Zhejiang Province, China, No. 050307. The Ultrasonograph SSD-5000 came from Aloka, Japan, and RM6240 multiplying channel electrophysiolograph of Chengdu Instrument Company was applied.METHODS: All animals were randomized into normal group (n=12), cell transplantation group (n=13), and DCM model group (n=13). Except the normal group, adriamycin was applied to create rabbit DCM model, I mg/kg, twice a week for successive 8 weeks. Bone marrow solution was harvested from the remaining 5 rabbits, and MSCs were isolated, amplified and purified using attachment method. Three weeks after modeling, the MSCs were transplanted into left ventricle anterior wall at four sites in cell transplantation group, model group was injected with matching DMEM/FI2 medium, while the normal group was not given any treatment.MAIN OUTCOME MEASURES: At four weeks postoperatively, left ventricular end-diastolic dimension, end systolic dimension,left ventricular ejection fraction, and shortening fraction were monitored by ultrasonograph; the value for monophasic action potential amplitude (MAPA) and the maximum velocity in 0 phase (V,,~), the value for 50% monophasic action potential durations (MAPDs0) and 90% monophasic action potential durations (MAPDg0) were detected by electrophysiolograph. In addition, the cardiac tissues harvested from implanted region were observed by light microscope and electron microscope, and also the expression of cardiac troponin T (cTnT) and connexin 43 (Cx43) was detected through immunohistochemistry.RESULTS: Of 43 rabbits, 9 rabbits each of the transplantation group died of the acute or chronic toxic effects of Adriamycin, finally, 25 rabbits were included in final analysis. Compared with model group, the end systolic dimension was diminished, and the left ventricular ejection fraction and shortening fraction in cell transplantation group were significantly increased (P < 0.05). The MAPDs0 and MAPDgo in cell transplantation group prolonged significantly compared with model group (P < 0.05). In model group,cardiac myocytes appeared mitochondria swelling and hyperplasia, and their sarcomere had different lengths, arranged unevenly,accompanied by abnormal contraction bands. In addition, myolysis was found in parts of myocardium under electron microscope.However, the structural abnormalities in the cell implantation group were less than the DCM model group, and the implanted MSCs could express cTnT and Cx43.CONCLUSION: Allogenic MSCs transplantation can improve cardiac function, lessen structural abnormalities and may inhibit the progression of electrophysiology derangement.