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Objective To investigate the etiological and antibiotic resistance profile in the old patients with bloodstream infection (BSI).Methods Microbiological and clinical data were collected and reviewed retrospectively for the patients with confirmed bloodstream infection and at least 65 years of age who were treated as inpatients in Tongling People′s Hospital from January to December 2015.Results A total of 107 strains of pathogen were isolated from the blood samples of 107 patients with bloodstream infections, of which community-acquired BSI accounted for 57.9 % (62/107), and hospital-acquired BSI 42.1 % (45/107). Gram negative bacilli accounted for 67.7 % in the pathogens of community-acquired BSI and gram positive cocci accounted for 55.5 % in the pathogens of hospital-acquired BSI. More male BSI patients were secondary to respiratory tract infection than female patients (P<0.001), while more female BSI patients were secondary to urinary tract infection than male patients (P<0.001). Of the 107 isolates, gram negative bacilli, gram positive cocci and fungi accounted for 55.1 % (59/107), 42.1 % (45/107) and 2.8 % (3/107), respectively. The top six pathogens were E. coli (30.9 %), coagulase negativeStaphylococcus (CNS) (20.6 %), S. aureus (10.3 %),K. pneumoniae (6.5 %),Enterococcusspp. (6.5 %) and Acinetobacter spp. (4.7 %). About 51.5 % of the E. coli isolates and 28.6 % of the K. pneumoniae isolates produced extended-spectrum β-lactamases (ESBLs).E. coli isolates showed low resistance rate (< 10 %) to amikacin,cefoxitin and piperacillin-tazobactam. No E. coli isolate was found resistant to carbapenem. About 14.3 % to 28.6 % of K. pneumoniae isolates were resistant to carbapenems. No tigecycline-resistant K. pneumoniae was found. The prevalence of MRSA and MRCNS was 36.4 % and 72.7 %, respectively. No staphylococcal isolates were found resistant to vancomycin, teicoplanin or linezolid. One strain of E. faecium was identified as resistant to vancomycin (VRE).Conclusions This surveillance data indicate that gram negative bacilli play an important role in the BSI of old patients. E. coli and CNS are the most common pathogens. We should pay more attention to the effect of gender and site of infection on the BSI in old patients.

Objective To investigate the bacterial resistance of clinical isolates collected in Tongling area. Methods Antimicrobial susceptibility test was conducted by Kirby-Bauer method.All the data were analyzed with WHONET 5.5 software.Results A total of 3 092 clinical isolates were collected during 2012,of which gram negative organisms and gram positive organisms accounted for 76.3% (2 359/3 092)and 23.7% (773/3 092),respectively.MRSA and MRCNS accounted for 50.9% of S.aureus and 73.0% of coagulase negative Staphylococcus,respectively.MRSA and MRCNS showed higher resistance to gentamicin,ciprofloxacin and erythromycin.No vancomycin-or teicoplanin-resistant strains of Staphylococcus spp.were found.No vancomycin-or teicoplanin-resistant strains of E.faecalis were found.Some E.faecium strains were resistant to vancomycin and teicoplanin.About 52.1% of E.coli isolates and 42.1% of Klebsiella isolates produced extended-spectrumβ-lactamases (ESBLs).Imipenem-or meropenem-resistant strains of K. pneumoniae were found. The percentage of P.aeruginosa strains resistant to amikacin, cefoperazone-sulbactam and cefepime was 3.4%,14.0% and 17.7%,respectively.More than 70% of Acinetobacter spp. strains were resistant to all the antibiotics tested except minocycline and cefoperazone-sulbactam,to which 42.1%and 4.4% of the strains were resistant.Conclusions The antibiotic resistance of clinical bacterial isolates is growing. The spread of multi-drug or pan-drug resistant strains in a specific region poses a serious threat to clinical practice.We should pay more attention to resistance surveillance and the rational use of antibiotics.

Objective To investigate the bacterial resistance profile of clinical isolates collected in Tongling area . Methods Antimicrobial susceptibility test was conducted by Kirby‐Bauer method . All the data were analyzed with WHONET 5 .6 software .Results A total of 3 419 clinical isolates were collected during 2013 ,of which gram negative organisms and gram positive organisms accounted for 75 .9% and 24 .1% .MRSA accounted for 41 .3% of S .aureus and MRCNS accounted for 73 .5% of coagulase negative Staphylococcus ,respectively .MRSA showed higher resistance to gentamicin ,ciprofloxacin , erythromycin and rifampicin . No vancomycin‐ or teicoplanin‐resistant strains of Staphylococcus spp . were found . No vancomycin‐or teicoplanin‐resistant strains of E . f aecalis and E . f aecium were found .About 51 .6% of E .coli isolates and 42 .8% of K . pneumoniae isolates produced extended‐spectrum β‐lactamases (ESBLs ) . The prevalence of imipenem‐ or meropenem‐resistant strains of K . pneumoniae increased significantly .The percentage of P . aeruginosa strains resistant to amikacin ,piperacillin‐tazobactam ,ciprofloxacin ,cefepime and cefoperazone‐sulbactam was lower than 20 .0% .The percentage of A .baumannii strains resistant to cefoperazone‐sulbactam , minocycline and amikacin w as 34 .7% ,57 .0% and 58 .3% , respectively . More than 68 .0 % of A . baumannii strains were resistant to any of the other antibiotics tested . Conclusions The antibiotic resistance is growing in clinical bacterial isolates .The spread of carbapenem‐resistant strains of K . pneumoniae in some departments poses a serious threat to clinical practice .We should pay more attention to resistance surveillance and rational use of antibiotics .

Objective To investigate the bacterial resistance of clinical isolates collected in Tongling area during 2011.Methods Antimicrobial susceptibility testing was conducted by Kirby-Bauer method.All the data were analyzed by WHONET 5.5 soft-ware.Results A total of 2 690 clinical isolates were collected during 2011,of which gram negative organisms and gram positive organisms accounted for 74.2% and 25.8%,respectively.MRSA and MRCNS accounted for 45.1% of S.aureus and 71.6%of coagulase negative Staphylococcus,respectively.MRSA and MRCNS showed higher resistance to gentamicin,ciprofloxacin and erythromycin than the corresponding methicillin-susceptible strains.No vancomycin- or teicoplanin-resistant strain of Staphylococcus spp.was identified.The resistance rate to penicillin,nitrofurantoin and fosfomycin was low in E.faecalis.No ampicillin-,vancomycin-or teicoplanin-resistant strains were found.For E.faecium,some strains were resistant to vancomy-cin and teicoplanin.About 46.6% of E.coli isolates and 27.7% of Klebsiella isolates produced extended-spectrumβ-lactamas-es (ESBLs).No imipenem-or meropenem-resistant isolate was found.The percentage of P .aeruginosa strains resistant to imipenem,meropenem and amikacin were 29.5%,36.9%and 2.3%, respectively. More than 60.0% of the Acinetobacter strains were resistant to all the antibiotics test-ed except minocycline and cefoperazone-sulbactam,to which 26.4% and 12.5% of the strains were resistant.Conclusions No glycopeptides-resistant isolate was found in gram positive organisms except E.faecium.The resistance rate of Enter-obacteriaceae isolates was lower to imipenem,meropenem, cefoperazone-sulbactam,piperacillin-tazobactam and amika-cin.The prevalence of resistant strains is still increasing,es-pecially carbapenem-resistant P .aeruginosa and carbapenem-resistant A.baumannii.It is mandatory to take effective antibiot-ic policy and infection control measures.

OBJECTIVETo explore the expression of KIF18A gene protein in gastric cancer tissues and its association with the prognosis of patients.

METHODSTwenty fresh paired gastric cancer specimens and adjacent normal mucosa(at least 5 cm from the edge of tumor) from 20 gastric cancer patients undergoing operation in Department of General Surgery at the First Affiliated Hosptial of Anhui Medical University between March 2015 and July 2015 were collected. Real-time PCR was used to examine KIF18A mRNA expression in above specimens. Meanwhile, paraffin embedded cancer tissue samples from 129 gastric cancer patients undergoing operation and 23 samples of randomly selected normal gastric tissue(adjacent non-cancer tissue) were collected to establish the microarray. Immunohistochemistry method was applied to detect the KIF18A protein expression in the microarray after confirmation by pathologists. Association of KIF18A expression with clinicopathological features in gastric cancer patients was evaluated. Cox proportional hazard model was used to identify prognostic risk factors.

RESULTSAmong 20 fresh paired gastric cancer specimens, mRNA expression of KIF18A in 16 specimens was obviously lower than that in adjacent normal tissues. The positive rate of KIF18A protein expression in gastric cancer tissues was significantly lower than that in normal gastric tissues in microarray[45.0%(58/129) vs. 69.6%(16/23), P=0.041]. KIF18A protein expression was significantly associated with invasion depth (P=0.008) and TNM staging (P=0.032). The median overall survival of all the 129 patients was 44.0(95% CI: 39.78-49.24) months. The three-year survival rates of patients with high and low KIF18A expression were 67.2% and 36.6% respectively(P=0.020). Cox regression analysis showed that KIF18A expression was an independent protective factor of the prognosis of gastric cancer patients (HR=0.570, 95% CI:0.335 to 0.970).

CONCLUSIONSKIF18A expression is down-regulated in gastric cancer tissue, which may play a critical role in gastric cancer carcinogenesis. Lower expression of KIF18A is associated with poor prognosis of gastric cancer patients. KIF18A may be a potential prognostic marker of gastric cancer.

Biomarkers, Tumor ; metabolism ; Humans ; Immunohistochemistry ; Kinesin ; metabolism ; Neoplasm Staging ; Prognosis ; Proportional Hazards Models ; Real-Time Polymerase Chain Reaction ; Regression Analysis ; Stomach Neoplasms ; diagnosis ; metabolism ; Survival Rate

Objective:To establish a scientific and systematic department rotation examination and evaluation system adapted to the development of Pulmonary and Critical Care Medicine according to the clinical needs and the actual situation of the hospital.Methods:The literature analysis method and Delphi method were adopted to determine the index system after two rounds of consultation. The weight of the index was determined by the method of optimal sequence diagram.Results:The positive coefficients of the two rounds of consulting experts were 100% and 95.65%. The average value of the authoritative coefficients of the two consulting groups was 0.85. And the coordination coefficients of the two rounds of expert consultations were 0.513 and 0.516 respectively. Finally, five first-level indicators and 14 second-level indicators were established.Conclusion:The enthusiasm and coordination coefficient of experts are good, and the results are credible. The established index system can be used for standardized residency training assessment of residents in Department of Pulmonary and Critical Care Medicine.

Silicosis is a leading cause of occupational disease-related morbidity and mortality worldwide, but the molecular basis underlying its development remains unclear. An accumulating body of evidence supports gasdermin D (GSDMD)-mediated pyroptosis as a key component in the development of various pulmonary diseases. However, there is little experimental evidence connecting silicosis and GSDMD-driven pyroptosis. In this work, we investigated the role of GSDMD-mediated pyroptosis in silicosis. Single-cell RNA sequencing of healthy and silicosis human and murine lung tissues indicated that GSDMD-induced pyroptosis in macrophages was relevant to silicosis progression. Through microscopy we then observed morphological alterations of pyroptosis in macrophages treated with silica. Measurement of interleukin-1β release, lactic dehydrogenase activity, and real-time propidium iodide staining further revealed that silica induced pyroptosis of macrophages. Additionally, we verified that both canonical (caspase-1-mediated) and non-canonical (caspase-4/5/11-mediated) signaling pathways mediated silica-induced pyroptosis activation, in vivo and in vitro. Notably, Gsdmd knockout mice exhibited dramatically alleviated silicosis phenotypes, which highlighted the pivotal role of pyroptosis in this disease. Taken together, our results demonstrated that macrophages underwent GSDMD-dependent pyroptosis in silicosis and inhibition of this process could serve as a viable clinical strategy for mitigating silicosis.