Objective ToestimatetheprevalenceofPanton-Valentineleukocidin (PVL)genes and antimicrobial resistance in methicillin-sensitive Staphylococcus aureus (MSSA)isolateds from outpatients with skin and soft-tissue infections (SSTIs)in Wuhan city. Methods A total of 182 MSSA isolates were collected from outpatients with SSTIs in 5 different hospitals in Wuhan city between 2011 and 2013. The Kirby-Bauer′s disk diffusion method was used to evaluate antimicrobial susceptibility of the MSSA isolates, and multiplex PCR was performed to detect mecA and PVL genes in these isolates. Results Of the 182 MSSA isolates, 65 (35.71%)carried PVL genes. The positive rate of PVL genes was significantly different among patients with different diseases (χ2 = 49.76, P = 0.00), and relatively higher in patients with furuncles/carbuncles(7/7), folliculitis(3/3), abscesses(55.53%, 30/57)or impetigo(2/4). The age of patients with PVL-positive MSSA infection was significantly younger than that with PVL-negative MSSA infection (35.40 ± 19.31 years vs. 43.21 ± 20.75 years,t = 2.50, P = 0.01). Among 65 PVL-positive MSSA isolates, the rate of resistance to clindamycin was highest (87.69%), followed by that to penicillin(53.85%)and erythromycin(41.54%). The frequency of resistance to clindamycin was highest in 117 PVL-negative MSSA isolates, followed by that to penicillin (20.51%)and ampicillin (12.82%). Furthermore, there was a significant increase in the rate of resistance to penicillin(χ2 = 21.19), ampicillin(χ2 = 97.97), doxycycline(χ2 =11.61), ciprofloxacin(χ 2 = 8.07), erythromycin(χ 2 = 25.04)and gentamicin(χ 2 = 10.86)in PVL-positive MSSA isolates compared with PVL-negative MSSA isolates (all P < 0.05). Conclusions MSSA isolates from outpatients with SSTIs in Wuhan city are resistant to most β-lactam antibiotics. Flucloxacillin, compound sulfamethoxazole tablets or doxycycline is recommended for empirical treatment of PVL-positive MSSA infections.

Objective To approach the efficiency of second-trimester prenatal screening using two serum markers for Down's syndrome (DS).Methods Retrospective analysis was conducted on the results of prenatal screening using two serum markers,alpha fetoprotein (AFP) and free beta subunit of human chorionic gonadotropin(free-β-hCG),in 50 cases of DS pregnancy identified among 60 931 pregnant women received prenatal screening from November 1997 to April 2008 in Nanjing Maternal and Child Health Hospital.Results Among the 50 DS cases,the detection rate of DS was 50% (25/50) when taking free-β-hCG≥2.5 MoM as the cut-off,with the positive rate of screening was 6.6%.And the detection rate of DS would be 18.0%(9/25) when taking AFP≤0.5 MoM as the cut-off,with the positive rate of screening was 4.6%.When the risk cut-off value of DS was set at 1/270,the detection rate changed to 52.0%,and the positive rate of screening was 4.7%;and the two figures changed to 62.0% and 5.5%,respectively,when the risk cut-off was set to 1/300.Thirteen DS cases showed the risk value between 1/1000 and 1/300,among which two were monomarker abnormality.Thirteen (26.0%) of the 50 DS fetus were found to have one or two abnormality markers by ultrasound scan,among which one was DS low risk,and the other 12 were DS high risk in serum screening.Conclusions The second-trimester prenatal screening using AFP or free β-hCG for Down's syndrome is effective in identifying DS pregnancy with limited specificity and sensitivity.But the detection rate can be elevated by the combination of these two markers.The second trimester systemic ultrasound scan is not ideal for DS identification,but it can increase the specificity and sensitivity of serum prenatal screening.

In order to solve the difficulties and challenges in the implementation of the original blood distribution and collection regulations caused by the expansion of hospital area, the extension of blood transfer time, the changeability of blood transfer environment, and the strain of personnel due to the increase of workload, as well as to ensure the accuracy of the information throughout blood remote verification and distribution and the safety of clinical blood transfusion, , Shanghai experts related to clinical transfusion and blood management had made a systematic study on the applicable scope and management rules of remote verification of blood distribution and collection, and formulated this Expert Consensus combined with the development status of digital, intelligent and remote communication technologies, so as to provide corresponding guidance for clinical medical institutions in line with the changes in reality.