Objective To investigate antimicrobial resistance of Escherichia coli (E.coli )isolated from patients with bloodstream infection,and provide evidence for rational use of antimicrobial agents in clinical practice.Methods BacT/A-lert automated blood culture system and VITEK 2 automated identification system were used for bacterial culture and identi-fication.Antimicrobial susceptibility testing and detection of extended-spectrum β-lactamases (ESBLs)-producing strains were performed by Kirby-Bauer method.Results From 2009 to 2011 ,a total of 235 strains of E.coli were isolated from patients with bloodstream infection,90 (38.30%)of which were ESBLs positive strains.The resistant rates of ESBLs-producing strains to ampicillin,cefotaxime and ceftriaxone were all 100%,but susceptibility rate to imi-penem/cilastatin and meropenem were all 100%,to cefmetazole and amikacin were >90%.The resistant rate of non-ESBLs-producing strains to ampicillin was the highest (70.63%),susceptibility rate to imipenem/cilastatin and meropenem were both 100%,to amikacin,cefotaxime,and cefmetazole were all >95%.The resistant rate of ES-BLs-producing strains was significantly higher than that of the non-ESBLs-producing strains.Ofβ-lactamase inhibi-tor,only susceptibility rate of ESBLs-producing E.coli to cefoperazone/sulbactam was>90%,susceptibility rates to piperacillin/tazobactam and ticarcillin/clavulanate were both<80%.Conclusion Antimicrobial resistant rate of ESBLs-producing strains causing bloodstream infection is high,individualized treatment strategies should be made according to antimicrobial resistance of bacteria causing infection in patients.

OBJECTIVEClinical features of 30 cases of amyloidosis, a rare disease in China, were analyzed in order to improve the recognition of the disease here.

METHODS30 cases of biopsy-proven amyloidosis, admitted to Beijing Friendship Hospital from July 1980 to December 2003 were retrospectively reviewed.

RESULTS12 of the 30 cases were systemic amyloidosis. Among them 9 were primary amyloidosis, 1 secondary amyloidosis and 2 familial amyloid polyneuropathy. The other 18 cases were localized amyloidosis. Males (17) were more than females (13). In the 12 primary amyloidosis patients, kidney (75.00%), liver (58.33%), peripheral nervous system (58.33%) and heart (50.00%) were most commonly involved. Nonspecific symptoms such as fatigue, weight loss, hepatomegaly, limb numbness, edema and heavy albuminuria were the most common clinical manifestations. Localized amyloidosis involved only one organ, such as skin, alimentary tract and nasopharynx without evidences of a systemic disease. Excision of the localized amyloid deposits was performed in 13 cases.

CONCLUSIONSystemic amyloidosis usually involves multiple organs and systems, leading to highly variable clinical manifestations. An increase in the vigilance of the awareness of this disease among clinicians will improve the possibilities for its diagnosis.

Adolescent ; Adult ; Aged ; Amyloidosis ; diagnosis ; Child ; Diagnostic Errors ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies

This study was aimed to observe the curative effect and safety of Danzhi Jiangtang Capsule ( DJC ) combined with atorvastatin on carotid artery intima-media thickness (IMT) in diabetes patients without hyper-tension . A total of 196 diabetes patients without hypertension with incrassate carotid artery IMT were randomly divided into the control group ( 98 cases ) and the treatment group ( 98 cases ) . The conventional diabetes thera-py was given to both groups . The atorvastatin of 20 mg/night was given to the control group . And the atorvas-tatin 20 mg/night added with DJC 9 . 0 g/night were given to the treatment group . The treatment course was
12 months . Carotid artery IMT , carotid atherosclerotic plaque area , FPG , FIns , HOMA-IR , HbA1c , blood lipids , hepatorenal function and etc . were examined before and after the treatment respectively . The results showed that there was a significant positive correlation between carotid artery IMT and FIns , HOMA-IR , HbAlc , LDL-C . After 12-month treatment , the total effectiveness is 85 . 87% in the treatment group . And there was significant difference compared with the control group ( P < 0 . 05 ) . The levels of FPG , FIns , HOMA-IR , HbAlc of the treatment group had no difference compared with the control group . Compared with the control group, TC and LDL-C of the treatment group was obviously decreased (P < 0.05). And HDL-C was significantly increased ( P < 0 . 05 ) . The carotid artery IMT of the treatment group decreased from ( 0 . 11 ±0 . 01 ) cm to ( 0 . 08 ± 0 . 01 ) cm . And compared with the control group , there was statistical significance ( P <0 . 05 ) . The carotid atherosclerotic plaque area of 58 cases in the treatment group decreased from ( 0 . 37 ±0.56) cm2 to (0.21 ± 0.25) cm2. However, there was no statistical significance compared to the control group. There were 5 adverse events in the control group and 9 adverse events in the treatment group . And there was no difference between two groups. It was concluded that DJC combined with atorvastatin can regulate lipid metabolism and reduce carotid artery IMT .

OBJECTIVETo study the expression of epithelial-cadherin (E-cad), CD44v6 and Cx43 in hepatocellular carcinoma (HCC) and its relationship with sex and age of patients, as well as tumor histopathologic grades.

METHODSDouble immunofluorescent staining and laser scanning confocal microscopy was used to study the expression of E-cad, CD44v6 and Cx43 in 30 cases of normal liver tissue, 25 cases of benign hepatic lesions and 38 cases of HCC. In the HCC group, correlation of antigen expression with sex and age of patients and tumor histopathologic grades was studied by T-test.

RESULTSSignificant decrease in expression of E-cad and Cx43 was noted in HCC group, as compared to normal liver tissue and benign hepatic lesion (P<0.05). On the other hand, CD44v6 expression was higher in HCC group than in the other two groups (P<0.05). In HCC group, the expression of E-cad and Cx43 did not correlate with sex, age and histopathologic grades (P>0.05). However, CD44v6 expression positively correlated with higher tumor histopathologic grades (P<0.05) but not sex and age of patients (P>0.05). In HCC group, the expression of E-cad positively correlated with that of Cx43, while the expression of CD44v6 negatively correlated with that of E-cad and Cx43.

CONCLUSIONSTumor immunophenotype alters during development and progression of HCC. Low expression of E-cad and Cx43 and high expression of CD44v6 may be related to aggressive clinical behavior of HCC, moreover, high expression of CD44v6 correlated with high tumor grades. Detection of E-cad, CD44v6 and Cx43 expression may thus be useful in predicting prognosis of HCC.

Adult ; Cadherins ; metabolism ; Carcinoma, Hepatocellular ; metabolism ; pathology ; Connexin 43 ; metabolism ; Female ; Fluorescent Antibody Technique ; Humans ; Hyaluronan Receptors ; metabolism ; Liver ; metabolism ; pathology ; Liver Neoplasms ; metabolism ; pathology ; Male ; Microscopy, Confocal ; Middle Aged ; Prognosis

Adult ; Aged ; Female ; Hepatitis B, Chronic ; complications ; Hepatorenal Syndrome ; diagnosis ; etiology ; therapy ; Humans ; Liver Cirrhosis ; complications ; Male ; Middle Aged ; Retrospective Studies

OBJECTIVETo study the correlation between Vibrio cholerae strains isolated from natural enviroment and fishery products and the source of infection during V. cholerae outbreaks.

METHODSCholera toxin gene was detected by polymerase chain reaction (PCR) amplification. Pulsed-field gel electrophoresis (PFGE) was used to subtype the isolates. Results of PFGE were analyzed and clustered by BioNumerics software (Version 4.0).

RESULTSDuring the outbreaks, a total number of thirty O139 V. cholerae related serogroups were collected from patients, carriers, sewage and fishery products were identified and proved to be toxigenic. They could be clustered into four PFGE patterns when digested by Not I. These two V. cholerae outbreaks were caused by the same source of infection because of the following reasons: (1) PFGE patterns of the predominant strains isolated from two outbreaks were identical; (2) they were identical to the PFGE patterns of the strains isolated from the green turtle and rana catesbiana which were bought from the same wholesale store.

CONCLUSIONGreen turtle and rana catesbiana that were contaminated by toxigenic O139 V. cholerae strains seemed to be the source of infection causing the O139 V. cholerae outbreaks in Jiangxi province. Rapid laboratory surveillance and epidemiologic investigation were important in identifying the source of infection during the outbreaks of V. cholera.

Animals ; China ; epidemiology ; Cholera ; epidemiology ; Cluster Analysis ; Disease Outbreaks ; Disease Reservoirs ; microbiology ; Electrophoresis, Gel, Pulsed-Field ; methods ; Fisheries ; Humans ; Ranidae ; microbiology ; Sewage ; microbiology ; Turtles ; microbiology ; Vibrio cholerae O139 ; isolation & purification

OBJECTIVETo investigate the changes of antisperm antibodies (AsAb), sexual hormones, and inhibin B (INH B) in patients before and after testicular torsion, as well as the effects of these factors on testicular function and reproduction.

METHODSTen patients with single acute testicular torsion (left side 9 and right side 1), aged 16-45 years (19.6 on average), disease course of 3-6 days (averaging 4.7 days), underwent surgical removal of the damaged testis. Before and after the operation, serum AsAb (IgG, IgM, IgA) and INH B were measured by ELISA, and serum follicle-stimulating hormone (FSH), luteotropic hormone (LH), and testosterone (T) determined by chemoluminescence autoanalyzer.

RESULTSAfter the operation, the AsAb levels rose significantly and remained high for at least 26 weeks. The level of INH B was the lowest in the 3rd week and restored to normal in the 12th week, with significant difference between preoperation and the 3rd or the 6th week after the operation. The levels of LH and INH B in the 26th week were elevated significantly compared with the 6th.

CONCLUSIONTesticular injury induced the elevation of AsAb, which would last a very long time. The change of INH B was closely related with the injury of the testis, which reflected the degree of testicular injury and functional restoration of the patients after the operation. Our study showed that AsAb and INH B can be used as useful tools for monitoring testicular function and reproduction.

Adolescent ; Adult ; Autoantibodies ; blood ; Follicle Stimulating Hormone ; blood ; Humans ; Inhibins ; blood ; Luteinizing Hormone ; blood ; Male ; Middle Aged ; Orchiectomy ; Spermatic Cord Torsion ; immunology ; physiopathology ; surgery ; Spermatozoa ; immunology ; Testis ; physiopathology ; Testosterone ; blood

OBJECTIVETo observe the effects of electroacupuncture (EA) of different intensities on lactate dehydrogernase (LDH), succinate dehydrogenase (SDH) and ATPase in brain tissue of rats with cerebral ischemia-reperfusion injury (CI/R).

METHODSForty male SD rats were uniformly randomized into sham operation group (group A), CI/R group (group B), CI/R+5 mA EA (group C), CI/R+3 mA EA (group D) and CI/R+1 mA EA (group E) groups with eight rats in each group. Transient general brain ischemia was induced by four-vessel occlusion and reperfusion. The rats in group C, group D and group E were punctured and stimulated at Baihui (GV20), Mingmen (GV4) and Zusanli (ST36) with the same intermittent and rarefaction-dense wave (30 to 50 Hz) and different electric current intensities: 5 mA, 3 mA and 1 mA for 20 min after CI/R. Then the activities of Na(+)-K(+)-ATPase, SDH and LDH in mitochondria of brain tissue were measured by spectrophotometry. The ischemic cerebral cortex tissue was taken for observing the ultrastructure changes of impaired nerve cells.

RESULTSCompared with group A, the activities of LDH, SDH and Na(+)-K(+)-ATPase were lowerer in the group B (P<0.05 or P<0.01). However, the activities of LDH, SDH and Na(+)-K(+)-ATPase were higher in the group D than those in the group B (P<0.05 orP<0.01). In group A, the anatomical structure of the cerebral cortex cells was basically normal; in group B, the neuronal cellular structures were severely damaged, the neuronal mitochondria got swelling, the mitochondrial cristae were broken, the medullated nerve fifibers were not integrated. In group C, group D and group E, the ultrastructure of impaired neuron were improved. Group D was the best among three groups above.

CONCLUSIONEA of 3 mA intensity could strengthen aerobic metabolism by elevating the activities of SDH and LDH, meanwhile maintaining the ionic equilibrium in the exterior and interior brain cell and relieving the cellular edema by reinforcing the activities of Na(+)-K(+)-ATPase.

Animals ; Brain ; metabolism ; Electroacupuncture ; Energy Metabolism ; Male ; Mitochondria ; metabolism ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; metabolism

Objective:To explore the influencing factors of seasonal influenza among pregnant woman in Suzhou from 2015 to 2018.Methods:Based on the data of the influenza follow-up cohort of pregnant women in Suzhou from 2015 to 2018, the basic and clinical characteristics of the cohort were described, and the influencing factors of laboratory-confirmed influenza cases in pregnant women were analyzed by unconditional logistic regression.Results:A total of 19 006 pregnant women were recruited, in whom 479 cases of influenza were laboratory confirmed. Influenza A (H3N2) (42.8%) was the main sub-type. In pregnant women with exposure risk in influenza season, unconditional univariate logistic analysis showed that pregnant women or their husbands had registered permanent residence in Suzhou, pregnant women worked as childminder or nanny, had more than 2 permanent residents in the family except themselves, had medical insurance in Suzhou, had fertility insurance in Suzhou, were in the third trimester at the time of enrollment, had cough in the past month, were pregnant for the first time, had children, before and after pregnancy, spent more time outdoors than before, wore masks more often than before and had changed the frequency of gathering were all related to influenza virus infection in pregnant women. Among them, the first pregnancy, increasing the time of outdoor activity, increasing the frequency of wearing masks, and changing the frequency of gathering were important protective factors. Unconditional multivariate logistic regression analysis showed that the number of permanent residents at home was >2 (a OR=1.24, 95% CI: 1.01-1.52) and being in the third trimester, (a OR=1.56, 95% CI: 1.26-1.91) were the risk factors for maternal infection with influenza virus. Conclusion:Pregnant women with a large number of permanent residents and late pregnancy should pay attention to preventing seasonal influenza.

Objective To evaluate the effect of bruceolic oil emulsion on the advanced colorectal carcinoma and life quality of patients.Meth-ods One hundred and thirty patients with advanced colorectal cancer were randomly divided into treatment group ( n=65 ) and control group ( n=65 ).The patients in treatment group were treated with bruceolic oil emulsion combined with mFOLFOX6,and those in the control group only with mFOLFOX6.The objective response rate (ORR)、disease control rate ( DCR ) , time to tumor progression ( TTP ) , toxicities and Karnofsky scores ( KPS) , and quality of life scores ( QOL) in two groups were com-pared.Resultes The 125 evaluable patients were assigned into the treatment group ( 63 patients ) and the control group ( 62 patients ) .The ORR and TTP in the treatment group were higher than in the control group [ 65.08% vs 41.94%, P <0.05;( 13.49 ±3.90 ) months vs (9.26 ±4.66 ) months,P<0.01 )].The treatment group was signifi-cantly superior to the control group in KPS and QOL ( P<0.01 ).The occurrence of bone marrow suppression was significantly lower than that in the control group ( 42.86% vs 69.35%, P<0.01 ).There were no significant differences between the two groups in DCR ( 77.77% vs 72.59%, P >0.05 ) , gastrointestinal reactions and neurotoxicity ( P>0.05 ).Conclusion Bruceolic oil emulsion could improve the clinical curative effect , extend TTP, improve the life quality of patients and decrease marrow suppression in treating advanced colorectal carcinoma.