Abstract: Objective To analyze the antimicrobial resistance rate and risk factors of multi drug resistant organisms (MDRO) in bloodstream infection for rational treatment. Methods　A total of 696 cases of bloodstream infections of Staphylococcus aureus, Enterococcus, Enterobacteriaceae (excluding Salmonella and Shigella), Pseudomonas aeruginosa and Acinetobacter in our hospital from 2017 to 2021 were selected, and 711 pathogenic strains were isolated from their whole blood samples. The antimicrobial resistance rates of various multi drug resistant strains were analyzed and the risk factors of MDRO infection were analyzed. Results　696 non repeated cases were screened out from 13 187 whole blood culture specimens, with a positive rate of 5.3%, and a total of 711 blood influenza pathogens were detected, among them, 350 strains of MDRO were detected with a detection rate of 49.23% (350/711). Among the pathogenic bacteria of bloodstream infection, Escherichia coli was the most, with 277 strains accounting for 38.96% (277/711), of which 201 strains were MDRO, accounting for 57.43% (201/350); followed by Klebsiella pneumoniae and Staphylococcus aureus, with 155 strains accounting for 21.80% (155/711) and 89 strains accounting for 12.52% (89/711), among which 43 strains of Klebsiella pneumoniae MDRO accounted for 12.29% (43/350) and 38 strains of Staphylococcus aureus MDRO accounted for 10.86% (38/350). The change trend of the three pathogens during 2017-2021 was not obvious. The drug sensitivity test showed that Escherichia coli and Klebsiella pneumoniae were highly resistant to cephalosporins and fluoroquinolones, and the drug resistance rate of aminoglycosides was relatively low. They had almost no resistance to cephalosporins and carbapenems. Staphylococcus aureus has a high resistance rate to lincomycin and macrolides, but no resistance to oxazolidinone, glycopeptides and glycylcyclins. There were 350 cases of MDRO infection and 361 cases of non MDRO infection. Univariate analysis showed that the age, sex, cardiovascular and cerebrovascular history, renal insufficiency, lung disease, hypoalbuminemia, hepatobiliary disease, electrolyte disorder and anemia of the patients had no statistical significance in MDRO infection (P>0.05); diabetes, urinary tract infection, surgical operation and burn were the influencing factors of MDRO (P<0.05). According to logistic analysis, diabetes, urinary tract infection, surgical operation and burn were the risk factors of MDRO infection (P<0.05). Conclusion　The infection of MDRO in patients with bloodstream infection is serious, and early prevention and control should be paid attention to, and the principle of graded use of antibiotics should be strictly observed, and the rational application should be carried out to actively and effectively control the production of MDRO.

OBJECTIVETo determine if multi-detector CT (MDCT) characterization of plaque is correlated with the classification of acute coronary syndrome (ACS).

METHODSAltogether 1900 patients were examined by MDCT from December 2007 to May 2009, of whom 95 patients fulfilled the criteria of ACS. Those patients were divided into the discrete plaque group ( n=61) and diffuse plaque group ( n=34) based on the findings in MDCT. The clinical diagnosis of ACS and CT results were analyzed, including segment stenosis score, segment involvement score, 3-vessel plaque score, left main score, calcification score, and remodeling index. The incidences of major adverse cardiac events in follow-up period were also recorded.

RESULTSThe patients of the diffuse plaque group were older than those of the discrete plaque group ( Pü0.0001). The diffuse plaque group presented more cases of hypertension, peripheral artery disease, diabetes, and heart failure than discrete plaque group (all P<0.05). All the 5 patients with ST-segment elevation myocardial infarction were found in discrete plaque group. The segment stenosis score of the discrete plaque group was lower than that of the diffuse plaque group(5.15±3.55 vs. 14.91±5.37, Pü0.001). The other four scores demonstrated significant inter-group difference as well (all P<0.05). The remodeling index of thediscrete plaque group was higher (1.12±0.16 vs.0.97±0.20, Pü0.05). Follow-up data showed that major adverse cardiac events occurred more frequently in diffuse plaque group than in discrete group (29.41% vs. 11.48%, P=0.0288).

CONCLUSIONSCharacteristics of discrete and diffuse plaques may be significantly different among different classes of ACS. The diffuse plaque may present higher risk, correlated to higher mortality. The diagnosis of discrete and diffuse plaques by MDCT would provide a new insight into the prognosis and treatment of ACS.

Acute Coronary Syndrome ; classification ; Adult ; Aged ; Coronary Artery Disease ; diagnostic imaging ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Plaque, Atherosclerotic ; diagnostic imaging ; Tomography, X-Ray Computed ; methods

Objective To help the medical student to master the principle and operation of magnetic resonance imaging instrument.Methods The imaging principle,structure and functions of HT-3DNMR-25 magnetic resonance imaging instrument were described,and its application to experiment teaching was introduced including one-dimension imaging,two-dimension imaging,free induction decay signal observation and etc.Results The instrument facilitated the student to master technical principle,imaging method as well as parameters setup and regulation,and could be a supplement to clinical practical teaching.Conclusion The instrument plays an irreplaceable role in teaching,and thus is worthy promoting in colleges.

Objective To assess the efficacy and safety of ultrasound-guided percutaneous puncturing gastric wall implantation of 125 I seeds in advanced pancreatic carcinoma . Methods Sixty-five cases ( 65 tumors ) of advanced pancreatic carcinoma implanted 125 I seeds by ultrasound-guided percutaneous puncturing gastric wall were retrospectively analyzed . The change of length diameter of tumor and pain relief were evaluated . Results The total 65 cases were performed successfully according to the preoperative plans . In the following 3 months after the operation ,the results showed that complete remission (CR) was achieved in 19 cases ,partial remission( PR) was 33 ,stable disease( SD) was 10 and the progressive disease ( PD) was 3 . The overall response rate was 80％ . About the relief of pain ,complete relief patients were 36 , partial response patients were 11 and the invalid patients were 5 . The pain relief rate was 90 .38％ . There were no bleeding ,pancreatic fistula ,biliary fistula ,gastric perforation which need to do the surgery therapy . Two cases of pancreatic pseudocyst occurred when reviewed in the third month after the operation . Conclusions It is effective and safe to adopt ultrasound-guided percutaneous puncturing gastric wall implantation of 125 I seeds in advanced pancreatic carcinoma .

Mesenchymal stem cell (MSC)-based cell therapy has shifted into clinical trials to repair the damage of various tissues. In this setting, the survival of the transplanted cells contributes critically to the therapeutic effectiveness. To investigate the in vivo tracing of MSCs, a recombinant retroviral vector carrying firefly-luciferase reporter gene [pL (FLUC) SN] was constructed and several GPE+86 cell clones that stably expressed fluc were selected. The retroviral supernatants were collected and used to transfect MSC derived from C57 mice. The cells were then screened with G418 and the expression of the exogenous gene was identified by luciferase enzyme activity analysis. Labeled mouse MSCs (2x10(6)) were injected into skeletal muscles, and the in situ expression was noninvasively tracked by in vivo bioluminescence imaging for 1, 3 and 6 days after transplantation. The results showed that the survival rates of the grafted cells dropped sharply with time, they were 57.2+/-11.7%, 8.6+/-2.5% and 5.4+/-3.1% on day 1, 3 and 6 after transplantation, and no fluorescent signals above background were detected on day 10. It is concluded that the method described above could be used for in vivo tracing of grafted cells. Furthermore, MSCs could not survive even transplanted into the none-ischemic skeletal muscles.
Animals ; Bone Marrow Cells ; cytology ; Bone Marrow Transplantation ; methods ; Cell Survival ; Female ; Genetic Vectors ; Green Fluorescent Proteins ; Luminescent Measurements ; methods ; Mesenchymal Stem Cell Transplantation ; methods ; Mesenchymal Stromal Cells ; cytology ; Mice ; Mice, Inbred C57BL

Different cytokines are needed in the course of culturing cells to do adoptive immunotherapy. This study was aimed to investigate the differentiation directions of lymphocytes and related gene expression characteristics after combined stimulation of lymphocytes by different cytokines or EBV antigen peptide combined with cytokines. The experiment was divided into 4 groups. The levels of total T lymphocytes (CD3(+)), T helper lymphocytes (CD3(+)CD4(+)), cytotoxic T-lymphocyte (CD3(+)CD8(+)), memory T cells (CD3(+)CD8(+)CD45RO(+)), naive T cells (CD3(+)CD8(+)CD45RA(+)), Th2 cells (CD3(+)CD30(+)), B cells (CD19(+)), NK cells (CD56(+)), naive T regulatory cells (CD4(+)CD25(+)), precise T regulatory cells (CD4(+)CD25(+)FOXP3(+)) were detected by flow cytometry. The expression levels of house-keeping gene (mad1, pten), T helper cells transcriptional regulatory gene t-bet (Th1), gata3 (Th2), cytokine IFN-γ(Th1), IL-4(Th2) were detected by using RT-PCR. The results showed that CTL in EBV polypeptide group were dominant cells with certain clinical effects. Comparison of result of EBV polypeptide group with other 3 different cytokine stimulating groups demonstrated that EBV antigen peptide had much more effects on stimulating CTL generation. The expression of IFN-γ gene was significantly increased; the T helper differentiation-related gene t-bet, gata3 also increased evidently, while expression change of house-keeping gene mad1 and pten were not evident. Addition of different cytokines and antigen peptides in culture may be much more effective on stimulating CTL generation. It is concluded that specific CTL can be obtained by using the lymphocytes co-cultured with EBV and cytokines, and the different cytokines play different roles in cell differentiation.
Cells, Cultured ; Cytokines ; immunology ; metabolism ; Epstein-Barr Virus Nuclear Antigens ; genetics ; Flow Cytometry ; Humans ; Immunotherapy, Adoptive ; Lymphocyte Count ; Lymphoma, Extranodal NK-T-Cell ; genetics ; immunology ; T-Lymphocytes, Cytotoxic ; immunology

With the development and improvement of new sequencing technology, next-generation sequencing (NGS) has been applied increasingly in cancer genomics research over the past decade. More recently, NGS has been adopted in clinical oncology to advance personalized treatment of cancer. NGS is used to identify novel and rare cancer mutations, detect familial cancer mutation carriers, and provide molecular rationale for appropriate targeted therapy. Compared to traditional sequencing, NGS holds many advantages, such as the ability to fully sequence all types of mutations for a large number of genes (hundreds to thousands) in a single test at a relatively low cost. However, significant challenges, particularly with respect to the requirement for simpler assays, more flexible throughput, shorter turnaround time, and most importantly, easier data analysis and interpretation, will have to be overcome to translate NGS to the bedside of cancer patients. Overall, continuous dedication to apply NGS in clinical oncology practice will enable us to be one step closer to personalized medicine.
High-Throughput Nucleotide Sequencing ; economics ; methods ; Humans ; Mutation ; Neoplasms ; genetics ; Precision Medicine ; Sequence Analysis, DNA

Objective:To investigate the impact of the CD4+CD25nt/hiCD127lo regulatory T cell subset frequency on the immune status and disease progression of Chinese HIV-1 infected individuals.Methods:83 untreated HIV-infected individuals and 312 healthy control individuals of four distinct age groups were enrolled in the research. The CD4+ T cell absolute counts, phenotypes and frequency determination of CD4+CD25nt/hiCD127lo Regulatory T cell subsets was performed on freshly obtained whole blood samples by 3-color immune staining flow cytometry. The HIV-1 specific cellular immune function was test at single cell level by ELISpot. The corresponding plasma viral load was determined by NASBA.Results:The frequency of peripheral CD4+CD25nt/hiCD127lo regulatory T cells of HIV infected individuals in distinct disease progression status was dissimilar in China , and significantly increased in contrast to the healthy controls(P

OBJECTIVETo investigate the clinical effects of electroacupuncture (EA) at Fenglong (ST 40) on blood lipids.

METHODSTwo hundred and four patients of hyperlipidemia were randomly divided into a Fenglong group and a Xuezhikang group, 102 cases in each group. The patients in the Fenglong group were treated with electroacupuncture at Fenglong (ST 40). After arrival of qi, the needles were connected with acupoint nerve stimulator (LH 202 H type, HANS). The primary parameters of EA: for high triglycerides (TG) type, AM 50 Hz, intensity 1 mA, needle-retained time 20 min, twice per week; for high cholesterol (CHO) type, AM 100 Hz, intensity 1 mA, needle-retained time 30 min, thrice per week; for high low-density-lipoprotein (LDL-C) type, the same parameters as the high CHO type except the tolerable and comfortable intensity; for the mixing type, corresponding methods were alternatively used. The patients in the Xuezhikang group received Xuezhikang capsule orally, 2 capsules each time and twice daily, for total 11 weeks.

RESULTSThe total effective rates of the Fenglong group and the Xuezhi-kang group were 83.0% and 85.9%, respectively, with no significant difference between the two groups (P > 0.05), and there was no significant differences in the function of regulating blood lipids between the two groups (all P > 0.05). After one month follow-up survey, the total CHO, TG and LDL-C decreased and high-density-lipoprotein (HDL-C) increased, of which there was a significant difference in TG reduction (P < 0.05). There were no relapses in both groups.

CONCLUSIONEA at Fenglong (ST 40) can effectively regulate blood lipids with a better after-effect, which can be applied as a safe and effective method to replace medication for regulating blood lipids.

Acupuncture Points ; Adult ; Aged ; Cholesterol ; blood ; Electroacupuncture ; Female ; Follow-Up Studies ; Humans ; Hyperlipidemias ; blood ; therapy ; Lipids ; blood ; Male ; Middle Aged ; Triglycerides ; blood

Objective To establish a 3D finite element model of cervicothoracic spinal segments C5-T2 based on CT images and test its validity and effectiveness. Methods By using the Mimics, Geomagic and Hypermesh software, the 3D model of cervicothoracic spinal segments C5-T2 was reconstructed, repaired and pre-processed. Moment of ±0.5, 1, 1.5, 2 N•m were applied on top of the model to simulate loads produced during the flexion and extension movement of human body. The range of motion (ROM) of the segments C5-T2 during flexion and extension was calculated by ANSYS, and the reliability of the model was verified by comparing the experimental results in the previous literature with the finite element analysis results obtained in this study. Results Under the moment of 1 N•m, the ROMs of C5-6, C6-7, C7-T1 and T1-2 during flexion were 4.30°,3.21°,1.66° and 1.41°, and those during extension were 3.47°, 2.86°, 0.96° and 0.92°, respectively. The maximum stress during flexion appeared on the front of the vertebral body, while that during extension appeared on the back of the vertebral body. The trends of ROM and stress distributions were consistent with results reported in the previous literature. Conclusions The 3D model established in this study is accurate and realistic, and conforms to biomechanical properties of the cervicothoracic spine. The simulation results can be further used to explore clinical pathology of the spine and provide theoretical references for evaluation on cervicothoracic spine surgery.