Objective To analyze Klebsiella pneumoniae by DiversiLab system, providing scientific evidence for the control of nosocomial infection. Methods Eight strains of non-duplicated clinical Klebsiella pneumoniae isolated from the surgical ward in a hospital in 2010 were typed by rep-PCR-based DiversiLab system. The results were compared with those of pulsed-field gel electrophoresis (PFGE). Results Antimicrobial susceptibility test showed that 7 clinical strains were the same sensitivity to 11 antimicrobial agents, except the strain K8-02. And these 7 clinical strains were all multi-drug re-sistant. The result of PFGE showed that 7 strains were the same pattern. The result of DiversiLab also showed that 7 strains were the same pattern, and the strain K8-02 was another pattern. Conclusion DiversiLab system is simple, quick, good re-peatability and accurate, which is a kind of standardization and automation system. DiversiLab system and PFGE method could get the same result.

Objective To explore the safety of fat reduction treated by non invasive focused ultrasound.Methods A randomized double-blind and negative control clinical trial was carried out on the excess fat of 40 subjects' abdomen by a JCS-01 non-invasive focused ultrasound device.Subjects received treatments with the device on day 1 and day 7.Observations on the area treated and inquiries on feelings were conducted during treatments.Before the first treatment and 14 days after the treatment,laboratory examinations were performed,including liver function,blood lipid tests,etc.Results 40 subjects participated in the trial and 36 subjects (18 each in both treatment and control groups) accomplished 2 times of treatments,all followed-up and laboratory examinations.During the process of treatments,4 subjects in the experimental group complained about feelings of tepidity or pricking.One subject on blood test of triglyceride showed slightly higher than her early normal result,which fell to the normal level at reexamination.Conclusions Subjects treated by non-invasive focused ultrasound at the area of no more than 500 cm2 every time and at an interval of 6 days manifest little changes on the blood test results,with slightly local reactions but no complaints during follow-up.

Objective To investigate the resistance mechanism and virulence genes of clinical strains of carbapenem-resistant Klebsiella pneumonia ( CRKP ) .Methods Twenty clinical CRKP strains were collected from Tianjin Medical University General Hospital during May 2014 and May 2015.Vitek-2 Compact system was used for identification of the strains and antibiotic susceptibility test .Modified Hodge Test and EDTA double disk phenotypic test were performed for screening of drug -resistant phenotypes .Drug-resistant genes , capsular serotypes and associated virulence genes were amplified by PCR , and positive products were sequenced and analyzed by DNA sequencing .Results Resistance to beta-lactam antibiotics including cephalosporins and carbapenems was observed in 80.0%and above strains , but more than 70.0%strains were sensitive to tigecycline , amikacin and levofloxacin .KPC gene and NDM gene were found in 7 strains (35.0%) and 8 strains (40.0%), respectively.SHV, the most common extended-spectrumβ-lactamases ( ESBLs ) gene, was found in 16 strains ( 80.0%). DHA plasmid-mediated AmpCβ-lactamase was found in 2 strains (10.0%).Deletions of porin-coding genes OmpK35 and OmpK36 were found in 8 stains ( 40.0%) and 13 strains ( 65.0%), respectively.Carbapenem-resistant genes in combination with ESBLs genes and/or variation of porin was found in 14 strains (70.0%), and ESBLs genes in combination with variation of porin was found in 4 strains (30.0%).Three strains were of capsular serotype K1 and 1 was of K57, and all of them carried KPC genes .Virulence gene rmpA was found in 8 strains and all carried carbapenemases , among which 5 strains with KPC, 2 strains with NDM, 1 strain with both KPC and NDM .Six strains were aerobactin gene positive , among which 4 strains carried KPC genes . FimH-1 was positive in all strains .Conclusions KPC and NDM genes mainly account for resistance in CPKP, and ESBLs with OmpK gene deletion may also be an important cause .Strains with capsular serotypes K1 and K57 carrying KPC genes are common .

OBJECTIVE To study the drug resistance,drug-resistant genes and(disinfectant)-resistant genes of(MRS)A.METHODS The drug resistance and mecA gene of the ?-lactamase and aac(6′)/aph(2″),aph(3′)-Ⅲ,ant(4′,4″) genes of aminoglycoside and qac(A/B) disinfectant-resistant genes were(detected) in 47 strains of MRSA.(RESULTS) In all 47 strains of MRSA,46 MRSA isolates were mecA positive,39 MRSA isolates were aac(6′)/aph(2″) positive,30 MRSA isolates were aph(3′)-Ⅲ positive,6 MRSA isolates were ant(4′,4″) positive,and 19 MRSA isolates were qac(A/B) positive.CONCLUSIONS MRSA is multiple-drug resistant.The main resistant mechanisms of MRSA to aminoglycosides and disinfectant are related to the drug-resistant genes of aminoglycoside and disinfectant-resistant genes.Clinic physician must pay attention to the diagnosis and(therapy) of MRSA,and control the hospital infection.

Objective To discuss the clinical application value of serum procalcitonin(PCT) in patients with Candida bloodstream infection.Methods The data of 783 hospitalized patients of Tianjin Medical University General Hospital including blood culture and serum PCT test were retrospectively analyzed,and the medical records of patients with Candida or bacterial bloodstream infection were evaluated by univaxiate and multivariate logistic regression analysis.The comparison of PCT value were carried out among the different blood culture groups using the Mann-Whitney U test.A receiver operating characteristic(ROC) curve was used to determine the diagnostic performance of the PCT.Results The PCT was 0.21 (0.06,1.02) ng/mL in the 510 patients with negative blood culture,but in 121 patients with Candida infection and 152 patients with bacteria infections,the PCT levels were 1.15 (0.38,6.85) ng/ mL and 2.34 (0.77,15.12) ng/mL,respectively.There were statistically significant differences in PCT levels among three groups(P＜0.05).According to ROC,when the value of PCT was 0.355 ng/mL,the sensitivity was 76.9％,and the specificity was 60.8％ with 0.726 area under the curve (AUC) (P＜0.01) for the identification of Candida infection by blood cultures.Conclusions Serum PCT levels have a certain diagnostic value for Candida bloodstream infection.In critically ill patients with factors associated with candidemia,the combination of clinical symptoms with PCT as an adjuvant diagnostic marker and other laboratory findings can be used to make a prompt and effective initiation of antifungal therapy.

OBJECTIVETo evaluate the safety and efficacy of using the JCS-01 focused ultrasound fat reduction machine for noninvasively breaking fat cells and abdomen sculpting treatment.

METHOD40 qualified subjects were enrolled in the study per the IRB-approved protocol and randomly assigned into trial and control groups. The fat reduction treatments were performed using the JCS-01 focused ultrasound fat reduction machine made by Beijing 3H Medical Technology Co., Ltd. The trial group received ultrasound energy treatment in their abdominal subcutaneous adipose tissue on the 1st and 7th days of the trial. The control group followed the similar procedure except that the ultrasound energy was turned off during treatments. Both the trial and control groups were followed-up on 1,7,14, 35 days post treatment.

RESULTSThe waist circumference measured on 14, 35 days were reduced 2.52 cm +/- 1.04 cm and 3.31 cm +/- 0.67cm in comparison with the baseline values in the trial group, reaching the protocol hypothesis of at least 1.5 cm abdominal circumference reduction, which demonstrated the treatment efficacy. The adverse events included minor and transient thermal sensation and mild pain in the treated abdomen area in the trial group. No other adverse events were observed. Clinical biochemistry assay testing showed that the subjects liver and kidney function indicators had no significant change.

CONCLUSIONIt is safe and effective to use the JCS-01 focused ultrasound fat reduction machine for abdomen fat reduction treatment.

Adult ; Body Fat Distribution ; Cosmetic Techniques ; Female ; High-Intensity Focused Ultrasound Ablation ; adverse effects ; instrumentation ; methods ; Humans ; Male ; Treatment Outcome ; Waist Circumference

Objective:To observe the change of the left ventricular(LV) wall shear stress (WSS) using vector flow mapping (VFM) in different segments at each phase of diastolic period among normal subjects.Methods:From August 2018 to March 2019, 200 healthy volunteers selected from the Physical Examination Center of the Second Affiliated Hospital of Harbin Medical University were recruited. The WSS values of LV segments at the same and at different phases[isovolumic relaxation period(D1), rapid filling period(D2), slow filling period(D3), atrial contraction period(D4)] in diastole were measured and analyzed.Results:①The relationships of the WSS of LV different segments at the same phase of diastolic period: The WSS values of anterior septum, posterior septum and posterior wall during D1, and the WSS values of posterior septum, posterior wall and inferior wall during D2 showed basal>middle>apical segments, the differences were statistically significant (all P<0.05). ②The changes of the WSS values of LV different segments during diastolic period: During D1-D2-D3-D4 period, the absolute values of WSS in anterior septum, posterior septum, anterior wall, lateral wall and inferior wall showed an increasing-decreasing-increasing trend. During D2-D3-D4 period, the absolute values of WSS in the posterior wall showed a decreasing-increasing trend. During D1-D2-D3-D4 period, the absolute values of WSS in the apical segment of anterior septum, basal and middle segments of posterior septum, basal, middle and apical segments of anterior wall, basal segment of lateral wall, the middle and apical segments of posterior wall, basal and middle segments of inferior wall all showed an increasing-decreasing-increasing trend, the difference was statistically significant (all P<0.05). Conclusions:The LV WSS in different segments at the same phase or in the same segment at the different phases in diastole exhibit a regular change and is consistent with the LV hemodynamic changes, which indicates that WSS can quantitatively reflect the hemodynamic changes of the LV in normal subjects.