Objective To investigate the distribution and susceptibility of carbapenem resistant citrobacter freundii for rational antimicrobial therapy.Methods The C.freumdii were collected between January 2011 and December 2014 from inpatients.The minimum inhibitory concentration (MIC) were detected by an automated analyzer (VITEK 2) to analyze the characteristic of tested bacteria.Results (1) Of the 21 strains of carbapenemresistant citrobacter freundii,95％ were collected from urine,among which most of the strains were isolated from the Department of Transplantology (66.7％) and Urology (19％);(2) Antimicrobials Susceptibility test showed that Citmbacter freund were highly resistant to Cephalosporins and relevant beta-lactamase inhibitors.Even carbapenem were highly resistant.Imipenem had a resistance rate of 90％ (95％ confidence interval:70 to 99),Meropenem 85.7％ (95％ confidence interval:64 to 97),The drug resistance rate to Amikacin was only 4.8％,followed by Nitrofuran toin (10.5％) and Fosfomycin (15％).Conclusions Carbapenem resistant citrobacter freundii,which often causes urinary tract infection in our hospital,was characterized by multi-drug resistant (MDR).Monitoring of the Citrobaeter freundii should be strengthened to control the prevalence of drug resistance.

Objective To detect the levels of anti-gliadin IgA and anti-gliadin IgG antibodies in the plasma of the patients with schizophrenia, and to investigate the association between schizophrenia and anti-gliadin IgA, IgG bodies in a Chinese Han population, and to clarify the effect of gliadin on the occurrence of schizophrenia.Methods The plasma samples were collected from 428 patients with schizophrenia and 555 cases of normal control subjects in a Chinese Han population.The gliadin antibodies in plasma,including IgA and IgG,were tested using a native anti-gliadin ELISA test kit.The positive rates of plasma anti-gliadin IgA,and anti-gliadin IgG were tested by Chi-square test between the patients with schizophrenia and control subj ects. The differences of the levels of anti-gliadin IgA and anti-gliadin IgG were tested by Mann-Whitney U test between the patients with schizophrenia and control subjects.Results Compared with normal control group,the anti-gliadin IgA level and the positive rate of plasma anti-gliadin IgA in patient group were increased significantly(P<0.01),but there were no significant differences of the positive rate and the level of anti-gliadin IgG in plasma between patient and control groups (P>0.05).The anti-gliadin IgA levels in the patients with delusion of observation,delusion of being revealed,delusion of persecution, delusion of j ealousy, delusion of grandeur, incoherence of thinking, illogic thought, bizarre behavior,aggressive behavior,hallucination-delusion syndrome,poverty of thought,emotional blunting/apathy and aboulia were higher than that of the normal controls (P<0.05);the anti-gliadin IgG levels in the patients with delusion of being revealed and delusion of grandeur were higher than that of the normal controls (P<0.05 ). Conclusion Gliadin is associated with the onset of schizophrenia in Chinese Han population, and the plasma antibodies of gliadin maybe play an important rale in the onset of schizophrenia.

Objective To assess the value of wave intensity (WI) on the discrimination of hypertension with concentric hypertrophy and non-obstructive hypertrophic cardiomyopathy(NOHCM).Methods 36 patients with hypertension with concentric hypertrophy,30 patients with NOHCM and 36 healthy volunteers were randomly selected to perform routine ultrasound examination and carotid arterial WI test.The conventional parameters,inlcuding interventricular septal thickness in diastole (IVSTd),left ventricular posterior wall thickness in diastole(LVPWd),left ventricular diameter in diastole(LVIDd) and WI parameters,including the first peak (W1),the second peak (W2),negative area (NA),the interval between the R wave of the ECG and the peak of W1 (R-1st),the interval between the peaks of W1 and W2 (1st-2nd) were archived and compared among the different groups.Results ① There were statistical significances in IVSTd among the three groups(P ＜0.01).LVPWd of hypertension group was obviously higher than that of normal and NOHCM groups (P ＜0.01),but there were no statistical significances in NOHCM and normal groups(P ＞0.05).There were no statistical significances in LVIDd among different groups(P ＞ 0.05).②Compared with the normal group,W1 in NOHCM group increased significantly,whereas W2 and R-1st was much lower (P ＜0.01);W1 and NA in hypertension group was obviously higher(P ＜0.01).W2 and R-1st in NOHCM group were much smaller than those of hypertension group (P＜0.01).③W2 in 850 mmHg · m · s-3 was an optimal cutoff value to identify NOHCM and hypertension and to yield the sensitivity of 78.9％ and specificity of 72.4％.R-1st in 98.5 ms was a cutoff point to discriminate NOHCM and hypertension and to bring the sensitivity 65.8％ and specificity 72.4％.Conclusions WI analysis can effectively distinguish the difference of NOHCM and hypertension and provide a new viewpoint for the discrimination of hypertension with concentric hypertrophy and non-obstructive hypertrophic cardiomyopathy.

Objective To evaluate the left ventricular flow field characteristics in patients with obstructive and non-obstructive hypertrophic cardiomyopathy (HCM) using vector flow mapping (VFM),then assess the left ventricular hemodynamics.Methods 40 patients with HCM were randomly selected as case group,among which 20 patients with left ventricular outflow tract(LVOT) obstruction (group Ⅰ) and 20 patients without LVOT obstruction(group Ⅱ),40 healthy adult volunteers served as control group.The conventional parameters:left ventricular ejection fraction(LVEF),interventricular septal thickness and radial and pressure gradient of left ventricular outflow tract and VFM parameters:left ventricular peak systolic velocity (Vs),systolic flow (Fs),total negative systolic flow (SQ-) and vortex parameters were measured and compared.The correlation between LVOT pressure gradient and VFM parameters were assessed.Results There was no significant difference of LVEF in three groups.Compared with control group,interventricular septal thickness in group Ⅰ and group Ⅱ was much higher(P ＜0.05).Radius in group Ⅰ was much lower than that of group Ⅱ and pressure gradient of LVOT in group Ⅰ was significantly higher compared with group Ⅱ (P ＜0.05).Comparison of VFM parameters:①Compared with control group,SQ-of basal segments in case groups were lower (P ＜0.05),while SQ-of mid and apical segments were higher(P ＜ 0.05),Vs and Fs of all segments increased (P ＜0.05),and number of vortex,vortex diameter and vorticity of obstruction and non-obstruction groups were higher(P ＜0.05).②Compared with group Ⅱ,SQ-of basal segments decreased and SQ-of mid and apical segments increased in group Ⅰ,Vs and Fs of all segments were higher.The number of vortex,vortex diameter were higher in group Ⅰ (P ＜ 0.05).③ Correlation analysis:Fs in apex,the number of vortex relatively correlated with press gradient of LVOT(r =0.60,0.65,respectively).Conclusions VFM can effectively evaluate the flow field characteristics of left ventricle in patients with obstructive and non-obstructive HCM,and Fs in apex,number of vortex were correlated with the degree of obstruction,then further assess the left ventricular hemodynamics quantitively.

Penicillins are one type of the most important antibiotics used in the clinic.Control of drug impurity profiles is an important part of ensuring drug safety.This is particularly important in penicillins where polymerization can lead to polymers as elicitors of passive cutaneous anaphylaxis.The current under-standing of penicillin polymerization is based on reactions with amino groups,but no comprehensive mechanistic understanding has been reported.Here,we used theoretical calculations and column switching-LC/MS techniques to study penicillin dimerization.Ampicillin and benzylpenicillin were selected as representative penicillins with or without amino groups in the side chain,respectively.We identified four pathways by which this may occur and the energy barrier graphs of each reaction process were given.For benzylpenicillin without an amino group in the 6-side chain,dimerization mode A is the dominant mode,where the 2-carboxyl group of one molecule reacts with the β-lactam of another molecule.However,ampicillin with an amino group in the 6-side chain favors dimerization mode C,where the amino group of one molecule attacks the β-lactam of another molecule.These findings can lead to a polymer control approach to maintaining penicillin antibiotics in an active formulation.

Objective Through the detection of the levels of serum betatrophin,anthropometric and biochemical indices,to determine the alteration of betatrophin levels in patients with polycystic ovary syndrome (PCOS) and the relationship between betatrophin levels and metabolic indexes such as 25-hydroxy vitamin D3 [25 (OH) D3].Methods The study group was composed of 24 women with PCOS and 20 age-natched healthy women as controls.Following general physical examination of the subjects,anthropometrie measurements were performed (height,weight,waist circumference,hip circumference).Body mass index (BMI) and waist-hip ratio were calculated;25 (OH) D3,Ca2+,fasting blood glucose,fasting insulin,triglycerides,high-density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C) were also measured and homeostasis model assessment of insulin resistance (HOMA-IR) were evaluated in all subjects.Serum betatrophin levels were examined with an enzyme-linked immunosorbent assay (ELISA).Using independent sample T test to compare the differences between groups,the linear correlation analysis was performed to study the correlation of betatrophin with anthropometric and biochemical indices,the influencing factors of betatrophin were analyzed by multiple linear regression.Results Circulating betatrophin levels [(0.341±0.034) ng/ml vs.(0.810±0.162) ng/ml,t=4.271,P＜0.001] and HDL-C [(1.014±0.321) mmol/L vs.(1.419±0.287) mmol/L,t=2.218,P＜0.05] significantly decreased in women with PCOS compared with controls,and BMI [(27.691±4.392) kg/m2 vs.(23.310±4.781) kg/m2,t=-2.073,P＜0.05],fasting blood glucose [(5.950±0.411) mmol/L vs.(4.883±0.314) mmol/L,t=-2.142,P＜ 0.05],HOMA-IR [(4.946 ± 0.741) vs.(3.387± 0.397),t=-2.493,P＜0.05],triglycerides [(1.510± 0.848) mmol/L vs.(1.037±0.402) mmol/L,t=-2.223,P＜0.05],LDL-C [(3.431±0.479) mmol/L vs.(2.396±0.435) mmol/L,t=-2.433,P＜0.05] were obviously increased.Moreover,there was a postive correlation between betatrophin and HOMA-IR (r=0.425,P＜0.05) as well as 25(OH)D3 (r=0.577,P＜0.05) and Ca2+ (r=0.448,P＜0.05),while the betatrophin was negatively related to BMI (r=-0.451,P＜0.05),triglycerides (r=-0.454,P＜0.05),LDL-C (r=-0.551,P＜0.05).Circulating betatrophin levels were higher when 25 (OH) D3 levels were beyond 35 nmol/L in PCOS patients [(0.539±0.092) ng/ml vs.(0.199±0.031) ng/ml,t=3.072,P＜0.001],and the multiple linear regression analysis showed that the main factors affecting the levels of betatrophin were BMI (OR=-0.260),HOMA-IR (OR=0.218),25(OH)D3 (OR=0.238),and glycerol (OR=-0.162).Conclusion It is speculated that betatrophin may be a valuable predictive factor of PCOS because betatrophin is closely associated with insulin resistance,lipid metabolism disorders and the lack of 25-hydroxy vitamin D3 in PCOS patients.

Alismatis Rhizoma(AR)is widely used in Chinese medicine,and its major bioactive components,tri-terpenes,reportedly possess various pharmacological activities.Therefore,it is very important to study the metabolism of triterpenes in vivo.However,the metabolism of AR triterpene extract has not been comprehensively elucidated due to its complex chemical components and metabolic pathways.In this study,an ultra-performance liquid chromatography quadrupole time-of-flight mass spectrometry method,which was based on the characteristic ions from an established database of known triterpenes,was used to analyze the major metabolites in rats following the oral administration of Alismatis Rhizoma extracts(ARE).As a result,a total of 233 constituents,with 85 prototype compounds and 148 metabo-lites,were identified for the first time.Hydrogenation,oxidation,sulfate and glucuronidation conjugation were the major metabolic pathways for triterpenes in AR.In addition,the mutual in vivo transformation of known ARE triterpenes was discovered and confirmed for the first time.Those results provide comprehensive insights into the metabolism of AR in vivo,which will be useful for future studies on its pharmacodynamics and pharmacokinetics.Moreover,this established strategy may be useful in meta-bolic studies of similar compounds.

OBJECTIVETo study changes and rules of the left ventricular functions in rabbits with myocardial contusion through parallel functional analysis by using echocardiography combined with cardiac catheter intervention.

METHODSThirty healthy rabbits were selected and impacted to make moderate or severe myocardial contusion by BIM-II biomedical impact machine. The changes of hemodynamics and cardiac systolic and diastolic functions were respectively observed before injury and 1, 4, 8 and 24 hours after injury.

RESULTSAfter myocardial contusion, the heart rate, systolic pressure, diastolic pressure and mean arterial pressure of rabbits decreased remarkably at 1-4 hours. The left ventricular end systolic pressure (LVESP), the maximum increasing rate of the left intraventricular pressure (+dp/dtmax), isovolumic pressure (IP) and the maximum systolic velocity of the left ventricle (Vmax) also decreased markedly. And then these parameters recovered to the level of preinjury at 8-24 hours. The left ventricular end-diastolic pressure (LVEDP), the rate of the left intraventricular pressure (-dp/dtmax) and the decreasing time constant of the left intraventricular pressure (T) increased remarkably 1 hour after myocardial contusion, and did not decrease until 8 hours after myocardial contusion. Detection by echocardiography showed that ejection fraction of the left ventricle markedly decreased at 24 hours after myocardial contusion, while the systolic volume decreased obviously as early as 1 hour after myocardial contusion, at 4-8 hours it recovered a little and again decreased at 24 hours. The end systolic volume and end diastolic volume increased after myocardial contusion, but statistical significance was only seen at 8 hours after myocardial contusion.

CONCLUSIONSCardiac functions of the left and right ventricles are markedly injured after myocardial contusion with disorders of the left ventricle diastolic function and of the right ventricle systolic function as the dominant injury. While the systolic function of the left ventricle can recover. Echocardiography shows clinical importance in detection of early injuries of cardiac functions.

Animals ; Contusions ; physiopathology ; Female ; Heart Function Tests ; Heart Injuries ; diagnostic imaging ; physiopathology ; Hemodynamics ; Male ; Rabbits ; Ultrasonography ; Ventricular Function, Left ; Ventricular Pressure

Objective To analyze the serotypes of enteroviruses(EVs) isolated from patients with influenza-like illness in Beijing in 2017. Methods Oropharyngeal swab specimens were collected from pa-tients with influenza-like illness in eight districts of Beijing from July 2017 to October 2017. EVs were detec-ted by real-time PCR. Specific primers were synthesized and used to amplify the VP1 fragments of EVs. PCR products were sequenced and the results were compared with the reference sequences by using Basic Lo-cal Alignment Search Tool(BLAST) to identify the serotypes of isolated EVs. Results A total of 666 spec-imens were collected and 91 (13.66%) were positive for EVs. VP1 sequences of 66 EVs were successfully amplified and BLAST analysis revealed that these strains belonged to 14 serotypes,including seven serotypes of EV-A species,six serotypes of EV-B species and one serotype of Rhinovirus species. The predominant se-rotypes were CVA2 and CVA6. Eight out of 14 CVA6 strains that were collected in Shunyi District shared high homology. All seven CVB5 strains were collected in Shijingshan District and grouped into one cluster. Conclusion EVs causing influenza-like illness in Beijing in 2017 belonged to 14 serotypes and CVA2 and CVA6 were the predominant serotypes.

Objective:To investigate the prevalence of enterovirus infection and its clinical characteristics in neonatal febrile cases.Methods:A total of 308 neonates in the neonatal ward of Kunming Children′s Hospital with febrile symptoms from March 2018 to February 2019 were selected for the study.Fecal specimens and some (271) cerebrospinal fluid specimens were collected from all neonates.Enterovirus was respectively detected in feces and cerebrospinal fluid by using reverse transcription-polymerase chain reaction (RT-PCR) method.The rate of enterovirus infection in febrile neonates was clarified.They were divided into enterovirus infection group ( n=91) and no enterovirus infection group ( n=217). The clinical data of the subjected neonates in the two groups were analyzed and the clinical manifestations of the neonates and their laboratory findings were compared statistically. Results:Ninety-one enteroviruses (90 enterovirus were general type, and 1 was coxsackievirus A16 type) were detected in 308 children, accounting for 29.55% of all neonates.Viral RNA was detected in only 1 case [0.37% (1/271)]of all examined cerebrospinal fluid specimens, which was significantly lower than the detection rate of 29.55% (91/308) in fecal specimens.There were no fatal cases, but there was one severe case in enterovirus infection group.Except for the severe case which was discharged automatically, all of them improved or healed and discharged from hospital.The clinical manifestations of the enterovirus infection group were non-specific statistically compared with the non-enterovirus infection group(all P>0.05), except for respiratory symptoms and skin rash(all P<0.05). The incidence of enterovirus infection was significantly seasonal[83.52%(76/91)in summer and autumn]. Conclusion:In the epidemic season of enterovirus, it is recommended to list fecal enterovirus as a routine test item to improve the accuracy and timeliness of diagnosis and treatment, and avoid the application of unnecessary antibiotics and the outbreak of enterovirus in the neonatal ward.