Objective To investigate the occurring time,pathogen distribution and drug resistance in kidney transplant pa-tients with lung infection and to provide basis for clinical treatment.Methods From January 2012 to December 2015,73 kid-ney transplant patients with lung infection were collected in this study.The timing of infection occurrence,the main source of specimen,the pathogenic bacteria and drug resistance of each case were analyzed retrospectively.The drug sensitivity was analyzed by WHONET 5.4 software.Results 83.56% (61/73)cases of lung infection occurred within 1 year in kidney transplant patients,among them,53.42% (39/73)cases occurred within 6 month after kidney transplantation,and 30.14%(22/73)cases occurred within 6~12 months after surgery.The 84.93% (62/73)source of specimen were sputum and blood,and the others were alveolar lavage fluid,pleural fluid and throat swab.Totally 7 9 strains of pathogenic bacteria were isolated,including gram negative bacilli (49.37%),gram positive bacteria (39.24%)and fungi (11.39%).The most com-mon strains were Pseudomonas aeruginosa 12 strains (15.19%),Staphylococcus aureus 11 strains (13.92%),Klebsiella pneumoniae 10 strains (12.66%),Staphylococcusaureus 9 strains (11.39%),BaumanAcinetobacter 8 strains (10.13%), and Escherichia coli 6 strains (7.5 9%).The detection rate of strains which producing broad-spectrumβ-lactamases were 30.0% in Escherichiacolil and 20.0% in Klebsiellapneumonia,respectively.Furthermore,the detection rate of methicillin-resistant Staphylococcus were 45.45% in Staphylococcusepidermidisl and 22.22% in Staphylococcusaureus,respectively. The drug sensitivity results showed that the Gram-negative bacilli were sensitive to Vancomycin,teicoplanin and rifampicin. The Gram-positive cocci were sensitive to Cefepime,meropenem and imipenem.Conclusion 83.56% (61/73)cases of lung infection occurred within 1 year in kidney transplant patients;Gram-negative bacteria were the main pathogenic bacteria in lung infection in kidney transplant patients;Gram-negative bacteria and Gram-positive bacteria were multi drug resistant and should be treated as early as possible.

Objective To explore the association between circulating endothelial cells (CECs)and atherosclerosis in maintenance hemodialysis(MHD)patients. Methods A crosssectional study was performed to investigate the association between CECs and carotid atherosclerotic change in 65 MHD patients,25 non-hemodialysis patients with chronic kidney disease(CKD)of stage 4 or 5(CKD-non-HD)and 24 age-and Sex-matched healthy controls. CECs in peripheral blood were determined by multiparametrie flow cytometry(FCM).CECs were labeled with CD3-PerCP and CD146-PE before FCM and identified as CD3dim,CD146bright.Atherosclerosis in both groups Was assessed by the measurement of common carotid arery intimamedia thickness (CCA-IMT)and plaque of the common carotid arteries with ultrasound scanner. Results CECs were significantly higher in pre-dialysis patients[(151.52±98.24) cell/ml]and CKD-non-HD patients[(183.00±81.38)cell/ml ] compared with control group[(106.50± 24.14)cell/ml](P<0.05 and P<0.01,respectively).But the number of CECs was not significantly different between MHD and CKD-non-HD patients.CCA-IMT was also significantly higher in MHD patients[(0.94±0.36)mm]and CKD-non-HD patients [(1.02±0.37)mml compared with control group[(0.75±0.15)mm](P<0.05 and P<0.01,respectively).The number of pre-dialysis CECs was positively correlated with CCA-IMT in MHD patients(r=0.328,P<0.01).Multivariate analysis showed that CEC level was a strong independent risk factor of CCA-IMT. Conclusion InMHD patients, CEC level is associated with carotid atherosclerosis and may be used as a marker to evaluate the endothelial damage.

Objective To explore possible associations between osteopontin(OPN) and intact parathyroid hormone(iPTH),to investigate effects of them on the progression of carotid artery calcification in patients receiving long-term hemodialysis.Methods Forty-eight maintenance hemodialysis (MHD) patients and 28 age-and sex-matched healthy volunteers were recruited.The concentration of OPN in peripheral blood was determined by enzyme linked immunosorbent assay (ELISA).Levels of iPTH and presence of plaques in the common carotid arteries were also measured.The demographics were recorded.Results Compared with controls,levels of OPN[(137.4±80.8) ng/L vs (31.6±6.7) ng/L,P ＜ 0.01] and iPTH[(456.4±326.4) ng/L vs (66.9±19.3) ng/L,P ＜ 0.01] were higher in MHD patients before hemodialysis,the numbers of calcific plaques in the common carotid arteries were increased in MHD patients (P ＜ 0.01).There was a positive correlation between pre-dialysis OPN levels and iPTH levels (r =0.620,P ＜ 0.01) in MHD patients.Higher levels of OPN and iPTH correlated with greater numbers of calcific plaques in the common carotid arteries after division into three subgroups of MHD patients based on calcific plaques.In multiple linear regression analysis,the correlation between the pre-dialysis OPN and iPTH levels remained the same even if adjusting for confounding effects[β =0.468,95％C1 (0.036,0.195),t =2.936,P =0.005].Conclusion OPN level is positively correlated with iPTH level in hemodialysis patients,which suggesting that both of them play important roles in the progression of carotid artery calcification.

Objective To discuss the influences of the establishment of breast milk bank to the premature infants in the hospital. Methods The clinical datas of 239 premature infants admitted in NICU from Feb 2017 to Jan 2018 were retrospectively analyzed. Dividing them into two groups, one was control group that the premature infants born before the establishment of breast milk bank, the other was observation group that the premature infants born after that. Both groups were taken the same treatment;and fed the autogenous breast milk or donated breast milk or premature milk based on the intention of infant′s family. Results In observation group,the breastfeeding rate was 67.5％ (85/126),the average hospital-stay time was (24.5±4.4) days.But in control group, the breastfeeding rate was 34.5％(39/113),the average hospital-stay time was (36.3±8.3) days, there were significant differences between the two groups (χ2=4.217, t=2.941, P<0.05).The complications in observation group included necrotizing enterocolitis (5 cases),bronchopulmonary dysplasia(3 cases), retinopathy of prematurity (5 cases) and sepsis (6 cases), the incidence of which was lower than that in control group. But, there was statistical significance in the incidence of necrotizing enterocolitis and sepsis only (χ2=3.989,5.386,P<0.05). Conclusions The establishment of breast milk bank can help to improve the breastfeeding rate of premature infants,shorten the hospital-stay time,reduce the incidence of NEC and sepsis,make premature infants recover more quickly.

OBJECTIVETo investigate the source, transmission route and risk factors of an outbreak of severe fever with thrombocytopenia syndrome (SFTS).

METHODSCase definition was made and suspected cases were searched. A standardized questionnaire was used to collect information on demographic features (age, gender, occupation, residential address), history of exposure, clinical signs and symptoms etc. Blood samples were collected from 12 suspected cases while index patient's blood samples were collected from walls of the residence. All samples were detected for SFTS virus using RT-PCR. Sero-prevalence rates of SFTS virus IgG were also conducted among healthy people, host and vectors.

RESULTSA total of 13 cases including 6 male and 7 female were identified during this outbreak in May 2014. Index patient developed illness onset on April 23 and died on May 1. Secondary patients would include 8 family members, 3 neighborhoods, 1 individual who lived in the same village, developing illness onset between May 10 and 16, with a peak on May 13. The incubation period was 9-15 days. Clinical signs and symptoms appeared as fever (100%), chill (92%), anergy (92%), body aches (92%), anorexia (92%), headache (77%), nausea (69%) etc. Neutropenia and thrombocytopenia also appeared. History of the index patient showed that she collected tea leaves in her hometown 1 month before the illness onset. After index patient died on May 1, 9 secondary patients had directly contacted the blood of the deceased. Data from the retrospective cohort study showed that 'direct contact with blood' was an important risk factor (RR = 43.36, 95% CI: 13.66-137.63, P = 0.000).

CONCLUSIONMajority of the secondary patients of these clusters contracted the SFTS virus infection through exposure to the blood of the index patient. However, aerosol transmission could not be ruled out, suggesting that precaution should be taken for doctors, nurses and family members when looking after the patients with SFTS virus infection.

China ; epidemiology ; Disease Outbreaks ; Environment ; Female ; Fever ; epidemiology ; Humans ; Male ; Retrospective Studies ; Risk Factors ; Severity of Illness Index ; Syndrome ; Thrombocytopenia ; epidemiology