Objective To learn the significance of detection of high sensitive troponin T and creatine kinase isoenzyme in diagnosis of pediatric myocarditis.To provide reliable laboratory diagnosis method for the disease.Methods 23 cases of pediatric myocarditis,28 cases of viral myocarditis with capillary bronchitis and 61.cases of myocarditis with neonatal pneumonia were selected as the research objects;and 48 cases of healthy control group,55 cases of capillary bronchitis and 49 cases of neonatal pneumonia were also selected.Blood samples were collected from all the patients and healthy controls,and the levels of high sensitive serum troponin T and creatine kinase isoenzyme were also measured.Results There was no significant difference in the detection results of high sensitive troponin T and creatine kinase isoenzyme between the healthy control group,children with capillary bronchitis and neonatal pneumonia (all P ＞ 0.05);high sensitive troponin T and creatine kinase isoenzyme detection results of myocarditis,myocarditis complicated with bronchiolitis,myocarditis complicated with neonatal pneumonia were higher than those in healthy control group,the differences were statistically significant (t =13.723,6.628,10.079,9.475,17.650,15.364,all P ＜ 0.05).The abnormal rates of combined detection of children with myocarditis,myocarditis combined with capillary bronchitis,myocarditis combined with neonatal pneumonia were higher than those of single detection of high sensitive troponin T and single detection of creatine kinase isoenzyme (x2 =7.426,6.310,6.720,4.308,4.381,6.900,all P ＜0.05).The high sensitive troponin T and creatine kinase isoenzyme in the children with the age of 1-12 months and 1-3 were lower than those with the age of ＜ 1 month,the differences were statistically significant (t =3.498,4.043,4.202,4.132,all P ＜ 0.05).Conclusion The simultaneous detection of high sensitive troponin T and creatine kinase isoenzyme can be used in the diagnosis of pediatric myocarditis,with good clinical application value.

Objective To characterize the prevalence of plasmid-mediated quinolone resistance determinants qnrA in extended-spectrum β-lactamase(ESBL)-producing Escherichia coli and Klebsiella pneumonia.Methods PCR was used to amplify qnrA gene in ESBL-rpoducing isolates(including 263isolates of Escherichia coli and 99 isolates of Klebsiella pneumonia).Conjugation experiments and southern blot hybridization were employed to definitude the location of the genes in ZJ96 isolate of Klebsiella pneumonia which had positive qnrA and CTX-M genes.Shot gun sequencing was performed for analyzing the complete nucleotide sequence of pKP96,a plasmid containing qnrA and CTX-M-24 genes in ZJ96 isolate.Results qnrA was detected in 5 out of 263(1.9%)Escherichia coli isolates and 8 out of 99(8.1%)Klebsiella pneumonia isolates.pKP96,a conjugative plasmid including qnrA gene and CTX-M-24 gene presented in ZJ96 isolate.The sequence of the plasmid pKP96 displayed the qnrA,CTX-M-24,aac(6')-Ib-cr,tetA and int Ⅰ 1 genes.Conclusion The plasmid-mediated genes,such as qnrA and CTX-M,may facilitate the prevalence of multi-drug resistant strains.

Objective To investigate the prevalence and dissemination mechanism of 16S rRNA methylase genes in extended-spectrum beta-lactamases(ESBLs)-producing Enterobacteriaceae in China.Methods PCR amplification and DNA sequencing were used for screening and identifing 16S rRNA methylase genes and ESBLs genes.Minimal inhibitory concentrations(MICs)of the antimicrobial agents were detected by Etest.Conjugation and plasmid extract were performed to study dissemination mechanism of 16S rRNA methylase genes and ESBLs genes.Results Only one strain.Klebsiella oxytoca strain ZJ157 was screened as positive for armA gene from 447 ESBLs-producing isolates,which also contained CTX-M-15 and TEM-1 genes.It was resistant to aminoglycesides,ciprofloxacin,and most β-lactams,except carbapenems,polymyxin E and tigecyeline.Resistance to amikacin and β-lactams was transferred to a recipient Escherichia coli 600 by conjugation experiment.arntA.CTX-M-15 and TEM-1 genes were detected in the transconjugant.A plasmid about 55 kb was extracted from Klebsiella oxytoca ZJl57 and the transconjugant.Conclusions A 16S rRNA methylase gene armA was detected in an isolate of Klebsiella oxytoca.armA,CTX-M-15 and TEM-1 genes can be co-transferred in the same plasmid leading to multi-drug resistance.

The epidemic of COVID-19 has lasted for nearly a year, the number of confirmed cases worldwide is still rising, and the trend of the epidemic is unclear. How will be the further development of COVID-19 epidemic? What is the current status of research on new drugs for coronary virus disease? Will the vaccine currently used change the epidemic pattern? In the context of the normalization of the epidemic, whether the epidemiology of other respiratory viruses will change? This article will discuss and analyze these hot and difficult issues.

Objective To clarify the infection risks and the value of endotoxin determination in urine during extracorporeal shock wave lithotripsy (ESWL).Methods According to the distribution and complications of upper urinary calculi, 164 patients were divided into five groups. Group A consisted of 48 patients with 1 to 4 renal calculi, which were or less than 2 crn in diameter. Group B was composed of 24 patients with renal calculus larger than 2 cm in diameter or one to multiple renal calculi. Group C wes composed of 22 patients with 1 to 3 renal calculi accompanied by 1 to 2 ureteric calculi. Group D consisted of 51 patients with 1 to 3 ureteric calculi that were 0.5 to 1.2 cm in diameter, respectively. Group E included 19 patients with complicated renal calculus, such es casting and staghom renal calculus. Urine and blood samples of these patients were obtained before and after ESWL, respectively. Their urine samples were proven sterile prior to treatment. All samples were cultured for bacteria and investigated for endotoxin concentration by the limulus lysate test.Results No significant difference in serum endotoxin wes noted before and after ESWL. Blood bacterial cultures were all negative in all patients after ESWL, similar to those before ESWL. Significant increases in urine endotoxin after ESWL compared with that before ESWL in patients of Groups B, C and E were observed, respectively (P ＜ 0.05). There was no significant difference in urine endotoxin after ESWL compared with that before ESWL in patients of Groups A and D. The positive incidences of urine bacterial culture were significantly increased (P ＜ 0.05) in Groups B and C and very significantly increased ( P ＜ 0.01 ) in Group E compared with those in Groups A and D.Conclusions Urinary infection risk following ESWL was lower in patients with one to several renal calculi,which were less than 2 cm in diameter and did not interfere obviously with the urine flow or in patients with 1 to 3 ureteric calculi that were 0. 5 to 1.2 cm in diameter. The risk was higher in those with complicated calculi, such as casting, staghom renal calculus, renal calculus larger than 2 cm in diameter or renal calculi accompanied by ureteric calculi. For patients with higher infection risk after ESWL, prophylactic antibiotics are necessary even if bacteriuria is not present before ESWL. Endotoxin determination in urine is a reliable,sensitive and simple method for the diagnosis of bacterial infection in patients undergoing ESWL.

Objective To evaluate the effects of multi-functional self-help lower extremity training band on elderly patients after hip fracture surgery. Methods A total of 120 elderly patients after hip fracture surgery were randomly divided into two groups experimental group (n=60) and control group (n=60). The patients of two groups were treated with routine care, but patients of experimental group also received functional exercise using multi-functional self-help lower extremity training. The compliance of functional exercise were compared between two groups, and the effects of postoperative rehabilitation exercise were evaluated. Results The exercise effects of knee joint and hip joint in experimental group were significantly better than those in control group (χ2 =14. 90,13. 89;P<0. 05). The patients′compliance of functional exercise in the experimental group was significantly higher than that in the control group (P<0. 01). Conclusions The using of multi-functional self-help lower extremity training band can improve the compliance of functional exercise and the effects of rehabilitation on elderly patients after hip fracture surgery, and can promote the progress of rehabilitation.

Objective:To investigate the risk factors for intracranial hematoma progression in patients within 24 h of traumatic brain injury.Methods:A prospective study was performed; 184 patients with traumatic brain injury admitted to our hospital from January 2018 to June 2021 were enrolled. According to the states of intracranial hematoma indicated by head CT within 24 h of injury, these patients were divided into intracranial hematoma progression group ( n=52) and intracranial hematoma stable group ( n=132). The clinical data of patients in the two groups were compared and the independent risk factors for intracranial hematoma progression were screened by multivariate Logistic regression analysis. Results:As compared with intracranial hematoma stable group, patients in the intracranial hematoma progression group had significantly advanced age, significantly higher systolic blood pressure and blood glucose levels, statistically higher proportions of patients with parenchymal hemorrhage, subarachnoid hemorrhage, and multiple hematomas, significantly longer prothrombin time, significantly higher international standardization index and D-dimer level, significantly higher proportion with patients with fibrinogen<2.0 g/L, statistically increased K value (blood coagulation time) of thromboelastic map, proportion of patients with α Angle (blood coagulation angle)<64°, level of vascular endothelial biomarker syndecan-1 (Syn-1), and von willebrand factor (vWF) activity, and significantly decreased Glasgow Coma Scale (GCS) scores at admission and platelet count ( P<0.05). Multivariate Logistic regression analysis showed that age ( OR=1.066, 95%CI: 1.018-1.117, P=0.007), systolic blood pressure ( OR=1.076, 95%CI: 1.041-1.111, P<0.001), multiple hematoma ( OR=6.559, 95%CI: 2.025-21.245, P=0.002), fibrinogen<2.0 g/L ( OR=6.164, 95%CI: 1.586-23.954, P=0.009), K value ( OR=6.500, 95%CI: 1.755-24.082, P=0.005) and Syn-1 level ( OR=1.111, 95%CI: 1.015-1.215, P=0.022) were independent risk factors for intracranial hematoma progression in patients with traumatic brain injury at early stage. Conclusion:Traumatic brain injury patients, at early stage, with advanced age, multiple intracranial hematoma, high systolic blood pressure, low fibrinogen, prolonged K value and high Syn-1 level are trend to have intracranial hematoma progression.

Objective To analyze the distribution and antimicrobial resistance profile of clinical bacterial strains isolated from blood culture in China.Methods Clinical bacterial strains isolated from blood culture from participating hospitals of Blood Bacterial Resistance Investigation Collaborative System (BRICS) during January 2014 to December 2015 were collected.Antibiotic susceptibility tests were conducted with agar dilution or broth dilution methods as recommended by US Clinical and Laboratory Standards Institute(CLSI)2018.The data were analyzed with Whonet 5.6 software.Results During the study period,4 801 clinical bacterial isolates were collected from 26 hospitals,of which 1 798 (37.5％) were Gram-positive bacteria and 3 003 (62.5％) were gram-negative bacteria.The top 10 isolates were Escherichia coli (33.8％),coagulase-negative Staphylococcus (19.0％),Klebsiella pneumoniae (11.9％),Staphylococcus aureus (10.1％),Acinetobacter baumannii (4.0％),Pseudomonas aeruginosa (3.8％),Streptococcus (3.0％),Enterobacter sulcus (2.9％),Enterococcus faecium (2.8％) and Enterococcus faecalis (1.8％).Methicillin-resistant Staphylococcus aureus (MRSA) and methicillinresistant coagulase-negative Staphylococcus (MRCNS) accounted for 33.9％ (165/487) and 56.9％ (520/913) of Staphylococcus aureus and coagulase-negative Staphylococcus respectively.No vancomycinresistant Staphylococcus was detected.The resistance rate of Enterococcus faecium to vancomycin was 0.7％ (1/135),and no vancomycin-resistant Enterococcus faecaliss was detected.The positive rates of extendedspectrum β-1actamases(ESBLs)-producing Escherichia coli,Klebsiella pneumoniae and Proteus were 56.9％ (923/1 621),30.1％ (172/572) and 29.2％ (7/24),respectively.The positive rates of carbapenemresistant Escherichia coli,Klebsiella pneumoniae,Enterobacter,Salmonella and Citrobacter were 1.2％ (20/1 621),7.2％ (41/572),4.3％ (6/141),1.5％ (1/67) and 2.9％ (1/34),respectively.The resistance rates of Acinetobacter baumannii to polymyxin and tegacycline were 2.6％ (5/190) and 8.9％ (17/190)respectively,and that of Pseudomonas aeruginosa to polymyxin and fosfomycin were 1.1％ (2/183)and 0.6％ (1/183),respectively.Conclusions The surveillance results from 2014 to 2015 show that the main pathogens of blood stream infection in China are Gram-negative bacteria,while Escherichia coli is the most common pathogen,the detection rate of MRSA is lower than other surveillance data in the same period in China;carbapenem-resistant Klebsiella pneumoniae and Escherichia coli are at a low level as shown in this surveillance.

Objective: To study serum HCV antibody (anti-HCV) with geographic distribution characteristics in Zhejiang Province. Methods: A stratified random cluster sampling method was used. Serum samples of the surveyed population were collected from selected hospitals, anti-HCV antibodies were examined, then hepatitis C infection rates among different genders, regions and age groups were analyzed. The anti-HCV rate was compared using the χ ² test. Results: The average anti-HCV positive rate in Zhejiang Province was 0.24% [95% confidence interval (CI): 0.16% ~ 0.32%]. The antibody positive rate in the plain area was 0.32% (95% CI: 0.19% ~ 0.45%), which was significantly higher than the coastal islands 0.05%(95% CI: 0.00% ~ 0.12%, χ ² = 7.638, P < 0.05). There was no significant difference between plain area and hilly area 0.22% (95% CI: 0.03% - 0.41%). There was no statistically significant difference in anti-HCV positive rates between males and females (χ ² = 2.238, P = 0.135). The highest positive rate of anti-HCV (0.93%) was in the population aged 56-60 years and the lowest in the population aged less than 20 years. Anti-HCV positive rate of all age groups in 2017 was lower than that of 2006 seroepidemiological study of hepatitis C. Conclusion Zhejiang Province is a region with low anti-HCV positive rate and the disease prevalence further reduced than 10 years ago. The positive rate of anti-HCV in plain areas is higher than islands. Middle-aged and elderly people are the age group with high prevalence, and the anti-HCV positive rate in people under 20 years old is exceptionally low. Gender differences in anti-HCV positive rate have little effect.

OBJECTIVE: To establish a cell lines for quality control of prenatal genetic diagnosis. METHODS: The recombined SV40LTag-pcDNA3.1(-) vector was constructed and transfected by lipidosome into human amniotic fluid cells with common aneuploidy. Positive clones were screened by G418, and the immortality of transfected cell line was identified. RESULTS: Cell line with karyotype of 46, XY, t(8;19)(q24.3;q13.1) from primary amniotic fluid cells was established. Karyotype analytical results indicated that the cell line at its 15th generation maintained the same karyotype of its primary cell. CONCLUSIONS Gene can lead to immortality of amniotic fluid cells, which contributes to preparing cell lines for internal and external quality control in prenatal genetic diagnosis.
Antigens, Polyomavirus Transforming ; genetics ; Cell Line ; Female ; Genetic Vectors ; Humans ; Karyotype ; Pregnancy ; Prenatal Diagnosis ; methods ; Quality Control ; Recombinant Proteins ; genetics ; Transfection