Objective To study the homology relationship among clinically isolated imipenem-resistant klebsiella pneumoniae strains and possible transmission route of drug resistant strains to provide a basis for blocking the transmission of this kind of bacteria in clinc.Methods Clinical samples collection and bacterial culture were routinely conducted,meanwhile the hand surface of ICU medical staffs and the surfaces of patien's bedside objects were performed the sample collection for conducting the bacterial count and culture.The bacterial identification and drug susceptibility test were performed by the VITEK-2 COMPACT system.The bacterial homology detection adopted the ERIC-rep-PCR method.Results Totally 642 strains of imipenem-resistant Klebsiella pneumoniae were clinically isolated from January 2011 to December 2013.Among them,389 strains(60.59％) were derived from ICU.72 strains (11.21％) fsrom the respiratory department,53 strains (8.26％) from the neurology department,41 strains (6.39 ％) from the cardiovascular department,31 strains (4.83％) from the surgical department,11 strains (1.71％) from the gastroenterology department,5 strains (0.78 ％) from the renal department,17 strains (2.65 ％) from the emergency department and 23 strains(3.58％) from the other departments.One strain of imipenem-resistant Klebsiella pneumoniae was isolated from the IGU object surface.Among 642 clinical bacterial strains,there were 8 main clones,these 8 clone strains added up to 394 strains,which accounted for 61.37％ of whole bacterial strains,the other 248 strains were single clones.Conclusion The monoclonal prevalence of imipenem-resistant klebsiella pneumonia in this hospital actually exists.The contact transmission may be the possible transmission route of this kind of infection.

Objective To compare the relativity between Tp-Te interval,Tp-Te /QT ratio with heart rate(HR)and explore their clinical significance retrospectively.Methods 200 normal individuals' ECG were randomly selected and the Tp-Te interval and Tp-Te/QT ratio were measured in precordial lead V6 retrospectively.The relativity between Tp-Te interval and Heart Rate,Tp-Te/QT ratio and Heart Rate were calculated retrospectively.Results The Tp-Te interval was about(83.17?12.64)ms in precordial lead V6 of normal individuals.The Tp-Te interval decreased linearly with the increase in HR with the range of Tp-Te interval being 56 to 114 milliseconds(Pearson's correlation coefficient r was-0.239,P=0.007 0.01).Conclusion There is an inverse correlation between Tp-Te interva and HR while no correlation between Tp-Te/QT ratio and HR.

Objective To present the experience in surgical treatment method and clinic application of axillary tuberculous lymphadenitis in infant.and discuss its etiology.Methods From 1995 to 2003, axillary tuberculous lymphadenitis mass in 14 hospitalized cases were resectioned.Results The incision healing was better in 3 cases of regional lymphadenectomy and 11 cases of axillary lyphoidectomy.The tuberculous lymphadenitis was not relapse during patients were followed-up.All discharge patients were not suffer from extrapulmonary and intrapulmonary tuberculosis.Conclusions The prompt regional lymphadenectomy and axillary lyphoidectomy are preferred to axillary tuberculous lymphadenitis and suspicious tuberculous lymphadenitis.It is effective to avoid the patients suffering from tuberculosis in other organs of human body and eliminate antituberculous drugs lesion to important organs of body.

BACKGROUNDBreast cancer remains the most important cancer among women worldwide. The disease itself and treatment may have a profound impact on the patients' psychological well being and quality of life. Depression is common in breast cancer patients and affects the therapeutic effects as well as prolongs the duration of hospital stay. However, few studies reported the effectiveness of music therapy on depression and duration of hospital stay of female patients with breast cancer after radical mastectomy.

METHODSOne hundred and twenty subjects were recruited to this clinical trial and randomly allocated to two groups. The experimental group (n = 60) received music therapy on the basis of routine nursing care, whereas the control group (n = 60) only received the routine nursing care. The whole intervention time was from the first day after radical mastectomy to the third time of admission to hospital for chemotherapy. Data of demographic characteristics and depression were collected by using the General Questionnaire and Chinese version of Zung Self-rating Depression Scale (ZSDS) respectively. One pre-test (the day before radical mastectomy) and three post-tests (the day before discharge from hospital, the second and third admission to hospital for chemotherapy) were utilized. Duration of hospital stay was calculated from the first day after radical mastectomy to the day of discharged from hospital.

RESULTSThe mean depression score of all subjects was 37.19 ± 6.30. Thirty-six cases (30%) suffered from depression symptoms, with 26 (72.2%) mild depression cases, 9 (25.0%) moderate depression cases, and 1 (2.8%) severe depression case. After music therapy, depression scores of the experimental group were lower than that of the control group in the three post-tests, with significant differences (F = 39.13, P < 0.001; F = 82.09, P < 0.001). Duration of hospital stay after radical mastectomy of the experimental group ((13.62 ± 2.04) days) was shorter than that of the control group ((15.53 ± 2.75) days) with significant difference (t = -4.34, P < 0.001).

CONCLUSIONSMusic therapy has positive effects on improving depression of female patients with breast cancer, and duration of hospital stay after radical mastectomy can be reduced. It is worthy of applying music therapy as an alternative way of nursing intervention in clinical nursing process of caring female patients with breast cancer.

Adult ; Aged ; Breast Neoplasms ; surgery ; Depression ; therapy ; Female ; Humans ; Mastectomy, Radical ; psychology ; Middle Aged ; Music Therapy ; methods

BACKGROUND: Short-term (1 week) vitreous cryopreservation avoiding the formation of ice crystals has been achieved in preserving tissue-engineered bone composed of adipose-derived stem cells (ADSCs)/demineralized bone matrix (DBM) compound through adjusting particular composition of cryopreservation fluid. However, whether vitreous cryopreservation can be utilized to cryopreserve tissue-engineered bone for long term (12 weeks) and maintain cellular viability and osteogenic function after rewarming remains unclear. OBJECTIVE: To investigate the effects of vitreous cryopreservation on viability and osteogenic function of ADSCs for short-term (1 week) and long-term (12 weeks) cryopreservation. METHODS: ADSCs were isolated from New Zealand rabbits and expended to passage 3. Cells at passage 3 were seeded onto DBM derived from porcine trabecular bone and followed by 1 week osteogenic induction. The tissue-engineered bone was transferred to freezing vials of 2 mL containing vitreous cryopreservation fluid and then directly quenched into liquid nitrogen. The composition of cryopreservation fluid was 30% dimethyl sulfoxide, 70% low glucose-Dulbecco's modified Eagle medium (L-DMEM), 0.8 mol/L trehalose. Following vitrification for 1 week or 12 weeks, the composite of ADSCs/DBM was removed and thawed. After rewarming, ADSCs viability were viewed under confocal laser microscope by staining viable cells with the green fluorescent dye Calcein AM and the red fluorescent dye Propidium iodide at days 1, 3, 7, 11 and 13. The number of cells seeded onto the DBM was assayed by Hochest33258 at days 1, 3, 5, 7, 9, 11 and 13. Meanwhile, alkaline phosphatase (ALP) activity was also assayed by PNP microplate method at days 1, 4, 7, 10, 14 and 21. Osteogenic gene expression including Runx2, OCN, ALP, COL-1 was detected by real- time PCR at days 1, 4, 7, 10, 14 and 21. RESULTS AND CONCLUSION: After cryopreservation of 1 week or 12 weeks, it was found that more red-staining live cells was observed at 1 day post-rewarming by live/dead double staining, and the green-staining live cells increased at 3 days. By Hoechst 33258 assay, it was found that the cell number decreased at 1 and 3 days post-rewarming, compared with pre-cryopreservation. However, a constant increase in the cell number was observed beginning at 3 days, reaching the pre-cryopreservation level at 5 days post-rewarming. By PNP microplate method, it was found that ALP activity reduced at 1 and 4days post-rewarming, but compared with the level of pre-cryopreservation there were no significant difference. However, a constant increase in ALP activity was detected since 4 days. By real-time PCR, osteogenic gene expression including Runx2, OCN, ALP, COL-1 reduced at days 1 and 4, but compared with the level of pre-cryopreservation there was no significant difference. However, a constant increase in the osteogenic gene expression was since 4 days. The cell viability and osteogenic function were observed without significant difference at each time point after rewarming of cells that had undergone vitreous cryopreservation for 1 or 12 weeks. Preliminary findings indicate that vitreous cryopreservation can maintain cellular viability and osteogenic function of tissue-engineered bone. Cryopreservation time (1 and 12 weeks) has no significant effect on the cell viability and osteogenic function of the tissue-engineered bone after rewarming.

BACKGROUND: Serum concentrations in culture medium influence the proliferation and differentiation of stem cells. OBJECTIVE: To study the proliferation and adipogenic differentiation potential of adipose-derived stem cells under culture with different concentrations of fetal bovine serum. METHODS: The mouse adipose-derived stem cells were harvested from subcutaneous adipose tissue of C57 mice at 7-10 days of age. Concentrations of fetal bovine serum in the culture medium were set to 5%, 10%, 15% and 20%. The passage 3 cells were used for subsequent studies. The proliferation of cells cultured with different serum concentrations was tested using the cell counting kit-8 assay. The adipogenic differentiation potential of cells was evaluated with Bodipy staining. Quantitative RT-PCR and western blot assay were used to determine expression levels of Cebpa and Pparg mRNA as well as C/EBP-α and PPAR-γ protein levels. RESULTS AND CONCLUSION: There was no statistical difference in the cell proliferation among cells cultured with different serum concentrations, even though adipose-derived stem cells cultured with 20% fetal bovine serum showed lower absorbance value at 450 nm than those cultured with 5%, 10% and 15% fetal bovine serum. The expression levels of Cebpa and Pparg mRNA and C/EBP-α and PPAR-γ protein in the 5% and 10% groups were considerably higher than those of the 15% and 20% groups, and the expression levels were highest in the 10% group. To conclude, different concentrations of fetal bovine serum have no significant effects on the proliferation of adipose-derived stem cells, while the adipogenic differentiation potentials of cells are different when cultured with different serum concentrations. High serum concentration can inhibit the adipogenic differentiation of adipose-derived stem cells.

OBJECTIVETo explore the molecular and epidemic characteristics of rifampin (RFP) and isoniazid (INH) resistance of mycobacterium tuberculosis (MTB) in Sichuan.

METHODSGenoType reg; MTBDRplus Assay GTplus was used to examine 68 clinical isolates of MTB and 105 clinical specimens for mutations in rpoB, katG and inhA genes related to RFP and INH resistance.

RESULTSOf the 151 valid tests obtained, 44 (29.14%) and 26 (17.22%) showed drug resistance and multidrug resistance, respectively. Resistance to RFP and INH was found in 21.85% (33/151) and 24.50% (37/151) of the samples, respectively. The most prevalent mutations were rpoB S531L, katG S315T1 and inhA C-15T. The multidrug resistance rate in the sputum specimens was significantly higher than that in the non-respiratory samples (19.35% vs 7.41%).

CONCLUSIONDrug-resistant, especially multidrug-resistant tuberculosis is highly prevalent in Sichuan. The multidrug-resistant bacteria most frequently show rpoB S531L combined with katG S315T1 mutations, suggesting the necessity of developing rapid clinical identification methods for drug-resistant MTB to control the spread of the resistant strains.

DNA, Bacterial ; analysis ; Drug Resistance, Multiple, Bacterial ; Genotype ; Humans ; Isoniazid ; pharmacology ; Mycobacterium tuberculosis ; drug effects ; isolation & purification ; Reagent Kits, Diagnostic ; Rifampin ; pharmacology ; Sputum ; microbiology ; Tuberculosis, Multidrug-Resistant ; diagnosis ; microbiology

Objective To investigate the effect of hypobaric hypoxia and cold exposure on brown adipose tissue in mice. Methods Twenty-four 6-week old SPF C57BL/6 male mice were randomly divided into 4 groups with 6 mice in each group: normal atmospheric pressure and temperature group ( 18~22℃, 20~60 m ) ( NTNP ) , low atmospheric pressure and normal temperature group ( 18~22℃, altitude of 5000 m ) ( NTLP ) , normal atmospheric pressure and cold exposure group(0~6℃, altitude of 20 ~60 m)(LTNP), low atmospheric pressure and cold exposure group(0 ~6℃, altitude of 5,000 m)(LTLP). The experimental period was 4 weeks. The body weight was measured at the beginning and end of the experiment. By the end of the four-week trial, the back and inguinal fat were dissected and observed by histology using HE staining. The expression of UCP-1 as the marker of brown adipose tissue in the back fat was detected by qPCR and western blot. Results The body weight gain of NTNP group was higher ( P< 0. 05 ) than the other three groups. Meanwhile, the color of the back and groin fat tissue of mice of LTNP and LTLP groups were darker, the blood supply in mice of these two groups was richer than the NTLP group. The volume of adipose tissue of NTNP group was higher than others. The histology showed that the back adipose cells of the mice were smaller and darker and full of multilocular lipid droplets, exhibiting a typical morphology of brown fat cells. Compared with the NTNP and NTLP groups, the mRNA and protein levels of UCP-1 were higher under cold exposure, while low atmospheric pressure had a tendency to reduce the mRNA expression of UCP-1. Conclusions The formation of brown fat is affected by the imitated conditions of low atmospheric pressure and cold exposure, and is more closely related to the decresed temperature.

OBJECTIVETo investigate the potential value of combined examinations of peripheral blood smear, bone marrow smear, bone marrow biopsy, chromosome banding analysis and flow cytometry (FCM) in the diagnoisis of myelodysplastic syndromes.

METHODSA total of 105 MDS patients who were admitted in our hospital from May 2013 to May 2015 and were diagnosed as MDS according to the criteria formulated by WHO were enrolled in this study. The accordance rate of diagnosis by the double test (peripheral blood smear plus bone marrow smear), triple test (above mentioned 2 tests plus bone marrow biopsy), quadruple test (above 3 tests plus chromosome banding analysis), and quintuple test (above 4 plus FCM) was amalyzed and compared.

RESULTSAmong the 105 MDS patients, the diagnosis accordance rate was 70.48% for double tests, while 83.81%, 84.76% and 93.33% for triple, quadruple and quintuplet tests, respectively which were significantly higher than that for double tests (peripheral blood smear plus bone marrow smear) (P < 0.05).

CONCLUSIONThe combined examination of the 5 methods can improve the accuracy of MDS diagnosis.

Biopsy ; Bone Marrow Examination ; Chromosome Banding ; Flow Cytometry ; Humans ; Myelodysplastic Syndromes ; diagnosis

BACKGROUND: Renal artery stenosis (RAS) is always associated with abnormalities in renal microvascular perfusion (RMP). However, few imaging methods can simultaneously evaluate the degree of luminal stenosis and RMP. Thus, this study will aim to evaluate the feasibility of using contrast-enhanced ultrasound (CEUS) for assessing both RAS and RMP to achieve a one-stop assessment of patients with suspected renovascular hypertension. METHODS: This will be a single-center diagnostic study with a sample size of 440. Patients with chronic kidney disease (CKD) and suspected of having resistant hypertension will be eligible. Patients with Stages 1-3 CKD will undergo CEUS and computed tomography (CT) angiography (CTA). Values obtained by CEUS and CTA for diagnosing low-grade (lumen reduced by <60%) and high-grade (lumen reduced by ≥60%) RAS will be compared. Moreover, all patients will also undergo radionuclide imaging. The diagnostic value for RAS will be assessed by the receiver operating characteristic curve, including the accuracy, sensitivity, specificity, positive predictive values, negative predictive values, and area under the ROC. Pearson correlation analysis will be performed to assess the association between CEUS findings for RMP and glomerular filtration rate measured by a radionuclide imaging method. CONCLUSION: The data gathered from this study will be used to evaluate the feasibility of expanding clinical applications of CEUS for evaluation of patients with suspected renovascular hypertension. TRIAL REGISTRATION Chinese Clinical Trial Registry, ChiCTR1800016252; https://www.chictr.org.cn.
Contrast Media ; Glomerular Filtration Rate ; physiology ; Humans ; Hypertension, Renovascular ; physiopathology ; ROC Curve ; Renal Artery ; physiopathology ; Renal Artery Obstruction ; physiopathology