Objective To investigate the distribution and antimicrobial resistance profile of the bacterial strains isolated from Chuzhou First People's Hospital in 2016.Methods The bacterial isolates were identified and tested for antibiotic susceptibility using MicroScan WalkAway 96 PLUS bacterial identification system.All the data were analyzed with WHONET 5.6 software.Results A total of 1 441 clinical isolates were collected during 2016,of which gram-positive organisms accounted for 28.4％ and gram-negative organisms 71.6％.Prevalence of methicillin-resistant strains in S.aureus (MRSA) and coagulase negative Staphylococcus (MRCNS) was 37.5％ and 83.0％,respectively.All Staphylococcus isolates were susceptible to vancomycin,daptomycin and linezolid.All E.faecium isolates were susceptible to daptomycin,vancornycin and linezolid.One strain (2.6％) of E.faecalis was resistant to linezolid.All Streptococcus pneumoniae strains (mainly isolated from children) were susceptible to penicillin.The prevalence of extended-spectrum beta-lactamases (ESBLs) positive strains was 49.1％,24.2％ and 62.5％ in E.coli,Klebsiella (K.pneumoniae and K.oxytoca) and P mirabilis,respectively.The resistance rate of ESBLs-positive strains was higher than ESBLs-negative strains to most antibiotics.The percentage of the P.aeruginosa isolates resistant to meropenem and imipenem was all 10.4％.The percentage of Acinetobacter (A.baumannii accounted for 95.0％) strains resistant to imipenem and meropenem was 79.0％ and 78.2％.Conclusions The situation of antibiotic resistance is still very serious in 2016 in this hospital.The prevalence of carbapenemresistant K.pneumoniae and 4.baumannii is still increasing,which is of great concern.

Objective To investigate the distribution and antibiotic resistance of bacterial isolates from Children's Hospital of Chuzhou during the period from January 2014 through December 2016.Methods A retrospective analysis was carried out for 1 057 bacterial strains isolated from clinical specimens from January 2014 through December 2016.Results Of the 1 057 clinical isolates collected,gram positive organisms and gram-negative organisms accounted for 45.3％ (479/1 057) and 54.7％ (578/1 057),respectively.The top 5 most frequently isolated microorganisms were E.coli (19.6％),S.aureus (15.9％),Klebsiella spp.(14.4％),coagulase negative Staphylococcus (12.6％) and S.pneumoniae (9.1％).All the S.pneumoniae isolates were susceptible to penicillin.Prevalence of MRSA was 29.8％ among S.aureus and the prevalence of MRCNS was 74.4％ in CNS.All Staphylococcus strains were susceptible to daptomycin,linezolid and vancomycin.E.faecium strains showed much higher resistance rate to most of the antimicrobial agents tested than E.faecalis.The prevalence of ESBLs-positive strains was 50.2％ in E.coli,32.4％ in Klebsiella spp.(K.pneumoniae and K.oxytoca) and 83.3％ in P.mirabilis,respectively.The Enterobacteriaceae strains were highly sensitive to carbapenems.A total of 12 (2.5％) carbapenem-resistant strains were identified from 485 Enterobacteriaceae isolates.P aeruginosa and Acinetobacter spp.were highly sensitive to carbapenems.Conclusion Gram negative bacteria are still dominant pathogens in clinical practice.It is necessary to strengthen monitoring of antibiotic resistance,which is still a serious issue of great concern.

OBJECTIVE: To assess the clinical efficacy and health economic value of non-invasive prenatal testing (NIPT) for the prenatal screening of common fetal chromosomal aneuploidies. METHODS: 10 612 pregnant women from October 2017 to December 2019 presented at the antenatal screening clinic of the General Hospital of Tianjin Medical University were selected as the study subjects. Results of NIPT and invasive prenatal diagnosis and follow-up outcome for the 10 612 pregnant women were retrospectively analyzed and compared. Meanwhile, NIPT data for two periods were analyzed for assessing the health economic value of NIPT as the second- or first-tier screening strategy for the prenatal diagnosis of fetal trisomies 21, 18 and 13. RESULTS: The NIPT was successful in 10 528 (99.72%) subjects, with the sensitivity for fetal trisomies 21, 18 and 13 being 100%, 92.86% and 100%, and the positive predictive value (PPV) being 89.74%, 61.90% and 44.44%, respectively. The PPV of NIPT for sex chromosome aneuploidies was 34.21%. Except for one false negative case of trisomy 18, the negative predictive value for trisomy 21, trisomy 13 and other chromosomal abnormalities were 100%. For pregnant women with high risk by serological screening, advanced maternal age or abnormal ultrasound soft markers, NIPT has yielded a significantly increased high risk ratio. There was no statistical difference in the PPV of NIPT among pregnant women from each subgroup. NIPT would have higher health economic value as a second-tier screening until 2019, while compared to 2015 ~ 2017, its incremental cost-effectiveness ratio as a first-tier screening had declined clearly. CONCLUSION The screening efficacy of NIPT for trisomies 21, 18 and 13 for a mixed population is significantly better than conventional serological screening, but it is relatively low for sex chromosomal abnormalities. NIPT can also be recommended for populations with relatively high risks along with detailed pre- and post-test genetic counselling. From the perspective of health economics, except for open neural tube defects, it is possible for NIPT to replace the conventional serological screening in the future as its cost continues to decrease.
Pregnancy ; Female ; Humans ; Trisomy/genetics* ; Retrospective Studies ; Prenatal Diagnosis/methods* ; Down Syndrome/genetics* ; Aneuploidy ; Chromosome Aberrations ; Trisomy 18 Syndrome/genetics* ; Sex Chromosome Aberrations ; Fetus

Objective To investigate the bacterial resistance profile of clinical isolates collected in the hospitals across Chuzhou in 2016. Methods Antimicrobial susceptibility testing was carried out by Kirby-Bauer method. The data were analyzed using WHONET 5.6 software according to CLSI 2015 breakpoints. Results A total of 5 465 clinical isolates were collected during 2016, of which gram positive organisms and gram negative organisms accounted for 25.9％ (1 416/5 465) and 74.1％ (4 049/5 465), respectively. Prevalence of MRSA was 37.6％ among S. aureus and the prevalence of MRCNS was 78.1％ in CNS. All Staphylococcus, E. faecalis and E. faecium isolates were sensitive to vancomycin and linezolid. The prevalence of extended spectrum-lactamases (ESBLs) positive strains was 51.2％ in E. coli, 23.4％ in Klebsiella spp. (K. pneumoniae and K. oxytoca), and 23.6％ in P. mirabilis isolates, respectively. The Enterobacteriaceae strains were highly sensitive to carbapenems. The percentage of the P. aeruginosa isolates resistant to the antimicrobials tested was lower than 30％. The percentage of the Acinetobacter strains resistant to meropenem and imipenem was 65.6％ and 67.4％, respectively. Conclusions The situation of antibiotic resistance is still very serious, especially multi-drug or pan-drug resistant strains, which is of great concern.

ObjectiveTo investigate the quality of life and demands of family members of patients with mental disorders in hospice care， in order to create a better medical care environment for patients to meet their demands. MethodsA total of 205 family members of patients with mental disorders in hospice care were consecutively sampled from two special psychiatric hospitals in Deyang city with convenient sampling method. The Chinese version of WHO Quality of Life-BREF （WHOQOL-BREF） and Critical Care Family Needs Inventory （CCFNI） were used to assess the quality of life and demands of family members. ResultsAmong the patients' family members， WHOQOL-BREF scored （68.08±9.98） in the physiological field， （63.82±9.39） in the psychological field， （70.73±12.61） in the social relations field， and （64.24±11.87） in the environmental field. Compared with the domestic general population， there were significant differences in other fields except the physiological field （t=3.066， 9.845， 16.109， P<0.01）. In CCFNI， the score of condition assurance factor was （3.20±0.41）， information support was （2.86±0.50）， proximity to patients was （2.79±0.46）， self comfort was （2.35±0.47）， and medical staff support was （2.60±0.44）. ConclusionThe quality of life of the family members of patients with mental disorders in hospice care may be higher than that of the general population， and their demands mainly focus on the condition assurance and information support.

Chuanxiong Rhizoma (CX, the dried rhizome of Ligusticum wallichii Franch.), a well-known traditional Chinese medicine, is clinically used for treating cardiovascular, cerebrovascular and hepatobiliary diseases. Cholestatic liver damage is one of the chronic liver diseases with limited effective therapeutic strategies. Currently, little is known about the mechanism links between CX-induced anti-cholestatic action and intercellular communication between cholangiocytes and hepatic stellate cells (HSCs). The study aimed to evaluate the hepatoprotective activity of different CX extracts including the aqueous, alkaloid, phenolic acid and phthalide extracts of CX (CX_AE, CX_AL, CX_PA and CX_PHL) and investigate the intercellular communication-related mechanisms by which the most effective extracts work on cholestatic liver injury. The active compounds of different CX extracts were identified by UPLC-MS/MS. A cholestatic liver injury mouse model induced by bile duct ligation (BDL), and transforming growth factor-β (TGF-β)-treated human intrahepatic biliary epithelial cholangiocytes (HIBECs) and HSC cell line (LX-2 cells) were used for in vivo and in vitro studies. Histological and other biological techniques were also applied. The results indicated that CX_AE, CX_AL and CX_PHL significantly reduced ductular reaction (DR) and improved liver fibrosis in the BDL mice. Meanwhile, both CX_AE and CX_PHL suppressed DR in injured HIBECs and reduced collagen contraction force and the expression of fibrosis biomarkers in LX-2 cells treated with TGF-β. CX_PHL suppressed the transcription and transfer of plasminogen activator inhibitor-1 (PAI-1) and fibronectin (FN) from the 'DR-like' cholangiocytes to activated HSCs. Mechanistically, the inhibition of PAI-1 and FN by CX_PHL was attributed to the untight combination of the acetyltransferase KAT2A and SMAD3, followdd by the suppression of histone 3 lysine 9 acetylation (H3K9ac)-mediated transcription in cholangiocytes. In conclusion, CX_PHL exerts stronger anti-cholestatic activity in vivo and in vitro than other CX extracts, and its protective effect on the intracellular communication between cholangiocytes and HSCs is achieved by reducing KAT2A/H3K9ac-mediated transcription and release of PAI-1 and FN.