Abstract: Objective To understand the distribution and drug resistance of pathogenic bacteria of bloodstream infection in Fujian Province, and to provide reference for clinical rational drug use. Methods Bacteria identification and antimicrobial susceptibility test were carried out on the isolated strains of blood culture samples in 31 medical institutions in Fujian Province according to the unified plan. The data were statistically analyzed by WHONET 5.6 software according to the Clinical and Laboratory Standards Institute (CLSI) drug sensitivity executive standard in 2021. Results After removing the duplicate strains, 10 356 strains of bacteria were collected, including 3 668 strains of Gram-positive bacteria (35.4%) and 6 688 strains of Gram-negative bacteria (64.6%). The top 5 bacteria are Escherichia coli, Klebsiella pneumoniae, coagulase negative Staphylococcus, Staphylococcus aureus and Pseudomonas aeruginosa. In this study, the detection rate of methicillin-resistant Staphylococcus aureus (MRSA) was 24.5%, and the detection rate of methicillin-resistant coagulase-negative Staphylococcus aureus (MRCNS) was 76.8%. Vancomycin, teicoplanin and linezolid resistant staphylococci were not found. The detection rate of penicillin resistant Streptococcus pneumoniae was 3.2%. Vancomycin resistant Enterococcus faecalis and Enterococcus faecium were 0.8% and 1.1% respectively. The resistance rate of Escherichia coli to carbapenems was 0.8%, and the resistance rate to levofloxacin was 41.9%; the resistance rate of Klebsiella pneumoniae to carbapenems was 15.0%. The resistance rate of Acinetobacter baumannii to carbapenems was 45.1%; the detection rate of Pseudomonas aeruginosa was only 14.2%, and it maintained a high sensitivity to most drugs. Conclusions Most bloodstream infections in Fujian Province are caused by Escherichia coli, Klebsiella pneumoniae and Staphylococcus. The drug resistance of some strains is not optimistic, so we should continue to strengthen the clinical application management of antibiotics and use them correctly and reasonably. Keywords: Bloodstream infection; bacteria; antibiotics; drug resistance monitoring

A new steroidal ester, beta-rosaterol palmitate (1) along with ten known compounds, uvaol(2), 3-epi-ursolic acid (3), 2alpha, 3beta, 24-trihydroxyolean-12-en-28-oic acid (4), 2alpha, 3alpha, 24-trihydroxyurs-12-en-28-oic acid (5), 2alpha, 3alpha, 24-trihydroxyolean-12-en-28-oic acid (6), 2alpha, 3alpha, 24-trihydroxyolean-12-en-28-oic acid-28-O-beta-D-glucopyranosyl ester (7), (Z)-9-hexadecenoic acid (8), octacosyl alcohol (9), beta-sitosterol (10) and beta-daucosterol (11), has been isolated from the stems and leaves of Vitex trifolia. Their structures were elucidated using a combination of 1D and 2D NMR techniques (COSY, HMQC, and HMBC)and HR-ESI-MS analyses. Compounds 2-7 were isolated from this plant for the first time.
Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Magnetic Resonance Spectroscopy ; Molecular Structure ; Spectrometry, Mass, Electrospray Ionization ; Vitex ; chemistry

Objective To analyze the etiology of cerebral ischemic complications occurring in perioperative period of interventional therapy for intracranial aneurysms,and to discuss its prevention and treatment.Methods From January 2011 to March 2015,a total of 1106 patients with intracranial aneurysms underwent interventional therapy at the First Affiliated Hospital of Zhengzhou University,China.Among the 1106 patients,48 patients developed cerebral ischemic complications;their clinical data and the imaging materials were retrospectively analyzed.The factors associated with complications,the effective therapeutic scheme and the clinical preventive methods were discussed.Three months after the treatment,the recovery of neurological function was assessed with modified Rankin Scale (mRS).Results The causes of ischemic complications were,in order of decreasing frequency,cerebral vasospasm/unable elimination of microemboli (n=19),thrombus (n=16),impaired blood flow of adjacent perforating or distal vascular branches caused by embolization (n=6),intra-procedural hypotension (n=4) and cerebral edema (n=3).Combined treatments,including integrated anticoagulation,anti-platelet aggregation,anti-vasospasm,medication of elevating blood pressure,endovascular intervention,etc.were adopted.The patients were followed up for 3 months.Thirty-four patients (70.8％) obtained a mRS of ≤2 (no serious sequelae),and mRS＞2 (poor prognosis) was seen in 14 patients (29.2％).Conclusion The etiology of cerebral ischemia occurring during interventional treatment of intracranial aneurysms is complicated.It is necessary to take useful measures such as individualized anticoagulation,anti-platelet aggregation,anti-vasospasm,etc.during perioperative period of interventional therapy.The procedure-related complications can be effectively treated with interventional therapy and reliably prevented by careful and skilled surgical manipulation.

Objective To evaluate the clinical training outcomes from two clinical practice modes for undergraduate students. Methods Total two grades 2009 and 2010,150 undergraduate students were randomly divided into two groups: 69 students in group A and 81 students in group B. The synthetic teaching mode was applied in group A,and group B received the traditional teaching mode. The Objective Structure Clinical Examination (OSCE)and a written comprehensive examination were used to evaluate the training outcomes by T test analyzed by SPSS 17.0(α= 0.05). Results The theoretical level of 2009 grade students was better than that of 2010 grade (P < 0.05). The clinical practice skills of the two groups had no significant difference(P > 0.05). There were no significant differences between two groups in theoretical and clinical training(P > 0.05). Comparing with the 2010 grade,the theoretical level of the 2009 was better,but the clinical skill level was weaker. Conclusion Synthetic teaching mode and traditional teaching mode both achieved good outcomes. In order to obtain better comprehensive progresses,the two teaching modes need to be combined. The orientation by following the requirements of oral practicing qualification examination may enhance the clinical skills of the students.

Objective To investigate the influence of curettage of uterine cavity and hysteroscopy detection before operation on detection rate of abdominal cavity and the survival rate of patients with endometrial carcinoma. Methods 120 patients with endometrial carcinoma were chosen in the period from March 2011 to December 2013 were divided into 2 groups including curettage of uterine cavity group (64 patients) with curettage of uterine cavity and hysteroscopy group (56 patients) with hysteroscopy detection according to preoperative examinations methods; and the eligible rate of specimens, the concordance rate of pathological diagnosis, the detection rate of peritoneal cytology, the overall survival rate and progression free survival rate in 3 years with follow-up of both groups were compared. Results There was no significant difference in the eligible rate of specimens and the concordance rate of pathological diagnosis between the two groups (P > 0.05). The detection rate of ascites cytology of hysteroscopy group were significantly higher than curettage of uterine cavity group (P < 0.05). There was no significant difference in the overall survival rate and progression free survival rate in 3 years with follow-up between the two groups (P > 0.05). Conclusion Curettage of uterine cavity and hysteroscopy detection before operation on patients with endometrial carcinoma posses the same diagnosis value; And hysteroscopy detection maybe peritoneal metastasis risk, but have no effect on long-term survival and larger randomized controlled trials should be necessary.

Adult ; Female ; Humans ; Male ; Medial Collateral Ligament, Knee ; injuries ; surgery ; Middle Aged ; Reconstructive Surgical Procedures ; methods

The overexpression of doublecortin-like kinase 1 (DCLK1) is closely related to the occurrence and development of various malignant tumors. Discovery of novel anti-tumor agents targeting DCLK1 represents a hot spot in this field. So far, several DCLK1 small molecule inhibitors with excellent anti-tumor activity in vitro and in vivo have been designed and synthesized, which is expected to provide a new strategy for tumor therapy. This article reviews the research progress in the discovery, structure type, structural optimization, biological activity and mechanism of action of DCLK1 small molecule inhibitors, and provides research basis for the development of new anti-tumor small molecule inhibitors targeting DCLK1.

Objective To investigate the evaluation value of magnetic resonance spectroscopy (MRS) combined with S-100B protein in the severity and prognosis in patients with acute subdural hematoma ( ASDH).Methods Eighty cases of ASDH patients and 20 cases of healthy check-up were selected.MRS was used to test NAA/Cr, Cho/Cr, NAA/Cho, and Glx /Cr in thalamus and corpus callosum.The blood S-100B protein was detected in 72 h after injury.The relationships of those MRS detection indices with glasgow coma scale ( GCS) and glasgow prognostic score ( GOS) for 2 months after injury were analyzed .Results MRS detection in-dex and the S100B protein in ASDH were compared between each group relative to normal control group , all difference had statistical significance ( P <0.05).As aggravating the severity of traumatic brain injury , Cho/Cr, Glx/Cr ratio, and S-100B protein concentra-tion were elevated , and NAA/Cho and NAA/Cr were reduced .All differences were statistically significant among poor recovery , good recovery, and normal control groups ( P <0.05).For patients with traumatic brain injury, there were worse prognosis, the higher ra-tios of Cho/Cr and Glx/Cr, higher concentration of S-100B protein, and lower ratios of NAA/Cho and of NAA/Cr.GCS score and GOS scores were negatively correlated with Cho/Cr and Glx/Cr ratios of corpus callosum , and were positively correlated with NAA/Cho, NAA/Cr ratios of corpus callosum .S-100B protein was positively correlated with Cho/Cr and Glx/Cr, and was negatively correlated with NAA/Cho and NAA/Cr.MRS combined S-100B can improve the prognosis of patients with up to the accuracy of 81%.Conclu-sions MRS detection in the early stage after injury of ASDH patients has important value in assessment of the severity of the injury and its prognosis , the accuracy of assessment of prognosis is improved with a combination of MRS detection and blood S -100 B protein meas-urement.

OBJECTIVETo study clinical outcomes of Chinese medidine fumigation and massage therapy for the treatment of knee stability and functional recovery after anterior cruciate ligament reconstruction operation,and to explore the effect on tendon-bone healing.

METHODSTotal 50 patients were divided into two groups: the control group (normal rehabilitation therapy group),the treatment group (Chinese medicine fumigation and manipulation group). There were 25 patients in the control group, including 16 males and 9 females, who were treated with isometric muscle training, with the gradually enlarging amplitude of flexion and progressive loading of bearing training for knee recovery. There were 25 patients in the treatment group, including 15 males and 10 females,who were treated with the conventional rehabilitation therapy combined with Chinese medicine fumigation and massage therapy. The Chinese herbs named as Haitongpi decoction was steamed by a special equipment to fumigate the knee after operation; Based on the biomechanical parameters of the ligament reconstruction, the massage therapy was designed to control the degree of the knee flexion and release the adhesion for early recovery of knee functions. The Lysholm knee function evaluation system was used, and MRI examination was performed to measure the change in width of ligament tunnel in femur and tibia to evaluate the safety and stability of the treatment.

RESULTSLysholm system showed that two groups both had improving results from the 1st month after operation to the 3rd month (treatment group, F=36.54, P<0.05; the control group, F=28.12, P<0.05), and the results of the treatment group was better than that of the control group at the observation point (the 1st month, t=0.105, P<0.05; the 3rd month, t=5.361, P<0.01). There was no difference between the two groups when evaluating the bone and tendon healing 3 and 12 months after operation (P>0.05), indicating that Chinese rehabilitation therapy was a safety treatment without the influence on the loosing of tendon.

CONCLUSIONChinese medicine fumigation and massage therapy can early improve the knee function after the anterior cruciate ligament reconstruction operation without the disturbance of the knee stability.

Adult ; Anterior Cruciate Ligament ; surgery ; Anterior Cruciate Ligament Injuries ; Anterior Cruciate Ligament Reconstruction ; Case-Control Studies ; Combined Modality Therapy ; Drugs, Chinese Herbal ; administration & dosage ; chemistry ; Female ; Fumigation ; Humans ; Knee Injuries ; drug therapy ; physiopathology ; surgery ; therapy ; Knee Joint ; drug effects ; physiopathology ; surgery ; Male ; Massage ; Range of Motion, Articular ; Recovery of Function

Animals ; Disease Progression ; Kidney Diseases ; physiopathology ; Kidney Glomerulus ; drug effects ; pathology ; Rats ; Renal Agents ; pharmacology ; Renin-Angiotensin System ; drug effects ; Sclerosis