Objective: To investigate distribution and drug resistance of pathogens of burn patients. Methods: A total of 3 357 strains were cultured and isolated from 25 286 specimens of wounds excretion, deep venous catheters, venous blood, stool, mid-stream urine, sputum, puncture fluid, and throat swab of 11 510 burn patients hospitalized in our burn wards from January 2007 to December 2015. After being identified by API bacteria identification panels and automatically bacteria identification equipment, drug-resistances of Staphylococcus aureus, Pseudomonas aeruginosa, Acinetobacter baumannii, and Klebsiella pneumoniae to 28 common antibiotics were tested by drug sensitivity test with K-B paper disk diffusion method. The WHONET 5.6 software was used to analyze constituent ratio of gram-negative bacteria and gram-positive bacteria in each year, distribution of pathogens in each year, and drug resistance of the above-mentioned 4 pathogens in 9 years to 28 common antibiotics. Data were analyzed by the linear model curve fitting. Results: (1) From 2007 to 2015, constituent ratios of gram-negative bacteria were respectively 41.22% (101/245), 41.88% (165/394), 45.92% (169/368), 42.54% (208/489), 52.35% (267/510), 56.89% (194/341), 58.99% (210/356), 56.95% (172/302), and 50.28% (177/352), with significantly increasing trend (R²=0.625, P<0.05); constituent ratios of gram-positive bacteria were respectively 58.78% (144/245), 58.12% (229/394), 54.08% (199/368), 57.46% (281/489), 47.65% (243/510), 43.11% (147/341), 41.01% (146/356), 43.05% (130/302), 49.72% (175/352), with significantly decreasing trend (R²=0.625, P<0.05). In 9 years, constituent ratio of Staphylococcus aureus ranked the first in all bacteria, and constituent ratios of Pseudomonas aeruginosa and Klebsiella pneumoniae were with significantly increasing trend (R²=0.811, 0.778, P<0.01). (2) In 9 years, drug-resistant rates of Staphylococcus aureus to gentamycin and rifampicin were with significantly decreasing trend (R²=0.727, 0.766, P<0.01); drug-resistant rates of Staphylococcus aureus to phosphonomycin were always in lower levels of 4.6% to 19.5%. In 9 years, drug-resistant rates of Pseudomonas aeruginosa to ceftazidime and ciprofloxacin had no significant change in trend (R²=0.023, <0.001, P>0.05), while drug-resistant rates of Pseudomonas aeruginosa to other 10 common antibiotics were with significantly increasing trend (R²=0.764, 0.793, 0.785, 0.768, 0.752, 0.749, 0.789, 0.786, 0.706, 0.629, P<0.01). In 9 years, drug-resistant rate of Acinetobacter baumannii to ampicillin/sulbactam was with significantly decreasing trend (R²=0.652, P<0.01), and drug-resistant rate of Acinetobacter baumannii to amikacin was with significantly increasing trend ( R²=0.531, P<0.05). In 9 years, drug-resistant rates of Klebsiella pneumoniae to piperacillin, ampicillin/sulbactam, cefuroxime, ceftazidime, cefotaxime, cefepime, imipenem, meropenem, amikacin, and gentamicin were with obviously increasing trend (R²=0.481, 0.672, 0.694, 0.532, 0.810, 0.641, 0.809, 0.709, 0.579, 0.810, P<0.05 or P<0.01). Conclusions Constituent ratios of gram-positive bacteria of Pseudomonas aeruginosa and Klebsiella pneumoniae of burn patients hospitalized in our burn wards from 2007 to 2015 were significantly increased, while constituent ratios of Staphylococcus aureus of those children always ranked the first. Drug-resistence of bacteria of those children in our burn wards was serious. Drug-resistant rate of Staphylococcus aureus only to phosphonomycin was always in lower level. Drug-resistant rates of Pseudomonas aeruginosa to 10 common antibiotics except ceftazidime and ciprofloxacin were significantly increased. Drug-resistant rate of Acinetobacter baumannii only to ampicillin/sulbactam was significantly decreased. Drug-resistant rates of Klebsiella pneumoniae to most common antibiotics were significantly increased.

OBJECTIVETo study changes in the drug-resistance of Pseudomonas aeruginosa (PA) and the use of antibiotics in burn wards so as to optimize the use of antibiotic in the future.

METHODSBacteria were isolated from specimens of blood, venous catheter, stool, sputum, urine, wound tissue from 5717 patients hospitalized in our burn wards within the duration of January 2005 to December 2009. The number of specimens examined and positive rates of bacteria were calculated. Changes in constituent ratio of cocci and bacilli, spectrum of bacteria, the drug-resistance rate of PA, and the usage of antibiotics were analyzed. The number of specimens examined, constituent ratio of cocci and bacilli, drug-resistance rate were processed with chi-square test. Bivariate correlation analysis was performed between the usage of antibiotics and the drug-resistance rate.

RESULTS(1) The number of specimens examined showed no statistical difference during the five years (with rates from 73.2% to 76.1%, χ(2) = 5.583, P > 0.05), while constituent ratio of cocci and bacilli showed statistical difference (with ratios from 105:134 to 169:126, χ(2) = 14.806, P < 0.01). The positive rates of bacteria were increasing in the five years. (2) One thousand six hundred and seventy-five strains were identified during the five years from different kinds of specimens, with 29 from blood, 39 from venous catheter, 3 from stool, 157 from sputum, 13 from urine, and 1434 from wound tissue. Among them, Staphylococcus aureus accounted for 28% to 42%, PA accounted for 10% to 25%, Acinetobacter baumannii accounted for 10% to 19%, and they were the predominant strains. (3) The difference among drug-resistance rates of PA to each kind of 12 antibiotics during the five years were statistically significant (with χ(2) values from 47.911 to 308.095, P values all below 0.01). The drug-resistance rates of PA to some antibiotics showed downward trend in the former four years, including amikacin, ceftazidime, and imipenem/cilastatin, but it rebounded in the fifth year. (4) There was descending trend in usage of cefoperazone/sulbactam and levofloxacin, but vancomycin was always used widely. (5) Drug-resistance rates of PA to 7 antibiotics, including amikacin, imipenem/cilastatin, and ciprofloxacin, etc., were positively correlated with usage of various antibiotics (with r values from 0.879 to 0.978, P < 0.05 or P < 0.01).

CONCLUSIONSIn our burn wards, drug-resistant PA was prevalent. Disinfection and isolation measures, appropriate use of antibiotics, etc. can reduce PA infection.

Anti-Bacterial Agents ; therapeutic use ; Burn Units ; Burns ; drug therapy ; microbiology ; Drug Resistance, Bacterial ; drug effects ; Female ; Humans ; Male ; Pseudomonas Infections ; drug therapy ; microbiology ; Pseudomonas aeruginosa ; drug effects ; isolation & purification

OBJECTIVETo explore the molecular mechanism of APL cell resistance to ATRA.

METHODSThe ATRA sensitive and resistant APL cell lines, NB4 and NB4-R1, were used as in vitro models. The effects of specific inhibitors and activators of adenylate cyclase (AC) and phosphodiesterase (PDE) on ATRA-induced differentiation was evaluated by cell morphology, cell surface antigen expression and nitroblue-tetrazolium (NBT) reduction assays.

RESULTSSQ22536, a specific antagonist of AC, could dramatically block ATRA-induced NB4 cell differentiation. When ATRA + SQ22536 group compared with ATRA group, the positivity of CD11b decreased from (95.9 +/- 2.5)% to (60.3 +/- 7.1)%, while the A(540) in NBT reduction assay decreased from 0.585 +/- 0.092 to 0.170 +/- 0.028 (P < 0.05). Forskolin, an agonist of AC, could overcome the resistance of NB4-R1 cells to ATRA. When ATRA + forskolin group compared with ATRA group, the positivity of CD11b increased from (34.3 +/- 5.3)% to (94.6 +/- 2.4)%, while the A(540) in NBT reduction assay increased from 0.110 +/- 0.028 to 0.395 +/- 0.049 (P < 0.05). In contrast, the specific antagonist and agonist of PDE, 3-isobutyl-1-methylxanthine (IBMX) and calmodulin, exerted little impact on ATRA treatment.

CONCLUSIONSThe defaults in the initiation of AC activation may contribute to the resistance to ATRA in some APL cells.

Adenine ; analogs & derivatives ; pharmacology ; Adenylyl Cyclase Inhibitors ; Adenylyl Cyclases ; metabolism ; Antineoplastic Agents ; pharmacology ; CD11b Antigen ; metabolism ; Cell Differentiation ; drug effects ; Cell Line, Tumor ; Drug Resistance, Neoplasm ; drug effects ; Enzyme Activation ; drug effects ; Enzyme Inhibitors ; pharmacology ; Humans ; Leukemia, Promyelocytic, Acute ; metabolism ; pathology ; Phosphoric Diester Hydrolases ; metabolism ; Tretinoin ; pharmacology

OBJECTIVETo study difference in curative effect between intermingled skin transplantation (IT) and microskin grafting (MG) in repairing massive deep burn.

METHODSClinical materials of 101 patients with massive deep burn hospitalized from 1992 to 2008 were retrospectively summarized. Patients were divided into IT group (n = 52) and MG group (n = 49). The size of initial donor site for autologous skin, the wound size initially covered with autologous skin, the survival rate of initial autologous skin grafting, the theoretical expansion multiple of the autologous skin, the actual expansion multiple of the autologous skin, the total size of donated autologous skin, the remained wound condition, and the function of large joint of patients in two groups were compared.

RESULTSIn IT group and MG group, the size of initial donor site for autologous skin was respectively (3.25 +/- 0.48)%TBSA and (3.01 +/- 0.21)%TBSA, the wound size initially covered by autologous skin was respectively (30.4 +/- 3.6)%TBSA and (41.4 +/- 1.3)%TBSA, the survival rate of autologous skin grafting was respectively (99.9 +/- 1.9)% and (87.5 +/- 6.8)%, the theoretical expansion multiple of the autologous skin was respectively 9.5 +/- 1.3 and 13.9 +/- 1.4, the actual expansion multiple of the autologous skin was respectively 9.5 +/- 1.3 and 12.0 +/- 1.5, the difference between two figures of each index was statistically significant (P < 0.05). There was no statistical significant difference between IT and MG group in respect of the total size of donated autologous skin [respectively (14.2 +/- 1.9) and (14.0 +/- 2.1)%TBSA, P > 0.05]. There were 23 patients (44.2%) with residual wounds over 0.5%TBSA in IT group, and 37 cases (75.5%) in MG group. There were 34 patients (65.4%) with good function of large joints in IT group, and 18 cases (36.7%) in MG group.

CONCLUSIONSExpansion multiple of autologous skin after MG is obviously larger than that after IT, thus limited skin source can be fully used. The wound healing quality and the restoration of large joint function of patients treated with IT are better than those of patients treated with MG.

Adult ; Burns ; surgery ; Humans ; Retrospective Studies ; Skin ; injuries ; Skin Transplantation ; methods ; Surgical Flaps ; Transplantation, Autologous ; Wound Healing

OBJECTIVETo study the distribution characteristics of pathogens, the drug resistance of Pseudomonas aeruginosa (PA), and the use of antibiotics against Gram negative bacilli (GNB) in burn wards, so as to provide a guide for future treatment.

METHODSA total of 2 758 strains of pathogens were isolated from specimens of wound excretion, venous catheter attachment, blood, stool, urine, and sputum from 7 441 patients hospitalized in our burn wards from January 2007 to December 2012. After being identified by API strips and automatic microorganism identification and drug sensitivity analyzer, drug resistance of all the pathogens to 13 antibiotics commonly used in clinic, including amikacin, cefoperazone/sulbactam, ceftazidime, etc., was tested by K-B paper disk diffusion method. The defined daily doses per 1 000 patient-day of 5 antibiotics including amikacin, cefoperazone/sulbactam, ceftazidime, imipenem, and ciprofloxacin each year was set as use intensity. The WHONET 5.6 software was used to analyze the distribution of pathogens and the drug resistance of PA to 13 antibiotics. The SPSS 19.0 software was used to analyze the relation between changes in drug-resistant rates of PA to 13 antibiotics and year, the relation between the proportion of PA in all the pathogens and the use intensity of 5 antibiotics commonly used against GNB, and the relation between the use intensity of ciprofloxacin and the change in drug-resistant rates of PA to amikacin, cefoperazone/sulbactam, and imipenem with Pearson correlation analysis.

RESULTS(1) In 6 years, Staphylococcus aureus ranked the first with the highest proportion (31%, 865/2 758). The proportion of PA increased to tie in with Acinetobacter baumannii (both accounting for 17%, 458/2 758), both taking the second place. (2) Drug-resistant rates of PA to amikacin, gentamicin, aztreonam, piperacillin, cefoperazone, cefepime, piperacillin/tazobactam, cefoperazone/sulbactam, imipenem, and meropenem were significantly increased and positively correlated with year (with r values from 0.844 to 0.988, P < 0.05 or P < 0.01), while the drug-resistant rate of PA to ciprofloxacin was decreased and negatively correlated with year (r = -0.836, P < 0.05). (3) In 6 years, the use intensity of amikacin (from 8.65 to 91.44), cefoperazone/sulbactam (from 9.62 to 63.56), imipenem (from 7.63 to 157.25), ceftazidime (from 18.39 to 86.11), and ciprofloxacin (from 0 to 19.77) was increased. (4) The proportion of PA in all the pathogens was positively correlated with the use intensity of imipenem and ciprofloxacin (with r values respectively 0.849, 0.933, P < 0.05 or P < 0.01), while it was not significantly correlated with the use intensity of amikacin, cefoperazone/sulbactam, or ceftazidime (with r values respectively 0.672, 0.668, 0.794, P values all above 0.05). (5) The use intensity of ciprofloxacin was positively correlated with the drug-resistant rates of PA to amikacin, cefoperazone/sulbactam, and imipenem (with r values respectively 0.878, 0.934, 0.928, P < 0.05 or P < 0.01).

CONCLUSIONSIn our burn wards, drug-resistant PA was prevalent, with positive correlation with the use intensity of antibiotics. The sensitive rate can be increased by a decrease in the use of amikacin, cefoperazone/sulbactam, and imipenem periodically.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents ; pharmacology ; therapeutic use ; Burns ; drug therapy ; microbiology ; Child ; Child, Preschool ; Cross Infection ; microbiology ; Drug Resistance, Bacterial ; Female ; Humans ; Infant ; Male ; Microbial Sensitivity Tests ; Middle Aged ; Pseudomonas aeruginosa ; drug effects ; isolation & purification ; Young Adult

OBJECTIVETo explore the feasibility of in vivo tracking of bone marrow mesenchymal stem cells (BMSCs) labeled with superparamagnetic iron oxide (SPIO) by magnetic resonance imaging (MRI) in rats after cerebral ischemia, and to analyze the influence of stem cell therapy on the volume of cerebral infarction.

METHODSThe samples of rat bone marrow were collected. BMSCs separated by density gradient centrifugation were cultivated and harvested until the third passage. BMSCs were labeled with SPIO, which was mixed with poly-L-lysine. The labeling efficiency was evaluated by Prussian blue staining. Transient middle cerebral arterial occlusion (MCAO) was performed successfully in 18 adult Sprague-Dawley rats that scored from 6 to 12 by the modified neurological severity test. The 18 rats were then randomly divided into group A, B, and C, with 6 rats in each group and Group C was regarded as control group. BMSCs were injected into the contralateral cortex of ischemia in group A, ipsilateral corpora striata in group B, while D-Hank's solution was injected into ipsilateral corpora striata (group C) 24 hours after MCAO. MRI was performed 1 day after MCAO, 1 day and 14 days after transplantation. The volume of infarcted brain tissue was measured and analyzed. Prussian blue staining of brain tissues was performed to identify the migration of BMSCs.

RESULTSThe labeling efficiency of BMSCs with SPIO was 96%. The transplanted BMSCs migrated to the ischemic hemisphere along the corpus callosum and to the border of the infarction, which was confirmed by MRI and Prussian blue staining. The changes of infarction volume were not significantly different among these three groups.

CONCLUSIONSMRI is feasible for in vivo tracking of BMSCs labeled with SPIO in rats. The stem cell therapy may not be able to affect the volume of cerebral infarction.

Animals ; Brain ; pathology ; Cells, Cultured ; Dextrans ; Disease Models, Animal ; Feasibility Studies ; Ferrosoferric Oxide ; Magnetic Resonance Imaging ; methods ; Magnetite Nanoparticles ; Male ; Mesenchymal Stem Cell Transplantation ; Rats ; Rats, Sprague-Dawley ; Staining and Labeling ; methods ; Stroke ; pathology ; surgery

BACKGROUNDOur previous studies have demonstrated that Tongxinluo (TXL), a traditional Chinese medicine, can protect hearts against no-reflow and reperfusion injury in a protein kinase A (PKA)-dependent manner. The present study was to investigate whether the PKA-mediated cardioprotection of TXL against no-reflow and reperfusion injury relates to the inhibition of myocardial inflammation, edema, and apoptosis.

METHODSIn a 90-minute ischemia and 3-hour reperfusion model, minipigs were randomly assigned to sham, control, TXL (0.05 g/kg, gavaged one hour prior to ischemia), and TXL + H-89 (a PKA inhibitor, intravenously and continuously infused at 1.0 µg/kg per minute) groups. Myocardial no-reflow, necrosis, edema, and apoptosis were determined by pathological and histological studies. Myocardial activity of PKA and myeloperoxidase was measured by colorimetric method. The expression of PKA, phosphorylated cAMP response element-binding protein (p-CREB) (Ser(133)), tumor necrosis factor α (TNF-α), P-selectin, apoptotic proteins, and aquaporins was detected by Western blotting analysis.

RESULTSTXL decreased the no-reflow area by 37.4% and reduced the infarct size by 27.0% (P < 0.05). TXL pretreatment increased the PKA activity and the expression of Ser(133) p-CREB in the reflow and no-reflow myocardium (P < 0.05). TXL inhibited the ischemia-reperfusion-induced elevation of myeloperoxidase activities and the expression of TNF-α and P-selectin, reduced myocardial edema in the left ventricle and the reflow and no-reflow areas and the expression of aquaporin-4, -8, and -9, and decreased myocytes apoptosis by regulation of apoptotic protein expression in the reflow and no-reflow myocardium. However, addition of the PKA inhibitor H-89 counteracted these beneficial effects of TXL.

CONCLUSIONPKA-mediated cardioprotection of TXL against no-reflow and reperfusion injury relates to the inhibition of myocardial inflammation, edema, and apoptosis in the reflow and no-reflow myocardium.

Animals ; Apoptosis ; drug effects ; Aquaporin 4 ; physiology ; Cyclic AMP Response Element-Binding Protein ; physiology ; Cyclic AMP-Dependent Protein Kinases ; physiology ; Drugs, Chinese Herbal ; pharmacology ; Edema ; prevention & control ; Hemodynamics ; drug effects ; Myocardial Reperfusion Injury ; prevention & control ; Myocarditis ; prevention & control ; Swine ; Swine, Miniature

Aim To discuss the potential key mechanism of mogroside V in relieving pulmonary inflammation in asthmatic mice based on transcriptomics and proteomics. Methods Ovalbumin(OVA)was chosen to induce female BALB/C mouse asthma model, and the mice were treated with mogroside V to observe the pathological changes of lung tissues. Lung tissues in groups of natural control, ovalbumin control and mogroside V control were chosen for transcriptomic and proteomic analysis, and differential genes and proteins were screened for tendency analysis, followed by KEGG enrichment analysis for the potential genes and proteins. Results The results of lung morphological observation and HE revealed that mogroside V attenuated the OVA-induced pulmonary inflammation. Differential genes and proteins were selected from RNA-seq and DIA analysis. In the analysis of omics 454 genes increased in comparison between groups of natural control with ovalbumin control and decreased in comparison between groups of mogroside V control with ovalbumin control in 1 122 potential genes, and 111 genes were of opposite features. A total of 238 proteins increased in comparison between groups of natural control with ovalbumin control and decreased in comparison between groups of mogroside V control with ovalbumin control in 497 potential proteins, and 91 proteins were of opposite features. The PI3K/Akt signaling pathway was enriched from KEGG and tendency analysis of transcriptomics and proteomics. The key factors of Igha, Ighg1, PI3K and Akt increased in ovalbumin control group and decreased in mogroside V control group by the validation of molecualr biology experiments. Conclusions Transcriptomic and proteomic analysis exhibits that mogroside V relieves asthma in mice through inhibiting the activation of key factors including Lgha, Lgh1, PI3K and Akt, depressing the signaling pathway, attenuating pulmonary inflammation to reach the goal of moistening lung and relieve cough, which provides a reference for drug development of asthma.

Catechol O-methyltransferase (COMT), one of the endogenous phase II metabolizing enzymes, expressed by chromosome 22. COMT catalyzes the transfer of a methyl group from common methyl donor S-adenosyl-L-methionine (AdoMet or SAM) to one of the catechol hydroxyls. COMT participates in the metabolism of many catechols in vivo, e.g. dopamine, epinephrine, noradrenaline, estradiol. Furthermore COMT also plays important roles in the metabolism of xenobiotic catechols from food and drug. COMT play a critical role in the management of catechols. Metabolism disorders of COMT can cause many diseases or an increased risk of diseases, e.g. Pakinson diseases, schizophrenia, and breast cancer. In this review, we explains the relationship of COMT and related-diseases through expounding disease caused by the COMT metabolic disorders. Finally, we hope that there will be more effective treatments for the COMT metabolism related diseases.

Humans ; Liver Cirrhosis ; Liver Diseases ; Liver Neoplasms ; Carcinoma, Hepatocellular