1.Experimental Study on Improvement Action of Katong Tablets Radix Astragali seu Hedysari,Radix et Rhizoma Rhei,etc.)on Blood Rheology of Animals
Chinese Traditional Patent Medicine 1992;0(09):-
After Katong Tablets(the equivalent dosage of over two times of adult daily administra- tion)were infused into the animal stomach for successive 10 days,it could strongly improve the increase of blood rheology of rat induced by adrenaline plus ice water or of rat with the deficiency of vital energy and blood stasis induced by swimming in successive days,and sig- nificantly strengthen the malformation ability of red cells of senile rat,inhibit the vitro circu- lation thrombosis of arteria carotis and jugular vein of normal rats,decrease the aggregate function of thrombocyte of rabbit induced by ADP.It showed the similar action strength with the control drug Kanlan Tablets.
2.The molecular characteristics and virulence factor of Methicillin-resistant Staphylococcus aureus isolatedfrom pediatric patients
Jianghong CAO ; Guanghui LI ; Xiaogang XU ; Demei ZHU ; Di QU ; Chuanqing WANG ; Hong ZHANG ; Weichun HUANG
Chinese Journal of Infectious Diseases 2012;30(7):391-397
Objective To investigate the molecular characteristic,the virulence factors and antimicrobial resistance of Methicillin-resistant Staphylococcus aureus (MRSA) isolated from pediatric patients.Methods Ninety-eight non-duplicate strains of and 49 non-duplicate strains of Methicillinsusceptible Staphylococcus aureus (MSSA) isolated from the three children's hospitals in Shanghai in 2008 were investigated.Panton-valentine leukocidin (PVL) gene was detected by polymerase chain reaction (PCR).The genotypes of staphylococcal cassette chromosome mec (SCCmec) of the MRSA isolates were confirmed by multiplex PCR.The sequence type (ST) of each strain was determined by multilocus sequence typing (MLST),and the algorithm eBURST was used to identify groups of clonal complex (CC).The minimal inhibitory concentrations (MIC) of fourteen antibiotics for all isolates were determined by agar dilution method.Results Among 98 isolates of MRSA,the positive rate of PVL genes was 6.1% (6/98).In contrast,the positive rate of PVL genes was 4.1% (2/48) of the MSSA strains.Among 98 isolates of MRSA,4.1% (4/98),23.5% (23/98),53.0% (52/98) and 15.3% (15/98) of the strains harboured SCCmec types Ⅱ,Ⅲ,Ⅳ and Ⅴ,respectively. The remaining four isolates (4.1 %) presented a unique SCCmec pattern that could not be classified to any known types by the employed typing assays.Combining the ST and SCCmec type,the predominant clones were ST59-SCCmec Ⅳ (30 strains) and ST239-SCCmec Ⅲ (23 strains),followed by ST5-SCCmecⅣ and ST1-SCCmecⅣ (8 strains for each clone),ST239-SCCmec Ⅴ (6 strains),ST88-SCCmecⅤ (5 strains),ST5 SCCmecⅡ (4 strains),ST59-SCCmec Ⅴ (3 strains),ST8-SCCmecⅣ and ST88-SCCmecⅣ (2 strains for each clone),ST22-SCCmecⅣ,ST910-SCCmecⅣ and S45-SCCmec Ⅴ (1 strain for each clone),eBURST analysis distributed the MRSA isolates into several CC.ST8 and ST239 belonged to ST8 CC,ST1 belonged to ST15 CC,ST910 belonged to ST 30 CC,ST59,ST5,ST88,ST45,ST22,ST9 and ST7 were the origin of their own CC.The results of MIC showed that the 67 strains of MRSA harboring SCCmec type Ⅳ or SCCmec type Ⅴ were more susceptible to various non-β-lactam antibiotics than 27 strains of MRSA harboring SCCmec type Ⅱ or SCCmec type Ⅲ,and no vancomycin-resistant strain was found.Conclusions In three children's hospitals in Shanghai,the PVL gene-positive rate of MRSA isolates is relatively low,SCCmec type Ⅳ and SCCmec type Ⅴ could spread among hospitals to cause a small scale epidemic and have a variety of ST.
3.Clinical Analyzation of Patients with Haff Disease in a Single Center
Jin LIU ; Hongdi CAO ; Ang LI ; Lei JIANG ; Weichun HE ; Lingling XU
Progress in Modern Biomedicine 2017;17(27):5247-5250
Objective:To explore the clinical characteristics of Haff disease in our hospital,be familiar with the disease and provide some experience in diagnosis and treatment.Methods:Inpatients with Haff disease in our Kidney disease center between July and August 2016 were retrospectively analyzed.The clinical data of patients was collected and statistically analyzed.Results:There were 66 patients (28 of male and 38 of female) in total with Haff disease between July and August 2016 in our ward.The average onset age was 35.5 years old (18-76 years old) and the average latency period was 5.6 hours (1-24 hours).All the patients had crayfish before the onset of the disease.The initial symptoms included muscle pain and concentrated brown urine (19 cases,28.8%).Laboratory tests suggested that transaminase and myotropin were increased significantly (alanine aminotransferase,aspartate aminotransferase,lactate dehydrogenase,creatine kinase,myoglobin and creatine kinase isoenzyme).A trace of blood (45%) and protein (16.7%) was present in some patients' urine test.After treatment,muscle pain was alleviated and urine color turned to clear in all patients.All the transaminase and muscle enzymes were significantly decreased (P<0.05).No blood or protein was detected in the urine test.Conclusions:The epidemiology of Haffdisease in summer at Nanjing was related to the intake of crayfish.The latency period was short and the initial symptoms were mostly muscle soreness,with or without myoglobinuria.Laboratory tests showed serum creatine phosphokinase,myoglobin,creatine kinase isoenzymes were increased significantly.The treatment period was short with good prognosis.Generally no sequelae was observed.
4.Analysis of intracranial infection induced by Acinetobacter baumannii in children
Yu ZHANG ; Weichun HUANG ; Hui YU ; Ting ZHANG ; Chunzhen HUA ; Qing CAO
Chinese Pediatric Emergency Medicine 2018;25(6):450-453
Objective To investigate the incidence of Acinetobacter baumannii induced paediatric bacterial meningitis and to explore the characteristics,treatment,and prognosis of Acinetobacter baumannii menin-gitis. Methods The cerebrospinal fluid specimens and the clinical data about patients who acquired intracranial infection of Acinetobacter baumannii were collected from 10 children′s hospital,and analysed by WHONET. Results A total of 318 positive cerebrospinal fluid specimens from 10 hospitals were collected,and 16(5%) of Acinetobacter baumannii were detected. Acinetobacter baumannii was completely resistant to Aztreonam (100%),Cefotetan(100%) and Cefazolin(100%),and the resistance rates of Acinetobacter baumannii to Ceftriaxone and Ciprofloxacin were above 80%,and the resistance rates of Acinetobacter baumannii to Cefta-zidime and Cefepime were all 68. 8%,and the resistance rates of Acinetobacter baumannii to Meropenem, Imipenem,Cefoperazone/Sulbactam were 69. 2%,68. 8% and 53. 3%,respectively. In 16 cases of intracrani-al infection caused by Acinetobacter baumannii,11 cases(68. 8%) had underlying diseases such as intracrani-al tumor,hydrocephalus,craniocerebral injury and intracranial hemorrhage,and all 11 cases underwent surgi-cal intervention,such as surgical resection and hydrocephalus drainage. Among 16 cases,14 cases(87. 5%) were admitted to SICU,PICU or NICU and other intensive care units,and the lengths of stay were all >20 d. Under the combined treatment of multiple antibiotics,16 cases of intracranial infection caused by Acinetobact-er baumannii,6 cases died,with a mortality of 37. 5%. Conclusion Acinetobacter baumannii meningitis is becoming an increasingly common clinical entity recently. Because of the resistance to antibiotics,the therapy for Acinetobacter baumannii infection encounters arduous challenge. Insisting on multi-center monitoring and using antibiotics reasonably and effectively appears to be particularly important.
5.The relationship between lung miacrobiome and lung cancer
Weichun LI ; Lingling SU ; Aiping ZHANG ; Rongrong ZHANG ; Yun CAO ; Liang YANG
Journal of Chinese Physician 2020;22(11):1757-1760,f3
The mucosal surfaces of the human body are typically colonized by polymicrobial communities, they exist in the gastrointestinal tract, skin, oral cavity, and genitourinary tract, as well as in anatomical sites previously considered sterile, including the lung. These communities interact with the mucosal immune system to maintain homeostasis in health, emphasizing the important role of " second genome" , which is very important to human health. The human lower respiratory tract also harbor many microbes, the imbalance of microbiome composition maybe critically related with many lung disease. Up to date, researches on microbiome of lung caner is still on the first step. Our review mainly describes the characteristic composition of lung microbiome, and the relationship with diseases, especially with lung cancer. We attempts to provide the basis information for further researches about the relationship between human lung microbiome and lung cancer.
6.The analysis of microflora distribution and drug resistance of urinary tract infection in children
Lijuan LUO ; Qing CAO ; Wei WANG ; Xihua WANG ; Jing WANG ; Weichun HUANG
Chinese Pediatric Emergency Medicine 2020;27(4):284-287
Objective:To investigate the distribution and drug resistance of pathogens in urinary tract infection in children.Methods:The clinical data of 108 cases of urinary tract infections with positive urinary culture from January 2018 to December 2018 in our hospital were analyzed retrospectively.The patients were divided into simple urinary tract infection group( n=29) and complex urinary tract infection group( n=79). Antibiotic resistance in each group was compared. Results:Gram-negative bacilli were found in 90 cases(77.59%, 90/116). Gram-positive cocci were found in 26 cases(22.41%, 26/116). Escherichia coli, Klebsiella pneumoniae and Enterococcus faecium were the main pathogens.Gram-negative bacilli had the lowest resistance rate to amikacin, imipenem and piperacillin/tazobactam(about 10%). The resistance rate of Gram-negative bacilli to furantoin and quinolones was about 20%, while 30% to 40% to the third and fourth generation cephalosporins and their enzymatic preparations.No Gram-positive cocci was found to be resistant to vancomycin and linezolid.The resistance rate of Gram-positive bacteria to streptomycin and furantoin was 0-20%.There was no significant difference in resistance rate of Gram-negative bacteria to common antibiotics between simple urinary tract infection group and complex urinary tract infection group( P>0.05). Conclusion:Gram-negative bacteria are the main pathogens of urinary tract infections.With the change of drug resistance of pathogens, it may be necessary to change the empirical treatment of urinary tract infection.Furantor can be used as a recommendation for the empirical treatment of mild infection.In the past, there may be underestimate of drug resistance of simple urinary tract infection, and further research is needed.
7.The clinical features of stenotrophomonas maltophili infection in children
Yuanjie ZHOU ; Nan SHEN ; Bailu DU ; Weichun HUANG ; Qing CAO ; Lijuan LUO
Chinese Pediatric Emergency Medicine 2024;31(5):333-336
Objective:To understand the clinical characteristics of stenotrophomonas maltophilia(SMA)infections in pediatric patients.Methods:This was a retrospective observational study.The children diagnosed with SMA infections between January 2018 and June 2023 at Shanghai Children's Medical Center were selected as the study population.The clinical characteristics of patients were analyzed.According to the outcome,the patients were categorized into survival and death groups to compare the clinical characteristics.Results:A total of 70 patients were included in the study,including 23 females and 47 males,with an onset age of 9.0 (3.0,12.6) years old.Sixty-five (92.9%) patients had underlying malignancies,primarily hematologic and solid tumors,of which 24(34.3%) cases underwent bone marrow hematopoietic stem cell transplantation,and 18(25.7%) cases underwent chimeric antigen receptor T cell immunotherapy (CAR-T).Forty (57.1%) cases of SMA infection sites were respiratory infections,19 (27.1%) cases were bloodstream infections,and 11 (15.7%) cases were soft tissue infections.Prior to infection,33(47.14%)patients were treated with glucocorticoids and 63(90.0%)patients with carbapenems.Eventually,39(55.7%)patients were discharged,while 31 patients died,with a mortality rate of 44.3%.Minocycline(100.0%),levofloxacin(98.1%),co-trimoxazole(96.2%),and cefoperazone/sulbactam(94.0%)showed high sensitivity rates to SMA.Compared with the survival group,the death group had a younger age [11.9 (8.4,13.8) years vs.6.3 (2.1,10.0) years],longer hospitalization before infection and duration after stem cell transplantation [28 (23,46) d vs.25 (16,34) d,140 (93,221) d vs.24 (12,49) d],and a higher proportion of pre-infection ICU admission,pre-infection glucocorticoids usage,receiving CAR-T treatment and lymphoma as the underlying disease [26 (83.9%) cases vs.15 (38.46%) cases,22 (71.0%) cases vs.11 (28.2%) cases,13 (41.9%) cases vs.5(12.8%) cases,11(35.5%)cases vs.3(7.7%)cases],and the differences were all statistically significant ( P<0.05). Conclusion:SMA infection pose a serious risk to pediatric patients with malignancies,compromised immune systems and exposured to broad-spectrum antibiotics.SMA maintains excellent sensitivity to compound sulfamethoxazole,minocycline,levofloxacin,and cefoperazone/sulbactam in pediatric patients.The mortality rate of SMA infection is very high,with longer pre-infection hospitalization,pre-infection ICU admission,pre-infection glucocorticoids usage,older onset age,longer duration after stem cell transplantation,receiving CAR-T treatment and lymphoma as the underlying disease possibly associated with post infection mortality
8.Pathogen and clinical characteristics of bacterial enteritis in a third class children′s hospital in Shanghai city from 2016 to 2020
Weichun HUANG ; Qiuhui PAN ; Qing CAO ; Jing WANG ; Wenjuan CHEN ; Yajuan ZHOU ; Yuanjie ZHOU ; Nan SHEN ; Lijuan LUO
Chinese Pediatric Emergency Medicine 2022;29(11):891-894
Objective:To investigate the pathogens and drug resistance of bacterial enteritis in children, analyze the clinical characteristics of bacterial enteritis in children, and provide basis for clinical diagnosis and treatment.Methods:The fecal culture strain and drug sensitivity of patients with bacterial enteritis admitted to our hospital from January 2016 to December 2020 were analyzed and summarized, and the clinical characteristics of patients who were infected by Salmonella and Escherichia coli were compared.Results:There were a total of 173 patients, aged from 21 days to 15 years, with a median age of 2.00(1.10, 3.54)years.Bacterial enteritis was most likely to occur in summer and autumn, and the incidence rate was 40.5% and 29.5%, respectively.One hundreds and seventy-three strains of bacteria were cultured in feces, including 148 strains of Salmonella(85.5%), 18 strains of Escherichia coli(10.4%), five strains of Staphylococcus aureus and two strains of Shigella.One hundreds and one of 141 patients who were infected with Salmonella were detected for leukocytes of in feces(71.6%), and four of 16 patients with Escherichia coli were detected for leukocytes(25.0%). The difference was significant( χ2=14.1, P<0.001). Eighty-eight of 113 patients(77.9%) who were infected by Salmonella with increased CRP(CRP>8 mg/L)and the proportion in Escherichia coli infection cases was 6/13(46.2%). There was significant difference( χ2=4.63, P=0.03). The drug sensitivity of Salmonella and Escherichia coli was summarized.There was no carbapenem resistant strain cultured; The sensitivity to piperacillin/tazobactam and cefoperazone/sulbactam was higher than 85%; The sensitivity to cefepime, ceftazidimeand ceftriaxone was higher than 75%; The sensitivity to ampicillin was lower than 30%, and the sensitivity to quinolones was between 20%-40%. Conclusion:Children aged 1-3 years are prone to bacterial enteritis in summer and autumn.The most common pathogens causing bacterial enteritis are Salmonella and Escherichia coli.White blood cells are more easily detected in feces of patients with Salmonella infection, and the increase rate of C-reactive protein in peripheral blood is higher.Patients with bacterial enteritis are recommended to use the third-generation cephalosporins and aforementioned antibiotics and piperacillin/tazobactam for empirical treatment.The sensitivity to quinolones is reduced, and may not be suitable for clinical application.
9.A multicentric study on clinical characteristics and antibiotic sensitivity in children with methicillin-resistant Staphylococcus aureus infection
Xia WU ; Hui YU ; Leiyan HE ; Chuanqing WANG ; Hongmei XU ; Ruiqiu ZHAO ; Chunmei JING ; Yinghu CHEN ; Jing CHEN ; Jikui DENG ; Jun SHI ; Aiwei LIN ; Li LI ; Huiling DENG ; Huijun CAI ; Yiping CHEN ; Zhengwang WEN ; Jinhong YANG ; Ting ZHANG ; Fangfei XIAO ; Qing CAO ; Weichun HUANG ; Jianhua HAO ; Conghui ZHANG ; Yuanyuan HUANG ; Xufeng JI
Chinese Journal of Pediatrics 2020;58(8):628-634
Objective:To investigate the clinical characteristics of pediatric methicillin-resistant Staphylococcus aureus (MRSA) infection and the antibiotic sensitivity of the isolates. Methods:The clinical data of children with MRSA infection and antibiotic sensitivity of the isolates from 11 children′s hospitals in Infectious Diseases Surveillance of Paediatrics (ISPED) group of China between January 1, 2018 and December 31, 2018 were collected retrospectively. The children′s general condition, high-risk factors, antimicrobial therapy and prognosis, differences in clinical disease and laboratory test results between different age groups, and differences of antibiotic sensitivity between community-acquired (CA)-MRSA and hospital-acquired (HA)-MRSA were analyzed. The t test and Wilcoxon rank sum test were used for statistical analysis of the quantitative data and Chi-square test were used for comparison of rates. Results:Among the 452 patients, 264 were males and 188 were females, aged from 2 days to 17 years. There were 233 cases (51.5%) in the ≤1 year old group, 79 cases (17.5%) in the>1-3 years old group, 29 cases (6.4%) in the >3-5 years old group, 65 cases (14.4%) in the >5-10 years old group, and 46 cases (10.2%) in the>10 years old group. The main distributions of onset seasons were 55 cases (12.2%) in December, 47 cases (10.4%) in February, 46 cases (10.2%) in November, 45 cases (10.0%) in January, 40 cases (8.8%) in March. There were 335 cases (74.1%) CA-MRSA and 117 (25.9%) cases HA-MRSA. Among all cases, 174 cases (38.5%) had basic diseases or long-term use of hormone and immunosuppressive drugs. During the period of hospitalization, 209 cases (46.2%) received medical interventions. There were 182 patients (40.3%) had used antibiotics (β-lactams, glycopeptides, macrolides, carbapenems, oxazolones, sulfonamides etc) 3 months before admission. The most common clinical disease was pneumonia (203 cases), followed by skin soft-tissue infection (133 cases), sepsis (92 cases), deep tissue abscess (42 cases), osteomyelitis (40 cases), and septic arthritis (26 cases), suppurative meningitis (10 cases). The proportion of pneumonia in the ≤1 year old group was higher than the >1-3 years old group,>3-5 years old group,>5-10 years old group,>10 years old group (57.5% (134/233) vs. 30.4% (24/79), 31.0% (9/29), 38.5% (25/65), 23.9% (11/46), χ 2=17.374, 7.293, 7.410, 17.373, all P<0.01) The proportion of skin and soft tissue infections caused by CA-MRSA infection was higher than HA-MRSA (33.4% (112/335) vs. 17.9% (21/117), χ 2=10.010, P=0.002), and the proportion of pneumonia caused by HA-MRSA infection was higher than CA-MRSA (53.0% (62/117) vs. 42.1% (141/335), χ 2=4.166, P=0.041). The first white blood cell count of the ≤1 year old group was higher than that children > 1 year old ((15±8)×10 9/L vs. (13±7)×10 9/L, t=2.697, P=0.007), while the C-reactive protein of the ≤1 year old group was lower than the 1-3 years old group,>5-10 years old group,>10 years old group (8.00 (0.04-194.00) vs.17.00 (0.50-316.00), 15.20 (0.23-312.00), 21.79(0.13-219.00) mg/L, Z=3.207, 2.044, 2.513, all P<0.05), there were no significant differences in procalcitonin (PCT) between different age groups (all P>0.05). After the treatment, 131 cases were cured, 278 cases were improved, 21 cases were not cured, 12 cases died, and 10 cases were abandoned. The 452 MRSA isolates were all sensitive to vancomycin (100.0%), linezolid (100.0%), 100.0% resistant to penicillin, highly resistant to erythromycin (85.0%, 375/441), clindamycin (67.7%, 294/434), less resistant to sulfonamides (5.9%, 23/391), levofloxacin (4.5%, 19/423), gentamicin (3.2%, 14/438), rifampicin (1.8%, 8/440), minocycline (1.1%, 1/91). The antimicrobial resistance rates were not significantly different between the CA-MRSA and HA-MRSA groups (all P>0.05). Conclusions:The infection of MRSA is mainly found in infants under 3 years old. The prevalent seasons are winter and spring, and MRSA is mainly acquired in the community. The main clinical diseases are pneumonia, skin soft-tissue infection and sepsis. No MRSA isolate is resistant to vancomycin, linezolid. MRSA isolates are generally sensitive to sulfonamides, levofloxacin, gentamicin, rifampicin, minocycline, and were highly resistant to erythromycin and clindamycin. To achieve better prognosis. clinicians should initiate anti-infective treatment for children with MRSA infection according to the clinical characteristics of patients and drug sensitivity of the isolates timely and effectively.