Objective To investigate antibiotic resistance and staphylococcal cassette chromosome mec(SCCmec)genotype of Staphylococcus aureus isolated from patients with nosocomial infections.Methods Antibiotic susceptibility pattern anti the gene mecA were examined in 89 Staphylococcus aureus isolates from patients with nosocomial infection in Tianjin Medical University Cancer Institute and Hospital.The SCCmec genotype in the mecA-positive strains were fuaher investigated with multiplex PCR.Results In 89 Staphylococcus aureus strains,21(23.6%)were phenotypic methicillin-resistant Staphylococcus aureus (MRSA)and 39(43.8%)were rnecA positive,the difierence was of statistical significance(χ2=8.146,P=0.004).MRSA strains showed multiple-antibiotic resistance but sensitive to vancomycin.Tvpe Ⅲ SCCmec carriers were the major epidemiological strains(26/39,66.7%).ConclusionMRSA strains isolated from Tianjin Medieal University Cancer Institute and Hospital are characterized by multi-drug resistance,and type Ⅲ is the dominant SCCmec earried by the MRSA strains.

Objective To examine the association of urinary neutrophil gelatinase-associated lipocalin(NGAL) and interleukin 18(IL-18) with acute kidney injury (AKI) in patients after cardiac surgery. Methods Thirty-three patients undergone cardiac surgery were divided into AKI group and non-AKI group according to the AKI criteria. The Scr, urinary NGAL and IL-18 were measured at different time points. Results Nine of 33 patients (27.27%)developed postoperative AKI, and Scr concentration in AKI group reached its peak within 12-48 hours after cardiac surgery. Urinary concentrations of NGAL and IL-18 at 2 h and 4 h after cardiac surgery were significantly higher than those before operation in AKI patients (P<0.01). The urinary concentrations of NGAL at each time point and that of IL-18 at 2 h and 4 h after cardiac surgery in AKI patients were significantly higher than those in non-AKI patients. After correction by urinary creatinine, the differences of NGAL/Ucr and IL-18/Ucr ratios were still significant (P< 0.01). For concentrations of urinary NGAL, IL-18 and ratios of NGAL/Ucr, IL-18/Ucr at 2 h after surgery, sensitivities and specificities were good with cutoff values at 250 μg/L, 250 μg/mmol and 1800 ng/L, 1800 ng/mmol, respectively. Urinary concentration of NGAL at 2 h after cardiac surgery was positively correlated with Scr at 12 h postoperation in AKI group (r=0.638, P<0.05).Conclusions The incidence of AKI in patients after cardiac surgery is quite high. Urinary concentrations of NGAL, IL-18 and ratios of NGAL/Ucr, IL-18/Ucr at 2 h after cardiac surgery are the early diagnostic markers for AKI, among which urinary NGAL/Ucr is the most sensitive one.

Objective To retrieve,evaluate and summarize the best evidence of physical activity in patients with venous leg ulcer(VLU),and to provide the evidence for clinical practice of physical activity intervention for patients with VLU.Methods We systematically searched all relevant literature on the physical activity of patients with VLU,including clinical practice guidelines,clinical decision-making,systematic reviews,evidence summaries,expert consensuses,and original studies,from the guideline websites,databases,and professional association websites,with the search period from the database establishment to May 19,2023.2 researchers independently evaluated the quality of the literature,and included and extracted and integrated evidence based on the judgment of professionals.Results A total of 18 articles were included,consisting of 6 guidelines,2 clinical decisions,6 systematic reviews,3 expert consensuses and 1 original study.Finally,26 pieces of best evidence were summarized,categorizing into 8 aspects which include timing of physical activity,patient assessment before physical activity,mode of physical activity,time and frequency of physical activity,intensity of physical activity,effect evaluation of physical activity,quality control and tips.Conclusion This study summarizes the best evidence of physical activity in patients with VLU.It is recommended that health care professionals should formulate individualized physical activity programs based on the practical conditions and clinical situation,and fully consider the evaluation results of patients.