BACKGROUNDThe emergence of heteroresistant vancomycin-intermediate Staphylococcus aureus (hVISA) is increasingly challenging the methods for detection in diagnostic microbiology laboratories. However, the report of hVISA is rare in China. This study summarizes the prevalence and clinical features associated with hVISA infections at our institution and the local impact they have on clinical outcome.

METHODSA total of 122 methicillin-resistant Staphylococcus aureus (MRSA) isolates which were of the causative pathogens were collected. One hundred and two patients for whom we had full information of MRSA pneumonia were included. Isolates of MRSA were collected using PCR to detect the mecA gene. Both Etest and macro Etest were performed to screen for hVISA. The Staphylococcal chromosome cassette mec (SCCmec) types were determined by multiplex PCR strategy. Logistic regression analysis was used to determine the risk factors.

RESULTSAmong the 122 MRSA isolates collected, 25 (20.5%) strains were identified as hVISA. There were 119 (97.5%) SCCmec III isolates, two (1.6%) SCCmec II isolates, and one (0.8%) SCCmec V isolate. The 30-day mortality of MRSA-hospital acquired pneumonia (HAP) was 37.3%, and 62.5% for hVISA-HAP. Vancomycin treatment was the independent risk factor of hVISA. Factors independently associated with 30-day mortality in all patients were acute physiology and Chronic Health Evaluation (APACHE) II score >20, multiple lobe lesions, and creatinine clearance rate (CCR) < 15 ml/min.

CONCLUSIONSThe prevalence of hVISA is 20.5% at our institution. hVISA-HAP patients had a poor clinical outcome. Vancomycin treatment was the independent predictors for hVISA infection. Factors independently associated with 30-day mortality in all patients were APACHE II score > 20, multiple lobe lesions and CCR < 15 ml/min.

Adult ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents ; therapeutic use ; China ; epidemiology ; Female ; Humans ; Male ; Microbial Sensitivity Tests ; Middle Aged ; Staphylococcal Infections ; drug therapy ; epidemiology ; mortality ; Staphylococcus aureus ; drug effects ; pathogenicity ; Tertiary Care Centers ; statistics & numerical data ; Vancomycin ; therapeutic use ; Vancomycin Resistance

The purpose of this study was to determine the changes of pathogens in hematological ward and susceptibility of patients received chemotherapy to antibiotics. The pathogens were taken from blood, urine and sputum of patients who accepted chemotherapy from years 2001 to 2005, then were isolated and identified. The susceptibility test was performed by disk diffusion method. The results showed that the total of 418 strains were detected. Gram-negative bacteria were the most common of nosocomial infection. Pseudomonas aeruginosa, Enterobacter cloacae, E. coli account for the most of Gram negative- bacteria infection and most resistant to broad-spectrum penicillin, Acinetobacter baumannii showed a trend of increase. The ratios of gram positive bacteria and fungi were increased slowly, mainly as Enterococcus and Candida. Enterococcus is the most common cause of Gram-positive bacterial infection. Vancomycin resistance did not occur. It is concluded that Gram-negative bacteria are main cause of nosocomial infection in patients with hematological malignancies. Gram positive bacteria and fungi had been more frequent. Strains resistant to antimicrobial agents increase.
Cross Infection ; epidemiology ; microbiology ; Drug Resistance, Bacterial ; Gram-Negative Bacteria ; drug effects ; isolation & purification ; Gram-Negative Bacterial Infections ; epidemiology ; microbiology ; Hematologic Diseases ; microbiology ; Hematologic Neoplasms ; microbiology ; Humans ; Microbial Sensitivity Tests

Objective To investigate the effect of fibronectin type Ⅲ and SPRY domain containing 1 (FSD1) protein on the invasion of glioma stem cells (GSCs), so as to probe into the new biomarkers or potential therapeutic targets for gliomas. Methods The Cancer Genome Altas (TCGA) database data were used to analyze and compare the FSD1 gene expression (the FSD1 mRNA level) in the glioblatoma (also known as glioblastoma multiforme, GBM) and normal brain tissues as well as in the different grade glioma tissues, and the correlation of the FDS1 gene expression (mRNA level) with the survival prognosis of patients was also analyzed using the TCGA database data. The lentivirus was used to overexpress the FSD1 protein in the GSCs, T4121 and D456. The effect of the overexpressed FSD1 protein on the invasive ability of the GSCs, T4121 and D456 was evaluated by Transwell invasion assay. Results The FSD1 gene expression (mRNA level) was significantly lower in GBM than in normal brain (P＜0.01). The FSD1 gene expression (the mRNA level) in gliomas significantly decreased with the increase of the gliomas grade (gradeⅡvs Ⅲ, P＜0.05;gradeⅢvs Ⅳ, P＜0.01). The survival prognosis of patients with gilomas was well associated with the level of FSD1 gene expression (the FSD1 mRNA level), as indicated by the overall survival rate of the patients, which was significantly lower in the patients with the low FSD1 mRNA level than in the patients with the high FSD1 mRNA level (P＜0.01). In the Transwell invasion assay, the count of the invasive cell numbers significantly decreased in the FSD1 protein-overexpressed T421 and D456 groups than in the corresponding control group (P＜0.01 in both T4121 and D456 cell lines). Conclusion There is a clinical relevance of the FSD1 expression for the malignant progression of gliomas (the grade of gliomas). The low level FSD1 is favorable for keeping the invasive ability in GSCs.

OBJECTIVE: To study the mechanisms of cultured neurons injury mediated by nitric oxide and free oxygen radical during hypoxia and oxidative stress. METHODS: The cultured newborn rat neurons were treated with hypoxia, H2O2 and pretreated superoxide dismutase (SOD) respectively. We examined the content of NO, malonaldehyde (MDA), lactate dehydrogenase (LDH) and SOD in cultured supernatant. RESULTS: Comparing with that of control group, the content of NO, LDH, MDA increased and the content of SOD decreased in hypoxia group and H2O2 group. The content between NO and SOD showed the negative correlation. Administration of 200 U/ml SOD before oxidative stress could efficiently decrease the release of NO, LDH and MDA in neurons. The content of NO, LDH and MDA manifested in positive correlation in each group. CONCLUSION Hypoxia and oxidative stress increased NO production which strengthen neurons injury induced by free radical. SOD played an important role in elimination of free oxygen radicals and protecting neurons from injury by NO.
Animals ; Animals, Newborn ; Cell Hypoxia ; Cells, Cultured ; Hydrogen Peroxide/toxicity* ; Neurons/pathology* ; Nitric Oxide/physiology* ; Oxidative Stress ; Rats ; Rats, Sprague-Dawley ; Superoxide Dismutase/pharmacology*

OBJECTIVETo analyze the changing of age patterns among rubella patients after implementing rubella vaccine immunization to children in Shandong province since 1995.

METHODSEpidemiologic data on rubella through surveillance system for suspected measles from 1999 to 2004 and data on rubella vaccination were used and analyzed.

RESULTSThe annual average incidence rate of rubella from 1999 to 2004 had been 0.59 per 100 thousands population while 81.17% of cases were concentrated during the outbreaks. 77.77% of the cases were school children between 7-15 years old and 7.93% of the cases were under 7 years old. The age-median of cases were 10.37, 11.66, 11.41, 12.81, 14.28 and 13.96 years old from 1999 to 2004, respectively. The estimated coverage of rubella vaccine for pre-school children was about 60% but only 20% were for school children.

CONCLUSIONThe peak age of cases moved from youth towards adolescence which indicated that women with child-bearing age might have been under risk of developing the congenital rubella syndrome (CRS). It is necessary to carry out screening test of rubella antibody and vaccination to women with child-bearing age and the immunization strategy should be established to guide the control of rubella and CRS.

Adolescent ; Adult ; Age Distribution ; Child ; Child, Preschool ; China ; epidemiology ; Disease Outbreaks ; Humans ; Immunization Schedule ; Infant ; Infant, Newborn ; Rubella ; complications ; epidemiology ; prevention & control ; Vaccination ; statistics & numerical data ; Viral Vaccines ; immunology ; Young Adult

OBJECTIVETo study the incidence of cases with rash and fever illness (RFIs) after measles vaccine (MV) inoculation.

METHODSDuring 1999 to 2002, 150 RFIs cases reported by the special measles surveillance system in Shandong province, China, were investigated and analyzed epidemiologically.

RESULTS7 674 690 ml MV were distributed during 1999 to 2002 and the annual average incidence of RFIs cases after MV inoculation was 0.20/10 000 ml (0.2 ml per dose). There was significant difference of incidences each year (chi(2) = 10.13, P < 0.05). All RFIs cases were sporadically distributed without epidemiological links. Clinical symptoms showed that 88.67% of the 150 RFIs cases having > 38.5 degrees C fever and 75.33% of all cases appeared typical rash after 4 to 11 days (the medium was 8 days) after MV inoculation. The order of rash onset among RFIs cases was consistent with that of regular measles cases caused by wild virus. 68.67% of the RFIs cases had first MV inoculation and 94.71% were 8 to 12 month-olds. IgM sera antibody test from RFIs cases were rubella negative and 45.65% positive for measles.

CONCLUSIONRFIs due to allergic reaction or measles vaccine virus infection might occur after MV inoculation. There seemed to be a correlation between RFIs incidence and the doses of MV. Measles virus genotype analysis needs to be carried out to confirm if the onset of some RFIs cases is aetiologically associated to MV vaccine virus infection.

Exanthema ; etiology ; virology ; Fever ; etiology ; virology ; Humans ; Measles ; prevention & control ; Measles Vaccine ; adverse effects ; Measles virus ; immunology ; Polymerase Chain Reaction ; Vaccination

OBJECTIVETo evaluate the safety and efficacy of umbilical cord-derived mesenchymal stem cells (MSCs) infusion in patients with steroid-resistant severe acute graft-versus-host disease (aGVHD).

METHODSA total of 19 patients with steroid-resistant severe aGVHD received MSCs infusion treatment. The treatment response, transplantation-related mortality, events associated with infusion and relapse rate were analyzed.

RESULTSTwo patients with grade II, 5 patients with grade III and 12 patients with grade IV aGVHD received a total of 58 infusions of MSCs. The mean total dose of MSCs was 2.13 (range 0.60 - 7.20)×10(6) cells per kg bodyweight. Seven patients received one infusion, 2 patients received two infusions, and 10 patients received three or more infusions. Eleven patients had a complete response and 4 had a partial response and 4 had no response. No patients had side-effects during or immediately after infusions, and no MSCs related tumorigenesis was detected to date. Eleven patients survived and 8 died, 4 for aGVHD, 1 for infection and 2 for aGVHD with concomitant infection and 1 for underlying leukemia relapse. The cell viability of freshly prepared MSCs is 93% (92% - 95%) by trypan blue staining. The cell viability of programmatically frozen and thawed MSCs is 72% (70% - 74%).

CONCLUSIONInfusion of umbilical cord-derived MSCs expanded in vitro is an effective therapy for patients with steroid-resistant severe aGVHD without negative impact on relapse. Freshly prepared MSCs are superior to frozen and thawed cells in terms of cell viability.

Adolescent ; Adult ; Cord Blood Stem Cell Transplantation ; Female ; Graft vs Host Disease ; etiology ; surgery ; Humans ; Male ; Mesenchymal Stem Cell Transplantation ; Mesenchymal Stromal Cells ; Middle Aged ; Steroids ; pharmacology ; Survival Rate ; Umbilical Cord ; cytology ; Young Adult

BACKGROUNDNo data on the incidence of pleural effusion (PE) in Chinese patients with pulmonary embolism are available to date. The aim of the current study was to investigate the frequency of PE in a Chinese population of patients with pulmonary embolism.

METHODSThis was a retrospective observational single-center study. All data of computed tomography pulmonary angiography (CTPA) performed over 6-year period on adult patients with clinically suspected pulmonary embolism were analyzed.

RESULTSFrom January 2008 until December 2013, PE was identified in 423 of 3141 patients (13.5%) with clinically suspected pulmonary embolism who underwent CTPA. The incidence of PE in patients with pulmonary embolism (19.9%) was significantly higher than in those without embolism (9.4%) (P < 0.001). Majority of PEs in pulmonary embolism patients were small to moderate and were unilateral. The locations of emboli and the numbers of arteries involved, CT pulmonary obstruction index, and parenchymal abnormalities at CT were not associated with the development of PE.

CONCLUSIONSPEs are present in about one fifth of a Chinese population of patients with pulmonary embolism, which are usually small, unilateral, and unsuitable for diagnostic thoracentesis.

Adult ; Aged ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Pleural Effusion ; diagnostic imaging ; epidemiology ; Pulmonary Embolism ; diagnostic imaging ; epidemiology ; Radiography ; Retrospective Studies

OBJECTIVETo provide scientific basis for angiostrongyliasis cantonensis control and prevention in Beijing.

METHODSDescriptive epidemiological method was used to analyze angiostrongyliasis cantonensis reported from June to September in 2006.

RESULTS141 cases were treated at the Beijing Friendship Hospital with the peak in July (61 cases) and August (68 cases). All patients had dined at the same restaurant in Beijing city and they ate undercooked Pomacea canaliculata or related eatables. The source of Pomacea canaliculata was from Guilin in Guangxi. Major manifestations would include fever (56.79%), headache (93.83%), neck stiffness (100%), and skin paresthesia (77.78%). Some cases had significant eosinophil increase in peripheral blood picture and cerebrospinal fluid respectively.

CONCLUSIONThe source of infection related to angiostrongyliasis cantonensis was clear, suggesting that the improvement of restaurant sanitation and on awareness of personal hygiene were important preventive and control measures on angiostrongyliasis cantonensis.

Adolescent ; Adult ; Aged ; Angiostrongylus cantonensis ; pathogenicity ; Animals ; China ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Strongylida Infections ; diagnosis ; epidemiology ; parasitology ; Young Adult

OBJECTIVE: To investigate the expression of ROBO3 in pediatric AML patients and explore its function on cell proliferation and apoptosis. METHODS: The expression of ROBO3 in pediatric AML patients at different treatment stage was detected by real-time quantitative polymerase chain reaction (RT-qPCR). The relationship between the expression of ROBO3 and clinic pathological characteristics in newly diagnosed pediatric AML patients was analyzed. Moreover, the effects of ROBO3 on the proliferation and apoptosis of AML cell lines HL-60 and THP-1 were estimated by using CCK-8 and flow cytometry after transfection with ROBO3 siRNA. RESULTS: It was found that ROBO3 expression was significantly increased in most of newly diagnosed pediatric AML patients, especially in non-M3 subtype, younger patients (<10 years old), and high risk group, compared to corresponding controls. Furthermore, the expression level of ROBO3 was sharply decreased in patients who achieved complete remission. Targeting ROBO3 significantly inhibited AML cell proliferation, as well as increased apoptosis by ROBO3 siRNA transfection in vitro. CONCLUSION ROBO3 is differentially expressed within distinct subtypes of the pediatric AML patients, which suggested that ROBO3 may be a potential biomarker and a new therapeutic target for pediatric AML.
Apoptosis ; Cell Line, Tumor ; Cell Proliferation ; Child ; Humans ; Leukemia, Myeloid, Acute/genetics* ; MicroRNAs/genetics* ; RNA, Small Interfering ; Receptors, Cell Surface ; Sincalide