Objective To characterize the whole-sequence of plasmid pB557-NDM isolate from Enterbacter cloacae and elaborate its antibiotic-resistant mechanisms .Methods Antibiotic resistance genes were determined by PCR , followed by amplicon sequencing .The activity of class A/B/D carbapenemases was determined by modified Carba NP test .Conjugation experiments were performed to verify the transferability of plasmid pB 557-NDM.The minimum inhibitory concentration (MIC) values of bacterial strains were tested using VITEK 2.The genetic structure, mobile elements and antibiotic-resistant mechanisms of transferable plasmid pB 557-NDM were determined by a whole genome sequencing method .Results The modified CarbaNP test showed that B557 and B557-EC600 had class B carbapenemase activity , and that the blaNDM was carried by plasmid pB557-NDM.This plasmid could be transferred into E.coli through conjugation experiments and therefore could confer corresponding antibiotic resistances to the transconjugant B 557-EC600.Plasmid pB557-NDM was an IncA/C2 plasmid, whose total length was 141.65 kb, and the GenBank accession number was KX786648.It had two inserted regions.One was the blaCMY-6 region where the blaCMY gene was carried by a transposition unit IS Ecp1-blaCMY , the other was the blaNDM-1 region which consisted of a ΔTn1696-In46-rmtC-ISKpn14-ΔTn125 complex structure.Conclusion The production of plasmid pB557-NDM in strain B557 contributes most to its high resistance to many antibiotics .The blaNDM-1 gene is carried in a trancated transposition ΔTn125.

Objective To construct the risk model for healthcare-associated infection (HAI)with multidrug-re-sistant organisms(MDROs)in intensive care unit (ICU).Methods 836 patients who were admitted to ICU for more than 48 hours between October 2012 and September 2015 were analyzed retrospectively,logistic regression model of HAI was constructed,the model was conducted goodness of fit tests and the area under ROC curve analysis. Results Among 836 patients,incidence of HAI with MDROs was 14.23%(n=119).15 variables that were statis-tically significant in univariate analysis were included in logistic multivariate analysis,the results showed that the following variables entered into logistic regression equation:length of ICU stay (OR,2.493 [95%CI ,1 .816 -3.494]),underlying diseases (OR,1 .536 [95%CI ,1 .243 - 1 .898 ]),hypoproteinemia (OR,87.211 [95%CI , 36.165-210.304]),ventilator days (OR,1 .723 [95%CI ,1 .399-2.121 ]),fever(OR,20.639 [95%CI ,3.462 -123.043]),and primary pulmonary infection (OR,0.295 [95%CI ,0.133 -0.664]).Evaluation of model effect:sensitivity 95%,specificity 87.9%,the area under ROC curve 0.973.Conclusion Logistic regression model has a high goodness of fit in predicting HAI among ICU patients.

Objective To compare the biomechanical stability of distal femoral fracture with metaphyseal comminution fixed by unilateral or bilateral locking plates. Methods Distal femoral fracture with metaphyseal comminution (AO type C2.3 fracture) models were established in 22 artificial femoral specimens, and randomly divided into single plate group (group A, n=11) and double-plate group (group B, n=11). In group A, the fractures were fixed by lateral anatomic locking plates, and in group B, the fractures were fixed by lateral anatomical locking plates at lateral side and straight locking plates medially, respectively. In each group, 5 specimens were applied with axial compression and 3 specimens were applied with cyclic axial loading to measure medial subsidence, and the remaining 3 specimens were applied with failure loading to record the maximum load to failure. Results For axial compression, the mean medial subsidence of group A and group B were (2.61±0.28) mm and (0.46±0.08) mm, respectively. For cyclic axial loading, the mean medial subsidence of group A and group B were (1.56±0.12) mm and (0.43±0.05) mm, respectively. For failure loading, the maximum loads to failure of group A and group B were (5 567±338) N and (9 147±186) N, respectively, which all showed significant differences in two groups (P＜0.05). Conclusions For fixing distal femoral fracture with metaphyseal comminution, bilateral locking plates show stronger resistance to medial compression than unilateral locking plates and thus increase the stability of medial column of distal femur, which contributes to patient rehabilitation at early stage.

OBJECTIVETo study the effect of dihydroartemisinin (DHA) combined irradiation on the apoptosis of human lung cancer GLC-82 cells and to study its mechanism.

METHODSThe growth inhibition rate of GLC-82 cells acted by different concentrations DHA was detected using MTT assay at 24, 48, and 72 h, respectively. Clone forming test was used. With multi-target single-hit model, the radiosensitization effect was assessed by calculating sensitizing enhancement ratio (SER).The effect of DHA combined irradiation on the apoptosis of GLC-82 cell cycle distribution and apoptosis were measured by flow cytometry. The protein expression of p53, p21, Bcl-2, and Bax were detected by Western blot.

RESULTSDifferent concentrations DHA (4, 8, 16, 32, 64, and 128 μg/mL) had cytotoxicity on GLC-82 cells. The IC50 for 24, 48, and 72 h was 38.25,20.58, and 10.36 μg/mL, respectively, in obvious dose- and time-dependent manner. The growth inhibition rate was more significantly increased than that of the blank control group (P < 0.01, P<0.05). DHA had sensitization enhancement effect on GLC-82 cells, with SER of 1.4. DHA combined irradiation could obviously change the structure of GLC-82 cells cell cycle and induce apoptosis (with the apoptosis rate of 21.5%), which was significantly different from that of the blank control group (P < 0.05). Western blot showed the expression of p53 and p21 protein could be increased by DHA combined irradiation, and the expression of Bcl-2 protein down-regulated (P <0.01, P <0. 05).

CONCLUSIONSDHA had stronger cytotoxicity and radiosensitization on GLC-82 cells. Its mechanisms might lie in making the arrest of GLC-82 cells' growth at G0/G1 phase, decreasing the ratio of cells at S phase, restoring the function of p53, decreasing the expression of Bcl-2 protein, and inducing apoptosis in GLC-82 cells.

Apoptosis ; drug effects ; Artemisinins ; pharmacology ; Cell Cycle ; drug effects ; Cell Proliferation ; drug effects ; Down-Regulation ; drug effects ; Flow Cytometry ; Humans ; Lung Neoplasms ; metabolism ; Neoplasm Proteins ; metabolism ; Radiation-Sensitizing Agents ; pharmacology ; Tumor Cells, Cultured ; bcl-2-Associated X Protein ; metabolism

Objective To investigate the association between serum nitric oxide (NO) and hypertension among women in Suzhou. Methods Blood pressure, height, weight and waist circumference (WC) were measured and factors including smoking, alcohol intake, family history of hypertension were investigated and blood glucose, blood lipid, serum NO were tested among 1453 women aged ≥30 years who lived in Jinchang district of Suzhou. Association between serum NO and hypertension was analyzed by univariate and multivariate methods. Results The mean levels of serum NO in hypertensive and normotensive persons were 28.17 (17.42-45.30)μmol/L and 27.56(17.19-44.42) μ mol/L, respectively, with no significant difference between the two groups (P ＞ 0.05).Results from multivariable logistic regression analysis showed that low serum NO was not associated with hypertension, after adjustment for confounders (OR=0.979, 95% CI: 0.747-1.283).The mean levels of systolic blood pressure / diastolic blood pressure were 130.1/83.3,128.5/82.7,129.8/83.2 and 129.1/83.3 mm Hg for whose serum NO level were in the first, second, third and fourth quartile,respectively. The risk of hypertension did not change along with the elevated serum NO levels.Compared to the first quartile of serum NO, the risks of hypertension in the second, third and fourth quartile did not change after adjustment for confounders and OR were 0.988 (0.709-1.377), 1.001(0.720-1.390) and 1.077 (0.774-1.499), respectively. Conclusion The serum NO level was not associated with hypertension in women in Suzhou.

OBJECTIVETo study the role of Helicobacter pylori (H. pylori) infection in newly diagnosed childhood immune thrombocytopenia (ITP).

METHODSA total of 495 children with newly diagnosed ITP who were hospitalized for the first time between January 2011 and December 2013 were included as the case group. A total of 123 children with common respiratory tract infection (not ITP or other diseases of blood system) were randomly selected as the control group. All patients were divided into four groups by age: <1 year group, 1-3 years group, 3-7 years group, and 7-14 years group. The incidence of H. pylori infection in all age groups and the clinical outcomes of ITP children with or without H. pylori infection were retrospectively analyzed.

RESULTSThe incidence rate of H. pylori infection in the case group increased with increasing age. There was no significant difference in the incidence rate of H. pylori infection between the case and the control groups among subjects of the same age (P>0.05). All the ITP patients were not given anti-H. pylori treatment and only received the treatment (glucocorticoid and/or immunoglobulin) for ITP, and their remission rate declined with increasing age. There was no significant difference in the remission rate between the ITP children with H. pylori infection and those without H. pylori infection in the same age group (P>0.05).

CONCLUSIONSH. pylori infection may not be a major cause of ITP in children, and the clinical outcomes of children with acute ITP are not affected by receiving anti-H. pylori treatment or not.

Adolescent ; Age Factors ; Child ; Child, Preschool ; Female ; Helicobacter Infections ; complications ; epidemiology ; Helicobacter pylori ; Humans ; Incidence ; Infant ; Male ; Purpura, Thrombocytopenic, Idiopathic ; etiology

To evaluate the papilla alterations around single-implant restorations in the anterior maxillae after crown attachment and to study the influence of soft tissue thickness on the papilla fill alteration. According to the inclusion criteria, 32 patients subjected to implant-supported single-tooth restorations in anterior maxillae were included. The patients were assigned to two groups according to the mucosal thickness: (i) group 1, 1.5 mm s mucosal thickness 3 mm; and (ii) group 2, 3 mm Adult ; Crowns ; Dental Implantation, Endosseous ; methods ; Dental Implants, Single-Tooth ; Dental Prosthesis Design ; Dental Prosthesis, Implant-Supported ; Esthetics, Dental ; Female ; Follow-Up Studies ; Gingiva ; anatomy & histology ; Humans ; Male ; Maxilla ; Middle Aged ; Outcome Assessment (Health Care) ; Prospective Studies ; Tooth Cervix ; anatomy & histology ; Young Adult

OBJECTIVEAnalysis the epidemiological characteristics on rabies cases occurred in Guangxi from 2004 to 2008 and summarize the result of healthy-dog infection rabies virus investigation from 2006 to 2008. Exploring the high-occurrence and correlated factors on rabies in Guangxi.

METHODSData collected from the National Disease Surveillance System and the National Active Surveillance System for Rabies from 2004 to 2008 and Data of healthy-dog infection rabies virus investigation from 2006 to 2008 were analyzed.

RESULTSThe total rabies cases were 2463 in Guangxi from 2004-2008 and average incidence rate was 0.98 per 100 thousand per year. There were 95 counties had rabies case reported, anyway more than 10 cases occurred county number was declined while less than 5 cases rose year by year. The rabies case incidence area was expanded and the cases in middle and west area of Guangxi rose significantly. Rabies cases were reported whole year and no seasonal peak. Human rabies cases mainly were farmers, students and children. Yanger than 20 years old and elder 40 years old were the highest age groups in the population of the investigation, 83.79% cases were attacked by dogs. 78.5% cases classification category III. 83.17% cases had exposed on the upper and lower limbs, 10.56% exposed to the head, face or neck. But 67.88% cases did not receive any PEP and only 18.31% cases vaccinated and 3.63% category III exposure cases combined administration of RIG. The incubation median was 60 days. The rabies virus infection rate among randomly collection healthy-dog brain samples from 2006 to 2008 was 1.92%, 0.93% and 0.89%.

CONCLUSIONUnsuccessful and inadequate PEP of patients were the main factors leading to the high-occurrence of human rabies in Guangxi. And there are a lot of infection rabies virus healthy-dogs alive in Guangxi also as a high-occurrence factor.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Animals ; Brain ; virology ; Child ; Child, Preschool ; China ; epidemiology ; Dogs ; Humans ; Infant ; Infant, Newborn ; Middle Aged ; Rabies ; epidemiology ; Risk Factors ; Young Adult

OBJECTIVETo investigate the effect of iron on the growth, physiology and photosynthesis of cyanobacteria.

METHODSA gradient of iron concentrations was employed to investigate the growth, photo-pigments (chlorophyll A and phycocyanin), and cell chemical contents (C, N, P) of Microcystis aeruginosa in response to different iron additions.

RESULTSThe specific growth rate during the exponential growth phase, as well as the cell chlorophyll A and the phycocyanin content, was limited by iron below 12.3 tmol Fe x L(-1). The growth was inhibited when the iron concentration was at 24.6 micromol Fe x L(-1). The cell chlorophyll A and the phycocyanin content were saturated when the iron concentration was above 12.3 micromol Fe x L(-1) and declined slightly at 24.6 micromol Fe x L(-1). At a low iron concentration (about 6.15 micromol Fe x L(-1) and less), the cell nitrogen and carbohydrate content were iron limited, and the variation of the cell phosphorus content was similar to that of the nitrogen and carbohydrate, with a transition point of 12.3 micromol Fe x L(-1).

CONCLUSIONThe variation of cynobacteria growth is synchronous with that of the photo-pigments or the cell chemical content, and there exist relationships among photosynthesis, growth and internal chemical content, which could be useful for the growth estimation from the cell characteristics.

Carbohydrates ; analysis ; Culture Media ; chemistry ; Dose-Response Relationship, Drug ; Iron ; pharmacology ; Microcystis ; chemistry ; cytology ; drug effects ; physiology ; Nitrogen ; analysis ; Phosphorus ; analysis

Objective To investigate the effect of 1.94 μm thulium laser enucleation of benign prostatic hyperplasia (BPH) with volume >80 ml by morcellator. Methods From September 2014 to June 2016, there were 95 BPH patients with prostate volume over 80 ml treated by thulium laser were divided into two groups according to the surgical procedure: 45 cases in group A, prostate tissue were washed out of bladder after vapoenucleation by 1.94 μm thulium laser; 50 cases in group B, the enucleated prostate tissue were extracted by morcellator. The operation time, the decreasing level of hemoglobin on the first day after surgery, the hospitalization time, the gland tissue weight, catheterization duration, short-term incidence of complications, and the IPSS, PVP, Qmax, QOL in 3 months after surgeon of the two groups were observed and recorded. Results There was significant difference in operation time and gland tissue weight between the two groups. The group B have significantly short operation time compared with group A (P < 0.05), and obtained gland tissue remarkably exceed the group A (P < 0.05). No significant difference was found in hemoglobin level, hospitalization time, catheterization duration, and short-term complication between the two groups (P > 0.05). The IPSS, PVR, Qmax and QOL of 3 month, after operation were significantly improved but without any significant difference between the two groups (P < 0.05). Conclusion Vaporization cutting tissue or morcellating tissue after 1.94 μm thulium laser enucleation has high safety, good curative effect and low complication, while extraction prostate tissue by morcellator can shorten the operation time and get more tissues.