Objective To analyze the distribution characteristics and drug resistance change of acinetobacter baumannii in prima‐ry hospital during 2005-2014 to provide reference for clinical rational drug use .Methods The infection characteristics of acineto‐bacter baumannii in primary hospital during 10 years and its resistance to 10 kinds of common antibacterial drugs was analyzed .Re‐sults A total of 576 strains of acinetobacter baumannii were isolated during 2005-2014 ,accounting for 31 .44% of all Gram nega‐tive bacteria ,which was significantly higher than that of Escherichia coli ,pseudomonas aeruginosa and klebsiella pneumonia bacillus (P<0 .05);446 strains were mainly originated from the sputum specimens (77 .43% ) and 290 strains(50 .35% ) from ICU ;the re‐sistant rate was 44 .44% for CSL ,62 .24% for MIN and more than 70 .00% for 8 kinds of antibacterial drugs of IPM ,MEM ,etc .;which to IPM ,CAZ ,SXT showed the declining trend year by year ,while which to MEM ,AMK ,LEV ,MIN showed the rising trend year by year .Conclusion The isolated acinetobacter baumannii strains in primary hospital are rised year by year ,and generally have resistance to commonly used antibacterial drugs ,the clinical doctors should rationally select antibacterial drugs according to the drug susceptibility test results for preventing the occurrence of acinetobacter baumannii infection .

ObjectiveTo investigate characteristics in vitro and contrast-enhanced effect in vivo with self-made nano-scale ultrasoud-enhanced contrast agent.MethodsNano-lipid microbubbles were prepared by machine vibration and low-speed centrifugation.The surface potential and the microbubbles size were assessed by Zetasizer nano ZS90.The bubbles dispersity and micromorphous were observed under light microscopy and electron microscope.The characteristics of microbubbles were studied at various times at 4℃ environment.The enhancement duration time and intensity of nano-lipid microbubbles in nude mice livers,kidneys and subcutaneous implanted tumors were observed,and compared with micro-scale microbubbles.ResnltsThe mean diameter of nano-lipid microbubbles was (580.6 ± 36.3) nm.The contrast imaging study in vivo showed the nano-lipid microbubbles could significantly enhance ultrasonic imaging in nude mice livers,kidneys and subcutaneous implanted tumors.ConclusionsSelf-made nano-scale ultrasoudenhanced contrast agent showed good stability and contrast-enhancement effect in vitro,and provide a experimental basis for ultrasound imaging and therapeutics of malignant tumors.

Objective To obtain in situ pairing of the variable region genes of the immunoglobulin heavy and light chains of B cells from vitiligo patients. Methods Fifty vitiligo patients were screened by a live melanocyte enzyme-linked immunoabsorbent assay. The sera from seven patients were proved to be strongly positive. Then CD19+ B cells were isolated from the peripheral blood lymphocytes of the 7 patients, then fixed in 10% buffered formaldehyde and permeabilised by Proteinase K. The mRNA was amplified within the cells by reverse transcription-polymerase chain reaction (RT-PCR) with specific primers. The immunoglobulin VH and VL DNA assembled within the same cells using the Cre/loxP system. Nested primers were designed to amplify the known major human VH and VL gene familes. Result A unique 800bp band was obtained corresponding in size to single chain Fv fragments. Conclusion The in situ pairing of the variable region genes of the immunoglobulin heavy and light chains of B cells is obtained from vitiligo patients by in-cell PCR.

Objective: To investigate the effects of silk fibroin on the immobilization of thrombin. Methods: The immobilized thrombin was prepared using silk fibroin as the carrier and glutaraldehyde as the crosslinking agent. With activity yield as the index, the process conditions of silk fibroin immobilized thrombin were determined by an orthogonal test. Results:The optimum process con-ditions of immobilized thrombin treated with silk fibroin were as follows:the immobilization time was 6 h, the enzyme dosage was 2 400 NIH·g-1 casein, the temperature was 25℃ and pH was 7. 6. The activity recovery of immobilized thrombin was 67. 22%. Conclu-sion:Silk fibroin has the positive immobilization effect on thrombin.

Objective: To investigate the relationship between urinary monohydroxylated metabolites of hydroxyl polycyclic aromatic hydrocarbons (OH-PAHs) and lung function, as well as the role of oxidative stress in these associations, so as to provide a scientific basis for air pollution control and policy formulation. Methods: A panel study was carried out among 45 young healthy adults. Four follow up surveys and health examinations were conducted from November 2017 to October 2018 to measure lung function parameters [forced vital capacity (FVC), second forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), FEV1/FVC, and forced expiratory flow between 25% and 75% vital capacity (FEF 25%~75% )], markers of exposure to 7OHPAHs [∑ 7OH PAHs], and markers of oxidative stress[8 hydroxy 2 deoxyguanosine (8 OHdG) and 8 isoprostaglandin F 2α (8 iso PGF 2α )]. The relationship between urinary PAH metabolites and lung function was quantified by linear mixed effects models. Mediation analysis was performed to assess the role of oxidative stress in the relationship between OH PAHs and lung function. Results: The median values of FVC, FEV1, FEVI/FVC, PEF, and FEF 25%-75% were 4.37 L, 3.58 L, 83.00%, 4.38 L/s, and 3.32 L/s, respectively. The results showed that each 1 unit increase in log transformed value of 2 Hydroxyfluorene (2 OHFlu) was associated with a 5.05% decrease ( β %=-5.05%，95% CI =-8.85%--1.09%) in FVC, 4.15% decrease ( β %=-4.15%，95% CI =-7.94%- -0.22% ) in FEV1 and 5.87% decrease ( β %=-5.87%，95% CI =-11.35%--0.05%) in FEF 25%-75% , respectively. Each 1 unit increase in log transformed values of 2 OHFlu and 9 Phenanthrol (9 OHPhe) was associated with a 7.03% decrease ( β %=-7.03%，95% CI =-12.60%--1.11%) and a 7.08% decrease ( β%=-7.08%，95% CI =-13.50%--0.17%) in PEF, respectively. Additionally, urinary ∑ 7OH PAHs had a positive correlation with the levels of urinary 8 OHdG and 8 iso PGF 2α ( r =0.64, 0.69, P <0.01). Meanwhile, the levels of 8 OHdG mediated 17.06% and 15.71% of the association between 2 OHFlu with FVC and FEV1. Conclusion The finding reveales a negative relationship between urinary OH PAHs and lung function among young healthy adults. The 8 OHdG plays a mediated role in the correlation of 2 OHFlu with FVC and FEV1. Active relevant policies are needed to control air pollution and maintain the healthy living conditions of young people.

Objective:To investigate the difference between the concentration of the peripheral ionized calcium (iCa) monitored at different blood collection points and the target concentration of anticoagulant efficacy in patients with continuous renal replacement therapy (CRRT), so as to provide scientific basis for the best blood collection point in clinical practice.Methods:Taking patients of department of critical care medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology receiving CRRT therapy with 4% citrate anticoagulation as research objects. Type of Prisma-FlexV8CRRT as well as department self-made substituate and dialyzate were adopted for all patients receiving CRRT therapy. Patients were divided into continuous veno- venous hemofiltration (CVVH) group ( n=10) and continuous veno- venous hemodialysis (CVVHD) group ( n=30) depending on their actual conditions and treatment needs. Blood collection was conducted at specific sites for extracorporeal peripheral ionized calcium concentration determination before and after the filter at the time of 2, 4, 8, 14, 20 hours following CRRT therapy for patients from both groups. Target concentration of extracorporeal peripheral ionized calcium was set as 0.2-0.4mmol/L for ensuring the efficacy of extracorporeal citrate anticoagulation. Results:Totally 400 testing results were obtained from 40 included patients during their treatment. In CVVH group, 100 testing results were obtained at the time of 2, 4, 8, 14, 20 hours following CRRT therapy and no significant statistical difference was shown ( P>0.05). In CVVHD group, 300 testing results were obtained at the time of 2, 4, 8, 14, 20 hours following CRRT therapy. The iCa concentration before the filter were (0.53±0.01), (0.50±0.01), (0.52±0.01), (0.53±0.01), (0.53±0.02) mmol/L while the iCa concentration after the filter were (0.41±0.01), (0.40±0.01), (0.39±0.02), (0.41±0.01), (0.40±0.01) mmol/L accordingly, and the difference was statistically significant ( t values were 75.24-103.41, P<0.01). Conclusions:For patients receiving CRRT treatment with citrate anticoagulation in different CRRT mode, testing results obtained from blood collection sites before and after the filter could not reflect the efficacy of citrate anticoagulation correctly and simultaneously to ensure the secure use of the extracorporeal pipelines and filter. In CVVH mode, iCa concentration determined from blood samples collected from sites before and after the filter could refelct the efficacy of citrate anticoagulation equally, while in CVVHD mode, blood collection and determination are suggested to conduct at the site before the filter to faciliate the assessment of the citrate anticoagulation efficacy.

Objective:To analyzes epidemiological characteristics of COVID-19 and provide evidence for adjustment for COVID-19 prevention and control strategies.Methods:The data of COVID-19 cases in Wuchang district reported as of 19 March, 2020 were obtained from National Notifiable Disease Report System of Chinese Disease Prevention and Control Information System. The software’s of Excel 2010, SPSSS 22.0, Arc GIS10.2 and Joinpoint regression program 4.8.0.0 were used for statistical analysis.Results:A total of 7547 COVID-19 cases had been reported as of 19 March, 2020 in Wuchang district, including 5 448 confirmed cases (72.19 %), 2009 clinical diagnosed cases (26.62 %) and 90 asymptomatic cases case (1.19 %). The age of the cases was (56.65±16.25) years and age ranged from 2 days to 105 years among confirmed cases, 2634 were males (48.35 %) and 2814 were females (51.65 %), 2 492 were retirees (45.74 %). A total of 545 health workers were infected with SARS-CoV-2 (7.22 % of all cases) including 365 confirmed cases and 5 cases have died. A total of 430 cases of death were reported with case fatality rate of 7.89 % (430/5 448), case fatality rate of males (10.9 %, 266/2 634) was higher than that of females (5.82 %, 164/2 814). The first phase of epidemic peak was from January 24 to January 26, the second phase of epidemic peak was from February 1 to February 5 and there was no one of new confirmed case in one day for the first time on March 18. The first four Streets with the highest incidence rates of confirmed cases were Huanghelou Street (1 043.77/100 000), Ziyang Street (627.97/100 000), Yangyuan Street (503.67/100 000) and Shuiguohu Street (486.02/100 000). Compared with females, aged ≤50 years and mild cases of clinical classification respectively, males ( RR=0.690, 95 %CI: 0.322-1.478), aged >50 years ( RR=11.745, 95 %CI: 6.878-20.058), severe cases ( RR=2.317, 95 %CI: 1.789-3.000) and critical cases of clinical classification ( RR=10.794, 95 %CI: 7.997-14.569), and gender time-dependent covariate ( RR=1.392, 95 %CI: 1.053-1.840) were major influencing factors of prognosis of COVID-19 confirmed cases. Conclusions:The gender, ages and occupation of distribution were wide among COVID-19 cases in Wuchang district. Males, aged >50 years, severe cases and critical cases of clinical classification were influencing factors of prognosis of COVID-19 confirmed cases. The standardized management of discharged cases, asymptomatic infected cases and close contact persons were main measures to reduce incidence rates of COVID-19 cases.

Objective:To investigate the clinical and gene variant characteristics of PCDH19 gene related epilepsy, and improve the ability of clinicians in early disease identification. Methods:The clinical data of 3 PCDH19 gene related epilepsy patients admitted to Children′s Hospital Affiliated to Zhengzhou University from October 2018 to August 2023 diagnosed by gene detection were reviewed and analyzed. Results:All the patients are female, and the onset age of seizure ranged in their infancy. Seizures in clusters and fever sensitivity were observed in all patients, and were very hard to control by single-drug treatment. Proband 1 was seizure-free after 2 kinds of anti-epileptic drug treatment, but with mild degree of intellectual disability. Proband 2 had refractory epilepsy with severe degree of intellectual disability. Proband 3 was seizure-free after 2 kinds of anti-epileptic drug treatment and without intellectual disability. In the first family, the proband carried heterozygous c.369C>G variant in the PCDH19 gene which was identified as de novo after parental validation. In the second family, the proband carried c.1652T>A variant inherited from her mother. In the third family, the proband carried c.278G>A variant inherited from her father. The 3 mutations had not been reported in the Human Gene Mutation Database. Conclusions:PCDH19 gene related epilepsy is one special kind of X-linked inherited epilepsy syndrome characterized by seizures in clusters and sensitivity to fever. And gene detection can help with early diagnosis and make rational clinical strategies in time. The variants c.369C>G, c.1652T>A and c.278G>A have enriched the gene variant spectrum of PCDH19.

Objective:To report a case of tocilizumab successfully used in a child with febrile infection-associated epilepsy syndrome (FIRES), and to provide a new idea for the treatment of FIRES in children.Methods:The diagnosis and treatment of 1 case of FIRES admitted in Children′s Hospital Affiliated to Zhengzhou University on February 15, 2021 were described, and the prognosis and follow-up of the child were evaluated. At the same time, the literatures on tocilizumab in the treatment of children′s FIRES were reviewed.Results:A 5-year-old case of FIRES was reported. The child was extremely refractory to immunotherapy and anti-seizure medicines, anesthetics and ketogenic diet. So he was treated with tocilizumab (each time 4 mg/kg) at the 36th day and 43rd day, and epileptic seizures were controlled 10 days after the 2nd doses of tocilizumab. During a follow-up of 10 months, his epileptic seizures were controlled and the cognitive behavior and speech function were well recovered. At present, only 3 cases of FIRES in children have been reported all over the world. All the seizures were well controlled and no obvious adverse reactions were observed.Conclusions:FIRES is a rare refractory epilepsy syndrome, resistant to many kinds of anti-seizure medicines or even anesthetic agents, which is difficult to treat and has poor prognosis. Preliminary trials have shown that tocilizumab is effective and well tolerated in children with FIRES. It may be a potential therapeutic modality for children with FIRES.

Objective To analyze the epidemiological patterns and pathogens of clusters of diarrhea in Xicheng Distract , Beijing during 2017-2022 , in order to update the policy of prevention. Mehods Between January 2017 and December 2022, stool samples of patients and partly cooks in clusters of diarrhea were collected and tested by Real-time PCR for Rotavirus, Norovirus, Adenovirus, Sapovirus and Astrovirus. Part of ORF1/ORF2 from Norovirus positive samples were amplified using RT-PCR. PCR products were sequenced and the genetypes were determined. Results Four hundreds and one clusters of diarrheas were reported. Among them , 369 were reported in kindergartens, primary schools and secondary schools. The morbidities were 4.14, 2.13 and 0.69 per thousand, respectively. Seventy four cooks in 15 clusters of diarrhea were Norovirus positive. The rate was 8.67%. Among these pathogens, Norovirus had the largest proportion , but the trend was declining. At least three kinds of genetype of GⅡ Norovirus were detected every year. Conclusion Clusters of diarrhea mainly occurred in kindergartens, primary schools and secondary schools. Result from the increasing proportions of unknown-cause clusters of diarrhea, the testing methods and scopes of pathogens should be extended. Diverse genetypes of Norovirus coexist and alternate in Beijing. So appearance of new genetypes and recombination of existed ones of Norovirus should be closely concerned.