Abstract: Objective　To analyze the distribution and drug resistance of pathogenic bacteria in blood culture specimens of patients with bloodstream infections before and after COVID-19 (2018-2019 and 2020-2021), and to provide scientific basis and reference for rational treatment and effective control of bloodstream infections in the post-epidemic period. Methods Blood culture specimens were collected from patients in Zhongnan Hospital of Wuhan University in the two years before and after the COVID-19 outbreak (2018-2021). The Automated Blood Culture Systems were used to perform blood culture on blood specimens sent for clinical inspection, and the Vitek MS automatic bacterial identification mass spectrometer was used for strain identification and the Vitek 2 automatic bacterial drug susceptibility analyzer was used for drug susceptibility testing and drug resistance analysis. Results　Blood culture specimens were performed on 28 736 patients with suspected bloodstream infection submitted for inspection from January 2018 to December 2019, and a total of 2 181 strains of pathogenic bacteria were detected after removing duplicate strains, with a positive rate of 7.69%, including 1 046 strains of Gram-negative bacteria, accounting for 47.96%. From January 2020 to December 2021, blood culture specimens from 26 083 patients with suspected bloodstream infection were submitted for inspection, and a total of 2 111 strains of pathogenic bacteria were detected after excluding duplicate strains, with a positive rate of 8.09%, including 1 000 strains of Gram-negative bacteria accounted for 47.37%. The drug resistance of Klebsiella pneumoniae was relatively serious, and the sensitivity rate to ertapenem, polymyxin B and tigecycline was more than 90%. The main non-fermentative bacteria Acinetobacter baumannii was more than 50% sensitive to piperacillin/tazobactam, amikacin and polymyxin B. The sensitivity rates of Pseudomonas aeruginosa to piperacillin/tazobactam, ceftazidime, cefepime, amikacin, gentamicin, tobramycin, ciprofloxacin, levofloxacin, piperacillin and meropenem were more than 50%. Conclusions　In the two years before and after COVID-19, there are many types of pathogenic bacteria in bloodstream infection, but the distribution do not differ significantly. The pathogens of bloodstream infection are mainly distributed in ICU, hepatobiliary research institute, and nephrology department. Among them, Gram-negative bacteria such as Escherichia coli, Klebsiella pneumoniae and Acinetobacter baumannii are the main ones, and different pathogens showed great differences in drug resistance.

Objective To evaluate the clinical efficacy of percutaneous haemostat stroke-poking reduction and elastic intramedullary nailing for pediatric radial neck fractures of O'Brien types Ⅱ & Ⅲ.Methods From January 2014 to June 2016,38 children (23 boys and 15 girls) with radial neck fracture of O'Brien type u or Ⅲ were treated by percutaneous haemostat stroke-poking reduction and elastic intramedullary nailing in our department.We had 26 left and 12 right sides.Their ages ranged from 5 to 14 years,averaging 8.6 years.All fractures were fresh.According to O'Brien classification,22 cases were type Ⅱ and 16 type Ⅲ.The operation time,frequency of intraoperative C-arm fluoroscopy,frequency of percutaneous haemostat stroke-poking reduction,and union time were recorded.The elbow function was assessed one day before removal of internal implants according to the Métaizeau scoring system.Results All operations succeeded,lasting from 12 to 25 min (average,16.4 min).The frequency of intraoperative fluoroscopy ranged from 3 to 11 times (average,6.4 times);the frequency of intraoperative percutaneous reduction ranged from 1 to 4 times (average,2.3 times).The patients were followed up for 6 to 22 months (average,1 1.2 months).Postoperative X-ray films showed satisfactory alignment of the fracture ends.All fractures demonstrated clinical and radiographic evidence of complete healing after a mean time of 58 days (from 38 to 72 days).The Métaizeau scoring showed 33 excellent,4 good and one fair cases,yielding an excellent to good rate of 97.4％.Follow-ups revealed no infection,implants breakage,nonunion,fracture redisplacement,or iatrogenic radial nerve injury.Conclusions As percutaneous haemostat stroke-poking reduction can increase the probability of successful reduction at first attempt,reduce frequency of close reduction and X-ray exposure for both children and medical staff,and shorten operation time,the procedure is effective,simple,reliable and minimally invasive,leading to fewer complications.

OBJECTIVETo evaluate the effect of electronic dental analgesia (EDA) device--Team Up Duo during ultrasonic scaling.

METHODSThe clinical trial was conducted as a randomized double-blind split-mouth design. Eighty-one patients requiring ultrasonic scaling were selected as subjects. Patients received treatment using the EDA device either in an active or an inactive state in paired quadrants. The patients scored their pain/discomfort levels with visual analog scale (VAS) after each procedure and filled a questionnaire.

RESULTSIn questionnaire, 79.0% patients felt EDA could relieve pain/discomfort during ultrasonic scaling. But the double-blind test showed that Team Up Duo was effective in 46.9% patients overall. The effective rate was 55.1% and 34.4% in groups with or without attachment loss, respectively. In CP group, the success rate of EDA was not statistically significantly different between the groups according to sex, age or site.

CONCLUSIONSWhen using Team Up Duo during ultrasonic scaling, most patients subjectively believed that it was effective for controlling pain. In fact, this EDA device was effective in partial patients.

Adolescent ; Adult ; Aged ; Child ; Dental Scaling ; methods ; Double-Blind Method ; Female ; Humans ; Intraoperative Complications ; prevention & control ; Male ; Middle Aged ; Pain ; prevention & control ; Surveys and Questionnaires ; Transcutaneous Electric Nerve Stimulation ; instrumentation ; Ultrasonic Therapy ; adverse effects ; Young Adult

Objective To investigate the relationship of-174G ＞ C polymorphism of interleukin 6 (IL-6) gene promoter region upstream-with coronary heart disease (CHD) of Chinese Han population in Nanjing area.Methods The polymorphism of IL-6-174G ＞C gene was confirmed in 235 patients with CHD and 175 healthy individuals by PCR-RFLP,and Hardy-Weinberg equilibrium was tested.DNA samples were selected for sequencing to verify their genotype.The concentration of blood sugar,lipid,C reaction protein (CRP) and glycosylated hemoglobin (HbAlc) in the samples were measured simultaneously.Results The genotype distributions of GG,GC and CC were 98.7％,1.3％ and 0 in CHD group and 97.7％,2.3％ and 0 in control group,respectively.The frequencies of G and C alleles were 99.4％,0.6％ and 98.9％,1.1％ in the two groups.There were no statistical significance for frequencies of genotype and alleles between the two groups (all P ＞ 0.05).Compared with the control group,the differences of smoking,systolic blood pressure (SBP),diastohc blood pressure (DBP),triglyceride (TG),cholesterol (CHOL),low-density lipoproteins-cholesterol (LDL-C),high-density lipoproteins-cholesterol (HDL-C),apolipoprotein A-I (ApoA-I),ApoB,CRP and HbA1 c were statistically significant (all P ＜ 0.05),while age,sex and blood glucose were not statistically significant (all P ＞ 0.05).Conclusion IL-6-174 G ＞ C gene polymorphism should not remarkably correlated with CHD in Chinese Han population in Nanjing area.

OBJECTIVETo evaluate the clinical efficiency and safety of two-micron laser resection of the prostate-tangerine technique (TmLRP-TT) for the treatment of large-volume ( > 70 ml) prostate in patients with benign prostatic hyperplasia (BPH).

METHODSThis retrospective analysis included 80 BPH patients with the prostatic volume larger than 70 ml, all treated by TmLRP-TT. We comparatively analyzed the levels of hemoglobin and serum sodium before and after surgery, recorded intra- and post-operative com- plications, and followed up the patients at 6 and 12 months after operation for International Prostate Symptom Score (IPSS), quality of life (QOL), maximum flow rate (Qmax), and postvoid residual urine volume (PVR).

RESULTSAll the operations were successfully completed. The mean hemoglobin decreased (0.68 +/- 0.43) g/dl intraoperatively, but no apparent reduction was observed in serum sodium. Lower urinary tract symptoms were relieved significantly in all the cases. At 12 months after surgery, IPSS was decreased by 73.89% as compared with the baseline (20.03 +/- 6.9 vs 5.23 +/- 3.59), QOL by 64.55% (4.09 +/- 1.19 vs 1.45 +/- 1.36), and PVR by 79.30% (97.31 +/- 57.90 vs 20.14 +/- 24.20 ml), while Qmax increased by 140.42% ([8.04 +/- 3.62] vs [19.33 +/- 3.28] ml/s). The incidence of complications was low either intraoperatively or during the 12 months after operation.

CONCLUSIONTmLRP-TT is a safe and effective surgical endoscopic approach to the treatment of large-volume prostate in BPH patients.

Aged ; Follow-Up Studies ; Humans ; Laser Therapy ; methods ; Male ; Middle Aged ; Prostatic Hyperplasia ; surgery ; Retrospective Studies ; Transurethral Resection of Prostate ; methods ; Treatment Outcome

Objective: To summarize the clinical data of elastic stable intramedullary nailing(ESIN) in the treatment of long bone fracture of children in a single medical center, and to analyze the problems occurred after the ESIN surgery and corresponding solutions. Methods: A retrospective analysis was conducted regarding the clinical data of 2 133 pediatric long bone fractures conforming to inclusion and exclusion criteria from June, 2005 to December, 2017 in Department of Orthopedics, Children′s Hospital of Nanjing Medical University.There were 1 191 boys and 942 girls, aged from 23 months to 14 years with mean age of (5.7 ± 3.1)years.There were 1 866 cases treated with closed reduction with ESIN, while 267 cases were treated with small incision assisted reduction with ESIN.Postoperative problems have been statistically analyzed. Results: There were altogether 2 133 children, including 603 cases of femur, 311 cases of tibia, 8 cases of fibula, 219 cases of humerus, and 992 cases of ulna/radius.The postoperative complications mainly consist of 62 cases of needle tail irritation reaction, 21 cases of misalignments of fracture alignment, 11 cases of intramedullary nail deformity or angular deformity, 7 cases of limb shortening, 14 cases of limited joint activity, 4 cases of nerve injury, 2 cases of tendon injury, 14 cases of difficult nail removal, 4 cases of cortical cleavage, 8 cases of delayed union, 1 case of nonunion, 6 cases of varus/valgus deformity, 5 cases of epiphyseal injury, 6 cases of ESIN exposure, and 2 cases of metal debris of ESIN′ end. Conclusions The complications of treatment for children with long bone fractures by ESIN cannot be ignored.To master the important biomechanical properties, to get familiar with the local anatomy and to avoid obvious technical errors can reduce the occurrence of postoperative complications.

Objective To observe the change of the salivary occult blood after periodontal mechanical therapy,and to assess the correlations between salivary occult blood and the level of volatile sulphur compounds (VSC) in oral cavity,periodontal clinical parameters,respectively.Methods Fifty patients with gingivititis,mild or moderate periodontitis were included.The level of VSC were measured by Halimeter(R) and salivary occult blood was tested by Periosereen(R) before periodontal examination.Then full mouth plaque index (PLI),probing depth (PD),bleeding index (BI) were charted.Attachment loss (AL) of the Ramfj(o)rd teeth were recorded lastly.Intensive periodontal mechanical therapy was conducted including oral hygiene instruction,scaling and root planing(SRP).Four weeks after SRP,the same examinations were repeated.Results Salivary occult blood was significantly correlated with BI (r = 0.294) and PLI (r =0.308) before periodontal therapy (P < 0.01),and also significantly correlated with VSC level (r = 0.386),PLI (r = 0.456),BI (r = 0.352),AL(r = 0.325) after therapy (P < 0.05).The improvement of VSC level [211.0(111.0-389.5)×10-9 vs 100.0(46.3～165.3)× 10-9],the clinical periodontal parameters including PLI[(1.3 ±1.0) vs (0.4±0.6)],PD[(3.7±l.5)mmvs (2.7±0.9)mm],BI[(1.8±1.2)vs (0.4±0.7) ]and AL[(1.0± 1.1)mm vs (0.1±0.5) mm after the treatment was statistically singnificant(P <0.001).However,standing on the viewpoint of salivary occult blood changes from positive before therapy to negative after therapy,only 80% (40/50) individuals were totally cured.VSC level in oral cavity and periodontal clinical parameters significantly decreased (P < 0.001) following the trends from strong positive,weak positive,to negative results of salivary occult blood test .Condnsions Salivary occult blood was correlated with VSC level in oral cavity of periodontal treated patients.It may be an objective parameter to evaluate the gingival inflammation and the efficacy of the periodontal therapy at individual level.

BACKGROUNDProstate stromal cells are known to regulate epithelial growth as well as support and maintain epithelial function. However, how stromal cells regulate epithelial cells and what differences among various histological/pathological prostate stromal cells in prostate cancer progression still remain unclear. This study aimed to investigate the different phenotypes of human various histological/pathological prostate stromal cells, and their role in tumor promotion.

METHODSThe different phenotypes of the human normal prostatic peripheral zonal primary stromal cells (NPPF), transitional zonal primary stromal cells (NPTF), and prostate cancer associated primary stromal cells (CAF) were examined with growth curves and Annexin V-fluorescein isothiocyanate (FITC) assay. The different effects on prostate cancer cell line C4-2B by NPPF, NPTF, and CAF were examined with MTT assay and Annexin V-FITC assay. The gene expression of different histological/pathological prostate stromal cells was profiled by microarray and hierarchical cluster analysis.

RESULTSThe growth rate of NPPF, NPTF and CAF gradually increased, followed by decreasing apoptosis. In vitro stromal-C4-2B cell line co-culture models, the proliferation and apoptosis of C4-2B cell line were differently affected by human various histological/pathological prostate stromal cells. CAF showed the most powerful effect to C4-2B cell line, as opposed to a weakest effect of NPTF. Microarray and hierarchical cluster analysis showed that the differentially expressed genes of CAF and NPPF were less than NPPF and NPTF, or CAF and NPTF. This was consistent with clinical observations that prostate cancer mostly derived from the peripheral zone and does not usually occur in the transitional zone.

CONCLUSIONNPPF, NPTF and CAF possess extremely different biological characteristics and gene expression, which may play an important role in genesis and development of prostate cancer.

Adult ; Apoptosis ; Cell Line, Tumor ; Cell Proliferation ; Cells, Cultured ; Cluster Analysis ; Flow Cytometry ; Humans ; Immunohistochemistry ; Male ; Prostate ; cytology ; Prostatic Neoplasms ; pathology ; Stromal Cells ; cytology ; metabolism ; Tumor Cells, Cultured

OBJECTIVETo investigate targeted degradation of the androgen receptor (AR) by chimeric molecules (DHT-PROTAC) via the ubiquitin-proteasome pathway in androgen-independent prostate cancer CA-2B cells, and explore the proliferation, secretion and apoptosis of the treated cells.

METHODSC4-2B cells were treated with DHT-PROTAC, and then the expressions of the AR protein and caspase3 in the C4-2B cells were detected by immunohistochemistry and Western blot. The concentration of PSA in the supernatant was examined by ELISA. The cells were counted and their proliferation analyzed by a growth curve. The inhibitory effect on the growth of C4-2B cells was evaluated by MIT assay.

RESULTSCompared with the control group, the DHT-PROTAC-treated group showed an obviously decreased expression of AR proteins with a significant attenuation of the band signals (P < 0.05), a 40% reduction of the AR-positive cells and a 60% decrease of the PSA concentration in the supernatant (P < 0.05). DHT-PROTAC exhibited an inhibitory effect on the C4-2B cells in a time-dependant manner (P < 0.05).

CONCLUSIONThe chimeric molecule (DHT-PROTAC) can target the degradation of androgen receptors, reduce the secretion of PSA and repress the in vitro growth of C4-2B cells.

Antineoplastic Agents ; pharmacology ; Apoptosis ; Cell Line, Tumor ; Cell Proliferation ; Humans ; Male ; Prostate-Specific Antigen ; metabolism ; Prostatic Neoplasms ; drug therapy ; metabolism ; pathology ; Receptors, Androgen ; metabolism

OBJECTIVETo investigate anti-tumor effect of the recombined adenovirus encoding NK4 gene regulated by human telomerase reverse transcriptase (HTERT) promoter (Ad HTERTp-NK4) on human colon cancer.

METHODSColon cell line HCT116 was infected with Ad HTERTp-NK4. NK4 expression was determined by RT-PCR and Western blot. The cell-growth inhibition rate and the invasive capacity of cells were evaluated by MTT method and reconstituted basement membrane invasion assay. The model of subcutaneous tumor was generated by injection of HCT116 cells into the dorsum of nude mice. Ad HTERTp-NK4 was injected around the tumor tissues, and tumor growth was observed.

RESULTSNK4 gene was highly expressed in infected HCT116 cells. The cell growth inhibition rate and the invasive inhibition rate in Ad HTERTp-NK4 cells were 47.14% and 40.63% respectively, which were significantly higher than those in the control cells (2.75% and 2.31%, P<0.05). Tumor growth was significantly inhibited in mice injected with Ad HTERTp-NK4, and the tumor growth inhibition rate was 47.3%, which was significantly higher than that in the controls (4.6%, P<0.05).

CONCLUSIONAd HTERTp-NK4 can inhibit tumor growth and decrease the invasive capacity of tumor cells, which makes it an ideal candidate for new gene therapy for colon carcinoma.

Adenoviridae ; genetics ; Animals ; Cell Line, Tumor ; Cell Proliferation ; Colonic Neoplasms ; genetics ; metabolism ; pathology ; therapy ; Genetic Therapy ; Humans ; Mice ; Mice, Nude ; Neoplasm Invasiveness ; Neoplasm Metastasis ; Promoter Regions, Genetic ; Telomerase ; genetics ; Transfection ; Xenograft Model Antitumor Assays