Objective:To explore the early warning value of carbapenem-resistant Klebsiella pneumoniae (CRKP) positivity in liver transplantation recipients with rectal swabs, examine the risk factors of CRKP bloodstream infection and provide the relevant treatments.Methods:From June 2018 to December 2019 in Organ Transplantation Research Institute Affiliated Tongji Hospital Tongji Medical College Huazhong University of Science & Technology, 148 cases of liver transplantation recipients with positive CRKP rectal swabbing were recruited. Clinical data were retrospectively analyzed. And the risk factors of CRKP bloodstream infections were examined for intervention and non-intervention groups to observe the effect of interventions of CRKP bloodstream infections.Results:Among them, 23 cases (15.5%) were positive for CRKP and 5 cases (21.7%) were infected with CRKP bloodstream. Rectal swab culture was negative in 125 cases and no bloodstream infection occurred. Long-term use of broad-spectrum antimicrobial agents, severe basic diseases (severe hepatitis), postoperative delayed graft liver function recovery, acute renal failure requiring renal replacement therapy (RRT) and postoperative anti-thymocyte globulin (ATG) induction were risk factors. In intervention group, there were 2 cases (11.1%) of 18 patients with positive CRKP in rectal swab culture in late stage. Among 5 CRKP-positive recipients without intervention, 3 cases (60%) developed later CRKP bloodstream infection. The incidence of bloodstream infection was significantly lower in intervention group than that in non-intervention group ( P<0.05). Conclusions:Rectal swab culture for liver transplantation recipients provides early warning for CRKP bloodstream infection. Interventions for CRKP positive high-risk recipients with rectal swab culture may reduce the occurrence of CRKP bloodstream infection and lower the risk of CRKP bloodstream infection in liver transplantation recipients.

Objective To evaluate the effects of infective necrosis (IN) on prognosis in moderately severe or severe acute pancreatitis (AP).Methods According to the revision of Atlanta classification,from January 2001 to January 2015,admitted patients with moderately severe or severe AP were retrospectively analyzed.According to whether with the presence of persistent organ failure (POF) and / or IN,the patients were divided into four groups:group one with weither IN nor POF,group two with IN but without POF,group three with POF but without IN,group four with both IN and POF.The differences in disease severity and prognosis among groups were compared.Logistic regression and Cox proportional hazard regression model were used to analyze the effect of IN on prognosis.Results A total of 375 moderately severe or severe AP patients were enrolled.There were 211,43,90 and 31 patients in group one,two,three and four,respectively.A total of 121 (32.3％) patients with POF,74 (19.7％) patients with IN,and death in 63 (16.8％) patients.The mortality rate in patients with IN was 32.4％ (24/74),and which was 13.0％(39/301) in patients without IN.The mortality rates of group one,two,three and four were 1.9％(4/211),11.6％(5/43),38.9％(35/90) and 61.3％(19/31),respectively;mortality rate was in a trend of increasing,and the difference was statistically significant (x2 =109.672,P＜0.01).Both IN (OR=8.24,95％CI2.09 to 32.46) andPOF (OR=8.31,95％ CI2.48 to 27.87)were independent risk factors of mortality of AP patients (both P＜0.01).Both IN (OR=2.04,95 ％CI 1.19 to 3.48,0.002) and POF (OR=5.25,95％CI 2.36 to 11.65) also were independent risk factors of shortened survival time of AP patients (both P＜0.01).Conclusions IN is an independent risk factor of disease severity and poor prognosis in AP.The prognosis is the worst in AP patients with both POF and IN.

Objective To evaluate the relationship between Henoch-Schonlein purpura (HSP) accompanying renal impairment and helicobater pylori(Hp) infection.Methods This study consisted of 304 patients with HSP.The patients were divided into 2 groups(group A and group B) based on Hp infection or not(91 cases in group A and 213 cases in group B).Compared with the rates of accompanying renal impairment in 2 groups.And observed the recovery from renal impairment between the patients who were turned into negative(group C)and patients still were positive after the anti-Hp therapy(group D).Numeration data were analyzed by ?2 test.Results Group A which was with Hp infected,the accompanying renal impairment ratio was 65.9%.Group B which was without Hp infected,the ratio was 35.2%.There was significant difference between 2 groups(?2=24.378 P

OBJECTIVETo investigate the association of artemin and GFRalpha3 expressions with perineural invasion and metastasis of pancreatic carcinoma.

METHODSSemi-quantitative reverse transcription polymerase chain reaction (RT-PCR) and immunohistochemistry were used to detect the expression of artemin and GFRalpha3 in pancreatic carcinoma tissues, adjacent tissues and normal pancreas tissues, and the relevance of artemin and GFRalpha3 expressions to the perineural invasion and metastasis of pancreatic carcinoma were analyzed.

RESULTSThe positivity rates of artemin and GFRalpha3 expressions were 72.09% and 67.44% in pancreatic carcinoma, respectively, significantly higher than those in the adjacent tissue (18.19% and 22.73%). The positivity rates of artemin and GFRalpha3 expressions were significantly higher in patients with perineural invasion than in those without perineural invasion (chi(2)=11.11 and 11.78, respectively, P<0.01). Significantly higher expression of artemin mRNA was noted in pancreatic carcinoma (0.741-/+0.014) than in the normal pancreas tissue (0.101-/+0.031, P<0.05), and patients with perineural invasion showed significantly higher positivity rates of artemin mRNA expression (0.843-/+0.012) than those without perineural invasion (0.512-/+0.017, P<0.05).

CONCLUSIONArtemin and GFRalpha3 expressions may play an important role in perineural invasion of pancreatic carcinoma and can be used a useful indicators for evaluating the biological behavior of pancreatic carcinomas.

Adult ; Aged ; Carcinoma, Pancreatic Ductal ; metabolism ; pathology ; Female ; Glial Cell Line-Derived Neurotrophic Factor Receptors ; genetics ; metabolism ; Humans ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Metastasis ; Nerve Tissue Proteins ; genetics ; metabolism ; physiology ; Neurons ; pathology ; Pancreatic Neoplasms ; metabolism ; pathology

BACKGROUNDTobacco-specific 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) is the most important carcinogen in cigarette. Models induced by NNK are widely used in investigations about the mechanisms of pulmonary neoplasia and chemoprevention studies. The aim of this study is to explore the pulmonary precancerous lesions induced by NNK and its possible mechanisms.

METHODSFifteen Wistar rats were divided into two trial groups, in which the high-dose group was instilled with iodized oil including 10 mg (50 mg/kg) NNK into the left lower lobar bronchus, and the low-dose group received 5mg ( 25mg/kg) NNK. Another 15 Wistar rats were instilled only with iodized oil as control group. All rats were examined immediately after instillation and followed up periodically by pulmogram. The pulmonary tissues of rats were pathologically examined, and the expression of AE1/AE3, PCNA and p53 was detected by immunohistochemical method.

RESULTSThe pulmograms showed that the iodized oil localized at the bottom of left lobe and disappeared 107 days later. In trial group, 10 of 15 rats (67%) had nodus at the bottom of left lobe. All of rats in trial group (15/15) displayed atypical hyperplasia in alveolar region, showing single or multiple layers of proliferative epithelial cells along intact alveolar septa with irregular and non-discrete margins of lesion, but continuous alveolar spaces were not obliterated by proliferative epithelial cells. Ten of 15 rats in trial group showed severe atypical hyperplasia of glandular epithelium with occasional infiltrating to muscular layer. All of those atypical hyperplasia cells showed positive AE1/AE3 expression. The positive rate of PCNA was 90% (9/10) and 100% (5/5) in low-dose group and high-dose group respectively, which was significantly higher than that in control group (13%, 2/15) (P=0.000, P=0.001). The positive rate of p53 expression was 50% (5/10) and 60% (3/5) in low-dose group and high-dose group respectively, which was significantly higher than that in control group (0) (P=0.005, P=0.009). However, there was no remarkable difference in PCNA and p53 expression between low-dose group and high-dose group (P > 0.05).

CONCLUSIONSTransbronchial instillation of iodized oil including tobacco-specific NNK can induce pulmonary lesions as atypical hyperplasia of alveolar cell and glandular epithelium in Wistar rats. This model can be used in experimental studies about tobacco-related lung cancer.

Autophagy is a self-renewing cellular process by which defective proteins and aged organs are eliminated. It is noteworthy that autophagy correlates with the initiation and progression of cancer. During epithelial-mesenchymal transition (EMT), cells with epithelial phenotype gain mesenchymal characteristics, thus facilitate invasion and metastasis. Autophagy may suppress EMT by the following mechanisms, such as decreasing hypoxia inducible factor-1 (HIF-1) in hypoxia to downregulate transcription of EMT related genes, regulating TGF-β/Smad signaling pathway negatively, utilizing selective autophagy adaptor, p62, to modulate EMT transcription factors. Further studies of the association between autophagy and EMT may contribute to indentify new targets of cancer therapy.

OBJECTIVETo observe the therapeutic effect of tiotropium bromide powder inhalation on stable bronchiectasis.

METHODSTwenty-two patients with stable bronchiectasis received inhalation of totropium bromide powder at the daily dose of 18 microg, and on days 1 and 28, the patients were examined for forced expiratory volume in one second (FEVl), predicted value [FEVl(%)], forced expiratory volume (FEV), and FEVl/FVC. The symptom score and BODE index were also recorded.

RESULTSAfter 1 month of inhalation therapy, the FEV1% of the patients showed a moderate increase but the increment was not statistically significant (t=-1.875, P>0.05); the symptom score and BODE index decreased significantly after the therapy (t=7.091, P<0.001; t=2.982, P<0.05).

CONCLUSIONLong-term inhalation of tiotropium bromide powder can improve the clinical symptoms and BODE index and enhance the exercise tolerance and quality of life of the patients with bronchiectasis.

Administration, Inhalation ; Adult ; Aged ; Bronchiectasis ; drug therapy ; Female ; Forced Expiratory Volume ; Humans ; Male ; Middle Aged ; Powders ; Receptor, Muscarinic M3 ; antagonists & inhibitors ; Scopolamine Derivatives ; administration & dosage ; Tiotropium Bromide

Objective To understand the genetic polymorphism of Salmonella and Staphylococcus aureus in Guangdong province, as well as to explore methods for identifying and tracing the source of these two foodbome pathogens. Methods Using the automated ribotyping system, two foodbome pathogens were tested with either EcoR Ⅰ or Pvu Ⅱ restriction enzymes. BioNumerics software was then applied for image analysis, database establishment and other corresponding analysis. Results Digestion of 32 Salmonella isolates with Pvu Ⅱ yielded 19 different ribotypes,and digestion of 14 Salmonella isolates with EcoR Ⅰ yielded 2 different ribotypes. Staphyloccus aureus isolates showed greater genetic diversity, whereas EcoR Ⅰ digestion of 49 different isolates yielded 31 different ribotypes. Conclusion Unique Salmonella and Staphylococcus aureus isolates could be identified through ribotyping. Although Salmonella serotyping and ribotyping were not strongly correlated, the combination of both restriction enzymes could be used to more effectively identify the genetic relationship among different strains as well as the source of food poisoning. Thus, not only could the genetic relationships amongst the different strains be inferred through ribotyping skills, the source of food poisoning and mode of transmission could also be determined under the use of this method.

OBJECTIVETo investigate water exposure modes and times of different populations in mountainous schistosomiasis endemic areas and to inform about the control strategies.

METHODSAll 1054 residents from populations around Qionghai Lake were randomly sampled according to occupation for a retrospective questionnaire survey in November 2001. Each individual was interviewed for his/her mode, frequency, and duration of water exposure occurring between April and October 2001.

RESULTSThe average exposure times and intensity were higher in farmers (median: 16 - 18 min/day and 2.41 - 2.5, respectively) who grow rice, tobacco, and vegetables than others (median: 3.74 - 7.39 min/day and 0.81 - 1.52, respectively); exposure frequency was found highest in farmers (median: 2.04 times/day) in all occupations; schoolchildren had low exposure frequency and times, but very high exposure intensity (median 2.34). Between April and June it is an agriculturally busy season, that is also a peak season of water exposure of adults. Schoolchildren's water exposure peaks on July and August, mainly due to playing water and swimming. Exposure times and intensities were higher in females than in males.

CONCLUSIONWater exposure modes, times, and intensities of different populations were different in mountainous schistosomiasis endemic areas of Xichang. Between April and June should be the peak infection season of adults who are engaging in agricultural activities, while July to August should be the peak infection season for schoolchildren with non-agricultural activities.

Adult ; China ; Environmental Exposure ; analysis ; Female ; Humans ; Male ; Retrospective Studies ; Schistosomiasis ; epidemiology ; Surveys and Questionnaires ; Topography, Medical ; Water ; parasitology

OBJECTIVETo study the effect of hydroquinone on apoptosis of bone marrow mononuclear cells, and to evaluate the toxic effect of benzene on stem cells.

METHODSCell morphology was observed by HT fluorescent stain method, and DNA fragments were analyzed by agarose gel electrophoresis. Anti-Annexin V FITC plus PI staining for apoptotic and necrotic rate was examined by flow cytometer.

RESULTSAfter adding different concentrations of hydroquinone to the cells for 6 h culture, the fluorescent intensity of nucleus increased, the color of nucleus became deep and inhomogeneous, and the chromatin was condensed and distributed around the neucleus. DNA ladder was detected in all samples. Cell apoptotic rate in different concentration of hydroquinone groups was significantly higher than that in blank control group (P < 0.05). With the increase of the concentration of hydroquinone, the apoptotic and necrotic rate also increased. The optimal concentration of hydroquinone was 50 micro mol/L. When it was >or= 75 micro mol/L, the necrotic rate increased significantly. Hydroquinone-induced apoptosis was associated with culture time at the concentration of 50 micro mol/L, and the peak apoptotic time was 10 h, then the apoptotic rate decreased and necrotic rate increased.

CONCLUSIONHydroquinone can induce apoptosis of bone marrow mononuclear cells in vitro with dose-effect and time-effect relationship.

Apoptosis ; drug effects ; Bone Marrow Cells ; cytology ; Cells, Cultured ; Dose-Response Relationship, Drug ; Humans ; Hydroquinones ; pharmacology ; Leukocytes, Mononuclear ; cytology ; drug effects ; Mutagens ; pharmacology