To analyze the biological characteristics of Pasteurella multocida in bovine respiratory tract and its prevalence in large-scale cattle farms,bacterial isolation,culture,and morphological observation were conducted on the lungs and liver samples of dead cows suffering from respiratory diseases in Hohhot,Inner Mongolia.The isolated strains were studied through biochemical testing,16S rRNA gene sequencing,specific primer PCR identification,capsule serotyping,pathogenicity testing,virulence gene testing,drug sensitivity testing,and drug resistance gene detection methods.The results showed that six strains of Pasteurella multocida serotype A were isolated and identi-fied from the lungs of diseased and dead cows.After sequencing the 16S rRNA sequence of the bac-teria,it was found that the six strains of Pasteurella multocida had the closest genetic relationship with the Chongqing isolate CQ2(CP033599.1).The results of mouse pathogenicity test and viru-lence gene detection showed that all isolates were pathogenic and carried at least 16 or more related virulence genes such as exbB,nanB,sodC,oma 87,etc.,but no hsf1 and toxA were detected.The results of drug sensitivity tests and resistance gene detection showed that the isolated strains were sensitive to different degrees of antibiotics such as ciprofloxacin,ofloxacin,and cefotaxime.They were resistant to streptomycin,clindamycin,and lincomycin,and resistance genes of str A,strB,and tet(H)were detected.The results indicate that there is a certain correlation between the pathoge-nicity and virulence genes,drug resistance phenotype,and drug resistance genes of Pasteurellamultocida type A in cattle.It is recommended to use quinolones(such as ciprofloxacin)and cepha-losporins(such as cefotaxime)antibacterial drugs in clinical practice,which can provide scientific basis and prevention and control plans for the prevention and treatment of respiratory diseases caused by Pasteurella multocida in cattle farms,and lay a foundation for the epidemiological mo-nitoring of bovine respiratory multocida pasteurellosis.

Objective: To investigate the origin of infection and risk factors of a case with SARS-CoV-2 infection associated with overseas countries in the Ningbo-Zhoushan Port, Zhejiang Province, so as to provide the evidence for improving the COVID-19 control measures at ports. Methods: Ningbo Center for Disease Control and Prevention ( CDC ) and Beilun CDC conducted case finding and epidemiological surveys immediately after being informed. The general information, history of vaccination and the travel during the latest 14 days were collected from the positive case, and all close contacts were tracked. Saliva samples were collected for SARS-CoV-2 nucleic acid testing and whole-genome sequencing, and the sequencing results were aligned with the GISAID's EpiCoV database. The origin of infection and transmission route of the positive case was investigated. Results: A case was identified positive for SARS-CoV-2 nucleic acid during company M's routine screening in the Ningbo-Zhoushan Port on August 10, 2021, and was confirmed positive for SARS-CoV-2 nucleic acid by Beilun CDC and Ningbo CDC on August 11. Whole-genome sequencing showed SARS-CoV-2 B.1.617.2 ( Delta ) variant, which shared the highest homology with the virus sequence uploaded by Russia on June, 2021 ( Russia/MOW-RII-MH27356S/2021 ). The case was a bundling worker for overseas container ships, and reported communicated with foreign boatmen and contacted materials without protected interventions on the SINOKOR AKITA Container Ship between August 4 and 5, 2021. This ship anchored at Vladivostok, Russia from July 27 to 29, anchored at Ningbo Harbor on August 4, and departed on August 5. Then, 11 boatmen from this ship were tested positive for SARS-CoV-2 nucleic acid on August 8. One asymptomatic case was reported in this epidemic; 254 close contacts and 617 secondary close contacts were identified, and all were tested negative for SARS-CoV-2 nucleic acid. No new cases with SARS-CoV-2 infections were detected until August 25, 2021, and the emergency response was therefore terminated. Conclusions The infection was a sporadic COVID-19 epidemic associated with overseas countries, which was caused by Delta variant infection through contacts with foreign boatmen or materials by a bundling worker in Ningbo-Zhoushan Port; fortunately, no epidemic spread occurred. Intensified closed-loop management and increased frequency of SARS-CoV-2 nucleic acid test among high-risk populations, and improving the precision and rapid emergency treatment of COVID-19 epidemics are required for the containment of COVID-19 at ports.

Objective:To investigate the bacterial composition and antimicrobial resistance profile of clinical isolates from bloodstream infections in China.Methods:The clinical bacterial strains isolated from blood culture were collected during January 2020 to December 2020 in member hospitals of Blood Bacterial Resistant Investigation Collaborative System (BRICS). Antibiotic susceptibility tests were conducted by agar dilution or broth dilution methods recommended by Clinical Laboratory Standards Institute(CLSI, USA). WHONET 5.6 was used to analyze data.Results:During the study period, 10 043 bacterial strains were collected from 54 hospitals, of which 2 664 (26.5%) were Gram-positive bacteria and 7 379 (73.5%) were Gram-negative bacteria. The top 10 bacterial species were Escherichia coli (38.6%), Klebsiella pneumoniae (18.4%), Staphylococcus aureus (9.9%), coagulase-negative Staphylococci (7.5%), Pseudomonas aeruginosa (3.9%), Enterococcus faecium (3.3%), Enterobacter cloacae (2.8%), Enterococcus faecalis (2.6%), Acinetobacter baumannii (2.4%) and Klebsiella spp (1.8%). The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase-negative Staphylococcus aureus were 27.6% and 74.4%, respectively. No glycopeptide- and daptomycin-resistant Staphylococci were detected. More than 95% of Staphylococcus aureus were sensitive to rifampicin and SMZco. No vancomycin-resistant Enterococci strains were detected. Extended spectrum β-lactamase (ESBL) producing Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis were 48.4%, 23.6% and 36.1%, respectively. The prevalence rates of carbapenem-resistance in Escherichia coli and Klebsiella pneumoniae were 2.3% and 16.1%, respectively; 9.6% of carbapenem-resistant Klebsiella pneumoniae strains were resistant to ceftazidime/avibactam combination. The prevalence rate of carbapenem-resistance in Acinetobacter baumannii was 60.0%, while polymyxin and tigecycline showed good activity against Acinetobacter baumannii. The prevalence rate of carbapenem-resistance of Pseudomonas aeruginosa was 23.2%. Conclusions:The surveillance results in 2020 showed that the main pathogens of bloodstream infection in China were gram-negative bacteria, while Escherichia coli was the most common pathogen, and ESBL-producing strains declined while carbapenem-resistant Klebsiella pneumoniae kept on high level. The proportion and the prevalence of carbapenem-resistant Pseudomonas aeruginosa were on the rise slowly. On the other side, the MRSA incidence got lower in China, while the overall prevalence of vancomycin-resistant Enterococci was low.

Objective:To investigate the distribution and antimicrobial resistance profile of clinical bacteria isolated from blood culture in China.Methods:The clinical bacterial strains isolated from blood culture from member hospitals of Blood Bacterial Resistant Investigation Collaborative System (BRICS) were collected during January 2018 to December 2019. Antibiotic susceptibility tests were conducted with agar dilution or broth dilution methods recommended by US Clinical and Laboratory Standards Institute (CLSI). WHONET 5.6 was used to analyze data.Results:During the study period, 14 778 bacterial strains were collected from 50 hospitals, of which 4 117 (27.9%) were Gram-positive bacteria and 10 661(72.1%) were Gram-negative bacteria. The top 10 bacterial species were Escherichia coli (37.2%), Klebsiella pneumoniae (17.0%), Staphylococcus aureus (9.7%), coagulase-negative Staphylococci (8.7%), Pseudomonas aeruginosa (3.7%), Enterococcus faecium (3.4%), Acinetobacter baumannii(3.4%), Enterobacter cloacae (2.9%), Streptococci(2.8%) and Enterococcus faecalis (2.3%). The the prevalence of methicillin-resistant S. aureus (MRSA) and methicillin-resistant coagulase-negative Staphylococcus were 27.4% (394/1 438) and 70.4% (905/1 285), respectively. No glycopeptide-resistant Staphylococcus was detected. More than 95% of S. aureus were sensitive to amikacin, rifampicin and SMZco. The resistance rate of E. faecium to vancomycin was 0.4% (2/504), and no vancomycin-resistant E. faecalis was detected. The ESBLs-producing rates in no carbapenem-resistance E. coli, carbapenem sensitive K. pneumoniae and Proteus were 50.4% (2 731/5 415), 24.6% (493/2001) and 35.2% (31/88), respectively. The prevalence of carbapenem-resistance in E. coli and K. pneumoniae were 1.5% (85/5 500), 20.6% (518/2 519), respectively. 8.3% (27/325) of carbapenem-resistance K. pneumoniae was resistant to ceftazidime/avibactam combination. The resistance rates of A. baumannii to polymyxin and tigecycline were 2.8% (14/501) and 3.4% (17/501) respectively, and that of P. aeruginosa to carbapenem were 18.9% (103/546). Conclusions:The surveillance results from 2018 to 2019 showed that the main pathogens of bloodstream infection in China were gram-negative bacteria, while E. coli was the most common pathogen, and ESBLs-producing strains were in majority; the MRSA incidence is getting lower in China; carbapenem-resistant E. coli keeps at a low level, while carbapenem-resistant K. pneumoniae is on the rise obviously.

Objective:To examine the surgical treatment of Stanford type A aortic dissection (type A dissection) after thoracic endovascular aortic repair (TEVAR).Methods:The data of 58 patients with reoccurrence of type A dissection after TEVAR admitted into the Department of Cardiovascular Surgery, Henan Chest Hospital from February 2012 to January 2020 were analyzed retrospectively. There were 40 males and 18 females, aged (57.0±6.7) years (range: 31 to 71 years). The time between recurrence of type A dissection and TEVAR ( M( Q R)) was 37 days (72.8 months) (range: 1 h to 14 years). Forty-eight cases underwent emergency operation, 9 cases underwent sub-emergency operation, and 1 case died of dissection rupture on the way to the operating room. All 57 patients underwent radical treatment. Fifty-four cases underwent the frozen elephant trunk technique under deep hypothermia circulatory arrest and selective cerebral perfusion, and 3 cases (>65 years old) underwent arch debranch anastomosis+ascending aorta replacement+descending arch covered stent implantation under mild hypothermia. Results:The operation time was (445±32) minutes (range: 382 to 485 minutes), the aortic crossclamp time was (103±19) minutes (range: 89 to 133 minutes), the cardiopulmonary bypass time was (189±27) minutes (range: 162 to 221 minutes), and the intraoperative blood loss was (665±343) ml (range: 450 to 1 750 ml). Postoperative ICU stay time was 5 (6) days (range: 2 to 27 days), and postoperative hospital stay was 14.0 (4.5) days (range: 2 to 36 days). Three cases died, including 2 cases with severe brain complications and 1 case with systemic multiple organ failure caused by severe liver insufficiency and gastrointestinal hemorrhage. Postoperative follow-up was 0.5 to 7.0 years, which showed that 1 case had left coronary artery anastomotic stoma fistula 3 months after operation and underwent reoperation, 2 cases underwent thoracoabdominal aortic replacement again, and the rest of patients had no anastomotic stoma fistula and incomplete stent distortion and expansion on CT angiography. Four cases died during follow-up, and 1 case died of sudden cerebral infarction 2 years after operation.Conclusion:The recurrent type A dissection after TEVAR is mostly related to stent graft, and the patients can undergo operation actively with good prognosis.

Objective:To examine the surgical treatment of Stanford type A aortic dissection (type A dissection) after thoracic endovascular aortic repair (TEVAR).Methods:The data of 58 patients with reoccurrence of type A dissection after TEVAR admitted into the Department of Cardiovascular Surgery, Henan Chest Hospital from February 2012 to January 2020 were analyzed retrospectively. There were 40 males and 18 females, aged (57.0±6.7) years (range: 31 to 71 years). The time between recurrence of type A dissection and TEVAR ( M( Q R)) was 37 days (72.8 months) (range: 1 h to 14 years). Forty-eight cases underwent emergency operation, 9 cases underwent sub-emergency operation, and 1 case died of dissection rupture on the way to the operating room. All 57 patients underwent radical treatment. Fifty-four cases underwent the frozen elephant trunk technique under deep hypothermia circulatory arrest and selective cerebral perfusion, and 3 cases (>65 years old) underwent arch debranch anastomosis+ascending aorta replacement+descending arch covered stent implantation under mild hypothermia. Results:The operation time was (445±32) minutes (range: 382 to 485 minutes), the aortic crossclamp time was (103±19) minutes (range: 89 to 133 minutes), the cardiopulmonary bypass time was (189±27) minutes (range: 162 to 221 minutes), and the intraoperative blood loss was (665±343) ml (range: 450 to 1 750 ml). Postoperative ICU stay time was 5 (6) days (range: 2 to 27 days), and postoperative hospital stay was 14.0 (4.5) days (range: 2 to 36 days). Three cases died, including 2 cases with severe brain complications and 1 case with systemic multiple organ failure caused by severe liver insufficiency and gastrointestinal hemorrhage. Postoperative follow-up was 0.5 to 7.0 years, which showed that 1 case had left coronary artery anastomotic stoma fistula 3 months after operation and underwent reoperation, 2 cases underwent thoracoabdominal aortic replacement again, and the rest of patients had no anastomotic stoma fistula and incomplete stent distortion and expansion on CT angiography. Four cases died during follow-up, and 1 case died of sudden cerebral infarction 2 years after operation.Conclusion:The recurrent type A dissection after TEVAR is mostly related to stent graft, and the patients can undergo operation actively with good prognosis.

Objective:To investigate the influence of Jinshuibao tablet on immune function, therapeutic efficacy and safety in treatment of advanced lung squamous cell carcinoma patients treated by chemotherapy.Methods:The clinical data of 124 patients with stage Ⅳ lung squamous cell carcinoma who were admitted to Shanxi Provincial Cancer Hospital from January 2015 to December 2017 were retrospectively analyzed, including 60 patients treated by Jinshuibao tablet combined with chemotherapy (the observation group) and 64 patients treated by chemotherapy alone (the control group). The changes of immune function, therapeutic effect, and side effects were compared between the two groups.Results:The percentage of CD4 + cells after treatment [(33.4±8.9)% vs. (45.5±11.8)%, t = 2.71, P < 0.05] and CD4 +/CD8 + (0.9±0.3 vs. 1.5±0.4, t = 3.31, P < 0.05) in the observation group was increased compared with that before treatment, CD8 + cells was decreased compared with that before treatment [(30.9±8.6)% vs. (21.1±8.1)%, t = 2.42, P < 0.05], interferon-γ (IFN-γ) [(7.7±2.8)% vs. (14.1±2.4)%, t = 2.74, P < 0.05] and interleukin-2 (IL-2) [(8.8±3.2)% vs. (12.7±1.6)%, t = 2.96, P < 0.05] was increased compared with that before treatment. The percentage of CD3 + cells [(57.9±8.2)% vs. (45.2±10.8)%, t = 2.70, P < 0.05], CD4 + cells [(32.9±9.0)% vs. (22.8±9.6)%, t = 3.19, P < 0.05], NK cells [(14.9±3.1)% vs. (9.3±1.4)%, t = 2.97, P < 0.05] in the control group was decreased compared with that before treatment. Tumor necrosis factor α (TNF-α) was decreased compared with that before treatment [(6.8±1.4)% vs. (4.3±0.5)%, t = 3.23, P < 0.05]. There was a statistically significant difference in the level of T-cell subsets of both groups after treatment (all P <0.05); and the level of CD3 +, CD4 +, CD4 +/CD8 +, NK cells in the observation group was higher than that in the control group; CD8 + cell in the observation group was lower than that in the control group. There was no statistical difference in the level of IFN-γ, IL-2, TNF-α of both groups before treatment (all P > 0.05); the level of IFN-γ, IL-2, TNF-α in the observation group was higher than that in the control group after treatment, and the difference was statistically significant of both groups (all P < 0.05). The total effective rate of the observation group was higher than that in the control group, and the difference was statistically significant [31.3% (20/64) vs. 48.3% (29/60), χ 2 = 4.538, P = 0.033]; and the disease control rate in the observation group was higher than that in the control [56.3% (36/64) vs. 71.7% (43/60), χ 2 = 5.276, P = 0.022]. There was no significant difference between the two groups in adverse reactions of chemotherapy (all P > 0.05). Conclusion:Jinshuibao tablet combined with chemotherapy can improve the immune function and the efficacy of chemotherapy for patients with advanced lung squamous cell carcinoma.

Objective To investigate the optimal HbA1Cthreshold to be used for the diagnosis of diabetes mellitus in Chongming rural area,and further to evaluate the optimal HbA1Ccutoff values in different age stratifications and body mass index classifications.Methods Data from 9,981 individuals aged greater than 40 years who participated in a population-based cross-sectional survey in Shanghai,China,were analyzed.A 2 h 75 g oral glucose tolerance test(OGTT)value was used to diagnose diabetes.The performance of HbA1Cwas evaluated against the results of the OGTTs by using receiver operating characteristic(ROC)curve analysis.Results At the optimal HbA1C cutoff point of 6.15%for newly diagnosed diabetes, sensitivity was 69.73%, and specificity was 89.71%.The optimal HbA1Ccutoff points for diabetes were 6.05%in subject with age less than 60 years(sensitivity was 72.88%, and specificity was 90.25%),and 6.25%in subjects with age≥60 years(sensitivity was 70.89%,and specificity was 92.34%).The optimal HbA1Ccutoff points for diabetes were 6.05% in normal-weight(with sensitivity 70.94%,and specificity 89.93%),6.25%in overweight(with sensitivity 70.21%,and specificity 90.32%), and 6.35% in obese population(with sensitivity 72.33%, and specificity 92.75%).Conclusion An HbA1C threshold of 6.15%was highly specific for detecting undiagnosed diabetes.The HbA1Cdiagnosis cutoff point can be affected by age and overweight/obesity status.

Purpose To explore the diagnostic value of multiple image technique derived from dual-energy CT in arterial+parenchymal phase scan mode in detecting pancreatic adenocarcinoma so as to provide more valuable information for clinical treatment.Materials and Methods Thirty two patients with pancreatic adenocarcinoma proved pathologically underwent dual-phase scan with dual-source CT.Linear blend image,non-linear blend image and iodine map were acquired.The absolute enhancement value of tumor (AEV),the relative enhancement value of tumor (REV),enhancement ratio (ER) of tumor to pancreatic parenchyma,and the image contrast to noise ratio (CNR) were also calculated,so that the diagnostic value and the ability image in two phases to display the pancreatic adenocarcinoma lesions could be assessed.Results On arterial phase,the differences in AEV,REV and CNR value were significant among the three groups images (P＜0.05).On parenchymal phase,the difference in REV,ER,and CNR value were also significant among the three groups (P＜0.05).When the three sequences on the 2 phases were compared with each other,the differences in AEV and REV value of tumor tissues were significant among the groups (P＜0.05).Moreover,the differences of ER value in linear blend image and CNR in the iodine map were significant in dual phase enhancement (P＜0.05).Conclusion Dualenergy CT enhanced scan mode on dual phase combined with multiple sequences can improve the sensitivity in detection of pancreatic adenocarcinoma lesions.

Objective To investigate the changes of sex hormones after lamivudine antiviral treatment in male hepa-titis B patients with compensated cirrhosis, and the significance of changes thereof. Methods Forty-six male patients with compensated cirrhosis were included in patient group. The patient group was given lamivudine antiviral treatment for 24 weeks. The sex hormone levels were compared between before and after treatment. Patients were divided into two groups (complete response group and incomplete response group) according to their response to the treatment. The sex hormone lev-els were compared between these two groups. Results (1)The level of PRL was significantly decreased, and the levels of T and E2 were significantly increased after lamivudine antiviral treatment in patient group.(2)There were significant differenc-es in levels of PRL, T and E2 between complete response group and incomplete response group. Conclusion (1)The lami-vudine antiviral treatment can improve the dysfunction of sex hormones.(2)There was a relationship between the changes of sex hormones and the responses of antiviral treatment.