OBJECTIVE To observe the effects of measures dominated by intensifying link quality on prevention and control of carbapenem-resistant Klebsiella pneumoniae(CRKP)among general ICU patients.METHODS The conventional intervention measures were taken from Jan.2016 to Oct.2020,which was assigned as the pre-inter-vention period;the intervention measures dominated by enhancement of link quality were taken for the general ICU patients(the study group)from Nov.2020 to Oct.2021,which was set as the intervention period,the inter-vention measures were taken for the neurosurgery ICU patients and the surgery ICU patients(the control group).A two-group interrupted time series of a quasi-experimental study was analyzed,and whether or not the intervention measures could reduce the incidence of CRKP hospital-associated infection among the general ICU patients was evaluated.RESULTS A total of 23 713 case-times of patients from three ICU wards were enrolled in the study.The incidence of CRKP hospital-associated infection among the general ICU patients was 4.49 cases per thousand patient-days during intervention period,3.71 cases per thousand patient-days during pre-intervention pe-riod,and there was no significant difference(u=-1.412,P=0.079);it was lower than 7.06 cases per thousand patient-days during nearly one year before the intervention period(from Nov.2019 to Oct.2020),and there was significant difference(u=3.128,P=0.002).The result of analysis of the interrupted time series showed that there was significant difference in the slope change between the study group and the control group after the inter-vention(P=0.035),indicating that the intervention measures could reduce the incidence of CRKP hospital-associ-ated infection in the study group,and there was significant difference in the changing trend between the study group and the control group.CONCLUSIONS The prevention and control measures for CRKP dominated by the link quality management can effectively reduce the incidence of CRKP hospital-associated infection among the gen-eral ICU patients.The prevention and control strategies may provide reference for prevention and control of CRKP in ICUs of other medical institutions.

OBJECTIVE To analyze the characteristics of imported malaria cases in West China Hospital of Sichuan University in recent years and to provide reference for the prevention and control of imported infectious diseases.METHOD A retrospective analysis of 62 cases of imported malaria from abroad reported in West China Hospital of Sichuan University from 2012 to 2023 were retrospectively analyzed.RESULTS From 2012 to 2023,62 cases of imported malaria were reported,including 49 cases(79.03％)of falciparum malaria,10 cases(16.13％)of vivax malaria,and 3 cases(4.84％)of ovale malaria.Among the imported malaria cases,9 cases were severe malaria,with 8(16.33％,8/49)severe cases caused by falciparum malaria,of which 6 cases(75.00％,6/8)were cere-bral malaria.The cases were mainly Chinese citizens and young-to-middle-aged adults,with the highest concentra-tion in the 40-49 age group(37.10％,23/62).There were more males than females,with a male-to-female sex ratio of 11.4∶1;the predominant occupation was worker(38.71％,24/62).The primary region of importation was Africa(90.32％,56/62).There was importation throughout the year,with no distinct seasonal distribution pattern.Two of the admitted cases died(severe cases of falciparum malaria,which developed into cerebral malari-a),while the rest were improved and discharged from the hospital after standardized treatment.CONCLUSIONS Cases of imported malaria from abroad are characterized by Chinese nationality,males,young adults and workers.The type of malaria is mainly falciparum malaria,and the prognosis for most cases is relatively good.It is necessary to strengthen the construction of joint prevention and control systems and other long-term mechanisms,and to continuously and scientifically implement various strategies and measures to prevent the re-emergence of malaria through imported ca-ses,in order to avoid the occurrence of secondary cases resulting from imported infections.

OBJECTIVE To observe the influence of carbapenem-resistant Klebsiella pneumoniae(CRKP)infec-tion/colonization on mortality risk of the intensive care unit(ICU)patients.METHODS The patients who were hospitalized in ICUs of West China Hospital of Sichuan University from Jan.1,2016 to Dec.31,2018 were recrui-ted as the research subjects.By means of retrospective cohort study,the enrolled patients were divided into the CRKP infection/colonization group and the non-CRKP infection/colonization group according to the status of isola-tion of CRKP strains from the clinical specimens of the ICU patients.The 30-day mortality risk of the CRKP in-fection/colonization group and the non-CRKP infection/colonization group was analyzed by Kaplan-Meier.The in-fluencing factors for the 30-day mortality risk of the ICU patients were analyzed by means of Cox proportional haz-ard model.RESULTS A total of 2229 patients were enrolled in the study,of which 89 were assigned as the CRKP infection/colonization group,and 2140 were assigned as the non-CRKP infection/colonization group.The sputum was the major specimen source from the patients with CRKP infection/colonization,and the lower respira-tory tract was the major infection site.The 30-day survival rate was 66.49％in the CRKP infection/colonization group,78.49％in the non-CRKP infection/colonization group,and there was significant difference(x2=7.200,P=0.007).The Cox proportional hazard model analysis showed that the CRKP infection/colonization could in-crease the 30-day mortality risk of the ICU patients(HR=1.839,95％CI:1.126 to 3.002,P=0.015);the age(HR=1.014,95％CI:1.006 to 1.022,P＜0.001),APACHE Ⅱ(HR=1.035,95％CI:1.018 to 1.053,P＜0.001),use of caspofungin(HR=1.398,95％CI:1.038 to 1.882,P=0.028),central venous catheter indwelling(HR=3.752,95％CI:1.808 to 7.790,P＜0.001)and blood purification(HR=2.061,95％CI:1.518 to 2.797,P＜0.001)may also increase the 30-day mortality risk of the ICU patients.CONCLUSIONS The CRKP infection/colonization patients are at higher 30-day mortality risk than the non-CRKP infection/colonization patients.It is necessary to formulate and implement the prevention and control measures to reduce the incidence of CRKP infection/colonization and take measures to reduce the mortality rate of the patients so as to improve the prognosis.

OBJECTIVE To observe the effects of measures dominated by intensifying link quality on prevention and control of carbapenem-resistant Klebsiella pneumoniae(CRKP)among general ICU patients.METHODS The conventional intervention measures were taken from Jan.2016 to Oct.2020,which was assigned as the pre-inter-vention period;the intervention measures dominated by enhancement of link quality were taken for the general ICU patients(the study group)from Nov.2020 to Oct.2021,which was set as the intervention period,the inter-vention measures were taken for the neurosurgery ICU patients and the surgery ICU patients(the control group).A two-group interrupted time series of a quasi-experimental study was analyzed,and whether or not the intervention measures could reduce the incidence of CRKP hospital-associated infection among the general ICU patients was evaluated.RESULTS A total of 23 713 case-times of patients from three ICU wards were enrolled in the study.The incidence of CRKP hospital-associated infection among the general ICU patients was 4.49 cases per thousand patient-days during intervention period,3.71 cases per thousand patient-days during pre-intervention pe-riod,and there was no significant difference(u=-1.412,P=0.079);it was lower than 7.06 cases per thousand patient-days during nearly one year before the intervention period(from Nov.2019 to Oct.2020),and there was significant difference(u=3.128,P=0.002).The result of analysis of the interrupted time series showed that there was significant difference in the slope change between the study group and the control group after the inter-vention(P=0.035),indicating that the intervention measures could reduce the incidence of CRKP hospital-associ-ated infection in the study group,and there was significant difference in the changing trend between the study group and the control group.CONCLUSIONS The prevention and control measures for CRKP dominated by the link quality management can effectively reduce the incidence of CRKP hospital-associated infection among the gen-eral ICU patients.The prevention and control strategies may provide reference for prevention and control of CRKP in ICUs of other medical institutions.

OBJECTIVE To analyze the characteristics of imported malaria cases in West China Hospital of Sichuan University in recent years and to provide reference for the prevention and control of imported infectious diseases.METHOD A retrospective analysis of 62 cases of imported malaria from abroad reported in West China Hospital of Sichuan University from 2012 to 2023 were retrospectively analyzed.RESULTS From 2012 to 2023,62 cases of imported malaria were reported,including 49 cases(79.03％)of falciparum malaria,10 cases(16.13％)of vivax malaria,and 3 cases(4.84％)of ovale malaria.Among the imported malaria cases,9 cases were severe malaria,with 8(16.33％,8/49)severe cases caused by falciparum malaria,of which 6 cases(75.00％,6/8)were cere-bral malaria.The cases were mainly Chinese citizens and young-to-middle-aged adults,with the highest concentra-tion in the 40-49 age group(37.10％,23/62).There were more males than females,with a male-to-female sex ratio of 11.4∶1;the predominant occupation was worker(38.71％,24/62).The primary region of importation was Africa(90.32％,56/62).There was importation throughout the year,with no distinct seasonal distribution pattern.Two of the admitted cases died(severe cases of falciparum malaria,which developed into cerebral malari-a),while the rest were improved and discharged from the hospital after standardized treatment.CONCLUSIONS Cases of imported malaria from abroad are characterized by Chinese nationality,males,young adults and workers.The type of malaria is mainly falciparum malaria,and the prognosis for most cases is relatively good.It is necessary to strengthen the construction of joint prevention and control systems and other long-term mechanisms,and to continuously and scientifically implement various strategies and measures to prevent the re-emergence of malaria through imported ca-ses,in order to avoid the occurrence of secondary cases resulting from imported infections.

OBJECTIVE To observe the influence of carbapenem-resistant Klebsiella pneumoniae(CRKP)infec-tion/colonization on mortality risk of the intensive care unit(ICU)patients.METHODS The patients who were hospitalized in ICUs of West China Hospital of Sichuan University from Jan.1,2016 to Dec.31,2018 were recrui-ted as the research subjects.By means of retrospective cohort study,the enrolled patients were divided into the CRKP infection/colonization group and the non-CRKP infection/colonization group according to the status of isola-tion of CRKP strains from the clinical specimens of the ICU patients.The 30-day mortality risk of the CRKP in-fection/colonization group and the non-CRKP infection/colonization group was analyzed by Kaplan-Meier.The in-fluencing factors for the 30-day mortality risk of the ICU patients were analyzed by means of Cox proportional haz-ard model.RESULTS A total of 2229 patients were enrolled in the study,of which 89 were assigned as the CRKP infection/colonization group,and 2140 were assigned as the non-CRKP infection/colonization group.The sputum was the major specimen source from the patients with CRKP infection/colonization,and the lower respira-tory tract was the major infection site.The 30-day survival rate was 66.49％in the CRKP infection/colonization group,78.49％in the non-CRKP infection/colonization group,and there was significant difference(x2=7.200,P=0.007).The Cox proportional hazard model analysis showed that the CRKP infection/colonization could in-crease the 30-day mortality risk of the ICU patients(HR=1.839,95％CI:1.126 to 3.002,P=0.015);the age(HR=1.014,95％CI:1.006 to 1.022,P＜0.001),APACHE Ⅱ(HR=1.035,95％CI:1.018 to 1.053,P＜0.001),use of caspofungin(HR=1.398,95％CI:1.038 to 1.882,P=0.028),central venous catheter indwelling(HR=3.752,95％CI:1.808 to 7.790,P＜0.001)and blood purification(HR=2.061,95％CI:1.518 to 2.797,P＜0.001)may also increase the 30-day mortality risk of the ICU patients.CONCLUSIONS The CRKP infection/colonization patients are at higher 30-day mortality risk than the non-CRKP infection/colonization patients.It is necessary to formulate and implement the prevention and control measures to reduce the incidence of CRKP infection/colonization and take measures to reduce the mortality rate of the patients so as to improve the prognosis.

Objective:To investigate the efficacy of arthroscopic superior capsular reconstruction using composite autologous patch graft combined with tenodesis of the long head of the biceps tendon in the treatment of irreparable massive rotator cuff tears (IMRCT).Methods:A retrospective case series study was performed on 11 IMRCT patients who were admitted to Affiliated Fuyang Hospital of Bengbu Medical University (Fuyang People′s Hospital) from May 2020 to June 2022, including 7 males and 4 females, aged 54-74 years [(62.6±7.3)years]. All the patients were treated with arthroscopic superior capsular reconstruction using composite patch graft combined with tenodesis of the long head of the biceps tendon. The Visual Analogue Scale (VAS), Acromiohumeral Distance (AHD), Constant-Murley score and University of California Los Angeles (UCLA) score and active range of motion of the shoulder joint before, at 6 months after surgery and at the last follow-up were compared. At the last follow-up, the integrity of reconstructed superior capsule and the long head of the biceps tendon was evaluated using MRI of the shoulder joint. Postoperative complications were observed.Results:All the patients were followed up for 13-39 months [16(13, 36)months]. The VAS score, AHD, Constant-Murley score, and UCLA score were 2(2, 3)points, (9.1±1.1)mm, (56.1±5.4)points, and (19.7±2.8)points respectively at 6 months after surgery, which were all significantly improved from those before surgery [6(5, 7)points, (5.1±1.2)mm, (37.9±2.2)points, and (11.8±1.2)points] ( P<0.05). The VAS score, AHD, Constant-Murley score, and UCLA score were 0(0, 1)points, (8.4±0.9)mm, (83.6±3.8)points, and (28.2±2.3)points respectively at the last follow-up, which were all significantly improved from those before surgery ( P<0.05). At the last follow-up, the VAS score or AHD were not significantly improved from those at 6 months after surgery ( P>0.05); Constant-Murley score and UCLA score were both significantly improved from those at 6 months after surgery ( P<0.05). At 6 months after surgery, shoulder active ranges of motion in forward flexion, abduction and external rotation were (134.6±13.5)°, (124.6±18.6)° and 45(40, 50)° respectively, which were all significantly improved compared with those before surgery [(63.2±36.1)°, (65.0±23.1)°, and [30(20, 40)°] ( P<0.05). At the last follow-up, shoulder active ranges of motion in forward flexion, abduction and external rotation were (144.1±12.6)°, (139.6±15.4)° and 60(45, 65)° respectively, which were all significantly improved compared with those before surgery ( P<0.05). There were no significant differences in active range of motion of the shoulder in forward flexion, abduction and external rotation between 6 months after surgery and the last follow-up ( P>0.05). At the last follow-up, MRI revealed integrity of the reconstructed superior joint capsule and the long head of the biceps tendon in 10 patients. One patient developed resorption of the greater tuberosity and 1 showed a partial tear of the supraspinatus tendon at 1 year after surgery. Conclusion:Arthroscopic superior capsular reconstruction using composite autologous patch graft combined with tenodesis of the long head of the biceps tendon can relieve shoulder pain, decrease upward displacement of the humerus head, improve the function and range of motion of the shoulder joint, and reduce complications in the treatment of IMRCT.

【Objective】 To understand the current situation of blood components distribution in domestic prefecture-level blood stations through analyzing the components distribution data of 24 prefecture-level blood stations in China. 【Methods】 The data of components distribution of 24 blood stations from 2017 to 2020 as well as the data of blood deployment of 24 blood stations from 2019 to 2020 were collected and analyzed. 【Results】 From 2017 to 2020, positive annual growth in red blood cells, plasma and cryoprecipitate was observed in 22, 19 and 15 out of the 24 blood stations, and the annual growth median rate of above three components was 5.24%, 3.80% and 3.25%, respectively. Among the 24 prefecture-level blood stations, 23 carried out the preparation of cryoprecipitate. 【Conclusion】 The distribution of red blood cells, cryoprecipitate and plasma in prefecture-level blood stations is increasing year by year. However, there is a overstock of plasma, and most blood stations need blood employment.

Objective: To investigate the efficacy of first-line administration of generic dasatinib or first-generation TKI (imatinib) in patients with Philadelphia chromosome positive acute lymphoblastic leukemia (Ph⁺ ALL) treated by hematopoietic stem cell transplantation (HSCT). Methods: Clinical features and prognoses of 63 newly diagnosed Ph⁺ ALL patients from Jan 2014 to June 2017 treated by HSCT combined with first-line administration of generic dasatinib or imatinib were retrospective analyzed. Results: Of 63 Ph⁺ ALL patients, 31 cases were administered generic dasatinib, and the other 32 ones imatinib. Complete remission (CR) rates at the fourth week of induction therapy in generic dasatinib and imatinib groups were 96.8% and 93.8% (P=1.000) , respectively. Meanwhile major molecular response (MMR; BCR-ABL/ABL reduce 3log) rates were 41.9% and 43.8% (χ²=0.021, P=0.884), respectively. Relapse rates before transplantation were 6.5% and 12.5% (P=0.672), respectively. MMR rates before HSCT were 83.9% and 68.8% (χ²=1.985, P=0.159), respectively. The 20-monthes overall survival (OS) rates of generic dasatinib and imatinib groups were 95.5% and 76.5% (χ²=0.990, P=0.320) respectively; 20-monthes event-free survival (EFS) rates were 93.5% and 61.4% (χ²=5.926, P=0.015), respectively. Statistically significant differences of EFS were reached. Multiple factors analysis showed that generic dasatinib (HR=0.201, 95% CI 0.045-0.896, P=0.035) and MMR before transplantation (HR=0.344, 95% CI 0.124-0.956, CI=0.041) could improve EFS. Conclusions First-line administration of generic dasatinib could improve EFS for Ph⁺ALL patients treated by HSCT when compered with imatinib.

Staphylococcal nuclease A (SNA) may be used to produce bacterial ghosts for further inactivation of host bacteria and elimination of residual genetic materials. It is still controversial if SNA without signal peptide can be secreted to extracellular matrix and if fusion with other peptide is required for its function in the cytoplasm of host bacteria. To clarify this dispute, a series of temperature-inducible plasmids carrying SNA alone or SNA fused with partial sequences of λ phage cro gene (cSNA) or Mycobacterium tuberculosis urease gene (uSNA) were constructed and evaluated in Escherichia coli. Results show that the percentages of inactivated E. coli by SNA, cSNA and uSNA after 4 h of induction were 99.9%, 99.8% and 74.2%, respectively. Moreover, SNA and cSNA in the cytoplasm of host bacteria were initially detectable after 30 min of induction, whereas uSNA was after 1 h. In comparison, SNA and cSNA in culture supernatant were initially detectable 1 h later, whereas uSNA was 2 h later. The nuclease activity in the cytoplasm or supernatant was ranked as follows: SNA > cSNA > uSNA, and the activity in the supernatant was significantly lower than that in the cytoplasm. Furthermore, host genomic DNA was degraded by SNA or cSNA after 2 h of induction but not by uSNA even throughout the whole experiment. In conclusion, this study indicates that SNA, cSNA and uSNA expressed in host bacteria all have nuclease activity, the enzymes can be released to culture media, and fusion with exogenous peptide negatively reduces the nuclease activity of SNA.
Bacteriolysis ; Bacteriophage lambda ; DNA ; chemistry ; Escherichia coli ; Genetic Vectors ; Micrococcal Nuclease ; chemistry ; Plasmids ; Protein Sorting Signals