Abstract: Objective　To analyze the epidemiological characteristics of 151 cases of melioidosis and the drug resistance of Burkholderia pseudomallei (BP), in order to provide the basis for diagnosis, treatment and reasonable prevention of melioidosis. Methods　A total of 151 inpatients and outpatients from the Second Affiliated Hospital of Hainan Medical University from January 1, 2013 to August 31, 2022 were collected, and clinical specimens were submitted for examination to isolate and identify BP strains. The clinical data of 151cases of melioidosis and the drug resistance characteristics of pathogenic bacteria were retrospectively analyzed, and using SPSS26.0 software for statistical analysis. Results　Among 151 cases with BP infection, there were 138 males (91.4%) and 13 females (8.6%); the most patients were aged from 45-<60 years old, accounting for 74 cases (49.0%); melioidosis incidence was concentrated in October (19.2%), November (19.2%), August (9.9%) and July (8.6%), and; the number of confirmed cases showed an increasing trend and the time for confirmation was <10 d; Internal medicine system (31.1%), surgery system (26.5%) and intensive care department (20.5%) were the common departments for treating melioidosis; blood (49.0%), sputum (9.9%) and wound secretion (8.6%) were the main clinical specimens for detecting BP; pulmonary infection (68.2%), sepsis (35.1%) and local suppurative infection (23.8%) were the top clinical manifestations in patients with BP infection; the effective rate of treating melioidosis was 74.8%; abnormal liver function was a risk factor for the curative effect of melioidosis (χ2=5.010, P<0.05); the sensitivity rates of BP strains to sulfamethoxazole-trimethoprim (SXT), doxycycline (DOX), imipenem(IPM), ceftazidime (CAZ), amoxicillin/clavulanate (AMC) and tetracycline (TCY) were generally more than 90%, with sensitivities of 98.7%, 97.2%, 96.7%, 94.0%, 93.2% and 90.7%, respectively. Conclusions　It can be concluded that misdiagnosis or missed diagnosis of melioidosis is easy to occur, and the understanding of the epidemiological characteristics and risk factors in this area should be strengthened. The sensitivity of BP to commonly used antibiotics has shown a certain downward trend, clinical use should be standardized, and drug resistance monitoring should be strengthened to improve the efficacy of melioidosis treatment.

【Objective】 To share the technical key points and experience of transvesical robot-assisted radical prostatectomy (TvRARP). 【Methods】 The clinical data of 13 patients with prostate cancer (PCa) receiving TvRARP during Nov.2021 and May 2022 were collected. The operation time, estimated blood loss, blood transfusion rate, catheter removal time, postoperative length of hospital stay, immediate urinary continence rate, postoperative IIEF-5 score and perioperative complications were evaluated. 【Results】 The operation time was (142±39) min, estimated intraoperative blood loss was (76±40) mL, and no transfusion was needed. The median postoperative IIEF-5 score was 16 (12-22), hospital stay 3 (2-5)days, and catheter removal time 7(5-14)days. Of all 13 patients, 12(92.3%) achieved immediate urinary continence at the removal of catheter. There were no postoperative complications of Clavien Ⅲ and above. Clavien Ⅰ-Ⅱ complications were observed in 4 patients (30.8%). 【Conclusion】 TvRARP is feasible and safe for selected patients with clinically localized PCa, which can ensure promising postoperative urinary continence and preserve erectile functional.

Objective To explore and analyze the risk factors of severe falciparum malaria cases,and to provide evidence for early clinical prevention and intervention measures. Methods A total of 114 imported cases of falciparum malaria in Wuhan from March 2012 to November 2019 were selected,divided into mild group(n=87)and severe group(n=27),and logistic regression analysis was performed on the risk factors of severe disease. Results There were significant differences in length of stay, erythrocyte, hemoglobin, platelet, urea, creatinine, albumin, creatine kinase isoenzyme, lactate dehydrogenase, urine occulting blood and urine protein between mild group and severe group (P<0.05).Multivariate Logistic regression analysis showed that alanine aminotransferase (OR=0.167, 95%CI: 0.042-0.668), albumin (OR=24.843, 95% CI: 5.170-119.383), urea (OR=0.240,95%CI: 0.074-0.779) and occulted blood in urine (OR=0.204, 95%CI: 0.062-0.672) were independent influencing factors for the occurrence of severe falciparum malaria. Conclusion Patients with liver function damage and alanine aminotransferase increased by more than 2 times(≥80U/L),albumin decreased(<30g/L),renal function damage,increased urea nitrogen,hematuria and other abnormal results, the possibility of severe falsiparum malaria development should be highly suspected.

Characteristics of collapsed tibial plateau fracture determines that the joint surface must remain anatomical reduction,line of force in tibial must exist and internal fixation must be strong. However, while renewing articular surface smoothness, surgeons have a lot of problems in dealing with bone defect under the joint surface. Current materials used for bone defect treatment include three categories: autologous bone, allograft bone and bone substitutes. Some scholars think that autologous bone grafts have a number of drawbacks, such as increasing trauma, prolonged operation time, the limited source, bone area bleeding,continuous pain, local infection and anesthesia,but most scholars believe that the autologous cancellous bone graft is still the golden standard. Allograft bone has the ability of bone conduction, but the existence of immune responses, the possibility of a virus infection, and the limited source of the allograft cannot meet the clinical demands. Likewise, bone substitutes have the problem that osteogenesis does not match with degradation in rates. Clinical doctors can meet the demand of the patient's bone graft according to patient's own situation and economic conditions.
Bone Substitutes ; Bone Transplantation ; Humans ; Tibial Fractures ; surgery

OBJECTIVEEstablished with amphotericin B perforated patch-clamp technique, to study the electrophysiological properties of calyx synapses.

METHODSIn the present experiments, we studied the application of perforated patch clamp technique on the calyx synapses of mice with Amphotericin B.

RESULTSThe use of Amphotericin B significantly slowed down the decay of channel currents and the optimum concentration was 400 microg/ml.

CONCLUSIONThe syudy developed a stable of perforated patch clamp whole cell recording technique, could be more effecitve, more real reaction neurons electrophysiological characteristics of the channel current. Our work might provide the basic information to future users studying the signal transmission and regulation of auditory system of rodents.

Amphotericin B ; pharmacology ; Animals ; Mice ; Neurons ; drug effects ; Patch-Clamp Techniques

Objective To evaluate the efficacy and safety of risperidone long-acting injectable (LAIR) for the treatment of schizophrenia in a large sample size in Chinese population.Methods This was an open-label, multi-center and prospective study in naturalistic treatment.Patients suffering from schizophrenia and schizoaffective disorder according to the Diagnostic and Statistical Manual of Mental Disorders-IV diagnostic criteria were treated with LAIR for 12 weeks, every two weeks a time.The PANSS total score, positive and negative symptom scores, Clinical Global Impressions-Severity and Clinical Global Impressions-Improvement were evaluated at baseline, and the 4th, 6th, 8th, 12th week treatment respectively.The adverse events were recorded.Results Altogether 251 patients from 17 hospitals across China were enrolled in the study.From the end of 4th week to the end of 12th week, the PANSS total score,positive and negative symptom scores, general psychopathology score significantly decreased compared with the baseline score (P<0.01).The effective rate, improvement rate and the percentage of patients who met the criteria of clinical relief were 57.4%, 79.9% and 76.6%, respectively.At the end of 4th week, the better decline level on PANSS score were in patients with illness duration of 2 years or shorter than that in ones with duration of longer than 2 year, and this trend persisted into the end of treatment.The total adverse events rate was 12.4%, and most were mild and moderate.Conclusions LAIR is effective and safe for treatment of schizophrenia and schizoaffective disorder, with better effect in patients with shorter illness duration.

Objective To evaluate the efficacy and safety of risperidone long-acting injectable (LAIR) for the treatment of schizophrenia in a large sample size in Chinese population.Methods This was an open-label, multi-center and prospective study in naturalistic treatment.Patients suffering from schizophrenia and schizoaffective disorder according to the Diagnostic and Statistical Manual of Mental Disorders-IV diagnostic criteria were treated with LAIR for 12 weeks, every two weeks a time.The PANSS total score, positive and negative symptom scores, Clinical Global Impressions-Severity and Clinical Global Impressions-Improvement were evaluated at baseline, and the 4th, 6th, 8th, 12th week treatment respectively.The adverse events were recorded.Results Altogether 251 patients from 17 hospitals across China were enrolled in the study.From the end of 4th week to the end of 12th week, the PANSS total score,positive and negative symptom scores, general psychopathology score significantly decreased compared with the baseline score (P<0.01).The effective rate, improvement rate and the percentage of patients who met the criteria of clinical relief were 57.4%, 79.9% and 76.6%, respectively.At the end of 4th week, the better decline level on PANSS score were in patients with illness duration of 2 years or shorter than that in ones with duration of longer than 2 year, and this trend persisted into the end of treatment.The total adverse events rate was 12.4%, and most were mild and moderate.Conclusions LAIR is effective and safe for treatment of schizophrenia and schizoaffective disorder, with better effect in patients with shorter illness duration.

BACKGROUNDH3N2 subtype influenza A viruses have been identified in humans worldwide, raising concerns about their pandemic potential and prompting the development of candidate vaccines to protect humans against this subtype of influenza A virus. The aim of this study was to establish a system for rescuing of a cold-adapted high-yielding H3N2 subtype human influenza virus by reverse genetics.

METHODSIn order to generate better and safer vaccine candidate viruses, a cold-adapted high yielding reassortant H3N2 influenza A virus was genetically constructed by reverse genetics and was designated as rgAA-H3N2. The rgAA-H3N2 virus contained HA and NA genes from an epidemic strain A/Wisconsin/67/2005 (H3N2) in a background of internal genes derived from the master donor viruses (MDV), cold-adapted (ca), temperature sensitive (ts), live attenuated influenza virus strain A/Ann Arbor/6/60 (MDV-A).

RESULTSIn this presentation, the virus HA titer of rgAA-H3N2 in the allantoic fluid from infected embryonated eggs was as high as 1:1024. A fluorescent focus assay (FFU) was performed 24-36 hours post-infection using a specific antibody and bright staining was used for determining the virus titer. The allantoic fluid containing the recovered influenza virus was analyzed in a hemagglutination inhibition (HI) test and the specific inhibition was found.

CONCLUSIONThe results mentioned above demonstrated that cold-adapted, attenuated reassortant H3N2 subtype influenza A virus was successfully generated, which laid a good foundation for the further related research.

Animals ; COS Cells ; Cercopithecus aethiops ; Dogs ; Hemagglutinin Glycoproteins, Influenza Virus ; genetics ; Influenza A Virus, H3N2 Subtype ; immunology ; Influenza Vaccines ; immunology ; Mice ; Mice, Inbred BALB C ; Neuraminidase ; genetics ; Plasmids ; Reassortant Viruses ; immunology ; Reverse Transcriptase Polymerase Chain Reaction ; Vaccines, Attenuated ; immunology ; Viral Proteins ; genetics

OBJECTIVETo retrospectively analysis the treatment characteristics of the systemic situation in patients with crush syndrome after Wenchuan earthquake happened in May 12th, 2008.

METHODSForty-nine patients with crush syndrome and subsequent acute renal failure (ARF) due to the earthquake were treated in West China Hospital. All of patients had been rescued from buildings that collapsed in Wenchuan earthquake. The major associated injuries were in the low extremities and upper extremities. 49 patients developed ARF with increased concentrations of serum creatinine (mean 64 022 U/L) had underwent haemodialysis. Hyperkalaemia was seen in 9 patients and four of them underwent haemodialysis. 49 patients were administered hemodialysis.

RESULTSNo patient died. All patients who suffered from the ARF were weaned from hemodialysis after admitted 7 to 35 days. Forty-five extremities underwent amputations and 52 extremities had fasciotomy.

CONCLUSIONSCrush syndrome requires urgent recognition and prompt surgical treatment with simultaneous measures to control hyperkalemia and ARF. The authors believe that immediate intensive care therapy and multi-subjective coordination would have improved the survival rate.

Acute Kidney Injury ; etiology ; surgery ; therapy ; Adolescent ; Adult ; Aged ; Amputation ; Child ; Crush Syndrome ; etiology ; surgery ; therapy ; Decompression, Surgical ; Earthquakes ; Female ; Humans ; Male ; Middle Aged ; Renal Replacement Therapy ; Retrospective Studies ; Treatment Outcome ; Wounds and Injuries ; complications

Objective To investigate the clinical features of unexpected sudden death (SUD) clustered in families in Yunnan province.Methods This retrospective study analyzed the clinical features of SUD occurred between July to September 2005 in 7 families in Yunnan province.Results All 16 SUD patients shared common clinical features such as fatigue and repeated syncope and one group of SUD patients (n = 8 from 4 families) presented with the gastric intestinal tract manifestations including nausea, vomiting, abdominal pain and diarrhea with suspected dietary history and abnormal laboratory enzyme findings (GOT/ GPT,CK/CKMB,LDH/LDH1 etc.).In SUD patients without gastric intestinal tract manifestations (n = 8 from 3 families), there were no clear symptoms before death and repeated ventricular tachycardia and ventricular fibrillation were recorded in one survivor.There was no clear evidence for the involvements of hereditary and infectious factors for observed SUD.conclusion The reason for the unexpected sudden death clustered in 7 families in Yunnan remains unclear.Repeated syncope and fatigue served as the common clinical features in the presence or absence of gastric intestinal tract manifestations in all SUD cases.Further studies are needed to clarify the pathology and detailed clinical manifestations of SUD occurred in this area.