OBJECTIVE To evaluate the value of matrix-assisted laser desorption ionization time-of-flight-mass spectrometry(MALDI-TOF MS)in direct identification of carbapenem-resistant Escherichia coli and Klebsiella pneumoniae positive for blood culture.METHODS The blood culture bottles that were positive for E.coli or K.pneumoniae were collected from the patients with bloodstream infection who were treated in Zhongshan Hospi-tal,Fudan University from Jul.2021 to Jun.2023.The isolates were collected by using a gel-contact clotting tube,then the tested strains were respectively mixed with 4 μg/ml of imipenem,4 μg/ml of meropenem and 2 μg/ml of ertapenem for coculture and were incubated at 35 ℃ for 4 and 5 hours,finally,the strains were i-dentified by using the mass spectrum.The minimum inhibitory concentrations(MICs)of the three types of drugs were tested by microbroth dilution method and were set as the golden standards for the test.RESULTS Totally 31 strains of E.coli and 28 strains of K.pneumoniae that were positive in blood culture bottles were collected,both of the effective rates of controlled growth of the E.coli strains were 100.00％after the incuba-tion for 4 and 5 hours,and the effective rates of controlled growth of the K.pneumoniae strains were 9 6.43％and 100.00％after the incubation for 4 and hours,respectively.The sensitivity,specificity,positive predictive value and negative predictive value of the K.pneumoniae strains against the three types of drugs were 100.00％after the incubation for 5 hours.The specificity and positive predictive value of the E.coli strains against imipenem,meropenem and ertapenem were 100.00％after the incubation for 5 hours;the sensitivities were 73.58％,78.93％and 78.93％,respectively;the negative predictive values were 70.60％,75.00％and 75.00％,respectively.CONCLUSIONS MALDI-TOF MS is rapid and accurate for direct identification of the carbapenem-resistant E.coli and K.pneumoniae strains positive in blood culture bottles,and the accuracy reaches at 100.00％for the test of drug-resistant K.pneumoniae strains after the incubation for 5 hours.The method may provide evidence for clinical treatment of bloodstream infections induced by carbapenem-resistant Enterobacteriaceae.

OBJECTIVE To evaluate the value of matrix-assisted laser desorption ionization time-of-flight-mass spectrometry(MALDI-TOF MS)in direct identification of carbapenem-resistant Escherichia coli and Klebsiella pneumoniae positive for blood culture.METHODS The blood culture bottles that were positive for E.coli or K.pneumoniae were collected from the patients with bloodstream infection who were treated in Zhongshan Hospi-tal,Fudan University from Jul.2021 to Jun.2023.The isolates were collected by using a gel-contact clotting tube,then the tested strains were respectively mixed with 4 μg/ml of imipenem,4 μg/ml of meropenem and 2 μg/ml of ertapenem for coculture and were incubated at 35 ℃ for 4 and 5 hours,finally,the strains were i-dentified by using the mass spectrum.The minimum inhibitory concentrations(MICs)of the three types of drugs were tested by microbroth dilution method and were set as the golden standards for the test.RESULTS Totally 31 strains of E.coli and 28 strains of K.pneumoniae that were positive in blood culture bottles were collected,both of the effective rates of controlled growth of the E.coli strains were 100.00％after the incuba-tion for 4 and 5 hours,and the effective rates of controlled growth of the K.pneumoniae strains were 9 6.43％and 100.00％after the incubation for 4 and hours,respectively.The sensitivity,specificity,positive predictive value and negative predictive value of the K.pneumoniae strains against the three types of drugs were 100.00％after the incubation for 5 hours.The specificity and positive predictive value of the E.coli strains against imipenem,meropenem and ertapenem were 100.00％after the incubation for 5 hours;the sensitivities were 73.58％,78.93％and 78.93％,respectively;the negative predictive values were 70.60％,75.00％and 75.00％,respectively.CONCLUSIONS MALDI-TOF MS is rapid and accurate for direct identification of the carbapenem-resistant E.coli and K.pneumoniae strains positive in blood culture bottles,and the accuracy reaches at 100.00％for the test of drug-resistant K.pneumoniae strains after the incubation for 5 hours.The method may provide evidence for clinical treatment of bloodstream infections induced by carbapenem-resistant Enterobacteriaceae.

Objective:To translate the simplified version of the Metamemory in Adulthood (MIA) Scale, and test its reliability and validity.Methods:The simplified Beaton 6-step method was used to translate and culturally adjust the simplified MIA Scale. From October 2018 to September 2019, 528 obstructive sleep apnea syndrome (OSAS) patients treated in a general ClassⅢhospital were selected for investigation with the simplified Chinese version of the revised MIA Scale. Cronbach's α coefficient and Guttman split-half reliability coefficient were used to evaluate the reliability of the scale.Results:The final simplified Chinese version of the MIA Scale had 35 items including 7 factors, which were respectively memory achievement, memory emotion, memory strategy, memory task, memory control, memory capacity and memory change. The Cronbach's α coefficient of the scale was 0.901, and the Guttman split-half reliability coefficient was 0.917; the item-level content validity index ( I- CVI) ranged from 0.80 to 1.00, and the average scale-level content validity index ( S- CVI/ Ave) was 0.928. The explanation rate of the cumulative variance of the 7 factors was 65.209%. Conclusions:The simplified Chinese version of the MIA Scale has good reliability and validity, and can effectively assess the metamemory level of OSAS patients.

Objective To evaluate the effect of the combination of lamivudine and adefovir dipivoxil on the treatment of decompensated hepatitis B cirrhosis patients. Methods One hundred thirty-six patients with decompensated hepatitis B cirrhosis were randomly administered the combination of lamivudine and adefovir dipivoxil (combination group), only lamivudine( LAM group)and only adefovir dipivoxil (ADV group). The liver founction tests, ChildPugh scores and the rate of negative conversion for the serum HBV-DNA were measured at baseline,six months after therapy and 12 months after therapy. Results The rate of negative conversion for the serum HBV-DNA ( ＜ 1 ×103cop/ml)of combination group were 78.3% and 85.2% respectively at six and twelve months after therapy. The rates of negative conversion for the serum HBV-DNA of LAM group were 62. 1% and 57.8% respectively at six and twelve months after therapy. The rates of negative conversion for the serum HBV-DNA of ADV group were 41.3% and 53.6% respectively at six and twelve months after therapy. Compared with the LAM and ADV group, The rates of negative conversion for the serum HBV-DNA of combination group were higher. In addition, the rates of better conversion of liver function tests and Child-Pugh scores were higher in combination group than LAM and ADV groups.Conclusion The combination of lamivudine and adefovir dipivoxil could more effectively improve liver founction tests, Child-Pugh scores and the rates of negative conversion for the serum HBV-DNA in patients with decompensated hepatitis B cirrhosis than only lamivudine and only adefovir dipivoxil.