Objective To analyze the basic epidemiological characteristics, drug resistance profiles, molecular characterization features, and phylogenetic relationships of mcr-1 (polymyxin resistance gene, mediated colistin resistance)-positive Salmonella typhimurium collected by Guangzhou Center for Disease Control and Prevention (GZCDC) from 2013 to 2020. Methods Strain identification was performed using a VITEK 2 Compact fully automated microbial biochemical identifier. The mcr-1-positive strains were screened using PCR and agarose gel electrophoresis. The mcr-1-positive strains were subjected to drug sensitivity tests and molecular typing experiments by micro broth dilution and pulse-field gel electrophoresis (PFGE). Whole genome sequencing and phylogenetic analysis were performed on the mcr-1-positive strains. Results From 2013 to 2020, 64 mcr-1-positive strains were screened out of 1 783 Salmonella typhimurium strains, and the mcr-1 positivity rate ranged from 0.37% to 6.84%. The drug sensitivity results showed that all 64 mcr-1 positive strains were resistant to polymyxin and exhibited resistance to ≥3 classes of antibiotics, with 90.63% (58/64) of strains resistant to ≥7 classes. The PFGE results indicated that the 64 positive strains could be grouped into 5 clusters with approximately 70% homology. The phylogenetic tree further suggested the diversity and complexity of transmission pathways of mcr-1-positive Salmonella typhimurium from different sources. Conclusions There has been a high detection rate of mcr-1-positive Salmonella typhimurium in Guangzhou City in recent years, along with a diverse drug resistance spectrum and high genetic diversity among different strains. Continued monitoring and tracing of drug resistance should be strengthened.

Despite growing prevalence and incidence, the management of gout remains suboptimal. The intermittent nature of the gout makes the long-term urate-lowering therapy (ULT) particularly important for gout management. However, patients are reluctant to take medication day after day to manage incurable occasional gout flares, and suffer from possible long-term toxicity. Therefore, a safe and easy-to-operate drug delivery system with simple preparation for the long-term management of gout is very necessary. Here, a chitosan-containing sustained-release microneedle system co-loaded with colchicine and uricase liposomes were fabricated to achieve this goal. This microneedle system was confirmed to successfully deliver the drug to the skin and maintain a one-week drug retention. Furthermore, its powerful therapeutic potency to manage gout was investigated in both acute gouty and chronic gouty models. Besides, the drug co-delivery system could help avoid long-term daily oral colchicine, a drug with a narrow therapeutic index. This system also avoids mass injection of uricase by improving its stability, enhancing the clinical application value of uricase. In general, this two-drug system reduces the dosage of uricase and colchicine and improves the patient's compliance, which has a strong clinical translation.

Objective To evaluate the effects of Chuanglingye decoction on angiogenesis and wound healing. Methods With a series of dosages of Chuanglingye decoction, their optimal effects of angiogenesis were searched for through the chicken embryo allantois membrane model(CAM). The vascular endothelial cell proliferation experiment (MTT) and the migration assay were used for the detection of effects. The gauze loading with Chuanglingye decoction of 0.2 ml as the experimental group and with saline of 0.2ml as the control group were applied on the total skin mechanical round wound of 1.5cm diameter and changed every other day. The sizes of area were detected on the day of 0,3,7,14 and 28 as well as the scores of inflammatory response, contains of TNF-αand Il-6 were detected on the day of 3 and 7. Results The CAM experiments showed that the angiogenic effects of 0.2 ml and 0.3 ml dosage of the Chuanglingye group were significantly lower than those of the control group(P<0.05). The 0.2 ml dosage of Chuanglingye decoction was chosen for the further experiment. The HUVEC proliferation rate of the experimental group decreased 21%, as compared with the results of control group. The cell migration movement of 12 hours, 24 hours in the experimental group were significantly lower than those in the control group. For theanimal experiments, the area sizes of the wound were similar in the experimental and control group without any significant differences. The scores of inflammatory response and contains of TNF-α(768±107)ng/L,(380±47)ng/L and Il-6(664±133)ng/L,(363±43)ng/L in the experimental group were significant decreased than those of the control group on the day of 3(958± 140)ng/L,(2215±314)ng/Land 7(512±62)ng/L,(1562±174)ng/L. Conclusion It showed that Chuanglingye decoction had negative effects on vascular endothelial cell migration and proliferation and thus inhibiting angiogenesis. These effects did not infer the process of the wound healing due to its ameliorating the inflammatory response which may be a help to wound healing.

ObjectiveTo study the risk factors of renal artery pseudoaneurysm (RAP) following partial nephrectomy.MethodsOpen partial nephrectomy was performed on a total of 464 cases of renal cell cancer from July 2003 to May 2010. Five patients ( 1.1％ ) had postoperative hemorrhage from RAP.The surgery technique of the open partial nephrectomy, the clinical presentation, imaging findings and treatment of RAP were reviewed. The anatomical characteristics of these five renal tumors on enhanced CT were quantified using the R.E.N.A.L. Nephrometry Score System.ResultsAll five cases were male, two had tumors on the left side and three on the right side. Median tumor size was 3.6 cm ( range from 2.5 to 5 cm; Radius score 1 - 2). Four tumors were exophytic of these, three had a major endophytic component (≥50％) deep in the parenchyma (Exophytic/endophytic score 2 ), one was entirely endophytic (score 3 ). The distance of all the tumors to the collecting system was ≤4 mm ( Nearness score 3 ). Four of the five tumors were across the polar line and/or renal axial midline ( Location score 3 ). The other tumor was located under the lower pole ( Location score 1 ) but close to the renal hilar. All patients presented with delayed gross haematuria and decreasing hemoglobin occurred on mean postoperative day 12 (3 -23 day). Four patients complained of flank pain, two of which had signs of hypovolemia requiring blood transfusion. The diagnosis was confirmed by the contrast medium-enhanced CT and selective angiography, and RAP was found most commonly arising from the segmental branch of renal artery. Superselective microcoil angioembolization was successfully performed in four cases, once in three cases and twice in the remaining case. The procedure failed in one patient and a nephrectomy was done. At a mean follow-up of 21 months (12 -30) , all patients had normal renal function without evidence of recurrence.ConclusionsRAP should be considered in all patients who had delayed hematuria after partial nephrectomy. A central, deep tumor and its relationship to the segmental branch of renal artery could be an important risk factor for this complication. Choosing the case properly for partial nephrectomy and suturing the transected vessels and the defect of parenchymal correctly could reduce occurrence of this serious complication. Early use of selective angioembolization could be a primary choice of treatment.

Objective To discuss the etiology and management of hemorrhage after partial nephrectomy because of renal cancer. Methods Of the 382 cases performed partial nephrectomy during a 10-year period, 5 patients(1.3%) had postoperative hemorrhage because of a renal artery pseudoaneurysm. The ages of these patients were from 42 to 63 years. All the tumors were malignant with an average diameter of 2. 8 cm. The renal pedicle was blocked in 2 cases with tumor size larger than 3 cm. The kidney was reconstructed with interrupted 0 chromic sutures in "8"or "U" style. Delayed postoperative hemorrhage occurred from 6 days to 3 months. The blood loss was from 1000 to 4500mi. Shock or lower blood pressure occurred in 3 patients. Nephrectomy was performed in 1 patient and selective angiographic embolization was performed in other 4 cases. Results Angiography revealed renal artery pseudoaneurysm in all 5 cases at the third (4 cases) or fourth branch(1 patient).Percutaneous embolization was successful in 4 patients. Four cases were followed up for 2 to 9 years without complication. Conclusions Delayed postoperative hemorrhage following partial nephrectomy is an uncommon but potentially life-threatening complication. Super-selective angiographic embolization could be the first choice of treatment.

Objective To evaluate the application significance of Bosniak renal cyst classification. Methods The operations of 497 cases of cystic renal masses were performed from 2002 to 2007 in our hospital.The average age of these cases was 42-years old,the average diameter of renal cysts was 5.4 cm. There were 212 left lesions,265 right and 20 bilateral.According to Bosniak classification,there were 339 cases of category I,49 cases of category Ⅱ(including 23 cases of category ⅡF),44 cases of category Ⅲ and 65 cases of category Ⅳ.Renal cystectomy was performed in 372 cases when nephron sparing surgery performed in 51 eases and radical nephrectomy performed in 74 cases.Results Malignant tumors were found in 89 cases and benign lesions were found in 408 cases.The malignant rate was 0.9% in category I,10.2% in category Ⅱ(13.O%in category ⅡF),52.3% in category Ⅲ,89.2% in category Ⅳ.There was significant difference among the 4 groups,but there was no significant difference between category ⅡF and non-Ⅱ F of category Ⅱ.403 cases were followed up for 1-5 years with 75 cases of malignancy and 328 cases of benign lesions.Recurrence or metastasis was found in 9 malignant cases.Conclusions Careful follow-up should be performed in category I and Ⅱ,especially in the cases of Ⅱ F category and the eases with changes of diameter or morphology.It is definite that surgery should be performed in the cases of renal cyst with category Ⅲ or Ⅳ for their high malignant rate.

Objective To understand the prevalence and the factors associated with depression and anxiety among patients attending the community-based methadone maintenance treatment(MMT) program.Methods 9 MMT clinics in 3 provinces were randomly selected,in which 1 301 MMT patients who met the criteria of recruitment were all interviewed.A cross-sectional study by administrative questionnaire was employed to investigate the demographics,drug abuse and MMT treatment status of the respondents.The 1301 respondents were also evaluated for depression and anxiety by SDS(Self-Rating Depression Scale) and SAS(Self-Rating Anxiety Scale) respectively.ANOVA and multivariate linear regressions analysis was used to verify the factors associated with depression and anxiety respectively.Results The prevalence of depression and anxiety among the MMT patients were 38.3%(498/1 301) and 18.4%(239/1 301).The multivariates linear regression analysis indicated that at the level of ?=0.05,gender,employment status were associated with depression,while gender,employnment status,educational level,drug abuse and methadone daily dosage were associated with anxiety.Conclusions There are certain proportions of MMT clients who suffer from depression and anxiety.The MMT clinic staff should put more emphasis on the efforts to reduce psychological disorders and its potential risks by enhancing psychological councelling,intervention and social support towards the MMT patients.

Objective To discuss the treatment of synchronous bilateral renal cell carcinoma.Methods Fourteen cases of synchronous bilateral renal cell carcinoma with 12 males and 2 females were treated from 1994 to 2005.Lumbago occurred in 4 cases and hematuria in 2 cases.All the cases were diagnosed with the CT scan,IVU,US and/or MR.Six cases received bilateral operation simultaneously,8 cases received sequential operations.Radical nephrectomy on one side and partial nephrectomy on the opposite side was conducted in 8 patients.Partial nephrectomy on both sides was performed for 6 patients. Results Twenty-two operations were performed in 14 cases.The average operative time was(263±52)min in simultaneous operation and(155±46)min in others.The length of hospital stay was(11.5±2.1)d in simultaneous operation and(7.4±1.2)d in staging operatiom Ten cases were followed up for 6-41 months.The renal function remained good in 7 patients.The SCr increased in 3 cases with no need for dialysis.One case died 25 months later with metastasis of lung.One case with local recurrence died 38 months later.One case died of cerebral hemorrhage.Conclusions The renal function and treating tumor must be considered in managing synchronous bilateral renal cell carcinoma.The geheral condition of patient and the position of tumor should be evaluated in order to make a treatment plan.

Objective To study the immunosuppression of Demethylzeylasteral (T-96) on the lymphocytic blastogenesis in vitro and compare the inhibitory effects on the rejection in renal transplant rats between T-96 with Glucosidorum Tripterygll Totorum (TII) in vivo. Methods Mixed lymphocyte cells were cultured through xenogenous antigen to stimulate C57BL/6 mouse spleen cell blast transformation, then different concentrations of T-96 or TII were added respectively. By 3H-TdR methods, the inhibitory effects of T-96 and TII on the blast transformation of spleen cells were measured. Different doses of T-96 or TII were given for different groups of renal transplant rats to evaluate the effects on survival time of renal transplant rats.Methods At the concentrations of 0.25 , 0.5 , 1.0 ??g/ml T-96, there was a significant inhibitory effect on the blast transformation of mouse spleen cells as compared with control group ( P

Objective To investigate the relations between p53 and K-ras gene mutation in portal venous blood of gastric carcinoma patients and cancer metastasis. Methods p53 and K-ras gene mutation was detected with PCR-SSCP technology in 62 cases of gastric carcinoma. Results p53 and K-ras mutation rate were 39% and 34% in portal venous blood, but only 8% and 4. 8% in peripheral blood; The rate of gene mutation in p53 and K-ras were 24% and 22% in patient without liver metastasis, 92% and 77% in patient with liver metastasis; The rate of gene mutation in p53 and K-ras in portal venous were 39% and 34% before surgical exploration, but 56% and 63% after exploration. The rate of positive detection of the mutation was significantly (P