Objective:To investigate the drug resistance gene characteristics, plasmid characteristics and genome tracing of Shigella sonnei causing a bacillary dysentery outbreak in Shandong Province. Methods:Sixty-five Shigella sonnei strains isolated from a 2021 outbreak in a county of Shandong Province were analyzed using antimicrobial susceptibility testing, whole genome sequencing (WGS), characterization of resistance and virulence genes, plasmid profiling, core genome multilocus sequence typing (cgMLST), and single nucleotide polymorphism (SNP) analysis. Results:All isolates had the same resistance phenotype and genotypes and were multidrug-resistant ESBL-producing Shigella sonnei, carrying important virulence genes. Plasmid analysis revealed a conserved genetic arrangement, pil( M/ N/ O2/ P)-tra( F/ H/ J/ K/ N/ O/ P/ Q)-IS Ecp1- blaCTX-M-14-Tn 903- yub( J/ I/ F/ G/ E/ D), and shared across strains from diverse regions and bacterial species. The cgMLST and SNP analyses demonstrated concordant clustering, with all 65 outbreak-related strains forming a single cluster alongside human-derived strains from Guangxi. Conclusion:The ESBL-producing Shigella sonnei responsible for the outbreak shares a homologous relationship with Guangxi human-derived strains, and the detected resistance plasmids and virulence genes underscore the need to strengthen drug resistance surveillance and genome tracing.

Objective:To investigate the drug resistance gene characteristics, plasmid characteristics and genome tracing of Shigella sonnei causing a bacillary dysentery outbreak in Shandong Province. Methods:Sixty-five Shigella sonnei strains isolated from a 2021 outbreak in a county of Shandong Province were analyzed using antimicrobial susceptibility testing, whole genome sequencing (WGS), characterization of resistance and virulence genes, plasmid profiling, core genome multilocus sequence typing (cgMLST), and single nucleotide polymorphism (SNP) analysis. Results:All isolates had the same resistance phenotype and genotypes and were multidrug-resistant ESBL-producing Shigella sonnei, carrying important virulence genes. Plasmid analysis revealed a conserved genetic arrangement, pil( M/ N/ O2/ P)-tra( F/ H/ J/ K/ N/ O/ P/ Q)-IS Ecp1- blaCTX-M-14-Tn 903- yub( J/ I/ F/ G/ E/ D), and shared across strains from diverse regions and bacterial species. The cgMLST and SNP analyses demonstrated concordant clustering, with all 65 outbreak-related strains forming a single cluster alongside human-derived strains from Guangxi. Conclusion:The ESBL-producing Shigella sonnei responsible for the outbreak shares a homologous relationship with Guangxi human-derived strains, and the detected resistance plasmids and virulence genes underscore the need to strengthen drug resistance surveillance and genome tracing.

Objective:To investigate the diagnostic and diagnostic values of plasma microRNA-21-3p (miR-21-3p) and miR-551-5p expression in patients with acute pancreatitis (AP).Methods:A prospective observational study was conducted. AP patients admitted to the Third People's Hospital of Hainan Province from January 1st 2017 to December 31st 2019 were enrolled. The patients were divided into mild acute pancreatitis (MAP) group, moderate severe acute pancreatitis (MSAP) group and severe acute pancreatitis (SAP) group according to their severity. Fasting venous blood was collected from all subjects the day after admission, and real-time quantitative polymerase chain reaction (PCR) as used to detect the expression levels of plasma miR-21-3p and miR-551-5p. Rehabilitation, discharge or death were end points of study. In addition, 50 healthy people in the same period were selected as the control group. The receiver operating characteristic (ROC) curve was used to analyze the value of the expression levels of plasma miR-21-3p and miR-551-5p for the diagnosis and prognosis of SAP. Pearson correlation was used to analyze the relationship between the expressions of miR-21-3p and miR-551-5p in SAP patients.Results:A total of 164 AP patients were enrolled, including 72 MAP patients, 47 MSAP patients and 45 SAP patients. Among the SAP patients, 27 cases survived and 18 cases died. There were no deaths in MAP group and MSAP group. The levels of plasma miR-21-3p and miR-551-5p in AP group were significantly higher than those in control group [miR-21-3p (2 -ΔΔCt): 2.17±0.90 vs. 0.65±0.12, miR-551-5p (2 -ΔΔCt): 1.80±0.73 vs. 0.42±0.08, both P < 0.01]. The expression levels of plasma miR-21-3p and miR-551-5p in AP patients increased gradually with the aggravation of the disease ( F values were 11.635, 10.204 respectively, both P < 0.01), and the expression levels of plasma miR-21-3p and miR-551-5p in SAP group were significantly higher than those in MSAP group and MAP group [miR-21-3p (2 -ΔΔCt): 3.16±1.08 vs. 1.85±0.71, 1.70±0.64; miR-551-5p (2 -ΔΔCt): 2.63±0.95 vs. 1.52±0.46, 1.36±0.40; all P < 0.01]. ROC curve analysis showed that the area under the ROC curve (AUC) and 95% confidence interval (95% CI) of the joint diagnosis of SAP with miR-21-3p and miR-551-5p were significantly higher than that of miR-21-3p or miR-551-5p alone [0.898 (0.841-0.960) vs. 0.820 (0.763-0.882), 0.806 (0.748-0.867), Z1 = 4.480, Z2 = 4.916, both P < 0.05], and the sensitivity was 90.7% and the specificity was 85.0%. The expression levels of plasma miR-21-3p and miR-551-5p in the death group of SAP patients were significantly higher than those in the survival group [miR-21-3p (2 -ΔΔCt): 3.75±1.17 vs. 2.66±0.87, miR-551-5p (2 -ΔΔCt): 3.17±1.04 vs. 2.24±0.83, both P < 0.01]. ROC curve analysis showed that the AUC and 95% CI of the combined prediction of death in SAP patients with miR-21-3p and miR-551-5p were significantly higher than that of miR-21-3p or miR-551-5p alone [0.933 (0.875-0.996) vs. 0.856 (0.794-0.917), 0.816 (0.759-0.874), Z1 = 4.395, Z2 = 5.520, both P < 0.05], and the sensitivity was 95.2% and the specificity was 87.5%. Correlation analysis showed a positive correlation between the expression level of plasma miR-21-3p and miR-551-5p in SAP patients ( r = 0.827, P < 0.001). Conclusions:The increased expression of plasma miR-21-3p and miR-551-5p are positively correlated with the severity of AP patients. The combination of the two items has a better value in the diagnosis and prognosis evaluation of SAP.

Objective To evaluate the efficacy and safety of Shenqi Fuzheng injection in the treatment of patients with laparoscopic gastric cancer. Methods A total of 94 cases with laparoscopic gastric cancer included in this study were divided into control group and experimental group with 47 cases in each group.The patients in both groups received laparoscopic gastric carcinoma.Patients in control group received fluorouracil, leucovorin and oxaliplatin infusion( FOLFOX4 ) chemotherapy and patients in the experimental group revieved Shenqi Fuzheng injection.Both groups received two courses treatment of 14 days for one course.The clinical efficacy, inflammatory levels, tumor indicators and adverse drug reactions were compared between the two groups.Results The clinical efficacy in experimental group was 95.74%, which was significantly higher than that in control group 82.98%(P<0.05 ) .The serum level of serum serum albumin (ALB), prealbumin (PA), glutathione-S-transferase (GST), carcinoembryonic antigen (CEA) and carbohydrate antigen 199 (CA199) after treatment in experimental group were lower than the control group (P<0.05) .The adverse drug reactions was not statistically different between the two groups.Conclusion Shenqi Fuzheng injection has significant efficacy in the treatment of laparoscopic gastric cancer with high safety.