Objective To understand the distribution and antimicrobial resistance profiles of bacterial strains isolated from blood cultures at Yunyang County People's Hospital from 2019 to 2023.Methods The data of bacterial isolates from blood samples and the results of antimicrobial susceptibility testing were analyzed retrospectively from 2019 to 2023 at Yunyang County People's Hospital.Results A total of 3 789 bacterial strains were isolated from blood culture,including 1 931(51.0％)strains of Gram negative bacteria and 1 858(49.0％)strains of Gram positive bacteria.Coagulase negative Staphylococcus(33.3％),Escherichia coli(25.4％),Klebsiella pneumoniae(13.7％),Staphylococcus aureus(9.9％),and Enterobacter cloacae(1.8％)were the top five bacterial pathogens.Antimicrobial susceptibility testing showed that the prevalence of methicillin-resistant strains was 27.1％in S.aureus,34.5％in S.epidermidis,and 49.9％in other coagulase-negative Staphylococcus.Methicillin resistant strains(MRSA,MRSE,and other MRCNS)showed significantly higher resistance rates to most antibiotics than corresponding methicillin-susceptible strains(MSSA,MSSE,and other MSCNS).No staphylococcal isolates were resistant to vancomycin,teicoplanin,linezolid,or tigecycline.Enterococcus faecium showed significantly higher resistance rate to antibiotics than Enterococcus faecalis.No enterococcal strains were resistant to vancomycin,teicoplanin,linezolid,or tigecycline.No streptococcal isolates were found resistant to vancomycin or linezolid.Serratia marcescens strains had a resistance rate of 25.0％to carbapenems.All other Enterobacterales species showed a resistance rate of less than 10.0％to carbapenems.No Enterobacterales isolates were found resistant to tigecycline.The resistance rates of P.aeruginosa to imipenem and meropenem were 5.7％and 3.8％,respectively.No P.aeruginosa isolates were found resistant to colistin.The resistance rates of Acinetobacter baumannii to imipenem and meropenem were 41.4％and 38.0％,respectively.Conclusions The proportion of Gram negative bacteria is slightly higher than that of Gram positive bacteria in the bacterial isolates from blood samples at Yunyang County People's Hospital.The prevalence of MRSA and MRCNS is relatively high,while A.baumannii and S.marcescens showed high resistance rates to carbapenems.Antimicrobial resistance surveillance should be strengthened for the bacterial isolates from blood samples in order to learn the changing resistance profiles,use antibiotics reasonably,and prevent the spread of drug-resistant bacteria.

Objective To understand the distribution and antimicrobial resistance profiles of bacterial strains isolated from blood cultures at Yunyang County People's Hospital from 2019 to 2023.Methods The data of bacterial isolates from blood samples and the results of antimicrobial susceptibility testing were analyzed retrospectively from 2019 to 2023 at Yunyang County People's Hospital.Results A total of 3 789 bacterial strains were isolated from blood culture,including 1 931(51.0％)strains of Gram negative bacteria and 1 858(49.0％)strains of Gram positive bacteria.Coagulase negative Staphylococcus(33.3％),Escherichia coli(25.4％),Klebsiella pneumoniae(13.7％),Staphylococcus aureus(9.9％),and Enterobacter cloacae(1.8％)were the top five bacterial pathogens.Antimicrobial susceptibility testing showed that the prevalence of methicillin-resistant strains was 27.1％in S.aureus,34.5％in S.epidermidis,and 49.9％in other coagulase-negative Staphylococcus.Methicillin resistant strains(MRSA,MRSE,and other MRCNS)showed significantly higher resistance rates to most antibiotics than corresponding methicillin-susceptible strains(MSSA,MSSE,and other MSCNS).No staphylococcal isolates were resistant to vancomycin,teicoplanin,linezolid,or tigecycline.Enterococcus faecium showed significantly higher resistance rate to antibiotics than Enterococcus faecalis.No enterococcal strains were resistant to vancomycin,teicoplanin,linezolid,or tigecycline.No streptococcal isolates were found resistant to vancomycin or linezolid.Serratia marcescens strains had a resistance rate of 25.0％to carbapenems.All other Enterobacterales species showed a resistance rate of less than 10.0％to carbapenems.No Enterobacterales isolates were found resistant to tigecycline.The resistance rates of P.aeruginosa to imipenem and meropenem were 5.7％and 3.8％,respectively.No P.aeruginosa isolates were found resistant to colistin.The resistance rates of Acinetobacter baumannii to imipenem and meropenem were 41.4％and 38.0％,respectively.Conclusions The proportion of Gram negative bacteria is slightly higher than that of Gram positive bacteria in the bacterial isolates from blood samples at Yunyang County People's Hospital.The prevalence of MRSA and MRCNS is relatively high,while A.baumannii and S.marcescens showed high resistance rates to carbapenems.Antimicrobial resistance surveillance should be strengthened for the bacterial isolates from blood samples in order to learn the changing resistance profiles,use antibiotics reasonably,and prevent the spread of drug-resistant bacteria.

Objective:To study the association of non-alcoholic fatty liver disease(NAFLD) and advanced liver fibrosis with osteoporosis in patients with type 2 diabetes mellitus(T2DM).Methods:Data was collected from 391 in-patients with type 2 diabetes mellitus(T2DM) from September 2019 to September 2020 at the Department of Endocrinology and Geriatric Medicine, Affiliated Huai′an First Hospital of Nanjing Medical University in this cross-sectional study. Participants were divided into T2DM with coexistent NAFLD(TCN) and with no NAFLD(TON) group via liver B-mode ultrasound.Also, the patients were divided into low and middle-high risk group via fibrosis index based on 4 factors index(FIB-4). Participant characteristics, laboratory results, and dual energy x-ray absorptiometry were obtained and analyzed. Multivariable logistic regression models were used to evaluate the association of NAFLD and advanced liver fibrosis with osteoporosis in T2DM. Interaction and stratified analyses were conducted according to age, sex, body mass index(BMI) and duration of diabetes(DD).Results:There was no significant difference in risk of osteoporosis and bone mineral density(BMD) loss between TCN and TON group(all P>0.05). After adjusting for age, sex, BMI, and DD, total hip BMD( β=-0.044, 95% CI -0.087--0.001, P=0.046) and lumbar L 1-L 4BMD( β=-0.044, 95% CI -0.087--0.002, P=0.044) were significantly reduced, and the risk of osteoporosis was significantly increased( OR=2.428, 95% CI 1.124-5.244, P=0.024) in FIB-4 middle-high risk group compared with low risk group. The subgroup analysis showed that overweight patients with T2DM had a significantly increased risk of osteoporosis( OR=4.240, 95% CI 1.637-10.987, interaction P=0.018) in FIB-4 middle-high risk group compared with low risk group. Conclusion:There was no significant difference in risk of osteoporosis and BMD loss between TCN and TON group. However, among T2DM patients who were overweight, NAFLD-related progressive liver fibrosis emerged as an independent risk factor for both BMD decline and the development of osteoporosis.

[Objective] To investigate the effectivity and reliability of individualized method to localize the entrance point of the lumbar pedicle screws by vertebral plate borderline.[Methods]Four vertebra specimen were taken the X-ray film of anterior-posterior views as the center of L2.On the X-ray film,the distance between the centre-point of the pedicle to the lateral and superior margins of the vertebral plate were measured,after applied barium at the centre-point of the pedicle,the specimen were taken the X-ray film once more,the relation of the barium to the centre-point of the pedicle was measured;the distance between the centre-point of the pedicle to the lateral and superior margins of the vertebral plate were measured on the normal lumbar X-ray film in 107 cases,the data in different sex and different projection 's center were compared;the method were applied to 40 patients of lumbar pedicle internal fixation,the information in hospital were reviewed to 30 patients of the lumbar pedicle screw localization by transverse process and transverse process.[Results]All(except L5)of lumbar plate borderline were displayed clear in the experiment,accurate rate of setpoint to be 92.5%.The principal X-ray affected scarely to the relation of the pedicle with the plate borderline of nearby two segment,but affected obviously far from three segment on the normal lumbar X-ray film;the accurate rate of one time 's setpoint in clinical application was 96%,average operation 's time being 96 minute,average lose blood being 212 ml,transverse articular process 's group showed significant difference.[Conclusion]Individualized localization of the lumbar pedicle screw entrance points by vertebral plate borderline is one of feasible method,displayed less trauma and accurate rate highly in the clinical application.

[Objective]To evaluate the radiographic and clinical results of locking compression plate and interlocking intramedullary nail in the treatment of distal tibial shaft fracture(4 to 11cm proximal to tibiotalar joint).[Method]A total of 65 cases of distal tibia shaft fractures were retrospectively reviewed from 2003 to 2007.Thirty-seven cases were treated with locking compression plate as group A,and 28 cases were treated with interlocking intramedullary nail as group B.According to AO classification system,32 cases were type A,12 were type B,21 were type C.[Result]All cases were followed up for 12-24 months(mean,16.5 months).Five cases were found delayed or nonunion,with 1 case in group A and 4 cases in group B.One case in group A and 2 cases in group B were found developed deep infection.Two cases in group A and 8 cases in group B received second operation.The good-to-excellent rates of ankle joint function were 91.9% in group A and 71.4% in group B.The good-to-excellent rates of knee joint function were 97.3% in group A and 78.6% in group B.[Conclusion]Distal tibial shaft fracture could be treated successfully with either percutaneous plates or intramedullary nails.Percutaneous locking plate is better than intramedullary nail in aspect of prevention of delayed union,malunion and second operation.

Post-translational modification by ubiquitin and ubiquitin-like modifiers(Ubls) is one of the most important mechanisms regulating a wide range of cellular processes in eukaryotes.Previous research showed that,through covalently modification by ubiquitin or ubls,the substrate proteins can be regulated in many different ways like stability,subcellular localization,enzymatic activity,protein-protein interaction and so on.Therefore,we believe,that ubiquitin and ubls play very important roles in cellular and biological processes by modifying plenty of proteins.To better understand the ubiquitin and ubls system,proteomic approaches have been developed to purify and identify more protein substrates.Large-scale idendification of ubiquitin/ubls-modification sites by mass spectrometry is particularly important for understanding the molecular mechanism and function of ubiquitin/ubls modification.Upto the present,more and more scientists are getting interested and participating in proteomics research of ubiquitin/Ubl modifications.This review summarizes the rencent results in this field.

Objective To express the human recombinant SUMO1 protein and prepare monoclonal antibody(mAb) against it.Methods The recombinant expression plasmid pET32a-HIS-SUMO1 was made and transformed into E.coli(BL21),then the recombinant fusion protein HIS-SUMO1 was expressed and purified.The BALB/c mice were immuned with pure protein HIS-SUMO1 as antigen.Monoclonal antibody against SUMO1 was prepared with standard hybridoma technology.The hybridoma cell lines were obtained by ELISA and Western blot screening procedure,the isotype of the mAbs were further identified by immune-double diffusion.Ascites were collected from one propagated hybridoma cell line and mAbs were purified by using the Kit of Millipore.The valence of mAb was detected by Western Blot.Results The recombinant protein HIS-SUMO1 is expressed and purified.Three hybfidmas producing antibodies against SUMO1 were obtained,the isotypes of three mAbs are IgG1,Western blot showed that the antibodies were specific for SUMO1.The antibody purified from the ascites has better specificity.Conclusion The SUMO1 mAb prepared by using recombinant SUMO1 protein as antigen can be used for detectingthe protein sumoylation.