OBJECTIVE To compare the efficacy of ceftazidime and avibactam （CZA） monotherapy and combination therapy in the treatment of carbapenem-resistant Gram-negative bacteria （CRGNB） infections， and analyze the influencing factors. METHODS The data of patients with CRGNB infection who received CZA treatment from January 2020 to March 2025 were collected retrospectively. The patients were divided into the CZA monotherapy group （52 cases） and the CZA combination therapy group （85 cases） according to treatment regimen. The therapeutic effects of the two groups were compared， and the drug susceptibility results of isolated strains were recorded. The multivariate Logistic regression model was used to analyze the factors influencing clinical efficacy of CRGNB patients. RESULTS The bacterial clearance rate of patients was significantly higher in the CZA combination therapy group than in the CZA monotherapy group （P＝0.012）. However， when comparing the 30-day mortality rate and the clinical response rate between the two groups， no statistically significant differences were observed （P＞0.05）. Among the isolates， carbapenem-resistant Klebsiella pneumoniae had the highest sensitivity to tigecycline （87.3%） and carbapenem-resistant Pseudomonas aeruginosa showed 90.9% sensitivity to amikacin. Five isolates were resistant to CZA. The multivariate Logistic regression showed， lung infection， receiving continuous renal replacement therapy （CRRT）， and inadequate treatment courses were significantly correlated with clinical treatment failure （P＜0.05）. CONCLUSIONS For CRGNB infection， the clinical efficacy of CZA combination therapy is similar to that of monotherapy， but the combination therapy has a higher bacterial clearance rate. Lung infections， receiving CRRT and inadequate treatment courses （No. are independent risk factors for clinical treatment failure.

Objective To observe the effect of calcified lymph nodes on video-assisted thoracoscopic surgery (VATS) lobectomy in the chronic obstructive pulmonary disease (COPD) patients with lung cancer. Methods A retrospective analysis was conducted on the COPD patients with lung cancer who underwent VATS lobectomy in the Department of Thoracic Surgery in the First Affiliated Hospital of Hebei North University from May 2014 to May 2018.The patients were assigned into a calcified lymph node group and a control group according to the presence or absence of calcified lymph nodes in CT,and the size,morphology,and calcification degree of the lymph nodes were recorded.The operation duration,intraoperative blood loss,chest tube retention time,hospitalization days,and overall complication rate were compared between the two groups. Results The 30 patients in the calcified lymph node group included 17 patients with one calcified lymph node and 13 patients with two or more calcified lymph nodes,and a total of 65 calcified lymph nodes were recorded.The calcified lymph nodes with the size ≤5 mm were the most common (53.8%),and complete calcification was the most common form (55.4%) in lymph node calcification.The mean operation duration had no significant difference between the calcified lymph node group and the control group (t=-1.357,P=0.180).The intraoperative blood loss (t=-2.646,P=0.010),chest tube retention time (t=-2.302,P=0.025),and hospitalization days (t=-2.274,P=0.027) in the calcified lymph node group were higher than those in the control group. Conclusion Calcified lymph nodes increase the difficulty and risk of VATS lobectomy in the COPD patients with lung cancer.The findings of this study are conducive to predicting the perioperative process of VATS lobectomy.
Humans ; Blood Loss, Surgical ; Retrospective Studies ; Lung Neoplasms/surgery* ; Pulmonary Disease, Chronic Obstructive ; Calcinosis ; Lymph Nodes

Objective: To investigate a SARS-CoV-2 epidemic reported in Rongcheng City, Weihai, Shandong Province. Methods: The SARS-CoV-2 nucleic acid positive patients and their close contacts were investigated, and the whole genome sequencing and genetic evolution analysis of 9 variant viruses were carried out. An infection source investigation and analysis were carried out from two sources of home and abroad, and three aspects of human, material and environment. Results: A total of 15 asymptomatic infections were reported in this epidemic, including 13 cases as employees of workshop of aquatic products processing company, with an infection rate of 21.67% (13/60). Two cases were infected people's neighbors in the same village (conjugal relation). The first six positive persons were processing workers engaged in the first process of removing squid viscera in the workshop of the company. The nucleic acid Ct value of the first time were concentrated between 15 and 29, suggesting that the virus load was high, which was suspected to be caused by one-time homologous exposure. The whole genome sequence of 9 SARS-CoV-2 strains was highly homologous, belonging to VOC/Gamma (Lineage P.1.15). No highly homologous sequences were found from previous native and imported cases in China. It was highly homologous with the six virus sequences sampled from May 5 to 26, 2021 uploaded by Chile. The infection source investigation showed that the company had used the squid raw materials captured in the ocean near Chile and Argentina from May to June 2021 over the last 14 days. Many samples of raw materials, products and their outer packages in the inventory were tested positive for nucleic acid. Conclusion: This epidemic is the first local epidemic caused by the VOC/Gamma of SARS-CoV-2 in China. It is speculated that the VOC/Gamma, which was prevalent in South America from May to June 2021, could be imported into China through frozen squid.
Humans ; SARS-CoV-2 ; COVID-19 ; Epidemics ; China/epidemiology*

Macrolide antibiotics are a class of broad-spectrum antibiotics with the macrolide as core nucleus. Recently, antibiotic pollution has become an important environmental problem due to the irregular production and abuse of macrolide antibiotics. Microbial degradation is one of the most effective methods to deal with antibiotic pollution. This review summarizes the current status of environmental pollution caused by macrolide antibiotics, the degradation strains, the degradation enzymes, the degradation pathways and the microbial processes for degrading macrolide antibiotics. Moreover, the critical challenges on the biodegradation of macrolide antibiotics were also discussed.
Anti-Bacterial Agents ; Biodegradation, Environmental ; Macrolides

Objective: To compare the calibration result of standard X-ray RQR radiation field between SSDL (NIRP) and CEA LIST LNHB(France), and to explore the feasibility of calibrating H_p(3) in standard X-ray RQR radiation field of SSDL(NIRP). Methods: Using a column model with a diameter and high of 20 cm, TLD was calibrated in SSDL (NIRP) and CEA LIST LNHB (France) to measure the personal dose equivalent eye lens dose H_p(3), X-ray RQR radiation field included RQR4(60 kV), RQR7(90 kV), RQR9(120 kV), with energy response, angle response and linear response. Results: In terms of energy response, the calibration results of TLD in both SSDL (NIRP) and CEA LIST LNHB (France) were in good agreement. The difference between exposure value and response value was less than 10%. In terms of angle response, the calibration result of TLD in CEA LIST LNHB (France) was better in SSDL(NIRP). The difference between exposure value and response value in CEA LIST LNHB (France) was less than 6%, while the difference between exposure value and response value in SSDL(NIRP) was more than 10% at angle of 20°. In terms of linear response, both calibration result of SSDL (NIRP) and CEA LIST LNHB (France) were in good agreement. Conclusions The standard X-ray RQR field in SSDL (NIRP) can be used for the calibration of H_p(3).

Objective To analyze the type-specific prevalence of human papillomavirus(HPV) among women aged 18-45 years from the general population in Liuzhou,Guangxi Zhuang Autonomous Region.Methods Totally,2 300 women aged 18-45 years old were enrolled in Liuzhou,from March to July,2013.Cervical exfoliated cells were collected for liquid based cytological and HPV DNA tests.Women were referred to colposcopy exam,based on the clinical practice guideline.Results Overall,the prevalence rates of any HPV or oncogenic HPV appeared as 22.7％ (95％CI:21.0％-24.4％) and 17.3％ (95％CI:16.0％-19.1％),respectively in this population under study.The high-risk HPV prevalence peaked at the age groups of 18-25 and 41-45,increasing along with the severity through cytological and histological tests.Statistically significant differences between the prevalence of CIN2 + (Cervical intraepithelial neoplasia 2 +) in women older than 26 years (1.7％,95％CI:1.0％-2.4％) and 18-25 years (1.2％,95％CI:0.5％-1.9％) of age,were not observed.Among samples diagnosed as CIN2+,positivity of HPV bivalent (16/18) and nine-valent (6/ 11/16/18/31/33/45/52/58) vaccine,related high risks on the types of HPV types appeared as 44.1％ and 97.1％.Conclusions The age-specific HPV prevalence rates in the general women aged 18-45 in Liuzhou presented as having bimodal distribution,suggesting that the disease burden of cervical diseases in women aged 26-45 years should not be ignored.Nine-valent HPV vaccine might provide more effective prevention outcomes on cervical cancer in China.

Objective:To explore the relationship between big endothelin-1 (big ET-1) and cardiac remodeling in patients with hypertrophic obstructive cardiomyopathy (HOCM).
Methods:A total of 167 consecutive HOCM patients admitted in our hospital from 2015-01 to 2016-05 were enrolled. Blood levels of big ET-1 and NT-proBNP were measured;electrocardiogram(ECG), dynamicECG,echocardiography (UCG) and cardiovascular magnetic resonance (CMR) were examined for relevant statistical analysis.
Results:In all 167 HOCM patients, blood level of Big ET-1 was positively related to NT pro-BNP (r=0.35, P=0.000), left atrial (LA) diameter (r=0.169, P=0.019) and heart rate (r=0.141, P=0.037);negatively related to hemoglobin (r=-0.173, P=0.013) and the ratio of interventricular septum (IVS)/posterior wall of left ventricle (r=-0.165, P=0.017). Based on the finding of positive correlation between Big ET-1 and LA diameter, the patients were divided into 2 groups:Normal LA group, n=74 and Enlarged LA group, n=93. Compared with Normal LA group,Enlarged LA group had the higher blood level of Big ET-1 (P=0.001);increased left ventricular end-diastolic diameter (LVEDD) (P=0.024), thicker IVS (P=0.003), lower LVEF (P=0.001);enlarged LVED volume (P=0.002) and IVS (P=0.002);elevated ratio of atrial fibrillation(AF);more patients with moderate to severe mitral regurgitation (MR) and NYHA functional classIII/IV.
Conclusion: Blood level of Big ET-1 was positively related to NT pro-BNP and LA diameter in HOCM patients;the patients with enlarged LA had increased Big ET-1, more obvious cardiac remodeling and the higher incidence of AF occurrence which implied that Big ET-1 might play the role in cardiac remodeling in HOCM patients.

Objective: Heart failure (HF) patients are usually associated with liver function impairment, Child-Turcotte-Pugh (CTP) scores can evaluate liver function, but its effect in HF patients has been unclear. We want to study the application of CTP scores in predicting the risk of death for in-hospital HF patients. Methods: A total of 1180 consecutive in-hospital HF patients were enrolled. According to CTP scores evaluated liver function at admission, the patients were divided into 3 groups: CTP grade A group, n=951, CTP grade B group, n=206 and CTP grade C group, n=23. The endpoint of this study was all-cause death. Results: There were 180 patients died at 1 year follow-up period, the in-hospital and 1 year mortalities were increased with the elevated CTP grades accordingly: for in-hospital mortalities in CTP grade A, B and C groups were (0.8%, 11.7% and 56.5%) respectively, P< 0.001; for 1 year mortalities were (9.6%, 34.5% and 78.3%) respectively, P< 0.001. Multivariable Cox regression analyses indicated that the higher CTP grades, the higher risk of in-hospital and 1 year mortalities in HF patients. The area under curve for CTP scores in predicting the in-hospital and 1 year mortalities were 0.88 and 0.74 respectively. Kaplan-Meier survival analysis presented that the patients with improved CTP scores from grade B or C to grade A at discharge had the higher 1 year survival rate than those without improvement, P=0.028.
Conclusion: CTP scores may independently predict the risk of death for in-hospital HF patients, the levels of CTP scores might be used for evaluating the efficacy of in-hospital treatment.

One unusual human G3P[3] group A rotavirus (RVA) strain M2-102 was identified in stool sample collected from a child with diarrhea in Guangxi Province, China in 2014. It is well known that G3P[3] is a genotype commonly identified in feline and canine RVAs. However, the preliminary phylogenetic analyses of the VP7 and VP4 genes of strain M2-102 indicated that these two genes were closely related to bat RVA strain MYAS33 and simian strain RRV, respectively, whereas both clustered distantly to feline/canine-like RVA strains. In this study, full genome sequencing and molecular analyses were conducted to obtain the true origin of strain M2-102. It was revealed that strain RVA/Human-wt/CHN/M2-102/2014/G3P[3] exhibited a G3-P[3]-I3-R3-C3-M3-A9-N3-T3-E3-H6 genotype constellation for VP7-VP4-VP6-VP1-VP2-VP3-NSP1-NSP2-NSP3-NSP4-NSP5 genes. Phylogenetic analyses revealed that 5 genes (VP7, VP1, VP2, NSP2 and NSP3) from strain M2-102 were closely related to those of bat strain MYAS33 from Yunnan Province which was thought a true bat RVA strain rather than a virus transmitted between species, while another 5 genes (VP4, VP3, NSP1, NSP4 and NSP5) clustered closely with those of simian strain RRV, yet the VP6 gene was closely related to that of human G3P[9] strain AU-1 and AU-1-like RVAs. The epidemiological data indicated that the child infected with M2-102 came from a countryside village, located in Dong Autonomous County of Sanjiang (subtropical hilly wooded area), Liuzhou city in Guangxi Province which might provide natural environment for reassortment events occurring among animal and human RVAs. Therefore, the data suggest that human strain M2-102 might originate from multiple reassortment events among bat, simian and human AU-1-like RVAs, yet it is not clear whether the genomic backbone based on bat MYAS33 (5 genes) and simian RRV (5 genes) like rotaviruses had been obtained through reassortment before being transmitted to the human. This is the first report on whole genome analysis of human G3P[3] RVA from China.
Child, Preschool ; China ; Genome, Viral ; Genomics ; Humans ; Male ; Molecular Sequence Data ; Phylogeny ; Reassortant Viruses ; classification ; genetics ; isolation & purification ; Rotavirus ; classification ; genetics ; isolation & purification ; Rotavirus Infections ; virology ; Viral Proteins ; genetics

OBJECTIVE:To establish a method for simultaneous determination of notoginsenoside R1,ginsenoside Rg1 and gin-senoside Rb1 in Shenqi xinshu capsule. METHODS:HPLC was performed on the column of Zorbax SB-C18(150 × 4.6 mm,5 μm) with mobile phase of acetonitrile-water at a flow rate of 1.0 ml/min,detection wavelength was 203 nm,column temperature was 30℃,and the injection volume was 10 μl. RESULTS:The linear range was 0.199 8-3.996 0 μg for notoginsenoside R1,0.842 8-10.143 0 μg for ginsenoside Rg1 and 0.823 4-9.978 0 μg for ginsenoside Rb1;RSDs of precision,stability and reproducibility tests were low-er than 2%;recoveries were 95.17%-100.17%(RSD=1.81%,n=9),97.32%-101.18%(RSD=1.44%,n=9)and 95.22%-98.89%(RSD=1.22%,n=9). CONCLUSIONS:The method is simple,accurate and reproducible,and can be used for the simultaneous contents determination of notoginsenoside R1,ginsenoside Rg1 and ginsenoside Rb1 in Shenqi xinshu capsule.