Objective To study the activity of ten kinds of antipyretic-antidotal traditional Chinese medicine(TCM),including radix tinosporae.herb of blin conyza and turmeric,against extensively drug-resistant Acineto-bacter baumannii(XDR-AB)infection,screen out the extracts of antipyretic-antidotal TCM which have in vivo anti-infection activity,provide a research basis for the discovery of novel antimicrobials against XD-RAB infection.Methods Ten antipyretic-antidotal TCM were extracted with water,50％ethanol and 95％ethanol respectively,and TCM extracts with different concentrations were prepared,which were co-incubated with the model of XDR-AB-infected Caenorhabditis elegans previously optimized by the research group.The in vivo activity of antipyretic-antidotal TCM against XDR-AB infection was judged through the survival rate of Caenorhabditis elegans.Results With the increase of concentration of turmeric and cortex pseudolaricis extracts,the survival rate of XDR-AB-infec-ted nematodes continued to improve.The water extract,50％ethanol extract,and 95％ethanol extract of turmeric at a concentration of 1 000 μg/mL could increase the survival rates of XDR-AB-infected Caenorhabditis elegans to 54.2％(compared to the negative control group,P＜0.001),18.8％,and 13.3％,respectively.The water ex-tract,50％ethanol extract,and 95％ethanol extract of cortex pseudolaricis at a concentration of 1 000 μg/mL could increase the survival rates of XDR-AB-infected Caenorhabditis elegans to 47.4％(compared to the negative control group,P＜0.001),23.8％,and 15.8％,respectively.Conclusion The water extracts of turmeric and cortex pseudolaricis have good activity against XDR-AB infection,and their main chemical components can be tested for in vitro antimicrobial efficacy to discover novel antimicrobial agents against XDR-AB infection.

Objective:To explore the clinical outcome of internal fixation in the treatment of AO C-type distal radius fracture accompanied with dorsoulnar fragment involving 1/8 to 1/3 of the articular surface of the lunate facet.Methods:A total of 55 patients of AO C-type distal radius fracture accompanied with dorsoulnar fragment involving 1/8 to 1/3 of the articular surface of the lunate facet from July 2017 to July 2022 in Tongji Hospital Affiliated to Tongji University were retrospectively analyzed. In the volar plate group (volar locking plate treatment alone), there were 22 cases, 11 males and 11 females, aged 56.7±10.1 years, 10 C1 type, 7 C2 type and 5 C3 type. There were 15 patients in the volar plate+dorsal plate group (treated with volar locking plate combined with dorsal plate), including 6 males and 9 females, aged 55.7±8.1 years old, 4 C1 type, 5 C2 type and 6 C3 type. In the volar plate+dorsal screw group (treated with volar locking plate combined with dorsal screw), there were 18 cases, 8 males and 10 females, aged 53.5±11.6 years, 7 cases of C1 type, 5 cases of C2 type, and 6 cases of C3 type. The operation time, postoperative radiographic indicators, wrist range of motion (ROM), disability of arm, shoulder and hand (DASH) score, visual analogue scale (VAS) and postoperative complications were evaluated and compared between the three groups.Results:All operations were successfully completed. Patients were followed up for 14.9 ± 2.2 months (range, 12-18 months), and the fracture healing time was 12.4±2.3 weeks (range, 9-16 weeks). The operative time of patients in the volar plate group, volar plate+dorsal plate group and volar plate+dorsal screw group was 54.3±7.6 min, 70.7±5.9 min and 65.8± 7.1 min, respectively. Patients in the volar plate group had less operative time ( F=27.04, P<0.001). The residual displacement of the dorsoulnar fragment in sagittal, coronal, and axial CT scans in the three groups were (1.3±0.8 mm, 0.6±0.4 mm, 0.7±0.4 mm), (1.1±0.8 mm, 0.6±0.4 mm, 0.6±0.6 mm), (1.4±0.8 mm, 0.7±0.4 mm, 0.7±0.5 mm). The displacement of the dorsoulnar fragment of the two groups of combined volar and dorsal internal fixation was smaller than that of the volar plate group ( P<0.05). The ROM of wrist flexion of the three groups at 3 months after operation were 44.2°±4.6°, 47.7°±5.9°, 48.8°±5.1°, the ROM of wrist extension were 39.8°±6.2°, 44.3°± 4.6°, 44.7°±5.1°, the wrist DASH scores were 23.0±4.2, 20.1±4.1 and 19.4±3.0, and the VAS were 2.3±1.2, 1.6±1.3 and 1.3±1.0, respectively. The ROM of wrist flexion and extension and DASH score in volar plate+dorsal plate group were better than those in volar plate group ( P<0.05). The ROM of wrist flexion and extension, DASH score and VAS in the volar plate+dorsal screw group were better than those in the volar plate group ( P<0.05). There were no significant differences in terms of the wrist ROM, DASH score and VAS at 12 months after operation among the three groups ( P>0.05). There were 2 patients in the volar plate group with reduction loss, 3 patients with wrist chronic pain; 1 patient in the volar plate combined with dorsal plate group with dorsal tendon irritation, and no complications in the volar plate combined with dorsal screw group. Conclusion:For AO C-type distal radius fractures accompanied with a dorsoulnar fragment involving 1/8 to 1/3 of the articular surface of the lunate facet, the use of combined volar and dorsal internal fixation can improve the reduction accuracy and stability of the dorsoulnar fragment, and contribute to the early rehabilitation of postoperative wrist joint function. The effect of combined dorsal screw is comparable to that of dorsal plate internal fixation, but the complications of screw internal fixation are less.

To understand the pathogenicity,virulence genes,drug resistance genes,and drug resistance of Staphylococcus aureus isolated from yaks in some areas of Lhasa and Nagqu City,55 yak nasal swab samples were analyzed for S.aureus in this study.The cocci were isolated and identified,and the carriage of virulence genes and drug resistance genes,as well as the pathogenicity and drug sensitivity of the isolated S.aureus strains,were detected with PCR,artificially infected mice,and the K-B drug susceptibility disk method.Seven strains of S.aureus were isolated from the 55 yak nasal swab samples,with an iso-lation rate of 12.73％.The isolated strains were all pathogenic to mice,with a fatality rate exceeding 60％.These seven strains of S.aureus carried three drug resistance genes(tetM,tet,and mecA)and six virulence genes(seb,sec,clfA,hla,hlb,and nuc).The detection rate of the three drug resistance genes was 100％,whereas the detection rate of the six virulence genes in the isolates ranged from 83.33％to 100％.The resistance rates of the isolated strains to penicillin,ampicillin,and cotrimox-azole reached 85.71％-100％,whereas the resistance rates to tetracycline and ceftazidime were both 28.57％.Thus,yaks in Lhasa and Nagqu cities were found to be infected by S.aureus strains carrying various drug-resistance genes and virulence genes.These strains were highly pathogenic and showed sensi-tivity to most antibacterial drugs.These findings may serve as a reference for treating S.aureus infection in yaks in the cities of Lhasa and Nagqu.

Objective:To analyze the efficacy and safety of flumatinib,a second-generation tyrosine kinase inhibitor(TKI)independently developed in China,in patients with chronic myelogenous leukemia in chronic phase(CML-CP)who falied first-line and second-line treatment.Methods:The clinical data of 30 CML-CP patients treated with flumatinib in Lianyungang First People's Hospital from January 2020 to September 2022 were collected retrospectively.Among them,15 patients who received imatinib first-line treatment but failed treatment were included in the second-line group,and the other 15 patients who failed second-line treatment with nilotinib or dasatinib were included in the third-line group.The hematological and molecular responses of the patients in the two groups at 3,6 and 12 months of treatment,and the event-free survival(EFS)and adverse reactions of patients at the end of follow-up were statistical analyzed.Results:At 3,6,and 12 months of treatment,10,11,and 12 patients in the second line group achieved major molecular response(MMR),which was higher than that of 3,4,and 5 patients in the third line group(P=0.010,P=0.011,P=0.010).At 3 months of treatment,12 and 13 patients achieved complete hematological response(CHR)and early molecular response(EMR)in the second-line group,which was higher than that of 9 and 13 patients in the third-line group,but the difference between the two groups was not statistically significant(P=0.232,P=1.000);At 6 and 12 months of treatment,6 and 7 patients in the second-line group achieved MR4.5,which were higher than of 3 and 2 cases in the third-line group,but the difference was not statistically significant(P=0.427,P=0.713).The hematological adverse reactions of patients in the second-line group during treatment the period were mainly grade 1-2 thrombocytopenia and anemia,and no grade 3-4 of adverse reactions occurred.In the third-line group,there were 2 cases of grade 1-2 thrombocytopenia,grade 1-2 anemia and white blood cell 3 cases were reduced each,1 case of grade 3-4 anemia,2 cases of grade 3-4 neutropenia.The non-hematological adverse reactions in the second-line group were rash(2 cases),headache(1 case),diarrhea(1 case),fatigue(1 case),limb pain(1 case).There were 1 cases of diarrhea,1 cases of nausea,and 1 cases of edema in the third-line group.There was no statistical significance in hematological and non-hematological adverse reactions between the two groups of patients(P＞0.05).At the end of follow-up,the EFS rate of patients in the second-line group was higher than that in the third-line group(100％vs 93.3％),but the difference was not statistically significant(P=0.317).Conclusion:The second-generation TKI flumatinib independently developed in China,has good curative effect and safety for CML-CP patients who failed first-line and second-line treatment.

Objective:To investigate the clinical efficacy and safety of ixazomib-containing regimens in the treatment of patients with multiple myeloma(MM).Methods:A retrospective analysis was performed on the clinical efficacy and adverse reactions of 32 MM patients treated with a combined regimen containing ixazomib in the Hematology Department of the First People's Hospital of Lianyungang from January 2020 to February 2022.Among the 32 patients,15 patients were relapsed and refractory multiple myeloma(R/RMM)(R/RMM group),17 patients who responded to bortezomib induction therapy but converted to ixazomib-containing regimen due to adverse events(AE)or other reasons(conversion treatment group).The treatment included IPD regimen(ixazomib+pomalidomide+dexamethasone),IRD regimen(ixazomib+lenalidomide+dexamethasone),ICD regimen(ixazomib+cyclophosphamide+dexamethasone),ID regimen(ixazomib+dexamethasone).Results:Of 15 R/RMM patients,overall response rate(ORR)was 53.3％(8/15),among them,1 achieved complete response(CR),2 achieved very good partial response(VGPR)and 5 achieved partial response(PR).The ORR of the IPD,IRD,ICD and ID regimen group were 100％(3/3),42.9％(3/7),33.3％(1/3),50％(1/2),respectively,there was no statistically significant difference in ORR between four groups(x2=3.375,P=0.452).The ORR of patients was 50％after first-line therapy,42.9％after second line therapy,60％after third line therapy or more,with no statistically significant difference among them(x2=2.164,P=0.730).In conversion treatment group,ORR was 88.2％(15/17),among them,6 patients achieved CR,5 patients achieved VGPR and 4 patients achieved PR.There was no statistically significant difference in ORR between the IPD(100％,3/3),IRD(100％,6/6),ICD(100％,3/3)and ID(60％,3/5)regimen groups(x2=3.737,P=0.184).The median progression-free survival(PFS)time of R/RMM patients was 9 months(95％CI:6.6-11.4 months),the median overall survival(OS)time was 18 months(95％CI:11.8-24.4 months).The median PFS time of conversion treatment group was 15 months(95％CI:7.3-22.7 months),the median OS time not reached.A total of 10 patients suffered grade 3-4 adverse event(AE).The common hematological toxicities were leukocytopenia,anemia,thrombocytopenia.The common non-hematological toxicities were gastrointestinal symptoms(diarrhea,nausea and vomit),peripheral neuropathy,fatigue and infections.Grade 1-2 peripheral neurotoxicity occurred in 7 patients.Conclusion:The ixazomib-based chemotherapy regimens are safe and effective in R/RMM therapy,particularly for conversion patients who are effective for bortezomib therapy.The AE was manageable and safe.

Objective To explore the changes of plasma metabolites in Uygur and Kazak patients with type 2 diabetes mellitus(T2DM)and people with normal glucose tolerance(NGT),construct the profile of different metabolites and analyze different metabolic pathways.Methods Plasma samples of T2DM and NGT from Uygur and Kazak were collected for detection.Ultra-high performance liquid chromatography tandem quadrupole time-of-flight mass spectrometry was used for detection.MetaboAnalyst 5.0 was used to analyze the data,and the screening conditions were P＜0.05 and fold change(FC)＜0.90 or FC＞1.10.We used The Kyoto Encyclopedia of Genes and Genomes database to enrich and explore the metabolic pathways of different metabolites.Results Compared with the Uighur NGT group,there are 109 differential metabolites in the T2DM group,and 43 unique differential metabolites are mainly concentrated in five pathways,such as phenylalanine biosynthesis,tyrosine biosynthesis,and tryptophan metabolism.Compared with the NGT group,Kazak T2DM has 86 differential metabolites,and 28 unique differential metabolites are mainly enriched in the urea cycle,arginine,and proline metabolism(impact＞0.10,P＜0.05).Conclusion In this study,the plasma metabolic profile of T2DM patients was constructed,and the unique metabolites of T2DM in Uygur and Kazak were screened out,which provided potential biomarkers for early prevention of T2DM.

Abstract: Objective To investigate the epidemiological characteristics of pathogens causing bloodstream infection in hematology patients during treatment and to compare the effects of allogeneic hematopoietic stem cell transplantation (HSCT) on them, so as to provide evidence for the diagnosis and treatment of bloodstream infection. Methods A total of 292 cases with bloodstream infection in hematology wards of the PLA General Hospital were collected from 2017 to 2021, which were divided into HSCT group and N-HSCT group according to whether performed HSCT or not. The epidemiological characteristics and influence of pathogenic bacteria in blood stream infection were analyzed and compared between the two groups. Results A total of 362 strains of pathogenic bacteria were collected from 292 cases, including 106 strains in HSCT group (84 cases) and 256 strains in N-HSCT group (208 cases). Bloodstream infections were more common in acute myeloid leukemia (130/392, 44.52%), followed by non-Hodgkin's lymphoma (74/292, 25.34%). The rate of once bloodstream infection in HSCT group was higher than that in N-HSCT Group, but the rate of twice bloodstream infections in N-HSCT group was higher. Gram-negative Bacilli were the most common pathogens (56.08%), with Escherichia coli being absolutely dominant (109/362, 30.11%), followed by Klebsiella pneumoniae (39/362, 10.77%). Coagulase-negative staphylococci (CoNS) (107/362, 29.56%) were the most common Gram-positive cocci. The detection rate of fungi in HSCT group (10/106, 9.43%) was significantly higher than that in N-HSCT Group (3.52%). The drug resistance rate of the common pathogenic bacteria was at a high level, and there was a certain proportion of multi-drug resistant strains (except for Pseudomonas aeruginosa). The resistance rates of CoNS to penicillin, gentamicin, moxifloxacin, clindamycin and rifampicin in HSCT group were higher than those in N-HSCT Group. The resistance rate of Escherichia coli to piperacillin/tazobactam, cephalosporins and etapenem in HSCT group was significantly higher than that in N-HSCT group. Conclusions The pathogens of blood stream infection in hematology patients are complicated and various. It is difficult for clinical diagnosis and treatment to detect multiple infections and multiple pathogens. HSCT patients have a higher risk of fungal bloodstream infection and more multi-drug resistant strains detected. Therefore, the identification of bloodstream infection and multi-drug resistant strains associated with HSCT patients should prompt surveillance.

Foot-and-mouth disease (FMD) is an acute, severe, and highly contagious infectious disease caused by foot-and-mouth disease virus (FMDV), which seriously endangers the development of animal husbandry. The inactivated FMD vaccine is the main product for the prevention and control of FMD, which has been successfully applied to control the pandemic and outbreak of FMD. However, the inactivated FMD vaccine also has problems, such as the instability of antigen, the risk of spread of the virus due to incomplete inactivation during vaccine production, and the high cost of production. Compared with traditional microbial and animal bioreactors, production of antigens in plants through transgenic technology has some advantages including low cost, safety, convenience, and easy storage and transportation. Moreover, since antigens produced from plants can be directly used as edible vaccines, no complex processes of protein extraction and purification are required. But, there are some problems for the production of antigens in plants, which include low expression level and poor controllability. Thus, expressing the antigens of FMDV in plants may be an alternative mean for production of FMD vaccine, which has certain advantages but still need to be continuously optimized. Here we review the main strategies for expressing active proteins in plants, as well as the research progress on the expression of FMDV antigens in plants. We also discuss the current problems and challenges encountered, with the aim to facilitate related research.
Animals ; Foot-and-Mouth Disease Virus/genetics* ; Foot-and-Mouth Disease/prevention & control* ; Antigens, Viral/genetics* ; Viral Vaccines

Objective: To understand the population structure of food-borne Staphylococcus (S.) aureus in China. Methods: Whole genome sequencing was used to analyze 763 food-borne S. aureus strains from 16 provinces in China from 2006 to 2020. Multilocus sequence typing (MLST), staphylococcal protein A gene (spa) typing, and staphylococcal chromosome cassettemec (SCCmec) typing were conducted, and minimum spanning tree based on ST types (STs) was constructed by BioNumerics 7.5 software. Thirty-one S. aureus strains isolated from imported food products were also included in constructing the genome phylogenetic tree. Results: A total of 90 STs (20 novel types) and 160 spa types were detected in the 763 S. aureus isolates. The 72 STs (72/90, 80.0%) were related to 22 clone complexes. The predominant clone complexes were CC7, CC1, CC5, CC398, CC188, CC59, CC6, CC88, CC15, and CC25, accounting for 82.44% (629/763) of the total. The STs and spa types in the predominant clone complexes changed over the years. The methicillin-resistant S. aureus (MRSA) detection rate was 7.60%, and 7 SCCmec types were identified. The ST59-t437-Ⅳa (17.24%, 10/58), ST239-t030-Ⅲ (12.07%, 7/58), ST59-t437-Ⅴb (8.62%, 5/58), ST338-t437-Ⅴb (6.90%, 4/58) and ST338-t441-Ⅴb (6.90%, 4/58) were the main types in MRSA strains. The genome phylogenetic tree had two clades, and the strains with the same CC, ST, and spa types clustered together. All CC7 methicillin sensitive S. aureus strains were included in Clade1, while 21 clone complexes and all MRSA strains were in Clade2. The MRSA strains clustered according to the SCCmec and STs. The strains from imported food products in CC398, CC7, CC30, CC12, and CC188 had far distances from Chinese strains in the tree. Conclusions: In this study, the predominant clone complexes of food-borne strains were CC7, CC1, CC5, CC398, CC188, CC59, CC6, CC88, CC15, and CC25, which overlapped with the previously reported clone complexes of hospital and community-associated strains in China, suggesting that close attention needs to be paid to food, a vehicle of pathogen transmission in community and food poisoning.
Humans ; Staphylococcus aureus/genetics* ; Methicillin-Resistant Staphylococcus aureus/genetics* ; Multilocus Sequence Typing ; Phylogeny ; Staphylococcal Infections/epidemiology* ; China/epidemiology*

Objective:To compare the clinical outcomes between anatomical locking plate, proximal humerus internal locking system (PHILOS) and anatomical locking plate combined with suture anchors in the treatment of comminuted fractures of humeral greater tuberosity.Methods:A total of 33 comminuted fractures of humeral greater tuberosity were surgically treated from October 2016 to October 2021 at Department of Orthopedics, Tongji Hospital Affiliated to Tongji University. There were 20 males and 13 females, with an age of (53.5±13.6) years. They were assigned into 3 groups according to different internal fixation techniques. Group A of 12 cases was subjected to fixation with anatomical locking plate via the deltoid approach, group B of 10 cases subjected to fixation with PHILOS via the pectoralis major and the deltoid approaches and group C of 11 cases subjected to fixation with anatomical locking plate combined with suture anchors via the deltoid approach. The operation time, intraoperative blood loss, range of shoulder motion, Constant-Murley shoulder score, visual analogue scale (VAS) and postoperative complications were compared between the 3 groups.Results:The 3 groups were comparable because there was no significant difference between them in the general clinical data ( P>0.05). The follow-up duration for all patients was (14.5±4.1) months. All fractures got united at the last follow-up. In groups A, B and C, respectively, the operation time was (57.9±7.8), (73.0±7.1) and (63.6±9.5) min, and the intraoperative blood loss (41.7±18.9), (82.0±22.9) and (46.4±13.6) mL, showing significant differences between the 3 groups ( P<0.05). The operation time and intraoperative blood loss in groups A and C were significantly less than those in group B ( P< 0.05). At the last follow-up, in groups A, B and C, respectively, the shoulder abduction was 144.0°±7.7°, 138.7°±10.7° and 148.5°±6.2°, showing significant differences between the 3 groups ( P<0.05). Group C was significantly better than group B ( P<0.05). There was no statistically significant difference in the forward flexion, external rotation, or internal rotation of the shoulder joint between the 3 groups ( P>0.05). The Constant-Murley scores in groups A, B and C, respectively, were (90.4±5.7), (86.1±6.6) and (93.1±3.4) points, showing significant differences between the 3 groups ( P<0.05). Group C was significantly better than group B ( P<0.05). The VAS scores in groups A, B and C, respectively, were 1 (0, 2), 1 (0, 2), and 1 (0, 1) point, showing insignificant differences between the 3 groups ( P>0.05). Group A had 1 case of shoulder joint stiffness and 1 case of fracture re-displacement complicated with acromial impingement syndrome, group B 1 case of shoulder joint stiffness and 3 cases of fracture re-displacement, but group C no post-operative complication. Conclusions:In the treatment of comminuted fracture of humeral greater tuberosity, all the 3 internal fixation techniques can lead to fine clinical outcomes. Conventional PHILOS may lead to relatively large trauma and a high incidence of postoperative complications. The anatomical locking plate may result in fine functional recovery of the shoulder due to advantages of less invasion, shorter operation time and fewer postoperative complications than PHILOS. The anatomical locking plate combined with suture anchors may lead to the best shoulder functional recovery and the least complications.