Objective To investigate the distribution and antimicrobial resistance profiles of the common pathogens isolated from urine from 2015 to 2021 in the CHINET Antimicrobial Resistance Surveillance Program.Methods The bacterial strains were isolated from urine and identified routinely in 51 hospitals across China in the CHINET Antimicrobial Resistance Surveillance Program from 2015 to 2021.Antimicrobial susceptibility was determined by Kirby-Bauer method,automatic microbiological analysis system and E-test according to the unified protocol.Results A total of 261 893 nonduplicate strains were isolated from urine specimen from 2015 to 2021,of which gram-positive bacteria accounted for 23.8％(62 219/261 893),and gram-negative bacteria 76.2％(199 674/261 893).The most common species were E.coli(46.7％),E.faecium(10.4％),K.pneumoniae(9.8％),E.faecalis(8.7％),P.mirabilis(3.5％),P.aeruginosa(3.4％),SS.agalactiae(2.6％),and E.cloacae(2.1％).The strains were more frequently isolated from inpatients versus outpatients and emergency patients,from females versus males,and from adults versus children.The prevalence of ESBLs-producing strains in E.coli,K.pneumoniae and P.mirabilis was 53.2％,52.8％and 37.0％,respectively.The prevalence of carbapenem-resistant strains in E.coli,K.pneumoniae,P.aeruginosa and A.baumannii was 1.7％,18.5％,16.4％,and 40.3％,respectively.Lower than 10％of the E.faecalis isolates were resistant to ampicillin,nitrofurantoin,linezolid,vancomycin,teicoplanin and fosfomycin.More than 90％of the E.faecium isolates were ressitant to ampicillin,levofloxacin and erythromycin.The percentage of strains resistant to vancomycin,linezolid or teicoplanin was＜2％.The E.coli,K.pneumoniae,P.aeruginosa and A.baumannii strains isolated from ICU inpatients showed significantly higher resistance rates than the corresponding strains isolated from outpatients and non-ICU inpatients.Conclusions E.coli,Enterococcus and K.pneumoniae are the most common pathogens in urinary tract infection.The bacterial species and antimicrobial resistance of urinary isolates vary with different populations.More attention should be paid to antimicrobial resistance surveillance and reduce the irrational use of antimicrobial agents.

Objective: To explore the improvement rate of liver fibrosis in patients with chronic hepatitis B virus infection who received entecavir alone or in combination with anluohuaxianwan for 78 weeks. Methods: Patients with chronic HBV infection were randomly treated with entecavir alone or in combination with anluohuaxian for 78 weeks. Ishak fibrosis score was used for blind interpretation of liver biopsy specimens. The improvement in liver fibrosis condition before and after the treatment was compared. Student's t test and non-parametric test (Mann-Whitney U-Test and Kruskal-Wallis test) were used to analyze the measurement data. The categorical variables were analyzed by Chi-square test method and Spearman’s rank correlation coefficient was used to test bivariate associations. Results: Liver fibrosis improvement rate after 78 weeks of treatment was 36.53% (80/219) and the progression rate was 23.29% (51/219). The improvement of liver fibrosis was associated to the degree of baseline fibrosis and treatment methods (P < 0.05). The improvement rate of hepatic fibrosis in patients treated with anluohuaxianwan combined with entecavir at baseline F < 3 (54.74%, 52/95) was significantly higher than that in patients treated only with entecavir (33.33%, 16/48), P = 0.016 and the progression rate of hepatic fibrosis (13.68%, 13/95) was lower than that in patients treated alone (18.75%, 9/48), P = 0.466. In patients with baseline F < 3, the proportion of patients with improved and stable liver fibrosis in the combined treatment group (68.1%, 32/47) was higher than that in the treatment group alone (51.7%, 15/29). Conclusion Combined anluohuaxianwan and entecavir treatment can significantly improve the improvement rate of liver fibrosis in patients with chronic hepatitis B virus infection. Furthermore, it has the tendency to improve the stability rate and reduce the rate of progression of liver fibrosis.

Objective To investigate the change of spinal G protein-coupled receptor kinase 2 (GRK2) expression in persistent postoperative pain evoked by skin/muscle incision and retraction (SMIR) in rats.Methods 40 male Sprague Dawley (SD) rats were divided into 2 groups (n =20) using a random number table:sham operation group and skin/muscle incision and retraction group (SMIR group).A rat model of peristent postoperativepain evoked by SMIR was made according to the method described by Flatters.Pain behavior was assessed by paw mechanical withdrawal threshold (MWT) to yon Frey filament stimulationintensity at 1 d before operation (T0) and 3 d (T1),7 d (T2),14 d (T3) and 21 d (T4) after operation.4 rats in each group were sacrificed at T0-4,the L4-L6 segments of the spinal cord were obtained for determination of GRK2 expression in the spinal cord by Western blot.Results Compared with T0,the MWT was significantly decreased and the expression of spinal GRK2 was down-regulated at T1-T4 in SMIR group (P ＜ 0.05).Compared with sham operation group,the MWT and the expression of spinal GRK2 was decreased at T1-T4 in SMIR group (P ＜ 0.05).Conclusions The down-regulation of expression of spinal GRK2 may be involved in the development and maintenance of persistent postoperative pain in rats evoked by SMIR.

Objective To analyze the bone metabolism in hospitalized patients with Graves disease and the changes after 131I therapy.Methods The differences of bone metabolism were analyzed between 315 patients with Graves disease and 300 normal controls in a case-control study.The changes in bone turnover markers and BMD levels before and one year after 131I therapy were observed in 60 patients.Results Compared to normal control,bone turnover markers were markly higher and BMD levels were lower in patients with Graves disease.The level of thyroid hormones were positively related to bone turnover markers,while negatively related to total hip BMD (Z-score).But there was no linear relationship with lumbarand femoral neck BMD (Z-score).After one year of 131I therapy,bone turnover markers were markly lower than that before treatment,while BMD levels were partly higher than that before treatment.Conclusions In Graves disease patients,bone turnover markers were generally increased,while BMD levels decreased compared with normal people.After 131I therapy,along with the improvement of thyrotoxicosis,the high bone turnover rate can be suppressed,and BMD can partly recover.

Objective:To explore the clinical characteristics, mechanism and countermeasures of drug-induced second thrombocy-tosis ( ST) in order to ensure safe medication. Methods:Drug-induced ST published during 1996 and 2016 in domestic and overseas medical journals was collected and statistically analyzed in respects of age, gender, kind and distribution of drug-induced ST, treatment and outcome of ST. Results:Totally 198 cases were collected, which involved 30 different drugs of eight types mainly including antitu-mor drugs, blood system drugs and antibiotics. Among the patients, 112 ones (56. 6％) were male and the other 86 ones (43. 4％) were female. Totally 14 patients had embolization with the overall incidence of 7. 0％. Conclusion:Without timely and favorable treat-ment, drug-induced ST may lead to thrombosis. To ensure the safety of medication, platelet level should be monitored regularly during medication.

Objective To investigate the epidemiological and clinical characteristics of measles in patients of different age groups in Northeast China in 2014.Methods The clinical data of patients with measles in ten hospitals of infectious diseases in Northeast China from January 2014 to June 2014 were collected.Patients were divided into <16 age group and ≥16 age group, and the epidemiology , clinical characteristics, treatment and prognosis of all patients were retrospectively reviewed .SPSS 17.0 was used for data analysis.Results There were 1 401 patients with measles, in which 402 were <16-year old, and 999 were ≥16-year old.Clinical manifestations were mainly maculopapule (100.0%), fever (84.58%), cough (85.80%), Koplik’ s spot (73.23%), pharyngeal hyperemia (71.23%), diarrhea (43.97%), expectoration (40.97%), tears (39.40%) and runny nose (30.55%).The incidences of Koplik’s spot, sputum, pharyngeal hyperemia and diarrhea in <16 age group were lower than those in ≥16 age group (χ2 =8.364, 29.768, 10.953 and 6.701, P<0.05 or <0.01); while the incidence of runny nose was higher than that in ≥16 age group (χ2 =6.703, P<0.05).Abnormalities were found in blood routine examination, C-reactive protein (CRP), liver and kidney function, serum electrolyte levels, myocardial enzymes, and so on.Increasing in WBC, PLT and creatine kinase isoenzyme (CKMB), and decreasing in WBC were observed in 38(9.45%), 122(30.35%), 279(69.40%) and 105(26.12%), patients in <16 age group, which were higher than those in ≥16 age group [45(4.5%), 14(1.40%), 347(34.73%) and 202(20.22%)], and the differences were of statistical significance (χ2 =12.593, 274.033, 139.385 and 5.830, P<0.05 or P<0.01).Increasing in alanine aminotransferase (ALT), CRP, total bilirubin level (TBil), creatine kinase (CK), and decreasing in albumin (Alb), K+, Na+, Cl-were observed in 70(17.41%), 7(1.74%), 38(9.45%), 7(1.74%), and 214(53.23%), 59(14.68%), 45(11.19%), 94(23.38%) patients in <16 age group, which were lower than those in ≥16 age group [668(66.87%), 89(8.91%), 277(27.73%), 714(71.47), and 268(26.83%), 339(33.93%), 642(64.26%), 450 (45.05%)], and the differences were of statistical significance (χ2 =281.230, 23.073, 50.687, 159.740, and 14.674,114.286, 44.268, 271.546, P<0.01).Laryngitis and pneumonia were the most common complications.The incidence of laryngitis in <16 age group was 12.69% (51/402), which was higher than that in ≥16 years group (93/999, 9.31%,χ2 =3.545, P<0.05);while the incidence of spot shadows demonstrated by X-ray in <16 years group ( 72.89%, 121/166 ) was higher than that in ≥16 years group (265/445, 59.55%,χ2 =9.249, P<0.01).Conclusions There are differences in clinical features of measles in patients between <16 age group and ≥16 age group.Basic immunization in children and revaccination in adults should be enhanced to control the epidemics of measles .

Objective:To investigate the pharmaceutical care methods for the patients with drug-induced liver injury. Methods:The participation process of clinical pharmacists in 3 cases of typical drug-induced liver injury was with detailed introduction and analy-sis in the paper. Results:The case 1 indicated that new drugs probably with drug-induced liver injury should be warned in the process of clinical medication. The case 2 suggested that TDM, as a useful assessment weapon, could be fully used to find the source medi-cines when drug-induced liver injury occurred. The case 3 showed the specific cases, especially the patients with abnormal liver func-tion, should be focused on, the medicines with high liver toxicity should be avoided and the medicines with mild liver toxicity could be chosen. Conclusion:Clinical pharmacists should participate in the clinical practice of drug-induced liver injury with multi-channel and multi-link, and pay attention to the drugs with high risk of liver injury. Meanwhile, clinical pharmacists should perform TDM monito-ring to provide positive evidence for the diagnosis of drug-induced liver injury, and focus on the liver and kidney functions to provide better pharmaceutical care for the patients.

BACKGROUNDTo observe the CT appearance and pathological changes of VX2 tumor in rabbit lung after radio-frequency ablation.

METHODSAfter VX2 tumor tissue suspension was injected into the lungs, the transplanted lung cancer models were established in 36 New Zealand white rabbits. Twenty-eight rabbits were treated with radio-frequency ablation, and another 8 rabbits without any treatment as control. The CT appearances and pathological changes were observed in different time intervals after the treatment in 14 rabbits out of experimental group. The survival periods of the rabbits were recorded in the rest 14 rabbits of experimental group and the control group respectively.

RESULTSCoagulative necrosis and cell apoptosis appeared in the tumor tissues after the ablation, and inflammatory cells were found in the lung tissues around the areas of ablation. Wadding shadows appeared in CT images after the treatment and disappeared with the inflammation vanished, but the tumor shadows ceased to increase. In the experimental group, tumor tissues were almost necrosed in the target areas of 21 rabbits, however, peripheral residual nests of histologically viable tumor were found in the target areas of the other 7 rabbits. The survival periods of rabbits in the experimental group and the control group were 38 days±3.4 days days and 26 days±2.8 days respectively (P < 0.05).

CONCLUSIONSRadio-frequency ablation may be an effective method in the treatment of lung cancer.

BACKGROUNDTo study the biological effects of multi-electrode radiofrequency ablation on pulmonary tissues of rabbits.

METHODSUnder the guidance of computer tomograph, electrodes were inserted into right lungs of New Zealand white rabbits and radiofrequency was performed. The biological effects were observed through CT image and microscopy.

RESULTSCoagulative necrosis was found immediately in ablation area after the procedure. On the 7th postradiofrequency ablation day, fibrous tissues appeared in the necrotic lesions. On the 30th postradiofrequency ablation day, bronchial and alveolar epithelium began to proliferate. Within 60 to 90 days after treatments, the necrotic lesions were almost replaced by normal pulmonary tissues. In group with electrodes into the right hilum, time for treating and initial impedance were significantly different from those with electrodes into the peripheral sites of the right-lower lobes (P < 0.01, P < 0.01).

CONCLUSIONSMulti-electrode radiofrequency ablation can be safely and effectivly performed in pulmonary tissue and cause coagulative necrosis within a certain extent.