Objective:To learn about the single nucleotide polymorphism (SNP) population structure and regional distribution characteristics of Yersinia pestis in the natural focus of plague in Qinghai-Tibet Plateau. Methods:A total of 319 representative strains of Yersinia pestis isolated from natural focus of plague in Qinghai-Tibet Plateau from 1954 to 2020 were selected, and 2 298 SNP loci included in the global Yersinia pestis phylogenetic tree were compared by whole genome sequencing technology. MEGA 6.0 software was used to construct phylogenetic trees of 319 strains of Yersinia pestis from Qinghai-Tibet Plateau, determine the SNP population structure of Yersinia pestis in the focus, and describe its regional distribution characteristics. Results:The 319 strains of Yersinia pestis isolated from Qinghai-Tibet Plateau natural plague foci were distributed in 5 clades, namely 1.IN, 2.ANT, 3.ANT, 0.PE and 2.MED. The 1.IN clade contained 209 strains (65.52%, 209/319), which was the dominant population of strains in Qinghai Province, accounting for 90.51% (143/158). The 2.ANT clade contained 83 strains (26.02%, 83/319), which was the dominant population in Tibet Autonomous Region, accounting for 67.24% (78/116). The 3.ANT, 0.PE, and 2.MED clades contained 12 (3.76%, 12/319), 9 (2.82%, 9/319) and 6 strains (1.88%, 6/319), respectively, which were scattered in Qinghai Province, Gansu Province, Sichuan Province, Tibet Autonomous Region, and Xinjiang Uygur Autonomous Region under the jurisdiction of Qinghai-Tibet Plateau. Conclusion:The SNP population structure of Yersinia pestis in natural focus of plague in Qinghai-Tibet Plateau is relatively rich, and the strains are distributed in 5 clades: 1.IN, 2.ANT, 3.ANT, 0.PE and 2.MED, showing the distribution characteristics of specific regions.

Objective: To investigate the current prevalence of excessive weight gain during pregnancy among pregnant and lying-in women in Xining City and to identify the influencing factors, so as to provide insights into reasonable weight control during pregnancy. Methods: The pregnant and lying-in women who were registered and delivered in the Red Cross Hospital of Qinghai Province, the Affiliated Hospital of Qinghai University and the First People's Hospital of Xining City from August 2021 to July 2022 were enrolled. Women's demographics, health status during pregnancy, diet, sleep and exercise were collected through prenatal testing data and questionnaires. Excessive weight gain during pregnancy was identified according to "Weight monitoring and evaluation during pregnancy of Chinese Women" (T/CNSS 009-2021), and the factors affecting excessive weight gain during pregnancy were identified using a multivariable logistic regression model. Results: A total of 902 questionnaires were allocated and 882 valid questionnaires were recovered, with an effective recovery rate of 97.78%. The pregnant and lying-in women had a mean age of (29.06±4.16) years, mean pregestational body mass index of (20.44±2.20) kg/m2 and mean gestational weight gain of (14.17±3.11) kg, and there were 447 primiparas (50.68%) and 360 women with excessive weight gain during pregnancy (40.82%). Multivariable logistic regression analysis identified an educational level of senior high school/technical secondary school (OR=1.400, 95%CI: 1.037-1.889), annual household income of >200 000 Yuan (OR=2.385, 95%CI: 1.924-2.956), a family history of diabetes (OR=1.475, 95%CI: 1.180-1.844), pregestational overweight/obesity (OR=4.079, 95%CI: 2.471-6.734), gestational hypertension (OR=2.061, 95%CI: 1.027-4.136), anxiety (OR=1.315, 95%CI: 1.139-1.518) and preference for sour foods (OR=1.715, 95%CI: 1.237-2.376) as risk factors for excessive weight gain during pregnancy, and early pregnancy reaction as a protective factor (OR=0.636, 95%CI: 0.546-0.742). Conclusions The prevalence of excessive weight gain during pregnancy was high in Xining City, and educational level, annual household income, family history of diabetes, pregestational body mass index, pregnant complications and dietary habits are factors affecting excessive weight gain during pregnancy.

OBJECTIVE: To study the effect of rapamycin on scar formation in rabbit eyes following filtering operation and explore the possible mechanism. METHODS: Ninety-six healthy adult rabbits were subjected to trabeculectomy of the left eye and subsequently randomly divided into 4 groups (=24) for treatment with castor oil (control) or rapamycin (1%, 3%, or 5%) eye drops of the operated eyes 4 times a day. The morphology and function of the filtering blebs of the rabbits were compared at 7, 14, 21 and 28 days after the operation; at each of the time points, 6 rabbits from each group were euthanized for detection of expressions of proliferating cell nuclear antigen (PCNA) and α-smooth muscle actin (α-SMA) in the tissues in the surgical area using immunohistochemistry. Cultured rabbit subconjunctival fibroblasts (RTFSs) were treated with different concentrations of rapamycin (0.06, 0.25, 1, and 4 mg/L) and the cell apoptosis was detected using flow cytometry. RESULTS: In the first, second and third weeks after the operation, the rate of functional follicle formation was significantly higher in the 3 rapamycin groups than in the control group ( < 0.05), and the number of α- SMA-positive fibroblasts decreased over time in the 3 rapamycin groups. In cultured RTFSs, treatment with rapamycin at different concentrations resulted in increased apoptosis of the cells, and rapamycin above 0.25 mg/L significantly increased the cell apoptosis in a dose-dependent manner. CONCLUSIONS Rapamycin can inhibit hyperplasia of the filtering passage tissue, helps to preserve the functional filtering blebs and prolong their life span, and induces apoptosis of RTFS.

Objective:To investigate the molecular characteristic and antimicrobial resistance of Staphyloco- ccus aureus ( S. aureus) isolated from children with pneumonia, in order to provide the evidence for clinical diagnosis and treatment. Method:s The S. aureus strains isolated from children diagnosed as S. aureus pneumonia in the Beijing Children′s Hospital, Capital Medical University, between January 2016 and March 2017 were collected.Methicillin-resistant S. aureus(MRSA)and Methicillin-susceptible S. aureus(MSSA)were identified using the cefoxitin disc method and the detection of the mecA gene. S. aureus isolates were characterized by multilocus sequence typing (MLST) and Staphylococcal protein A (spa) typing, and MRSA strains were characterized by Staphylococcal chromosome cassette (SCC mec) typing.Besides, 21 superantigens (SAgs) genes, panton-valentine leucocidin (PVL) genes, adhesion genes fnbb and cna were detected by PCR; E-test was used to detect in vitro drug sensitivity of 14 antibiotics. Result:s A total of 42 S. aureus were collected, and 21 isolates were MSSA, the same to MRSA, while MSSA strains had relatively dispersed typing, with ST25-t078 (14.2%) as the most common one.ST59-SCC mecⅣa-t437 (71.4%) were the most predominant clones of MRSA.Of the 42 isolates, 36 strains (85.7%) had at least 1 superantigen gene, and sek- seq (21.4%) was the main virulence genotype.The ratio of pvl in MRSA strains (52.3%)was significantly higher than that in MSSA strains (14.2%), while the detection rate of fnbB and cna in MRSA(9.5%, 9.5%) was significantly lower than that in MSSA(42.8%, 47.6%), and the differences were statistically significant (all P<0.05). Ninety point four percent (38/42 strains) of the S. aureus isolates were multidrug resistant. Conclusions:In children with S. aureus pneumonia, MRSA has a high detection rate, and its dominant clonotype is ST59-SCC mecⅣa-t437.The pre-valence of superantigen genes and the multidrug resistant rate of S. aureus are relatively high.MRSA strains often carry pvl, while MSSA strains usually carry fnbB and cna gene.

Objective: To study the clinical and molecular characteristics of Staphylococcus aureus(S.aureus ) isolated from neonates of Beijng Children′s Hospital. Methods: The clinical information of S. aureus infection in newborns of Beijing Children′s Hospital from February 2016 to January 2017 was collected.The molecular biological characteristics of S. aureus isolates were detected.Methicillin-resistant S. aureus (MRSA) and methicillin-susceptible S. aureus(MSSA)were identified, using the cefoxitin disc method and the detection of the mecA gene.Multilocus sequence typing(MLST)and spa typing were analyzed using the PCR, and the staphylococcal chromosomal cassette mec(SCCmec) type was analyzed for the MRSA isolates.Eleven adhesion gene and three virulence genes(pvl, psma, hlα )were also detected by PCR.Antimicrobial susceptibility testing was performed by agra dilution method or E-test method. Results: The total of 57 cases of neonatal S. aureus infection were collected during the study.The most common clinical diagnosis was 38 cases (66.7%) of pneumonia and 28 cases (49.1%) of skin infection syndrome (SSTI). There were 31 cases (54.4%) with MRSA infection and 26 cases (45.6%) with MSSA infection.The proportion of SSTI in the MRSA group (64.5%) and the infection of more than 2 sites (61.3%, 19/31) were significantly higher than those in the MSSA group (30.8%, 8/26 and 23.1%, 6/31). There were 16 MLST types and 29 spa types, the most common ones were ST59 (40.4%) and t437 (33.33%), respectively.The most common popular clones of MRSA and MSSA were ST59-SCCmecIVa-t437 (54.8%) and ST22-t309, respectively(11.5%). The sdrE carrying rate of MRSA was higher than that of MSSA, while the sdrD and cna carrying rates were lower than those of MSSA (P<0.05). The other adhesion and virulence gene carrying rates were not significantly different between the two strains.The multi-drug resistance rate of all strains was 61.4%(35/57). Except for lactam antibiotics, the most common resistant phenotypes of MRSA and MSSA were ERY-CLI, accounting for 74.2% and 26.9%, respectively. Conclusion The main types of neonatal S. aureus infection in our hospital were pneumonia and SSTI.SSTI and multi-site infections of MRSA infection are more common.MRSA and MSSA isolates have clonal dissemination characteristics.The most common clones are ST59-SCCmecIVa-t43 and ST22-t309, which show no significant differences in the status of carrying virulence factors between them.The multi-drug resistance rate of neonatal S. aureus isolates is higher.

Autophagy is a “self-devouring” biological process of the degradation of organelles and proteins by lysosomes in eukaryotic cells. In the past few years, some results revealed that autophagy played an important role in the regulation of vascular calcification. This review summarized the recent studies on autophagy in the process of vascular calcification, and discussed the effects of electrolyte imbalance, matrix vesicle release, oxidative stress, inflammatory reaction of vascular endothelial cells, and lipid metabolism in autophagy. The research progress of β-catenin/AMPK/CREB/Nrf2-ARE/Erα signal transduction pathways in autophagy induction was reviewed.

Objective To evaluate the efficacy of bronchial blocker outside the endotracheal tube for one-lung ventilation (OLV) in pediatric patients. Methods Thirty-eight American Society of Anesthe-siologists physical status ⅠorⅡ patients of both sexes, aged 4-8 yr, weighing 14. 0-28. 6 kg, scheduled for elective thoracic surgery under general anesthesia, were enrolled in this study. The size of tracheal tube was selected according to the endotracheal diameter at the level of clavicle and sternum on chest X-ray. Af-ter anesthesia induction, the distal end of the bronchial blocker was bent toward the target bronchus with a videolaryngoscope and then inserted until resistance was felt, and the preselected tracheal tube was inserted with a videolaryngoscope at a depth of (age∕2+12) cm. The position of the bronchial blocker was adjusted using a bronchofiberscope so that the upper edge of the blue cuff was 0. 5-1. 0 cm below the carina. The heart rate, mean arterial pressure, SpO2and airway pressure were recorded, arterial blood gas analysis was performed, and PaCO2and PaO2were recorded immediately before OLV (T1), at 30 min after OLV (T2) and at the end of OLV (T3). The intubation time, success rate of intubation at first attempt, displacement of bronchial blocker and occurrence of postoperative laryngeal pain and hoarseness were recorded. The pul-monary collapse was evaluated according to the standard described by Campos.Results Compared with the baseline at T1, PaO2was significantly decreased and airway pressure was increased at T2,3(P＜0. 05), and no significant change was found in heart rate, mean arterial pressure, PaCO2or SpO2at T2,3( P＞0. 05). The average intubation time was (185±38) s. The success rate of intubation at first attempt, rate of bronchial blocker displacement, excellent and good rates of pulmonary collapse and incidence of laryngeal pain and hoarseness were 95%, 16%, 100% and 11%, respectively. Conclusion Bronchial blocker outside the endotracheal tube can be effectively used for OLV in pediatric patients.

Objective To investigate the molecular characteristics,virulence genes and antimicrobial susceptibility to Staphylococcus aureus strains isolated from children with skin and soft tissue infections (SSTIs) in Beijing.Methods A total of 52 Staphylococcus aureus isolates were collected from children with SSTIs in Beijing Children's Hospital,Capital Medical University,and the clinical data were collected and analyzed.Methicillin-resistant Staphylococcus aureus(MRSA) and methicillin-susceptible Staphylococcus aureus(MSSA) were identified by using the cefoxitin disc method and the detection of mecA gene.Multilocus sequence typing (MLST) and staphylococcal protein A (spa) typing were analyzed by the PCR method,and the staphylococcal chromosomal cassette mec (SCCmec) type was analyzed for the MRSA isolates.The pvl,eta,etb,tsst-1 and hlg genes were also detected by PCR.The susceptibility strains to 16 antibiotics were evaluated by using the agar dilution method.Results A total of 52 Staphylococcus aureus SSTIs patients,30 with MRSA infections and 22 with MSSA infections were included in the study.There were 23 patients (44.2％) less than 1 year old.The most frequent infections were the newborn omphalitis (12/52 strains,23.1％)and abscess(11/52 strains,21.2％).ST59-MRSA-SCCmecⅣa-t437 was the most predominant clones of MRSA isolates.Among the MSSA isolates(14/30 strains,46.7％),no significant epidemic clone was found.Ten sequence types (STs) and 14 spa types were identified in MSSA,and the most common types were ST22(6/22 strains,27.3％)and t309 (5/22 strains,22.7％),respectively.Notably,the multidrug resistant rates of MRSA and MSSA isolates were all ＞ 85％.The percentages of the Staphylococcus aureus SSTIs strains resistant to Erythromycin,Penicillin,Chloramphenicol and Clindamycin were 100.0％,94.2％,69.2％ and 63.5％,respectively.The tested isolates were susceptible to Trimethoprim/Sulfamethoxazole,Mupirocin,Fusidic acid,Tigecycline,Linezolid and Vancomycin.The pvl gene's positive rate was 40.4％,and no significant difference between MRSA and MSSA was observed (P ＞ 0.05).Eta and etb genes were detected in 2 patients with staphylococcal scalded skin syndrome.Conclusions The Staphylococcus aureus SSTIs strains are most frequently isolated from newborn omphalitis and abscess in Beijing.The multidrug resistant rate is relatively high,so the erythromycin and clindamycin should not be preferred in empiric treatment of children with Staphylococcus aureus SSTIs.The prevalence of pvl gene is 40.1％.ST59-MRSA-SCCmecⅣa-t437 is the common clone of MRSA,while the MSSA isolates have a more diverse genetic background.

OBJECTIVETo investigate clinicopathological features and prognostic factors of appendiceal neuroendocrine neoplasms(a-NEN).

METHODSClinical data of 20 patients diagnosed with a-NEN at Zhongshan Hospital of Fudan University between January 2000 and December 2016 were retrospectively analyzed. Pathological diagnosis was based on the WHO classification criteria of digestive system tumors (2010 edition). Based on the mitotic count and Ki-67 index, a-NENs were divided into grade 1 neuroendocrine tumor (NET G1), grade 2(G2) NET G2) and grade 3 (neuroendocrine carcinoma, NEC). Some special types of a-NEN (e.g. goblet cell carcinoid) and mixed adenoneuroendocrine neoplasms were classified as mixed adenoneuroendocrine carcinoma (MANEC). Follow-up was conducted by telephone or return visits. Univariate analysis was carried out using the Kaplan-Meier method, and the log-rank test was used to draw survival curves.

RESULTSOf 20 patients, 14 were male and 6 were female with median age of 54 years. Seventeen cases presented acute right lower quadrant abdominal pain, 1 chronic right lower quadrant abdominal pain, 1 persistent abdominal discomfort with outburst whole abdominal pain and 1 was found during body check without symptoms. Twenty cases comprised 8 G1 patients, 4 G2 patients, 3 G3 patients, and 5 MANEC patients. When diagnosed, there was 1 patient with liver metastasis, 1 patient with abdominal and pelvic metastases, and 2 patients with postoperative pathological findings of lymph node metastasis. Six patients underwent appendectomy, 12 underwent right hemicolectomy, 1 underwent right hemicolectomy plus small intestine resection, and 1 underwent partial hepatectomy plus right hemicolectomy. The follow-up time was 7-187 months(average, 36 months). The total 1- and 3-year survival rates were 94.7% and 60.2%, respectively. Univariate analysis showed that age >50 years (χ=7.036, P=0.008), pathology grade as MANEC (χ=5.297, P=0.021), and metastasis (χ=6.558, P=0.010) indicated lower 5-year survival rate.

CONCLUSIONSMost a-NEN patients have no typical symptoms, and the main complaint at consultation is acute right lower quadrant abdominal pain. Prognosis is poor for patients with age >50 years, MANEC pathology grade and metastasis.

Appendiceal Neoplasms ; complications ; diagnosis ; surgery ; Carcinoma, Neuroendocrine ; complications ; diagnosis ; therapy ; Female ; Gastrointestinal Neoplasms ; Humans ; Male ; Middle Aged ; Neuroendocrine Tumors ; complications ; diagnosis ; surgery ; Prognosis ; Retrospective Studies

Objective To investigate the effect and potential mechanism of autophagy inhibitor chloroquine on the calcium oxalate crystals formation in rats.Methods From September 2016 to October 2016,Thirty healthy male SD rats were randomly divided into 3 groups:control group,model group and chloroquine intervention group.The method to establish calcium oxalate stone model was drinking water with 1％ ethylene and 1％ ammonium chloride freely.The rats of chloroquine intervention group were treat with chloroquine (40mg/kg · d) by intraperitoneal injection.Modeling was finished after 28 days.The amounts of renalcalcium oxalate crystals were detected by polarizing microscope.For all groups,the amounts of autophagosome were detected by transmission electron microscope.Twenty four hour urine compositions for stone risk factors were detected.The expressions of oxidative stress injury related molecular markers (SOD,MCP-1 and 8-OHdG) and the expressions of autophagy markers (LC3 and P62) were detected by immunohistochemistry.The RNA expressions of SLC26A6 in kidney were detected by Real-time PCR.Results Compared to the model group,the amounts of renal calcium oxalate crystals were significantly reduced in chloroquine intervention group (32.37 ± 5.14 vs.4.18 ± 0.25,P ＜ 0.05).Compared to the control group,the level of autophagy was increased in the model group.Compared to the model group,the level of autophagy was inhibited in the chloroquine intervention group.For control group,model group and chloroquine intervention group,the excretion of urinary oxalate were (3.1 ± 1.5) mmol,(22.5 ± 8.1) mmol,(2.8 ± 1.2) mmol,respectively;the excretion of urinary citrate were (63.4 ± 7.4) mmol,(45.9 ± 9.5)mmol,(15.6 ± 8.2) mmol,respectively.Compared to the control group,the amounts of urinary oxalate weresignificantly elevated in model group (P ＜ 0.05),but citrate were significantly reduced in the chloroquineintervention group(P ＜ 0.05).For control group,model group and chloroquine intervention group,theexpressions of SOD were 42.24 ±4.16,19.21 ± 2.25,39.08 3.53,respectively;the expressions of MCP-1 were 4.02 0.51,8.45 ± 0.55,5.52 ± 0.34,respectively;the expressions of 8-OHdG were 7.16 ± 0.54,11.21 ± 1.12,8.67 ±0.34,respectively;the RNA expressions of SLC26A6 were 0.35 ±0.07,1.02 ±0.17,0.70 ± 0.06,respectively.Compared to the control group,the expressions of SOD were significantly reduced in the model group,but the expressions of MCP-1,8-OHdG and SLC26A6 were significantly elevated(P ＜0.05).Compared to the model group,the expressions of SOD were significantly elevated chloroquine intervention group (P ＜ 0.05),but the expressions of MCP-1,8-OHdG and SLC26A6 were significantly elevated(P ＜ 0.05).Conclusions The autophagy inhibitor chloroquine could inhibit the formation of calcium oxalate crystals induced by ethylene in rat kidney via inhibit the renal autophagy level and expressions of the SLC26A6,reducing the renal oxidative stress injury and urinary oxalate excretion.