Objective:To identify a pathogenic strain JM-1 isolated from the pus of a patient stabbed by a sea shrimp and to analyze its antibiotic susceptibility and virulence genes, aiming to provide reference for screening clinically related infections caused by Cysteiniphilum litorale as a rare pathogen and improving prognosis. Methods:Biochemical phenotype identification, matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS), 16S rRNA gene sequencing, analysis of average nucleotide identity (ANI) and average amino acid identity (AAI) based on the whole genome and phylogenetic analysis of the 16S rRNA gene and the whole genome were performed to accurately determine the taxonomic status of the strain JM-1. E-test was used to detect antibiotic susceptibility, and the results were interpreted according to the interpretation standards of Francisella tularensis in CLSI M45-A3. The virulence factor database (VFDB) was used for genome-wide annotation and analysis of virulence genes. Results:After culturing the strain JM-1 on the Columbia blood plate for 3 d, some grey-white, medium-sized, smooth, round and convex hemolytic colonies were observed. Gram staining result showed lightly colored Gram-negative Coccobacillus. API NH identification results suggested that the isolate JM-1 was Moraxella catarrhalis (biochemical code: 3010), while there was no identification result in Vitek2 system NH card (biochemical code: 0211002121). The EXS3000 mass spectrometer self-built database identified the isolate JM-1 as Cysteiniphilum litorale. The phylogenetic analysis based on the 16S rRNA gene and the whole genome showed that the isolate JM-1 and Cysteiniphilum litorale DSM 101832 T clustered into the same branch, and the ANI and AAI values between the two strains were 95.07% and 95.65%, respectively. The biochemical phenotype identification indicated the isolate JM-1 producing β-lactamase and penicillinase. Antibiotic susceptibility test results showed the strain was resistant to penicillin and sensitive to gentamicin, streptomycin, doxycycline, tetracycline, ciprofloxacin, levofloxacin, and chloramphenicol. Genome annotation suggested the virulence genes of the isolate JM-1 were similar to those of Francisella, including Francisella pathogenicity island (FPI), type Ⅳ fimbriae, capsule and lipopolysaccharide. Conclusions:Cysteiniphilum litorale was a rare pathogen with virulence genes similar to those of Francisella, and its antibiotic susceptibility was also similar to that of Francisella. This study confirmed a case of clinical infection caused by Cysteiniphilum litorale. The self-built MALDI-TOF MS system could be used for its rapid identification.

Objective:To assess the significance of counting the number of caudal vertebral ossification centers (OCN) below fetal terminal conus medullaris in the screening for closed spina bifida and tethered cord syndrome (TCS).Methods:The OCN was counted in 961 normal fetuses(normal group) between 17 and 41 gestational weeks and in 140 fetuses with closed spina bifida or tethered cord syndrome(abnormal group) from Jan.2013 to Dec.2020 in Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Women and Children′s Hospital, School of Medicine, Xiamen University and Maternity and Child Health Care of Guangxi Zhuang Autonomous Region. The OCN was counted in the dorsal mid-sagittal section of fetal caudal spine.The reliability and agreement test were evaluated by intraclass correlation coefficients in another 50 normal fetuses. The OCN was compared between two groups. ROC curve and the cut-off value were constructed and calculated.Results:In normal group, the N increased with the growing of gestational age.In the subgroup of 17-20 weeks, the OCN ranged from 5 to 7 in most fetuses. In the others subgroups, the OCN was equal to or greater than 6 in 99.9% cases and more than 6 in 97.1% cases. In abnormal group, OCN was less than 7 in 93.0% fetuses and less than 6 in 82.8% cases. There were statistical differences between the two groups except for the subgroup of 17-20 gestational weeks( P<0.05). With the cut-off value of 6.5, the specificity and sensitivity were 93.0% and 94.3% respectively for predicting the presence of closed spinal dysraphism or TCS. Conclusions:OCN is a simple way to evaluate the position of conus medullaris and to screen for the skin-covered spine dysraphism or TSC. OCN is more than 6 in most normal fetuses. Further evaluation of spine is required in fetuses with N less than or equal to 6.

Objective To investigate the effect of acupoint catgut embedding combined with Ziwu-Liuzhu theory based acupuncture on the clinical efficacy and sleep quality of depressive patients. Methods A total of 64 patients who met the inclusion criteria were randomly divided into two groups, 32 in each group. The control group was treated with routine electro-acupuncture, while the observation group was treated with acupoint catgut embedding combined with Ziwu-Liuzhu theory based acupuncture. Both groups were treated for 8 weeks. Sleep quality was assessed by Pittsburgh Sleep Quality Index (PSQI), and depression was assessed by Hamilton Depression Scale (HAMD) to evaluate the clinical efficacy. Results After treatment, the HAMD score (11.3 ± 2.4 vs. 14.5 ± 2.6, t=4.986) and PSQI index (9.6 ± 2.3 vs. 11.8 ± 2.5, t=3.307) in the observation group were significantly lower than those in the control group (P<0.01). The quality of life (12.9 ± 2.3 vs. 11.3 ± 2.5, t=2.598) and mental health score (13.5 ± 2.4 vs. 11.3 ± 2.6, t=3.413) of WHOQOL-BREF scale in the observation group were significantly higher than those in the control group (P<0.01). The total effective rate was 93.8％ (30/32) in the observation group and 75.0％ (24/32) in the control group. There were significant differences between the two groups (χ2=4.246, P=0.038). Conclusions Acupoint catgut embedding combined with Ziwu-Liuzhu theory based acupuncture can effectively improve depressive state, sleep quality and quality of life in patients with depression, and the curative effect is better than conventional electro- acupuncture treatment.

Objective To understand the etiology and clinical characteristics of candidemia, and the diagnostic value of(1, 3)-β-Dglucan. Methods This analysis included 31 patients with candidemia, 39 patients with Candida deep colonization, and 50 healthy subjects, who were enrolled from Wuyi Chinese Hospital Affiliated to Jinan University during the period from September 2015 to March 2018. Clinical data such as fungal culture, clinical features, and serum(1, 3)-β-D-glucan level were analyzed and compared between groups. Results Overall, 13 strains of Candida albicans and 18 strains of non-albicans Candida were isolated from the 31 patients with candidemia. The incidence of candidemia was associated with old age(>65 years), prior surgery(≤7 days), indwelling catheter(≥2 catheters and lasting ≥5 days), duration of mechanical ventilation(≥5 days)(P<0.05), but not associated with sex, underlying disease, prior use of anmicrobial and antifungal agents, immunosuppressant or glucocorticoid, or hypoproteinemia(P>0.05). Serum level of(1, 3)-β-D-glucan was significantly higher in candidemia patients than in the patients with candida deep colonization and healthy controls(P<0.05). The sensitivity and specificity of(1, 3)-β-D-glucan in diagnosing candidemia were 87.1％ and 96.0％, respectively. The level of(1, 3)-β-D-glucan was significantly higher in candidemia with bacterial infection than candidemia without bacterial infection(P<0.05). The level of of(1, 3)-β-D-glucan was also significantly higher in the candidemia caused by Candida albicans alone than that caused by non-albicans Candida alone(P<0.05). Conclusions Non-albicans Candida is more prevalent than Candida albicans in candidiasis, but Candida albicans is still the most important Candida species. The incidence of candidemia is asociated with advanced age(>65 years), prior surgery within 7 days, indwelling catheters(≥2 catheters and lasting ≥5 days), and mechanical ventilation(≥5 days). Serum(1, 3)-β-D-glucan level is valuable for early diagnosis of candidemia.

This study aimed to explore the mechanism of volatile oil from purslane in treating itch induced by eczema through establishing the itch model,stimulating the keratinocyte with capsaicine (CAP).SD rats were divided into the control group,the model group,the high dose group of volatile oil from purslane,and low dose group of volatile oil from purslane.After finishing the experiment,the morphology of keratinocytes was observed by immunofluorescence technique,while Ca2+ concentration was detected by flow cytometry,and the contents of leukotriene A4 methyl ester (LTA4),interleukin-31 (IL-31) and hydroxy trptamine H1 (HTH1) were quantified by ELISA assay.The expression of TRPV1 mRNA in keratinocytes was tested by RT-PCR,while the protein level of TRPV1 was quantified by western blot.Compared with the model group,it was found that the cell count of positive keratinocytes,the Ca2+ concentration,the levels of LTA4,IL-31 and HTH1,and the mRNA and protein expressions of TRPV1 in the high dose and low dose groups were significantly decreased (P ＜ 0.05).In conclusion,it was demonstrated that the volatile oil from purslane may relieve itch through inhibiting the activation of TRPV1 and reducing secondary inflammatory reaction.

Objective To study the application value of T lymphocyte subsets and inflammatory factors in evaluating severity andprognosisofaplasticanemia.Methods 40patientswithaplasticanemiainthehospitalwereenrolledinthestudyasAAgroup, which was further divided into acute aplastic anemia(AAA) subgroup and chronic aplastic anemia(CAA) subgroup .In addition to that ,40 healthy people who received physical examination in the hospital during the same period were enrolled in the study as con‐trol group .Then blood routine tests were performed ,T lymphocyte subsets content in peripheral blood and serum inflammatory fac‐tor content were detected and the results were compared .Results Th1 ,Th17 contents and Th1/Th2 ,Th17/Treg ratio in AA group were higher than those in control group(P<0 .05) ,while Th2 ,Treg contents were lower(P<0 .05);Th1 ,Th17 contents and Th1/Th2 ,Th17/Treg ratio in AAA group were higher than those in CAA group(P<0 .05) ,while Th2 ,Treg cells contents were lower . Serum IL‐2 ,IFN‐γ ,IL‐17 contents in AA group were higher than those in control group(P<0 .05) ,while IL‐4 ,IL‐6 ,IL‐10 contents were lower(P<0 .05);serum IL‐2 ,IFN‐γ,IL‐17 contents in AAA group were higher than those of CAA group ,while IL‐4 ,IL‐6 , IL‐10 contents were lower .Hb ,PTL contents were negatively correlated with Th1 ,Th17 contents and serum IL‐2 ,IFN‐γ ,IL‐17 contents ,while positively correlated with Th2 ,Treg cells contents and serum IL‐4 ,IL‐6 ,IL‐10 contents .Conclusion Peripheral blood T lymphocyte subsets and serum inflammatory factors contents in aplastic anemia are abnormal and are correlated with the severity and prognosis related indicators .

Objective To explore the clinical efficacy of Shuxuening combined with epalrestat in the treatment of diabetic nephropathy. Methods Eighty patients from March 2014 to June 2015 in Metabolic Disease Department of the Second Hospital of Tianjin were randomly divided into observation group and control group with 40 patients in each group.The control group received epalrestat, and the observation group received Shuxuening injection on the baisis of control group. The related indicators were compared between two groups.Results After treatment, the 24 h-urine microalbumin, plasma low density lipoprotein and serum creatinine in observation group [(239.31 ±106.54)mg/L,(2.45 ±0.55)mmol/L,(95.54 ± 22.13)mol/L]were lower than those in control group [(349.90 ±148.40),(3.41 ±0.52),(108.76 ±34.30)](P<0.05).The β2-microglobulin (β2-MG) and plasma high-sensitive C-reactive protein (hs-CRP) in observation group [(0.39 ±0.06),(6.31 ±1.58)mg/L]were lower than those in control group [(0.49 ±0.12),(7.89 ±1.35)](P<0.05).The total efficacy in observation group was higher than that in control group (70.0%vs.45.0%,P<0.05).Conclusion Shuxuening injection joint epalrestat has the exact efficacy in treatment of patients with diabetic nephropathy.

This paper analyzes the recently epidemic status of schistosomiasis,the change of natural and social factors,and field survey and evaluation data of schistosomiasis in Ya’an City after Lushan Earthquake on April 20,2013,and proposes that it is necessary to strengthen the conventional schistosomiasis control measures,the control of exogenous infection sources,the con-trol of Oncomelania hupensis snails and health education for ensuring no major epidemics after the disaster. This paper also recom-mends the direction and suggestions for future schistosomiasis control in Ya’an City.

ABSTRACT:Objective To compare and analyze tip malposition of 2 central venous catheteri-zations in cancer patients.Methods Totally 1656 cancer patients received 1799 cases of peripheral-ly inserted central catheter(PICC)/conventional central venous catheter(CVC)were consecutively assessed by means of routine post-catheterization chest X-ray.The catheter with its tip strike and terminal position were confirmed individually.All tip malpositions were calculated.And the catheters with tip malpositions were readjusted and reevaluated.Results The failure rate in PICC group (2.68%)was significantly higher than that in CVC group(0.34%,P <0.01).Eighty three catheters(4.84%)were found tip malpositioned,in which 38 catheters(6.42%)were from PICC group and 45 ones(4.01%)from CVC group (P <0.01).The achievement ratio of readjustment for tip malposition in PICC group (71.1%)was much higher than that in CVC group (26.7%,P<0.01).Conclusion Compared with CVCs in cancer patients,the prevalence of tip malposition from PICCs was higher although the tip malpositions in PICCs were more likely to be corrected with readjustment.These findings suggest that tip position of PICC /CVC should be confirmed post-catheterization with chest x-ray.

ABSTRACT:Objective To compare and analyze tip malposition of 2 central venous catheteri-zations in cancer patients.Methods Totally 1656 cancer patients received 1799 cases of peripheral-ly inserted central catheter(PICC)/conventional central venous catheter(CVC)were consecutively assessed by means of routine post-catheterization chest X-ray.The catheter with its tip strike and terminal position were confirmed individually.All tip malpositions were calculated.And the catheters with tip malpositions were readjusted and reevaluated.Results The failure rate in PICC group (2.68%)was significantly higher than that in CVC group(0.34%,P <0.01).Eighty three catheters(4.84%)were found tip malpositioned,in which 38 catheters(6.42%)were from PICC group and 45 ones(4.01%)from CVC group (P <0.01).The achievement ratio of readjustment for tip malposition in PICC group (71.1%)was much higher than that in CVC group (26.7%,P<0.01).Conclusion Compared with CVCs in cancer patients,the prevalence of tip malposition from PICCs was higher although the tip malpositions in PICCs were more likely to be corrected with readjustment.These findings suggest that tip position of PICC /CVC should be confirmed post-catheterization with chest x-ray.