Effects of evidence-based care on diabetic foot ulcers: A meta-analysis.

This analysis systematically reviewed the efficacy of evidence-based care on diabetic foot ulcers. A computerised literature search was conducted for randomised controlled studies (RCTs) of evidence-based care interventions for the treatment of diabetic foot ulcers using the PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), China Biomedical Literature Database (CBM) and Wanfang databases from the date of inception of each database to June 2023. The articles were independently screened, data were extracted by two researchers, and the quality of each study was assessed using the Cochrane bias assessment tool. Meta-analysis of the data was performed using RevMan 5.4 software. Twenty-five RCTs with a total of 2272 patients were included. Meta-analysis showed that, compared with other care methods, evidence-based care significantly improved the treatment efficacy of diabetic foot ulcers (odds ratio: 3.91, 95% confidence interval [CI]: 2.76 to 5.53, p < 0.001) and significantly reduced their fasting plasma glucose (mean difference [MD]: -1.10, 95% CI: -1.24 to -0.96, p < 0.001), 2-h postprandial glucose (2hPG) (MD: -1.69, 95% CI: -2.07 to -1.31, p < 0.001) and glycated haemoglobin (HbA1c) (MD: -0.71, 95% CI: -0.94 to -0.48, p < 0.001). Evidence-based care intervention is effective at reducing FPG, 2hPG and HbA1c levels and improving treatment efficacy in patients with diabetic foot ulcers.

Virtual mutation and directional evolution of anti-amoxicillin ScFv antibody for immunoassay of penicillins in milk.

In this study, an anti-amoxicillin single chain variable fragment (ScFv) antibody was evolved by directional mutagenesis of a contact amino acid residue based on the analysis of virtual mutation. Comparison with its parental ScFv, the mutant showed highly improved affinity for 11 penicillins with up to 6-folds increased sensitivity. Then, its recognition mechanisms for the 11 drugs were studied by using molecular docking. Results showed that the mutant-penicillins intermolecular forces increased and the total binding energies decreased dramatically, which were responsible for the improvement of antibody sensitivity. The ScFv mutant was used to develop an indirect competitive enzyme linked immunosorbent assay for determination of the 11 drugs in milk. The limits of detection were in the range of 0.2-3.0 ng/mL, the crossreactivities were in the range of 31%-132%, and the recoveries from standards fortified blank milk were in the range of 65.7%-92.4%. This is the first study reporting the directional evolution of a ScFv antibody based on virtual mutation and the use of ScFv antibody for determination of penicillins in foods of animal origin.

A survey of plasmid-mediated fluoroquinolone resistance genes from Escherichia coli isolates and their dissemination in Shandong, China.

Bacterial resistance to fluoroquinolones result from mutations in the quinolone resistance-determining regions of the drug targets, overexpression of efflux pumps, and/or the more recently identified plasmid-mediated low-level resistance mechanisms. We investigated the prevalence of and characterized plasmid-mediated fluoroquinolone resistance genes (qnrA, qnrB, qnrS, aac(6')-Ib-cr, and qepA) by polymerase chain reaction in fluoroquinolone-resistant Escherichia coli (n = 530) isolated from a chicken farm, a pig farm, and hospitalized patients in Shandong, China, in 2007. The aac(6')-Ib-cr gene was the most prevalent resistance gene that was detected in bacteria isolated from all sources. Next was the qnrS gene, which was predominantly present in isolates from the pig farm. Only eight (5.8%) isolates from hospital patients were found to possess the qepA gene, and these isolates were first reported in qepA-carrying E. coli from humans in China. The qnrA and qnrB genes were not detected in any of the isolates. Further, most of the isolates were also resistant to beta-lactams and aminoglycosides as determined by the broth microdilution method. Pulsed-field gel electrophoresis analysis of the E. coli isolates with similar resistance patterns that also carried resistance genes showed great genomic diversity among these bacteria, suggesting that the multiresistant E. coli isolates carrying the qnr, aac(6')-Ib-cr, or qepA genes were not derived from a specific clone, but represented a wide variety of different genotypes. The results of Southern hybridization revealed that qepA, qnrS, and parts of aac(6')-Ib-cr genes were localized on plasmids and/or chromosome. qepA and aac(6')-Ib-cr genes were colocalized with aac(6')-Ib-cr and qnrS genes, respectively, on the same plasmids. Our study demonstrated that two different genes (qepA and aac(6')-Ib-cr) were identified on the same plasmid in E. coli strains derived from patients and qnrS and aac(6')-lb-cr genes on the same plasmid in an E. coli strain of animal origin.

Increased prevalence of plasmid-mediated quinolone resistance determinants in chicken Escherichia coli isolates from 2001 to 2007.

To evaluate the temporal change in the plasmid-mediated quinolone resistance (PMQR) determinants from 2001 to 2007 in chicken, a total of 532 chicken Escherichia coli isolates were screened for PMQR determinants by polymerase chain reaction and sequencing. The prevalence of qnr genes, aa(6')-Ib-cr, and qepA were 9.8%, 11.7%, and 0.75%, respectively. Among the qnr determinants, qnrA-, qnrB-, and qnrS-type genes were detected in 4 (0.75%), 21 (3.9%), and 27 (5.1%) of the examined isolates, respectively. None of the isolates carried qnrC gene. Ciprofloxacin resistance increased over time (p < 0.01), and a clear trend of increase in the prevalence of qnr and aac(6')-Ib-cr genes among the isolates was shown from 2001 to 2007 (p < 0.01). Pulsed-field gel analysis showed that the PMQR-positive isolates were not clonally related and genetically diverse. Quinolone resistance was transferred by conjugation from qnrB-, qnrS-, and aac(6')-Ib-cr-positive isolates to recipient E. coli. The qnrB and aac(6')-Ib-cr alleles were located on the plasmids with the size of 49 and 50 kb, respectively. However, the qnrS alleles were located on different plasmids with sizes from 57.4 to 88.6 kb, indicating diverse genetic backgrounds. The increasing frequency of ciprofloxacin resistance in E. coli was associated with increasing prevalence of qnr genes and aac(6')-Ib-cr (r(s) = 0.964, p = 0.00045). This survey showed that PMQR determinants were highly prevalent in chicken E. coli isolates in China with a trend of increase from 2001 to 2007. Horizontal transfer and widespread use of quinolone antimicrobials may have contributed to the spread of PMQR determinants in the poultry production system. The widespread dissemination of PMQR could potentially fuel the rapid development of fluoroquinolones resistance.

Characterization of antimicrobial resistance among Escherichia coli isolates from chickens in China between 2001 and 2006.

Escherichia coli is a common commensal bacterium and is regarded as a good indicator organism for antimicrobial resistance for a wide range of bacteria in the community and on farms. Antimicrobial resistance of E. coli isolated from chickens from 49 farms in China between 2001 and 2006 was studied. A total of 536 E. coli isolates were collected, and minimal inhibitory concentrations (MICs) of eight antimicrobials were determined by the broth microdilution method. Isolates exhibited high levels of resistance to ampicillin (80.2%), doxycycline (75.0%) and enrofloxacin (67.5%). Relatively lower resistance rates to cephalothin (32.8%), cefazolin (17.0%) and amikacin (6.5%) were observed. Strains were comparatively susceptible to colistin (MIC(50) = 1 microg mL(-1)). A marked increase in isolates with elevated MICs for florfenicol was observed over the study period. Therefore, five resistance genes leading to the dissemination of phenicol resistance in the isolates (n = 113) with florfenicol MICs > or = 32 microg mL(-1) were analyzed. The gene floR was the most prevalent resistance gene and was detected in 92% of the 113 isolates, followed by the cmlA (53%), catA1 (23%) and catA2 (10%) genes. catA3 was not detected in these isolates. Eight isolates with florfenicol MICs = 32 microg mL(-1) and one with MIC = 64 microg mL(-1) were negative for the floR gene.

[Analysis of 72 affective disorder cases in forensic psychiatric expertise].

OBJECTIVE: To explore criminal characteristics of patients with affective disorder. METHODS: Analysis was conducted in 72 cases of affective disorder diagnosed in Ankang Hospital, Public Security Bureau of Hangzhou, from 2000 to 2004. RESULTS: There was a correlation between outbreak of the affective disordered and frequency of committing crime. There was a significant difference between the mania and the depression (P<0.01) with respect to harmful behavior. The criminal behavior characteristics of patients with affective disorder were different from that of the schizophrenia, with more realistic and less pathologic intention. CONCLUSION: Recurrent attacks are warning signs for affective disorder patients committing crime. The criminal behavior characteristics of the affective disorder are different from that of the schizophrenia, probably because of the differences in etiological factor, development, symptom, and severity of the disorders.

[Analysis and follow up research of 74 cases without psychosis in forensic psychiatric expertise].

OBJECTIVE: To explore the characteristics and return of cases without psychosis in forensic psychiatry. METHODS: Seventy four cases without psychosis were follow up researched,and statistics relevant data. RESULTS: Five point seven percent cases were diagnosed without psychosis. They had explicit motive and purpose, protect by one's own was good, "the psychotic symptom" disappears after authenticate. CONCLUSION: Analysis of many factor contribute to authenticate cases without psychosis. That schizophrenia symptom in early days should be identified to prevent from the misdiagnosis.

Preliminary study of urine metabolism in type two diabetic patients based on GC-MS.

OBJECTIVE: Comparative study of type 2 diabetes and healthy controls by metabolomics methods to explore the pathogenesis of Type II diabetes. METHODS: Gas chromatography - mass spectrometry (GC-MS) with a variety of multivariate statistical analysis methods to the healthy control group 58 cases, 68 cases of Type II diabetes group were analyzed. Chromatographic conditions: DB-5MS column; the carrier gas He; flow rate of 1 mL·min(-1), the injection volume 1 uL; split ratio is 100: 1. MS conditions: electron impact (EI) ion source, an auxiliary temperature of 280°C, the ion source 230°C, quadrupole 150°C; mass scan range 30~600 mAu. RESULTS: Established analytical method based on urine metabolomics GC-MS of Type II diabetes, determine the urine succinic acid, L-leucine, L-isoleucine, tyrosine, slanine, acetoace acid, mannose, L-isoleucine, L-threonine, Phenylalanine, fructose, D-glucose, palmi acid, oleic acid and arachidonic acid were significantly were significantly changed. CONCLUSION: Based on metabolomics of GC-MS detection and analysis metabolites can be found differences between type 2 diabetes and healthy control group, PCA diagram can effectively distinguish Type II diabetes and healthy control group, with load diagrams and PLS-DA VIP value metabolite screening, the resulting differences in metabolic pathways involved metabolites, including amino acid metabolism, lipid metabolism, glucose metabolism and energy metabolism.

Production of the polyclonal antibody against Sudan 3 and Immunoassay of Sudan dyes in food samples.

In this study, 4-aminophenylacetic acid was covalently coupled to aniline to synthesize an intermediate hapten and the intermediate hapten was coupled to ß-naphthol to synthesize a tentative hapten of Sudan 3. The hapten was coupled to bovine serum albumin as the immunogen to produce the polyclonal antibody. The obtained antibody was highly specific to Sudan 3, Sudan 1, and Para red, but showed relative low binding ability to Sudan 2, Sudan 4, and Sudan red G. After evaluation of different coating antigens, a heterologous indirect competitive immunoassay was developed to multidetermine the six red dyes in food samples. The cross reactivities to the six analytes were in a range of 21-105%, and the limits of detection were in a range of 0.1-0.8 ng/mL depending on the compound. Intra- and interassay recoveries from the standard fortified blank samples were in a range of 74.5-96.3% with coefficients of variation lower than 15.1%.

Development of a class-specific polyclonal antibody-based indirect competitive ELISA for detecting fluoroquinolone residues in milk.

Modified 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide (EDC) method was employed to synthesize the artificial antigen of norfloxacin (NOR), and New Zealand rabbits were used to produce anti-NOR polyclonal antibody (pAb). Based on the checkerboard titration, an indirect competitive enzyme-linked immunosorbent assay (icELISA) standard curve was established. This assay was sensitive and had a working range from 0.12 to 68.40 ng/ml, with the half maximal inhibitory concentration (IC(50)) and limit of detection (LOD) values of 2.7 ng/ml and 0.06 ng/ml, respectively. The produced pAb exhibited high cross-reactivity to fluoroquinolones (FQs) tested, and the IC(50) values to enoxacin, ciprofloxacin, and pefloxacin were 3.1, 3.4, and 4.1 ng/ml, respectively. It also indicated that the concentrations of NaOH and methanol in assay buffer should not be higher than 10% and 30%. When spiked in milk at 5, 20, and 50 ng/ml, the recoveries for NOR, enoxacin, ciprofloxacin, and pefloxacin ranged 90.5%-98.0%, 84.0%-95.2%, 94.0%-106.0%, and 89.5%-100.0%, respectively. The results suggest that this class-specific pAb-based icELISA could be utilized for the primary screening of FQ residues in animal-original products.

Distribution of superantigenic toxin genes in Staphylococcus aureus isolates from milk samples of bovine subclinical mastitis cases in two major diary production regions of China.

To evaluate the distribution of most known staphylococcal superantigen (SAg) genes in Staphylococcus aureus isolated from bovine mastitis cases, a genetic analysis of 15 SAg genes and genotypes was performed in a total of 283 S. aureus isolates collected from milk samples of cows with subclinical mastitis in two major diary production regions of China. Almost 65% of the isolates possessed at least one toxin gene. The most frequently found genes were sea (36.0%) followed by sei (31.8%), seg (31.4%) and selm (26.9%). The genes see, selk, or selo were not found in any of the isolates tested. Overall, 28 SAg genotypes were observed, among which the genotypes sea-seg-sei-selm, seg-sei-selm-seln, and sea-sed-selj predominated at the rate of 8.8%, 7.4%, and 6.7%, respectively. Marked geographical variations were noticed in the distribution of individual SAg genes and genotypes among S. aureus isolates from the two different regions. The relationship between toxin genotypes and toxin genes encoding profiles of mobile genetic elements (MGEs) was analyzed, revealing that majority of SAg genes were present in certain MGEs, which were in accordance with current knowledge about MGEs carrying those genes. However, some gene combinations suggest the possibility of the existence of variants or new types of MGEs.

[Environmental impact assessment of the land use change in china based on ecosystem service value].

The environmental impact of land use change is long-term and cumulative. The ecosystem service change results from land use change. Therefore, the ecosystem service function change is the key object in the environmental impact assessment of land use change. According to the specific situation of China, this paper adjusted the unit ecosystem service value of different land use types. Based on this, the ecosystem service value change of different provinces in China resulted from the land use change since the implementation of the last plan of land use (1997-2010) was analyzed. The results show that the ecosystem service value in China increased 0.91% from 1996 to 2004. Thereinto, Tianjin is the province that the ecosystem service value increased most quickly, which was 5.69% from 1996 to 2004, while Shanghai is the province that the value decreased most quickly, which was 9.79%. Furthermore, the change of 17 types of ecosystem services was analyzed. Among them, the climate regulation function enhanced 3.43% from 1996 to 2004 and the biology resource control was weakened by 2.26% in this period. The results also indicate that the increase of the area of water surface and forest is the main reason for why the ecosystem service value increased in China in that period.