ABSTRACT
Chronic hepatitis B is a public health issue worldwide. Nucleotide analogues and interferon therapy can effectively inhibit HBV replication, but they still have the shortcomings such as inability to achieve the clearance of HBV cccDNA and low HBsAg clearance rate. The academic viewpoint of "kidney-tonifying therapy for chronic hepatitis B" provides new ideas and methods for the treatment of hepatitis B. During long-term clinical practice, Department of Hepatology in Shuguang Hospital has identified that "deficiency of spleen and kidney with damp heat remaining" is the key pathogenesis of the continuous progression of chronic hepatitis B and has established the treatment regimen for chronic hepatitis B with the basic treatment method of tonifying the kidney, strengthening the spleen, and promoting diuresis. The clinical research of National Science and Technology Major Project from The 11th Five Year Plan to The 13th Five Year Plan has validated the clinical efficacy of this regimen and clarified that regulating the immune function of the body is the main mechanism of the kidney-tonifying, spleen-strengthening, and diuresis-promoting therapy in the treatment of chronic hepatitis B.
ABSTRACT
Objective To evaluate the clinical effect of direct identification of microorganisms from the midstream urine by MALDI-TOF MS combined with separation gel tube and differential centrifugation. Methods A total of 2150 samples of midstream urine were collected from the outpatient and inpatients in Huadong Hospital affiliated to Fudan University from May 2017 to April 2018, including 934 males and 1216 females with an age of (72.0 ± 17.5) years. After preliminary quantification by microscopic examination, samples with a bacterial acount of ≥ 105cfu/ml were treated with two kinds of pretreatment methods to enrich the bacteria for directly identification by MS. Based on the results of quantitative urine culture and MS identification,the coincidence rates of two kinds of pretreatment methods combined with MS were analyzed. All statistical analyses were performed using Stata/SE 14.0, differences between the groups were compared by Pearson Chi-square tests. Results 464 out of 2150 midstream urine samples (21.6％) had a bacterial count ≥ 105cfu/ml after microscopic examination. In traditional culture combined with MALDI-TOF MS, 436(94.0％)cases were single species, 28(6.0％)cases were double species. Among single species of bacteria samples infection, the gram-negative bacteria accounted for 78.9％(344/436),the Gram-positive bacteria accounted for 15.8％(69/436),and the fungus accounted for 5.3％(23/436). In two methods that the separation gel tube combined MALDI-TOF MS and the differential centrifugation combined MALDI-TOF MS, the gram-negative bacteria coincidence rates were 92.4％(318/344)and 89.0％(306/344) respectively, the Gram-positive bacteria coincidence rates were 68.1％(47/69)and 62.3％(43/69) respectively,and the fungi coincidence rates were 56.5％(13/23) and 34.8％(8/23)respectively. Meanwhile,the double bacteria infection coincidence rates were 64.3％(18/28)and 60.7％(17/28). Conclusions The separation gel tube combined MALDI-TOF MS and the differential centrifugation combined MALDI-TOF MS identify directly the gram-negative bacteria in the midstream urine samples with high detection rate and accuracy,and they are rapid and simple pretreatment method,suitable for rapid screening of midstream urine.
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Objective To optimize the pre-treatment method before detecting Helicobacter pylori ( H.pylori ) by matrix-assisted laser desorption ionization/time-of-flight mass spectrometry ( MALDI-TOF MS) and evaluate the ability of the Superspectra by MALDI-TOF MS for identifying clinical isolated H.pylori strains.Methods H.pylori were isolated from 469 biopsy samples of gastric mucosa collected from January 2015 to July 2016 in Huadong Hospital affiliated to Fudan University , 16 s rRNA sequencing were then performed to validate the strains.Then 91 isolated H.pylori strains were used for the subsequent MALDI-TOF analysis.The effect of pre-treatment of 50%isopropanol, formic acid and acetonitrile (1∶1), 70%formic acid were compared before H.pylori detecting by MALDI-TOF MS.40 out of 91 clinical H.pylori strains were detected by MALDI-TOF MS and the spectra were randomly assigned to 4 groups including 5, 10, 20, 30 spectra, each group had 3 repeats.Then 4 groups with different amount of spectra were used for creating Superspectra with SARAMIS Premium software , respectively.The remaining 51 H.pylori strains including 306 spectra were used for validating the identification rate of the Superspectra.Results With the use of 70%formic acid, the greater number of ion signals and higher relative intensity of the main peaks were observed than other pre-treatment reagents.The identification rate of Superspectra created by 30 strains group was the highest ( 90.2%).Among the 306 spectra, 46.1% of them achieved highly reliable identification , 22.2% achieved lower degree of reliable identification , and 31.7% of them achieved “no identification”.Conclusions The study optimized the pre-treatment method before H.pylori detecting by MALDI-TOF MS.The Superspectra was created with the good ability to rapidly identify clinical isolated H.pylori strains.
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Objective To investigate the antibacterial activity of Schisandra to Acinetobacter baumannii including metallo-β-lac-tamase(MBL)-producing and non-MBL-producing stains in vitro.Methods 75 strains of Acinetobacter baumannii were preliminary screened for clinical isolates of MBL-producing strains,to which confirmatory tests of MBL producing were performed.Drug sensi-tivities of the Acinetobacter baumannii to 14 antibacterial drugs were tested.In vitro antibacterial tests was adopted to determine the MIC of schisandra to 75 strains of Acinetobacter baumannii(including MBL and non-MBL-producing Acinetobacter baumannii).Re-sults MBL confirmatory test showed that among the 50 strains selected 38 strains were positive accounted for 76% (38/50).Con-clusion Schisandra has some antibacterial effect on Acinetobacter baumannii especially MBL-producing Acinetobacter baumannii, and can be combined with western medicine in the treatment of Acinetobacter baumannii infection.