Investigation and control of a suspected outbreak of carbapenem-resistant Klebsiella pneumoniae bloodstream infection in patients with hematologi-cal tumors / 中国感染控制杂志

Objective To investigate a suspected outbreak of carbapenem-resistant Klebsiella pneumoniae(CRKP)healthcare-associated bloodstream infection(HA-BSI),provide reference for effective control of CRKP in-fection.Methods The characteristics of CRKP infected patients and the risk factors for the event transmission in an adult hematology department of a teaching hospital in June 2022 were obtained by field epidemiological investigation.The specimens of environmental target strains were co-llected by blood nutrient agar inoculation,the removal status of environmental microorganisms and the effect of infection control after implementing control measures were com-pared.Results There were a total of 6 cases of CRKP HA-BSI,with an attacking rate of 1.29％(6/464),which was significantly higher than 0 during the same period in 2021,and difference was statistically significant(P=0.011).In environmental hygiene monitoring,the detection rate of CRKP was 2.27％(1/44),which was from the surface of bed curtain in the living unit of infected patients,homology analysis with CRKP detected from 2 patients revealed that the 16s RNA of 3 CRKP strains was completely identical,with a similarity of 100％.Seven house-keeping genes of 3 CRKP strains were all identical and belonged to the ST11 type.Comprehensive control measures were taken:appropriate closure of the ward,centralized isolation of patients,terminal disinfection of the ward,reg-ular health care workers and relative restriction of their activity areas.After the measures were taken,the qualified rate of microbial colony count in the ward increased compared to before taking the measures(2.27％vs 68.89％,P＜0.001),with a statistically significant difference,there were no more CRKP infected cases after the intervention,indicating that the control measures were effective.Conclusion This outbreak was caused by ST11 type of common CRKP in China,and laminar bed curtains are carriers of pathogen transmission.It is speculated that non-standard cleaning and disinfection,as well as inadequate implementation of hand hygiene are the main causes for transmis-sion.Adopting an appropriate strategy of closing the ward and concentrating patient isolation can quickly and effec-tively prevent the transmission of the event.

Effect of Modified Longdan Xiegantang in Treatment of Anal Sinusitis Patients with Syndrome of Interior Dampness-heat and on Immune Response, Oxidative Stress / 中国实验方剂学杂志

Objective::To explore the effect of modified Longdan Xiegantang in treatment of anal sinusitis patients with syndrome of interior dampness-heat and on immune response, oxidative stress. Method::A total of 80 cases of anal sinusitis patients with syndrome of interior dampness-heat treated in our hospital from May 2017 to May 2018 were randomly divided into two groups, with 40 cases in each group. The control group was treated by enema with Metronidazole injection combined with gentamicin sulfate injection. In addition to the therapy of the control group, the treatment group was also given modified Longdan Xiegantang. The symptoms and signs score, interleukin (IL)-2, IL-4, IL-6, IL-10, tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), procalcitonin (PCT), CD3+, CD4+, CD8+, immunoglobulin A(IgA), IgG, IgM, IgE, SOD, propylene glycol (MDA) levels of two groups were observed before and after treatment, and the curative effect, reactions and relapse were observed. Result::The clinical efficacy of treatment group was significantly better than that of control group, and the rank-sum test showed statistically significant differences (Z=1.981, P<0.05). After treatment, the scores of symptoms, such as anal distension and pain, and signs, such as anal sinus tenderness, hyperemia and edema in the treatment group were lower than those in control group (P<0.05). The levels of TNF-α, PCT, IL-2, IL-6 and MDA in treatment group were lower than those in control group (P<0.05). The levels of IL-4, IL-10, IFN-γ and SOD in treatment group were higher than those in control group (P<0.05). The recurrence rate was 5.13%in treatment group, and 21.05%in control group, indicating a significant difference (χ2=4.319, P<0.05). Conclusion::Modified Longdan Xiegantang is effective in treating syndrome of interior dampness-heat anal sinusitis. It can effectively relieve symptoms, regulate pro-inflammatory/anti-inflammatory balance and Th1/Th2 balance, improve cellular immune function and humoral immune function, inhibit oxidative stress response, and reduce recurrence rate, with a high safety.

Clinical and laboratory characteristics of rheumatoid arthritis with positive antinuclear antibody / 北京大学学报(医学版)

OBJECTIVE@#To analyse the clinical and laboratory characteristics of antinuclear antibody (ANA) positive rheumatoid arthritis (RA) patients.@*METHODS@#The clinical and laboratory data of 428 RA cases from Department of of Rheumatology and Immunology Peking University Third Hospital from Jan 2013 to Dec 2018 were collected and used to analyse characters between ANA positive group and ANA negative group. T test was used for the quantitative data in accordance with normal distribution. Wilcoxon rank sum test was used for the quantitative data of non normal distribution. The qualitative data were analyzed by chi square test. But while 1≤theoretical frequency < 5, chi square test of corrected four grid table was used. And Fisher exact probability method was used when theoretical frequency < 1.@*RESULTS@#The number of ANA positive group was 231 (54%). The female rate was obviously higher in ANA positive group (82.7% vs. 63.5%, χ2=20.355, P < 0.01). The rate of metatarsophalangeal joints (MTPJs) involvement was lower in ANA positive group (22.1%) than in ANA negative group (33.0) (χ2=6.414, P < 0.05). The incidence of secondary Sjögren's syndrome (sSS) was much higher in ANA positive group(19.5% vs. 4.1%, χ2=23.300, P < 0.01). The positivity of rheumatoid factor (RF), as well as the positivity of anti-cyclic citrullinated peptide(CCP) antibody was much higher in ANA positive group (77.1% vs. 53.8%, χ2=25.743, P < 0.01, 74.9% vs. 59.4%, χ2=11.694, P < 0.01, respectively). The levels of immunoglobulin G (IgG) and immunoglobulin M (IgM) of ANA positive group were higher [(15.1±5.1) g/L vs. (13.8±5.3) g/L, t=2.359, P < 0.05, 1.25 (0.92) g/L vs. 1.05 (0.65) g/L, Z=-3.449, P < 0.01, respectively]. But the levels of hemoglobin (Hb) and platelet (PLT) was lower in ANA positive group[(109.64±17.98) vs. (114.47±18.48) g/L, t=-2.734, P < 0.01; (266.4×109±104.6×109) vs. (295.9×109±100.1×109) /L, t=-2.970, P < 0.01, respectively].@*CONCLUSION@#The incidence of sSS was obviously higher in ANA positive group than in ANA negative group. Serum IgG of ANA positive group was higher, but Hb and PLT were lower.

Effect of Modified Qingre Shenshi Tang on Inflammatory Factors, Oxidative Stress and Immune Function in Chronic Antral Sinusitis Patients with Damp-heat Pouring Downward Syndrome / 中国实验方剂学杂志

Objective:To explore effect of modified Qingre Shenshi Tang on inflammatory factors, oxidative stress and immune function in chronic antral sinusitis patients with damp-heat pouring downward syndrome. Method:A total of 94 cases of chronic antral sinusitis treated in our hospital from June 2017 to April 2018 were randomly divided into two groups, with 47 cases in each group. Control group was treated with metronidazole combined with gentamicin enema. In addition to the therapy of control group, the treatment group was given modified Qingre Shenshi Tang. The symptom scores, interleukin-2 (IL-2), IL-6, IL-8, tumor necrosis factor-α (TNF-α), gamma interferon (IFN-γ), super oxide dismutase (SOD), malondialdehyde (MDA), advanced oxidation protein products (AOPP), 8-hydroxy deoxyguanosine (8-OHDG), CD3+, CD4+, CD8+ levels of the two groups were observed before and after treatment, and the curative effect, reactions and relapse were observed. Result:After treatment, the total effective rates of treatment group(87.23%) and control group (78.72%) showed statistically significant differences (Z=2.067, PPα, IL-6, IL-8, MDA, AOPP, 8-OHDG, CD8+in the treatment group were lower than those in control group (Pγ, SOD, CD3+, CD4+, CD4+/CD8+were higher than those in control group (Pχ2=4.681, PConclusion:Modified Qingre Shenshi Tang has a good curative effect in the treatment of chronic antral sinusitis patients with damp-heat pouring downward syndrome by relieving symptoms, inhibiting inflammatory response, regulating oxidative stress, improving immune function and controlling recurrence rate.

Clinicopathological Observation of Primary Renal Non-Hodgkin's Lymphoma--A Report of Two Cases / 中国实验血液学杂志

OBJECTIVE@#To investigate the clinicopathological and immunohistochemical features as well as diagnosis, differential diagnosis,treatment and prognosis of patients with primary renal non-hodgkin's lymphoma (PRNHL).@*METHODS@#Clinical data of 2 patients with PRNHL from January 2013 to October 2017 were retrospectively analyzed.@*RESULTS@#One of the two male patients PRNHL aged 51 years old, admitted to hospital for swelling and pain in the right waist, B-ultra sonic examination showed a very solid upper right renal space occupying lesion. CT showed the soft tissue mass of the right kidney about 10.5 cmx 8.6 cm. Preoperative diagnosis was a right kidney cancer subjected to radical surgery, and the postoperative pathological diagnosis was a right renal diffuse large B cell lymphoma (DLBCL). Expression of CD20, CD79a, Mum-1, BCL-2, BCL-6 in tumor cells was identified by inmmunohistochemistry, and Ki-67 proliferation index was 90%. Six courses of chemotherapy with R-CHOPE regimen were carried out supplemented local radiotherapy. The patients were followed up for 32 months, which were generally in good condition and stable. The another patient was 65 years old, no without obvious clinical symptoms, B-ultrasonic examination found a space occupying lesion in the left kidney. Abdomind CT scan plus enhancement showed the left kidneydisplayed uneven enhanced lesions of size 9 cm x 5 cm, the preoperative diagnosis was left kidney cancer, the pathological diagnosis was diagnosed as mall B cell lymphoma of the left kidney after the radical operation. Immunohistochemistry determined expression of CD20, CD79a, pax-5, BCL-2 in tumor cells and Ki-67 proliferation index 10%. 6 courses of chemotherapy with CHOPE regimen had been performed and followed up for 20 months, the conditions were generally good and stable.@*CONCLUSION@#PRNHL is a rare extranodal non-Hodgkin lymphoma with atypical clinical symptoms characterized by lumbar swelling pain. It is easy to be misdiagnosed as renal cell carcinoma before operation. The diagnosis depends on pathology and immunohisto-chemistry. The prognosis of 2 patients was relatively good. PRNHL should be differetiated with renal sarcomatoid cancer, nephroblastoma and other diseases. Surgical resection plus chemotherapy is recommended.

Effect of Fuzi Lizhong decoction in reducing liver injury of rats with non-alcoholic fatty liver via activating AMPK and suppressing NF-κBp65 pathway / 中国中药杂志

To investigate the protective effect and relevant mechanism of Fuzi Lizhong decoction (FZLZD) on liver of rats with non-alcoholic fatty liver disease (NAFLD), totally 32 male SPF Wistar rats were randomly divided into 4 groups: control group, model group, Yishanfu (YSF) group (200 mg·kg⁻¹·d⁻¹) and FZLZD group (10 g·kg⁻¹·d⁻¹), with 8 rats in each group. Rat model of NAFLD was prepared through the intragastric administration with fat emulsion for 4 weeks. After the successful modeling, rats in each administration group were continuously administered for 4 weeks. After 8 weeks, the rats in each group were put to death, and the pathological changes in liver tissue were detected by HE staining. Automatic biochemical analyzer was used to detect fasting serum lipid levels (T-Chol, TG, LDL-C, HDL-C) and liver functions (ALT, TP, ALB) of rats in each group. The rat liver index was calculated by weighing method. Enzyme-linked immunosorbent assay (ELISA) was used to detect the secretion of inflammatory cytokines TNF-α and IL-6 in liver tissue. Real-time quantitative PCR (qRT-PCR) was used to detect the mRNA expressions of fat metabolism-related factors SREBP-1c and FASN in liver tissue. Western blot was used to detect the p-AMPK and p-NF-κBp65 protein expressions in liver tissue. The results of HE staining showed that compared with the control group, the pathological changes in liver tissue in the model group rats were obvious; specifically, the outline of hepatic lobule was unclear, the hepatic cells showed diffuse steatosis of adipose tissue, and were accompanied by inflammatory infiltration, nuclear condensation, coloring deep; compared with the model group, liver lesions of all of the treatment groups were significantly alleviated; especially, the FZLZD group showed the most significant degree of remission. The results of serum test showed that the levels of serum lipids (T-Chol, TG, LDL-C, HDL-C), liver functions (ALT, TP, ALB) and liver index in model group were significantly higher than those in control group (<0.01); compared with the model group, the indexes of serum lipid and liver function of rats in each treatment group were significantly decreased (<0.01), and those in FZLZD group were significantly decreased (<0.05), while those in YSF group were not significantly changed. The results of ELISA and qRT-PCR showed that compared with the control group, the secretion levels of TNF-α, IL-6 and the mRNA levels of SREBP-1c and FASN in the liver tissue of model group rats were significantly increased (<0.01); compared with model group, the secretion levels of TNF-α, IL-6 and the mRNA levels of SREBP-1c, FASN in liver tissue of rats in each treatment group were significantly decreased (<0.01); compared with YSF group, the secretion levels of TNF-α and IL-6 and the mRNA levels of SREBP-1c and FASN in FZLZD group were significantly different (<0.01). Western blotting showed that compared with the model group, the protein expression of p-AMPK in liver tissue of rats in FZLZD group was significantly increased (<0.01), while the protein expression of p-NF-κBp65 was significantly decreased (<0.01). FZLZD can significantly improve hepatic pathological changes, reduce serum lipid levels, promote liver function and liver index in NAFLD rats, which may be associated with the activation of the AMPK pathway and thereby the inhibition of the expressions of SREBP-1c and FASN, and the inhibition of the NF-κBp65 pathway and thereby the reduction of the release of inflammatory factors.

The Effects of Clinical Pathway of Nursing on Pulmonary Function Index and Complications in Patients with COPD / 昆明医科大学学报

Objective To explore the effects of clinical pathways of nursing on pulmonary function index and complication in patients with COPD. Methods From October 2015 to June 2017, 94 patients with COPD were divided into two groups according to the order of admission and the nursing method: 47 patients undergoing routine nursing care and 47 patients receiving clinical pathways of nursing. We compared the incidence of complications, lung function, satisfaction, sense of comfort, anxiety, average hospitalization, health knowledge score and hours of ventilator use between the observation group and the control group. Results The incidence of complications in the observation group was significantly lower than that in the control group (P＜0.05) . The lung function index of the observation group was better than that of the control group, but the difference was not statistically significant (P＞0.05) . In the observation group, the satisfaction, the sense of comfort and the health knowledge score were higher.The anxiety degree was lower and the average hospital stay and hours of ventilator use were shorter compared to the control group (P＜0.05) . Conclusion The clinical pathways of nursing are used to reduce the incidence of complications, to improve the lung function index, the nursing satisfaction, sense of comfort and health knowledge score,and to reduce the average length of hospital stay, anxiety and hours of ventilator use in patients with COPD care.

Effect of Bushen Tongdu Capsule on RANK/RANKL/OPG pathway of collagen induced arthritis rats / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To study the effect of Bushen Tongdu Capsule (BTC) on RANK/RANKL/ OPG pathway of collagen induced arthritis (CIA) rats, thereby laying theoretic evidence for treating rheumatic arthritis (RA) by Chinese medicine.</p><p><b>METHODS</b>RA model was induced by CIA. Totally 42 rats were randomly divided into six groups, i.e., the normal control group, the model group, the low dose BTC (BSL) group, the medium dose BTC (BSM) group, the high dose BTC (BSH) group, and the Tripterygium Glycosides (TG) group, 7 in each group. BTC at the daily dose of 120, 240, and 480 mg/kg was given by gastrogavage to rats in the BSL, BSM, and BSH group respectively from the 13th day of modeling. TG at the daily dose of 24 mg/kg was given by gastrogavage to rats in the TG group. All medication was given once daily, 2 mL each time. Two mL normal saline was administered to rats in the normal control group and the model group. All medication lasted for 18 days. Samples were taken at day 31. The TRAP section of the ankle joint was fixed in 10% formalin for TRAP stain. Serum levels of osteoprotegerin (OPG), receptor activator of nuclear factor-κB ligand (RANKL), and macrophage colony-stimulating factor (M-CSF) were detected using ELISA.</p><p><b>RESULTS</b>Compared with the normal control group, positive reactions of pathological ankle joint section, inflammation, and osteoclasia degree were significantly improved in the model group, serum levels of RANKL and M-CSF were up-regulated, levels of OPG and OPG/RANKL were significantly lowered (all P < 0.01). Compared with the model group, positive reactions of pathological ankle joint section, inflammation, and osteoclasia degree also significantly decreased in the BSH group and the TG group (all P < 0.01). RANKL and M-CSF were significantly down-regulated in each medicated group, while levels of OPG and OPG/RANKL were significantly up-regulated (all P < 0.01). Compared with the TG group, M-CSF was lower, but levels of OPG and OPG/RANKL were significantly up-regulated in the normal control group (all P < 0.01). RANKL and M-CSF were significantly up-regulated, while levels of OPG and OPG/RANKL were significantly down-regulated in the model group and each BS group (all P < 0.01).</p><p><b>CONCLUSION</b>BTC could relieve bone damage of CIA rats possibly through regulating and controlling osteoclasts.</p>

Health inspection and monitoring results analysis on secondary water supply in Shanghai / 上海预防医学

[Objective] To investigate the quality of secondary water supply in Shanghai , in order to provide the basis for efficient management measures . [ Methods] Secondary water supply data were collected and analyzed from Shanghai drinking water health inspection and monitoring information system . [ Results] Cleaning and disinfection of secondary water supply facilities and water quality self -check and others were found to be low in pass rate .The drinking water quality of secondary water supply was lower . The main unqualified monitoring indexes were oxygen consumption , total number of bacteria and residual chlorine. [ Conclusion] Several problems exist in secondary water supply .By using Shanghai drinking water health inspection and monitoring information system , we can take effective measures to achieve sec-ondary water supply scientific supervision , then ensuring water safety .

Establishment and evaluation of animal model with methamphetamine poisoning / 法医学杂志

Amphetamine-type stimulants (ATS) is the most widespread narcotics in the 21st century. The methamphetamine's intoxication mechanism, psychological dependence, drug resistance and therapeutic drug development are the hot spots in current research. Establishment of animal model with methamphetamine poisoning is the basic for the relative studies, the normalization and standardization of the animal model settles the foundation for methamphetamine's further research. This article reviews the animal model of methamphetamine poisoning in China and abroad, the brief history of the acute, subacute and chronic animal model of methamphetamine poisoning, as well as the principles and methods of the animal model establishment and its evaluation criteria. The necessity, significance and its scientific expansion of performing experimental research on the methamphetamine poisoning animal model are also discussed.

Association of p16, p53, Ki-67 expressions with high-risk human papilloma virus infection in cervical intraepithelial neoplasia / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the association between p16, p53 and Ki-67 expression and high-risk human papilloma virus (HPV) infection in cervical intraepithelial neoplasia (CIN).</p><p><b>METHODS</b>Using a self-prepared tissue microarray, p16, p53, and Ki-67 expression was detected in 243 cases of CIN and 30 cases of normal cervical epitheliums by immunohistochemistry, and high-risk HPV infection was detected by gene hybridization capture II.</p><p><b>RESULTS</b>p16, p53 and Ki-67 expressions were all negative in normal cervical epitheliums, but all positive in CIN. The expression of p16 and Ki-67 was 88.2 (67/76) and 92.1% (70/76) in CIN grade 1, respectively, and both were 100% in CIN grades 2 and 3, and the intensity of positive expression was significantly correlated with CIN grade (P<0.001). The positive cells in CIN grade 1 were mostly within the lower 1/3 of the squamous epithelium, while in CIN grade 2, the positive cells involved the lower 2/3 of the epithelium layers; in CIN grade 3, more than 2/3 or almost the full thickness of the epithelium was involved, suggesting significant correlation between the involvement and CIN grades (P<0.001). p53 expression was positive in 31.6% (24/76) of the cases in CIN grade 1, 53.4% (47/88) in CIN grade 2 and 58.2% (46/79) in CIN grade 3, and the intensity of positive expression was in significantly correlation with CIN grades (P<0.001), but no significant difference occurred between CIN 2 and CIN 3. High-risk HPV were detected in 37/52 (71.2%) of the cases in CIN grade 1, 50/58 (86.2%) in CIN 2 and 50/55 (90.9%) in CIN 3, and the relative DNA amount was significantly correlated with CIN grade (P<0.001), but there as no significant difference between CIN 2 and CIN 3.</p><p><b>CONCLUSIONS</b>High-risk HPV infection and p16, p53, Ki-67 overexpression all play important roles in the carcinogenesis of cervical precancerous lesion, and both p16 and Ki-67 expression are useful markers in diagnosis and staging of CIN.</p>

Expressing of N gene encoding nucleocapsid protein of vesicular stomatitis virus and elementary application in ELISA / 生物工程学报

The gene encoding the nucleocapsid (N) protein of vesicular stomatitis virus (VSV-NJ) was subcloned from pMD-VN5, and inserted into pBAD/Thio TOPO vector. The recombinant plasmid was identified by restriction analysis and PCR. It was sequenced to confirm the correct sequences and the correct junctional orientations of the inserted N gene. The results of SDS-PAGE and Western immunoblotting revealed that the N protein was expressed in Escherichia coli LGM194 in a high level and the recombinant fusion protein, which contained a N-terminal HP-Thioredoxin and a C-terminal polyhistidine tag. It had a molecular mass of approximately 63.5 kD and immunologically reactive activity. The recombinant protein was characterized and tested in an enzyme-linked immunosorbent assay (ELISA) format for potential application in the serodiagnosis of vesicular stomatitis using 186 serum samples from experimentally infected goats and guinea-pigs with VSV-NJ and VSV-IN, and from field origin and reference serum samples. The sensitivity and specificity of the ELISA were compared with those of the standard microtiter serum neutralization (MTSN) tests. The ELISA and MTSN test results were highly correlated for detection of VSV antibodies. The ELISA was as sensitive as the SN assay in detecting positive serum to VSV. The correlation between SN titers and ELISA titers was statistically significant. These data suggest that the recombinant fusion N protein of VSV could be used as a recombinant test antigen for the serodiagnosis of vesicular stomatitis. The ELISA based on the reconmbinant nucleocapsid protein may offer the best combination of rapidity, sensitivity, simplicity, economy, and laboratory biosafety of any of the methods yet developed for VSV serodiagnosis. This study lay on foundation for the development of the diagnosis methods in serology for VSV.

Expression and location of heme oxygenase in the lung of experimental cirrhotic rats / 中华肝脏病杂志

<p><b>OBJECTIVES</b>To observe the function of heme oxygenase (HO) in the lung damage in hepatic cirrhosis rats.</p><p><b>METHODS</b>Liver cirrhosis model rats were made by CCl4. Lung samples taken from normal and cirrhotic rats were examined for HO-1 and HO-2 protein and expression distribution with immunohistochemical staining and western blot.</p><p><b>RESULTS</b>Liver cirrhosis model rats were successfully constructed. There was a notable increase of HO-1 staining (0.062+/-0.021 vs 0.185+/-0.044, t=11.24, P<0.01) and protein expression (0 vs 5294.92+/-46.02, t=11.45, P<0.01) in both vascular and bronchial smooth muscle cells and endothelium in cirrhotic rats, however, no statistical difference of HO-2 between cirrhotic and normal rats was observed.</p><p><b>CONCLUSION</b>The HO-CO pathway is probably involved in the pathogenesis of lung damage in hepatic cirrhosis rats.</p>