[A multicentric study on clinical characteristics and antibiotic sensitivity in children with methicillin-resistant Staphylococcus aureus infection].

Objective: To investigate the clinical characteristics of pediatric methicillin-resistant Staphylococcus aureus (MRSA) infection and the antibiotic sensitivity of the isolates. Methods: The clinical data of children with MRSA infection and antibiotic sensitivity of the isolates from 11 children's hospitals in Infectious Diseases Surveillance of Paediatrics (ISPED) group of China between January 1, 2018 and December 31, 2018 were collected retrospectively. The children's general condition, high-risk factors, antimicrobial therapy and prognosis, differences in clinical disease and laboratory test results between different age groups, and differences of antibiotic sensitivity between community-acquired (CA)-MRSA and hospital-acquired (HA)-MRSA were analyzed. The t test and Wilcoxon rank sum test were used for statistical analysis of the quantitative data and Chi-square test were used for comparison of rates. Results: Among the 452 patients, 264 were males and 188 were females, aged from 2 days to 17 years. There were 233 cases (51.5%) in the ≤1 year old group, 79 cases (17.5%) in the>1-3 years old group, 29 cases (6.4%) in the >3-5 years old group, 65 cases (14.4%) in the >5-10 years old group, and 46 cases (10.2%) in the>10 years old group. The main distributions of onset seasons were 55 cases (12.2%) in December, 47 cases (10.4%) in February, 46 cases (10.2%) in November, 45 cases (10.0%) in January, 40 cases (8.8%) in March. There were 335 cases (74.1%) CA-MRSA and 117 (25.9%) cases HA-MRSA. Among all cases, 174 cases (38.5%) had basic diseases or long-term use of hormone and immunosuppressive drugs. During the period of hospitalization, 209 cases (46.2%) received medical interventions. There were 182 patients (40.3%) had used antibiotics (ß-lactams, glycopeptides, macrolides, carbapenems, oxazolones, sulfonamides etc) 3 months before admission. The most common clinical disease was pneumonia (203 cases), followed by skin soft-tissue infection (133 cases), sepsis (92 cases), deep tissue abscess (42 cases), osteomyelitis (40 cases), and septic arthritis (26 cases), suppurative meningitis (10 cases). The proportion of pneumonia in the ≤1 year old group was higher than the >1-3 years old group,>3-5 years old group,>5-10 years old group,>10 years old group (57.5% (134/233) vs. 30.4% (24/79), 31.0% (9/29), 38.5% (25/65), 23.9% (11/46), χ(2)=17.374, 7.293, 7.410, 17.373, all P<0.01) The proportion of skin and soft tissue infections caused by CA-MRSA infection was higher than HA-MRSA (33.4% (112/335) vs. 17.9% (21/117), χ(2)=10.010, P=0.002), and the proportion of pneumonia caused by HA-MRSA infection was higher than CA-MRSA (53.0% (62/117) vs. 42.1% (141/335), χ(2)=4.166, P=0.041). The first white blood cell count of the ≤1 year old group was higher than that children > 1 year old ((15±8)×10(9)/L vs. (13±7)×10(9)/L, t=2.697, P=0.007), while the C-reactive protein of the ≤1 year old group was lower than the 1-3 years old group,>5-10 years old group,>10 years old group (8.00 (0.04-194.00) vs.17.00 (0.50-316.00), 15.20 (0.23-312.00), 21.79(0.13-219.00) mg/L, Z=3.207, 2.044, 2.513, all P<0.05), there were no significant differences in procalcitonin (PCT) between different age groups (all P>0.05). After the treatment, 131 cases were cured, 278 cases were improved, 21 cases were not cured, 12 cases died, and 10 cases were abandoned. The 452 MRSA isolates were all sensitive to vancomycin (100.0%), linezolid (100.0%), 100.0% resistant to penicillin, highly resistant to erythromycin (85.0%, 375/441), clindamycin (67.7%, 294/434), less resistant to sulfonamides (5.9%, 23/391), levofloxacin (4.5%, 19/423), gentamicin (3.2%, 14/438), rifampicin (1.8%, 8/440), minocycline (1.1%, 1/91). The antimicrobial resistance rates were not significantly different between the CA-MRSA and HA-MRSA groups (all P>0.05). Conclusions: The infection of MRSA is mainly found in infants under 3 years old. The prevalent seasons are winter and spring, and MRSA is mainly acquired in the community. The main clinical diseases are pneumonia, skin soft-tissue infection and sepsis. No MRSA isolate is resistant to vancomycin, linezolid. MRSA isolates are generally sensitive to sulfonamides, levofloxacin, gentamicin, rifampicin, minocycline, and were highly resistant to erythromycin and clindamycin. To achieve better prognosis. clinicians should initiate anti-infective treatment for children with MRSA infection according to the clinical characteristics of patients and drug sensitivity of the isolates timely and effectively.

[Clinical study of Chinese Medicine fumigation combined with "Zhuyuan Decoction" in the treatment of chronic rhinosinusitis].

Objective:To investigate the clinical efficacy of "Zhuyuan soup" by combination with fumigation and oral administration on chronic rhinosinusitis（CRS）, further exploring effective Chinese medicine for the disease, and giving full play to the unique advantages of external treatment of traditional Chinese medicine. Method:By using randomized and positive drug controlled methods, patients with moderate-to-severe chronic rhinosinusitis were randomly divided into western medicine group and traditional Chinese medicine group, 30 cases in each group. In the western medicine group, the nasal spray hormone Budesonide was used, and the patients in the traditional Chinese medicine group were treated with the traditional Chinese medicine prescription"Zhuyuan soup"by combination with fumigation and oral administration. All of the above patients were followed up for 2 weeks, and 1 course for 1 month. Visual analogue scores were taken at each follow-up, and CT and nasal endoscopy were performed before and after treatment. Result:The total effective of "Zhuyuan soup" group was 67.1%, which was higher than that of western medicine group（59.6%）, but there was no statistically significant difference（P>0.05）. After treatment, there were no significant differences between the two groups with regard to the symptom of nasal congestion, dizziness, facial pain or fullness, dysosmia, nasal discharge or postnasal drip, total sensation, total symptom score（P>0.05）. According to the total symptom score, the effect of the two groups of patients was not significantly correlated with the gender, age, course of disease, alcohol and tobacco hobbies, previous medication and surgery（P>0.05）. Based on the results of the study, we found that the Chinese medicine group is superior to the western medicine group in improving the total feeling of the disease, dizziness or headache, facial pain or fullness, and postnasal drip, olfactory disorder. Conclusion:Both traditional Chinese medicine and western medicine are effective methods for treating chronic rhinosinusitis. Clinically, individualized comprehensive treatment should be carried out according to the patient's condition. The above methods may be applied alone or in combination with Chinese and Western medicine. Further optimization and improvement of the combination of traditional Chinese and Western medicine in chronic sinusitis can help improve the clinical efficacy and satisfaction of patients, which deserves further study.

[Clinical characteristics of 84 children with invasive Haemophilus influenzae infection from 2014 to 2018].

Objective: To investigate the clinical characteristics of invasive Haemophilus influenzae (HI) infection in children. Methods: The clinical manifestations, laboratory examinations and treatment outcomes of 84 children with HI infection confirmed by bacterial culture in 7 tertiary children's hospitals from 2014 to 2018 were analyzed retrospectively. Results: Among the 84 cases, 50 were males. The age was 1.54 years (ranged from 5 days to 13 years).Twenty cases (24%) had underlying diseases and 48 cases (57%) had not received antibiotics before collecting specimens. Eighty-two cases (98%) had fever and 75 cases (89%) had clear infection foci, among which 31 cases (37%) had meningitis and 27 cases (32%) had pneumonia. Blood culture was positive in 62 cases (74%), cerebrospinal fluid culture was positive in 10 cases (12%), blood culture and cerebrospinal fluid culture were both positive in 11 cases (13%). Antibiotics susceptibility test showed that 27% (22/82) of all HI strains produced ß-lactamases and 48% (37/77) strains were resistant to ampicillin. The drug resistance rates to cefuroxime, ampicillin-sulbactam, trimethoprim-sulfamethoxazole and azithromycin were 25% (20/80) , 20% (9/45) , 71% (44/62) and 19%(11/58), respectively. All strains were sensitive to meropenem, levofloxacin and ceftriaxone. After sensitive antibiotic therapy, 83% (70/84) of all patients were cured and improved, the mortality rate and loss of follow-up rate were 13% (11/84) and 4% (3/84) respectively. Conclusions: Meningitis and pneumonia are common presentation of invasive HI infections in children. Mortality in HI meningitis children is high and the third generation of cephalosporins, such as ceftriaxone can be used as the first choice for the treatment of invasive HI infection.

[Curative effects of Ningmitai capsules on the residual fragments and postoperative complications following lithotripsy treatment of upper urinary calculi].

Objective: To observe the clinical efficacy of Ningmitai capsules, a traditional Chinese medicine using for clearing heat and dampness, in the treatment of residual fragments and postoperative complications following lithotripsy for upper urinary stones. Methods: During October 2016 and March 2018, patients from Wuhan 1st Hospital, Wuhan 2nd Hospital, Wuhan 3rd Hospital, and Wuhan Puai Hospital having upper urinary residual fragments following minimally-invasive stone treatment were randomly assigned to control group and Ningmitai group with a proportion of 1∶3. The patients in control group were treated with antibiotics or sodium diclofenac suppository on demand, while patients in Ningmitai group took additional Ningmitai capsule orally (4 capsules per time, 3 times per day). The observation was started when a patient was enrolled in this study and continued for a maximum of 12 weeks or until stone-free status. During the observation, the stone expulsion time, stone-free time, stone-free rate were observed, and the difference in curative effect between the two groups on postoperative complications such as pain and infection were compared. Statistical analysis was done using t-test or χ2 test by GraphPad Prism 5 software. Results: Totally 269 cases enrolled in this study. Eighty-six patients were from Wuhan 1st Hospital, 69 patients from Wuhan 2nd Hospital, 58 patients from Wuhan 3rd Hospital, 56 patients from Wuhan Puai Hospital, respectively. There were 66 cases in control group and 203 cases in Ningmitai group. The residual fragments expulsion time in Ningmitai group was significantly earlier than that in control group ((4.5±0.4) days vs. (7.5±1.3) days, t=2.877, P=0.004), the residual fragments clearance time in Ningmitai group was significantly shorter than that in control group ((13.6±1.0) days vs.(25.6±3.8) days, t=4.252, P=0.000), and the stone-free rate within 4 weeks post operation in Ningmitai group was significantly higher than control group (91.6% vs. 68.2%, χ2=22.57, P=0.000). After 12 weeks of treatment, the total effective rate of control group was 89.4%, and the total effective rate of Ningmitai group was 99.5%, with statistically significant difference (χ2=17.65, P=0.000). The proportion of caregivers that offered analgesia in Ningmitai group was significantly lower than that in control group (16.3% vs. 30.3%, χ2=6.212, P=0.013), the recovery rate of routine urinalysis following 4 weeks' treatment was significantly higher in Ningmitai group than that in control group (88.2% vs.71.2%, χ2=10.67, P=0.001). No obvious adverse effects were observed in both groups. Conclusions: Ningmitai capsule can facilitate the stone passage and increase the stone-free rate in the treatment of residual fragments and postoperative complications of upper urinary stones. It is also helpful for the prevention and treatment of postoperative pain, infection and other complications.

[Experimental observation of hyperbaric oxygen combined with radioactive seed implantation in the treatment of nude mice bearing esophageal squamous cell carcinoma].

Objective: To investigate the effect and mechanism of hyperbaric oxygen combined with radioactive seed implantation in the treatment of esophageal squamous cell carcinoma. Methods: Subcutaneous tumor model of esophageal squamous cell carcinoma using TE-8 cells was established. Tumor bearing Balb/c(nu/nu) mice (60 mice) were divided into four groups, Cont group that treated with normal oxygen level, HBO group that treated with hyperbaric oxygen, RSI group that treated with radioactive seed implantation, and HBO+ RSI group that treated with hyperbaric oxygen combined with radioactive seed implantation. Tumor volume ratio and mean survival time of tumor bearing mice were observed. Pathological changes of tumor tissue after treatment were observed by hematoxylin eosin (HE) staining. Enzyme linked immunosorbent assay kit was used to detect oxidative stress. Apoptosis related proteins were detected by Western blot. Results: After treatment, the tumor volume ratio of HBO+ RSI group was 3.51±0.80 and was significantly lower than that of Cont group, HBO group, and RSI group (P<0.05). The mean survival time of HBO+ RSI group tumor bearing mice was 62 d and was significantly longer than that in Cont group, HBO group, and RSI group (P<0.05). HE staining showed that the pathological changes of tumor tissues were most obvious in HBO+ RSI group. After treatment, the MDA and Bax levels in nude mice of HBO+ RSI group were significantly higher than those in Cont group, HBO group and RSI group, but the levels of GSH, SOD and Bcl-2 were significantly lower than those of Cont group, HBO group and RSI group (P<0.05). Conclusion: Hyperbaric oxygen combined with radioactive seed implantation could slow tumor growth and increase survival time of tumor bearing mice. The possible mechanism is that hyperbaric oxygen combined with radioactive seed implantation can improve the oxidative stress response and the expression of apoptosis protein in tumor bearing nude mice.

An update on acupuncture point injection.

This overview reports the global research advances in acupuncture point injection in the last 5 years. Acupuncture point injection can be applied to a wide range of curable diseases, predominantly those involving pain, but it has poor clinical evidence. Progress has been attained in the mechanism research on acupuncture point injection, but further studies remain necessary. With the reported adverse effects of acupuncture point injection, the need to standardize its clinical procedure has become urgent.

Nutrient assessment of olive leaf residues processed by solid-state fermentation as an innovative feedstuff additive.

AIMS: Olive leaf residue feedstuff additives were prepared by solid-state fermentation (SSF), and its feeding effects on broiler chickens were examined. METHODS AND RESULTS: The fermentation's nutrient value, that is, protein enrichment, cellulase activity, tannic acid degradation and amino acid enhancement, was determined. The effect of different strains, including molds (Aspergillus niger, Aspergillus oryzae and Trichoderma viride) and yeasts (Candida utilis, Candida tropicalis and Geotrichum candidum), and the fermentation time on the nutrient values of the feedstuff additives was investigated. The experimental results showed that the optimal parameters for best performance were A. niger and C. utilis in a 1 : 1 ratio (v/v) in co-culture fermentation for 5 days. Under these conditions, the total content of amino acids in the fermented olive leaf residues increased by 22·0% in comparison with that in the raw leaf residues. Both Glutamic acid and Aspartic acid contents were increased by more than 25·4%. Broiler chickens fed with different amounts of feedstuff additives were assessed. The results demonstrated that the chicken weight gains increased by 120%, and normal serum biochemical parameters were improved significantly after 10% of the feedstuff additives were supplemented to the daily chicken feed for 28 days. CONCLUSIONS: The co-culture combination of A. niger and C. utilis with SSF for olive leaf residue had the best nutrient values. The addition of 10% fermented olive leaf residue facilitated the chicken growth and development. SIGNIFICANCE AND IMPACT OF THE STUDY: This study reveals that olive leaf residues fermented by SSF exhibited considerable potential as feed additives for feeding poultry.

Content and distribution of different phosphorus forms in broiler chickens.

To understand the background value of phosphorus in chickens, the quantitative distribution of different phosphorus forms, including total phosphorus (TP), free phosphate (FP) and phospholipid (PL), in viscera, blood and bones of broiler chickens was investigated. Results showed that phosphorus contents exhibited significant differences in different parts of chickens. TP content of breast and thigh meat was over 5.0 g/kg, in which most of the phosphorus was in the form of water-soluble phosphates. TP content in viscera was higher than that in meat, and spleen was observed to contain the highest amount of phosphorus (10.0 g/kg). In all tested organs, FP and PL contents in liver were the highest, ranging between 1207-1989 and 81-369 mg/kg respectively. TP content in chicken bone was in the range of 52,716-136,643 mg/kg, and FP content in the bone was relatively lower than that in chicken meat.

Analysis of the genetic diversity of beach plums by simple sequence repeat markers.

The purpose of this study was to measure the genetic diversity of wild beach plum and cultivated species, and to determine the species relationships using SSRs markers. An analysis of genetic diversity from ten beach plum germplasms was carried out using 11 simple sequence repeat (SSR) primers selected from 35 primers to generate distinct PCR products. From this plant material, 44 allele variations were detected, with 3-5 alleles identified from each primer. The analysis showed that the genetic similarity coefficient varied from 0.721 ± 0.155 to 0.848 ± 0.136 within each of the ten beach plum germplasms and changed within the range of 0.551 ± 0.084 to 0.695 ± 0.073 between any two pairs of germplasms. According to the genetic dissimilarity coefficient matrix, a cluster analysis of SSRs using the unweighted pair group mean average method in the NTSYSpc 2.10 software revealed that the ten germplasms could be divided into two groups at the dissimilarity coefficient of 0.606. Class I included 77.8, 12.5, 30, and 33.3% of MM, MI, NY, and CM, respectively. Class II contains the remaining 9 beach plum germplasms. The markers generated by 11 SSR primers proved very effective in distinguishing the beach plum germplasm resources. It was clear that the geographical distribution did not correspond with the genetic relationships among the different beach plum strains. This result will be of value to beach plum breeding programs.

Effects of inoculum size and age on biomass growth and paclitaxel production of elicitor-treated Taxus yunnanensis cell cultures.

Suspension cultures of Taxus yunnanensis cells were inoculated with cells of different culture ages (12-24 days) at various densities [50-250 g fresh weight (fw)/l], and treated (on day 7) with a mixture of elicitors, including Ag(+), chitosan and methyl jasmonate. The biomass productivity (during the production stage) increased dramatically with inoculum size, but decreased with inoculum age over 16 days. The volumetric yield and productivity of taxol (paclitaxel) also increased with inoculum size, while the specific taxol yield (per cell) was mainly dependent on inoculum age, with an optimum of 20 days, during the early stationary phase. The highest taxol yield and productivity, 39.8 mg/l and 1.9 mg/l per day, respectively, were obtained with a 20-day-old inoculum at 200 g fw/l. Taxol excretion by the cells increased with inoculum age but decreased with inoculum size. The elicitor-induced activities of catalase (CAT) and phenylalanine ammonia-lyase (PAL) also depended mainly on inoculum age; higher PAL activity and lower CAT activity were obtained with an older inoculum, corresponding to a higher taxol yield. The results show that both inoculum size and age are important variables for taxol production, though the latter more profoundly influences elicitor-induced taxol biosynthesis of the cells. Inoculum size and age are also interrelated and should be optimized together in a two-stage culture process.

[Peroxidase isoenzymes analysis on some plants under simulated microgravity].

The detection technology of peroxidase isoenzyme pattern were adopted in the study of the effect of simulated microgravity on some plants. Biochemical analysis indicated that the microgravity samples displayed an increased activity of peroxidase.

[A study on the ultrastructure of plant cell under simulated microgravity].

OBJECTIVE: To study the effects of microgravity on plant cell ultrastructure. METHOD: Analyzing the biological and physiological differences between the plants grown in the simulated microgravity conditions and their correspondent ground controls. RESULT: Various variances in cell walls, chloroplasts and mitochondria were observed with electron microscope. Those ultrastructure changes included plasmolysis, twist, contraction and deformation of cell walls, curvature and loose arrangement of chloroplast lamellae, breach of mitochondria, overflow of inclusions, disappearance of cristae, and significant increase in number of starch grains per cell. CONCLUSION: Simulated microgravity conditions exert some coerce influence on the plant growth and the changes above-mentioned were the responses in cell level.

[Effects of the preparation of xiao long ling on experimental prostatic hyperplasia in mice].

The results of the experiments indicate that the prostatic hyperplasia caused by Testosteroni Propionatis in mice, cotton oil-induced local swollen ears of mice and the proliferation of granuloma produced by subcutaneous implantation of cotton pill in rats are inhibited significantly by the preparation of Xiao Long Ling. Xiao Long Ling depresses the increase of vascular permeability induced by a variety of inflammatory media such as histamine, 5-HT and PGE. Xiao Long Ling is found capable of inhibiting the platelet aggregation induced by ADP as well as depolymerizing the aggregated platelets.