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OBJECTIVE: The aim of this study was to compare the difference between proximal femoral bionic nail (PFBN) and hip replacement (HR) for femoral intertrochanteric fracture. MATERIALS AND METHODS: A retrospective analysis of the differences in operative time, length of stay, postoperative Harris score, and postoperative mortality between patients with femoral intertrochanteric fracture treated by PFBN and HR admitted to Jinzhai County People's Hospital from October 2020 to September 2022 was performed. RESULTS: A total of 56 patients with femoral intertrochanteric fracture, 26 with PFBN and 30 with HR, were included in the study. There were no differences in the length of surgery, pre- and post-operative hemoglobin, or post-operative Harris score at 3 months between the two groups. Compared to the HR group, the PFBN group had a lower total cost, shorter hospital stays, and lower mortality but a longer ambulation time, with a difference of 3.36 weeks. CONCLUSIONS: PFBN may be a promising new treatment for femoral intertrochanteric fracture.
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Fracturas del Fémur , Fracturas de Cadera , Humanos , Biónica , Estudios Retrospectivos , Fracturas de Cadera/cirugía , FémurRESUMEN
We report a new attentional cueing effect, which shows how attention models the physical force of friction. Most objects we see are in frictive contact with a 'floor', such that clockwise rotation causes rightward movement and counterclockwise rotation leftward movement. Is this regularity encoded in spatial orienting responses? In Experiment 1, seeing a clockwise-rotating 'wheel' produced faster responses to subsequent targets appearing on the right vs. left (and vice versa for counterclockwise rotation). Thus, when viewing a lone rotating wheel, we orient attention toward where we predict it will move next, assuming frictive floor contact. But what happens if the rotating wheel is seen touching another visible surface? In Experiment 2, rotational cueing was stronger for wheels touching a visible floor, was abolished for wheels near but not touching another surface, and reversed for wheels touching a ceiling. We conclude that the visual system makes an assumption of frictive floor contact, and rapidly analyzes visual cues to frictive contact with other surfaces, in order to orient attention toward where objects are likely to move next.
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Atención , Señales (Psicología) , Humanos , Tiempo de Reacción/fisiología , Atención/fisiología , Percepción , Percepción Espacial/fisiología , Percepción Visual/fisiologíaRESUMEN
To investigate the safety and efficacy of "quadri-combination" therapy including maximal transurethral resection of bladder tumor (mTURBT), combined with systemic chemotherapy and immunotherapy, concurrent radiotherapy, and immune maintenance therapy. The clinical data of 8 patients with bladder cancer who could not tolerate or refused radical cystectomy at the Department of Urology, Peking University Cancer Hospital from November 2019 to October 2021 were retrospectively analyzed. There were 5 males and 3 females with a mean age of 69 years. The Eastern Cooperative Oncology Group(ECOG) score was 0 in 6 cases and 1 in 2 cases. There were 5 cases of high-grade urothelial carcinoma (1 case of T3b; 2 cases were T2; 2 cases of T1 stage, with multiple tumors and repeated recurrence), 1 case of high-grade urothelial carcinoma with carcinoma in situ (T1/Tis stage), 1 case of high-grade urothelial carcinoma with squamous differentiation (T3b stage), and 1 case of high-grade urothelial carcinoma with glandular differentiation (T2). All patients underwent "quadri-combination" therapy.The patient's tolerance, success rate of bladder preservation and prognosis were evaluated.The median follow-up time was 22.5 (12-35) months. One patient with high-grade muscle-invasive bladder cancer (T2) received mTURBT, albumin-bound paclitaxel and durvalumab combined therapy for 3 cycles, concurrent radiotherapy, and immune maintenance therapy for 18 months, and the tumor recurrence was found. The pathology was high-grade urothelial carcinoma. Salvage radical cystectomy combined with pelvic lymph node dissection is recommended. The remaining 7 patients were regularly reexamined, and no recurrence or metastasis was found.The 2-year progression-free survival rate was 80%, and the success rate of bladder preservation was 87.5%(7/8). Treatment-related adverse reactions were resolved by symptomatic treatment, and patients' compliance and tolerance were acceptable.The "quadri-combination" bladder-preserving therapy is feasible and well tolerated, but further studies are needed.
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Carcinoma de Células Transicionales , Neoplasias de la Vejiga Urinaria , Masculino , Femenino , Humanos , Anciano , Neoplasias de la Vejiga Urinaria/terapia , Estudios Retrospectivos , Recurrencia Local de Neoplasia/cirugía , CistectomíaRESUMEN
Beyond seemingly lower-level features such as color and motion, visual perception also recovers properties more commonly associated with higher-level thought, as when an upwardly accelerating object is seen not just as moving, but moreover as self-propelled, and resisting the force of gravity. Given past research demonstrating the prioritization of living things in attention and memory, here we hypothesized that observers would be more sensitive to an object's speed changes if those speed changes were opposite to natural gravitational acceleration. Across six experiments, we found that observers were more sensitive to objects' accelerations when they moved upward (when those accelerations were opposite to gravity) and less sensitive to their accelerations when they moved downward (when those accelerations were consistent with gravity). Moreover, observers were more sensitive to objects' decelerations when they moved downward (when those decelerations appeared as "braking" against gravity), and less sensitive to their decelerations when they moved upward (when those decelerations were consistent with gravity). This greater visual sensitivity to speed changes opposite to gravity is consistent with previous results suggesting that we readily monitor the world for cues to animacy. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Señales (Psicología) , Percepción de Movimiento , Humanos , Atención , Aceleración , Gravitación , Percepción VisualRESUMEN
As a member of the dibenzyl isoquinoline alkaloid family, cepharathine is an alkaloid from the traditional Chinese medicine cepharathine, which is mainly used for treatment of leukopenia and other diseases. Recent studies of the inhibitory effect of cepharathine against SARS-CoV-2 have attracted widespread attention and aroused heated discussion. As the original discoverer of the anti-SARS-CoV-2 activity of cepharanthine, here we briefly summarize the discovery of cepharanthine and review important progress in relevant studies concerning the discovery and validation of anti-SARS-CoV-2 activity of cepharathine, its antiviral mechanisms and clinical trials of its applications in COVID-19 therapy.
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Bencilisoquinolinas , COVID-19 , Antivirales/farmacología , Antivirales/uso terapéutico , Bencilisoquinolinas/farmacología , Bencilisoquinolinas/uso terapéutico , Humanos , SARS-CoV-2Asunto(s)
Cesárea , Procedimientos Quirúrgicos Electivos , Femenino , Humanos , Embarazo , Factores de RiesgoRESUMEN
Research suggests that integrated STEM activities can best support students in developing their mathematical and scientific understanding. On one hand, while science provides mathematics with real-life authentic problems to investigate, mathematics provides science powerful tools to explore those problems. In line with this call, in this study, we designed an integrated lesson at the cross-section of proportional reasoning and added sugar present in food products to explore how added sugar provides students with a meaningful context to engage in proportional reasoning and how proportional reasoning helps students identify the quantity of added sugar present in different food products and provides students with a platform to initiate a conversation around quality of food products. Developed on the theoretical framework of Realistic Mathematics Education (RME), this lesson was remotely implemented on three middle school students. The result section highlights the design principle of the lesson that provided students with an opportunity to construct an understanding of both the disciplines through a mutual interaction.
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Curriculum , Azúcares , Humanos , Matemática , Solución de Problemas , EstudiantesRESUMEN
Objective: To explore the safety and efficacy of laparoscopic microwave ablation combined with partial nephrectomy in the treatment of renal tumors. Methods: The 65 patients with renal tumors undergoing laparoscopic microwave ablation combined with partial nephrectomy from November 2017 to May 2021 were retrospectively analyzed. There were 46 males and 19 females. The average age was (56.6±14.1) years. The mean body mass index was (25.7±3.3) kg/m2. The tumors located in the left kidney in 30 cases and the right kidney in 35 cases. The ECOG score was 0 in 59 patients and 1 in 6 patients. The mean maximum diameter of the tumors was (2.3±1.0) cm(1.0-5.0 cm). According to R.E.N.A.L. scoring, 41 cases were of low difficulty (4-6 points), 23 cases of medium difficulty (7-9 points) and 1 case of high difficulty (10-12 points). The renal tumors were ablated by laparoscopic microwave ablation, then followed by partial nephrectomy. Postoperative complications were observed and the prognosis was assessed by CT or MRI. Results: The mean duration of operation was (76.6±19.4) min (40-120 min). The median intraoperative blood loss was 20 ml(5-50 ml). The median duration of postoperative hospitalization was 4 d(3-6 d). Complications of Clavien grade â were found in 11 patients (fever, nausea and vomiting, lumbar pain), and no complications were grade â ¡ or above. Postoperative pathology showed that no positive margin was found, and 46 cases of clear cell renal cell carcinoma (AJCC stage: T1a stage 42 cases, T1b stage 4 cases; WHO/ISUP classification: 21 cases of grade 1, 23 cases of grade 2, 2 cases of grade 3); 2 cases of type 1 papillary renal cell carcinoma (stage T1a, grade 1); 1 case of type 2 papillary renal cell carcinoma (T1b stage, grade 2); 2 cases of renal chromophobe carcinoma (all stage T1a); 1 case of low-grade malignant potential multilocular cystic renal tumor; 2 cases of adenocarcinoma (combined with the postoperative history of rectal cancer, metastasis was considered); 6 cases of renal angiomyolipoma; 2 cases of eosinophiloma; 1 case of papillary adenoma; 1 case of benign renal cyst and 1 case of renal hemangioma with calcification. The median follow-up was 24 months (1-42 months). Sixty-three patients survived and two died (one due to heart disease and one due to metastatic colorectal cancer). According to postoperative imaging, there were no signs of tumor recurrence or metastasis in other cases. Blood tests were performed regularly, and no significant abnormalities occurred. Conclusions: The safety and efficacy of laparoscopic microwave ablation combined with partial nephrectomy for the treatment of renal tumor is satisfactory, such as less intraoperative bleeding, fewer complications, less effect on renal function and postoperative pathology, providing a potential option for renal tumor treatment.
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Angiomiolipoma , Neoplasias Renales , Laparoscopía , Adulto , Anciano , Femenino , Humanos , Neoplasias Renales/cirugía , Masculino , Microondas , Persona de Mediana Edad , Recurrencia Local de Neoplasia , Nefrectomía , Estudios RetrospectivosRESUMEN
OBJECTIVE: To investigate the molecular mechanism triggering pyroptosis of synovial fibroblast-like synoviocytes(FLSs)and the release of high mobility group protein 1(HMGB1)in a rat model of knee osteoarthritis(KOA). METHODS: Twelve SD rats were randomized equally into blank control group without any treatment and KOA group with anterior cruciate ligament amputation (ACLT) to induce KOA.HE staining and Mankin score were used to evaluate the damage of knee cartilage.Western blotting was used to detect the expression of pyroptosis-related proteins and HMGB1 in the synovial tissue.In the cell experiment, rat FLSs were treated with PBS (control group), LPS+ATP (to induce cell pyroptosis), or LPS+ATP+siRNAs (to inhibit pyroptosis of the FLSs), and the cellular expressions of apoptosis-related proteins and HMGB1 were detected using Western blotting; the level of HMGB1 in the culture supernatant was detected with ELISA. RESULTS: In the rat models of KOA, the expressions of pyroptosis-related proteins and HMGB1 in the synovial tissue and Mankin score were significantly increased as compared with those in the control group(P < 0.05).In cultured rat FLSs, the expressions of apoptosis related proteins and HMGB1 were significantly higher in the pyroptosis group than in the control group and in cells transfected with the siRNAs targeting NLRP1, NLRP3, ASC and caspase-1(P < 0.05).The protein level of HMGB1 in the culture supernatant was significantly higher in pyroptosis group than in the control and siRNA groups (P < 0.05). CONCLUSION: In the pathological process of KOA, NLRPs inflammasome-mediated FLS pyroptosis causes massive release of HMGB1, which is associated with the activation of the downstream molecule caspase-1.
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Proteína HMGB1 , Osteoartritis de la Rodilla , Sinoviocitos , Animales , Proteína HMGB1/genética , Proteína con Dominio Pirina 3 de la Familia NLR/genética , Piroptosis , Ratas , Ratas Sprague-DawleyRESUMEN
High surface area nickel oxide nanowires (NiO NWs), Fe-doped NiO NWs andα-Fe2O3/Fe-doped NiO NWs were synthesized with nanocasting pathway, and then the morphology, microstructure and components of all samples were characterized with XRD, TEM, EDS, UV-vis spectra and nitrogen adsorption-desorption isotherms. Owing to the uniform mesoporous template, all samples with the same diameter exhibit the similar mesoporous-structures. The loadedα-Fe2O3nanoparticles should exist in mesoporous channels between Fe-doped NiO NWs to form heterogeneous contact at the interface of n-typeα-Fe2O3nanoparticles and p-type NiO NWs. The gas-sensing results indicate that Fe-dopant andα-Fe2O3-loading both improve the gas-sensing performance of NiO NWs sensors.α-Fe2O3/Fe-doped NiO NWs sensors presented the highest response to 100 ppm ethanol gas (55.264) compared with Fe-doped NiO NWs (24.617) and NiO NWs sensors (3.189). The donor Fe-dopant increases the ground state resistance and the absorbed oxygen content in air.α-Fe2O3nanoparticles in electron depletion region result in the increasing resistance in ethanol gas and decreasing resistance in air. In this way,α-Fe2O3/Fe-doped NiO NWs sensor presents the excellent gas-sensing performance due to the formation of heterogeneous contact at the interface.
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The Superconducting Analyzer for MUlti-particles from RAdioIsotope (SAMURAI) Pion-Reconstruction and Ion-Tracker Time Projection Chamber (SπRIT TPC) was designed to enable measurements of heavy ion collisions with the SAMURAI spectrometer at the RIKEN radioactive isotope beam factory and provides constraints on the equation of state of neutron-rich nuclear matter. The SπRIT TPC has a 50.5 cm drift length and an 86.4 × 134.4 cm2 pad plane with 12 096 pads that are equipped with the generic electronics for TPCs. The SπRIT TPC allows for an excellent reconstruction of particles and provides isotopic resolution for pions and other light charged particles across a wide range of energy losses and momenta. The details of the SπRIT TPC are presented, along with discussion of the TPC performance based on cosmic rays and charged particles emitted in heavy ion collisions.
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Many neutron star properties, such as the proton fraction, reflect the symmetry energy contributions to the equation of state that dominate when neutron and proton densities differ strongly. To constrain these contributions at suprasaturation densities, we measure the spectra of charged pions produced by colliding rare isotope tin (Sn) beams with isotopically enriched Sn targets. Using ratios of the charged pion spectra measured at high transverse momenta, we deduce the slope of the symmetry energy to be 42
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Urothelial carcinoma (UC) is the predominant form of bladder cancer. Significant molecular heterogeneity caused by diverse molecular alterations brings about large variations in the response to treatment in UC. An improved understanding of the genetic mechanisms underlying the development and progression of UC is essential. Through deep analysis of next-generation sequencing data of 99 UC patients, we found that 18% of cases had recurrent somatic mutations in zinc finger protein gene zinc finger protein 83 (ZNF83). ZNF83 mutations were correlated with poor prognosis of UC. We also found a hotspot mutation, p.E293V, in the evolutionarily well-conserved region of ZNF83. ZNF83-E293V increased tumor growth and reduced the apoptosis of UC cells compared to wild-type ZNF83 both in vitro and in mice xenografted tumors. ZNF83-E293V activated nuclear factor κB (NF-κB) more potently than did the wild-type protein owing to its decreased transcriptional repression for S100A8. The NF-κB inhibitors could pharmacologically block the tumor growth in mice engrafted with ZNF83-E293V-transfected UC cells. These findings provide a mechanistic insight and a potential therapeutic strategy for UC, which established a foundation for using the ZNF83-E293V mutation as a predictive biomarker of therapeutic response from NF-κB inhibitors.
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Alelos , Calgranulina A/genética , Factores de Transcripción de Tipo Kruppel/genética , Mutación , FN-kappa B/metabolismo , Neoplasias de la Vejiga Urinaria/genética , Neoplasias de la Vejiga Urinaria/metabolismo , Biomarcadores de Tumor , Calgranulina A/metabolismo , Línea Celular Tumoral , Progresión de la Enfermedad , Regulación Neoplásica de la Expresión Génica , Humanos , Pronóstico , Transducción de Señal , Neoplasias de la Vejiga Urinaria/patologíaRESUMEN
Autotaxin (ATX) is a secreted enzyme that hydrolyzes lysophosphatidylcholine (LPC) to lysophosphatidic acid (LPA) and choline. ATX has been implicated in multiple chronic inflammatory diseases, but little is known about its role in the development of inflammatory bowel disease (IBD). Here, we investigated how ATX contributed to intestinal inflammation during colitis. We found that ATX expression levels were upregulated in the intestines of ulcerative colitis (UC) patients in acute state as well as in the intestines of dextran sulfate sodium (DSS)-induced colitis mice, which is likely due to increased infiltration of inflammatory cells including macrophages. Intriguingly, the inhibition of ATX activity led to reduced production of inflammatory cytokines, as well as attenuated colitis. These findings suggest that ATX may display strong pro-inflammatory properties. Supporting this, treatment with recombinant mouse ATX (rmATX) increased the production of inflammatory cytokines and enzymes in mouse macrophage cell line RAW264.7 and bone marrow-derived macrophages (BMDM), whereas silencing ATX by siRNA reduced LPS-stimulated production of pro-inflammatory factors. Notably, we found that the levels of LPA2 (an LPA receptor) were dramatically upregulated in rmATX-treated RAW264.7 cells and DSS-treated mice. Gene silencing of lpa2 in RAW264.7 cells by siRNA led to reduced production of inflammatory cytokines. Moreover, adenovirus-mediated delivery of lpa2 short hairpin RNA into DSS-treated mice ameliorated colitis. Collectively, our research suggests that ATX may exacerbate DSS-induced colitis by activating LPA2 receptor in macrophages and represent a promising target for the treatment of IBD. KEY MESSAGES: Increased ATX expression and secretion in colitic colons are likely due to increased infiltration of inflammatory cells including macrophages. Recombinant ATX promotes, but ATX silencing inhibits, the production of inflammatory cytokines in LPS-stimulated RAW264.7 cells and BMDM. â¢LPA2 mediates the pro-inflammatory effects of ATX on macrophages. Inhibition of ATX and downregulation of LPA2 ameliorate DSS-induced colitis.
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Colitis/etiología , Colitis/metabolismo , Macrófagos/inmunología , Macrófagos/metabolismo , Hidrolasas Diéster Fosfóricas/metabolismo , Receptores del Ácido Lisofosfatídico/agonistas , Animales , Colitis/patología , Citocinas/metabolismo , Sulfato de Dextran/efectos adversos , Modelos Animales de Enfermedad , Susceptibilidad a Enfermedades , Mediadores de Inflamación/metabolismo , Ratones , Hidrolasas Diéster Fosfóricas/genética , Células RAW 264.7RESUMEN
BACKGROUND: Survivors of critical coronavirus disease 2019 (COVID-19) suffer from severe physical functional disability. Recent reports from several countries suggest that rehabilitative intervention is needed to improve physical functional decline in the challenging situation of COVID-19. CASE REPORT: A 58-year-old woman, previously without gait difficulty, was diagnosed with COVID-19 requiring endotracheal intubation and mechanical ventilation. She also developed stress-induced cardiomyopathy. After management in intensive care unit for 15 days, she could not sit on a bed without back support. After receiving short-term inpatient rehabilitation therapy, lower limb muscle strength, balance function, and gait speed had rapidly and significantly improved at the time of hospital discharge and at 1-month follow-up. CLINICAL REHABILITATION IMPACT: As COVID-19 tends to progress rapidly in the acute phase, early rehabilitation is necessary, despite challenges to its implementation. Feasible inpatient rehabilitation for patients with critical COVID-19 will pave the way to improve physical functional disability.
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COVID-19/epidemiología , Cuidados Críticos/métodos , Enfermedad Crítica/rehabilitación , Unidades de Cuidados Intensivos , COVID-19/rehabilitación , Comorbilidad , Enfermedad Crítica/epidemiología , Femenino , Humanos , Persona de Mediana Edad , Pandemias , SARS-CoV-2RESUMEN
ABSTRACT: Schizophrenia is a common disease characterized by thinking obstructions and accompanied by cognitive, emotional and behavioral disorders. Under the control of psychiatric symptoms, patients with schizophrenia may self-injure or impulsively wound others, resulting in public risk and increase in the burden of family and society. In recent years, many studies have shown that the violent behavior of patients with schizophrenia is related to genetic factors. This article reviews the research progress on the relationship between genetic polymorphism and violent behavior of patients with schizophrenia, analyzes the possible mechanism of the correlation between the two, puts forward the limitations of current research and the directions of future research, and provides scientific basis for risk assessment and prevention of violent behavior of patients with schizophrenia.
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Polimorfismo Genético , Esquizofrenia , Psicología del Esquizofrénico , Violencia , Agresión , Humanos , Medición de Riesgo , Esquizofrenia/genéticaRESUMEN
Transverse single-spin asymmetries of very forward neutral pions generated in polarized p+p collisions allow us to understand the production mechanism in terms of perturbative and nonperturbative strong interactions. During 2017, the RHICf Collaboration installed an electromagnetic calorimeter in the zero-degree region of the STAR detector at the Relativistic Heavy Ion Collider (RHIC) and measured neutral pions produced at pseudorapidity larger than 6 in polarized p+p collisions at sqrt[s]=510 GeV. The large nonzero asymmetries increasing both in longitudinal momentum fraction x_{F} and transverse momentum p_{T} have been observed at low transverse momentum p_{T}<1 GeV/c for the first time, at this collision energy. The asymmetries show an approximate x_{F} scaling in the p_{T} region where nonperturbative processes are expected to dominate. A non-negligible contribution from soft processes may be necessary to explain the nonzero neutral pion asymmetries.
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A broad range of fungi has been detected in molecular surveys of the oral mycobiome. However, knowledge is still lacking on interindividual variability of these communities and the ecologic and clinical significance of oral fungal commensals. In this cross-sectional study, we use internal transcribed spacer 1 amplicon sequencing to evaluate the salivary mycobiome in 59 subjects, 36 of whom were scheduled to receive cancer chemotherapy. Analysis of the broad population structure of fungal communities in the whole cohort identified 2 well-demarcated genus-level community types (mycotypes), with Candida and Malassezia as the main taxa driving cluster partitioning. The Candida mycotype had lower diversity than the Malassezia mycotype and was positively correlated with cancer and steroid use in these subjects, smoking, caries, utilizing a removable prosthesis, and plaque index. Mycotypes were also associated with metabolically distinct bacteria indicative of divergent oral environments, with aciduric species enriched in the Candida mycotype and inflammophilic bacteria increased in the Malassezia mycotype. Similar to their fungal counterparts, coexisting bacterial communities associated with the Candida mycotype showed lower diversity than those associated with the Malassezia mycotype, suggesting that common environmental pressures affected bacteria and fungi. Mycotypes were also seen in an independent cohort of 24 subjects, in which cultivation revealed Malassezia as viable oral mycobiome members, although the low-abundance Malassezia sympodialis was the only Malassezia species recovered. There was a high degree of concordance between the molecular detection and cultivability of Candida, while cultivation showed low sensitivity for detection of the Malassezia mycotype. Overall, our work provides insights into the oral mycobiome landscape, revealing 2 community classes with apparently distinct ecologic constraints and specific associations with coexisting bacteria and clinical parameters. The utility of mycotypes as biomarkers for oral diseases warrants further study.
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Micobioma , Adulto , Anciano , Bacterias , Estudios Transversales , Femenino , Hongos , Humanos , Malassezia , Masculino , Persona de Mediana Edad , Micobioma/genéticaRESUMEN
OBJECTIVES: The aim was to investigate the activity of ceftazidime/avibactam (CAZ/AVI) against carbapenem-resistant Klebsiella pneumoniae (CRKP) and identify the resistance mechanisms before CAZ/AVI coming to Chinese market. METHODS: Clinical CRKP isolates were continuously collected from 36 tertiary hospitals in China from 1 March 2017 to 31 July 2017. CAZ/AVI MICs were determined by agar dilution method. CAZ/AVI resistant isolates were submitted to whole genome sequencing. The copy number and relative expression of blaKPC were determined by quantitative PCR. RESULTS: A total of 872 CRKP isolates were collected, and MIC50 and MIC90 of CAZ/AVI were 4 and 8 mg/L. The resistant rate of CAZ/AVI was 3.7% (32/872). Among the resistant isolates, 53.1% (17/32) were metallo-ß-lactamase-producing K. pneumoniae (MBL-KP), 40.6% (13/32) were Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae (KPC-KP) and 6.3% (2/32) produced both MBL and KPC. One of the KPC-KP with high level CAZ/AVI resistance (>128 mg/L) harboured mutated blaKPC-2 (D179Y). In 12 wild-type blaKPC-2 isolates, the relative copy number and expression of blaKPC-2 gene were 2.5-fold and 2.7-fold higher than that in the CAZ/AVI MIC ≤0.5 mg/L group (p < 0.05), and when added avibactam at a fixed concentration of 8 mg/L, 91.7% (11/12) isolates could restore susceptibility. CONCLUSIONS: Resistance against CAZ/AVI in CRKP emerged before clinical use of CAZ/AVI in China, although most of the CRKP isolates maintained the susceptibility. MBL production, blaKPC-2 point mutation and high KPC expression played an important role in CAZ/AVI resistance.
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Antibacterianos/farmacología , Compuestos de Azabiciclo/farmacología , Carbapenémicos/farmacología , Ceftazidima/farmacología , Farmacorresistencia Bacteriana Múltiple/genética , Klebsiella pneumoniae/efectos de los fármacos , Klebsiella pneumoniae/genética , Proteínas Bacterianas/genética , China , Combinación de Medicamentos , Humanos , Infecciones por Klebsiella/microbiología , Klebsiella pneumoniae/enzimología , Pruebas de Sensibilidad Microbiana , Mutación Puntual , Centros de Atención Terciaria/estadística & datos numéricos , Secuenciación Completa del Genoma , beta-Lactamasas/genéticaRESUMEN
BACKGROUND: This study examined the prevalence of somatization disorder in Urological Chronic Pelvic Pain Syndrome (UCPPS) and the utility of two self-report symptom screening tools for assessment of somatization in patients with UCPPS. METHODS: The study sample included 65 patients with UCPPS who enrolled in the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Study at Washington University. Patients completed the PolySymptomatic PolySyndromic Questionnaire (PSPS-Q) (n = 64) and the Patient Health Questionnaire-15 Somatic Symptom Severity Scale (PHQ-15) (n = 50). Review of patient medical records found that only 47% (n = 30) contained sufficient documentation to assess Perley-Guze criteria for somatization disorder. RESULTS: Few (only 6.5%) of the UCPPS sample met Perley-Guze criteria for definite somatization disorder. Perley-Guze somatization disorder was predicted by definite PSPS-Q somatization with at least 75% sensitivity and specificity. Perley-Guze somatization disorder was predicted by severe (> 15) PHQ-15 threshold that had > 90% sensitivity and specificity but was met by only 16% of patients. The moderate (> 10) PHQ-15 threshold had higher sensitivity (100%) but lower specificity (52%) and was met by 52% of the sample. CONCLUSIONS: The PHQ-15 is brief, but it measures symptoms constituting only one dimension of somatization. The PSPS-Q uniquely captures two conceptual dimensions inherent in the definition of somatization disorder, both number of symptoms and symptom distribution across multiple organ systems, with relevance for UCPPS as a syndrome that is not just a collection of urological symptoms but a broader syndrome with symptoms extending beyond the urological system.