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In recent years, with the change of natural and social factors, such as climate warming, urbanization, land reclamation, human population growth, change of life customs, and convenient transportation, the human infectious diseases transmitted by insect vectors, well known as insect-borne infectious diseases, has increased significantly, causing a serious threat to public health. This paper focuses on the epidemiology, clinical characteristics, especially laboratory diagnosis of insect-borne infectious diseases, and emphasizes that medical institutions should pay attention to the rapid and accurate laboratory diagnosis of insect-borne infectious diseases. Metagenomic next generation sequencing has potential value in the diagnosis of insect-borne infectious diseases with unknown causes.
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Stenotrophomonas species are non-fermentative Gram-negative bacteria that are widely distributed in environment and are highly resistant to numerous antibiotics. Thus, Stenotrophomonas serves as a reservoir of genes encoding antimicrobial resistance (AMR). The detection rate of Stenotrophomonas is rapidly increasing alongside their strengthening intrinsic ability to tolerate a variety of clinical antibiotics. This review illustrated the current genomics advances of antibiotic resistant Stenotrophomonas, highlighting the importance of precise identification and sequence editing. In addition, AMR diversity and transferability have been assessed by the developed bioinformatics tools. However, the working models of AMR in Stenotrophomonas are cryptic and urgently required to be determined. Comparative genomics is envisioned to facilitate the prevention and control of AMR, as well as to gain insights into bacterial adaptability and drug development.
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Stenotrophomonas/genética , Farmacorresistencia Bacteriana/genética , Antibacterianos/farmacología , Bacterias Gramnegativas , Genómica , Pruebas de Sensibilidad MicrobianaRESUMEN
Objective:To investigate the predictive value of the National Institutes of Health Stroke Scale (NIHSS) score at baseline and 24 h after the onset for the outcomes after endovascular mechanical thrombectomy (EMT) in patients with acute ischemic stroke.Methods:Patients with anterior circulation large vessel occlusive acute ischemic stroke received EMT in the Affiliated Hospital of Qingdao University from July 2018 to June 2020 were enrolled prospectively. According to the modified Rankin Scale scores at 3 months after the onset, they were divided into good outcome group (0-2) and poor outcome group (3-6). The demographic and clinical data between the groups were compared. Multivariate logistic regression analysis was used to determine the independent influencing factors of clinical outcomes. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of the independent influencing factors for outcomes. Results:A total of 124 patients were included. Their age was 65.23±12.40 years, 80 were males (64.5%). The baseline NIHSS score was 15 (interquartile range, 11-19). Seventy-two patients (58.1%) had a good outcome and 52 (41.9%) had a poor outcome. Univariate analysis showed that there were significant differences in age, degree of vascular recanalization, baseline and 24 h NIHSS score after onset, and whether having intracranial hemorrhage or not between the good outcome group and the poor outcome group ( P<0.05). Multivariate logistic regression analysis showed that there was a significant independent correlation between the NIHSS score at 24 h after onset and the poor outcome (odds ratio [ OR] 1.243, 95% confidence interval [ CI] 1.125-1.373; P<0.001). ROC curve analysis showed that the area under the curve of poor outcome predicted by baseline NIHSS score was 0.639 (95% CI 0.542-0.737), and the predictive sensitivity and specificity were 80.8% and 45.8% respectively. The area under the curve of poor outcome predicted by NIHSS score at 24 h after onset was 0.830 (95% CI 0.759-0.902), and the predictive sensitivity and specificity were 94.2% and 65.3% respectively. Conclusion:In patients with anterior circulation large vessel occlusive acute ischemic stroke receiving EMT, the NIHSS score at 24 h after onset has higher predictive value for poor outcomes at 3 months after onset, and is significantly better than the baseline NIHSS score.
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Objective@#To analyze the distribution of uncorrected visual acuity in children and adolescents aged 3-18 years with relative safe refractive range, and to develop the growth curve and reference range of uncorrected visual acuity in children and adolescents of different ages, so as to provide reference for formulating the referral threshold for myopia screening practice.@*Methods@#Using cluster sampling method, 9 146 children and adolescents aged 3-18 years old in Shanghai were selected for uncorrected visual acuity, cycloplegic refraction, slit lamp and other ophthalmic examinations, and the percentiles and growth curve of uncorrected visual acuity of children and adolescents in the relative safe refractive range were fitted by LMS method. Besides, the area under the ROC curve and the sensitivity and specificity of different cut-off values were analyzed.@*Results@#The uncorrected visual acuity was skewed, with a median of 4.8. There were 4 675 individuals with safe refraction, the median of uncorrected visual acuity in which was 4.9. The LMS curve showed that the uncorrected visual acuity increased with age in the lower age group, and gradually stabilized to the best level at the age of 6-10. P 50 was 4.8 in 3-4 years old, 4.9 in 5-8 years old, 5.0 in 9 years old and above. The area under ROC curve of uncorrected visual acuity predicting refractive abnormality increased with age, with the lowest value of 0.55(95%CI=0.50-0.61) at 3 years old and the highest value of 0.95 (95%CI=0.94-0.96) at 12-18 years old. The Youden index was the highest for P25 at 3-6 years old, and the highest for P 10 at 7 years old and above. With the increase of the cut off value, the sensitivity increased and the specificity decreased.@*Conclusion@#The uncorrected visual acuity increases gradually with age, and reaches the best level after 6-10 years old. The screening effect of uncorrected visual acuity predicting refractive abnormality increased with age. It is suggested that the referral threshold of children and adolescents with abnormal uncorrected visual acuity should be set according to their ages, and P 25-P 75 can be selected according to the screening purposes.
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Objective:To develop the discrimination experience questionnaire for HIV/acquired immunodeficiency syndrome(AIDS) patients and test the reliability and validity of the questionnaire.Methods:Based on the literature review and semi-structured interviews to clarify the operational definition of discrimination for HIV/AIDS and develop the item pool. The questionnaire was developed though 2 rounds Delphi consultation and a pilot test. A total of 410 HIV/AIDS patients in Shanghai Public Health Clinical Center of Fudan University from June to December 2020 were selected to investigate the questionnaire, item analysis was used to screen items. SPSS 22.0 software was used for reliability test and exploratory factor analysis, the AMOS 21.0 software was used for confirmatory factor analysis to test the reliability and validity of the questionnaire.Results:The questionnaire consisted 2 dimensions(external discrimination and internal discrimination) and 10 items. Exploratory factor analysis showed that two common factors were extracted from the frequency of discrimination and the degree of negative psychological impact of discrimination experience on patients, and the cumulative variance contribution rates were 48.367% and 55.403%, respectively. The confirmatory factor analysis on the frequency of discrimination showed that Chi square degree of freedom ratio ( χ2/ df) was 2.831, P<0.05, root mean square of approximation error (RMSEA) was 0.093, goodness of fit index (GFI) was 0.928, comparative fit index (CFI) was 0.925, incremental fit index (IFI) was 0.926; the confirmatory factor analysis on the negative psychological impact of discrimination experience on patients showed that χ2/ df was 1.740, P<0.05; RMSEA was 0.076, GFI was 0.925, CFI was 0.936, IFI was 0.938. The content validity of the questionnaire was 0.9. The Cronbach α coefficientof questionnaire was 0.811, and the test-retest coefficient was 0.862 ( P<0.01). Conclusions:The discrimination experience questionnaire for HIV/AIDS patients has good reliability and validity, and it can be used to measure the discrimination for HIV/AIDS patients.
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Objective To explore the clinical effect of different thoracoscopic operation modes in the treatment of early lung cancer.Methods One hundred and twenty cases of early lung cancer surgery were selected as the research subjects and divided into 38 cases of thoracoscopic assisted small incision lobectomy group (group A),42 cases of thoracoscopic lobectomy (group B) and 40 cases of thoracoscopic lung segment resection (group C).Then the perioperative indicators,lung function recovery,complications occurrence rate and prognosis were compared among 3 groups.Results The perioperative indicators in the group B and C were decreased compared with the group A (P<0.05),the postoperative pleural drainage amount in the group C was lower than that in the group B (P<0.05).The postoperative lung function indexes in the group A were lower than those in the group B and C (P< 0.05),while the lung function indicators in the group C were higher than those in the group B (P<0.05).The incidence rate of postoperative complications in the group B and C was lower than that in the group A,the difference was statistically significant (P<0.05);the median follow up period in the three groups was 15 months(12-18 months).No recurrence or metastasis was found.Conclusion For the treatment of early lung cancer,the thoracoscopic lung segment resection can reduce postoperative pleural effusion and better protect pulmonary function,moreover the survival and prognosis have no obvious difference and its clinical curative effect is worth to be affirmed.
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Objective To investigate the influence of proline-rich tyrosine kinase 2 (Pyk2)gene RNA interference on proliferation,invasion and migration of Hep3B hepatocellular carcinoma cells.Methods The Pyk2 gene RNA interference vector was transfected in Hep3B hepatocellular carcinoma cells by lipofectamine. The Hep3B cells divided into three groups:siRNA group (the vector with Pyk2 RNAi gene was transfected), negative control group (the vector without Pyk2 RNAi gene was transfected),and blank control group (no vectors was transfected).Pyk2 mRNA and protein were detected using reverse transcription reverse transcription-poly-merase chain reaction (RT-PCR)and Western blotting.The biological behavior including cell proliferation,inva-sion and migration were detected by 3-(4,5-dimethyl-2-thiazoly)-2,5-diphenyl-2H-tetrazolium bromide (MTT), transwell and wound healing assay,respectively.Results The expression of Pyk2 mRNA of Hep3B cell line in siRNA group (0.1 6 ±0.03)was significantly decreased than those in negative group (0.74 ±0.1 3)and blank control group (0.77 ±0.1 6),with statistically significant differences (t=51 .46,P=0.000;t=53.21 ,P=0.000).The expression of Pyk2 protein of Hep3B cell line in siRNA group (0.24 ±0.06)was significantly decreased than those in negative group (0.83 ±0.05)and blank control group (0.91 ±0.06),with statisti-cally significant differences (t=57.29,P=0.000;t=68.53,P=0.000).The cell proliferation inhibition rate at 48 hours in siRNA group (26.1 7%±0.28%)was significantly raised than those in negative group (9.28%± 0.22%)and blank control group (6.47%±0.31%),with statistically significant differences (t=31 .45,P=0.004;t=34.64,P=0.002).The number of transmembrane cells in siRNA group (32.5 ±8.5)/1 0 HP was significantly declined than those in negative group (98.4 ±1 2.3 )/1 0 HP and blank control group (1 1 2.6 ± 1 1 .3)/1 0 HP,with statistically significant differences (t=95.64,P=0.000;t=1 05.1 7,P=0.000).The wound healing assay in siRNA group (28.1 7%±1 .46%)was significantly lower than those in negative group (77.38%±2.24%)and blank control group (79.41%±3.1 7%),with statistically significant (t=85.86,P=0.000;t=89.37,P=0.000).Conclusion Pyk2 gene involves the proliferation,invasion and migration of Hep3B cells,which has close correction with development and metastasis of hepatocellular carcinoma.Pyk2 gene is very helpful to become a molecular target for the diagnosis and treatment of hepatocellular carcinoma.