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2.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(0): E082, 2020 Nov 16.
Artigo em Chinês | MEDLINE | ID: mdl-33197990

RESUMO

As the approaching of autumn and winter in northern hemisphere, COVID-19, mainly transmitted through respiratory tract, has posed new challenge to the countries across the world. This paper summarizes the current status of COVID-19 pandemic and related responses performed in terms of the variation of SARS-CoV-2, global situation reports, herd immunity and the influence of asymptomatic infection on COVID-19 prevention and control in China, as well as vaccine development progress and case treatment for the purpose of providing reference to further improve the COVID-19 prevention and control strategy in China.

3.
Nature ; 587(7832): 63-65, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33149293

RESUMO

Fast radio bursts (FRBs) are millisecond-duration radio transients of unknown physical origin observed at extragalactic distances1-3. It has long been speculated that magnetars are the engine powering repeating bursts from FRB sources4-13, but no convincing evidence has been collected so far14. Recently, the Galactic magnetar SRG 1935+2154 entered an active phase by emitting intense soft γ-ray bursts15. One FRB-like event with two peaks (FRB 200428) and a luminosity slightly lower than the faintest extragalactic FRBs was detected from the source, in association with a soft γ-ray/hard-X-ray flare18-21. Here we report an eight-hour targeted radio observational campaign comprising four sessions and assisted by multi-wavelength (optical and hard-X-ray) data. During the third session, 29 soft-γ-ray repeater (SGR) bursts were detected in γ-ray energies. Throughout the observing period, we detected no single dispersed pulsed emission coincident with the arrivals of SGR bursts, but unfortunately we were not observing when the FRB was detected. The non-detection places a fluence upper limit that is eight orders of magnitude lower than the fluence of FRB 200428. Our results suggest that FRB-SGR burst associations are rare. FRBs may be highly relativistic and geometrically beamed, or FRB-like events associated with SGR bursts may have narrow spectra and characteristic frequencies outside the observed band. It is also possible that the physical conditions required to achieve coherent radiation in SGR bursts are difficult to satisfy, and that only under extreme conditions could an FRB be associated with an SGR burst.

4.
Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi ; 38(10): 721-725, 2020 Oct 20.
Artigo em Chinês | MEDLINE | ID: mdl-33142371

RESUMO

Objective: To study the effect of p38 mitogen-activated protein kinase (MAPK) gene silencing on expression of apoptotic genes and oncogenes in hepatocytes treated with PM(2.5). Methods: From June to September 2019, according to the p38MAPK gene mRNA sequence provided by GenBank, three interfering sequences were designed and synthesized, ligated into PLVX-shRNA2-puro after annealing, and the recombinant lentiviral vector was transfected into L02 hepatocytes. The p38MAPK silencing cells were identified by real-time fluorescent quantitative PCR and western blotting. The normal L02 cells and p38MAPK silencing cells were treated with 50 µg/mL PM(2.5) water soluble solution, 10 µmol/L positive control Cr(6+), and a blank control group was set up, the treatment time was 24 h. The mRNA levels of oncogenes (c-fos, c-myc, k-ras) , tumor suppressor gene (p53) and apoptotic genes (Caspase-3, Caspase-8, Caspase-9) were detected by real-time PCR. The protein levels of oncogenes and apoptotic genes were detected by Western blotting. Results: The expression levels of p38MAPK mRNA and protein in p38MAPK gene silencing cells were significantly lower than those in L02 hepatocytes (P<0.05) , and the p38MAPK gene silencing cell line was successfully constructed. Compared with the blank control group, the expression levels of the oncogenes c-fos, c-myc, k-ras and the apoptosis genes Caspase-3, Caspase-8 and Caspase-9 increased, the expression level of tumor suppressor gene p53 decreased in the L02 hepatocyte group treated with PM(2.5) water soluble matter, and the differences were statistically significant (P<0.05) . Compared with the L02 hepatocytes group treated with PM(2.5) water soluble matter, the expression levels of the oncogenes c-fos, c-myc, k-ras and apoptosis genes Caspase-3, Caspase-8 and Caspase-9 decreased, the expression level of tumor suppressor gene p53 increased in the p38MAPK gene silencing cells group treated with PM(2.5) water soluble matter, and the differences were statistically significant (P<0.05) . Conclusion: PM(2.5) has effects on the expression of oncogenes, tumor suppressor genes and apoptotic genes in L02 hepatocytes, while p38MAPK gene silencing can inhibit the effects of PM(2.5) on L02 hepatocytes.


Assuntos
Hepatócitos , Oncogenes , Apoptose , Inativação Gênica , Humanos , Material Particulado
6.
Artigo em Chinês | MEDLINE | ID: mdl-33036525

RESUMO

Objective: To study the effects on learning and memory, mitochondrial energy metabolism and ATPase activity of hippocampus in mice with subacute exposure to n-hexane. Methods: The SPF 40 Kunming mice were randomly divided into low, middle and high dose groups and control groups according to different dosages. Each group consisted of 10 mice. The mice were given n-hexane by gavage, the mice in the low, middle and high dose groups were given 0.2 ml/d of n-hexane at concentrations of 500, 1000 and 2000 mg/kg respectively, while the mice in the control group were given 0.2 ml/d of cooking oil once a day for 28 days. The y-type maze test, the activity of ATP Enzyme, mitochondrial respiratory chain enzyme complex Ⅰ-IV, the mrna of mitochondrial fusion gene (MFn1, Mfn2) and fission gene (FIs1) in brain tissues were performed. Results: Except for the wrong reaction times of low-dose exposure group in the first test, there existed significantly different in the first and second Y-maze tests in exposure groups and control group (P<0.05) ; in low, middle and high-dose group, the Na(+)-K(+)-ATPase activities were (8.27±2.65) , (5.38±1.55) , (3.55±1.69) µmol/gprot/h, and Ca(2+)-Mg(2+)-ATPase activities were (10.32±2.96) , (7.19±1.94) and (4.49±1.33) µmol/gprot/h, respectively. Compared with those in control group, the activities of Na(+)-K(+)-ATPase and Ca(2+)-Mg(2+)-ATPase decreased significantly in middle-dose group and high-dose group (P<0.05) . Compared with those in control group, the activities of mitochondrial respiratory chain enzyme complex I-IV in each dose group were significantly decreased (P<0.05) . The expressions of Mfn1mRNA and Mfn2mRNA in each dose group was significantly lower than those in control group (P<0.05) . Conclusion: Subacute exposure to n-hexane can result in the decrease of activities of mitochondrial respiratory chain enzyme complex in hippocampus of mice, which may lead to the disorder of mitochondrial energy metabolism by the decrease of ATPase activity and the imbalance of mitochondrial fusion-division, which must be one of the mechanisms of impairment of learning and memory of mice induced by n-hexane.


Assuntos
Hipocampo , Memória , Animais , Metabolismo Energético , Hexanos , Camundongos
7.
Artigo em Chinês | MEDLINE | ID: mdl-33036527

RESUMO

Objective: To construct the c-myc gene silenced hepatocytes, study the effect of c-myc gene silence on expression of oncogenes and apoptosis genes in hepatocytes treated with PM2.5. Methods: According to the c-myc gene mRNA sequence provided by GenBank, three interfering sequences were designed and synthesized, the recombinant lentiviral vector was transfected into L02 hepatocytes. The real-time quantitative PCR and western blotting were used to identify the effect of c-myc gene silencing. L02 cells and c-myc gene silenced cells were used as experimental subjects. The normal L02 cells and c-myc silenced cells were treated with 50 µg/ml PM(2.5) water soluble solution, 10 µM positive control Cr(6+) and a blank control, the treatment period was 24 h. The mRNA levels of oncogenes (c-myc, c-fos, k-ras, p53) and apoptotic genes (Caspase-3, Caspase-8, Caspase-9) were detected by real-time PCR. The protein levels of oncogenes and apoptotic genes were detected by western blotting. Results: The mRNA level and protein level of c-myc decreased by 81% and 70% in c-myc silenced cells when compared with the normal L02 hepatocytes, the above results indicate that c-myc gene silenced cells were successfully constructed. After c-myc silenced cells were treated with PM2.5 water soluble solution, The mRNA levels of c-myc, c-fos, and k-ras decreased by 84.1%, 45.4%, and 54.6% (P<0.05) , p53 increased by 192.9% (P<0.05) , and the expression of Caspase-3, Caspase-8, and Caspase-9 decreased by 24.4%, 36.1%, 60.9% (P<0.05) . In the Cr(6+) positive control group, the expression of c-myc, c-fos, and k-ras decreased by 72.1%, 82.2%, and 54.0% (P<0.05) , p53 increased by 250.0% (P<0.05) , the expression of Caspase-3, Caspase-8, and Caspase-9 decreased by 34.6%, 36.0%, 68.9% (P<0.05) , respectively, when compared with the normal L02 hepatocytes (P<0.05) . Western blotting results showed that the protein levels of c-myc and c-fos increased, p53 decreased after PM(2.5) exposure; the protein levels of Caspase-3, Caspase-8, Caspase-9 increased after PM(2.5) exposure (P<0.05) . When in comparison with the c-myc silenced group, the protein levels of c-myc and c-fos decreased, p53 protein increased in PM(2).5 exposed group (P<0.05) . Conclusion: c-myc gene silenced cells were successfully constructed in this paper. PM(2.5) could promote the expression of oncogenes and apoptotic genes in L02 cells, and c-myc gene silencing can inhibit the expression of oncogenes and apoptotic genes after PM(2.5) treatment in L02 cells.


Assuntos
Genes myc , Oncogenes , Apoptose , Genes myc/genética , Hepatócitos , Humanos , Proteínas Proto-Oncogênicas c-fos
8.
Zhonghua Zhong Liu Za Zhi ; 42(10): 798-806, 2020 Oct 23.
Artigo em Chinês | MEDLINE | ID: mdl-33113620

RESUMO

Human epidermal growth factor receptor-2 (HER-2) tyrosine kinase inhibitors (TKI) is the targeted drug of HER-2-positive breast cancer. Lapatinib, pyrotinib and neratinib, as ErbB family TKIs, have been approved by National Medical Products Administration and applied in the treatment of HER-2 positive breast cancer in China. The most common adverse effects (AEs) of TKI agents include diarrhea, drug-induced liver injury (DILI), nausea, vomiting, skin toxicity, cardiotoxicity and oral mucositis. The Breast Cancer Expert Group of Chinese Society of Clinical Oncology (CSCO) summarized the incidence and characteristics of AEs of TKI, evaluated the manifestations and severity of AEs, and formulated the consensus of the management of common AEs based on the clinical experiences and updated advances from domestic and abroad studies. This consensus aims to provide the practical strategy for clinicians in the management of ErbB-family TKI-related AEs in China, and eventually enhance the patients' compliance and improve the therapeutic efficacy.

9.
Nature ; 586(7831): 693-696, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33116290

RESUMO

Fast radio bursts (FRBs) are millisecond-duration radio transients1,2 of unknown origin. Two possible mechanisms that could generate extremely coherent emission from FRBs invoke neutron star magnetospheres3-5 or relativistic shocks far from the central energy source6-8. Detailed polarization observations may help us to understand the emission mechanism. However, the available FRB polarization data have been perplexing, because they show a host of polarimetric properties, including either a constant polarization angle during each burst for some repeaters9,10 or variable polarization angles in some other apparently one-off events11,12. Here we report observations of 15 bursts from FRB 180301 and find various polarization angle swings in seven of them. The diversity of the polarization angle features of these bursts is consistent with a magnetospheric origin of the radio emission, and disfavours the radiation models invoking relativistic shocks.

10.
Zootaxa ; 4802(3): zootaxa.4802.3.12, 2020 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-33056052

RESUMO

The extinct genus Scydmobisetia Jaloszynski Yamamoto comprises three species known from inclusions in the mid-Cretaceous Myanmar amber. Another species, Scydmobisetia dentipes Jaloszynski Bai sp. n. is described from the same source. The holotype is a male showing a unique sub-basal tooth-like projection on the profemur.


Assuntos
Besouros , Âmbar , Animais , Cor , Fósseis , Masculino
11.
Zhonghua Er Ke Za Zhi ; 58(11): 933-934, 2020 Nov 02.
Artigo em Chinês | MEDLINE | ID: mdl-33120467
12.
Zhonghua Nei Ke Za Zhi ; 59(11): 872-879, 2020 Nov 01.
Artigo em Chinês | MEDLINE | ID: mdl-33120491

RESUMO

Objective: To identify objective markers between the Parkinson variant of multiple system atrophy (MSA-P) and Parkinson's disease (PD). Methods: Retrospective analysis was performed on 10 patients with MSA-P, 15 patients with PD, and 15 healthy control group during the period from August 2016 to February 2019 in Baoshan Branch of Shanghai First People's Hospital.We combined the novel tract based spatial statistics (TBSS) and region of interest (ROI) analyses for the first time to investigate three groups with diffusion tensor imaging. By TBSS, we performed pairwise comparisons of mean diffusivity and fractional anisotropy (FA) maps. The clusters with significant differences between MSA-P and PD were used as ROIs for further analyses. Results: FA values in the left anterior thalamic radiation(ATR) (ROI values were 0.371(0.287-0.535), 0.472(0.390-0.594), 0.473(0.388-0.555); P values were 0.008, 0.008) and left superior longitudinal fasciculus (SLF)(ROI values were 0.397(0.291-0.469), 0.456(0.338-0.560), 0.473(0.427-0.530); P values were 0.013,<0.001) were significantly decreased in MSA-P compared with PD or controls, and significantly correlated with clinical data((r =-0.807, P =0.005),(r =-0.455, P =0.022)). Conclusion: Our findings indicate the abnormalities of left ATR and left SLF as specific biomarkers for differential diagnosis.

13.
Eur Rev Med Pharmacol Sci ; 24(19): 9965-9972, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33090401

RESUMO

OBJECTIVE: The study aimed to uncover the role of circ-PRMT5 in triggering the migratory ability of esophageal cancer by regulating microRNA-203 (miR-203) level. PATIENTS AND METHODS: Circ-PRMT5 levels in 56 matched esophageal cancer tissues and paracancerous ones were detected. The relationship between circ-PRMT5 level and clinical data of esophageal cancer patients was analyzed. Migratory abilities in TE-1 and OE33 cells influenced by circ-PRMT5 were evaluated by transwell and wound healing assay. Regulatory effect of circ-PRMT5 on miR-203 level, and the involvement of miR-203 in the development of esophageal cancer were determined through Dual-Luciferase reporter assay and rescue experiments. RESULTS: Circ-PRMT5 was upregulated in esophageal cancer tissues and cell lines. The expression level of circ-PRMT5 was positively correlated to the rates of lymphatic metastasis and distant metastasis of esophageal cancer. Knockdown of circ-PRMT5 attenuated migratory abilities in TE-1 and OE33 cells. MiR-203 was verified to be the target gene binding circ-PRMT5, with a negative correlation between each other. Notably, miR-203 was responsible for the regulatory effect of circ-PRMT5 on migratory ability in esophageal cancer. CONCLUSIONS: Circ-PRMT5 is positively correlated to the rates of lymphatic metastasis and distant metastasis of esophageal cancer. It promotes migratory ability in esophageal cancer by targeting miR-203.

14.
Epidemiol Infect ; 148: e239, 2020 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-32993819

RESUMO

Severe fever with thrombocytopenia syndrome (SFTS) is a disease with a high case-fatality rate that is caused by infection with the SFTS virus (SFTSV). Five electronic databases were systematically searched to identify relevant articles published from 1 January 2011 to 1 December 2019. The pooled rates with 95% confidence interval (CI) were calculated by a fixed-effect or random-effect model analysis. The results showed that 92 articles were included in this meta-analysis. For the confirmed SFTS cases, the case-fatality rate was 0.15 (95% CI 0.11, 0.18). Two hundred and ninety-six of 1384 SFTS patients indicated that they had been bitten by ticks and the biting rate was 0.21 (95% CI 0.16, 0.26). The overall pooled seroprevalence of SFTSV antibodies among the healthy population was 0.04 (95% CI 0.03, 0.05). For the overall seroprevalence of SFTSV in animals, the seroprevalence of SFTSV was 0.25 (95% CI 0.20, 0.29). The infection rate of SFTSV in ticks was 0.08 (95% CI 0.05, 0.11). In conclusion, ticks can serve as transmitting vectors of SFTSVs and reservoir hosts. Animals can be infected by tick bites, and as a reservoir host, SFTSV circulates continuously between animals and ticks in nature. Humans are infected by tick bites and direct contact with patient secretions.

15.
J Biol Regul Homeost Agents ; 34(4): 1269-1275, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32896113

RESUMO

To uncover the potential influence of microRNA-589 (miRNA-589) on cerebral ischemia-reperfusion injury (IRI) and the underlying mechanism, BV2 cells were stimulated by lipopolysaccharide (LPS) or conditioned medium (CM) of primary cortical neurons undergoing oxygen-glucose deprivation (OGD). Regulatory effects of miRNA-589 on the release of inflammatory factors in BV2 cells induced with LPS or CM of primary cortical neurons undergoing OGD were detected by quantitative real-time polymerase chain reaction (qRT-PCR) and enzyme-linked immunosorbent assay (ELISA). The interaction between miRNA-589 and TRAF6 was finally assessed by dual-luciferase reporter gene assay. MiRNA-589 was downregulated in BV2 cells induced with LPS or CM of primary cortical neurons undergoing OGD. Overexpression of miRNA-589 reduced the release of inflammatory factors in LPS or CM-induced BV2 cells. TRAF6 was verified to be the downstream gene of miRNA-589, and its level was negatively regulated by miRNA-589. MiRNA-589 is downregulated following cerebral IRI and alleviates inflammatory response through negatively regulating TRAF6.


Assuntos
Traumatismo por Reperfusão , Animais , Glucose , Camundongos , MicroRNAs/genética , Neurônios , Oxigênio , Traumatismo por Reperfusão/genética
16.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(9): 624-628, 2020 Sep 09.
Artigo em Chinês | MEDLINE | ID: mdl-32878396

RESUMO

Objective: To evaluate the altered brain volume of the patients with painful temporomandibular disorders (TMD) using voxel-based morphometry (VBM). Methods: One hundred forty-six TMD patients ï¼»age (36.8±15.8) years, male/female=44/102ï¼½ and 193 normal controls (NC) ï¼»age (43.3±15.6) years, male/female = 92/101ï¼½ were performed with 3 dimensional brain structural images at 3.0 T MR scanner from November 2011 to December 2019 in Department of Radiology, Hainan Hospital and General Hospital of Chinese PLA. The brain structural images were segmented into gray matter, white matter and cerebrospinal fluid, and the gray matter images were performed with two-samples t-test with total intracranial volume, age and gender as covariates. Results: The gray matter volume (GMV) presented significantly higher in TMD group ï¼»(632.4±65.4) mlï¼½ than that in NC group ï¼»(596.1±76.3) mlï¼½ (t=4.70, P<0.05). The brain regions with increased GMV for TMD located in left inferior temporal gyrus, bilateral fusiform gyrus, bilateral middle temporal gyrus and right lingual gyrus compared with NC. Conclusions: The temporal lobe was the targeting brain region for TMD patients with increased GMV, which should further be investigated to elucidate the neuromechanism.


Assuntos
Transtornos da Articulação Temporomandibular/diagnóstico por imagem , Substância Branca , Encéfalo , Substância Cinzenta/diagnóstico por imagem , Humanos , Imagem por Ressonância Magnética , Masculino
17.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(9): 639-646, 2020 Sep 09.
Artigo em Chinês | MEDLINE | ID: mdl-32878399

RESUMO

Objective: To compare the caries experience and the kinds of dental treatment between children with autism spectrum disorders (ASD) and children without systemic disease who were all treated under general anesthesia. Methods: Totally 103 children with ASD who received dental treatments under general anesthesia in 13 professional dental hospitals around China from April to November 2016 were included in the present study. A group of 97 children without systemic disease, according to the age, gender and application propensity score matching method, were chosen as controls, who received dental treatments under general anesthesia between January 2015 to November 2018 in the same hospitals as the children with ASD. Decay missing filling tooth (DMFT/dmft, DMFT for permanent teeth and dmft for primary teeth) indices of two groups of children and the contents of the dental treatments under general anesthesia were analyzed. Results: No significant difference of DMFT/dmft index ï¼»M (Q 25, Q 75)ï¼½ was found between children with ASD group ï¼»0 (0, 3)/11(8, 14)ï¼½ and control group ï¼»0 (0, 3)/9(7, 13)ï¼½ (P>0.05). The average number of dental treatments under general anesthesia and the average number of endodontic treatment in children with ASD were 13 (11, 15) and 3 (2, 6) teeth respectively, while those in the control group were 12 (9, 14) and 2 (1, 4) teeth respectively, the differences were statistically significant (P<0.01, P<0.05). Conclusions: No significant difference was found between children with ASD and the normal controls who receive dental treatments under general anesthesia in DMFT/dmft index, but the treatment needs of children with ASD is relatively higher, and their tooth decay is relatively severer.


Assuntos
Transtorno do Espectro Autista , Cárie Dentária , Anestesia Geral , Criança , China , Índice CPO , Assistência Odontológica , Humanos , Dente Decíduo
18.
Clin Exp Immunol ; 202(3): 300-307, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32757273

RESUMO

Food allergy is related to increasing risk of the development of allergic asthma, but the precise interplay between sensitization to different allergens in different compartments of the body is not fully understood. The aim of this study was to develop a novel humanized murine model of mixed food and respiratory allergy that recapitulates the human anaphylactic response and to more clearly understand the impact of food allergies on asthma. Immunodeficient mice transferred with peripheral blood mononuclear cells (PBMCs) from donors with peanut and house dust mite (HDM) allergy were exposed and challenged to peanut. Between peanut exposure and challenge, mice were intranasally treated to HDM. Allergic parameters were analyzed. Allergen-specific immunoglobulin (Ig)E in sera could only be measured in mice treated with peripheral blood mononuclear cells (PBMCs) plus allergen. A preceding peanut exposure increased IgE levels, histamine release, bronchial hyper-responsiveness and lung inflammation. Recruitment of inflammatory cells to the airways was aggravated associated with an enhanced T helper type 2 (Th2)/Th17 cytokine secretion when the two allergies were present. A preceding peanut exposure amplifies allergic asthma in this humanized model, which may contribute to the understanding of underlying immunological mechanism of polysensitization occurring in allergic individuals and evaluation of therapeutic interventions.

19.
Zhonghua Shao Shang Za Zhi ; 36(8): 751-753, 2020 Aug 20.
Artigo em Chinês | MEDLINE | ID: mdl-32829620

RESUMO

The maintenance of posture and anti-contracture treatment are the critical elements of comprehensive burn rehabilitation in the overall treatment period of pediatric burns. Although domestic experts in burn discipline have formulated guidelines for burn rehabilitation, the maintenance of posture and design and manufacture of splints for anti-scar contractures in children with burns are different from that for adults with burns in many ways. Starting with paying the attention to the rehabilitation problems in pediatric burns, especially considering the anatomical, psychological, and social behavior characteristics of children in developmental period, the author's team effectively applies splints to maximize the prevention of contractures in children and maintain and improve the range of their joint movements. The splints designed to prevent contractures in pediatric burns shall fit the small limb and meet their expected goals of rehabilitation. In each aspect of the production and use of splints, it is necessary to fully evaluate and consider the scar characteristics, growth and development status, activity level, and compliance of children, and adaptability and fixation methods of the splints, so as to select the appropriate splint type and formulate the wearing plan.


Assuntos
Queimaduras , Contenções , Criança , Cicatriz , Contratura , Extremidades , Humanos
20.
Zhonghua Er Ke Za Zhi ; 58(8): 640-645, 2020 Aug 02.
Artigo em Chinês | MEDLINE | ID: mdl-32842384

RESUMO

Objective: To explore the clinical features and treatment of carbapenem-resistant Enterobacteriaceae (CRE) infection in pediatric liver transplantation recipients and discuss the significance of CRE colonization by screening with rectal swabs. Methods: A total of 286 cases of pediatic liver transplantation recipients, who came from Tianjin First Central Hospital during August 1,2017 to August 1, 2018, were retrospectively investigated. The clinical characteristics, antibiotic susceptibity test, treatment outcomes and prognosis of CRE infection patients were analyzed. CRE colonization were screened by rectal swabs after liver transplantation. All cases were divided into CRE colonization group and non-CRE colonization group based on CRE colonization results. The high risk factors of CRE colonization and its relationship with CRE infection were investigated. χ(2) test was used for the comparison between groups.The single-factor analysis was used to screen risk factors. Results: The 286 cases included 132 male and 154 female cases. The age was (8±4) months.CRE infection rate after liver transplantation was 7.3% (21/286). The time of CRE infection was the 5(th) (1(th)-14(th)) days after transplantation. Abdominal infection was the most common (95.2%, 20/21), followed by bloodstream infection (12 cases) and pulmonary infection (8 cases). Infection in two or more sites accounted for 71.4% (15/21); 27 CRE strains, in which 24 strains were carbapenem-resistant Klebsiella pneumonia (88.9%), 2 strains were carbapenem-resistant Escherichia coli (7.4%) and one strain was carbapenem-resistant Enterobacter aerogenes (3.7%). The drug resistance rate of CRE strains to carbapenems, penicillin antibiotics, second-and third-generation cephalosporin was 100.0%. Medication treatment included meropenem+fosfomycin (13 cases) and meropenem+tegacycline (8 cases). The treatment was effective in 16 cases and the time was 19 (1-27) d. The 1-year survival rate among CRE infection group and non-CRE infection group were 71.4% (15/21) and 98.1% (260/265), respectively (χ(2)=37.460, P<0.01). CRE infection rate among CRE colonization group and non-CRE colonization group were 26.4% (19/72) and 0.9% (2/214), respectively (χ(2)=51.300, P<0.01). Factors before transplantation, including third-generation cephalosporin or carbapenems exposure, prolonged hospital stay within 3 months, CRE infection, and factors after transplantation, including emergency surgery, mechanical ventilation more than 24 hours (χ(2)=20.570, 6.411, 13.960, 14.600, 9.560, all P<0.01) were high risk factors for CRE colonization. Conclusions: The prognosis of CRE infection after pediatric liver transplantation is poor. Timely diagnosis and treatment are of great importance. Much attention should be paid on CRE rectal colonization and its risk factors. Screening of CRE colonization is important for early warning and control of CRE infection.


Assuntos
Antibacterianos/uso terapêutico , Enterobacteriáceas Resistentes a Carbapenêmicos/isolamento & purificação , Carbapenêmicos/farmacologia , Infecções por Enterobacteriaceae/tratamento farmacológico , Infecções por Enterobacteriaceae/epidemiologia , Transplante de Fígado , Complicações Pós-Operatórias/microbiologia , Criança , China , Infecções por Enterobacteriaceae/diagnóstico , Infecções por Enterobacteriaceae/microbiologia , Feminino , Humanos , Masculino , Estudos Retrospectivos , Fatores de Risco , Resistência beta-Lactâmica
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