Division of Blastocystis ST10 into three new subtypes: ST42-ST44.

The Blastocystis subtype ST10 has been recognized to contain a great deal of diversity at the sequence level, potentially indicating the presence of multiple new STs within the clade. However, the data needed to validate these new STs were not available. To help resolve this diversity, full-length small subunit (SSU) rRNA gene reference sequences were generated using Oxford Nanopore MinION long-read sequencing from 21 samples representing multiple domestic and wild hosts and geographic regions and covering the sequence diversity previously described using fragments of the SSU rRNA gene. Phylogenetic and pairwise distance analyses were used to compare full-length sequences of the SSU rRNA gene generated in this study with all other valid STs of Blastocystis. We present data supporting the division of ST10/ST23 cluster into five subtypes, ST10, ST23, and three new subtypes with the proposed ST designations of ST42, ST43, and ST44. As the host range of Blastocystis continues to expand with new subtypes and new hosts being frequently identified, the reference sequences provided in this study will assist in accurate sequence classification and help to clarify the epidemiology of this common intestinal microeukaryote.

[Professor YIN Ke-jing's experience of Jingluo Bietong acupuncture technique for shoulder arthralgia].

Professor YIN Ke-jing's experience of Jingluo Bietong acupuncture technique for shoulder arthralgia is summarized. According to the location of pain, shoulder arthralgia is divided into hand-taiyin type, hand-yangming type, hand-shaoyang type, hand-taiyang type and mixed type. The acupoint selection is based on Jingluo Bietong acupuncture technique, and Shugu (BL 65) or Feiyang (BL 58) are selected for hand-taiyin type, Taichong (LR 3) for hand-yangming type, Taixi (KI 3) and Dazhong (KI 4) for hand-shaoyang type, and Taibai (SP 3) or Diji (SP 8) for hand-taiyang type. In addition, combined with acupuncture at the blocking points of meridians and Xiangu (ST 43), better efficacy could be obtained.

Molecular Epidemiology of Escherichia coli Clinical Isolates from Central Panama.

Escherichia coli represents one of the most common causes of community-onset and nosocomial infections. Strains carrying extended spectrum ß-lactamases (ESBL) are a serious public health problem. In Central America we have not found studies reporting the molecular epidemiology of E. coli strains implicated in local infections, so we conducted this study to fill that gap. Materials and Methods: We report on an epidemiological study in two reference hospitals from central Panama, identifying the susceptibility profile, associated risk factors, and molecular typing of E. coli strains isolated between November 2018 and November 2019 using Pasteur's Multilocus Sequence Typing (MLST) scheme. Results: A total of 30 E. coli isolates with antimicrobial resistance were analyzed, 70% of which came from inpatients and 30% from outpatients (p < 0.001). Two-thirds of the samples came from urine cultures. Forty-three percent of the strains were ESBL producers and 77% were resistant to ciprofloxacin. We identified 10 different sequence types (STs) with 30% of the ESBL strains identified as ST43, which corresponds to ST131 of the Achtman MLST scheme-the E. coli pandemic clone. Thirty-eight percent of the E. coli strains with the ESBL phenotype carried CTX-M-15. Conclusions: To the best of our knowledge, this is the first report confirming the presence of the pandemic E. coli clone ST43/ST131 harboring CTX-M-15 in Central American inpatients and outpatients. This E. coli strain is an important antimicrobial-resistant organism of public health concern, with potential challenges to treat infections in Panama and, perhaps, the rest of Central America.