目的：为临床合理应用抗生素提供依据。方法：采用VITEK 32及GNS--120药敏卡、GPS -107药敏卡进行细菌的鉴定及药敏实验。结果：320 株病原菌中，革兰氏阳性菌占28.75 %，革兰氏阴性菌占71.25 %，其中大肠埃希菌、铜绿假单胞菌、鲍曼复合醋酸钙不动杆菌、阴沟肠杆菌、金黄色葡萄球菌是临床上主要致病菌。结论：临床应科学合理选用抗生素，尽量减少和延缓耐药菌的发生及发展。
Objective To introduce the research progress in the effect of chemotherapeutic resistance of metabolic enzymes of gemcitabine to pancreatic cancer.Methods Recent literatures about metabolic enzymes that played key roles in mediating gemcitabine chemotherapeutic resistance of pancreatic cancer were collected and reviewed. Results The metabolic enzymes of gemcitabine, such as hENT1, dCK, RRM1 and CDA, were closely related to chemotherapeutic resistance of pancreatic cancer. The relationship between the single nucleotide polymorphism of metabolic enzymes and the resistance to gemcitabine remained to be clarified. Conclusion Multiple factors are involved in the mechanism of chemotherapeutic resistance of pancreatic cancer to gemcitabine, which needs further research.
ObjectiveTo explore the distribution and rule of pathogen strains in the third quarter and fourth quarter of 2012, and to provide the basis for clinical medication. MethodsTo retrospectively analyze the bacterial culture and drug susceptibility test results in the third quarter and the fourth quarter of 2012. ResultsThere were isolated 932 plants in the third quarter, and 915 plants isolated in the fourth quarter. Heavy drug resistance rates of detection of Pseudomonas aeruginosa decrease slightly. There was more multiple drug resistance of A. baumanii, Escherichia coli, Klebsiella pneumoniae, and methicillin-resistant Staphylococcus aureus in the fourth quarter than in the third one. ConclusionThe resistant strain increases in the fourth quarter. We should attach importance to the clinical examination, bacterial drug resistance monitoring, and rational use of antimicrobial agents.
ObjectiveTo investigate the condensate pollution in the pipeline of severe pneumonia patients undergoing mechanical ventilation.MethodsFrom January 2017 to January 2019, 120 patients with severe pneumonia treated by mechanical ventilation in our hospital were collected continuously. The lower respiratory tract secretions were collected for bacteriological examination. At the same time, the condensed water in the ventilator exhaust pipe was collected for bacteriological examination at 4, 8, 12, 16, 20 and 24 hours after tracheal intubation and mechanical ventilation. The bacterial contamination in the condensed water at different time points was analyzed and separated from the lower respiratory tract. The consistency of bacteria in secretion and drug resistance analysis of bacterial contamination in condensate water were carried out.ResultsOf the 120 patients with severe pneumonia after mechanical ventilation, isolates were cultured in the lower respiratory tract secretions of 102 patients. One strain was cultured in 88 cases, two strains were cultured in 10 cases, and three strains were cultured in 4 cases. The isolates were mainly Gram-negative bacteria (57.5%) and Gram-positive bacteria (42.5%). The most common isolates were Pseudomonas aeruginosa, Staphylococcus aureus and Acinetobacter baumannii. The contamination rate of condensate water was 5.0% at 4 hours, 37.5% at 8 hours, 60.0% at 12 hours, 76.7% at 16 hours, 95.0% at 20 hours, and 100.0% at 24 hours, respectively. The bacterial contamination rate in condensate water at different time points was statistically significant (P=0.000). The pollution rate at 4 hours was significantly lower than that at 8 hours (P=0.000). Gram-negative bacteria accounted for 57.5% and Gram-positive bacteria accounted for 42.5%. The most common isolates were Staphylococcus aureus, Pseudomonas aeruginosa and Acinetobacter baumannii. The consistency of bacteria in lower respiratory tract and condensate water was 83.3% in severe pneumonia patients undergoing mechanical ventilation. The overall resistance of Pseudomonas aeruginosa, Acinetobacter baumannii and Staphylococcus aureus was higher, but the resistance to imipenem/cilastatin was lower.ConclusionsThe bacterial contamination in the condensate of patients with severe pneumonia during mechanical ventilation is serious. The pollution rate is low within 4 hours. It is consistent with the bacterial contamination in lower respiratory tract and the bacterial resistance is high.
Objective To investigate the role of long non-coding RNA metastasis-associated in colon cancer 1-antisense RNA （MACC1-AS1）in cisplatin resistant gastric cancer and its possible mechanism. Methods Human gastric cancer cell line BGC823 and cisplatin resistant gastric cancer cell line (BGC823/DDP) were selected as the research objects. BGC823/DDP cells were transfected and divided into negative control group (si-NC group, transfected with si-NC empty plasmid) and MACC1-AS1 gene silencing group (si-MACC1-AS1 group, transfected with si-MACC1-AS1 plasmid). The BGC823 cells were transfected and divided into positive control group (pcDNA-NC group, transfected with pcDNA-NC empty plasmid) and MACC1-AS1 gene overexpression group (pcDNA-MACC1-AS1 group, transfected with pcDNA-MACC1-AS1 plasmid). MTT was used to detect the inhibition and 50% inhibition concentration (IC50). Flow cytometry was used to detect apoptosis. Real-time fluorescence quantitative PCR was used to detect the mRNA expression levels of MACC1-AS1, B-lymphoma-2 gene (Bcl-2), Bcl-2 related X gene (Bax), mammalian target of rapamycin (mTOR), phosphorylated mTOR (p-mTOR), protein kinase B (AKT), and phosphorylated AKT (p-AKT). Western blot was used to detect the protein expression levels of Bax, Bcl-2, p-mTOR, mTOR, AKT, and p-AKT. Results The relative expression level of MACC1-AS1 mRNA in BGC823/DDP cells was higher than that in BGC823 gastric cancer cells (P<0.01). The relative expression level of MACC1-AS1 mRNA in the si-MACC1-AS1 group cells was lower than that in the si-NC group cells (P<0.01). The relative expression level of MACC1-AS1 mRNA in the pcDNA-MACC1-AS1 group cells was higher than that in the pcDNA-NC group cells (P<0.01). The cell growth inhibition rate and IC50 of the si-MACC1-AS1 group were higher than those of the si-NC group (P<0.01). The cell growth inhibition rate and IC50 of the pcDNA-MACC1-AS1 group were lower than those of the pcDNA-NC group (P<0.01). The mRNA and protein relative expression levels of Bcl-2, p-AKT/AKT and p-mTOR/mTOR in the pcDNA-MACC1-AS1 group were significantly higher than those in the pcDNA-NC group (P<0.01). The relative expression levels of Bax protein and mRNA in the pcDNA-MACC1-AS1 group were significantly lower than those in the pcDNA-NC group (P<0.01). The apoptosis rate of the pcDNA-MACC1-AS1 group was significantly lower than that of the pcDNA-NC group (P<0.01). The mRNA and protein relative expression levels of Bcl-2, p-AKT/AKT and p-mTOR/mTOR in the si-MACC1-AS1 group were significantly lower than those in the si-NC group (P<0.01). The relative expression levels of Bax protein and mRNA in the si-MACC1-AS1 group were significantly higher than those in the si-NC group (P<0.01). The apoptosis rate of the si-MACC1-AS1 group was significantly higher than that of the si-NC group (P<0.01). Conclusions MACC1-AS1 highly expresses in cisplatin resistant gastric cancer cells. Overexpression of MACC1-AS1 regulates AKT/mTOR pathway mediated apoptosis and enhances cisplatin resistance of gastric cancer cells.
Antimicrobial resistance is a rigorous health issue around the world. Because of the short turn-around-time and broad pathogen spectrum, culture-independent metagenomic next-generation sequencing (mNGS) is a powerful and highly efficient tool for clinical pathogen detection. The increasing question is whether mNGS is practical in the prediction of antimicrobial susceptibility. This review summarizes the current mNGS-based antimicrobial susceptibility testing technologies. The critical determinants of mNGS-based antibacterial resistance prediction have been comprehensively analyzed, including antimicrobial resistance databases, sequence alignment tools, detection tools for genomic antimicrobial resistance determinants, as well as resistance prediction models. The clinical challenges for mNGS-based antibacterial resistance prediction have also been reviewed and discussed.
目的 探讨鲍曼不动杆菌感染的临床分布及药敏情况。 方法 对2009年1月－2011年12月的微生物送检标本进行统计分析，鲍曼不动杆菌2009年培养出19株，2010年29株（多重耐药菌株1株），2011年35株（多重耐药菌株2株），并对其分布的标本类型、科室及耐药情况进行分析。 结果 鲍曼不动杆菌在痰中检出率最高；科室分布依次为重症监护室（ICU）、神经外科、呼吸科；该菌对亚胺培南敏感性最高，对青霉素和头孢类抗生素耐药率均在55%以上。 结论 鲍曼不动杆菌感染患者的经验性抗生素治疗应根据其地区、医院最新的院内感染病原体分布及耐药性，合理选择抗生素；病情、高龄、免疫抑制剂、机械通气、多种侵入性操作及抗生素的使用为鲍曼不动杆菌医院感染危险因素；ICU存在多重耐药鲍曼不动杆菌的感染，应加以控制。
【Abstract】ObjectiveTo establish adriamycin (ADM) resistant pancreatic cancer cell line SW1990/ADM and to investigate its drug resistance mechanism.MethodsADM-resistant pancreatic cancer cell line SW1990/ADM was obtained by culture of pancreatic cancer cell line SW1990 in vitro with intermittently increasing the concentration of ADM in the culture medium for ten months. After two months of drug free culture, its biological characteristics, drug sensitivity as well as the expression and function of multidrug resistant gene 1 (mdr1) were detected, respectively. ResultsCompared with the parental cell line, SW1990/ADM showed great changes in biological characteristics and developed a cross resistance to various chemotherapy drugs. The drug resistance indexes of cell line SW1990/ADM to ADM, mitomycin, fluorouracil and gemcitabine were 49.60, 7.25, 3.80 and 1.25, respectively. The level of mdr1 mRNA expression in cell line SW1990/ADM was much higher than that of the parental cell line（P＜0.01). ConclusionWe have established adriamycin resistant pancreatic cancer cell line SW1990/ADM with multidrug resistance phenotype, its multidrug resistance is positively relevant to the expression of mdr1.
Objective To compare the infection characteristics and pathogen resistance between dialysis and non-dialysis patients with chronic kidney disease (CKD) in West China Hospital of Sichuan University, and provide a reference for clinical diagnosis and treatment. Methods The clinical data of CKD patients with non-repeated etiological evidence admitted to West China Hospital of Sichuan University between January 2010 and December 2021 were retrospectively analyzed. The patients were divided into dialysis group and non-dialysis group according to treatment methods. The infection characteristics and pathogen resistance of the two groups were analyzed by WHONET 5.6 and SPSS 23 softwares. Results A total of 1387 patients with CKD with positive etiology were included, excluding coagulase-negative Staphylococcus, which was common contamination pathogens of bloodstream infections. There were 527 patients in the dialysis group and 860 patients in the non-dialysis group in this study. There was no significant difference in gender between the two groups (P>0.05). There were significant differences in age, disease stage and specimen type between the two groups (P<0.01). The pathogenic bacteria samples of dialysis patients were mainly blood (25.81%) and dialysate (44.02%), and Staphylococcus aureus was the main pathogenic bacteria. In the non-dialysis group, sputum (49.88%) and urine (35.47%) were the main contents. In main Gram-positive pathogens, there were high resistance rates to penicillin and cephalosporin, and high sensitive rates to vancomycin and linezolid. In Gram-negative pathogenic bacteria, there were high resistance rates to penicillins, the first generation cephalosporins and the third generation cephalosporins, and high sensitive rates to β-lactamase inhibitor compound preparation, the fourth generation cephalosporins and other antibiotics. Conclusions CKD patients are easy to be complicated with infections. In clinical practice, it is necessary to pay attention to pathogen culture results, and selectively use antibiotics based on drug sensitivity results. At the same time, medical staff in hemodialysis centers should pay attention to aseptic operation and hand hygiene to reduce the risk of concurrent infection in dialysis patients.