Objective To observe the regional expression of hypoxia inducible factor-1alpha; (HIF-1alpha;) in retinoblastoma and its relationships with vascular endothelial growth factor (VEGF), Bax and Ki-67. Methods Immunohistochemical study for HIF-1alpha;, VEGF, Bax and Ki-67 was performed in 39 paraffinaceous examples of retinoblastoma. Each pathological section was divided into five regions: the surface region, the central part, the bottom part, the choroidal region and seeding tumors. The expressions, correlations and distributional differences of these factors were all invested both integrally and regionally. Results In the 39 cases of retinoblastoma, 10 cases (25.6%) were negative for HIF-1alpha;; 29 cases (74.4%) were positive for HIF-1alpha;, including 17 cases (43.6%) (+), 12 cases (30.8%) (++). Regionally, HIF-1alpha; was positive in 71.1%, 36.8%, 84.2%, 54.5% and 82.1% of the cases in the surface region, the central part, the bottom part, the choroidal region and seeding tumors, respectively, which was statistically reliable (chi;2=24.55，P＜0.001). The positive rate of VEGF, Bax and Ki-67 was 53.8%, 66.7% and 59.0%, respectively. In different regions, the positive rates of VEGF and Bax were different (chi;2=26.77, 22.79; P＜0.001), but there was no regional distinctions in the expression of Ki-67 (chi;2=0.47, P=0.976). Both the expression of VEGF and Bax had a positive correlation with that of HIF-1alpha;(rs=0.48, 0.39; P=0.002, 0.021), but there was no relationship between the expressions of Ki-67 and that of HIF-1alpha; (rs=0.09, P=0.606). Regionally, the expressions of VEGF, Bax and HIF-1alpha; shared similar distributional features: positive rates were higher in the surface region, bottom part and seeding tumors, and were lower in the central part and choroidal region, which was different from the expression of Ki-67. Conclusion The anoxic zones are more likely to be located in the marginal parts in retinoblastoma, and the expressions of VEGF and Bax had a positive correlation with that of HIF-1alpha; in different regions in retinoblastoma.
Objective To investigate the clinical manifestations,diagnosis and treatment of extensively drug-resistant tuberculosis (XDR-TB)meningitis. Methods One case of primary tuberculousis meningitis infected with multidrug-resistant mycobacteria was analyzed retrospectively.Relevant literatures were also reviewed by retrieving information through Wanfang Database and Pubmed using key words "multiple drug resistant tuberculosis meningitis","MDR tuberculosis meningitis","multiple drug resistant TBM","mul-drug resistant tuberculous meningitis","extensively drug resistant tuberculosis meningitis","XDR TBM","extensively drug resistant TBM" both in Chinese and English. Results A 24-year-old male patient,complained of headache,vomiting for 5 days,aggravated with mental abnormalities for 10 hours,with no history of pulmonary tuberculosis,was hospitalized in the Affiliated Hospital of Zunyi Medical College.The chest plain film was normal.Craniocerebral CT scan showed mild-hydrocephalus and cisterna ambiens stenosis.The patient died after undergoing anti-TB treatments with isoniazid(INH)0.3g iv qd,INH 0.3g po qd,rifampicin(RFP)0.45g qd,pyrazinamide(PZA)1.5g qd,ethambutol(EMB)0.75g qd,and dexamethasone(DEX)15mg qd.He was diagnosed as XDR-TB meningitis(as drug-resistant to isoniazid,rifampicin,streptomycin,ciprofloxacin,paminosalicylic acid,kanamycin,and protionamide ).Mycobacteria tuberculosis was isolated from his cerebrospinal fluid after 3 months.Five cases in 4 literatures were retrieved through Wanfang database and Pubmed among which 2 cases were initial treated,3 cases was unknown about initial treatment or re-treatment. Conclusions XDR-TB meningitis is rare in clinical practice with serious condition,rapid progress and high mortality rate.It is necessary to acquire drug susceptibility test results as soon as possible and adjust treatments according different conditions.A molecular drug susceptibility test may be helpful in the future.
Objective To investigate the drug resistance and homogeneous analysis of Acinetobacter baumanii in emergency intensive care unit ( EICU) . Methods Four multidrug-resistant Acinetobacter baumannii ( MDR-Ab) strains isolated fromnosocomial inpatients fromJuly 25 to September 7 in 2009 were collected and tested for drug sensitivity and MIC determination as well. The A. baumannii isolates were typed with pulsed-field gel electrophoresis ( PFGE) to determine whether they derived fromthe same clone.Results Four isolates from nosocomial inpatients were resistant to multiple antibiotics including carbapenem. The PFGE types identified from four isolates were A and B. The A. baumannii isolates did not derived from the same clone. Conclusion The prevalence of nosocomial infection is not due to transmission of the same strains among different individuals in EICU.
ObjectiveTo study the clinical distribution and the change of drug resistance of Acinetobacter baumannii from different inpatient specimens sources during 2008 to 2012, and to provide guidance for rational use of antibiotics. MethodsThe identification of Acinetobacter baumannii was conducted by VITEK-2 based on clinical and laboratory standards institute (CLSI) guideline between January 2008 and December 2012. The susceptibility of antibiotics was determined by K-B test, and data analysis was conducted by Excel and SAS. ResultsA total of 3 139 stains of Acinetobacter baumannii were isolated from 2013 patients during this period. The Acinetobacter baumannii was mainly obtained from the Burn ward, Intensive Care Unit ward and Thoracic ward. Sputum was the most specimens of Acinetobacter baumannii, accounting for 48.4%. The drug resistance rates of Acinetobacter baumannii to most of the antimicrobial agents were more than 55%. Compound antibacterial is more effective than the single drug ingredient. Compared with other antimicrobial agents, β-lactams/β-lactamase inhibitor compound and carbapenems antimicrobial agents were more sensitive. ConclusionThe drug resistance of Acinetobacter baumannii is serious and has differences among hospitals. Clinicians should monitor the drug resistance of Acinetobacter baumannii timely and choose proper antibiotics according to the results of drug sensitivity.
Objective To observe the effect of resveratrol on multidrug resistance (MDR) in human retinoblastoma cells treated. Methods RB cells in logarithmic growth phase were divided into experimental group and control group. RB cells in experimental group were cultured with different concentrations of resveratrol (6.25, 12.50, 25.00, 50.00, 100.00 mu;mol/L) for 24 and 48 hours. The proliferation (absorbance value) was assayed using methyl thiazolyl tetrazolium (MTT). RB cells were cultured with 50.00 mu;mol/L resveratrol for 48 hours. The expressions of MDR-1, cyclooxygenase-2 (COX-2)、multidrug resistance-associated protein-1 (MRP-1), glutathione-S-transferases-pi; (GST-pi;) were determined by reverse transcription-polymerase chain reaction (RT-PCR) and Western blot. The RB cells of the control group were cultured with 0.5% dimethyl sulfoxide. Results Compared with the control group, the absorbance value decreased in experimental groups (6.25, 12.50, 25.00, 50.00 mu;mol/L) in a dose dependent manner (F=4.782，P＜0.05). The difference of absorbance value between 50.00 and 100.00 mu;mol/L experimental groups was not significant (F=6.351,P＞0.05). Compared with the control group, the mRNA (t=9.170, 5.758, 4.152, 4.638) and protein (t=3.848, 5.955, 4.541, 3.514) expression levels of MDR-1, MRP1, COX-2, and GST-pi; decreased in the experimental group (P＜0.05). Conclusion Resveratrol can down-regulate the expression of MDR in RB cells.
The issue of bacterial drug resistance has remained unresolved, and in recent years, biomimetic nanostructured surfaces inspired by nature have garnered significant attention due to their bactericidal properties demonstrated through mechanical mechanisms. This article reviewed the main research progress in the field of nanostructured mechanical bactericidal surfaces, including various preparation methods for nanostructured surfaces with mechanical bactericidal properties, as well as the basic mechanisms and related physical models of the interaction between bacteria and nanostructured surfaces. In addition, the application of nanostructured surfaces in biomedicine was introduced. Finally, the article proposed the major challenges faced by mechanical bactericidal research and the future development direction.
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.
0bjective To compare the effect of closed airway management system and open suction system on distribution and drug susceptibility of pathogenic bacteria in lower respiratory tract of mechanical ventilated patients.Methods Fifty-nine cases in ICU who received mechanical ventilation for more than 48 h from May 2006 to Dec 2006 were randomly divided into two groups.Group A(29 patients)received closed—tracheal suction and Group B(30 patients)received open-tracheal suction.Quantitative bacteriological culture and sensitivity of antibacterial drugs were conducted on lower respiratory tract secretion samples.Results In group A，a total of 91 strains were isolated，in which a single pathogen infection(41.4％)was the most frequent，followed by mixed infection of two pathogens(34.5％)and three or more pathogens(24.1％).In group B，a total of 141 strains were isolated，in which three or more pathogen infection(53.33％)was the most frequent，followed by two pathogen infection(30％)and a single pathogen infection(16.7％ ).Pathogen distribution between the two groups was not significantly different(Pgt;0.05).Drug susceptibility test did not show significant difference in main pathogens between the two groups(Pgt;0.05).Conclusions Closed airway management system can reduce the infection or colonization of mixed pathogens，but can not change the distribution and drug susceptibility of pathogens.
ObjectiveTo understand the drug resistance of Mycobacterium tuberculosis complex in West China Hospital, Sichuan University, analyze its drug resistance characteristics, and provide reference for the monitoring of drug-resistant tuberculosis.MethodsFrom January 2016 to March 2018, Mycobacterium tuberculosis drug susceptibility testing kit was used to detect the drug susceptibility of Mycobacterium tuberculosis culture-positive strains in Department of Laboratory Medicine, West China Hospital, Sichuan University. The tested drugs included four of the first-line anti-tuberculosis drugs: rifampicin, isoniazid, ethambutol, and streptomycin, and ten of the second-line anti-tuberculosis drugs: capreomycin, ofloxacin, ethionamide, p-aminosalicylic acid, levofloxacin, moxifloxacin, rifabutin, amikacin, kanamycin, and chlorine phenazine.ResultsA total of 130 patients (130 strains) were enrolled, including 82 newly diagnosed patients (82 strains) and 48 re-treated patients (42 strains). The drug resistance rate of the 130 patients was 37.69%. The drug resistance rate of the newly diagnosed patients (28.05%) was significantly lower than that of the re-treated patients (54.17%), and there was a statistical difference (χ2=8.794, P=0.003). The multi-drug resistance rate of the newly diagnosed patients (6.10%) was significantly lower than that of the re-treated patients (25.00%), and the difference was statistically significant (χ2=9.517, P=0.002). The resistance rate of isoniazid, rifampicin, and streptomycin in newly diagnosed patients (23.17%, 8.54%, and 7.32%, respectively) were significantly lower than those in the re-treated patients (45.83%, 41.67%, and 29.17%, respectively), and the differences were statistically significant (P<0.05). The resistance rate of ofloxacin, moxifloxacin, rifabutin and ethionamide in the newly diagnosed patients (9.76%, 8.54%, 7.31%, and 4.88%, respectively) were significantly lower than those in the re-treated patients (39.58%, 27.08%, 25.00%, and 22.92%, respectively), and the differences were statistically significant (P<0.05).ConclusionIt is necessary to strengthen the standardized treatment of patients with newly diagnosed tuberculosis, increase the treatment and management of re-treated tuberculosis patients, and prevent the generation and spread of drug-resistant patients, especially multidrug-resistant patients.
ObjectiveTo investigate the distribution and drug resistance of the pathogens isolated from hospitalized pediatric patients with respiratory tract infections, and to provide guidance for empiric therapy. MethodsRespiratory tract specimens from hospitalized pediatric patients with respiratory tract infections from 2011 to 2015 were collected, and the strains were identified and the drug susceptibility was tested. ResultsA total of 1995 strains of pathogens, 1281 (64.21%) from boys and 714 (35.79%) from girls, were isolated from 6236 specimens and the detection rate was 31.99%. The mean age of the hospitalized pediatric patients was (1.22±2.05) years (ranged from 1 day to 14 years). 1393 (69.82%) pediatric patients were younger than 1 year. Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Candida albicans and Acinetobacter baumannii ranked the top five species, accounting for 29.82%, 15.09%, 13.18%, 12.73% and 5.91%, respectively. 1995 strains included gram-negative bacteria (50.93%), gram-positive bacteria (35.29%), and fungi (13.78%). The resistance rate of Staphylococcus aureus to oxacillin was 31.76%, but it was 100% sensitive to vancomycin and linezolid. The resistant rate of gram-negative bacteria to imipenem was ranged from 1.52% to 5.93%. The resistant rate of gram-negative bacteria to ceftazidime, cefepime, piperacillin tazobactam and tobramycin was less than 30.00%. ConclusionsThe infants whose age are younger than 1 year comprise the majority of the hospitalized pediatric patients with respiratory tract infections. The proportion of male is more than that of female. Staphylococcus aureus and enterobacteriaceae were the main isolated pathogens. There is difference in drug resistance between different pathogens, so antibiotics should be chosen according to the results of drug sensitivity testing.