广泛耐药革兰阴性菌感染的实验诊断、抗菌治疗及医院感染控制:中国专家共识

广泛耐药革兰阴性杆菌(XDR-GNB),是指除1~2类抗菌药物(主要指多黏菌素和替加环素)外,几乎对所有类别抗菌药物均不敏感的革兰阴性杆菌。XDR-GNB常见于肠杆菌科细菌、鲍曼不动杆菌、铜绿假单胞菌和嗜麦芽窄食单胞菌等。近年来,中国XDR-GNB的发生率呈不断上升趋势,由于缺乏有效的治疗药物,XDR-GNB感染成为公共卫生安全的一大威胁。我国有关感染的临床、微生物学及临床药理学专家们就XDR-GNB感染的实验室诊断、临床诊疗和医院感染控制等问题深入讨论,形成此共识。其中细菌药敏试验的抗菌药物品种及结果判定标准遵循美国临床和实验室标准化协会(CLSI)、欧洲抗菌药物敏感性试验委员会(EUCAST)或美国食品与药物监督管理局(FDA)的指南。研究提示长疗程使用广谱抗菌药物是引发XDR-GNB感染最重要的危险因素。根据现有的临床研究和实验室数据,共识提供治疗各种XDRGNB感染的联合用药推荐方案,其中常用的抗菌药物有替加环素、多黏菌素、碳青霉烯类、氨基糖苷类和磷霉素等。同时建议实行严格的感染控制措施,包括手卫生、接触隔离、主动筛查、环境消毒、去定植和抗菌药物应用管理等遏制XDRGNB感染的传播。

Methods for a blind analysis of isobar data collected by the STAR collaboration

In 2018,the STAR collaboration collected data from^(96)_(44)Ru+^(96)_(44)Ru and^(96)_(40)Zr+^(96)_(40)Zr at√^(S)NN=200 Ge V to search for the presence of the chiral magnetic effect in collisions of nuclei.The isobar collision species alternated frequently between 9644 Ru+^(96)_(44)Ru and^(96)_(40)Zr+^(96)_(40)Zr.In order to conduct blind analyses of studies related to the chiral magnetic effect in these isobar data,STAR developed a three-step blind analysis procedure.Analysts are initially provided a"reference sample"of data,comprised of a mix of events from the two species,the order of which respects time-dependent changes in run conditions.After tuning analysis codes and performing time-dependent quality assurance on the reference sample,analysts are provided a species-blind sample suitable for calculating efficiencies and corrections for individual≈30-min data-taking runs.For this sample,species-specific information is disguised,but individual output files contain data from a single isobar species.Only run-by-run corrections and code alteration subsequent to these corrections are allowed at this stage.Following these modifications,the"frozen"code is passed over the fully un-blind data,completing the blind analysis.As a check of the feasibility of the blind analysis procedure,analysts completed a"mock data challenge,"analyzing data from Au+Au collisions at√^(S)NN=27 Ge V,collected in 2018.The Au+Au data were prepared in the same manner intended for the isobar blind data.The details of the blind analysis procedure and results from the mock data challenge are presented.

Search for the doubly heavy baryon Ξ_(bc)^(+)→ decaying to J/ψΞ_(c)^(+)

A first search for the Ξ_(bc)^(+)J/ψΞ_(c)^(+) decay is performed by the LHCb experiment with a data sample of proton-proton collisions, corresponding to an integrated luminosity of 9 fb−1 recorded at centre-of-mass energies of 7, 8, and 13 TeV. Two peaking structures are seen with a local (global) significance of 4.3(2.8) and 4.1(2.4) standard deviations at masses of 6571 and 6694 MeV/c2, respectively. Upper limits are set on the Ξ+bc baryon production cross-section times the branching fraction relative to that of the B+c→J/ψD+s decay at centre-of-mass energies of 8 and 13 TeV, in the Ξ+bc and in the B+c rapidity and transverse-momentum ranges from 2.0 to 4.5 and 0 to 20GeV/c, respectively. Upper limits are presented as a function of the Ξ+bc mass and lifetime.

Microwave dielectric properties of CaCu_(3)Ti_(4)O_(12) ceramics:A clue to its intrinsic dielectric response

CaCu_(3)Ti_(4)O_(12)(CCTO)is a potential dielectric material with giant permittivity,good stability over the wide temperature and frequency range.However,the dielectric responses of CCTO-based ceramics are mainly investigated in the frequency of 102-106 Hz,which is far low to clarify the intrinsic dielectric feature.So,microwave dielectric properties have been investigated for the CCTO porous ceramics sintered at low temperature(≤1000°C).Good microwave dielectric properties of permittivityε=62.7,quality factor Qf=3062 GHz and temperature coefficient of the resonant frequencyτf=179 ppm/°C are achieved for the CCTO ceramics sintered at 1000°C,the dielectric loss significantly decreases two orders to 0.002 compared to that of CCTO ceramics sintered at critical temperature of 1020°C confirmed by differential scanning calorimetry(DSC).This clue indicates that giant permittivity and high loss is not intrinsic for CCTO ceramics,but derives from composition segregation,liquid phase and defects associated with internal barrier layer capacitor(IBLC).It suggests that CCTO-based ceramics is a promising microwave dielectric materials with high permittivity.

Search for the rare decays W^(+)→D_(s)^(+)γ and Z→D^(0)γ at LHCb

A search for the rare decays W^(+)→D_(s)^(+)γ and Z→D0γis performed using proton-proton collision data collected by the LHCb experiment at a centre-of-mass energy of 13TeV,corresponding to an integrated luminosity of 2.0fb−1.No significant signal is observed for either decay mode and upper limits on their branching fractions are set using W^(+)→D_(s)^(+)γ and Z→μ+μ−decays as normalization channels.The upper limits are 6.5×10^(−4) and 2.1×10^(−3) at 95% confidence level for the W^(+)→D_(s)^(+)γ and Z→D^(0)γ decay modes,respectively.This is the first reported search for the Z→D^(0)γ decay,while the upper limit on the W+→D+sγbranching fraction improves upon the previous best limit.

Evidence of a J/ψΛstructure and observation of excited■^(-)states in the■b^(-)→J/ψΛK^(-) decay

First evidence of a structure in the J/ψΛinvariant mass distribution is obtained from an amplitude analysis of■b^(-)J/ψΛK^(-)decays.The observed structure is consistent with being due to a charmonium pentaquark with strangeness with a significance of 3.1r including systematic uncertainties and lookelsewhere effect.Its mass and width are determined to be 4458:8±2:9t4:7-1:1 MeV and 17:3±6:5t8:0-5:7 MeV,respectively,where the quoted uncertainties are statistical and systematic.The structure is also consistent with being due to two resonances.In addition,the narrow excited■^(-)states,N■(1690)and■(1820),are seen for the first time in a■b^(-)decay,and their masses and widths are measured with improved precision.The analysis is performed using pp collision data corresponding to a total integrated luminosity of 9 fb^(-1),collected with the LHCb experiment at centre-of-mass energies of 7,8 and 13 TeV.

Measurement of away-side broadening with self-subtraction of flow in Au+Au collisions at √sNN=200 GeV

High transverse momentum(pT)particle production is suppressed owing to the parton(jet)energy loss in the hot dense medium created in relativistic heavy-ion collisions.Redistribution of energy at low-to-modest pT has been difficult to measure,owing to large anisotropic backgrounds.We report a data-driven method for background evaluation and subtraction,exploiting the away-side pseudorapidity gaps,to measure the jetlike correlation shape in Au+Au collisions at √sNN=200 GeV in the STAR experiment.The correlation shapes,for trigger particles pT>3GeV/c and various associated particle pT ranges within 0.5<pT<10GeV/c,are consistent with Gaussians,and their widths increase with centrality.The results indicate jet broadening in the medium created in central heavy-ion collisions.

Gradient microstructure,recrystallization and mechanical properties of copper processed by high pressure surface rolling

The microstructure,hardness and tensile properties have been studied in copper processed by high pressure surface rolling(HPSR)both in the as-deformed condition and after subsequent annealing at 150℃.It is found that a gradient structure with significant differences in the scale of microstructural features is formed by HPSR.The deformed microstructure varies from nano-and ultrafine-scale structures with a large fraction of high angle boundaries near the surface to lightly deformed grains at depths of 1-3 mm below the surface.Tensile tests of 1-mm-thick specimens demonstrate that the asdeformed material has a high strength and a low uniform elongation.Annealing at 150℃results in partial recrystallization,which creates new through-thickness gradients.Except for the topmost layer and several bands in the adjacent layer,recrystallization is more pronounced close to the surface.The fraction recrystallized is at least 80%at depths of 60-300μm after annealing for 960 min.The fraction recrystallized in the subsurface decreases with increasing depth,and the deformed layer at depths greater than 500μm re-mains largely non-recrystallized after annealing.This partially recrystallized condition demonstrates an improved combination of strength and ductility.

On Temperature and Strain Rate Dependent Strain Localization Behavior in Ti-6.5Al-3.5Mo-1.5Zr-0.3Si Alloy

Deformation behaviors of Ti-6.5Al-3.5Mo-1.5Zr-0.3Si alloys with α/β lamellar structure were investigated systematically at different temperatures from room temperature to 950 ~C and different strain rates. Results reveal that when the deformation temperature is higher than a critical temperature of 600℃, an evident transition of deformation behavior from localized shear banding to α/β lamella kinking, flow softening and temperature/strain rate-dependent peak flow stress occurred in the alloy. The critical conditions for the occurrence of internal cracking and strain localization behavior associated with temperature and strain rate were determined.

Search for the rare decay B^(0)→J/ψФ

A search for the rare decay B^(0)→J/ψФis performed using Pp collision data collected with the LHCb dete-ctor at centre-of-mass energies of 7,8 and 13 TeV,corresponding to an integrated luminosity of9 fb.No significant signal of the decay is observed and an upper limitof 1.1x 10^(-7)at 90%confidence level is set on the branching fraction.

Search for the doubly heavy baryons Ω^(0)_(bc) and E^(0)_(bc) decaying to Λ^(+)_(c)π^(-) and E^(+)_(c)π^(-)

The first search for the doubly heavyΩ^(0)_(bc)baryon and a search for the E^(0)_(bc)baryon are performed using pp collision data collected via the LHCb experiment from 2016 to 2018 at a centre-of-mass energy of 13 TeV,corresponding to an integrated luminosity of 5.2 fb^(-1).The baryons are reconstructed via their decays to Λ^(+)_(c)π^(-)and E^(+)_(c)π^(-).No significant excess is fbund for invariant masses between 6700 and 7300 MeV/c^(2),in a rapidity range from 2.0 to 4.5 and a transverse momentum range from 2 to 20 MeV/c.Upper limits are set on the ratio of the Ω^(0)_(bc)and E^(0)_(bc)production cross-section times the branching fraction to Λ^(+)_(c)π^(-)(E^(+)_(c)π^(-))relative to that of the Λ^(0)_(b)(E^(0)_(b))baryon,for different lifetime hypotheses,at 95%confidence level.The upper limits range from 0.5 x 10^(-4)to 2.5 x 10^(-4)for theΩ^(0)_(bc)→Λ^(+)_(c)π^(-)(E^(0)_(bc)→Λ^(+)_(c)π^(-))decay,and from 1.4x 10^(-3)to 6.9 x 10^(-3)for theΩ^(0)_(bc)→E^(+)_(c)π^(-)(E^(0)_(bc)→E^(+)_(c)π^(-))decay,depending on the considered mass and lifetime of theΩ^(0)_(bc)(E^(0)_(bc))baryon.

3D-Stacked Multistage Inertial Microfluidic Chip for High-Throughput Enrichment of Circulating Tumor Cells

Whether for cancer diagnosis or single-cell analysis,it remains a major dhallenge to isolate the target sample cells from a large background cell for high-efficiency downstream detection and analysis in an integrated chip.Therefore,in this paper,we propose a 3D stacked multistage inertial microfluidic sorting chip for high-throughput enrichment of circulating tumor cells(CTCs)and convenient downstream analysis.In this chip,the first stage is a spiral channel with a trapezoidal cross-section,which has better separation performance than a spiral channel with a rectangular cross-section.The second and third stages adopt symmetrical square serpentine channels with different rectangular cross-section widths for further separation and enrichment of sample cells reducing the outlet flow rate for easier downstream detection and analysis.The multistage channel can separate 5 pum and 15 um particles with a separation efficiency of 92.37%and purity of 98.10%at a high inlet flow rate of 1.3 mL/min.Meanwhile,it can separate tumor cells(SW480,A549,and Caki-1)from massive red blood cells(RBCs)with a.separation efficiency of>80%,separation purity of>90%,and a concentration fold of~20.The proposed work is aimed at providing a high-throughput sample processing system that can be easily integrated with flowing sample detection methods for rapid CTC analysis.