Surveillance on the multi-drug resistance and the β-lactamase resistance genes in Pseudomonas aeruginosa

In the present study,27 multi-drug resistant strains of Pseudomonas aeruginosa were isolated from clinical specimens in our hospital from Jan 2005 to Nov 2005,in which the resistant genes encodingβ-lactamase including TEM,SHV,OXA,PER,VEB,GES,CARB,IMP,VIM,SPM,GIM,DHA and OprD2 were tested by PCR amplification and sequenced by DNA sequencer.It was found that the detection rates of bla_(VEB),bla_(GES) and bla_(CARB) genes in these 27 isolates of P.aeruginosa were 11.1%, 11.1% and 48.1%,respectively,but almost the oprD2 gene was lacked(92.6%).In addition,the resistant genes encoding TEM,SHV,OXA,PER,IMP,VIM,SPM,GIM and DHAβ-lactamase were all not found.It was also demonstrated that the sequence of bla_(VEB) gene appeared to be identical to that of the bla_(VEB-1)(AY536743),while the bla_(CES) and bla_(CARB) genes shared 99% identity with bla_(GES-1) (AY219651)and bla_(CARB-3)(S46063) genes.From these observations,it is evident that P.aeruginosa carrying the bla_(VES),bla_(GES) and bla_(CARB) resistant genes isolated in our hospital confers the resistance toβ- lactams,and the loss of the oprD2 gene may be the important cause to develop resistance to imipenem in P.aeruginosa.

Standard Operating Procedures for Chinese Medicine Data Monitoring Committees of Clinical Studies

Although there is guidance from different regulatory agencies,there are opportunities to bring greater consistency and stronger applicability to address the practical issues of establishing and operating a data monitoring committee(DMC)for clinical studies of Chinese medicine.We names it as a Chinese Medicine Data Monitoring Committee(CMDMC).A panel composed of clinical and statistical experts shared their experience and thoughts on the important aspects of CMDMCs.Subsequently,a community standard on CMDMCs(T/CACM 1323-2019)was issued by the China Association of Chinese Medicine on September 12,2019.This paper summarizes the key content of this standard to help the sponsors of clinical studies establish and operate CMDMCs,which will further develop the scientific integrity and quality of clinical studies.

Effect of Maxingganshi decoction on the expression of STAT4 and STAT6 in lung tissues of rats with chronic obstructive pulmonary disease

Objective:To investigate the effect of Maxingganshi decoction on the expression of STAT4 and STAT6 in lung tissues of rats with chronic obstructive pulmonary disease (COPD).Methods:A total of 30 COPD Wistar rat models with phlegm-heat depression and lung depression were established, with half male and half female. The 30 model rats were fed in different cages, weighed and labeled. They were randomly divided into three groups: Maxingganshi decoction group, roxithromycin tablets control group, model control group. At the same time, 10 normal rats were selected as a blank control group. The white blood cell count and other cell count levels in the alveolar lavage fluid of the rats in the four groups, as well as the STAT4 and STAT6 protein levels in the lung tissues, were observed and compared.Results: After treatment, the white cell counts in Maxingganshi decoction group were significantly higher than that of the model control group (P<0.05);lymph, neutral particles and eosinophil levels were significantly lower than those of the model control group (P<0.05). Compared with roxithromycin tablets control group, white blood cell count and other classification level of cell count in Maxingganshi decoction group were not significantly different (P>0.05). After treatment, STAT4 protein levels in roxithromycin tablets control group and Maxingganshi decoction group were lower than that in the model control group (P<0.05), and STAT6 protein levels in roxithromycin tablets control group and Maxingganshi decoction group were higher than that of the model control group (P<0.05), suggesting the two means of intervention in this study could inhabit the STAT4 protein expression in lung tissue of COPD rats and promote effect on STAT6 protein. In addition, the level of STAT4 and STAT6 in the Maxingganshi decoction group was not significantly different from that in the roxithromycin tablets control group (P>0.05), suggesting that the effect of Maxingganshi decoction was similar to that of roxithromycin tablets.Conclusions: The action mechanism of Maxingganshi decoction group treating COPD may be through the STAT4 and STAT6 protein expression level to impose an effect, and thus interfere with IL-12 / STAT4 and IL-4 / STAT6 these two signaling pathways of Th1 cells and Th2 cells in the body of the gene expression, inhibiting the Th1 polarization and adjusting the imbalance of Thl/Th2 cells, so as to lower inflammatory response mediated by T cells and various kinds of pathological damage.

Study of Klebsiella pneumoniae producing extendedspectrum β-lactamases against aminoglycosides

Klebsiella pneumoniae(K.pneumoniae)is one of the main gram-negative bacilli in clini- cal practice.Nosocomial infections caused by K.pneumoniae producing extended-spectrumβ-lactama- ses(ESBLs)are very difficult to treat.This paper investigated the resistant characteristics of K.pneu- moniae producing ESBLs and their aminoglycoside-modifying enzyme gene expressions including N- acetyhransferases and O-adenyhransfemses.Bacteria identification and ESBLs confirmatory tests were performed by Phoenix^(TM)-100 system.And minimum inhibitory concentrations(MICs)of gentamicin, amikacin,kanamycin,tobramycin,netilmicin and neomycin in 53 K.pneumoniae isolates were de- tected by agar dilution.In addition,six aminoglycoside-modifying enzyme genes were amplified by polymerase chain reaction(PCR)and verified by DNA sequencer.It was found that imipenem and meropenem against 120 K.pneumoniae isolates produced powerful antimicrobial activities.The resis- tant rates of gentamicin and amikacin were 55.0% and 46.7%,respectively.Except neomycin, MIC_(50)and MIC_(90)of gentamicin,amikacin,kanamycin,tobramycin and netilmicin in 53 K.pneumoni- ae were all>128μg/ml,and the resistant rates were 83.0%,52.3%,75.5%,81.1% and 69.8%,respectively.However,neomycin was only 39.6%.In addition,five modifying enzyme genes,including aac(3)-Ⅰ,aac(3)-Ⅱ,aac(6')-Ⅰb,ant(3″)-Ⅰ,ant(2″)-Ⅰgenes,were found in 53 isoahes except aac(6')-Ⅱ,and their positive rates were 11.3%,67.9%,47.2%, 1.9% and 39.6%,respectively.It was also confirmed by nucleotide sequence analysis that the above resistant genes shared nearly 100% identities with GenBank published genes.The results obtained in the present study indicated that K.pneumoniae producing ESBLs strains are rapidly spreading in our hospital,and their resistance to aminoglycosides may be associated with aminoglycoside-modifying enz- yme gene expressions.

Mechanism of Acupuncture and Moxibustion on Promoting Mucosal Healing in Ulcerative Colitis

The latest guideline about ulcerative colitis(UC) clinical practice stresses that mucosal healing, rather than anti-inflammation, is the main target in UC clinical management. Current mucosal dysfunction mainly closely relates to the endoscopic intestinal wall(mechanical barrier) injury with the imbalance between intestinal epithelial cells(IECs) regeneration and death, as well as tight junction(TJ) dysfunction. It is suggested that biological barrier(gut microbiota), chemical barrier(mucus protein layer, MUC) and immune barrier(immune cells) all take part in the imbalance, leading to mechanical barrier injury. Lots of experimental studies reported that acupuncture and moxibustion on UC recovery by adjusting the gut microbiota, MUC and immune cells on multiple targets and pathways, which contributes to the balance of IEC regeneration and death, as well as TJ structure recovery in animals. Moreover, the validity and superiority of acupuncture and moxibustion were also demonstrated in clinic. This paper aims to review the achievements of acupuncture and moxibustion on mucosal healing and analyse the underlying mechanisms.

针刺结合整脊疗法治疗颈椎病临床观察(英文)

目的:观察通督调阳针刺结合整脊疗法治疗上段颈椎病的疗效。方法:将符合纳入标准的64例患者按随机数字表法随机分观察组和对照组,每组32例。观察组采用通督调阳针刺结合上颈段微调法和腰骶侧扳法整脊手法治疗;对照组采用常规针刺及与观察组相同的整脊治疗。两组均每日治疗1次,连续治疗10次后观察疗效。结果:观察组总有效率为78.1%,对照组为67.5%,两组总有效率差异有统计学意义(P<0.05)。结论:通督调阳针刺结合整脊疗法治疗上段颈椎病疗效优于常规针刺结合整脊疗法。