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.
Objective To analyze the species distribution and resistance of the pathogens isolated fromblood cultures of the patients in intensive care unit ( ICU) , and provide a basis for prevention and control of bloodstream infections in critically ill patients. Methods The data of blood cultures of the patients in ICUduring January 2009 to December 2011 was investigated retrospectively.Results In the last 3 years, positive rate of blood cultures of ICU patients was 15. 4% , 15. 7% , and 17. 6% respectively. Among the isolates, Gram-positive bacteria were predominant ( 52. 3% ) , followed in order by gram-negative bacteria ( 33. 1% ) and fungi ( 14. 7% ) . Aerobe and facultative anaerobe were the predominant bacterial isolates ( 99. 7% ) . Enterococcus faeciumand Staphylococcus spp. were the most common gram-positive bacteria, and 4. 5% of E. faecium isolates were resistant to vancomycin. Rate of methicillin-resistance for S. aureus and S. epidermidis was 73. 5% and 93. 7% respectively. In terms of gram-negative bacteria, Acinetobacter calcoaceticus- A. baumannii complex were the leading species, 96. 9% of the isolates had multi-drug resistance and 14. 1% of the isolates had extra-drug resistance. Klebsiella pneumonia and Escherichia coli isolates were less frequently isolated and those producing extended spectrum beta-lactamases accou ted for 70. 3% and 80. 0% of the isolates respectively. Candida spp. was the most common fungi isolates ( 96. 7% )with an annual change of species distribution and declining susceptibility to azoles.Conclusions Gram-positive bacteria should be the major target for prevention and control of bloodstream infections in critically ill patients. Whereas, more attention should be paid to the infection caused by candida spp. and multidrug resistant gram-negative bacteria.
ObjectiveTo investigate the distribution and drug resistance of Acinetobacter baumannii (AB) in a women and children's hospital.
MethodsStrains of AB isolated from clinical specimens between January 2011 and December 2013 were identified with Vitek2-compact microbiology analyzer; antimicrobial susceptibility test was performed by Kirby-Bauer disk diffusion method. The resistant rate, intermediate rate and susceptibility rate of drugs were calculated according to the criteria in guidelines of Clinical and Laboratory Standards Institute. WHONET 5.6 software was used to analyze the data.
ResultsA total of 167 strains of AB were isolated and tested. Neonatal ward had the highest detection proportion. Most strains of AB were isolated from sputum. The drug resistance rate of AB to piperacillin tazobactam, cefepime and carbapenem was<25%.
ConclusionThe drug sensitivity rate of AB to piperacillin/tazobactam, cefepime and carbapenems was high, but drug resistence to antimicrobial drugs increased continuously in three years. Medical institutions should strengthen the monitoring of AB resistance, implement rational use of antibiotics, and carry out hand hygiene education, to reduce the generation and dissemination of AB resistant strains.
Objective To study the distribution and drugresistance of pathogens isolated from patients who suffered from lower respiratory infections after thoracotomy and provide basis for rational use of antibiotics in clinical practice. Methods A total of 118 patients suffered from lower respiratory infections after thoracotomy in Beijing Lung Cancer Center and the Thoracic Surgery Department of Xuanwu Hospital between January 1,2006 and December 31, 2009. We performed a retrospective study on pathogens from their lower respiratory tract. Of these patients, 89 are male and 29 are female with a mean age of 64.6 years. Sputum specimens were obtained by sterile sputum collectors or bronchofibroscopes, and then were sent to microorganism laboratory immediately. Cytological screening was carried out before specimen inoculation. Bacterial culture, identification and drug sensitivity test were performed with routine methods. Results A total of 201 strains of pathogens from the lower respiratory tract were identified. There were 126(62.7%) strains of gramnegative bacilli, 66(32.8%) strains of grampositive cocci, and 9(4.5%) strains fungi. The four prevalent gramnegative bacilli strains with the highest isolating rate between 2006 and 2009 included 34(27.0%) strains of acinetobacters, 28(22.2%) strains of verdigris Pseudomonas, 19(15.1%) strains of Klebsiellas and 19(15.1%) strains of Escherichia coli. Verdigris Pseudomonas ranked first in isolating rate among prevalent gramnegative bacilli strains from 2006 to 2008, but it was replaced by cinetobacters (9 strains, 40.9%) in 2009. The most prevalent strains of grampositive cocci were staphylococcus aureus (35 strains, 53%) from 2006 to 2009. Gramnegative bacilli were most sensitive to imipenem and no grampositive cocci were resistant to vancomycin. Conclusion Gramnegative bacilli are the most common pathogens in lower respiratory infections after thoracotomy and show extremely high drugresistance rate. Drugresistance monitoring of pathogens should be promoted. It may contribute to rational antimicrobial therapy and effective control of infections.
ObjectiveTo explore the effects of different exercise methods on serum short-chain fatty acids (SCFA) in type 2 diabetic mice, determine the best exercise method to improve SCFAs in type 2 diabetic mice, and provide a theoretical basis for the preventive intervention for patients with early diabetes.MethodsAccording to different exercise methods, 48 8-week-old male db/db type 2 diabetic mice were randomly divided into four groups, including aerobic exercise group, resistance exercise group, combined resistance- aerobic exercise (referred to as combined exercise) group, and the control group; with 10 mice in each group and another 2 as the substitutes. The mice were fed in the same manner in each group. The control group did not perform exercise intervention, the aerobic exercise group performed weightless running exercise, the resistance exercise group performed tail weight-bearing ladder exercise, and the combined exercise group alternated aerobic exercise and resistance exercise. Blood glucose and body weight were measured before and 8 weeks after the intervention. The content of serum SCFAs in mice was determined by gas chromatography-mass spectrometry.ResultsA total of 40 mice completed the experiment successfully. Before the exercise intervention, there was no significant difference in blood glucose or weight among the groups (P>0.05). After 8 weeks of exercise intervention, the blood glucose and weight in each exercise group were significantly lower than those in the control group (P<0.05), and the blood glucose and weight in the combined exercise group were significantly lower than those in the aerobic exercise group and the resistance exercise group (P<0.05). The contents of SCFA were higher in the aerobic exercise group, resistance exercise group, and combined exercise group than those in the control group (P<0.05); the contents of acetic acid and butyric acid in the combined exercise group were better than those in the aerobic exercise group (P<0.05), and the contents of propanoic acid and valeric acid in the combined exercise group were better than those in the resistance exercise group (P<0.05).ConclusionsDifferent exercise methods can improve the SCFA content in serum of type 2 diabetic mice. Compared with aerobic exercise and resistance exercise, combined exercise has the best effect in improving SCFA.
ObjectiveTo systematically review the dose-effect relationship between resistance exercise intervention and lower extremity muscle strength and function enhancement in the aging. MethodsEBSCO, PubMed, Web of Science, CNKI, VIP, and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) on the effects of resistance exercise on muscle strength and function of the lower extremities in older adults from inception to July 2022. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. A network meta-analysis was then performed by using RevMan 5.4 and Stata 15.0 software. ResultsA total of 32 RCTs with a total sample size of 1 594 individuals were included. The results of network meta-analysis showed that the elements of resistance exercise prescription: intensity 50%-70% 1RM, period 8-12 weeks, frequency 3-4 times/week, duration 30-45 min, and intervals 1.1-2 min were superior to other doses. ConclusionThe optimal dose of resistance exercise for improving lower extremity muscle strength and function in older adults is moderate exercise intensity (50%-70% 1RM) for 8-12 weeks, 3-4 times per week, 30-45 min per exercise, and 1.1-2 min interval between sets.
ObjectiveTo explore the risk factors for neonatal nosocomial infection and the pathogen resistance, in order to provide the basis for hospital infection control. MethodsSurveillance of hospital infection in newborns hospitalized for more than 48 hours were carried out from January to December 2012, and the risk factors for hospital infection were analyzed. ResultsThere were 54 newborn cases with neonatal nosocomial infection, and the infection rate of newborns was 1.25%. The major infection sites were respiratory tract (66.7%), gastrointestinal tract (18.5%), skin and soft tissues (9.2%). Birth weight (χ2Trend=126.88, P<0.001), hospitalization days (χ2Trend=106.89, P<0.001), invasive operation (χ2=5.338, P=0.021) were the major risk factors. A total of 54 strains of pathogenic bacteria were isolated from 54 newborn cases with neonatal nosocomial infection. Twenty-three strains of gram-positive bacteria accounted for 42.6%, which were generally resistant to penicillin and large ring lactone class antibiotic drugs. Thirty-one strains of gram-negative bacteria accounted for 57.4%, which were mainly resistant to the three generations of cephalosporins. ConclusionThe hospital infection rate of newborns is low. Birth weight, hospitalization days and invasive operation are the major risk factors for neonatal nosocomial infection.
Objective To systematically review the resistance of pseudomonas aeruginosa to quinolone in China. Methods Such databases as CNKI, WanFang Data, CBM, VIP, PubMed, EMbase and The Cochrane Library were electronically searched from inception to December 2012, for relevant studies on the resistance mechanism of pseudomonas aeruginosa to quinolone. Two reviewers independently screened literature according to inclusion and exclusion criteria. Then, meta-analysis was performed using RevMan 5.0 software. Results Totally 19 studies were included, involving 723 strains of quinolone-resistant pseudomonas aeruginosa. The statistical results showed that, in the areas to the north of Huai River, the detection rates of gyrA, gyrB, parC and parE were 88.0%, 13.3%, 31.4% and 16.7%, respectively; and in the areas to the south of Huai River, they were 64.6%, 50.0%, 35.4% and 16.7%, respectively. The detection rates of plasmid mediated resistant genes aac (6’)-Ib-cr was 0 (0/66) in the areas to the north of Huai River, and 39% (25/64) in the areas to the south of Huai River. The outer membrane protein expression rate of active efflux system was 68.1%. Conclusion In China, gyrA gene mutation and the active efflux system mainly account for pseudomonas aeruginosa’s resistance to quinolone. DNA topoisomerase IV abnormalities and plasmid mediated resistance is the secondary mechanism.
Objective To evaluate the influence on the estimation of respiratory mechanics with dynamic signal analysis approach during noninvasive positive pressure ventilation (NPPV) under different inspiratory effort conditions. Methods The Respironics V60 ventilator was connected to a ASL5000 lung simulator, which simulate lung mechanics in healthy adults with body weight from 65 to 70 kg, and patients with chronic obstructive pulmonary disease (COPD) and acute respiratory distress (ARDS). Each lung models was subjected to 4 different muscle pressures (Pmus): 0, 5.0, 10.0, and 15.0 cm H2O. Inspiratory pressure support level was adjusted to maintain tidal volume (VT) achieving 7.0 mL/kg outputted by ventilator respectively. Positive end expiratory pressure was set at 5.0 cm H2O and back-up rate was 10 beats per minute. Measurements were conducted at system leaks with 25 to 28 L/min. The respiratory system compliance (Crs), inspiratory and expiratory resistance (Rinsp and Rexp) were estimated by special equations, which was derived from the exhaled VT, flow rate and airway pressure. Results The driving pressure (DP) was decreased with Pmus increasing, and was 1.0 cm H2O after Pmus exceeding 10.0 cm H2O and the VT was larger than 7.0 mL/kg in normal adult model. The estimated value of Crs was affected by the changes of Pmus in all three lung models. The significant underestimation of Raw and the overestimation of Crs were observed when Pmus level exceed 10.0 cm H2O. The measured errors of Crs and Rexp were within 10% in COPD and ARDS model when Pmus was at 5.0 cm H2O. The underestimation of Rinsp was always existed in all Pmus level (P<0.01). Conclusions Using dynamic signal analysis approach, the real-time estimation of respiratory mechanics (Crs and Raw) is no need to interrupt the spontaneous breathing during NPPV. Excessive effort will increase the patient’s inspiratory workload, which is not benefit to accurate estimation of respiratory mechanics.
ObjectiveTo systematically review the intervention efficacy of resistance exercise on prediabetes and type 2 diabetes. MethodsPubMed, The Cochrane Library, EMbase, Web of Science, EBSCO, VIP, WanFang Data and CNKI databases were electronically searched to collect randomized controlled trials (RCTs) of resistance exercise applied to pre-diabetic and type 2 diabetic population from 2010 to April, 2021. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was then performed using Revman 5.1 and Stata 12.0 software. ResultsA total of 26 RCTs involving 2 078 patients were included. The results of meta-analysis showed that resistance exercise could improve fasting blood glucose (MD=?0.57, 95%CI ?0.69 to ?0.45, P<0.000 01), glycosylated hemoglobin (MD=?0.28, 95%CI ?0.33 to ?0.22, P<0.000 01), high density lipoprotein (MD=0.06, 95%CI 0.01 to 0.11, P=0.01), low density lipoprotein (MD=?0.35, 95%CI ?0.47 to ?0.24 , P<0.000 01), total cholesterol (MD=?0.25, 95%CI ?0.39 to ?0.12, P=0.000 3), steady-state model-insulin resistance index (MD=?0.74, 95%CI ?0.80 to ?0.68, P<0.000 01), and body mass index (MD=?0.54, 95%CI ?1.03 to ?0.05, P=0.03) compared with control group. ConclusionsResistance exercise can improve the blood glucose, blood lipid, and insulin resistance levels of individuals with abnormal glucose and lipid metabolism. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify above conclusions.
