Carbapenemase producing Enterobacteriaceae (CPE) has emerged as a significant global public health challenge and placing infected patients at risk of potentially untreatable infections. When resistance to carbapenems occurs, there are often few alternative treatments available. Numerous international guidelines have performed systematic and evidence review to identify new strategies to prevent the entry and spread of CPE in healthcare settings. Several key strategies have been shown to be highly effective. Firstly a new strategy that is proven to be effective is the early identification of the CPE carrier patients through active surveillance cultures. While waiting for the screening results, suspected CPE carriers will be put on preemptive isolation in single room and healthcare worker will at the same time practice contact precautions. The active surveillance culture and prompt preemptive isolation will limit the entry and spread of CPE from getting into hospital. Secondly, it is of utmost importance to incorporate enforcement of the basic infection prevention and control best practices in the hospital including, full compliance to hand hygiene, appropriate use of personal protective equipment, execute antibiotic stewardship program to control abuse of antibiotics, effective environmental cleaning and decontamination, staff education and feedback, as well as surveillance of healthcare-associated infections. Such a holistic approach has been shown to be effective in inhibiting CPE from gaining foothold in the hospital.
ObjectiveTo introduce a new method for identifying intersegmental planes during thoracoscopic segmentectomy using pulmonary circulation single-blocking in the target segment. MethodsTo retrospectively analyze the clinical data of 83 patients who underwent thoracoscopic pulmonary segmentectomy from January 2019 to March 2020 using the pulmonary circulation single-blocking method. There were 33 males and 50 females, with a median age of 54 (46-65) years, and they were divided into a single vein group (SVG, n=31) and a single artery group (SAG, n=52), and the clinical data of two groups were compared. ResultsThe intersegmental planes were identified successfully in both groups and there were no statistically significant differences between the two groups in terms of intersegmental plane management (P=0.823), operating time (P=0.786), intraoperative blood loss (P=0.775), chest drainage time (P=0.659), postoperative hospital stay (P=0.824) or the incidence of postoperative complications (P=1.000). ConclusionThe use of pulmonary circulation single-blocking for intersegmental plane identification during thoracoscopic segmentectomy is safe and feasible, and the intersegmental plane can be satisfactorily identified by the single-blocking of arteries or veins.
Forced oscillation technique (FOT) is an active method to test pulmonary function, which can derive the mechanical characteristics of the respiratory system with liner system identification theory by pushing in an oscillation air signal and measuring the changes of output pressure and flow. A pulmonary function determination system was developed based on the FOT in this paper. Several critical technologies of this determination system were analyzed, including the selection criteria of oscillation air generator, pressure and flow sensor, the signal design of oscillation air generator, and the synchronous sampling of pressure and flow data. A software program on LabVIEW platform was set up to control the determination system and get the measuring data. The performance of sensors and oscillation air generator was verified. According to the frequency response curve of the pressure, the amplitude of driving signal to the oscillation air generator was corrected at the frequency range between 4~40 Hz. A simulation experiment was carried out to measure the respiratory impedance of the active model lung ASL5000 and the results were close to the setting values of the model lung. The experiment testified that the pulmonary function determination system based on FOT had performance good enough to provide a tool for the in-depth research of the mechanical properties of the respiratory system.
Lung cancers are highly heterogeneous and resistant to available therapeutic agents, with a five-year survival rate of less than 15%. Despite significant advances in our knowledge of the genetic alterations and aberrations in lung cancer, it has been difficult to determine the basis of lung cancer's heterogeneity and drug resistance. Cancer stem cell model has attracted a significant amount of attention in recent years as a viable explanation for the heterogeneity, drug resistance, dormancy, recurrence and metastasis of various tumors. At the same time, cancer stem cells have been relatively less characterized in lung cancers. This review summarizes the current understanding of lung cancer stem cells, including their molecular features and signaling pathways that drive their stemness. This review also discusses the prognosis of lung cancer and its relationship with lung cancer stem cell, in an effort to eradicate these cells to combat lung cancer.
Based on bioelectrical impedance theory and pattern recognition algorithm, we in this study measured varieties of people's bioelectrical impedance in hands and identified different people according to their bioelectrical impedance. We designed a bioelectrical impedance collection circuit with AD5933 chip to measure the impedance in different people's hands, and we obtained the bioelectrical impedance spectrum for each person under 1-100 kHz electrical stimulation. We calculated the segmentation slopes of bioelectrical impedance spectrum, and took the slopes as characteristic parameters. In order to promote the recognition rate and prevent the overfitting of the model, we divided the people into the training set and the test set, and designed a 3 layer back propagation neural network model to train and test the samples. The results showed that back propagation neural network model could identify the test set effectively. The recognition rate of the training sets was as high as 97.62%, recognition rate of validation sets was 88.79%, recognition rate of test sets was 86.34%, and the synthetical recognition rate was 94.22%. It gives a clue that the network can perfectly recognize people in the training network as well as strangers that comes from the outside of the tests. Our work can verify the feasibility and reliability of using bioelectrical impedance and pattern recognition algorithm for identification, and can provide a simple and supplementary way to identify people.
Objective To evaluate the effectiveness and safety of pure carbon dioxide (CO2) combined with a modified inflation-deflation technique for identifying the intersegmental plane during thoracoscopic segmentectomy. Methods A prospective study was conducted, enrolling 30 patients diagnosed with pulmonary nodules who underwent thoracoscopic anatomical segmentectomy at the Department of Thoracic Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, from March 2024 to March 2025. Patients were randomly assigned to one of two groups using a random number table: A pure oxygen group (O2 group, n=15, 8 females, 7 males, age 28-75 years) and a pure carbon dioxide group (CO2 group, n=15, 8 females, 7 males, age 37-69 years). All patients underwent preoperative three-dimensional computed tomography bronchovascular angiography to reconstruct pulmonary vessels, bronchi, and the virtual intersegmental plane. The time to identification of the ideal intersegmental plane was recorded intraoperatively, along with arterial blood gas measurements before lung inflation and at 5 and 15 minutes after lung inflation on the surgical side. Results The time to identify the intersegmental plane was significantly shorter in the CO2 group compared to the O2 group [(151.1±39.5) s vs. (998.7±78.9) s, P<0.001], and there were no significant fluctuations in intraoperative oxygen saturation in patients in the CO2 group. Furthermore, there were no statistically significant differences between the two groups in terms of operation duration, intraoperative blood loss, postoperative extubation time, total postoperative chest tube drainage, postoperative length of hospital stay, or postoperative complication rate (all P>0.05). Conclusion Pure CO2 combined with a modified inflation-deflation technique can rapidly, accurately, and clearly identify the intersegmental plane, and its safety is non-inferior to that of the pure O2 method, making it worthy of clinical promotion and application.
Objective To investigate the effect of monocyte chemoattractant protein 1 (MCP-1) on the migration of the induced and differentiated mouse bone marrow mesenchymal stem cells (BMSCs) for raising the efficacy of intravenous transplantation of BMSCs. Methods The BMSCs were cultured with the method of differential adhesion and density gradient centrifugation of C57/BL10 mice, and were identified by alkal ine phosphatase Gomori modified staining after osteogenic inducing. At the 3rd passage, the BMSCs were induced to the myoblasts with 5-azacytidine (5-Aza). The chemotaxis of MCP-1 in the induced and differentiated BMSCs in vitro at concentrations of 25, 50, 100, 200, and 400 ng/mL was observed through the migration test, by counting the number of the migrated cells. The expression of the chemokine receptor 2 (CKR-2) in the induced and differentiated BMSCs was detected with the flow cytometry. Results The cells could be cultured with the methods of differential adhesion and density gradient centrifugation and still had higher prol iferative and differentiative potency; the induced cells at the 3rd passage could differenciate to the osteoblasts, confirming that the cells were BMSCs; the myogenic induced BMSCs possesed the sarcotubule structure. The number of the migrating BMSCs at MCP-1 concentrations of 25-400 ng/ mL were respectively 35.066 7 ± 6.584 2, 43.200 0 ± 6.460 8, 44.466 7 ± 4.823 5, 45.600 0 ± 8.650 3, and 50.733 3 ± 7.582 5; showing significant difference when compared with control group (28.333 3 ± 8.917 6, P lt; 0.05), and presenting significant difference among 25, 50, 400 ng/mL groups compared with each other (P lt; 0.05). The expression of CKR-2 in the mouse BMSCs (48.0%) was significantly higher (P lt; 0.001) than those of blank control (0.6%) and negative control (17.0%). Conclusion The results indicate that the MCP-1 can induce the migration of mouse BMSCs by MCP-1/CKR-2 pathway.
ObjectiveTo evaluate the accuracy and practicability of matrix assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF MS) in clinical isolates of mycobacteria.MethodsWe collected all tested strains, which were positive for Mycobacterium tuberculosis culture and positive for acid-fast staining, from West China Hospital of Sichuan University from 2014 to 2017, eliminating duplicate strains sent by the same patient at the same time. The traditional method was used with the P-nitrobenzoic acid (PNB)/ 2-Thiophenecarboxylic acid hydrazide (TCH) indicator to initially identify acid-resistant positive strains. Mycobacteria was identified by MALDI-TOF MS; the specificity and sensitivity of the MALDI-TOF MS was analyzed by duplex primer-polymerase chain reaction (Duplex-PCR) method and DNA sequencing method as the "gold standard" for the identification.ResultsA total of 237 anti-acid positive strains were collected; Mycobacterium tuberculosis complex (MTC) and non-tuberculous mycobacteria (NTM) were identified by mycobacterium double primer PCR, and NTM was identified by 16S rRNA gene sequencing. There were 218 cases of MTC and 19 cases of NTM. The results of preliminary identification using the traditional identification method of PNB/TCH indicator showed that there were 209 cases of MTC (with the sensitivity of 95.9%, specificity of 100.0%, positive predictive value of 100.0%, and negative predictive value of 67.9%) and 28 cases of NTM (with the sensitivity of 100.0%, specificity of 95.9%, positive predictive value of 67.9%, and negative predictive value of 100.0%). The results of MALDI-TOF MS method indicated that there were 199 cases of MTC (with the sensitivity of 91.3%, specificity of 100.0%, positive predictive value of 100.0%, and negative predictive value of 50.0%), 32 cases of NTM (with the sensitivity of 68.4%. specificity of 94.0%, positive predictive value of 40.6%, and negative predictive value of 97.1%), and 6 cases of others. There were 168 strains (84.4%) with the identification score>1.9 obtained by MALDI-TOF MS method.ConclusionsMALDI-TOF MS is a better method for identifying mycobacteria, which has the same identification results as the traditional methods, and has low cost and is suitable for routine use in clinical microbiology laboratories.
In this research a strain of isolated Pseudomonas alcaligenes which causes degradation of dexamethasone was acclimated further and its proteins of every position in the bacterium were separated by the osmotic shock method. The separated intracellular proteins which had the highest enzyme activity were extracted by the salting out with ammonium sulfate and were purified with the cation exchange chromatography and gel chromatography. The purified proteins which was active to cause degradation of dexamethasone had been detected were cut with enzyme and were analyzed with mass spectrometry. The results showed that the degradation rate to dexamethasone by acclimated Pseudomonas alcaligenes were increased from 23.63% to 52.84%. The degrading enzymes were located mainly in the intracellular of the bacteria and its molecular weight was about 41 kD. The specific activity of the purified degrading enzymes were achieved to 1.02 U·mg-1. Its 5-peptide amino acid sequences were consistent with some sequences of the isovaleryl-CoA dehydrogenase. The protein enzyme may be a new kind degrading enzyme of steroidal compounds. Our experimental results provided new strategies for cleanup of dexamethasone in water environment with microbial bioremediation technique.
Objective To observe the morphology and growing status of mesenchymal stem cells(MSCs) of human bone marrow in vitro, in order to confirm that MSCs of human bone marrow are ideal seed cells and provide basic theory for further MSCs research. Methods The methods of density gradient centrifugation with lymphocyte separation medium for human and adherent filtration were used to isolate and purify MSCs of human bone marrow. We observed the cellular growth status and morphology of the primary MSCs and the surface antigens of second passage MSCs were tested. Results The primary culture cells fused into monolayer after 14-16 d. The passage cells kept the same morphological characteristics of primary culture cells. Ultrastructure of the second passage MSCs showed that the shape of nuclei was irregular, there were multiple nucleoli in some of the nuclei, and morphological differentiation of intracytoplasm organelles was immature. The growth curve of the first, fifth and tenth passage cells showed a logarithmic growth at day 3, a peak growth at day 5, and no clones occurred after tenth passage. Cloning efficiency of first passage, fifth passage and tenth passage was respectively 25.83%±2.93%, 14.67%±1.63% and 4.67%±0.52%. Test of MSCs phenotypic characteristics showed a high homogeneity among the cells and surface antigen profiles were positive for CD29, CD44 and negative for CD34, CD45. Conclusion The methods of density gradient centrifugation with lymphocyte separation medium for human and adherent filtration are simple, economic and efficient to isolate and purify MSCs from human bone marrow. With a high proliferating ability in vitro, MSCs from human bone marrow are ideal seed cells for tissue engineers.