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An Outbreak of Infections Caused by a Klebsiella pneumoniae ST11 Clone Coproducing Klebsiella pneumoniae Carbapenemase-2 and RmtB in a Chinese Teaching Hospital

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Chinese Medical Journal 2016年第17期129卷 2033-2039页

作者： Jun Li Ming-Xiang Zou Hai-Chen Wang qing-ya dou Yong-Mei Hu Qun yan Wen-En Liu Department of Clinicat Laboratory Xiangya Hospital Central South University Changsha Hunan 410008 China Department of Infection Control Center Xiangya Hospital Central South University Changsha Hunan 410008 China

Background： Klebsiellapneumoniae carbapenemase （KPC）-producing K. pneumoniae bacteria, which cause serious disease outbreaks worldwide, was rarely detected in Xiangya Hospital, prior to an outbreak that occurred from August 4, 2014, to March 17, 2015. The aim of this study was to analyze the epidemiology and molecular characteristics of the K. pneumoniae strains isolated during the outbreak. Methods： Nonduplicate carbapenem-resistant K. pneumoniae isolates were screened for blanc,＂ and multiple other resistance determinants using polymerase chain reaction. Subsequent studies included pulsed-field gel electrophoresis （PFGE）, multilocus sequence typing, analysis of plasmids, and genetic organization ofblaKPC-2 locus. Results： Seventeen blaKPC-2-positive K. pneumoniae were identified. A wide range of resistant determinants was detected. Most isolates （88.2%） coharbored blaKPC-2 and rmtB in addition to other resistance genes, including biaSHV-1, blaTEM-1, and aac（3）-lla. The blaKPC-2 and rmtB genes were located on the conjugative IncFIB-type plasmid. Genetic organization of blaKPC-2 locus in most strains was consistent with that of the plasmid pKP048. Four types （A l, A2, A3, and B） were detected by PFGE, and Type A1, an ST11, was the predominant PFGE type. A novel K. pneumoniae sequence type （ST1883） related to STI 1 was discovered. Conclusions： These isolates in our study appeared to be clonal and STI 1 K. pneumoniae was the predominant clone attributed to the outbreak. Coharbing of blaKPC-2 and rmtB, which were located on a transferable plasmid, in clinical K. pneumoniae isolates may lead to the emergence of a new pattern of drug resistance.

关键词： Carbapenem： Klebsiella pneumoniae： Klebsiella pneumoniae Carbapenemase Outbreak： RmtB

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Inetetamab combined with pyrotinib and chemotherapy in the treatment of breast cancer brain metastasis: A case report

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World Journal of Clinical Cases 2024年第3期12卷 575-581页

作者： qing-qing dou Ting-Ting Sun Guo-Qiang Wang Wei-Bing Tong Graduate Student Institute Inner Mongolia Medical UniversityHohhot 010000Inner Mongolia Autonomous RegionChina Central Breast Area B Beijing University Cancer Hospital Inner Mongolia HospitalHohhot 010000Inner Mongolia Autonomous RegionChina

BACKGROUND Breast cancer brain metastasis(BCBM)is an advanced breast disease that is difficult to treat and is associated with a high risk of death.Patient prognosis is usually poor,with reduced quality of life.In this context,we report the case of a patient with HER-2-positive BCBM treated with a macromolecular mAb(ine-tetamab)combined with a small molecule tyrosine kinase inhibitor(TKI).CASE SUMMARY The patient was a 58-year-old woman with a 12-year history of type 2 diabetes.She was compliant with regular insulin treatment and had good blood glucose control.The patient was diagnosed with invasive carcinoma of the right breast(T3N1M0 stage IIIa,HER2-positive type)through aspiration biopsy of the ipsilateral breast due to the discovery of a breast tumor in February 2019.Immunohistochemistry showed ER(-),PR(-),HER-2(3+),and Ki-67(55-60%+).Preoperative neoadjuvant chemotherapy,i.e.,the AC-TH regimen(epirubicin,cyclophosphamide,docetaxel-paclitaxel,and trastuzumab),was administered for 8 cycles.She underwent modified radical mastectomy of the right breast in November 2019 and received tocilizumab targeted therapy for 1 year.Brain metastasis was found 9 mo after surgery.She underwent brain metastasectomy in August 2020.Immunohistochemistry showed ER(-)and PR.(-),HER-2(3+),and Ki-67(10-20%+).In November 2020,the patient experienced headache symptoms.After an examination,tumor recurrence in the original surgical region of the brain was observed,and the patient was treated with inetetamab,pyrotinib,and capecitabine.Whole-brain radiotherapy was recommended.The patient and her family refused radiotherapy for personal reasons.In September 2021,a routine examination revealed that the brain tumor was considerably larger.The original systemic treatment was continued and combined with intensity-modulated radiation therapy for brain metastases,followed by regular hospitalization and routine examinations.The patient’s condition is generally stable,and she has a relatively high quality of life.This case report demonstrates that

关键词： Breast cancer brain metastasis Resistance to trastuzumab Macromolecule inetetamab Small molecule tyrosine kinase inhibitor Radiation therapy HER2-positive Case report

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Fabricating functionally graded Fe-Cr-Co permanent magnetic alloys via laser powder bed fusion

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Journal of Iron and Steel Research(International) 2024年第3期31卷 729-737页

作者： ya-zhou He ya-qing Hou Peng Shen Hao Zhang Dong Zhou Hang Su Central Iron and Steel Research Institute Co. Ltd.Beijing 100081China Material Digital R&D Center China Iron and Steel Research Institute Group Co.Ltd.Beijing 100081China

Laser powder bed fusion(LPBF)in-situ alloying technology offers the possibility to construct gradient materials with varied structures and properties.Functionally graded Fe-Cr-Co permanent magnetic alloys were fabricated by LPBF and in-situ alloying mixed powders of Fe,Cr,and Co elements.The effects of different Fe,Cr and Co contents on the microstructure,magnetic properties and hardness of Fe-Cr-Co alloys prepared by LPBF were studied.The as-built Fe-Cr-Co alloys present a single body-centered-cubic phase and have a homogeneous distribution of elements.The mechanical properties and magnetic properties of the compositionally graded sample show a gradient variation.With the increase in Cr content,the Vickers hardness of the sample increases,and the saturation magnetization of the sample decreases.The optimal magnetic properties in an isotropic state are given as coercivity HcB=21.65 kA/m,remanence Br=0.70 T and energy product(BH)_(max)=5.35 kJ/m^(3),which are comparable to or higher than the reported magnetic properties in an isotropic state prepared by traditional powder metallurgy.LPBF in-situ alloying technology has the potential to further explore Fe-Cr-Co magnetic materials,such as those consisting of multiple or more constituent elements,and to maximize the compositional flexibility of magnetic materials.

关键词： Fe-Cr-Co alloy Laser powder bed fusion In-situ alloying Functional material Magnetic property

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Acupuncture for obesity and related diseases:Insight for regulating neural circuit

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Journal of Integrative Medicine 2024年第2期22卷 93-101页

作者： Lin-yan Jiang Jun Tian ya-nan yang Shao-hui Jia qing Shu Department of Rehabilitation Medicine Zhongnan HospitalWuhan UniversityWuhan 430071Hubei ProvinceChina School of Sports Medicine Wuhan Sports UniversityWuhan 430079Hubei ProvinceChina Department of Traditional Chinese Medicine China Resources&Wu Gang General HospitalWuhan 430080Hubei ProvinceChina

Obesity is defined as abnormal or excessive fat accumulation that may impair health.Obesity is associated with numerous pathological changes including insulin resistance,fatty liver,hyperlipidemias,and other obesity-related diseases.These comorbidities comprise a significant public health threat.Existing anti-obesity drugs have been limited by side effects that include depression,suicidal thoughts,cardiovascular complications and stroke.Acupuncture treatment has been shown to be effective for treating obesity and obesity-related conditions,while avoiding side effects.However,the mechanisms of acupuncture in treating obesity-related diseases,especially its effect on neural circuits,are not well understood.A growing body of research has studied acupuncture’s effects on the endocrine system and other mechanisms related to the regulation of neural circuits.In this article,recent research that was relevant to the use of acupuncture to treat obesity and obesity-related diseases through the neuroendocrine system,as well as some neural circuits involved,was summarized.Based on this,acupuncture’s potential ability to regulate neural circuits and its mechanisms of action in the endocrine system were reviewed,leading to a deeper mechanistic understanding of acupuncture’s effects and providing insight and direction for future research about obesity.

关键词： Obesity Acupuncture Neural circuit Appetite Energy metabolism

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Precision targeting in hepatocellular carcinoma:Exploring ligandreceptor mediated nanotherapy

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World Journal of Hepatology 2024年第2期16卷 164-176页

作者： Xia-qing Zhou ya-Ping Li Shuang-Suo Dang Department of Infectious Diseases Second Affiliated Hospital of Xi'an Jiaotong UniversityXi'an 710004Shaanxi ProvinceChina

Hepatocellular carcinoma(HCC)is the most common primary liver cancer and poses a major challenge to global health due to its high morbidity and mortality.Conventional chemotherapy is usually targeted to patients with intermediate to advanced stages,but it is often ineffective and suffers from problems such as multidrug resistance,rapid drug clearance,nonspecific targeting,high side effects,and low drug accumulation in tumor cells.In response to these limitations,recent advances in nanoparticle-mediated targeted drug delivery technologies have emerged as breakthrough approaches for the treatment of HCC.This review focuses on recent advances in nanoparticle-based targeted drug delivery systems,with special attention to various receptors overexpressed on HCC cells.These receptors are key to enhancing the specificity and efficacy of nanoparticle delivery and represent a new paradigm for actively targeting and combating HCC.We comprehensively summarize the current understanding of these receptors,their role in nanoparticle targeting,and the impact of such targeted therapies on HCC.By gaining a deeper understanding of the receptor-mediated mechanisms of these innovative therapies,more effective and precise treatment of HCC can be achieved.

关键词： Targeting Hepatocellular carcinoma Receptor Nanomedicine Chemotherapy

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Association between childhood obesity and gut microbiota:16S rRNA gene sequencing-based cohort study

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World Journal of Gastroenterology 2024年第16期30卷 2249-2257页

作者： Xu-Ming Li qing Lv ya-Jun Chen Lu-Biao yan Xin Xiong Laboratory Department Nanjing Medical University Affiliated Obstetrics and Gynecology Hospital(Nanjing Maternal and Child Health Hospital)Nanjing 210004Jiangsu ProvinceChina Department of Pediatrics Shenzhen University General HospitalShenzhen 518055Guangdong ProvinceChina Department of Inspection Division Women’s Hospital of Nanjing Medical University(Nanjing Maternity and Child Health Care Hospital)Nanjing 210004Jiangsu ProvinceChina Department of Pediatrics Women’s Hospital of Nanjing Medical University(Nanjing Maternity and Child Health Care Hospital)Nanjing 210004Jiangsu ProvinceChina Department of Neonatology Chenzhou First People’s HospitalChenzhou 423000Hunan ProvinceChina

BACKGROUND This study aimed to identify characteristic gut genera in obese and normal-weight children(8-12 years old)using 16S rDNA sequencing.The research aimed to provide insights for mechanistic studies and prevention strategies for childhood obesity.Thirty normal-weight and thirty age-and sex-matched obese children were included.Questionnaires and body measurements were collected,and fecal samples underwent 16S rDNA sequencing.Significant differences in body mass index(BMI)and body-fat percentage were observed between the groups.Analysis of gut microbiota diversity revealed lowerα-diversity in obese children.Differences in gut microbiota composition were found between the two groups.Prevotella and Firmicutes were more abundant in the obese group,while Bacteroides and Sanguibacteroides were more prevalent in the control group.AIM To identify the characteristic gut genera in obese and normal-weight children(8-12-year-old)using 16S rDNA sequencing,and provide a basis for subsequent mechanistic studies and prevention strategies for childhood obesity.METHODS Thirty each normal-weight,1:1 matched for age and sex,and obese children,with an obese status from 2020 to 2022,were included in the control and obese groups,respectively.Basic information was collected through questionnaires and body measurements were obtained from both obese and normal-weight children.Fecal samples were collected from both groups and subjected to 16S rDNA sequencing using an Illumina MiSeq sequencing platform for gut microbiota diversity analysis.RESULTS Significant differences in BMI and body-fat percentage were observed between the two groups.The Ace and Chao1 indices were significantly lower in the obese group than those in the control group,whereas differences were not significant in the Shannon and Simpson indices.Kruskal-Wallis tests indicated significant differences in unweighted and weighted UniFrac distances between the gut microbiota of normal-weight and obese children(P<0.01),suggesting substantial disparities in both the species

关键词： Childhood obesity Gut microbiota 16S rDNA sequencing Diversity analysis Genus identification Body mass index

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To explore the mechanism of Yigong San anti-gastric cancer and immune regulation

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World Journal of Gastrointestinal Oncology 2024年第5期16卷 1965-1994页

作者： dou-dou Lu Ling Yuan Zhao-Zhao Wang Jian-Jun Zhao Yu-Hua Du Na Ning Guo-qing Chen Shi-Cong Huang Yi yang Zhe Zhang Yi Nan School of Clinical Medicine Ningxia Medical UniversityYinchuan 750004Ningxia Hui Autonomous RegionChina College of Pharmacy Ningxia Medical UniversityYinchuan 750004Ningxia Hui Autonomous RegionChina Traditional Chinese Medicine College Ningxia Medical UniversityYinchuan 750004Ningxia Hui Autonomous RegionChina Department of Chinese Medical Gastrointestinal China-Japan Friendship HospitalBeijing 100029China Key Laboratory of Ningxia Minority Medicine Modernization Ministry of Education Ningxia Medical UniversityYinchuan 750004Ningxia Hui Autonomous RegionChina

BACKGROUND Yigong San(YGS)is a representative prescription for the treatment of digestive disorders,which has been used in clinic for more than 1000 years.However,the mechanism of its anti-gastric cancer and regulate immunity are still remains unclear.AIM To explore the mechanism of YGS anti-gastric cancer and immune regulation.METHODS Firstly,collect the active ingredients and targets of YGS,and the differentially expressed genes of gastric cancer.Secondly,constructed a protein-protein interaction network between the targets of drugs and diseases,and screened hub genes.Then the clinical relevance,mutation and repair,tumor microenvironment and drug sensitivity of the hub gene were analyzed.Finally,molecular docking was used to verify the binding ability of YGS active ingredient and hub genes.RESULTS Firstly,obtained 55 common targets of gastric cancer and YGS.The Kyoto Encyclopedia of Genes and Genomes screened the microtubule-associated protein kinase signaling axis as the key pathway and IL6,EGFR,MMP2,MMP9 and TGFB1 as the hub genes.The 5 hub genes were involved in gastric carcinogenesis,staging,typing and prognosis,and their mutations promote gastric cancer progression.Finally,molecular docking results confirmed that the components of YGS can effectively bind to therapeutic targets.CONCLUSION YGS has the effect of anti-gastric cancer and immune regulation.

关键词： Gastric cancer Yigong San Mechanism Immune

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Basilic vein variation encountered during surgery for arm vein port:A case report

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World Journal of Clinical Cases 2024年第12期12卷 2086-2091页

作者： Cheng-Da Hu Rui Lv ya-Xin Zhao Ming-Hao Zhang Hong-dou Zeng Yi-Wen Mao Department of Breast Surgery The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical UniversityWenzhou 325000Zhejiang ProvinceChina

BACKGROUND Venous variations are uncommon and usually hard to identify,and basilic vein variation is particularly rare.Basilic vein variation usually presents without any clinical symptoms and is often regarded as a benign alteration.This case was a patient with congenital basilic vein variation encountered during surgery for an infusion port.CASE SUMMARY We documented and analyzed an uncommon anatomical variation in the basilic vein encountered during arm port insertion.This peculiarity has hitherto remained undescribed in the literature.We offer remedial strategies for addressing this anomaly in the future and precautionary measures to circumvent its occurrence.We conducted a comprehensive review of analogous cases in the literature,offering pertinent therapeutic recommendations and solutions,with the aim of enhancing the efficacy and safety of future arm port implantations.CONCLUSION Venous variation is rare and requires detailed intraoperative and postoperative examination to ensure accuracy,so as not to affect subsequent treatment.

关键词： Totally implantable venous access ports Arm ports Venous variation Postoperative breast cancer Systematic review Case report

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Recovering from prolonged cardiac arrest induced by electric shock:A case report

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World Journal of Clinical Cases 2024年第13期12卷 2248-2253页

作者： Jian Zhang yan-Ru Qiao ya-Dong yang Guo-Zheng Pan Chong-qing Lv Department of General Surgery Shengli Oilfield Central HospitalDongying 257000Shandong ProvinceChina Department of Emergency Medicine Shengli Oilfield Central HospitalDongying 257000Shandong ProvinceChina

BACKGROUND Cardiac arrest(CA)induced by electric shock is a rare occurrence,particularly in cases of prolonged CA.Currently,there is limited literature on similar incidents,and we present a relevant case report.CASE SUMMARY A 27-year-old Asian male man,experiencing respiratory CA due to electric shock,was successfully restored to sinus rhythm after 50 min of cardiopulmonary resuscitation and 8 electrical defibrillation sessions.In the subsequent stages,the patient received multiple organ function protection measures,leading to a successful recovery and eventual discharge from the hospital.CONCLUSION Prolonging resuscitation time can enhance the chances of survival for patients,this study provide valuable insights into the management of electric shock-induced CA.

关键词： Electric shock Cardiac arrest Prolonged cardiopulmonary resuscitation Cerebral resuscitation Case report

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Evaluation of the efficacy and safety of endoscopic band ligation in the treatment of bleeding from mild to moderate gastric varices type 1

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World Journal of Gastroenterology 2024年第5期30卷 440-449页

作者： Yue Deng ya Jiang Tong Jiang Ling Chen Hai-Jun Mou Bi-Guang Tuo Guo-qing Shi Department of Gastroenterology Digestive Disease HospitalThe Affiliated Hospital of Zunyi Medical UniversityZunyi 563000Guizhou ProvinceChina Department of Gastroenterology Guizhou Hospital of the First Affiliated HospitalSun Yat-sen UniversityGuiyang 550000Guizhou ProvinceChina Department of Gastroenterology Yinjiang Autonomous County People’s HospitalTongren 554300Guizhou ProvinceChina

BACKGROUND According to practice guidelines,endoscopic band ligation(EBL)and endoscopic tissue adhesive injection(TAI)are recommended for treating bleeding from esophagogastric varices.However,EBL and TAI are known to cause serious complications,such as hemorrhage from dislodged ligature rings caused by EBL and hemorrhage from operation-related ulcers resulting from TAI.However,the optimal therapy for mild to moderate type 1 gastric variceal hemorrhage(GOV1)has not been determined.Therefore,the aim of this study was to discover an individualized treatment for mild to moderate GOV1.AIM To compare the efficacy,safety and costs of EBL and TAI for the treatment of mild and moderate GOV1.METHODS A clinical analysis of the data retrieved from patients with mild or moderate GOV1 gastric varices who were treated under endoscopy was also conducted.Patients were allocated to an EBL group or an endoscopic TAI group.The differences in the incidence of varicose relief,operative time,operation success rate,mortality rate within 6 wk,rebleeding rate,6-wk operation-related ulcer healing rate,complication rate and average operation cost were compared between the two groups of patients.RESULTS The total effective rate of the two treatments was similar,but the efficacy of EBL(66.7%)was markedly better than that of TAI(39.2%)(P<0.05).The operation success rate in both groups was 100%,and the 6-wk mortality rate in both groups was 0%.The average operative time(26 min)in the EBL group was significantly shorter than that in the TAI group(46 min)(P<0.01).The rate of delayed postoperative rebleeding in the EBL group was significantly lower than that in the TAI group(11.8%vs 45.1%)(P<0.01).At 6 wk after the operation,the healing rate of operation-related ulcers in the EBL group was 80.4%,which was significantly greater than that in the TAI group(35.3%)(P<0.01).The incidence of postoperative complications in the two groups was similar.The average cost and other related economic factors were greater for the EBL than for the TAI(P<0.01).CONC

关键词： Gastric varices Type 1 gastric variceal hemorrhage Endoscopic band ligation Tissue adhesive injection

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