Objective:To explore the clinical characteristics and the pathogen characteristics of viridans streptococci infection in elderly patients.Methods:A total of 75 elderly patients aged 65 years and above who were diagnosed with viridans streptococcal infection in the bacterial database of the Affiliated Hospital of Jining Medical University from June 2016 to December 2020 were sellected, and their related clinical data were summarized and retrospectively analyzed.Results:75 elderly patients were collected, including 39 males (52.00%). There were 55 cases (73.33%) with basic diseases. Thirty cases (40.00%) conset by acute fever. The most common type of bacterial culture specimen was sterile body fluid. The classifications of bacterium were as follows: streptococcus mitis in 11 cases (14.67%), streptococcus sanguis in 14 cases (18.67%), streptococcus anginosus in 50 cases (66.67%). Six cases (8.00%) were infected combining with gram-negative bacilli, 2 cases (2.67%) underwent toxic shock syndrome. The drug resistance rates of erythromycin, clindamycin and levofloxacin were 65.33% (49/75), 68.00% (51/75) and 16.00% (12/75) and low resistance rate to ceftriaxone (6.67%, 5/75) and cefotaxime (4.00%, 3/75).Conclusions:Streptococcus virifolia is a common infection group, which is prone to opportunistic infection in the elderly population. Fever is the most common clinical symptom, and pathogenic bacteria may involve multiple systems, and toxic shock syndrome may be induced in severe cases.

Objective:To explore the clinical characteristics, chest imaging manifestations, RAPID score and therapeutic situation in patients with parapneumonic pleural effusion (PPE) caused by streptococcus anginosus group (SAG), in order to provide help for the early diagnosis and treatment in clinical practices. Methods:The clinical data of 39 patients with PPE caused by SAG from January 2015 to May 2020 in Affiliated Hospital of Jining Medical University and Jining First People′s Hospital were retrospectively analyzed. The patients were classified by RAPID score.Results:Among 39 cases, males was in 31 cases (79.5%), females in 8 cases (20.5%), and aged 46 to 89 (65.31±10.53) years old. Fever was in 27 cases (69.2%), chest pain in 19 cases (48.7%), and dyspnea in 18 cases (46.2%). The chest CT findings showed consolidation shadows was in 30 cases (76.9%), encapsulated pleural effusion in 21 cases (53.8%), ground glass shadow in 18 cases (46.2%), nodules in 12 cases (30.8%), atelectasis in 8 cases (20.5%), and pneumothorax in 5 cases (12.8%). The complexity PPE was in 23 cases (59.0%), and empyema in 16 cases (41.0%). The microbiological culture results showed that streptococcus constellatus was detected in 25 cases (64.1%), streptococcus anginosus in 13 cases (33.3%), and streptococcus intermadius in 1 case (2.6%). After comprehensive treatment, 36 cases (92.3%) were improved, 3 cases (7.7%) died. According to the RAPID score, low-risk was in 13 cases (33.3%), intermediate-risk in 16 cases (41.0%), and high-risk in 10 cases (25.7%). The RAPID score in patients with low-risk, intermediate-risk and high-risk was (1.85 ± 0.38), (3.43 ± 0.51) and (5.30 ± 0.67) scores, and there was statistical difference ( F = 124.88, P<0.05). the length of stay in patients with low-risk, intermediate-risk and high-risk of RAPID score was (16.84 ± 5.57), (16.56 ± 7.05) and (28.20 ± 17.97) d, and there was statistical difference ( F = 4.41, P<0.05); the length of stay in patients with high-risk was significantly longer than that in patients with low-risk and intermediate-risk, and there was statistical difference ( P<0.05), there was no statistical difference between intermediate-risk patients and low-risk patients ( P>0.05). Conclusions:SAG, as important pathogens for the PPE, tends to induce CPPE and even pyopneumothorax. Clinical manifestations and imaging are not specific, which should be payed attention in clinical work. The patients with high-risk of RAPID score have more serious condition and worse prognosis.

目的:基于药代动力学/药效学理论，利用蒙特卡洛模拟研究评价和优化碳青霉烯类药物治疗产超广谱β-内酰胺酶(ESBLs)肠杆菌科细菌血流感染的给药方案。方法:收集全国血流感染细菌耐药监测联盟2018至2019年分离自患者血液的产ESBLs肠杆菌科细菌3 225株，其中大肠埃希菌2 731株，肺炎克雷伯菌494株。采用蒙特卡洛模拟计算并比较亚胺培南、美罗培南、厄他培南3种药物不同给药方案对肠杆菌科细菌感染的达标概率(PTA)和累积反应分数(CFR)。结果:对于亚胺培南，当肠杆菌科细菌最低抑菌浓度(MIC)≤0.25 μg/mL时，所有给药方案的PTA值均>93.00%；当MIC＝0.5或1 μg/mL时，除500 mg次/12 h所得PTA不达标外，其余给药方案PTA值均>97.00%；当MIC＝2 μg/mL时，仅500 mg次/6 h，750 mg次/8 h，750 mg次/6 h和1 g次/6 h四种方案的PTA值>90.00%。对于美罗培南，当肠杆菌科细菌MIC＝0.007 μg/mL时，8种给药方案所得PTA值均>90.00%；当MIC≤0.125 μg/mL时，除500 mg次/12 h和1 g次/12 h两种方案外，其余PTA值均>92.00%；当MIC＝0.25 μg/mL时，仅500 mg次/6 h，750 mg次/6 h，1 g次/8 h和2 g次/8 h四种方案的PTA值>90.00%；当MIC＝0.5 μg/mL时，仅500 mg次/6 h，750 mg次/6 h和2 g次/8 h三种方案PTA值>90.00%；当MIC＝1 μg/mL时，8种给药方案PTA值均不达标。对于厄他培南，当肠杆菌科细菌MIC≤0.125 μg/mL时，3种方案PTA值均>92.00%；当MIC＝0.25 μg/mL时，500 mg次/24 h和750 mg次/24 h两种方案的PTA值分别为57.22%和82.75%，1 g次/24 h方案PTA值为92.87%；当MIC≥0.5 μg/mL时，3种给药方案PTA值均<60.00%。亚胺培南7种给药方案CFR值均>92.00%。美罗培南除500 mg次/12 h和1 g次/12 h两种方案的CFR值分别为69.92%和82.33%外，其余6种给药方案CFR值均>98.00%。厄他培南3种给药方案CFR值均>92.00%。结论:通过蒙特卡洛模拟分析，亚胺培南、美罗培南、厄他培南的推荐经验给药方案分别为500 mg次/8 h、500 mg次/8 h或500 mg次/6 h、1 g次/24 h。目的给药需根据肠杆菌科细菌实际MIC值适当调整方案。

Nocardia is a pathogen responsible for a variety of clinical infections. Here, we aimed to investigate the species distribution, clinical manifestations, and antimicrobial susceptibility of Nocardia species over 3 years in two tertiary general hospitals in China. In this retrospective study, a total of 27 Nocardia species were isolated from 27 individuals between January 2017 and December 2019. Nocardia isolates were identified to species level by mass spectrometry and 16S rRNA PCR sequencing. Clinical data were collected from medical records. Antimicrobial susceptibility was determined by the standard Broth microdilution method. The 27 patients with Nocardia infection included 12 males and 15 females with a mean age of 60.11 years. Among 27 Nocardia isolates, 7 species were identified, with the most common species being Nocardia otitidiscaviarum (40.7%). The antimicrobial susceptibility profiles varied between different Nocardia species. Notably, all Nocardia isolates were linezolid susceptible. The majority of Nocardia isolates were collected from a department of respiratory medicine (55.56%) and sputum specimen (44.44%). Pulmonary region was the most involved body site (70.37%) followed by skin (7.4%) and pleural cavity (7.4%). Most patients with Nocardia infection needed combination antibiotic therapy. Two deaths were reported during the treatment period and 24 patients achieved improvement after antibiotic therapy. The clinical manifestations of Nocardia infection and antimicrobial susceptibility profiles varied with diverse Nocardia species. Thus, the accurate identification of these species is crucial for the diagnosis and the selection of antibiotic treatment.

INTRODUCTION:Cancer stem cells have been implicated angiogenesis of tumor and invasiveness, drug resistance in tumors. Yes-associated protein 1 (YAP) owns carcinogenic roles in various organs, but the role of YAP in cancer stem cells of gastric cancer (GC) remains unclear. In this study, we explored the function and mechanism of YAP in GC cancer stem cells.MATERIALS AND METHODS, AND RESULTS:First, we confirmed that the expression of YAP mRNA and protein in GC tissues was higher than in adjacent tissues by RT-PCR, western blot and immunohistochemistry. Immunofluorescence staining of the GC tissues revealed that the region of YAP expression coincided with the region of expression of the cancer stem cell marker SALL4 but did not overlap with that of the epithelial marker cytokeratin 14 (CK14). Additional research revealed that spherical cells expressed relatively high levels of YAP protein, and YAP overexpression reinforced self-renewal and expression of stem cell markers in the GC cells. Knockdown the expression of YAP reversed this phenomenon. Second, we examined the expression patterns of lipocalin-type prostaglandin D2 synthase (L-PTGDS) and prostaglandin D2 receptor 2 (PTGDR2) in GC tissues and proved that there was negatively correlation between the expression of L-PTGDS and PTGDR2 and YAP in GC tissues. Finally, we confirmed that YAP inhibited the expression of L-PTGDS and PTGDR2 by gain- and loss-of-function experiments. Moreover, the overexpression of L-PTGDS and PTGDR2 suppressed the proliferation and self-renewal induced by YAP in vitro and reversed the pro-tumor effect of YAP in vivo.CONCLUSION:Our results revealed a novel function of YAP and the mechanism underlying cancer stem cell regulation by YAP.

A total of 159 patients with Streptococcus milleri (S. milleri) infection were diagnosed in our hospital between January 2014 and January 2019. The demographic data, underlying diseases, infection sites, laboratory tests, and prognosis of patients were retrospectively analyzed; the clinical and microbiological data were compared among different age groups. Of the 159 patients there were 103 were males and 56 females; there were 19 patients aged<18 years [(8.1±5.3) years], 113 patients aged ≥18 and < 65 years [(45.5±13.1) years] and 27 patients aged ≥65 years[(74.7±8.6) years]. The incidence peaked in the 34-55 year age group (50 cases, 31.4%). Streptococcus anginosus was identified in 97 cases (61.0%), Streptococcus constellatus in 55 patients (34.6%) and Streptococcus intermedius in 7 cases (4.4%). The abdomen (44 cases, 27.7%) and the chest (19 cases, 11.9%) were the main involving sites. For patients younger than 18 years and those aged ≥18 and<65 years, suppurative appendicitis was the most common condition[12 cases(12/19) and 21 cases(18.6%), respectively]; while in patients aged ≥65 years, chest infection ranked the first (9 cases, 33.3%). All 159 patients were treated with anti-infection therapy alone or anti-infection and invasive procedures with a favorable prognosis, 2 patients died with a overall fatality rate of 1.3%.

目的 探讨血清GM抗原检测联合肺部CT在COPD合并IPA诊断中的应用价值.方法 对我院2016年1月～2016年12月诊断为COPD且无粒细胞缺乏的316例患者,均行血清GM抗原检测和肺部CT检查.后参照国内外IPA诊断标准,将316例COPD患者分为确诊、临床诊断、拟诊和非曲霉感染组.本研究将确诊、临床诊断和拟诊组纳入IPA组.GM≥0.65判为阳性,将肺部结节、空洞、斑片或索条状高密度影、肺实变作为肺部CT特征性表现.分析数据并比较单独GM实验、GM+CT联合检测对IPA诊断的价值.结果 316例COPD患者IPA组47例,非曲霉感染组269例,发病率14.9％.47例IPA患者中,单独GM阳性20例,阴性27例;GM+CT联合检测阳性17例,阴性30例.两组试验的敏感性、特异性、阳性预测值、阴性预测值分别为42.6％,91.8％,47.6％,90.1％;36.2％,98.9％,85％,89.9％.269例非曲霉感染者中,单独GM阳性22例,GM+CT联合阳性3例.GM+CT联合检测的特异性和阳性预测值与单独GM实验相比,差异有统计学意义(P<0.05).结论 GM+CT联合检测,其特异性和阳性预测值均比单独GM实验显著提高,在非粒缺的COPD合并IPA的诊断中,有较好的应用价值.

目的 探讨联合检测血清(l,3)-β-D-葡聚糖及半乳甘露聚糖抗原在恶性肿瘤患者并发侵袭性真菌感染的早期诊断价值.方法 检测血清(1,3)-β-D 葡聚糖、半乳甘露聚糖抗原在患者体内水平,并对检测结果进行分析.结果 (1,3)-β-D葡聚糖(G试验)的灵敏度、特异度、阳性预测值、阴性预测为 87%、91%、80%和 94%,半乳甘露聚糖抗原(GM试验)为 76%、95%、86%和 91%,G试验联合GM试验联合试验为 97%、81%、69%和99%;治疗前后的G试验均值分别为(251.20±49.90)和(46.20±7.90)pg/mL.GM均值分别为(1.15±0.61)和(0.63±0.25)μg/L.结论 G试验联合GM试验在诊断恶性肿瘤患者并发侵袭性真菌感染患者中具有较高的可靠性,动态监测G试验和GM试验检测结果对临床用药有指导意义.

The aim of the present study was to investigate the effect of Lycium barbarum polysaccharides (LBP) on the treatment of ITP mice and to explore its mechanism. Forty idiopathic thrombocytopenic purpura (ITP) mice were divided randomly into a model control group and LBP groups I, II, III and IV. ITP mice in LBP groups I, II, III, and IV were administered LBP at four different doses (50, 100, 200 and 400 mg·kg-1·d-1, respectively) for 7 days by gavage. Blood samples were collected from the tail veins of the mice after treatment. Platelet counts were determined, and the total antioxidant status (TAS), total oxidant status (TOS) were measured with ELISA kits. The platelet count was (30.28 ± 13.42) × 109/L in the model control group, and the number of platelets in all LBP groups was higher than that in the model control group. The platelet count increased, and it reached (67.09 ± 10.81) × 109/L in LBP group I; the platelet counts in the other three groups increased significantly compared to LBP group I, and they did not differ significantly. TAS concentrations in the LBP groups were significantly increased compared to the model control group, whereas TOS concentrations were significantly decreased. Taken together, these results indicate that LBP is effective at increasing the number of platelet (PLT), and LBP may treat ITP mice via suppressing oxidative stress.

OBJECTIVE To evaluate the production of CHBls,ESBLs and AmpC in clinical specimens-derived Enterobacter cloacae from the affiliated hospital of jining medical college and analyze the drug resistance to 17 common antibiotics,so as to guide rational use of antibiotics in clinical practice.METHODS A total of 112 non-repeated strains of E.cloacae were isolated in our hospital from May 2009 to May 2010.Modified Hodge test was applied to detect CHBls.AmpC was checked by cefoxitin three-dimensional test.Phenotypic confirmatory test was used to detect ESBLs.The drug susceptibility test was performed by Kirby-auer method.RESULTS The 112 strains of E.cloacae were mainly isolated from sputum,accounting for 60.7%,followed by secretions and urine,accounting for 16.1% and 13.4% respectively.Positive rates of CHBls,AmpC and ESBLs in the 112 strains of E.cloacae were 1.8%(2 strains),53.6%(60 strains) and 41.1%(46 strains),respectively.In these strains,28 strains(25.0%) only had ESBLs,42 strains(37.5%) only had AmpC,and 18 strains(16.07%) had both ESBLs and AmpC.CONCLUSION We should enhance the detection and control of E.cloacae producing CHBls.There are very high positive rates of ESBLs and AmpC produced by E.cloacae.Clinical therapy should based on drug susceptibility test and antibacterials are rationally selected according to different enzyme-producing E.cloacae.

Objective To carry out a taxonomic identification of a strain of claviform bacteria iso-lated from prostatic fluid of a patient who suffered from chronic prostatitis, and to approach its phylogenic and biologic position. Methods We undertaked an initial identification by phenotypic characters such as morphologecal, physiological and biochemical characteristics to ascertain its phylogeny by chemical composi-tion analysis of cell wall and 16S rRNA gene sequencing and alignment. Results A club-shaped gram posi-tive rod bacillus was isolated in pure culture state. Its biochemical reactions were not active. The diamino-acid of cell wall was meso-diaminopimelic acid (meso-DAP) and it had wall chemotype Ⅳ ( contained arabi-nose, galactose and maltose ). Sequence searches of the GenBank database revealed that this strain had a highest level of 16S rDNA sequence similarity (99.4%) to C. tuberculostearicurn strain ATCC35692 with only 8 nucleotides difference. Conclusion On the basis of phenotypic and phylngenetie analysis, it is rea-sonable to assign this strain to the species C. tuberculostearicum, and this is the first isolation of C. tubercu-lostearicum from prostatic fluid home and abroad.

Objective To explore the effect of Daicong solution on gene expression of β-APP for aged rat dementia model.Methods 22-month old rats whose basal nuclei were destroyed by kainic acid-induced were used as aged dementia model which had learning and memory disability.The effect of Daicong solution on learning and memory ability and β-APP gene expression for aged rat dementia model by water maze and RT-PCR methods.Results Learning and memory ability of dementia model decreased,gene expression of β-APP increased.three dosage treated groups have remarkably increased learning and memory ability and decreased the contents of β-APP mRNA,compared with model groups(P<0.05).Dose-effect relationship appeared in some degree.Conclusion Daicong solution can improve learning and memory ability and down regulate gene expression of β-APP.

Objective To describe the characteristics and identify a strain of gram-positive club-shaped rod isolated from submaxillary lymphadenitis.Methods The isolated culture and biochemical test were carried on.The DNA was extracted by routine procedure.The interest gene was obtained by PCR with specific primers and purified by gel electrophoresis and sequenced.Results The biological and biochemical characteristics were similar to that of Curtobacterium luteum on the whole.The total 16S rRNA gene was 1 387 bp.The result of sequencing was closely similar(99.7%) to that of C.luteum.Conclusion On the basis of the physiological and biochemistry characteristic analysis and 16S rRNA gene sequence alignment,this strain was assigned to C.luteum and regarded as a new subtype of C.luteum initially.

Burkholderia cocovenenans is the pathogenic bacteri um resulting in food-poisoning of fungus and fermental roce powder.The toxoflavin is one ki nd of toxin produced by this kind of bacteria.Recently,there are some re ports related to its separation and extraction Its poisoning mechanism is studied from different points including its bypass effect on electr on transfer in respiratory chain,inhibition of isozyme activity of lactate de hydrogenase,influence on artery smooth muscle tension and experimental studie s detecting induction of mutation by micronuclei technology and so on.Others findings showed that using technique of electron spin resonance to observe tox oflavin can damage free radical in mouse tissue and human blood cells.This article reviews research progresses of toxoflavin about its chemical extract ion and separation,poisonous mechanism and physiological and biochemical acti vity.

Drug-resistance of pathogenic bacteria resulting from antibiotics abusage in recent several decades has done great threaten to human health.Aggravation of bacterial drug resistance makes people face a draconic reality,that is post-antibiotics era.With the increasing of drug resistance bacteria,antibiotics have not achieved ideal therapeutic efficacy,phagotherapy is attracting more attention from people as a new therapeutic method.Studies showed that phagotherapy has many advantages that many antibiotics can not achieved.If we can deal with it using a feasible method,it will really play great antibacterial action in therapy.

Except for corynebacterium diphtheriae,the other bacteria belonging to corynebacterium are often considered to be conditional pathogenic bacteria which parasitize in oral cavity,nasal cavity,pars laryngea pharyngis,alvearium,eye conjunctiva,cunnus and skin of human and further result in kinds of infection in host with low resistance.Corynebacterium parvum is a kind of drastic immunoactivator,which can inhibit the growth and metastasis of tumor.So corynebacterium parvum has been widely used in research and clinic as a kind of nonspecific immunoactivator in the treatment of human tumor immunotherapy.

Objective To explore the effect of Daicong solution on gene expression of M1,M3 receptor in aged rat dementia model.Methods 22-month old rats whose basal nuclei were destroyed by kainic acid-induced were used as aged dementia model which had learning and memory disability.Water maze and RT-PCR methods were used to detect the effect of Daicong solution on learning and memory ability and M1,M3 receptor gene expression in aged rat dementia model.Results Learning and memory ability of dementia model decreased,gene expression of M1,M3 receptor increased remarkably in moderate and high dose treated groups,compared with model groups(P0.05).Dose-effect relationship appeared in some degree.Conclusion Daicong solution can improve learning and memory ability and up regulate gene expression of M1,M3 receptor.

Objective To explore a new fast and effective method curing intractable pyogenic infection of pate. Methods Polyvalency staphylococcus vaccine was combined with different types of staphylococcus which were separated,identified and screened from infected positions of clinical patients and was used to cure intractable furunculosis of pate.Results The cure rate achieved 77.3% and the total effective rate achieved above 97.7% of 88 clinical patients suffering from intractable furunculosis of pate.Conclusion Polyvalency staphylococcus vaccine worked fast and persistant in curing intractable pyogenic infection of pate.There were no obvious adverse reaction and the therapeutic effect was satisfying.