Background:Hypertension (HTN) and anemia contribute to left ventricular (LV) hypertrophy and are associated with adverse outcomes. Anemia is often overlooked in patients with HTN, and its combined impact on the heart may be underestimated. The study aims to investigate the additive effects of anemia on LV function and global strains in individuals with essential HTN, utilizing cardiac magnetic resonance (CMR) imaging. Methods:A total of 238 patients diagnosed with HTN and 67 sex- and age-matched controls who underwent CMR examination were retrospectively included. All HTN patients were divided into two groups: 88 with anemia and 150 without anemia. LV performance was evaluated using CMR including LV function parameters, LV global radial peak strain (GRPS), global circumferential peak strain (GCPS), and global longitudinal peak strain (GLPS). Comparisons among the three groups were conducted using one-way analysis of variance (ANOVA), the Kruskal-Wallis test, or the Chi-squared test. Additionally, multivariable linear regression analysis was performed to investigate factors associated with LV global strains. Results:The HTN patients with anemia were older and had lower hemoglobin concentration and estimated glomerular filtration rate, and higher indices for LV end-diastolic volume, end-systolic volume, mass index, and mass/volume ratio compared with the control group and HTN without anemia group (all P<0.001). Additionally, the GLPS and GCPS deteriorated progressively from the HTN without anemia group to the HTN with anemia group when compared with the control group (all P<0.001). After adjusting for age, GLPS (-10.40%±0.46% vs. -11.95%±0.35%, P=0.008), GCPS (-16.60%±0.52% vs. -18.08%±0.39%, P=0.025), and GRPS (28.95%±1.49% vs. 32.72%±1.14%, P=0.048) were significantly poorer in HTN patients with anemia compared with those without anemia. Furthermore, multivariate analysis revealed significant independent associations between anemia and GLPS (β =0.308, P=0.002), GCPS (β =0.273, P=0.004), and GRPS (β =-0.142, P=0.021). Conclusions:Anemia has additive deleterious effects on LV function and global strains in patients with HTN. Regular monitoring and early intervention of anemia might be beneficial for patients with HTN.

BACKGROUND:Understanding the impact of aortic regurgitation (AR) on hypertensive patients' hearts is important. PURPOSE:To assess left ventricular (LV) strain and structure in hypertensive patients and investigate the relationship with AR severity. STUDY TYPE:Retrospective. POPULATION:263 hypertensive patients (99 with AR) and 62 controls, with cardiac MRI data. FIELD STRENGTH/SEQUENCE:Balanced steady-state free precession (bSSFP) sequence at 3.0T. ASSESSMENT:AR was classified as mild, moderate, or severe based on echocardiographic findings. LV geometry was classified as normal, concentric remodeling, eccentric hypertrophy, or concentric hypertrophy based on MRI assessment of LV mass/volume ratio and LV Mass index (LVMI). LV global radial peak strain (GRPS), global circumferential peak strain (GCPS), and global longitudinal peak strain (GLPS) were obtained by post-processing bSSFP cine datasets using commercial software. STATISTICAL TESTS:ANOVA, Kruskal-Wallis test, Spearman's correlation coefficients (r), chi-square test, and multivariable linear regression analysis. A P value <0.05 was considered statistically significant. RESULTS:Hypertensive patients with AR had significantly lower LV myocardial strain and higher LVMI than the group without AR (GRPS 26.25 ± 12.23 vs. 34.53 ± 9.85, GCPS -17.4 ± 5.84 vs. -20.57 ± 3.57, GLPS -9.86 ± 4.08 vs. -12.95 ± 2.94, LVMI 90.56 ± 38.56 vs.58.84 ± 17.55). Of the 99 patients with AR, 56 had mild AR, 26 had moderate AR and 17 had severe AR. The degree of AR was significantly negatively correlated to the absolute values of LV GRPS, GCPS and GLPS (r = -0.284 - -0.416). LV eccentric hypertrophy increased significantly with AR severity (no AR 21.3%, mild AR 42.9%, moderate AR 73.1%, severe AR 82.4%). In multivariable analysis, the degree of AR was an independent factor affecting LV global strain and LVMI even after considering confounding factors (β values for global myocardial strain were -0.431 to -0.484, for LVMI was 0.646). DATA CONCLUSION:Increasing AR severity leads to decreased cardiac function and worse ventricular geometric phenotypes in hypertensive patients. LEVEL OF EVIDENCE:4 TECHNICAL EFFICACY: Stage 3.

Objective:To study the distribution and drug resistance characteristics of pathogenic bacteria in the elderly population of China by collecting and analyzing the standardized case data on the pathogens of infections in elderly patients, and to facilitate the establishment of a standardized layered surveillance system for pathogenic bacteria in China. Methods:We collected the case data of elderly patients (≥65 years old) from 62 sentinel hospitals across the country in 2021. Then, we statistically analyzed the data by patient age, their geographical region, the distribution of pathogenic bacteria, and the drug resistance characteristics of main pathogens. Results:A total of 3468 cases from across the country were included in the study. The top three sources of patients were the intensive care unit (13.2%), the department of respiratory medicine (11.2%), and the department of general surgery (8.4%). The top three types of specimens were urine (25.5%), sputum (20.6%), and blood (18.7%). A total of 3468 strains of pathogens were isolated, among which, 78.9% were gram-negative bacteria and 21.1% were gram-positive bacteria. The top five types of bacteria were Escherichia coli (20.9%), Klebsiella pneumoniae (18.3%), Pseudomonas aeruginosa (11.2%), Staphylococcus aureus (9.0%), and Acinetobacter baumannii (7.0%). The isolation rates of common important drug-resistant bacteria were 38.0% for methicillin-resistant Staphylococcus aureus (MRSA), 68.7% for carbapenem-resistant Acinetobacter baumannii (CRAB), and 38.2% for carbapenem-resistant Pseudomonas aeruginosa (CRPA), 20.1% for carbapenem-resistant Klebsiella pneumoniae (CRKP), 5.2% for carbapenem-resistant Escherichia coli (CRECO), and 2.1% for vancomycin-resistant Enterococcus (VRE). There were differences in the isolation rates of CRAB and CRKP in clinical care in the elderly population in seven geographical regions of China (P<0.05). Klebsiella pneumoniae is the most important pathogen in the elderly population ≥85 years old, and the isolation rates of CRKP showed significant differences in different age groups (P<0.05). Conclusion:There are significant differences in the drug resistance of pathogenic bacteria in the elderly populations of different regions and age groups in China. Therefore, monitoring the distribution and drug resistance of pathogenic bacteria in the elderly population and formulating targeted treatment plans according to the characteristics of the specific regions and age groups are of great significance to the improvement in the treatment outcomes and prognosis of the elderly population.

Acinetobacter baumannii is emerging as a pathogen that is a focus of global concern due to the frequent occurrence of the strains those are extensively resistant to antibiotics. This study was aimed to analyze the clinical and microbiological characteristics of a cohort of patients with A. baumannii bloodstream infections (BSIs) in western China. A retrospective study of the patients at West China Hospital of Sichuan University with A. baumannii BSIs between Jan, 2018 and May, 2023 was conducted. Antimicrobial susceptibility of A. baumannii isolates was tested by microdilution broth method. Whole-genome sequencing and genetic analysis were also performed for these isolates. Among the 117 patients included, longer intensive care unit stay, higher mortality, and more frequent invasive procedures and use of more than 3 classes of antibiotics were observed among the carbapenem-resistant A. baumannii (CRAB)-infected group (n = 76), compared to the carbapenem-susceptible A. baumannii (CSAB)-infected group (n = 41, all P ≤ 0.001). Twenty-four sequence types (STs) were determined for the 117 isolates, and 98.7

OBJECTIVE:To assess the influence of FLT3 expression on the prognosis of patients with acute myeloid leukemia (AML) by cell experiment and clinical data analysis.METHODS:Models for FLT3 over-expression and interference-expression in AML cells were constructed. The level of BAK gene expression and its protein product was determined, along with the proliferation and apoptosis of leukemia cells. FLT3 gene expression and FLT3-ITD variant were determined among patients with newly diagnosed AML.RESULTS:Compared with the interference-expression group, the level of BAK gene expression and its protein in FLT3 over-expression AML cells was significantly lower (P < 0.001), which also showed significantly faster proliferation (P < 0.001) and lower rate of apoptosis (P < 0.001). The expression level of FLT3 gene among patients with newly diagnosed AML was also significantly higher compared with the healthy controls (P < 0.001). The FLT3 gene expression of FLT3-ITD positive AML patients was higher than that of FLT3-WT patients (P = 0.002). Survival analysis showed that AML patients with high FLT3 expression in the medium-risk group had a lower complete remission rate and overall survival rate compared with those with a low FLT3 expression (P < 0.001).CONCLUSION:Over-expression of FLT3 may influence the course of AML by promoting the proliferation of leukemia cells and inhibiting their apoptosis, which in turn may affect the prognosis of patients and serve as a negative prognostic factor for AML.

Objective:To analyze the detection rate, in vitro susceptibility to antibiotics, and carbapenemase types of carbapenem-resistant Enterobacteriaceae (CRE) strains in the clinical samples of a hospital and to provide support for the prevention, control and treatment of CRE-related infections.Methods:Clinical specimens were examined according to the operating procedures of bacteriological tests. Species identification and in vitro drug susceptibility testing were performed on the isolated strains. Carbapenemase inhibitor enhancement testing, which combined the use of 3-aminobenzeneboronic acid and ethylenediaminetetraacetic acid, was conducted to identify the types of carbapenemase in the CRE strains.Results:In 2021, 2215 CRE strains were isolated from 157196 clinical samples collected in this hospital, presenting a detection rate of 1.4% (2215/157196). A total of 1134 non-repetitive strains of CRE were isolated from 903 patients. The main sources of samples were respiratory tract (494/1134, 43.6%), secretion (191/1134, 16.8%) and blood (173/1134, 15.3%) samples. The cases with the same CRE strain isolated from the samples of two, three and four sites accounted for 12.5%, 4.9%, and 1.1%, respectively. The most common species was Klebsiella pneumoniae (883/1134, 77.9%), followed by Enterobacter cloacae complex (107/1134, 9.4%) and Escherichia coli (96/1134, 8.5%). The rates of resistance to polymyxin B and tigecycline of different species of CRE strains were not significantly different ( P<0.05). Serine carbapenemase-producing strains, metallo-β-lactamase-producing strains, and those producing both enzymes accounted for 82.6% (809/979), 17.2% (168/979), and 0.2% (2/979), respectively.Conclusion:CRE strains are frequently isolated from samples collected from the respiratory tract, secretion, and blood. The most common strain is serine carbapenemase-producing K. pneumoniae, which has a high resistance rate to various antimicrobial drugs, and risk factors of its associated infections deserve more attention.

Mitral regurgitation may occur when hypertension causes left ventricular (LV) and left atrial (LA) remodeling. However, its role in LA function in hypertensive patients remains unclear.

Forecasts help businesses allocate resources and achieve objectives. At LinkedIn, product owners use forecasts to set business targets, track outlook, and monitor health. Engineers use forecasts to efficiently provision hardware. Developing a forecasting solution to meet these needs requires accurate and interpretable forecasts on diverse time series with sub-hourly to quarterly frequencies. We present Greykite, an open-source Python library for forecasting that has been deployed on over twenty use cases at LinkedIn. Its flagship algorithm, Silverkite, provides interpretable, fast, and highly flexible univariate forecasts that capture effects such as time-varying growth and seasonality, autocorrelation, holidays, and regressors. The library enables self-serve accuracy and trust by facilitating data exploration, model configuration, execution, and interpretation. Our benchmark results show excellent out-of-the-box speed and accuracy on datasets from a variety of domains. Over the past two years, Greykite forecasts have been trusted by Finance, Engineering, and Product teams for resource planning and allocation, target setting and progress tracking, anomaly detection and root cause analysis. We expect Greykite to be useful to forecast practitioners with similar applications who need accurate, interpretable forecasts that capture complex dynamics common to time series related to human activity.

ObjectivesHypertension is one of the leading risk factors for cardiovascular disease. Mitral regurgitation (MR) is a heart valve disease commonly seen in hypertensive cases. This study aims to assess the effect of MR on left ventricle (LV) strain impairment among essential hypertensive cases and determine factors that independently impact the global peak strain of the LV.Materials and methodsWe enrolled 184 essential hypertensive patients, of which 53 were patients with MR [HTN (MR +) group] and 131 were without MR [HTN (MR−) group]. Another group of 61 age-and gender-matched controls was also included in the study. All participants had received cardiac magnetic resonance examination. The HTN (MR +) group was classified into three subsets based on regurgitation fraction, comprising mild MR (n = 22), moderate MR (n = 19), and severe MR (n = 12). We compared the LV function and strain parameters across different groups. Moreover, we performed multivariate linear regression to determine the independent factors affecting LV global radial peak strain (GRS), circumferential peak strain (GCS), and global longitudinal peak strain (GLS).ResultsHTN (MR−) cases exhibited markedly impaired GLS and peak diastolic strain rate (PDSR) but preserved LV ejection fraction (LVEF) compared to the controls. However, HTN (MR +) patients showed a decrease in LVEF and further deteriorated GRS, GCS, GLS, PDSR, and the peak systolic strain rate (PSSR) compared to the HTN (MR−) group and controls. With increasing degrees of regurgitation, the LV strain parameters were gradually reduced in HTN (MR +) patients. Even the mild MR group showed impaired GCS, GLS, PDSR, and PSSR compared to the HTN (MR−) group. Multiple regression analyses indicated that the degree of regurgitation was independently associated with GRS (β = -0.348), GCS (β = -0.339), and GLS (β = -0.344) in HTN (MR +) patients.ConclusionGLS was significantly impaired in HTN (MR−) patients. MR may further exacerbate the deterioration of LV strain among essential hypertensive cases. Besides, the degree of regurgitation was independently correlated with GRS, GCS, and GLS in HTN (MR +) patients.

目的 探究本地区肺炎克雷伯菌(KP)临床分离株的毒力特征及其与耐药表型的关系.方法 菌株来源于2018年8月-2020年4月四川大学华西医院收治的临床诊断为KP相关感染病例送检样本中分离出的KP菌株,根据菌株对碳青霉烯类药物的敏感性,分为碳青霉烯类耐药肺炎克雷伯菌(CRKP)组和碳青霉烯类敏感肺炎克雷伯菌(CSKP)组,两组各随机选择30株,采用基质辅助激光解吸电离质谱进行菌株鉴定,Vitek2 Compact全自动微生物系统进行药物敏感性分析,拉丝试验检测高黏表型,多重聚合酶链反应(PCR)检测毒力基因rmpA、entB、iutA、allS、aerobactin、fimH、ureA 和 wabG.结果 CSKP 组和 CRKP 组对常见抗菌药物的耐药率差异均具有统计学意义(P＜0.05);CSKP分离株中高黏液表型占63.30％(19/30),CRKP分离株中高黏液表型占6.70％(2/30),差异具有统计学意义(P＜0.05);CSKP组的毒力基因检出率高于CRKP组(iutA除外),但rmpA、wabG、aerobactin、entB、fimH和ureA基因检出率CSKP组和CRKP组比较,无统计学差异;菌株rmpA、aerobactin、entB和allS基因携带率与常用抗菌药物的敏感性呈正相关(P＜0.05),iutA基因携带率与常用抗菌药物的耐药性呈正相关(P＜0.05).结论 CSKP分离株的高黏液表型呈现率高、毒力基因检出率高.携带rmpA、aerobactin、entB和allS基因的KP分离株对常用抗菌药物的敏感性更高,携带iutA基因的KP分离株对常用抗菌药物的耐药性更高.

Purpose To investigate the different imaging features of contrast-enhanced multidetector-row-computed tomography (MDCT) for distinguishing between silicosis and tuberculosis involving the mediastinal lymph nodes. Methods 86 silicosis patients and 61 tuberculosis patients with mediastinal lymphadenopathy based on contrast-enhanced MDCT were included. The enhanced patterns, anatomical distribution and calcification features of the enlarged lymph nodes were retrospectively compared between the groups using the Pearson chi-square test or Fisher's exact test. Results Homogeneous enhancement of the mediastinal lymph nodes was more commonly observed in silicosis (94.2%, 81/86) than in tuberculosis (19.7%, 12/61). Peripheral enhancement was more frequent in tuberculosis (n = 44, 72.1%) than in silicosis involving the mediastinal lymph nodes (n = 1, 1.2%), and multilocular appearance was more frequent in TB than in silicosis. Tuberculosis was more likely to affect regions 1R, 2R, 2L, 3A, 5 and 6 than silicosis (all p < 0.05), especially region 2R. Calcification of the lymph nodes was more common in the silicosis group than in tuberculosis group. The sensitivity, specificity, and accuracy of silicosis with lymphadenopathy with homogeneous enhanced pattern were 94.2%, 80.3% and 88.4%, respectively. The sensitivity, specificity, and accuracy of tuberculosis lymphadenopathy with peripheral enhanced pattern were 72.1%, 98.8%, and 87.7%, respectively. Conclusion The predominant enhanced patterns, anatomical distribution, and calcification features of mediastinal lymph nodes were different between tuberculosis and silicosis. These radiographic features might help differentiate tuberculosis from silicosis, which provides imaging information for the differential diagnosis of the two diseases in a clinical setting.

Background To assess the morphological features of persistent truncus arteriosus (PTA) on low-dose dual-source computed tomography (DSCT) and compare its diagnostic value for associated cardiovascular anomalies with that of transthoracic echocardiography (TTE). Methods :Twenty-four PTA patients were enrolled in this retrospective study. The types of PTA, diameters of the truncus artery (TA), main pulmonary artery (MPA), right pulmonary artery (RPA), left pulmonary artery (LPA), and ventricular septal defect (VSD) on DSCT were recorded. Besides, all associated cardiovascular abnormalities were assessed. The diagnostic performance of DSCT and TTE for associated anomalies were compared. The effective doses of DSCT were calculated. Results: Four types were found: type A1(n=13/24, 54.17%), type A2(n=7/24, 29.16%), type A3（n=3/24, 12.50%）and type A4(n=1/24,4.17%). The mean diameter of VSD, TA, MPA, RPA, and LPA was 1.47±0.56cm, 3.92±1.56cm, 2.27±1.65cm, 1.48±0.74cm and 1.38±0.66cm, respectively. 78 associated cardiovascular anomalies were confirmed. The most common associated abnormalities were VSD (100%), right-sided aortic arch (33.33%) and aortopulmonary collateral vessels (29.17%). Although TTE was better at diagnosing intracardiac anomalies (accuracy:99.17% vs. 95%; sensitivity: 97.06% vs. 88.24%; specificity: 100% vs. 97.67%), DSCT had an advantage in diagnosing the associated cardiovascular abnormalities (accuracy: 98.61% vs. 96.07%; sensitivity: 94.87% vs. 82.05%; specificity: 99.44% vs. 99.15%). The estimated mean effective doses was 0.98±0.37mSv (＜1mSv). Conclusions: Low-dose DSCT could accurately confirm the morphological features of PTA. Compared to TTE, low-dose DSCT is a better diagnostic tool for associated cardiovascular abnormalities. Combining with TTE will be beneficial to provide more accurate information for clinical interventions.

目的 总结新型冠状病毒肺炎疫情期间四川大学医学检验技术专业线上实习录播教学经验,以探索医学检验技术实习教学新模式,为提高医学检验实习教学效率与质量提供参考.方法 2020年6月8日-30日,对参与了疫情期间线上实习教学的带教老师和实习同学进行网络问卷调查,对线上实习教学效果进行评估调查,并比较线上、线下实习的优缺点.结果 共收回有效问卷65份,来自35名实习同学和30名带教老师.实习同学线上、线下实习总体满意度评分的中位数(最小值,最大值)分别为100(80,100)、100(80,100)分,差异无统计学意义(P＞0.05);带教老师中,90.0％认为线上实习教学的带教前准备更复杂耗时,60.0％认为线上实习带教中的讲授更困难,63.3％认为线上实习相对线下实习更不能达到预期效果;被调查师生均认为线上、线下实习各有优缺点,可取长补短.结论 单一的线上实习模式不可取代传统的线下实习,线上、线下结合的多样化实习模式可帮助进一步发展和完善医学检验实习教学.

目的 采用心脏磁共振电影成像(cine-CMR)技术快速定量评价保留射血分数的肥厚型心肌病(HCM)患者的双心房结构及功能改变.方法 回顾性分析2015年7月至2019年9月在本院诊断为HCM的患者资料,且左心室射血分数(LVEF)≥50％的患者53例,设为HCM组;同时选取同时期在本院行心脏磁共振(CMR)检查的53名健康体检者为对照组.测量HCM组及对照组双心房指标,包括左、右心房舒张末期及收缩末期纵径、横径及面积,并分别计算其纵径、横径及面积变化率.采用两独立样本t检验进行分析.结果 HCM组左心房舒张末期纵径、横径及面积均大于对照组,左心房横径、纵径及面积变化率均小于对照组,差异有统计学意义(P＜0.05);HCM组右心房舒张末期纵径、横径、面积及纵径、横径、面积变化率与对照组比较,差异均无统计学意义(P＞0.05).结论 采用cine-CMR技术能够快速评价保留射血分数的HCM患者双心房结构及功能的改变,在LVEF保留时期患者已有左心房结构及功能的改变.

目的 建立马尔尼菲篮状菌血流感染的实验室诊断路径,为该类疾病的诊治提供参考.方法 采集疑似发生真菌血流感染的患者外周血液样本,进行血细胞计数、血涂片染色及镜检;同时进行血培养检测,将仪器报阳且涂片查见丝状真菌的样本进行温度依赖型双相生长试验,对可疑菌落采用形态学和基质辅助激光解析电离飞行时间质谱进行菌种鉴定;采用显色法检测患者血清中(1-3)-β-D葡聚糖含量;收集患者临床资料,进行统计学分析.结果 纳入病例24例,平均年龄42.2岁(20～55岁),男21例,女3例,基础疾病均为艾滋病.8例(34.8％)外周血白细胞计数降低,20例(87.0％)血红蛋白下降.24例分离株经形态学及质谱鉴定为马尔尼菲篮状菌,其中1例(4.2％)外周血涂片镜检见马尔尼菲篮状菌特征形态.8例进行血清(1-3)-β-D葡聚糖检测,其中5例阳性(62.5％).16例住院患者中,10例(62.5％)有呼吸系统感染症状,12例(75.0％)发生继发感染,住院时长平均12.0 d,住院病死率为52.3％.结论 马尔尼菲篮状菌血流感染的实验室诊断应综合外周血细胞计数、血培养、真菌G试验以及临床资料,这类病例免疫力差,易继发感染,预后较差.

Objective Todeterminetherelationshipbetweenthetumorvolumeoftheperipherallungadenocarcinomawith maximum diameter≤3cmandlymphnodemetastasis(LNM).Methods TheMSCTmanifestationsof235subjectswhowerediagnosedasperipheral lungadenocarcinomawithmaximumdiameter≤3cm wereretrospectivelyanalyzed.Thesepatientsweregroupedaccordingtodifferent parametersincludingsmokinghistory,differentiation,tumorconsistencyandavailabilityoftumornecrosis.Tumorvolumeandratesof LNMamongthesegroupswerecompared.ROCanalysiswasusedtocalculatethecut-offvalueanddiagnosticaccuracy.Results (1) ThetumorvolumeofLNMgroupwaslargerthanthatofnoLNMgroup,cut-offvaluewas5.5cm3,andAUCwas0.76;(2)Therates ofLNMofthewell,moderate-well,moderate,moderate-poorandpoordifferentiationgroupswere0%,8.7%,17.7%,45.6%and46.7%respectively.Theratesofpuregroundglassopacity(p-GGO),mixedandsolidtumorwere0%,8.3%and29.3%respectively.The ratesofthetumorpresentandabsentofnecrosiswere47.8%,22.0%respectively(P＜0.05).Conclusion Usingthevolumeoftumor on MSCTtopredictLNMisanewnon-invasivewayofassessingLNM,withhighsensitivityandspecificity,whichcouldsupplymore imaginginformationforsurgeonstochoosethewayoflymphnodedissection.

目的 评价基质辅助激光解吸电离飞行时间质谱仪(matrix assisted laser desorption ionization time of flight mass spectrometry,MALDI-TOF MS)法在临床分离的分枝杆菌鉴定中的准确性和实用性.方法 收集2014年—2017年四川大学华西医院所有结核分枝杆菌培养阳性且抗酸染色阳性的待测菌株,并剔除同一时间、同一患者送检的重复菌株,经传统方法对硝基苯甲酸(P-nitrobenzoic acid,PNB)/噻吩-2-羧酸肼(2-thiophenecarboxylic acid hydrazide,TCH)指示剂初步鉴定.运用MALDI-TOF MS法鉴定分枝杆菌,以双重引物聚合酶链反应(duplex primer-polymerase chain reaction,Duplex-PCR)法和DNA测序法作为鉴定结果的“金标准”,统计分析MALDI-TOF MS法的特异性和敏感性.结果 共计收集237例抗酸染色阳性菌株,经分枝杆菌Duplex-PCR鉴定区分结核分枝杆菌复合群(Mycobacterium tuberculosis complex,MTC)和非结核分枝杆菌(non-tuberculous mycobacteria,NTM),再用16S核糖体RNA基因测序将NTM鉴定到种,其中MTC 218例,NTM 19例,经传统鉴定方法PNB/TCH指示剂初步鉴定,其中MTC 209例,鉴定灵敏度为95.9％、特异度为100.0％、阳性预测值为100.0％、阴性预测值为67.9％,NTM 28例,灵敏度为100.0％、特异度为95.9％、阳性预测值为67.9％、阴性预测值为100.0％.MALDI-TOF MS鉴定结果为MTC 199株,NTM 32株,其他6株,MALDI-TOF MS鉴定MTC的灵敏度为91.3％、特异度为100.0％、阳性预测值为100.0％、阴性预测值为50.0％,NTM鉴定灵敏度为68.4％、特异度为94.0％、阳性预测值为40.6％、阴性预测值为97.1％,MALDI TOF鉴定分数＞1.9分的菌株168株(84.4％).结论 MALDI-TOF MS是较好的鉴定分枝杆菌的方法,具有与传统方法较一致的鉴定结果,且成本低廉,适合临床微生物实验室常规使用.

The BCR-ABL fusion gene (BCR-ABL) has different subtypes such as p210 and p190 with p190 appear to lead to a worse prognosis. To explore the mechanism of difference in pathogenesis and prognosis in different BCR-ABL subtype-related leukemia, expression profile microarray analysis was conducted between p190 and p210 patients and verified by RT-PCR. The p21-activated kinase (PAK1) gene was chosen and regulation of the PAK1-STAT5 biological axis and its influence on proliferation and apoptosis in leukemia cells were also analyzed. The results showed that PAK1 might be an important molecular mechanism of the pathogenic difference between different BCR-ABL subtypes. In P210 (+) chronic myelogenous leukemia (CML), down-regulated PAK1 gene expressions may lead to the suppression of cell proliferation and promotion of apoptosis through phosphorylation of STAT5, with a reverse effect in P190 (+) acute lymphoblastic leukemia(ALL), especially acute B lymphoblastic leukemia (B-ALL). Additionally, in P210 (+) CML, down-regulated PAK1 expression may enhance the effect of TKI, whereas the reverse is true in P190 (+) B-ALL, demonstrating that PAK1 might also be an important therapeutic target between different BCR-ABL subtypes.

目的 对四川大学华西医院361例疑似肺孢子菌肺炎(PC P)患者核酸检测结果进行统计分析,分析PCP发病率以及PCP患者年龄、科室和病种分布情况.方法 采用实时荧光定量PCR(qPCR)技术对PCP疑似病例进行核酸检测和诊断,通过实验室信息系统(LIS)和医院信息系统(HIS)收集患者耶氏肺孢子菌(PJ)核酸检测结果和患者临床信息.使用SPSS22.0和EXCLE2007软件对数据进行统计分析.结果 361例疑似PC P病例的总体患病率为31.02％(112/361),总体病死率为8.93％(10/112);年龄为31～40岁的疑似病例PCP发病率最高,达46.51％(20/43),41～50岁年龄段PJ核酸检测阳性病例32例(28.75％),占比最高;HIV患者和肾脏病患者的PC P发病率最高.结论 PC P发病呈现年轻化趋势,肾脏疾病正成为PC P的高发基础病种.