Background Our study was to investigate the prevalence of carbapenemase genes in strains of Enterobacteriaceae species exhibiting decreased susceptibility to carbapenems in our hospital. Methods The carbapenemase producing Enterobacteriaceae species were confirmed by modified Hodge test (MHT) and EDTA-disc synergy test which indicating the production of class B carbapenemases. PCR and sequencing analysis were used to identify the drug-resistant genes. DNA fingerprinting based on enterobacterial repetitive intergenic consensus (ERIC)-PCR was applied to investigate the homology of Enterobacteriaceae species. Results From a collection of 1,472 Enterobacteriaceae species, 18 isolates with decreased susceptibility to carbapenem treatment were identified and 9 of which were positive by MHT, and 6 of which produced class B carbapenemases. PCR and sequencing analysis of the 18 isolates revealed 4 different carbapenemase genes ( bla IMP-8 , bla oxa-1 , bla IMP-26 , and bla oxa-47 ) in 10 isolates, with the bla IMP-8 and bla oxa-1 genes being the most common (60-70% prevalence). ERIC-PCR showed 5, 2, and 2 unique genotypes for Enterobacter cloacae , Escherichia coli , and Klebsiella pneumoniae , respectively. Three E. coli strains isolated from different patients from the urologic surgery department exhibited the same DNA banding pattern, suggesting a possible clonal dissemination. Majority (17/18) of the carbapenem-unsusceptible Enterobacteriaceae species isolates was obtained from the surgery department of our hospital. Conclusions The main carbapenemase genes of Enterobacteriaceae species in our hospital were bla IMP-8 and bla oxa-1 . Prevalence of carbapenem resistance may be existed in surgery department and infection control should be taken for preventing further dissemination of drug-resistant strains.

Pseudomonas aeruginosa is a ubiquitous bacterium which is able to attach to many abiotic and biotic surfaces and form biofilms resulting in infections.

To determine the safety of low-calcium-dialysate in patients undergoing maintenance hemodialysis (MHD) and its effects on coronary artery calcification (CAC) and analyze clinical risk factors for CAC. A total of 174 MHD patients were recruited and randomly divided into two groups: high-calcium dialysate (HCD, 1.5 mmol/L Ca2+) and low-calcium dialysate (LCD, 1.25 mmol/L Ca2+). Changes in CAC score (CACS) and cardiac function were evaluated using spiral computed tomography and echocardiography, respectively. Clinical and laboratory parameters were measured. Intra-dialysis adverse reactions were recorded and compared between the two groups. CACS was significantly lower in the LCD group than in the HCD group by the end of the study. Cardiac E/Amax was significantly higher in the LCD group than in the HCD group by the end of the study. There was no significant difference in the frequency of any intra-dialysis adverse reactions between the two groups during the study. LCD is helpful in maintaining cardiac diastolic function and postponing CAC progression. LCD does not increase intra-dialysis adverse reactions. Age may be the most important factor impacting CAC in MHD patients.

Objectives: Although congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), and asthma patients typically present with abnormal auscultatory findings on lung examination, respiratory sounds are not normally subjected to rigorous analysis. The aim of this study was to evaluate in detail the distribution of respiratory sound intensity in CHF, COPD, and asthma patients during acute exacerbation.Methods: Respiratory sounds throughout the respiratory cycle were captured and displayed using an acoustic-based imaging technique. Breath sound distribution was mapped to create a gray-scale sequence of two-dimensional images based on intensity of sound (vibration). Consecutive CHF (n = 22), COPD (n = 19), and asthma (n = 18) patients were imaged at the time of presentation to the emergency department (ED). Twenty healthy subjects were also enrolled as a comparison group. Geographical area of the images and respiratory sound patterns were quantitatively analyzed.Results: In healthy volunteers and COPD patients, the median (interquartile range [IQR]) geographical areas of the vibration energy images were similar, at 75.6 (IQR = 6.0) and 75.8 (IQR = 10.8) kilopixels, respectively (p > 0.05). Compared to healthy volunteers and COPD patients, areas for CHF and asthma patients were smaller, at 66.9 (IQR = 9.9) and 53.9 (IQR = 15.6) kilopixels, respectively (p < 0.05). The geographic area ratios between the left and right lungs for healthy volunteers and CHF and COPD patients were 1.0 (IQR = 0.2), 1.0 (IQR = 0.2), and 1.0 (IQR = 0.1), respectively. Compared to healthy volunteers, the geographic area ratio between the left and right lungs for asthma patients was 0.5 (IQR = 0.4; p < 0.05). In healthy volunteers and CHF patients, the ratios of vibration energy values at peak inspiration and expiration (peak I ⁄ E ratio) were 4.6 (IQR = 4.4) and 4.7 (IQR = 3.5). In marked contrast, the peak I ⁄ E ratios of COPD and asthma patients were 3.4 (= 2.1) and 0.1 (IQR = 0.3; p < 0.05), respectively.

A femoral artery pseudoaneurysm (FAP) is a serious complication of arterial injury. It can cause compression of the surrounding nerves and tissues, rupture and bleeding of the aneurysm, and formation and dislodgement of thrombi, and can lead to distal limb embolism, tissue necrosis, and infection. Computed tomography angiography and ultrasonography are the preferred techniques for diagnosis of FAP. This report describes the successful treatment of an FAP using an ultrasound-guided percutaneous intracavitary injection of a lyophilized human fibrin sealant. This treatment was safe, associated with minimal pain and complications, and clinically effective. K E Y W O R D S chronic kidney disease, femoral artery pseudoaneurysm, lyophilized human fibrin sealant, thrombin, ultrasound

Background and Aims The novel coronavirus disease 2019 (COVID‐19) causes severe respiratory illnesses, following exposure to air‐borne droplets or direct contact, posing a great threat to human life. This study aimed to investigate perceived stress and its correlation with the health behaviors of Chinese residents during the COVID‐19 epidemic. Methods An Internet survey was conducted among 2449 residents in 20 provinces of China on residents' perceived stress, perception of COVID‐19, and health behaviors. SAS 9.4 was used to analyze the relationship between health behaviors and perceived stress, and logistic regression was used to explore the factors influencing health risk stress. Results The participants' perceived stress score was 22.25 ± 7.2 (total 56), and the incidence of health risk stress was 39.89% (977/2449). Females, students, and medical staff were at high risk. Health risk stress refers to a level of stress that is hazardous to health (score over 25). Perceived stress increased, while the frequency of health behaviors decreased. Age, perception of susceptibility to COVID‐19, life‐threatening level of COVID‐19, perception of the importance of home isolation, and perception of the difference between a common cold and COVID‐19 were positively related to the occurrence of health risk stress. Conclusions A negative correlation was found between health behaviors and perceived stress. Therefore, it is of great significance to provide psychological interventions for those who are experiencing health risk stress and to promote their health behaviors.