ObjectiveTo explore the prognostic risk factors of bloodstream infections caused by Acinetobacter baumannii in the hospital, to provide a basis for clinical diagnosis and treatment.MethodsA retrospective analysis was performed on the medical records of patients diagnosed with Acinetobacter baumannii bloodstream infection in Guangxi Zhuang Autonomous Region People’s Hospital between January 2013 and December 2018. The patients were divided into survival group and non-survival group according to the outcome within 30 days after blood culture was collected. Univariate and multivariate logistic analyses were used to identify the risk factors of Acinetobacter baumannii bloodstream infections.ResultsA total of 123 patients were included, including 48 in the survival group and 75 in the non-survival group. Third generation cephalosporins [odds ratio (OR)=2.492, 95% confidence interval (CI) (2.125, 2.924), P<0.001], carbapenems [OR=1.721, 95%CI (1.505, 1.969), P<0.001], multidrug resistant-Acinetobacter baumannii infection [OR=1.240, 95%CI (1.063, 1.446), P=0.006], post-operation [OR=0.515, 95%CI (0.449, 0.590), P<0.001], mechanical ventilation [OR=1.182, 95%CI (1.005, 1.388), P=0.043], indwelling central venous catheter [OR=0.116, 95%CI (0.080, 0.169), P<0.001], mixed infection or septic shock [OR=3.935, 95%CI (2.740, 5.650), P<0.001], APACHE Ⅱ score (≥15) [OR=5.939, 95%CI (5.029, 7.013), P<0.001], chronic kidney disease [OR=1.440, 95%CI (1.247, 1.662), P<0.001], immune system disease [OR=28.620, 95%CI (17.087, 47.937), P<0.001], use of corticosteroids [OR=0.520, 95%CI (0.427, 0.635), P<0.001], and combined antifungal agents [OR=0.814, 95%CI (0.668, 0.992), P=0.041] were independent factors for predicting the prognosis of patients with bloodstream infections caused by Acinetobacter baumannii.ConclusionsThe third generation cephalosporins, carbapenem, MDR-Acinetobacter baumannii infection, post-operation, mechanical ventilation, indwelling central venous catheter, mixed infection or septic shock, APACHE Ⅱ score (≥15), chronic kidney disease, immune system disease, use of corticosteroids, and combined antifungal agents were independent factors for predicting the prognosis of patients with bloodstream infections caused by Acinetobacter baumannii. In the clinical work, it is needed to carry out timely detection of microbial etiology, timely report, and reasonable treatment.
Objective To review the application advancements of ATP-binding cassette (ABC) transporter in medical research.Methods Relevant literatures about the applications of ABC families in medical research were reviewed. Results ABC families mainly took roles in transporting substances across cell membrane. Some of them were useful for the prediction of drug resistance and the prognosis of malignant tumors. Others were target s for molecular researches. Their expressions or mutations might be related with the occurrence of diseases. Conclusion ABC families are very important in the diagnosis and therapy for diseases. Thus they are very promising tools for future medical research.
Objective To study the expression and significance of multidrug resistance-associated protein (MRP) gene in hepatocellular carcinoma (HCC). Methods Reverse transcription polymerase chain reaction (RT-PCR) assay was used to detect the expression of MRP mRNA in 25 fresh specimens of the primary HCC and its surrounding liver tissues. Immunohistochemistry LSAB technique was adopted to test MRP in 60 HCC specimens. The drug sensitivity was also tested by flow cytometry.Results The positive expression rates of MRP mRNA and MRP protein in primary HCC were 44.00%(11/25) and 45.00%(27/60) respectively. All the intensity of expression was low, but significant higer than its surrouding liver tissues (P＜0.05). The intensity and expression rate of MRP protein in 5 recurrent HCC had a tendency to increase. There was a correlation between the expression of MRP mRNA and MRP protein in 25 patients using RT-PCR and immunohistochemistry assay (Plt;0.05). Detected by flow cytometry, the average sensitivity of drugs in vitro of 60 HCC sp-cimens were 5-FU （15.80±7.63）%，DDP（18.45±9.59）%，ADM（17.95±7.99）%，MMC（16.60±8.69）% and CTX（17.40±10.14）%. Only 5FU and ADM were significantly affected by the expression of MRP protein (Plt;0.05).Conclusion The expression of MRP in primary HCC may be one of the important mechanisms of the intrinsic and acquired drug resistance in HCC. To study the expression of MRP could give a predictive value in HCC chemotherapy.
【Abstract】 Objective To detect the expression of lung resistance protein (LRP) and investigate its significance in pancreatic carcinoma cell lines (SW1990, PCT-2, PCT-3, PCT-4, Aspc-1, Capan-1, Mia-PaCa-2 and Panc-1). Methods Reverse transcription PCR (RT-PCR) and immunocytochemistry (ICC) were carried out to investigate the expression of LRP. Results LRP mRNA was absent in PCT-2 cell line by RT-PCR. Mild to moderate expression level was found in other pancreatic carcinoma cell lines. PCT-4, Aspc-1 and Panc-1 presented the highest LRP mRNA expression level, in contrast, SW1990, PCT-3, Capan-1 and Mia-PaCa-2 showed moderate LRP mRNA expression. The median value was 0.56±0.33. LRP was further validated by ICC. Absent to weak protein expression of LRP was found in PCT-2 and PCT-3. Overexpressed LRP was present in SW1990, Capan-1 and Aspc-1, furthermore, the highest expression of LRP was found in Panc-1, Mia-PaCa-2 and PCT-4 cell lines. Conclusion All these data showed that LRP might play an important role in multidrug resistance of pancreatic carcinoma.
Objective To investigate the reversal effect of antisense phosphorothioate oligonucleotide （ASOND) on human hepatoma resistant cells. Methods Human hepatoma resistant cells SMMC-7721 was transfected with synthetic antisense phosphorothioate oligonucleotide complementary to the 5′ region flanking the AUG initiation codon mediated by lipofectamine. In vitro drug sensitivity was measured by MTT assay. The expression of P-170 was determined by flow cytometry and mRNA was assessed by RT-PCR. Results ASOND inhibited the expression of mRNA and p-170 in SMMC-7721, enhanced the sensitivity of SMMC-7721 to chemotherapeutic drug. The best inhibitory effect was achived by the dose of 0.5μmol/L. Conclusion ASOND enhanced the sensitivity of SMMC-7721 to chemotherapeutic drug and reversed the multidrug resistance of SMMC-7721 partially.
ObjectiveTo explore the relationship between mdr1 gene expression of hepatocellular carcinoma (HCC) and pathological characteristics,chemotherapy and prognosis. MethodsThe mdr1 gene expression of HCC in 56 patients with the methods of immunohistochemistry was studied. The results were analysed with the pathological data by statistic methods. ResultsThe positive expression of mdr1 gene in cancer tissues and pericancerous tissues of HCC were 30/56(53.6%) and 19/56 (33.9%) respectively. The difference was statistically significant (χ2=4.39,P＜0.05). The positive expression of mdr1 gene in cancer tissues of untreated patients and in recurrent patients were 22/48(45.8%) and 8/8(100%) respectively.The expression of mdr1 gene was not associated with tumor size, number, tumor thrombus, differentiation, HBsAg and liver cirrhosis. The patients with positive mdr1 expression had a shorter survival time than that of negative ones. But the difference was not statistically significant. Conclusion The positive expression of mdr1 in HCC is 53.6%. It is not associated with tumor size, number, tumor thrombus, tumor differentiation, HBsAg and liver cirrhosis. There are innate multidrug resistance in HCC.
【Abstract】Objective To review the advances in overcoming multidrug resistance of tumors caused by mdr1 gene.Methods Different ways of overcoming multidrug resistance of tumors caused by mdr1 gene in the literatures were reviewed. Results One of the important reasons causing multidrug resistance was due to the overexpression of mdr1 gene and its product Pglycoprotein. There were two ways to overcome multidrug resistance of tumors through mdr1 genes mRNA and its product Pglycoprotein effectively.Conclusion The clinical test of the unitary way to overcome multidrug resistance of tumors is unsatisfactory, combining different ways to overcome multidrug resistance of tumors will be the hot spot of tumors research in the future.
Objective To investigate the detection of multidrug-resistant organisms (MDRO) by targeted monitoring in a tertiary hospital, and to understand the distribution of MDRO. Methods We retrospectively analyzed the detection and distribution of methicillin-resistantStaphylococcus aureus (MRSA), carbon black alkeneAcinetobacter baumannii (CRABA), carbapenem-resistantPseudomonas aeruginosa (CRPAE), vancomycin-resistantEnterococci (VRE) and carbapenem-resistantEnterobacter (CRE) in clinical samples collected from 2013 to 2015. Results A total of 990 multidrug-resistant bacteria strains were isolated from 2013 to 2015, of which 445 were MRSA (44.95%), 328 were CRABA (33.13%), 99 were CRPAE (10.00%), 12 were VRE (1.21%), and 106 were CRE (10.71%). They were mainly distributed in the Department of Burn, Comprehensive ICU, Department of Neurosurgery, Department of Respiratory Medicine and Department of Orthopedic Surgery. The detection rates of multidrug-resistant organisms of 2013-2015 were 10.85% (352/3 244), 9.20% (304/3 303), and 7.11% (334/4 699) respectively, which reduced year by year with significant difference (χ2= 34.42,P< 0.001). The detection rates of CRPAE, CRE and VRE all reduced with significant differences (P< 0.05). Conclusions The detection rate of multidrug-resistant organisms under targeted monitoring shows an obvious downward trend. MRSA and CRABA are still the major MDROs, which show no obvious change. The detection rates of CRPAE, VRE and CRE show obvious downward trend. Department of Burn, Comprehensive ICU, Department of Neurosurgery, Department of Respiratory Medicine and Department of Orthopedic Surgery have the highest risks of MDRO. In the future, we should strengthen the monitoring of high-risk departments, and focus on the reasonable choice of special antimicrobial agents to avoid special MDROs.
Objective To review the recent studies on the multidrug resistance of breast cancer. Methods The literatures of recent years on the studies of multidrug resistance, multidrug resistance protein and breast cancer resistance protein were reviewed. Results Multidrug resistance resulted from multiple factors. How to identify the sensibility of chemotherapy drugs and select individual therapeutic regime early were important to improve the survival rate and life quality of breast cancer patients. Conclusion These studies on multidrug resistance of breast cancer are helpful to predicting the effect and outcome of chemotherapy and overcoming the barrier of drug resistance.
【Abstract】ObjectiveTo construct an mdr1 expression vector and detect its expression in HepG2 cells in vitro. MethodsThe 4.5-kb mdr1 cDNA was obtained from the plasmid pHaMDR1 cloned into the PCIneo mammalian expression vector, which was later transferred into human hepatocarcinoma cell line HepG2 by liposome. Then the HepG2 cells resisting G418 were clustered and proliferated，and the specific fragment of mdr1 cDNA, mRNA and the Pgp in these HepG2 cells were detected by means of PCR, RT-PCR and FCM respectively. ResultsThe mdr1 expression vector was constructed successfully，and the stable multidrug resistance(MDR) hepatocarcinoma cell line （HepG2/mdr1） was developed as well. The outcome of PCR analysis showed that the specific fragment of mdr1 cDNA could be found in HepG2/mdr1 cells, but not in the nontransfection HepG2 cells. Furthermore,the content of the specific fragment of mdr1 mRNA and the expression of P-gp in HepG2/mdr1 cells were (59.7±7.9)% and (12.5±5.45)% respectively, the corresponding value in HepG2 cells were (16.9±3.2)% and (4.63±2.59)% respectively. The difference was statistically significant (P＜0.05). ConclusionIt is praticable to develop MDR hepatocarcinoma cell line by transferring mdr1 cDNA into HepG2 cells, which is useful in the research of MDR mechanism.