Pathogenic characteristics and drug resistance spectrum of Enteroaggregative Escherichia coli in infant food in Liaoning Province from 2018 to 2020

ObjectiveTo give a solid foundation for the epidemiological data of diarrheagenic Escherichia coli （DEC）， and provide a basis for the rational drug use for foodborne diseases caused by DEC， the continuous monitoring of DEC from 2018 to 2020 in Liaoning Province was carried out. The pathogenic characteristics and drug sensitivity characteristics of DEC were investigated.MethodsA total of 208 infant food in Liaoning Province were collected， from which Enterobacteriaceae was isolated， and 16S rRNA gene sequencing analysis and biochemical identification were carried out. The virulence genes of E.coli were detected. The serotype and drug resistance spectrum of EAEC were identified.ResultsIdentified species of Enterobacteriaceae by 16S rRNA gene sequencing method was consistent with the biochemical results. The detection rate of EAEC in infant food was high， and the detection rate of virulence gene pic of EAEC was high. Virulence genotyping was consistent with the serum typing. According to the virulence gene carried by Escherichia coli， 25 strains of EAEC were detected， of which 40% of the strains （serotype O134：H9） carried virulence gene pic， 28% of the strains （serotype O3：H2） carried virulence gene aggR and astA， 16% of the strains （serotype O9：H6） carried virulence gene aggR， and 16% of the strains （serotype O62：H7） carried virulence gene astA. The carrying rate of EAEC virulence gene in 78 strains was 32.1%. The drug resistance of 25 EAEC strains was not optimistic， and there were multiple drug-resistant strains. The resistance was mainly for β lactams， macrolides， quinolones and tetracyclines.ConclusionEAEC was the main contamination of Escherichia coli in infant food in Liaoning Province， and had high drug resistance， which need more attention to be paid to

The effects of torsion on horizontal motor fusion and stereopsis

Abstract To investigate the effects of ocular torsion on horizontal motor fusion and stereopsis in normal adults and to probe the effects of torsion on peripheral fusion, macular fusion and foveal fusion. Twenty-five normal adults aged 30–38 were enrolled in this study. During the synoptophore assessment, the break points (BP) and recovery points (RP) of convergent fusion (CF) and divergent fusion (DF) and random-dots stereopsis were measured and analyzed at intorsion and extorsion of 3°, 5°, 7°, and 9°. According to the different sizes of the retinal areas stimulated by the synoptophore slides, fusion was classified into three categories: peripheral fusion (p-F), macular fusion (m-F) and foveal fusion (f-F). The p-F, m-F and f-F were analyzed and compared at the same torsional angle. There were significant differences in BPCF, RPCF, BPDF and RPDF among different torsion angles (ANOVA, P < 0.05). The Tukey's multiple comparison test showed that BPCF and RPCF of p-F, m-F and f-F decreased significantly at extorsion and intorsion ≥ 5°, compared with baseline (0° torsion) (P < 0.05). Compared with the baseline, BP of DF decreased significantly at torsion angles ≥ 3°, ≥ 5° and ≥ 7° for p-F, m-F, and f-F, respectively (P < 0.05), and RP of DF decreased significantly at torsion angles ≥ 5°, ≥ 9° and ≥ 7° for p-F, m-F, and f-F, respectively (P < 0.05). Comparison among p-F, m-F and f-F revealed significant differences only in BPCF at an intorsion of 3°, extorsion of 3° and the baseline (ANOVA, P < 0.05). There was a significant difference in the proportion of subjects with different sizes of RDS at different torsional angles (Fisher's exact test, P = 0.000). Fine stereopsis was damaged with increasing torsion. Torsion within the normal range of cyclofusion affects the horizontal motor fusion of convergent and divergent fusion and stereopsis. Torsion ≥ 5° should be considered during strabismus surgery for regaining fine binocular vision

A Revised Surgical Strategy for the Distal Tibiofibular Interosseous Osteochondroma

Osteochondroma is one of the most common benign bone tumor; however, the surgical treatment still remains a challenge for those that occur at the distal tibiofibular interosseous location. Previously, the transfibular approach has been successfully described, but the potential damage of the syndesmosis would give rise to the instability of the ankle joint and thus may result in the unfavorable long-term outcome. Here, a revised strategy which can protect the syndesmotic complex is introduced. From 2010 to 2017, eleven patients with the distal tibiofibular interosseous osteochondroma who underwent the revised surgery were collected. The distal fibular osteotomy and posterior tibial osteotomy were performed to keep the inferior syndesmosis intact for better stability of the ankle joint. Both the anterior tibiofibular ligaments (AITFL) and posterior tibiofibular ligaments (PITFL) have been preserved successfully, and thus, the stability of the ankle joint has been maintained due to our strategy. The VAS and AOFAS scores were utilized to assess the clinical outcome and function. Postoperatively, all the patients were pain-free and were able to wear the appropriate shoes at the last follow-up. Preoperative and postoperative AOFAS scores were 93.63±6.91 and 47.27±5.27 (P<0.05), respectively. Moreover, the average VAS score was 1.73±0.27 (compared with preoperative as 7.45±2.15, P<0.05), demonstrating obvious improvement after the operation. To our best knowledge, this is the first time to perform the resection of the distal tibial interosseous osteochondroma involving the fibula without interrupting the inferior syndesmotic complex especially the AITFL and PITFL. We believe that this strategy may pave a new way for optimized clinical outcome for these patients with distal tibiofibular interosseous osteochondroma. This clinical trial study is registered with number ChiCTR1900024690