ABSTRACT Objective: To evaluate objective treatment efficacy and safety, and subjective patient-reported outcomes in patients with complex ureteral strictures (US) undergoing minimally invasive lingual mucosal graft ureteroplasty (LMGU). Materials and Methods: We prospectively enrolled patients underwent robotic or laparoscopic LMGU between May 2020 and July 2022. Clinical success was defined as symptom-free and no radiographic evidence of re-obstruction. Patient-reported outcomes, including health-related quality of life (HRQoL), mental health status and oral health-related quality of life (OHRQoL), were longitudinally evaluated before surgery, 6 and 12 months postoperatively. Results: Overall, 41 consecutive patients were included. All procedures were performed successfully with 32 patients in robotic approach and 9 in laparoscopic. Forty (97.56%) patients achieved clinical success during the median follow-up of 29 (range 15-41) months. Although patients with complex US experienced poor baseline HRQoL, there was a remarkable improvement following LMGU. Specifically, the 6-month and 12-month postoperative scores were significantly improved compared to the baseline (p < 0.05) in most domains. Twenty-eight (68.3%) and 31 (75.6%) patients had anxiety and depression symptoms before surgery, respectively. However, no significant decrease in the incidence of these symptoms was observed postoperatively. Moreover, there was no significant deterioration of OHRQoL at 6 months and 12 months postoperatively when compared to the baseline. Conclusions: LMGU is a safe and efficient procedure for complex ureteral reconstruction that significantly improves patient-reported HRQoL without compromising OHRQoL. Assessing patients’ quality of life enables us to monitor postoperative recovery and progress, which should be considered as one of the criteria for surgical success. Objective safety patientreported patient reported (US . (LMGU) Methods 202 2022 symptomfree symptom free reobstruction. reobstruction re obstruction. obstruction re-obstruction Patientreported Patient healthrelated related , (HRQoL) OHRQoL, (OHRQoL) surgery 1 Results Overall 4 included 3 97.56% 9756 97 56 (97.56% followup follow up 2 range 1541 15 15-41 Specifically 6month month 12month p 0.05 005 0 05 domains Twentyeight Twenty eight 68.3% 683 68 (68.3% 75.6% 756 75 (75.6% respectively However Moreover Conclusions progress (LMGU 20 (HRQoL (OHRQoL 97.56 975 5 (97.56 154 15-4 0.0 00 68.3 (68.3 75.6 7 (75.6 97.5 (97.5 15- 0. 68. (68. 75. (75. 97. (97. (68 (75 (97 (6 (7 (9 (

ABSTRACT Introduction: Atrial fibrillation is one of the common complications of mitral valve disease. Currently, in the absence of freezing equipment, it’s still impossible to fully conduct a minimally invasive Cox-maze IV procedure to treat atrial fibrillation. Methods: We analyzed the clinical data of 28 patients who underwent thoracoscopic minimally invasive mitral valve full maze surgery in our hospital from October 2021 to September 2022; 13 patients were male and 15 were female, three suffered from paroxysmal atrial fibrillation, and 25 suffered from permanent atrial fibrillation; average age was 61.88±8.30 years, and mean preoperative left atrial diameter was 47.12±8.34 mm. Isolation of left atrial posterior wall (box lesion) was completed in all patients by cut-and-sew technique and bipolar clamp ablation. Results: For these subjects, the median cardiopulmonary bypass time was 169 (109.75-202.75) minutes, aortic cross-clamping time was 106 (77.75-125.50) minutes, and ventilator assistance time was 6.5 (0-10) hours. Among them, eight subjects had the endotracheal tubes removed immediately after surgical operation. Three subjects were in the blanking period; two subjects still had atrial fibrillation at three months after operation, one of whom resumed sinus rhythm after electrical cardioversion therapy; and all the remaining 23 subjects had sinus rhythm. Conclusion: The minimally invasive cut-and-sew technique for electrical isolation of left pulmonary veins can improve sinus conversion rate of patients suffering from both mitral valve disease and atrial fibrillation. In selected subjects, it is safe and has good results in the short-term postoperative period. Introduction Currently equipment its s Coxmaze Cox Methods 2 202 2022 1 female 6188830 61 88 8 30 61.88±8.3 years 4712834 47 12 34 47.12±8.3 mm box lesion cutandsew cut sew ablation Results 16 109.75202.75 1097520275 109.75 202.75 109 75 (109.75-202.75 minutes crossclamping cross clamping 10 77.75125.50 777512550 77.75 125.50 77 125 50 (77.75-125.50 65 6 5 6. 010 0 (0-10 hours them operation period therapy Conclusion shortterm short term 20 618883 3 61.88±8. 471283 4 47.12±8. 75202 109.75202.7 109752027 10975 109.7 20275 202.7 7 (109.75-202.7 75125 77.75125.5 77751255 7775 77.7 12550 125.5 (77.75-125.5 01 (0-1 61888 61.88±8 47128 47.12±8 7520 109.75202. 10975202 1097 109. 2027 202. (109.75-202. 7512 77.75125. 7775125 777 77. 1255 125. (77.75-125. (0- 6188 61.88± 4712 47.12± 752 109.75202 1097520 (109.75-202 751 77.75125 777512 (77.75-125 (0 618 61.88 471 47.12 109.7520 109752 (109.75-20 77.7512 77751 (77.75-12 ( 61.8 47.1 109.752 (109.75-2 77.751 (77.75-1 61. 47. (109.75- (77.75- (109.75 (77.75 (109.7 (77.7 (109. (77. (109 (77 (10 (7 (1

Abstract Glansreginin A is an indicative component in walnut and is abundant in walnut meal. The aim of this study was to isolate and purify glansreginin A from the walnut meal, and to investigate the weight loss and lipid-lowering potential of glansreginin A by studying the effect of glansregin A on the proliferation of 3T3-L1 preadipocytes. Firstly, the response surface methodology was used to effectively improve the extraction yield of glansreginin A. The maximum extraction rate of glansreginin A was 0.363%, and the optimal extraction process conditions were determined. In addition, the lipid-lowering activity of glansreginin A was investigated by cell experiments. The results showed that glansreginin A could inhibit the proliferation of 3T3-L1 preadipocytes in a dose-dependent manner. And cell cycle of different groups of cells treated with glansreginin A was also measured using flow cytometry. The results showed most of the cells were blocked in G0/G1 phase and significantly decreased in S phase. These results suggest that glansreginin A could inhibit the proliferation of 3T3-L1 preadipocytes by causing cell cycle arrest. These findings provided a theoretical basis for the future research of glansreginin A and the development of slimming and fat-reducing foods. meal lipidlowering lipid lowering 3T3L1 TL 3T3 L1 T L 3T3-L Firstly 0363 0 363 0.363% determined addition experiments dosedependent dose dependent manner cytometry G0G1 GG G0 G1 G G0/G arrest fatreducing fat reducing foods 3T3L 3T 036 36 0.363 G0G 03 3 0.36 0.3 0.

Resumo Fundamento: O enxerto de bypass na artéria coronária (CABG) continua a ser eficiente como tratamento para pacientes portadores de doença arterial coronariana; entretanto, o enxerto venoso tende a apresentar reestenose ou oclusão. A adiponectina (ADP) é uma proteína hormonal plasmática com a função de regular a proliferação celular. Objetivo: Foram utilizadas duas doses diferentes da proteína ADP em um modelo de enxerto venoso em ratos para estimular a alteração do enxerto venoso. O objetivo deste estudo foi investigar o efeito da ADP sobre a reestenose em enxerto venoso. Métodos: Veias jugulares autólogas foram implantadas como enxertos interposicionais de carótida pela técnica de anastomose de manga em ratos Sprague Dawley. A adiponectina (2,5 μg e 7,5 μg) foi entregue ao enxerto venoso por bypass de forma perivascular, suspensa em gel Pluronic-F127 a 30%. O grupo tratado apenas com bypass e o grupo tratado com gel veículo carregado apenas com Pluronic funcionaram como controle. Foram feitas comparações com análise de via única de variância e teste post-hoc, com p <0,05 sendo considerado significativo. Resultados: A proliferação celular (índice de PCNA) foi significativamente baixa no grupo tratado com adiponectina em comparação com o grupo de controle e o grupo tratado com o gel veículo na íntima e na adventícia dos enxertos a partir do dia 3 (p <0,01). VCAM-1 e ICAM-1 avaliados por imuno-histoquímica diminuíram significativamente em enxertos venosos tratados com adiponectina na quarta semana (p <0,01). O tratamento de enxertos venosos com gel carregado com adiponectina reduziu a espessura da íntima, da média e da adventícia, em comparação com os enxertos de controle e tratados com gel veículo no dia 28 (p <0,01). Conclusões: Este estudo oferece evidências adicionais do possível papel terapêutico da adiponectina na modulação de lesão vascular e seu reparo.

Abstract Background: Coronary artery bypass grafting (CABG) continues to be an effective therapy for coronary artery disease patients, but the vein graft is prone to restenosis or occlude. Adiponectin (ADP) is a plasma hormone protein with the function of regulating cell proliferation. Objective: This study used two different doses of ADP protein in a rat vein graft model to stimulate vein graft change. The aim of our study was to investigate the effect of ADP on vein graft restenosis. Methods: Autologous jugular veins were implanted as carotid interposition grafts through the anastomotic cuff technique in Sprague Dawley rats. Adiponectin (2.5 μg and 7.5 μg) was delivered to the vein bypass grafts in a perivascular fashion, suspended in a 30% Pluronic-F127 gel. No treatment (bypass only) and vehicle loaded Pluronic gel served as controls. Comparisons were made with one-way analysis of variance and a post-hoc test, with p < 0.05 considered significant. Results: Cell proliferation (PCNA index) was significantly low in adiponectin-treated versus control and vehicle-gel-treated grafts, both in intima and adventitia, as of day 3 (p < 0.01). VCAM-1 and ICAM-1 evaluated by immunohistochemistry significantly down-regulated in the adiponectin-treated vein grafts in the fourth week (p <0.01). Treatment of vein grafts with adiponectin-loaded gels reduced intimal, media, and adventitia thickness when compared with the control and vehicle-gel-treated vein grafts at day 28 (p < 0.01). Conclusions: Our studies provide further support for the potential therapeutic role of adiponectin in modulating vascular injury and repair.

Abstract This study investigated the physical and chemical composition of three jujube fruits cultivated in China. The objective was to explore the effect of jujube genotype and cultivation districts on the quality of jujube fruits. Results showed significant differences on their physical and chemical composition. The Junzao cultivar contained relatively low level on the total dietary fiber, protein, total sugar, and total titratable acids. The Huizao cultivar possessed the mediate level of the sugar-to-acid ratio and ascorbic acid. The Dazao cultivar showed high level of the total dietary fiber, protein, sugar, and total acids. The cultivation districts exerted important roles in altering the physicochemical indexes of the same jujube cultivar. The Junzao cultivar harvested in the Hami and Kashi districts showed the significant difference on the level of the sugar-to-acid ratio and ascorbic acid compared with that in the Akesu and Hetian districts. The Huizao cultivar in the Kashi area possessed higher content of the total soluble dietary fiber than that in the Akesu and Hetain districts. Principal component analysis indicated that the parameters that differentiated these jujube cultivars appeared to be the total dietary fiber, protein, total sugar, fructose, glucose, sucrose, and total titratable acids.

Ultrasound-measured inferior vena cava (IVC) and abdominal aorta (Ao)-associated parameters have been used to predict volume status for decades, yet research focusing on the impact of individual physical characteristics, including gender, height/weight, body surface area (BSA), and age, assessed simultaneously on those parameters in Chinese children is lacking. The aim of the present study was to explore the impact of individual characteristics on maximum IVC diameter (IVCmax), Ao, and IVCmax/Ao in healthy Chinese children. From September to December 2015, 200 healthy children from 1 to 13 years of age were enrolled. IVCmax and Ao diameters were measured by 2D ultrasound. We found that age (years), height (cm), weight (kg), waist circumference (cm), and BSA (m2) were positively correlated with IVCmax and Ao. Multivariate linear regression showed that age was the only independent variable for IVCmax (mm) in female children, height was the only independent variable for IVCmax in male children, and age was the only independent variable for Ao in both females and males. IVCmax/Ao was not significantly influenced by the subjects’ characteristics. In conclusion, IVCmax and Ao were more susceptible to subjects’ characteristics than IVCmax/Ao. IVCmax/Ao could be a reliable and practical parameter in Chinese children as it was independent of age, height, and weight.

Abstract Streptococcus pneumoniae is one of the most frequent opportunistic pathogens worldwide. DNA processing protein A (DprA) is an important factor involved in bacterial uptake and DNA integration into bacterial genome, but its role in S. pneumoniae virulence remains unclear. The aim of this study was to characterize the effects of the pneumococcal dprA gene on the pathogenesis of S. pneumoniae. To construct a dprA-deficient pneumococcal strain, the dprA gene of the S. pneumoniae strain D39 was inactivated. The virulence of this dprA-deficient strain, designated ΔD39, was compared with that of the wild-type strain by evaluating their respective capabilities to adhere to human pulmonary epithelial cells (PEC-A549) and by analyzing their choline-binding protein expression levels. In addition, the expression profiles of genes associated with virulence and host survival assays were also conducted with the mutant and the wild-type strain. Our results indicate that the capability of ΔD39 to adhere to the PEC-A549 airway cells was significantly lower (p < 0.01) compared with D39. Additionally, the 100-KD choline-binding protein was not detected in ΔD39. The addition of competence-stimulating peptide (CSP) lead to a significantly reduction of psaA mRNA expression in the dprA-deficient mutant and an increased level of psaA transcripts in the wild-type strain (p < 0.01). The median survival time of mice intraperitoneally infected with ΔD39 was significantly higher (p < 0.01) than that of mice infected with D39. The results of this study suggest that DprA has a significant effect on virulence characteristics of S. pneumoniae by influencing the expression of choline-binding protein and PsaA.

Abstract The projectile impact resistance of sandwich panels with cellular cores with different layer numbers has been numerically investigated by perpendicular impact of rigid blunt projectile in ABAQUS/Explicit. These panels with corrugation, hexagonal honeycomb and pyramidal truss cores are impacted at velocities between 50 m/s and 202 m/s while the relative density ranges from 0.001 to 0.15 The effects of core configuration and layer number on projectile impact resistance of sandwich panels with cellular cores are studied. At low impact velocity, sandwich panels with cellular cores outperform the corresponding solid ones and non-montonicity between relative density and projectile resistance of sandwich panels is found and analyzed. Multiplying layer can reduce the maximum central deflection of back face sheet of the above three sandwich panels except pyramidal truss ones in high relative density. Hexagonal honeycomb sandwich panel is beneficial to increasing layer numbers in lowering the contact force and prolonging the interaction time. At high impact velocity, though corrugation and honeycomb sandwich panels are inferior to the equal-weighted solid panels, pyramidal truss ones with high relative density outperform the corresponding solid panels. Multiplying layer is not the desirable way to improve high-velocity projectile resistance.

Objective: Posterior pilon fractures are rare injuries and have not yet gained well recognition. The purpose of this study was to present the treatment outcome for patients with posterior pilon fractures treated with buttress plate. Method: In this retrospective study we identified patients with posterior pilon fractures of the distal tibia who had undergone open reduction and internal fixation at our institute. Between January 2007 and December 2009, 10 patients (mean age, 46.5 years) who had undergone buttress plating via either a posterolateral approach or a dual posterolateral-posteromedial approach, were selected. All 10 patients were available for follow-up. The clinical outcome was evaluated with the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and the visual analogue scale (VAS). The radiological evaluation was performed using the osteoarthritis-score (OA-score). Results: Satisfactory reduction and stable fixation were accomplished in all patients. At a mean follow-up of 36.2 months, all patients had good radiological results and showed satisfactory clinical recovery. The mean AOFAS sore was 87.8, the mean OA-score was 0.6, and the mean VAS scores during rest, active motion, and weight-bearing walking were 0.6, 0.8, and 1.4, respectively. Conclusion: Buttress plating for posterior pilon fractures gave satisfactory clinical outcomes. It also ensured rigid fixation which in turn enabled earlier postoperative mobilization. Level of Evidence IV, Retrospective Study.

OBJETIVO: Apresentar nossas experiências no tratamento de más uniões ou não consolidações talares. MÉTODO: Entre janeiro de 2000 e setembro de 2009, 26 pacientes com má união ou não-união depois de fraturas do tálus foram submetidos a tratamento cirúrgico de acordo com os diferentes tipos de deformidade talar. Os desfechos do tratamento foram avaliados pela escala tornozelo-retropé da AOFAS, assim como por radiografias simples. RESULTADOS: 20 pacientes ficaram disponíveis para acompanhamento por 30 (24 a 60) meses. Não houve problema de cicatrização ou infecção das feridas e foram obtidas uniões sólidas em todos os pacientes. As uniões radiológicas foram atingidas em tempo médio de 14 (faixa de 12 a 18) semanas. O tempo médio para concluir o apoio de carga foi 16 (faixa de 14 a 20) semanas. O escore AOFAS médio aumentou significantemente de 36,2 (27 a 43) para 85,8 (74 a 98). CONCLUSÃO: as intervenções cirúrgicas das fraturas mal-unidas ou não consolidadas dos tálus podem produzir resultados satisfatórios e o procedimento apropriado deve ser adotado, de acordo com diferentes tipos de deformidades pós-traumáticas. Nível de Evidência: IV, Estudo retrospectivo.

OBJECTIVE: To present our experiences of treating talar malunions and nonunions. METHOD: Between January 2000 and September 2009, 26 patients with malunions or nonunions after talar fractures underwent surgical treatment according to different types of talar deformities. The treatment outcomes were evaluated using AOFAS ankle-hindfoot scale as well as plain radiographs. RESULTS: 20 patients were available for follow-up for 30 (range, 24 to 60) months. No wound healing problems or infections occurred and solid unions were achieved in all patients. Radiological unions were achieved at a mean time of 14 (range, 12 to 18) weeks. The mean time to complete weight-bearing was 16 (range, 14 to 20) weeks. The mean AOFAS score increased significantly from 36.2 (range, 27 to 43) to 85.8 (range, 74 to 98). CONCLUSION: Surgical interventions for malunions and nonunions after talar fractures can bring about satisfactory outcomes, and the appropriate procedure should be adopted according to different types of posttraumatic deformities. Level of Evidence: IV, Retrospective Study.

OBJETIVO: Investigar os métodos cirúrgicos no tratamento de fratura de tornozelo de Weber tipo C e estimar a necessidade de exploração cirúrgica da sindesmose. MÉTODOS: Quarenta e três pacientes que apresentavam fratura de tornozelo de Weber tipo C foram tratados com redução aberta e fixação interna de outubro de 2004 a dezembro de 2009. Vinte e nove pacientes foram tratados com o procedimento de rotina, que envolve redução aberta e fixação interna, exploração de sindesmose. Nos outros pacientes, foram realizados reparos adicionais. Trinta e quatro pacientes foram acompanhados durante um período médio de 31,2 meses (faixa, 18 a 50 meses), 22 pacientes desse total foram tratados com procedimentos de rotina e 12 foram tratados com exploração cirúrgica adicional da sindesmose. RESULTADOS: Todas as fraturas estavam unidas no período médio de 13,1 semanas (faixa, 10 a 18 semanas), tendo início o apoio de peso total. A escala média de tornozelo e retropé do escore da american orthopaedics foot and ankle society foi 79,86 (faixa, 65 a 98) no grupo procedimentos de rotina e 86,67 (faixa, 78 a 100) no grupo exploração da sindesmose. Os valores do escore de Olerud-Molander foram 77,27 (faixa, 55 a 100) e 86,67 (faixa, 75 a 100), respectivamente. Constatou-se diferença estatisticamente significante entre os dois grupos (P < 0,05). CONCLUSÃO: A exploração cirúrgica da sindesmose é essencial em certas fraturas de tornozelo de Weber tipo C, que torna possível o desbridamento e a redução direta da sindesmose, permitindo maior estabilização da articulação do tornozelo. Nível de evidência III, Estudo retrospectivo comparativo.

OBJECTIVE: to investigate the surgical methods in treating weber type C ankle injury and estimate the necessity of syndesmosis operative exploration. METHODS: forty three patients presenting weber type C ankle injury were treated with open reduction and internal fixation from october 2004 to december 2009. twenty nine patients were treated with routine procedure involving open reduction and internal fixation, syndesmosis exploration. additional repair was performed in the others. thirty four patients were followed during an average time of 31.2 months (range, 18 to 50 months), 22 patients of those were treated with routine procedures and 12 were treated with additional syndesmosis surgical exploration. RESULTS: all the fractures were united within the average time of 13.1 weeks (range, 10 to 18 weeks) and full weight bearing began. the mean ankle and hindfoot scale of the american orthopaedics foot and ankle society score was 79.86 (range, 65 to 98) in the routine procedures group and 86.67 (range, 78 to 100) in the syndesmosis exploration group. the values of olerud-molander score were 77.27 (range, 55 to 100) and 86.67 (range, 75 to 100), respectively. statistcally significant difference was found between the two groups (p<0.05). CONCLUSION: syndesmosis surgical exploration is essential in some weber type C ankle injuries, which make debridement and direct reduction of the syndesmosis possible, allowing higher stabilization of the ankle joint. Level of Evidence III, Retrospective Comparative Study.

Taurine has positive effects on bone metabolism. However, the effects of taurine on osteoblast apoptosis in vitro have not been reported. The aim of this study was to investigate the activity of taurine on apoptosis of mouse osteoblastic MC3T3-E1 cells. The data showed that 1, 5, 10, or 20 mM taurine resulted in 16.7, 34.2, 66.9, or 63.75% reduction of MC3T3-E1 cell apoptosis induced by the serum deprivation (serum-free α-MEM), respectively. Taurine (1, 5, or 10 mM) also reduced cytochrome c release and inhibited activation of caspase-3 and -9, which were measured using fluorogenic substrates for caspase-3/caspase-9, in serum-deprived MC3T3-E1 cells. Furthermore, taurine (10 mM) induced extracellular signal-regulated kinase (ERK) phosphorylation in MC3T3-E1 cells. Knockdown of the taurine transporter (TAUT) or treatment with the ERK-specific inhibitor PD98059 (10 μM) blocked the activation of ERK induced by taurine (10 mM) and abolished the anti-apoptotic effect of taurine (10 mM) in MC3T3-E1 cells. The present results demonstrate for the first time that taurine inhibits serum deprivation-induced osteoblast apoptosis via the TAUT/ERK signaling pathway.

OBJECTIVE: We aimed to determine the burden of bacillary dysentery in China, its cross-regional variations, trends in morbidity and mortality, the causative bacterial species and antimicrobial resistance patterns. METHODS: We extracted and integrated governmental statistics and relevant medical literature published from 1991 to 2000. Data were also collected from one general hospital each for the six provinces and Jin-an district, Shanghai, representative of six geographical regions and a modern city. FINDINGS: In 2000, 0.8-1.7 million episodes of bacillary dysentery occurred of which 0.5 to 0.7 million were treated at health-care facilities and 0.15-0.20 million patients were hospitalized. The highest morbidity and mortality rates were among the youngest and oldest age groups. Bacillary dysentery peaked during the summer months. The major causative species was Shigella flexneri (86%) and the predominant S. flexneri serotype was 2a (80%). About 74-80% of Shigella isolates remained susceptible to fluorinated quinolones. CONCLUSION: We conclude that while morbidity and mortality due to bacillary dysentery has decreased considerably in China in the past decade due to increasing access to affordable health care and antibiotics, a considerable burden exists among the youngest and oldest age groups and in regions with low economic development. We suggest that while a vaccine would be effective for short- and medium-term control of bacillary dysentery, improved water supply, sanitation, and hygiene are likely to be required for long-term control.

OBJETIVO: Decidimos determinar la carga de disentería bacilar en China, las diferencias interregionales en ese sentido, las tendencias de la morbilidad y la mortalidad, las especies bacterianas causantes, y la distribución de la resistencia a los antimicrobianos. MÉTODOS: Procedimos a extraer e integrar estadísticas gubernamentales y publicaciones médicas relacionadas aparecidas entre 1991 y 2000. También obtuvimos datos de un hospital general de cada una de las seis provincias consideradar y del distrito de Jin-an, Shanghai, como información representativa de seis regiones geográficas y una ciudad moderna. RESULTADOS: En 2000 se produjeron entre 0,8 y 1,7 millones de episodios de disentería bacilar, de los cuales 0,5 - 0,7 millones fueron tratados en establecimientos de salud, y 0,15 - 0,20 millones fueron hospitalizados. Las mayores tasas de morbilidad y mortalidad fueron las registradas entre los grupos más jóvenes y en las personas mayores. La disentería bacilar alcanzó la máxima cota en los meses de verano. La principal especie causante fue Shigella flexneri (86%), con la variante 2a como serotipo predominante (80%). Aproximadamente un 74% - 80% de las colonias de Shigella seguían siendo vulnerables a las quinolonas fluoradas. CONCLUSIÓN: Aunque la morbimortalidad por disentería bacilar ha disminuido considerablemente en China durante el último decenio, gracias al mayor acceso a la atención sanitaria y los antibióticos, sigue habiendo una carga considerable de la enfermedad entre los grupos más jóvenes y de mayor edad, así como en las regiones con bajo desarrollo económico. En nuestra opinión, aunque una vacuna sería una opción eficaz para controlar la disentería bacilar a corto y medio plazo, todo control a largo plazo exigirá probablemente mejoras del abastecimiento de agua, el saneamiento y la higiene.

OBJECTIF: L'étude visait à déterminer la charge de dysenterie bacillaire en Chine, les variations interrégionales, les tendances de la morbidité et de la mortalité, les agents étiologiques bactériens et les schémas de résistance aux antimicrobiens. MÉTHODES: Les statistiques publiques et les documents médicaux pertinents publiés de 1991 à 2000 ont été extraits et pris en compte dans l'étude. On a également recueilli des données auprès d'un hôpital général de chacune des six provinces considérées et du district de Jin an à Shanghai, ces hôpitaux étant représentatifs de six régions géographiques et d'une ville moderne. RÉSULTATS: En 2000, 0,8 à 1,7 million d'épisodes de dysenterie bacillaire on été enregistrés, dont 0,5 à 0,7 million ont été traités dans des établissements de soins et 150 000 à 200 000 ont donné lieu à des hospitalisations. Les taux de morbidité et de mortalité les plus élevés ont été relevés parmi les classes d'âge correspondant aux plus jeunes et aux plus âgés. La dysenterie bacillaire a atteint un pic au cours des mois d'été. Le principal agent étiologique était Shigella flexneri (86 %) et le sérotype prédominant de S. flexneri était le sérotype 2a (80 %). De 74 % à 80 % des isolements de Shigella étaient sensibles aux quinolones fluorés. CONCLUSION: Malgré une baisse considérable de la morbidité et de la mortalité dues à la dysenterie bacillaire en Chine au cours de la dernière décennie, imputable à l'amélioration de l'accès à des soins de santé et à des antibiotiques à des prix abordables, une importante charge de morbidité subsiste chez les classes d'âge extrêmes et dans les régions faiblement développées sur le plan économique. Si un vaccin constituerait un moyen efficace à court et à moyen terme pour lutter contre la dysenterie bacillaire, il est probable que la lutte à long terme contre cette maladie exige une amélioration de l'approvisionnement en eau, des installations d'assainissement et de l'hygiène.