PurposeThe incidence and severity of Clostridium difficile infection (CDI) have markedly increased over the past decade. However, there is very limited epidemiological data on CDI in China so far, specifically no data in Shandong Province. The aim of this study was to evaluate diagnostic algorithm for CDI and to gain data on molecular epidemiology of CDI in the Shandong Province of China.Materials and methodsNonrepetitive unformed fecal specimens (n=504) were investigated by the glutamate dehydrogenase (GDH), C. difficile toxin A&B (CDAB) tests and toxigenic culture. Furthermore, 85 isolates were characterized by toxin gene detection, multilocus sequence typing, ribotyping and antimicrobial susceptibility testing.ResultsThe algorithm of combining GDH and CDAB tests could define diagnosis of 54.2% CDI cases and excluded 90% of non-CDI. Further adding the toxigenic culture to the algorithm enhanced the detection sensitivity to 100%. Toxigenic strains comprised 84.7% of isolates, including A+B+CDT− (71.8%, 61/85), A−B+CDT− (11.8%, 10/85) and A+B+CDT+ (1.2%, 1/85) isolates. RT046/ST35 (13.9%, 10/72), RT014/ST2 (12.5%, 9/72) and RT017/ST37 (12.5%, 9/72) were the more common genotypes among toxigenic C. difficile strains. The clinical severity score of A−B+CDT− toxin genes genotype (3.50±0.85) was significantly higher than the A+B+CDT− type (2.59±0.93) (P<0.05). RT046/ST35 isolates were highly prevalent and had high clinical severity scores (3.80±0.92). Variations in resistance from different sequence types (STs) were observed. Toxigenic strains showed higher resistance rates to erythromycin, clindamycin and ciprofloxacin compared to nontoxigenic strains (P<0.05).ConclusionThe epidemiology of C. difficile in Shandong Province differed from other regions in China. Comprehensive optimized diagnosis strategy and continuous surveillance should be established and applied in order to curb the spread of toxigenic C. difficile strains, especially for hospitalized patients.

We compare estimates of three-dimensional brain activity extracted from averaged and from selected single-trial magnetoencephalographic signals, in order to study activation sequences related to motor preparation, inhibition, and movement, cued on two tones (S1 and S2). We studied all possible hand-ear combinations in a right-handed subject in both initiation and inhibition, and found some marked differences between combinations. Averaging revealed activity in the right motor cortex in all combinations requiring movement inhibition, irrespective of laterality of finger and ear, and in the contralateral motor cortex during movement (but considerably reduced for the task with the practiced ear and finger). These activation patterns are seen in single trials with variability of latency but not position. In the average signal, a long silent period between the warning and imperative stimuli is seen; in single trials, however, recurring sequences of activation linking frontal and posterior areas are seen throughout the analysis period in all combinations. These results show that single-trial analysis is needed to understand all the significant neural correlates of this task.

Pocket corner in the high-speed milling (HSM) often occur under-cut, over-cut, vibration and other phenomena. This not only reduces tool life, seriously affected the work-piece machining accuracy and processing efficiency. In the paper, the impact of cutting speed on cutting forces is studied in the pocket corner based on the high-speed milling experiments. The results show that cutting force increased slightly with the increase in cutting speed, and that cutting force no significant change with the increase in radial depth of cut.

The concept of reliability of road service level was put forward and the threshold determination method based on this concept was studied in this paper. Results of case studies showed that the proposed method for threshold determination was valuable in practice.

The forming scheme of a side-plate of the core part in parallel flow evaporator was studied. Two forming schemes were compared and the explicit dynamic software DYNAFORM was applied to make simulations about the forming processes. According to comparisons between two forming schemes, the optimized scheme and process parameters were determined. Multi-station dies were designed based on the optimized process. Successful experiments with the dies showed that numerical simulation provided an efficient way for the optimization of the forming scheme in the side-plate production.