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Objective To analyze the pathogenic characteristics and resistance of severe lung infection patients in Suining area, and to provide a reference for early clinical intervention. Methods A total of 359 patients with pulmonary infection were selected in Suining city from December 2019 to December 2020.The patients were divided into mild group (231 cases) and severe group (128 cases) according to the severity of nosocomial pneumonia.Sputum samples were collected for pathogen identification and drug sensitivity test. Multivariate logistic regression was used to analyze the influencing factors of severe pulmonary infection. Results There were 128 cases of severe pneumonia in 359 patients with traumatic brain injury. 147 strains of pathogenic bacteria were isolated, including 91 strains (61.90%) of gram-negative bacteria, mainly including 42 strains (28.57%) of Acinetobacter baumannii, 29 strains (19.73%) of Pseudomonas aeruginosa and 16 strains (10.88%) of Klebsiella pneumoniae. There were 37 gram-positive strains (25.17%), and 31 strains (21.09%) were staphylococcus aureus. A total of 19 strains of fungi (12.93%); Acinetobacter baumannii and Klebsiella pneumoniae were more sensitive to cefoperazone sodium sulbactam sodium and iaropenem, and more resistant to benzylbenzicillin, sulfamethoxazole/trimethoprazine and cefazolin. Pseudomonas aeruginosa had higher sensitivity to ceftazidine, piperacillin/tazobactam, and higher resistance to cefazolin sodium, ampicillin and other drugs. Staphylococcus aureus was highly sensitive to linezolid, vancomycin and teicoranin, and had high resistance to cefazolin and penicillin. There were statistically significant differences between the two groups in age, GCS score, combined basic diseases >2, coma time >24h, hypoproteinemia and invasive operation (P<0.05). Logistic regression analysis showed that GCS score, hypoproteinemia and invasive operation were independent risk factors for severe pulmonary infection in patients with traumatic brain injuries (P<0.05). Conclusion Suining patients with gram-negative bacteria, mainly Acinetobacter baumannii, Pseudomonas aeruginosa, aeruginosa, should be based on the pathogen susceptibility results of patients, for invasive operation, high GCS score should be positive treatment, and actively correct hypoproteinemia, can reduce the occurrence of severe lung infection.
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Objective To evaluate the function of regulatory T (Treg) cells in peripheral blood from patients with rheumatoid arthritis (RA),and to explore the possible role of the signal transducer and activator of transcription 3 (STAT3) signaling pathway in Treg cell dysfunction.Methods Totally,60 patients with rheumatoid arthritis,were enrolled into this study.Sixty healthy blood donors served as the control group.Peripheral heparin anticoagulant venous blood was collected from 60 patients with RA and 60 healthy controls respectively.Flow cytometry was used to detect the proportion of Treg cells in peripheral blood.Mixed culture of lymphocytes in vitro was used to detect the proliferation of Treg cells and the inhibition of effective T cells (Tresp) in peripheral blood of RA patients and healthy controls.Phosphorylated STAT3 protein and secretion of pro-inflammatory factors (IFN)-γ,Tumor necrosis factors (TNF)-α and interleukin-17A (IL-17A) in Treg cells were tested by flow cytometry and Quantitative Real-time polymerase chain reaction (qRT-PCR).Treg cells of RA patients were handled with STAT3 pathway inhibitor StatticV to observe the recovery of proliferation and inhibition function and the change of secretion of pro-inflammatory factors.The differences between groups were analyzed by analysis of Variance,and Dunnett's test was used to compare the mean of multiple samples.Results Significant differences were observed in the proportion of Treg cells in peripheral blood between the patient group and the control group [(6.51±0.24)％ vs (2.23±0.18)％,t=4.22,P＜0.05].Compared with controlderived Treg cells,the patient-derived Treg cells showed significantly decreased proli-ferative activity and inhibitory effects on Tresp cells,but increased propòrtion of cells secreting p-STAT3,IFN-γ TNF-α and IL-17A (all P＜0.05).After treated with 50 μg/L Stattic V,a significant increase was observed in the inhibitory effect of patient-derived Treg cells on Tresp cells [inhibition rate:(61.24±4.62)％ vs (28.15±10.37)％,P＜0.05],but a significant decrease in the mRNA expressions of IFN-γ(2-△△Ct:(1.65±0.88) vs (23.32±6.71),P＜0.05],TNF-α (0.85±0.71) vs (4.85±1.53),P＜0.05) and IL-17A (0.57±0.14) vs (3.10±0.62),all P＜0.05] in patientderived Treg cells compared with untreated patient-derived Treg cells.Conclusion The negative regulatory effect of Treg cells on Tresp cells is decreased in patients with rheumatoid arthritis,which may be associated with abnormal activation of the STAT3 signaling pathway,and inhibition of the pathway may restore the function of Treg cells to a certain extent.
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Objective To assess the effectiveness of a novel mobile health patient management system involving doctors, nurses, and patients ( TRIO mode) on glycemic control and self-monitoring of blood glucose (SMBG) compliance among the type 2 diabetes mellitus ( T2DM) patients using basal insulin standardization treatment in China. Methods From April 2014 to April 2015, 416 hospitals in 110 cities of 30 provinces, municipalities, and autonomous regions across China were selected to participate in the program. A Online-to-Offline ( O2O) integrated mobile health patients management system with mobile terminals for the doctors, nurses, and patients was applied in the program for patient education, follow-up, and data collection. For all the newly recruited patients, the baseline information was collected and a first-day patient education program were provided by a designated nurse. In the 12-week follow-up period, data of basal insulin doses and fasting plasma glucose ( FPG) values were collected from the patients by text messages or tracking phone call by the nurse. The patients also received timely standardized patients health education and glycemic control guidance by participating in thepatient education forum anddoctors' hotline in order to help them achieve the glycemic control goals. Results A total of 102 524 patients using basal insulin treatment were eligible and enrolled in the program. 64 420 patients completed the 12 weeks follow-up and provided at least one FPG value at all five follow-ups. In total, 62. 6% (40 334 / 64 420) of the patients reached the FPG control target(FPG≤7. 0 mmol/ L) at the end of follow-up period. The weekly average FPG for patients with complete SMBG data decreased from 10. 58 mmol/ L to 6. 91 mmol/ L while the FPG control rates increased from 13. 4% to 69. 2% . The weekly average FPG for the patients provided incomplete SMBG data decreased from 10. 54 mmol/ L to 7. 13 mmol/ L while the FPG control rates increased from 13. 6% to 62. 2% . The FPG control rates for the patients provided complete SMBG were 1. 74 times higher than those patients provided incomplete SMBG. Based on a GEE model, the average decline of the FPG and the increase of the FPG control rates were significantly better for patients who provided complete SMBG as compared to the patients with incomplete SMBG data. The results of the multivariate logistic regression analysis showed that factors such as receiving the first-day education, participating in the follow-up patient education forum, and the doctors' hotline were significantly associated with the improvement of the SMBG compliance, the treatment adherence, and the FPG control rates. The SMBG compliance and the treatment adherence for patients who completed first-day education were 1. 68 times and 1. 22 times higher, respectively. For the patients who participated in follow-up education activities, their SMBG compliance and treatment adherence were 3. 17 times and 3. 36 times higher, respectively. Conclusion The innovativeTRIOmobile health patient management mode was feasible and effective for better managing the type 2 diabetes patients initiated on basal insulin treatment in China. Active participation in the first-day education program and the follow-up patient education activities can effectively improve the SMBG compliance and the treatment adherence, and therefore play an important role in helping patient achieving FPG control in a faster manner.
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Objective:To investigate the expression and clinical significance of microRNA-30a in renal cell carcinoma (RCC). Methods:The miRNA-30a expression in renal tissues and cell lines was detected using quantitative real-time polymerase chain reac-tion (qRT-PCR), and the relationship between miRNA-30a expression and the clinicopathological features of RCC was analyzed. The effect of miRNA-30a on cancer cells was evaluated using methyl thiazolyl tetrazolium (MTT) assay. In addition, a bioinformatics algo-rithm was adopted to predict the potential targets of miRNA-30a. Results:miRNA-30a was downregulated both in RCC tissues and cell lines. Patients with higher miRNA-30a expression exhibited better prognosis than those with lower miRNA-30a expression. Bioin-formatics algorithm and qRT-PCR both indicated that metadherin (MTDH) was a target of miRNA-30a. Moreover, MTT results showed that miRNA-30a could inhibit cell proliferation. Conclusion:miRNA-30a was inhibited in renal cancer, and low miRNA-30a expres-sion was associated with poor prognosis. In addition, miRNA-30a could inhibit the growth of cells through MTDH.
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Objective To explore the feasibility of in-flow inversion recovery (IFIR)sequence of magnetic resonance imaging (MRI)at 1.5T in diagnosis of Budd-Chiari syndrome (BCS).Methods A total of 45 patients with Budd-Chiari syndrome diagnosed by surgery or interventional surgery in our institution were enrolled.The prerequisite of the study was that all medical imaging data including MRI and digital subtraction angiography (DSA)should be integrated.Then,the diagnostic accuracy rates between IFIR sequence and DSA were analyzed and compared.Results Of all 45 patients with BCS,40 (88.9%)were diagnosed accurately by IF-IR sequence,including typeⅠa in 10,typeⅠb in 14,typeⅡ in 10 and type Ⅲ in 6.Meanwhile,41 (91.1%)were diagnosed accu-rately by DSA,including typeⅠa in 8,typeⅠb in 14,typeⅡ in 13 and type Ⅲ in 6.No significant difference was showed in diag-nostic accuracy between two imaging methods (P >0.05).Spearman rank correlation analysis revealed that the diagnostic accuracy of IFIR sequence was highly consistent with that of DSA(r =0.853,P <0.001 ).However,there existed significant difference be-tween two methods in accurate diagnosis of typeⅠa and typeⅡ BCS (P <0.05).Conclusion MRI IFIR sequence at 1.5T is highly consistent with DSA in diagnosis and classification of BCS,which can be used as a reliable method of preoperative screening for BCS diagnosis.
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Recently,to assess the reproductive effects of bisphenol A (BPA),the environmental estrogen,has become a focus of stusy. Investigations,to date,have focused on the effects on the reproductive system including the morphogenesis of tissues and organs,endocrine and the toxic mechanisms of action,particularly in males. Based on the study results concerning BPA’s impacts on male reproduction,the further study directions in this field were presented in this paper.