Oral anti-coagulants use in Chinese hospitalized patients with atrial fibrillation / 中华医学杂志(英文版)

BACKGROUND@#Oral anti-coagulants (OAC) are the intervention for the prevention of stroke, which consistently improve clinical outcomes and survival among patients with atrial fibrillation (AF). The main purpose of this study is to identify problems in OAC utilization among hospitalized patients with AF in China.@*METHODS@#Using data from the Improving Care for Cardiovascular Disease in China-Atrial Fibrillation (CCC-AF) registry, guideline-recommended OAC use in eligible patients was assessed.@*RESULTS@#A total of 52,530 patients with non-valvular AF were enrolled from February 2015 to December 2019, of whom 38,203 were at a high risk of stroke, 9717 were at a moderate risk, and 4610 were at a low risk. On admission, only 20.0% (6075/30,420) of patients with a diagnosed AF and a high risk of stroke were taking OAC. The use of pre-hospital OAC on admission was associated with a lower risk of new-onset ischemic stroke/transient ischemic attack among the diagnosed AF population (adjusted odds ratio: 0.54, 95% confidence interval: 0.43-0.68; P  <0.001). At discharge, the prescription rate of OAC was 45.2% (16,757/37,087) in eligible patients with high stroke risk and 60.7% (2778/4578) in eligible patients with low stroke risk. OAC utilization in patients with high stroke risk on admission or at discharge both increased largely over time (all P  <0.001). Multivariate analysis showed that OAC utilization at discharge was positively associated with in-hospital rhythm control strategies, including catheter ablation (adjusted odds ratio [OR] 11.63, 95% confidence interval [CI] 10.04-13.47; P <0.001), electronic cardioversion (adjusted OR 2.41, 95% CI 1.65-3.51; P <0.001), and anti-arrhythmic drug use (adjusted OR 1.45, 95% CI 1.38-1.53; P <0.001).@*CONCLUSIONS@#In hospitals participated in the CCC-AF project, >70% of AF patients were at a high risk of stroke. Although poor performance on guideline-recommended OAC use was found in this study, over time the CCC-AF project has made progress in stroke prevention in the Chinese AF population.Registration:ClinicalTrials.gov, NCT02309398.

Mechanism of Fufang Congrong Yizhi Capsules in treatment of mild cognitive impairment based on network pharmacology / 中国药理学通报

Aim To predict the mechanism of Fufang Congrong Yizhi Capsules (FCYC) in the treatment of mild cognitive impairment (MCI) by network pharmacology method, and further validate it in combination with cellular experiments. Methods TCMSP, Gene-Cards, OMIM and TTD databases, Chinese Pharmacopoeia and related literature were used to screen the active ingredients of FCYC and the targets of MCI treatment. The TCM-compound-target-disease network and PPI of intersection targets were constructed, and the GO and KEGG analysis were performed by the Ehamb bioinformation platform. GO and KEGG analysis were performed through Yihanbo biological information platform. Cell model of MCI was established by PC-12 injury induced by Aβ

Mediating role of mental fatigue between nature exposure and mental health of prison police / 环境与职业医学

Background The mental health status of prison officers is crucial to the efficiency, security, and stability of a prison, and it is essential to pay attention to the factors that influence their mental health. Objective To understand the mental health status of prison officers, and analyze how nature exposure affects their mental health problems and a potential mediating role of mental fatigue. Methods A cross-sectional survey was carried out from May to June 2022 among 1392 prison officers from eight prisons in a province, and a total of 1284 valid questionnaires were recovered. The Nature Exposure Scale, Mental Fatigue Scale, and Depression-Anxiety-Stress Scale were used to assess nature exposure, mental fatigue, and mental health indicators among prison officers, and to explore the effect of nature exposure on mental health problems and a potential mediating role of mental fatigue. Results The recruited prison officers showed high levels of depression, anxiety, and stress. The prevalence rates of depression, anxiety, and stress were 59.11% (759/1284), 60.67% (779/1284),and 43.93% (564/1284), respectively. The results of correlation analysis revealed that nature exposure was negatively related with mental fatigue and mental health indicators (depression, anxiety, and stress) (rs=−0.242, −0.308, −0.235, −0.254, P<0.01), while mental fatigue was positively correlated with mental health indicators (depression, anxiety, and stress) (rs=0.546, 0.533, 0.536, P<0.01). The PROCESS macro results showed that the level of nature exposure among prison officers negatively associated with depression, anxiety, and stress (β=−0.180, −0.104, −0.123), and mental fatigue played a mediating role, with indirect effects of −0.200, −0.192, and −0.199, respectively. Conclusion The levels of depression, anxiety, and stress of prison officers are higher than those of other occupations. Nature exposure negatively associates with depression, anxiety, and stress, that is, it may directly alleviate the mental health problems of prison officers; and it may also alleviate mental health problems by relieving mental fatigue.

A Novel Retrograde AAV Variant for Functional Manipulation of Cortical Projection Neurons in Mice and Monkeys / 神经科学通报·英文版

Retrograde adeno-associated viruses (AAVs) are capable of infecting the axons of projection neurons and serve as a powerful tool for the anatomical and functional characterization of neural networks. However, few retrograde AAV capsids have been shown to offer access to cortical projection neurons across different species and enable the manipulation of neural function in non-human primates (NHPs). Here, we report the development of a novel retrograde AAV capsid, AAV-DJ8R, which efficiently labeled cortical projection neurons after local administration into the striatum of mice and macaques. In addition, intrastriatally injected AAV-DJ8R mediated opsin expression in the mouse motor cortex and induced robust behavioral alterations. Moreover, AAV-DJ8R markedly increased motor cortical neuron firing upon optogenetic light stimulation after viral delivery into the macaque putamen. These data demonstrate the usefulness of AAV-DJ8R as an efficient retrograde tracer for cortical projection neurons in rodents and NHPs and indicate its suitability for use in conducting functional interrogations.

Management of lung diseases under ultrasound monitoring: potential to make bronchopulmonary dysplasia in preterm infants as an avoidable disease / 中国当代儿科杂志

Bronchopulmonary dysplasia (BPD) is the most common chronic lung disease in preterm infants. Despite significant progress in the understanding of its etiology, mechanisms, prevention, and treatment, the prognosis remains poor. BPD not only has a high mortality rate but also causes persistent respiratory, neurological, and cardiovascular impairments in survivors. The author's team has successfully prevented the occurrence of BPD by managing neonatal lung diseases under lung ultrasound monitoring for nearly 7 years, opening up a new approach in BPD prevention. This article provides a brief overview of the approach, aiming to facilitate further research and provide more scientifically sound management strategies to prevent or minimize the occurrence of BPD.

Expressions of eukaryotic initiation factor-4B and eukaryotic initiation factor-5A in papillary thyroid carcinoma and their effects on cell proliferation in vitro / 肿瘤研究与临床

Objective:To investigate the expressions of eukaryotic initiation factor-4B (eIF4B) and eukaryotic initiation factor-5A (eIF5A) in papillary thyroid carcinoma tissues, and to analyze their regulatory effects on cell proliferation in vitro.Methods:The clinical data of 61 patients diagnosed with papillary thyroid carcinoma who received surgical resection at Yuncheng Central Hospital from January 2020 to October 2021 were retrospectively analyzed. The postoperative tumor tissues and paracancerous normal thyroid tissues (>1 cm from the margin of the mass) were retained. Immunohistochemistry was used to detect the expressions of eIF4B, eIF5A and proliferating cell nuclear antigen (PCNA) in different tissues. The correlation of eIF4B, eIF5A expressions with the clinicopathological characteristics of patients, and the relationship between eIF4B, eIF5A and PCNA were analyzed. The thyroid cancer cell line SW1736 and normal thyroid cell line HT-ori3 were selected. The expressions of eIF4B mRNA and eIF5A mRNA were detected by using real-ime quantitative polymerase chain reaction (qRT-PCR). After the small interfering RNA (siRNA) of siRNA-eIF4B and siRNA-eIF5A were synthesized, the interfering plasmids were constructed, and SW1736 cells were transfected, siRNA-eIF4B group and siRNA-eIF5A group were obtained; the empty plasmid transfection group and the blank control group without transfection intervention were established. The cell proliferation activity was detected by using CCK-8 assay, and the expression of PCNA mRNA was detected by using qRT-PCR.Results:The positive rates of eIF4B and eIF5A in papillary thyroid cancer tissues were higher than those in paracancerous normal thyroid tissues [65.57% (40/61) vs. 29.51% (18/61), 57.38% (35/61) vs. 9.84% (6/61), P < 0.001]. The positive rates of eIF4B and eIF5A were statistically different in patients with different tumor diameter [>3 cm vs. ≤3 cm: 88.89% (16/18) vs. 55.81% (24/43),77.78% (14/18) vs. 48.84% (21/43), all P < 0.05], lymph node metastasis [with vs. without: 85.00% (17/20) vs. 56.10% (23/41), 80.00% (16/20) vs. 46.34% (19/41), all P < 0.05] and the number of different nodes [multiple vs. single: 86.67% (13/15) vs. 58.70% (27/46), 86.67% (13/15) vs. 47.83% (22/46), all P < 0.05]; there were no statistically significant differences in the positive rates of eIF4B and eIF5A among patients with different age and gender (all P > 0.05). Positive correlation was found between eIF4B score and the positive cell proportion of PCNA ( r = 0.66, P = 0.0324), eIF5A score and the positive cell proportion of PCNA ( r = 0.62, P = 0.024), eIF4B score and eIF5A score ( r = 0.63, P = 0.021). The expression levels of eIF4B mRNA and eIF5A mRNA in thyroid cancer cell line SW1736 cell was higher than that of HT-ori3 cell in normal thyroid (all P < 0.05). The cell proliferation activity of SW1736 and PCNA mRNA expression level in siRNA-eIF4B group and siRNA-eIF5A group were lower than those in the empty vector transfected group and the blank control group (all P < 0.05). Conclusions:eIF4B and eIF5A are expressed elevated in papillary thyroid carcinoma, and both are involved in tumor development and progression. The role of eIF4B and eIF5A may be related to promoting the proliferation of tumor cells.

Expression of fibrinogen-like protein 1 in clear cell renal cell carcinoma and its clinical significance / 肿瘤研究与临床

Objective:To investigate the expression of fibrinogen-like protein 1 (FGL1) in clear cell renal cell carcinoma (ccRCC) and its correlation with clinicopathological characteristics of patients with ccRCC.Methods:The clinicopathological data of 242 patients with ccRCC who were diagnosed and treated surgically from January 2015 to December 2018 were retrospectively analyzed. The cancerous tissues and paracancerous tissues (2 cm away from the edge of cancerous tissues) of patients were collected. The expression of FGL1 protein was detected by using immunohistochemistry, and the relative expression level of FGL1 mRNA was detected by using reverse transcription polymerase chain reaction (RT-PCR). Cox proportional risk model was used to make univariate and multivariate analysis of the influencing factors of progression-free survival (PFS).Results:The positive rate of FGL1 protein in ccRCC tissues was higher than that in paracancerous tissues [28.5% (69/242) vs. 2.1% (5/242)], and the difference was statistically significant ( χ2 = 65.34, P < 0.001); the relative expression level of FGL1 mRNA in ccRCC tissues was higher than that in paracancerous tissues (1.67±0.12 vs. 0.60±0.15), and the difference was statistically significant ( t = 25.33, P < 0.001). The expression of FGL1 was positively correlated with pathological staging ( r = 0.164, P = 0.011), renal vascular tumor thrombus ( r = 0.130, P = 0.043), regional lymph node metastasis ( r = 0.153, P = 0.018), and distant metastasis ( r = 0.160, P = 0.012). Univariate analysis showed that the tumor diameter, regional lymph nodes metastasis, pathological staging, distant metastasis, and FGL1 expression were factors influencing the PFS of ccRCC patients (all P < 0.05). Multivariate regression results showed that high expression of FGL1 ( HR = 11.679, 95% CI 7.432-15.673, P = 0.015), pathological staging of Ⅲ-Ⅳ ( HR = 13.654, 95% CI 8.765-18.761, P = 0.013), and distant metastasis ( HR = 11.387, 95% CI 7.662-14.831, P = 0.038) were independent risk factors for PFS in patients. Conclusions:FGL1 is highly expressed in ccRCC, which is correlated with pathological staging, renal vascular tumor thrombus, regional lymph nodes metastasis, and distant metastasis. The high expression of FGL1 is a risk factor affecting the prognosis of patients with ccRCC.

Preparation and immunogenicity evaluation of recombinant influenza hemagglutinin trimer vaccine / 中华微生物学和免疫学杂志

Objective:To prepare a recombinant hemagglutinin trimer (HA-Tri) vaccine against influenza viruses and to study its immunogenicity in a mouse model.Methods:A stable CHO cell line that could express HA-Tri was constructed. Western blot, single radial immunodiffusion, protein particle size detection and N-glycosylation site analysis were performed for qualitative and quantitative analysis of the recombinant protein. According to the different treatment conditions such as dosage and adjuvant, BALB/c mice were divided into 11 groups and subjected to consistent immunization procedures. Serum neutralizing antibody titers were measured on 56 d after the first immunization to evaluate the immunogenicity of HA-Tri.Results:The constructed CHO cells could secret and express HA-Tri proteins. The HA-Tri proteins were biologically active and capable of forming precipitation rings in the single radial immunodiffusion. The particle size of HA-Tri was approximately 18.79 nm and 10 N-glycosylation sites were detected, including high mannose, complex glycoforms and heterozygous glycoforms. After prime-boost immunization, there was no statistically significant difference in the titers of neutralizing antibodies induced in mice by 3.75 μg of HA-Tri in combination with RFH01 adjuvant and 15 μg of monovalent vaccine stock solution ( P=0.431 2, U=36). Serum antibody titers in the HA-Tri+ RFH01 groups were higher than those in the corresponding HA-Tri groups without RFH01 adjuvant, and the highest titer was induced in the 15 μg HA-Tri+ RFH01 group, which was 1 280. Conclusions:The recombinant HA-Tri protein was successfully prepared. HA-Tri in combination with RFH01 adjuvant could induce humoral immune responses against influenza viruses in BALB/c mice, which would provide reference for the development of influenza virus recombinant subunit vaccines.

The effects of high-intensity interval training on the renin-angiotensin system in spontaneously hypertensive rats / 中华物理医学与康复杂志

Objective:To observe any effect of high-intensity interval training on the blood pressure and renal function of Wistar-Kyoto rats modeling spontaneous hypertension (SHR) and to explore the mechanism of the renal renin-angiotensin system′s (RAS′s) role in this process.Methods:Twenty male SHR were randomly divided into a sedentary group and an exercise group, each of 10. Another 10 Wistar-Kyoto rats formed a normotensive control group. The rats in the normotensive and hypertensive sedentary groups were fed quietly in their cage, while the hypertensive exercise group performed high-intensity interval training for 8 weeks. After the last exercise, blood pressure, renal function, the kidney levels of nitric oxide and interleukin-6 (IL-6) and the protein expressions of angiotensin converting enzyme (ACE), ACE2, angiotensin type 1 receptor (AT1R), AT2R and Mas receptor (MasR) were measured.Results:Compared with the normotensive group, the hypertensive sedentary group showed a significant increase in average blood pressure, IL-6, ACE and AT1R protein and the ratio of AT1R to AT2R. There was a significant decrease in the renal function, the average NO level and the expression of ACE2, AT2R and MasR protein. That group also showed a significant decrease in blood pressure, IL-6, ACE and AT1R protein expression and the AT1R: AT2R ratio compared with the hypertensive sedentary group, but a significant increase in renal function, average NO content and the expression of ACE2, AT2R and MasR protein.Conclusion:Eight weeks of high-intensity interval training has a protective effect on the kidneys by regulating the renin-angiotensin system, at least in rats.

The effects of aerobic exercise on renal fibrosis and apoptosis in spontaneously hypertensive rats / 中华物理医学与康复杂志

Objective:To explore any effect of regular aerobic exercise on renal fibrosis and apoptosis in rats with spontaneous hypertension.Methods:Thirty 6-week-old male spontaneously hypertensive rats were randomly divided into a sedentary group (group HS) and an exercise group (group HE). Ten age- and sex-matched Wistar-Kyoto rats formed a control group. The rats in group HE underwent 12 weeks of swimming exercise lasting 60 minutes, five times a week, while the other two groups were kept quiet in their cages. Before and after the training, the tail artery blood pressure of each rat was measured. Renal function was evaluated after the experiment by measuring 24h urine protein, blood urea nitrogen and serum creatinine levels, while the degree of renal interstitial fibrosis was measured using Masson staining and the collagen volume fraction was calculated. The number of apoptotic cells in the renal tubular epithelial tissue was recorded by TUNEL staining and the apoptosis rate was calculated. The expression of renal transforming growth factor β1 (TGF-β1), Smad2/3, Smad7, Bax and Bcl-2 protein were detected using western blotting.Results:After the intervention, the average systolic and diastolic blood pressure and mean arterial pressure of group HS had increased significantly, while those of group HE had decreased significantly, with no significant changes in those measurements among the control group. Compared with the control group, after the intervention, the average blood pressure, 24h urinary protein, blood urea nitrogen and serum creatinine, as well as the cell apoptosis rate and expression of TGF-β1, Smad2/3 and Bax had increased significantly, and that of Smad7 and Bcl-2 had decreased significantly in group HS. And compared with group HS, in group HE the average blood pressure, 24h urinary protein, blood urea nitrogen, serum creatinine and the cell apoptosis rate had decreased significantly, together with the expression of TGF-β1, Smad2/3 and Bax, but the average expression of Smad7 and Bcl-2 had increased significantly.Conclusion:Regular aerobic exercise can relieve the renal dysfunction seen in spontaneous hypertension, at least in rats, by inhibiting renal fibrosis and apoptosis.

Effects of stem cells therapy combined with aerobic exercise on ventricular remodeling in rats with acute myocardial infarction / 中华物理医学与康复杂志

Objective:To explore the effect of supplementing stem cell therapy with aerobic exercise in left ventricle remodeling after myocardial infarction.Methods:Sixty 6-week-old male Wistar rats had acute myocardial infarction induced by ligation of the anterior descending coronary artery. They were then randomly divided into a model group, a stem cell group, an exercise group and an observation group. Another ten healthy Wistar rats formed a sham operation group. The rats in the stem cell and observation groups were infused with a suspension of bone marrow mesenchymal stem cells through the tail vein. Beginning four weeks later, the exercise and observation groups underwent 60 minutes of aerobic treadmill exercise 5 days per week for 8 weeks. At the beginning and end of the eight weeks the rats′ exercise performance was evaluated using a graded treadmill exercise test. And after the last training session cardiac structure and function were detected using ultrasound imaging. Tissue was then collected from the left ventricles and the collagen volume fractions were calculated. The expression of myocardial brain natriuretic peptide (BNP), heavy chain β-myosin (β-MHC) and α-MHC mRNA was detected using real-time fluorescence quantitative PCRs.Results:Compared with the sham operation group, the time and distance to exhaustion shortened significantly in the model group, with a significant decrease in the average maximum running speed, left ventricle ejection fraction (LVEF), left ventricle shortening fraction (LVFS), expression of α-MHC and the α-MHC/β-MHC ratio. There was a significant increase in the average resting heart rate, collagen volume fraction, expression of BNP and β-MHC in the model group. Compared with the model group, there was a significant increase in the average LVEF and LVFS of the stem cell group as well as in the time and distance to exhaustion, maximum running speed, expression of α-MHC and in the α-MHC/β-MHC ratio of the observation group, but a significant decrease in the average collagen volume fraction of the stem cell group compared with the observation group, together with the resting heart rate, collagen volume fraction, the expression of BNP and of β-MHC. Compared with the stem cell group, the observation group showed a significant increase in the average time and distance to exhaustion, maximum running speed, expression of α-MHC and the α-MHC/β-MHC ratio, with a significant decrease in the average resting heart rate, collagen volume fraction, expression of BNP and β-MHC.Conclusion:Aerobic exercise or stem cell therapy alone can inhibit left ventricular remodeling and improve cardiac function after myocardial infarction, at least in rats. The combination of the two treatments has a synergistic effect and can further enhance the effect of stem cell therapy.

Prevalence and risk factors of diabetic kidney disease in plain-sand areasand loess hilly areas of Gansu province / 中华全科医师杂志

Objective:To investigate the risk factors of diabetic kidney disease (DKD) in type 2 diabetes mellitus (T2DM) patients in plain-sand areas and loess hilly areas of Gansu province.Methods:A total of 1 599 T2DM patients who participated in chronic disease and risk factors monitoring and basic public health service management were selected by multi-stage stratified random sampling method in the sandy plain areas and loess hilly areas of Gansu province. Questionnaire survey, physical measurement and laboratory tests were performed. Multivariate binary logistic model was used to analyze the influencing factors.Results:The prevalence of DKD was 22.1% (174/787) among T2DM patients in the sandy plain areas and 19.1%(155/812) in the loess hilly area, respectively. Hypertension ( OR=3.022), hyperuricemia ( OR=2.114) and HbA1c≥7%( OR=2.231) were the risk factors for DKD in the plain-sand areas, and the risk of DKD increased with age. In the loess hilly areas, female sex ( OR=0.379) was the protective factor for DKD; while duration of disease≥10 years ( OR=2.476), hyperuricemia ( OR=1.907), HbA1c≥7% ( OR=1.927) were the risk factors for DKD; and the risk of DKD increased with the increase of age, and decreased with the increase of per capita monthly income. Conclusions:The prevalence of DKD and its influencing factors are different between sandy plain areas and loess hilly areas in Gansu province. The prevention and treatment of hypertension should be given more attention in sandy plain areas. In addition, the screening of DKD should be conducted among T2DM patients, particularly for those with old age, hyperuricemia and HbA1c≥7% in both areas of the province.

Discussion on application of control level of radioactive contamination on personnel′s body surface in a nuclear and radiological emergency / 中华放射医学与防护杂志

There are differences and inconsistencies to some degree in the radioactive contamination control level of personnel′s body surface availiable in many national standards, thus puzzling the users. Therefore, it is proposed to compare the applicable scope, conditions and differences between relevant national standards, and combine with similar clinical nuclear medicine standards of radiological protection content to presevent recommendations on the contamination control level that should be correctly applied in an event of nuclear and radiological emergency. Based on the discussion of similar standards, the contaminated personnel with α of 0.04-10 Bq/cm 2 and β of 0.4-100 Bq/cm 2 are advised to be treated in the institutions with higher than secondary medical insititution. Both α econtamination control levels less than 0.04 Bq/cm 2 and β levels less than 0.4 Bq/cm 2 could be achivable, if fully decontaminated.

Hemodynamic study of patients with early allograft dysfunction after liver transplantation / 中华超声影像学杂志

Objective:To explore the characteristics of postoperative hemodynamic changes in patients with early allograft dysfunction (EAD), and to provide clinical imaging support for the early diagnosis of EAD.Methods:A total of 907 patients who underwent liver transplantation in Tianjin First Central Hospital from December 2012 to June 2021 were retrospectively selected, and they were divided into EAD group (361 cases) and non-EAD group (546 cases) according to EAD diagnostic criteria. The peak systolic velocity(PSV) of the hepatic artery, end-diastolic velocity(EDV) of the hepatic artery, resistance index(RI), S/D(PSV/EDV), diameter of the portal vein(PVD), velocity of the portal vein(PVV), diameter of the middle hepatic vein(MHVD), velocity of the middle hepatic vein(MHVV), the diameter of the right hepatic vein(RHVD), and the velocity of the right hepatic vein (RHVV) were collected from 1 to 7 days after operation (a total of 5 573 ultrasound examination results), and the differences in ultrasound hemodynamic parameters were compared between the two groups. The correlation of S/D<2, PSV<25 cm/s, PVV<15 cm/s, MHVV or RHVV<15 cm/s within 3 days after operation with the occurence of EAO were analyzed by multivariate Logistic regression analysis.Results:①The PSV and EDV of the hepatic artery in the EAD group and the non-EAD group showed a slow upward trend at 1-7 days after operation, while the hepatic artery RI and PVV showed a downward trend, the MHVV and RHVV did not fluctuate significantly. ②The hepatic artery in the EAD group showed low-resistance blood flow in the early postoperative period, and the EDV were significantly higher than that in the non-EAD group on 1 d, 2 d, 3 d and 5 d, RI was significantly lower than that of the non-EAD group (all P<0.05); At 4 d, 6 d and 7 d, there was no significant differences of EDV and RI between the two groups(all P>0.05). The PSV of the EAD group was higher than that of the non-EAD group on 3 d ( P<0.05). Among the parameters of portal vein blood flow, the PVV in the EAD group was significantly higher than that in the non-EAD group on 1 d ( P<0.05), and there was no significant difference of PVD between the two groups at day 1-7. Among the parameters of hepatic venous blood flow, the MHVV and RHVV in the EAD group were significantly lower than those in the non-EAD group (all P<0.05), there was no significant difference between the two groups of MHVD and RHVD at 1-7 days. ③The incidence of grafted hepatic artery S/D<2 within 3 days after operation in EAD group was higher than that in non-EAD group. Binary Logistic regression multivariate analysis showed that the occurrence of grafted hepatic artery S/D<2 within 3 days after operation was significantly correlated with the occurrence of EAD[Exp(B)=1.878, P<0.05]. Conclusions:Patients who develop EAD after liver transplantation show low-resistance blood flow in the hepatic artery during the perioperative period, and the occurrence of hepatic artery S/D<2 within 3 days after operation can early predict the occurrence of EAD.

The characteristics and changes of bacterial infection and drug resistance in pediatric intensive care unit from 2016 to 2020 / 中国小儿急救医学

Objective:To investigate the characteristics and changes of bacterial infection and drug resistance in PICU at Children′s Hospital of Fudan University from 2016 to 2020.Methods:All the strains were collected at Children′s Hospital of Fudan University from January 1 st, 2016 to December 31 st, 2020.Antimicrobial susceptibility test was carried out according to a unified protocol using Kirby-Bauer method or automated systems.Results were analyzed according to CLSI 2020 breakpoints. Results:(1)Bacterial distribution: 2 551 bacteria were monitored from 2016 to 2020 in our center.The top 3 bacteria were all gram-negative bacteria.Among them, Burkholderia cepacian showed a tortuous downward trend(13.45% to 1.18%), and Klebsiella pneumoniae showed an upward trend(6.05% to 10.61%).The most common infected site was respiratory tract, although the strains in the respiratory tract decreased year by year.Baumanii was the most common bacteria in respiratory infections.Staphylococcus epidermidis was the most common bacteria from 2016 to 2017 in blood infections, but Achromobacter xylosoxidans were became the most common bacteria from 2018 to 2020.Enterococcus faecium was the most common bacteria in urinary infections.(2) Drug resistance: Baumanii had a high drug resistance rate to amikacin, gentamicin, cefepime, and cefitadine, with no obvious changes over the years, which had a gradually decreasing drus resistance rate to cefoperazone sulbactam, showing a tortuous upward trend to imipenem and meropenem.Baumanii and Pseudomonas aeruginosa had a low drug resistance to levofloxacin over the years, but with high resistance rates in 2020.Escherichia coliand and Klebsiella pneumoniae still had high resistance rates to beta-lactam antibiotics, and their resistance rates to levofloxacin were decreasing.Escherichia coli and Klebsiella pneumoniae showed decreasing resistance rates to imipenem and increased resistance rates to meropenem.The resistance rate of Enterococcus faecium to levofloxacin decreased and always showed a high susceptibility rate to polypeptide antibiotics.Neither Staphylococcus epidermidis nor Staphylococcus aureus were currently resistant to tetracycline antibiotics, and the resistance rates of aminoglycoside antibiotics, such as gentamicin, was also declining.Conclusion:The bacterial infection in PICU shows as the main characteristics of respiratory infection and gram-negative bacteria infection.Carbapenem-resistant Enterobacteriaceae bacteria, Enterococci and Staphylococcus species are becoming increasingly more resistant.

Longitudinal study on the track of postoperative supportive care needs and influencing factors in patients with non-small cell lung cancer / 中国实用护理杂志

Objective:To explore the potential categories of post-operative supportive care demand trajectory for patients with non-small cell lung cancer (NSCLC), analyze the influencing factors, and propose targeted interventions.Methods:This was a prospective observational study. A convenient sampling method was used to select 177 NSCLC patients who received surgical treatment in Shanghai Lung Hospital Affiliated to Tongji University from January 2021 to February 2022. The Supportive Care Demand Scale for cancer patients was used to investigate the level of patients′supportive care demand 1 day before operation, 3 days after operation, 1 day before discharge, 1 week after discharge, 1 month after discharge, and 3 months after discharge, and the potential growth model was used to identify the trajectory category and multi category Logistic regression analysis was used to explore the influencing factors.Results:Three supportive care demand trajectories were fitted out in this study, which were the continuous high demand group (46.33%), the slowly decreasing demand group (30.51%), and the low decreasing demand group (23.16%). With the potential category group 3, low demand reduction group as the reference category, Logistic regression analysis showed that high psychological distress, low social support, high disease stage, high comorbidities were more likely to enter the continuous high demand group ( OR = 0.826 to 18.526, all P<0.05), and high education level (college education and above and high school) were more likely to enter the slowly decreasing demand group ( OR = 6.076, 4.199, both P<0.05). Conclusions:The demand track of NSCLC patients for supportive care after surgery has population heterogeneity. Clinical medical staff should provide personalized social support and emotional support for patients with high disease stage, more complications and low education level in the early postoperative period.

Correlation between meconium-stained amniotic fluid and intrauterine infection / 中华实用儿科临床杂志

Fetal hypoxia has long been described as the main cause of meconium-stained amniotic fluid (MSAF). However, recent studies have reported the presence of a variety of pathogenic microorganisms in meconium and amniotic fluid, and even more bacterial species in MSAF.Clinical observations also revealed that MSAF was closely related to fetal-neonatal infection and perinatal infection of pregnant women.Shortly after birth, the fetuses with MSAF developed infectious symptoms or showed abnormalities in infection-related laboratory indicators.Therefore, intrauterine infection may be one major cause of MSAF.To further our understanding of the factors leading to MSAF will improve the clinical management and prognosis of infants.

Research Progress in the Regulation of Follicle Development by Melatonin / 中国医学科学院学报

Melatonin,an endocrine hormone synthesized by the pineal gland,plays an important role in the reproduction.The growth and development of follicles is the basis of female mammalian fertility.Follicles have a high concentration of melatonin.Melatonin receptors exist on ovarian granulosa cells,follicle cells,and oocytes.It regulates the growth and development of these cells and the maturation and atresia of follicles,affecting female fertility.This paper reviews the protective effects and regulatory mechanisms of melatonin on the development of ovarian follicles,granulosa cells,and oocytes and makes an outlook on the therapeutic potential of melatonin for ovarian injury,underpinning the clinical application of melatonin in the future.

Causative Microorganisms Isolated from Patients with Intra-Abdominal Infections and Their Drug Resistance Profiles: An 11-Year (2011-2021) Single-Center Retrospective Study / 生物医学与环境科学（英文）

OBJECTIVE@#To investigate the distribution and antimicrobial susceptibility of causative microorganisms recovered from patients with intra-abdominal infections (IAIs).@*METHODS@#A total of 2,926 bacterial and fungal strains were identified in samples collected from 1,679 patients with IAIs at the Peking Union Medical College Hospital between 2011 and 2021. Pathogenic bacteria and fungi were identified using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Antimicrobial susceptibility testing (AST) was performed using the VITEK 2 compact system and the Kirby-Bauer method. AST results were interpreted based on the M100-Ed31 clinical breakpoints of the Clinical and Laboratory Standards Institute.@*RESULTS@#Of the 2,926 strains identified, 49.2%, 40.8%, and 9.5% were gram-negative bacteria, gram-positive bacteria, and fungi, respectively. Escherichia coli was the most prevalent pathogen in intensive care unit (ICU) and non-ICU patients; however, a significant decrease was observed in the isolation of E. coli between 2011 and 2021. Specifically, significant decreases were observed between 2011 and 2021 in the levels of extended-spectrum β-lactamase (ESBL)-producing E. coli (from 76.9% to 14.3%) and Klebsiella pneumoniae (from 45.8% to 4.8%). Polymicrobial infections, particularly those involving co-infection with gram-positive and gram-negative bacteria, were commonly observed in IAI patients. Moreover, Candida albicans was more commonly isolated from hospital-associated IAI samples, while Staphylococcus epidermidis had a higher ratio in community-associated IAIs. Additionally, AST results revealed that most antimicrobial agents performed better in non-ESBL-producers than in ESBL-producers, while the overall resistance rates (56.9%-76.8%) of Acinetobacter baumanmii were higher against all antimicrobial agents than those of other common gram-negative bacteria. Indeed, Enterococcus faecium, Enterococcus faecalis, S. epidermidis, and S. aureus were consistently found to be susceptible to vancomycin, teicoplanin, and linezolid. Similarly, C. albicans exhibited high susceptibility to all the tested antifungal drugs.@*CONCLUSION@#The distribution and antimicrobial susceptibility of the causative microorganisms from patients with IAIs were altered between 2011 and 2021. This finding is valuable for the implementation of evidence-based antimicrobial therapy and provides guidance for the control of hospital infections.

More than two courses of pre-transplant consolidation therapy benefits patients with acute myeloid leukemia in the first complete remission who underwent human leukocyte antigen-matched sibling allografts: a multicenter study / 中华医学杂志(英文版)

BACKGROUND@#Although the need for consolidation chemotherapy after successful induction therapy is well established in patients with acute myeloid leukemia (AML) in first complete remission (CR1), the value of consolidation chemotherapy before allogeneic hematopoietic stem cell transplantation remains controversial.@*METHODS@#We retrospectively compared the effect of the number of pre-transplant consolidation chemotherapies on outcomes of human leukocyte antigen-matched sibling stem cell transplantation (MSDT) for patients with AML in CR1 in multicenters across China. In our study, we analyzed data of 373 AML patients in CR1 from three centers across China.@*RESULTS@#With a median follow-up of 969 days, patients with ≥ 3 courses of consolidation chemotherapy had higher probabilities of leukemia-free survival (LFS) (85.6% vs . 67.0%, P < 0.001) and overall survival (89.2% vs . 78.5%, P  = 0.007), and better cumulative incidences of relapse (10.5% vs . 19.6%, P  = 0.020) and non-relapse mortality (4.2% vs . 14.9%, P  = 0.001) than those with ≤ 2 courses of consolidation chemotherapy. Pre-transplantation minimal residual disease-negative patients with AML in CR1 who received MSDT with ≥ 3 courses of consolidation chemotherapy had a higher probability of LFS (85.9% vs . 67.7%, P  = 0.003) and a lower cumulative incidence of relapse (9.6% vs . 23.3%, P  = 0.013) than those with ≤ 2 courses.@*CONCLUSION@#Our results indicate that patients with AML in CR1 who received MSDT might benefit from pre-transplant consolidation chemotherapy.