The Efficacy and Safety of Daratumumab-Based Regimen in Treatment of Multiple Myeloma Patients with Renal Impairment / 中国实验血液学杂志

OBJECTIVE@#To investigate the efficacy and safety of daratumumab in treatment of multiple myeloma (MM) patients with renal impairment (RI).@*METHODS@#The clinical data of 15 MM patients with RI who received daratumumab-based regimen from January 2021 to March 2022 in three centers were retrospectively analyzed. Patients were treated with daratumumab or daratumumab combined with dexamethasone or daratumumab combined with bortezomib and dexamethasone and the curative effect and survival were analyzed.@*RESULTS@#The median age of 15 patients was 64 (ranged 54-82) years old. Six patients were IgG-MM, 2 were IgA-MM,1 was IgD-MM and 6 were light chain MM. Median estinated glomerular filtration rate (eGFR) was 22.48 ml/(min·1.73 M2). Overall response rate of 11 patients with MM was 91% (≥MR), including 1 case of stringent complete response (sCR), 2 cases of very good partial response (VGPR), 3 cases of partial response (PR) and 4 cases of minor response (MR). The rate of renal response was 60%(9/15), including 4 cases of complete response (CR), 1 case of PR and 4 cases of MR. A median time of optimal renal response was 21 (ranged 7-56) days. With a median follow-up of 3 months, the median progression-free survival and overall survival of all patients were not reached. After treatment with daratumumab-based regimen, grade 1-2 neutropenia was the most common hematological adverse reaction. Non-hematological adverse reactions were mainly infusion-related adverse reactions and infections.@*CONCLUSION@#Daratumumab-based regimens have good short-term efficacy and safety in the treatment of multiple myeloma patients with renal impairment.

Efficacy of foldable capsular vitreous body implantation in ocular trauma and silicone oil-dependent eyes / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To observe the clinical effect of foldable capsular vitreous body(FCVB)implantation on ocular trauma and silicone oil-dependent eyes.METHODS: A prospective case study was performed on 17 cases(17 eyes)with ocular trauma and silicone oil-dependent in the First Hospital of Changsha from October 2017 to April 2022. All patients underwent FCVB or silicone oil removal combined with FCVB implantation. The follow-up time was 6mo, and the visual acuity, intraocular pressure, ocular axes, normal external appearances and FVCB were observed at 1wk and 6mo after operation.RESULTS: Only 6 cases had visual acuity before operation, and there were no statistical differences in the visual acuity before and at 1wk and 6mo after operation(P>0.05). The intraocular pressure was low before operation, but it was elevated at 1wk and 6mo after operation. The axial length was unchanged at 1wk and 6mo after operation, and the appearance and structure of eyeball were well maintained, and FCVB was stable with no atrophy during the follow-up period.CONCLUSIONS: FCVB implantation can preserve the appearance of eyeball, and avoid atrophy of eyeball and repeated operation, which has favorable clinical application value in the treatment of ocular trauma and silicone oil-dependent eyes.

Organizing Pneumonia in A Patient Double-Positive for ANCA and Anti-GBM Antibodies: A Case Report / 中国医学科学杂志(英文版)

Both anti-glomerular basement membrane (GBM) disease and the anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) are common causes of pulmonary-renal syndrome. Organizing pneumonia (OP), a special pattern of interstitial lung disease, is extremely rare either in AAV or anti-GBM disease. We report an old woman presented with OP on a background of co-presentation with both ANCA and anti-GBM antibodies.

Three dimensional finite element analysis of optimal distribution model of fillers in vertebroplasty / 中国骨伤

OBJECTIVE@#To establish a three-dimensional finite element model of osteoporosis and to study the stiffness recovery of injured vertebrae and stress analysis of adjacent vertebrae after percutaneous vertebroplasty under different perfusion and distribution conditions by simulating fluid flow into the vertebral body.@*METHODS@#A male healthy volunteer was selected. CT scans were performed from T@*RESULTS@#(1) The VonMises stress of T@*CONCLUSION@#Reliable biomechanical model of lumbar vertebral fracture can be established by using CT scanning data through software simulation. Vertebral fracture and vertebroplasty will cause biomechanical changes of adjacent vertebral bodies. With the increase of bone cement injection, the influence of biomechanical changes will increase significantly. Neighbouring vertebral fractures are more likely. For this experiment, percutaneous vertebroplasty has a suitable amount of cement injection of 4 ml.

Acute cerebral ischemia-induced down-regulation of Sirt3 protein expression contributes to neuronal injury via damaging mitochondrial function / 生理学报

This study was aimed to determine the effect of acute cerebral ischemia on the protein expression level of silent mating type information regulator 2 homolog 3 (Sirt3) in the neurons and clarify the pathological role of Sirt3 in acute cerebral ischemia. The mice with middle cerebral artery occlusion (MCAO) and primary cultured rat hippocampal neurons with oxygen glucose deprivation (OGD) were used as acute cerebral ischemia models in vivo and in vitro, respectively. Sirt3 overexpression was induced in rat hippocampal neurons by lentivirus transfection. Western blot was utilized to measure the changes in Sirt3 protein expression level. CCK8 assay was used to detect cell viability. Immunofluorescent staining was used to detect mitochondrial function. Transmission electron microscope was used to detect mitochondrial autophagy. The results showed that, compared with the normoxia group, hippocampal neurons from OGD1 h/reoxygenation 2 h (R2 h) and OGD1 h/R12 h groups exhibited down-regulated Sirt3 protein expression levels. Compared with contralateral normal brain tissue, the ipsilateral penumbra region from MCAO1 h/reperfusion 24 h (R24 h) and MCAO1 h/R72 h groups exhibited down-regulated Sirt3 protein expression levels, while there was no significant difference between the Sirt3 protein levels on both sides of sham group. OGD1 h/R12 h treatment damaged mitochondrial function, activated mitochondrial autophagy and reduced cell viability in hippocampal neurons, whereas Sirt3 over-expression attenuated the above damage effects of OGD1 h/R12 h treatment. These results suggest that acute cerebral ischemia results in a decrease in Sirt3 protein level. Sirt3 overexpression can alleviate acute cerebral ischemia-induced neural injuries by improving the mitochondrial function. The current study sheds light on a novel strategy against neural injuries caused by acute cerebral ischemia.

Mechanism of neuronal damage induced by sevoflurane: the relationship between phosphorylation of Tau protein and apolipoprotein E containing 18 kDa fragments / 中华麻醉学杂志

Objective:To evaluate the relationship between phosphorylation of Tau protein and apolipoprotein E (ApoE) containing 18 kDa fragments and investigate the mechanism of neuronal damage induced by sevoflurane.Methods:Primary neurons (ApoE3 and ApoE2 genotypes, 24 dishes for each genotype) of fetal mice cultured until the 5th day were divided into 4 groups ( n=12 each) using a random number table method: ApoE3 control group (A3C group), ApoE3 sevoflurane group (A3S group), ApoE2 control group (A2C group) and ApoE2 sevoflurane group (A2S group). Neurons were treated with 21% oxygen + 5% carbon dioxide + 4.1% sevoflurane for 4 h in A3S and A2S groups, while the neurons were only treated with 21% oxygen + 5% carbon dioxide in A3C and A2C groups.The cell proteins were then extracted to detect the expression of full-length ApoE and ApoE, AT8 and PHF1 containing 18 kDa fragments (by Western blot), expression of ApoE mRNA (by real-time polymerase chain reaction), and concentrations of tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) in the supernatant (by enzyme-linked immunosorbent assay). Results:Compared with A2C group, the expression of ApoE mRNA and full-length ApoE in neurons was up-regulated ( P<0.05), and no significant change was found in the expression of AT8 and PHF1 and concentrations of TNF-α and IL-6 in the supernatant in A2S group ( P>0.05). Compared with A3C group, the expression of ApoE mRNA, full-length ApoE, and ApoE, AT8 and PHF1 containing 18 kDa fragments was up-regulated, and the concentrations of TNF-α and IL-6 in the supernatant were increased in A3S group ( P<0.05). Conclusion:Sevoflurane may promote phosphorylation of Tau proteins and increase inflammatory responses through up-regulating the expression of ApoE containing 18 kDa fragments, thus leading to neuronal damage.

Depressive symptoms detection among the urban elderly in Ya'an city and its influencing factors six years after Lushan earthquake / 四川精神卫生

ObjectiveTo investigate the prevalence and characteristics of depressive symptoms among urban elderly six years after Lushan earthquake in Ya'an， so as to provide references for the mental health interventions for elderly following catastrophic stressful life events. MethodsFrom March to April 2019， a multi-stage stratified cluster random sampling method was adopted to enroll 885 urban elderly people aged 60 and above in Ya'an. A self-compiled questionnaire was used to collect the general demographic information， health-related and disaster-related information， meantime， the elderly was assessed using Geriatric Depression Scale （GDS-30）. Thereafter， univariate and multivariate Logistic regression were applied to explore the influencing factors of depressive symptoms in urban elderly. ResultsA total of 783 valid questionnaires were collected， with a questionnaires response rate of 88.47%. Depressive symptoms were detected in 161 cases （20.56%）. The prevalence of depression showed statistical differences among the elderly of different gender， age， marital status， family relationship， monthly per capita household income， physical exercise status， health status， self-care ability， sleep status and disaster-affected degree （P<0.05 or 0.01）. Logistic regression analysis showed that the urban elderly of the female gender （OR=1.552， P=0.040）， monthly per capita household income of 2000~3000 yuan （OR=6.982， P<0.01）， monthly per capita household income≤2000 yuan （OR=6.857， P<0.01）， lack of physical exercise （OR=1.693， P<0.01）， being less capable of self-care （OR=3.838， P<0.01）， being incapable of self-care （OR=8.547， P<0.01）， complicating multiple curable diseases （OR=4.892， P<0.01） and complicating refractory chronic diseases （OR=5.657， P=0.031） were at high risk of depressive symptoms. The risk of depressive symptoms among the divorced or widowed elderly was greater than that among married elderly （OR=0.063， P<0.01）. ConclusionThe prevalence of depressive symptoms is relatively high among the urban elderly six years after Lushan earthquake in Ya'an， moreover， female gender， low monthly per capita household income， lack of physical exercise， being incapable of self-care and poor health status are risk factors affecting the depressive symptom， while being married is a protective factor.

One-stage surgery in patients with both cardiac and non-cardiac diseases / 北京大学学报(医学版)

OBJECTIVE@#To investigate the possibility and feasibility of one-stage cardiac and non-cardiac surgery.@*METHODS@#From July 1999 to August 2018, one hundred and eleven patients suffering from cardiac and non-cardiac diseases were treated by one-stage cardiac and non-cardiac operation in Department of Cardiac Surgery and Thoracic Surgery, General Surgery, Urinary Surgery, and Gynecology, Peking University First Hospital. There were 83 males (74.8%) and 28 females (25.2%), aged 41 to 84 years [mean age: (64.64±8.97) years]. The components of the cardiac disease included coronary heart disease, valvular heart disease, cardiac tumors, chronic constrictive pericarditis and congenital heart disease. The components of the non-cardiac diseases included lung benign and malignant diseases, thymoma and thymic cyst, breast cancer, chest wall giant hemangioma, digestive tract benign and malignant diseases, urinary system carcinoma and gynecological diseases.@*RESULTS@#Two patients died after operations in hospital; thus, the hospital mortality rate was 1.8%. One patient died of multiple organ failure on the 153th days after emergency coronary artery bypass grafting (CABG) combined with radical resection of bladder cancer. The other of pericardium stripping with lung cancer operation died of the multiple organ failure on the tenth day after surgery. The remaining 109 patients recovered and were discharged. There were 13 cases of complications during the days in hospital. The total operative morbidity was 11.7%: postoperative hemorrhage in 2 cases (1.8%), pulmonary infection and hypoxemia in 3 cases (2.7%), hemorrhage of upper digestive tract in 1 case (0.9%), incisional infection in 3 cases (2.7%), subphrenic abscess in 1 case (0.9%), and postoperative acute renal failure and hemofiltration in 3 case (2.7%). Of the 109 patients discharged, 108 patients were followed up. All the patients survived for 6 months, and 21 patients died due to tumor recurrence or metastasis within 1 to 5 years of follow-up, but no cardiogenic death. During the follow-up period, 1 patient developed cardiac dysfunction, 1 patient underwent percutaneous coronary intervention (PCI), 1 patient had cerebral hemorrhage due to excessive postoperative anticoagulation, and 1 patient suffered from incisional hernia.@*CONCLUSION@#One-stage surgeries in patients suffering from both cardiac and non-cardiac benign or malignant diseases are safe and possible with satisfactory short-term and long-term survival.

Laparoscopy in the gynecological acute abdomen in pregnancy / 中华围产医学杂志

Acute abdomen in pregnancy can be divided into pregnancy-related and non-pregnancy-related type.This article reviewed the different types of acute abdomen caused by gynecological problems during pregnancy.Also,the progress of laparoscopic surgical technique and the perioperative management and the influence of the operation on pregnancy outcomes in patients who developed acute abdomen and underwent laparoscopic surgery in pregnancy were also analyzed,to provide information for the application of emergency laparoscopic surgery in pregnancy.

Laparoscopy in the gynecological acute abdomen in pregnancy / 中华围产医学杂志

Acute abdomen in pregnancy can be divided into pregnancy-related and non-pregnancy-related type. This article reviewed the different types of acute abdomen caused by gynecological problems during pregnancy. Also, the progress of laparoscopic surgical technique and the perioperative management and the influence of the operation on pregnancy outcomes in patients who developed acute abdomen and underwent laparoscopic surgery in pregnancy were also analyzed, to provide information for the application of emergency laparoscopic surgery in pregnancy.

Effect of Music Therapy on Cognition and Emotion for Stroke Patients / 中国康复理论与实践

Objective:To explore the effect of early cognitive rehabilitation combined with music therapy on cognitive function, activities of daily living (ADL) and psychology in stroke patients. Methods:From March, 2016 to September, 2017, 56 stroke patients were were randomly divided into control group (n = 28) and observation group (n = 28). All the patients accepted early motor and cognitive rehabilitation, the observation group accepted music therapy in addition, for four weeks. They were assessed with Mini-Mental State Examination (MMSE), Loewenstein Occupational Therapy Congnitive Assessment (LOTCA), modified Barthel Index (MBI), Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS). Results:The scores of MMSE, scores of subscales and total scale of LOTCA, and MBI increased in both group after treatment (t > 5.480, P < 0.05), while the scores of SAS and SDS decreased (t > 10.227, P < 0.001). The total scores of MMSE, LOTCA and MBI increased more (t > 2.648, P < 0.05), and the scores of SDS decreased more (t = 2.818, P < 0.05) in the observation group than in the control group. Conclusion:Combination of music therapy may promote the recovery of cognitive function, ADL and mental health for stroke patients.

Clinical Effect of Dahuang Zhechong Wan on Pelvic Pain Caused by Endometriosis with Qi Stagnation and Blood Stasis Syndrome / 中国实验方剂学杂志

Objective: To discuss the clinical effect of Dahuang Zhechong Wan on pelvic pain caused by endometriosis with Qi stagnation and blood stasis syndrome and study the mechanism of action. Method: One hundred and twenty-six patients were randomly divided into control group (64 cases) and observation group (62 cases) by random number table. Both groups' patients got Duphaston from the 5th to 25th days of menstrual cycle, 1 tablet/day, 2 times/days. Patients in control group got Sanjie Zhentong Jiaonang at the first day of menstruation, 4 grains/time, 3 times/days. Patients in observation group got Dahuang Zhechong Wan, 3 g/time, 2 times/days. The treatment in two groups continued for 3 menstrual cycles. Before treatment and at the first, second and third menstrual cycles after the treatment, visual analogue score (VAS) of pain was used for dysmenorrheal. Before AND after the treatment, scores of symptoms, signs, Qi stagnation and blood stasis syndrome and endometriosis were scored by endometriosis health profile-5 (EHP-5). And hemorheology was detected, and levels of matrix metalloproteinases-2 (MMP-2), MMP-9, tumor necrosis factor-α (TNF-α), interleukin-1 (IL-1), prostaglandin E2 (PGE2), prostaglandin F2α(PGF2α) and substance P (SP) were detected. Result: By rank sum test, the clinical effect of disease in observation group was better than that in control group (Z=2.198, PPPPα, IL-1, PGF2α and SP were lower than those in control group (P2 was higher than that in control group (PConclusion: In addition to treatment of progestogen, Dahuang Zhechong Wan can relieve pelvic pain, improve quality of life and clinical effect, and regulate levels of prostaglandins, matrix metalloproteinases and proinflammatory factors.

Epidemiological survey and study of hepatitis E virus among HIV-infected population in Hubei Province / 中华疾病控制杂志

Objective To determinate the seroprevalence of hepatitis E virus (HEV) exposition among HIV-infected people in Hubei Province so as to provide basic data for effective prevention and control of HIV and hepatitis E virus． Methods A total of 335 serum samples of HIV-infected people were collected from January to June 2017．Serum samples were subjected to anti-HEV IgG andanti-HEV IgM screening. Data were statistically analyzed. Results In 335 HIV-infected people，0.89% (3/335) of serum samples were anti-HEV IgM positive and 41.49% (139/335) of them were anti-HEV IgG positive．The anti-HEV IgG positive rate was not linearly correlated with age ( 2linear=0.756，P=0.385), and there was no significant difference between the age groups (P>0.05). There was no significant difference in anti-HEV IgG positive rate between different gender( 2=0.085，P=0.771)．Anti-HEV IgG positive rate for the crowd with CD4 value ≤ 200 cell/μl was higher than that with CD4 ＞200 cell/μl，but showed no significant difference( 2=1.016，P=0.314)，and CD4 indexes of three positive anti-HEV IgM patients were 222, 446 and 198 in cell/μl．The anti-HEV IgG positive rate in HIV-infected population in eastern Hubei (30.77%, 32/1 041) was statistically different from that in central Hubei (47.92%, 46/96) ( 2=6.169，P=0.013) , and it was also different from that in southeastern Hubei (45.79%， 49/107) ( 2=5.034，P=0.025). Conclusions There were higher HEV infection rate among HIV-infected people in Hubei Province; thus, it is essential to positively carry out double-way screening for these two diseases at the same time, and effective prevention and control of these viruses are required.

Effects of metformin on the expression of estrogen synthetase and ER mRNA in uterine leiomyoma tissues / 中华妇产科杂志

Objective To elucidate whether metformin could regulate the mRNA expression level of estrogen synthetase and ER in human uterine leiomyoma tissues. Methods (1) Seventeen pairs of uterine leiomyoma tissues and adjacent myometrium (>2 cm) were collected from patients underwent hysterectomy in Peking University First Hospital between December 2016 and January 2017. Real-time PCR was used to measure the mRNA expression level of estrogen synthetase [including cytochrome P450 cholesterol side chain cleavage enzyme (P450scc), cytochrome P450 17 α-hydroxylase (P450c17), 3-beta-hydroxysteroid dehydrogenase type 2 (3β-HSD-2), 17-beta-hydroxysteroid dehydrogenase type 1 (17β-HSD-1) and aromatase cytochrome P450 (P450arom)] and ER (including ERα and ERβ) in the uterine leiomyoma tissues and adjacent myometrium. (2) Uterine leiomyoma cells derived from uterine leiomyoma tissues were identified by immunocytochemistry method and cultured to the third generation. The treatment groups were cultured with different concentrations of metformin (10, 50 and 100 μmol/L) for 48 hours, and the control group was cultured with deionized water for 48 hours. The mRNA expression level of estrogen synthetase and estrogen receptor subtypes were measured by real-time PCR. Results (1) P450scc, P450c17, 3β-HSD-2, 17β-HSD-1, P450arom mRNA median expression levels were 112, 4, 13, 42 and 194 in the uterine leiomyoma tissues, and were respectively 114, 5, 11, 32 and 6 in the myometrium. Compared to those of the myometrium, 3β-HSD-2 and P450arom mRNA expression levels in the uterine leiomyoma tissue were significantly higher (P<0.05), while there were no significant change of mRNA expression levels among P450scc, P450c17 and 17β-HSD-1 (P>0.05). ERα and ERβ mRNA median expression levels were 208 and 116 in the uterine leiomyoma tissues, and were 24 and 95 in the myometrium. Compared to that of the myometrium, ERα mRNA level in the uterine leiomyoma tissue was significantly higher (P=0.001), while there were no significant change of ERβ mRNA level (P=0.193). (2) After cultured with different concentrations of metformin (10, 50 and 100 μmol/L), the P450arom mRNA levels in the uterine leiomyoma tissues were 9 ± 4, 8 ± 5 and 8 ± 3 respectively in the treatment groups and was 16 ± 5 in the control group. Compared to that of the control group, P450arom mRNA expression levels in the treatment groups were significantly declined (P<0.05). There were no significant different change of mRNA expression levels among 3β-HSD-2, ERα and ERβ between the treatment groups and the control group (P>0.05). Conclusions Metformin could down-regulate the mRNA expression level of aromatase in the uterine leiomyoma cells. These results indicate that metformin may inhibit the local estrogen synthesis and therefore suppress the development of uterine leiomyoma.

Interventional treatment experience in multiple injury with major abdominal or pelvic injuries: 160 cases analysis / 中华创伤杂志(英文版)

<p><b>PURPOSE</b>To observe the therapeutic effect of interventional embolization and haemorrhage control in multiple trauma patients with a major abdominal or pelvic injury.</p><p><b>METHODS</b>Data of 160 multiple trauma patients with a major abdominal or pelvic injury were retrospectively analyzed. They were admitted into the Department of Emergency of the First Affiliated Hospital of Zunyi Medical College from October 2013 to April 2016. Eighty-seven patients who received emergent intervention for embolization and haemorrhage control were set as group A, including 72 males and 15 females, with an average age of (39.32 ± 14.0) years. Patients underwent emergent intervention for embolization and hemostasis. The other 73 patients who received traditional surgeries were set as group B, including 62 males and 11 females, with an average age of (38.48 ± 13.12) years. The time from admission to emergency intervention, the time of interventional embolization, transfusion during hospitalization, length of stay and prognosis were observed. The whole treatment and prognosis were compared between group A and group B.</p><p><b>RESULTS</b>In group A, the average time from admission to intervention exploration was (132.05 ± 86.80) min, the average operation time was (149 ± 49.69) min, the average hospitalization time was (18.37 ± 4.71) days, the average amount of RBC transfusion during hospitalization was (7.2 ± 4.33) units, and the mortality was 4.60% (4 patients died). The corresponding data in group B were respectively (138.95 ± 82.49) min, (183 ± 52.39) min, (22.72 ± 6.63) days, (12.23 ± 5.43) units, and 9.59% (7 cases died). There was no statistical difference in the time from admission to operation between the two groups (p > 0.05), but there was statistical difference in operation time, RBC transfusion, hospitalization time, prognosis, and mortality between the two groups (all p < 0.05).</p><p><b>CONCLUSION</b>The emergent intervention for embolization and haemorrhage control of multiple trauma patients with a major abdominal or pelvic injury and visceral organ haemorrhage has the advantages of less trauma, shorter operation time, shorter hospital stay, less blood transfusion in comparison to the traditional emergency surgeries.</p>

Relationship between microRNA-335 expression and prognosis in tumor tissue / 国际肿瘤学杂志

The low expression of microRNA-335 (miR-335) indicates poor prognosis in many types of cancer,such as gastric cancer,breast cancer,lung cancer and other solid tumors.The low expression of miR-335 can promote tumor metastasis and progression,and is associated with histological grading,lymph node metastasis and tumor staging,which provids a new way of thinking for the diagnosis and treatment of tumors.

The investigation on current status of ICU nurse about knowledge and practice on venous thromboembolism in Guizhou province / 重庆医学

Objective To know about current statusof ICU nurses about knowledge and practice on venous thromboembolism(VTE) in Guizhou province.Methods A total of 321 ICU nurses were interviewed by self-designed questionnaires to analyses the related factors of the score of the related knowledge and practice on VTE.Results The score of the VTE related knowledge was (17.070±4.340)point and the score of the practice was (62.410±14.640)point respectively.The score of the practice on VTE was positively related to that of ICU nurses knowledge (P＜0.05).The result of multiple linear stepwise regression analysis showed that "departments" and "had the VTE related knowledge in school" were the significant factors on knowledge (P＜0.05)."Active learning the VTE related knowledge" " the levels of hospitals" and "had the VTE related knowledge in school" were the significant factors on the scores of the practice on VTE (P＜0.05).Conclusion The ICU nurses had better knowledge about VTE,and the current status of practice on VTE was ideal in Guizhou province,but further research is needed to make unified and normative processes of VTE preventive interventions.

Effect of Cryptosporidium parvum infection on Toll-like receptors of intesti-nal mucosa in mice / 中国血吸虫病防治杂志

Objective To investigate the mechanism of Toll-like receptor in intestinal mucosal injury induced by Cryptospo-ridium parvum infection in mice.Methods Totally 30 male BALB/c mice were randomly divided into a normal control group,1-week infection group and 2-week infection group.The mice of the 1-week and 2-week infection groups were sacrificed 7 days and 14 days after the infection respectively,and the mice of the normal control group were sacrificed 14 days after the infection.The model of intestinal infection of C.parvum in mice was built by using the immunosuppressive method and oocyst intragastric ad-ministration.The pathological changes of the intestinal mucosa of mice were observed with a light microscope and the villus height,crypt depth and ratio of villus height/crypt depth were measured.The ultrastructure of the intestinal mucosa of mice was observed by a transmission electron microscope(TEM).The expressions of TLR2 and TLR4 in the intestinal mucosa were tested by qPCR and Western blotting.Results Under the light microscope,the intestinal villi were dropsical,obviously atrophied and shortened,and the submucosal structure was dropsical.The height of chorionic villi and the ratio of villus height to crypt depth in the jejunum of the 1-week and 2-week infection groups were significantly lower than those in the normal control group(all P<0.05),while the depth of the recess of the former two was significantly increased(all P<0.05).With the extension of the infection time,the villus height and the ratio of villus height to crypt depth in the jejunum of mice decreased significantly(both P<0.05),and the crypt depth increased significantly(P<0.01).The TEM observation showed that the structure of the oocyst of C.parvum in the jejunum of the infected mouse was intact,the villi around the oocyst were abscission seriously,and the oocyst wall was fused with the epithelial cell membrane.The qPCR observation showed that compared with the normal control group,the expressions of TLR2 mRNA and TLR4 mRNA in the intestinal mucosa of the 1-week and 2-week infection groups were significantly higher(all P<0.05).In addition,the expressions of TLR2 and TLR4 mRNA in the 2-week infection group were significantly higher than those in the 1-week infection group(both P<0.05).The Western blotting showed that the expres-sions of TLR2 protein and TLR4 protein in the intestinal mucosa of the 1-week and 2-week infection groups were significantly higher than those of the normal control group(all P<0.05).Furthermore,the expressions of TLR2 and TLR4 protein in the 2-week infection group were significantly higher than those in the 1-week infection group(both P<0.05).Conclusions TLR2 and TLR4 are important receptors for intestinal mucosal recognition of C.parvum.The C.parvum infection may lead to intestinal mucosal damage possibly via the mechanisms associated with the up-regulation of TLR2 and TLR4 expressions.

Effect of business process reengineering on multisectors' participation in prevention and control of multidrug-resistant organism infection / 中国感染控制杂志

Objective To investigate the effect of business process reengineering(BPR)on improving multisectors'participation in management of multidrug-resistant organism(MDRO)infection, and provide methodological guidance for hospital multisectors'collaborative management.Methods Related data about management and disposal of 672 cases of MDRO infection occurred from July 2015 to June 2017 were selected, 370 patients before BPR (from July2015to June 2016)were as control group, 302 patients after BPR(from July2016to June 2017)were as a trial group, BPR was used to improve the process of detection, report, cooperation, and disposal of MDROs in hospital, various quality evaluation indexes of healthcare-associated infection before and after BPR were compared. Results After the BPR was implemented, time of MDRO information transmitted from laboratory to clinical departments shortened from(240±30)minutes to(8±2)minutes;incidence of MDRO HAI decreased from2.39‰to 1.56‰, isolation rate of MDROs decreased from13.42％ to 11.09％, differences were all significant(all P＜ 0.05).Compliance rates and awareness rates of various MDRO prevention and control measures increased from 58.11％-71.89％to 84.11％-92.05％, usage rate of antimicrobial agents decreased from53.18％to 48.45％, defined daily doses(DDDs)of antimicrobial use density decreased from44.76 to 38.26, specimen submission rate before antimicrobial use increased from46.68％to 53.62％.Conclusion BPR can enhance the cooperation between different departments, give full play to the complementary advantages of interdisciplinary, and improve the efficiency of HAI management.

Methodological Research on Latex Enhanced Immune Turbidimetric Method for the Detection of Urine Free Hemoglobin / 现代检验医学杂志

Objective To establish the test way of latex enhanced immune turbidimetric method for the concentration detection of urine free hemoglobin on the automatic biochemical analyzer,and evaluated the detection performance.Methods Prepared the detection reagents of latex enhanced immune turbidimetry method for detection of urine free hemoglobin with materials such as hemoglobin HBA0 antibody (8.5 mg/ml),80 nm carboxylic olystyrene latex microspheres (estapor,nanometer microspheres) and so on.Then,seted the project parameters on TBA120 automatic biochemical analyzer and proceeded the calibrations.Evaluated the detection performance by accuracy,precision,linear range,sensitivity,specificity and other indicators.Lastly,established the biological reference interval for urine free hemoglobin of healthy people in the region and verified it.Results To seted the project parameters on TBA120 automatic biochemical analyzer and passed the calibration.The calibration fitting curve had a smooth trend and no obvious deviation with each measuring point.In the recovery tests,added standard liquid with different concentrations of 100 mg/L and 500 mg/L to the samples with low values,the recovery rate was 95.3％ and 102.7％ respectively.Same to the samples with high values,the recovery rate was 104.2％ and 103.5％ respectively.In the precision test,samples with low and high value had a precision CV of 6.52％ and 4.18％ respectively.The linear range was 0 ～ 1 100 mg/L,analysis sensitivity was 2.8 mg/L.In the interference test,found that,samples had no obvious disturbance to the test with lower concentrations of free bilirubin,combined with bilirubin,vitamin C,animal hemoglobin lower than 342 μmol/L,342 μmol/L,0.03 g/L,500 mg/L respectively,while had significant interference when the concentration of chyle was higher than 870 FTU.Their study had established the biological reference interval of healthy people,male was 0～ 13.3 mg/L and female 0 ～ 17.1 mg/L,there was no significant difference between them by a t test (P＞0.05).Conclusion The latex enhanced immune turbidimetric method for the detection of urine free hemoglobin has the performance of testing clinical urine specimen,which not only solved the lackage problem of specificity for occult blood in the urine dry chemistry test and realized batch automation quantitative detection.The experimental data of this study provides a theoretical basis for the application of the method in other types of clinical samples.