Effectiveness of early warning management of nosocomial infection based on neural network model and decision tree model / 公共卫生与预防医学

Objective To predict the effectiveness of nosocomial infection management and effectively control the risk of nosocomial infection. Methods In this study, with the population of ICU patients in a Grade A hospital , 345 ICU patients seen from June 2020 to June 2021 were included in the analysis to collect the infection data in the hospital. Based on the use of the decision tree model to analyze the influencing factors of nosocomial infection, the neural network model was also used to predict the risk of developing nosocomial infection. Results The decision tree model showed that advanced age (age> 80 years) influenced the root node. Type 2 diabetes, gender by male, and BMI level were child nodes, which had different synergistic effects on the occurrence of nosocomial infection. At the same time, random forest (RF), support vector machine (SVM), logical regression (LR) and K nearest neighbor (KNN) algorithms were used to construct a neural network prediction model of nosocomial infection risk, suggesting that the condition, sex and body size of basic diseases are related to the occurrence of nosocomial infection. The combined use of the above model in parallel can effectively increase the specificity and reduce the missed diagnosis. Conclusion The neural network model joint decision tree model in parallel and joint early warning of nosocomial infection risk have excellent effect, and can effectively provide information support for the prevention, management and disposal of nosocomial infection.

Evolvement of HIV-1 drug resistant mutations in vitro without drug pressure / 中华微生物学和免疫学杂志

Objective To isolate stable passage primary HIV-1 drug resistant strains and observe replication dynamics of the drug resistant isolates and evolvement tendency of the drug resistant mutations in vitro.Methods Peripheral blood mononuclear cells(PBMCs)from 15 AIDS patients receiving highly active antiretroviral therapy(HAART)were collected,and the primary HIV-1 stains were separated utilizing co-cultivated with PBMCs from normal people.HIV-1 pol genes from those strains were obtained by RT-PCR and sequenced.The drug resistant mutations were analyzed in the Stanford HIV Drug Resistance Database.Results Eight strong positive strains were isolated from 15 AIDS patients with viral loads higher than 1000 copies/ml,and two of them were drug resistant.Drug resistant mutations of the two strains were respectively K103N/K238T and M184V/K103N/Y181C/H221Y which show high-level resistance to NVP and 3TC/NVP,respectively.K103N,M184V,Y181C and H221Y exist stably in the environment without drug pressure,however,RT K238T reverted to K238.Conclusion Two drug resistant strains were successfully isolated in vitro without drug pressure.Strains with K103N shows superior fitness and can exist steadily.Strains with M184V and K103N/Y181C/H221Y can also replicate stably in vitro without drug pressure.NNRTI mutation K238T reproduces astatically,which suggests that RT 238 codon might revert gradually to wild genotype.

Selective kinetics of HIV-1 non-nucleoside reverse transcriptase inhibitor drug resistanace-associated mutations in AIDS patients receiving highly active anti-retrovirul therapy / 中华检验医学杂志

Objective To elucidate the molecular evolutional characteristics of HIV-1 non-nucleoside reverse transcriptase inhibitor (NNRTI) drug resistance-associated mutations in AIDS patients receiving highly active antiretroviral therapy (HAART).Methods Four AIDS patients receiving HAART with good adherence within a HlV-1 drug resistance cohort from a rural region in central China were selected,who possessed susceptible virus at the beginning of treatment and gradually came to produce resistance to NNRTIs during the process of antiretroviral therapy (ART),reverse transcriptase (RT) genes from each patient's peripheral blood samples (from 3 to 30 months after withdrawal) were cloned and sequenced in succession.Results To sequenced total 855 clones and obtained the HIV-1 NNRTI drug resistance-asseciated mutations patterns of the four patients: (1)G190A often appeared with F227 L and had the tendency of accumulating P236V during the process of treatmenL (2)Y188C always presented alone and sometimes it concured with P236V.(3) YI81C frequently concured with VI79D or KIO3N and the combination varies from patient to patient.(4)K103N often combined with Y181C or M230L Conclusions The molecular evolutional characteristics of HIV-1 NNRTI drug resistance-asseciated mutations in the 4 AIDS patients are summarized.They showed different pathways on HIV-1 NNRTI drug resistance-associated mutations and those mutations detected early tend to be predominant strains.