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OBJECTIVE To construct a risk prediction model for bloodstream infection （BSI） induced by carbapenem-resistant Klebsiella pneumoniae （CRKP）. METHODS Retrospective analysis was conducted for clinical data from 253 patients with BSI induced by K. pneumoniae in the First Hospital of Qinhuangdao from January 2019 to June 2022. Patients admitted from January 2019 to December 2021 were selected as the model group （n＝223）， and patients admitted from January 2022 to June 2022 were selected as the validation group （n＝30）. The model group was divided into the CRKP subgroup （n＝56） and the carbapenem- sensitive K. pneumoniae （CSKP） subgroup （n＝167） based on whether CRKP was detected or not. The univariate and multivariate Logistic analyses were performed on basic information such as gender， age and comorbid underlying diseases in two subgroups of patients； independent risk factors were screened for CRKP-induced BSI， and a risk prediction model was constructed. The established model was verified with patients in the validation group as the target. RESULTS Admissioning to intensive care unit （ICU）， use of immunosuppressants， empirical use of carbapenems and empirical use of antibiotics against Gram-positive coccus were independent risk factors of CRKP-induced BSI （ORs were 3.749， 3.074， 2.909， 9.419， 95%CIs were 1.639-8.572， 1.292- 7.312， 1.180-7.717， 2.877-30.840， P＜0.05）. Based on this， a risk prediction model was established with a P value of 0.365. The AUC of the receiver operating characteristic （ROC） curve of the model was 0.848 [95%CI （0.779， 0.916）， P＜0.001]， and the critical score was 6.5. In the validation group， the overall accuracy of the prediction under the model was 86.67%， and the AUC of ROC curve was 0.926 [95%CI （0.809， 1.000]， P＜0.001]. CONCLUSIONS Admission to ICU， use of immunosuppressants， empirical use of carbapenems and empirical use of antibiotics against Gram-positive coccus are independent risk factors of CRKP- induced BSI. The CRKP-induced BSI risk prediction model based on the above factors has good prediction accuracy.
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Ischemic stroke in young adults has attracted more and more attention due to the diversity of its etiology. Although atherosclerosis is the most common cause of stroke in young adults, other or unknown causes are not uncommon . To improve clinicians′ understanding of the etiological diagnosis of stroke in young adults, this article reports a case of ischemic stroke in the First Affiliated Hospital of Jinan University. The patient was a 22-year-old male with acute onset who was diagnosed with acute ischemic stroke based on clinical presentation, physical examination, and magnetic resonance imaging of the brain. After actively searching for the cause, laboratory and genetic tests revealed that the patient had inherited thrombophilia (protein C and protein S deficiency), and cardiac magnetic resonance imaging examination found that the patient had noncompaction of the ventricular myocardium.
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Objective:To explore the risk factors of mortality in patients with Klebsiella pneumoniae bloodstream infection, and to construct a predictive model. Methods:The clinical data of 234 patients with Klebsiella pneumoniae bloodstream infection admitted in the First Hospital of Qinhuangdao from January 2020 to December 2022 were retrospectively analyzed, including 202 cases admitted during January 2020 to June 2022 (model set), and 32 cases admitted during July to December 2022 (validation set). There were 64 cases died (fatal group) and 138 cases survived (survival group) within 28 d after admission in model set. Multivariate Logistic regression was used to analyze the risk factors of death in patients with Klebsiella pneumoniae bloodstream infection and a mortality prediction model was constructed. The constructed model was applied in validation set, and the consistency between predicted mortality and real mortality was analyzed. Results:Multivariate Logistic regression analysis showed that male sex ( OR=2.598, 95% CI 1.179-5.725, P=0.018), age≥65 years ( OR=4.420, 95% CI 2.029-9.627, P<0.001), admitted to intensive care unit (ICU) ( OR=10.299, 95% CI 4.752-22.321, P<0.001), and the empirical use of quinolones antibiotics ( OR=4.288, 95% CI 1.127-16.317, P=0.033) were independent risk factors for 28-day mortality in Klebsiella pneumoniae bloodstream infection patients. The regression equation for predicting the risk of death was -3.469+ male × 0.955+ age ≥ 65 years × 1.486+ admitted to ICU × 2.332+ empirical use of quinolone antibiotics × 1.456. The area under the ROC curve (AUC) for predicting death in the model set was 0.831, with sensitivity and specificity of 71.9% and 80.4%, respectively. The AUC for predicting death in the validation set was 0.881, with sensitivity and specificity of 91.7% and 75.0%, respectively. Conclusion:The constructed mortality prediction model in the study has good application value for the prognosis of patients with Klebsiella pneumoniae bloodstream infection.
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Objective From the perspective of biophysics and immunology, the effects of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) on biophysical characteristics, cytoskeleton and migration ability of mouse derived dendritic cells (DCs) were analyzed, so as to explore the effect of ω-3 polyunsaturated fatty acids (ω-3 PUFAs) on immune function of DCs and its potential mechanism. Methods The bone marrow-derived monocytes from C57BL/6J mice were isolated and induced to differentiate into immature dendritic cells (imDCs) by 20 ng/mL recombinant murine granulocyte-macrophage colony-stimulating factor (rmGM-CSF) and 10 ng/mL recombinant mouse interleukin-4 (rmIL-4), After 6 days, 100 ng/mL lipopolysaccharide was added to induce mature dendritic cells (mDCs). Further the morphological observation and positive rate of CD11c in imDCs and mDCs were analyzed, Then at different concentrations of EPA and DHA (0-60 μmol/L), the cell viability and apoptosis of DCs were detected by cell counting kit-8 (CCK-8) kit and flow cytometry. After the optimal concentration of EPA and DHA were determined, the changes of the membrane fluidity, electrophoretic mobility (EPM) and osmotic fragility of DCs were separately detected by the fluorescence polarization, cell electrophoresis and concentration gradient. The expression of filamentous actin (F-actin) was detected by the immunofluorescence. Finally, the migration ability of DCs was detected by the Transwell system. Results The positive rate of CD11c in DCs was about 80%. The viability of DCs decreased in a dose-dependent manner under the action of EPA and DHA of different concentrations, which didn’t induce the apoptosis of DCs. Under the action of 50 μmol/L EPA and DHA, the osmotic fragility and EPM of DCs significantly decreased, and the membrane fluidity significantly increased. The expression of F-actin in DCs obviously increased, and the migration rate of cells obviously decreased. Conclusions ω-3 PUFAs may affect the cytoskeleton structure and biophysical characteristics of DCs, inhibit the migration, and then affect its immune function.
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ObjectiveTo analyze the quality changes of Platycladi Semen before and after the deterioration of moth-eaten and rancidity during storage. MethodFour types samples of Platycladi Semen， including normal， moth-eaten， oxidative rancidity and hydrolytic rancidity， were determined for volatile components， odor， and taste based on headspace solid phase microextraction/gas chromatography-mass spectrometry （HS-SPME/GC-MS） and electronic sensory techniques such as electronic nose and electronic tongue. Volatile components were identified by searching the database and manual comparison， the odor and taste were determined by the response values of the electronic nose and electronic tongue sensors， and the difference between samples before and after deterioration was studied by multivariate statistical analysis. ResultA total of 85 compounds were identified in Platycladi Semen samples. Compared with the normal samples， the number of volatile compounds in samples after hydrolytic rancidity decreased by 5， the number of volatile compounds in samples after moth-eaten and oxidative rancidity increased by 1 and 21， respectively. Aldehydes and acids accounted for majority of types. Among them， the contents of N-hexanoic acid， hexanal and propionic acid in the samples of oxidative rancidity reached 11.49%， 10.21% and 7.52%， which became the key indicators of rancidity. There was significant variance among the odor components corresponding to W1W， W2W and W1S sensors by electronic nose analysis. It was indicated that the value of sourness in deteriorated samples generally increased by mean of electronic tongue analysis. Compared with normal samples， the moth-eaten samples had changed slightly and rancidity samples had changed significantly especially oxidative rancidity samples of volatile components， odor and taste by multivariate statistical analysis. ConclusionIn terms of Platycladi Semen， the oxidative rancidity caused by nature storage for 12 months has the greatest impact on the quality. Therefore， it should be mainly to prevent oxidative rancidity to ensure the quality of Platycladi Semen.
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Objective@#To investigate the associations between single nucleotide polymorphisms of UDP glucuronosyltransferase Family 1 Member A1 ( UGT1A1 ) with non alcoholic fatty liver disease (NAFLD) and levels of serum lipids in Beijing children, and to provide scientific evidence for the study of genetic mechanism.@*Methods@#In total, 1 027 children aged 7-18 years were recruited from two primary schools and three middle schools from Haidian district of Beijing, who were randomly assigned to case group ( n =162) and control group ( n =865). General condition and medical history were collected by trained field health workers. Height, weight and liver ultrasound were examined. Additionally, fasting venous blood were collected to detect serum total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and alanine aminotransferase (ALT). The single nucleotide polymorphisms (SNPs) of UGT1A1 were genotyped. Binary logistic regression and multiple linear regression were applied to analyze the associations between three SNPs of UGT1A1 and NAFLD, ALT and levels of serum lipids.@*Results@#The SNP rs 10929303 (C>T) of UGT1A1 was negatively associated with NAFLD( OR=0.51, 95%CI=0.32- 0.83 , P =0.01), while the SNP rs 4148323 (G>A) was negatively associated with the serum level of TC ( B=-0.10, 95%CI=-0.19- -0.02 , P =0.02); in addition, results were consistent regardless of whether the TC level was measured using a categorical variable or continuous variable.@*Conclusion@#The SNP rs 10929303 of UGT1A1 is associated with NAFLD, and the SNP rs 4148323 of UGT1A1 is associated with TC levels in Beijing children.
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Objective:To investigate the relationship between Tei index and right heart function in patients with pneumoconiosis complicated with pulmonary heart disease (PHD).Methods:108 cases of pneumoconiosis patients with PHD in our hospital from January 2018 to January 2020 were randomly selected and divided into three groups according to the X-ray diagnostic criteria of pneumoconiosis, including 50 cases in stage Ⅰ group, 25 cases in stage Ⅱ group and 33 cases in stage Ⅲ group. All patients were examined by ultrasonic cardiography (UCG); the right ventricular Tei index and brain natriuretic peptide (BNP) levels, right ventricular outflow tract (ROVT) diameter, main pulmonary artery (MPA) diameter, right ventricular anterior wall thickness (RVAW), right ventricular diameter (RV), right atrial diameter (RA), pulmonary artery pressure (PASP), Tei index were compared in groups; Pearson correlation analysis was used to analyze the correlation between UCG index and BNP level; multiple linear regression analysis was used to analyze the influencing factors of BNP.Results:The levels of RV, Tei index and BNP in Ⅰ stage group were significantly lower than those in Ⅱ stage group, and the levels of RV, Tei index and BNP in Ⅱ stage group were significantly lower than those in Ⅲ stage group ( P<0.05). There was no difference in ROVT, MPA, RVAW, RA, PASP in the three groups ( P>0.05). Pearson correlation analysis showed that ROVT, RV, Tei index in UCG indicators and BNP level were positively correlated ( P<0.05); multiple linear regression analysis showed that RVAW and Tei indexes were the main influencing factors of BNP levels ( P<0.05). Conclusions:The right heart Tei index of patients with pneumoconiosis and PHD has a good correlation with BNP level, and is the main influencing factor of BNP level, which can make up for BNP deficiency and effectively evaluate the right heart function of patients.
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Objective@#To explore the clinical effect of traditional Chinese medicine (TCM) syndrome differentiation in the treatment of pneumoconiosis.@*Methods@#We selected 160 pneumoconiosis patients who were hospitalized in our hospital from July 2015 to July 2016. 102 patients were divided into experimental groups, and the other 58 patients were assigned to the control group. These patients were randomly assigned. The control group was given routine treatment, while the experimental group received conventional treatment combined with TCM syndrome differentiation. We rated patients' quality of life using the SF-36 Quality of Life Scale. C-reactive protein levels in both groups before and after treatment were detected by ELISA. Furthermore, we detected the expression levels of IL-6 mRNA and TGF-β mRNA in serum before and after treatment by RT-PCR.The analysis was performed with SPSS19.0 software. The normal distribution measurement data was expressed by Mean±SD, and the t-test was used for statistical analysis. Non-normal distribution measurement data were expressed as median(M) and interquartile range (P25, P75), and non-parametric test was used for statistical analysis.@*Results@#Compared with the control group, the readmission rate in the experimental group decreased within 3 months; The SF-36 quality of life score results of the two groups showed a statistically significant difference in BP, VT and RE (P<0.05);The levelofCRPdecreasedsignificantlyafter treatment in bothgroups,and thedifferencewasstatistically significant (P<0.05).Comparedwith thecontrolgroup, the levelsofIL-6mRNAandTGF-β1mRNA alsodecreased (P<0.05).@*Conclusion@#TCM syndromedifferentiation and treatmentofpneumoconiosis can effectively improve the patient's condition and life quality. We predict that it may inhibit the progression of pulmonary fibrosis in pneumoconiosis.
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Surgery is the first choice for the treatment of early non-small cell lung cancer(NSCLC),and lymph node metastasis is the most important factor influencing prognosis of resectable NSCLC.A large number of studies have identified the importance of systematic mediastinal lymph node(N2) dissection,which is also an important basis for the development of NCCN guidelines.But there are few reports about the dissection of intrapulmonary lymph node(N1),especially no detailed study on the dissection of the lymph nodes around the bronchi of non-primary tumor-bearing lobes and segments in lung cancer,and the NCCN guidelines were not detailed elaborate.This article will make a summary of the research on the correlation of intrapulmonary lymph node(N1) dissection.
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Mutations or inactivation of parkin, an E3 ubiquitin ligase, are associated with familial form or sporadic Parkinson's disease (PD), respectively, which manifested with the selective vulnerability of neuronal cells in substantia nigra (SN) and striatum (STR) regions. However, the underlying molecular mechanism linking parkin with the etiology of PD remains elusive. Here we report that p62, a critical regulator for protein quality control, inclusion body formation, selective autophagy and diverse signaling pathways, is a new substrate of parkin. P62 levels were increased in the SN and STR regions, but not in other brain regions in parkin knockout mice. Parkin directly interacts with and ubiquitinates p62 at the K13 to promote proteasomal degradation of p62 even in the absence of ATG5. Pathogenic mutations, knockdown of parkin or mutation of p62 at K13 prevented the degradation of p62. We further showed that parkin deficiency mice have pronounced loss of tyrosine hydroxylase positive neurons and have worse performance in motor test when treated with 6-hydroxydopamine hydrochloride in aged mice. These results suggest that, in addition to their critical role in regulating autophagy, p62 are subjected to parkin mediated proteasomal degradation and implicate that the dysregulation of parkin/p62 axis may involve in the selective vulnerability of neuronal cells during the onset of PD pathogenesis.
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Animals , Humans , Mice , Adaptor Proteins, Signal Transducing , Chemistry , Metabolism , HEK293 Cells , Heat-Shock Proteins , Chemistry , Metabolism , Lysine , Metabolism , Neurons , Metabolism , Pathology , Oxidopamine , Pharmacology , Parkinson Disease , Metabolism , Pathology , Proteasome Endopeptidase Complex , Metabolism , Protein Stability , Proteolysis , Sequestosome-1 Protein , Ubiquitin-Protein Ligases , Metabolism , UbiquitinationABSTRACT
<p><b>OBJECTIVE</b>To analyze the clinical features and investigate the clinical diagnostic methods of hard metal lung disease (HMLD), then provide reference for the diagnostic criteria of occupational HMLD.</p><p><b>METHODS</b>Retrieved the open published case reports associated with HMLD from January, 2000 to June, 2014. Regarding the ages, sex, types and years of work, clinical features and laboratory results for analyzing.</p><p><b>RESULTS</b>Collected 21 clinical cases of HMLD belonged to 6 internal reports and 15 oversea reports. Among them 15 male and 6 female, ages were from 22 to 58, length of service between 1 year and 43 years. Clinical presentations included cough (20 cases), dyspnea on progressive (10 cases), and pulmonary function testing showed a restrictive abnormality. The imaging features presented as bilateral areas of ground-glass attenuation, diffuse small nodules, extensive reticular opacities and traction bronchiectasis. The finding of giant cell interstitial pneumonia (GIP) was almost pathognomonic for hard metal pneumoconiosis. The main pathological findings contained a different levels of lymphocyte, acidophilic cell infiltration, hyperplasia of fibrous tissue and numerous large multinucleated histiocytes which ingested inflammatory cells were admixed with macrophages. 16 cases of the 21 reports showed GIP.</p><p><b>CONCLUSIONS</b>Clinical presentations include cough and dyspnea on progressive, and pulmonary function testing show a restrictive abnormality. The imaging features present as bilateral areas of ground-glass attenuation, areas of consolidation, diffuse small nodules, extensive reticular opacities and traction bronchiectasis. The prime pathological findings contain interstitial pneumonia with intra-alveolar macrophages and a large amount of multinucleated histiocytes.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Young Adult , Alloys , Cobalt , Lung , Lung Diseases, Interstitial , Pathology , Macrophages, Alveolar , Occupational Diseases , Pathology , Pneumoconiosis , Pathology , TungstenABSTRACT
<p><b>OBJECTIVE</b>To review the clinical features of acute toxicity of aromatic amino and nitro compounds.</p><p><b>METHODS</b>A total of 110 papers reporting 1240 cases of acute toxicity induced by aromatic amino and nitro compounds from 1979 to 2013 were collected from CNKI, VIP, and Wanfang database, and were analyzed in this study.</p><p><b>RESULTS</b>Of all included cases, 939 were caused by occupational exposure, and 301 were caused by exposure in daily life. A total of 1044 cases were male, and 196 were female. Age ranged from 9 days to 75 years. There were 13 cases of contact reaction. The numbers of mild, moderate, and severe toxicities were 358, 348, and 139, respectively, and the other 382 cases were not graded for severity. The average incubation period was 4.50±5.71 h (M = 3 h). The average incubation period of aniline toxicity was significantly shorter than that of nitrobenzene toxicity. Methemoglobinemia was found in 1146 cases, while cases of poisonings with 5-nitro-o-toluidine, 2-methyl-4-nitroaniline, and 3-chloro-2-methyl aniline were not found to have methemoglobinemia. The detection rates of MHb and HzB were 83.73% (674/805) and 40.19% (129/321), respectively. Sixty-two (19.31%) out of 321 cases were complicated by intravascular hemolysis, 270 (30.93%) out of 873 cases suffered hepatic impairment, 50 (12.25%) out of 408 cases were accompanied by renal damage. Consciousness disorders were found in 66 cases, and chemical cystitis was found in 36 cases. Oral poisoning could immediately induce severe symptoms including cyanosis, unconsciousness, and hemolysis. In prognosis analysis, it was found that the cure rate was 98.71% (1224/1240), and 14 cases of death were caused by multiple organ dysfunction syndrome, renal failure, uncontrolled hemorrhagic shock, myocardial infarction, and sudden death. Two cases were left with neurological sequelae.</p><p><b>CONCLUSION</b>The clinical manifestations of poisoning with aromatic amino and nitro compounds are methemoglobinemia, intravascular hemolysis, liver damage, and renal damage. Treatment with specific medicine methylene blue can produce ideal clinical prognosis, but severe poisoning may cause death from multiple organ failure.</p>
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Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Young Adult , Acute Disease , Benzene Derivatives , Poisoning , Nitro Compounds , PoisoningABSTRACT
Objective:To investigate the expression of HERG1 and Kv3.4 in normal oral mucosa(NOM)and oral lichen planus (OLP).Methods:20 OLP and 1 6 NOM specimens were collected and immunohistochemically stained(IHC)by SP method for the detection of HERG1 and Kv3.4 protein expression.Results:HERG1 and Kv3.4 were negative or weak-positive in the sapmles of bas-al layer of NOMand non-erosive OLP,but positive in basal layer,spinous layer and granular layer of erosive OLP.The expression of HERG1 and Kv3.4 was higher in OLP than in NOM tissues (P <0.05);and higher in erosive OLP than in non-erosive OLP(P <0.05).In OLP HERG1 expression was positively related to Kv3.4(P <0.05).Conclusion:HERG1 and Kv3.4 may be related to the development of OLP.
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In surgical operation of the non-small cell lung cancer (NSCLC),the resection of lymph node involvement is highly correlated with the prognosis of NSCLC patients.The precise estimation of localized lymph node involved and the determination of relevant pattern of lymphadenectomy are the significant predictors for the prognosis and postoperative treatment in NSCLC patients.Therefore to identify the lymph node metastasis earlier has more important significance for tumor clinical staging and making therapeutic schedule.In recent years,the value of sentinel lymph node (SIN) has attracted more and more researchers attention in detecting the occult lymph node micrometastases and surgical staging.
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<p><b>OBJECTIVE</b>To investigate ingredient differences of the aerial part of Bupleurums from different germplasm resources by HPLC.</p><p><b>METHOD</b>Twenty-one different germplasm resources were sown and cultured at the same conditions and the aerial parts of the biennial plants were analyzed by HPLC.</p><p><b>RESULT</b>The chromatograms were established and the data were analyzed by Hierarchical Cluster Analysis to compare the similarity of the samples. The results showed that ingredients from various germplasm resources were significantly different, which indicated the germplasm diversity of Bupleurum.</p><p><b>CONCLUSION</b>The method can be used for comparison of the ingredient differences and quality control, the results provide important references for classification of Bupleurum species.</p>