Neobaicalein prevents isoflurane anesthesia-induced cognitive impairment in neonatal mice via regulating CREB1

Abstract Objectives: Isoflurane (ISO) is widely used in the clinic and research. The authors aimed to explore whether Neobaicalein (Neob) could protect neonatal mice from ISO-induced cognitive damage. Method: The open field test, Morris water maze test, and tail suspension test was performed to assess the cognitive function in mice. Enzyme-linked immunosorbent assay was used to evaluate inflammatory-related protein concentrations. Immunohistochemistry was used to assess Ionized calcium-Binding Adapter molecule-1 (IBA-1) expression. Hippocampal neuron viability was detected using the Cell Counting Kit-8 assay. Double immunofluorescence staining was employed to confirm the interaction between proteins. Western blotting was used to assess protein expression levels. Results: Neob notably improved cognitive function and exhibited anti-inflammatory effects; moreover, under isotreatment, it exhibited neuroprotective effects. Furthermore, Neob suppressed interleukin-1β, tumor necrosis factor-α, and interleukin-6 levels and upregulated interleukin-10 levels in ISO-treated mice. Neob significantly mitigated iso-induced increases in IBA-1 - positive cell numbers of the hippocampus in neonatal mice. Furthermore, it inhibited ISO-induced neuronal apoptosis. Mechanistically, Neob was observed to upregulate cAMP Response Element Binding protein (CREB1) phosphorylation and protected hippocampal neurons from ISO-mediated apoptosis. Moreover, it rescued ISO-induced abnormalities of synaptic protein. Conclusions: Neob prevented ISO anesthesia-induced cognitive impairment by suppressing apoptosis and inflammation through upregulating CREB1.

Relationship between father s emotional symptoms and emotional and behavioral problems in preschool children / 中国学校卫生

Objective@#To explore the relationship between father s emotional symptoms with offspring s emotional and behavioral problems, so as to provide reference for the prevention and intervention of emotional and behavioral problems in preschool children.@*Methods@#Using the method of multi stage sampling, two kindergartens from each of the two counties, two districts and two development zones were selected from Hefei during February to April 2023. A total of 3 672 children aged 3 to 6 years old and their fathers were selected from 12 kindergartens. Fathers filled out the Depression Anxiety and Stress Scale (DASS-21) and mothers filled out the Strength and Difficulty Questionnaire (SDQ). Multivariate Logistic regression model was established to analyze the relationship between father s emotional symptoms and preschool children s emotional and behavioral problems.@*Results@#The detection rate of emotional and behavioral problems in preschool children was 18.65%, and the detection rates of stress, anxiety and depression in fathers were 4.82%, 10.05% and 6.64%, respectively. Multivariate Logistic regression model analysis showed when fathers had negative emotions of stress, anxiety and depression, the detection rate of emotional and behavioral problems in their offspring was higher than children with father without negative emotion group ( OR =1.77-2.13, P <0.01). Father s stress symptoms were associated with increased risk of emotional and behavioral problems in boys, while father s anxiety and depressive symptoms were associated with increased risk of emotional and behavioral problems in boys and girls ( OR =1.45-2.69, P <0.05). Father s stress symptoms were associated with increased risk of emotional and behavioral problems in the first child, while father s anxiety and depressive symptoms were associated with increased risk of emotional and behavioral problems in the first child, second child and above ( OR =1.81-2.49, P <0.05).@*Conclusions@#Father s negative emotional symptoms are important factors affecting preschool children s emotional and behavioral problems. Early detection and targeted intervention of father s negative emotional symptoms are beneficial to the prevention and control of preschool children s emotional and behavioral problems.

Growth and intelligence development among a cohort of low birth weight infants / 中国学校卫生

Objective@#To explore growth and intelligence development of low birth weight infants (LBWI) at 24 and 36 months of age, so as to provide reference for early monitoring and intervention of the development of LBWI.@*Methods@#A total of 100 LBWI born and managed in Hefei Maternal and Child Health Care Institution were selected from 2012 October 1 to 2015 December 30, and 99 normal birth weight infants (NBWI) under child health management in the same sitinstitution were selected as controls. According a prospective cohort study method, and based on the establishment of a cohort and monitoring of childhood growth and development, a unified method was used to longitudinally follow up and observe the physical fitness of two groups of infants at the determined time points. The development of LBWI and NBWI at 24 and 36 months of age was surveyed using the Gesell Development Scale.@*Results@#Weight, length and head circumference of LBWI children at the age of 15-36 months were significantly lower than those of NBWI children ( P <0.05). In addition, 117 children (43.98%) completed the full assessment of intelligent development scale, including 62 LBWI and 55 NBWI. The scores of Gesell in NBWI group was higher than that in LBWI group at 24 and 36 months of age, including adaptability, gross motor, fine metor skills, language and personal social functions ( t =-4.17, -3.82, -3.21 , -3.03, -2.61; -4.23, -3.16, -3.07, -3.13, -3.99, P <0.05). Multivariate linear regression analysis found that birth weight was positively correlated with adaptability, gross motor, fine motor skills, language functions at 24 and 36 months of age and personal social function at 36 months of age ( β =0.004, 0.010; 0.003, 0.008; 0.003, 0.007; 0.004, 0.009; 0.011, P ＜0.05).@*Conclusion@#The growth and development of LBWI children are significantly delayed compared to NBWI children. The scores of LBWI children are lower than those of NBWI children in all functional areas. Weight is the main factor affecting children s intellectual development. Early monitoring and intervention of low birth weight infants should be carried out to avoid or mitigate adverse consequences.

Value of serum interleukin-6 and tumor necrosis factor-α in early diagnosis of severe acute pancreatitis / 临床肝胆病杂志

Objective To investigate the value of serum cytokines in the early diagnosis of severe acute pancreatitis (SAP), and to improve the accuracy of the diagnosis of SAP by establishing a mathematical model with composite indices based on LASSO algorithm. Methods A total of 130 patients with acute pancreatitis (AP) who attended Changshu First People's Hospital from January 2019 to June 2022 were enrolled, among whom there were 73 SAP patients and 57 non-SAP patients.Peripheral serum samples were collected from all patients, and Luminex xMAP liquid chip technique was used to measure 13 serum cytokines.Meanwhile, Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ), Bedside Index for Severity in Acute Pancreatitis (BISAP), and Computed Tomography Severity Index (CTSI) scores were determined for all patients.The Kolmogorov-Smirnov method was used for normality test; the independent-samples t test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups.Furthermore, the binary logistic regression analysis was used to evaluate the effect of cytokines on SAP, and the linear regression analysis was used to investigate the correlation between cytokines and SAP severity.The partial correlation analysis was used to evaluate the correlation between cytokines and SAP severity score after adjustment for covariates[age, sex, body mass index (BMI), and history of hypertension and diabetes].The LASSO algorithm was used to establish a mathematical model with composite indices; the receiver operating characteristic (ROC) curve was used to assess the performance of serum cytokines in the clinical diagnosis of SAP, and the area under the ROC curve (AUC) was calculated. Results Compared with the SAP group, the non-SAP group had significantly lower APACHE Ⅱ, BISAP, CTSI, and modified Marshall scores (all P < 0.001).Compared with the non-SAP group, the SAP group had significantly higher levels of interferon-γ(IFN-γ), interleukin-6(IL-6), interleukin-8, and tumor necrosis factor-α(TNF-α) and a significantly lower level of interleukin-12(all P < 0.05).The logistic regression analysis showed that IFN-γ(odds ratio[ OR ]=1.190, 95% confidence interval[ CI ]: 1.036-1.367, P =0.014), IL-6 ( OR =1.148, 95% CI : 1.070-1.231, P < 0.001), and TNF-α ( OR =1.100, 95% CI : 1.048-1.155, P < 0.001) were independent influencing factors for SAP.The partial correlation analysis showed that after adjustment for sex, age, BMI, and history of chronic diseases (diabetes and hypertension), the levels of IL-6 and TNF-α were positively correlated with APACHE Ⅱ score in SAP patients (IL-6: r =0.503, P < 0.001;TNF-α: r =0.557, P < 0.001).The linear regression analysis showed that the levels of IL-6 and TNF-α were associated with APACHE Ⅱ score in SAP patients (IL-6: β =0.049, P =0.044;TNF-α: β =0.054, P =0.046), and there was an interaction between IL-6 and TNF-α, which affected APACHE Ⅱ score.The ROC curve analysis showed that the risk score based on IL-6 and TNF-α using LASSO algorithm had the largest AUC of 0.925 in distinguishing SAP from non-SAP, while IL-6 or TNF-α alone had an AUC of 0.885 and 0.878, respectively.The partial correlation analysis showed that after adjustment for sex, age, BMI, and history of chronic diseases (diabetes and hypertension), the risk score was positively correlated with APACHE Ⅱ score in SAP patients ( r =0.565, P < 0.001). Conclusion The serum levels of IL-6 and TNF-α can reflect the severity of AP.The risk score combining serum IL-6 and TNF-α can significantly improve the accuracy of the early diagnosis of SAP, which has an important clinical value in the clinical diagnosis and treatment of SAP.

Threading lasso fixation versus full-thickness conversion in repairing articular-sided partial-thickness supraspinatus tendon tears / 中国骨伤

OBJECTIVE@#To compare the effect of two different arthroscopic procedures, threading lasso fixation and full-thickness conversion, for repairing articular-sided partial-thickness supraspinatus tendon tear.@*METHODS@#From July 2015 to November 2018, 21 patients with articular-sided partial-thickness supraspinatus tendon tears underwent arthroscopic modified threading lasso fixation repair(group A). There were 12 males and 9 females in the group, with an average age of(53.2±6.4)years old. Twenty-four patients with articular-sided partial-thickness supraspinatus tendon tears received arthroscopic full-thickness conversion repair(group B). In this group, there were 14 males and 10 females, with an average age of (55.7±5.2) years old. The American Shoulder and Elbow Surgeons (ASES) score and University of California Los Angeles (UCLA) shoulder score were used to evaluate preoperative and postoperative clinical function. MRI was used to examine the healing status of the reconstructed rotator cuff.@*RESULTS@#All patients were followed up, and the duration ranged from 20 to 27 months, with a mean of (23.7±3.1) months. In threading lasso fixation group, ASES score and UCLA score increased from 50.6±6.4 and 15.6±2.7 preoperatively to 87.3±5.2 and 31.6±2.4 postoperatively. In full-thickness conversion group, ASES score and UCLA score increased from 52.3±5.6 and 16.8±2.4 scores to 90.1±4.8 and 32.1±2.8. There were also no significant differences in ASES score and Constant score between the two groups before and after operation. There were no significant differences in rotator cuff healing between the two groups(χ2=2.374, P=0.128).@*CONCLUSION@#For the treatment of articular-sided partial-thickness supraspinatus tendon tears both arthroscopic repairs employing threading lasso fixation and full-thickness conversion could achieve satisfactory clinical results, and there are no significant differences in clinical outcomes between the two techniques. Arthroscopic repair with threading lasso fixation is a novel transtendinous procedure in which integrity of the tendon can be preserved.

Application value of high-flow nasal cannula oxygen therapy in patients with moderate acute respiratory failure / 中华急诊医学杂志

Objective:To evaluate the effect of high-flow nasal cannula (HFNC) therapy on patients with moderate acute respiratory failure.Methods:This was a randomized controlled trial. The patients with moderate acute respiratory failure in the Intensive Care Unit (ICU) of Changshu Hospital Affiliated to Soochow University from March 2019 to September 2020 were included. Patients with severe asthma or acute exacerbation of chronic respiratory failure, hemodynamic instability, disturbance of consciousness, non-invasive ventilation (NIV) contraindication, urgent need for endotracheal intubation, refusal of intubation, age <18 years and pregnancy were excluded. The patients were randomized to HFNC or NIV. Treatment failure was defined as the need for intubation and invasive ventilation. The vital signs, ROX index, blood gas analysis index, ultrasound parameters and endotracheal intubation rate were recorded at 1, 6, 12, 24 and 48 h after treatment. Kaplan-Meier method was used to draw the survival curve, and multivariate logistic regression was used to analyze the risk factors of treatment failure.Results:A total of 91 patients were included in the study, including 46 patients in the HFNC group and 45 patients in the NIV group. PaO 2/FiO 2 of the two groups were significantly increased after treatment compared with baseline ( P<0.05). The respiratory rate was lower in the NIV group than in the HFNC group at 1 and 24 h ( P<0.05). There were no significant differences in other vital signs, arterial blood gas and ultrasound parameters between the two groups (all P>0.05). The intubation rate was 52.2% in the HFNC group and 48.9% in the NIV group. Kaplan-Meier survival analysis showed that there was no significant difference in intubation rate and mortality between the two groups ( P>0.05). Multivariate logistic regression analysis showed that increased end-diastolic right ventricle/left ventricle ratio ( OR=1.044, 95% CI: 1.012~1.077) and high acute physiology and chronic health evaluationⅡ score ( OR=1.082, 95% CI: 1.006~1.163) at 0 h, lung ultrasound score ( OR=1.353, 95% CI: 1.034~1.772) and end-diastolic RV/LV ratio ( OR=1.097, 95% CI: 1.038~1.159) at 1 h were independent risk factors for non-invasive respiratory strategies failure. Increased diaphragm excursion ( OR=0.341, 95% CI: 0.165~0.704) at 0 h, high PaO 2/FiO 2 ( OR=0.929, 95% CI: 0.884~0.977), increased ROX index ( OR=0.524, 95% CI: 0.332~0.826), and increased diaphragm mobility ( OR=0.119, 95% CI: 0.030~0.476) at 1 h were independent protective factor for successful treatment. Conclusions:HFNC and NIV can improve oxygenation in patients with acute hypoxemic respiratory failure. There is no significant difference in intubation rate and mortality between HFNC and NIV. Ultrasound parameters may be helpful for predicting treatment failure.

The association between the neutrophil-to-lymphocyte ratio and bacteremia in elderly patients admitted to the emergency department

Objective@#Bacteremia is a common cause of increased morbidity and mortality in elderly patients, but early diagnosis and identification are complex. The neutrophil-to-lymphocyte count ratio (NLR) is suggested as a useful indicator for diagnosing bloodstream infections. This study evaluated whether the NLR at admission is associated with bloodstream infections in older patients admitted to the emergency department. @*Methods@#A retrospective, multicenter analysis was performed on patients admitted to the emergency department from November 2016 to February 2017. We included patients aged 65 years and older who visited the emergency department with medical problems. Baseline NLR values were measured upon admission to the emergency department. The primary outcome was a positive blood culture. @*Results@#A total of 1,815 patients were included in this study. The median age was 77.25±7.38 years, and bacteremia was identified in 290 older patients (15.9%). The NLR was significantly higher in the bacteremia group (15.95±22.03) than in the non-bacteremia group (8.76±8.74, P<0.001). In the multivariate logistic regression analysis, the NLR was associated with bacteremia after adjusting for confounding factors as continuous variables (odds ratio [OR], 1.033; 95% confidence interval [CI], 1.009-1.057) and categorical variables (NLR ≥10; OR, 2.018; 95% CI, 1.246-3.268). The area under the curve of the NLR was determined to be 0.667 (95% CI, 0.639-0.694). @*Conclusion@#These results indicate that the NLR at admission to the emergency department is associated with bloodstream infections. Early suspicion of bacteremia, by determining the initial NLR value, will help treat bacteremia in elderly patients.

Relationships between maternal adverse childhood experiences and autistic behaviors in preschool children / 中国学校卫生

Objective@#To explore the prevalence of maternal adverse childhood experiences (ACEs) and the association with autistic behavior of preschool children, to provide a basis for the effective prevention of autism occurrence in preschool children.@*Methods@#Through stratified cluster sampling, 3 655 preschool children in Hefei City were selected and surveyed regarding general information. Maternal ACEs and childhood autistic behaviors were assessed using the Adverse Childhood Experiences International Questionnaire and the Clancy Autism Behaviour Scale, respectively. Multiple Logistic regression model was used to analyze the correlation between maternal ACEs and child autistic behaviors.@*Results@#The prevalence of autistic behavior was 6.10%, with significantly higher in boys (7.22%) than girls(4.86%)( χ 2=8.85, P <0.01). After adjustment for the confounding factors, the detection rate of autistic behaviors was higher in children of mother with ACEs than those of mother without( OR=2.77, 95%CI=1.92-3.99, P <0.05). Maternal ACEs were associated with an increased risk of autistic behaviors both in preschool boys and girls (boys: OR=2.90, 95%CI =1.81-4.64; girls: OR=2.56, 95%CI =1.43-4.61, all P <0.05).@*Conclusion@#Maternal ACEs are associated with increased risk of autistic behaviors among preschool children. More attention should be paid to the intergenerational effects of maternal ACEs to reduce risk of autism among preschool children.

Correlation between unintentional injury and behavioral problems in preschool children / 中国学校卫生

Objective@#To explore the relationship between behavioral problems and accidental injuries among preschoolers, and to provide evidence for the targeted prevention of children s accidental injuries.@*Methods@#During September to October 2019, parent of 2 062 children aged 3 to 6 selected from 8 kindergartens in Hefei through stratified clustering method were investigated. The prevalence of accidental injuries and behavioral problems among preschoolers was collected by questionnaire survey.@*Results@#The prevalence of accidental injury during the past year was 14.55%(300), and behavioral problems 14.21%(293). Total rate of behavioral problems and rate of each dimensions in children with accidental injury were 32.67%, 2.33%, 19.67%, 15.00%, 2.00%, 1.00 % and 5.00%, compared to 11.07%, 0.45%, 6.41%, 4.88%, 0.40%, 0.17% and 0.79% in children without accidental injury ( χ 2=98.11, 12.54, 58.90, 44.12, 10.51, 6.08, 32.68, P <0.01). Multivariate Logistic regression analysis showed that psychosomatic problems( OR =3.13, 95% CI =2.11-4.66), learning problems( OR =2.73, 95% CI =1.86-3.99), abnormal hyperactivity index ( OR =3.16, 95% CI =1.40-7.14) and left behind children ( OR =1.53, 95% CI =1.13-2.07) were associated with higher risk of accidental injuries( P <0.05).@*Conclusion@#Behavioral problems are significantly associated with unintentional injuries among preschool children, which deserved further attention and intervention when formulating prevention and control measures for childhood accidental injury.

The value of acute gastrointestinal injury grading combined with qSOFA score in the diagnosis of sepsis / 中华急诊医学杂志

Objective:To develop a prediction model of acute gastrointestinal injury (AGI) grading combined with qSOFA score for the diagnosis of sepsis, and evaluate its value.Methods:This was a prospective observational study. The patients with infection or suspected infection in the General Ward of Changshu Hospital Affiliated to Soochow University from September 2018 to September 2019 were included. Patients younger than 18 years, pregnant, abandoned treatment and died within 3 days after admission were excluded. Clinical characteristics, laboratory test results and AGI grading from 48 h before the infection to 24 h after the onset of infection were recorded. The patients were divided into the sepsis and non-sepsis groups according to whether they were diagnosed with sepsis. The patients were allocated randomly to a modeling cohort and a validation cohort with a ratio of 7:3. Univariate and multivariate logistic regression analyses were used to analyze the relevant risk factors for sepsis in the modeling cohort. Three types of diagnostic models were constructed in the modeling cohort: model A (qSOFA model), model B (the combined model of AGI grading and qSOFA score), and model C (the combined model of clinical parameters). The clinical usefulness of the diagnostic models was assessed by receiver operating characteristic curve (ROC), calibration curve and decision curve analysis (DCA) in the validation cohort. The nomograms were developed based on these models.Results:A total of 2 553 patients were enrolled in the study, 1 789 patients in the modeling cohort and 764 patients in the validation cohort. and 326 were diagnosed with sepsis. There was no statistical difference in the basic conditions of patients in the two groups. Univariate analysis showed that age, gender, the source of infection, temperature, heart rate, polypnea, changes in consciousness, severe edema, hyperglycemia, white blood cell, C-reactive protein and procalcitonin, hypotension, hypoxemia, acute oliguria, coagulation disorders, hyperlacticemia, capillary filling damage or piebaldskin, AGI grading and qSOFA score were significantly correlated with sepsis (all P<0.01). Multivariate logistic regression analysis showed that age ( OR=1.027, P<0.01), source of infection ( OR=2.809, P=0.03), hypotension ( OR=35.449, P<0.01), hypoxemia ( OR=57.018, P<0.01), and AGI grading ( OR=19.313, P<0.01) were significantly associated with sepsis. ROC analysis showed that the area under the curve (AUC) of model A, B and C were 0.784, 0.944 and 0.971 in the modeling cohort, and 0.832, 0.975 and 0.980 in the validation cohort, respectively. The sensitivities were 63.9%, 89.5% and 97.5% in the modeling cohort, and 72.7%, 90.9% and 96.6% in the validation cohort; and the specificities were 90.8%, 90.3% and 88.1% in the modeling cohort, and 92.2%, 94.5% and 92.8% in the validation cohort, respectively. AUC of model B and C were significantly higher than that of model A ( P<0.01). Model A in the validation cohort was poorly calibrated, with low accuracy and high risk of missed sepsis diagnosis ( P=0.044). The net benefits of model B and C were better than that of model A. Conclusions:AGI grading combined with qSOFA score has a high predictive value and accuracy in the diagnosis of sepsis.

Nursing Leadership Competencies among New Nurses: Perceptions of Nursing Managers’ / 간호행정학회지

Purpose@#This study to identify valuated the competency in nursing leadership among new nurses through the perception of nursing managers. @*Methods@#This a total of 136 nursing managers from two general hospitals in the Seoul metropolitan area were included in this study. Nursing leadership competencies in new nurses were measured using the Student Leadership Practices Inventory developed by Kouzes and Posner. We identified priorities in the development of nursing leadership competencies for new nurses. @*Results@#The overall importance and performance of nursing leadership competencies for new nurses were assessed by nursing managers at an average of 3.92±0.37 and, 2.84±0.50, respectively. Of the 30 nursing leadership competencies, 11 would need to be maintained and strengthened, seven would need to focus on improvement efforts, and 11 would have low priority. The last one was overdone. @*Conclusion@#Of the 18 items of high importance based on the nursing leadership competencies among new nurses identified, for seven items indicating low performance, the performance of nurses should be improved by introducing nursing leadership development programs after they enter the work environment. Eleven low-priority nursing leadership competencies require a long-term strategic approach and need to spread the understanding of nursing leadership throughout the nursing organization.

An updated meta-analysis of the relationship between glutathione S-transferase T1 null/presence gene polymorphism and the risk of lung cancer

Aim of Study: There were many reports published on the relationship between glutathione S-transferase T1 (GSTT1) null/presence gene polymorphism and the risk of lung cancer in these years. In previous, we conducted a meta-analysis to evaluate the relationship between GSTT1 null/presence gene polymorphism and the risk of lung cancer. This study was conducted to update it. Materials and Methods: The association studies were identified from PubMed and Cochrane Library on March 1, 2016. Results: Sixty-three reports were recruited into this meta-analysis for the association of null genotype of GSTT1 with lung cancer susceptibility, consisting of 21,220 patients with lung cancer and 21,496 controls. There was a marked association between GSTT1 null genotype and lung cancer risk in overall populations and in Asians (overall populations: Odds ratio [OR] = 1.17, 95% confidence interval [95% CI]: 1.07–1.28, P = 0.006; Asians: OR = 1.41, 95% CI: 1.23–1.62, P < 0.00001). However, GSTT1 null genotype was not associated with the risk of lung cancer in Caucasians, Brazilian population, and Africans. Conclusion: GSTT1 null genotype is associated with the lung cancer risk in overall populations and in Asians

Comparison of clinicopathological characteristics of endogenous and exogenous cervical cancer with its clinical significance

Background:Cervical cancer is the third leading cause of cancer death in women of less developed countries due to poor screening and decreased diagnostic approaches. We aimed to investigate and differentiate the distinct clinicopathological characteristics and prevalence of endogenous and exogenous cervical in hospitalized patients. Methods:A study was performed contained 663 patients that were enrolled and underwent for screening of endogenous and exogenous cervical cancer in Qilu Hospital of Shandong University, from January 2010 to March 2015.Results:Our results indicated that combined examination of thin-prep liquid-based cytology test and human papillomavirus(HPV)-DNA are effective for diagnosis of endogenous and exogenous cervical cancer. The clinicopathological characteristics based on tumor growth pattern, and highrisk HPV-DNA incidence had no significant difference (p>0.05) in endogenous and exogenous cervicalcancer patients. The higher ratio of lymph node metastasis in endogenous cervical cancer and exogenous cervical cancer during IB1-stage (24.3% vs 12.9%), and in IIA2-stage (36.4% vs 25%) was observed respectively. In addition, our data provide compelling evidence that the level of deep interstitial infiltration, and lymphatic vascular infiltration in endogenous cervical cancer was collectively higher (82.7% and 33%) compared to exogenous cervical cancer (62.4% and18.3%) respectively during all stages.Conclusions:The higher percentage of lymph node metastasis,deep interstitial infiltration, and lymphatic vascular infiltration was observed in endogenous cervical cancer which might be the biomarker and differential key points for the diagnosis of endogenous cervical cancer. Taken together, our study provides clinicopathological features to diagnose, and differentiate the endogenous and exogenous type cervical cancer with its prevalence.

Phylogenetic Positioning of a Strongyloides stercoralis Isolate Recovered from a Korean Patient and Comparison with Other Asian Isolates

Strongyloidiasis is caused by Strongyloides stercoralis and is one of the most neglected tropical diseases in tropical and subtropical regions. Although several strongyloidiasis cases have been reported in Korea, genetic analysis of Korean isolates is still incomplete. In this study, a parasite was isolated from a 61-year-old man diagnosed with strongyloidiasis during the treatment of lymphoma on his retroperitoneal lymph node. Diffuse symmetric wall thickening from the ascending to descending colon and a nematode-infected intestine was observed following microscopic examination. Genomic DNA was isolated from a patient tissue block, and S. stercoralis was identified by PCR and sequencing (18S rDNA). In order to determine phylogenetic location of a Korean isolate (named KS1), we analyzed cox1 gene (500-bp) and compared it with that from 47 previous S. stercoralis isolates (28 human isolates and 19 canid isolates) from Asian countries. Our results showed that phylogenetic tree could clearly be divided into 5 different groups according to hosts and regions. KS1 was most closely related with the Chinese isolates in terms of genetic distance.

Identification of Free-Living Amoebas in Tap Water of Buildings with Storage Tanks in Korea

Free-living amoebas (FLAs) can cause severe disease in humans and animals when they become infected. However, there are no accurate survey reports on the prevalence of FLAs in Korea. In this study, we collected 163 tap water samples from buildings, apartments, and restrooms of highway service areas in 7 Korean provinces with high population density. All these buildings and facilities have water storage tanks in common. The survey was separated into categories of buildings, apartments, and highway service areas. Five hundred milliliters of tap water from each building was collected and filtered with 0.2 µm pore filter paper. The filters were incubated in agar plates with heated E. coli at 25°C. After axenization, genomic DNA was collected from each FLA, and species classification was performed using partial 18S-rDNA PCR-sequencing analysis. We found that 12.9% of tap water from buildings with storage tanks in Korea was contaminated with FLAs. The highway service areas had the highest contamination rate at 33.3%. All of the FLAs, except one, were genetically similar to Vermamoeba vermiformis (Hartmannella vermiformis). The remaining FLA (KFA21) was very similar to Acanthamoeba lugdunensis (KA/E26). Although cases of human infection by V. vermiformis are very rare, we must pay attention to the fact that one-third of tap water supplies in highway service areas have been contaminated.

Phylogenetic Characteristics of Echinococcus granulosus Sensu Lato in Uzbekistan

Echinococcosis occurs mainly in areas with heavy livestock farming, such as Central Asia, America, and Australia. Echinococcus granulosus sensu lato (s.l.) infection causes echinococcosis in intermediate hosts, such as sheep, cattle, goats, camels, and horses. Numerous cases of echinococcosis occur in Uzbekistan as stock farming is a primary industry. Epidemiological and genetic studies of E. granulosus s.l. are very important for mitigating its impact on public health and the economy; however, there are no such studies on E. granulosus s.l. in Uzbekistan. In the present study, to determine which genotypes exist and are transmitted, we isolated Echinococcus sp. from definitive hosts (one isolate each from jackal and dog) and intermediate hosts (52 isolates from humans and 6 isolates from sheep) in Uzbekistan and analyzed the isolates by sequencing 2 mitochondrial DNA components (cox1 and nad1). The results showed that all of isolates except one belonged to the E. granulosus sensu stricto (s.s.) G1 and G3 genotypes. Phylogenetic analysis based on cox1 sequences showed that 42 isolates from humans, 6 isolates from sheep, and one isolate from jackal were the G1 genotype, whereas the remaining 8 isolates from human and the one isolate from dog were the G3 genotype. These results suggest that the G1 and G3 genotypes of E. granulosus s.s. are predominant in Uzbekistan, and both wild animals and domestic animals are important for maintaining their life cycle. Only one isolate from human sample was confirmed to be E. eqiinus (G4 genotype), which is known to be for the first time.

Anti-staphylococcal Effect of a Nephrite-containing Contact Lens Storage Case

Purpose@#To compare the anti-staphylococcal effect of nephrite-containing contact lens (CL) storage cases and conventional CLstorage cases.Method: The degree of proliferation and adhesion of Staphylococcus aureus (S. aureus) on first- to third-generation silicone hydrogelcontact lenses (SHCLs) was analyzed through comparison of 5% nephrite-containing CL storage cases and conventionalCL storage cases. The degree of adhesion of S. aureus to the CL was also compared between 1% or 5% nephrite solution andmultipurpose solution (MPS).Result: Nephrite-containing CL storage cases showed a significant inhibitory effect on S. aureus proliferation (p = 0.004) and significantlyreduced the number of adherent S. aureus on all first- to third generation SHCLs compared with conventional CL storagecases (p = 0.026, p = 0.043, and p = 0.001, respectively). The anti-staphylococcal effect of 1% and 5% nephrite solutionswas not significantly better than that of MPS. @*Conclusions@#Nephrite shows potential as a next-generation substance for reducing infectious keratitis caused by S. aureuswhen added to CL storage cases.

Investigation on compliance with sepsis bundle and outcomes in patients with septic shock in Changshu area / 中华急诊医学杂志

Objective:To investigate the rate of compliance with sepsis Bundle and outcomes in patients with septic shock in intensive care units (ICU) in Changshu area.Methods:A multi-center retrospective study was conducted on patients who were diagnosed as septic shock in ICU of three hospitals in Changshu area from January 2014 to October 2017. Patients who were diagnosed as septic shock meeting the 2016 diagnostic criteria were enrolled. The exclusion criteria were paients younger than 18 years, pregnancy, death within 6 h of admission, halfway abandoned treatment, and those who had entered other studies on septic shock intervention. Clinical characteristics, past history, situation on admission, Bundle completion at 1 h, 3 h and 6 h, and prognosis were recorded. Patients were divided into the survival group and death groups according to whether they survived or not. The differences of completion of Bundle indicators between the two groups were compared. The independent risk factors of prognosis were analyzed by Logistic regression analysis, and the survival curve was plotted by Kaplan-Meier method.Results:Totally 207 patients from 3 hospitals were enrolled in this study. The complition rate of 1 h Bundle was 27.1%, of which the completion rate of serum lactate determination was 81.2%, the completion rate of blood culture before antibiotic administration was 72.5%, the completion rate of broad-spectrum antibiotic administration was 48.4%, the completion rate of fluid resuscitation was 74.4%, and the completion rate of vasopressors to maintain MAP≥65 mmHg was 86.0%; the completion rate of 3 h Bundle was 67.6%, of which the completion rate of serum lactate determination was 97.1%, the completion rate of blood culture before antibiotic administration was 84.5%, the completion rate of broad-spectrum antibiotic administration was 97.1%, and the completion rate of fluid resuscitation was 76.8%; the completion rate of 6 h Bundle was 30.4%, of which the completion rate of vasopressors to maintain MAP≥65 mmHg was 98.1%, the completion rate of reassessed volume stasis (at least two indexes) was 48.3%, the completion rate of central venous pressure (CVP) was 42.5%, the completion rate of ScvO 2 was 10.6%, the completion rate of bedside ultrasound was 48.8%, the completion rate of passive leg raising and rehydration therapy was 42.5%, and the completion rate of re-evaluation of lactate was 55.1%. The total Bundle completion rate at 3 h and 6 h was 27.1%. There was no significant difference in the completion of the three hospitals. The mortality of patients with septic shock was 58.9%, length of stay in the ICU was 10 d (5, 23) d, and length of hospital stay was 14 d (6, 26) d. Univariate analysis showed that antibiotic use time, CVP, bedside ultrasound, passive leg raising and rehydration experiments, re-evaluation after elevated lactate, 6 h Bundle completion, total Bundle completion at 3 and 6 h, and APACHE Ⅱ score were associated with the prognosis (all P<0.01). Logistic regression analysis showed that CVP ( OR=23.236, P=0.001), passive leg raising and rehydration experiments ( OR=0.102, P=0.012), re-evaluation after elevated lactate ( OR=0.197, P=0.001) and APACHEⅡ score ( OR=1.103, P<0.01) were risk factors of the prognosis. Kaplan-Meier analysis showed that the 28 d survival rate was significantly higher if 6 h Bundle was completed (Log Rank χ 2=8.944, P=0.003). Conclusions:The compliance with sepsis Bundle is not high in Changshu area, and the compliance is closely related to the prognosis, so it needs to improve compliance with the guidelines.

Phylogenetic Positioning of a Strongyloides stercoralis Isolate Recovered from a Korean Patient and Comparison with Other Asian Isolates

Strongyloidiasis is caused by Strongyloides stercoralis and is one of the most neglected tropical diseases in tropical and subtropical regions. Although several strongyloidiasis cases have been reported in Korea, genetic analysis of Korean isolates is still incomplete. In this study, a parasite was isolated from a 61-year-old man diagnosed with strongyloidiasis during the treatment of lymphoma on his retroperitoneal lymph node. Diffuse symmetric wall thickening from the ascending to descending colon and a nematode-infected intestine was observed following microscopic examination. Genomic DNA was isolated from a patient tissue block, and S. stercoralis was identified by PCR and sequencing (18S rDNA). In order to determine phylogenetic location of a Korean isolate (named KS1), we analyzed cox1 gene (500-bp) and compared it with that from 47 previous S. stercoralis isolates (28 human isolates and 19 canid isolates) from Asian countries. Our results showed that phylogenetic tree could clearly be divided into 5 different groups according to hosts and regions. KS1 was most closely related with the Chinese isolates in terms of genetic distance.

Correlación entre los microorganismos oxidantes del amonio y los factores ambientales durante el compostaje de estiércol de ganado / Correlation between ammonia-oxidizing microorganisms and environmental factors during cattle manure composting

Abstract Cattle manure composting was performed in an aerated vessel. Community structure and diversity of ammonia-oxidizing bacteria (AOB) and ammonia-oxidizing archaea (AOA) were investigated using polymerase chain reaction and denaturing gradient gel electrophoresis (PCR-DGGE) techniques targeting the ammonia monooxygenase alpha subunit (amoA) gene and the correlation between AOB and AOA communities and environmental factors was explored. Thirteen (13) AOB sequences were obtained, which were closely related to Nitrosomonas spp., Nitrosomonas eutropha, and Nitrosospira spp. and uncultured bacteria, among which Nitrosomonas spp. were predominant. Excessively high temperature and high ammonium concentration were not favorable for AOB growth. Five AOA sequences, belonging to Candidatus Nitrososphaera gargensis and to an uncultured archaeon, were obtained. During composting, community diversity of AOB and AOA fluctuated, with AOA showing a higher Shannon-Wiener index. The AOB community changed more dramatically in the mesophilic stage and the early thermophilic stage, whereas the most obvious AOA community succession occurred in the late thermophilic stage, the cooling stage and the maturity stage. Water content, total nitrogen (TN) and ammonium concentration were more relevant to the AOB community structure, while higher correlations were observed between ammonia, nitrate and TN and the AOA community. AOB community diversity was negatively correlated with pH (r = -0.938, p < 0.01) and water content (r = -0.765, p < 0.05), while positively correlated with TN (r = 0.894, p < 0.01). AOA community diversity was negatively correlated with ammonium concentration (r = -0.901, p < 0.01). Ammonium concentration played an important role in the succession of AOB and AOA communities during composting.

Resumen Se llevó a cabo un compostaje de estiércol de ganado en un recipiente aireado. Se investigó la estructura de la comunidad y la diversidad de bacterias oxidantes del amoníaco (AOB) y las arqueas oxidantes del amoníaco (AOA) mediante el uso de las técnicas de reacción en cadena de la polimerasa y la electroforesis en gel con gradiente de desnaturalización (PCR-DGGE) dirigidas al gen de la subunidad alfa de la amonio monooxigenasa (amoA), y se exploró la correlación entre las comunidades AOB, AOA y los factores ambientales. Se obtuvieron 13 secuencias de AOB, las cuales se relacionaron estrechamente con Nitrosomonas spp., Nitrosomonas eutropha y Nitrosospira spp., y bacterias no cultivadas, entre las cuales fueron predominantes las Nitrosomonas spp. La temperatura excesivamente alta y la concentración de amonio elevada no fueron favorables para el crecimiento de las AOB. Se obtuvieron 5 secuencias de AOA, pertenecientes a Candidatus Nitrososphaera gargensis y un Archaeon no cultivado. Durante el compostaje, la diversidad de AOB y AOA fluctuó y las AOA mostraron un índice de Shannon-Wiener más alto. La comunidad de AOB cambió significativamente en la etapa mesofílica y la etapa termofílica temprana, mientras que la sucesión más obvia de la comunidad AOA ocurrió en la etapa termofílica tardía y las etapas de enfriamiento y de maduración. El contenido de agua, el nitrógeno total (TN) y la concentración de amonio fueron más relevantes para la estructura de la comunidad AOB, mientras que se observaron correlaciones mayores entre amoníaco, nitrato y TN, y la comunidad AOA. La diversidad de la comunidad AOB se correlacionó negativamente con el pH (r= -0,938; p < 0,01) y el contenido de agua (r = -0,765; p < 0,05), mientras que se relacionó positivamente con TN (r = 0,894; p < 0,01). La diversidad de la comunidad AOA se correlacionó negativamente con la concentración de amonio (r = -0,901; p < 0,01). La concentración de amonio desempenó un papel importante en la sucesión de las comunidades AOB y AOA durante el compostaje.