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The global COVID-19 coronavirus pandemic has infected over 109 million people, leading to over 2 million deaths up to date and still lacking of effective drugs for patient treatment. Here, we screened about 1.8 million small molecules against the main protease (Mpro) and papain like protease (PLpro), two major proteases in severe acute respiratory syndrome-coronavirus 2 genome, and identified 1851Mpro inhibitors and 205 PLpro inhibitors with low nmol/l activity of the best hits. Among these inhibitors, eight small molecules showed dual inhibition effects on both Mpro and PLpro, exhibiting potential as better candidates for COVID-19 treatment. The best inhibitors of each protease were tested in antiviral assay, with over 40% of Mpro inhibitors and over 20% of PLpro inhibitors showing high potency in viral inhibition with low cytotoxicity. The X-ray crystal structure of SARS-CoV-2 Mpro in complex with its potent inhibitor 4a was determined at 1.8 Å resolution. Together with docking assays, our results provide a comprehensive resource for future research on anti-SARS-CoV-2 drug development.
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Humans , Antiviral Agents/chemistry , COVID-19 , COVID-19 Drug Treatment , High-Throughput Screening Assays , Molecular Docking Simulation , Protease Inhibitors/chemistry , SARS-CoV-2/enzymology , Viral Nonstructural ProteinsABSTRACT
Objective:Based on cognitive behavioral therapy, to construct a physical and mental adjustment intervention plan for the main caregiver of cancer patients through the network platform.Methods:Through evidence-based literature published from July 2012 to July 2022 screening and evaluation, combined with qualitative interviews for 10 primary caregivers of cancer patients, the intervention plan for physical and mental adjustment of the main caregivers of cancer patients was preliminarily formulated. After consultation with Delphi experts (15 cases) through two rounds, the intervention plan was finally determined.Results:In the two rounds of expert letter inquiries, 15 questionnaires were distributed and 15 valid questionnaires were recovered. The effective recovery rate was 100.00% and the expert authority coefficient were 0.89 and 0.90 in the two rounds of expert letter inquiries respectively, the Kendall harmony coefficients were 0.279 and 0.323 respectively, and the differences were all statistically significant ( P<0.01). The intervention plan for physical and mental adjustment ofthe main caregivers of cancer patients included 5 first-level indicators (basic knowledge, symptom education, home care knowledge, relaxation training, social support), 27 second-level indicatorsand 54 third-level indicators. Conclusions:The method of the psychosomatic regulation intervention program is scientific and practical, which can be initially applied to the psychological adjustment of the main caregivers of cancer patients, so as to provide a reference for improving their negative emotions.
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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.
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Objective:To analyze 18F-FDG PET/CT imaging features of non-functional pancreatic neuroendocrine neoplasms (NF-pNENs) and investigate its correlation with pathology and prognosis. Methods:A total of 35 cases (17 males, 18 females; age (51±12) years) of pathologically confirmed NF-pNENs who underwent pretherapeutic 18F-FDG PET/CT from January 2011 to July 2017 in Peking Union Medical College Hospital were retrospectively enrolled. Clinical data were collected and patients were followed up. PET/CT parameters including number and maximum diameter of lesions, SUV max and pancreatic tumor-to-liver ratio (T/L) were measured. Mann-Whitney U test and Kruskal-Wallis rank sum test, Spearman correlation analysis were used to analyze the data. Results:Among the included 35 NF-pNENs patients (G1, n=6; G2, n=21; G3, n=8) with maximum diameter of 3.0(2.1, 6.1) cm and SUV max of 5.5(4.0, 8.9), 32 were positive in PET/CT. There were 1 patient with cystic, 2 with calcification and 3 with dilatation of pancreaticobiliary duct. Among 10 patients with metastases, 8 revealed multiple liver metastases. There was statistical difference of T/L among G1-G3 tumor (1.23(0.60, 2.00), 3.05(1.80, 4.00), 3.90(1.90, 7.60); H=8.29, P=0.016), but there were no statistical differences of SUV max or maximum diameter among G1-G3 tumor ( H values: 4.34, 3.37, P values: 0.114, 0.186). There was a significant correlation between T/L (2.78(1.48, 3.94)) and Ki-67 index (8.0(3.0, 20.0); rs=0.631, P<0.001). Among 27 patients with available follow-up results, T/L in patients with complete remission or stable disease ( n=20) was statistically lower than that in patients with progressive disease or death ( n=7) (2.1(1.2, 3.2) vs 7.5(3.4, 13.4); z=-3.37, P=0.001). Conclusions:18F-FDG PET/CT can detect primary and metastatic lesions of NF-pNENs. T/L can better reflect the proliferative activity based on Ki-67 index than SUV max and it may be favorable on prognostic value.
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Objective:To investigate the value of intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI) parameters combined with T 2WI texture analysis of primary lesions of rectal adenocarcinoma in preoperative prediction of lymph node metastasis with short diameter ≤9 mm. Methods:Retrospective analysis was performed on 115 cases of rectal adenocarcinoma confirmed by surgical pathology in Affiliated Provincial Hospital of Anhui Medical University from June 2015 to October 2020. All patients underwent total mesorectal resection and received conventional rectal MRI and IVIM-DWI scan before surgery. According to the pathological results of lymph node, the patients were divided into lymph node metastatic group ( n=44) and non-metastatic group ( n=71). IVIM-DWI parameters of primary rectal adenocarcinoma were measured including apparent diffusion coefficient (ADC), diffusion coefficient (D), pseudo diffusion coefficient (D *) and perfusion fraction (f). The region of interest (ROI) of the whole lesion of rectal adenocarcinoma was delineated on axial T 2WI; then the ROIs were imported into GE Analysis Kit software to extract 3D texture feature. The differences of IVIM-DWI parameters and texture feature parameters were compared between two groups using independent sample t test or Mann-Whitney U test. The optimal texture feature parameters with independent predictive function were screened by multivariate logistic regression. Then the texture feature model and combined model based IVIM-DWI and texture feature parameters were established. The receiver operating characteristic (ROC) curves were used to evaluate the performances of IVIM-DWI, texture feature parameters, texture feature model and combined model in predicting lymph node metastasis in patients with rectal adenocarcinoma. The area under the ROC curve (AUC) were compared with DeLong test. Results:Among all the IVIM-DWI parameters, the D * and f values of primary rectal adenocarcinoma were significantly different between the lymph node metastasis group and the non-lymph node metastasis group ( Z=3.39, P=0.001, Z=-3.06, P=0.002); no statistical significance was found in the ADC and D values between two groups (both P>0.05). A total of 828 texture feature parameters were obtained based on T 2WI of primary lesion of rectal adenocarcinoma, among which 3 optimal texture feature parameters were selected, including firstorder_Skewness, shape_Sphericity and glcm_Idn. The ROC curve results showed that the AUC of D * and f were 0.689 and 0.670, respectively. The AUC of 3 texture feature parameters were 0.651, 0.628, 0.631, respectively. The AUC of texture feature model and the combined model were 0.775 and 0.803. The AUC of combined model was larger than D *, f and the three texture feature parameters (all P<0.05). Conclusion:IVIM-DWI parameters combined with T 2WI texture feature parameters in primary lesion of rectal adenocarcinoma show good diagnostic efficacy in preoperative prediction of lymph node metastasis with short diameter≤9 mm.
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Objective:To predict and evaluate the antibacterial efficacy of linezolid, teicoplanin and daptomycin against Staphylococci bloodstream infections with Monte Carlo simulation, and to optimize the clinical administration program. Methods:A total of 1 847 Staphylococci strains isolated from blood samples between January 2018 to December 2019 were collected with the help of the Blood Bacterial Resistant Investigation Collaborative System (BRICS). Minimum inhibitory concentrations (MIC) of linezolid and daptomycin were detected by broth dilution method, while MIC of teicoplanin were detected by agar dilution method. The dosage regimens of linezolid were 800 mg once daily, 500 mg once every 12 hours, 600 mg once every 12 hours and 600 mg once every eight hours. The dosage regimens of teicoplanin were 400 mg once every 12 hours, 600 mg once every 12 hours, 800 mg once every 12 hours, and 1 000 mg once every 12 hours. The dosage regimens of daptomycin were 4 mg·kg -1·d -1, 6 mg·kg -1·d -1, 8 mg·kg -1·d -1, 10 mg·kg -1·d -1and 12 mg·kg -1·d -1. The probability of target attainment (PTA) and cumulative fraction of response (CFR) of three different dosage regimens were calculated by Monte Carlo simulation. A dosage regimen with CFR≥90.0% was a reasonable choice for empirical antimicrobial therapy. Results:PTA of linezolid against Staphylococci when MIC≤0.500 mg/L at four dosage regimens (800 mg once daily, 500 mg once every 12 hours, 600 mg once every 12 hours and 600 mg once every eight hours) were all over 90.0%. When MIC was 1.000 mg/L, the PTA of linezolid against Staphylococci under the dosages of 500 mg once every 12 hours, 600 mg once every 12 hours and 600 mg once every eight hours were 92.2%, 96.6% and 97.6%, respectively. The CFR of the four dosage regimens of linezolid were 73.9%, 83.7%, 90.8% and 95.3%, respectively. When MIC≤1.000 mg/L, PTA of teicoplanin against Staphylococci were all 100.0% at four dosage regimens (400 mg once every 12 hours, 600 mg once every 12 hours, 800 mg once every 12 hours and 1 000 mg once every 12 hours). When MIC was 2.000 mg/L, the PTA of teicoplanin (800 mg once every 12 hours and 1 000 mg once every 12 hours) against Staphylococci were both 100.0%. The CFR of the four dosage regimens of teicoplanin were 90.8%, 92.8%, 93.5% and 94.6%, respectively. When MIC≤0.500 mg/L, PTA of daptomycin against Staphylococci under the five dosages of 4 mg·kg -1·d -1, 6 mg·kg -1·d -1, 8 mg·kg -1·d -1, 10 mg·kg -1·d -1 and 12 mg·kg -1·d -1 were all over 90.0%. When MIC was 1.000 mg/L, the PTA of daptomycin against Staphylococci under the three dosages of 8 mg·kg -1·d -1, 10 mg·kg -1·d -1 and 12 mg·kg -1·d -1were 96.9%, 100.0% and 100.0%, respectively. The CFR of the five dosage regimens of daptomycin against Staphylococci were 97.4%, 99.2%, 99.9%, 100.0% and 100.0%, respectively. Conclusions:Linezolid (600 mg once every 12 hours), teicoplanin (400 mg once every 12 hours) and daptomycin (4 mg·kg -1·d -1) can achieve satisfactory antibacterial activity for Staphylococci bloodstream infections.
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Objective@#To explore the buffering effect of positive childhood experiences (PCEs) on mental health risks among adolescents before and after COVID-19 epidemic.@*Methods@#In October 2019 (before the outbreak of COVID-19), 1 322 students from grades 4 to 9 were recruited from primary and secondary schools in two counties of Chizhou city, Anhui Province. A questionnaire survey was conducted to collect general demographic information, PCEs, depressive symptoms, anxiety symptoms, self harm behavior, suicidal ideation. Follow up survey was conducted after school re opening (May 2020). Mental health status before and after the COVID-19 epidemic was compared among students with different PCEs by multiple logistic regression analyses.@*Results@#The detection rates of depressive symptoms, anxiety symptoms, self harm behavior and suicidal ideation (22.6%, 16.0%, 40.0%, 29.9%) of the respondents after school re opening were significantly higher compared that before the epidemic (16.5%, 13.5%, 31.1 %, 22.6%). There were no significant differences in the detection rates of depressive symptoms, anxiety symptoms,self harm behavior and suicidal ideation between high PCEs group before and after the epidemic ( Z =-0.05,0.27,0.84,1.84, P >0.05). Multivariate Logistic regression analysis showed that the risk of depressive symptoms and self harm behavior in the low PCEs group after school re opening was 1.39 times higher than that before the epidemic (95% CI= 1.05 -1.84, P <0.05). The risk of non suicidal self injury behavior in the low PCEs group after school re opening was 1.31 times higher than that before the epidemic (95% CI= 1.05 -1.62, P <0.05). There were no significant differences in mental health detection rates in high PCEs group before and after the epidemic ( P >0.05).@*Conclusion@#During the time of COVID-19 epidemic, PCEs is associated with lower rates of depressive symptoms, anxiety symptoms, self harm behavior and suicide ideation in adolescents. The findings suggest that more support and help should be given to adolescents from the perspectives of family, school and peers, so as to reduce the adverse effects of public health emergencies on adolescents mental health.
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Objective:In China, although axillary osmidrosis is common in plastic surgery, there is no standard procedure for the treatment of axillary osmidrosis. So we compared the efficacy of 6 axillary osmidrosis surgical treatments with network meta-analysis in order to provide reference for the clinical surgical treatment of axillary osmidrosis in Chinese patients.Methods:From January 2018 to December 2021, Chinese and English databases including Wanfang Database, VIP Chinese Science and Technology Periodical Full-text Database (VIP) and CNKI, PubMed, Cochrane Library, Embase were searched by the Plastic Surgery Department of Zhangqiu People′s Hospital in Jinan, Shandong province. And some relevant studies were collected for network meta-analysis.Results:47 studies including a total of 6543 subjects were identified for meta-analysis. After analysis, 4 of the 15 pairwise comparisons were not statistically significant, and the effect of swelling aspiration + subcutaneous pruning was more significant. According to the surface under the cumulative ranking curve (SUCRA), the efficacy of 6 surgical methods for the treatment of axillary osmidrosis was as follows: swelling aspiration + subcutaneous pruning > subcutaneous scratching+ subcutaneous pruning > subcutaneous pruning > fusiform skin resection > subcutaneous scratching > swelling aspiration.Conclusions:In surgical treatment of axillary osmidrosis, swelling aspiration + subcutaneous pruning is the best. It is worth popularizing in the clinical work of treating axillary osmidrosis patients. Due to the limitations of this study, the conclusion of this network meta-analysis still needs to be further confirmed by a well-designed randomized controlled trial.
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Objective:To investigate the distribution and antimicrobial resistance profile of clinical bacteria isolated from blood culture in China.Methods:The clinical bacterial strains isolated from blood culture from member hospitals of Blood Bacterial Resistant Investigation Collaborative System (BRICS) were collected during January 2018 to December 2019. Antibiotic susceptibility tests were conducted with agar dilution or broth dilution methods recommended by US Clinical and Laboratory Standards Institute (CLSI). WHONET 5.6 was used to analyze data.Results:During the study period, 14 778 bacterial strains were collected from 50 hospitals, of which 4 117 (27.9%) were Gram-positive bacteria and 10 661(72.1%) were Gram-negative bacteria. The top 10 bacterial species were Escherichia coli (37.2%), Klebsiella pneumoniae (17.0%), Staphylococcus aureus (9.7%), coagulase-negative Staphylococci (8.7%), Pseudomonas aeruginosa (3.7%), Enterococcus faecium (3.4%), Acinetobacter baumannii(3.4%), Enterobacter cloacae (2.9%), Streptococci(2.8%) and Enterococcus faecalis (2.3%). The the prevalence of methicillin-resistant S. aureus (MRSA) and methicillin-resistant coagulase-negative Staphylococcus were 27.4% (394/1 438) and 70.4% (905/1 285), respectively. No glycopeptide-resistant Staphylococcus was detected. More than 95% of S. aureus were sensitive to amikacin, rifampicin and SMZco. The resistance rate of E. faecium to vancomycin was 0.4% (2/504), and no vancomycin-resistant E. faecalis was detected. The ESBLs-producing rates in no carbapenem-resistance E. coli, carbapenem sensitive K. pneumoniae and Proteus were 50.4% (2 731/5 415), 24.6% (493/2001) and 35.2% (31/88), respectively. The prevalence of carbapenem-resistance in E. coli and K. pneumoniae were 1.5% (85/5 500), 20.6% (518/2 519), respectively. 8.3% (27/325) of carbapenem-resistance K. pneumoniae was resistant to ceftazidime/avibactam combination. The resistance rates of A. baumannii to polymyxin and tigecycline were 2.8% (14/501) and 3.4% (17/501) respectively, and that of P. aeruginosa to carbapenem were 18.9% (103/546). Conclusions:The surveillance results from 2018 to 2019 showed that the main pathogens of bloodstream infection in China were gram-negative bacteria, while E. coli was the most common pathogen, and ESBLs-producing strains were in majority; the MRSA incidence is getting lower in China; carbapenem-resistant E. coli keeps at a low level, while carbapenem-resistant K. pneumoniae is on the rise obviously.
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Objective:To examine the clinical effectiveness of modified vaginal hysterectomy for the treatment elderly women with uterine prolapse.Methods:Eighty-two elderly patients with uterine prolapse treated in the Affiliated Hospital of Jiangnan University from January 2017 to August 2020 were selected as research subjects, who were randomly and double-blindly divided into the control group and the observation group, with 41 patients in each group.The control group was treated with traditional vaginal hysterectomy, while the observation group was treated with modified vaginal hysterectomy.Surgical parameters(operating time, intraoperative blood loss and length of hospital stay), total clinical effectiveness rates and the incidences of complications in the two groups were compared.Results:The total effectiveness rate of the observation group was higher than that of the control group(97.6% vs.78.0%, χ2=7.291; P<0.05). The operation time[(71.3±15.5)min vs.(122.7±22.2)min, t=7.379, P=0.008], intraoperative blood loss[(122.5±15.3)ml vs.(297.7±20.7)ml, t=9.820, P=0.000]and hospitalization time[(7.2±1.5)d vs.(10.0±2.9)d, t=7.164, P=0.014]of the observation group were lower than those of the control group.The incidence of complications in the observation group was lower than that in the control group(0.0% vs.14.6%, χ2=7.159, P<0.05). Conclusions:Modified vaginal hysterectomy for elderly patients with uterine prolapse can help improve the clinical effectiveness and reduce the operating time, postoperative length of hospital stay and the incidence of postoperative complications.
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Objective:To investigate the clinical efficacy of laparoscopic resection of retrorectal cystic lesions.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 58 patients undergoing laparoscopic resection of retrorectal cystic lesions in the Peking Union Medical College Hospital, Chinese Academy of Medical Sciences from August 2012 to August 2019 were collected. There were 5 males and 53 females, aged from 15 to 70 years, with a median age of 38 years. All the 58 patients underwent laparoscopic resection of retrorectal cystic lesions and the combined operation through the transsacral approach was chosen according to the patient condition. Observation indicators: (1) surgical situations; (2) postoperative situations; (3) postoperative histopathological examination; (4) follow-up. Patients were followed up regularly using outpatient examination once every 6 months during the first postoperative year and once every 12 months after the first postoperative year. The recurrence of cysts was evaluated by computed tomography or magnetic resonance imaging examinations during the follow-up up to August 2020. Measurement data with normal distribution were represented as Mean± SD and measurement data with skewed distribution were described as M(range). Count data were described as absolute numbers. Results:(1) Surgical situations: of the 58 patients, 54 cases underwent laparoscopic resection of retrorectal cystic lesions and 4 cases underwent laparoscopic resection of retrorectal cystic lesions combined with the transsacral approach operation. One of the 58 patients who had a huge cyst surrounding the rectum underwent transverse colostomy after repairing the damage of separated posterior wall of rectum. Two cases underwent preventive transverse colostomy because the external rectal wall heat injury could not be excluded after separation of the tight adhesion between cyst and rectum. The operation time and volume of intraoperative blood loss were (123±56)minutes, 20 mL(range, 5?500 mL) of 54 cases who underwent laparoscopic resection of retrorectal cystic lesions and (232±38)minutes, 90 mL(range, 30?800 mL) of 4 cases who underwent laparoscopic resection of retrorectal cystic lesions combined with the transsacral approach operation, respectively. (2) Postoperative situations: 7 of the 58 patients had complica-tions. Of the 7 patients, 2 cases had postoperative rectal fistula and were cured after the treatment of transverse colostomy combined with pelvic drainage, 2 cases had postoperative urinary tract infection and were relieved after anti-infection treatment, 2 cases had urinary retention after removal of catheter and were recovered after 3 weeks of re-indwelling catheter, and 1 case had poor incision healing of transsacral and was healed after wound dressing change. The duration of postoperative hospital stay of the 58 patients was (7±4)days. (3) Postoperative histopathological examination: results of the postoperative histopathological examination showed that there were 26 of 58 patients with epidermoid cyst, 20 patients with teratoma (2 cases with mature teratoma accompanied by mucinous adenocarcinoma and 1 case with mature teratoma accompanied by neuroendocrine carcinoma), 10 patients with dermoid cyst, and 2 patients with tailgut cyst. (4) Follow-up: 57 of the 58 patients were followed up for 2-85 months, with a median follow-up time of 51 months. Of the 57 patients who were followed up, 1 patient was diagnosed with buttock subcutaneous cyst at postoperative 8 months and treated with local excision, 1 patient was diagnosed with a small presacral cyst recurrence by pelvic magnetic resonance imaging at postoperative 6 months and continued follow-up as the cyst without obvious enlargement, and the other 55 patients had no cyst recurrence.Conclusion:The laparoscopic resection of retrorectal cystic lesions is safe and feasible.
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Objective:To study the rate of capsule contracture after operation of the textured surfaces breast implants and the smooth surfaces breast implants, to provide evidence for plastic surgeons to select the type of breast implants during breast augmentation.Methods:This study started from January 2018 to May 2019. Chinese and English databases including Wanfang Science and Technology Periodical Full-text Database, VIP Chinese Science and Technology Periodical Full-text Database (VIP) and CNKI, PubMed, Cochrane Library, Web of Science, Science Drirect Online were searched by computer. Some relevant studies were collected for this meta-analysis.Results:We identified 9 studies including a total of 13165 subjects for the meta-analysis. The OR value of the study was 0.43 (95% CI: 0.35, 0.51), and the incidence rate of capsule contracture in the experimental group was lower than that in the control group. In cumulative meta-analysis and sensitivity test, the conclusion was stable. And there was no publication bias found by Egger regression test. Conclusions:The textured surfaces breast implants are better than the smooth surfaces breast implants in terms of incidence rate of capsule contracture after augmentation mammoplasty.
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Objective@#To survey on the home blood pressure measurement and blood pressure control rate among patients with hypertension in Beijing Yuetan community.@*Methods@#A questionnaire survey was conducted among 504 hypertensive patients, who were visiting Beijing Yuetan Community Health Service Center and selected by convenience-sampling method during June 2018 to January 2019. The status of home blood pressure measurement, the awareness of hypertension, the blood pressure control rate and factors related to not regularly measuring were surveyed.@*Results@#Of the 504 patients, 93.7% (472/504) took regular medication, but only 61.5% (310/504) had regular blood pressure measurements; 92.5% (466/504) had sphygmomanometers at home with electronic type mainly; 89.9% (453/504) patients knew the method of blood pressure measurement, but only 11.5% (52/453) had their sphygmomanometer calibrated. Among those who measured blood pressure, 77.4% (240/310) measured per week. The main reason for not measuring blood pressure regularly was that there was no need to measure blood pressure without any discomfort, accounting for 50.0% (97/194). The office blood pressure control rate (with desktop mercury sphygmomanometer) was 62.3% (314/504); the blood pressure control rate both in the morning and at bed time was 61.3% (73/119), that in the morning was 68.1% (81/119) and at bed time was 75.6% (90/119). The control rates of systolic blood pressure and heart rate by home measurement at morning and bedtime were significantly higher than those by office measurement (χ2=5.02, 9.97, 15.51, 13.72; all P<0.05).@*Conclusions@#The home blood pressure monitoring rate and knowledge level of hypertension among patients with hypertension in Yuetan community are relatively low. There are some differences in blood pressure control rate between office measurement and home measurement. Comprehensive evaluation is needed in the management process, and the treatment plan should be adjusted according to the specific condition of patients.
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Objective:To survey on the home blood pressure measurement and blood pressure control rate among patients with hypertension in Beijing Yuetan community.Methods:A questionnaire survey was conducted among 504 hypertensive patients, who were visiting Beijing Yuetan Community Health Service Center and selected by convenience-sampling method during June 2018 to January 2019. The status of home blood pressure measurement, the awareness of hypertension, the blood pressure control rate and factors related to not regularly measuring were surveyed.Results:Of the 504 patients, 93.7% (472/504) took regular medication, but only 61.5% (310/504) had regular blood pressure measurements; 92.5% (466/504) had sphygmomanometers at home with electronic type mainly; 89.9% (453/504) patients knew the method of blood pressure measurement, but only 11.5% (52/453) had their sphygmomanometer calibrated. Among those who measured blood pressure, 77.4% (240/310) measured per week. The main reason for not measuring blood pressure regularly was that there was no need to measure blood pressure without any discomfort, accounting for 50.0% (97/194). The office blood pressure control rate (with desktop mercury sphygmomanometer) was 62.3% (314/504); the blood pressure control rate both in the morning and at bed time was 61.3% (73/119), that in the morning was 68.1% (81/119) and at bed time was 75.6% (90/119). The control rates of systolic blood pressure and heart rate by home measurement at morning and bedtime were significantly higher than those by office measurement (χ 2=5.02, 9.97, 15.51, 13.72; all P<0.05). Conclusions:The home blood pressure monitoring rate and knowledge level of hypertension among patients with hypertension in Yuetan community are relatively low. There are some differences in blood pressure control rate between office measurement and home measurement. Comprehensive evaluation is needed in the management process, and the treatment plan should be adjusted according to the specific condition of patients.
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Objective:To investigate the effect of circRNA-102231 on the sensitivity of colon cancer HT-29 cells to cisplatin and its mechanism.Methods:The expression of circRNA-102231 and ABCB1 were detected by Western blot and RT-qPCR in cisplatin-resistant HT-29/DDP cell lines. Overexpress or knockdown circRNA-102231 in HT-29 cells were respectively followed by treatment with cisplatin, CCK-8 method was used to detect cell viability, Western blot and RT-qPCR were used to detect the protein and mRNA expression levels of circ-102231 and ABCB1; The circRNA-102231 combined microRNA was predicted by the database and verified with RT-qPCR; Activation or inhibition of ERK and overexpression of miR-145, Western blot and RT-qPCR were used to detect the protein and mRNA levels of ABCB1, and the luciferase reporter assay was used to detect the ABCB1 promoter activity.Results:Compared with HT-29 cells, the expression levels of circRNA-102231 and ABCB1 were significantly up-regulated in HT-29/DDP cells(all P<0.05). Overexpression of circRNA-102231 up-regulated the expression of ABCB1 and decreased the sensitivity of cells to cisplatin( P<0.05). Knockdown of circRNA-102231 down-regulated the expression of ABCB1, hence increased the sensitivity to cisplatin( P<0.05); circRNA-102231 can recruit miR-145 and promote its expression; miR-145 induce ERK phosphorylation, activation or inhibition of ERK activity can promote or up regulate the expression level and promote activity of ABCB1( P<0.05). Conclusion:circRNA-102231 may increase the resistance of HT-29 cells to cisplatin by promoting the up-regulation of ABCB1 through miRNA-145/ERK pathway.
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Objective:To investigate the distribution and antimicrobial resistance profile of clinical bacteria isolated from blood culture in China.Methods:The clinical bacterial strains isolated from blood culture from member hospitals of Blood Bacterial Resistant Investigation Collaborative System (BRICS) were collected during January 2016 to December 2017. Antibiotic susceptibility tests were conducted by agar dilution or broth dilution methods recommended by US Clinical and Laboratory Standards Institute (CLSI) 2019. WHONET 5.6 was used to analyze data.Results:During the study period, 8 154 bacterial strains were collected from 33 hospitals, of which 2 325 (28.5%) were Gram-positive bacteria and 5 829 (71.5%) were Gram-negative bacteria. The top 10 bacterial species were Escherichia coli (34.7%), Klebsiella pneumoniae (15.8%), Staphylococcus aureus (11.3%), coagulase-negative Staphylococci (7.4%), Acinetobacter baumannii (4.6%), Pseudomonas aeruginosa (3.9%), Enterococcus faecium (3.8%), Streptococci (2.9%), Enterobacter cloacae (2.7%) and Enterococcus faecalis (2.5%). Methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase-negative Staphylococcus (MRCNS) accounted for 34.2%(315/922) and 77.7%(470/605), respectively. No vancomycin-resistant Staphylococcus was detected. The resistance rate of Enterococcus faecium to vancomycin was 0.6%(2/312), and no vancomycin-resistant Enterococcus faecium was detected. The ESBLs-producing rates in Escherichia coli, Klebsiella pneumoniae and Proteus were 55.7%(1 576/2 831), 29.9%(386/1 289) and 38.5%(15/39), respectively. The incidences of carbapenem-resistance in Escherichia coli, Klebsiella pneumoniae were 1.2%(33/2 831), 17.5%(226/1 289), respectively. The resistance rates of Acinetobacter baumannii to polymyxin and tigecycline were 14.8%(55/372) and 5.9%(22/372) respectively, and those of Pseudomonas aeruginosa to polymyxin and carbapenem were 1.3%(4/315) and 18.7%(59/315), respectively. Conclusion:The surveillance results from 2016 to 2017 showed that the main pathogens of blood stream infection in China were gram-negative bacteria, while Escherichia coli was the most common pathogen; the MRSA incidence was lower than other surveillance data in the same period in China; carbapenem-resistant Escherichia coli was at a low level during this surveillance, while carbapenem-resistant Klebsiella pneumoniae is on the rise.
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Objective@#To explore the value of baseline geriatric nutritional risk index (GNRI) in evaluating the prognosis of patients with end-stage renal disease (ESRD) who underwent peritoneal dialysis (PD).@*Methods@#The clinical data of patients who underwent PD catheterization and started PD therapy at the First Affiliated Hospital of Zhengzhou University from January 1, 2013 to December 30, 2018 were collected retrospectively. The follow-up endpoint was death or hemodialysis. The follow-up deadline was March 1, 2019. The GNRI cut-off value was determined according to the ROC curve, and the patients were divided into GNRI≤90.5 group and GNRI>90.5 group. The differences of clinical data and laboratory tests were compared between the two groups. Kaplan-Meier survival curves were used to compare the difference in PD rate between the two groups during follow-up, and the factors that affecting patients PD withdrawal were analyzed by Cox regression.@*Results@#The GNRI cut-off value was determined to be 90.5 based on the ROC curve. Until the deadline for follow-up, the drop-out rate of GNRI≤90.5 group was significantly higher than the GNRI>90.5 group (35.88% vs 21.58%, P=0.003). Kaplan-Meier survival curves showed a higher rate of maintaining PD in the GNRI>90.5 group than that in GNRI≤90.5 group during follow-up (P=0.021). Cox univariate regression showed that male, GNRI and serum Alb were protective factors for PD patients, and Scr was a risk factor. After multiple factors correction, male and GNRI were also the protective factors for PD patients.@*Conclusion@#As an objective indicator of nutritional evaluation, baseline GNRI can be used as a prognostic indicator for PD patients.
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To evaluate the feasibility of magnetic navigation ultrasonography system in guiding the puncture of percutaneous posterior endoscopic cervical discectomy ( PPECD ) . Methods T he cervical CT data of 6 patients with cervical spondylosis were used to made 3D printing model ,then the localized puncture of the model was guided by the magnetic navigation ultrasonography system ,1‐mm‐slice transection CT scans were obtained to confirm the placement of the needle tips after puncture . T he total puncture time and the distance between the pinpoint in the lateral and longitudinal directions from the ＂V point＂were recorded . Results All the 36 puncture operations accurately located the target segment without penetrating the spinal canal . T he average lateral distance of the needle tip from the ＂V point＂was 2 .88 mm ( 0－7 .12 mm ) ,meanw hile the average longitudinal distance was 1 .64 mm ( 0 －4 .45 mm ) ,and the the w hole process took 3 .72 min( 2 .42－5 .20 min) . T hirty‐three of 36 points were in the circle with ＂V point＂as the center and 5mm as the radius ,puncture success rate was 91% . Conclusions T he puncture model established in this study can be used as a teaching tool ,magnetic navigation ultrasonography system has successfully guided the posterior cervical intervertebral disc puncture on the model ,and there is no radiation exposure during the operation process ,which has a promising clinical application prospect .
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Objective To understand the changes of the levels of serum cortisol,pro‐B‐type natri‐uretic peptide(Pro‐BNP) and interleukin‐6(IL‐6) in the critical stress children. Methods The experimental group enrolled the children with severe infection,polytrauma and cardiopulmonary resuscitation admitted in PICU of Children′s Hospital of Fudan University from May 2015 to December 2015. The children admitted to the surgical ward during the same period without trauma,infection,heart,kidney and adrenal diseases or dys‐function,and without a long history of glucocorticoid use were selected as the control group. According to the pediatric critical illness score(PCIS),the experimental group was divided into 3 subgroups:severe critically ill group(PCIS≤70,n＝17),critically ill group(PCIS 71‐89,n＝26),and non‐critically ill group( PCIS≥90,n＝15). What′s more,the experimental cases were divided into survival group (n＝39) and death group ( n＝19) according to the prognosis. On the day of admission and during the period with stable condition,the peripheral blood sample were collected to detect serum cortisol,Pro‐BNP and IL‐6. While the control cases were detected the same items on the day of admission or pre‐operation. Results The concentrations of serum cortisol,Pro‐BNP and IL‐6 on the day of admission in severe critically ill group,critically ill group and non‐critically ill group were higher than those in the period with stable condition (P<0. 05). The concentrations of serum cortisol, Pro‐BNP and IL‐6 on the day of admission in control group, non‐critically ill group, critically ill group and severe critically ill group increased in sequence (P<0. 05). While in stable condition, there were no statistically significant differences among severe critically ill group,critically ill group and non‐critically ill group( P >0. 05). The concentrations of Pro‐BNP and IL‐6 in death group were significantly higher than those in survival group(P<0. 05). While the level of cortisol showed no statistically significant difference between death group and survival group( P>0. 05). PCIS was negatively correlated with serum cortisol,Pro‐BNP and IL‐6 (r＝ －0. 571,－0. 661 and －0. 504,P<0. 05,respectively). Conclusion The levels of serum cortisol,Pro‐BNP and IL‐6 in critically ill children all significantly increase in acute critically ill period,which are all negatively correlated with PCIS. They can be used as the indicators of severity of ill‐ness. Pro‐BNP and IL‐6 also can be used as the indicators of the prognosis of disease.
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Objective To explore the classic MRI appearance of secondary hemochromatosis (SHC)related liver iron overload, and the feasibility of quantitative evaluation of liver iron overload by iterative decomposition of water and fat with echo asymmetry and leastGsquares estimationGiron quantification (IDEALGIQ).Methods 20 patients with SHCGrelated liver iron overload (experimental group)and 20 healthy adults (control group)underwent routine liver MRI and IDEALGIQ.The MRI images were comparatively analyzed to assess the hallmark of liver iron overload.In both two groups,the R2 ? values were measured on R2 ? maps,which were generated by IDEALGIQ,then the differences in age,gender and R2 ? value between two groups were comparatively analyzed.In experimental group,the serum ferritin (SF)was detected,and a correlation analysis was tested with R2 ? value.Results For all of the 20 patients, there was signal drop of liver parenchyma on T1 and T2 Gweighted images,signal loss with susceptibility artifact on DWI images,and signal dropped on inGphase images relative to outGofGphase images.Among the 20 patients,18 cases appeared "a dark liver parenchyma"on T2 G weighted images,and the spleen signal in 3 cases was similar to liver parenchyma’s hallmark.The R2 ? values in experimental group and control group were 395.58±255.75 Hz and 41.18±7.86 Hz (t＝－6.12,P＝0.00),respectively.No significant differences between two groups were found in gender and age (χ2＝0.10,P＝0.10 and t＝0.09,P＝0.93).The liver iron overload R2? value was not correlated with SF (r＝0.1 5 3 , P＝0.15).Conclusion On MRI,the typical appearance of liver iron overload is hypointense on T1 and T2Gweighted images,especially"a dark liver parenchyma"on T2 WI,signal drops on inGphase images relative to outGofGphase images,and signal loss with susceptibility artifact on DWI images.R2 ? value of IDEALGIQ can quantitatively evaluate the liver iron overload,without a correlation with SF.