Clinical Outcome and Risk Factors of Treatment Failure of Peritoneal Dialysis Associated Peritonitis Caused by Klebsiella Pneumoniae:A Multicenter Study / 中国医学科学院学报

Objective To investigate the treatment outcomes,prognosis,and risk factors of treatment failure of peritoneal dialysis associated peritonitis (PDAP) caused by Klebsiella pneumoniae,and thus provide clinical evidence for the prevention and treatment of this disease. Methods The clinical data of PDAP patients at four peritoneal dialysis centers from January 1,2014 to December 31,2019 were collected retrospectively.The treatment outcomes and prognosis were compared between the patients with PDAP caused by Klebsiella.pneumoniae and that caused by Escherichia coli.Kaplan-Meier method was employed to establish the survival curve of technical failure,and multivariate Logistic regression to analyze the risk factors of the treatment failure of PADP caused by Klebsiella pneumoniae. Results In the 4 peritoneal dialysis centers,1034 cases of PDAP occurred in 586 patients from 2014 to 2019,including 21 cases caused by Klebsiella pneumoniae and 98 cases caused by Escherichia coli.The incidence of Klebsiella pneumoniae caused PDAP was 0.0048 times per patient per year on average,ranging from 0.0024 to 0.0124 times per patient per year during 2014-2019.According to the Kaplan-Meier survival curve,the technical failure rate of Klebsiella pneumoniae caused PDAP was higher than that of Escherichia coli caused PDAP (P=0.022).The multivariate Logistic regression model showed that long-term dialysis was an independent risk factor for the treatment failure of Klebsiella pneumoniae caused PDAP (OR=1.082,95%CI=1.011-1.158,P=0.023).Klebsiella pneumoniae was highly sensitive to amikacin,meropenem,imipenem,piperacillin,and cefotetan,and it was highly resistant to ampicillin (81.82%),cefazolin (53.33%),tetracycline (50.00%),cefotaxime (43.75%),and chloramphenicol (42.86%). Conclusion The PDAP caused by Klebsiella pneumoniae had worse prognosis than that caused by Escherichia coli,and long-term dialysis was an independent risk factor for the treatment failure of Klebsiella pneumoniae caused PDAP.

Fancd2os Reduces Testosterone Production by Inhibiting Steroidogenic Enzymes and Promoting Cellular Apoptosis in Murine Testicular Leydig Cells

Background@#It is well-established that serum testosterone in men decreases with age, yet the underlying mechanism of this change remains elusive. @*Methods@#The expression patterns of Fancd2 opposite-strand (Fancd2os) in BALB/c male mice and testicular tissue derived cell lines (GC-1, GC-2, TM3, and TM4) were assessed using real-time polymerase chain reaction (RT-PCR), Western blot and immunofluorescence. The Fancd2os-overexpressing or knockdown TM3 cells were constructed by infecting them with lentivirus particles and were used to evaluated the function of Fancd2os. The testosterone production was measured using enzyme linked immunosorbent assay (ELISA) and the steroidogenic enzymes such as steroidogenic acute regulatory protein (StAR), P450 cholesterol side-chain cleavage (P450scc), and 3β-hydroxysteroid dehydrogenase (3β-HSD) were analysed using RT-PCR. The apoptosis of TM3 cells induced by ultraviolet light or testicular tissues was detected using flow cytometry, Western blot or dUTP-biotin nick end labeling (TUNEL) assays. Pearson correlation analysis was used to assess the correlation between the Fancd2os expression and TUNEL-positive staining in mouse testicular Leydig cells. @*Results@#The Fancd2os protein was predominantly expressed in mouse testicular Leydig cells and its expression increased with age. Fancd2os overexpression inhibited testosterone levels in TM3 Leydig cells, whereas knockdown of Fancd2os elevated testosterone production. Fancd2os overexpression downregulated the levels of StAR, P450scc and 3β-HSD, while Fancd2os knockdown reversed this effect. Fancd2os overexpression promoted ultraviolet light-induced apoptosis of TM3 cells. In contrast, Fancd2os knockdown restrained apoptosis in TM3 cells. In vivo assays revealed that higher Fancd2os levels and mouse age were associated with increased apoptosis in Leydig cells and decreased serum testosterone levels. Pearson correlation analysis exhibited a strong positive correlation between the expression of Fancd2os and TUNEL-positive staining in mouse testicular Leydig cells. @*Conclusion@#Our findings suggest that Fancd2os regulates testosterone synthesis via both steroidogenic enzymes and the apoptotic pathway.

Development and validation of a prediction model for treatment failure in peritoneal dialysis-associated peritonitis patients: a multicenter study / 南方医科大学学报

OBJECTIVE@#To develop and validate a risk prediction model of treatment failure in patients with peritoneal dialysis-associated peritonitis (PDAP).@*METHODS@#We retrospectively analyzed the data of patients undergoing peritoneal dialysis (PD) in 3 dialysis centers in Jilin Province who developed PDAP between January 1, 2013 and December 31, 2019. The data collected from the Second Hospital of Jilin University and Second Division of First Hospital of Jilin University) were used as the training dataset and those from Jilin Central Hospital as the validation dataset. We developed a nomogram for predicting treatment failure using a logistic regression model with backward elimination. The performance of the nomogram was assessed by analyzing the C-statistic and the calibration plots. We also plotted decision curves to evaluate the clinical efficacy of the nomogram.@*RESULTS@#A total of 977 episodes of PDAP were included in the analysis (625 episodes in the training dataset and 352 episodes in the validation dataset). During follow-up, 78 treatment failures occurred in the training dataset and 35 in the validation dataset. A multivariable logistic regression prediction model was established, and the predictors in the final nomogram model included serum albumin, peritoneal dialysate white cell count on day 5, PD duration, and type of causative organisms. The nomogram showed a good performance in predicting treatment failure, with a C-statistic of 0.827 (95% CI: 0.784-0.871) in the training dataset and of 0.825 (95% CI: 0.743-0.908) in the validation dataset. The nomogram also performed well in calibration in both the training and validation datasets.@*CONCLUSION@#The established nomogram has a good accuracy in estimating the risk of treatment failure in PDAP patients.

Clinical Efficacy on Yishen Tongluofang for Treatment of Male Infertility with Deficiency and Stasis of Kidney / 中国实验方剂学杂志

Objective:To observe the clinical efficacy of Yishen Tongluofang in treating oligosperm type male infertility with kidney deficiency and blood stasis syndrome and explore its effect on serum sex hormones and seminal plasma microenviro. Method:One hundred and four patients were randomly divided into observation group and control group with 52 cases each. Patients in control group took compound Xuanju capsules orally， 3 capsules/time， 3 times/day. Patients in observation group took Yishen Tongluofang， 1 dose/day. Treatment courses continued three months and followed up for three months in both groups. The pregnancy situations of spouses within six months were recorded. Examination of semen parameters before and after treatment and score of kidney deficiency and blood stasis syndrome were conducted. The levels of seminal plasma zinc， fructose， elastase， acid phosphatase and <italic>α</italic>-glucosidase， serum follicle stimulating hormone （FSH）， luteinizing hormone （LH）， prolactin （PRT） and testosterone （T） were detected before and after treatment. Result:During the observation period of six months， the pregnancy rate of spouses in the observation group was 22.00%， higher than 10.00% in the control group， but the difference was not statistically significant （<italic>χ</italic>²=2.678，<italic>P</italic>>0.05）. The clinical efficacy in the observation group was better than that of the control group （<italic>Z</italic>=2.326，<italic>P</italic><0.01）. Sperm concentration， sperm motility， sperm motility， normal morphological sperm and linear movement speed of the observation group were all superior to those of the control group<italic> </italic>（<italic>P</italic><0.01）. The levels of zinc and fructose in seminal plasma of the observation group were higher than those of the control group （<italic>P</italic><0.01）， and the score of kidney deficiency and blood stasis syndrome was lower than that of the control group （<italic>P</italic><0.01）. Serum FSH， LH and PRT levels in the observation group were lower than those in the control group （<italic>P</italic><0.01）， and the T level was higher than that in the control group （<italic>P</italic><0.01）. The seminal plasma elastase of the observation group was lower than that of the control group， while the levels of acid phosphatase and <italic>α</italic>-glucosidase were higher than those of the control group （<italic>P</italic><0.01）. Conclusion:Yishen Tongluofang can significantly improve sperm parameters， regulate the level of sex hormones and seminal plasma environment in patients with oligosperm type male infertility， and improve the tendency of spouse pregnancy. Its clinical efficacy is better，so it is worthy of further research and application.

Effect of gap junction blockers on hippocampal ripple energy expression in rats with status epilepticus / 中国当代儿科杂志

OBJECTIVES@#To study the effect of gap junction blockers, quinine (QUIN) and carbenoxolone (CBX), on hippocampal ripple energy expression in rats with status epilepticus (SE).@*METHODS@#A total of 24 rats were randomly divided into four groups: model, QUIN, valproic acid (VPA), and CBX (@*RESULTS@#Ripple expression was observed in the hippocampal CA1, CA3, and dentate gyrus regions of normal rats. After 10 minutes of PILO injection, all groups had a gradual increase in mean ripple energy expression compared with 1 day before modeling, with the highest expression level before chloral hydrate injection in the model, VPA and CBX groups (@*CONCLUSIONS@#The change in ripple energy can be used as a quantitative indicator for early warning of seizures, while it cannot predict seizures in the interictal period. Gap junction blockers can reduce ripple energy during seizures.

Research Progress on Role and Mechanism of Elabela in Organ Fibrosis / 中国医学科学院学报

Elabela is a newly discovered peptide in recent years.It is the endogenous ligand of Apelin receptor(APJ)and plays an important role in embryonic development and adult organs.Elabela-APJ axis is closely related to organ fibrosis.Elabela can protect the functions of heart and kidney by antagonizing renin-angiotensin system and regulating blood pressure.In addition,it can prevent kidney and heart fibrosis by down-regulating the expression of fibrosis and inflammatory factors.However,there is a positive correlation between the level of Elabela and the degree of liver fibrosis,suggesting that Elabela may play a role in promoting liver fibrosis.This review aims to explore the role of Elabela-APJ axis in renal fibrosis,cardiac fibrosis,and liver fibrosis,and to provide a new therapeutic target for organ fibrosis.

Analysis of research status and hotspots of snail intestinal flora based on bibliometrics / 中国血吸虫病防治杂志

Objective To understand the current research focus and trends in the field of snail intestinal flora. Methods The literature focusing on snail intestinal flora and published from 1998 to 2017 were retrieved from the core database of Web of Science. The quantitative analysis of literature was then conducted by using CiteSpace software based on the bibliometricsmethod.The research trends were then summarized systematically, and the potential research fronts and focuses were explored. Results Totally 139 articles were identified in the field of snail intestinal flora. The top three countries with highest publications included the United States of American, Brazil, and South Korea; while the top three institutions were Kyung Hee University, Osvaldo Cruz Foundation, and Oxford University. Five terms were identified as the key words in this field, including diversity, cellulose, Achatina fulica, lignocelluloses, and species nova. Meanwhile, 5 critical papers with the citation frequency over 15 were recognized, and 5 study clusters were formed including the application, diversity, and function of intestinal flora, difference of snail source and flora, and newly discovered bacteria in the snail intestine. Conclusion The current research focuses on intestinal flora of snails include the diversity, function and application of intestinal flora.

Analysis of research status and hotspots of snail intestinal flora based on bibliometrics / 中国血吸虫病防治杂志

Objective To understand the current research focus and trends in the field of snail intestinal flora. Methods The literature focusing on snail intestinal flora and published from 1998 to 2017 were retrieved from the core database of Web of Science. The quantitative analysis of literature was then conducted by using CiteSpace software based on the bibliometricsmethod.The research trends were then summarized systematically, and the potential research fronts and focuses were explored. Results Totally 139 articles were identified in the field of snail intestinal flora. The top three countries with highest publications included the United States of American, Brazil, and South Korea; while the top three institutions were Kyung Hee University, Osvaldo Cruz Foundation, and Oxford University. Five terms were identified as the key words in this field, including diversity, cellulose, Achatina fulica, lignocelluloses, and species nova. Meanwhile, 5 critical papers with the citation frequency over 15 were recognized, and 5 study clusters were formed including the application, diversity, and function of intestinal flora, difference of snail source and flora, and newly discovered bacteria in the snail intestine. Conclusion The current research focuses on intestinal flora of snails include the diversity, function and application of intestinal flora.

Study on effect of oligochitosan in promoting intestinal absorption of protoberberine alkaloids in extracts from Corydalis saxicola total alkaloids / 中国中药杂志

<p><b>OBJECTIVE</b>To investigate the effect of oligochitosan in promoting intestinal absorption of protoberberine alkaloids in extracts from Corydalis saxicola total alkaloids.</p><p><b>METHOD</b>The in vitro single-pass intestinal perfusion model in rats was established to study the changes in absorption kinetic parameters of dehydrocavidine, berberine hydrochloride and palmatine chloride in C. saxicola total alkaloids after the addition of different concentrations oligochitosan and evaluate the effect of oligochitosan in promoting intestinal absorption of the drugs.</p><p><b>RESULT</b>The concentration of oligochitosan had different effects on the absorption rate constant (Ka) and apparent permeability coefficient (Peff) of the three active component in rat intestines. Ka and Peff in 0.5% oligochitosan group significantly increased, indicating a stronger effect in promoting the absorption.</p><p><b>CONCLUSION</b>Oligochitosan has a certain effect in promoting the intestinal absorptions of protoberberine alkaloids in C. saxicola total alkaloids.</p>

Progress in research of chitosan derivatives in bioadhesive drug delivery system / 中国药学杂志

OBJECTIVE: To review the applications and progress in research of chitosan derivatives in bioadhesive drug delivery system.

Application of titrated target-controlled infusion anesthesia in laparoscopic colorectal surgery / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the effect of titrated target-controlled infusion with propofol and remifentanil on anesthetics consumption and anesthesia depth in patients undergoing elective laparoscopic colorectal surgery.</p><p><b>METHODS</b>Sixty ASA I-III patients for elective laparoscopic colorectal surgery were enrolled. Titrated target-controlled infusion (TCI) with propofol and remifentanil was performed. Plasma concentration of the drugs was administered by titrated method to maintain bispectral index (BIS) in the range of 40-60 with systolic blood pressure (SBP) fluctuation within 20% of the basic value. BIS, SBP, plasma concentration of propofol and remifentanil were recorded at different time points. Awareness during operation was inquired postoperatively.</p><p><b>RESULTS</b>During the entire anesthesia period, the blood pressure was stable and BIS was maintained less than 60. There was no awareness during operation. The plasma concentrations (95% confidence interval) for TCI of propofol and remifentanil were 2.55-2.65 mg/L and 4.09-4.26 μg/L respectively when existing surgical stimulation during anesthesia, and the plasma target concentration of propofol was lower than the recommended dosages.</p><p><b>CONCLUSION</b>Titrated target-controlled infusions with propofol and remifentanil for elective laparoscopic colorectal surgery can maintain proper anesthesia depth and reduce the drug consumption.</p>