Death-Related Factors in Patients With Acute Exacerbation of Chronic Obstructive Pulmonary Disease Treated by Sequential Mechanical Ventilation / 中国医学科学院学报

Objective To analyze the death-related factors of elderly patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) treated by sequential mechanical ventilation,so as to provide evidence for clinical practice. Methods The clinical data of 1204 elderly patients (≥60 years old) with AECOPD treated by sequential mechanical ventilation from June 2015 to June 2021 were retrospectively analyzed.The probability and influencing factors of death were analyzed. Results Among the 1204 elderly patients with AECOPD treated by sequential mechanical ventilation,167 (13.87%) died.Multivariate analysis showed that plasma procalcitonin ≥0.5 μg/L (OR=2.762, 95%CI=1.920-3.972, P<0.001),daily invasive ventilation time ≥12 h (OR=2.202, 95%CI=1.487-3.262,P<0.001),multi-drug resistant bacterial infection (OR=1.790,95%CI=1.237-2.591,P=0.002),oxygenation index<39.90 kPa (OR=2.447,95%CI=1.625-3.685,P<0.001),glycosylated hemoglobin >6% (OR=2.288,95%CI=1.509-3.470,P<0.001),and acute physiology and chronic health evaluation Ⅱ score ≥25 points (OR=2.126,95%CI=1.432-3.156,P<0.001) were independent risk factors for death in patients with AECOPD treated by sequential mechanical ventilation.Oral care>twice/d (OR=0.676,95%CI=0.457-1.000,P=0.048) and sputum excretion>twice/d (OR=0.492, 95%CI=0.311-0.776, P=0.002) were independent protective factors for death in elderly patients with AECOPD treated by sequential mechanical ventilation. Conclusions The outcomes of sequential mechanical ventilation in the treatment of elderly patients with AECOPD are affected by a variety of factors.To reduce the mortality,we put forward the following measures:attaching great importance to severe patients,restoring oxygenation function,shortening unnecessary invasive ventilation time,controlling blood glucose,preventing multidrug resistant bacterial infection,oral care twice a day,and sputum excretion twice a day.

Study of nonlinear viscoelastic mechanical properties of degenerated intervertebral discs / Estudio de las propiedades mecánicas viscoelásticas no lineales de discos intervertebrales degenerados

SUMMARY: Biomechanical factors are important factors in inducing intervertebral disc degeneration, in this paper, the nonlinear viscoelastic mechanical properties of degenerated intervertebral discs were analyzed experimentally. Firstly, the loading and unloading curves of intervertebral discs before and after degeneration at different strain rates were compared to analyze the changes of their apparent viscoelastic mechanical properties; The internal stress/strain distribution of the disc before and after degeneration was then tested by combining digital image technology and fiber grating technology. The results show that the intervertebral disc is strain-rate- dependent whether before or after degeneration; The modulus of elasticity and peak stress of the degenerated disc are significantly reduced, with the modulus of elasticity dropping to 50 % of the normal value and the peak stress decreasing by about 55 %; Degeneration will not change the distribution of the overall internal displacement of the intervertebral disc, but has a greater impact on the superficial and middle AF; The stress in the center of the nucleus pulposus decreases, and the stress in the outer AF increases after degeneration. Degeneration has a great impact on the nonlinear viscoelastic mechanical properties of intervertebral disc, which has reference value for the mechanism, treatment and prevention of clinical degenerative diseases.

RESUMEN: Los factores biomecánicos son importantes en la inducción de la degeneración del disco intervertebral. En este estudio se analizaron experimentalmente las propiedades mecánicas viscoelásticas no lineales de los discos intervertebrales degenerados. En primer lugar se compararon las curvas de carga y descarga de los discos intervertebrales, antes y después de la degeneración, a diferentes velocidades de deformación para analizar los cambios aparentes de sus propiedades mecánicas viscoelásticas. La distribución interna de tensión/deformación del disco antes y después de la degeneración se probó luego combinando tecnología de imagen digital y tecnología de rejilla de fibra. Los resultados mostraron que el disco intervertebral depende de la velocidad de deformación antes o después de la degeneración; El módulo de elasticidad y la tensión máxima del disco degenerado se reducen significativamente, cayendo el módulo de elasticidad al 50 % del valor normal y la tensión máxima disminuyendo en aproximadamente un 55 %; La degeneración no cambiará la distribución del desplazamiento interno general del disco intervertebral, pero tiene un mayor impacto en la FA superficial y media; El estrés en el centro del núcleo pulposo disminuye y el estrés en el FA externo aumenta después de la degeneración. La degeneración tiene un gran impacto en las propiedades mecánicas viscoelásticas no lineales del disco intervertebral, que tiene valor de referencia para el mecanismo, tratamiento y prevención de enfermedades clínicas degenerativas.

Effects of pueraria lobata combined with high-intensity intermittent training on skeletal muscle quality and gene expression / Efeitos da pueraria lobata combinados com treino intermitente de alta intensidade na qualidade músculoesquelética e expressão genética / Efecto de pueraria lobata y entrenamiento intermitente de alta intensidad sobre la calidad del músculo esquelético y la expresión génica

ABSTRACT Extraction of effective components from Pueraria lobata has important value for skeletal muscle quality and gene expression. The improvement effect of traditional high-intensity intermittent training on skeletal muscle has not been obvious, and it is difficult to guarantee the properties of some volatiles. Based on this, this paper analyzes the effect of high-intensity intermittent training on skeletal muscle quality and gene expression in Pueraria lobata. Based on a brief summary of extraction of Pueraria lobata, status of research on the pharmaceutical components of Pueraria lobata was summarized. Different specimens of Pueraria lobata were selected as research objects, and the process of high-intensity intermittent training was designed. High-intensity intermittent training, solvent extraction and water solvent extraction were combined together to design the fixed-bed continuous extraction scheme. According to the influence of Pueraria lobata on skeletal muscle quality, the influence of intermittent training on skeletal muscle quality was analyzed. The extraction results showed that Pueraria lobata combined with high-intensity intermittent training can effectively improve the content of skeletal muscle and ensure the effective expression of skeletal muscle gene.

RESUMO A extração de componentes eficazes da Pueraria lobata tem importante valor para a qualidade músculoesquelética e para a expressão genética. O efeito da melhoria do tradicional treinamento intervalado de alta intensidade na estrutura músculoesquelética não tem sido óbvio, e é difícil garantir as propriedades de alguns voláteis. Com base nisso, este estudo analisa o efeito do treinamento intervalado de alta intensidade na qualidade músculoesquelética e na expressão genética na Pueraria lobata. Com base num breve resumo da extração da Pueraria lobata, resumiu-se o andamento das pesquisas sobre os componentes farmacêuticos da Pueraria lobata. Diferentes amostras de Pueraria lobata foram selecionadas como objeto de pesquisa, e formulou-se o processo do treinamento intervalado de alta intensidade. O treinamento intervalado de alta intensidade, a extração de solventes e a extração de solventes à base de água foram combinadas para conceber o sistema de extração contínua de leito fixo. De acordo com a influência da Pueraria lobata na qualidade músculoesquelética, analisou-se a influência do treino intervalado na qualidade músculoesquelética. Os resultados da extração mostraram que a Pueraria lobata, combinada com treino intervalado de alta intensidade, pode melhorar, de maneira eficaz, o teor músculoesquelético e garantir a expressão eficaz da expressão genética do músculoesquelético.

RESUMEN La extracción de componentes eficaces de la Pueraria lobata tiene un importante valor para la calidad músculoesquelética y para la expresión genética. El efecto de la mejora del tradicional entrenamiento intercalado de alta intensidad en la estructura músculoesquelética no ha sido obvio, y es difícil garantizar las propriedades de algunos volátiles. Basándose en eso, este estudio analiza el efecto del entrenamiento intercalado de alta intensidad en la calidad músculoesquelética y en la expresión genética en la Pueraria lobata. Basándose en un breve resumen de la extracción de la Pueraria lobata, se resumió el andamiento de las investigaciones sobre los componentes farmacéuticos de la Pueraria lobata. Diferentes muestras de Pueraria lobata fueron seleccionadas como objeto de investigación, y se formuló el proceso del entrenamiento intercalado de alta intensidad. El entrenamiento intercalado de alta intensidad, la extracción de solventes y la extracción de solventes a base de agua fueron combinadas para concebir el sistema de extracción continua de lecho fijo. De acuerdo con la influencia de la Pueraria lobata en la calidad músculoesquelética, se analizó la influencia del entrenamiento intercalado en la calidad músculoesquelética. Los resultados de la extracción mostraron que la Pueraria lobata, combinada con entrenamiento intercalado de alta intensidad, puede mejorar, de manera eficaz, el tenor músculoesquelético y garantizar la expresión eficaz de la expresión genética del músculoesquelético.

Relationship between Stress Hyperglycemia and Catheter-related Urinary Tract Infection in Stroke Patients / 中国医学科学院学报

Objective To verify the relationship between catheter-related urinary tract infection(CAUTI)and stress hyperglycemia during catheter retention in stroke patients. Methods We used nosocomial infection monitoring system to track the status of CAUTI in stroke patients in a hospital.The study cohort was all the patients who received retention catheterization from January 2016 to March 2020.According to the nested case-control design,multivariate logistic regression analysis was performed to explore the relationship between stress hyperglycemia and CAUTI in stroke patients with indwelling catheter. Results A total of 322 cases of CAUTI and 644 cases of non-CAUTI were enrolled in this study.The length of stay in the case group was(20.68 ± 3.73)d,significantly longer than that[(13.00 ± 4.01)d]in the control group(t=29.473,P <0.001).Compared with non-stress hyperglycemia,stress hyperglycemia posed a higher risk of CAUTI in the stroke patients with indwelling catheter(OR=2.020,95% CI=1.447-2.821,P=0.000)and led to the higher incidence of CAUTI in one thousand days(P<0.001). Conclusion Stress hyperglycemia in the stroke patients with indwelling catheter can significantly increase the risk of CAUTI.

G604S-HERG mutation in LQT2 leads to autophagy via the UPR-related pathway

Congenital long QT syndrome (LQTS) is a heart channel disease associated with fatal ventricular arrhythmiasor cardiac arrest. Human ether-a-go-go-related gene (HERG) mutation is one of the main causes in type 2LQTS since it may lead to abundant immature HERG channel protein accumulate in the endoplasmic reticulum(ER). In our study, we have successfully constructed the G604S-HERG mutation in HEK293 cells anddemonstrated that the immature HERG protein on ER via Western blot and immunofluorescence. Herein wefound that unfolded protein reaction (UPR) process has been activated in order to counter this endoplasmicreticulum stress (ERS) since the main sensors got upregulated. Meanwhile, autophagy was also observed inthis process and verified by Western blot and transmission electron microscopy. To explore the relationshipunderlying autophagy and UPR in the condition of ERS, we found that PERK-EIF2a-CHOP axis was activated. Our findings provides insight for G604S-HERG mutation in type 2 LQTS.

Risk Factors for Postoperative Recurrence of Chronic Suppurative Otitis Media / 中国医学科学院学报

To analyze the risk factors for postoperative recurrence of chronic suppurative otitis media(CSOM) and explore the intervention measures to prevent postoperative recurrence of CSOM. A total of 1066 patients with CSOM who underwent concurrent surgical treatment and achieved clinical cure in our hospital from January 2012 to December 2018 were enrolled.The clinical data and laboratory findings were reviewed by using an electronic medical record system and the patients were followed up for 1 year.The patients were divided into the non-recurrent group and the recurrent group.Chi-square test and multivariate logistic regression were used to compare the factors may contribute to the postoperative recurrence. The recurrence rate of CSOM was 6.38%.Multi-drug-resistant(MDR) infection before surgery(=16.338,=0.000),aged ≥60 years(=5.182,=0.023),frequency of occurrence ≥3 times/year(=4.388,=0.036),duration of active period>7 d(=4.729,=0.030),repeated upper respiratory tract infection>3 times/year(=11.913,=0.001),accompanied by chronic sinusitis(=11.077,=0.001),blood glucose>6.11 mmol/L(=15.327,=0.000),postoperative serum procalcitonin(PCT)>0.5 μg/L(=8.337,=0.004) were the risk factors for postoperative recurrence.The use of snorkel was a protective factor for postoperative recurrence(=5.308,=0.021).Multivariate analysis showed that MDR infection(=3.373,95%:1.825-6.234,=0.000),repeated upper respiratory tract infection>3 times/year(=2.727,95%:1.479-5.030,=0.001),accompanied by chronic sinusitis(=2.980,95%:1.654-5.369,=0.000),blood glucose>6.11 mmol/L(=3.219,95%:1.741-5.953,=0.000),and postoperative serum PCT>0.5 μg/L(=2.085,95%:1.106-3.931,=0.023) were independent risk factors for postoperative recurrence in CSOM patients. Effective prevention and control of MDR infection,control of blood sugar,prevention of upper respiratory tract infection,and lowering the recurrence of chronic sinusitis are the main measures to reduce postoperative recurrence of CSOM.Monitoring of the infection marker PCT can help to achieve early intervention.

Prognostic Factors of Central Venous Catheter-related Bloodstream Infections / 中国医学科学院学报

Objective To explore the prognostic factors of central venous catheter-related bloodstream infection(CR-BSI)and provide reference for clinical practice. Methods The clinical data of 346 CR-BSI patients from February 2014 to July 2019 were retrospectively reviewed,and the prognostic factors were analyzed. Results Of the 346 CR-BSI patients,62 died,yielding a case-fatality rate of 17.92%.Univariate analysis showed that 18 factors including age(

Correlation between Asymptomatic Bacteriuria and Surgical Site Infection in Middle-aged and Elderly Patients Undergoing Open Hysterectomy / 中国医学科学院学报

Objective To explore the correlation between asymptomatic bacteriuria(AB)and surgical site infection(SSI)in middle-aged and elderly women undergoing open hysterectomy.Methods The clinical data of 1469 middle-aged and elderly women undergoing open hysterectomy in the Third Affiliated Hospital of Guizhou Medical University from June 2011 to August 2018 were retrospectively analyzed.Factors associated with SSI after operation were analyzed by univariate and multivariate regression models to identify the relationship of AB with SSI after open hysterectomy.Results Of these 1469 patients,101(6.88%)had SSI and 124 had AB[including 14 patients(11.29%)with infections].In addition,1345 patients had no AB,among whom 87(6.47%)had infections.Thus,the infection rate in patients with AB was significantly higher than that in patients without AB(=4.123,=0.042).Univariate analysis showed AB,history of diabetes mellitus,surgical procedure,length of stay(>15 d),season(summer and autumn),body mass index(≥25 kg/m ),nature of lesions(malignant tumors),ASA grade(>grade Ⅱ),incision length(≥10 cm),and operative time(≥3 h),bleeding volume(≥1000 ml),serum albumin concentration(grade Ⅱ)were risk factors for SSI in these patients(all <0.05). Conclusions AB is one of the risk factors for SSI in middle-aged and elderly women undergoing open hysterectomy.Screening and treatment of AB before surgery can reduce the risk of SSI.ASA grading shall be performed before surgery before corresponding preparation was offered.Effective control of blood glucose,improved surgical skills,and shorter operative time are helpful for lowering postoperative SSI.

Relationship of Peripheral Blood IL-37 Expression with T Lymphocytes Subsets and NK Cells in Patients with Primary Immune Thrombocytopenia / 中国实验血液学杂志

OBJECTIVE@#To study the correlation of IL-37 with T lymphocytes subsets and NK cells in ITP patients, and to explore its possible mechanisms involved in the pathogenesis of ITP.@*METHODS@#Forty-five patients with newly diagnosed ITP(newly diagnosed group), 32 patients of complete remission (remission group) and 22 healthy persons(control group) were selected. The serum level of IL-37 in 3 groups was determined by enzyme linked immunosorbent assay (ELISA). The mRNA expression of IL-37, IL-17 and IL-18 in peripheral blood mononuclear cells（PBMNC） in 3 groups was measured by real-time fluorescence quantitative polymerase chain reaction (PCR). The number of IL-18RαCD4 T cells and Tim-3NK cells in the peripheral blood in 3 groups was detected by flow cytometry (FCM).@*RESULTS@#The serum level of IL-37 in the peripheral blood of ITP patients in the newly diagnosed group was significantly higher than that in the control group and the remission group(P＜0.01) . The expression level of IL-37 in PBMNC of the ITP patients in newly diagnosed group was higher than that in the control group and the remission group(P＜0. 05). The expression level of IL-17 and IL-18 in PBMNC of the ITP patients in newly diagnosed group was higher than that in the control group and the remission group(P＜0. 01); the expression of IL-18Rα in CD4 T cells in newly diagnosed group was significantly higher than that in both the control and the remission group(P＜0.01).The expression of Tim-3 in NK cells in ITP patients was significantly lower than that in the control group (P＜0. 01). In ITP patients, the serum IL-37 level and IL-18RαCD4T cells ratio both negatively correlated with Plt count (r=-0.58, r=-0.48) moreo-ver the serum IL-37 level also negatively correlated with amount of CD4 T cells and NK cells (r=-0.29, r=-0.28), but positively correlated with amount of CD8 T cells (r=0.329).@*CONCLUSION@#The IL-37 and its receptors may play an immunoregulatory role in CD4 T cells and NK cells, the IL-37 may be a therapeutic target for ITP patients.

Clinical Efficacy by Kidney Tonifying and Essence Strengthening Method in Regulating Pulse Wave Velocity to Delay Physiological Vascular Aging / 中国实验方剂学杂志

Objective: To observe the clinical efficacy of kidney tonifying and essence strengthening method in delaying physiological vascular aging. Method: Sixty-two subjects who completed the study were randomly divided into experimental group (31 cases) and control group (31 cases) with the matching research method. The experimental group was treated with kidney tonifying and essence strengthening recipe orally for 24 weeks, while the control group was not interfered with traditional Chinese medicine (TCM). Score of TCM syndrome in kidney deficiency syndrome, pulse wave velocity, intima-media thickness, plasma homocysteine level and serum superoxide dismutase level were evaluated before and after treatment. Result: Compared with before treatment period, the score of TCM syndrome in kidney deficiency syndrome, pulse wave velocity and plasma homocystenine level decreased, while the serum superoxide dismutase level increased in the experimental group after treatment (PPPPPConclusion: The kidney tonifying and essence strengthening method may delay the aging of physiological blood vessels caused by aging.

Clinical efficacy of two different tricuspid annuloplasty techniques in left cardiac valve surgery

Objective: To investigate the mid-and long-term clinical effects of tricuspid valvuloplasty with the implantation of an artificial plastic ring. Methods: Data of 677 patients who had functional tricuspid regurgitation and left cardiac valve disease and underwent tricuspid valvuloplasty and left cardiac valve surgery were retrospectively. Among these patients, 353 underwent simple suture annuloplasty (group A) while the rest 324 patients underwent artificial plastic ring annuloplasty (group B). The two-year and more-than-two-year clinical and ultrasonocardiograph (UCG) follow-up data of the two groups were obtained and compared. Results: A total of 600 patients (88.6%) completed the long-term follow-up (more than two years). The two-year follow-up showed no significant difference in the incidence of mild tricuspid regurgitation between the two groups (82.2% vs. 92.7%, P=0.37). However, there were significantly more cases that developed into moderate to severe tricuspid regurgitation in group A than in group B (17.8% vs. 7.3%, P=0.031). The long-term follow-up revealed that the recurrence rate of tricuspid regurgitation in group B was significantly lower than that in group A (11.0% vs. 25.0%, P=0.029), and the ratio of cases developing into moderate to severe tricuspid regurgitation in group A was significantly higher than that in group B (28.9% vs. 9.9%, P=0.007). The comparison between the two intra-group time segments showed that the development of tricuspid regurgitation in group A was significantly increased (28.9% vs. 17.8%, P=0.022), but in group B it was relatively stable (9.9% vs. 7.3%, P=0.52). Conclusions: Artificial ring annuloplasty is associated with significantly less tricuspid regurgitation than simple suture annuloplasty.

Clinical efficacy of two different tricuspid annuloplasty techniques in left cardiac valve surgery

Objective:To investigate the mid-and long-term clinical effects of tricuspid valvuloplasty with the implantation of an artificial plastic ring.Methods:Data of 677 patients who had functional tricuspid regurgitation and left cardiac valve disease and underwent tricuspid valvuloplasty and left cardiac valve surgery were retrospectively. Among these patients, 353 underwent simple suture annuloplasty (group A) while the rest 324 patients underwent artificial plastic ring annuloplasty (group B). The two-year and more-than-two-year clinical and ultrasonocardiograph (UCG) follow-up data of the two groups were obtained and compared.Results:A total of 600 patients (88.6%) completed the long-term follow-up (more than two years). The two-year follow-up showed no significant difference in the incidence of mild tricuspid regurgitation between the two groups (82.2% vs. 92.7%, P=0.37). However, there were significantly more cases that developed into moderate to severe tricuspid regurgitation in group A than in group B (17.8% vs. 7.3%, P=0.031). The long-term follow-up revealed that the recurrence rate of tricuspid regurgitation in group B was significantly lower than that in group A (11.0% vs. 25.0%, P=0.029), and the ratio of cases developing into moderate to severe tricuspid regurgitation in group A was significantly higher than that in group B (28.9% vs. 9.9%, P=0.007). The comparison between the two intra-group time segments showed that the development of tricuspid regurgitation in group A was significantly increased (28.9% vs. 17.8%, P=0.022), but in group B it was relatively stable (9.9% vs. 7.3%, P=0.52).Conclusions:Artificial ring annuloplasty is associated with significantly less tricuspid regurgitation than simple suture annuloplasty.

Quality Measurement and Improvement Study of Surgical Coronary Revascularization: Medication Adherence (MISSION-2) / 中华医学杂志(英文版)

Background@#Secondary preventive therapies play a key role in the prevention of adverse outcomes after coronary artery bypass grafting (CABG). However, medication adherence after CABG is often poor, and conventional interventions for improving adherence have limited success. With increasing penetration of smartphones, health-related smartphone applications might provide an opportunity to improve adherence. Carefully designed trials are needed to provide reliable evidence for the use of these applications in patients after CABG.@*Methods@#The Measurement and Improvement Studies of Surgical Coronary Revascularization: Medication Adherence (MISSION-2) study is a multicenter randomized controlled trial, aiming to randomize 1000 CABG patients to the intervention or control groups in a 1:1 ratio. We developed the multifaceted, patient-centered, smartphone-based Heart Health Application to encourage medication adherence in the intervention group through a health self-management program initiated during hospital admission for CABG. The application integrated daily scheduled reminders to take the discharge medications, cardiac educational materials, a dynamic dashboard to review cardiovascular risk factors and secondary prevention targets, and weekly questionnaires with interactive feedback. The primary outcome was secondary preventive medication adherence measured by the Chinese version of the 8-item Morisky Medication Adherence Scale at 6 months after randomization. Secondary outcomes included all-cause death, cardiovascular rehospitalization, and a composite of death, myocardial infarction, stroke, and repeat revascularization.@*Discussion@#Findings will not only provide evidence regarding the feasibility and effectiveness of the described intervention for improving adherence to CABG secondary preventive therapies but also explore a model for outpatient health self-management that could be translated to various chronic diseases and widely disseminated across resource-limited settings.@*Trial Registration@#https://clinicaltrials.gov (NCT02432469).

Logistic Regression Analysis of the Risk Factors for Multidrug-resistant Bacterial Infections in Chronic Rhinosinusitis / 中国医学科学院学报

Objective To analyze the risk factors of multidrug-resistant bacterial infections in patients with chronic rhinosinusitis.Methods The clinical data of 221 patients with chronic rhinosinusitis who were treated in our center from January 2010 to January 2017 were collected retrospectively. Specimens were collected for bacterial culture and antibiotic susceptibility testing. The risk factors for multidrug-resistant bacterial infections were analyzed.Results Univariate analysis showed that combined use of 3 or more antibiotics,high visual analogue scale score,high Lund-Kennedy score,long disease course(>5 years),high frequency of acute infections(more than 3 times a year),long duration of acute infection(>7 days),recurrent upper respiratory tract infections(>3 times per year),chronic otitis media,smoking history,allergic rhinitis,poor drainage,high frequency of antimicrobial use(≥3 times/year),use of multiple antibiotics(more than 3 types),aged over 60 years,and use of antibacterial drugs for over 7 days were the risk factors for production of multi-drug-resistant organism(MDRO) in patients with chronic sinusitis(all P3 times per year),smoking history,allergic rhinitis,poor drainage,and high frequency of antimicrobial use(≥3 times/year) remained the risk factors for MDRO in patients with chronic sinusitis(all P<0.05).Conclusions Multidrug-resistant bacterial infections in patients with chronic sinusitis can be caused by a variety of factors. In the clinical practice,by focusing on the major risk factors,a comprehensive management strategy should be adopted to reduce the production of MDRO and improve the therapeutic outcomes.

Logistic regression analysis on postoperative pulmonary infection in hospitalized patients undergoing spinal surgery / 中国感染控制杂志

Objective To understand the risk factors for postoperative pulmonary infection in patients undergoing spinal surgery,and put forward the intervention measures.Methods Patients who underwent spinal surgery in a hospital from May 2008 to June 2016 were analyzed retrospectively,they were divided into non-pulmonary infection group and pulmonary infection group according to whether they had postoperative pulmonary infection,clinical data of two groups were compared.Results A total of 612 patients who underwent spinal surgery were monitored,43 had postoperative pulmonary infection,incidence of postoperative pulmonary infection was 7.03％.Univariate analysis showed that 14 risk factors for pulmonary infection in patients after spinal surgery were as follows:length of hospital stay≥30 days,long-term smoking,chronic pulmonary disease,diabetes,number of surgical level≥2,general anesthesia,duration of operation≥4 hours,bleeding≥500mL,time of bed rest≥7 days,use of glucocorticoid,indwelling urinary catheter,mechanical ventilation,serum albumin＜30 g/L,blood glucose≥1 1mmol/L,and hemoglobin＜90 g/L(P＜0.05);while atomization inhalation was a protective factor(P＜0.05).Multivariate logistic regression analysis showed that 6 independent risk factors for pulmonary infection in patients after spinal surgery were as follows:length of hospital stay≥30 days,long-term smoking,chronic pulmonary disease,general anesthesia,time of bed rest≥7 days,and use of glucocorticoid(all P＜0.05),while atomization inhalation was a independent protective factor(P＜0.05).Conclusion Patients with pulmonary infection after spinal surgery is related to multiple factors,comprehensive and effective preventive measures should be taken according to the risk factors of postoperative pulmonary infection,so as to reduce the incidence of postoperative pulmonary infection in spinal surgery patients.

A Cross-sectional Survey Assessing Carriage of Streptococcus pneumoniae in a Healthy Population in Xinjiang Uygur Autonomous Region of China / 生物医学与环境科学（英文）

The carriage rate and serotype distribution of Streptococcus pneumoniae (S. pneumoniae) in a healthy population in China remains unclear. In this study, we collected the oropharyngeal swabs from 513 individuals in Xinjiang, China. Real-time PCR targeting the lytA gene and 12 serotypes were assessed to identify S. pneumoniae carriage. The total carriage rate of S. pneumoniae was 70.4% (361/513). The most prevalent serotypes were 19B/F, 18B/C, 5, and 6A/B. The highest carriage rate of S. pneumoniae was noted in children aged 6-10 years (88.6%), which merits further attention. The co-colonization rate of two or more S. pneumoniae serotypes was 79.8% (264/331). This study aimed to investigate the baseline pneumococcal carriage rate among healthy individuals in China to improve our understanding of the epidemiology of S. pneumoniae.

Number and Function of Myeloid-Derived Suppressor Cells in Patients with Adult Primary Immune Thrombocytopenia / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To analyze the number of myeloid-derived suppressor cells(MDSC) and the level of prostaglandin E2(PGE2) in the bone marrow of adult ITP patients, and to explore their possible mechanisms involved in the pathogenesis of this disease.</p><p><b>METHODS</b>Twenty-five patients of newly diagnosed ITP, 25 patients of complete remission group and 15 patients of control group were selected. The number of MDSC in the bone marrow between 3 groups was detect by flow cytometry (FCM). The serum level of prostaglandin E2 (PGE2) in 3 groups was determined by enzyme linked immunosorbent assay (ELISA). The relative expression of IFN-γ mRNA in bone marrow mononuclear cells was measured by real time fluorescence quantitative polymerase chain reaction (RT-qPCR) in each groups.</p><p><b>RESULTS</b>The number of MDSC in the complete remission group was significantly higher than that in the control group (P<0.05); the number of MDSC in the newly diagnosed group was higher than that in the control group; the number of MDSC in the complete remission group was higher than that in the newly diagnosed group. The serum level of PGE2 in bone marrow of ITP patients in the newly diagnosed group was higher than that of the control group（P<0.05）. The serum level of PGE2 in the bone marrow of ITP patients of the complete remission group was higher than that of the control group (P<0.05）. The level of PGE2 in bone marrow serum of ITP patients of the newly diagnosed group was lower than that in the complete remission group(P<0.05）. The relative expression level of IFN-gamma in bone marrow mononuclear cells of the ITP patients in newly diagnosed group was higher than that in the control group and the complete remission group（P<0.001）. The relative quantification (RQ) of IFN-γ in bone marrow mononuclear cells was 2.60 between the newly diagnosed group and the complete remission group.</p><p><b>CONCLUSION</b>When adult ITP disease is remitted, the number of MDSC rises and correlates with the therapeutic response and PGE2 level in the bone marrow.</p>

Epidemiological characteristics and antimicrobial resistance of 91 strains of Pseudomonas putida / 中国感染控制杂志

Objective To analyze the epidemiological characteristics and antimicrobial resistance of clinically isolated Pseudomonas putida (P.putida),and provide basis for rational prevention and treatment of P.putida infection.Methods P.putida isolated between January 2010 and December 2015,as well as clinical data of patients infected with P.putida were collected,antimicrobial susceptibility of isolates was determined by Kirby-Bauer disk diffusion susceptibility testing of Clinical and Laboratory Standards Institute (CLSI) of America,susceptibility testing results of isolated strains were analyzed by WHONET 5.5 software.Results A total of 91 strains of P.putida were isolated from clinical specimens,most were from elderly patients aged ＞60 years(70.33％);the major underlying disease was community-acquired pneumonia (23.08％),followed by chronic pulmonary heart disease (15.38％);the main specimen was sputum(57.14％),followed by urine(27.47％);P.putida mainly distributed in department of respiratory medicine (28.57 ％),followed by department of cardiovascular medicine (13.19 ％).P.putida had high resistance rate to aztreonam (52.75 ％),while resistance rates to gentamicin,imipenem,levofloxacin,ceftazidime,meropenem,and ciprofloxacin were 7.78％,9.89％,2.20％,9.89％,7.69％,and 2.22％ respectively,resistance rates to amikacin and polymyxin were both 0.Conclusion P.putida infection mainly occurs in elderly patients with underlying diseases,mainly respiratory tract infection,resistance rates to most antimicrobial agents were ＜ 10 ％.

A new biflavone from Dysosma versipellis / 药学学报

This study was conducted to investigate the chemical constituents in the root of Dysosma versipellis (Hance) M. Cheng. The constituents were isolated by silica gel, lichroprep RP-C18 and pharmadex LH-20 column chromatography and the IR, MS, NMR, 2D-NMR spectroscopic analysis were employed for the structural elucidation. Ten compounds were isolated from the 95% ethanol extract of Dysosma versipellis, their structures were elucidated as dysoverine D (1), dysoverine F (2), dysoverine A (3), podoverine A (4), α-peltatin (5), rutin (6), kaempferol-3-O-β-D-glucopyranoside (7), quercetin-3-O-β-D-glucopyranoside (8), kaempferol (9) and quercetin (10). Compound 2 is a new compound, and compounds 1 and 3-6 were isolated from this plant fo r the first time.

Glycosides constituents of whole plant of Swertia binchuanensis / 中国药学杂志

OBJECTIVE: To study the chemical constituents of Swertia binchuanensis. METHODS: The constituents were isolated and purified by column chromatography of silica gel. Their structures were identified on the basis of spectral analysis and chemical properties. RESULTS: Five compounds are isolated and identified as 7-O-[α-L-rhamnopyranosyl-(1→2)-β-D-xylopyranosyl]-1, 8-dihydroxy-3-methoxyxanthone(1), 3-O-β-D-glucopyranosyl-1,8-dihydroxyl-5-methoxyxanthone(2), 7-O-β-D-glucopyranosyl-1,8-di-hydroxyl-3-methoxyxanthone(3), amarogentin(4), and amaroswerin(5). CONCLUSION: All of the compounds were isolated from S. binchuanensis for the first time.