Clinical efficacy and safety of venetoclax combined with multidrug chemotherapy in the treatment of 15 patients with relapsed or refractory early T-cell precursor acute lymphoblastic leukemia / 中华血液学杂志

Objective: To explore the efficacy and safety of Venetoclax combined with multidrug chemotherapy in patients with relapsed or refractory early T-cell precursor acute lymphoblastic leukemia (R/R ETP-ALL) . Methods: This study retrospectively analyzed 15 patients with R/R ETP-ALL who received Venetoclax combined with multidrug chemotherapy from December 2018 to February 2022. Among them, eight cases were combined with demethylated drugs, four cases were combined with demethylated drugs and HAAG chemotherapy regimen, two cases were combined with demethylated drugs and CAG regimen, and one case was combined with Cladribine. Specific usage and dosage of Venetoclax: 100 mg on day 1, 200 mg on day 2, 400 mg on day 3-28, orally; when combined with azole antifungal drugs, dosage was reduced to 100 mg/d. Results: Fifteen patients (10 males and 5 females) with R/R ETP-ALL were treated with Venetoclax and multidrug chemotherapy with a median age of 35 (12-42) years old. Of 4 refractory and 11 relapsed patients, the efficacy was evaluated on the 21th day following combined chemotherapy: the overall response rate, the complete response (CR) rate, and the CR with incomplete hematological recovery (CRi) rate were 67.7% (10/15), 60.0% (9/15), and 6.7% (1/15), respectively. For the overall study population, the 12-month overall survival (OS) rate was 60.0%, and the median OS was 17.7 months. The disease-free survival (DFS) rate of all CR patients at 12 months was 60.0%, and the median DFS did not reach. About 14 patients had Ⅲ-Ⅳ hematological toxicity, but these adverse reactions were all controllable. No adverse reaction in the nervous system and tumor lysis syndrome occurred in this study, and no adverse reaction of organs above grade Ⅲ occurred. Conclusion: Venetoclax combined with multidrug chemotherapy may be a safe and promising treatment option for patients with R/R ETP-ALL.

Serum miR-149-5p and matrix metalloproteinase-9 predict hemorrhagic transformation after intravenous thrombolysis in patients with acute ischemic stroke / 国际脑血管病杂志

Objective:To investigate the correlation and predictive value of serum miR-149-5p and matrix metalloproteinase-9 (MMP-9) and hemorrhagic transformation (HT) after intravenous thrombolysis in patients with acute ischemic stroke (AIS).Methods:Patients with AIS received intravenous thrombolytic therapy in Shangqiu First People's Hospital from September 2019 to February 2022 were enrolled prospectively. They were divided into HT group and non-HT group according to whether HT occurred after intravenous thrombolysis. Serum miR-149-5p and MMP-9 were measured by real-time fluorescence quantitative polymerase chain reaction and enzyme-linked immunosorbent assay respectively. Multivariate logistic regression analysis was used to determine the independent risk factors for HT after thrombolysis. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of serum miR-149-5p, MMP-9 and their combination for HT after intravenous thrombolysis. Results:A total of 358 patients with AIS received intravenous thrombolytic therapy were enrolled, 71 of them (19.83%) developed HT. The serum MMP-9 in the HT group was significantly higher than that in the non-HT group (273.95±35.23 μg/L vs. 202.71±30.52 μg/L; t=17.062, P<0.001), while the serum miR-149-5p was significantly lower than that in the non-HT group (0.26±0.06 vs. 1.03±0.15; t=42.387, P<0.001). Multivariate logistic regression analysis showed that atrial fibrillation (odds ratio [ OR] 2.282, 95% confidence interval [ CI] 1.731-3.008; P<0.001), time from onset to intravenous thrombolysis ( OR 2.334, 95% CI 1.458-3.735; P<0.001), miR-149-5p ( OR 1.758, 95% CI 1.142-2.705; P=0.010) and MMP-9 ( OR 1.535, 95% CI 1.106-2.129; P=0.010) were the independent risk factors for HT after intravenous thrombolysis. Serum miR-149-5p (area under the curve 0.856, 95% CI 0.803-0.909; when the optimal cut-off value was 0.741, the sensitivity was 80.3% and the specificity was 89.9%), MMP-9 (area under the curve 0.875, 95% CI 0.821-0.929; when the optimal cut-off value was 240.051 μg/L, the sensitivity was 83.1% and the specificity was 90.2%) and their combination (area under the curve 0.897, 95% CI 0.854-0.941; sensitivity 84.5% and specificity 90.6%) had better predictive value for HT after thrombolysis, and there were no significant differences in the predictive value among the three. Conclusions:After intravenous thrombolysis, the serum miR-149-5p is lower and MMP-9 is higher at admission in patients with HT in patients with AIS. Both of them and their combination have better predictive value for HT after intravenous thrombolysis.

Translation and reliability and validity of the development of a delirium knowledge test for intensive care nurses / 中国实用护理杂志

Objective:This study aimed to translate the development of a delirium knowledge test for intensive care nurses (DKT-ICN) and test its reliability and validity.Methods:The DKT-ICN was translated and adapted according to Chinese culture following the translation, back translation and culture adaptation of DKT-ICN using Brislin′s translation model. The Chinese version of DKT-ICN was tested among 316 nurses conveniently sampled in the First Affiliated Hospital of Zhengzhou University from September to December 2021, the reliability and validity of the scale were evaluated by cross-sectional survey method.Results:The scale-content validity index was 0.98, and the item-content validity index ranged from 0.83 to 1.00, the Cronbach′s α for the total scale was 0.884, and the Cronbach′s α for five dimensions ranged from 0.608 to 0.679. The test-retest reliability was 0.753 for the overall scale, and 0.880-0.978 for each domain.Conclusion:The Chinese version of DKT-ICN has acceptable reliability and validity. The DKT-ICN is a valid and reliable instrument for evaluating the knowledge level of ICU nurses in China.

Practical Application Strategies of Cre-LoxP Conditional Gene Knockout / 中国生物化学与分子生物学报

Cre-loxP is an efficient recombination system originated from P1 phage. Its specific recombination patterns based on the locus of X-over P1 make it one of the most commonly used tools for gene editing in recent years. This paper focuses on the practical application of Cre-loxP system. Firstly, the functions and advantages of CRISPR/Cas9 system in Cre sequence insertion and loxP sequence insertion are analyzed. Then, a series of practical application problems of Cre-loxP system are described. For example, in this paper, the selection of Cre recombinase sequence in situ and safe site, the strategy of loxP sequence insertion, the identification of Cre recombinase tag protein, fluorescence identification of "ectopic" expression, primer design of PCR identification and reproductive strategy of mouse were described. At the same time, the optimization of Cre-loxP system in conditional gene knockout is introduced, such as ligand-induced Cre, promoter activated Cre, photo-induced Cre and activity modification of Cre. Through these optimized applications, we can obtain time-controlled conditional gene knockout, regulate the activity of Cre recombinase, and even avoid the toxicity of Cre recombinase itself. Finally, this paper discusses the defects and challenges of Cre-loxP system, and looks into the future development direction of Cre-loxP system. In summary, this paper reviews the practical application of gene knockout based on Cre-loxP system, summarizes the latest research progress and optimization strategies of Cre-loxP system, and prospects the future gene editing based on Cre-loxP system. This paper aims to provide theoretical guidance for solving practical operation problems based on Cre-loxP system, and to provide new research ideas for more accurate, more controllable and more adaptive gene editing in the future.

Coefficient of variation of heart rate and blood pressure in rapid identification of children with suspected orthostatic intolerance / 中华儿科杂志

Objective: To investigate the clinical value of coefficient of variation of heart rate and blood pressure in rapid identification of children with suspected orthostatic intolerance(OI). Methods: This was a retrospective study. The medical records of 379 children with OI were collected, who were admitted to the Department of Pediatrics of Qilu Hospital of Shandong University from January 2015 to January 2020. Another 20 out-patient children without syncope or syncope aura were selected as control. According to the results of standing test and head-up tilt test (HUTT), all the patients with OI were divided into the following 4 groups: vasovagal syncope (VVS) group, postural tachycardia syndrome (POTS) group, POTS combined with VVS (POTS+VVS) group and HUTT negative group. Then, coefficient of variation of systolic pressure (SBPCV), coefficient of variation of diastolic pressure (DBPCV) and coefficient of variation of heart rate (HRCV) in standing test and HUTT were calculated. Kruskal-Wallis test was used for comparison among the five groups, and Dunnett's T3 method for comparison between two groups. Paired t test was used to compare the coefficient of variation between supine and erect position and tilt position in each group. The predictive values of HRCV,SBPCV and DBPCV for negative HUTT were evaluated by receiver operating characteristic (ROC) curve. Results: Among the 379 children, there were 79 in HUTT negative group, 208 in VVS group, 52 in POTS group, and 40 in POTS+VVS group. The SBPCV of supine-erect position of the control group, HUTT negative group, VVS group, POTS group, POTS+VVS group were (3.8±1.0)%, (5.3±2.2)%, (6.6±3.4)%, (5.9±3.6)%, (6.9±2.8)%, respectively. Similarly, the SBPCV of supine, erect and head-up tilt position were (4.5±0.8)%, (6.0±1.9)%, (7.1±2.6)%, (6.0±2.1)%, (7.3±2.5)%; the DBPCV of supine-erect position were (7.3±1.2)%, (9.1±3.7)%, (9.1±4.9)%, (9.1±4.8)%, (11.6±4.6)%; the DBPCV of supine, erect and tilt position were (7.4±1.1)%, (9.4±2.9)%, (10.1±3.8)%, (9.2±3.3)%, (11.0±4.7)%; the HRCV of supine-erect position were (7.6±2.6)%, (12.9±3.7)%, (16.2±4.3)%, (21.2±5.9)%, (24.9±5.3)%; and the HRCV of supine, erect and tilt position were (8.1±1.6)%, (10.1±2.7)%, (14.1±4.3)%, (15.6±3.7)%, (18.9±4.0)%, respectively. All the indexes showed significant differences among the five groups (χ2=21.91, 25.47, 19.82, 14.65, 104.52, 92.51, all P<0.05). ROC curve analysis showed that when the SBPCV and HRCV of supine-erect position reached 4.4% and 10.5%, the area under the curve of ROC were 0.713 and 0.877, the sensitivity of predicting negative HUTT were 58.2% and 78.5%, and the specificity were 80.0% and 95.0%, respectively. Conclusions: Coefficient of variation of heart rate and blood pressure may serve as potential diagnostic indexes in evaluating autonomic function of OI patients. SBPCV ≥ 4.4% or HRCV ≥ 10.5% of supine-erect position could be an indication of HUTT.

Illness perception and self-management in patients with lung cancer: the mediating role of patient activation / 中华行为医学与脑科学杂志

Objective:To explore the relationship among illness perception, patient activation and self-management in patients with lung cancer, and to investigate the mediating effect of patient activation between illness perception and self-management.Methods:A total of 270 inpatients with lung cancer were selected by convenience sampling method.They were investigated by self-made social demographic questionnaire, brief illness perception questionnaire(BIPQ), patient activation measure(PAM13)and cancer patient self-management scale.SPSS 26.0 software was used for data analysis.T-test, analysis of variance, Pearson correlation analysis and mediating effect test were used for statistical analysis.Results:A total of 255 questionnaires were collected effectively.The total score of illness perception, patient activation and self-management in patients with lung cancer were (41.91±7.94), (62.31±16.39)and (142.20±20.59) .The total score of illness perception of lung cancer patients was significantly negatively correlated with the total score of patient activation and patient self-management( r=-0.652, P<0.01; r=-0.762, P<0.01), and the total score of patient activation was significantly positively correlated with the total score of self-management in patients with lung cancer( r=0.746, P<0.01). Patient activation had a partial mediating effect between illness perception and self-management in patients with lung cancer, and the mediating effect accounted for 37.10% of the total effect. Conclusion:Patient activation plays a partial mediating role between illness perception and self-management in lung cancer patients, and it is an important protective factor for patients to actively participate in self-management of disease.On the basis of assessing the illness perception and patient activation of lung cancer patients, medical staff can timely correct the negative illness perception and help them establish and maintain a high positivity level to improve their self-management.

Mental health status of students with self reported learning disabilities in Beijing / 中国学校卫生

Objective@#Understanding mental health status of students with learning disabilities in Beijing to provide a basis for mental health promotion of students with learning disabilities.@*Methods@#By means of random cluster sampling, 5 787 enrolled students in grade one and grade two of 11 public junior middle schools in Beijing were selected as the survey subjects. A self designed questionnaire was used to investigate the students’ learning disabilities and mental health status through anonymous self filling.@*Results@#About 11.6% students self reported learning disabilities. The proportions of students with learning difficulty in mathematical reasoning and calculation were higher, 44.1% and 40.7% respectively. The reported rate of mental health problems was 38.3%. The top four of the 10 symptoms were obsessive compulsive symptoms, learning pressure, emotional instability and anxiety(2.19±0.77)(2.17±0.99)(2.09±0.90)(2.07±1.08). Compared with students without learning disabilities, students with self reported learning disabilities had poorer mental health status(OR=1.47), and learning disabilities were related to most factors of mental health. Different types of learning disabilities were associated with different mental health factors.@*Conclusion@#Mental health problems of students with learning disabilities are higher than that of students without learning disabilities. It is necessary to strengthen the mental health support for students with learning disabilities and improve their mental health.

Atypical Gerstmann-Str(a)ussler-Scheinker syndrome caused by PRNP P102L mutation: a case report and literature review / 中华神经科杂志

Objective To improve the clinician's recognition of Gerstmann-Str(a)ussler-Scheinker syndrome (GSS).Methods The detailed clinical information,neuropsychological examination,cerebrospinal fluid examination,imaging characteristics,electroencephalogram examination and gene detection were analyzed in a case of GSS similar to Creutzfeldt-Jakob disease (CJD) in symptomatology.The differences between the two different prion diseases were compared in combination with the literature review.Results The patient is a 62-year-old woman,with cerebellar ataxia as the first symptom,followed by rapid dementia,accompanied by pyramidal and extrapyramidal signs.Magnetic resonance imaging showed hyper-intense signal in diffusion weighted imaging in caudatum and cortical ribboning,and protein 14-3-3was negative.PRNP gene analysis showed P102L gene mutation.Conclusions The typical clinical manifestation of GSS is hereditary ataxia followed by cognitive decline of varying severity.Detection of PRNP plays an important role in the diagnosis of GSS.

Atypical Gerstmann-Sträussler-Scheinker syndrome caused by PRNP P102L mutation: a case report and literature review / 中华神经科杂志

Objective@#To improve the clinician′s recognition of Gerstmann-Sträussler-Scheinker syndrome (GSS).@*Methods@#The detailed clinical information, neuropsychological examination, cerebrospinal fluid examination, imaging characteristics, electroencephalogram examination and gene detection were analyzed in a case of GSS similar to Creutzfeldt-Jakob disease (CJD) in symptomatology. The differences between the two different prion diseases were compared in combination with the literature review.@*Results@#The patient is a 62-year-old woman, with cerebellar ataxia as the first symptom, followed by rapid dementia, accompanied by pyramidal and extrapyramidal signs. Magnetic resonance imaging showed hyper-intense signal in diffusion weighted imaging in caudatum and cortical ribboning, and protein 14-3-3 was negative. PRNP gene analysis showed P102L gene mutation.@*Conclusions@#The typical clinical manifestation of GSS is hereditary ataxia followed by cognitive decline of varying severity. Detection of PRNP plays an important role in the diagnosis of GSS.

Effect of Rehabilitation on Patients with Anterior Talofibular Ligament Injury at Different Stages / 中国康复理论与实践

Objective:To compare the clinical efficacy of rehabilitation training at different stages on patients with anterior talofibular ligament injury after conservative treatment. Methods:From October 2017 to October 2018, 58 patients with anterior talofibular ligament injury were divided into six-week rehabilitation group (n = 29) and twelve-week rehabilitation group (n = 29), according to the time they began rehabilitation after injury. Visual Analogue Score (VAS) and American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot function scoring system were used to evaluate ankle function before rehabilitation, and two weeks, four weeks and eight weeks after rehabilitation, respectively. Results:Two weeks, four weeks and eight weeks after rehabilitation, the scores of VAS and AOFAS improved in both groups (|t| > 4.137, P < 0.001), the scores of VAS were lower (|t| > 3.110, P < 0.01), and the scores of AOFAS were higher (|t| > 3.016, P < 0.01) in the six-week rehabilitation group than in the twelve-week rehabilitation group. Conclusion:It is suggested to begin rehabilitation within six weeks for patients with anterior talofibular ligament injury after conservative treatment.

On Research Progress of Western and Chinese Medicine Treatment on Pre-Rheumatoid Arthritis / 中国结合医学杂志

Pre-rheumatoid arthritis is the inevitable phase before the actual onset of rheumatoid arthritis and has the crucial clinical significance of early controlling and preventing disease progression. Full understanding, from both Western medicine (WM) and Chinese medicine (CM), could offer new ideas for decision making in clinical and mechanism research. This paper reviews the novel studies of WM and CM to discuss the advantages and potential mechanisms working behind.

Effects of Notch signal on the expressions of HIF-α and autophagy- related genes Beclin1, LC3I, LC3II in oxygen-glucose deprivation induced myocardial cell injury / 中国应用生理学杂志

OBJECTIVE@#To investigate the effects of Notch signal on hypoxic induction factor (HIF-1α) and autophagy-associated genes Beclin1, LC3I, LC3II in oxygen-glucose deprivation (OGD) induced myocardial cell injury.@*METHODS@#The OGD model was established using hypoxic culture box and hypoglycemic DMEM medium. The cells were divided into normal control group, OGD group, OGD + NC siRNA group, OGD + Notch1 siRNA group and OGD + HIF-1α siRNA group. Western blot was used to detect the interference effects of HIF-1α siRNA and Notch1 siRNA. The effects of Notch1 siRNA and HIF-1α siRNA on the activity of myocardial cells in OGD model were detected by the CCK-8 assay. The effects of Notch1 siRNA and HIF-1α siRNA on autophage-associated genes Beclin1, LC3I and LC3II expression were detected by Western blot.@*RESULTS@#The results of Western blot showed that HIF-1α siRNA could effectively knock down the expression of HIF-1α in myocardial cells in OGD model, and Notch1 siRNA could effectively knock down the expression of Notch1 and HIF-1α in myocardial cells in OGD model. The result of CCK-8 assay showed that Notch1 siRNA and HIF-1α siRNA reduced the activity of myocardial cells in OGD model, and there was no statistical difference between the two groups. Western blot results showed that Notch1 siRNA and HIF-1α siRNA could reduce the expressions of the autophagy-associated genes Beclin1, LC3I and LC3II, and reduce the ratio of LC3II to LC3I at mRNA level.@*CONCLUSION@#Notch1 plays a role in myocardial protection by regulating the expression of HIF-1α to regulate the autophagy in OGD model cells.

CRISPR-Cas9-based site-directed knock-in of VEGF165 gene in a HEK293T cell / 国际生物医学工程杂志

Objective To construct a human renal epithelial cell line HEK293T by CRISPR-Cas9-based site-directed knock-in of vascular endothelial growth factor 165 (VEGF165) gene, and avoid the off-target effect caused by lentivirus infection. Methods The VEGF165 expression vector with homologous arm (pUCm-T-VEGF165 plasmid) and the sgRNA expression vector [pSpCas9(BB)-2A-Puro-sgRNA plasmid] were designed and constructed based on the DNA sequence of the EZH2 gene, and then co-transfected into HEK293T cells. The expression of VEGF165 mRNA was detected by qPCR and the expressions of VEGF165 proteins were detected by Western Blot. Results The qPCR and Western Blot results showed that, comparing with the control, the pUCm-T-VEGF165 plasmid and pSpCas9(BB)-2A-Puro-sgRNA plasmid, the expression of the co-transfection plasmid were significantly increased, i.e. 3.42±0.30 vs. 1.02±0.21, 1.13±0.16 and 0.98±0.18 for the VEGF165 mRNA level (all P<0.01), and 1.13±0.16 vs. 1.02±0.06, 0.88±0.03 and 0.80±0.05 for the VEGF165 protein level (all P<0.01), respectively. Besides, the expression of EZH2 was significantly down-regulated, i.e. 0.14±0.06 vs. 1.08±0.11, 1.02±0.12 and 1.13±0.16 for the EZH2 mRNA level (all P<0.01), and 0.23±0.03 vs. 1.05±0.13, 0.91±0.04 and 0.81±0.06 for the EZH2 protein level (all P<0.01), respectively. This result showed that the VEGF165 was successfully inserted into the EZH2 genome, interfering the EZH2 expression. Conclusions VEGF165 gene can be successfully knocked into HEK293T cells by CRISPR/Cas9 system.

Correlation analysis of reject reaction and corneal endothelial cells after penetrating keratoplasty from donation after cardiac death / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To study the relativity between reject reaction from donation after cardiac death (DCD) and corneal endothelial cell source of corneal graft after penetrating keratoplasty.METHODS:Totally 28 cases of corneal graft rejection after penetrating keratoplasty with cardiac death donor cornea were analyzed using corneal endothelial microscope at less than 1mo,2-3mo,4-6mo,7-12mo after operation.RESULTS:Coefficient variation of corneal endothelial cell of the 28 cases at less than 1 mo,2-3mo,4-6mo and 7-12mo were 38.23％,49.56％,57.18％,65.04％.Corneal endothelial cell density were 2071.15 ± 311.47,1771.33 ± 348.18,1626.59±353.92,1553.14±307.31.The coefficient variation of corneal endothelial cells was positively correlated with rejection (r =0.95,P ＜ 0.05).The postoperative corneal endothelial cell density was negatively correlated with rejection (r=-0.93,P＜0.05).CONCLUSION:The corneal endothelial cell coefficient variation increased gradually and the corneal endothelial cell density decreased gradually after DCD corneal allograft rejection.Corneal endothelial cell coefficient variation and corneal endothelial cell density can be used as indicators of early detection of postoperative rejection.

Research advances in pathophysiology, diagnosis and therapy of trauma-induced coagulopathy / 中华创伤杂志

Objective Trauma-induced coagulopathy (TIC)is an acute coagulopathy in which coagulation,fibrinolysis,and anticoagulant pathways are activated after trauma due to massive hemorrhage and tissue damage.TIC is caused by hypothermia,acidosis,blood dilution,hyperfusion,tissue injury,etc.To diagnose TIC,we mainly rely on traditional coagulation function analysis and thrombelastogram (TEG).At present,the key to treat TIC is quick hemostasis.The basic treatment procedure includes transfusion of packed red blood cells and fresh frozen plasma by appropriate proportion,and timely infusion of platelets and coagulant material so as to stabilize blood pressure and reconstruct the blood coagulation mechanism.In this paper,we reviewed recent advances in the pathophysiological and treatment of TIC in order to provide references for further research in related fields.

Effect of continuous renal replacement therapy on the function of CD8+T lymphocytes in patients with sepsis / 中国感染控制杂志

Objective To investigate the changes in CD8+T lymphocyte count and effect on immune function in patients with sepsis after continuous renal replacement therapy (CRRT).Methods General data of septic patients who admitted to the emergency department of a hospital between October 2015 and August 2016 were collected,pe-ripheral blood was taken from patients before and after single CRRT,the total CD8+T cell count,interferon-γ(IFN-γ)-secreting CD8+T cell count,the levels of inhibitory molecules and costimulatory molecules as well as IFN-γand tumor necrosis factor-α(TNF-α)produced by CD8+T cells were detected.Results A total of 37 hospitalized septic patients were infected with gram-negative bacteria, pathogens causing infection were Klebsiella pneumoniae (22 strains),Acinetobacter baumannii (1 1 strains),and Enterobacter cloacae (3 strains).After CRRT,the body temperature,heart rate,white blood cell count,urea nitrogen,and serum creatinine levels in septic patients were all lower than those before CRRT (all P＜0.05).After CRRT,the total CD8+T cell count in septic patients didn’t change significantly (P＞0.05),but IFN-γ-secreting CD8+T cell count increased (P＜0.05).Levels of cytotoxic T lymphocyte-associated antigen 4(CTLA-4),programmed death-1 (PD-1),T-cell immunoglobulin and mucin-do-main-containing molecule 3 (TIM-3)after CRRT were all lower than those before CRRT (all P＜0.05 ),while levels of costimulatory molecules CD28 and secreting IFN-γ elevated after CRRT(all P＜0.05).Conclusion CRRT can not only improve the vital signs and renal function of patients with sepsis,but also enhance the immune function of CD8+T cells.

Changes in renal function after catheter ablation in patients with persistent atrial fibrillation / 中华内科杂志

Objective@#The aim of the study was to evaluate the changes and outcome of kidney function after catheter ablation in patients with persistent atrial fibrillation (PAF).@*Methods@#A total of 146 patients with PAF underwent primary atrial fibrillation (AF) ablation were enrolled from January 2013 to December 2014 and followed up. The subjects were divided into the AF recurrence and AF non recurrence groups. The estimated glomerular filtration rate (eGFR) was calculated and serum creatinine levels were detected before ablation and during follow-up. Renal failure was defined as ≥ 25% decline in eGFR. Kaplan-Meier survival curves was applied for the incidence of renal failure. Cox proportional hazards models were conducted to assess the relationship between recurrence of AF and renal failure.@*Results@#After (16.3±11.8) months of follow-up, the eGFR in patients with no recurrence of AF was higher than that in patients with recurrence. eGFR and ΔeGFR in patients with no AF recurrence differed significantly from those in patients with recurrence [(114.15±18.24) ml·min-1·1.73m-2 vs. (98.64±24.09) ml·min-1·1.73m-2, and (7.42±6.36) ml·min-1·1.73m-2 vs. (-11.40±10.19) ml·min-1·1.73m-2, all P<0.001]. The incidence of the renal failure was significantly lower (4.41% vs. 16.67%, P<0.05) and the survival prognosis was significantly better in patients with no recurrence than those in patients with recurrence (χ2=5.965, log-rank P=0.05). The multivariate Cox regression analysis revealed that age, baseline eGFR, recurrences of AF and diabetes were independent predictors of the renal failure, with the HR 1.152, 1.086, 13.442 and 6.076, respectively.@*Conclusions@#PAF patients with no recurrence after ablation had a better renal function than those with recurrence, and the recurrence of AF is associated with the deterioration of kidney function in patients with PAF.

Prevalence rates of healthcare-associated infection and community-associated infection in hospitalized patients in 253 hospitals of Hebei Province / 中国感染控制杂志

Objective To investigate prevalence of healthcare-associated infection(HAI) and community associated infection(CAD in hospitalized patients in Hebei Province.Methods A certain day from August 17 to August 28,2015 was selected as the survey day,unified questionnaires were formulated,the prevalence of HAI and CAI in hospitalized patients in secondary and above comprehensive hospitals in Hebei Province was surveyed,pathogens causing infection were analyzed and compared.Results A total of 65 065 patients in 253 hospitals were surveyed,prevalence rates of HAI and CAI were 2.89％ and 16.84％ respectively.The top three sites of HAI were respiratory tract(61.32％),urinary tract(12.49％),and surgical site(9.83％),the top three sites of CAI were respiratory tract (56.70％),urinary tract(10.89％),and gastrointestinal tract(8.35％).Distribution of sites of HAI and CAI was significantly different(P＜0.01).The top 5 pathogens were of the same species,but ranked differently,the main bacteria causing HAI was Pseudomonas aeruginosa (22.69％),CAI was Escherichia coli (23.79％).There was significant difference in the distribution of pathogens between HAI and CAI (P＜0.01).There were significant differences in pathogenic species causing respiratory tract,gastrointestinal tract,urinary tract,and intra abdominal infection(all P＜0.05).Isolation rates of extended spectrum β-lactamase-producing/carbapenem-resistant Klebsiella pneumoniae,methicillin-resistant Staphylococcus aureus between HAI and CAI were all significantly different(all P ＜0.001).Conclusion Incidence of infection,infection sites,as well as constituent of pathogens and multidrugresistant organisms between HAI and CAI are varied,besides monitoring on HAI,monitoring on drug resistance of pathogens causing CAI should be paid attention,so as to provide scientific basis for rational antimicrobial use in clinical practice.

Mechanical properties, fluorine release behavior and bacterial inhibition of hydroxyapatite-glass ionomer cement / 实用口腔医学杂志

Objective:To investigate mechanical properties,fluorine release behavior and bacteria inhibition effect of hydroxyapatite-improved glass ionomer cement(HA/GIC).Methods:HA/GIC was prepared with HA mass fraction of 28％.Bending strength and compressive strength of HA/GIC and GIC were measured by an universal material testing machine.Microstructure of the materials was observed by scanning microscope technique (SEM).Accumulation of fluorine release was measured by fluorine ion selective electrode.Bacterial inhibition of total bacteria and Streptococcus mutans was monitored by fluorescence in situ hybridization.Results:Bending strength,compressive strength and fluorine release accumulation of HA/GIC were significantly higher than those of GIC (P ＜ 0.05).There were many.irregular polymerized particle monomers and micro cracks within the GIC.In HA/GIC,hydroxyapatite particles were connected with original composition.Bacterial inhibition of total bacteria and Streptococcus mutans by HA/GIC was more effective than that by GIC.Conclusion:HA/GIC has perfect mechanical properties,fluorine release behavior and bacterial inhibition effect.

Whether Warfarin Therapy is Associated with Damage on Renal Function in Chinese Patients with Nonvalvular Atrial Fibrillation / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Warfarin is the most common oral anticoagulant to decrease the stroke risk associated with atrial fibrillation (AF). There are very few prospective studies that have explored whether warfarin has an association with damage on renal function in Chinese patients with nonvalvular AF (NVAF). The aim of this study was to evaluate the effects of warfarin on renal function and study the factors associated with kidney dysfunction in Chinese adult NVAF patients without dialysis therapy.</p><p><b>METHODS</b>From January 2011 to December 2013, a total of 951 NVAF patients from 18 hospitals were enrolled. The estimated glomerular filtration rate (eGFR) was calculated from baseline and follow-up serum creatinine levels. Kaplan-Meier survival curves compared the survival of a ≥25% decline in eGFR (hereafter, endpoint), while Cox models estimated hazard ratios (HR s) and 95% confidence intervals for this event after adjustment for age, gender, and selected potential risk factors for renal dysfunction. Cox regression analysis of the various clinical potential variables was performed to identify the predictors of a ≥25% decline in eGFR.</p><p><b>RESULTS</b>After a 58-month follow-up, 951 NVAF patients were divided by observation into warfarin (n = 655) and no anticoagulation groups (n = 296) and 120 (12.6%) patients experienced renal endpoint. Kaplan-Meier survival curves showed that the survival period was not different in the two groups (χ2 = 0.178, log-rank P= 0.67), but patients with systolic blood pressure (SBP) <140 mmHg have significant difference with patients with SBP ≥140 mmHg (χ2 = 4.903, log-rank P= 0.03). Multivariate Cox regression analysis revealed baseline eGFR and SBP as independent predictors of the endpoint, with HR s of 1.00, and 1.02, respectively.</p><p><b>CONCLUSION</b>In patients with NVAF, eGFR and SBP are associated with the deterioration of kidney function while Warfarin is not the risk factor of the ≥25% decline in eGFR.</p><p><b>TRIAL REGISTRATION</b>Chinese Clinical Trial Registry (No. ChiCTR-OCH-13003729); http://www.chictr.org.cn/showproj.aspx?proj = 5831.</p>