Chloroplast genomic characterization and phylogenetic analysis of Castanopsis hystrix / 生物工程学报

The structure and size of the chloroplast genome of Castanopsis hystrix was determined by Illumina HiSeq 2500 sequencing platform to understand the difference between C. hystrix and the chloroplast genome of the same genus, and the evolutionary position of C. hystrix in the genus, so as to facilitate species identification, genetic diversity analysis and resource conservation of the genus. Bioinformatics analysis was used to perform sequence assembly, annotation and characteristic analysis. R, Python, MISA, CodonW and MEGA 6 bioinformatics software were used to analyze the genome structure and number, codon bias, sequence repeats, simple sequence repeat (SSR) loci and phylogeny. The genome size of C. hystrix chloroplast was 153 754 bp, showing tetrad structure. A total of 130 genes were identified, including 85 coding genes, 37 tRNA genes and 8 rRNA genes. According to codon bias analysis, the average number of effective codons was 55.5, indicating that the codons were highly random and low in bias. Forty-five repeats and 111 SSR loci were detected by SSR and long repeat fragment analysis. Compared with the related species, chloroplast genome sequences were highly conserved, especially the protein coding sequences. Phylogenetic analysis showed that C. hystrix is closely related to the Hainanese cone. In summary, we obtained the basic information and phylogenetic position of the chloroplast genome of red cone, which will provide a preliminary basis for species identification, genetic diversity of natural populations and functional genomics research of C. hystrix.

The effect of combining transcranial magnetic stimulation with escitalopram on neurological functioning, depression and serum inflammatory factors after a stroke / 中华物理医学与康复杂志

Objective:To investigate the effect of combining repeated high-frequency transcranial magnetic stimulation (rTMS) with escitalopram in treating the neurological functioning and post-stroke depression of stroke survivors.Methods:Eighty persons with post-stroke depression were randomly divided into an observation group and a control group, each of 40. The control group was treated with oral escitalopram, while the observation group also received transcranial magnetic stimulation at 5Hz. The magnetic stimulation intensity was 80% of each person′s resting motion threshold. The rTMS was administered once a day, 5 days a week for 8 weeks. Neurological functioning and depression were evaluated using National Institutes of Health stroke scoring (NIHSS) and the Hamilton depression scale before and after the 8 weeks of treatment. The levels of tumor necrosis factor-α (TNF-α), interleukin-2 (IL-2) and interleukin-6 (IL-6) in serum samples from the two groups were detected using enzyme-linked immunosorbent assays.Results:After treatment, the NIHSS and Hamilton scores and TNF-α, IL-2 and IL-6 levels in both groups had improved significantly, but in each case they were significantly better in the treated group, on average.Conclusion:Supplementing escitalopram with high-frequency transcranial magnetic stimulation more effectively improves depression and neurological functioning after a stroke.

Post-marketing multi-center safety surveillance of inactivated enterovirus A71 vaccine (Vero cell) / 中华预防医学杂志

Objective@#To evaluate the post-marketing safety profiles of the inactivated enterovirus type 71 (EV-A71) vaccine (Vero cell) after routine inoculation.@*Methods@#Eleven cities of Zhejiang Province, Fengtai district of Beijing, Qinnan district, two counties as Pingle and Pingguo of Guangxi Zhuang Autonomous Region, and Dongtai city of Jiangsu Province were selected as the field sites. A total of 45 239 subjects were enrolled in this study from children who seeked the vaccination of EV-A71 vaccine during the period from July, 2016 to June, 2018. Different sampling method were adopted in different sites. All vaccinated children were invited to participate in the study in Fengtai and Dongtai, however, systematic sampling method were adopted in other sites. Active surveillance was conducted and information about adverse reactions (ARs) occurred in 30 min, 3 d and 30 d following each dose of EV-A71 immunization was collected by field observation, phone-call or face-to-face interview. The incidence of ARs in different types, symptoms and grades were described.@*Results@#In total, there were 45 239 children who received 71 243 doses EV-A71 vaccine. The overall incidence of ARs was 1.079% (769 doses), with the highest incidence of 1.182% (177/14 973) in 5-11 month group and the lowest incidence of 0.849% (18/2 119) in ≥ 36 month group among different age groups. There was a higher incidence in solicited ARs, which was 1.047% (746 doses). The incidences of grade 1 and grade 2 ARs were also higher, which were 0.404% (288 doses) and 0.554% (395 doses), respectively. No grade 4 ARs occurred. The doses of the first and the second vaccination was 40 736 and 30 507, respectively, and the incidences of ARs were 1.281% (522 doses) and 0.810% (247 doses). Also, the incidences of ARs were 0.091% (37 doses) and 0.043% (13 doses) in local, and 1.168% (476 doses) and 0.760% (232 doses) in system. The symptoms of ARs after the two doses of vaccination were basically the same. Redness at the injection site was the most common local ARs after each dose vaccination, with doses of 24 and 11, while fever was the most common systemic ARs, with doses of 362 and 190. Moreover, ARs mainly occurred in 30 min to 3 d after each dose vaccination, with incidence of 1.016% (414 doses) and 0.698% (213 doses) in the first and second dose, respectively.@*Conclusion@#The ARs had a low incidence after vaccination in children and most were mild or moderate. EV-A71 vaccine with good safety is suitable for inoculation in a large scale.

Artesunate attenuate chronic graft-versus-host disease by regulating Th17/Treg balance / 中华血液学杂志

Objective: To investigate the effects of artesunate treatment on chronic graft-versus-host disease (cGVHD). Methods: Recipient BALB/c mice received 8 × 10(6) bone marrow cells with 8×10(6) spleen cells from B10D2 mice. Artesunate solubilized in acetone was injected intraperitoneally every day at the dose of 1 mg/kg at Day 28 after BMT. The clinical scores, survival and histopathological damage were analyzed. The frequency of Th17 and Tregs in PB and spleens from the mice were evaluated by flow cytometry. In addition, CD4(+) T cells from the spleens of mice were cultured in vitro, then stimulated with artesunate, the frequency of Th17 and Tregs in these splenocytes were evaluated by flow cytometry. Results: Artesunate administration diminished clinical and histopathological damage, and improved the survival of cGVHD mice[(46.57±7.83)% vs (55.71±6.99)%, χ(2)=5.457, P=0.020]; Artesunate contributed to Tregs development [(4.45±0.04)% vs (8.40±0.23)%, t=15.679, P<0.001; (6.62±0.24)% vs (10.48±0.48)%, t=6.587, P=0.003] while decreased Th17 cells [(1.51±0.18)% vs (0.58±0.19)%, t=7.233, P<0.001; (1.48±0.38)% vs (0.71±0.18)%, t=3.653, P=0.011] expressions in both PB and spleens, and decreased the Th17/Treg ratio (0.34±0.05 vs 0.09±0.03, t=7.621, P=0.002; 0.19±0.03 vs 0.06±0.02, t=6.993, P=0.002). Moreover, artesunate suppressed the Th17 cells expressions [(0.82±0.37) % vs (3.39±1.22) %, t=4.044, P=0.007] and contributed to Tregs development [(34.63±1.29) % vs (14.28±1.69) %, t=19.119, P<0.001], and also decreased the Th17/Treg ratio (0.24±0.09 vs 0.02±0.01, t=4.780, P=0.003) in vitro. Conclusions: Artesunate suppressed the Th17 cells expressions and contributed to Tregs development, which provided new sights into the development of a novel drug for cGVHD, e.g., artemisinin.

Microbiological profiles of pathogens causing nosocomial bacteremia in 2011, 2013 and 2016 / 生物工程学报

To dynamically investigate the distribution and antimicrobial resistance profiles of bacteremia pathogens isolated from different regions in China in 2011, 2013 and 2016. Non-repetitive isolates from nosocomial bloodstream infections were retrospectively collected and detected for antimicrobial susceptibility tests (AST) by agar dilution or microbroth dilution methods. Whonet 5.6 was used to analyze the AST data. Among 2 248 isolates, 1 657 (73.7%) were Gram-negative bacilli and 591 (26.3%) were Gram-positive cocci. The top five bacteremia pathogens were as follows, Escherichia coli (32.6%, 733/2 248), Klebsiella pneumoniae (14.5%, 327/2 248), Staphylococcus aureus (10.0%, 225/2 248), Acinetobacter baumannii (8.7%, 196/2 248) and Pseudomonas aeruginosa (6.2%, 140/2 248). Colistin (96.5%, 1 525/1 581, excluding innate resistant organisms), tigecycline (95.6%, 1 375/1 438, excluding innate resistant organisms), ceftazidine/clavulanate acid (89.2%, 1 112 /1 246), amikacin (86.4%, 1 382/1 599) and meropenem (85.7%, 1 376/1 605) showed relatively high susceptibility against Gram-negative bacilli. While tigecycline, teicoplanin and daptomycin (the susceptibility rates were 100.0%), vancomycin and linezolid (the susceptibility rates were 99.7%) demonstrated high susceptibility against Gram-positive cocci. The prevalence of extended-spectrum β-lactamases (ESBLs)-producing Enterobacteriaceae were 50.6% (206/407), 49.8% (136/273) and 38.9% (167/429) in 2011, 2013 and 2016 respectively; carbapenem-non-susceptible Enterobacteriaceae were 2.2% (9/408), 4.0% (16/402) and 3.9% (17/439) in 2011, 2013 and 2016 respectively; The prevalence of multidrug-resistant A. baumannii (MDRA) was 76.4% (55/72) in 2011, 82.7% (43/52) in 2013 and 87.5% (63/72) in 2016, respectively. The prevalence of multidrug-resistant P. aeruginosa (MDRP) was 9.8% (5/51) in 2011, 20.0% (7/35) in 2013 and 13.0% (7/54) in 2016, respectively. The prevalence of methicillin-resistant S. aureus (MRSA) was 51.9% (41/79) in 2011, 29.7% (19/64) in 2013 and 31.7% (26/82) in 2016, respectively. The prevalence of high level gentamicin resistance (HLGR) of Enterococcus faecium and Enterococcus faecalis were 43.2% (48/111) and 40.9% (27/66), respectively. The predominant organism of carbapenem-non-susceptible Enterobacteriaceae was K. pneumoniae with its proportion of 57.1% (24/42). Among 30 tigecycline-non-susceptible Enterobacteriaceae, K. pneumoniae was the most popular organism with 76.7% (23/30). Among 39 colistin-resistant Enterobacteriaceae, E. coli, Enterobacter cloacae and K. pneumoniae were constituted with the percent of 43.6 (17/39), 35.9 (14/39) and 15.4 (6/39), respectively. The Gram-negative bacilli (E. coli and K. pneumoniae were the major organisms) were the major pathogens of nosocomial bacteremia, to which tigecycline, colistin and carbapenems kept with highly in vitro susceptibility. Whereas, among the Gram-positive cocci, S. aureus was the top 1 isolated organism, followed by E. faecium, to which tigecycline, daptomycin, linezolid, vancomycin and teicoplanin kept with highly in vitro susceptibility. Isolation of colistin-resistant Enterobacteriaceae, tigecycline-non-susceptible Enterobacteriaceae, linezolid- or vancomycin-non-susceptible Gram-positive cocci suggests more attention should be paid to these resistant organisms and dynamic surveillance was essential.

Clinical significance of coagulase-negative Staphylococci isolated from blood cultures / 中华传染病杂志

Objective To analyze clinical characteristics of bloodstream infections caused by coagulase-negative Staphylococci (CNS) and antibiotic resistance of the bacteria,so that to provide basis for the clinical diagnosis and treatment.Methods A retrospective analysis of CNS in blood cultures collected from 108 hospitalized patients in Puai Hospital of Tongji Medical College from January 2016 to December 2017 was performed.The antimicrobial susceptibilities were tested by Kirby-Bauer method and E test method.For measurement variables,normally distributed variables were compared using t test,and non-normal distributed data were compared using Mann-Whitney U test.Categorical variables were compared using x2 test.Results Of the 108 patients,66 were male and 42 were female;the age range was 26 to 98 years and the average was 49 years.According to the criteria for bacteremia,36 of 108 (33.3％) patients with CNS-positive blood cultures were diagnosed with bacteremia and 72 (66.7％) cases were contaminated.CNS bacteremia mainly occurred in the intensive care unit and nephropathy ward.Among them,23 (62.2％) patients were catheter-related blood stream infections,and 11 (29.7 ％) patients were dialysis catheter-related bloodstream infections.Fifteen of 36 (41.7％) strains were isolated within 48 hours of admission.The level of serum procalcitonin (PCT) for bacteremia patients was 2.56 (1.44,7.60) μg/L,and that was 0.13 (0.05,0.23) μg/L in contaminated patients.The difference was statistically significant (Z=8.097,P＜0.05).The white blood cell count of patients with bacteremia was (11.50±4.54) × 109/L,and that was (10.61 ±5.00) × 109/L for contaminated patients.There was no statistical significance (t=0.895,P＞0.05).After antibiotic treatment,26 of 36 bacteremia patients were survived.The PCT levels before antibiotic treatment were 2.05 (1.42,4.32) μg/L,and 0.24 (0.07,0.61) μg/L after antibiotic treatment.Serum PCT was decreased significantly after antibiotic treatment (Z=4.457,P＜0.05).The PCT levels of 10 deaths within 28 days before antibiotic treatment were 4.78 (1.51,19.75) μg/L,whereas 22 (6.40,55.75) μg/L,after antibiotic treatment.The PCT was increased significantly after antibiotic treatment (Z=2.497,P＜0.05).No significant difference was found in PCT between survivors and deaths within 28 days (Z=0.300,P＞0.05).No significant difference was found in white blood cell count between survivors and deaths at 28 days (t=0.771,P＞0.05).There was no statistical difference of the anti-bacterial drug susceptibility between pathogens and contaminants (P＞0.05).All strains were sensitive to vancomycin,teicoplanin and linezolid.Conclusions The incidence of CNS contamination in blood culture is relatively high.It is important to distinguish true bacteraemia from contamination by a review of the clinical and laboratory indicators.PCT is of clinical value to indicate CNS infection and to monitor therapeutic effect.

Treatment of proximal humeral fractures with proximal humeral locking system plate via an intertubercular sulcus approach / 中国骨伤

OBJECTIVE@#To observe the effect of proximal humerus internal locking system (PHILOS) plate in the treatment of Neer 2 and 3 part fractures of proximal humerus through tuberosity approach.@*METHODS@#From July 2015 to January 2018, 15 cases of proximal humerus Neer 2 and 3 fractures were treated with PHILOS plate through intertubercular sulcus approach. There were 7 males and 8 females. The age ranged from 23 to 67 years old, with an average of 46 years old. There were 5 cases on the left side and 10 cases on the right side (including 7 cases of Neer 2 partial fracture and 8 cases of Neer 3 partial fracture). X-ray films and CT were taken before and after operation to assess fracture location and fracture healing. Clinical evaluation included Constant-Murley shoulder function score and operative complications. All 15 patients were treated with the PHILOS. Constant-Murley score was used to evaluate shoulder function after operation.@*RESULTS@#All the 15 cases were followed up, and the duration ranged from 14 to 36 months. All the fractures healed and the healing time ranged from 14 to 26 weeks, averaged 19.1 weeks. There were no complications such as humeral head necrosis, axillary nerve injury and fracture nonunion after operation. At the 3rd month after operation, the shoulder function score of Constant-Murley ranged from 72 to 94 points, with an average of 81 points; 2 cases got an excellent result and 13 good.@*CONCLUSIONS@#The PHILOS plate for the treatment of proximal humerus fractures has the advantages of simple operation, small injury and quick recovery of shoulder joint function.

Meta plate and cannulated screw fixation for treatment of type Letenneur III lateral Hoffa fracture through posterolateral approach / 中国骨伤

<p><b>OBJECTIVE</b>To explore clinical effect of meta plate with cannulated screw fixation in treating Letenneur III lateral Hoffa fracture through posterolateral approach.</p><p><b>METHODS</b>From June 2012 to June 2016, 12 patients with Letenneur III lateral Hoffa fracture were treated with meta plate and cannulated screw fixation through posterolateral approach, including 8 males and 4 females;aged from 22 to 66 years with an average of 42 years old;and 5 cases on left side, 7 cases on right side. Preoperative and postoperative X-ray and CT were taken before and after operation to assess location of fracture and fracture healing. Letenneur scoring standard was used to evaluate clinical effects. All patients were treated with meta plate combined with cannulated screws.</p><p><b>RESULTS</b>All incisions healed at stage I. The fractures were healed from 11 to 32 weeks with an average of 17.2 weeks. No internal fixation loosening, displacement and necrosis of femoral condyle and deep vein thrombosis of lower extremity occurred. All patients were followed up from 8 to 24 months with an average of 12.8 months. At the latest follow-up, 7 cases got excellent results, 4 good and 1 moderate according to Letenneur scoring standard.</p><p><b>CONCLUSIONS</b>Posterlateral approach is easy to expose, meta plate fixation with cannulated screws has advantages of strong internal fixation, high fracture healing rate, early knee joint function exercise and good recovery of joint function.</p>

Analysis of pathogen spectrum and antimicrobial resistance of clinical common organisms from twelve teaching hospitals in 2016 / 中华检验医学杂志

Objective To investigate the spectrum and antimicrobial resistance of major pathogens causing nosocomial infections in China, 2016. Methods Non-duplicated nosocomial cases as well as pathogens causing bloodstream infections ( BSI) , hospital-acquired pneumonia ( HAP) and intra-abdominal infections ( IAI ) from 12 teaching hospitals across China were collected. The minimum inhibitory concentrations (MICs) of important clinical common strains were determined by agar dilution method or broth microdilution method. The CLSI M100-S27 criteria was used for interpretation. Data were analyzed by using WHONET-5. 6 software. Results A total of 2060 cases were collected, including 894 cases from BSI, 630 cases from HAP and 536 cases from IAI. The MICs of 1896 important clinical common strains were determined. Escherichia coli and Klebsiella pneumoniae were the most prevalent pathogens causing BSI and IAI, while Acinetobacter baumanii and Pseudomonas aeruginosa were dominated in HAP. All Staphylococcus aureus were susceptible to tigecycline, linezolid, daptomycin and glycopeptides. Methicillin-resistant S. aureus accounted for 44. 4％ ( 75/169 ) of all the S. aureus. The rate of methicillin-resistant coagulase-negative staphylococci was 80. 9％ ( 72/89 ) . No Enterococcus strains were found resistant to tigecycline, linezolid or daptomycin. Vacomycin resistant enterococcus was found in Enterococcus faecium, accounting for 1. 8％ ( 2/111 ) of all E. faecium strains. Tigecycline, meropenem, amikacin, imipenem, and polymyxin B exhibited high potency against Enterobacteriaceae and the susceptibility rates were 96. 6％(865/895), 94. 3％ (859/911), 94. 2％ (858/911), 94. 1％ (857/911), and 91. 6％ (820/895), respectively. The prevalence of extended-spectrum β-lactamase was 58. 4％ ( 263/450 ) in E. coli and 28. 6％ ( 84/294 ) in K. pneumonia. The rate of carbapenem resistant K. pneumonia and E. coli was 15. 3％ ( 45/294 ) and 1. 8％ ( 8/450 ) , respectively. The percentage of polymyxin B resistant K. pneumonia and E. coli was 4. 1％ ( 12/294 ) and 4. 4％ ( 20/450 ) , respectively. The rate of tigecycline resistant K. pneumonia and E. coli was 2. 4％ ( 7/294 ) and 0. 2％ ( 1/450 ) , respectively. A. baumanii showed low susceptibility to the antimicrobial agents except tigecycline ( 91. 4％, 235/257 ) and polymyxin B (100％, 257/257). The rate of carbapenem resistant A. baumanii was 80. 5％ (207/257). The rate of carbapenem resistant P. aeruginosa was 31. 7％ ( 59/186 ) . Polymyxin B and amikacin demonstrated high antibacterial activity against P. aeruginosa with susceptility rate of 100％ ( 186/186 ) and 90. 9％ ( 169/186), respectively. Conclusions Nosocomial pathogens showed high susceptibilities against tigecycline and polymyxin B. Antimicrobial resistance in A. baumannii is a serious problem. The prevalence of carbapenem-resistant Enterobacteriaceae and polymyxin B resistant Enterobacteriaceae has increased, which should be monitored continuously in China.

Overexpression of miRNA-199a-3p targets at expression of MAP3K4 in gastric cancer / 实用医学杂志

Objective To investigate the effect of miRNA-199a-3p overexpression on the expression of MAP3K4 protein in gastric cancer. Methods 35 gastric cancers and the matched adjacent tissue specimens were collected. Expression of miRNA-199a-3p and MAP3K4 were detected by stem-loop real-time reverse transcription polymerase chain reaction and western blot. Cell transfection was employed to explore the regulation of miRNA-199a-3p on MAP3K4 gene. Luciferase reporter assay was performed to identify target MAP3K4 gene. Results Com-pared with the adjacent tissue specimens ,miRNA-199a-3p was upregulated in the gastric cancers ,and MAP3K4 protein was down-regulated in the gastric cancers. Cells transfected with miR-199a-3p mimics showed lower MAP3K4 protein. MAP3K4 was identified as target gene of miR-199a-3p. Conclusions miRNA-199a-3p acts as an oncogene in gastric cancer and functions by targeting MAP3K4.

Overexpression of miRNA-199a-3p targets at expression of MAP3K4 in gastric cancer / 实用医学杂志

Objective To investigate the effect of miRNA-199a-3p overexpression on the expression of MAP3K4 protein in gastric cancer. Methods 35 gastric cancers and the matched adjacent tissue specimens were collected. Expression of miRNA-199a-3p and MAP3K4 were detected by stem-loop real-time reverse transcription polymerase chain reaction and western blot. Cell transfection was employed to explore the regulation of miRNA-199a-3p on MAP3K4 gene. Luciferase reporter assay was performed to identify target MAP3K4 gene. Results Com-pared with the adjacent tissue specimens ,miRNA-199a-3p was upregulated in the gastric cancers ,and MAP3K4 protein was down-regulated in the gastric cancers. Cells transfected with miR-199a-3p mimics showed lower MAP3K4 protein. MAP3K4 was identified as target gene of miR-199a-3p. Conclusions miRNA-199a-3p acts as an oncogene in gastric cancer and functions by targeting MAP3K4.

Mini-locking plates for the treatment of Regan-Morrey type III fracture of ulnar coronoid process through anterior approach of elbow joint / 中国骨伤

<p><b>OBJECTIVE</b>To explore clinical effects of mini-locking plates for the treatment of Regan-Morrey type III fractures of ulnar coronoid process through an anterior approach of elbow joint.</p><p><b>METHODS</b>A retrospective analysis on 12 patients with Regan-Morrey type III fractures of the ulnar coronoid process was performed from January 2011 to June 2014, who were treated with unini-locking plates through the anterior approach of elbow joint. There were 7 males and 5 females, ranging in age from 23 to 65 years old, averaged 43 years old. Four patients had fractures on the left and 8 patients had fractures on the right. The X-ray films were taken to evaluate the location and healing of the fracture before and after operation. Clinical evaluation included analysis on surgical complications, range of motion and Mayo elbow function score. All the patients were treated with mini-locking plates, and the elbow joint was stable after operation.</p><p><b>RESULTS</b>All the patients were followed up, and the duration ranged from 14 to 36 months. All the fractures were healed, and the healing time ranged from 12 to 20 weeks. The average healing time was 15.6 weeks. There were no complications occurred such as heterotopic ossification, traumatic arthritis and others. At the latest follow-up, the average angle of elbow flexion was (127.0±5.6)°(120° to 135°); the average extension angle was(4.2±4.5)° (0° to 10°); the average pronation angle of forearm was (86.0±6.1)°(75° to 90°); the average supination angle of forearm was (87.0±6.9)°(80° to 100°). Mayo elbow function score was 80 to 96 points, with an average of 88 points, of which 2 cases got an excellent result, 10 good.</p><p><b>CONCLUSIONS</b>Elbow anterior approach can clearly expose the Regan-Morrey type III coronoid fractures, and mini-locking plate fixation has a satisfactory effect.</p>

Clinical Observation of Paroxetine Combined with Buspirone in the Treatment of Geriatric Depression with Anxiety / 中国药房

OBJECTIVE:To observe the efficacy and safety of paroxetine combined with buspirone in the treatment of geriatric depression with anxiety. METHODS:78 patients with geriatric depression with anxiety were randomly divided into control group (39 cases) and observation group (39 cases). Control group received 20-40 mg Paroxetine hydrochloride tablet,within half an hour after breakfast. Observation group additionally received 5-10 mg Buspirone hydrochloride tablet for 3 times. The treatment course for both groups was 8 weeks. Clinical efficacy,HAMD,HAMA and TESS before and after 2,4 and 8 weeks of treatment in 2 groups were observed. RESULTS:The total effective rate in observation group was significantly higher than control group,the difference was statistically significant(P0.05). CONCLUSIONS:The effi-cacy of buspirone combined with paroxetine is superior to paroxetine alone in the treatment of geriatric depression with anxiety, with better safety.

Analysis on factors associated with taking subsequent confirmation test among men who have sex with men after being tested positive in oral fluid HIV antibody test in Beijing / 中华预防医学杂志

<p><b>OBJECTIVE</b>To analyze the proportion and associated factors of taking subsequent confirmation test among men who have sex with men (MSM) after being tested positive in oral fluid HIV antibody test.</p><p><b>METHODS</b>By using successive sampling, 1 003 MSM, who were tested positive in oral fluid HIV antibody test in China-Bill & Melinda Gates Foundation AIDS prevention Program (Extension program) in Beijing during May 1 to December 31, 2013, were recruited. The inclusion criteria included: the objects were men who reported having sex with men; the objects aged more than 18 years old; the objects were tested positive in oral fluid HIV antibody test; the objects had not been reported as HIV positives in China Information System for Disease Control and Prevention previously. According to the program strategy, MSM grassroots organizations transferred the respondents to seek subsequent confirmation tests in specific Center for Disease Control and Prevention (CDCs) or hospitals. The subsequent confirmation tests included: fingertip blood HIV antibody rapid test, venous blood Enzyme Linked Immunosorbent Assay (ELISA) HIV antibody test and venous blood Western Blot (WB) HIV antibody test. Chi-square test was adopted to compare the proportion of taking subsequent confirmation tests in different groups. Nonconditional multivaritae binarylogistic regression analysis was taken to identify the associated factors with whether taking subsequent confirmation tests and to calculate the OR (95% CI) values.</p><p><b>RESULTS</b>The 1 003 respondents were (30.9 ± 9.1) years old. Among all objects, 87.8% (881/1 003) of them took fingertip blood HIV antibody rapid tests and the positive rate was 85.4% (752/881). 98.0% (737/752) of those who were identified as positive in fingertip blood HIV rapid tests took ELISA and WB tests, and the positive rate was 94.4% (696/737). Comparing with those who were expected to seek subsequent confirmation tests in CDCs, the OR (95% CI) value of those who were expected to seek tests in hospitals was 5.10 (1.69-15.36). The OR (95% CI) values of those who used condom sometimes and those who never used condom in anal sex were 5.81 (2.14-15.77) and 3.45 (2.00-5.97) respectively, in comparison with those who reported not having anal sex or using condom consistently in anal sex during the past 6 months. Comparing with the respondents recruited from the internet, the OR (95% CI) values of those recruited in bathrooms, parks/toilets and bars were 0.17 (0.05-0.53), 0.10 (0.04-0.29) and 0.22 (0.06-0.79) respectively. The likelihood of taking subsequent confirmation test decreased with the increase of number of male sexual partners in the past 3 months, and the OR (95% CI) value was 0.92 (0.86-0.99).</p><p><b>CONCLUSION</b>The potential HIV positive MSM in the bathroom, park/toilet and bars are less likely to take subsequent confirmation test. Those who do not use condom consistently during anal sex are more likely to seek subsequent confirmation test. Medical organization conducting subsequent confirmation tests is more likely to increase the confirmation test rate of potential HIV positive MSM. The number of male sexual partners has negative correlation with whether to accept the subsequent confirmation test.</p>

Study on spousal notification in HIV discordant couples and associated factors in four provinces of China / 中华流行病学杂志

<p><b>OBJECTIVE</b>This study was aimed to investigate the ways of spousal notification and its associated factors among HIV discordant couples.</p><p><b>METHODS</b>A face-to-face questionnaire survey was conducted in Henan, Yunnan, Sichuan provinces and Guangxi Zhuang Autonomous Region in China. Information including democratic characteristics, knowledge and behaviors correlated with HIV infections and ways of HIV infectious status notification was collected. 'Data information system' on AIDS prevention and control was used to collect information on the transmission route.</p><p><b>RESULTS</b>A total of 770 pairs of HIV discordant couples were studied, among which 414 (53.77%) HIV positive respondents reported as self-notification, with another 44.68% were notified by medical staff. Factors associated with ways of notification included gender, nation, transmission route, and education level. HIV positive respondents who were female, under Han nationality, being paid blood donors, having had higher education level, were more likely to inform their HIV negative spouse by themselves.</p><p><b>CONCLUSION</b>Nationality and HIV transmission route of the HIV positive individuals were found as significant factors associated with ways of spousal notification. Therefore, HIV discordant couples notification should be strengthened, especially in the Minority-living areas and areas where HIV transmission was predomint through sexual contact and/or via injected drug use.</p>

Gender and its impact on condom use among HIV male serodiscordant couples / 中华预防医学杂志

<p><b>OBJECTIVE</b>To study the gender-based factors which influence the condom use among the HIV serodiscordant couples in selected regions of China.</p><p><b>METHODS</b>Based on the analysis of the existing case reporting database and convenient sampling in the cross-sectional study, a total of 481 female HIV-negative spouses completed an interviewer-administered questionnaire regarding demographic characters, the knowledge, behaviors and the gender-based factors in five sites of four provinces Sichuan (Zhaojue), Yunnan (Dali), Henan (Weishi) and Guangxi (Lingshan and Luzhai), during June-September 2011. χ(2) analysis and logistic regression were used to study the gender-based factors influencing condom use among the participants.</p><p><b>RESULTS</b>Among the 481 female HIV-negative spouses, the average age was (35.1 ± 6.7) years, and the proportion of Han and Yi nationality were high, 43.5% (209/481) and 41.8% (201/481), respectively. The awareness of knowledge related to HIV spousal transmission was high (≥ 79.6%). A total of 86.9% (418/481) used condom more frequently after informed the status of HIV infection of their spouses, and the condom use consistency was 56.6% (272/481). A total of 57.6% (277/481) reported low sexual relationship power; 34.5% (166/481) experienced forced sex in the past 1 year. And the proportion of condom use self-efficacy from 0 to 3 scores were 12.7% (61/481), 23.9% (115/481), 8.7% (42/481) and 54.7% (263/481), respectively (median = 3). Han and other nationality were significantly more likely to use condom consistently than Yi, with odds ratio (95%CI) of 0.01 (0.00 - 0.03) and 0.01 (0.00 - 0.04), and the female spouses with higher condom use self-efficacy used condom more consistently than the lower ones, with odds ratio (95%CI) of 0.20(0.11 - 0.34).</p><p><b>CONCLUSION</b>The female spouses with higher condom use self-efficacy were more likely to use condom consistently after excluding the confounding effect of nationality.</p>

High-altitude hypoxia induces disorders of the brain-endocrine-immune network through activation of corticotropin-releasing factor and its type-1 receptors / 中国应用生理学杂志

High-altitude hypoxia can induce physiological dysfunction and mountain sickness, but the underlying mechanism is not fully understood. Corticotrophin-releasing factor (CRF) and CRF type-i receptors (CRFR1) are members of the CRF family and the essential controllers of the physiological activity of the hypothalamo-pituitary-adrenal (HPA) axis and modulators of endocrine and behavioral activity in response to various stressors. We have previously found that high-altitude hypoxia induces disorders of the brain-endocrine-immune network through activation of CRF and CRFR1 in the brain and periphery that include activation of the HPA axis in a time- and dose-dependent manner, impaired or improved learning and memory, and anxiety-like behavioral change. Meanwhile, hypoxia induces dysfunctions of the hypothalamo-pituitary-endocrine and immune systems, including suppression of growth and development, as well as inhibition of reproductive, metabolic and immune functions. In contrast, the small mammals that live on the Qinghai-Tibet Plateau alpine meadow display low responsiveness to extreme high-altitude-hypoxia challenge, suggesting well-acclimatized genes and a physiological strategy that developed during evolution through interactions between the genes and environment. All the findings provide evidence for understanding the neuroendocrine mechanisms of hypoxia-induced physiological dysfunction. This review extends these findings.

HIF-1 signal pathway in cellular response to hypoxia / 浙江大学学报·医学版

HIF-1 is composed of HIF-1α and HIF-1β subunits. It promotes target genes transcription under hypoxia and plays essential roles in cell development, physiological adaptations, and pathological processes. In the past 10 years, the research on signaling pathways of HIF-1 in response to cell hypoxia stress, especially on HIF-1α-mediated gene transcription has made great progress.

Antimicrobial resistance surveillance among nosocomial pathogens in 13 teaching hospitals in China in 2009 / 中华检验医学杂志

Objective To investigate distribution and antimicrobial resistance among nosocomial pathogens from 13 teaching hospitals in China in 2009. Methods Non-repetitive pathogens from nosocomial BSI, HAP and IAI were collected and sent to the central lab for MIC determination by agar dilution method.WHONET5.6 software was used to analyze the data. Results A total of 2 502 clinical isolates were collected. The top three pathogens of BSI were Escherichia coli [27. 1% (285/1 052 )] , coagulase-negutive staphylococcus [12. 6% ( 133/1 052)] and Klebsiella pneumoniae [10. 8% ( 114/1 052)]. The top three pathogens of HAP were Acinetobacter baumannii [28. 8% (226/785)], Pseudomonas aeruginosa [16. 1% (126/785)] and Klebsiella pneumoniae [14.6% (115/785 )] . The top three pathogens of IAI were Escherichia coli[31.0% ( 206/665 )], Klebsiella pneumonia [11.3% ( 75/665 )] and Enterococcus faecium [10. 8% (72/665)]. Against Escherichia coil and Klebsiella spp. , the antimicrobial agents with higher than 80% susceptibility rate included imipenem and meropenem (98. 1%-100% ), tigecycline (95.3%-100% ), piperacillin-tazobactam ( 88.6% -97. 1% ) and amikacin ( 88. 3% -92. 5% ). Against Enterobacter spp. , Citrobacter spp. and Serratia spp. , the susceptibility rates of tigecycline were 93.5% -100% whereas the value of imipenem and meropenem were 92.9% -100%. Other antimicrobial agents with high activity included amikacin ( 85.2% -96. 7% ), pipcracillin-tazobactam ( 82.4% -96.4% ), cefepime ( 79. 6% -96. 7% ) and cefoperazonc-sulbactam (78. 7%-90. 0% ). Polymyxin B showed the highest susceptibility rateagainst Pseudomonas aeruginosa ( 100% ), followed by amikacin ( 81.9% ) and piperacillin-tazobactam (80.1% ). Polymyxin B also showed the highest susceptibility rate against Acinetobacter baumannii (98. 8% ), followed by tigecycline (90. 1% ) and minocycline (72. 0% ). The incidence of carbapenemresistant Acinetobacter baumannii was 60. 1%. The MRSA rate was 60. 2% and the MRSCoN rate was 84. 2%. All Staphylococcus strains were susceptible to tigecycline, vancomycin, teicoplanin and linezolid except for one isolate of Staphylococcus haemolysis with intermediate to teicoplanin. Two Enterococcus faecalis isolates which were intermediate to linezolid and one Enterococcus faecium isolate which was resistant to vancomycin and teicoplanin was found in this surveillance, while the MICs of tigecycline against these three isolates were 0. 032-0. 064 μg/ml. Conclusions Tigecycline, carbapenems, piperacillin-tazobactam,amikacin and cefepime remain relatively high activity against nosocomial Enterobacteriaceae. Pseudomonas aeruginosa exhibite high susceptibility to polymyxin B, while Acinetobacter baumanni shows high susceptibility to polymyxin B and tigecycline. Tigecycline, vancomycin, teicoplanin and linezolid remain high activity against nosocomial gram-positive cocci.

Analysis of inpatient cost of AIDS related opportunistic infection in a high HIV epidemic area / 中华预防医学杂志

<p><b>OBJECTIVE</b>To analyze the inpatient cost of AIDS related opportunistic infection in a high HIV epidemic area of China.</p><p><b>METHODS</b>Information was collected and analyzed from 158 inpatients with AIDS related opportunistic infection, including demographic characteristics of patients, types of opportunistic infection and treatment cost (median) from 2008 to 2010 in a high HIV epidemic area.</p><p><b>RESULTS</b>The inpatient cost per visit for AIDS related opportunistic infection was 2935.7 yuan. The fee per visit for examination, laboratory test, medicine, diagnosis and treatment, nursing, bed was 132.5, 269.0, 1485.5, 367.3, 302.5 and 264.0 yuan, respectively. The inpatient cost per visit for AIDS related opportunistic infection was 4383.1 yuan for male and 3418.6 yuan for female inpatient (U = -1.279, P = 0.201). The cost per visit for AIDS related opportunistic infection was 4703.1 yuan for Han nationality and 3475.9 yuan for minority patient (U = -1.025, P = 0.305). The inpatient cost per visit for AIDS related opportunistic infection was respectively 3429.3, 5022.2, 6705.5 and 2396.7 yuan for farmers, individual businessmen, employees of enterprise and public institution and jobless (H = 28.633, P = 0.000). The cost per visit was lowest for illiteracy patients (2590.2 yuan), 3626.5 yuan for primary school, 4214.3 yuan for junior high school and 6865.8 yuan for high school and higher education (H = 10.828, P = 0.013). The cost per visit for AIDS related opportunistic infection was respectively 2873.6, 4534.3, 3077.8 and 3208.1 yuan for under the age of 29, 30-39 years old, 40-49 years old and beyond the age of 50 (H = 1.515, P = 0.679). The AIDS related opportunistic infection cost per visit for inpatients infected through sex (4621.3 yuan) was higher than that of intravenous drug users (3208.6 yuan, U = -2.588, P = 0.010). Among various types of opportunistic infections, the cost was highest for neurological diseases (5819.7 yuan), 4300.8, 2806.8, and 2083.9 yuan for respiratory diseases, digestive system diseases and skin and mucous membrane diseases, respectively (H = 15.142, P = 0.004).</p><p><b>CONCLUSION</b>The study shows difference of inpatient cost per visit between subgroups, the cost of public institution was higher than that of other professions, the cost of illiteracy patients was lower than other education level, the cost of inpatients infected through sex was higher than that of intravenous drug users, the cost of neurological diseases was higher than that of other types of opportunistic infections.</p>