The value of hs-CRP and albumin ratio in predicting the prognosis of patients with in-hospital cardiac arrest / 中华急诊医学杂志

Objective:To investigate the predicting value of high sensitivity C-reactive protein (hs-CRP) and albumin (Alb) ratio on prognosis of patients with in-hospital cardiac arrest (IHCA).Methods:A total of 107 patients with IHCA and spontaneous circulation recovery (ROSC) after cardiopulmonary resuscitation (CPR) in the Affiliated Hospital of Xuzhou Medical University during January 1, 2017 and September 30, 2020 were selected as the subjects and divided into the survival group and death group according to the survival condition on day 14 after IHCA. The correlation between ratio of high sensitivity C-reactive protein/albumin (hs-CRP/Alb) and the prognosis of patients was analyzed.Results:No statistical significant differences were found between the survival and death groups in sex, age, medical history, ECG monitoring, recovery ventilation mode, percentage of first monitoring of heart rate and pre-resuscitation Alb (all P > 0.05). However, there were significant differences in the percentage of non-cardiogenic CA and adrenaline dose > 5 mg, time of CPR, concentrations of blood lactic acid, Alb, hs-CRP, and ratio of hs-CRP/Alb (all P < 0.05). Logistic regression analysis showed that percentage of adrenaline dose > 5 mg, concentration of blood lactic acid, time of CPR, and ratio of hs-CRP/Alb were independent risk factors for predicting death. ROC curve analysis showed that hs-CRP/Alb ratio, and concentration of hs-CRP and Alb had predictive value on the death of patients with IHCA; the areas under the curves of hs-CRP/Alb ratio, hs-CRP and Alb concentration were 0.876, 0.864 and 0.745, respectively. The predictive efficiency of hs-CRP/Alb ratio was better than that of hs-CRP concentration or Alb concentration. Conclusions:hs-CRP/Alb ratio has predictive value for the prognosis of patients with IHCA and the predictive value is superior to that of hs-CRP and Alb concentration.

Construction and optimization of cordycepin-producing Saccharomyces cerevisiae / 生物工程学报

Cordycepin is the key active component of medicinal fungus Cordyceps militaris, and it shows multiple functional activities such as anti-tumor and anti-virus. Cordycepin was conventionally produced by liquid fermentation of C. militaris, but the long production cycle and the low productivity constrained its development and application. In this study, two key genes for cordycepin biosynthesis (ScCNS1 and ScCNS2) were introduced into Saccharomyces cerevisiae S288C, producing 67.32 mg/L cordycepin at 240 h. Analysis of gene expression profiles indicated that ZWF1, PRS4, ADE4, ScCNS1 and ScCNS2 which encode enzymes involved in pentose phosphate pathway, purine metabolism and cordycepin biosynthesis pathway, were significantly up-regulated in the late phage of fermentation. Optimization of fermentation medium determined that 50 g/L initial glucose followed by feeding, supplemented with 5 mmol/L Cu²⁺ and 1.0 g/L adenine were the best condition. Fed-batch fermentation using the engineered yeast in a 5 L stirred fermenter produced 137.27 mg/L cordycepin at 144 h, with a productivity up to 0.95 mg/(L·h) reached, which was 240% higher than that of the control.

Advances in biosynthesis of cordycepin from Cordyceps militaris / 生物工程学报

Cordycepin as the main active ingredient of Cordyceps militaris, a traditional medicinal fungus in China, has many physiological functions such as anti-cancer, anti-tumor and anti-virus activity. The most potential route for effective cordycepin production has been considered as liquid fermentation of C. militaris though with low productivity at present. Thus, it is urgent to apply both process engineering strategy and metabolic engineering strategy to enhance the productivity of cordycepin. In this review, the effects of medium components (i.e. the carbon/nitrogen source, precursor substances and metal ions) and operation factors (i.e. pH, dissolved oxygen and light) on cordycepin biosynthesis in liquid fermentation system are summarized. Besides, separation of cordycepin, the gene cluster involved and predicted biosynthesis pathways of cordycepin are also discussed, providing possible solutions of finally realizing efficient production of cordycepin.

Clinical features in chronic insomnia comorbidity with silent cerebral small vessel disease / 中国脑血管病杂志

Objective To investigate the clinical features of chronic insomnia patients with cerebral small vessel disease (CSVD). Methods This cross-sectional study consecutively enrolled one hundred out-patient and in-patient patients meeting the diagnostic criteria of chronic insomnia at the department of psychiatry and neurology in tlie third affiliated hospital, Sun Vet-sen University from January 2018 to April 2019.Tlie patients (52-75 years) received magnetic resonance ( MR) .polysomnography ( PSG) , Montreal Cognitive Assessment (MoCA) in two weeks after enrollment. The subjective symptoms were evaluated by visual analogue scale ( VAS). Patients with comorbid CSVD were in the experimental group (28cases) .while those with simple insomnia were in the control group (72 cases). 11 ie differences of symptoms,I∗SC parameters and cognitive function between the two groups were compared. Results In the experimental group, only dizziness of subjective symptoms was higher than that in the control group (7. 0 [4. 5,8. 0] vs. 4. 0 [2. 0, 6. 0] ). The experimental group also had higher PSC monitored awakening time after sleep (105. 8 [66. 7, 141.3] min to 70. I [35.4,116.8] min) .arousal index ([29 ±8] limes/h vs. [21 ±6] times/h) , ratio of nonrapid eye movement sleep 1 phase ([15 ±4] % vs. [ 10 ±3] %) than the control group,but lower sleep efficiency ([67 ± 18] % vs. [75 ± 15] % ). The total MoCA score (19.0 [15.0,24.0] to 23.5 [ 17.0,26. 5]) .visuospatial score (2.0 [ 1.0,3.0] vs. 2. 5 [ 1.5,3.0]) .executive function score (2.0 [ I. 0,3.0] vs. 2.5 [2.0,3.0]) and short-term memory score (2. 5 [ I. 0,4.0] vs. 3. 0 [2.0,4. 0]) in the study group were significantly lower than that in the control group (/' <0. 05). Conclusion Chronic insomnia with CSVD is common with concealing subjective symptoms,and it needs to be identified from the aspects of cognitive assessment and sleep monitoring.

The validation of atypical depression among Chinese outpatients with depressive episodes in general hospital / 中华行为医学与脑科学杂志

Objective to evaluate the validation of atypical depression among Chinese outpatients with depressive episodes and explore the role of atypical depressive symptoms in distinguishing bipolar depression from unipolar depression.Methods Structural clinical interviews with self-compiled questionnaires were performed on 276 outpatients with current depressive episode,then comparison of clinical characteristics including age of onset,gender proportion,seasonality,comorbidity of anxiety disorder,bipolar property,psychotic features,number of depressive episodes,and maximum duration of depressive episode were conducted between atypical (defined by DSM-Ⅳ-TR) and nonatypical depression.then the rate of atypical depressive symptoms were compared between unipolar depression and bipolar depression.Results The proportion of atypical depression among all the participants was 23.9％.Compared to nonatypical depression,psychotic features were more likely seen in atypical depression (20.0％ vs 9.1％,P＜0.05),but no difference was found in other clinical features between atypical and nonatypical depression.Except mood reactivity,atypical symptoms including oversleeping(45.5％ vs 26.0％),overeating (22.7％ vs 15.4％),weight gain(24.1％ vs 14.6％),leaden paralysis (56.6％ vs 47.2％),interpersonal rejection sensitivity(66.7％ vs 34.2％) were more likely to occur in bipolar depression than in unipolar depression,the difference was statistically significant for oversleeping and interpersonal rejection sensitivity (P ＜ 0.05).Patients with mood reactivity differed little from those without mood reactivity in other clinical features.No association was found between mood reactivity,leaden paralysis and other criteria symptoms of atypical depression.Conclusion-Atypical depression might be a useful concept,but its diagnostic criteria needs further validation among Chinese population.

Effective of cognitive behavioral self help therapy on efficacy and dependence for chronic insomnia patients with hypnotic long-term use / 中华行为医学与脑科学杂志

Objective To test the efficacy of cognitive behavioral self help therapy for chronic insomnia (CBTI-SH) patients with hypnotic long-term use.Methods A total of 60 adults with chronic insomnia and common comorbidities were recruited.Participants were randomly assigned to either intervention group (IG,n =30) if they had used hypnotics more than 6 months,or control group(CG,n =30) if they had never used hypnotics in the past 6 months.All the patients were given CBTI-SH for 4 weeks.The primary outcome was self-report symptom,based on sleep diaries (including Sleep Latency(SL),Wake after Sleep Onset(WASO),Total Sleep Time(TST),Time In Bed(TIB),Sleep Efficiency(SE) which were evaluated on baseline and at the end of the 2nd,4th week treatment.Continuous variables were evaluated by repeated-measures multivariate analyses of variance (MANOVA).At the conclusion of treatment,each participant was asked how many days per week they enacted each of 6 core elements of the CBT regimen.Linear regression models were examined to determine net predictors of CBTI-SH adherence.Results The MANOVA showed a significant treatment group × time interaction,as well as time main effects for SE,TIB and WASO(P＜0.05).The patients in CG made better improvements than those in IG on SE,TIB and WASO((0.19 ±0.08) vs(0.09 ±0.09),(92.48 ± 32.64) vs (78.06 ±60.05),(103.08 ±64.82) vs (64.92 ±56.36),respectively) (P ＜ 0.05).Effect size were 1.14,0.85 and 0.62 respectively.Self-ratings of treatment adherence showed patients in the IG reported less adherence to standard rise time and TIB prescription than those in CG.(P ＜ 0.05).According to the linear regression models,both age and the comorbidity of chronic somatic diseases explained net associations with CBTI-SH adherence (P ＜ 0.05).Conclusion Chronic insomnia patients with hypnotic long-term use show less sleep improvement and less adherence to CBTI-SH compared with those who don' t use these medicines.Both age and the comorbidity of chronic somatic diseases explain net associations with CBTI-SH adherence.

A comparison research of the Big Five Personality factors among Han Chinese women with recurrent depression / 中华行为医学与脑科学杂志

ObjectiveTo explore the personality traits of Han Chinese women with recurrent depression.MethodsAssessed by the Big Five Inventory (BFI),a comparison research was conducted between 118 Han Chinese women with recurrent depression and 65 sex,race and culture background matched health controls.Results Han Chinese women with recurrent depression scored lower in extraversion,conscientiousness and openness ( 17.93± 5.43,30.24 ± 5.94,30.03 ± 7.33 ) than matched controls ( 20.72 ± 3.79,31.94 ± 3.84,32.75 ± 5.32 ),while scored higher in neuroticism (21.38 ± 3.91) than the later one ( 27.57 ± 6.19 ).A binary logistic regression model,with group (case vs.control) as dependent variable and extroversion,conscientiousness,openness and neuroticism as independent variables,was built to assess each personality dimension's independent impact on recurrent depression.It came out to be that only extraversion ( OR =0.881,95％ CI =0.083-0.966,P=0.007) and neuroticism ( OR =1.225,95％ CI =1.134-1.323,P ＜ 0.01 ) were statistically significantly associated with recurrent depression ( P＜ 0.05 ).ConclusionIn the big five personality model,extraversion and neuroticism might act as independent personality traits to impact Han Chinese women with recurrent depression in a positive and negative way respectively.

The condition of benzodiazepines use in generalized anxiety disorder patients and the relationship with the first BZD prescription / 中华行为医学与脑科学杂志

Objective To study the condition of benzodiazepines use in generalized anxiety disorder (GAD) patients and the relationship with the first benzodiazepine(BZD) prescription.Methods 70 outpatients with GAD were investigated retrospectively and divided into either research group( n = 54, M21, F33; age (18 ～73)year) or control group( n= 16,M7,F9; age( 18 ～53)year) based on whether the first prescription included BZD or not.Results The duration and dose of BZD used in research group ( separately (9.7 ± 4.4) months, ( 1.6 ± 0.7 ) mg/d) were significantly higher than those in control group ( separately(2.3 ± 2.4) months, (0.9 ± 0.9 ) mg/d) (P＜0.01).The long-term use of BZD was positively related to whether the first prescription include BZD or not,patients' insomnia on first visit,the duration of follow-up and the dose of BZD,which showed significantly difference (P＜ 0.05 ).The standardized rates of long-term use of BZD and dependence in research group were significantly higher than those in control group (P ＜ 0.01 ).Conclusion Prescribing BZD on the first visit is partly responsible for the long-term use of BZD and doctors should better be very careful of prescribing BZD on first visit.

Syphilis among Inpatients:General Survey and Analysis / 中华医院感染学杂志

OBJECTIVE To investigate the current situation and epidemiological features of syphilis among inpatients in our hospital since 2003.METHODS This study was retrospective.The data were obtained from the inpatients′ files from Jan 2003 to May 2006,All patients with syphilis were analyzed with epidemiological methods.RESULTS Of the 127 586 inpatients screened for syphilis,740(0.58%) were positive,in which 13 were congenital syphilis,371 were latent syphilis and 356 were dominant syphilis.The yearly syphilis positive rate steadily increased,especially the proportion of latent syphilis,being higher among male(0.70%) than female(0.49%)(OR=1.47).The syphilis positive rate of the elder was higher than that of the younger.The syphilis occurred in all departments and all age groups.CONCLUSIONS There is a need for a routine syphilis screening among all inpatients in order to prevent the misdiagnosis of syphilis among them,especially for the latent syphilis.This could be benefit for the latent syphilis patients to get treatment earlier and minimize the spreading of syphilis.

Clinical Study of Efficacy of Terbinafine Combined with Fluconazole in the Treatment of Recurrent Vulvovaginal Candidiasis / 药物流行病学杂志

Objective:To assess the efficacy of terbinafine combined with fluconazole in the treatment of recurrent vulvovaginal candidiasis(RVVC).Method:94 patients with recurrent vulvovaginal candidiasis were randomly divided into three groups.30 cases in the terbinafine monotherapy group were treated with an oral 250mg-dose of terbinafine once daily; 31 cases in the fluconazole monotherpy group were treated with an oral 150mg-dose of fluconazole once daily;33 cases in the combined therapy group were given terbinafine and fluconazole together,and the usage and dosage were the same as those of the monotherapy groups.The treatment period of the three groups was 7 days.The efficacy was evaluated in the second week,sixth month and twelfth month after the treatment.Result:In the second week or sixth month or twelfth month after the treatment,the clinical cure rate,clinical effective rate and fungous clearance rate of the combined therapy group were higher than those of the monotherapy groups,which had statistically significant difference.Conclusion:The combined therapy with terbinafine and fluconazole can effectively improve the clinical signs and symptoms of RVVC patients and eliminate candida,which is more effective than the monotherapy with terbinafine or fluconazole.