Clinical value of combined detection of placenta associated 8 and platelet activating factor acetylhydrolase for early identification of sepsis and non-infectious systemic inflammatory response syndrome / 中华传染病杂志

Objective:To evaluate the clinical value of combined detection of placenta associated 8 (PLAC8) and platelet activating factor acetylhydrolase (PLA2G7) for early identification of sepsis and non-infectious systemic inflammatory response syndrome (SIRS).Methods:A cross-sectional study was conducted. A total of 189 febrile patients suspected infection who were admitted to Huashan Hospital, Fudan University from October 2022 to April 2023 were included. Based on etiological, laboratory test results and clinical data, patients were classified as infection or non-infection, and further classified as sepsis or non-infectious SIRS according to diagnostic criteria. Real-time fluorescence polymerase chain reaction was used to detect the mRNA levels of PLAC8 and PLA2G7 in peripheral venous blood of patients. Hematology, inflammatory markers including C-reactive protein (CRP), interleukin-6 (IL-6) and procalcitonin, sepsis-related organ failure assessment (SOFA) score, and the difference of cycle threshold (Ct) values between PLA2G7 and PLAC8 ((PLA2G7-PLAC8)ΔCt value))were compared between the sepsis and non-infectious SIRS groups. Statistical comparison was analyzed using Mann-Whitney U test, and the diagnostic performance of (PLA2G7-PLAC8)ΔCt value in discriminating sepsis from non-infectious SIRS was evaluated using receiver operating characteristic curve. Results:Among the 189 febrile patients suspected infection, there were 80 non-infectious patients, including 51 non-infectious SIRS patients, and 109 infection patients, including 53 sepsis patients. The neutrophil ratio, CRP, IL-6, procalcitonin, and SOFA score of non-infectious SIRS patients were lower than those of the sepsis group, and the differences were all statistically significant ( Z=-2.70, -3.11, -2.16, -3.76 and -2.33, respectively, all P<0.05). The (PLA2G7-PLAC8)ΔCt value in the non-infectious SIRS group was 4.38(1.41), which was lower than 8.18 (6.19) in the sepsis group, with a statistically significant difference ( U=193.50, P<0.001). The area under the receiver operating characteristic curve (AUROC) for (PLA2G7-PLAC8)ΔCt value in the differential diagnosis of sepsis and non-infectious SIRS was 0.859, with the optimal cut-off value of 5.86. The sensitivity and specificity were 82.2% and 71.9%, respectively. When combined with procalcitonin, the AUROC was 0.917, with a sensitivity of 95.6% and specificity of 70.6%. Conclusions:The (PLA2G7-PLAC8)ΔCt value in peripheral blood has good clinical value for early identification of sepsis and non-infectious SIRS, especially when combined with procalcitonin, which could further improve the accuracy of differential diagnosis.

Research status,hotspots and trends of long COVID based on bibliometric analysis / 复旦学报（医学版）

Objective By analyzing relevant literature of long COVID,we aimed to understand the current research status,hotspots and trends in this field.Methods Based on Web of Science core collection data,bibliometric analysis was used as the main research method.The results were visualized with VOSviewer.A comprehensive analysis was performed from various perspectives including trends in publication,journal distribution,highly cited papers,international research collaboration networks,and clusters of keywords,etc.Results The field of long COVID has garnered significant global academic attention.A total of 7 877 related articles were retrievable,with a total citation count of 103 389 and an average citation count of 13.13 per article.Among them,the United States published the most articles(1 780 articles,22.59%),while China ranked fifth in publication volume(686 articles,8.71%).The international scientific cooperation network reflected the close collaborative relationships between countries in long COVID research,predominantly involving the United States,the United Kingdom,Italy,India,and China.Keywords clustering indicated that the current main research focuses in the long COVID field include:clinical manifestations,epidemiological characteristics,risk factors,and mechanisms of occurrence,treatment and rehabilitation measures of long COVID,and its impact on public and social life.Conclusion This article reveals the current state,research hotspots and trends in the long COVID field,providing valuable references for related research institutions,scholars as well as health administrative office.

Research progress on genetic model of mouse with glaucoma / 国际眼科杂志(Guoji Yanke Zazhi)

Glaucoma, currently the world's first irreversible blindness, is a complex multifactorial disease with a genetic predisposition, and pathologically elevated intraocular pressure is its risk factor. The pathogenesis of glaucoma is not fully understood, and most existing studies are based on animal models, with mice as the main research object, and the pathological damage process of glaucoma is reconstructed through experimental induction means or transgenic manipulation to further investigate the relevant pathogenesis and pathological changes. The technique of experimentally induced construction of glaucoma mouse models has been studied by many scholars and is gradually becoming mature. And as research in molecular biology and genetics has advanced, more and more studies have focused on the disease genes associated with glaucoma, and transgenic mouse models have become a hot topic in recent years. In contrast to experimental manipulation to control a single factor, gene editing is better able to simulate the complex process of disease pathogenesis. This paper focuses on providing a more complete direction and strategy for model selection in the future research by describing the progress of research on relevant transgenic mouse model of glaucoma.

Echinococcus granulosus cyst fluid(EgCF) inhibits the migration and phagocytic function of mouse macrophages induced by LPS via inducing cytoskeletal rearrangement / 细胞与分子免疫学杂志

Objective To investigate the effect of Echinococcus granulosus cyst fluid(EgCF) on the cytoskeletal rearrangement and phagocytosis and the migration of macrophages induced by lipopolysaccharide(LPS). Methods Peritoneal macrophages of C57BL/6 mice were isolated and cultured in vitro, and divided into control group and LPS group and LPS combined with EgCF group. After 48 hours of treatment, filamentous actin (F-actin) changes were observed with rhodamine-labelled phalloidin staining and fluorescence microscopy; TranswellTM chamber was used to test cell migration ability and flow cytometry to test cell phagocytosis. After 1 hour of treatment, PI3K and AKT, phosphorylated AKT (p-AKT), Rac1, guanosine triphospho-Rac1 (GTP-Rac1), WASP and Arp2 protein expressions were detected with Western blot analysis. Results Compared with the control group, after LPS stimulation, macrophages were deformed significantly; pseudopodia increased; actin cytoskeleton increased and was more distributed in pseudopodia; the ability of migration and phagocytosis were significantly improved, and the expression of PI3K, p-AKT, GTP-Rac1, WASP and Arp2 proteins significantly increased. EgCF treatment caused cell shrinkage and disappearance of pseudopodia protrusions of LPS-activated cells, and led to the reduced phagocytic and migratory of cells; the protein expression of PI3K, p-AKT, GTP-Rac1, WASP and Arp2 decreased significantly compared with the LPS group. Conclusion LPS induces the migration and enhances phagocytosis of macrophages while EgCF inhibits these effects, which is related to actin cytoskeleton rearrangement.

Effect of nursing intervention based on interaction model of Cox health behavior on health outcomes of patients with chronic sinusitis with nasal polyps and olfactory disorders / 中国实用护理杂志

Objective:To explore the value of the nursing intervention based on interaction model of Cox health behavior in patients with chronic rhinosinusitis with nasal polyps (CRSwNP) with olfactory disorders, so as to provide reference for clinical caregivers to improve the olfactory function and quality of life of such patients and reduce negative emotions.Methods:This study was a prospective, randomized, single blind controlled trial. A convenient sampling method was used to select 50 patients with olfactory disorders of CRSwNP who were hospitalized in the Department of Otolaryngology, Second Affiliated Hospital of Kunming Medical University from February 2022 to August 2022 as the study population. According to the random number table method, 25 patients in each group were divided into a test group and a control group. The control group was given conventional perioperative nursing measures, while the test group was given nursing intervention based on interaction model of Cox health behavior. Patients in the two groups were recorded and compared in terms of olfactory function, anxiety and depression, and quality of life scores before and after the intervention. Patient satisfaction scores at the time of discharge were also compared between the two groups.Results:Finally, 24 cases were included in the control group and 23 cases in the test group. The comparison of olfactory perception threshold, recognition threshold score, anxiety-depression score and quality of life score between the two groups before the intervention was not statistically significant ( P>0.05) and was comparable. The perceptual domain scores were (-0.18 ± 1.89), (-1.30 ± 1.06) points in the test group at 2 weeks and 1 month after the intervention, respectively, which were lower than the (0.92 ± 1.65), (-0.29 ± 1.40) points in the control group. The differences were statistically significant ( t=2.09, 2.72, both P<0.05). The recognition threshold returned to its normal value (0.38 ± 1.67) points in the test group 1 month after the intervention, with a lower score than the control group′s (1.46 ± 1.77) points. The difference was statistically significant ( t=2.10, P<0.05). After the intervention, the anxiety, depression and quality of life scores in the test group were (31.93 ± 3.55), (32.31 ± 5.80), (31.30 ± 6.00) points respectively, which were lower than the (35.10 ± 5.46), (36.84 ± 6.98), (38.53 ± 9.27) points in the control group. The differences were statistically significant ( t=2.30, 2.36, 3.09, all P<0.05). In addition, the patient satisfaction score was higher in the trial group (49.31 ± 3.95) points than in the control group (44.30 ± 2.60) points, with a statistically significant difference ( t=-5.05, P<0.05). Conclusions:The nursing intervention based on interaction model of Cox health behavior can effectively improve the patients' olfactory function and quality of life, reduce the level of anxiety and depression, and improve the patients' satisfaction.

Jiao's scalp acupuncture combined with virtual reality rehabilitation training for motor dysfunction in patients with Parkinson's disease: a randomized controlled trial / 中国针灸

OBJECTIVE@#To compare the clinical efficacy between Jiao's scalp acupuncture combined with virtual reality (VR) rehabilitation training and VR rehabilitation training alone for motor dysfunction in patients with Parkinson's disease (PD).@*METHODS@#A total of 52 patients with PD were randomly divided into an observation group and a control group, 26 cases in each group. The patients in both groups were treated with routine basic treatment, and the patients in the control group were treated with VR rehabilitation training. The patients in the observation group were treated with Jiao's scalp acupuncture on the basis of the control group. The scalp points included the movement area, balance area and dance tremor control area. Both groups were treated once a day, 5 times a week for a total of 8 weeks. Before treatment and 4 and 8 weeks into treatment, the gait parameters (step distance, step width, step speed and step frequency), timed "up and go" test (TUGT) time and unified Parkinson's disease rating scale part Ⅲ (UPDRS-Ⅲ) score were compared between the two groups, and the clinical efficacy was evaluated.@*RESULTS@#Four weeks into treatment, except for the step width in the control group, the gait parameters of the two groups were improved, the TUGT time was shortened, and the UPDRS-Ⅲ scores were reduced (P<0.01, P<0.05); the step distance in the observation group was better than that in the control group, and the UPDRS-Ⅲ score in the observation group was lower than that in the control group (P<0.05). Eight weeks into treatment, the gait parameters of the two groups were improved, the TUGT time was shortened, and the UPDRS-Ⅲ scores were reduced (P<0.01); the step distance and step speed in the observation group were better than those in the control group, the TUGT time in the observation group was shorter than that in the control group, and the UPDRS-Ⅲ score in the observation group was lower than that in the control group (P<0.05, P<0.01). The total effective rate was 92.3% (24/26) in the observation group, which was higher than 69.2% (18/26) in the control group (P<0.05).@*CONCLUSION@#Jiao's scalp acupuncture combined with VR rehabilitation training could improve the gait parameters, walking ability and motor function in patients with PD. The clinical effect is better than VR rehabilitation training alone.

Comprehensive Evaluation and Application of Experimental Sources of Variation in Gut Microbiome Sequencing Studies / 中国生物化学与分子生物学报

Gut microbiome sequencing studies have great potential to translate microbial analysis outcomes into human health research. Sequencing strategies of 16S amplicon and whole-metagenome shotgun (WMS) are two main methods in microbiome research with respective advantages. However, how sample heterogeneity, sequencers and library preparation protocols affect the sequencing reproducibility of gut microbiome needs further investigation. This study aims to provide a reference for the selection of sequencing technologies by comparing differences in microbial composition from different sampling sites. The results of three widely adopted sequencers showed that the technical repetition correlation (r= 0. 94) was high in WMS method, while the biological repetition correlation (r = 0. 69) was low. Bray-Curtis distance identified that dissimilarity from biological replicates was larger than that of technical replicates (P<0. 001). In addition, dissimilarity and specific taxonomic profiles were observed between 16S and WMS datasets. Our results imply that homogenization is a necessary step before sample DNA extraction. The sequencers contributed less to taxonomic variation than the library preparation protocols. We developed an empirical Bayes approach that " borrowed information" in calculations and analyzed batch effect parameters using standardized data and prior distributions of (non-) parameters, which may improve population comparability between 16S and WMS and provide a basis for further application to fusion analysis of published 16S and microbial datasets.

Effect of electroacupuncture at Neiguan (PC 6) on pulmonary function during one-lung ventilation in patients with lobectomy / 中国针灸

OBJECTIVE@#To observe the protective effect of electroacupuncture (EA) at Neiguan (PC 6) on pulmonary function during one-lung ventilation (OLV) in patients with lobectomy, and explore its action mechanism.@*METHODS@#Sixty patients with lobectomy were randomly divided into an observation group and a control group, 30 cases in each one. The patients in the control group were treated with general anesthesia, and OLV was given when surgery began; when the surgery finished, air was removed from the thoracic cavity and two-lung ventilation was performed. On the basis of the treatment in the control group, the patients in the observation group were treated with EA (disperse-dense wave, 2 Hz/100 Hz of frequency) at Neiguan (PC 6) 30 min before anesthesia induction until the end of the surgery. The pulmonary function indexes [arterial partial pressure of oxygen (PaO@*RESULTS@#Compared with T@*CONCLUSION@#EA at Neiguan (PC 6) has protective effects on lung injury induced by OLV after lobectomy, and its mechanism may be related to the improvement of oxidative stress and inflammatory response.

Prediction of intensive care unit readmission for critically ill patients based on ensemble learning / 北京大学学报(医学版)

OBJECTIVE@#To develop machine learning models for predicting intensive care unit (ICU) readmission using ensemble learning algorithms.@*METHODS@#A publicly accessible American ICU database, medical information mart for intensive care (MIMIC)-Ⅲ as the data source was used, and the patients were selected by the inclusion and exclusion criteria. A set of variables that had the predictive ability of outcome including demographics, vital signs, laboratory tests, and comorbidities of patients were extracted from the dataset. We built the ICU readmission prediction models based on ensemble learning methods including random forest, adaptive boosting (AdaBoost), and gradient boosting decision tree (GBDT), and compared the prediction performance of the machine learning models with a conventional Logistic regression model. Five-fold cross validation was used to train and validate the prediction models. Average sensitivity, positive prediction value, negative prediction value, false positive rate, false negative rate, area under the receiver operating characteristic curve (AUROC) and Brier score were used as performance measures. After constructing the prediction models, top 10 predictive variables based on importance ranking were identified by the model with the best discrimination.@*RESULTS@#Among these ICU readmission prediction models, GBDT (AUROC=0.858) had better performance than random forest (AUROC=0.827), and was slightly superior to AdaBoost (AUROC=0.851) in terms of AUROC. Compared with Logistic regression (AUROC=0.810), the discrimination of the three ensemble learning models was much better. The feature importance provided by GBDT showed that the top ranking variables included vital signs and laboratory tests. The patients with ICU readmission had higher mean arterial pressure, systolic blood pressure, diastolic blood pressure, and heart rate than the patients without ICU readmission. Meanwhile, the patients readmitted to ICU experienced lower urine output and higher serum creatinine. Overall, the patients having repeated admissions during their hospitalization showed worse heart function and renal function compared with the patients without ICU readmission.@*CONCLUSION@#The ensemble learning based ICU readmission prediction models had better performance than Logistic regression model. Such ensemble learning models have the potential to aid ICU physicians in identifying those patients with high risk of ICU readmission and thus help improve overall clinical outcomes.

Advances about perineuronal nets in the repair of nerve function after spinal cord injury / 中国骨伤

Perineuronal nets (PNNs) is a complex network composed of highly condensed extracellular matrix molecules surrounding neurons. It plays an important role in maintaining the performance of neurons and protecting them from harmful substances. However, after spinal cord injury, PNNs forms a physical barrier that surrounds the neuron and limits neuroplasticity, impedes axonal regeneration and myelin formation, and promotes local neuroinflammatory uptake. This paper mainly describes the composition and function of PNNs of neurons and its regulatory effects on axonal regeneration, myelin formation and neuroinflammation after spinal cord injury.

Predicting prolonged length of intensive care unit stay via machine learning / 北京大学学报(医学版)

OBJECTIVE@#To construct length of intensive care unit (ICU) stay (LOS-ICU) prediction models for ICU patients, based on three machine learning models support vector machine (SVM), classification and regression tree (CART), and random forest (RF), and to compare the prediction perfor-mance of the three machine learning models with the customized simplified acute physiology score Ⅱ(SAPS-Ⅱ) model.@*METHODS@#We used medical information mart for intensive care (MIMIC)-Ⅲ database for model development and validation. The primary outcome was prolonged LOS-ICU(pLOS-ICU), defined as longer than the third quartile of patients' LOS-ICU in the studied dataset. The recursive feature elimination method was used to do feature selection for three machine learning models. We utilized 5-fold cross validation to evaluate model prediction performance. The Brier value, area under the receiver operation characteristic curve (AUROC), and estimated calibration index (ECI) were used as perfor-mance measures. Performances of the four models were compared, and performance differences between the models were assessed using two-sided t test. The model with the best prediction performance was employed to generate variable importance ranking, and the identified top five important predictors were pre-sented.@*RESULTS@#The final cohort in our study consisted of 40 200 eligible ICU patients, of whom 23.7% were with pLOS-ICU. The proportion of the male patients was 57.6%, and the age of all the ICU patients was (61.9±16.5) years.Results showed that the three machine learning models outperformed the customized SAPS-Ⅱ model in terms of all the performance measures with statistical significance (P < 0.01). Among the three machine learning models, the RF model achieved the best overall performance (Brier value, 0.145), discrimination (AUROC, 0.770) and calibration (ECI, 7.259). The calibration curve showed that the RF model slightly overestimated the risk of pLOS-ICU in high-risk ICU patients, but underestimated the risk of pLOS-ICU in low-risk ICU patients. Top five important predictors for pLOS-ICU identified by the RF model included age, heart rate, systolic blood pressure, body tempe-rature, and ratio of arterial oxygen tension to the fraction of inspired oxygen(PaO2/FiO2).@*CONCLUSION@#The RF algorithm-based pLOS-ICU prediction model had a best prediction performance in this study. It lays a foundation for future application of the RF-based pLOS-ICU prediction model in ICU clinical practice.

Effect of Sanhuang Xiexintang in Inhibiting 7-Ketocholesterol-induced Endothelial Disfunctional by NIRP3 Inflammasome Pathway / 中国实验方剂学杂志

<b>Objective::To study whether Sanhuang Xiexintang (SHXXT) can restore endothelial function by inhibiting the activation of NOD-like receptor protein 3 (NIRP3) induced by 7-ketocholesterol (7-keto) in vascular endothelial cells. <b>Method::The aortic rings of mice were cultured in normal group, model (7-keto) group, SHXXT groups (1%, 2% and 5% drug-containing serum). Vasodilation function of mice was observed. Microvascular endothelial cells were cultured according to the above experimental groups, and NIRP3 inhibitor isoglycyrrhizin (ISO) group, was also set. Western blot was used to detect the expressions of endothelial nitric oxide synthase (eNOS), NIRP3, cysteinyl aspartate specific proteinase-1 (Caspase-1), interleukin-1<italic>β</italic> (IL-1<italic>β</italic>) protein. In addition, nitric oxide (NO) quantitative kit was used to detect the concentration of NO. <b>Result::Compared with the normal group, the endothelium-dependent vasodilation function of vascular rings was significantly reduced in model group (<italic>P</italic><0.01), and the drug group significantly restored the endothelium-dependent vasodilation function in a concentration-dependent manner (<italic>P</italic><0.05, <italic>P</italic><0.01). Meanwhile, microvascular endothelial cells were also studied. Compared with the normal group, the content of eNOS protein in the model group decreased (<italic>P</italic><0.05), while the concentration of NO decreased significantly (<italic>P</italic><0.01). After treatment with SHXXT serum, eNOS and NO could be restored, with significant differences in the concentration of NO with 5% (<italic>P</italic><0.05) and 10% (<italic>P</italic><0.01) SHXXT serum. At the same time, the expressions of NIRP3 (<italic>P</italic><0.05), cle-Caspase-1 activation (<italic>P</italic><0.01) and IL-1<italic>β</italic> production (<italic>P</italic><0.01) in endothelium were significantly increased under 7-keto stimulation, and the SHXXT serum could significantly inhibit the expression and activation of relevant proteins. Subsequently, endothelial cells were treated with NIRP3 inhibitor ISO. Compared with the model group, eNOS expression increased, and NO concentration increased significantly (<italic>P</italic><0.01) after treatment with ISO, but ISO had no synergistic effect on SHXXT serum. <b>Conclusion::SHXXT can improve endothelium-dependent vascular dysfunction induced by 7-keto, which is achieved by NO signaling pathway mediated by inhibiting the activation of endothelial NIRP3-related proteins.

Effect of electroacupuncture at "Jiaji" (EX-B 2) points on the proliferation and differentiation of oligodendrocyte precursor cells in rats with acute spinal cord injury / 中国针灸

OBJECTIVE@#To observe the effect of electroacupuncture (EA) at "Jiaji" (EX-B 2) points on the proliferation and differentiation of oligodendrocyte precursor cells in rats with acute incomplete spinal cord injury, and to explore the mechanism of EA on improving motor function of spinal cord injury.@*METHODS@#A total of 72 male SPF SD rats were randomly divided into a sham operation group, a model group, an EA group and a medication group, 18 rats in each group. Each group was further divided into 1-day subgroup, 7-day subgroup and 14-day subgroup, 6 rats in each subgroup. The T acute incomplete spinal cord injury model was established by modified Allen's method in the model group, EA group and medication group. The rats in each group received intraperitoneal injection of 5-bromodeoxyuridine (BrdU, 50 mg/kg), once a day, and each subgroup received continuous injection for 1, 7, 14 times for cell proliferation labeling. The rats in the EA group were treated with EA at "Jiaji" (EX-B 2) points 3-4 mm next the spinous process of the upper and lower segments of the injured spinal cord (T, T) with a frequency of 2 Hz/100 Hz and intensity of 1-2 mA. The muscle twitch at the treatment site was taken as the degree. The treatment was given 20 min each time, once a day. In the medication group, monosialogangliosides (GM1) was injected intraperitoneally (10 mg/kg), once a day. The subgroups of EA group and medication group were treated for 1, 7, 14 times. The score of Basso Beattie Bresnahan (BBB) was used to evaluate the motor function of hind limbs. The co-expression of BrdU/NG2 positive cells was detected by immunofluorescence, and the expression of Olig2 and Sox10 was detected by Western blot.@*RESULTS@#Compared with the sham operation group, the BBB score was decreased 1 day, 7 days and 14 days after operation in the model group (<0.05), the expression of Olig2 and Sox10 was increased (<0.05), and the co-expression of BrdU/NG2 positive cells was increased 7 days and 14 days after operation (<0.05). Seven days and 14 days after operation, the BBB score in the EA group and medication group was higher than that in the model group (<0.05), and the co-expression of BrdU/NG2 in the medication group was higher than that in the model group (<0.05). Fourteen days after operation, the co-expression of BrdU/NG2 in the EA group was higher than that in the model group (<0.05); 1 day, 7 days and 14 days after operation, the expression of Olig2 and Sox10 in the EA group and medication group was higher than that in the model group (<0.05). Compared with the medication group, the co-expression of BrdU/NG2 positive cells in the EA group 14 days after operation was decreased (<0.05); 1 day, 7 days and 14 days after operation, the expression of Olig2 and Sox10 in the EA group was decreased (<0.05).@*CONCLUSION@#EA at "Jiaji" (EX-B 2) points could promote the expression of Olig2 and Sox10 after spinal cord injury, which has similar effects with GM1. It could promote the proliferation and differentiation of oligodendrocyte precursor cells into oligodendrocytes, so as to promote the recovery of motor function of rats.

Simulation experiment of retrograde contamination of drainage bag outlets / 中国感染控制杂志

Objective To explore the retrograde contamination of drainage bag outlets,and provide basis for the formulation of related guideline for healthcare-associated infection(HAI)management. Methods On October 14,2016,with sterile manipulation,urine,5% glucose solution,glucose normal saline,sterile water,and 0.9% nor-mal saline were injected into anti-reflux drainage bags(anti-reflux group)and common drainage bags(common group)respectively,entrances of bags were sealed and bags were hung in two ways:outlets were 10 cm away from the ground(suspended group)and touched the ground(ground-touching group)respectively,specimens were col-lected from bag outlets to perform bacterial culture every 3 days,a total of 10 times of cultures were performed,re-trograde contamination of drainage bag outlets was observed dynamically.Results Retrograde contamination rate of drainage bag outlets of anti-reflux group was significantly lower than common group(7.7% vs 46.0%,P=0.000);suspended group was significantly lower than ground-touching group(17.9% vs 35.8%,P=0.000). Retrograde contamination rates of outlets of drainage bags filled with different properties of liquid were as follows:urine (54.3%)>5% glucose solution(34.5%)>glucose normal saline(24.3%)>0.9% normal saline(10.8%)>ste-rile water(10.5%),pairwise comparison showed a significant difference(P=0.000).The initial occurrence time of contamination in anti-reflux group and common group was on the 13thday and 7thday respectively,two group was significantly different on the 7thday(P=0.041). There was a medium intensity correlation between the types of drainage bags and liquid properties(PearsonC=0.5).Conclusion Different types of drainage bags,retention time,and liquid property can impact retrograde contamination of drainage bag outlets,regular urine culture during the use of drainage bags should be paid attention in clinical practice,so as to use antimicrobial agents rationally and guide replacement time of drainage bags.

Expression of Serum miR-141 and miR-224 in Patients with Non-Small Cell Lung Cancer and Its Clinical Significance / 现代检验医学杂志

Objective To investigate the expression of miR-141 and miR-224 in non-small cell lung cancer (NSCLC) and its clinical significance.Methods The levels of serum miR-141,miR-224 and squamous cell carcinoma associated antigen (SCC-Ag) were detected by RT-PCR in 128 patients with NSCLC,60 patients with benign lesions (benign group) and 60 healthy subjects (control group).To analyze the relationship between the expression levels of miR-141 and miR-224 and the clinicopathological features of NSCLC.The sensitivity and specificity of miR-141,miR-224 and SCC-Ag in the diagnosis of NSCLC were evaluated by ROC curve,and the correlation between serum miR-141 and miR-224,SCC-Ag were analyzed by Pearson correlation analysis in NSCLC patients.Results The levels of serum miR-141,miR-224 and SCC-Ag in NSCLC group were significantly higher than those in the benign group and the control group[miR-141(2-△△Ct):2.56±0.48 vs 1.08±0.24 and 1.02±0.21,miR-224 (2-△△Ct):3.94±0.82 vs 1.42±0.35 and 1.26±0.30,SCC-Ag (ng/ml):2.75±1.36 vs 0.64±0.47 and 0.52±0.24,all P＜0.01].In patients with NSCLC,the levels of serum miR-141 and miR-224 were correlated with pathological stage,pathological grade and lymph node metastasis (P＜0.05).ROC curve analysis showed that the optimal cut-off values of serum miR-141,miR 224 and SCC Ag (ng/ml) for diagnosis of NSCLC were 1.84,2.85 and 2.03,respectively.The AUC (0.913) of the three combined diagnosis of NSCLC was the largest,and the sensitivity and specificity were better,with 92.5 ％ and 82.7 ％,respectively.Pearson correlation analysis showed that serum miR-141 were positively corre lated with miR-224 and SCC-Ag (r=0.782,0.594,all P＜0.01),and serum miR 224 was positively correlated with SCC-Ag (r=0.594,P＜0.01).Conclusion Serum miR-141 and miR-224 are up-regulated in patients with NSCLC and are associated with clinicopathological features,and may be a new biomarker for the diagnosis of NSCLC.

Application of support vector machine in predicting in-hospital mortality risk of patients with acute kidney injury in ICU / 北京大学学报(医学版)

OBJECTIVE@#To construct an in-hospital mortality prediction model for patients with acute kidney injury (AKI) in intensive care unit (ICU) by using support vector machine (SVM), and compare it with the simplified acute physiology score II (SAPS-II) which is commonly used in the ICU.@*METHODS@#We used Medical Information Mart for Intensive Care III (MIMIC-III) database as data source. The AKI patients in the MIMIC-III database were selected according to the 2012 Kidney Disease: Improving Global Outcomes (KDIGO) definition of AKI. We employed the same predictor variable set as used in SAPS-II to construct an SVM model. Meanwhile, we also developed a customized SAPS-II model using MIMIC-III database, and compared performances between the SVM model and the customized SAPS-II model. The performance of each model was evaluated via area under the receiver operation characteristic curve (AUROC), root mean squared error (RMSE), sensitivity, specificity, Youden's index and accuracy based on 5-fold cross-validation. The agreement of the results between the SVM model and the customized SAPS-II model was illustrated using Bland-Altman plots.@*RESULTS@#A total number of 19 044 patients with AKI were included. The observed in-hospital mortality of the AKI patients was 13.58% in MIMIC-III. The results based on the 5-fold cross validation showed that the average AUROC of the SVM model and the customized SAPS-II model was 0.86 and 0.81, respectively (The difference between the two models was statistically significant with t=13.0, P<0.001). The average RMSE of the SVM model and the customized SAPS-II model was 0.29 and 0.31, respectively (The difference was statistically significant with t=-9.6, P<0.001). The SVM model also outperformed the customized SAPS-II model in terms of sensitivity and Youden's index with significant statistical differences (P=0.002 and <0.001, respectively).The Bland-Altman plot showed that the SVM model and the customized SAPS-II model had similar mortality prediction results when the mortality of a patient was certain, but the consistency between the mortality prediction results of the two models was poor when the mortality of a patient was with high uncertainty.@*CONCLUSION@#Compared with the SAPS-II model, the SVM model has a better performance, especially when the mortality of a patient is with high uncertainty. The SVM model is more suitable for predicting the mortality of patients with AKI in ICU and early intervention in patients with AKI in ICU. The SVM model can effectively help ICU clinicians improve the quality of medical treatment, which has high clinical value.

Analysis of monitoring results on iodine deficiency disorders in Hongkou District of Shanghai from 2012 to 2016 / 中华地方病学杂志

Objective To understand the coverage of iodized salt and the iodine nutritional status of schoolchildren in Hongkou District of Shanghai City and to provide a basis for adjusting corresponding intervention measures.Methods From 2012 to 2016,according to the "Shanghai Iodine Deficiency Disease Surveillance Program",a street was chosen from five directions as east,west,south,north and centre in Hongkou District.According to the annual monitoring plan,a certain amount of residents or schoolchildren aged 8-10 were chosen for monitoring,collecting salt samples from residents or children's home to detect salt iodine,and collecting urine samples of children to detect urinary iodine level (which was not tested in 2013).Determination of iodine salt was based on "Determination of Iodine by the General Test Method for the Salt Industry" (GB/T 13025.7-2012),urinary iodine determination was based on "Arsenic and Cerium Catalytic Spectrophotometric Determination of Iodine in Urine" (WS/T 107-2006).Results From 2012 to 2016,a total of 1 550 edible salt samples were tested,including 847 qualified iodized salts,299 unqualified iodized salts and 404 non-iodized salts,the coverage of iodized salt was 73.9％,and the consumption rate of qualified iodized salt was 54.6％.A total of 591 urine samples were tested in 2012,2014-2016.The median of urinary iodine was 177.2 μg/L;of which ＜ 100 μg/L was 103,accounting for 17.4％;100-199 μg/L was 248,accounting for 42.0％;and ≥300 μg/L was 91,accounting for 15.4％.Conclusions The residents in Hongkou District of Shanghai City do not meet the target of iodized salt coverage and consumption rates of qualified iodized salt.The average urinary iodine level of schoolchildren aged 8-10 years has reached the national standard for eliminating iodine deficiency disorders;we should further improve the consumption rate of qualified iodized salt.

The practice and effect of quality nursing care in operating room / 中国实用护理杂志

Objective To explore the effect of high quality nursing care performing in the operating room and reasonable approach for assessment. Methods Stratified random sampling was used to select 93 nurses from two tertiary hospitals. The task performance and contextual performance was assessed before and after implementing a range of high quality nursing care program. Results The task performance scores and patient care, nursing information, nurse skills dimension scores respectively were 58.59 ±1.77, 19.27±1.16, 19.50±1.11, 19.80±0.70 after the operating room junior high quality nursing service project, which were 37.21 ± 1.92, 5.55 ± 0.86, 13.78 ± 1.12, 17.87 ± 0.98 before the implementation, the differences were statistically significant (t=-82.48--15.15, P<0.01). The performance scores and mutual support between colleagues, work out the extra burden, organizational support dimension scores were respectively 70.43 ± 2.94, 28.23 ± 1.21, 18.52 ± 1.29, 23.67 ± 1.86 after the operating room junior high quality nursing service project, which were 36.20 ± 1.79, 15.52 ± 1.94, 7.33 ± 1.11, 13.34 ± 0.87 before the implementation, the differences were statistically significant (t=-91.99--46.68, P<0.01). Conclusions The high quality nursing care program is a range of nursing service which can advance task performance and contextual performance of nurses in the operating room. Task performance and contextual performance are effective approaches by which high quality nursing care in operating room could be reasonably assessed.

Macrophage Inhibitory Cytokine-1 as a Novel Diagnostic and Prognostic Biomarker in Stage I and II Nonsmall Cell Lung Cancer / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Increased level of serum macrophage inhibitory cytokine-1 (MIC-1), a member of transforming growth factor-μ superfamily, was found in patients with epithelial tumors. This study aimed to evaluate whether serum level of MIC-1 can be a candidate diagnostic and prognostic indicator for early-stage nonsmall cell lung cancer (NSCLC).</p><p><b>METHODS</b>A prospective study enrolled 152 patients with Stage I-II NSCLC, who were followed up after surgical resection. Forty-eight patients with benign pulmonary disease (BPD) and 105 healthy controls were also included in the study. Serum MIC-1 levels were measured using an enzyme-linked immunosorbent assay, and the association with clinical and prognostic features was analyzed.</p><p><b>RESULTS</b>In patients with NSCLC, serum protein levels of MIC-1 were significantly increased compared with healthy controls and BPD patients (all P< 0.001). A threshold of 1000 pg/ml of MIC-1 was found in patients with early-stage (Stage I and II) NSCLC, with sensitivity and specificity of 70.4% and 99.0%, respectively. The serum levels of MIC-1 were associated with age (P = 0.001), gender (P = 0.030), and T stage (P = 0.022). Serum MIC-1 threshold of 1465 pg/ml was found in patients with poor early outcome, with sensitivity and specificity of 72.2% and 66.1%, respectively. The overall 3-year survival rate of NSCLC patients with high serum levels of MIC-1 (≥1465 pg/ml) was lower than that of NSCLC patients with low serum MIC-1 levels (77.6% vs. 94.8%). Multivariate Cox regression survival analysis showed that a high serum level of MIC-1 was an independent risk factor for reduced overall survival (hazard ratio = 3.37, 95% confidential interval: 1.09-10.42, P= 0.035).</p><p><b>CONCLUSION</b>The present study suggested that serum MIC-1 may be a potential diagnostic and prognostic biomarker for patients with early-stage NSCLC.</p>

The characteristics of attentional bias in high anxiety sensitivity individuals / 中华行为医学与脑科学杂志

Objective To investigate the characteristics and mechanisms of attentional bias in anxiety sensitivity individuals.Methods By using Anxiety Sensitivity Index (ASI),23 participants were included in the high score group and 20 participants were included in the low score group.Then,2 (between-subject factor:the high and low score group) ×2 (within-subject factor:the positive and negative picture) mixed design experiments were adopted.Emotional faces picture pairs were chosen as stimuli.Picture pairs were presented 100 ms in experiment 1 and 1 250 ms in experiment 2.Dot-probe task was adopted to inspect the attentional bias and the response time and correct rate were recorded.Results Experiment 1 implied the main effect of type of pictures was found in mixed design experiments(F(1,41)=4.40,P＜0.05).The reaction time of two groups in positive pictures was greater than zero((12.22±30.24) ms vs (10.07±21.55) ms).It showed input effect to positive pictures.An input effect due to the reaction time of the high score group was greater than zero to negative pictures((4.81± 17.88)ms),while the low score group tended to avoid the negative pictures ((-6.81 ±21.33) ms).Experiment 2 implied positive score was not significant between two groups (F(1,41) =0.29,P＞0.05).And positive score showed the attentional bias to some certain extent.Significant outcome was found by negative score between two groups (F(1,41) =6.41,P＜0.05).It implied that the high score group tended to avoid the negative pictures and the low score group had the tendency of input effect.Conclusion At the initial stage of attention,anxiety sensitivity individuals had the attentional bias to negative emotional faces and avoidance in the late stage of attention.It suggests that the attentional bias of anxiety sensitivity individuals may have an important effect on the development of the mental disorders.