Analysis of antibiotic usage for viral community-acquired pneumonia in adults / 医学前沿

The rationale for the antibiotic treatment of viral community-acquired pneumonia (CAP) in adults was analyzed to develop a clinical reference standard for this condition. Clinical data from 166 patients diagnosed with viral pneumonia across 14 hospitals in Beijing from November 2010 to December 2017 were collected. The indications for medications were evaluated, and the rationale for the use of antibiotics was analyzed. A total of 163 (98.3%) patients with viral pneumonia were treated with antibiotics. A combination of C-reactive protein (CRP) and procalcitonin (PCT) was used as markers to analyze the possible indications for antibiotic use. With threshold levels set at 0.25 µg/L for PCT and 20 mg/L for CRP, the rate of unreasonable use of antibiotics was 55.2%. By contrast, at a CRP level threshold of 60 mg/L, the rate of antibiotic misuse was 77.3%. A total of 39 of the 163 (23.9%) patients did not meet the guidelines for drug selection for viral CAP in adults. The unreasonable use of antibacterial drugs for the treatment of viral CAP in adults is a serious concern. Clinicians must reduce the unnecessary use of antibiotics.

Associations of smoking and air pollution with peripheral blood RNA N6-methyladenosine in the Beijing truck driver air pollution study.

BACKGROUND: Post-transcriptional modifications of RNA constitute fundamental mechanisms of gene regulation. N6-methyladenosine (m6A) is critical for health and disease and is modulated by cellular stressors. However, associations between environmental exposures and m6A have not been studied in humans. We aimed to examine associations between tobacco smoking and particulate air pollution with m6A and mRNA expression levels of its reader, writer and eraser (RWE) genes in blood. METHODS: Using the Beijing Truck Driver Air Pollution Study, we investigated global m6A in RNA from peripheral blood collected from 106 human subjects in Beijing, China, in 2008. We measured m6A with nano-flow liquid chromatography-tandem mass spectrometry and investigated gene expression of six m6A RWEs with real-time-quantitative PCR. Using linear models, we examined associations with smoking status, pack-years, and smoking on day of visit in men, and with environmental tobacco smoke in nonsmokers. We also examined associations with ambient PM10 (particulate matter ≤ 10 µm in diameter), and personal black carbon (BC) and PM2.5 measured with a portable monitor. RESULTS: Smoking in men was significantly associated with a relative 10.7% decrease in global m6A levels in comparison to nonsmokers (p = 0.02). In men, smoking greater than 3.8 pack-years was associated with a 14.9% lower m6A than in nonsmokers. BC exposure trended towards positive associations with m6A (5.95% per 10 µg/m3 increase in BC; 95% CI: -0.96, 13.3). Global m6A levels were not correlated with RWE gene expression levels. No associations were detected between smoking or air pollutants and m6A RWE gene expression. DISCUSSION: m6A was negatively associated with long-term smoking, yet positively associated with short-term BC exposure. These results indicate variable m6A responses to environmental stressors, providing early evidence into the impacts of toxicants on RNA modifications and suggesting potential for m6A as a biomarker or mechanism in environmental health research.

Histone 3 modifications and blood pressure in the Beijing Truck Driver Air Pollution Study.

CONTEXT: Histone modifications regulate gene expression; dysregulation has been linked with cardiovascular diseases. Associations between histone modification levels and blood pressure in humans are unclear. OBJECTIVE: We examine the relationship between global histone concentrations and various markers of blood pressure. MATERIALS AND METHODS: Using the Beijing Truck Driver Air Pollution Study, we investigated global peripheral white blood cell histone modifications (H3K9ac, H3K9me3, H3K27me3, and H3K36me3) associations with pre- and post-work measurements of systolic (SBP) and diastolic (DBP) blood pressure, mean arterial pressure (MAP), and pulse pressure (PP) using multivariable mixed-effect models. RESULTS: H3K9ac was negatively associated with pre-work SBP and MAP; H3K9me3 was negatively associated with pre-work SBP, DBP, and MAP; and H3K27me3 was negatively associated with pre-work SBP. Among office workers, H3K9me3 was negatively associated with pre-work SBP, DBP, and MAP. Among truck drivers, H3K9ac and H3K27me were negatively associated with pre-work SBP, and H3K27me3 was positively associated with post-work PP. DISCUSSION AND CONCLUSION: Epigenome-wide H3K9ac, H3K9me3, and H3K27me3 were negatively associated with multiple pre-work blood pressure measures. These associations substantially changed during the day, suggesting an influence of daily activities. Blood-based histone modification biomarkers are potential candidates for studies requiring estimations of morning/pre-work blood pressure.

Traffic-derived particulate matter exposure and histone H3 modification: A repeated measures study.

BACKGROUND: Airborne particulate matter (PM) may induce epigenetic changes that potentially lead to chronic diseases. Histone modifications regulate gene expression by influencing chromatin structure that can change gene expression status. We evaluated whether traffic-derived PM exposure is associated with four types of environmentally inducible global histone H3 modifications. METHODS: The Beijing Truck Driver Air Pollution Study included 60 truck drivers and 60 office workers examined twice, 1-2 weeks apart, for ambient PM10 (both day-of and 14-day average exposures), personal PM2.5, black carbon (BC), and elemental components (potassium, sulfur, iron, silicon, aluminum, zinc, calcium, and titanium). For both PM10 measures, we obtained hourly ambient PM10 data for the study period from the Beijing Municipal Environmental Bureau's 27 representatively distributed monitoring stations. We then calculated a 24h average for each examination day and a moving average of ambient PM10 measured in the 14 days prior to each examination. Examinations measured global levels of H3 lysine 9 acetylation (H3K9ac), H3 lysine 9 tri-methylation (H3K9me3), H3 lysine 27 tri-methylation (H3K27me3), and H3 lysine 36 tri-methylation (H3K36me3) in blood leukocytes collected after work. We used adjusted linear mixed-effect models to examine percent changes in histone modifications per each µg/m3 increase in PM exposure. RESULTS: In all participants each µg/m3 increase in 14-day average ambient PM10 exposure was associated with lower H3K27me3 (ß=-1.1%, 95% CI: -1.6, -0.6) and H3K36me3 levels (ß=-0.8%, 95% CI: -1.4, -0.1). Occupation-stratified analyses showed associations between BC and both H3K9ac and H3K36me3 that were stronger in office workers (ß=4.6%, 95% CI: 0.9, 8.4; and ß=4.1%, 95% CI: 1.3; 7.0 respectively) than in truck drivers (ß=0.1%, 95% CI: -1.3, 1.5; and ß=0.9%, 95% CI: -0.9, 2.7, respectively; both pinteraction <0.05). Sex-stratified analyses showed associations between examination-day PM10 and H3K9ac, and between BC and H3K9me3, were stronger in women (ß=10.7%, 95% CI: 5.4, 16.2; and ß=7.5%, 95% CI: 1.2, 14.2, respectively) than in men (ß=1.4%, 95% CI: -0.9, 3.7; and ß=0.9%, 95% CI: -0.9, 2.7, respectively; both pinteraction <0.05). We observed no associations between personal PM2.5 or elemental components and histone modifications. CONCLUSIONS: Our results suggest a possible role of global histone H3 modifications in effects of traffic-derived PM exposures, particularly BC exposure. Future studies should assess the roles of these modifications in human diseases and as potential mediators of air pollution-induced disease, in particular BC exposure.

Effects of particulate matter exposure on blood 5-hydroxymethylation: results from the Beijing truck driver air pollution study.

Previous studies have reported epigenetic changes induced by environmental exposures. However, previous investigations did not distinguish 5-methylcytosine (5mC) from a similar oxidative form with opposite functions, 5-hydroxymethylcytosine (5hmC). Here, we measured blood DNA global 5mC and 5hmC by ELISA and used adjusted mixed-effects regression models to evaluate the effects of ambient PM10 and personal PM2.5 and its elemental components-black carbon (BC), aluminum (Al), calcium (Ca), potassium (K), iron (Fe), sulfur (S), silicon (Si), titanium (Ti), and zinc (Zn)-on blood global 5mC and 5hmC levels. The study was conducted in 60 truck drivers and 60 office workers in Beijing, China from The Beijing Truck Driver Air Pollution Study at 2 exams separated by one to 2 weeks. Blood 5hmC level (0.08%) was ∼83-fold lower than 5mC (6.61%). An inter-quartile range (IQR) increase in same-day PM10 was associated with increases in 5hmC of 26.1% in office workers (P = 0.004), 20.2% in truck drivers (P = 0.014), and 21.9% in all participants combined (P < 0.001). PM10 effects on 5hmC were increasingly stronger when averaged over 4, 7, and 14 d preceding assessment (up to 132.6% for the 14-d average in all participants, P < 0.001). PM10 effects were also significant after controlling for multiple testing (family-wise error rate; FWER < 0.05). 5hmC was not correlated with personal measures of PM2.5 and elemental components (FWER > 0.05). 5mC showed no correlations with PM10, PM2.5, and elemental components measures (FWER > 0.05). Our study suggests that exposure to ambient PM10 affects 5hmC over time, but not 5mC. This finding demonstrates the need to differentiate 5hmC and 5mC in environmental studies of DNA methylation.

Air pollution exposure and lung function in highly exposed subjects in Beijing, China: a repeated-measure study.

BACKGROUND: Exposure to ambient particulate matter (PM) has been associated with reduced lung function. Elemental components of PM have been suggested to have critical roles in PM toxicity, but their contribution to respiratory effects remains under-investigated. We evaluated the effects of traffic-related PM(2.5) and its elemental components on lung function in two highly exposed groups of healthy adults in Beijing, China. METHODS: The Beijing Truck Driver Air Pollution Study (BTDAS) included 60 truck drivers and 60 office workers evaluated in 2008. On two days separated by 1-2 weeks, we measured lung function at the end of the work day, personal PM(2.5), and nine elemental components of PM(2.5) during eight hours of work, i.e., elemental carbon (EC), potassium (K), sulfur (S), iron (Fe), silicon (Si), aluminum (Al), zinc (Zn), calcium (Ca), and titanium (Ti). We used covariate-adjusted mixed-effects models including PM(2.5) as a covariate to estimate the percentage change in lung function associated with an inter-quartile range (IQR) exposure increase. RESULTS: The two groups had high and overlapping exposure distributions with mean personal PM(2.5) of 94.6 µg/m³ (IQR: 48.5-126.6) in office workers and 126.8 µg/m³ (IQR: 73.9-160.5) in truck drivers. The distributions of the nine elements showed group-specific profiles and generally higher levels in truck drivers. In all subjects combined, forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) did not significantly correlate with PM(2.5). However, FEV1 showed negative associations with concentrations of four elements: Si (-3.07%, 95% CI: -5.00; -1.11, IQR: 1.54), Al (-2.88%, 95% CI: -4.91; -0.81, IQR: 0.86), Ca (-1.86%, 95% CI: -2.95; -0.76, IQR: 1.33), and Ti (-2.58%, 95% CI: -4.44; -0.68, IQR: 0.03), and FVC showed negative associations with concentrations of three elements: Si (-3.23%, 95% CI: -5.61; -0.79), Al (-3.26%, 95% CI: -5.73; -0.72), and Ca (-1.86%, 95% CI: -3.23; -0.47). In stratified analysis, Si, Al, Ca, and Ti showed associations with lung function only among truck drivers, and no significant association among office workers. CONCLUSION: Selected elemental components of PM(2.5) showed effects on lung function that were not found in analyses of particle levels alone.

Clinical research of medicinal vesiculation for perennial allergic rhinitis / 中国针灸

<p><b>OBJECTIVE</b>To compare the efficacy differences between dog-days medicinal vesiculation and regular-day medicinal vesiculation for perennial allergic rhinitis (PAR), and observe their effects on serum immune globulin E (IgE) and interleukin-4 (IL-4).</p><p><b>METHODS</b>Seventy-two patients were randomly divided into a dog-days moxibustion group (34 cases) and a regular-day moxibustion group (38 cases). In the dog-days moxibustion group, medicinal vesiculation was applied on the 1st dog-day, 2nd dog-day and last dog-day in summer by lunar calendar, 3 treatments per dog-day for totally 9 times. In the regular-day moxibustion group, the moxibustion was given on the regular day for continuous 9 times. The symptom score, rhinoconjunctivitis quality of life questionnaire (RQLQ) and the level of IgE and IL-4 were compared before and after treatment in two groups; the short-term and two-year efficacy evaluation were performed too.</p><p><b>RESULTS</b>The short-term total effective rate was 88.2% (30/34) in the dog-days moxibustion group, which was not significantly different to 86.8% (33/38) in the regular-day moxibustion group (P>0.05). The long-term total effective rate was 97.1% (33/34) in the dog-days moxibustion group, which was significantly superior to 81.6% (31/38) in the regular-day moxibustion group (P<0.05). After treatment, the serum IgE, IL-4 and RQLQ were significantly reduced (all P<0.01), but the difference between two groups was not significant (all P>0.05).</p><p><b>CONCLUSION</b>Medicinal moxibustion could be taken as a regular treatment for PAR, which could be performed during the whole year, and dog-days moxibustion could be considered as an enhanced method for prevention and treatment of PAR.</p>

Effect of inorganic carbon source on lipid production with autotrophic Chlorella vulgaris / 生物工程学报

We studied the effects of three inorganic carbon sources, Na2CO3, NaHCO3 and CO2, and their initial concentrations on lipid production of Chlorella vulgaris. Chlorella vulgaris could utilize Na2CO3, NaHCO3 and CO2 to produce lipids. After 10-day cultivation with each of the three inorganic carbon sources, lipid yield of Chlorella vulgaris reached its peak with the concentration increase of the inorganic carbon source, but dropped again by further increase of the concentration. The pH value of the culture medium for Chlorella vulgaris increased after the cultivation on inorganic carbon source. The optimal concentration of both Na2CO3 and NaHCO3 was 40 mmol/L, and their corresponding biomass dry weight was 0.52 g/L and 0.67 g/L with their corresponding lipid yield 0.19 g/L and 0.22 g/L. When the concentration of CO2 was 6%, Chlorella vulgaris grew the fastest and its biomass dry weight was 2.42 g/L with the highest lipid yield of 0.72 g/L. When the concentration of CO2 was too low, the supply of inorganic carbon was insufficient and lipid yield was low. A too high concentration of CO2 caused a low pH and lipid accumulation was inhibited. Na2CO3 and NaHCO3 were more favorable for Chlorella vulgaris to accumulate unsaturated fatty acids than that of CO2.

Effect of energy compound on skeletal muscle strain injury and regeneration in rats.

This study was designed to determine whether the supplement of energy compound could attenuate strain-induced damage to skeletal muscle in rats. Energy compound is a saline mixture of the following ingredients: ATP (10mg), Coenzyme-A (50 units), Coenzyme-Q(10) (50mg), Cytochrome C (30 mg) and Vitamin B(6) (50mg). Experimental animals were injured in right gastrocnemius muscles by a strain injury model. Energy compound groups were given energy compound 10 ml/kg body weight per day since injured, while saline groups were given saline at the same dose. And a sham operation was performed on the right hindlimb of control group. Plasma was centrifuged to measure lactate dehydrogenase (LDH), lactic acid (La) and creatine kinase (CK) on 3, 7 and 14 d post injury. Muscles were removed and fixed for histology observation and immunohistochemistry assay of desmin and vimentin. The results showed a similar tendency of plasma CK, La and LDH in saline and energy compound groups, while the lower level was found in the energy-compound group. The histological examination of muscle sections revealed a lower degree of damage in the energy compound group in which the expression levels of desmin and vimentin were higher than in the saline group. It is suggested that energy compound supplement may attenuate strain-induced muscle damage and facilitate its regeneration.

[Effect of acupuncture at three acupoints of eye on Bell palsy].

OBJECTIVE: To probe the effect of acupuncture at three acupoints of eye on Bell palsy. METHODS: Seventy-six cases were randomly divided into a routine acupuncture group and a Yan three needling group, 38 cases in each group. The routine acupuncture group were treated with electroacupuncture (EA) at routinely selected acupoints including Yifeng (TE 17), Dicang (ST 4), etc. and the Yan three needling group were treated by EA at the routinely selected acupoints combined with acupuncture at three acupoints of eye including Jingming (BL 1), Shangming, Chengqi (ST 1). The intensity on 0.05 ms in the intensity/time (I/t) curve for frontal ventral fronto-occipital muscle and orbicular muscle of mouth at the affected side was used for assessment criteria of course of disease, and frontal ventral fronto-occipital muscle restoring the raising eyebrow action and orbicular muscle of mouth restoring to House-Brackmann grade I and II were regarded as the therapeutic time limit. RESULTS: Routine EA treatment combined with acupuncture at the 3 acupoints of eye could significantly increase clinical therapeutic effect on Bell palsy with a cured rate of 89.5%, which was better than 65.8% in the routine acupuncture group (P<0.05), and the therapeutic cycle was shorted. CONCLUSION: Acupuncture at the 3 acupoints of eye can significantly improve Bell palsy and promote recovery of functions of facial nerves.

Effect of acupuncture at three acupoints of eye on Bell palsy / 中国针灸

<p><b>OBJECTIVE</b>To probe the effect of acupuncture at three acupoints of eye on Bell palsy.</p><p><b>METHODS</b>Seventy-six cases were randomly divided into a routine acupuncture group and a Yan three needling group, 38 cases in each group. The routine acupuncture group were treated with electroacupuncture (EA) at routinely selected acupoints including Yifeng (TE 17), Dicang (ST 4), etc. and the Yan three needling group were treated by EA at the routinely selected acupoints combined with acupuncture at three acupoints of eye including Jingming (BL 1), Shangming, Chengqi (ST 1). The intensity on 0.05 ms in the intensity/time (I/t) curve for frontal ventral fronto-occipital muscle and orbicular muscle of mouth at the affected side was used for assessment criteria of course of disease, and frontal ventral fronto-occipital muscle restoring the raising eyebrow action and orbicular muscle of mouth restoring to House-Brackmann grade I and II were regarded as the therapeutic time limit.</p><p><b>RESULTS</b>Routine EA treatment combined with acupuncture at the 3 acupoints of eye could significantly increase clinical therapeutic effect on Bell palsy with a cured rate of 89.5%, which was better than 65.8% in the routine acupuncture group (P<0.05), and the therapeutic cycle was shorted.</p><p><b>CONCLUSION</b>Acupuncture at the 3 acupoints of eye can significantly improve Bell palsy and promote recovery of functions of facial nerves.</p>

[Changes of nitric oxide and nitric-oxide synthase in the development of cold-induced hypertension].

OBJECTIVE: To study the changes of nitric oxide(NO) and nitric-oxide synthase(NOS) in the development of cold-induced hypertension (CIH). METHODS: Sixty male Sprague-Dawley adult rats were used. Thirty were exposed to cold (4 +/- 1) degrees C as cold-treated group while the other 30 were at (25 +/- 1) degrees C as controls, 4 hours a day for 6 weeks for both groups. Systolic blood pressure (SBP) and heart rate were measured twice every week. Each group was further subdivided into three groups, 10 rats each. A subgroup of the cold-treated and control rats were sacrificed at 2, 4 and 6 week. Plasma was saved to measure superoxide dismutase (SOD) and malondiadehycle (MDA), while heart was homogenated to measure NO, NOS. RESULTS: 1 SBP increased during 6 weeks of exposure to cold. From the second week, SBP of cold-treated group [(94.16 +/- 3.81) mm Hg] was significantly greater than that of control group [(88.77 +/- 4.45 mm Hg), P<0.01]. The highest SBP level was achieved at the sixth week [(116.78 +/- 3.79)mm Hg, P<0.01]. 2 Compared to the control group, SOD in cold-treated group decreased significantly from the second week, and maintained throughout the time of exposure to cold (P<0.05). MDA levels did not differ significantly between cold-treated and control groups though it increased mildly during 6 weeks of cold exposure (P>0.05). Heart NOS in cold-treated group decreased significantly from the fourth week to the sixth week. And a mild decrease was observed in heart NO of cold-treated group during 6 weeks of exposure (P>0.05). CONCLUSION: Cold-induced hypertension is induced in rats after repeated exposure to cold. The levels of NOS, NO decrease accordingly to the rise of blood pressure. This indicates that the dysfunction of NO and NOS is involved in the development of CIH.

Effect of Du Meridian Electroacupuncture of the Scalp on Deglutition Disorder after Stroke / 中国康复理论与实践

@#ObjectiveTo investigate the effect of Du meridian electroacupuncture of the scalp on deglutition disorder after stroke.Methods67 patients with deglutition disorder after stroke were randomly divided into the experimental group (n=34) and control group (n=33). The patients of the experimental group were received Du meridian electroacupuncture of the scalp as main therapy, combined with routine medicine treatments; the patients of the control group were only received routine medicine treatments. Before and after treatments, deglutition function of all patients was assessed by drinking water test and clinical effect was also assessed.ResultsAfter treatment, the deglutition function of the patients in the experiment group was markedly improved and superior to those in the control group ( P<0.01).ConclusionDu meridian electroacupuncture can markedly improve the clinical effect of routine medicine treatments on deglutition disorder after stroke.