Molecular Characteristics of Salmonella Spp. Responsible for Bloodstream Infections in a Tertiary Hospital in Nanjing, China, 2019-2021.

Objective: To investigate the clinical and molecular characteristics of Salmonella spp. causing bloodstream infections (BSIs) in our hospital. Methods: We studied 22 clinical Salmonella isolates from BSIs and 16 from non-BSIs, performing antimicrobial susceptibility testing (AST) and whole genome sequencing (WGS). The analysis included serovars, antibiotic resistance genes (ARGs), virulence factors (VFs), sequence types (STs), plasmid replicons, and genetic relationships. We also assessed pathogenicity of the isolates causing BSIs through growth, biofilm formation, and anti-serum killing assays. Results: WGS analysis identified 13 Salmonella serovars, with four responsible for BSIs. S. Enteritidis was the most prevalent serovar, involved in 19 (50.0%) cases. BSIs were caused by 17S. Enteritidis, two S. Typhimurium, two S. Munster and one S. Diguel. Of the 38 isolates, 27 (71.1%) exhibited high resistance to ampicillin, and 24 (63.2%) to ampicillin/sulbactam. Thirty-six types of ARGs were identified, with blaTEM-1B (n = 25, 65.8%) being the most frequent. Ten plasmid replicons were found; the combination of IncFIB(S)-IncFII(S)-IncX1 was the most common in S. Enteritidis (94.7%). Fifteen STs were identified, among which ST11 was the most prevalent and clonally disseminated, primarily responsible for BSIs. A total of 333 different VFs were detected, 177 of which were common across all strains. No significant differences were observed between the BSI and non-BSI isolates in terms of resistance rates, ARGs, plasmid replicons, and VFs, except for seven VFs. No strong pathogenicity was observed in the BSI-causing isolates. Conclusion: BSIs were predominantly caused by clonally disseminated S. Enteritidis ST11, the majority of which carried multiple ARGs, VFs and plasmid replicons. This study provides the first data on clonally disseminated S. Enteritidis ST11 causing BSIs, highlighting the urgent need for enhanced infection control measures.

Biases and limitations in observational studies of Long COVID prevalence and risk factors: A rapid systematic umbrella review.

BACKGROUND: Observational studies form the foundation of Long COVID knowledge, however combining data from Long COVID observational studies has multiple methodological challenges. This umbrella review synthesizes estimates of Long COVID prevalence and risk factors as well as biases and limitations in the primary and review literatures. METHODS AND FINDINGS: A systematic literature search was conducted using multiple electronic databases (PubMed, EMBASE, LitCOVID) from Jan 1, 2019 until June 9, 2023. Eligible studies were systematic reviews including adult populations assessed for at least one Long COVID symptom four weeks or more after SARS-CoV-2 infection. Overall and subgroup prevalence and risk factors as well as risk of bias (ROB) assessments were extracted and descriptively analyzed. The protocol was registered with PROSPERO (CRD42023434323). Fourteen reviews of 5-196 primary studies were included: 8 reported on Long COVID prevalence, 5 on risk/protective factors, and 1 on both. Prevalence of at least 1 Long COVID symptom ranged from 21% (IQR: 8.9%-35%) to 74.5% (95% CI: 55.6%-78.0%). Risk factor reviews found significant associations between vaccination status, sex, acute COVID-19 severity, and comorbidities. Both prevalence and risk factor reviews frequently identified selection and ascertainment biases. Using the AMSTAR 2 criteria, the quality of included reviews, particularly the prevalence reviews, were concerning for the adequacy of ROB assessments and justifications for conducting meta-analysis. CONCLUSION: A high level of heterogeneity render the interpretation of pooled prevalence estimates of Long COVID challenging, further hampered by the lack of robust critical appraisals in the included reviews. Risk factor reviews were of higher quality overall and suggested consistent associations between Long COVID risk and patient characteristics.

Progress of SARS-CoV-2 Main protease peptide-like inhibitors.

The pneumonia outbreak caused by Severe Acute Respiratory Syndrome 2 (SARS-CoV-2) infection poses a serious threat to people worldwide. Although vaccines have been developed, antiviral drugs are still needed to combat SARS-CoV-2 infection due to the high mutability of the virus. SARS-CoV-2 main protein (Mpro ) is a special cysteine protease that is a key enzyme for SARS-CoV-2 replication. It is encoded by peptides and is responsible for processing peptides into functional proteins, making it an important drug target. The paper reviews the structure and peptide-like inhibitors of SARS-CoV-2 Mpro , also the binding mode and structure-activity relationship between the inhibitors and Mpro are introduced in detail. It is hoped that this review can provide ideas and help for the development of anti-coronavirus drugs such as COVID-19, and help to develop broad-spectrum antiviral drug for the treatment of coronavirus diseases as soon as possible.

Discovery a series of novel inhibitors of human dihydroorotate dehydrogenase: Biological activity evaluation and molecular docking.

Human dihydroorotate dehydrogenase (hDHODH) is a key enzyme that catalyzes the de novo synthesis of pyrimidine. In recent years, various studies have shown that inhibiting this enzyme can treat autoimmune diseases such as rheumatoid arthritis (RA) and cancer. This study designed and synthesized a series of novel thiazolidone hDHODH inhibitors. Through biological activity evaluation, Compound 14 was found to have high inhibitory activity, with an IC50 value reaching nanomolar level. Preliminary structure-activity relationship studies found that the carboxyl group in R1 and the naphthalene in R2 are key factors in improving activity. Through molecular docking, the binding mode between inhibitors and proteins was elucidated. This study provides an important reference for further optimizing hDHODH inhibitors.

Trustworthiness, Not Trust: How Systemic Racism Impacts COVID-19 Vaccine Receipt.

To illuminate the forces of structural racism influencing COVID-19 vaccine receipt, we developed a conceptual model that recontextualizes trust and presents potential pathways to address structural racism. Our model emerged from Chicagoland CEAL, a partnership of community and academic experts collaborating to encourage COVID-19 vaccine uptake for communities of color. We concluded that systemic factors influenced by racism contribute to an overall lack of trustworthiness in vaccine-affiliated institutions. We highlight the need to recenter discussions of COVID-19 vaccination on our system's trustworthiness rather than mistrust and suggest using the model to test pathways to close racial gaps in COVID-19 vaccination.

Prevalence and Characteristics of Long COVID 7-12 Months After Hospitalization Among Patients From an Urban Safety-Net Hospital: A Pilot Study.

Introduction: Little is known about the burden of long COVID among Black and Hispanic patients in the U.S. We surveyed adult patients hospitalized for COVID-19 at John H. Roger, Jr. Hospital of Cook County, a safety-net hospital predominantly serving Black and Hispanic patients in Chicago, for persistent symptoms after hospitalization to assess prevalence and identify risk factors. Methods: Cross-sectional data were obtained over 6 months after discharge from patients hospitalized at John H. Roger, Jr. Hospital of Cook County who tested positive for SARS-CoV-2 between October 1, 2020 and January 12, 2021. Multivariable logistic regression was used to analyze the associations between patient characteristics and symptom persistence. Results: Of 145 patients surveyed at a median follow-up period of 255 days (IQR=238-302), 80% were Black or Hispanic, and 50 (34%) reported at least 1 symptom. In multivariable logistic regression, the risk of long COVID was associated with the severity of acute COVID-19 illness, consistent with findings from population-based cohort studies. Conclusions: Long COVID prevalence remains high 7 months to a year after an initial illness in a majority Black and Hispanic hospitalized cohort. There is a long-term and ongoing need to assess and address the burden of long COVID, especially among minority communities disproportionately affected by acute COVID-19.

Variations in COVID-19 Hospital Mortality by Patient Race/Ethnicity and Hospital Type in Illinois.

BACKGROUND AND OBJECTIVES: It is controversial whether hospital care mitigated or exacerbated population level racial and ethnic disparities in COVID-19 mortality. To begin answering that question, this study analyzed variations in COVID-19 hospital mortality in Illinois by patient race and ethnicity and by hospital characteristics, while providing an estimate of hospital-level variation in COVID-19 mortality. METHOD: This is a retrospective cohort study based on hospital administrative data for adult patients with COVID-19 discharged from acute care, non-federal Illinois hospitals from April 1, 2020 through June 30, 2021. The association of patient and hospital characteristics with the likelihood of death was analyzed using multilevel logistic regression. RESULTS: There were 158,569 COVID-19-coded admissions to 181 general hospitals in Illinois; 14.5% resulted in death or discharge to hospice. Hospital deaths accounted for nearly 90% of all COVID-19-associated deaths over 15 months in Illinois. After adjusting for patient- and hospital-level characteristics, Hispanic patients had higher mortality risk (aOR 1.26, 95% CI: 1.20-1.33) as compared with non-Hispanic White patients, while non-Hispanic Black patients had lower mortality risk (aOR 0.75, 95% CI: 0.71-0.79). Safety net hospitals receiving disproportionate share hospital (DSH) funds had higher mortality risk (aOR 1.81, 95% CI: 1.43-2.30) compared with other hospitals. CONCLUSION: Risk-adjusted COVID-19 hospital mortality was highest among patients of Hispanic ethnicity, while non-Hispanic Black patients had lower risk than non-Hispanic White patients. There was significant variation in hospital mortality rates, with particularly high safety net hospital mortality.

Intraoperative IPC combined with 3M warming instrument to prevent lower extremity deep venous thrombosis in patients undergoing proximal femoral anti rotation intramedullary nailing / 中国骨伤

OBJECTIVE@#To explore the effect of intermittent pneumatic compression(IPC) combined with 3M thermometer on the prevention of deep venous thrombosis(DVT) in patients with femoral intertrochanteric fracture.@*METHODS@#From March 2016 to August 2019, 127 patients with femoral intertrochanteric fractures who underwent proximal femoral nail antirotation(PFNA) were retrospectively analyzed. They were divided into two groups according to different methods of thrombus prevention and treatment. Among them, 63 patients in group A did not use IPC and 3M thermometer;64 cases in group B were treated with IPC combined with 3M thermometer. Color Doppler ultrasound was used to dynamically monitor the DVT and changes of lower limbs during perioperative period. The venous thrombosis of lower limbs was monitored at 0, 24, 72 h and > 72 h after operation(recheck every 3 days until discharge).@*RESULTS@#Occurrence of DVT of lower limbs after PFNA operation in two groups:there were 5 cases (7.8%) in group B and 20 cases (31.7%) in group A, there was significant difference between two groups (P=0.001). There was no significant difference in lower limb DVT between two groups at 0, 72 and > 72 h after operation(P>0.05), but the formation rate of group A was significantly higher than that of group B at 24 h after operation (P=0.049). There was no significant difference in DVT formation between group A and group B(P>0.05). However, the formation of DVT in group A was significantly higher than that in group B(P=0.012).@*CONCLUSION@#Intraoperative IPC combined with 3M thermostat can effectively prevent DVT of lower limbs in patients undergoing PFNA surgery.

Precise resection and defect repair of external nose malignant tumor / 中华耳鼻咽喉头颈外科杂志

Objective: To explore the methods for the accurate resection of malignant tumors of the external nose, and the accurate evaluation and repair of tissue defects. Methods: We collected 48 cases with nasal malignant tumors treated in 980 Hospital, Joint Support Force of the People's Liberation Army from January 2010 to June 2020, including 28 males and 20 females, aged 36-86 years. The pathological types of tumors included basal cell carcinomas (n=29), squamous cell carcinomas (n=11), trichilemmal carcinomas(n=6), denoid cystic carcinoma (n=1) and non-Hodgkin lymphoma (n=1). Tumor resection was mainly based on the traditional extended resection determined by the safety margin, and Mohs surgery was used to minimize the scope of resection, for the margin that significantly affected the repairing results, such as the lesion adjacent to the nasal alar margin, nasal columella or deep easy-penetrating margin. All cases obtained tumor resection and primary/secondary defect reconstruction. Results: According to the pathological type and tumor size, the safe resection margin was mainly 4-10 mm, and Mohs surgery was used in 24 cases. Limited-size defects in 38 cases were repaired with double-leaf flaps, kite flaps, nasal dorsum brow flaps, nasolabial flaps or free tissues. Among 10 cases with compound defects, 8 cases were repaired with frontal flaps, including 4 cases with single frontal flaps, 2 cases with additional titanium mesh stent reconstruction and 2 cases with over and out frontal flaps. During follow-up of 1 to 10 years, all the flaps survived without flap necrosis, and the postoperative nasal contour and ventilation were satisfactory. One patient had tumor recurrence 18 months after operation, 2 patients died of cardiovascular and cerebrovascular diseases, and other patients survived without tumors. Conclusions: Mohs surgery can basically meet the requirements for precise resection of external nasal malignant tumors. Individualized application of adjacent tissue flaps and various frontal flaps is a reasonable choice to achieve the satisfactory outcome of external nasal repair and to take into account the complexity of operation.

Gadolinium angiography of inner ear in patients with sudden deafness and its clinical analysis / 中华耳鼻咽喉头颈外科杂志

Objective: To observe the gadolinium imaging findings of inner ear in patients with sudden deafness and to analyze its clinical features. Methods: From November 2017 to July 2020, 21 patients with sudden deafness in the People's Hospital of Dongsheng District, Ordos City were selected as the research objects, including 14 males and 7 females, aged 36-76 years, with a median age of 50 years. The course of disease was 1-19 days, with an average of 5.5 days. The patients received audiology tests, laboratory examination, and intravenous gadolinium angiography, each of whom was scanned twice by 3D-FLAIR sequence: once before intravenous gadolinium injection, and once again 4.5-6.0 h after intravenous gadolinium injection. The following corresponding clinical treatment was given. The imaging manifestations and clinical features were observed. Results: Among 21 cases of sudden deafness in acute stage, the signal intensity of 11 cases was significantly higher than that of the contralateral ear, and 2 cases had vestibular labyrinthine hydrops. In laboratory examination, only 2 cases of total deafness had increased WBC count and faster erythrocyte sedimentation rate, and the rest had no abnormality. The hearing types of 21 patients with sudden deafness were: total deafness in 8 cases, flat decline in 10 cases, low frequency decline in 1 case, high frequency decline in 2 cases. The total effective rate was 57% (12/21). The hearing types of 11 patients with abnormal gadolinium angiography were total deafness in 5 cases, flat decline in 5 cases and high frequency decline in 1 case. The total effective rate was 64% (7/11). Conclusion: Gadolinium angiography is abnormal in some patients with sudden deafness, and the permeability of blood labyrinth barrier may be increased, which is worthy of further study.

Overview of Compilation and Research of Lao Herbal Pharmacopoeia / 中国实验方剂学杂志

In order to promote the standardization of traditional medicines in Laos， China and Laos jointly formed a census team to conduct resource survey， market survey， species identification and others of medicinal plants in Laos. According to the principles of nationality， tradition， effectiveness and commonness， 160 medicinal materials and 40 prescriptions were selected and collected into Lao Herbal Pharmacopoeia after recommendation， examination of experts and review by the established expert committee. Moreover， quality standards of traditional medicine and scientific and clear translation methods were formulated in line with the national conditions of Laos， and the contents were finally compiled according to the 2010 edition of Chinese Pharmacopoeia. The promulgation and implementation of Lao Herbal Pharmacopoeia is a successful example of cooperation in the field of health care between China and Laos， which is conducive to promoting mutually beneficial cooperation between China and Association of Southeast Asian Nations （ASEAN） countries in the field of traditional medicine， and making traditional medicine play a greater role in the medical and health services of ASEAN countries.

Large Piezoelectric Response in Hybrid Rare-Earth Double Perovskite Relaxor Ferroelectrics.

Piezoelectric materials are technologically important, and the most used are perovskite ferroelectrics. In recent years, more and more emerging areas have put forward new requirements for piezoelectric materials, such as light weight, low acoustic impedance, good flexibility, and biocompatibility. In this context, hybrid organic-inorganic perovskite ferroelectrics have emerged as promising supplements, because they combine attractive features of inorganic and organic materials. Among them, hybrid double-metal perovskites have recently been found to exhibit excellent ferroelectricity. However, their potential as piezoelectric materials has not been exploited. Here, we describe large piezoelectric response in hybrid rare-earth double perovskite relaxor ferroelectrics (RM3HQ)2RbLa(NO3)6 and (RM3HQ)2NH4La(NO3)6 (RM3HQ = R-N-methyl-3-hydroxylquinuclidinium). They are simultaneously ferroelectric and ferroelastic crystals, with the R3 ferroelectric phase and P213 paraelectric phase. We found that ferroelectric polar microdomains and paraelectric nonpolar regions coexist in a wide temperature range through variable-temperature piezoresponse force microscopy images. The two-phase coexistence reveals low energy barriers of transitions between the two phases and between the polar microdomains with different polarization directions. These lead to the easy polarization rotation of the polar microdomains upon applying a stress and, accordingly, the large piezoelectric response up to 106 pC N-1 for (RM3HQ)2RbLa(NO3)6. This finding represents a significant step toward novel applications of piezoelectric materials based on lead-free hybrid perovskites.

Hybrid Organic-Inorganic Antiperovskites.

Substitution of A-site and/or X-site ions of ABX3 -type perovskites with organic groups can give rise to hybrid perovskites, many of which display intriguing properties beyond their parent compounds. However, this method cannot be extended effectively to hybrid antiperovskites. Now, the design of hybrid antiperovskites under the guidance of the concept of Goldschmidt's tolerance factor is presented. Spherical anions were chosen for the A and B sites and spherical organic cations for the X site, and seven hybrid antiperovskites were obtained, including (F3 (H2 O)x )(AlF6 )(H2 dabco)3 , ((Co(CN)6 )(H2 O)5 )(MF6 )(H2 dabco)3 (M=Al3+ , Cr3+ , or In3+ ), (Co(CN)6 )(MF6 )(H2 pip)3 (M=Al3+ or Cr3+ ), and (SbI6 )(AlF6 )(H2 dabco)3 . These new structures reveal that all ions at A, B, and X sites of inorganic antiperovskites can be replaced by molecular ions to form hybrid antiperovskites. This work will lead to the synthesis of a large family of hybrid antiperovskites.

Two-Dimensional Organic-Inorganic Hybrid Rare-Earth Double Perovskite Ferroelectrics.

As a major branch of hybrid perovskites, two-dimensional (2D) hybrid double perovskites are expected to be ideal systems for exploring novel ferroelectric properties, because they can accommodate a variety of organic cations and allow diverse combinations of different metal elements. However, no 2D hybrid double perovskite ferroelectric has been reported since the discovery of halide double perovskites in the 1930s. Based on trivalent rare-earth ions and chiral organic cations, we have designed a new family of 2D rare-earth double perovskite ferroelectrics, A4MIMIII(NO3)8, where A is the organic cation, MI is the alkaline metal or ammonium ion, and MIII is the rare-earth ion. This is the first time that ferroelectricity is realized in 2D hybrid double perovskite systems. These ferroelectrics have achieved high-temperature ferroelectricity and photoluminescent properties. By varying the rare-earth ion, variable photoluminescent properties can be achieved. The results reveal that the 2D rare-earth double perovskite systems provide a promising platform for achieving multifunctional ferroelectricity.

Current quality standards of Andrographis Herba of different countries and regions / 中国中药杂志

Andrographis Herba is a commonly used plant medicine, and has been recorded in pharmacopeias of different countries. However, there are some differences in the quality standards. Based on this, this paper compare the quality standards of Andrographis Herba between Chinese Pharmacopoeia, Hong Kong Chinese Materia Medica Standards, United States Pharmacopoeia, European Pharmacopoeia and Indian Pharmacopoeia, including origin, botanical characteristics, identification(microscopic identification and chromatographic identification), content determination, specific test(such as impurities, loss on drying, extractives, pesticides, heavy metals, mycotoxins, and other items) and storage requirements, so as to provide a reference for studying international quality standards of Andrographis.

Study on herbal textual evolution and flavonoids and their pharmacological of Spatholobi Caulis / 中国中药杂志

Spatholobi Caulis, the vine stem of Spatholobus suberectus and widely used in China and Southeast Asian nations, has the effects on nourishing the blood and promoting blood flow, regulating menstruation and relieving pain, and invigorating the nerves. Through consulting the herbal textual and local chronicles, we summarized the original textual research and medicinal evolution on Spatholobi Caulis to analyze the changes of varieties in different historical periods. Further, the major active ingredient in Spatholobi Caulis was discussed. According to the literature to date, 60 flavonoids compounds have been isolated and could be divided into isoflavones, dihydroflavones, flavanols, dihydroflavonols, procyaninides, chalcones, pterocarpans, isoflavanols, isoflavanones and aurone according to their molecular structures. These indicative ingredients in Spatholobi Caulis showed pharmacological activities on regulation of the blood system, anti-tumor, anti-oxidation, anti-virus, anti-bacteria and inhibition of melanin deposition. This review will provide reference and basis for the sustainable use of resources and industry development on Spatholobi Caulis.

[Study on Chinese Medical Syndrome Distribution in Adjuvant Chemotherapy Period of Colorectal Cancer].

Objective To study the Chinese Medical (CM) syndrome distribution in patients with colorectal cancer in adjuvant chemotherpay period. Methods Totally 160 patients with colorectal cancer were recruited and clinical data for the CM syndromes before receiving adjuvant chemotherapy, in the early, mid and after period of adjuvant chemotherapy were collected. The distribution and dynamic chan- ges of CM syndromes were observed. Results The primary CM syndrome before chemotherapy were yin deficiency induced inner heat with dampness (40 cases, 40. 0%) and qi deficiency syndrome(30 ca- ses,30. 0%) concluded by 14 symptoms during cluster analyses among 100 cases.The primary CM syn- drome at the early period of adjuvant chemotherapy was Pi and blood deficiency syndrome (60 cases, 50.0%) , closely followed by syndrome of yin deficiency induced inner heat (45 cases, 37.5%) by 16 symptoms during cluster analyses among 120 cases. The CM syndrome at the mid period of adjuvant chemotherapy consisted of syndrome of Gan-heat and Pi-deficiency(51 cases ,44. 7%), syndrome of qi and blood deficiency (40 cases,35. 1%) , as well as Pi-deficiency with dampness syndrome (19 cases, 16.7%) by 22 symptoms during cluster analyses among 114 cases; at the period after adjuvant chemo- therapy, the major CM syndromes was deficiency syndrome, including qi and blood deficiency syndrome (32 cases,29. 1%), Pi-deficiency syndrome(29 cases,26. 4%) and Gan-Shen yin deficiency syndrome (49 cases,44. 6%) by 24 symptoms during cluster analyses among 110 cases. Conclusion During the period of adjuvant chemotherapy in colorectal cancer patients, the mainly CM syndromes shows the defi- ciency syndrome.

Reforming Medical Education in China: A Traditional Chinese Medicine Perspective.

This article was migrated. The article was marked as recommended. Introduction: While the Chinese medical education system is undergoing comprehensive reform, traditional forms of Chinese medicines (TCM) continue to be a unique and indispensable part of health care system. However, few studies have explored how various forms of TCM are incorporated with biomedicine in clinical practice. Purpose: To explore clinicians' professional and extraprofessional experience with TCM and to assess whether their medical education has prepared them for clinical work that requires drawing on knowledge of TCM. Methods: Surveys were distributed in 2013 to 18 clinicians, 33 undergraduates and 60 post-graduate students. The survey combined forced-choice and open-ended questions assessing personal and professional experiences with TCM. Mixed qualitative and quantitative methods were used to investigate trends in open-ended survey responses. Results: The majority of clinicians (89%), post-graduate students (60%) and undergraduate students (67%) have personally used TCM treatments. The vast majority of all three groups indicated that they would continue to recommend TCM to patients. Respondents expressed an overall positive attitude towards their extraprofessional experience with TCM whereas their professional experience with TCM was mixed. Conclusion: The extraprofessional and professional experiences of clinicians and students with various types of TCM for a diverse array of indications reveal the sustained clinical presence of TCM. The survey reveals the importance of more training in applying TCM, especially in a clinical setting, and imminent hurdles that must be overcome in implementing clinical training reforms.