Effectiveness evaluation of pharyngeal swabs combined with anal swabs as multidrug-resistant organisms admission screening in intensive care unit / 中国感染控制杂志

Objective To evaluate the effectiveness of pharyngeal swabs combined with anal swabs as multidrug-resistant organism(MDRO)admission screening for patients in intensive care unit(ICU),and provide reference for healthcare-associated infection(HAI)prevention and control strategies.Methods Patients who underwent MDRO admission screening by pharyngeal swabs combined with anal swabs within 24 hours of admission to an ICU of a hospital in Shanghai from August 1 to December 31,2022 were included as the experimental group,and those who underwent MDRO admission screening only by pharyngeal swabs from August 1 to December 31,2021 were as the control group.Positive rate of screening,occurrence and pathogen of HAI between the two groups,as well as the sensitivity and specificity of combined admission screening for MDRO in the experimental group were compared.Results A total of 917 patients were included in the study,with 442 cases in the experimental group and 475 cases in the control group.The positive rates of admission screening for MDRO in the experimental and control groups were 7.40％and 3.37％,respectively.The incidences of HAI with MDRO in the experimental and control groups were 2.71％and 5.68％,respectively.Incidences of digestive system HAI with MDRO in the experimental and control groups were 0.68％and 2.32％,respectively.Differences were all statistically significant(all P＜0.05).The area under the ROC curve of admission screening by pharyngeal swabs combined with anal swabs for predicting HAI with MDRO in patients were 0.897(P＜0.01,95％CI:0.802-0.993).The sensitivity and specificity of admi-ssion screening for MDRO by pharyngeal swabs combined with anal swabs in the experimental group were 72.73％and 97.65％,respectively.Conclusion The combination of pharyngeal swabs and anal swabs can be used as an ICU admission screening method for MDRO,and has an important clinical application value.

A longitudinal study of trajectories of change in benefit finding among family caregivers of patients with lung cancer / 中国实用护理杂志

Objective:To explore the change trajectory and influencing factors of benefit finding of family caregivers of patients with lung cancer, so as to provide reference for formulating individualized intervention strategies.Methods:This study was a cross-sectional survey. From September 2021 to October 2022, 232 family caregivers of patients with lung cancer from General Hospital of PLA Central Theater Command and Tianyou Hospital affiliated to Wuhan University of Science and Technology were collected by convenience sampling method. The level of benefit finding of family caregivers was investigated at 1 month, 3 months and 6 month, after the patients were diagnosed. Growth Mixture Model was applied to identify distinct trajectory categories. Multinomial Logistic regressions were performed to analyze predictors of trajectory categories.Results:The overall level of benefit finding of family caregivers of lung cancer patients showed an upward trend over time ( F=83.06, P<0.01), from 1 month (47.02 ± 14.79) to 6 months (58.13 ± 13.18). Three categories of benefit finding trajectories were identified, named as "the high level-decline group" 12 cases, "the moderate level-stability group" 67 cases, and "the low level-elevation group" 153 cases. Univariate analysis showed that age and education level of family caregivers, average income per person in patient family, type of medical payment, whether the tumor was metastasized, the treatment method of the patient, whether they lived with the patient, and whether they had co-caregivers were related to the category of benefit finding trajectory ( χ2 values were 6.71-15.05, all P<0.05). Multivariate Logistic regression analysis showed that age and education level of family caregivers, average income per person in patient family, treatment method of the patient and whether they lived with the patients were the main influencing factors of benefit finding trajectory categories(all P<0.05). Conclusions:The benefit finding of family caregivers of lung cancer patients showed different trajectories with the time of diagnosis, and the overall level shows an upward trend. More than half of the family caregivers belong to the low level-elevation group. Medical staff should give family caregivers stage and specific nursing intervention according to the change trajectory of benefit finding and its influencing factors.

Investigation and control of a suspected nosocomial outbreak of pan-drug resistant Acinetobacter baumannii in an intensive care unit.

Acinetobacter baumannii, a non-fermenting Gram-negative bacterium, is a common pathogen in intensive care units (ICU) that is easily spread through contact and can cause nosocomial outbreaks. This study investigated the risk factors associated with outbreaks of pan-drug resistant Acinetobacter baumannii (PDR-Ab) infection by studying a suspected nosocomial outbreak in a comprehensive ICU in a teaching hospital in China, and discusses the effectiveness of current prevention and control measures. Pathogen detection methods involving pulsed field gel electrophoresis (PFGE) were employed to survey patients infected or colonized with PDR-Ab. An epidemiological investigation was conducted to determine the risk factors for infection or colonization with PDR-Ab between 1 October 2014 and 16 January 2015. The rate of PDR-Ab infection in the ICU was higher during the period from 1 October 2014 to 16 January 2015 than it was between 1 October 2013 and 16 January 2014. Only two cases were confirmed to have the same genotype. Risk factors were explored and the rate of infection was found to be controlled by interventions targeting these risk factors. A decrease in the number of infections was observed after multiple prevention and control measures were implemented, preventing the outbreak of a nosocomial infection.

Relationship between anti-cyclic Citrullinated petide antibody and cardiovascular complication associated with rheumatoid arthritis / 中国基层医药

Objective The aim of this study was to assess the relationship between the level of anti-CCP antibody and cardiovascular(CV) risk in rheumatoid arthritis(RA) patients.Methods A total of 78 RA patients were enrolled in the study.They were divided into two groups:40 cases with CV comphtations which were secondary from RA and 38 cases with no complications.The anti-CCP antibody was diagnosed by enzyme - linked immunoabsorbent assay(ELISA) and rheumatoid factor(RF) were assessed by immunoturbidimetry method.The relationship between the levels of the two sera auto-antibodies and CV disease associated with RA was analyzed.Results The results showed that the level of anti-CCP antibody in RA-CV disease group was significantly higher than that in simple RA group(74.6％ VS 87.3％ ).Compared with the simple RA group,the level of anti-CCP antibody in the RA-CV disease group was higher,and with significant difference between the two groups( x2 =5.07,9.04,6.48,all P ＜ 0.05 ).RF positive rate was 95.8％ of the patients with RA-CV disease while it was 76.5％ in simple RA group,and the difference between the two groups was statistically significant( x2 =33.41,26.05,34.14,all P ＜ 0.05 ).The morbidi ty between the different level of RF had remarkable difference.In RA patients with CV complations,we compared antiCCP antibody and RF by Spearman analysis,whish showed no relationship between them ( r =0.301,P =0.174 ).Conclusion The results indicated that CV disease secondary from RA was more common in old patients.In RA patients the high level of anti-CCP antibody and RF maybe play an important role in the appearance of CV disease.

Clinical efficacy of cyclophosphamide pulse therapy combined with leflunomide on 36 cases of refractory lupus nephropathy / 中国医师进修杂志

Objective To study the effect of cyclophosphamide pulse therapy combined with leflunomide (LEF) on refractory lupus nephropathy (RLN).Methods Thirty-six patients diagnosed as RLN were selected.Several observation parameters were compared before and after cyclophosphamide pulse therapy combined with LEF.The observation parameters included serum albumin,serum complement C3 and C4,systemic lupus erythematosus (SLE) activity index and urinary protein change.The side effects of cyclophosphamide pulse therapy combined with LEF were observed.Results The serum albumin was (20.17 ± 4.09) g/L,complement C3 was (0.40 ± 0.19) g/L,complement C4 was (0.08 ± 0.03) g/L,SLE activity index was 16.06 ± 4.17,and urinary protein was ( 9.79 ± 3.42 ) g/24 h before treatment and (38.10 ± 5.16) g/L,(0.78 ± 0.11 ) g/L,(0.16 ± 0.13)g/L,4.01 ± 1.24,( 1.14 ± 0.59) g/24 h after treatment,and there were significant differences between before treatment and after treatment (P ＜ 0.01 ).During the therapy,side effects were reported in 22 patients.However,these side effects had no impact on the therapy.After further treatment,these side effects gradually decreased and eventually disappeared.Conclusions Cyclophosphamide pulse therapy combined with LEF is effective in treating RLN.Patients' tolerance to the therapy is generally very good.

Passive cigarette smoking induces inflammatory injury in human arterial walls / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Epidemiological studies have shown that both active and passive cigarette smoking increase the risk of atherosclerosis. But very little is known about the biological processes induced by passive cigarette smoking that contribute to atherosclerosis. We observe the expression of a few of biological and inflammatory markers in human arterial walls in vitro which were treated with the second-hand smoke solution (sidestream whole, SSW), and discuss the possible mechanism of inflammatory injury induced by second-hand smoke.</p><p><b>METHODS</b>The biological markers (platelet endothelial cell adhesion molecule-1, PECAM-1; alpha-smooth muscle actin, alpha-SMA; collagen IV, Col IV) and inflammatory markers (vascular cell adhesion molecule-1, VCAM-1; monocyte chemoattractant protein-1, MCP-1; interleukin-8, IL-8) of human aortal wall were tested by immunofluorescence staining. The levels of MCP-1 and IL-8 mRNA expression were detected by reverse transcription-polymerase chain reaction (RT-PCR).</p><p><b>RESULTS</b>No distinct difference was observed between SSW and the control group on the expression of biological markers as assessed by the light microscope. But the inflammatory markers VCAM-1, MCP-1 and IL-8 on the subendothelial layer and smooth muscle cell layers, which are near the endothelium of arterial wall, were strongly stained in the SSW group compared with the control group. Their fluorescence intensities in the 1:40 SSW group (VCAM-1: 0.35 +/- 0.04, MCP-1: 0.34 +/- 0.05, IL-8: 0.37 +/- 0.05) and the 1:20 SSW group (VCAM-1: 0.40 +/- 0.04, MCP-1: 0.52 +/- 0.09, IL-8: 0.51 +/- 0.07) were significantly stronger than the control group (VCAM-1: 0.12 +/- 0.04, MCP-1: 0.06 +/- 0.02, IL-8: 0.24 +/- 0.03) by semi-quantitative analysis of immunofluorescence (P < 0.001 vs control). MCP-1 mRNA expression in the 1:40 SSW (0.15 +/- 0.04) and the 1:20 SSW (0.19 +/- 0.06) group was significantly higher than in the control group (0.09 +/- 0.03) (P < 0.05, P < 0.01 vs control); IL-8 mRNA expression in the 1:40 SSW (0.64 +/- 0.12) and 1:20 SSW (0.72 +/- 0.13) groups was also significantly higher than that in the control group (0.49 +/- 0.13) (P < 0.05, P < 0.01 vs control) by RT-PCR.</p><p><b>CONCLUSIONS</b>It is implied that a second-hand smoke solution induces the inflammatory reaction of the arterial wall by release of inflammatory factors even though there is no distinct structural change on the arterial walls under light microscope, indicating that passive cigarette smoking is related to inflammatory injury in human arterial wall and could be closely related to the early inflammatory stage of atherosclerosis.</p>

Artificial synthesized scaffold materials of bone tissue engineering / 中国组织工程研究

The scaffold material is one of the most key topics about the study of bone tissue engineering. The scaffold material of bone tissue engineering is divided into natural biomaterials and artificial synthesized biomaterials. Each kind of the materials includes organic materials and inorganic materials. Each scaffold material has its virtues and shortages. Although the existing scaffold materials merely carry some effects of the ideal materials require, the optimal scaffold may be designed using the necessary evidences provided by analyzing their virtues and shortages. This article summarized the study about the tissue engineering scaffold materials, such as porcelain and ceramics material, polymers material, natural organism-derived material and composite material.

Relationship between bone metabolism and aging / 中国组织工程研究

OBJECTIVE: To summarize and analyze the characteristics of bone metabolism with the growing of age, and explore the skeletal change with the increase of age especially in the elderly people and the females of postmenopause so as to provide scientific evidence for the prevention and treatment of osteoporosis.DATA SOURCES: Literatures about age growth and bone metabolism were computer-searched in Medline database published from January 1993 to December 2003, with the key words of "The bone metabolism,The age growth" in English. Meanwhile, it was also manually searched in library published between January 1993 and December 2003 for related articles in Japanese.STUDY SELECTION: After the primary search, inclusive criteria: ①Physiological characteristics, mechanism and influenced factors of the bone metabolism with the growing of age. ②Analysis of retrospective study was done in clinical cases. Repetitive experimental studies were excluded.DATA EXTRACTION: Totally 21 papers were accorded with the abovementioned requirements, and 14 repetitive studies were excluded. Seven articles were referred to the inclusive criteria, in which 3 articles were researchful; 2 articles were diagnostic criterions; 2 articles were textbook.DATA SYNTHESIS: Bone metabolism changed greatly; skeleton became mature gradually and bone calcium increased with the age growth. Bone metabolism reached homeostasis after 20 years, and then appeared negative growth after 40 years and bone calcium decreased. Bone metabolism was the most intense and variable parameter with the growing of age. The rate of osteoporosis increased greatly in elderly people, especially in the females of postemenopause, which might be related to endocrine disorder and so on, except degeneration in elderly people. Studying these could provide scientific evidence for the prevention and treatment of osteoporosis.CONCLUSION: On the basis of understanding the relationship between age growth and bone metabolism, we realize that osteoporosis may be prevented mainly by means of establishing healthy life-style, full nutrition and high calcium ingestion.