Thyroid Hormone Changes Correlate to Combined Breast Cancer with Primary Thyroid Cancer.

Background: Breast cancer and thyroid cancer are two prevalent malignancies in women, and a potential association between the two diseases has been suggested. Methods: This retrospective case-control study was conducted involving 97 patients with breast cancer and thyroid cancer (BC-TC group) and 97 age-matched patients with breast cancer alone (BC group). Thyroid hormone levels, including triiodothyronine (T3), thyroxine (T4), free triiodothyronine (FT3), free thyroxine (FT4) and thyroid-stimulating hormone (TSH), were analyzed in healthy controls, BC patients, and BC-TC patients. Results: BC-TC patients exhibited a higher rate of estrogen receptor (ER) and progesterone receptor (PR) positivity compared to BC patients. Serum T3 levels were significantly decreased in BC and BC-TC patients compared to healthy controls. However, there was no significant difference in T3 levels between BC and BC-TC patients. Serum TSH levels were significantly higher in BC-TC patients compared to BC patients. Conclusion: ER positivity, PR positivity, and serum TSH levels greater than 4.45 mU/L were independent risk factors for primary thyroid cancer in breast cancer patients.

Inertial migration of polymer micelles in a square microchannel.

Using a hybrid simulation approach that combines a lattice-Boltzmann method for fluid flow and a molecular dynamics model for polymers, we investigate the inertial migration of star-like and crew-cut polymer micelles in a square microchannel. It is found that they exhibit two types of equilibrium positions, which shift further away from the center of the microchannel when the Reynolds number (Re) increases, as can be observed for soft particles. What differs from the behaviors of soft particles is that here, the blockage ratio is no longer the decisive factor. When the sizes are the same, the star-like micelles are always relatively closer to the microchannel wall as they gradually transition from spherical to disc-like with the increase of Re. In comparison, the crew-cut micelles are only transformed into an ellipsoid. Conversely, when the hydrophobic core sizes are the same, the equilibrium position of the star-like micelles becomes closer to that of the crew-cut micelles. Our results demonstrate that for polymer micelles with a core-shell structure, the equilibrium position is no longer solely determined by their overall dimensions but depends on the core and shell's specific dimensions, especially the hydrophobic core size. This finding opens up a new approach for achieving the separation of micelles in inertial migration.

In Situ Observations of Halogenated Gases at the Shangdianzi Background Station and Emission Estimates for Northern China.

Halogenated gases include ozone-depleting substances and greenhouse gases, such as chlorofluorocarbons, halons, hydrochlorofluorocarbons, hydrofluorocarbons, and perfluorinated gases. In situ atmospheric observations of major halogenated gases were conducted at the Shangdianzi (SDZ) background station, China, from October 2020 to September 2021 using ODS5-pro, a newly developed measurement system. The measurement time series of 36 halogenated gases showed occasional pollution events, where background conditions represented 25% (CH2Cl2) to 81% (CF3Cl, CFC-13) of the measurements. The annual mean background mole fractions of most species at SDZ were consistent with those obtained at the Mace Head station in Ireland. The background conditions were distinguished from pollution events, and the enhanced mole fractions were used to estimate the emissions of four categories of fluorinated gases (F-gases) from northern China using a tracer ratio method. The CO2-equivalent (CO2-equiv) emission of F-gases from northern China reached 181 ± 18 Tg year-1 during 2020-2021. Among the four categories of F-gases estimated, SF6 accounted for the highest proportion of CO2-equiv emissions (24%), followed by HFC-23 (22%), HFC-125 (17%), HFC-134a (13%), NF3 (10%), CF4 (5.9%), HFC-143a (3.9%), HFC-32 (3.4%), and HFC-152a (0.2%).

Study on Clinicopathological Features and Risk Factors of Patients with Multiple Primary Breast Cancers and Thyroid Disease.

Objective: To explore the clinicopathological features and risk factors of patients with multiple primary breast cancers and thyroid disease. Method: An analytic approach of the reviewing method was adopted to analyze the clinical data of 80 breast cancer patients who were admitted to our hospital from January 2020 to January 2022. They were divided into an observation group (breast cancer with thyroid lesions) and a control group (simple breast cancer) according to whether the clinical data were accompanied with thyroid lesions to compare the clinical characteristics, pathological types, staging characteristics, and molecular biological characteristics of the two groups and to research the risk factors of the two groups. Result: (1) In the comparison of clinical data, the number of people aged ≥60 in the observation group was higher than that in the control group, and there was significant difference between the groups in the menopausal status data (P < 0.05). There was no statistical difference between the observation group and the control group in the comparison of clinical data of the body mass index, pregnancy frequency, labor frequency, and abortion history (P > 0.05). (2) In the comparison of pathological type and staging data, there was no statistical difference in the comparison of data on the pathological type, histological grade, T staging, N staging, and TNM staging between the observation group and the control group (P > 0.05). (3) In the comparison of data on molecular biology characteristics, there was a statistical difference in the nuclear proliferation antigen data between the observation group and the control group (P < 0.05). There was no statistical difference in the comparison of data on the estrogen receptor, progesterone receptor, human epidermal growth factor receptor-2, and molecular typing between the observation group and the control group (P > 0.05). (4) Logistic regression analysis showed that age, menopausal status, and nuclear proliferation antigen index were the high-risk inflammatory factors for combined thyroid lesions (P < 0.05). Conclusion: For patients with simple breast cancer, age, menopausal status, and nuclear proliferation antigen index are risk factors for combined thyroid lesions. Therefore, clinical attention should be paid to the above factors in the process of clinical treatment, and early-risk screening should be performed to achieve the purpose of improving the prognosis to the greatest extent.

Association between the overall burden of comorbidity and Ct values among the older patients with Omicron infection: Mediated by inflammation.

Objectives: To investigate the associations between the overall burden of comorbidity, inflammatory indicators in plasma and Ct values among the elderly with COVID-19. Methods: We conducted a retrospective observational study. The results of each nucleic acid test of during hospitalization were obtained. Linear regression models assessed the associations between the overall burden of comorbidity, inflammatory indicators in plasma and Ct values among the elderly. A causal mediation analysis was performed to assess the mediation effects of inflammatory indicators on the association between the overall burden of comorbidity and Ct values. Results: A total of 767 COVID-19 patients aged ≥ 60 years were included between April 2022 and May 2022. Patients with a high burden of comorbidity had significantly lower Ct values of the ORF gene than subjects with a low burden of comorbidity (median, 24.81 VS 26.58, P < 0.05). Linear regression models showed that a high burden of comorbidity was significantly associated with higher inflammatory responses, including white blood cell count, neutrophil count and C-reactive protein. Also, white blood cell count, neutrophil count, C-reactive protein and the overall burden of comorbidity assessed by age-adjusted Charlson comorbidity index were independent risk factors for the Ct values. A mediation analysis detected the mediation effect of white blood cells on the association between the burden of comorbidity and Ct values, with the indirect effect estimates of 0.381 (95% CI: 0.166, 0.632, P < 0.001). Similarly, the indirect effect of C-reactive protein was -0.307 (95% CI: -0.645, -0.064, P = 0.034). White blood cells and C-reactive protein significantly mediated the relationship between the burden of comorbidity and Ct values by 29.56% and 18.13% of the total effect size, respectively. Conclusions: Inflammation mediated the association between the overall burden of comorbidity and Ct values among elderly with COVID-19, which suggests that combined immunomodulatory therapies could reduce the Ct values for such patients with a high burden of comorbidity.

Structure of Randomly Distributed Nanochain Aggregates on Silicon Substrates: Modeling and Optical Absorption Characteristics.

Nanoparticle aggregate structures allow for efficient photon capture, and thus exhibit excellent optical absorption properties. In this study, a model of randomly distributed nanochain aggregates on silicon substrates is developed and analyzed. The Gaussian, uniform, and Cauchy spatial distribution functions are used to characterize the aggregate forms of the nanochains and their morphologies are realistically reconstructed. The relationships between the structural parameters (thickness and filling factor), equivalent physical parameters (density, heat capacity, and thermal conductivity), and visible absorptivity of the structures are established and analyzed. All the above-mentioned parameters exhibit extreme values, which maximize the visible-range absorption; these values are determined by the material properties and nanochain aggregate structure. Finally, Al nanochain aggregate samples are fabricated on Si substrates by reducing the kinetic energy of the metal vapor during deposition. The spectral reflection characteristics of the samples are studied experimentally. The Spearman correlation coefficients for the calculated spectral absorption curves and those measured experimentally are higher than 0.82, thus confirming that the model is accurate. The relative errors between the calculated visible-range absorptivities and the measured data are less than 0.3%, further confirming the accuracy of the model.

The Effect of High-Quality Nursing Management on Thyroid Tumor Patients after Bipolar Coagulation.

Objective: To evaluate the effect of high-quality nursing on thyroid tumor patients after bipolar coagulation and its impact on nursing satisfaction. Methods: From January 2019 to January 2020, 90 patients with thyroid tumors treated with bipolar coagulation in our hospital were identified as the study objects and randomized to the control group (n = 45) and the experimental group (n = 45) random number table method. Both groups received conventional nursing, and the experimental group additionally adopted high-quality nursing. The incidence of postoperative complications and nursing satisfaction between the two groups was compared. The Exercise of Self-Care Agency Scale (ESCA) was used to assess the self-care ability of patients after the intervention, and the Generic Quality of Life Inventory-74 (GQOLI-74) was used to evaluate the quality of life of the two groups of patients after the intervention. The Hospital Anxiety and Depression (HAD) scale was adopted to evaluate the emotional state of the patient before and after the intervention, and the Numerical Rating Scale (NRS) was employed to evaluate the pain intensity of the patient after the intervention. Counting data was analyzed by the X2 test, and the measurement data was analyzed by t-test. Results: After the intervention, the total incidence of postoperative complications in the experimental group was significantly lower than that in the control group (11.11% versus 33.33%, P < 0.05). The experimental group obtained remarkably higher nursing satisfaction (93.33% versus 71.11%), ESCA scores, and GQOLI-74 scores than the control group (P < 0.05). Lower HAD scores were observed in the experimental group than those of the control group (P < 0.001). Lower HAD scores were observed in the experimental group than those of the control group (P < 0.001). The NRS score of the experimental group was significantly lower than that of the control group 12 h and 24 h after the intervention (P < 0.001). Conclusion: High-quality nursing for patients with thyroid tumors can effectively alleviate the negative emotions, improve the quality of life, and contribute to a harmonious nurse-patient relationship, which is worthy of promotion and application.

TEAD4 overexpression suppresses thyroid cancer progression and metastasis in vitro by modulating Wnt signaling.

TEAD4 has been reported to act as an oncogenic gene in various types of cancer. This study intends to investigate the role and regulatory mechanism of TEAD4 in thyroid cancer (TC). GEPIA was used to predict the expression pattern of TEAD4 in TC. Expressions of TEAD4 and wnt3a in TC tissues and cells were analyzed by qRT-PCR and Western blot. TC cells were transfected with TEAD4 overexpression plasmids and treated with or without IWR-1-endo (a Wnt signaling inhibitor), and then TC cell viability, migration and invasion were assessed by MTT and Transwell assay. Expressions of E-cadherin, N-cadherin and Vimentin in cells were analyzed by Western blot. TEAD4 was low-expressed in TC tissues and cells. TEAD4 overexpression inhibited the viability, inhibited migration and invasion of TC cells, and downregulated N-cadherin and Vimentin expression, while promoted E-cadherin and wnt3a expression. The wnt3a expression was positively correlated with TEAD4 expression in TC. IWR-1-endo treatment reversed the effect of TEAD4 in TC cells. TEAD4 overexpression suppresses TC progression and metastasis in vitro through modulating Wnt signaling.

Using a non-invasive multi-sensor device to evaluate left atrial pressure: an estimated filling pressure derived from ballistocardiography.

BACKGROUND: Heart failure is a global health problem, and elevated left atrial pressure (LAP) is a precursor to identifying decompensated heart failure. At present, out-of-hospital monitoring of patients with heart failure is mostly based on the patient's symptoms and signs, and the use of non-invasive technology is scarce. In this study, a non-invasive ballistocardiography (BCG) device was used to collect thoracic vibration signals generated by heartbeat. We collected these signals from more than 1,000 adults, including those with different heart diseases, and used a sensor system and a composite index related to LAP recognition named the LAP-index, to analyze them. This study aimed to verify the reliability and accuracy of the LAP-index in identifying elevated LAP within heart failure patients. METHODS: We prospectively included 158 patients with various extent of diastolic function, some of whom had various underlying diseases, and collected BCG and echocardiographic data using a cross-section methodology. The BCG signal was recorded from multiple optical fiber vibration sensors placed on the back of each patient. We adopted the 2016 ASE/EACVI echocardiography guideline as the standard for determining LAP level from echocardiography parameters. To evaluate the diagnostic efficacy of the LAP-index, we drew a receiver operating characteristic (ROC) curve and calculated the area under the ROC curve (AUC). RESULTS: The LAP-index of the 158 patients ranged from 6 to 32. Of them, 39 were diagnosed as high LAP by echocardiography, and 119 cases had normal or slightly elevated LAP. Comparison of the LAP-index results and echocardiographic results revealed the ROC c-statistic of the LAP-index for identifying high LAP was 0.86 (95% CI: 0.79-0.93; P<0.0001). When the LAP-index was at the best cut-off value of 15.5, the positive agreement rate between it and echocardiography LAP was 0.85, the negative agreement rate was 0.80, and the overall agreement rate was 0.81. CONCLUSIONS: The sensor system and the LAP-index, a composite index derived from BCG, have high reliability and accuracy in identifying elevated LAP, which provides a novel possibility for the non-invasive detection of hemodynamic congestion in heart failure patients.

Ballistocardiography to identify high left atrial pressure in patients with heart failure.

BACKGROUND: Due to a high prevalence and morbidity rate, heart failure (HF) constitutes an immense economic burden on the global health care system. An increase in left atrial pressure (LAP) precedes the occurrence of any HF symptoms. In this study, we applied a novel non-invasive method of ballistocardiography (BCG) to extract early diastolic ventricular vibration waves [the BCG-B3 index, which corresponds to the third heart sound (S3) at the end of the rapid filling phase of diastole]. This study evaluated the predictive value of the BCG-B3 index for LAP in HF patients. METHODS: A total of 83 HF patients and 20 patients with underlying diseases were prospectively enrolled, and their cross-sectional BCG and echocardiography (ECHO) data were collected. BCG obtains a signal through a high-precision fiber-optic sensor placed on the patient's back. LAP or pulmonary capillary wedge pressure (PCWP) was estimated by the ratio of mitral inflow peak early diastolic velocity to the early diastolic velocity of the mitral annulus (E/e') or the Nagueh equation (LAP = 1.24 × E/e' + 1.9). To evaluate the diagnostic efficacy of the BCG-B3 index, a receiver operating characteristic (ROC) curve was plotted, and the area under the ROC curve (AUC) was calculated. The best cutoff value for the BCG-B3 index was determined by the maximum Youden index. RESULTS: The correlation coefficient between the BCG-B3 index and E/e' ratio was 0.51 (P<0.01). Under an optimal cutoff value of 55.13, the BCG-B3 index showed a positive consistency value of 0.93, a negative consistency value of 0.53, and an overall consistency value of 0.82 for identification of significantly elevated LAP. CONCLUSIONS: The BCG-B3 index derived by noninvasive BCG using a built-in fiber-optic sensor has important diagnostic value for identifying significantly elevated LAP in HF patients with high accuracy. BCG examination is not limited by place or the doctor's experience. Therefore, BCG can provide timely assessments for HF patients, enabling early diagnosis and treatment.

Chelerythrine Ameliorates Pulmonary Fibrosis via Activating the Nrf2/ARE Signaling Pathway.

Chelerythrine (CHE) is a natural benzophenanthridine alkaloid, which has shown its anti-fibrosis activity in kidney and liver, while the impact of CHE in pulmonary fibrosis is still unclear. This study is developed to explore the impact and mechanism of CHE in pulmonary fibrosis. Pulmonary fibrosis mouse models were established through intratracheal injection of bleomycin (BLM), after which the mice were intraperitoneally injected with CHE (0.375 or 0.75 mg/kg/d) every other day. The mice were sacrificed at the 28th day to collect blood serum, bronchoalveolar lavage fluid (BALF), and pulmonary tissues. Then, the severity of pulmonary fibrosis and the expression of nuclear factor erythroid 2 [NF-E2]-related factor 2 (Nrf2) in the pulmonary tissues were detected. Western blot analysis quantified the expressions of fibronectin and alpha-smooth muscle actin (α-SMA). The levels of 4-hydroxynonenal (4-HNE), glutathione (GSH), superoxide dismutase (SOD), TGF-ß and hydroxyproline (HP) in the BALF, and pulmonary tissues were measured. The expression levels of Nrf2 and its downstream genes, hemeoxygenase-1 (HO-1) and NAD (P) H: quinone oxidoreductase (NQO1) were examined. CHE at the concentration of 0.375 or 0.75 mg/kg/d could attenuate pulmonary fibrosis. CHE injection reduced the expression levels of fibronectin, α-SMA, and TGF-ß, upregulated the levels of SOD and GSH and decreased the levels of 4-HNE and HP. Also, CHE increased the expressions of Nrf2, HO-1, and NQO1. Treatment of Nrf2/antioxidant response element (ARE) inhibitor could block the Nrf2/ARE signaling pathway, thus perturbing the inhibition of CHE on BLM-stimulated pulmonary fibrosis in mice. CHE alleviates BLM-induced pulmonary fibrosis in mice through activating the Nrf2/ARE pathway to increase the activity of antioxidant enzymes.

Efficacy of early hydroxychloroquine treatment in preventing COVID-19 pneumonia aggravation, the experience from Shanghai, China.

The aim of this study is to assess the efficacy of multiple treatments, especially hydroxychloroquine, used in different disease stages of coronavirus disease 2019 (COVID-19). All consecutive patients with COVID-19 admitted to Shanghai Public Health Clinical Center (Shanghai, China) between January 20, 2020, and April 30, 2020, were enrolled, and their clinical data were retrospectively collected. Binary logistic regression was used to screen the factors associated with disease aggravation, and multivariable analyses with the Cox proportional hazards model were used to estimate the effects of prognostic factors on the improvement time and PCR conversion days in throat swabs and stool swabs. A total of 616 patients, including 50 (8.11%) severe and 18 (2.92%) critical patients, were enrolled in our retrospective cohort study. The early use of hydroxychloroquine was a protective factor associated with disease aggravation (95% CI: 0.040-0.575, p = 0.006). Clinical improvement by 20 days was significantly different between patients with hydroxychloroquine used early and those with hydroxychloroquine not used (p = 0.016, 95% CI: 1.052-1.647). The median time to clinical improvement was 6 days in the hydroxychloroquine used early group, compared with 9 days in the without hydroxychloroquine used group and 8 days in the with hydroxychloroquine not used early group (p < 0.001). Hydroxychloroquine used early was associated with earlier PCR conversion in both throat swabs (HR = 1.558, p = 0.001) and stool swabs (HR = 1.400, p = 0.028). The use of hydroxychloroquine at an early stage is a potential therapeutic strategy for treating patients before irreversible severe respiratory complications occur. The early use of hydroxychloroquine decreased the improvement time and the duration of COVID-19 detection in throat and stool swabs.

A Robust Infrared Transducer of an Ultra-Large-Scale Array.

A robust micro-electro-mechanical systems (MEMS) infrared thin film transducer of an ultra-large-scale array was proposed and fabricated on a 4-inch silicon wafer. The silicon substrate and micro cavities were introduced. This novel transducer had excellent mechanical stability, time response, and state-of-the-art pixel scale. It could bear a load of 1700 g and its load pressure was improved by more than 5.24 times and time constant decreased by 50.7% compared to the traditional soft infrared thin film transducer. The array scale of its pixels exceeded 2k × 2k. The simulation and measured results of the transient temperature and radiation intensity were well consistent. Illuminated by a 532 nm laser with a frequency of 50 Hz and 50% duty cycle, the thermal decay time of the proposed transducer was 6.0 ms. A knife-edge image was utilized for spatial resolution test and the full width at half maximum (FWHM) of the proposed transducer was 24% smaller than the traditional soft one. High-resolution infrared images were generated using the proposed robust transducer. These results proved that the robust transducer was promising in infrared image generation.

Scutellarin ameliorates pulmonary fibrosis through inhibiting NF-κB/NLRP3-mediated epithelial-mesenchymal transition and inflammation.

Idiopathic pulmonary fibrosis (IPF) is featured with inflammation and extensive lung remodeling caused by overloaded deposition of extracellular matrix. Scutellarin is the major effective ingredient of breviscapine and its anti-inflammation efficacy has been reported before. Nevertheless, the impact of scutellarin on IPF and the downstream molecular mechanism remain unclear. In this study, scutellarin suppressed BLM-induced inflammation via NF-κB/NLRP3 pathway both in vivo and in vitro. BLM significantly elevated p-p65/p65 ratio, IκBα degradation, and levels of NLRP3, caspase-1, caspase-11, ASC, GSDMDNterm, IL-1ß, and IL-18, while scutellarin reversed the above alterations except for that of caspase-11. Scutellarin inhibited BLM-induced epithelial-mesenchymal transition (EMT) process in vivo and in vitro. The expression levels of EMT-related markers, including fibronectin, vimentin, N-cadherin, matrix metalloproteinase 2 (MMP-2) and MMP-9, were increased in BLM group, and suppressed by scutellarin. The expression level of E-cadherin showed the opposite changes. However, overexpression of NLRP3 eliminated the anti-inflammation and anti-EMT functions of scutellarin in vitro. In conclusion, scutellarin suppressed inflammation and EMT in BLM-induced pulmonary fibrosis through NF-κB/NLRP3 signaling.

D-dimer as a biomarker for disease severity and mortality in COVID-19 patients: a case control study.

BACKGROUND: Over 5,488,000 cases of coronavirus disease-19 (COVID-19) have been reported since December 2019. We aim to explore risk factors associated with mortality in COVID-19 patients and assess the use of D-dimer as a biomarker for disease severity and clinical outcome. METHODS: We retrospectively analyzed the clinical, laboratory, and radiological characteristics of 248 consecutive cases of COVID-19 in Renmin Hospital of Wuhan University, Wuhan, China from January 28 to March 08, 2020. Univariable and multivariable logistic regression methods were used to explore risk factors associated with in-hospital mortality. Correlations of D-dimer upon admission with disease severity and in-hospital mortality were analyzed. Receiver operating characteristic curve was used to determine the optimal cutoff level for D-dimer that discriminated those survivors versus non-survivors during hospitalization. RESULTS: Multivariable regression that showed D-dimer > 2.0 mg/L at admission was the only variable associated with increased odds of mortality [OR 10.17 (95% CI 1.10-94.38), P = 0.041]. D-dimer elevation (≥ 0.50 mg/L) was seen in 74.6% (185/248) of the patients. Pulmonary embolism and deep vein thrombosis were ruled out in patients with high probability of thrombosis. D-dimer levels significantly increased with increasing severity of COVID-19 as determined by clinical staging (Kendall's tau-b = 0.374, P = 0.000) and chest CT staging (Kendall's tau-b = 0.378, P = 0.000). In-hospital mortality rate was 6.9%. Median D-dimer level in non-survivors (n = 17) was significantly higher than in survivors (n = 231) [6.21 (3.79-16.01) mg/L versus 1.02 (0.47-2.66) mg/L, P = 0.000]. D-dimer level of > 2.14 mg/L predicted in-hospital mortality with a sensitivity of 88.2% and specificity of 71.3% (AUC 0.85; 95% CI = 0.77-0.92). CONCLUSIONS: D-dimer is commonly elevated in patients with COVID-19. D-dimer levels correlate with disease severity and are a reliable prognostic marker for in-hospital mortality in patients admitted for COVID-19.

Increased multidrug resistant isolates: new clinical burdens for 66 hospitals in Shanghai, 2015 to 2017.

BACKGROUND: To investigate the etiology of urinary tract and respiratory infections and the rate of drug resistant bacteria in Shanghai from 2015 to 2017, provide the support to the promotion of the correct clinical etiological specimens detection. METHODS: The retrospective questionnaire survey was conducted to obtain the antibiotic prescription rate, pathogen detection rate, and isolation rate of drug-resistant bacteria of the inpatients in 66 hospitals of Shanghai in 2015 and 2017. RESULTS: Although the detection rate of multidrug-resistant bacteria in sputum specimens has decreased, the clinical pathogen detection still relied mainly on sputum specimens in 2017. Among the sputum specis, the detection rates of extended-spectrum ß-lactamase-producing Escherichia (ESBL-ESC), extended-spectrum ß-lactamase Klebsiella pneumoniae (ESBL-KP), carbapenem-resistant Acinetobacter baumannii (CRAB), carbapenem-resistant Pseudomonas aeruginosa (CRPA) and methicillin-resistant Staphylococcus aureus (MRSA) in 2017 were 66.67%, 32.46%, 61.74%, 32.01% and 58.55% respectively. The detection rates of ESBL-ESC, ESBL-KP, CRAB, CRPA in 2017 were increased while the MRSA was decreased than 2015 (P<0.001). Among the blood samples, the detection rates of ESBL-ESC, ESBL-KP, CRAB, CRPA, MRSA and vancomycin-resistant Enterococcus sp (VRE) in 2017 were 53.71%, 31.43%, 50.80%, 19.43%, 43.87% and 0.55% respectively. The detection rates of ESBL-KP, CRAB, CRPA and MRSA increased while the rates of ESBL-ESC and VRE decreased compared with 2015 (P<0.005). The pathogens of multi-drug resistant bacteria were mainly detected from sputum specimens in 2017, which were all higher than detected from the blood specimens (P<0.001). CONCLUSIONS: Most of the multi-drug resistant bacteria in Shanghai, especially in Acinetobacter baumannii or Pseudomonas aeruginosa are mainly detected from sputum specimens, indicating that the actual drug resistance may be overestimated.

Colonization of Toxigenic Clostridium difficile Among Intensive Care Unit Patients: A Multi-Centre Cross-Sectional Study.

Background:Clostridium difficile (CD) is a major cause of healthcare-associated infections and antibiotic-associated diarrhea in hospitalized patients worldwide. Carriers of toxigenic CD (tCD) have a higher risk of developing CD infections and can transmit CD to the environment and susceptible patients. However, little is known regarding the carriers and transmission of tCD in China. Methods: A multi-center cross-sectional study of tCD colonization (tCDC) was conducted from October 24 to 31, 2014, at 33 hospitals in Shanghai, China. Rectal swabs or stool samples were collected and tested, and the clinical and demographic status, epidemiological data, and blood parameters of 531 participants were recorded. The status of tCDC was defined by a positive result on the nucleic acid amplification test for the tcdA (toxin A), tcdB (toxin B), and cdtAB (toxin CDT) genes after positive bacterial culture. Results: The overall prevalence of CD colonization (CDC) was 19.02%, tCDC accounted for 92.08%, and A+B+CDT- was the dominant genotype (87.13%). The CD infection (CDI) prevalence was 1.51%. Potential tCDC-associated factors were admission to secondary grade hospitals, a body mass index <18.5, hospitalization during the previous 30 days, underlying diseases (including hypertension, diabetes mellitus, coronary heart disease, and respiratory failure), diarrhea during the previous 7 days, and exposure to fluoroquinolones or lansoprazole. Conclusions: This study reveals the prevalence of CDC and tCDC in Shanghai, elucidates several associated factors, contributes to the awareness of the current epidemiology in parts of eastern China and provides new insights for further study and infection control practices.

Thermodynamics characteristics of MEMS infrared thin film.

This work demonstrates a micro electro mechanical system (MEMS) technology based infrared thin film, which converts absorbed visible light energy into infrared radiation. The principle of the film and the experiment for studying its thermodynamic characteristics are presented. The radiation spectrum of the thin film conforms to the characteristics of blackbody spectrum, and the average emissivity in infrared band is 0.638. The thermal diffusion distance decreases with the decrease of substrate thickness. Moreover, the fabrication of periodic pixel arrays on substrates can effectively reduce the thermal conductivity. The thermal conductivity of the pixel inscribed thin film with a substrate thickness of 360nm is 0.1W/m·K. The temporal constant decreases with the decrease of substrate thickness. The time constant of the film with a substrate thickness of 360nm is 2.72ms while the working temperature is 5 degrees Celsius. These characteristics indicate that the infrared thin film has a promising application prospect in infrared scene projection.

A survey of sharps injuries and occupational infections among healthcare workers in Shanghai.

BACKGROUND: Healthcare workers (HCWs) are at greater risk of occupational exposure to sharp injuries in their daily routine work, which is extremely worrying due to the potential risk of transmitting bloodborne pathogens. This study aims to assess what procedures and factors present the greatest risk of sharp injuries to HCWs in Shanghai and to provide an evidence base for improving measures to reduce sharps injuries. METHODS: A cross-sectional study was administered to all HCW who might be exposed to sharp instruments in 81 hospitals in Shanghai. According to the voluntary, investigate as many HCWs as possible and get feedbacks N=61,309. The survey addressed the sharp injury (SI) incidents, SIs of common instruments, SIs of common locations, SIs of operating procedures, SIs of common instruments and common sources of SI occurrences. Statistical analysis was performed using the SPSS program. RESULTS: A total of 61,309 HCWs were surveyed for this study, and 935 (1.53%) HCWs experienced the various types of sharp injuries in one month. Of the 1,140 sharp injuries, 292 (25.61%) sharp injuries were reported, and 815 (71.49%) sharp injuries were traced to their sources. Interns experienced the highest proportion of sharps injuries (4.12%). General wards were the most common location where sharp injuries occurred to HCWs (36.05%), while disposable syringes were the most common medical devices that caused sharp injuries (32.11%). Nurses, doctors and logistical workers who did not receive relevant training had a higher incidence of SI (4.40%, 4.95% and 4.03%, respectively) than those who received training (1.58%, 1.03% and 0.67%, respectively, P<0.001). HBV infection was the main source of exposure to sharp injuries, with scalpel cuts being the most common related occurrence. CONCLUSIONS: Sharp injuries occur among HCWs in Shanghai dented optimism. There are multiple high-risk factors for SI and exposure to blood-borne pathogens in their work such as interns, general wards, disposable syringes, and lack of relevant training. HBV infection was the main source of exposure to sharp injuries. As such, medical institutions shall pay closer attention to this topic.

Modeling method of a ladar scene projector based on physically based rendering technology.

The ladar scene projector is a key device in the hardware-in-the-loop (HWIL) simulation system. Ladar scene modeling is a fundamental work of developing a ladar scene projector. A modeling method based on physically based rendering technology and OpenGL is proposed in this paper. This modeling method can quickly generate delay, amplitude, and pulse width data for all return signals in a large-array-scale ladar scene. A 100×100-array-sized ladar scene model with a distance range of 0-3 km is simulated. The average data generation time is only 5.31 ms. Distance resolution is 1.5 m, and the peak-valley error is less than 0.15 m. This method achieves efficient modeling and fast hardware update rates, which greatly improves the real-time performance of the ladar scene projector. It has strong practicality and can be directly applied in the HWIL simulation system.