[Study on the etiological characteristics and prevention and control of adult community-acquired pneumonia in hospitalized patients in a hospital in Beijing from 2015 to 2019].

Objective: To explore the distribution characteristics of pathogens in adult patients with community-acquired pneumonia (CAP) and to provide basis for the diagnosis, treatment, prevention of CAP. Methods: 1 446 inpatients with CAP were prospectively enrolled in a third-class hospital in Beijing in recent 5 years (from January 2015 to December 2019). Respiratory tract samples were collected for smear, culture, nucleic acid, antigen and antibody detection to identify the pathogen of CAP. Mann-Whitney U test was used for continuous variables and χ2 test or Fisher's exact test was used for categorical data for statistical analysis. Results: Among the 1 446 patients, 822 (56.85%) patients were infected with a single pathogen, 231 (15.98%) patients were infected with multiple pathogens, and 393 (27.18%) patients were not clear about the pathogen. Influenza virus is the first pathogen of CAP (20.95%, 303/1 446), mainly H1N1 (8.51%, 123/1 446), followed by mycoplasma pneumoniae (7.19%, 104/1 446), Mycobacterium tuberculosis (5.33%, 77/1 446) and Streptococcus pneumoniae (5.05%, 73/1 446). The outbreak of H1N1 occurred from December 2018 to February 2019, and the epidemic of mycoplasma pneumoniae pneumonia was monitored from August to November 2019. Patients under 65 years old had high detection rates of Mycoplasma pneumoniae (14.41% vs. 2.41%, χ²=74.712,P<0.001), Streptococcus pneumoniae (8.16% vs. 2.99%, χ²=18.156, P<0.001), rhinovirus (6.08% vs. 3.56%, χ²=5.025, P<0.025), Chlamydia pneumoniae (5.90% vs. 1.15%, χ²=26.542, P<0.001) and adenovirus (3.13% vs. 0.92%, χ²=9.547, P=0.002). The severe disease rate of CAP was 14.66% (212/1 446), and the average mortality rate was 3.66% (53/1 446). The severe illness rate and mortality rate of bacterial-viral co-infection were 28.97% (31/107) and 19.63% (21/107), respectively. Conclusions: Influenza virus is the primary pathogen of adult CAP. Outbreaks of Mycoplasma pneumoniae and H1N1 were detected in 2018 and 2019, respectively. The remission rate and mortality rate of virus-bacteria co-infection were significantly higher than those of single pathogen infection. Accurate etiological basis not only plays a role in clinical diagnosis and treatment, but also provides important data support for prevention and early warning.

[The effects of posterior chamber intraocular lens implantation on accommodative function in high myopia].

Objective: To investigate the effects of implantable Collamer lens (ICL) with a central hole on the accommodative function of patients with high myopia at different ages after implantation. Methods: A retrospective cohort study was conducted on 75 patients (150 eyes, 23 men and 52 women) with high myopia who underwent ICL implantation in Department of Ophthalmology of First Affiliated Hospital of Army Medical University from January 2017 to December 2018. The age was (28.99±7.26) years (range, 18-48 years). Forty patients (80 eyes) aged 18-34 years were included in the younger group and 35 patients (70 eyes) aged 35-48 years were included in the elderly group. To compare the changes and differences of accommodative function between the two groups, the uncorrected visual acuity, best corrected visual acuity, spherical equivalent error, amplitude of accommodation (AMP), negative relative accommodation (NRA), positive relative accommodation, single and both eyes' accommodation of facility (AF), fused cross cylinder, near and far distance horizontal phoria, accommodative convergence/accommodation and visual satisfaction questionnaire before surgery and at 1, 3, 6 and 12 months after surgery were analyzed. ANOVA for repeated design, LSD, unpaired sample t-test, Paired t-test, Chi-square test and Fisher's exact test were used for data analyses. Results: At each time point before and after operation, there were significant differences between the two groups in the AMP (F=16.511, P<0.05). The AMP of the younger group increased from (8.88±2.27) D at baseline to (9.51±1.34) D at 12 months, while it was decreased in the elderly group from (7.67±2.36) D at baseline to (6.56±2.63) D at 12 months. The trend of changes was significantly different (F=15.044,P<0.05). The AMP of the elderly group was significantly lower than that of the younger group at all time points (F=47.678, P<0.05). The NRA of the younger group was better than that of the elderly group (F=13.459, P<0.05), but the NRA had no significant changes in both groups postoperatively (F=1.788, P=0.141). We could not find any significant changes of positive relative accommodation between two groups (F=1.447, P=0.233). The monocular and binocular AF of two groups was increased significantly after surgery (F=34.296, 21.839, P<0.05). The AF of the younger group was better than that of the elderly group (F=80.327, 43.08, P<0.05). The fused cross cylinder was improved from baseline (0.12±0.32) D to (0.38±0.49) D at 12 months (F=4.752, P<0.05), while the difference was not found in the younger group (F=2.110, P=0.151). We could not find any significant changes of accommodative convergence/accommodation between two groups (F=0.389, P=0.505) or in each group (F=1.049, P=0.309) preoperatively and at 1, 3, 6 and 12 months after surgery. Conclusions: ICL implantation is effective in the treatment of high myopia. The visual acuity, AMP, monocular and binocular AF may increase obviously. Big improvements in the accommodative function and high satisfaction of vision can be achieved, especially in younger patients. (Chin J Ophthalmol, 2021, 57: 113-121).

[Prevalence status and influencing factors of visual impairment in the elderly people in rural areas of Yugan County, Jiangxi Province].

Objective: To assess the prevalence of visual impairment and the influencing factors among rural residents aged 60 years and above in Yugan county, Jiangxi province. Researchers analyzed influencing factors and provided scientific rationale for blindness prevention and control. Methods: Stratified cluster random sampling was used in randomly selecting 3 789 rural residents aged ≥ 60 in Yugan county. Eligible residents were invited to receive ophthalmic examinations and epidemiological investigations. Multivariate logistic regression was performed to analyze any influencing factors. Results: Three thousand seven hundred and eighty-nine rural residents completed the ophthalmic examination and investigation. Based on presenting visual acuity, the prevalence of visual impairment was 24.1%(915), of which blindness and moderate and severe was 2.9%(108) and 21.3%(807). The top five causes ranked are (1) cataract (283, 30.9%), (2) Refractive error (81, 8.9%), (3) macular degeneration (29, 3.2%), (4) Corneal opacity (14, 1.5%). Multivariate logistic regression showed that age, gender, education, occupation, marital status, ophthalmic anamnesis, smoking situation, and daily fruit intake were the main factors that were the influencing factors of visual impairment. Conclusions: The prevalence of visual impairment in the elderly population in rural areas of Yugan County is quite high. Keep a healthy diet, timely correction of eye disease, could reduce the risk of visual impairment. (Chin J Ophthalmol, 2018, 54:605-610).

[Intratympanic methylprednisolone perfusion remedy refractory sudden sensorineural hearing loss].

Objective:To observe the clinical efficacy and characteristics of intratympanic methylprednisolone perfusion (IMP) as a salvage treatment in sudden sensorineural hearing loss（SSNHL） patients who failed in conventional treatments.Method:One hundred and ten SSNHL patients who failed to respond to conventional therapies were recruited. And a 10-day IMP was adopted as a salvage treatment to improve their hearing. Twenty five SSNHL patients who failed to respond to conventional therapies and without any other treatment were recruited as control group. The pure tone average(PTA) before and after IMP treatment was observed by pure tone audiometry. Data analysis was performed using SPSS13.0 and test level was set α=0.05. Result:The total effective rate of IMP was 49.09%, significantly higher than control group 16.00%. Significant hearing improvement was observed at all frequencies after IMP treatment. Especially PTA gain at the low frequencies was (13.45±18.10) dB, obviously higher than high frequency. An obvious improvement of PTA were detected in profound group(15.62±13.95)dB compared with in moderate group(7.97±14.90) dB and in severe groupï¼»PTA gain(5.59±13.88) dBï¼½. However, there was no significant difference between the two latter groups. PTA gain was(12.26±14.69) dB,(13.37±17.11) dB and (3.21±10.51) dB respectively in patients who suffer from SSNHL within 2 weeks, >2-4 weeks and over 4 weeks. Whether accompanied with vertigo or tinnitus had no significant influence on the efficacy of IMP treatment in SSNHL patients who failed investigated. Conclusion:IMP treatment could improve the hearing in SSNHL patients who failed to respond to conventional therapies. The gain was closely related to the onset time and the severity of hearing loss before IMP treatment.

[Value of non-invasive models of liver fibrosis in judgment of treatment timing in chronic hepatitis B patients with ALT < 2×upper limit of normal].

Objective: To investigate the value of non-invasive liver fibrosis models, FIB-4, S index, aspartate aminotransferase to platelet ratio index(APRI), globulin-platelet(GP)model, aspartate aminotransferase/platelet/gamma-glutamyl transpeptidase/alpha-fetoprotein(APGA), and platelet/age/phosphatase/alpha-fetoprotein/aspartate aminotransferase(PAPAS), in the diagnosis of marked liver fibrosis in chronic hepatitis B(CHB)patients with ALT < 2×upper limit of normal(ULN), as well as treatment timing for this population. Methods: A total of 389 CHB patients with ALT < 2×ULN who were admitted to Beijing Ditan Hospital and whose treatment timing was difficult to judge were enrolled. Transdermal liver biopsy was performed to obtain pathological results, and routine serological tests were performed, including routine blood test, serum biochemical parameters, hepatitis B virus(HBV)markers, and HBV DNA. According to liver pathology, the patients were divided into non-marked liver fibrosis group(S < 2)with 324 patients and marked liver fibrosis group(S≥2)with 65 patients. The non-invasive models for predicting liver fibrosis was established with reference to original articles. SPSS 19.0 software was used for statistical analysis, and the receiver operating characteristic(ROC)curve was used to compare the value of different non-invasive models in predicting marked liver fibrosis in this population. Results: All the non-invasive models had a certain diagnostic value for liver fibrosis degree in these patients, and the areas under the ROC curve for APRI, FIB-4, APGA, S index, PAPAS, and GP model were 0.718, 0.691, 0.758, 0.729, 0.673, and 0.691, respectively. APGA had the largest area under the ROC curve(0.758, 95% CI 0.673-0.844), and gamma-glutamyl transpeptidase was significantly positively correlated with liver fibrosis degree. Conclusion: The non-invasive models of liver fibrosis can identify marked liver fibrosis in CHB patients with ALT < 2×ULN in whom it is difficult to judge treatment timing and help to determine treatment timing for them. APGA model has the highest value and can reduce the need for liver biopsy to the certain degree.

Effects of destrin pathway mutations on the gene expression profile.

This study aimed to explore the interaction and crosstalk between pathways in response to destrin mutations. All the pathways from the MINT database were downloaded, a protein-protein interaction network was then constructed, and the crosstalk between pathways was investigated, in particular, the overlap of 2 significant pathway analysis results. As expected, the results showed that regulation of the actin cytoskeleton was the significant pathway of destrin mutations in mice. Further analysis indicated that 28 significant pathways cross-talked with the pathway regulating the actin cytoskeleton. Importantly, 3 pathways, including regulation of actin cytoskeleton pathway, pathways in cancer, and the B cell receptor signaling pathway were linked by inositol phosphate metabolism based on crosstalk analysis of Gene Ontology relationships among pathways. All of these pathways have been demonstrated to participate in cytoskeleton dynamics. These findings might provide valuable insights into cytoskeleton dynamic abnormalities in destrin mutations of corneal diseases.

Orofacial deep and cutaneous tissue inflammation and trigeminal neuronal activation. Implications for persistent temporomandibular pain.

A rat model has been developed to characterize the responses of brainstem trigeminal neurons to orofacial deep and cutaneous tissue inflammation and hyperalgesia. Complete Freund's adjuvant (CFA) was injected unilaterally into the rat temporomandibular joint (TMJ) or perioral (PO) skin to produce inflammation in deep or cutaneous tissues, respectively. The TMJ and PO inflammation resulted in orofacial behavioral hyperalgesia and allodynia that peaked within 4-24 h and persisted for at least 2 weeks. Compared to cutaneous CFA injection, the injection of CFA into the TMJ produced a significantly stronger inflammation associated with a selective upregulation of preprodynorphin mRNA in the trigeminal spinal complex, an enhanced medullary dorsal horn hyperexcitability, and a greater trigeminal Fos protein expression, a marker of neuronal activation. The Fos-LI induced by TMJ inflammation persisted longer, was more intense, particularly in the superficial laminae, and more widespread rostrocaudally. Thus, the inflammatory irritant produces a stronger effect in deep than in cutaneous orofacial tissue. As there is heavy innervation of the TMJ by unmyelinated nerve endings, a strong nociceptive primary afferent barrage is expected following inflammation. An increase in TMJ C-fiber input after inflammation and strong central neuronal activation may initiate central hyperexcitability and contribute to persistent pain associated with temporomandibular disorders. Since deep inputs may be more effective in inducing central neuronal excitation than cutaneous inputs, greater sensory disturbances may occur in pain conditions involving deep tissues than in those involving cutaneous tissues.

[Higher lint percent and drought tolerant cotton line selected by radiation breeding].

The Gossypium hirsutum cv. Liaomian No. 9 were mutagenized by 60Co gamma ray, from which the mutant line Zhonghuzhi PI 935 (be called "PI 935" for short) was bred by family selection method. The PI 935 not only has some good traits (growing period, drought tolerance, lint color and fiber quality) similar to the original cultivar, but also has higher lint outturn and lint yield than that of the Liaomian No. 9. The PI 935 has been identified and regional tested in nine places times for four years in the southern Xinjiang Weiwuer autonomous region. It was shown that the PI 935 had the higher lint outtrn for the average 47.3% was ten-point percentage more than that of the check cultivars (Junmian No. 1 or Xinluzhong No. 5), the similar lint yield by and large and the growing period by five days later than that of the checks. The PI 935 was collected in the National Bank of Crop Germplasm (unified No. ZM 114274 and named "Zhonghuzhi PI 935").

[Experimental study of gastrointestinal mucopathy after severe burns].

Changes in gastrointestinal tract mucous membrane after serious burns were studied with light microscopy, transmission electron microscopy and scanning electron microscopy. The results showed that changes in the gastrointestinal tract mucous membrane included not only erosions and ulcers, but also mucoid necrosis and bacterial translocation. The injuries of the intestinal mucous membrane began from the apex of villi. There are epithelial necrosis, with desquamation and exposure of villi. The injuries are much more serious and extensive than that of gastric mucous membrane, especially in the jejunum. These results suggested that after serious burns, not only there were stress ulcers of the gastroduodenum, but the whole gastrointestinal tract was involved.