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Objective:To evaluate the value of implementing strict aseptic operation procedures in preventing central venous catheter-related infections.Methods:This retrospective cohort study consisting of non-surgical patients who underwent central venous catheterization from 2015 to 2019 were conducted.The patients were divided into 2 groups according to routine aseptic procedures and strict aseptic procedures, the patients between 2015 and 2017 served as routine aseptic procedure group (group C), and the patients between 2017 and 2019 served as strict aseptic procedure group (group E ). The occurrence of central venous catheter-related infections (local infection, bloodstream infection) was recorded within 6 days after catheterization.Results:Compared with group C, the incidence of central venous catheter-related local infection was significantly decreased (1.79% vs. 0.48%, P<0.001; the rate ratio being 0.27 ranged in 0.10-0.30), while no significant change was found in the incidence of central venous catheter-related bloodstream infection in group E (0.29% vs. 0.19%, P>0.05). The cumulative incidence of central venous catheter-related infections was 0.67%(<1.00%) in group E. Conclusions:Implementation of strict aseptic procedures during central venous catheterization can further reduce the occurrence of central venous catheter-related infections, which has significant clinical value.
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Histone acetylation is a well-characterized epigenetic modification controlled by histone acetyltransferases (HATs) and histone deacetylases (HDACs). Imbalanced histone acetylation has been observed in many primary cancers. Therefore, efforts have been made to find drugs or small molecules such as HDAC inhibitors that can revert acetylation levels to normal in cancer cells. We observed dose-dependent reduction in the endogenous and exogenous protein expression levels of KAT8 (also known as human MOF), a member of the MYST family of HATs, and its corresponding histone acetylation at H4K5, H4K8, and H4K16 in chemotherapy drug gemcitabine (GEM)-exposed T24 bladder cancer (BLCA) cells. Interestingly, the reduction in MOF and histone H4 acetylation was inversely proportional to GEM-induced γH2AX, an indicator of chemotherapy drug effectiveness. Furthermore, pGL4-MOF-Luc reporter activities were significantly inhibited by GEM, thereby suggesting that GEM utilizes an MOF-mediated anti-BLCA mechanism of action. In the CCK-8, wound healing assays and Transwell ® experiments, the additive effects on cell proliferation and migration were observed in the presence of exogenous MOF and GEM. In addition, the promoted cell sensitivity to GEM by exogenous MOF in BLCA cells was confirmed using an Annexin V-FITC/PI assay. Taken together, our results provide the theoretical basis for elucidating the anti-BLCA mechanism of GEM.
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Objective:To explore the clinical value of procalcitonin (PCT) in predicting mortality of patients with acute biliary pancreatitis (ABP).Methods:The clinical data of 196 ABP patients admitted in the emergency department of Ruijin Hospital Affiliated to Shanghai Jiaotong University Medical College from January 2013 to June 2017 were analyzed retrospectively. The enrolled patients were divided into survival group ( n=176) and death group ( n=20) according to clinical outcome, and their clinical characteristics, laboratory results(including WBC, CRP, PCT), APACHEⅡ score, BISAP score, modified Marshall score, SOFA score and CTSI at admission were compared between two groups. The ROC curve and AUC were used to evaluate the effectiveness of PCT and multiple scoring systems in predicting mortality in ABP patients, and the Delong test was used to compare the predictive efficacy of various methods at 1-2 d, 3-4 d, and 5-7 d days after onset. Results:The PCT level, APACHEⅡ score, BISAP score, modified Marshall score, SOFA score, and CTSI of patients in the death group were significantly higher than those in the survival group [6.98(3.12, 13.64) μg/L vs 0.55(0.17, 1.74) μg/L, 12.00(6.00, 18.75) vs 6.00(3.00, 9.00), 3.20±1.47 vs 1.59±1.05, 2.85±0.37 vs 1.96±0.64, 5.50(4.00, 9.50) vs 2.00(1.00, 4.25), 5.05±2.33 vs 3.39±1.74], and all the differences were statistically significant (all P values <0.05). The AUC of PCT for predicting death was 0.881 (95% CI 0.820-0.938)and the cut-off value was 2.44. The predictive value of PCT was similar to that of the modified Marshall score, BISAP score and SOFA score, but higher than that of APACHEⅡ score and CTSI (all P values <0.05). The predictive AUC of PCT at 3-4 days after onset was higher than that of modified Marshall score, BISAP score and SOFA score, and were significantly higher than those at 1-2 days after onset. Conclusions:PCT can be used to predict the mortality of ABP within 7 days of onset. The predictive value of PCT was comparable to the modified Marshall score, BISAP score and SOFA score, and the best predictive time was 3-4 days after onset.
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Bordetella pertussis is one of the most common respiratory infectious diseases leading to the death of infants in the world.With the introduction of pertussis vaccination and effective prevention and treatment measures, the incidence and mortality of pertussis decreased significantly.However, in the past 20 years, some countries, especially developed countries with relatively complete vaccination, have seen " re-emergence of pertussis" . At the same time, the incidence of pertussis in China is not optimistic, there is also a significant increase in the incidence of the phenomenon.This article reviews the epidemiology and clinical manifestations of Bordetella pertussis.
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Clonorchiasis is one key food-borne parasitic disease in China.Owing to several years' efforts and preparation,the national clonorchiasis surveillance system in China has been established preliminarily since 2016.In this article,the necessity to establish the national clonorchiasis surveillance system is explained.Then,the structure,content and corresponding methods of the surveillance system are briefly introduced.Key points in the surveillance are summarized and the development of surveillance in future is discussed.Furthermore,the contribution of clonorchiasis surveillance in China to the world is also analyzed.
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Objective To assess the predictive effect of myocardial injury biomarkers (proBNP, CK-MB, and cTnI) on the severity of acute pancreatitis (AP). Methods The records of 246 patients diagnosed with acute pancreatitis who were treated at Ruijin Hospital Emergency Department from January 2015 to December 2016 were retrospectively analyzed. According to the revised 2012 Atlanta guidelines, these patients were divided into the mild acute pancreatitis (MAP, n=47), moderately severe acute pancreatitis (MSAP, n=151) and severe acute pancreatitis (SAP, n=48) groups. The highest plasma levels of troponin I (cTnI), creatine kinase (CK)-MB, N-terminal B-type brain natriuretic peptide (NT-proBNP), C-reactive protein (CRP), and procalcitonin (PCT) were recorded for comparison within 72 h after admission. The acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ ) score, sequential organ failure assessment (SOFA), bedside index for severity in acute pancreatitis (BISAP) and Balthazar computed tomography severity index (CTSI) were calculated at admission within 72 h. Whether there is an occurrence of organ dysfunction, and the organ types and persist time of organ dysfunction were recorded. The analysis of variance, SNK-q test and paired samples t test were used for the statistical analysis. Results The levels of proBNP, CK-MB, and cTnI were significantly higher in the SAP group than in the non-SAP group. The receiver operating characteristic (ROC) curve demonstrated cTnI had the maximum predictive power (AUC=0.872), while proBNP had the least predictive ability (AUC=0.763). The established model, which is to explore whether the myocardial injury markers had the predictive value, showed that the combination of myocardial injury indicators (CK-MB, cTnI) and traditional indicators had higher predictive value for SAP than traditional indicators alone (AUC=0.966 vs. AUC=0.945, P=0.04). Conclusions The elevated markers of myocardial injury had certain predictive value for severe acute pancreatitis.
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Clonorchiasis is one key food-borne parasitic disease in China.Owing to several years' efforts and preparation,the national clonorchiasis surveillance system in China has been established preliminarily since 2016.In this article,the necessity to establish the national clonorchiasis surveillance system is explained.Then,the structure,content and corresponding methods of the surveillance system are briefly introduced.Key points in the surveillance are summarized and the development of surveillance in future is discussed.Furthermore,the contribution of clonorchiasis surveillance in China to the world is also analyzed.
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Objective To explore the thyroid nodule in Shanghai among the health physical examination population.Methods A retrospective method was used to analyze the examination data of 61 725 cases of people,who had a health examination in Huadong Sanatorium in 2015,including 38 648 men and 23 077 women,aged from 12 to 91 years old,and the average age was (49.3 ± 11.3) years old.They came from every district of Shanghai,and covered every level of living standards.Thyroid color Doppler Ultrasonography was used in the examination,and thyroid nodules were diagnosed in accordance with "the Guidelines for Thyroid Nodules and Differentiated Thyroid Cancer (2015)".All patients with thyroid nodules were divided by age (＜ 21,21-,31-,41-,51-,61-,＞ 70 years old) and gender,and the detection rate of multiple nodules and micro-nodules (the maximum diameter was less than or equal to 1.0 cm) of each group was calculated to reveal the current situation of multiple nodules and micronodules among the patients with thyroid nodules.Results The detection rate of thyroid diseases was 54.5％ (33 654/61 725),and was conspicuously higher in female (62.6％,14 448/23 077) than in male (49.7％,19 206/38 648,x2 =971.706,P＜ 0.05).The detection rate of thyroid nodule was 50.4％ (31 126/61 725),and the detection rate of female (53.8％,12 420/23 077) was higher than that of male (48.4％,18 706/38 648,x2 =28.572,P ＜ 0.05).Start from the age of 21,thyroid nodule detection rates of male and female (22.5％,30.3％,42.9％,60.8％,71.1％,79.2％;29.5％,39.3％,54.5％,70.0％,78.5％,86.4％) were increased along with increasing age,and the detection rates of female among all age groups were higher than those of male (x2 =34.253,116.647,235.972,139.312,28.053,11.427,P ＜ 0.05).In patients with thyroid nodules,multiple nodules and micro-nodules were the main,and the detection rate of multiple nodules (57.5％,17 911/31 126) was higher than that of the single nodules (42.5％,13 215/31 126,x2 =152.933,P ＜ 0.05).The detection rate of micro-nodules was 84.4％ (26 282/31 126),and the detection rate of female (82.0％,10 181/12 420) was lower than that of male (86.1％,16 101/18 706,x2 =95.548,P ＜ 0.05).Conclusions The detection rate of thyroid nodule is relatively high in the group of people receiving physical examination in Shanghai,and this disease is closely correlated with age and gender.Among patients with thyroid nodules,multiple nodules and micro-nodules constitute the majority.
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Artemisia argyi,a well-known traditional Chinese materia medica commonly used in clinics,is widely distributed in China. It is recorded to possess the effects of warming meridians for hemostasis and eliminating cold for analgesia. The species is rich in terpenoids,flavonoids,phenylpropanoids,aromatic acids(aldehydes),steroids,and fatty acids,and exhibits pharmacologi?cal activities of analgesia,anti-inflammatory,hemostasis,antibacterial and antiviral,anti-tumor,antihypertensive effect,antidiabet?ics,anti-asthmatic,immunoregulation activities,and so on. The paper reviews the chemical constituents and pharmacological activi?ties of A. argyi,which can provide references for future research and utilization of it.
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Objective To evaluate the effect of recombinant human erythropoietin (rHuEPO) on lung injury induced by hepatic ischemia-reperfusion (I/R) in rats.Methods Sixty healthy male SpragueDawley rats, aged 6-8 weeks, weighing 220-280 g, were randomly divided into 3 groups (n=20 each) using a random number table: sham operation group (group S) , hepatic I/R group (group I/R), and rHuEPO group (group E).I/R and E groups underwent I/R of 70 percent of the liver.The rHuEPO 4 000 U/kg was injected intraperitoneally at 24 h before I/R in group E, while the equal volume of normal saline was given in S and I/R groups.The rats were sacrificed at 3 h of reperfusion, and lungs were removed and cut into sections which were stained with haematoxylin and eosin and examined under light microscope.Wet to dry lung weight ratio (W/D ratio) was calculated.The expression of heme oxygenase-1 (HO-1) and inducible nitric oxide synthase (iNOS) in lung tissues was determined by immunohistochemistry.The content of malondialdehyde (MDA), and activities of superoxide dismutase (SOD) and myeloperoxidase (MPO) in lung tissues were detected.Results Compared with group S, the W/D ratio, MDA content, and MPO activity were significantly increased, the SOD activity was decreased, the expression of HO-1 and iNOS was up-regulated (P＜0.05) , and the pathological changes of lung tissues were obvious in E and I/R groups.Compared with group I/R, the W/D ratio, MDA content, and MPO activity were significantly decreased, the SOD activity was increased, the expression of HO-1 was up-regulated, the expression of iNOS was down-regulated (P＜0.05) , and the pathological changes of lung tissues were reduced in group E.Conclusion The rHuEPO can alleviate hepatic I/R-induced lung injury in rats, and the mechanism may be related to up-regulated expression of HO-1 and down-regulated expression of iNOS.
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Objective To understand the infection status and variation tendercy of Enterobius vermicularis infection among children at national monitoring spots of soil-transmitted nematodosis from 2006 to 2010,and master the epidemic regularity,so as to provide the evidence for making control strategy and evaluating the control effect. Methods A total of 22 national monitor-ing spots of soil-transmitted nematodosis were established according to the National Surveillance Program of Soil-Transmitted Ne-matodiasis(Trial),and the children aged 3-12 years were examined through adhesive cellophane anal swabs,then the infec-tion rates of children with different ages,genders,nationalities and education levels were analyzed. In addition,the advantage, disadvantage,opportunity and threat of the monitoring work were analyzed by SWOT analysis. Results A total of 17 068 chil-dren were examined in 22 monitoring spots from 2006 to 2010,and 1 363 of them were found being infected with E. vermicu-laris,the average infection rate was 7.99%,and the infection rates of male and female children were 7.39%and 8.70%,respec-tivel;the average infection rates in each year were 10.01%,9.68%,7.41%,6.96%and 6.57%,respectively. From 2006 to 2009,the infection rates of E. vermicularis in children in Fujian Province was the highest,which were 56.15%,53.42%, 37.82%and 49.53%,respectively,but in 2010,the infection rate in Guangdong Province(46.06%)was the highest. The fur-ther analysis demonstrated that the female children,3-6 age group,Li nationality and children at kindergarten stage had relative-ly high infection rates. The SWOT analysis showed that the advantage of E. vermicularis monitoring in China was its wide cover-age and continuity,and the disadvantage was the relatively small investment from the government,the opportunity was that the national monitoring spot could drive the monitoring work at the provincial,county and other levels,and the threat was that the work was paid less and less attention to in recent years. Conclusion Though the infection rate of E. vermicularis in children at national monitoring spots of soil-transmitted nematodosis has been decreased year by year,high-endemic areas still exist,and thus the work on enterobiasis control and prevention still needs to be strengthened.
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Objective To understand the status of Ascaris eggs pollution in soil at national monitoring spots of soil-transmit-ted nematodiasis,so as to provide the evidence for making countermeasures and evaluating the control effect. Methods Ten households were selected from each of the 22 national monitoring spots annually according to the National Surveillance Program of Soil-Transmitted Nematodiasis(Trial),and the soil samples from vegetable gardens,toilet periphery,courtyards and kitchens were collected and examined by using the modified floatation test with saturated sodium nitrate. Fertilized or unfertilized eggs as well as live or dead fertilized eggs were discriminated and identified. In addition,a SWOT analysis of monitoring of Ascaris eggs pollution in the soil of rural China was carried out. Results A total of 1 090 households were monitored in 22 monitoring spots from 2006 to 2010. The total detection rate of Ascaris eggs in the soil was 30.73%,and the detection rates of fertilized,unfertilized and live fertilized eggs were 13.21%,26.42%and 20.28%,respectively. The total detection rates of Ascaris eggs in the vegetable garden,toilet periphery,courtyard and kitchen were 16.51%,13.49%,14.22% and 10.73% respectively. The SWOT analysis demonstrated that the monitoring work had both advantages and disadvantages,and was faced with opportunities as well as threats. Conclusion The pollution status of Ascaris eggs in the soil is still quite severe at some national monitoring spots,and the counter-measures such as implementing hazard-free treatment of stool,improving water supply and sanitation and reforming environment should be taken to protect people from being infected.