Risk of multi-drug-resistant organism acquisition from prior bed occupants in the intensive care unit: a meta-analysis.

Multi-drug-resistant organisms (MDROs) have become a global threat to human health. Prior bed occupancy with MDRO infection/colonization is an exposure factor that is closely associated with the MDRO acquisition rates in subsequent bed patients in intensive care units (ICUs). A meta-analysis was conducted to investigate the risk of MDRO acquisition from prior bed occupants in the ICU. PubMed, Cochrane Library, Web of Science, and Embase databases and reference lists were searched for articles published up to December 2021. The Newcastle-Ottawa scale was used for quality assessment. The risk measure was calculated as the odds ratio (OR) and corresponding 95% confidence interval (CI), and the heterogeneity was tested using I2 method and Q test. Eight articles were analysed using a random-effects model. Of the 8147 patients exposed to prior bed occupants infected or colonized with MDROs, 421 had acquired MDROs. The control group consisted of 55,933 patients without exposure factors, of which 1768 had been infected/colonized with MDROs. The pooled acquisition OR for MDROs was 1.80 (95% CI: 1.42, 2.29), P<0.00001. Subgroup analysis based on multi-drug-resistant Gram-positive and Gram-negative organisms was conducted using a fixed-effects model. The results significantly varied between the groups. Heterogeneity was partially explained by the MDRO type. In conclusion, exposure of bed occupants to infected/colonized MDROs significantly increased the risk of MDRO acquisition in subsequent bed occupants.

[Analysis of screening results and risk factors of high-risk populations of lung cancer in Nanchang city from 2018 to 2019].

Objective: To collate and analyze the screening results of high-risk lung cancer populations in communities in Nanchang from 2018 to 2019, and to explore the lung-positive nodules and risk factors for lung cancer. Methods: Data of the screening subjects in 8 administrative districts and 15 street health service centers in Nanchang city, Jiangxi province from November 2018 to October 2019 were collected, people at high risk of lung cancer was assessed, clinical screening of high-risk groups of lung cancer was conducted by low-dose helical computed tomography (LDCT), and risk factors for suspected lung cancer and lung-positive nodules were analyzed. Results: Of the 25 871 people participated in screening, 5 220 were at high risk for lung cancer and 15 374 without other malignant tumors were at high risk. There were 2 417 cases participated in clinical LDCT screening, including 193 cases of lung-positive nodules, 67 cases of suspected lung cancer, 912 cases of other lung diseases, the positive rate of lung cancer or lung-positive nodules was 10.76% (260/2 417). Univariate analysis showed that age, coarse grain intake, oil intake, housing heating, passive smoking, alcohol consumption and mental trauma were associated with positive pulmonary nodules or lung cancer (all P<0.05). Multivariate analysis showed that gender, age, housing heating, smoking and drinking were related to the occurrence of lung nodules or lung cancer (all P<0.05). Conclusions: Men are more likely to develop lung cancer or lung-positive nodules than women. The age is an independent risk factor for lung-positive nodules or lung cancer. In a certain range, age will increase the incidence of lung cancer, housing heating may be the protective factor for lung cancer, while smoking and drinking are risk factors.

[The Mongolian physicians in the Chuo Ban Chu of the Shang Si Yuan in the Qing Dynasty].

The Chuo Ban Chu of Shang Si Yuan in the Qing Dynasty was an institution for Mongolian physicians who provided bone injury diagnosis and treatment for the royal family. This paper reports on an examination of the archives at the First Historical Archives of China, where 171 relevant archives were obtained. Based on this data, the paper summarises and verifies the directories of 112 Mongolian physicians, the authenticity and inheritance of 26 of these physicians, and a brief biography of 16 of them in each period of the Qing Dynasty.

Bacillus velezensis WLYS23 strain possesses antagonistic activity against hybrid snakehead bacterial pathogens.

AIM: The aims of this study were to screen an antagonistic probiotic for the prevention and control of bacterial diseases in snakehead fish and to evaluate the antimicrobial activities, biosafety and biocontrol effect of the antagonistic strain. METHODS AND RESULTS: In this study, the WLYS23 strain exhibiting the most effective antagonistic properties against several fish pathogens was selected from the intestine of healthy snakehead fish. The strain was identified as Bacillus velezensis based on morphological, physiological and biochemical characteristics, and phylogenetic analysis. This strain showed amylase, cellulase, protease and lipase activities according to extracellular enzyme activity assays. Moreover, the cell-free extract of the WLYS23 strain exhibited strong antibacterial activity, with MICs of ≤64 µg ml-1 for most fish pathogens. Additionally, the cell-free extract was heat and pH stable, and resistant to protease, whereas their antimicrobial activities were significantly influenced by metal ions at high concentration. The WLYS23 strain and its cell-free extract were safe for snakehead and zebrafish. The disease resistance of snakehead fish was significantly increased following administration of the WLYS23 strain and its cell-free extract respectively. The complete genome of the WLYS23 strain was sequenced and found to harbour seven gene clusters encoding secondary metabolites with antimicrobial activity. CONCLUSION: The WLYS23 strain possesses great potential as a biocontrol agent, which can be commercially developed to improve disease control in freshwater aquaculture. SIGNIFICANCE AND IMPACT OF THE STUDY: Snakehead fish are important commercially farmed fish worldwide. However, the bacterial diseases caused by Aeromonas sp. and Nocardia seriolae in farmed snakehead fish lead to huge economic losses. Safe, economical and efficient probiotics are limited to prevent and control these diseases. Here, we provide a promising biocontrol agent with antagonistic activity against bacterial diseases of snakehead.

[Prevalence and associated risk factors of pre-hypertension and hypertension in young and middle-aged population in Nanjing].

Objective: To investigate the prevalence and associated risk factors of pre-hypertension and hypertension in young and middle-aged population in Nanjing. Methods: Subjects of the study were those who underwent physical examination in the physical examination center of Nanjing Drum Tower Hospital from 2009 to 2016. The prevalence and risk factors of pre-hypertension and hypertension in young (aged 18-44 years old) and middle-aged people (aged 45-59 years old) were analyzed. Results: A total of 142 857 participants aged 18-59 years old were analyzed. Among them, 64 220 cases in the pre-hypertension group and 13 912 cases in the hypertension group. The prevalence of hypertension was 9.74% (12.51% in males and 5.82% in females). The prevalence of pre-hypertension was 44.95% (53.31% in males and 33.15% in females). In the middle-aged group, the prevalence of pre-hypertension and hypertension were 51.68% and 15.13%, respectively, which was higher than that in the young group (37.95% and 4.13%, respectively). The prevalence of pre-hypertension and hypertension in 2013-2016 was 45.37% and 10.65%, respectively, which was higher than that in 2009-2012(44.52% and 8.78%). In addition, the prevalence of abnormal blood glucose metabolism, abnormal blood lipid metabolism and abnormal glucose and lipid metabolism in the pre-hypertension group was higher than that in the normal blood pressure group, but lower than that in the hypertension group (P<0.001). A logistic regression analysis indicated that age, overweight or obesity, hyperglycemia, hypertriglyceridemia and hypercholesterolemia were risk factors of pre-hypertension in male. Age, overweight or obesity, hyperglycemia, hypertriglyceridemia, hypercholesterolemia and hyper-low density cholesterolemia were associated with hypertension in male and with pre-hypertension and hypertension in female. Conclusions: Middle age, overweight/obesity, elevated fasting plasma glucose, elevated triglyceride and elevated total cholesterol were risk factors of pre-hypertension and hypertension in both men and women. Intervention on the related risk factors should be conducted as early as possible.

Diagnostic accuracy of fasting plasma glucose as a screening test for gestational diabetes mellitus: a systematic review and meta-analysis.

OBJECTIVE: Fasting plasma glucose (FPG) is suggested as a potential screening test for further confirmatory testing by oral glucose tolerance test (OGTT) for diagnosing gestational diabetes mellitus (GDM). The diagnostic accuracy of FPG has been investigated in several studies with varying results. This meta-analysis is done to evaluate the diagnostic accuracy of FPG for the screening of GDM. MATERIALS AND METHODS: We conducted a systematic search for all studies reporting the diagnostic accuracy of FPG with OGTT as the reference standard in the databases of Medline, Scopus, Cochrane and Embase from inception till January 2020. Quality assessment of diagnostic accuracy studies-2 tool was used to assess the quality of trials. RESULTS: 29 studies with 74,481 patients were included. Eleven studies used the cut-off values of 92mg/dl for FPG to diagnose GDM, whereas 10 studies used the value of 92 mg/dl. The pooled sensitivity and specificity of FPG for cut-off ≥92 mg/dl was 68.6% (95% CI: 51.8%-81.9%), and 93.2% (95% CI: 80.5%-97.8%) respectively. The AUC was 0.88 (95% CI: 0.79-0.94). The pooled sensitivity and specificity of FPG for cut-off ≥90 mg/dl was 58.5% (95% CI: 41.1%-73.9%), and 89.2% (95% CI: 78.5%-94.9%) respectively. The AUC was 0.83 (95% CI: 0.75-0.91). The overall quality of studies was moderate. CONCLUSIONS: To summarize, our study found that FPG may have a role in the screening of GDM among pregnant women with satisfactory sensitivity and specificity at a cut-off of 92 mg/dl. Further studies exploring its accuracy in different ethnic populations in reference to a standard OGTT are required to strengthen the evidence.

[A study on the knowledge construction of the transformation of Borneol into traditional Chinese medicine].

Borneol was widely used in Arabia in medieval times. After Borneol had been introduced into China and experienced theoretical thinking and clinical practice, traditional Chinese medicine(TCM) went"Chinese materia medicalized"knowledge construction on it with absorbing related foreign knowledge.In the Tang Dynasty, borneol has been officially included in the Chinese materia medica works.Since the Song Dynasty, the medicinal knowledge of borneol has been continuously expanded.The process of TCM"culturelized"foreign drug(assimilating foreign drug with TCM culture) can reveal the way of formation and accumulation of drug knowledge. It not only provides a reference for how to"Chinese materia medicalized"foreign drugs, but also provides ideas for exploring the model of the formation and accumulation of TCM knowledge.

Use of tolvaptan vs. furosemide in older patients with heart failure : Meta-analysis of randomized controlled trials.

BACKGROUND: It is not known whether older patients with acute heart failure (HF) receiving tolvaptan have decreased mortality rates and a better long-term prognosis than patients who receive furosemide. We conducted a systematic review of randomized controlled trials (RCTs) to address this issue. METHODS: The Medline, Embase, and Cochrane Library databases were searched for English-language RCTs published before September 2016 comparing tolvaptan with furosemide treatment in older patients (>65 years old) after acute HF. The primary outcomes assessed were 6­month all-cause mortality and worsening renal function (WRF); the secondary outcomes were electrolyte disorders, hospital readmissions, and adverse events. RESULTS: Out of 669 citations, six RCTs met the inclusion criteria for this meta-analysis. There was a significant decrease in WRF (relative risk [RR] = 0.67, 95% confidence interval [CI] = 0.52-0.86, p = 0.002) and in the hospitalization period (mean difference [MD] = -1.86, 95% CI = -3.70--0.02, p = 0.05), as well as a significant increase in urine volume within 3 days of tolvaptan administration (MD = 1.59, 95% CI = 1.41-1.76, p < 0.00001). There were significant differences in creatinine levels between subgroups (MD = 0.33, 95% CI = 0.14-0.52, p = 0.0006). However, for the outcome of 6­month all-cause mortality (RR = 0.56, 95% CI = 0.29-1.06, p = 0.07), there was no significant difference among all subgroups. There were significant differences in serum sodium concentration (MD = 0.68, 95% CI = 0.02-1.34, p = 0.04) but no significant changes in systolic blood pressure (MD = 3.57, 95% CI = -2.33-9.47, p = 0.24) between groups. CONCLUSION: In older patients, tolvaptan relieves WRF, reduces the hospitalization period, and increases urine volume without significant effects on blood pressure. However, surprisingly, the use of tolvaptan did not influence 6­month all-cause mortality.

[Role of farnesoid X receptor in rats with acute cholestatic hepatitis].

OBJECTIVE: To investigate the role of farnesoid X receptor (FXR) and its downstream molecules small heterodimer partner (SHP), UDP-glucuronosyltransferase 2B4 (UGT2B4), and bile salt export pump (BSEP) in rats with acute cholestatic hepatitis. METHODS: A total of 20 Sprague-Dawley rats were randomly divided into normal control group and model group, with 10 rats in each group. The rats in the model group were given a single dose (50 mg/kg) ofα-naphthyl isothiocyanate by gavage to establish the animal model of acute cholestatic hepatitis. Quantitative real-time PCR was used to measure the mRNA expression of FXR, UGT2B4, and BSEP in liver tissue at 48 hours after gavage. An automatic biochemical analyzer was used to measure the serum levels of total bilirubin, direct bilirubin, alanine aminotransferase, total bile acid, aspartate aminotransferase, alkaline phosphatase, andγ-glutamyl transferase. The independent samples t-test was used for comparison of means between groups. RESULTS: The model group had significantly lower mRNA expression of FXR, SHP, UGT2B4, and BSEP in liver tissue than the normal control group (0.152±0.088/0.559±0.194/0.177±0.039/0.561±0.123 vs 1.137±0.215/1.512±0.309/2.394±0.462/1.631±0.376, t = 13.408, 8.260, 15.121, and 8.553, all P < 0.05). The model group had significantly higher liver function parameters than the normal control group (all P < 0.01). CONCLUSION: FXR, SHP, UGT2B4, and BSEP are involved in the development of acute cholestatic hepatitis. Reduced expression of FXR may cause reduced expression of downstream SHP, UGT2B4, and BSEP, increase the synthesis of bile acid, weaken detoxicating and transporting functions, and thus mediate the development of cholestatic hepatitis.

In vitro and in vivo evaluation of SLA titanium surfaces with further alkali or hydrogen peroxide and heat treatment.

The present study aimed to evaluate the bioactivity of titanium surfaces sandblasted with large-grit corundum and acid etched (SLA) plus further alkali or hydrogen peroxide and heat treatment for dental implant application. Pure titanium disks were mechanically polished as control surface (Ti-control) and then sandblasted with large-grit corundum and acid etched (SLA). Further chemical modifications were conducted using alkali and heat treatment (ASLA) and hydrogen peroxide and heat treatment (HSLA) alternatively. The surface properties were characterized by scanning electron microscopy (SEM), x-ray photoelectron spectroscopy (XPS), and contact angle and roughness measurements. Further evaluation of surface bioactivity was conducted by MC3T3-E1 cell attachment, proliferation, morphology, alkaline phosphatase (ALP) activity and calcium deposition on the sample surfaces. After insertion in the beagle's mandibula for a specific period, cylindrical implant samples underwent micro-CT examination and then histological examination. It was found that ASLA and HSLA surfaces significantly increased the surface wettability and MC3T3-E1 cell attachment percentage, ALP activity and the quality of calcium deposition in comparison with simple SLA and Ti-control surfaces. Animal studies showed good osseointegration of ASLA and HSLA surfaces with host bone. In conclusion, ASLA and HSLA surfaces enhanced the bioactivity of the traditional SLA surface by integrating the advantages of surface topography, composition and wettability.

Influence of in ovo injection of disaccharides, glutamine and ß-hydroxy-ß-methylbutyrate on the development of small intestine in duck embryos and neonates.

1. The objective of the present study was to examine the effect of in ovo injection of disaccharides (DS), disaccharides and glutamine (DS + Gln) or disaccharides and ß-hydroxy-ß-methylbutyrate (DS + HMB) at d 23 of incubation on the development of the small intestine. 2. In DS + Gln-injected ducks, the greatest relative small intestine mass and muscularis layer thickness among 4 treatments was observed from d 25 of incubation to 7 d of age. 3. Jejunal sucrase activity in DS-injected ducks was significantly greater than in controls at hatch and on d 7. 4. In DS + HMB-treated ducks, a tendency toward slightly higher jejunal DNA concentration was observed throughout the experiment. 5. Greater body weight was found in DS + Gln and DS + HMB treated ducks in the first two weeks. However, there was no significant difference in the market weight (35 d) of ducks among the 4 treatments. 6. The results of present study suggest that administering disaccharides and Gln, or disaccharides and HMB, to the duck embryos exerted a beneficial effect on the early development of small intestine and on growth performance.

Influence of in ovo injection of glutamine and carbohydrates on digestive organs and pectoralis muscle mass in the duck.

1. We hypothesise that administration of available glutamine and carbohydrates by in ovo injection may provide energy for small intestine and duck embryo activity, in turn alleviating energy lack, sparing the pectoralis muscle protein and increasing breast muscle mass. To test this hypothesis, 220 duck eggs at 21 d of incubation were chosen and assigned to two treatments. At 23 d of incubation, glutamine, digestible sucrose and maltose were injected into the amniotic fluid in the treatment group. 2. In ovo injection of glutamine and carbohydrates improved small intestine development, as reflected in the increase in weight and sucrase activity, though gizzard, proventriculus and liver weight were not affected by the in ovo injection. 3. Compared with control, pectoralis weight in treatment ducks was increased by 24% at 25 d of incubation and 15% at hatch and this advantage was sustained until 7 d posthatch. In ovo injection improved duck weight gain in the early days posthatch. 4. The results of the present study suggest that in ovo injection of glutamine and carbohydrates improves small intestine development and pectoralis mass, which is probably due to sparing of breast muscle protein.

Alkali-heat treatment of a low modulus biomedical Ti-27Nb alloy.

This study focuses on the surface modification of a near beta-type Ti-27 wt.% Nb alloy by alkali-heat treatment. The influence of alkali concentration, alkali-treated time and alkali-treated temperature on the microstructure and constitutional phases of the modified surface is investigated by SEM, XRD and ICP. Immersion experiments in a simulated body fluid (SBF) were carried out to examine the Ca-P phase forming ability of the modified surfaces. The SEM observation and XRD analysis revealed that a sodium titanate layer is formed after alkali-heat treatment. The morphology and Ca-P phase forming of the layer are greatly affected by the surface roughness of the samples, the alkali concentration, the alkali-treated time and alkali-treated temperature. The results of SBF immersion, which are obtained by ICP analysis, indicate that the activated sodium titanate layer prepared by alkali-heat treatment is beneficial to further improving the biocompatibility of the Ti-27 wt.% Nb alloy.

[The anti-cicatrization effect of low dosage 5-Fu after trabeculectomy in late glaucoma].

54 patients (66 eyes) of late primary glaucoma were divided into 5-Fluorouracil and control groups before trabeculectomy surgery. The 5-Fu group received subconjunctival injections of 5-Fu 3mg postoperatively and on each of the 6 ensuing days. An average follow-up of 14 months revealed that (1) functional filtering blebs in the 5-Fu group and the control group were 100% and 60% respectively; (2) the postoperative mean diurnal peak IOP was 16.3 +/- 4.9 mmHg in the 5-Fu group and 20.1 +/- 5.2 mmHg in the control group (P < 0.01), and eyes with diurnal IOP < 21 mmHg were 90% in the 5-Fu group and 26% in the control group at the end of the second postoperative year; and (3) the postoperative complications between the 2 groups were comparable, except for shortterm corneal defects in 7 eyes (21.2%) of the 5-Fu group.