[A multi-center epidemiological study on pneumococcal meningitis in children from 2019 to 2020]. / 2019­2020å¹´160ä¾‹å„¿ç«¥è‚ºç‚Žé“¾çƒèŒè„‘è†œç‚Žä¸´åºŠæµè¡Œç— å­¦å¤šä¸­å¿ƒç ”ç©¶.

OBJECTIVES: To investigate the clinical characteristics and prognosis of pneumococcal meningitis (PM), and drug sensitivity of Streptococcus pneumoniae (SP) isolates in Chinese children. METHODS: A retrospective analysis was conducted on clinical information, laboratory data, and microbiological data of 160 hospitalized children under 15 years old with PM from January 2019 to December 2020 in 33 tertiary hospitals across the country. RESULTS: Among the 160 children with PM, there were 103 males and 57 females. The age ranged from 15 days to 15 years, with 109 cases (68.1%) aged 3 months to under 3 years. SP strains were isolated from 95 cases (59.4%) in cerebrospinal fluid cultures and from 57 cases (35.6%) in blood cultures. The positive rates of SP detection by cerebrospinal fluid metagenomic next-generation sequencing and cerebrospinal fluid SP antigen testing were 40% (35/87) and 27% (21/78), respectively. Fifty-five cases (34.4%) had one or more risk factors for purulent meningitis, 113 cases (70.6%) had one or more extra-cranial infectious foci, and 18 cases (11.3%) had underlying diseases. The most common clinical symptoms were fever (147 cases, 91.9%), followed by lethargy (98 cases, 61.3%) and vomiting (61 cases, 38.1%). Sixty-nine cases (43.1%) experienced intracranial complications during hospitalization, with subdural effusion and/or empyema being the most common complication [43 cases (26.9%)], followed by hydrocephalus in 24 cases (15.0%), brain abscess in 23 cases (14.4%), and cerebral hemorrhage in 8 cases (5.0%). Subdural effusion and/or empyema and hydrocephalus mainly occurred in children under 1 year old, with rates of 91% (39/43) and 83% (20/24), respectively. SP strains exhibited complete sensitivity to vancomycin (100%, 75/75), linezolid (100%, 56/56), and meropenem (100%, 6/6). High sensitivity rates were also observed for levofloxacin (81%, 22/27), moxifloxacin (82%, 14/17), rifampicin (96%, 25/26), and chloramphenicol (91%, 21/23). However, low sensitivity rates were found for penicillin (16%, 11/68) and clindamycin (6%, 1/17), and SP strains were completely resistant to erythromycin (100%, 31/31). The rates of discharge with cure and improvement were 22.5% (36/160) and 66.2% (106/160), respectively, while 18 cases (11.3%) had adverse outcomes. CONCLUSIONS: Pediatric PM is more common in children aged 3 months to under 3 years. Intracranial complications are more frequently observed in children under 1 year old. Fever is the most common clinical manifestation of PM, and subdural effusion/emphysema and hydrocephalus are the most frequent complications. Non-culture detection methods for cerebrospinal fluid can improve pathogen detection rates. Adverse outcomes can be noted in more than 10% of PM cases. SP strains are high sensitivity to vancomycin, linezolid, meropenem, levofloxacin, moxifloxacin, rifampicin, and chloramphenicol.

Incidence and warning signs for complications of human brucellosis: a multi-center observational study from China.

BACKGROUND: Brucellosis is a severe zoonotic disease that is often overlooked, particularly in impoverished countries. Timely identification of focal complications in brucellosis is crucial for improving treatment outcomes. However, there is currently a lack of established indicators or biomarkers for diagnosing these complications. Therefore, this study aimed to investigate potential warning signs of focal complications in human brucellosis, with the goal of providing practical parameters for clinicians to aid in the diagnosis and management of patients. METHODS: A multi-center cross-sectional study was conducted in China from December 2019 to August 2021. The study aimed to investigate the clinical characteristics and complications of patients with brucellosis using a questionnaire survey and medical record system. The presence of warning signs for complications was assessed using univariate and multivariate logistic regression models. Receiver operating characteristic (ROC) curves and the area under the curve (AUC) were used for variable screening and model evaluation. RESULTS: A total of 880 participants diagnosed with human brucellosis were enrolled. The median age of the patients was 50 years [interquartile range (IQR): 41.5-58.0], and 54.8% had complications. The most common organ system affected by complications was the osteoarticular system (43.1%), with peripheral arthritis (30.0%), spondylitis (16.6%), paravertebral abscess (5.0%), and sacroiliitis (2.7%) being the most prevalent. Complications in other organ systems included the genitourinary system (4.7%), respiratory system (4.7%), and hematologic system (4.6%). Several factors were found to be associated with focal brucellosis. These factors included a long delay in diagnosis [odds ratio (OR) = 3.963, 95% confidence interval (CI) 1.906-8.238 for > 90 days], the presence of underlying disease (OR = 1.675, 95% CI 1.176-2.384), arthralgia (OR = 3.197, 95% CI 1.986-5.148), eye bulging pain (OR = 3.482, 95% CI 1.349-8.988), C-reactive protein (CRP) > 10 mg/L (OR = 1.910, 95% CI 1.310-2.784) and erythrocyte sedimentation rate (ESR) elevation (OR = 1.663, 95% CI 1.145-2.415). The optimal cutoff value in ROC analysis was > 5.4 mg/L for CRP (sensitivity 73.4% and specificity 51.9%) and > 25 mm/h for ESR (sensitivity 47.9% and specificity 71.1%). CONCLUSIONS: More than 50% of patients with brucellosis experienced complications. Factors such as diagnostic delay, underlying disease, arthralgia, eye pain, and elevated levels of CRP and ESR were identified as significant markers for the development of complications. Therefore, patients presenting with these conditions should be closely monitored for potential complications, regardless of their culture results and standard tube agglutination test titers.

Molecular dynamics study on the interaction of phosphorus building gypsum /surfactant composites.

While surfactants are widely used in phosphogypsum, their interactions with the phosphogypsum-water interface remain unclear. This study investigates the impact of three types of surfactants, namely polycarboxylate-based surfactant (PCE-TPEG), naphthalene-based surfactant (NS), and melamine-based surfactant (MS), on the performance of phosphorus building gypsum (PBG). Additionally, a nanoscale model of the PBG-surfactant-water interface is constructed using molecular dynamics to elucidate the mechanisms underlying the interaction between different surfactants and PBG at multiple scales. The results demonstrate that all surfactants enhance the mechanical properties of PBG. PCE-TPEG exhibits the most pronounced improvement. In the model, PCE-TPEG molecules likely undergo comb-like adsorption, while NS and MS molecules tend to adsorb on both ends of the crystal plane. Changes in the potential difference between CaSO4·2H2O and H2O, as well as between CaSO4·2H2O and the surfactant, play a crucial role in adsorption. PCE-TPEG, NS, and MS molecules tend to spread horizontally in a vacuum state. With the addition of water molecules, they transition to spatial adsorption. Ca2+ easily interacts with -COO- and -SO3- groups, leading to reduced migration and flexibility of the main chain. The adsorption process of surfactants at the gypsum-water interface occurs spontaneously and Electrostatic forces are the main driving factor. This study contributes to a more comprehensive understanding on the behaviour of the phosphorus building gypsum/surfactant composites.

Effect of intrathecal exosomes derived from human amniotic fluid on neuropathic pain in mice / 中华麻醉学杂志

Objective:To evaluate the effect of intrathecal exosomes derived from human amniotic fluid (hAF exo) on neuropathic pain induced by spared nerve injury (SNI) in mice.Methods:Eighteen clean-grade healthy male Kunming mice, aged 7-8 weeks, weighing 30-35 g, were divided into 3 groups ( n=6 each) using a random number table method: sham operation group (Sham group), SNI group, and SNI+ hAF exo group. Spared nerve injury was produced by exposing the sciatic nerve and its branches and ligation and transection of tibial nerve and common fibular nerve in anesthetized mice. Another three mice were selected to develop the model of neuropathic pain after anesthesia. PKH-26 labeled hAF exo 7 μl was intrathecally injected on days 1, 2 and 3 after developing the model. The mice were sacrificed at 10 h after the end of administration, and the uptake of hAF exo by the dorsal horn of the injured lumbar enlargement of the spinal cord was observed with the fluorescence microscope. On 1, 2 and 3 days after developing the model, 1 μg/μl hAF exo 7 μl was intrathecally injected in SNI+ hAF exo group, and PBS 7 μl was intrathecally injected in Sham group and SNI group. The mechanical paw withdrawal threshold (MPWT) was measured at 1 day before and 1, 3, 5 and 7 days after operation. And then the mice were sacrificed after measurement of the pain threshold at 7 days after developing the model, and the ipsilateral lumbar enlargement of the spinal cord was taken for determination of the expression of CD11b, interleukin-1beta (IL-1β) and IL-10 by Western blot. Results:The dorsal horn of the lumbar enlargement of the spinal cord on the injured side could absorb hAF exo with the fluorescence microscope. Compared with Sham group, the MPWT was significantly decreased at 3-7 days after developing the model, the expression of CD11b and IL-1β was up-regulated ( P<0.05), and no significant change was found in the expression of IL-10 in SNI group ( P>0.05). Compared with SNI group, the MPWT was significantly increased at 3-7 days after developing the model, the expression of CD11b and IL-1β was down-regulated, and the expression of IL-10 was up-regulated in SNI+ hAF exo group ( P<0.05). Conclusions:Intrathecal exosomes derived from human amniotic fluid can alleviate neuropathic pain in mice, and the mechanism may be related to mediation of the polarization of microglia from M1 type to M2 type and attenuation of neuroinflammation.

Supplementing early pulmonary rehabilitation with acupuncture can better promote recovery from stroke-associated pneumonia / 中华物理医学与康复杂志

Objective:To observe any therapeutic effect of combining early pulmonary rehabilitation training with acupuncture at the back-shu and front-mu acupoints in treating stroke-associated pneumonia (SAP).Methods:Eighty SAP patients were randomly divided into a treatment group and a control group, each of 40. Both groups were given routine symptomatic treatment for pneumonia, nutritional support, lipid-lowering and anti-infection measures, as well as acupuncture at the back-shu and front-mu acupoints. The treatment group additionally received pulmonary rehabilitation training. Before and after 14 days of the treatment, both groups were evaluated in terms of their forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), peak flow rate (PEF), white blood cell count (WBC), C-reactive protein (CRP), and procalcitonin (PCT). Chinese medicine (TCM) scores for expectoration of phlegm, shortness of breath, pulmonary rales, cough, fever and weakness were also assigned. The duration of antibiotic use and intensive care unit (ICU) stay were compared between the two groups.Results:Treatment efficacy was significantly higher in the treatment group (97.5%) than in the control group (85.0%). The treatment group′s average duration of antibiotic use and ICU stay were significantly shorter than in the control group. The treatment improved the average FVC, FEV1, PEF, WBC, CRP and PCT of both groups significantly leaving the average FVC and PEF of the treatment group significantly higher than the control group′s average, but its average WBC, CRP, PCT and the total TCM syndrome score significantly lower.Conclusions:Combining early pulmonary rehabilitation training with acupuncture at the back-shu and front-mu acupoints has a definite therapeutic effect on SAP patients. It can significantly shorten the use of antibiotics and ICU stay, promote the recovery of lung function, reduce inflammation and relieve clinical symptoms.

Effect of behavioral activation therapy on depressive mood and behavioral characteristics among subliminal depressed students / 中国学校卫生

Objective@#To explore the effect of behavioral activation (BA) therapy on depressive mood and behavioral characteristics among subliminal depressed nursing students, and to provide a reference for effective mental health education to nursing students.@*Methods@#A cluster sampling method was used to select 614 sophomore nursing students from a medical college in Jiangxi Province. Sixty subjects who met the inclusion criteria were enrolled in the study, and divided into a control group and an intervention group using a random number table method, with 30 participants in each group. The control group received general mental health education, and the intervention group participated in a BA intervention on the basis of general mental health education. The Center for Epidemiologic Studies Depression (CES-D), Beck Depression Inventory II(BDI-II) and the Behavioral Activation For Depression Scale Short Form (BADS-SF) were used to evaluate students depression status before, immediately after, and 1 month after the intervention, respectively.@*Results@#The time effect, group effect, and time group interaction of the CES-D, BDI-II and BADS-SF scores of the two groups of students were all statistically significant ( F =82.78, 9.65, 69.92; 42.19, 10.52, 13.50; 15.59 , 19.61, 8.49, P <0.01). Immediately after the intervention and 1 month after the intervention, the CES-D and BDI-II scores of the intervention group were significantly lower than those of the control group, and the BADS-SF score of the intervention group (14.63±4.63, 14.80±4.85; 11.23±4.98, 11.13±5.53) was significantly lower than that of the control group (22.67±6.70, 22.13±5.66; 17.57±9.59, 18.37±7.91); the differences were all statistically significant ( P <0.05).@*Conclusion@#BA shows lasting effects on alleviating depressive symptoms among nursing students with subthreshold depression, improve their behavioral activation level, and have a lasting effect. Nursing educators can improve the depression of nursing students and improve their mental health through individual BA.

Static balance and limits of stability in patients with cervical vertigo / 中国康复理论与实践

@#Objective To analyze the characteristics of static balance and limits of stability (LOS) in patients with cervical vertigo (CV). Methods From January, 2020 to August, 2021, 30 CV patients in our hospital (vertigo group) and 30 healthy people (control group) were selected and tested with PRO-KIN system, under the conditions of eyes open and closed. The standard deviation of the vertical and horizontal amplitude, the mean of vertical and horizontal sway velocities, the area of the movement, the length of the movement, and LOS at eight directions, The Romberg ratios of the area and the length were caculated. Results All the indicators of the static balance were higher under eyes closed than under eyes open in both groups (|Z| > 2.138, P < 0.05); whether under the eyes open or closed, the static balance indicators were higher in the vertigo group than in the control group (|Z| > 2.004, P < 0.05), except for the mean of horizontal sway velocities (|Z| < 1.026, P > 0.05). The LOS and total LOS completion percentage in the front (upper right, right above, upper left) were lower in the vertigo group than in the control group (|Z| > 2.240, P < 0.05). Conclusion The static balance abilities decrease for CV patients, and the balance control depends on visual compensation. The range of LOS reduces, means a higher risk of falling.

Pepsin and Laryngeal and Hypopharyngeal Carcinomas

Laryngeal and hypopharyngeal carcinomas are common malignant tumors of the head and neck, and the incidence of both is increasing. Laryngopharyngeal reflux refers to the retrograde flow of gastric contents into the larynx, oropharynx, and/or nasopharynx. It remains controversial whether laryngopharyngeal reflux is a risk factor for laryngeal and hypopharyngeal cancers. The refluxing substances mainly include hydrochloric acid, pepsin, and occasionally bile acids and bile salts, as well as bacteria that colonize the gastrointestinal tract. Loss of epithelium in the mucous membrane of the larynx and hypopharynx is thought to be caused by pepsin. Here, we review the relationships between laryngopharyngeal reflux and both laryngeal and hypopharyngeal carcinomas, as well as the significance of pepsin, methods of clinical detection, and the mechanism of carcinogenesis.

Pepsin and Laryngeal and Hypopharyngeal Carcinomas

Laryngeal and hypopharyngeal carcinomas are common malignant tumors of the head and neck, and the incidence of both is increasing. Laryngopharyngeal reflux refers to the retrograde flow of gastric contents into the larynx, oropharynx, and/or nasopharynx. It remains controversial whether laryngopharyngeal reflux is a risk factor for laryngeal and hypopharyngeal cancers. The refluxing substances mainly include hydrochloric acid, pepsin, and occasionally bile acids and bile salts, as well as bacteria that colonize the gastrointestinal tract. Loss of epithelium in the mucous membrane of the larynx and hypopharynx is thought to be caused by pepsin. Here, we review the relationships between laryngopharyngeal reflux and both laryngeal and hypopharyngeal carcinomas, as well as the significance of pepsin, methods of clinical detection, and the mechanism of carcinogenesis.

Application of propofol closed-loop target-controlled infusion for different anesthesia depth combined with nerve block in elderly artificial hip replacement / 中国医师杂志

Objective:To investigate the effect of propofol closed-loop target-controlled infusion system in controlling the bispectral index (BIS) at different levels during artificial hip replacement in the elderly under general anesthesia combined with nerve block on postoperative delirium, postoperative pain and intraoperative circulation control.Methods:From October 2017 to May 2019, 95 elderly patients with elective unilateral artificial hip replacement were selected from Xiangya Hospital of Central South University. They were randomly divided into light anesthesia group (48 cases) and deep anesthesia group (47 cases). Under general anesthesia combined with nerve block, the target BIS value of propofol closed-loop target-controlled infusion in the light anesthesia group was set to 55±5, and the target BIS value of the deep anesthesia group was 45±5. The incidence of postoperative delirium and postoperative pain visual analogue scale (VAS) score were observed. The changes of hemodynamics, intraoperative vasoactive drug use, propofol dosage and intraoperative BIS value at different time points were compared between the two groups.Results:There was no significant difference in the incidence of postoperative delirium and the VAS score of postoperative pain between the two groups ( P>0.05). The average intraoperative BIS and the ratio of intraoperative BIS>50 in the light anesthesia group were higher than those in the deep anesthesia group ( P<0.001), and the intraoperative propofol consumption was lower than the deep anesthesia group ( P<0.001); In the light anesthesia group, the arterial systolic blood pressure level after laryngeal mask implantation and skin incision during the induction period of general anesthesia was higher than that in the deep anesthesia group ( P<0.05), and the number of cases of phenylephrine use in the light anesthesia group was lower than that of the deep anesthesia group ( P<0.05). Conclusions:When using general anesthesia combined with nerve block for the elderly artificial hip replacement, the different control levels of BIS in the closed-loop target-controlled infusion of propofol have no effect on postoperative pain and postoperative delirium, but the intraoperative BIS value controlled at a lower level is related to the suppression of the patient′s hemodynamics and brings more propofol consumption.

Role of SPP1 in endogenous protective mechanism underlying neuropathic pain in mice with spinal cord injury: relationship with VEGF-AKT signaling pathway / 中华麻醉学杂志

Objective:To evaluate the role of secreted phosphoprotein 1 (SPP1) in endogenous protective mechanism underlying neuropathic pain (NP) in mice with spinal cord injury and the relationship with the vascular endothelial growth factor (VEGF)/kinase B (Akt) signaling pathway.Methods:Seventy-two clean-grade healthy female Kunming mice, aged 7-8 weeks, weighing 30-35 g, were divided into 4 groups ( n=18 each) using a random number table method: sham group (Sham group), NP caused by spinal cord injury group (NP group), NP caused by spinal cord injury+ SPP1-siRNA group (NS-siRNA group), and NP caused by spinal cord injury+ adeno-associated virus vector group (NP-EV group). A model of NP was established by a semi-transecting of the spinal cord.AAV-SPP1-siRNA-GFP adenovirus and AAV-vector-GFP adenovirus 7 μl were intrathecally injected in NS-siRNA group and NP-EV group, respectively, and 5 days later the model was established.At 1, 2 and 3 weeks after operation, 6 mice in each group were randomly selected to measure paw withdrawal threshold to mechanical stimulation (PWMT) and tail flick latency (TFL) to thermal stimuli.And then the mice were sacrificed and the ipsilateral injured spinal cord tissues were taken for determination of the expression of SPP1 mRNA (by real-time polymerase chain reaction) and expression of SPP1, VEGF, Akt and phosphorylated Akt (p-Akt) (by Western blot). Results:Compared with group Sham, PWMT was significantly decreased, TFL was shortened, and the expression of SPP1 mRNA, SPP1, VEGF and p-Akt protein was up-regulated at 1, 2 and 3 weeks after operation in NP, NS-siRNA and NP-EV groups( P<0.05). Compared with group NP, PWMT was significantly decreased, TFL was shortened, and the expression of SPP1 mRNA, SPP1, VEGF and p-Akt protein was down-regulated at 1, 2 and 3 weeks after operation in group NS-siRNA( P<0.05). Compared with group NS-siRNA, PWMT was significantly increased, TFL was prolonged, and the expression of SPP1 mRNA, SPP1, VEGF and p-Akt protein was up-regulated at 1, 2 and 3 weeks after operation in group NS-siRNA( P<0.05). Conclusion:SPP1 is involved in the endogenous protective mechanism underlying NP in mice with spinal cord injury, which may be related to the activation of the VEGF/AKT signaling pathway.

Perioperative management for patients with coronavirus disease 2019 / 中南大学学报(医学版)

The coronavirus disease 2019 (COVID-19) is a new infectious disease, which has a strong virus transmission power and complex transmission routes. This disease is prone to outbreak of cluster infection. It is difficult for medical workers to provide a better perioperative treatment for surgery patient with COVID-19 while avoiding hospital spread effectively. The perioperative management for such patients needs to fully consider the possible lung injury factors caused by anesthesia and surgery. It also needs to choose the suitable timing of the operation, carry out preoperative infection screening and evaluation, and implement lung protection strategies during and after the operation to avoid aggravating the lung injury. Meanwhile, it is necessary to pay more attention to infection prevention and control in order to avoid nosocomial infection.

Effects of blood glucose fluctuation on the expression of TLR4 and TNF-α in the liver of diabetic rats / 预防医学

Objective@# To investigate the effect of blood glucose fluctuation on the expression of toll-like receptor 4（TLR4）and tumour necrosis factor-α（TNF-α）in the liver of diabetic rats .@*Methods @#The adult male Sprague-Dawley（SD）rats were used to establish diabetic rats model and then they were randomly assigned to sustained hyperglycemia group（MS group,n=20） and fluctuating hyperglycemia group（MF group,n=20）. The two groups continued high-fat and high-sugar diet,while MF group alternately received intraperitoneal injection of glucose and subcutaneous injection of short-acting insulin. Another 10 SD rats were assigned to the control group. After 6 weeks,the physical signs,blood glucose,triglyceride（TG）,total cholesterol（TC）,low density lipoprotein cholesterol（LDL-C）,high density lipoprotein cholesterol（HDL-C）,alanine aminotransferase（ALT）and aspartate aminotransferase（AST）of the rats were measured;the mRNA expression of TLR4 and TNF-α in liver tissues were detected by reverse transcription-polymerase chain reaction （RT-PCR）;pathological changes of liver tissues were observed after HE staining .@*Results @#Compared with the control group,the rats in the MS group were always at the hyperglycemia status,the blood glucose of the rats in the MF group drifted between the peak and the trough. The weight growth of the rats in the MS group and MF group were slower. The levels of TC,TG and LDL-C significantly increased and the level of HDL-C significantly decreased in the MS group and MF group （all P<0.05）. The activities of ALT and AST increased both in the MS group and MF group,with the MF group increased more significantly（P<0.05）. The mRNA expression levels of TLR4 and TNF-α in liver tissues of the rats in MS group and MF group increased,with the MF group increased more significantly（P<0.05）. HE staining results showed that the liver cells of the rats in the MF group had more lipid droplet deposition,with the disordered hepatocyte line arrangement and more severe lipid droplet vacuolation. The lesion rate of the MS group and MF group were 83.30% and 100.00% .@*Conclusion@# The rats in this model showed signs of hyperglycemia complicated by dyslipidemia and liver injury. The expression of TLR4 and TNF-α increased in rats with blood glucose fluctuation,which might play a role in the aggravation of diabetic liver injury.

Short Form of Weinstein Noise Sensitivity Scale (NSS-SF): Reliability, Validity and Gender Invariance among Chinese Individuals / 生物医学与环境科学（英文）

OBJECTIVE@#Independent from noise exposure, noise sensitivity plays a pivotal role in people's noise annoyance perception and concomitant health deteriorations. The present study empirically investigated the psychometric properties of the Chinese version of the Weinstein Noise Sensitivity Scale-Short Form (CNSS-SF), the widely used inventory measuring individual differences in noise perception.@*METHODS@#In total, 373 Chinese participants (age = 21.41 ± 3.36) completed the online, anonymous questionnaire package. Examination of the CNSS-SF's reliability (internal consistency), factorial validity through validation and cross-validation, nomological validity and measurement invariance across gender groups were undertaken.@*RESULTS@#The Cronbach alpha coefficients and composite reliabilities indicated sufficient reliability of the CNSS-SF. Two confirmatory factor analyses (CFA), in two randomly partitioned groups of participants, substantiated the factorial validity of the scale. The nomological validity of the scale was also corroborated by the significant positive association of its score with the trait anxiety score. Measurement invariance of the CNSS-SF was also found across genders via multi-group CFA.@*CONCLUSION@#Though not without limitations, findings from the present research provide promising evidence for the utility of the scale in measuring noise sensitivity among the Chinese population. The availability of the CNSS-SF can promote research related to environmental noise and health in China, as well as facilitate cross-cultural comparisons.

Monitoring of Coagulation Status and Evaluation of Antiplatelet Aggregation in Patients with CHD by Using TEG / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To evaluate the performance of thromboelastography (TEG) to monitor in vivo blood coagulation status and the efficacy of antiplatelet aggregation drugs in the patients with coronary heart disease (CHD) after oral anticoagulation.</p><p><b>METHODS</b>Seventy one CHD patients were enrolled in CHD group and 380 healthy persons with normal TEG were enrolled in the control group. After admission, all CHD patients were administrated with routine anti-platelet aggregation drugs at a clinically recommended dose. Then, TEG was applied to monitor the basic blood coagulation indexes, such as R value, K value, α angle, MA value, CI value and a series of related indexes on platelet inhibition.</p><p><b>RESULTS</b>Above 80% of the basic blood coagulation indexes in TEG were within normal reference range in the CHD group. the R value, MA value, α angle and CI value in the CHD group were not significanly different, from that in the control group, but the K value significantly increased (P<0.05). Compared with the control group, relatively higher ratio of male was included in the CHD patients at much older age (P<0.05), 83.1% of the CHD patients achieved significant anti-platelet aggregation effect (platelet inhibition rate>50%). Other antiplatelet aggregation indexes, MA, MAck and MA suggested a 9.86%, 4.23% and 12.68% risk of thrombogenesis, respectively. Among all the related antiplatelet aggregation indexes, MAck showed the strongest correlation with age (correlation coefficient, 0.111), and ADP% most highly correlated with body mass (correlation coefficient, 0.160).</p><p><b>CONCLUSION</b>TEG results can provide valuable coagulation information for clinicians, thus certainly guiding in the treatment for CHD patients receiving anti-platelet therapy. Moreover, the application of TEG can also provide accurate information for further individualized treatment of CHD patients, which would funther inprove the safety of anti-thrombotic therapy.</p>

Antibacterial and anti-biofilm activity of the lipid extract from Mantidis ootheca on Pseudomonas aeruginosa / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

The aim of this study is to assess the antibacterial and anti-biofilm properties of the lipid extract from Mantidis ootheca against the gentamycin resistant Pseudomonas aeruginosa. The chemical composition of the lipid extract and its relative proportion were determined using the technique of gas chromatography coupled with mass spectrometry (GC-MS). Antibacterial susceptibility tests were performed using a disc diffusion assay and the minimum inhibition concentration (MIC) was determined by way of the agar dilution method. The anti-biofilm test was carried out with crystal violet staining and scanning electron microscopy (SEM). There were 16 compounds detected, and the most abundant components were sesquiterpenoids, monoterpenes, and trace aromatic compounds. The MIC for P. aeruginosa was 4 mg/ml and the eradication effect on preformed biofilms was established and compared with a ciprofloxacin control. The results of our study indicated that a lipid extract from M. ootheca could be used as a topical and antibacterial agent with anti-biofilm activity in the future.

Effectiveness of omega-3 polyunsaturated fatty acids against microbial pathogens / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Microorganisms provide both beneficial and harmful effects to human beings. Beneficial effects come from the symbiotic relationship that exists between humans and microbiota, but then several human illnesses have turned some friendly microbes into opportunistic pathogens, causing several microbial-related diseases. Various efforts have been made to create and utilize antimicrobial agents in the treatment and prevention of these infections, but such efforts have been hampered by the emergence of antimicrobial resistance. Despite extensive studies on drug discovery to alleviate this problem, issues with the toxicity and tolerance of certain compounds and continuous microbial evolution have forced researchers to focus on screening various phytochemical dietary compounds for antimicrobial activity. Linolenic acid and its derivatives (eicosapentaenoic acid and docosahexaenoic acid) are omega-3 fatty acids that have been studied due to their role in human health, being important for the brain, the eye, the cardiovascular system, and general human growth. However, their utilization as antimicrobial agents has not been widely appreciated, perhaps due to a lack of understanding of antimicrobial mechanisms, toxicity, and route of administration. Therefore, this review focuses on the efficacy, mechanism, and toxicity of omega-3 fatty acids as alternative therapeutic agents for treating and preventing diseases associated with pathogenic microorganisms.

Efficacy of high versus low plasma: red blood cell ratio resuscitation in patients with severe trauma requiring massive blood transfusion: a meta-analysis / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the efficacy of high (≥1:2) and low (<1:2) plasma: red blood cell (RBC) ratio resuscitation in patients with severe trauma requiring massive blood transfusion.</p><p><b>METHODS</b>The databases including the Cochrane Library, Pubmed, Web of Science, and EMBASE were systemically searched for relevant studies published between January, 2009 and April, 2016. The selection of studies, assessment of methodological quality and data extraction were performed by two researchers independently according to the inclusion and exclusion criteria. The main endpoint was 24-h mortality, 30-day mortality and 24-h survival rate.</p><p><b>RESULTS</b>Five observational studies reporting outcomes of 1024 patients were included in this meta-analysis. Four studies documented civilian cases and one study had a military setting. No significant differences were found in the Injury Severity Score (ISS) between patient groups receiving high and low plasma: RBC ratio resuscitation. Compared with the low-ratio group, the patients with high-ratio resuscitation showed a significant reduction in the 24-h mortality rate (OR=0.35, 95%CI [0.25, 0.48], P<0.000 01) and the 30-day mortality rate (OR=0.55, 95%CI [0.41, 0.75], P=0.0001). An increased survival rate was observed in patients receiving high plasma: RBC ratio resuscitation within the initial 24 h following the trauma (HR=2.34, 95%CI [1.46, 3.73], P=0.00001).</p><p><b>CONCLUSION</b>Raising the plasma: RBC ratio to 0.5 or higher may decrease the mortality rate of the patients with severe trauma who need massive blood transfusion.</p>

Cephalocaudal relationship ofabdominal aortic bifurcation relative toumbilicus and iliac crest vertex:a comparative study from imaging anatomical prospective / 实用医学杂志

Objective To studythe cephalocaudal relationship ofabdominal aortic bifurcation relative toumbilicus and iliac crest vertex and their correlations with abdominal adipose tissue thickness and age. Methods The vertical distances,cephalocaudal relationship and other related anatomic parameters of aortic bifurcation relative to umbilicus and iliac crest vertex in 108 patientswere measured by consecutive abdominal CT scanning. The correlations of the acquired data with abdominal adipose tissue thickness and age were analyzed using Pearson correlation coefficient. Results Umbilicus was located at cephalad to aortic bifurcation in 67 patients(62.0%), caudal in 34(31.4%)andthe same level in 7(6.5%),with the vertical distance of(4.53 ± 17.51)mm to the aortic bifurcation. No statistically significant relationship was found between abdominal adipose tissue thickness(P>0.05) or age(P>0.05). Iliac crest vertex relative to aortic bifurcationwas located at cephalad,caudal and the same level in 31,71 and 6 patients,taking up 28.7%,65.7%and 5.6%,respectively. Its vertical distance to the bifurcation was(-6.34 ± 14.49)mm,nonrelated with abdominal adipose tissue thickness(P>0.05),but positively correlated with age(P<0.01). The difference in the cephalocaudal relationship of aortic bifurcation relative to umbilicus and iliac crest vertex was statistically significant(P<0.01). Conclusion Compared with iliac crest vertex,umbilicus is an important landmark of locating abdominal aortic terminal occlusion position in vitro because it mostly lies cephalad to aortic bifurcation in the front of the body,not easy to vary with abdominal adipose tissue thickness and age.

A case-control study on the relationship between serum 25-hydroxy vitamin D and the risk of Henoch-Schonlein purpura / 重庆医学

Objective To explore the relationship between serum 25-hydroxy vitamin D [25(OH)D] concentrations and the risk of Henoch-Schonlein purpura (HSP).Methods A case control study was designed.Serum 25 (OH)D concentrations were measured by radioimmunoassay in 214 participants,including 53 H SP patients and 161 status-matched healthy controls.Information concerning demographic data,genetic,background,and environmental exposures was collected using questionnaire.The study participants were divided into four groups according to quartile range of 25(OH)D concentration and logistic regression modeling was used to evaluate the relation with HSP risk by estimating odds ratios(OR)and 95％confidence intervals(CI).Results The HSP group had a significantly lower concentration of 25(OH)D than the control group (the median in the HSP group was 11.4 ng/mL;controls:15.36 ng/mL,P＜0.05).When the first interval was set as the reference level,the OR (95 ％ CI) of the second,third,and fourth intervals were:0.468(0.341-0.771),0.442(0.302-0.627),0.339 (0.199-0.501).After adjusting the analysis for the presence of pathogenic related confounding fact OR,the OR(95％CI)of the second,third,and fourth intervals were:0.459(0.333-0.741),0.408(0.317-0.611),0.387 (0.221-0.517).The 25 (OH) D level was inversely correlated with the risk of HSP(P＜ 0.05).Conclusion The risk of HSP was decreased with the increase of serum 25 (OH) D concentration,25 (OH) D may be a protection factor in the pathogenesis of HSP.