The complete mitochondrial genome of Anthrenus museorum (Coleoptera: Bostrichiformia: Dermestidae) from China.

Dermestid beetles (Coleoptera: Bostrichiformia: Dermestidae) are important pests of various storage products and pose a potential threat to international trade. In this study, the whole mitogenome of Anthrenus museorum was first sequenced and annotated and was found to have the same gene order observed in known dermestid beetles. It comprised 13 protein-coding genes (PCGs), 22 transfer RNAs, 2 ribosomal RNAs and a control region. The typical ATN start codon was observed in all PCGs, except for ND3 (TTG), and all 13 PCGs showed three types of stop codons (TAA, TAG, and T-). Phylogenetic analysis based on the PCGs indicated that the relationships within Bostrichiformia were reconstructed, with the exception of one early emerging species of Bostrichidae that actually makes the group polyphyletic, as (Dermestidae + (Bostrichidae + Anobiidae)). Moreover, it revealed a close relationship between A. museorum and A. verbasci using maximum likelihood and Bayesian inference analysis.

[Comparison of positive and negative pressure extubation after mechanical ventilation in intensive care unit patients].

OBJECTIVE: To investigate the effect of positive and negative pressure extubation on mechanical ventilation patients in the intensive care unit (ICU). METHODS: A prospective randomized controlled study was performed, 105 ICU patients who successfully passed the spontaneous breathing test (SBT) after mechanical ventilation of Nanjing Jiangbei Hospital Affiliated to Nantong University from January 2019 to March 2021 were enrolled. According to random number table method, they were randomly divided into positive pressure extubation group (53 cases) and negative pressure extubation group (52 cases). During extubation, all patients were placed in semi-decubitus position (raising the head of bed at an angle range from 30 degree angle- 45 degree angle), the secretions from mouth, nose, throat and trachea were removed. In the negative pressure extubation group, the sputum suction tube was inserted into the tracheal tube and passed over the distal opening to carry out continuous negative pressure suction in the tracheal tube after disconnecting the ventilator. Meanwhile, after the tracheal tube balloon was evacuated, the sputum suction tube was pulled out together with the tracheal tube. In the positive pressure extubation group, the patients were guided to inspiratory forcibly under the original SBT mode. When the patients reached the inspiratory peak, the ballon was evacuated and the tracheal tube was removed. After extubation, all patients were given nasal catheter oxygen inhalation (oxygen flow 5 L/min). Arterial blood gas analysis indexes [pH value, arterial partial pressure of oxygen (PaO2) and arterial partial pressure of carbon dioxide (PaCO2)] were recorded 5 minutes and 1 hour after extubation in both groups. Vital signs (including tachypnea, tachycardia, elevated blood pressure and decreased oxygen saturation) and complications (including severe cough, airway hyperresponsiveness and pneumonia) were observed 30 minutes after extubation in both groups. RESULTS: Five minutes after extubation, blood gas analysis showed that the PaO2 of positive pressure extubation group was significantly higher than that of negative pressure extubation group [mmHg (1 mmHg ≈ 0.133 kPa): 123.4±30.2 vs. 111.0±21.1, P < 0.05], the pH value and PaCO2 in positive pressure extubation group were slightly lower than that of negative pressure extubation group [pH value: 7.411±0.042 vs. 7.419±0.040, PaCO2 (mmHg): 39.7±4.7 vs. 40.5±5.6], but the differences were not statistically significant (both P > 0.05). One hour after extubation, the pH value, PaO2 and PaCO2 in positive pressure extubation group were slightly lower than those in negative pressure extubation group, but the differences were not statistically significant. Within 30 minutes after extubation, the incedences of tachypnea, tachycardia, elevated blood pressure and oxygen desaturationin in positive pressure extubation group were significantly lower than those in negative pressure extubation group [tachypnea: 9.4% (5/53) vs. 28.8% (15/52), tachycardia: 15.1% (8/53) vs. 32.7% (17/52), elevated blood pressure: 11.3% (6/53) vs. 30.8% (16/52), oxygen desaturation: 7.5% (4/53) vs. 34.6% (18/52), all P < 0.05], the incidence of severe cough in positive pressure extubation group was significantly lower than that in negative pressure extubation group [9.4% (5/53) vs. 30.8% (16/52), P < 0.05], but there was no significant difference in the incidence of complications of airway hyperresponsiveness between the two groups [1.9% (1/53) vs. 5.8% (3/52), P > 0.05]. No pneumonia occurred in both groups within 48 hours after extubation. CONCLUSIONS: The positive pressure extubation method can ensure full oxygenation of patients undergoing mechanical ventilation in ICU, avoid hypoxia, and reduce the occurrence of hypoxia and severe cough, which is more conducive to the stability of vital signs.

[The value of neutrophil CD64 index in the diagnosis of patients with sepsis in intensive care unit].

OBJECTIVE: To investigate the diagnostic value of neutrophil CD64 index in sepsis patients in intensive care unit (ICU). METHODS: A prospective case-control study was conducted, the patients admitted to ICU of Jiangbei People's Hospital Affiliated to Nantong University from December 2016 to June 2020 were enrolled. According to the criteria of Sepsis 3, 107 patients diagnosed with sepsis were classified as the sepsis group, 112 patients without infection were classified as control group. Peripheral venous blood samples were collected within 24 hours after ICU admission, neutrophil CD64 index, C-reactive protein (CRP), procalcitonin (PCT), white blood cell count (WBC) were detected. Receiver operating characteristic curve (ROC curve) was used to evaluate the diagnostic value of neutrophil CD64 index, CRP, PCT and WBC for sepsis. RESULTS: The neutrophil CD64 index, CRP and PCT in sepsis group were significantly higher than those in control group [neutrophil CD64 index: 9.03±5.59 vs. 3.18±1.50, CRP (mg/L): 146.9±68.3 vs. 46.5±35.8, PCT (ng/L): 31.82±14.71 vs. 1.87±1.42, all P < 0.05]. ROC curve analysis showed that neutrophil CD64 index, CRP and PCT had certain diagnostic value for sepsis, the area under ROC curve (AUC) were 0.924, 0.915 and 0.879, respectively, the 95% confidence intervals (95%CI) were 0.871-0.978, 0.855-0.975, 0.807-0.951, respectively, P values were 0.016, 0.017 and 0.026, respectively. Among the three indicators, the diagnostic value of neutrophil CD64 index was much higher. When the optimal cut-off value was 4.32, the sensitivity and specificity were 83.6% and 88.7%, respectively, which were higher than the sensitivity (75.1%, 76.3%) and specificity (87.2%, 82.5%) of CRP and PCT. CONCLUSIONS: Neutrophil CD64 index is a valuable biomarker for the diagnosis of sepsis in ICU.

Iliopsoas hematoma associated with low-molecular-weight heparin use: A case report.

Iliopsoas hematoma is an uncommon clinical entity that may develop in association with anticoagulation states, coagulopathies and hemodialysis, or anticoagulant therapy. Here, we report a case of unilateral iliopsoas hematoma in a 60-year-old man who received low-molecular-weight heparin for anticoagulation due to continuous veno-venous hemofiltration. The patient presented with fever and productive cough for 2 days. He received continuous veno-venous hemofiltration due to rising blood urea nitrogen (22.7 mmol/L; normal references: 3.2-7.1 mmol) and creatinine (1345 µmol/L; normal references: 53-106 µmol/L). Low-molecular-weight heparin (enoxaparin, 3500-5500 Da, 5-10 IU/kg/h) was delivered continuously by pumps for anticoagulation therapy. At day 12 post heparin treatment, the patient complained left back pain. Platelet count (243 × 109/L) was normal, but both activated partial thromboplastin time (67.5 s) and prothrombin time (17.3 s) were prolonged. Abdominal computed tomography scan revealed left iliopsoas swelling with an indistinct border. Low-molecular-weight heparin was discontinued. Anti-Xa was not monitored throughout the treatment. No improvement was seen, and 3 days later, the patient died after his family decided to terminate therapy. This case highlights the needs for careful anticoagulation as well as close monitoring, and particularly the use of anti-Xa to guide the treatment.

Critical illness-related corticosteroid insufficiency after multiple traumas: a multicenter, prospective cohort study.

BACKGROUND: Given that the observed prevalence and time course of critical illness-related corticosteroid insufficiency (CIRCI) remain inconsistent in trauma patients, the present study was designed to investigate the prevalence, time course, and effect of CIRCI on the outcome of critically ill patients with multiple injuries. METHODS: In this multicenter, prospective cohort study, patients with multiple injuries in seven intensive care units in China were enrolled. Adrenocorticotropic hormone (ACTH) stimulation tests were performed by administering intravenously 250 µg of synthetic ACTH on Days 1, 2, 3, 5, and 7 after traumatic injury. CIRCI was defined as baseline cortisol level of less than 10 µg/dL or a Δcortisol (difference baseline and highest cortisol level at 30 or 60 minutes after ACTH stimulation) less than 9 µg/dL. The incidence and time course of CIRCI and 28-day mortality were recorded. RESULTS: CIRCI occurred in 54.3% (38 of 70) of the patients with multiple injuries, including 10 patients with total cortisol level of less than 10 µg/dL and 28 patients with Δcortisol of less than 9 µg/dL. Most (94.7%) diagnosis of CIRCI was made in the first 48 hours after traumatic injury. The CIRCI patients had significantly more severe illness on the day of admission. At each time point, the baseline cortisol level was comparable between the CIRCI and non-CIRCI patients, while Δcortisol in the CIRCI group was significantly lower compared with the non-CIRCI group. The CIRCI patients with a Δcortisol of less than 9 µg/dL had a significantly higher 28-day mortality (39.3%) compared with those with a baseline cortisol level of less than 10 µg/dL (10.0%) and non-CIRCI patients (6.3%). Only Δcortisol of less than 9 µg/dL but not baseline cortisol level of less than 10 µg/dL seemed to be an independent risk factor for death (odds ratio, 1.19; p = 0.023). CONCLUSION: CIRCI is common in critically ill trauma population and usually occurs in the early stages. Only the results of the ACTH stimulation test but not baseline cortisol level was associated with poor prognosis. LEVEL OF EVIDENCE: Prognostic study, level II.

[Research on the composition characteristics of Chinese ancient southern white porcelain].

The southern white porcelain is the rise in our country's pottery, it is later than the development of northern white porcelain, but it is rising stars, blockbuster, well-grounded, keeping continuous. Jingdezhen kiln and Dehua kiln are the most representative kilns among the southern white porcelain kilns. the present paper used EDXRF to test 30 pieces of Song, Yuan and Ming period' Dehua white porcelains and Jingdezhen Yuan dynasty Shufu white porcelains samples to analyze the different characteristics of the bodies and the glaze of these samples in terms of time and space. The results show that in the bodies and the glaze of Jingdezhen Shufu white porcelains the iron content is obviously on the high side, and the Dehua white porcelains' potassium content is obviously on the high side, and along with time development they have been in a rising trend, which should be the main reason for the sudden rise of Dehua white porcelain sculptures.

[Effect of Xuebijing injection treatment on acute respiratory distress syndrome: a multicenter prospective randomized control clinical trial].

OBJECTIVE: To assess the therapeutic effect of Xuebijing injection on adult patients with acute respiratory distress syndrome (ARDS). METHODS: A multicenter prospective randomized control study was conducted at 10 intensive care units in Jiangsu province. A total of 172 early ARDS patients were randomly divided into Xuebijing treatment and control groups. All patients received routine therapy of ARDS while additional Xuebijing injection 100 ml was administered in the treatment group intravenously for 7 days. Lung injury score, acute physiology and chronic health evaluation II (APACHE II) score, multiple organ dysfunction score (MODS) and PaO2/FiO2 of the patients was recorded before and after treatment. Mortality at 28 days and the duration of mechanical ventilation were compared between two groups. RESULTS: Ninety-one patients were assigned to receive Xuebijing injection and 81 patients as control; Mortality at Days 28 and 90, the duration of mechanical ventilation and ventilation free days showed no difference between two groups (P > 0.05). PaO2/FiO2 improved after randomization versus pre-treatment in all patients. There was no significant difference between two groups. Murray scores were not significantly different between two groups. In a subgroup analysis of patients with pulmonary infection, pulmonary contusion and extra-pulmonary cause, two groups had no difference in mortality at Day 28, mortality at Day 90, the duration of mechanical ventilation, ventilation free days and days of ICU stay (P > 0.05). CONCLUSION: The treatment of Xuebijing injection early in course of ARDS does not improve the mortality of ARDS patients. But it may improve lung function and oxygenation. Further studies are warranted.