Bornyl acetate extracted from Sharen () inhibits proliferation, invasion and induces apoptosis by suppressing phosphatidylinositol-3-kinase/protein kinase B signaling in colorectal cancer.

OBJECTIVE: To investigate the antitumor effects of bornyl acetate (BA) isolated from Sharen (Fructus Amomi) in colorectal cancer (CRC) and the underlying mechanisms. METHODS: SW480 and HT29 cells were treated with increasing doses of BA in order to determine its antitumor effects in vitro. Cell viability, colony formation, cell cycle, and apoptosis as well as migration and invasion were assessed using various assays. In addition, the in vivo antitumor effects of BA were assessed using a xenograft mouse model. We then assessed the mechanism of action of BA by conducting pathway activator-mediated rescue experiments and assessed the protein levels by Western blot analysis. RESULTS: BA showed anti-CRC tumor activities in vitro by suppressing cell proliferation and colony formation, inducing apoptosis, blocking cell cycle, and inhibiting migration and invasion. These effects were mediated via suppression of the phosphatidylinositol-3-kinase/protein kinase B (PI3K/AKT) pathway. In the tumor xenograft experiment, BA was found to repress tumor growth in vivo with low toxicity. CONCLUSIONS: The results demonstrated that BA exerts antitumor effects by suppressing the PI3K/AKT pathway, with low toxicity. Thus, BA might be a potential novel therapeutic agent for CRC.

Source apportionment of potentially toxic elements in soils using APCS/MLR, PMF and geostatistics in a typical industrial and mining city in Eastern China.

Source apportionment of potentially toxic elements in soils is a critical step for devising soil sustainable management strategies. However, misjudgment or imprecision can occur when traditional statistical methods are applied to identify and apportion the sources. The main objective of the study was to develop a robust approach composed of the absolute principal component score/multiple linear regression (APCS/MLR) receptor model, positive matrix factorization (PMF) receptor model and geostatistics to identify and apportion sources of soil potentially toxic elements in typical industrial and mining city, eastern China. APCS/MLR and PMF were applied to provide robust factors with contribution rates. The geostatistics coupled with the variography and kriging methods was used to present factors derived from these two receptor models. The results indicated that mean concentrations of As, Cd, Cr, Cu, Hg, Ni, Pb and Zn exceeded the local background levels. Based on multivariate receptor models and geostatistics, we determined four sources of eight potentially toxic elements including natural source (parent material), agricultural practices, pollutant emissions (industrial, mining and traffic) and the atmospheric deposition of coal combustion, which accounted for 68%, 12%, 12% and 9% of the observed potentially toxic element concentrations, respectively. This study provides a reliable and robust approach for potentially toxic elements source apportionment in this particular industrial and mining city with a clear potential for future application in other regions.

Pathogenic bacteria distribution,drug resistance changes and risk factors of death in patients with acute myeloid leukemia complicated with bloodstream infection / 天津医药

Objective To explore the distribution and drug resistance changes of pathogenic bacteria in adult acute myeloid leukemia(AML)with bloodstream infection,and to analyze risk factors of death of patients.Methods Changes of detection rate of pathogenic bacteria and drug resistance rate of main pathogenic bacteria of 85 patients with AML and bloodstream infection 30 months before confirmed diagnosis(pathogenic bacteria detected from January 2017 to June 2019)and 30 months after diagnosis(from July 2019 to December 2021)were compared.According to the prognosis at 6 months after bloodstream infection,patients were divided into the death group(33 cases)and the survival group(52 cases).Logistic regression analysis was used to analyze risk factors of death in patients with AML complicated with bloodstream infection.Results A total of 98 strains of pathogenic bacteria were detected in 85 patients with AML complicated with bloodstream infection,mainly gram-negative bacteria(65/98,66.33%),followed by Gram-positive bacteria(29/98,29.59%)and fungi(4/98,4.08%).The proportion of fungi(all were candida)detected in the last 30 months was more than that in the first 30 months(P<0.05).There were no significant differences in proportions of gram-negative bacteria and gram-positive bacteria and drug resistance rates of Escherichia coli and Staphylococcus aureus between the late 30 months and the first 30 months(P>0.05).Logistic regression analysis showed that the history of antibiotic use within 1 month before confirmed diagnosis and septic shock were independent risk factors for death in patients with AML complicated with bloodstream infection(P<0.05).Conclusion The main pathogens of adults with AML combined with bloodstream infection are gram-negative bacteria.However,candida infection rate has increased in recent years,and patients with antibiotic use before bloodstream infection and complicated with septic shock are prone to poor prognosis.

Effects of Modified Shenling Baizhu Powder （参苓白术散）and Xiaoluo Pills（消瘰丸）on Quality of Life and Serum Inflammatory Factors in Children with Adenoid Hypertrophy due to Spleen Deficiency and Phlegm Accumulation / 中医杂志

ObjectiveTo investigate the clinical effect and possible mechanism of modified Shenling Baizhu Powder （参苓白术散） and Xiaoluo Pill （消瘰丸） in the treatment of children with adenoid hypertrophy due to spleen deficiency and phlegm accumulation. MethodsOne hundred and thirty children with adenoid hyperplasia due to spleen deficiency and phlegm accumulation were randomly divided into 65 cases each in the observation group and control group. The control group was given mometasone furoate nasal spray， one spray into each nostril， once a day， while the observation group was given modified Shenling Baizhu Powder and Xiaoluo Pill orally， one dose per day， and both groups were treated for 8 months. The pre- and after-treatment electronic nasopharyngoscope scores， specific quality of life survey scale （OSA-18） scores， total TCM symptom scores， serum cysteine leukotrienes （CysLTs）， interleukin 2 （IL-2）， tumor necrosis factor α （TNF-α）， and interleukin 10 （IL-10） levels were compared to determine the clinical efficacy after treatment. ResultsAfter treatment， the electronic nasopharyngoscope scores， OSA-18 scores， total TCM symptom scores， serum CysLTs， IL-2 and TNF-α levels significantly decreased， while IL-10 levels increased in both groups （P＜0.01）. Compared between the two groups after treatment， the electronic nasopharyngoscope score， OSA-18 score， total TCM symptom score， serum CysLTs， IL-2 and TNF-α levels were significantly lower， and the IL-10 level was higher in the observation group than in the control group （P＜0.01）. The total effective rate of the observation group was 95.38% （62/65）， superior to 81.54% （53/65） of the control group （P＜0.05）. ConclusionFor children with adenoid hypertrophy due to spleen deficiency and phlegm accumulation， modified Shenling Baizhu Powder and Xiaoluo Pill can help to improve symptoms， increase quality of life and clinical efficacy， and its mechanism may be related to reducing the inflammatory response.

Effects of ropivacaine on biological behavior and AMPK/Nrf2 signaling pathway of gastric cancer BGC-823 cells / 国际检验医学杂志

Objective To investigate the effect of ropivacaine on biological behavior of gastric cancer BGC-823 cells and AMP activated protein kinase(AMPK)/nuclear factor E2-related factor 2(Nrf2)signaling path-way.Methods Gastric cancer BGC-823 cells were cultured in vitro.When BGC-823 cells were cultured to log-arithmic growth phase,they were divided into control group(routine culture),cisplatin group(medium con-taining 5 mg/L cisplatin),and low-level(medium containing 25 mg/L ropivacaine),medium-level(medium containing 50 mg/L ropivacaine),and high-level(medium containing 100 mg/L ropivacaine)ropivacaine groups.The cells were cultured for 48 h.Cell counting kit-8(CCK-8)was used to detect the survival rate of BGC-823 cells.Transwell chamber assay was used to detect the invasion ability of BGC-823 cells.The apopto-sis rate of BGC-823 cells was detected by flow cytometry.The mRNA levels of AMPK and Nrf2 in BGC-823 cells were detected by real-time fluorescence quantitative PCR(qPCR).The protein levels of AMPK and Nrf2 in BGC-823 cells were detected by Western blot.Results Compared with the control group,the survival rate,invasion number,AMPK and Nrf2 mRNA and protein levels of BGC-823 cells in the cisplatin group and the low-level,medium-level and high-level ropivacaine groups were decreased(P＜0.05),while the apoptosis rate was increased(P＜0.05).Compared with the cisplatin group,the survival rate,invasion number,AMPK and Nrf2 mRNA and protein levels of BGC-823 cells in the low-level,medium-level and high-level ropivacaine groups were increased(P＜0.05),while the apoptosis rate was decreased(P＜0.05).Compared with the low-level ropivacaine group,the survival rate,invasion number,AMPK,Nrf2 mRNA and protein levels of BGC-823 cells in the medium-level and high-level ropivacaine groups were decreased in oder(P＜0.05),while the apop-tosis rate was increased in oder(P＜0.05).Conclusion Ropivacaine could inhibit the survival and invasion of BGC-823 cells and promote the apoptosis of BGC-823 cells,which may be related to the inhibition of AMPK/Nrf2 signaling pathway.

Sublethal Effects of Four Insecticides on the Seven-Spotted Lady Beetle (Coleoptera: Coccinellidae).

To further develop integrated pest management (IPM) strategies against two sucking insect pests, Aleurocanthus spiniferus (Quaintanca) (Hemiptera: Aleyrodidae) and Toxoptera aurantii Boyer (Hemiptera: Aphididae), in Chinese tea plantations, it is important to evaluate the effects of insecticides on biological control agents, such as the seven-spot lady beetle, Coccinella septempunctata L. (Coleoptera: Coccinellidae). Therefore, we tested the toxicity and sublethal effects of spirotetramat, clothianidin, lambda-cyhalothrin, and bifenthrin on C. septempunctata. The side effects of the active ingredients of the insecticides were evaluated with residual contact tests on the larvae of C. septempunctata in the laboratory. Spirotetramat and clothianidin exhibited lower lethality to C. septempunctata as shown by the higher LC50 values and had higher selectivity for A. spiniferus and T. aurantii based on the selective toxicity ratios being superior to other tested insecticides. Spirotetramat also did not affect survival, longevity, fecundity, and egg hatching of C. septempunctata. Clothianidin and bifenthrin prolonged the duration of larval development stages of C. septempunctata obviously. Clothianidin at >2.5 mg/liter, lambda-cyhalothrin at >0.03 mg/liter, and bifenthrin at >0.125 mg/liter significantly reduced the survival and pupation rates of C. septempunctata larvae. Furthermore, spirotetramat at 3.125 mg/liter was harmless (IOBC class 1) to larvae of this coccinellid species. Based on the results, spirotetramat was innocuous to C. septempunctata larvae compared with clothianidin, lambda-cyhalothrin, and bifenthrin. Therefore, spirotetramat might be incorporated into IPM programs in combination with C. septempunctata for control of A. spiniferus and T. aurantii in the tea plantations.

Construction of luciferase-expressing pancreatic cancer cell lines and evaluation of their application in detecting cytotoxicity efficacy of immune cells / 中华微生物学和免疫学杂志

Objective:To construct pancreatic cancer cell lines expressing luciferase and mesothelin (MSLN), and evaluate the feasibility of using them as target cells in analyzing the cytotoxicity activity of immune cells.Methods:Lentiviral vectors expressing luciferase and MSLN genes were constructed, and pancreatic cancer cell lines were infected after lentivirus packaging. Single-cell clones were obtained by limited dilution following antibiotic screening, and the stable expression of the target genes were verified. These cells were used as target cells to detect the cytotoxicity of immune cells by real-time cell analysis (RTCA) and luciferase activity. Besides, these luciferase-expressing cells were transplanted into B-NDG mice to establish the animal models of pancreatic cancer, and in vivo optical imaging technology was used to detect the expression of luciferase and monitor the tumor growth in mice. The cytotoxicity of chimeric antigen receptor T (CAR-T) cells was verified in these animal models. Results:Three pancreatic cancer cell lines, panc-1-luc, panc-1-luc-MSLN and capan-2-luc, that could stably express luciferase and MSLN genes were successfully constructed. The expression of the reporter gene in these cells were high, and positively correlated with the number of cells. There were 95.6% of panc-1-luc-MSLN cells expressing MSLN. MSLN-CAR-T cells had specific killing effect on MSLN-positive panc-1-luc-MSLN cells and capan-2-luc cells, with the minimum killing rates of (70.00±18.19)% and (57.00±5.29)%, respectively. But they had no cytotoxicity to MSLN-negative panc-1-luc cells. RTCA results showed that MSLN-CAR-T cells were able to lyse all three pancreatic cancer cell lines, and the minimum killing rates were (56.33±7.64)%, (93.00±2.65)% and (26.33±28.15)%, respectively. The killing of target cells by NK-92MI cells was not depended on MSLN expression. The cytotoxicity in the mice models of pancreatic cancer was consistent with the results in vitro. The in vivo and in vitro test results suggested that the expression of luciferase by target cells could reflect the cytotoxicity of immune cells. Conclusions:This study establishes three pancreatic cancer cell lines stably expressing luciferase, which can be used to evaluate the cytotoxicity of immunotherapy products targeting tumor cells in vitro and in vivo.

Exploration of Myopia Prevention and Control Strategies of Myopia in Children and Adolescents from the Perspective of "Rhythmic Equilibrium" / 中医杂志

The theory of “rhythmic equilibrium” is developed based on the idea of sharing the same laws between nature and human， and by integrating with the medical concept of homeostasis of calm yin and sound yang. "Rhythmic instability" runs through the entire process of the occurrence and development of myopia， covering four aspects including imbalance of rhythm （high-risk period of myopia）， imbalance of qi and blood （premyopia）， imbalance of sinew-membranes （low myopia）， and imbalance of essence and blood （high myopia）. The treatment should focus on adjusting the rhythm and harmonizing situation， which can help balance yin and yang， and nourish the eye system. For high-risk period of myopia， adjusting sleeping time and increasing outdoor activities are stressed to adjust the rhythm in a timely manner. In the stage of premyopia， appropriate techniques of traditional Chinese medicine （TCM） such as pressing needles can be added to harmonize qi and blood. In the period of low myopia， appropriate TCM techniques such as pressing needles and ear acupuncture are mainly used， supplemented by modified Danggui Buxue Decoction （当归补血汤） to soften tendons and unblock collaterals. During the period of high myopia， it is recommended to control the development of existing disease and put focus on nourishing essence and blood， usually with Zhujing Pill （驻景丸） or modified Siwu Wuzi Decoction （四物五子汤） to restore the stability of the eyes and the whole body.

Magnifying endoscopy combined with narrow-band imaging,acetate-indigo rouge staining combined with multi-slice spiral CT in the diagnosis of early gastric cancer and precancerous lesions and clinical significance / 中国内镜杂志

Objective To analyze the diagnostic efficacy and clinical significance of magnifying endoscopy combined with narrow-band imaging(ME-NBI),acetate-indigo rouge staining and multi-slice spiral CT for early gastric cancer and precancerous lesions.Methods 202 patients with suspected early gastric cancer and precancerous lesions from February 2019 to March 2022 were regarded as the subjects of this study,all the patients underwent ME-NBI,acetate-indigo rouge staining,and multi-slice spiral CT examination;The diagnostic value of different examination methods for early gastric cancer and precancerous lesions was analyzed using the receiver operator characteristic curve(ROC curve),using the pathological results of gastric cancer as the gold standard,the diagnostic value of ME-NBI,acetate-indigo rouge staining combined with multi-slice spiral CT and their combination in early gastric cancer and precancerous lesions was analyzed using a four grid table.Results The image quality of ME-NBI and acetate-indigo rouge staining combined examinations was significantly higher than that of their respective independent examinations(P<0.05).There was significant difference in the degree of differentiation in the clinical features of patients with early gastric cancer and precancerous lesions(P<0.05).The area under the curve(AUC)of ME-NBI for the diagnosis of early gastric cancer and precancerous lesions was 0.853,the accuracy was 85.64%,the sensitivity was 88.37%,and the specificity was 83.62%.The AUC of acetate-indigo rouge staining for the diagnosis of early gastric cancer and precancerous lesions was 0.814,the accuracy was 81.68%,the sensitivity was 83.72%,and the specificity was 80.17%.The AUC of multi-slice spiral CT for the diagnosis of early gastric cancer and precancerous lesions was 0.804,with an accuracy of 80.69%,a sensitivity of 82.56%,and a specificity of 79.31%.And the AUC of the three methods combined to diagnose early gastric cancer and precancerous lesions was 0.893,with an accuracy of 89.60%,a sensitivity of 93.02%,and a specificity of 87.07%.Conclusion ME-NBI,acetate-indigo rouge staining combined with multi-slice spiral CT has high diagnostic efficacy in early gastric cancer and precancerous lesions,and can be used in clinical practice.

Effects of Different Processing Methods on the Volatile Components of Amomi Fructus Based on GC-MS and Multivariate Statistical Analysis / 医药导报

Objective To analyze the influence of different processing methods,including frying,ginger frying,and salt frying,on the volatile components of A.fructus.Methods The volatile components in different processed products of A.fructus were detected and analyzed by gas chromatography-mass spectrometry(GC-MS)based on multivariate statistical analysis.After OPLS-DA analysis,the different components were screened under the conditions of VIP＞1.5 and P＜0.05 and were qualitatively searched using the NIST 11 spectral library.Results A total of 49 different components were identified,with 14 components only changing in the seed mass and 22 components changing in the peel.The content of camphor could be significantly reduced in the seed mass after A.fructus was processed and the content of bornyl acetate significantly increased in the peel of frying A.fructus.Salt frying had a great influence on the alkanes in A.fructus,and ginger processing did not only increase the volatile components in ginger,which reflected the complexity of the processing mechanism.Conclusion At present,the specific processing mechanism is not clear,but the experimental results provide theoretical data for the "detoxification and efficiency enhancement" effect of A.fructus processing,reflecting the scientific nature of the processing,enriching the processing theory of A.fructus,and providing a reference for further in-depth research on the activity of different processed products of A.fructus.

National bloodstream infection bacterial resistance surveillance report (2022) : Gram-negative bacteria / 中华临床感染病杂志

Objective:To report the results of national surveillance on the distribution and antimicrobial resistance profile of clinical Gram-negative bacteria isolates from bloodstream infections in China in 2022.Methods:The clinical isolates of Gram-negative bacteria from blood cultures in member hospitals of national bloodstream infection Bacterial Resistant Investigation Collaborative System（BRICS）were collected during January 2022 to December 2022. Antibiotic susceptibility tests were conducted by agar dilution or broth dilution methods recommended by Clinical and Laboratory Standards Institute（CLSI）. WHONET 5.6 and SPSS 25.0 software were used to analyze the data.Results:During the study period，9 035 strains of Gram-negative bacteria were collected from 51 hospitals，of which 7 895（87.4%）were Enterobacteriaceae and 1 140（12.6%）were non-fermenting bacteria. The top 5 bacterial species were Escherichia coli（ n=4 510，49.9%）， Klebsiella pneumoniae（ n=2 340，25.9%）， Pseudomonas aeruginosa（ n=534，5.9%）， Acinetobacter baumannii complex（ n=405，4.5%）and Enterobacter cloacae（ n=327，3.6%）. The ESBLs-producing rates in Escherichia coli， Klebsiella pneumoniae and Proteus spp. were 47.1%（2 095/4 452），21.0%（427/2 033）and 41.1%（58/141），respectively. The prevalence of carbapenem-resistant Escherichia coli（CREC）and carbapenem-resistant Klebsiella pneumoniae（CRKP）were 1.3%（58/4 510）and 13.1%（307/2 340）；62.1%（36/58）and 9.8%（30/307）of CREC and CRKP were resistant to ceftazidime/avibactam combination，respectively. The prevalence of carbapenem-resistant Acinetobacter baumannii（CRAB）complex was 59.5%（241/405），while less than 5% of Acinetobacter baumannii complex was resistant to tigecycline and polymyxin B. The prevalence of carbapenem-resistant Pseudomonas aeruginosa（CRPA）was 18.4%（98/534）. There were differences in the composition ratio of Gram-negative bacteria in bloodstream infections and the prevalence of main Gram-negative bacteria resistance among different regions，with statistically significant differences in the prevalence of CRKP and CRPA（ χ2=20.489 and 20.252， P<0.001）. The prevalence of CREC，CRKP，CRPA，CRAB，ESBLs-producing Escherichia coli and Klebsiella pneumoniae were higher in provinicial hospitals than those in municipal hospitals（ χ2=11.953，81.183，10.404，5.915，12.415 and 6.459， P<0.01 or <0.05），while the prevalence of CRPA was higher in economically developed regions（per capita GDP ≥ 92 059 Yuan）than that in economically less-developed regions（per capita GDP <92 059 Yuan）（ χ2=6.240， P=0.012）. Conclusions:The proportion of Gram-negative bacteria in bloodstream infections shows an increasing trend，and Escherichia coli is ranked in the top，while the trend of CRKP decreases continuously with time. Decreasing trends are noted in ESBLs-producing Escherichia coli and Klebsiella pneumoniae. Low prevalence of carbapenem resistance in Escherichia coli and high prevalence in CRAB complex have been observed. The composition ratio and antibacterial spectrum of bloodstream infections in different regions of China are slightly different，and the proportion of main drug resistant bacteria in provincial hospitals is higher than those in municipal hospitals.

Reevaluation of Systematic Evaluation of the Efficacy and Safety of Transcatheter Arterial Chemoembolization Combined with Sorafenib in the Treatment of Unresectable Hepatocellular Carcinoma / 医学研究杂志

Objective To conduct reevaluation of systematic review/Meta-analysis on the efficacy and safety of transcatheter arteri-al chemoembolization(TACE)combined with sorafenib in the treatment of unresectable hepatocellular carcinoma(HCC).Methods The systematic reviews and Meta-analysis of TACE combined with sorafenib in the treatment of HCC were collected through computer searches on PubMed,Embase,the CochraneLibrary,CNKI and Wanfang data knowledge service platform.The time limit was from data-base inception to August 2022.The experimental group received TACE combined with sorafenib,and the control group received other con-ventional treatments.After screening the literature and extracting the data,PRISMA statement was adopted to evaluate the quality of the included reports,AMSTAR 2scale was used for methodological quality evaluation,and GRADE tool was used for outcome indicator and evidence quality evaluation.Results A total of 9 literatures were included,including 43 outcome indicators.The PRISMA score was 20.5-25.5,including 7 articles of high quality and 2 articles of moderate quality.The results of AMSTAR 2 quality evaluation show that all the literatures were of extremely low quality,and the key items with the most problems were item 2 and item 7.The results of GRADE evaluation showed that there were 4 high quality indicators,15medium quality indicators,21 low quality indicators and 3 unevaluable indi-cators.The main factor leading to degradation was bias risk,followed by inconsistency.In terms of curative effect,compared with the con-trol group,the 1-year survival rate,time to progression,objective response rate and disease control rate of patients in the experimental group were significantly improved.However,the incidence of adverse reactions(diarrhea,hand and foot syndrome,hypertension)in the control group was significantly better than those in the experimental group.Conclusion The methodology quality and evidence quality of systematic review/Meta-analysis related to TACE combined with sorafenib in the treatment of HCC is poor,and the standardization still needs to be further improved.

The formula for orogastric tube insertion length in preterm infants based on growth indicators and gestational age / 中国新生儿科杂志

Objective:To develop a formula for estimating the insertion length of orogastric (OG) tube for preterm infants based on growth indicators and gestational age (GA).Methods:From January 2020 to December 2021, preterm infants admitted to the neonatal intensive care unit of our hospital were retrospectively reviewed. OG tubes were inserted within 24 h of admission and the lengths of OG tubes were adjusted according to chest and abdominal X-ray results. The formula for OG tube placement was developed using stepwise regression analysis method with GA, body weight (BW) and body length (BL) as the independent variables and the corrected length of OG tube as the dependent variable. The weight-based formula developed by Freeman et al. were compared.Results:A total of 180 preterm infants were included, with 90 cases GA<32 weeks, 84 cases GA 32~35 weeks and 6 cases GA 36 weeks. No significant differences ( P>0.05) existed in the incidences of misplacement of OG tube and the specific types of misplacement among GA groups. For infants with GA≤35 weeks, the insertion length of OG tube was positively correlated with BW and BL and for preterm infants with GA 36 weeks, the insertion length of OG tube was positively correlated with BW only. Stepwise regression analysis showed the formula as OG tube length (cm)=11.8+2.1×BW (kg) or OG tube length (cm)=9.5+1.6×BW (kg)+0.091×GA (week). Comparing with the formula developed by Freeman et al., the differences of OG tube length estimated using our formula were more prominent as BW increased. Conclusions:The length of OG tube is positively correlated with BW and GA with BW shows more influence.

Comparison of the diagnostic effect on different machine learning predictive model of imipenem sensitivity of Klebsiella pneumoniae based on MALDI-TOF MS / 中华检验医学杂志

Objective:Machine learning is not only an important branch of artificial intelligence, but also supporting technologies for bioinformatics analysis. In the presence work, four machine-learning-predictive model for the drug-sensitivity of Klebsiella pneumoniae to imipenem were established based on matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF-MS) and the diagnostic effect of these methods was exmained. Methods:A retrospective study was performed and the data of MALDI-TOF-MS and imipenem sensitivity of a total number of 684 cases Klebsiella pneumoniae isolated from clinical specimens in the laboratory of microbiology department of Tianjin Haihe Hospital from 2019 January to 2020 December were collected. The mass spectrometry and imipenem sensitivity data of 70 cases identified as imipenem-sensitive and 70 resistant cases were simple randomly selected to establish the training set model; whereas 30 cases of sensitive and 30 cases of resistant cases were randomly selected to establish the test set model. Mass spectral peak data were subjected to Orthogonal Partial least squares Discriminant Analysis (OPLS-DA). The training set data model was established by machine learning least absolute shrinkage and selection operator (LASSO) algorithm, Logistic Regression (LR) algorithm, Support vector machines (SVM) algorithm, neural network (NN) algorithm. The area under the curve (AUC) and confusion matrix of training set and test set model were calculated and selected by Grid search and 10-fold Cross-validation respectively, the accuracy of the prediction model was verified by test set confusion matrix. Results:The R2Y and Q2 of OPLS-DA were 0.546 3 and 0.017 8. The AUC of the best training set and test set models were 1.000 0 and 0.858 1, 1.000 0 and 0.820 1, 0.940 8 and 0.756 1, 1.000 0 and 0.697 2 evaluated by LASSO, LR, SVM and NN model respectively. The accuracy of the model were 99% (69/70), 100% (70/70), 91% (64/70) and 100% (70/70) for prediction of drug resistance, 100% (70/70), 100% (70/70), 90% (63/70) and 100% (70/70) for drug sensitivity prediction, the correct rate were 99% (139/140), 100% (140/140), 91% (127/140) and 100% (140/140) in training set, the test set showed that the accuracy were 93% (28/30), 87% (26/30), 60% (18/30) and 60% (18/30) for prediction of drug resistance, 100% (30/30), 80% (24/30), 93% (28/30) and 67% (20/30) for drug sensitivity prediction, the correct rate were 97% (58/60), 83% (50/60), 77% (46/60) and 63% (38/60) by LASSO, LR, SVM and NN model respectively.Conclusion:The LASSO prediction model of Klebsiella pneumoniae sensitivity to imipenem established in this study has a high accuracy rate and has potential clinical decision support ability.

Antimalarial and neuroprotective ent-abietane diterpenoids from the aerial parts of Phlogacanthus curviflorus / 中国天然药物

Six new ent-abietane diterpenoids, abientaphlogatones A-F (1-6), along with two undescribed ent-abietane diterpenoid glucosides, abientaphlogasides A-B (7-8) and four known analogs were isolated from the aerial parts ofPhlogacanthus curviflorus (P. curviflorus). The structures of these compounds were determined using high-resolution electrospray ionization mass spectrometry (HR-ESI-MS), one-dimensional and two-dimensional nuclear magnetic resonance (NMR) spectroscopy, electronic circular dichroism (ECD) spectra, and quantum chemical calculations. Notably, compounds 5 and 6 represented the first reported instances of ent-norabietane diterpenoids from the genus Phlogacanthus. In the β-hematin formation inhibition assay, compounds 2, 4, 7-10, and 12 displayed antimalarial activity, with IC50 values of 12.97-65.01 μmol·L-1. Furthermore, compounds 4, 5, 8, and 10 demonstrated neuroprotective activity in PC12 cell injury models induced by H2O2 and MPP+.

BRICS report of 2021: The distribution and antimicrobial resistance profile of clinical bacterial isolates from blood stream infections in China / 中华临床感染病杂志

Objective:To report the results of national surveillance on the distribution and antimicrobial resistance profile of clinical bacterial isolates from bloodstream infections in China in 2021.Methods:The clinical bacterial strains isolated from blood culture from member hospitals of Blood Bacterial Resistant Investigation Collaborative System (BRICS) were collected during January 2021 to December 2021. Antibiotic susceptibility tests were conducted by agar dilution or broth dilution methods recommended by Clinical Laboratory Standards Institute (CLSI). WHONET 5.6 was used to analyze data.Results:During the study period, 11 013 bacterial strains were collected from 51 hospitals, of which 2 782 (25.3%) were Gram-positive bacteria and 8 231 (74.7%) were Gram-negative bacteria. The top 10 bacterial species were Escherichia coli (37.6%), Klebsiella pneumoniae (18.9%), Staphylococcus aureus (9.8%), coagulase-negative Staphylococci (6.3%), Pseudomonas aeruginosa (3.6%), Enterococcus faecium (3.6%), Acinetobacter baumannii (2.8%), Enterococcus faecalis (2.7%), Enterobacter cloacae (2.5%) and Klebsiella spp (2.1%). The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase-negative Staphylococcus aureus were 25.3% and 76.8%, respectively. No glycopeptide- and daptomycin-resistant Staphylococci was detected; more than 95.0% of Staphylococcus aureus were sensitive to ceftobiprole. No vancomycin-resistant Enterococci strains were detected. The rates of extended spectrum B-lactamase (ESBL)-producing isolated in Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis were 49.6%, 25.5% and 39.0%, respectively. The prevalence rates of carbapenem-resistance in Escherichia coli and Klebsiella pneumoniae were 2.2% and 15.8%, respectively; 7.9% of carbapenem-resistant Klebsiella pneumoniae was resistant to ceftazidime/avibactam combination. Ceftobiprole demonstrated excellent activity against non-ESBL-producing Escherichia coli and Klebsiella pneumoniae. Aztreonam/avibactam was highly active against carbapenem-resistant Escherichia coli and Klebsiella pneumoniae. The prevalence rate of carbapenem-resistance in Acinetobacter baumannii was 60.0%, while polymyxin and tigecycline showed good activity against Acinetobacter baumannii (5.5% and 4.5%). The prevalence of carbapenem-resistance in Pseudomonas aeruginosa was 18.9%. Conclusions:The BRICS surveillance results in 2021 shows that the main pathogens of blood stream infection in China are gram-negative bacteria, in which Escherichia coli is the most common. The MRSA incidence shows a further decreasing trend in China and the overall prevalence of vancomycin-resistant Enterococci is low. The prevalence of Carbapenem-resistant Klebsiella pneumoniae is still on a high level, but the trend is downwards.

Perinatal outcome and risk factors of precipitate labor in term primipara: an analysis of 381 cases / 浙江大学学报·医学版

OBJECTIVE@#To investigate the perinatal outcome and risk factors of precipitate labor in term primipara.@*METHODS@#A total of 6951 full-term singleton primiparas with cephalic vaginal delivery in Women's Hospital, Zhejiang University School of Medicine from January 2020 to December 2020 were enrolled, among whom 381 cases of precipitate labor were classified as the precipitate labor group and 762 cases of normal labor were randomly selected as the control group. The perinatal outcomes of the two groups were compared, and the risk factors of precipitate labor were analyzed by multivariate logistic regression.@*RESULTS@#The incidence of precipitate labor in full-term, singleton pregnancy and cephalic primiparas was 5.48% (381/6951). The durations of the first and second stages of labor in the precipitate labor group were significantly shorter than that in the control group ( P<0.01); while there was no significant difference in the duration of the third stage of labor between the two groups ( P>0.05). Compared with the control group, the incidence of soft birth canal laceration in the precipitate labor group was increased ( P<0.01). However, there was no significant difference in postpartum hemorrhage and neonatal related perinatal outcomes between the two groups (all P>0.05). Multivariate logistic regression analysis showed that maternal height ( OR=1.038, 95% CI: 1.010-1.067, P<0.01), gestational age at delivery ( OR=0.716, 95% CI: 0.618-0.829, P<0.01), late miscarriage ( OR=1.986, 95% CI: 1.065-3.702, P<0.05), membrane rupture before labor ( OR=1.802, 95% CI: 1.350-2.406, P<0.01), labor induction by transcervical balloon ( OR=3.230, 95% CI: 2.027-5.147, P<0.01), labor induction by propess ( OR=2.332, 95% CI: 1.632-3.334, P<0.01) and labor induction by oxytocin ( OR=0.291, 95% CI: 0.219-0.386, P<0.01) were independently associated with precipitate labor.@*CONCLUSIONS@#The incidence of precipitate labor in full-term, singleton pregnancy was not low. Precipitate labor could lead to a significant increase in perineal laceration. Maternal height, history of late miscarriage, membrane rupture before labor and labor induction by transcervical balloon, labor induction by propess are risk factors, while labor induction by oxytocin and late gestational time of delivery are protective factors for precipitate labor in term primipara.

Recent advance in correlation between cerebral micro-infarct and other imaging markers of cerebral small vessel disease / 中华神经医学杂志

Cerebral small vessel disease (CSVD) is a prevalent disease in elder people, which is related to cognitive dysfunction, neuropsychological disorder, motor and gait dysfunction, and urinary incontinence. The imaging markers of CSVD mainly include recent subcortical small infarct, lacuna, white matter hyperintensity, enlarged perivascular space, cerebral micro-bleed, cerebral micro-infarct, and cerebral atrophy. At present, the correlation and interaction of CSVD imaging markers and their synergistic effects on clinical symptoms have gradually become the research focus. This article reviews the correlations of cerebral micro-infarct with other CSVD imaging markers to further clarify the pathogenesis of coexistence of a variety of CSVD imaging markers and guide the prevention and treatment of CSVD.

The influence of mindfulness cognitive therapy on the early maladaptive schema in patients with depression / 中华行为医学与脑科学杂志

Objective:To evaluate the effect of mindfulness-base cognitive therapy (MBCT) in improving patients with depression, and to explore its effect on patients early maladaptive schemas (EMSs).Methods:Sixty patients with depressive disorder were included in the pre- and post-control design, and MBCT treatment was carried out for 8 weeks. The Hamilton depression scale-17 (HAMD-17), Hamilton anxiety scale (HAMA), five facet mindfulness questionnaire (FFMQ), and Young schema questionnaire-short form (YSQ-SF) were used for evaluation. The scores of the three time points were compared by one-way repeated measure ANOVA and Kruskal Wallis test. Pearson correlation analysis and multiple linear regression analysis were used to explore the relationship between the improvement degree of depression and anxiety symptoms, as well as the changes of mindfulness level and schema.Results:There were significant differences in the total scores of HAMD-17, HAMA and FFMQ at baseline((15.4±5.0), (21.0±9.6), (115.8±11.7)), 4 weeks after intervention((11.4±6.7), (15.9±10.1), (121.9±14.2)) and 8 weeks((11.0±6.2), (15.4±8.7), (122.6±15.5)) after intervention ( F=25.22, 20.95, 14.02, all P<0.01). Further pairwise comparison, compared with baseline, the total scores of HAMD-17 and HAMA in patients with depression decreased (all P<0.05), and the total scores of FFMQ increased (all P<0.05) in 8 weeks and 4 weeks after treatment.There were no significant differences in the total scores of HAMD-17, HAMA and FFMQ between 8 weeks and 4 weeks after treatment (all P>0.05). There were significant differences on the scores of the emotional deprivation, abandonment/instability, failure, vulner ability to harm or illness, enmeshment/undeveloped self, unrelenting standards/hypercriticalness, and entitlement/grandiosity subscales in the YSQ-SF( H=2.00-17.11, all P<0.05). Regression analysis showed that the FFMQ total score difference has a linear relationship with the HAMA total score difference ( β=-0.363). There was a linear relationship between the emotional deprivation scale score difference and the HAMD-17 total score difference ( β=-0.292). Dependence/incompetence and submission scale score difference showed a linear relationship with the HAMA total score difference ( β=0.334, 0.278). Conclusion:MBCT can improve the anxiety and depression symptoms of patients with depression, and the improvement of some EMSs may be the mechanism of MBCT in the treatment of depression.

Comparison of the performance of SCORTEN and ABCD-10 in evaluating the prognosis of Stevens-Johnson syndrome/toxic epidermal necrolysis / 中华皮肤科杂志

Objective:To compare the performance of the severity-of-illness score for toxic epidermal necrolysis (SCORTEN) and ABCD-10 (age, bicarbonate, cancer, dialysis, 10% body surface area) scoring systems in predicting death in patients with Stevens-Johnson syndrome (SJS) /toxic epidermal necrolysis (TEN) .Methods:Clinical data were collected from 85 patients with SJS/TEN who were hospitalized in Sichuan Provincial People′s Hospital from January 2010 to April 2021, and retrospectively analyzed. The predicted mortality and actual mortality were compared at each score level of SCORTEN and ABCD-10. The receiver operating characteristic (ROC) curve and Hosmer-Lemeshow goodness-of-fit test were used to evaluate the predictive power and calibration of SCORTEN and ABCD-10 on mortality.Results:Among the 85 patients, 37 were males and 48 were females, and their ages were 52.36 ± 19.31 years (range, 14 - 88 years) . There were 61 cases of SJS, 6 of SJS/TEN overlap, and 18 of TEN. Ten patients died in hospital and the fatality rate was 11.76%. Among the SCORTEN and ABCD-10 components, age > 40 years or ≥ 50 years, epidermal exfoliation > 10% body surface area on the 1st day after admission, heart rate > 120 beats per minute, serum urea nitrogen level > 10 mmol/L and serum bicarbonate level < 20 mmol/L were significantly correlated with death ( χ2 = 4.46, 6.18, 25.50, 15.13, 7.59, 8.38, respectively, all P < 0.05) , while malignancies, serum glucose level > 14 mmol/L, and pre-hospital dialysis were not significantly correlated with death ( χ2 = 0.35, 0.10, 1.38, respectively, all P > 0.05) . There were no significant differences between the predicted mortality and actual mortality at every score level of SCORTEN and ABCD-10 (all P > 0.05) . The ROC curve showed that both SCORTEN and ABCD-10 had good predictive power for death (areas under the curve: 0.874 and 0.867, 95% CI: 0.758 - 0.990, 0.773 - 0.962, respectively) , but the model goodness-of-fit of SCORTEN was superior to that of ABCD-10 ( P = 0.944, 0.048, respectively) . Conclusion:Both SCORTEN and ABCD-10 scoring systems could accurately predict mortality of SJS/TEN patients at early stage, but SCORTEN showed more favourable predictive power and calibration.