[Etiological diagnostic value of metagenomic next-generation sequencing in peritoneal dialysis-related peritonitis].

Objective: To explore the etiological diagnostic value of metagenomic next-generation sequencing (mNGS) in peritoneal dialysis (PD)-related peritonitis. Methods: The study was a retrospective cohort study. The clinical data of patients with PD-related peritonitis who were treated and underwent microbial cultivation and mNGS test at the same time from June 2020 to July 2021 in the Affiliated Drum Tower Hospital, Medical School of Nanjing University were analyzed. The positive rate, detection time and consistency between mNGS test and traditional microbial culture were compared. Results: A total of 18 patients with age of (50.4±15.4) years old and median dialysis time of 34.0 (12.4, 62.0) months were enrolled in the study, including 11 males and 7 females. Pathogenic microorganisms were isolated in 17 patients by mNGS test, with a positive rate of 17/18, which was higher than 13/18 of microbial culture, but the difference was not statistically significant (P=0.219). Both mNGS test and microbial culture isolated positive pathogenic bacteria in 12 patients, and mNGS test isolated the same types of pathogenic bacteria as microbial cultivation did in 11 patients. In five patients with negative microbial culture, mNGS test also isolated pathogenic microorganisms, including 3 cases of Staphylococcus epidermidis, 1 case of Mycobacterium tuberculosis and 1 case of Ureaplasma urealyticum. In 1 patient, microbial culture isolated pathogenic bacteria (Escherichia coli) whereas mNGS test did not. The detection time of mNGS was 25.0 (24.0, 27.0) h, which was significantly shorter than 89.0 (72.8, 122.0) h of microbial culture (Z=3.726, P<0.001). Conclusions: mNGS test can improve the detection rate of pathogenic microorganisms in PD-related peritonitis and greatly shorten the detection time, and has good consistency with microbial culture. mNGS may provide a new approach for pathogen identification of PD-related peritonitis, especially refractory peritonitis.

[The role of respiratory therapy in respiratory rehabilitation of critically ill patients].

The job description of respiratory therapists can cover emergency room, intensive care unit (ICU), post-ICU ward and specialized wards. Therefore, patient-centered respiratory rehabilitation in critically ill patients includes prevention of admission to ICU, respiratory care during ICU, and respiratory care after ICU. Respiratory therapists evaluate, diagnose and treat patients' respiratory function, forming a closed-loop management scheme of prevention, evaluation, treatment, reassessment, and adjustment.

[Icariin reduces S-nitrosogultathione induced endothelial cell apoptosis through modulating AKT/P53 pathway].

OBJECTIVE: To observe the effects of icariin on S-nitrosogultathione(GSNO) induced endothelial cell apoptosis, and to explore the relative mechanisms. METHODS: EA.hy926 cell line was provided by Zhejiang University and cells were divided into blank control group, GSNO group (1 mmol/L GSNO), icariin (ICA) intervention group (GSNO+ different concentrations (high, medium and low: 10, 1 and 0.1 µmol/L ICA) and 1 µmol/L LY294002 pretreatment groups (AKT protease pathway inhibitor on top of ICA groups) by cluster random sample method. After 48 hours. EA.hy 926 cell survival was detected by thiazolyl blue tetrazolium bromicle (MTT) method. Lactate dehydrogenase (LDH) activity, malonaldehyde (MDA) content, reactive oxygen species (ROS) level, mitochondrial membrane potential were also measured. The protein expression of protein kinase B(AKT)/phosphorylation protein kinase B(p-AKT), people tumor-suppressor protein (protein 53, P53), cytochrome C (CYC), endothelial nitric oxide synthetase (eNOS)/phosphorylation endothelial nitric oxide synthetase (p-eNOS), procaspase-3/caspase-3 was detected by Western blot. RESULTS: (1) The cell survival rate was significantly lower in GSNO group than in the blank control group (P< 0.01), which was significantly higher in the high, medium and low concentration ICA groups than in the GSNO group (all P< 0.01). (2) The LDH activity was significantly higher in the GSNO group than in the blank control group ((142.65±5.56) U/L vs. (50.01±3.42) U/L, P< 0.05), which was significantly reduced by high, medium and low concentration ICA ((98.02±3.52), (105.29±6.89) and (117.16±4.27) U/L vs. (142.65±5.56) U/L, all P< 0.05) in a dose-dependent manner. (3) The MDA content was significantly higher in GSNO group than in the blank control group ((11.14±0.37) nmol/mg vs. (5.21±0.18) nmol/mg, P< 0.05), which could be reduced by pretreatment with high, medium and low concentration ICA ((6.60±0.41), (6.83±0.21) and (8.29±0.07) nmol/mg vs. (11.14 ±0.37) nmol/mg, all P< 0.05). (4) The ROS content was significantly higher in GSNO group than in the blank control group ((173.15±11.12)% (relative ratio to the blank control group), P< 0.05), which could be significantly reduced by pretreatment with high, medium and low concentration ICA ((122.56±8.09)%, (134.52±9.09)%, and(149.89±9.16)% (the ratio of the above are compared with the blank control group), P< 0.05). (5) The mitochondrial membrane potential was significantly higher in the GSNO group (0.84 ± 0.04) than in the blank control group (0.12 ±0.12), which could be significantly reduced by pretreatment with high, medium and low concentration ICA ((0.57±0.08), (0.63±0.02), (0.66±0.04) vs. (0.84±0.04), all P<0.05). (6) The expression of AKT/p-AKT was significantly lower in GSNO group than in the blank control group (P< 0.05), which could be significantly upregulated by pretreatment with high, medium and low concentration ICA in a concentration-dependent manner, above effects could be blocked by LY294002 (all P<0.05). (7) The expression of P53 was significantly higher in GSNO group than in the blank control group (P< 0.05), which could be significantly down regulated by pretreatment with high, medium and low concentration ICA in a concentration-dependent manner, above effects could be blocked by LY294002(all P<0.05). (8) The expression of CYC and caspase-3 was significantly reduced in the mitochondria and increased in cytoplasm post GSNO treatment compared to blank control group, which could be reversed by pretreatment with high, medium and low concentration ICA(all P<0.05). (9) The expression of eNOS/p-eNOS was similar between GSNO and the blank control group, while it was significantly upregulated by pretreatment with high, medium and low concentration ICA and this effect could be blocked by LY294002(all P<0.05). CONCLUSION: Icariin could reduce GSNO induced endothelial cell apoptosis through activating AKT pathway and downregulating P53 activity.

[Efficacy of PD-1 inhibitors combined with nab-paclitaxel and cisplatin in the neoadjuvant treatment of locally advanced hypopharyngeal squamous cell carcinoma].

Objective: To assess the efficacy of neoadjuvant treatment with PD-1 (programmed cell death protein 1) inhibitors combined with paclitaxel (albumin-conjugated) and cisplatin (TP regimen) for locally advanced hypopharyngeal squamous cell carcinoma and laryngeal organ function preservation. Methods: Data of 53 patients, including 51 males and 2 females, aged 38-70 years old, who were diagnosed with locally advanced hypopharyngeal squamous carcinoma confirmed by histology and enhanced CT at the Cancer Prevention and Control Center of Sun Yat-sen University during the initial treatment from January 1, 2019 to January 15, 2023, were retrospectively analyzed. All patients received neoadjuvant therapy with PD-1 inhibitors combined with albumin-bound paclitaxel (260 mg/m2) and cisplatin (60 mg/m2) for 3 to 4 cycles. The main outcome measures were larynx dysfunction-free survival (LDFS), overall survival (OS), and progression-free survival (PFS). Survival curves were plotted using the Kaplan-Meier method, and Cox multifactorial analysis was further performed if Cox univariate analysis was statistically significant. Results: The overall efficiency was 90.6% (48/53). The 1-year and 2-year LDFS rates were 83.8% (95%CI: 74.0% to 94.8%) and 50.3% (95%CI: 22.1% to 91.6%), the 1-year and 2-year OS rates were 95.2% (95%CI: 88.9% to 100.0%) and 58.2% (95%CI: 25.6% to 81.8%), and the 1-year and 2-year PFS rates were 83.9% (95%CI: 74.2% to 94.9%) and 53.5% (95%CI: 32.1% to 89.1%). Adverse events associated with the neoadjuvant therapy were mainly myelosuppression (45.3%), gastrointestinal reactions (37.7%) and hypothyroidism (20.8%). Conclusion: The neoadjuvant treatment of locally advanced hypopharyngeal squamous cell carcinoma using PD-1 inhibitors combined with paclitaxel and cisplatin can provide with a higher survival rate with a improved laryngeal organ function preservation rate.

MiR-372-3p inhibits the growth and metastasis of osteosarcoma cells by targeting FXYD6.

OBJECTIVE: Growing evidence has suggested that dysregulation of miR-372-3p may contribute to tumor development and progression in various tumors. However, the function of miR-372-3p in osteosarcoma has not been investigated. In the present study, we aimed to study the effects of miR-372-3p on osteosarcoma cell proliferation and metastasis and its regulation on FXYD6. MATERIALS AND METHODS: The expression levels of miR-372-3p and FXYD6 mRNA were quantified by RT-PCR in human osteosarcoma cell lines and tissues. The effects of miR-372-3p up-regulation on osteosarcoma cell proliferation and metastasis were assessed by MTT, wound healing assay and transwell assay. Finally, the potential regulatory effect of miR-372-3p on FXYD6 expression was confirmed. RESULTS: Our data showed that miR-372-3p was downregulated in osteosarcoma tissues compared with matched normal tissues, and the expression level of miR-372-3p was significantly lower in osteosarcoma cell lines in comparison with the normal human osteoblastic cell line. Transfection with the miR-372-3p mimic enhanced the osteosarcoma proliferation and metastasis. In vivo assay indicated that forced expression of miR-372-3p significantly suppressed tumor growth. Then, Bioinformatics prediction and experimental validation results confirmed that the function of miR-372-3p was achieved by targeting FXYD6 expression. CONCLUSIONS: Our findings revealed that miR-372-3p served as a tumor suppressor gene by targeting FXYD6 in osteosarcoma. Thus, miR-372-3 might be a potential therapeutic method for osteosarcoma.

[Antigen signature analysis of dengue-2 viruses strains in Hainan China].

In this paper, we try to define the extent of antigenic variation between dengue-2 viruses from Hainan province, which had been isolated over a period of 3 years (1985-1987). The dengue-2 viruses were compared with the prototype New Guinea B strain and were subjected to antigen signature analysis. Eight strains of dengue-2 virus were analyzed by three monoclonal antibodies: flavivirus group, subcomplex dengue-2 type-specific reactive epitopes, over a range of antigen concentration. Five out of eight dengue-2 virus strains showed them to be antigenically homogeneous, and the remaining three strains showed them to be heterogeneous. Signature analysis provides a rapid and simple means to different strains derived from different sources, thus permit monitoring changes or introductions of hew dengue virus populations in certain geographic region.

Voxel-based morphometry study of the insular cortex in female patients with current and remitted depression.

OBJECTIVE: Women are more prone to major depressive disorders (MDDs) and the incidence of MDD in women is almost twice that of men. Insular cortex abnormalities are a common finding in neuroanatomical studies of patients with MDD. However, it remains largely unclear whether female MDD patients at different clinical stages show morphologic changes in a specific subregion of the insular cortex. Additionally, it is not understood if any subregion changes can be used as a state or trait marker of MDD, and whether the diagnostic performance of any marker is sufficient to identify MDD. METHODS: Nineteen right-handed current MDD (cMDD) female patients and 19 remitted MDD (rMDD) patients, as well as 19 healthy controls matched for age and educational level, were recruited into the study. By means of voxel-based morphometry (VBM), we investigated gray matter volume abnormalities in insular subregions among the three groups and further conducted region-of-interest (ROI)-based receiver operating characteristic (ROC) analyses. The data from these investigations were correlated with clinical data to confirm the effectiveness of the identified changes in the subregions in differentiating the three groups. RESULTS: Both the cMDD and rMDD groups showed significantly decreased gray matter volumes in the left dorsal anterior insula compared to the healthy controls. The cMDD groups also showed decreased gray matter volumes in the right dorsal anterior insula relative to healthy controls. Further ROC comparisons demonstrated that the left dorsal anterior insula can effectively differentiate cMDD and rMDD groups from healthy controls. CONCLUSIONS: Our findings suggest that the volume changes in the left dorsal anterior insular cortex may be a trait-related marker of vulnerability to MDD and that the right dorsal anterior insular cortex may involve pathological changes of MDD.

Hypoxia decreased chemosensitivity of breast cancer cell line MCF-7 to paclitaxel through cyclin B1.

Hypoxia, frequently found in the center of solid tumors, may lead to enhance the production of key factor in cell survival, invasion, angiogenesis and loss of apoptosis. The low oxygen tension in hypoxic tumors is also known to interfere with the efficacy of chemotherapy, but the underlying mechanisms are not very clear. Paclitaxel (PTX) is an active agent used in breast cancer chemotherapy, which disturbs microtubule dynamics and impairs the transition of cells from metaphase to anaphase in mitosis, leading to cell death by apoptosis. In the present study, we try to determine whether hypoxia can decrease the chemosensitivity of human breast carcinoma cells to PTX and elucidate the underlying mechanism. We found that hypoxia could decrease PTX-induced cell death and G(2)/M arrest. Furthermore, our results showed that hypoxia inhibit PTX-induced soluble tubulin polymerized. In addition, we also found hypoxia could suppress PTX-induced cell cycle protein-cyclin B1 expression in MCF-7 cells. To further investigate whether the inhibitory effect of hypoxia on PTX-induced cell death is mediated by decreasing levels of cyclin B1, cyclin B1-transfected MCF-7 cells were used under hypoxic condition. The data showed that the hypoxia-based decreasing chemosensitivity of breast cancer cells to PTX was reversed by cyclin B1. We also found that overexpression of cyclin B1 could significantly increase the sensitivity of MCF-7 cells to PTX by stimulating soluble polymerized tubulin. Overall, hypoxia decreases cyclin B1, which could in turn reverse hypoxia-induced decreasing chemosensitivity to PTX in breast cancer cell line MCF-7.

[Study on the psychological character of pregnant women and nursing applications].

This study was conducted to explore the psychological character of healthy pregnant women. 81 four to ten months pregnant and 96 non pregnant women participated the study. SCL-90 was used to measure the psychological health state. The result showed that the average total and subtotal scores such as compulsion, sensitivity, stress, hostility, terror, obstinate, and psychiatric factor in pregnant women were obvious higher than in non pregnant women (P < 0.05 or P < 0.01). It indicated that pregnant women's psychological health state was not good. The major influencing factor was unhealthy characteristic type. It recommends that nurses should give advice and care to the pregnant women according to the individual's unhealthy psychological character to benefit both the mother and baby.