Objective To study the occurrence,risk factors,and direct economic losses caused by healthcare-asso-ciated infection(HAI)in hemodialysis patients in a hospital.Methods 840 patients who underwent hemodialysis in this hospital from April 2012 to September 2014 were selected,incidence of HAI,related factors,and economic los-ses due to HAI were investigated.Results Among 840 hemodialysis patients,89 patients developed 104 times of HAI,HAI density was 4.27‰ . Multivariate regression analysis showed that young age and old age,combined mul-tiple diseases,long duration of hemodialysis,two or more intubation sites,prolonged intubation,long length of hospital stay were all risk factors for HAI(OR= 1.123-2.325);Fees for bed,consultation,examination,treat-ment,nursing,medicine,and others in HAI group were all significantly higher than non-infected group(H= 49.6-1 038.9,all P<0.01 ),difference in medicine fees was most significant.Conclusion Risk factors for HAI are young age and old age,combined multiple diseases,long duration of hemodialysis,two or more intubation sites, prolonged intubation,and long length of hospital stay,the occurrence of HAI can increase the economic burden of hemodialysis patients.

Objective To investigate the curative effects of oxalic acid Ai Sciplan in assisting psychological therapy for coronary heart disease accompanied with depression. Methods A total of 136 patients of coronary heart disease with de?pression were randomly divided into control group and treatment group. The routine drug treatment was given to control group. Treatment group was given oxalic acid Ai Sciplan which is assisted by the psychological therapy based on the routine drug treatment schedule for six months. HAMD score before treatment, one-week, one-month, 3-month and 6-month after treatment were compared between two groups. Homocysteine (Hcy) and high sensitive C reactive protein (hs-CRP) levels were detected by circulating enzymatic method before treatment and 6-month after treatment. The WHO quality of life scale (WHOQOL-BREF) was used to assess the quality of life in two groups of patients. The improvements of angina and depressive symptoms were evaluated after 6-month treatment. The cardiovascular events were followed up in two groups. Re?sults HAMD scores significantly decreased after treatment in both groups (P < 0.05). HAMD scores at all different time points were significantly lower after treatment than those before treatment in treatment group. In control group, HAMD scores at different time points were also significantly lower after treatment than those before treatment, except time point of one week after treatment. The levels of Hcy and hs-CRP were decreased after treatment in two groups, and the levels were lower in treatment group than those of control group. Values of WHOQOL-BREF score, mental status, social relations and the sur?rounding environment scores were higher after treatment in both groups. Also they are higher in treatment group than that of control group. The angina and depressive symptoms were improved in treatment group. The incidences of angina, myocardial infarction, arrhythmia, heart failure, sudden cardiac death and other cardiovascular events were significantly lower in treat?ment group than those of control group (χ2=9.396, P<0.05). Conclusion Escitalopram oxalate combined with psychological therapy shows a significant beneficial effect and a better prognosis in the treatment of coronary heart disease and depression.

Objective To explore the correlation between CAE and the ratio of white blood cell count to mean platelet volume ratio(WMR)in elderly patients.Methods A retrospective analysis was conducted on 238 patients who underwent coronary angiography(CAG)between January 2018 and January 2023 in Department of Cardiology of Tianjin First Central Hospital.According to the results of CAG and patient's age,they were divided into in elderly CAE group(age ≥65 years,100 cases)and non-elderly CAE group(age＜65 years,138 cases).Another 127 age-matched elderly individuals with normal coronary artery(age ≥65 years)served as normal con-trol group.The WMR levels were measured in all participants.Results The elderly CAE group had significantly higher WMR than the non-elderly CAE group and the normal control group(745.50±237.46 vs 672.43±194.52 and 610.11±144.22,P=0.000).Spearman correlation analy-sis showed that WMR was positively correlated with platelet count,neutrophil count and high-sensitivity C-reactive protein level(r=0.380,P=0.000;r=0.819,P=0.000;r=0.283,P=0.000).Multiple logistic analysis indicated that readmission,male,TC and WMR were significantly associated with CAE in elderly patients.ROC curve analysis revealed that the value of WMR to distinguish the presence of CAE in elderly patients was 0.604(95％CI:0.531-0.677,P=0.006).Conclusion Elevated WMR might be a cost-effective monitor in elderly CAE patients.

Objective To evaluate the effect of artemether on the cell cycle and the radiosensitivity in human nasopharyngeal carcinoma cell line CNE-1.Methods Cell growth inhibition was assessed with MTT.The method of colony-forming was used to detect the radiation sensitivity.Cell cycle distribution was analyzed by using flow cytometry.The protein expressions of clyclin B1 and Weei were detected by using Western blot.Results The growth of CNE-1 cells was inhibited in a dose-dependent manner.The concentration of 20 μmol/L artemether had radiosensitive effect on CNE-1 cells at 24 h after administration,and SER was 1.481.When CNE-1 cell was irradiated,the G2/M cells increased (t =4.59,P ＜ 0.05).After exposure to combination of artemether and irradiation,the G2/M cells were decreased (t= 10.60,P ＜ 0.05).Western blot showed that artemether increased the level of cyclin B1 expression and inhibited the level of Weel expression.Conclusions The noncytotoxic concentration of artemether could enhance radiosensitization of CNE-1 cells.The radiosensitivity enhancement of artemether might depend on the exposure time.The effect is most obvious when radiation is delivered 24 h after expose to artemetherr.The radiosensitizing effect could be related to apoptosis.

Objective:To compare and analyze the clinical features of patients with severe coronavirus disease 2019 (sCOVID-19) and severe community acquired pneumonia (sCAP) who meet the diagnostic criteria for severe pneumonia of the Infectious Diseases Society of America/American Thoracic Society (IDSA/ATS).Methods:A retrospective comparative analysis of the clinical records of 116 patients with sCOVID-19 admitted to the department of critical care medicine of Wuhan Third Hospital from January 1, 2020 to March 31, 2020 and 135 patients with sCAP admitted to the department of critical care medicine of Shanghai First People's Hospital from January 1, 2010 to December 31, 2017 was conducted. The basic information, diagnosis and comorbidities, laboratory data, etiology and imaging results, treatment, prognosis and outcome of the patients were collected. The differences in clinical data between sCOVID-19 and sCAP patients were compared, and the risk factors of death were analyzed.Results:The 28-day mortality of sCOVID-19 and sCAP patients were 50.9% (59/116) and 37.0% (50/135), respectively. The proportion of arterial partial pressure of oxygen/fraction of inspired oxygen (PaO 2/FiO 2)≤250 mmHg (1 mmHg ≈ 0.133 kPa) in sCOVID-19 patients was significantly higher than that of sCAP [62.1% (72/116) vs. 34.8% (47/135), P < 0.01]. The possible reason was that the proportion of multiple lung lobe infiltration in sCOVID-19 was significantly higher than that caused by sCAP [94.0% (109/116) vs. 40.0% (54/135), P < 0.01], but the proportion of sCOVID-19 patients requiring mechanical ventilation was significantly lower than that of sCAP [45.7% (53/116) vs. 60.0% (81/135), P < 0.05]. Further analysis of clinical indicators related to patient death found that for sCOVID-19 patients PaO 2/FiO 2, white blood cell count (WBC), neutrophils (NEU), neutrophil percentage (NEU%), neutrophil/lymphocyte ratio (NLR), total bilirubin (TBil), blood urea nitrogen (BUN), albumin (ALB), Ca 2+, prothrombin time (PT), D-dimer, C-reactive protein (CRP) and other indicators were significantly different between the death group and the survival group, in addition, the proportion of receiving mechanical ventilation, gamma globulin, steroid hormones and fluid resuscitation in death group were higher than survival group. Logistic regression analysis showed that the need for mechanical ventilation, NLR > 10, TBil > 10 μmol/L, lactate dehydrogenase (LDH) > 250 U/L were risk factors for death at 28 days. For sCAP patients, there were significant differences in age, BUN, ALB, blood glucose (GLU), Ca 2+ and D-dimer between the death group and the survival group, but there was no significant difference in treatment. Logistic regression analysis showed that BUN > 7.14 mmol/L and ALB < 30 g/L were risk factors for 28-day death of sCAP patients. Conclusions:The sCOVID-19 patients in this cohort have worse oxygen condition and symptoms than sCAP patients, which may be due to the high proportion of lesions involving the lungs. The indicators of the difference between the death group and the survival group were similar in sCOVID-19 and sCAP patients. It is suggested that the two diseases have similar effects on renal function, nutritional status and coagulation function. But there were still differences in risk factors affecting survival. It may be that sCOVID-19 has a greater impact on lung oxygenation function, inflammatory cascade response, and liver function, while sCAP has a greater impact on renal function and nutritional status.

Gradual distraction with an external fixator is a widely used treatment for severe postburn ankle contracture (SPAC). However, application of external fixators is complex, and conventional two-dimensional (2D) imaging-based surgical planning is not particularly helpful due to a lack of spatial geometry. The purpose of this study was to evaluate the surgical planning process for this procedure with patient-specific three-dimension-printed models (3DPMs). In this study, patients coming from two centers were divided into two cohorts (3DPM group vs. control group) depending on whether a 3DPM was used for preoperative surgical planning. Operation duration, improvement in metatarsal-tibial angle (MTA), range of motion (ROM), the American Orthopedic Foot and Ankle Society (AOFAS) scores, complications, and patient-reported satisfaction were compared between two groups. The 3DPM group had significantly shorter operation duration than the control group ((2.0±0.3) h vs. (3.2±0.3) h,