To investigate the effects of serum containing Yiqi Huayu Bushen Recipe, a compound Chinese herbal medicine, on expressions of aggrecan and type X collagen mRNAs of the degenerated intervertebral disc cells in patients with cervical spondylotic myelopathy.

Objective To investigate the value of detection of human epididymal epithelial secretory protein (HE4) ,carbohy-drate antigen (CA125) and carbohydrate antigen (CA199) in the early diagnosis of ovarian cancer .Methods The clinical data of patients admitted to the hospital from June 2014 to August 2016 were collected from Renmin Hospital of Wuhan University .Ac-cording to the postoperative pathology ,the patients were divided into ovarian cancer group and ovarian benign tumor group .There were 90 cases in ovarian cancer group and 94 cases in ovarian benign tumor group ,98 cases of healthy women in the physical exami-nation center of this hospital were selected as healthy control group .HE4 was detected by ELISA ,serum CA125 and CA199 were detected by chemiluminescence method .Results Compared with healthy control group ,the tumor markers of serum HE4 ,CA125 and CA199 levels were significantly increased (P<0 .01) ,and HE4 and CA125 levels increased more significantly .Compared with ovarian benign tumor group ,the levels of HE4 and CA125 significantly increased in ovarian cancer group ,the difference was statisti-cally significant (P<0 .01) ,and the increase of CA199 less(P<0 .05) .Compared with healthy control group ,the levels of CA125 and CA199 in the benign ovarian tumor group were significantly increased (P<0 .05) .Correlation analysis showed that there were strong correlations between the 3 indexes of HE4 ,CA125 and CA199 in the ovarian cancer group(P<0 .01) .The sensitivity of ser-um CA125 was highest (87 .8% ) in the detection of single marker of ovarian cancer ,while the specificity of serum HE4 was the highest(95 .7% ) .The sensitivity of combined detection of serum HE4 ,CA125 and CA199 was the highest (96 .7% ) ,but the speci-ficity was poor (61 .0% ) .Conclusion Combined detection of serum HE4 ,CA125 and CA199 could significantly improve the early detection rate of ovarian cancer ,but the specificity must be combined with other laboratory tests ,comprehensive analysis and diag-nosis .

BACKGROUNDTo evaluate the clinical significance of predicting post-operative respiratory failure in patients with lung cancer using cardiopulmonary exercise test (CPET).

METHODSBefore operation, 260 patients with lung cancer underwent CPET with incremental protocol. W%, VO₂%P, VO₂/kg, AT, MET, O₂ pulse, VTe, BF and VE were measured in the end of load exercise.

RESULTS(1) In patients after pneumonectomy, the values of the above indexes of CPET in the respiratory failure group were significantly lower than those in the non-respiratory failure group ( P < 0.05 or P < 0.01) except VTe. In patients after lobectomy, the values of 9 indexes of CPET in the respiratory failure group were similar to those in the non-respiratory failure group ( P > 0.05). However, when the patients after lobectomy were further divided into groups of upper and lower lobectomy, W% in the respiratory failure group was remarkably lower than that in the non-respiratory failure group after lower lobectomy ( P < 0.05). (2) Chi-Square test showed that abnormality of CPET indexes in different degrees was related to the morbidity of respiratory failure after pneumonectomy. Logistic regression showed that O₂ pulse < 80% and BF < 30/min correlated with the morbidity of post-operative respiratory failure. (3) For predicting post-operative respiratory failure, the sensitivity and specificity of VO₂%P < 60%, BF < 30/min, VE < 35 L/min were all more than 60% and their negative predictive values were all more than 90%.

CONCLUSIONSCPET is suitable to predict post-pneumonectomy respiratory failure. As a comprehensive index indicating cardiopulmonary function during exercise, VO₂%P < 60% should be selected to predict respiratory failure and evaluate indication of lung resection for patients with lung cancer.

BACKGROUNDTo explore the characteristics of exercise cardio-pulmonary function and its possible influencing factors in patients with lung cancer.

METHODSThe pulmonary function, ECG and exercise cardio-pulmonary function were measured in 198 patients with lung cancer and 20 healthy controls.

RESULTS1. Compared with healthy group, VO₂%P, VO₂/kg, AT, VO₂/HR%, VE and VT/VC significantly decreased in lung cancer patients with normal resting pulmonary ventilation, however, BR remarkably increased (P < 0.05 or P < 0.01). 2. In patients with normal resting pulmonary ventilation, there was no significant difference of exercise cardio-pulmonary function between the central and peripheral lung cancer groups. 3. The exercise cardio-pulmonary function was closely related to the TNM stages (P < 0.05 or P < 0.01). 4. W%, VO₂%P , AT and VO₂/HR% in patients with great vessel invasion were remarkably lower than those without great vessel invasion (P < 0.05 or P < 0.01).

CONCLUSIONSThe results suggest that exercise ventilation is impaired in lung cancer patients with normal resting ventilation. And the decrease of exercise cardio-pulmonary function may be related to TNM stage and to great vessel involvement.

Objective To summarize the treatment status and key nursing point of 56 liver cancer patients with iAPA DC-CTL.Methods According to the treatment document of 56 cases using vein transfused iAPA DC-CTL immune cell therapy, we summarized the reaction and explained nursing status and matters needed attention before transfusion, blood taking, transfusion and after transfusion. Results All 56 patients completed the therapy and no one found out the adverse effects.Conclusions To strengthen the nursing of iAPA DC-CLT treatment in primary liver cancer patients can improve patients quality of life and immune function, and reduce adverse effects.

Objective:To analyze the occurrence characteristics of heat-related diseases in the 19th Hangzhou Asian Games beach volleyball events, strengthen the ability of prevention and early identification of heat-related diseases, and provide reference for the holding of large-scale outdoor events in summer and reasonable allocation of medical resources.Methods:The medical insurance of heat-related diseases of relevant personnel in the beach volleyball competition from September 19 to September 28, 2023 was retrospectively analyzed, and the incidence of heat-related diseases in the personnel involved in Asia was analyzed.Results:During the beach volleyball competition in Ningbo Region of the Hangzhou Asian Games, a total of 103 people were provided with health services in the medical service field (61 people had mild discomfort due to excessive outdoor temperature; Other cold, minor injury, bandage 42 people); Medical services provided 44 times (4 referrals). Among them, 11 cases were sports injury and trauma (29.5%), 11 cases were heat stroke and other related symptoms (25%), 6 cases were sunburn (13.6%), 10 cases were oral diseases of five senses (22.8%), 4 cases were upper respiratory tract infection (9.1%).Conclusions:The holding of large-scale outdoor events in summer should focus on heat-related diseases, and it is necessary to effectively do the corresponding planning work in advance in terms of reasonable allocation of medical resources and targeted training of professionals.

Objective To compare the influence between self-monitoring of blood gluocose(SMBG)combined with digital diabetes management and traditional management mode on the related clinical indexes in the patients with type 2 diabetes mellitus(T2DM).Methods A total of 100 patients with T2DM treated in the endocrinology and metabolism outpatient department of this hospital from January 2022 to June 2022 and meeting the inclusion criteria of this study were successively included.They were divided into the experimental group and control group.The experimental group was managed by SMBG combined with digital diabetes man-agement mode,while the control group adopted the traditional management mode,the outpatient clinic follow up once a month.After 6 months of follow-up,fasting blood glucose,glycosylated hemoglobin(HbA1c),low density lipoprotein cholesterol(LDL-C)and urinary microalbumin/creatinine ratio(UACR)were compared between the two groups.Results The FBG,HbA1c,LDL-C,and UACR of the experimental group decreased after intervention when compared with baseline.Compared with the control group,the FBG[8.7(7.7,9.2)mmol/L vs.10.8(8.8,12.7)mmol/L,Z=-4.660,P＜0.001],HbA1c[6.3％(5.3,7.8)％vs.8.5％(7.2,10.0)％,Z=-5.130,P＜0.001],LDL-C[2.6(1.8,3.1)mmol/L vs.3.3(2.6,4.0)mmol/L,Z=-4.112,P＜0.001],UACR[16.1(3.5,46.5)mg/g vs.58.4(11.9,108.0)mg/g,Z=-2.220,P=0.026]for patients in the expriemental group after intervention were significantly decreased.Conclusion SMBG combined with digital diabetes management model can significantly improve the clinical indicators of patients.

Objective:To study the current status of longitudinal extrauterine growth restriction (EUGR) in extremely preterm infants (EPIs) and to develop a prediction model based on clinical data from multiple NICUs.Methods:From January 2017 to December 2018, EPIs admitted to 32 NICUs in North China were retrospectively studied. Their general conditions, nutritional support, complications during hospitalization and weight changes were reviewed. Weight loss between birth and discharge > 1SD was defined as longitudinal EUGR. The EPIs were assigned into longitudinal EUGR group and non-EUGR group and their nutritional support and weight changes were compared. The EPIs were randomly assigned into the training dataset and the validation dataset with a ratio of 7∶3. Univariate Cox regression analysis and multiple regression analysis were used in the training dataset to select the independent predictive factors. The best-fitting Nomogram model predicting longitudinal EUGR was established based on Akaike Information Criterion. The model was evaluated for discrimination efficacy, calibration and clinical decision curve analysis.Results:A total of 436 EPIs were included in this study, with a mean gestational age of (26.9±0.9) weeks and a birth weight of (989±171) g. The incidence of longitudinal EUGR was 82.3%(359/436). Seven variables (birth weight Z-score, weight loss, weight growth velocity, the proportion of breast milk ≥75% within 3 d before discharge, invasive mechanical ventilation ≥7 d, maternal antenatal corticosteroids use and bronchopulmonary dysplasia) were selected to establish the prediction model. The area under the receiver operating characteristic curve of the training dataset and the validation dataset were 0.870 (95% CI 0.820-0.920) and 0.879 (95% CI 0.815-0.942), suggesting good discrimination efficacy. The calibration curve indicated a good fit of the model ( P>0.05). The decision curve analysis showed positive net benefits at all thresholds. Conclusions:Currently, EPIs have a high incidence of longitudinal EUGR. The prediction model is helpful for early identification and intervention for EPIs with higher risks of longitudinal EUGR. It is necessary to expand the sample size and conduct prospective studies to optimize and validate the prediction model in the future.

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.

Objective:To investigate the distribution and antimicrobial resistance profile of clinical bacteria isolated from blood culture in China.Methods:The clinical bacterial strains isolated from blood culture from member hospitals of Blood Bacterial Resistant Investigation Collaborative System (BRICS) were collected during January 2016 to December 2017. Antibiotic susceptibility tests were conducted by agar dilution or broth dilution methods recommended by US Clinical and Laboratory Standards Institute (CLSI) 2019. WHONET 5.6 was used to analyze data.Results:During the study period, 8 154 bacterial strains were collected from 33 hospitals, of which 2 325 (28.5%) were Gram-positive bacteria and 5 829 (71.5%) were Gram-negative bacteria. The top 10 bacterial species were Escherichia coli (34.7%), Klebsiella pneumoniae (15.8%), Staphylococcus aureus (11.3%), coagulase-negative Staphylococci (7.4%), Acinetobacter baumannii (4.6%), Pseudomonas aeruginosa (3.9%), Enterococcus faecium (3.8%), Streptococci (2.9%), Enterobacter cloacae (2.7%) and Enterococcus faecalis (2.5%). Methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase-negative Staphylococcus (MRCNS) accounted for 34.2%(315/922) and 77.7%(470/605), respectively. No vancomycin-resistant Staphylococcus was detected. The resistance rate of Enterococcus faecium to vancomycin was 0.6%(2/312), and no vancomycin-resistant Enterococcus faecium was detected. The ESBLs-producing rates in Escherichia coli, Klebsiella pneumoniae and Proteus were 55.7%(1 576/2 831), 29.9%(386/1 289) and 38.5%(15/39), respectively. The incidences of carbapenem-resistance in Escherichia coli, Klebsiella pneumoniae were 1.2%(33/2 831), 17.5%(226/1 289), respectively. The resistance rates of Acinetobacter baumannii to polymyxin and tigecycline were 14.8%(55/372) and 5.9%(22/372) respectively, and those of Pseudomonas aeruginosa to polymyxin and carbapenem were 1.3%(4/315) and 18.7%(59/315), respectively. Conclusion:The surveillance results from 2016 to 2017 showed that the main pathogens of blood stream infection in China were gram-negative bacteria, while Escherichia coli was the most common pathogen; the MRSA incidence was lower than other surveillance data in the same period in China; carbapenem-resistant Escherichia coli was at a low level during this surveillance, while carbapenem-resistant Klebsiella pneumoniae is on the rise.