Objective:To compare the efficacy of individualized PEEP determined by lung electrical impedance tomography (EIT) and dynamic lung compliance (Cdyn) during lung-protective ventilation strategies in the patients undergoing general anesthesia.Methods:Sixty patients of both sexes, aged 18-64 yr, of American Society of Anesthesiologists physical status Ⅰor Ⅱ, with body mass index of 18.5-28.0 kg/m 2, undergoing elective surgery with general anesthesia and endotracheal intubation in the Second Affiliated Hospital of Soochow University, were selected.Lung-protective ventilation strategy was applied in supine position after general anesthesia.The peak value of PEEP did not exceed 10 cmH 2O, with an increment/decrement of 2 cmH 2O for titration.The corresponding Cdyn value and lung EIT data were collected during titration.The patients were divided into 2 groups ( n=30 each) using a random number table method: titration first increased and then decreased group (group A) and titration first decreased and then increased group (group B). The determination method of individualized PEEP: Cdyn method was the PEEP corresponding to the maximum Cdyn value; EIT method was obtained through PV500 PC software analysis.The level and success rate of individualized PEEP determined by the Cdyn and EIT methods were compared, and the ICC consistency analysis of the determined individualized PEEP was performed. Results:Compared with the Cdyn method, the success rate of individualized PEEP determined by EIT method was significantly increased, and the level of individualized PEEP was decreased in the two group ( P<0.05). In group A, the individualized PEEP titrated by the EIT and Cdyn methods showed good agreement (the ICC value of the increment-Cdyn and increment-EIT methods was 0.761, P<0.05; the ICC value of the decrement-Cdyn and decrement-EIT methods was 0.763, P<0.05). In group B, the individualized PEEP titrated by the EIT and Cdyn methods showed good agreement (the ICC value of the increment-Cdyn and increment-EIT methods was 0.809, P<0.05; the ICC value of the decrement-Cdyn and decrement-EIT methods was 0.797, P<0.05). Conclusion:The agreement between the individualized PEEP determined by lung EIT method and Cdyn method during lung-protective ventilation is good in the patients undergoing general anesthesia, and the success rate of EIT method is higher, and the level of individualized PEEP is lower.

Objective To analyze the correlation between the drug resistance rate of common pathogens in blood culture of inpatients from the First Hospital Affiliated to Hebei North University from 2019 to 2021 and the frequency of antimicrobial drug use(DDDs).Methods Strains isolated from positive blood cultures of inpatients from 2019 to 2021 were collected,and data on antimicrobial drug use in patients with positive blood cultures during the same period were also collected.WHONET 5.6 software and Pearson correlation analysis were used to explore the correlation between pathogenic bacterial resistance rate and antimicrobial DDDs.Results A total of 916 samples tested positive in blood cultures from 2019 to 2021.Among the top antimicrobial drugs in DDDs,the DDDs of cefazolin,cefuroxime,and ceftazidime all showed an upward trend year by year(the increase from 2019 to 2021 was 38.8％,228.3％,and 87.1％,respectively).A total of 739 pathogenic bacteria strains were isolated from positive blood culture samples from 2019 to 2021,and the top five pathogenic bacteria were Escherichia coli,Klebsiella pneumoniae,Staphylococcus epidermidis,Staphylococcus aureus,and Pseudomonas aeruginosa,accounting for 37.2％,16.1％,8.1％,7.4％,and 6.5％,respective-ly.The drug resistance rates of Escherichia coli to cefazolin,ceftazidime,cefotaxime,and polymyxin B were positively correlated with their DDDs(r=0.961,0.907,0.988,0.997,P＜0.05).The drug resistance rates of Klebsiella pneumoniae to piperacillin,cefazolin,cefotaxime,cefepime,az-treonam,imipenem,meropenem,levofloxacin,and polymyxin B were positively correlated with their DDDs(r=0.766,0.772,0.838,0.667,0.734,0.821,0.904,0.980,0.997,P＜0.05).The drug resistance rate of Pseudomonas aeruginosa to gentamicin was positively correlated with their DDDs(r=0.878,P＜0.05).The drug resistance rate of Acinetobacter baumannii to moxi-floxacin was positively correlated with its DDDs(r=0.856,P＜0.05).However,there was no corre-lation between the drug resistance rates of Staphylococcus aureus and Staphylococcus epidermidis to most commonly used antimicrobial drugs and antimicrobial DDDs(P＞0.05).Conclusion The patho-genic bacteria causing bloodstream infections in inpatients at the First Hospital Affiliated to Hebei North University from 2019 to 2021 are complex and diverse(mainly Gram-negative bacteria).The overall drug resistance rate of pathogenic bacteria shows an upward trend,and there is a correlation between the drug resistance rates of most pathogenic bacteria and antimicrobial DDDs.

Objective To analyze the correlation between the drug resistance rate of common pathogens in blood culture of inpatients from the First Hospital Affiliated to Hebei North University from 2019 to 2021 and the frequency of antimicrobial drug use(DDDs).Methods Strains isolated from positive blood cultures of inpatients from 2019 to 2021 were collected,and data on antimicrobial drug use in patients with positive blood cultures during the same period were also collected.WHONET 5.6 software and Pearson correlation analysis were used to explore the correlation between pathogenic bacterial resistance rate and antimicrobial DDDs.Results A total of 916 samples tested positive in blood cultures from 2019 to 2021.Among the top antimicrobial drugs in DDDs,the DDDs of cefazolin,cefuroxime,and ceftazidime all showed an upward trend year by year(the increase from 2019 to 2021 was 38.8％,228.3％,and 87.1％,respectively).A total of 739 pathogenic bacteria strains were isolated from positive blood culture samples from 2019 to 2021,and the top five pathogenic bacteria were Escherichia coli,Klebsiella pneumoniae,Staphylococcus epidermidis,Staphylococcus aureus,and Pseudomonas aeruginosa,accounting for 37.2％,16.1％,8.1％,7.4％,and 6.5％,respective-ly.The drug resistance rates of Escherichia coli to cefazolin,ceftazidime,cefotaxime,and polymyxin B were positively correlated with their DDDs(r=0.961,0.907,0.988,0.997,P＜0.05).The drug resistance rates of Klebsiella pneumoniae to piperacillin,cefazolin,cefotaxime,cefepime,az-treonam,imipenem,meropenem,levofloxacin,and polymyxin B were positively correlated with their DDDs(r=0.766,0.772,0.838,0.667,0.734,0.821,0.904,0.980,0.997,P＜0.05).The drug resistance rate of Pseudomonas aeruginosa to gentamicin was positively correlated with their DDDs(r=0.878,P＜0.05).The drug resistance rate of Acinetobacter baumannii to moxi-floxacin was positively correlated with its DDDs(r=0.856,P＜0.05).However,there was no corre-lation between the drug resistance rates of Staphylococcus aureus and Staphylococcus epidermidis to most commonly used antimicrobial drugs and antimicrobial DDDs(P＞0.05).Conclusion The patho-genic bacteria causing bloodstream infections in inpatients at the First Hospital Affiliated to Hebei North University from 2019 to 2021 are complex and diverse(mainly Gram-negative bacteria).The overall drug resistance rate of pathogenic bacteria shows an upward trend,and there is a correlation between the drug resistance rates of most pathogenic bacteria and antimicrobial DDDs.

Targeted protein degradation (TPD) technology facilitates specific and efficient degradation of disease-related proteins through hijacking the two major protein degradation systems in mammalian cells: ubiquitin-proteasome system and lysosome pathway. Compared with traditional small molecule-inhibitors, TPD-based drugs exhibit the characteristics of a broader target spectrum. Compared with techniques interfere with protein expression on the gene and mRNA level, TPD-based drugs are target-specific, efficaciously rapid, and not constrained by post-translational modification of proteins. In the past 20 years, various TPD-based technologies have been developed. Most excitingly, two TPD-based therapeutic drugs have been approved by FDA for phase Ⅰ clinical trials in 2019. Despite of the early stage characteristics and various obstructions of the TPD technology, it could serve as a powerful tool for the development of novel drugs. This review summarizes the advances of different degradation systems based on TPD technologies and their applications in disease therapy. Moreover, the advantages and challenges of various technologies were discussed systematically, with the aim to provide theoretical guidance for further application of TPD technologies in scientific research and drug development.
Animals ; Proteasome Endopeptidase Complex/metabolism* ; Protein Processing, Post-Translational ; Proteins/metabolism* ; Proteolysis ; Technology