Objective To investigate the mycelia growth of the mutant strain Paecilomyces bainier sp229-7 and it's biotransformation from ginsenoside Rb1 to Rd. Methods The substrate was biotransformed by the mutant in different conditions, and the products were analyzed by HPLC. Results The period of vigorous growth of the mutant was 12-48 h. The optimal transformation temperature range was from 27 ℃ to 32 ℃. The best time for adding substrate was 36 h after inoculation and the substrate (Rb1 20 mg/mL) was specifically transformed into ginsenoside Rd. The transformation process was terminated at 72 h. The ginsenoside Rb1 could be transformed to Rd by all of mycelia, crude enzymes and external enzymes. Conclusions Compared with the reference, the mutant of Paecilomyces bainier sp229-7 growth is quicker and the transformation efficiency has been greatly improved. The reaction time can be shortened to 3 days, and the amount of substrate increased at least 20 times.

OBJECTIVE To realize the status and the impact factors of nosocomial infection among Jizheng patients.METHODS To investigate 562 former inpatients suffered from Jizheng in hospital from Jan 2004 to Dec 2005.RESULTS The incidence rates of nosocomial infection that calculated by the patients and the cases were 14.59% and 16.55%,respectively.Infection mostly occurred on the 22nd day in hospital on average.The main infection sites were lower respiratory tract(48.78%),urinary tract(15.85%),and alimentary tract(12.20%).The most risk factor was aging.CONCLUSIONS The high incidence of nosocomial infection is due to various factors.We should take measures respectively aiming at different factors to reduce the occurrence of nosocomial infection.

Objective To investigate the pathogen distribution and drug resistance of gram-negative bacteria causing lower respiratory tract infections in patients with acute exacerbation of chronic obstructive pulmonary disease ( AECOPD) .Methods A total of 742 sputum samples were collected from AECOPD patients with lower respiratory tract infections in Taizhou Hospital of Zhejiang Province during January 2013 and December 2014.Vitek 2 Compact system combined with disk diffusion was used for strains identification and drug susceptibility test.Modified Hodge test and ethylenediamine tetraacetic acid (EDTA) synergic test were used to screen carbapenem-resistant strains.Statistical analysis was performed using WHONET 5.6 and SPSS 20.0 software.Results A total of 593 strains of gram-negative bacteria were isolated , in which 367 strains were nonfermentative bacteria (61.89%), 220 strains were enterobacteriaceae (37.10%), and the rest 6 strains ( 1.01%) were other gram-negative bacteria.Acinetobacter baumannii ( 186 strains ), Pseudomonas aeruginosa (99 strains), Stenotrophomonas maltophilia (33 strains) and Burkholderia cepacia (22 strains ) were top 4 nonfermentative bacteria , and they all showed high resistance to ampicillin , ampicillin/sulbactam, cefazolin, ceftriaxone, cefotetan and nitrofurantoin with resistant rates of 67.20%-100.00%. Drug resistance rates to other β-lactams, fluoroquinolones, aminoglycoside, compound sulfamethoxazole and minocycline were significantly higher in carbapenem-resistant Acinetobacter baumannii and Pseudomonas aeruginosa strains than those in non-carbapenem-resistant strains , and the differences were statistically significant (P <0.05 or <0.01).Stenotrophomonas maltophilia and Burkholderia cepacia strains were only sensitive to levofloxacin , compound sulfamethoxazole and minocycline . Klebsiella pneumonia (89 strains), Escherichia coli (80 strains) and Enterobacter cloacae (25 strains) were top 3 enterobacteriaceae , which were almost completely resistant to ampicillin , but were sensitive to piperacillin/tazobactam , cefoperazone/sulbactam , amikacin and carbapenems ( with resistant rates <15%) .More than 50%strains of extended spectrum β-lactamases ( ESBLs )-producing Klebsiella pneumonia and Escherichia coli were moderately or highly resistant to ampicillin/sulbactam , most cephalosporins ( except cefotetan and cefoperazone/sulbactam ), gentamycin, tobramycin, fluoroquinolones, aztreonam, compound sulfamethoxazole and minocycline , and the resistant rates were higher than those in non-ESBLs-producing strains (P <0.05 or <0.01).Conclusions Nonfermentative bacteria and enterobacteriaceae are the most prevalent gram-negative bacterial pathogens in lower respiratory tract infections in patients with AECOPD . Carbapenem-resistant Acinetobacter baumannii and Pseudomonas aeruginosa strains, as well as ESBLs-producing Klebsiella pneumonia and Escherichia coli strains are highly resistant to most antibacterial agents .

OBJECTIVETo evaluate the risk factors of psychiatric adverse events associated with PEG interferon and ribavirin treatment for chronic hepatitis C and assess the efficacy of escitalopram intervention for these adverse effects.

METHODSFifty-nine patients with chronic hepatitis C undergoing interferon-based treatment for 12 weeks were assessed for major depression using DSM-IV and SCL-90, and the patients identified to have major depression received escitalopram treatment for intervention. SCL-90 was used to assess the psychological condition of the patients at the forth and eighth weeks of escitalopram treatment.

RESULTSA male gender, 1b genotype, and intravenous infection are all risk factors of major depression. The morbidity rate of interferon-based depression was 32.2% with rates of hostility, anxiety, depression and sensitivity of 19.7%, 9.2%, and 5.26%, respectively. The total score of SCL-90 and scores for hostility, anxiety, depression and sensitivity all significantly declined after escitalopram treatment in the 19 patients with major depression.

CONCLUSIONSPsychological symptoms are common in HCV patients receiving interferon treatment, for whom regular psychological assessment is essential especially for those patients with drug abuse. Prompt use of escitalopram is recommended for effective control of major depression or other psychological symptoms in these patients.

Adult ; Antidepressive Agents, Second-Generation ; therapeutic use ; Antiviral Agents ; adverse effects ; therapeutic use ; Citalopram ; therapeutic use ; Depression ; chemically induced ; drug therapy ; Female ; Hepatitis C, Chronic ; drug therapy ; psychology ; Humans ; Interferon-alpha ; adverse effects ; therapeutic use ; Male ; Middle Aged ; Polyethylene Glycols ; adverse effects ; therapeutic use ; Recombinant Proteins ; adverse effects ; therapeutic use ; Risk Factors ; Treatment Outcome ; Young Adult

Objective:To investigate the molecular mechanism of PIEZO1 in promoting the invasion and aggression of glioma via Yes-associated protein (YAP) delivering mechanical signals.Methods:(1) Specimen detection: specimens from 94 patients accepted glioma resection in our hospital from February 2015 to March 2017 were chosen; immunohistochemical staining was used to detect the PIEZO1 expression in these glioma tissues of different grades. (2) Cell experiment: human glioma cell lines U87 and U251 were cultured under different matrix; the expressions of PIEZO1 and YAP were detected by immunofluorescent staining, and the PIEZO1 protein expression was detected by Western blotting. (3) Cell experiment after lentivirus transfection: the U87 and U251 cells were divided into negative control group and sh-PIEZO1 group according to the presence or lack of shRNA lentivirus vector; the role of PIEZO1 in glioma proliferation and invasion was detected by clone formation assay, proliferation and invasion assay, and Western blotting; after PIEZO1 silencing, Western blotting was used to detect the expressions of mechanical signal pathway proteins, YAP, FAK, and β1-integrin; real time-PCR was used to detect the mRNA expressions of CTGF and CYR61, which were downstream target genes of YAP; immunofluorescent staining was used to detect the YAP expression after PIEZO1 silencing. Results:(1) The PIEZO1 expression in glioma specimens increased with glioma grading, and the PIEZO1 expression in IDH wild-type patients was higher than that in IDH mutant patients. (2) The PIEZO1 and YAP expressions increased with the increase of matrix stiffness; as compared with that in the 0.2 kPa group, the PIEZO1 protein expression in stromal cultured cells of 16 and 64 kPa groups was significantly increased ( P<0.05). (3) After PIEZO1 silencing, U87 cells became large and tentacles increased, while U251 cells were mostly with long fusiform; as compared with those in the negative control group, the number of cell clones, and the proliferation rate and invasive cell count at each time point in the sh-PIEZO1 group were significantly smaller/decreased ( P<0.05); as compared with those in the negative control group, the epithelial marker E-cadherin expression was significantly increased, while the expressions of stromal markers Vimentin, Snailin and Slug were significantly decreased in the sh-PIEZO1 group ( P<0.05). Finally, Western blotting and immunofluorescent staining showed that PIEZO1 silence significantly increased the phosphorylated-YAP expression, significantly decreased the YAP nuclear expression, significantly down-regulated the CYR61 and CTGF expressions, and significantly reduced the levels of integrin β1 and phosphorylated-FAK; there were significant differences on these indexes between the negative control group and sh-PIEZO1 group ( P<0.05). Conclusion:PIEZO1 regulates the response of glioma cells to mechanical signal and promotes proliferation and invasion of glioma cells through YAP, which is an attractive therapeutic target for glioma treatment.

Objective:To investigate the clinical characteristics of patients with epithelioid glioblastoma (ep-GBM) and their influencing factors for survival.Methods:Sixteen ep-GBM patients admitted to Department of Neurosurgery, First Affiliated Hospital of Zhengzhou University from August 2015 to March 2022 were chosen. Clinical data such as age, gender, maximum tumor diameter, degrees of tumor resection, treatments, and immunohistochemical staining-related indexes were obtained. Survival curves of the patients were plotted by Kaplan-Meier method, and differences of progression-free survival (PFS) and overall survival (OS) among patients with different clinical characteristics were compared. Log-rank test was used to compare the survival rates, and Cox proportional risk regression model was constructed to analyze the influencing factors for PFS and OS.Results:In these 16 patients, median OS was 11.8 months and median PFS was 7.0 months. Significant differences in PFS and OS were noted between groups of age<32 years and age≥32 years, between groups of maximum tumor diameter<4.8 cm and diameter≥4.8 cm, and between groups of positive p53 expression and negative p53 expression ( P<0.05). Log-rank test indicated that OS and PFS ratios were significantly different between groups of age<32 years and age≥32 years, between groups of maximum tumor diameter<4.8 cm and diameter≥4.8 cm, between S100 positive group and S100 negative group, between Olig-2 positive group and Olig-2 negative group, and between groups of positive p53 expression and negative p53 expression ( P<0.05). Cox proportional hazard regression model showed that age ( HR=1.070, 95% CI: 1.013-1.134, P=0.016), preoperative maximum tumor diameter ( HR=2.150, 95% CI: 1.142-4.055, P=0.018) and Olig-2 expression ( HR=0.040, 95% CI: 0.003-0.498, P=0.013) had influences in PFS; preoperative maximum tumor diameter ( HR=2.350, 95%CI: 1.149-4.798, P=0.019) and Olig-2 expression ( HR=0.080, 95% CI: 0.007-0.972, P=0.047) had influences in OS. Conclusion:Older ep-GBM patients are prone to progress after surgery; ep-GBM patients with larger tumor diameter and negative Olig-2 expression likely progress and have poor prognosis after surgery.

Objective To investigate the diagnostic value of digital tomosynthesis in Schatzker classification of tibial plateau fractures.Methods A total of 43 patients with tibial plateau fractures who had underwent injured knee joints coronal tomosynthesis examinations and as well as digital radiography (DR) examinations including anteroposterior and lateral positions before the surgery were selected from January to June 2015.The imaging evaluation was performed by two diagnostic radiologists independently.Each radiologist consecutively performed Schatzker classification of the DR and tomosynthesis images of the knees of each patient.The consistent Schatzker classification results were finally given,while the inconsistent classification results were discussed.Recording the reading results of two methods and comparing the classification results of two methods with the subsequent intra-operative classification results,evaluating their consistency.Results Twenty-eight patients were included with 14 males and 14 females.The age ranged from 25 to 76 years old with an average of 48.5 years.Fifteen patients were excluded due to combined injuries and the low quality of imaging.Schatzker classification of tibial plateau fractures was performed with DR images,19 cases of fracture classification results were consistent with intra-operative classification,and 9 cases were inconsistent.Twenty-six cases of fracture classification results were consistent with intra-operative classification based on tomosynthesis images but 2 cases with inconsistent results.Intra-operative findings for each fracture were used as the gold standard for classification.The accuracy of the Schatzker classification for tibial plateau fractures were 68％ and 93％ in the two imaging techniques with significant difference (x2=5.143,P=0.016),respectively.The classification results of two imaging methods in 2 patients were both inconsistent with intra-operative classification.The fracture severity of 6 patients was underestimated when using DR images for interpretation,while 1 patient had a missed diagnosis of the lateral tibial plateau collapsed fracture.The consistency between the classification results of DR images as well as classification results of tomosynthesis images and intra-operative typing were moderately and highly consistent,respectively (Kappa coefficient were 0.604 and 0.908,respectively).Conclusion Schatzker classification of tibial plateau fractures was performed with DR images,the lateral tibial plateau collapsed fracture and the lateral plateau splitting fracture could be easily missed or misdiagnosed.However,tomosynthesis imaging could provide a higher accuracy.

OBJECTIVE: To estimate the social and economic burden of Downs syndrome for patients and their families residing in Changsha, China. METHODS: An 160-item self-administered questionnaire was designed and distributed to the primary caregivers of the patients in March 2020. A total of 81 eligible participants had completed the questionnaire, among which 20 were excluded for incomplete data. A patient perspective was taken to estimate the economic burden of the disease. The social impact of the disease on the patient's family was evaluated through questions adapted from the Stanford Psychological Wellbeing (PWB) Scale. RESULTS: The estimated life-course cost of a Downs syndrome patient in Changsha is 4 985 659 RMB, with the patient and caregiver's loss of income taking the greater proportion. In addition, as the majority of the patients' primary caregivers, female caregivers experienced not only considerable financial hardship caused by the care provision, but also a significant amount of psychological pressure and social discrimination. CONCLUSION Increased level of social welfare for the patients and social support for their female caregivers are essential for reducing economic burden and improving their quality of life in the area. In addition, prenatal screening and diagnosis for Downs syndrome are important for reducing both the social and economic burden of the disease by preventing its occurrence.
Caregivers ; China ; Down Syndrome ; Female ; Financial Stress ; Humans ; Quality of Life ; Social Discrimination ; Surveys and Questionnaires

Objective To investigate the role of AMP-activated protein kinase (AMPK) signal path in cell autophagy activation at early brain injury in rats after subarachnoid hemorrhage (SAH).Methods Adult male SD rats (weighting 300-350 g) were divided into five groups (n=12):sham-operated group,SAH group,and SAH+AICAR group,SAH+Compound C group and SAH+vehicle group.SAH models in the later four groups were established by endovascular perforation technique,and rats in the later three groups were performed left intracerebroventricular injection of AMPK agonist AICAR,AMPK inhibitor Compound C or normal saline 30 min before modeling;animals were subsequently sacrificed at 24 h after modeling.Immunohistochemical method was used to detect the phosphorylated mammalian target of rapamycin (p-mTOR) expression.Expressions of cortex autophagy related proteins LC3,AMPK and phosphorylated AMPK (p-AMPK) were observed by Western blotting.Loeffler's method was used to evaluate the neurologic behavior scores.Results As compared with those in the sham-operated group,the p-AMPK level,p-mTOR expression level and LC3Ⅱ/LC3Ⅰ ratio were significantly increased,while the behavioral deficit scores were significantly lower in the SAH group,with statistical differences (P＜0.05);the p-mTOR mainly expressed at cortex surrounding the hemorrhage areas,and integration areas of deep cortex and brain white matter.As compared with the sham-operated group and SAH+vehicle group,SAH+AICAR group had significantly increased p-AMPK level,decreased p-mTOR expression level,increased LC3Ⅱ/LC3Ⅰ ratio,and decreased behavioral deficit scores (P＜0.05);as compared with the sham-operated group and SAH+vehicle group,SAH+Compound C group had significantly decreased p-AMPK level,decreased LC3Ⅱ/LC3Ⅰ ratio,and decreased behavioral deficit scores (P＜0.05).Conclusion AMPK is involved in the process ofautophagy activation after SAH through regulating mTOR,and the regulation of AMPK may contribute to neuroprotection related to autophagy.

OBJECTIVE: To compare the clinical application and health economic values of non-invasive prenatal testing (NIPT) and second trimester serum screening (STSS). METHODS: A retrospective analysis was carried out on 54 026 singleton pregnant women undergoing NIPT and STSS from March 1, 2018 to December 31, 2019 in Changsha Maternal and Child Health Care Hospital. For pregnant women with high-risk results of NIPT, prenatal diagnosis and follow-up of pregnancy outcomes were conducted. The data was grouped to 4 screening models, and their cost-benefit was analyzed. RESULTS: The sensitivity, specificity and positive predictive value of NIPT were all higher than STSS. Screening models 1 to 4 have prevented the birth of 71, 29, 52 and 54 patients with Down syndrome, respectively. The safety index of screening models 1 to 4 were 0.0036, 0.3944, 02215 and 0.1281, respectively. When the price of NIPT was decreased to 600 RMB, the cost-benefit of the screening models 1 to 4 was 0.46, 0.65, 0.44 and 0.40 million RMB, respectively. CONCLUSION NIPT has a better detection performance than STSS. When the price of NIPT is 600 RMB, screening model 1 has the best screening effect and the highest accuracy, safety index and health economical value.
Child ; China ; Cost-Benefit Analysis ; Down Syndrome/diagnosis* ; Female ; Humans ; Pregnancy ; Prenatal Diagnosis/methods* ; Retrospective Studies