Objective To observe the clinical efficacy and adverse reactions of tigecycline in treatment of health-care-associated pneumonia (HAP ) caused by extensively drug-resistant Acinetobacter baumannii (XDRAB ). Methods Clinical data of patients who used tigecycline for the treatment of XDRAB HAP in intensive care units of a hospital from March 2013 to June 2014 were retrospectively analyzed.Results XDRAB isolated from 31 patients with HAP were all sensitive to tigecycline,the resistance rates to carbapenems and sulbactams (including cefopera-zone-sulbactam,SCF)were all 100%,17 cases (54.84%)were mixed infection.Combined use rates of tigecycline and SCF were 85.71 %(12/14)in respiratory intensive care unit(RICU)and 47.06%(8/17)in general intensive care unit(GICU).Of 31 patients,the cure rate,effective rate,bacterial clearance rate,and antimicrobial adverse reac-tion rate were 29.03%,45.16%,61 .29%,and 16.13% respectively,no serious adverse drug reactions occurred. In RICU group and GICU group,the cure rates were 42.86% and 17.65% respectively,effective rates were 71 .43% and 23.53% respectively,and bacterial clearance rates were 78.57 % and 47.06% respectively,difference in effective rate between two groups was significant (P <0.05).Among patients receiving combination of tigecycline and SCF as well as not receiving combined SCF,the cure rates were 35.00% and 18.18% respectively,effective rates were 60.00% and 18.18% respectively,and bacterial clearance rates were 65.00% and 54.55% respectively, difference in effective rate between two groups was significant (P <0.05).Conclusion Tigecycline has a good clini-cal efficacy and little adverse reaction in treating XDRAB HAP;tigecycline combined with SCF is a good choice.

Objective:To study the status quo of directive and nondirective support from family or friends among patients with diabetes in community and to explore the association between directive, nondirective support from family or friends and self-management behaviors.Methods: The data of the subjects were from the Community Diagnosis in Tongzhou District, Beijing survey.Questionnaire-based investigation, physical examination and glycated hemoglobin test were conducted on 474 eligible patients in community.The summary of diabetes self-care activities measure (SDSCA) was adopted to investigate the self-management behaviors, and directive and nondirective support scale among patients with diabetes (DNSS-PD) was adopted to measure the directive and nondirective support among patients with diabetes.Results: A total of 452 patients with diabetes were included in the analysis.The average score of directive support was 2.53±1.07, and only 27.6% patients had high level directive support.The average score of nondirective support was 3.13±1.12 and 50.8% patients had high level nondirective support.The average SDSCA total score was 35.38±14.21 and the corresponding scoring percentage was 45.95%.Only 20.6% patients had optimal self-management.The total score, score of diet and physical activity, general self-management situation, diet self-management situation and physical activity self-management situation of the patients in high level directive support group were significantly better than in low level directive support group.The total score, score of self-management behaviors in five aspects (diet, physical activity, blood glucose self-monitoring, foot care and smoking), general self-management situation, self-management situation of five aspects of patients in high level nondirective support group were significantly better than in low level nondirective support group.Gender (OR=2.729), nondirective support level (OR=4.890), age (OR=0.969) and body mass index (BMI) (OR=0.819) were important influencing factors of self-management behavior.Conclusion: The status quo of self-management among patients with diabetes is not optimistic.Patients obtain more nondirective support than directive support from family and friends.However, the support level of both nondirective and directive support should be improved in the future.Both high level directive support and high level nondirective support had positive correlation with better self-management behaviors.Nondirective support had positive correlation with five aspects of self-management behavior, while directive support had positive relation with self-management behavior in aspects of diet and physical activity.In addition, more consideration and support of self-management should be provided for older obese male patients with diabetes in community, especially nondirective support.

Objective To investigate the clinical characteristics and prognostic factors after percutaneous coronary intervention of women with the first non-ST-segment elevation myoeardial infarction.Methods A total of 123 female patients with AMI,including 70 patients with NSTEMI and 53 patients with ST-segment elevation myocardial infarction (STEMI),who received PCI within 24 hours of onset were selected from June 2013 to June 2015.The clinical data were compared between patients with NSTEMI and with STEMI.Cox regression model was used to analyze the prognostic factors for the elderly patients with NSTEMI.Results The female patients with NSTEMI had more cases of patients with hypertension (48 vs.26),diabetes (38 vs.38) and hyperlipidemia (52 vs.29)than the female patients with STEMI.Significant differences in systolic blood pressure [(134.31±22.26)mmHg vs.(125.04 ± 19.63) mmHg],levels of white blood cell [(9.02 ± 3.75) 109/L vs.(11.37 ± 3.63) 109/L] and troponin Ⅰ [(8.63 ± 18.34) μg/L vs.(18.79 ± 27.76) μg/L] were observed in the above two groups (l P ＜ 0.05,respectively).The rates of revascularization,major adverse cardiovascular events in NSTEMI group were higher than those in STEMI group during 1 year after discharge (47.7％ vs.28.0％,62.9％ vs.35.8％) (P ＜ 0.05,respectively).Cox survival analysis showed that white blood cell (HR =1.241) and troponin-Ⅰ (HR =1.026) elevation were the risk prognostic factors after PCI for women with the first NSTEMI.Conclusion More hypertension,diabetes,hyperlipidemia and higher levels of systolic blood pressure,lower levels of white blood cell and troponin Ⅰ were observed in women with the first NSTEMI.The long-term prognosis of female patients with NSTEMI is poor.And elevated levels of white blood cell and troponin-Ⅰ were the risk prognostic factors after PCI for women with the first NSTEMI.

AIM: To investigate the interactive effects of blood glucose and blood calcium on the prognostic impact of patients with acute severe pancreatitis (SAP) and to analyze their predictive efficacy on prognosis. METHODS: One hundred and seven patients with SAP admitted to our hospital from September 2019 to October 2022 were selected for the study and were divided into poor and good groups according to their prognosis within 28 d. The blood glucose, blood calcium, modified Marshall score, bedside acute pancreatitis severity score (BISAP) were compared between the two groups before treatment, after 3 d of treatment, and after 7 d of treatment, and the correlation between blood glucose, blood calcium and modified Marshall score and BISAP score was analyzed. The blood glucose levels of patients with different blood calcium were compared. Cox regression was used to analyze the factors associated with prognosis. The presence and type of interaction between blood glucose and blood calcium on prognosis were analyzed using the interaction coefficient γ and relative risk (RR) values. The subject operating characteristic curve (ROC) was used to analyze the predictive efficacy of blood glucose and blood calcium on prognosis. RESULTS: The blood glucose, modified Marshall score, and BISAP score of the adverse group after treatment were higher than those of the good group, while the blood calcium was lower than that of the good group (P<0.05). After 3 and 7 days of treatment, blood glucose was positively correlated with improved Marshall score and BISAP score (P<0.05). The blood glucose level in patients with decreased blood calcium was higher than that in patients with normal blood calcium (P<0.05). The decrease of blood calcium had positive interaction with the increase of blood glucose (P<0.05). After 3 and 7 days of treatment, the AUC of blood glucose combined with blood calcium was greater than that predicted by single index (P< 0.05). CONCLUSION: Blood glucose and blood calcium are related to the severity of the disease in SAP patients. There is an interaction between blood glucose and blood calcium in predicting the prognosis of SAP patients. The combined detection of blood glucose and blood calcium has a certain predictive effect on the prognosis of SAP patients.

Objective To observe the analgesic effect of acupuncture at Guanyuan (CV4) and its effect on vasomotor substances in rats with dysmenorrhea due to coagulated cold syndrome. Method The coagulated-cold dysmenorrhea rat model was developed by Estrodiol benzoate and Oxytocin injectin plus physical freezing. The writhing response (writhing latency, writhing frequency, and writhing score) was observed, and the contents of TXB2 and 6-keto-PGF1a were detected by using enzyme-linked immunosorbent assay (ELISA). Result Compared with the saline water group, the writhing latency was significantly shortened, the writhing frequency was significantly increased, and the writhing score was more significantly increased in the model group (P<0.01);compared with the model group, the writhing latency was significantly prolonged, the writhing frequency was decreased, and the writhing score was significantly lower in the acupuncture group (P<0.05, P<0.01). Compared with saline water group, the content of plasma 6-keto-PGF1a was significantly lower (P<0.05) and the content of plasma TXB2 showed an increasing tendency (P>0.05) in the model group. Compared with the model group, the content of plasma 6-keto-PGF1a showed an increasing tendency (P>0.05) and the content of plasma TXB2 showed a decreasing tendency (P>0.05) in the acupuncture group. Conclusion The vasomotor substances are obviously disordered in the blood of cold-coagulated dysmenorrhea rat models. Acupuncture at Guanyuan can improve the writhing response and release pain, and meanwhile positively regulate the vasomotor substances such as TXB2 and 6-keto-PGF1a. The vasomotor substances are plausibly one of the major substances in the action of acupuncture in preventing and treating dysmenorrhea.

Objective To explore the classification and changes of macrophage subsets in liver transplant rejection.Methods Rat liver transplantation model were established and divided into immune tolerance group(B-B),where the liver of BN rat donors was transplanted to BN rat recipients,and immune rejection group(L-B),in which the liver of Lewis rat donors was transplanted to BN rat recipients.Single-cell RNA sequencing and high-throughput RNA sequencing were used to distinguish the macrophage subsets of rat liver transplantation,and to find differential gene in rejection reactions.Immunohistochemistry was used to determine the changes and distribu-tion of protein expression and cell subsets.Results CD68 positive macrophages were higher in the rejection group than that in the tolerance group(P<0.05),and macrophages could be divided into 9 subsets.During the rejection reaction,the CXC chemokine ligand 9(CXCL9)in the 8th subsets of macrophages was significantly increased,while the gene for white blood cell differentiation antigen 74(CD74)in the 5th subsets was significantly increased(P<0.05).CD74 ranked first in the differential gene synthesis of macrophages during rejection,followed by CXCL9.Compared with the tolerance group,a large number of CD74 positive macrophages were observed in the hepatic portal area of the rejection group,and the infiltration of CD74 positive macrophages in the hepatic sinuses was also significantly increased(P<0.05),while a large number of CXCL9 positive macrophages were observed in the hepatic portal area and hepatic sinuses of the rejection group,especially in the portal area(P<0.05),and CD14 positive cells were significantly increased(P<0.05).Conclusions The CD74 positive macrophage subsets and CXCL9 positive macrophage subsets may be key subgroups in promoting liver transplant rejection,improving the mechanism of macrophage action in liver transplant rejection.

Objective: To investigate the safety and efficacy of 125I radioactive seed implantation in the treatment of mediastinal lymph node metastasis. Methods: Records of 53 patients enrolled in Shaanxi Provincial Tumor Hospital from June 2014 to June 2018 with me-diastinal lymph node metastasis treated by computed tomography (CT)-guided 125I seed implantation were analyzed retrospectively. The preoperative treatment planning system was validated after the surgery. Intraoperative and post-operative complications were re-corded. The improvement in quality of life was observed. Chest CT follow-up was conducted 1 month, 3 months, 6 months, 1 year, and 2 years after treatment. The local focus control was evaluated. The median survival and total survival were recorded, and the survival prognosis and causes of death were analyzed. Results: The median survival time was 254 days (8.5 months), one-year survival rate was 48.67%, and complete and partial response rate was 83.02% (44/53). Multivariate Cox model analysis showed that the survival progno-sis was related to the Eastern Cooperative Oncology Group (ECOG) score, distant metastasis at the time of implantation, concurrent chemotherapy after implantation, and secondary seed implantation (P<0.05). The rates of developing pneumothorax and hemoptysis during and after the surgery were 20.75% (11/55) and 13.20% (7/55), respectively. No patients died. After implantation, the remission rate of cough, shortness of breath, pain, hoarseness, and superior vena cava syndrome was 60.00%-82.61%. Conclusions: CT-guid-ed 125I seed implantation in the treatment of mediastinal lymph node metastasis has the advantages of minimal trauma, remarkable cu-rative effect, safety, and feasibility. It has important application value and is worthy of further clinical application.

Irritable bowel syndrome (IBS) is a functional bowel disorder characterized by abdominal pain and changes in bowel habits. IBS is a multifactorial, stress-sensitive disease. Epigenetic changes include DNA methylation change, histone modification, and differential expressions of microRNA and long non-coding RNA. Explaining the changes in IBS from the perspective of epigenetics could bring new insights for the pathogenesis and treatment of the disease. This article reviewed the progress in research on the epigenetics of IBS.

The neural stimulator is a core component of animal robots. While the control effect of animal robots is influenced by various factors, the performance of the neural stimulator plays a decisive role in regulating animal robots. In order to optimize animal robots, embedded neural stimulators had been developed using flexible printed circuit board technology. This innovation not only enabled the stimulator to generate parameter-adjustable biphasic current pulses through control signals, but also optimized its carrying mode, material, and size, overcoming the disadvantages of traditional backpack or head-inserted stimulators, which have poor concealment and are prone to infection. Static, in vitro, and in vivo performance tests of the stimulator demonstrated that it not only had precise pulse waveform output capability, but also was lightweight and small in size. It had excellent in vivo performance in both laboratory and outdoor environments. Our study has high practical significance for the application of animal robots.
Animals ; Robotics

Humans ; COVID-19 ; Epidemics ; Respiratory Tract Diseases ; Hospitalization