Objective To explore the effect and mechanism of atorvastatin on pulmonary hypertension (PAH) in chronic pulmonary heart disease.Methods Seventy eight patients with chronic pulmonary heart disease were randomly signed into treating group and observing group.Forty healthy people were picked up from people taking physical examination at the same stage as control group.Patients in observing group were given routine treatment,and patients in treating group were given atorvastatin (20 mg/d) supplement beside routine treatment.Pulmonary function,ultrasound cardiogram,plasma interleukin 6 (IL-6) and tumor necrosis factor α (TNF-α) were measured before and after 24 weeks of treatment.Results There were no difference in terms of forced expiratory volume in one second(FEV1),FEV1/forced vital capacity(FVC),pulmonary arterial pressure (PAP) and the levels of IL-6 and TNF-α between the observing group and treating group before treatment(P ＞ 0.05).While there were significant difference in terms of the serum levels of IL-6,TNF-α and PAP of treating group,observing group and normal control group at before treatment (IL-6:(106.61 ± 31.34) ng/L,(105.33 ± 30.16) ng/L,(73.81 ± 31.12) ng/L,F =67.17 ; TNF-α:(19.41 ± 10.21) ng/L,(18.25 ± 11.37) ng/L,(14.82 ± 4.33) ng/L,F =15.43 ; PAP:(58.33 ± 8.95) mmHg,(56.04 ± 8.57) mmHg,(15.88 ±7.01) mmHg,F =88.78;P =0.00),and these levels in observing and treating group were higher than those in normal control group(P ＜0.01).After 24 weeks treatment,the IL-6,TNF-α,PAP in the treating group were (73.90 ± 27.12) ng/L,(14.91 ± 5.35) ng/L and (45.96 ± 5.61) mmHg respectively,significantly lower than those in observing group ((103.00 ± 28.12) ng/L,(17.22 ± 7.17) ng/L and (53.11 ± 9.21) mmHg respectively; P =0.025,0.045 and 0.031 respectively).The pulmonary function indexes including FEV1 and FEV1/FVC in treating group were much better than those in observing group at 24 weeks treatment (FEV1:(57.85±10.31)％ vs.(43.9±31.33)％;FEV1/FVC:(57.83±10.38)％ vs.(47.97± 14.79) ％ ;P =0.001,0.024 respectively).Conclusion Atorvastatin can effectively improve the life quality and pulmonary function,decrease PAP of patients with chronic pulmonary heart disease,and the mechanism may be related to the inhibition of inflammation in pulmonary vessels.

Objective To determine whether rTFPI could inhibit vascular thrombosis and salvage random pattern skin flaps following AIRC in rat models.Methods From April,2013 to June,2015,30 adult male Sprague-Dawley rats were randomized into 3 groups;a control group,an avulsion injury with roll compaction (AIRC) group,and an AIRC plus rTFPI therapy group.An 8.0 cm× 2.5 cm random flap was raised on the dorsum of each rat.The AIRC and AIRC plus rTFPI flaps were then altered with a device designed to simulate avulsion injury with roll compaction.After flap closure primarily,treatment was initiated immediately and continued for 3 days.Phosphate buffered saline was used in the control group and the AIRC group,while the AIRC plus rTFPI group received the recombinant Tissue Factor Pathway Inhibitor.Laser Doppler flowmetry and infra-red thermalgraphy were used on postoperative day three to assess nicrocirculatory blood flow and viability of the avulsed flaps.At postoperative day seven,final flap survival was determined.Using SPSS19.0 statistical analysis.Results The flap survival in AIRC group was only (32.7 ± 5.2)％ versus (62.5 ± 6.5)％ in control group,but the flap survival significantly increased (51.6 ± 8.2)％ after topical injecting rTFPI in experimental group.Statistically significant differences exist (P ＜ 0.05) between every two groups.The detection results of Laser-Doppler flowmetry and infra-red thermography showed that perfusion arrived the centre of the flaps in experimental group,while perfusion only arrived the proximal part of the flaps in the AIRC control group.Conclusion rTFPI therapy is effective in reducing ischemic necrosis of random pattern flaps following avulsion injury in the rat model.It suggests that rTFPI therapy may play an important role in clinical salvage of the failing avulsion injuries with roll compaction.

Objective:To investigate the risk factors affecting the prognosis of patients with extremely severe burns.Methods:Totally 46 patients with extremely severe burn in the dust explosion of aluminum powder in Kunshan, Jiangsu province on August 2, 2014 were included in this study. The patients were divided into the survival group and death group according to the prognosis of the patients. The patients' age, sex, burn degree, white blood cell, and lactic acid at admission, lactic acid at 48 h, creatinine, albumin, urine volume, blood calcium, acute physiology and chronic health score system II (APACHE II) and SOFA scores, and 90 d mortality were collected. COX regression analysis was used to analyze the possible relationship between the indicators of the two groups and the prognosis.Results:There were no significant differences in white blood cell at admission, creatinine, albumin, urine volume, SOFA score, and APACHE II score in the survival group compared with those in the death group (all P>0.05) and burn degree, the levels of lactic acid at admission, lactic acid at 48 h and blood calcium were significantly different (all P<0.05). Multivariate regression analysis showed that age, albumin and lactic acid at 48 h were independent predictors of death in patients with severe burn ( P<0.05), and these are independent outcome predictors of patients with severe burns ( P<0.05). Conclusions:Age, albumin level and lactic acid at 48 h are independent risk factors affecting the prognosis of patients with severe burns.

Summary: The interaction of high-fat diet and the peptide YY (PYY) gene expression in diet-induced obesity and the mechanisms which predisposed some individuals to become obese on high-fat diet were explored. Thirty-six male SD rats were randomly divided into high-fat diet group (n=27) and chow fed control group (n=9). After 15 weeks of either a high-fat diet or chew fed diet, the high-fat diet group was subdivided into dietary induced obesity (DIO) and dietary induced obesity resistant (DIR) group according to the final body weight. Then the DIO rats were subdivided into two groups for a 8-week secondary dietary intervention. One of the group was switched to chew fed diet, whereas the other DIO and DIR rats continued on the initial high-fat diet. Weight gain and food intake were measured, food efficiency was calculated, and the concentrations of plasma neuropeptide Y (NPY) and PYY were assayed. Hypothalamic NPY mRNA expression and PYY mRNA expression in ileum and colon was detected by RT-PCR. The results showed that at the end of 15th week, the levels of body weight and caloric intake were significantly higher in DIO group than in DIR or control group (P<0.01), while no significant difference was found between DIR and control group (P>0.05). The concentration of plasma PYY was significantly higher in DIR group than in DIO and CF group, while no significant difference was found between DIO and CF group (P<0.01). After switching the DIO rats to chow fed diet, their body weight gains were significantly lower than that of the DIO-HF group. The expression of PYY mRNA was increased in DIO-HF/CF rats than in DIO-HF rats, and the expression of hypothalamic NPY mRNA was decreased in DIO-HF/CF rats than in DIO-HF group. It was concluded that both dietary composition and PYY gene expression could potently alter the hypothalamic NPY expression and result in different susceptibility to obese and overeating. The decreased PYY was associated with the increased NPY expression and their predisposal to obese and overeating in rats.

Objective:To understand the biological characteristics, identification methods, genome structure and clinical significance of a rare strain of Aureimonas altamirensis isolated from clinical blood sample. Methods:The culture and biochemical characteristics of a strain isolated from blood culture were observed. The routine biochemical identification methods, MALDI-TOF mass spectrometer and 16S rRNA gene sequencing were used to identify the isolate. A phylogenetic tree based on the 16S rRNA gene sequences of the isolate and related strains was constructed. The genome of the isolated strain was sequenced and assembled, and gene prediction and functional annotation were made using related software. Phylogenetic analysis based on 31 house-keeping genes and genome-wide average nucleotide identity (ANI) analysis were conducted between the isolate and other Aureimonas sp. strains.Results:The isolated bacteria were gram-negative bacillus positive for catalase, urease and oxidase. It grew slowly on blood plate and could not be reliably identified by automatic bacterial biochemical identification systems or MALDI-TOF mass spectrometry. Results of the 16S rRNA gene sequencing and phylogenetic tree showed that the 16S rRNA gene sequence of the isolated strain was highly homologous to the strains of Aureimonas altamirensis NML070722 and IARI-ABL-26 (GenBank accession number: EU442518.1 and KC581669.1) in GenBank, and the gene sequence similarity was 99.93%. The total genome (National Microbiology Data Center genome accession number: NMDC60043566) length was 4 332 458 bp and GC content was 65.14%. There were 4 088 protein-coding genes and functional gene annotation showed that functional genes were mainly enriched in protein, amino acid, carbohydrate transport and metabolic functional regions. Pathogenic gene analysis predicted two high reliable virulence factor genes, but no drug resistance genes. House-keeping gene phylogenetic tree analysis showed that this strain was highly homologous to Aureimonas altamirensis strains of DSM21988 and C2P003 (GenBank accession number: GCF 001463885.1 and GCF 000800175.1), but ANI analysis showed that its genome was significantly different from those of the two strains. Conclusions:A rare strain of Aureimonas altamirensis was isolated from clinical specimen in China. As the biological and genomic characteristics of Aureimonas altamirensis had not been fully recognized, it was difficult to be correctly identified by conventional methods. The pathogenicity of Aureimonas altamirensis to immunocompromised patients and the significance of isolation in clinical specimens might need more case studies.

Objective? To investigate the effect of midline catheter in intravenous treatment after renal transplantation. Methods? From May 2018 to February 2019, 84 renal transplant patients were treated with central line catheters, which were placed through cubital fossa or superior superficial cubital vein. The length of catheters was 22-36 cm. During catheterization, the maintenance of catheters was well done, the prevention and treatment of complications were emphasized, and the situation of catheter extraction was observed. Results? Totally 84 patients had catheter indwelling time of 10-41 days, 2 cases of puncture point oozing, 2 cases of tube plugging, 2 cases of shoulder pain, 1 case of upper extremity edema. After careful care and treatment, no serious complications occurred and the effect was satisfactory. Conclusions? The application of midline catheter vein treatment, without repeated venipuncture, reduces the pain of patients′ puncture and the occurrence of phlebitis, achieves the expected treatment effect, and reduces the workload of nurses.

Objective To evaluate the accuracy of simple anthropometric parameters in diagnosing obesity in children in Guangzhou. Methods A cross-sectional study, including 465 children aged 6-9 years, was carried out in Guangzhou. Their body height and weight, waist circumference (WC) and hip circumference were measured according to standard procedure. Body mass index (BMI), waist to hip ratio (WHR) and waist-to-height ratio (WHtR) were calculated. Body fat percentage (BF%)was determined by dual-energy X-ray absorptiometry. Multiple regression analysis was applied to evaluate the correlations between age-adjusted physical indicators and BF%, after the adjustment for age. Obesity was defined by BF%. Receiver operating characteristic (ROC) curve analyses were performed to assess the diagnostic accuracy of the indicators for childhood obesity. Area under-ROC curves (AUCs) were calculated and the best cut-off point that maximizing'sensitivity+specificity-1'was determined. Results BMI showed the strongest association with BF% through multiple regression analysis. For'per-standard deviation increase' of BMI, BF%increased by 5.3%(t=23.1, P<0.01) in boys and 4.6%(t=17.5, P<0.01) in girls, respectively. The ROC curve analysis indicated that BMI exhibited the largest AUC in both boys (AUC=0.908) and girls (AUC=0.895). The sensitivity was 80.8% in boys and 81.8% in girls, and the specificity was 88.2%in boys and 87.1%in girls. Both the AUCs for WHtR and WC were less than 0.8 in boys and girls. WHR had the smallest AUCs (<0.8) in both boys and girls. Conclusion BMI appeared to be a good predicator for BF%in children aged 6-9 years in Guangzhou.

ObjectiveTo analyze the surveillance results of influenza-like illness （ILI） cases in a sentinel hospital in Nantong from 2014 to 2021 and to understand the seasonal and etiological characteristics of influenza. MethodsThe routine ILI case information in a sentinel hospital in Nantong from 2014 to 2021 was collected from China Influenza Surveillance Information system， and the surveillance results were described and analyzed. ResultsA total of 64 110 ILI cases were reported in the hospital from 2014 to 2021， and accounted for 3.93% of outpatient and emergency visits. ILI is mainly concentrated in children under 15 years old， accounting for 55.39% of the total ILI cases. ILI% roughly showed two epidemic peaks in spring and winter. A total of 8 639 nasopharyngeal swab samples of ILI cases were collected during 2014‒2021， of which 838 were influenza positive， with an average positive rate of 10.01% （3.27%‒16.75%）. The epidemic strains varied from year to year and in different age groups. In 2014 and 2015， H3N2 influenza was the epidemic strain； in 2016 and 2017， H3N2 influenza and B-Victoria influenza were the co-epidemic strains； in 2018， H1N1 influenza was the epidemic strain； and in 2019‒2021， B Victoria influenza was the epidemic strain. The epidemic strain in 0‒4 years old， 15‒24 years old， 25‒59 years old and >60 years old was H3N2， and the epidemic strain in 5‒14 years old was B Victoria. There was a significant difference in the positive rate between different gender groups （χ²=7.364， P=0.006）. ConclusionInfluenza often occurs in winter and spring in a sentinel hospital in Nantong. Influenza subtypes are prevalent alternately in different age groups and different years. We need to closely monitor the etiology of influenza virus in Nantong to provide a basis for influenza prevention and control.

OBJECTIVES: To evaluate the sensitivity and specificity of immunohistochemistry (IHC) for detecting common epidermal growth factor receptor (EGFR) mutations in non-small cell lung cancer (NSCLC) and to estimate the cost-effectiveness of IHC testing. METHODS: A total of 208 NSCLC patients were included in the trial, and the EGFR mutation status in the patients were detected by PCR and IHC. Two mutation-specific antibodies against the most common exon 19 deletion (clone SP111) and exon 21 L858R mutation (clone SP125) were tested by using automated immunostainer. A cost-effectiveness analysis model was built for the analysis of optimal detection scheme. RESULTS: With a cutoff value of IHC 1+, the overall sensitivity and specificity of the IHC-based method compared with the PCR-based method were 81.7% (95% CI 72.4% to 89.0%) and 94.7% (95% CI 92.6% to 99.5%), respectively. EGFR 19del mutation was detected by SP111 antibody with a sensitivity of 65.9% (95% CI 49.4% to 79.9%) and specificity of 98.8% (95% CI 95.7% to 99.9%). EGFR L858R mutation was detected by SP125 antibody with a sensitivity of 94.2% (95% CI 84.1% to 98.8%) and specificity of 99.4% (95% CI 96.5% to 100%). The IHC and PCR cost ratio needed to be 1-to-3 or more in our patients to economically justify before the use of IHC. CONCLUSIONS The study confirms an excellent specificity with fairly good sensitivity of IHC and mutation-specific antibodies for common EGFR mutations. It is cost-effective to use IHC method to detect EGFR mutation first when the IHC and PCR cost ratio is 1-to-3 or more in Chinese populations.
Carcinoma, Non-Small-Cell Lung/genetics* ; ErbB Receptors/genetics* ; Humans ; Immunohistochemistry ; Lung Neoplasms/genetics* ; Mutation