Objective To compare inter-hospital transport and clinical outcome in severe acute respiratory distress syndrome(ARDS)patients whom were transported either on extracorporeal membrane oxygenation(ECMO) or on conventional ventilation,and to investigate the optimal means of inter-hospital transport. Methods Eleven patients with severe ARDS who were invalid under conventional ventilation and were transported from other hospitals to Tianjin Third Central Hospital from November 2009 to January 2014 were analyzed. Five patients were transported on ECMO(observation group)and 6 on conventional ventilation(control group). The clinical characteristics,outcomes, transportation,vital signs before and after transportation,respiratory parameters,and Murray score between two groups were compared. Results Patients in observation group were significantly older than those in control group〔years:73(46,77)vs. 34(23,46),Z=-2.293,P=0.022〕. There was no significant difference between observation group and control group in acute pathologic and chronic health evaluationⅡ(APACHEⅡ)score,Murray score,oxygenation index(PaO2/FiO2)before transportation,transit time,and transit distance〔APACHEⅡscore:36(33,39)vs. 27(23,35),Z=-1.830,P=0.067;Murray score:3.5±0.3 vs. 3.4±0.2,t=0.667,P=0.524;PaO2/FiO2(mmHg, 1 mmHg=0.133 kPa):61±14 vs. 63±14,t=-0.249,P=0.809;transit time(minutes):24(18,74)vs. 79(41, 86),Z=-1.654,P=0.098;transit distance(km):12.9(8.3,71.8)vs. 72.4(39.5,86.8),Z=-1.651,P=0.099〕. There was no significant difference between two groups in vital signs and respiratory parameters before transportation. When arrived in ECMO centre,heart rate,respiratory rate,fractional inspired oxygen,inspiratory pressure and Murray score in observation group were significantly lower than those in control group〔heart rate(beat/min):102±16 vs. 136±8, t=-4.374, P=0.002;respiratory rate(beat/min):23±3 vs. 37±2,t=-7.967,P=0.000;fractional inspired oxygen:0.40±0.05 vs. 0.96±0.09,t=-12.152,P=0.000;inspiratory pressure(cmH2O, 1 cmH2O=0.098 kPa):21±1 vs. 34±4,t=-6.887,P=0.000;Murray score:2.7±0.2 vs. 3.8±0.2,t=-8.573, P=0.000〕,but PaO2/FiO2 was higher than that of control group(mmHg:278±65 vs. 41±5 ,t=8.075,P=0.001). Four patients were survived in observation group,and one died from the shortage of oxygen induced lung injury deterioration during transportation. Three patients died in control group,which was directly associated with lung injury deterioration. Conclusion For patients with severe ARDS who need the support of ECMO,ECMO-assisted transfer is safer than conventional ventilation,but transfer should be implemented by experienced team.

Objective To study the difference in pathogenicity and genotype between two isolates of Veronaeae botryosa with different temperature tolerance. Methods Two strains of Veronaeae botryose were isolated from two patients with phaeohyphomycosis in Jiangsu and Henan province respectively. Of them, the Jiangsu strain could grow well at 37 ℃, but Henan strain could not grow at 36 ℃. Eighty mice were equally classified into immunocompetent and immune-suppressed (induced by cyclophosphamide) groups to be inoculated with the two strains of Veronaeae botryosa respectively. Ten mice remained uninoculated and served as the control. The general condition, growth and organic involvement of mice were observed for 4 weeks followed by the killing of surviving mice. Homogenated tissue samples were obtained from liver, spleen, lung, kidney and brain; then, tissue culture, direct microscopy and pathological examination were performed. Genomie DNA was extracted from tissue samples and subjected to random amplified polymor-phic DNA (RAPD) analysis. PCR was performed to amplify the intemal transcribed spacer (ITS) of rDNA followed by sequencing Results Systemic phaeohyphomycosis was induced in both immunocompetent and immune-suppressed mice by the Jiangsu strain of Veronaeae botryose; the mortality was 30% in immune-competent mice and 65% in immune-suppressed mice with statistical significance between the two groups. In immune-suppressed mice inoculated with the Jiangsu strain, the infection rate was 100% in the lung,signifi-cantly higher than in other organs; on direct microscopy the infection rate reached 64.7% in the liver, and 70.5% on tissue culture. There was no significant difference in the infection rate among these organs in immunocompetent mice inoculated with the Jiangsu strain, with the infection rate being 57.8% in the lung and 42.1% in the liver. Increased infection rate was observed in the lung of immune-suppressed mice com-pared with immunocompetent mice (P < 0.05). No definite infection was seen in immunoeompetent or immune-suppressed mice innoculated with the Henan strain. RAPD analysis and sequencing revealed that there was a base variation (A/G) at position 236 of ITS gene between the two strains. Conclusions The two strains of Veronaeae botryosa have different genotypes. Systemic phaeohyphomycosis can be caused in immunocompetent and immuno-suppressed mice by the Veronaeae botryosa isolate from Jiangsu Province; the mortality was higher in immuno-suppressed mice than in immunocompetent mice. The pathogenicity of Veronaeae botryose is associated with the immune status of hosts. In immuno-suppressed mice, lung is the organ most susceptible to infection by Veronaeae botryosa.

Inflammation response is an important pathological process of neuronal cell death after stroke.Interleukin (IL)-33/ST2 system is involved in the inflammatory response process of ischemic stroke and has been proved to be a protective factor.This article reviews the role and mechanism of IL-33/ST2 system in the regulation of immune inflammation after ischemic stroke.

Objective:To investigate phobia of acute myocardial infarction(AMI)patients after percutaneous coronary intervention(PCI), analyze its latent profile and explore the influencing factors in different categories.Methods:Three hundreds and thirty-five AMI patients who received PCI in Emergency Department ofthe First Affiliated Hospital of Naval Medical University from January 2021 to June 2022 were selected by convenient sampling method and prospective research as the survey objects. The basic situation questionnaire, cardiophobia scale (TSK-SV Heart), Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), Connor Davidson Psychoelasticity Scale (CD-RISC) and Posttraumatic Stress Disorder Checklist (PCL) were selected to investigate them, and the linear growth model was selected to analyze the latent profile of postoperative phobia in AMI patients.Results:The score of post-operative phobia in AMI patients was (44.47 ± 7.25) points, and the latent profile analysis showed that AMI patients were classified into psychological type (156 cases, 46.57%), physiological type (164 cases, 48.96%) and severe type (15 cases, 4.47%). The severe phobia type was selected as the reference group, and multiple logistic regression analysis showed that compared with the severe phobia type, age, resilience, posttraumatic stress disorder (PTSD) and no or mild anxiety were significant influencing factors for phobia after PCI in patients with psychophobia type AMI ( P<0.05), while age and resilience were significant influencing factors for phobia after PCI in patients with physiological phobia type AMI ( P<0.05). Conclusions:Through latent profile analysis, there are three types of phobia in AMI patients after PCI: psychophobia, physiological phobia and severe phobia. Postoperative phobia is affected by psychological resilience, PTSD, age, chronic disease and depression. Therefore, targeted intervention should be carried out for AMI patients based on different characteristics of phobia after PCI to enhance their enthusiasm for rehabilitation.