Objective To explore the clinical characteristics and risk factors of healthcare-associated infection (HAI)in patients with severe viral hepatitis,so as to provide basis for clinical prevention and treatment of HAI. Methods Clinical data of 193 patients with severe viral hepatitis and admitted to a hospital from January 2012 to November 2015 were analyzed retrospectively,clinical characteristics and risk factors for HAI in patients were evaluated,all data were statistically analyzed.Results Among 193 patients,75 developed 112 times of HAI, incidence and case incidence of HAI were 38.86% and 58.03% respectively.The main infection sites were abdomi-nal cavity,lower respiratory tract,and gastrointestinal tract,infection rates were 33.93%,25.00% and 16.96%respectively.A total of 58 strains of pathogens were isolated,including fungi,gram-negative bacteria,and gram-positive bacteria,accounting for 53.45%,36.21%,and 10.34% respectively.Mulvariate logistic regression analy-sis showed that underlying diseases,use of glucocorticoid,invasive procedure,and white blood cell count<4.0×109/L were independent risk factors for HAI in patients with severe viral hepatitis (P<0.05).Conclusion Incidence of HAI in patients with severe viral hepatitis is high,risk factors are multiple.It is necessary to take targeted prevention measures during the treatment,so as to reduce the incidence of HAI.

Herpesviruses is one of the most common human infectious diseases, which can be divided into different types based on clinical infection degree.Herpes simplex virus usually results in buccal and genital mucocutaneous infections, while cytomegalovirus is the most common opportunistic pathogen associated with significant morbidity and mortality in immunocompromised hosts, especially in transplant and cancer patients.Although nucleoside analogues are effective antiviral drugs, the emergence of drug-resistant viruses has created a barrier for the treatment of herpesviruses infections, especially in immunocompromised patients.Therefore, novel therapeutic agents are needed to avoid the limitations of drug resistance.In this article, research progress in the therapeutic agents for drug-resistant herpesviruses was reviewed from the aspects of non-nucleoside analogues, novel antiviral targets and newly antiviral mechanisms.

Oral hydroxycamptothecin nanosuspension (HCPT-Nano) with high supersaturated dissolution level, high permeation and well physical stability, was manufactured by microprecipitation-high press homogenization method. Its pharmaceutical properties were investigated, such as size and distribution, zeta potential, particle shape, physical existence condition, supersaturated dissolution level and so on. Particle size was measured by laser diffraction, and the mean diameters before and after lyophilization were 138 +/- 11.72 nm and 175 +/- 12.74 nm, respectively, for HCPT-Nano. Zeta potentials of HCPT-Nano was over -20 mV. The nanoparticles, being observed by transmission electron microscopy (TEM), were claviform or column in shape. DSC and X-ray diffraction revealed that HCPT existed in the form of crystal for HCPT-Nano. And HCPT-Nano could maintain higher supersaturated dissolution level for long time. So it supplied the possibility of improving oral bioavailability of HCPT when combining together admoveatur of P-gp inhibitor, CsA.

Cardiovascular risk and related medical burden due to influenza in patients with chronic disease were higher than those of healthy subjects. As a result, influenza vaccination is recommended as a strategy for secondary prevention in cardiovascular disease by major cardiovascular organizations, but the prevalence of influenza vaccination in these population is still low. Whether influenza vaccine can prevent cardiovascular events such as myocardial infarction and death is still controversial based on current evidences from observational studies and case-control studies, which may result from study desion,subjects selection,outcome definition and sample size issues. Recent meta-analysis showed that influenza vaccination may reduce cardiovascular risk, but large-scale random controlled trials with adequately power should be conducted to confirm these findings as well as the target population for this strategy further.
Cardiovascular Diseases ; epidemiology ; prevention & control ; Humans ; Influenza Vaccines ; therapeutic use ; Influenza, Human ; epidemiology ; prevention & control ; Risk Factors ; Secondary Prevention ; Vaccination

Objective To construct the prokaryotic recombinant expression vector of PTD4-Cu,Zn-SOD.Methods By using the techniques of gene recombination,the primers of Cu,Zn-SOD and the oligonucleotide sequences of PTD4 were designed,PCR amplification was performed for Cu,Zn-SOD genes,the PCR products were identified,reclaimed and purified,and pET16b served as carrier.The prokaryotic recombinant expression vector of pET16b-Cu,Zn-SOD was constructed using double digestion with Xho Ⅰ and BamH Ⅰ,ligated reaction and plasmid transformation.Then PTD4 gene and pET16b-Cu,Zn-SOD carrier were double digested with Nde Ⅰ and Xho Ⅰ and ligated,and the plasmid was transformed,and the prokaryotic recombinant expression vector of pET16b-PTD4-Cu,Zn-SOD was constructed.The reconstructed vector was analyzed by restriction mapping and was verified by gene sequencing.Results The prokaryotic recombinant expression vector of pET16b-PTD4-Cu,Zn-SOD with a length of 6 207 bp was constructed successfully.The carrier fragment about 5.7 kp and PTD4-Cu,Zn-SOD gene fragment about 510 bp were obtained by double digestion with Nde Ⅰ and BamH Ⅰ,which was consistent with the expected results.The results of gene sequencing showed that the base sequences of pET16b-PTD4-Cu,Zn-SOD were correct when compared with the expected gene sequences.Conclusion The prokaryotic recombinant expression vector of pET16b-PTD4-Cu,Zn-SOD is constructed successfully.

Objective To evaluate the effect of chidamide combined with matrine on proliferation and apoptosis of cutaneous T-cell lymphoma (CTCL) cell lines HH and Hut78,and to explore their apoptotic mechanisms.Methods Both HH and Hut78 cells were treated with 0.4 μmol/L chidamide and 0.6 g/L matrine alone or in combination for 24,48 and 72 hours,with those treated with dimethyl sulfoxide (DMSO) serving as control groups.MTS assay was performed to deteet cellular proliferation rates of HH and Hut78 cells at each time point.After 48-hour treatment,flow cytometry was conducted to detect cell apoptosis,and Western blot analysis to determine expression of apoptosis-related proteins in these cells.Statistical analysis was carried out by using repeated measures analysis of variance,one-way analysis of variance,and least significant difference (LSD)-t test for multiple comparisons.Results Compared with DMSO,chidamide and matrine alone or in combination could inhibit the proliferation of HH and Hut78cells to different extents (F =15.88,558.26,P ＜ 0.05,＜ 0.001,respectively).At 48 hours,the apoptosis rate in Hut78 cells was significantly higher in the matrine group (20.98％ ± 1.53％),chidamide group (22.44％ ± 7.74％) and combination group (44.53％ ± 1.85％) than in the control group (8.42％ ± 4.23％;LSD-t =4.76,5.31,13.69 respectively,all P ＜ 0.05),as well as in the combination group than in the matrine group and chidamide group (LSD-t =8.93,8.37 respectively,both P ＜ 0.01);no significant differences were observed in the apoptosis rate of HH cells between the matrine group (13.98％ ± 3.86％)or chidamide group (13.61％ ± 1.62％) and control group (11.44％ ± 1.43％,both P ＞ 0.05),while the combination group (20.94％ ± 0.64％) showed a significantly higher apoptosis rate compared with the control group,matrine group and chidamide group (LSD-t =7.37,5.40,5.69 respectively,all P ＜ 0.05).In the case of HH cells,the combination group showed significantly higher cleaved caspase-3 expression (all P ＜ 0.05),but significantly lower protein expression of E-cadherin,nuclear factor (NF)-κB,phosphorylated-Bad (p-Bad) and Bcl-2 compared with the other 3 groups (all P ＜ 0.05).In the case of Hut78 cells,the expression of E-cadherin,NF-κB,p-Bad and Bcl-2 was significantly lower in the matrine group,chidamide group and combination group than in the control group (all P ＜ 0.05),while cleaved caspase-3 expression was significantly higher in the chidamide group and combination group than in the control group (both P ＜0.05).No matter in HH cells or in Hut78 cells,there were no significant differences in Bad protein expression between the 4 groups (all P ＞ 0.05).Conclusion Chidamide in combination with matrine can inhibit proliferation and induce apoptosis of HH and Hut78 cells,likely by regulating the expression of apoptosis-related proteins E-cadherin,NF-κB,p-Bad,Bcl-2 and cleaved caspase-3.

Objective:To systematically review the risk prediction models for diabetic retinopathy in patients with type 2 diabetes mellitus (T2DM) .Methods:Literature regarding the risk prediction models for diabetic retinopathy in T2DM were searched from CINAHL, PubMed, Web of Science, Cochrane Library, Embase, Wanfang, CNKI, VIP, and China Biology Medicine disc, with the search timeframe extending to October 1, 2022. Two researchers independently selected literature and extracted data, and the bias risk and applicability of the included literature were analyzed using the PROBAST tool for assessing risk of bias in prediction model studies.Results:A total of 14 articles were included. Age, duration of diabetes, glycated hemoglobin, proteinuria, blood pressure, and serum creatinine levels were the main predictive factors for diabetic retinopathy in T2DM; the Area Under the Receiver Operating Characteristic (ROC) curve of the predictive models ranged from 0.683 to 0.984, with calibration conducted in 6 models; 4 studies used external validation, while the rest used internal validation. All studies demonstrated good applicability, but all presented bias risk.Conclusions:The risk prediction models for diabetic retinopathy in T2DM demonstrate good predictive performance. However, high bias risk due to methodological flaws (such as improper handling of missing data, inappropriate methods for variable selection, lack of blinding, etc.) indicates they cannot be directly applied to clinical practice. Future work should either conduct extensive validation on existing models or undertake large-scale, diverse prospective studies to develop predictive models with superior performance and user-friendly application.

Objective To understand the postoperative nutritional status and symptoms of gastric cancer patients,and to analyze the correlation between nutritional status and symptoms.Methods A total of 1 1 0 postoperative gastric cancer patients in Peking University Cancer Hospital were enrolled from April to December 201 4 and selected using convenience sampling.We assessed the patient′s nutritional status by human body measurement,lab test and subjective global assessment (SGA).Memorial symptom assessment scale (MSAS) was used to evaluate these patients′symptoms after operation.Results Based on different nutrition indicators, rate of malnutrition in patients after surgery was from 6.3% to 52.7%.About 77 patients (70.0%)suffered from multiple symptoms,51 (46.4%)patients with physical symptoms,34 (30.9%)with psychological symptoms.The top 1 0 symptoms included difficulty in falling asleep,numb,abdominal distension,weight loss, nausea,diarrhea,poor appetite,thirst,anenergia,and hair loss.According to the SGA result,patients in worse nutritional status had higher symptom scores than those with normal nutrition (P <0.01 ),such as PHYS (physical symptom subscale score),PSYCH (psychological symptom subscale score),GDI (global distress index),and TMSAS (total MSAS score).Conclusions Our results show that postoperative malnutrition is common and the majority of patients may experience symptoms.Nutritional status is positively correlated with symptoms during recovery.Thus,when assessing nutritional status and performing nutrition intervention,we should consider patients′symptoms,and manage their symptoms appropriately as well.

Objective:To analyze clinical and pathological features of 6 cases of papular acantholytic dyskeratosis of the anogenital area.Methods:Clinical and histopathological data were collected from 6 patients with papular acantholytic dyskeratosis of the anogenital area in the Department of Dermatology, Peking University Third Hospital from January 2013 to December 2022, and retrospectively analyzed.Results:Among the 6 patients, 3 were males and 3 were females. Their ages at onset ranged from 22 to 58 years. The time from the onset to diagnosis ranged from 1 to 18 months. All patients had no family history of similar skin lesions. The 6 patients all clinically presented with multiple clustered millet-sized flesh-colored or gray-whitish papules in the perianal and genital areas, with erosions and crusts on the surface of some lesions, sometimes accompanied by pruritus. Histopathological findings of skin lesions were similar, including hyperkeratosis with focal parakeratosis, as well as acantholytic and dyskeratotic cells scattered in the epidermis. The 6 patients were treated with topical glucocorticoids or tacrolimus ointment, etc., which exhibited varying efficacy, and some skin lesions persisted with repeated attacks.Conclusions:Papular acantholytic dyskeratosis was a rare skin disease, and mostly occurred in the anogenital area. Its diagnosis should rely on both clinical manifestations and histopathological findings.

Objective:To analyze clinical and histopathological diagnoses of patients with solid tumors localized on the perianal and external genitalia regions, aiming to help clinicians correctly identify benign and malignant tumors.Methods:A retrospective analysis was conducted on clinical, histopathological, and dermoscopic features, diagnosis and treatment of 389 patients diagnosed with solid tumors localized in the perianal and external genitalia regions in the Department of Dermatology, Peking University Third Hospital from January 2016 to May 2023.Results:Among the 389 patients with solid tumors in perianal and external genitalia regions, 123 were males and 266 were females, with the age being 8 - 89 (41.86 ± 16.62) years. Based on the histological classification of skin tumors, melanocytic tumors were the most common type (33.16% [129/389]), followed by other tumors (21.59%, 84/389), keratinocytic tumors (21.08%, 82/389), soft tissue and neural tumors (13.62%, 53/389), and appendageal tumors (10.54%, 41/389). There were 83.03% (323/389) of benign tumors and 16.97% (66/389) of malignant tumors. Melanocytic nevus was the most common benign tumor, mostly involving the labia majora of females and mons pubis of males. Among the malignant tumors, squamous cell carcinoma was relatively common in females (40%, 10/25), while extramammary Paget′s disease was relatively common in males (39.02%, 16/41). The initial misdiagnosis rate of Bowenoid papulosis was the highest (11/11), followed by squamous cell carcinoma (78.26%, 18/23) and basal cell carcinoma (40%, 4/10) ; there was no significant difference in the initial misdiagnosis rate between different gender groups or different age groups (both P>0.5). A total of 367 patients underwent surgical excision under local anesthesia and all showed a good prognosis; the remaining 22 with malignant tumors were treated with photodynamic therapy, extended resection, free flap transfer, etc., and experienced no recurrence during the follow-up of 3 months to more than 3 years. Conclusions:Solid tumors in the perianal and external genitalia regions were polymorphous, melanocytic tumors, keratinocytic tumors and other tumors accounted for a large proportion, while malignant tumors were relatively rare, and some were easily misdiagnosed. Most of the tumors in the regions had a good prognosis, without recurrence after the surgical resection.