Objective To investigate the effect of simple carbohydrate given 2 h before operation on postoperative insulin resistance and gastrointestinal function in elderly patients with trauma undergoing spinal anesthesia.Methods This was a randomized controlled clinical study.A total of 90 elderly patients with intertrochanteric femoral fracture/femoral neck fracture admitted to the Traumatic Orthopedics Department of the Fourth Medical Center of Chinese PLA General Hospital from October 2023 to February 2024 were randomly divided equally into control group(fasting with water before surgery)and carbohydrate group(CHO group,drinking 200 ml of pulsatile water at 2 h before surgery).All the patients received spinal anesthesia.The control group excluded 2 patients who completed surgery and were admitted to the ICU,2 patients received epidural anesthesia,and finally included 41 patients;3 patients were excluded from the CHO group under epidural anesthesia,2 patients underwent surgery under general anesthesia,and finally 40 patients were included.Baseline data of patients were collected,including gender,age,Charlson comorbidity index(CCI),presence or absence of diabetes,body mass index(BMI),American Association of Anesthesiologists(ASA)classification,etc.The patient's surgical time,intraoperative blood loss,first postoperative exhaust time,type of surgery,length of hospital stay,mean arterial pressure(MAP)and heart rate(HR)at four time points during surgery[entry(T1),post-anesthesia(T2),mid-operation(T3),and exit(T4)],perioperative blood glucose,insulin levels,C-reactive protein(CRP),and intestinal barrier function indicators(diamine oxidase,D-lactate,and bacterial endotoxin),as well as self-rating anxiety scale(SAS),visual analogue scale of pain(VAS),and Ramsay scores were recorded.Preoperative and postoperative use of the delirium diagnostic scale(3D-CAM)assessed the presence of delirium in patients.Results Eighty-one patients aged(77.7±9.5)years were included.Compared with control group,the first exhaust time in CHO group was significantly shorter[4.59(3.25,7.39)h vs.10.23(7.97,14.76)h,P<0.001],postoperative insulin resistance index(HOMA-IR)was significantly decreased[5.13(2.38,10.30)vs.7.34(2.31,12.55),P<0.001].The change rate of HOMA-IR(ΔHOMA-IR)also decreased significantly(P<0.001);There were no significant differences in intestinal barrier function indexes between the two groups(P>0.05);The levels of D-lactic acid and bacterial endotoxin in control group were significantly increased after operation,and the differences were statistically significant(P=0.010,P=0.031),In CHO group,there was no significant difference in preoperative and postoperative indexes(P>0.05).There was no significant difference in the perioperative scale score,incidence of delirium and the length of hospital stay between the two groups(P>0.05).Conclusions Taking simple carbohydrates 2 h before surgery can significantly shorten the first exhaust time,reduce insulin resistance and the incidence of delirium,and improve gastrointestinal function in elderly trauma patients undergoing spinal anesthesia,thus providing clinical basis for accelerated postoperative rehabilitation in elderly patients.

Objective To investigate the factors influencing global longitudinal strain(GLS)measured by cardiac magnetic resonance(CMR)in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods Clinical data of 315 hospitalized patients diagnosed with acute STEMI who underwent percutaneous coronary intervention(PCI)at the First Medical Center of Chinese PLA General Hospital from June 2016 to September 2021 were retrospectively collected.After analyzing CMR images of all patients,GLS and other strain parameters were obtained,and then the patients were divided into two groups according to the median GLS.In order to balance gender and age differences,1:1 propensity score matching was performed,and 206 patients were eventually included:GLS>-11.3%group(indicating severe GLS impairment,n=103)and GLS≤-11.3%group(n=103).Baseline characteristics,laboratory indicators,coronary angiographic parameters,electrocardiogram(ECG)features,and CMR parameters were compared between the two groups.Variables showing significant differences were analyzed for their correlation with GLS.Multivariate logistic regression and multiple stepwise linear regression analyses were performed to identify factors associated with GLS impairment.Results Compared with GLS≤-11.3%group,GLS>-11.3%group had significantly higher peak levels of creatine kinase-MB(CK-MB)and troponin T(TnT)(P<0.001).A higher proportion of patients in GLS>-11.3%group had the left anterior descending artery(LAD)as the culprit vessel,while a lower proportion had the right coronary artery(RCA)as the culprit vessel(P<0.001).Additionally,GLS>-11.3%group had longer QRS duration(P<0.001)and a higher incidence of pathological Q waves(P=0.001).Regarding CMR parameters,GLS>-11.3%group exhibited larger global circumferential strain(GCS),infarct size(IS),and left ventricular end-systolic volume(LVESV),as well as lower global radial strain(GRS)and left ventricular ejection fraction(LVEF)(P<0.001).Multivariate logistic regression indicated that peak TnT(OR=1.092,P=0.001),LAD culprit vessel(OR=3.744,P<0.001),and QRS duration(OR=1.026,P<0.001)were significantly associated with severely impaired GLS.Multiple stepwise linear regression analysis showed that the logarithmic value of peak TnT,LAD as the culprit vessel,and the square root of QRS duration were linearly correlated with GLS values(adjusted R2=0.301,P<0.001),and these independent variables explained 30.1%of the variation in GLS.Conclusion Elevated peak TnT,prolonged QRS duration,and LAD as the culprit vessel are significantly associated with severe GLS impairment in STEMI patients,indicating more severe myocardial infarction and worse left ventricular function.

Objective To establish a rapid detection method for zika virus based on direct amplification re-al-time fluorescent quantitative reverse transcription polymerase chain reaction(RT-PCR)technique.Methods A direct amplification RT-PCR technique for the rapid detection of zika virus in 5 samples(whole blood,serum,saliva,throat swab and urine)was established by using a special function DNA polymerase and a preferred PCR enhancer.Results The detection limits of the 5 samples were 103 PFU/mL in serum,102 PFU/mL in urine,throat swab,and saliva,and 104 PFU/mL in whole blood.The coefficient of goodness-fit of stand-ard curves was above 0.98,and the amplification efficiency was 90％-110％.Zika virus nucleic acid was suc-cessfully amplified,but non-zika virus nucleic acid was not amplified.Based on the repeatable detection of sam-ples from urine,whole blood,and saliva,the variation coefficient of 6 repeated Ct values at 106 PFU/mL and 102 PFU/mL concentrations were all＜5％.The zika virus detection method established by the direct amplifi-cation RT-PCR technique was consistent with the detection results of conventional RT-PCR technique.Only two serum samples were detected in eight zika virus samples,and the remaining 62 non-zika virus samples and 12 negative samples were not amplified.Conclusion A rapid detection method for zika virus based on direct ampli-fication RT-PCR technique is successfully established.The method is simple,rapid,sensitive and specific.

AIM To study the chemical constituents from Lonicera japonica Thunb.and their antioxidant activities.METHODS The extract from L.japonica was isolated and purified by D101 macroporous resin,silica gel column and semi-preparative HPLC,then the structures of obtained compounds were identified by physicochemical properties and spectral data.The antioxidant activity was determined by DPPH free radical scavenging method.RESULTS Fifteen compounds were isolated and identified as dearabinosyl pneumonanthoside(1),5α-carboxystrictosidine(2),apigenin 7-O-glucoside(3),ethyl caffeate(4),isorhamnetin-3-O-β-D-glucopyranoside(5),luteolin 7-O-glucoside(6),quercetin 3-O-β-glucoside(7),luteolin 7-O-rutinoside(8),luteolin-7-O-neohesperidoside(9),hydnocarpin(10),methyl chlorogenate(11),(Z)-aldosecolohanin(12),kaempferol 3-O-β-D-glucoside(13),chlorogenic acid butyl ester(14),(-)-syringaresinol(15).The IC50 values of DPPH free radical scavenging of compounds 3,5-10,13-14 were 6.70-36.25 μmol/L.CONCLUSION Compounds 1-2,8,9-11 and 15 are isolated from genus Lonicera for the first time.Compounds 3,5-10,13-14 show good antioxidant activities.

Graphene,as a new type of two-dimensional nanomaterial,has unique physical and chemical properties,which make it characterized by low resistivity,large specific surface area,good biocompatibility,and high chemical stability.It is expected to develop into an ideal material for highly sensitive electrochemical sensors.With the development of electrochemical sensor technology,graphene based electrochemical sensors with high sensitivity,specificity,speed,and convenience can be used to detect various infectious disease patho-gens.This article summarizes the application of electrochemical sensor detection technology based on graphene nanomaterials in the detection of respiratory pathogens,mosquito borne infectious disease pathogens,intestinal infectious disease pathogens,and other infectious disease pathogens,providing new ideas for achieving rapid detection technology and methods for early detection and diagnosis of infectious diseases.

Pulmonary infection by pathogenic microorganisms is a common disease of the respiratory system with high mortality and poor prognosis,but its pathogenesis remains unclear.In recent years,single-cell RNA sequencing(scRNA-seq)has been widely used in the study of lung infection to provide an atlas of immune cells of patients,identify new immune cell subsets,analyze differential expression genes,reveal pathways related to inflammatory immune pathways in pathogenic microbial infection,monitor the levels of cytokines,and identify novel biomarkers of lung infection.There-fore,this paper presents a review of the application of scRNA-seq in pulmonary infection by pathogenic microorganisms.

Objective To construct a prediction model for postoperative healthcare-associated infection(HAI)in elderly patients with hip fracture,analyze the economic burden,provide a reference and basis for the development of clinical prevention and control programs.Methods 627 elderly patients who underwent hip fracture surgery in a hospital from January 1,2017 to May 31,2023 were selected as the study subjects.Patients were randomly divided into a modeling group and a validation group at a 7:3 ratio.A logistic regression prediction model was constructed based on data from the modeling group,the discriminant and consistency of the model were evaluated by receiver ope-rating characteristic(ROC)curve and Hosmer-Lemeshow test,and the direct economic burden of postoperative HAI in patients was analyzed with 1∶1 propensity score matching(PSM).Results The incidence of postoperative HAI in elderly patients with hip fracture surgery was 12.1％,with pulmonary infection being the most common(52.6％).Logistic regression analysis showed that male,old age,perioperative disturbance of consciousness,gradeⅣ of American Society of Anesthesiologists(ASA)classification,low albumin level,and intensive care unit(ICU)admission were all independent risk factors for postoperative HAI in patients(all P＜0.05).There was good model discrimination and consistency between the training and validation groups in predicting the risk of postoperative HAI.The direct economic burden of postoperative HAI in patients was 7 927.4 Yuan,of which the burden of wes-tern medicine was the largest(3 139.7 Yuan).HAI prolonged patients hospitalization time by 3.6 days.Conclusion Postoperative HAI increases the economic burden of patients,the nomogram model constructed in this study can effectively predict the risk of postoperative HAI in patients,which can provide a basis for the early identification,as well as the implementation of targeted preventive and diagnostic measures for high-risk patients in the clinic.

Based on the species-specific peptides of Pheretima and its common counterfeit (Metaphire magna), an identification method was established using ultra-high performance liquid chromatography tandem triple quadrupole mass spectrometry (UHPLC-MS/MS) for quality evaluation of Pheretima and its preparations. Separation was performed on a CORTECS T3 C18 column with 0.1% formic acid and acetonitrile as the mobile phases. Mass spectrometry with multiple reaction monitoring (MRM) using ESI⁺ mode was used to simultaneously monitor three ion pairs. The results indicated that the method was specific and could distinguish Guang Dilong, Hu Dilong, and M. magna, which were consistent with those of DNA barcode identification. The adulteration test showed that the LOD of peptide M was 1 μg·g^-1. Peptide M could be detected when 1% M. magna was added to Guang Dilong, indicating the high sensitivity of the method. Fifty-four batches of commercially available samples contained 35% Guang Dilong, 35% Hu Dilong, and 15% M. magna. No ions were detected in 15% of the samples, and DNA barcode identification revealed that they were mainly from Amynthas, with similar appearance to Hu Dilong. The analysis results of the formulation showed that no peptide ions were detected in 3 batches of Xiaohuoluo pills (3/6) and M. magna were detected in 2 batches of Shenjindan capsules (2/4). The developed method in the study has good specificity, sensitivity, and feasibility, and could be used for quality control of Pheretima and its related preparations. It is of great significance for improving quality standards and regulating the medicinal market of Pheretima.

Lipopolysaccharides (LPS) are major outer membrane components of Gram-negative bacteria. Unlike most Gram-negative bacteria, Acinetobacter baumannii can still survive and acquire polymyxin resistance after complete loss of LPS. Previous studies of LPS-deficient Acinetobacter baumannii mostly focused on LPS-deficient strains induced by polymyxin, whose background was complex and unstable. To investigate LPS loss-mediated polymyxin resistant-Acinetobacter baumannii, this study constructed a stable and clear background LPS-deficient strain by knocking out lpxC gene in Acinetobacter baumannii ATCC 19606 with CIRSPR/Cas9, and then studied the phenotypic changes of the lpxC-deficient strain including morphology, growth rate, antibiotic susceptibility, virulence, membrane permeability, and membrane potential. Animal experiments were approved by the Animal Care and Welfare Committee Institute of Medicinal Biotechnology, CAMS and PUMC (approval number: IMB-20240119D₉). The results indicated that the lpxC gene of Acinetobacter baumannii ATCC 19606 was successfully knocked out. After losing the lpxC, the strain underwent the morphological change from rod-shaped to spherical. Furthermore, it leads to reduced growth rate, enhanced membrane permeability, decreased membrane potential, lower virulence, and increased antibiotic susceptibility to β-lactams, quinolones, aminoglycosides, macrolides, glycopeptides. The lpxC deletion results in significant changes in membrane homeostasis and adaptability of Acinetobacter baumannii. Understanding the phenotypic changes of colistin-resistant Acinetobacter baumannii mediated by LPS loss is useful for exploring the resistance mechanism of Acinetobacter baumannii and developing new therapeutic strategies.

Neuromyelitis optic spectrum disorders(NMOSD)is a serious inflammatory demyelinating disease.Clinical treatment of NMOSD mainly involves acute phase treatment and remission phase prevention treatment.Disease-modifying therapy(DMT)in remission phase of NMOSD can effectively reduce disease re-currence and delay disability progression.At present,the drugs commonly used for DMT at home and abroad in-clude classical immunosuppression,B-cell surface antigen monoclonal antibody,complement targeting mono-clonal antibody,IL-6 receptor-targeting monoclonal antibody,etc.This paper mainly reviews the DMT drugs ef-ficacy,safety,as well as the marketing status of NMOSD.