Objective To explore species distribution of bacteria colonizing the indwelling double J tube in pregnant women.Methods From March2013 to December 2017, patients with double J tube during pregnancy in urology department of a hospital were collected.According to the time of indwelling double J tubes, they were divided into group A (indwelling time≤1 month) and group B (indwelling time＞1 month).All patients underwent bladder urine and double J tube bacterial culture before and after extubation.Species and positive detection rates of bacteria in bladder urine and double J tube between two groups were compared and analyzed.Results A total of 237 pregnant women with ureteral obstruction were included in the study, 129 cases in group A and 108 in group B.A total of 78 strains of bacteria were isolated in double J tube culture, 35 strains in group A and 43 in group B.Gram-negative bacilli were predominant in both groups, accounting for 54.29％ and 67.44％ respectively, followed by grampositive cocci, accounting for 37.14％ and 25.58％ respectively;isolated bacteria were Escherichia coli (n=30), Enterococcus spp. (n=12), Staphylococcus spp. (n=12), Klebsiella pneumoniae (n=11), Pseudomonas aeruginosa (n=7) and so on.Positive rate of double J tube bacterial culture was higher than that of bladder urine culture in both group A and group B, difference were both statistically significant (both P＜0.05).Positive rate of double J tube bacterial culture in group B was higher than that in group A (39.81％ VS 27.13％, P＜0.05), but there was no significant difference in the positive rate of bladder urine culture between group A and group B (P＞0.05).Conclusion The main colonized bacteria for pregnant women who are inserted double J tubes are gram-negative bacilli, the longer time the double J tube is placed, the higher rate the bacteria colonize and the higher positive of bacterial culture.

Objective To investigate epidemical situation of drinking-tea fluomsis in Qinghai province, in order to understand diet structure to provide the scientific basis for the prevention and control and the scientific research. Methods In 2007, according to "Scheme for Survey on Epidemical Drinking-tea Fluorosis", we carried out an customized investigation in 28 counties, 3 townships sampled in each county, 2 villages in each township, 50 adults and 50 school-age children in each village; at same time, 1 monk temple was sampled in each county, 50 clergy adults and 50 children in each temple. Then we investigated the resident income, the diet structure, the brick tea consumption and so on, and applied Dean method to diagnose dental fluorosis. The patient number estimated based on the survey result. Results ①Yeady per capita income of people was mostly 500 - < 1000yuan, next 1000 - < 3000 yuan; economic income in pasturing area was higher than that of agriculture, half area and half agriculture and half pastoral region and township. ②Staple food was bread flour primarily in the animal husbandry agricultural half pastoral area,next were the roasted barley and the rice;the bread flour was the principle food in the agricultural region and the cities,next were the rice and the roasted barley;among non-staple food,meat came fimt and milk foHowed,egg the last.③The frequently edible vegetables Was potato.cabbage and greenpepper,eaten by a majority of people[62.82%(6497/10 343)];as for fruits,apple,pear and orange was primarily consumed,75.95%(7856/10 343)of people ate less than 10 times every month.④Sixty-one thousand nine hundred and ninety-nine residents were registered,153 335 kg ofbrick tea was consumed in villages and towns,2.47 kg per person;in 1001 monks investigated,4120 kg of brick tea was consumed every year,4.12 kg per person.⑤Detection rate of adult dental fluorosis in the villages and towns was 24.11%(2494/10 343),that of the children was 24.38% (3012/12 355);detection rate of dental fluorosis in monks was 26.13%(203/777),that of the children was 39.73% (89/224).⑥Detection rate of adult skeletal fluorosis in villages and towns was 15.60%(17/109);that of monks was 4.88%(2/41).⑦The 95%confidence limit estimated a total number of dental fluorosis patients were 1 084 306- 1 134 170 persons.the median Was 1 109 238 persons;the 95% confidence limit estimated a total number of skeletal fluorosis patients were 309 177-758 199 persons,the median was 533 688 persons.Conclusions Qinghai province has a great quantity of brick tea consumption,having lots of people with drinking-tea fluorosis which is in severe degree.The resident food structure was monotonous and mostly transpolted from other region.

Coenurosis is an important zoonotic helminthic disease caused by the larval stage of the tapeworm Taenia multiceps. This parasite typically infects the brain of the intermediate hosts, including sheep, goat, cattle and even humans. We report a case of T. multiceps infection in a yak confirmed by clinical symptoms, morphological characteristics, and molecular and phylogenetic analyses. The coenurus was thin-walled, whitish, and spherical in shape with a diameter of 10 cm. The parasite species was identified as T. multiceps by PCR amplification and sequencing of the 18S rRNA, cox1 and nad1 genes. Three gene sequences all showed high homology (all above 97%) with the reference sequences from different hosts. Moreover, phylogenetic reconstructions with the 3 published Taenia gene sequences confirmed that the Qinghai yak isolate was closely related to T. multiceps. Although there are advanced diagnosis and treatment methods for coenurosis, early infection is difficult to diagnose. Importantly, the findings of yak infection case should not be ignored due to its zoonotic potential.
Animals ; Brain ; Cattle ; Cestoda ; China ; Diagnosis ; Goats ; Helminths ; Humans ; Parasites ; Polymerase Chain Reaction ; Sheep ; Taenia

Objective:To investigate the efficacy and safety of liraglutide combined with metformin in the treatment of overweight or obese patients with type 2 diabetes, and to analyze the factors influencing the response to liraglutide.Methods:Seventy-three overweight or obese patients with well-controlled type 2 diabetes on metformin were selected and treated with liraglutide at 1.8 mg/d in addition to metformin at 1500 mg/d for 48 weeks. Relevant data were collected before and after treatment, including blood glucose, glycosylated hemoglobin (HbA1c), fasting insulin, serum lipid, body weight, waist circumference, hip circumference, body mass index (BMI), homeostatic model assessment for β-cell function (HOMA-β) and homeostatic model assessment for insulin resistance (HOMA-IR). Changes in metabolic markers, incidence of side effects, weight loss efficacy and corresponding influencing factors were evaluated.Results:After 48 weeks of treatment, fasting blood glucose, 2-hour postprandial blood glucose, HbA1c, fasting insulin, HOMA-IR, blood lipid, waist circumference, hip circumference and BMI decreased significantly compared with baseline ( P < 0.05). The most common side effects were tolerable gastrointestinal adverse events. The average weight loss after the initial 4-week treatment was 3.99 kg, accounting for 48.8% of the total weight loss, and then the change displayed a more subdued trend during the remaining treatment period. After the 48-week treatment, 73.1% and 34.6% of the patients lost more than 5% and 10% of body weight, respectively. Absolute weight loss was positively correlated with baseline weight and weight loss within the initial 4-week treatment was an independent predictor of weight loss ≥ 5% at the 48th week. Conclusions:Liraglutide combined with metformin is safe and effective in the treatment of overweight or obese patients with type 2 diabetes mellitus. Weight loss is significant during the initial 4 weeks and the early response seems to be a predictor for better long-term effect on weight loss.

Objective:The decline in nutritional status in patients with severe pneumonia may contribute to an increase in in-hospital mortality. Enteral nutrition support can improve the nutritional status of patients, and is relatively easy to manage, with low cost and fewer serious complications. On the other hand, adverse reactions such as gastric retention and gastric microbiota translocation may increase the incidence of nosocomial pneumonia and increase the uncertainty of patient prognosis. There is no predictive model for in-hospital death in severe pneumonia patients receiving enteral nutrition support. The objective of this study was to investigate the risk factors of in-hospital death in patients with severe pneumonia receiving enteral nutrition support and to establish a prognostic model for such patients.Methods:This was a single-center retrospective study. Patients with severe pneumonia who were hospitalized in Peking Union Medical College Hospital and received enteral nutrition support were included from January 1, 2015 to December 31, 2020. The primary endpoints were in-hospital mortality rate and unordered discharge rate. The independent risk factors were determined using univariate and multifactorial logistic regression analysis, the nomogram scoring model was constructed, and the decision curve analysis (DCA) was performed.Results:A total of 632 severe pneumonia patients who received enteral nutrition support were included. Patients were divided into death and survival groups according to the presence or absence of in-hospital death, and 24 parameters were found with significant differences between groups. Nine parameters were independent predictors of mortality, namely the duration of ventilator use, the presence of malignant hyperplasia diseases, the maximal levels of platelet and prothrombin during hospitalization, and the nadir levels of alanine aminotransferase, serum albumin, sodium, potassium, and blood glucose. Based on these variables, a risk prediction scoring model was established (ROC = 0.782; 95% CI: 0.744 to 0.819, concordance index: 0.772). Calibration curves, DCA, and clinical impact curve were plotted to evaluate the goodness of function, accuracy, and applicability of the predictive nomogram, using the training and test sets. Conclusion:This study summarized the clinical characteristics of patients with severe pneumonia receiving enteral nutrition support and developed a scoring model to identify risk factors and establish prognostic models.

开展漏斗胸微创矫形手术的生物力学研究以及阐述矫形机制对于提高矫形手术水平、开展个性化手术治疗、发展新的矫形手术方法和扩展微创矫形手术的应用范围具有重要意义。漏斗胸微创矫形手术已经成功用于儿童的漏斗胸矫形，但是成人漏斗胸矫形手术的应用还未普及。面对漏斗胸矫形可能会加重脊柱侧弯的风险，医生被迫放弃手术，致使部分漏斗胸合并脊柱侧弯的患者终生不能得到治疗。总结漏斗胸微创矫形手术的生物力学研究进展，包括胸廓模型的三维重建、矫形模型的应用、矫形过程的数值模拟以及数值模拟结果在临床的应用。结合成人漏斗胸矫形数值模拟的特点提出解决方法，并针对漏斗胸的生物力学研究现状提出需要解决的问题，如计算模型需要考虑主要肌肉、椎间盘、前后纵韧带、椎体横凸棘间韧带和棘上韧带，验证数值计算结果的实验研究方法等。

BACKGROUND: Norepinephrine infusion decreases hypotension after spinal anesthesia during cesarean section. This study aimed to compare the efficacy of norepinephrine infusion and ephedrine bolus against post-spinal hypotension in parturients. METHODS: In this double-blinded, randomized controlled clinical trial, parturients scheduled for elective cesarean section were randomly allocated to receive norepinephrine infusion (0.05 μg·kg-1·min-1) just before spinal anesthesia continuing for 30 min or ephedrine bolus (0.15 mg/kg) just before spinal anesthesia. A rescue bolus (5 μg norepinephrine for the norepinephrine group, and 5 mg ephedrine for the ephedrine group) was administered whenever hypotension occurred. Our primary outcome was the incidence of hypotension within 30 min of spinal anesthesia administration. Secondary outcomes included maternal and neonatal outcomes 30 min after spinal block, and neonatal cerebral oxygenation 10 min after birth. RESULTS: In total, 190 patients were enrolled; of these patients, 177 were included in the final analysis. Fewer patients suffered hypotension in the norepinephrine group than in the ephedrine group (29.5% vs. 44.9%, odds ratio [OR]: 0.51, 95% confidence interval [CI]: 0.28-0.95, P = 0.034). Moreover, the tachycardia frequency was lower in the norepinephrine group than in the ephedrine group (OR: 0.22, 95% CI: 0.11-0.44, P < 0.001), and patients suffered less nausea and vomiting (OR: 0.28, 95% CI: 0.11-0.70, P = 0.004). There was no difference in Apgar scores and umbilical arterial blood gas analysis between the two groups. However, neonatal cerebral regional saturations were significantly higher after birth in the norepinephrine group than in the ephedrine group (mean difference: 2.0%, 95% CI: 0.55%-3.45%, P = 0.008). CONCLUSION: In patients undergoing elective cesarean section with spinal anesthesia, norepinephrine infusion compared to ephedrine bolus resulted in less hypotension and tachycardia, and exhibited potential neonatal benefits. TRIAL REGISTRATION ClinicalTrials.gov, NCT02542748; https://clinicaltrials.gov/ct2/show/record/NCT02542748.
Anesthesia, Spinal/adverse effects* ; Cesarean Section/adverse effects* ; Double-Blind Method ; Female ; Humans ; Hypotension/prevention & control* ; Infant, Newborn ; Phenylephrine ; Pregnancy ; Randomized Controlled Trials as Topic ; Vasoconstrictor Agents/therapeutic use*