Objective To study the epidemiological features of Cryptococcus neoformans and Cryptococcus gattii isolated from clinical samples in Shenzhen and to elucidate the distribution of species,varieties,genotypes and mating types within the strains tested.Methods The strains involved in this study were 55 cryptococcal strains isolated from our clinical samples.The canavanine-glycine bromthymolblue (CGB) culture was performed to distinguish Cryptococcus neoformans from Cryptococcus gattii.The genotype was characterized by polymerase chain reaction (PCR) fingerprinting with primer M13.The Cryptococcus gattii species and varieties of grubii and neoformans together with two opposite mating type α and a were identified by PCR with variety-specific and mating type-specific primers.The GEF1-restriction fragment length polymorphism analysis was conducted to simultaneously determine the genotype and mating types of strains tested.The sequence type of IGS1 region was analyzed for the VG Ⅱ genotype.Results Of the 55 tested cryptococcal strains,52 were Cryptococcus neoformans,all of which were var.grubii,genotype VN Ⅰ and mating type α.The remaining 3 strains were Cryptococcus gattii,among which,one was genotype VG Ⅰ and mating type α,and two were genotype VG Ⅱ and mating type α.The two VGⅡ genotype strains belonged to the sequence type Ⅱ.Conclusions The strains belonging to the Cryptococcus neoformans var.grubii,genotype VN Ⅰ and mating type α predominate in causative pathogens of cryptococcosis in Shenzhen.Cryptococcus gattii accounts for minority of the cryptococcal isolates,and the highly pathogenic VG Ⅱ genotypes in foreign countries are also characterized.The sequence types of IGS1 region of the two VG Ⅱ strains are in accord with VG Ⅱb sub-genotype.

Objective To investigate the effects of acupoint catgut-embedding therapy(ACT) on hypothalamic of hypothalamic norepinephrine(NE),dopamine(DA),5-hydroxytryptamine(5-HT),5-hydroxyindole acetic acid(5-HIAA) in menopause rats,and to explore the preventive and therapeutic mechanism of ACT for climacteric syndrome.Methods Sixty female SD rats were equally randomized into treatment group,model group and sham-operation group.Except the rats in the sham-operation group,the rats in other groups received removal of bilateral ovaries to establish ovariectomized menopause rat models.The treatment group received catgut-embedding on acupoints of Shenshu,Sanyinjiao and Zigong,once per week,and the treatment lasted 4 weeks.After treatment,the hypothalamic NE,DA,5-HT,5-HIAA levels were measured by radioimmunoassay.Results NE and DA levels were significantly decreased(P

Objective To observe the regulatory role of long non-coding RNA HIF1A-AS1 on the autophagy of pancreatic cancer PANC1 cells induced by hypoxia.Methods The pancreatic cancer PANC1 cells were cultured in a three-gas incubator filled with hypoxic gas mixture (94% N2,5% CO2,1% O2) for 3, 6, 12, 24, 36 and 48 h.HIF1A-AS1 overexpression and low expression PANC1 cells were obtained by the infection of recombinant adenovirus carrying HIF1A-AS1 and the transfection of HIF1A-AS1 targeting siRNA by liposome, and routinely cultured PANC1 cells served as control.The expression of HIF1A-AS1 of PANC1 cells was detected by real-time quantitative PCR after being cultured in hypoxia-induced condition for 24 h.The apoptosis rate was detected by flow cytometry.The autophagy related proteins Beclin 1 were detected by western blot.Results The expression of HIF1A-AS1 in hypoxic cells was increased as the hypoxic time increased since 6 h and peaked at 36 h, which was significantly higher than that in control group (P<0.01).HIF1A-AS1 relative expression in HIF1A-AS1 overexpression and low expression PANC1 cells was 4.49±0.53 and 0.49±0.07, which were normalized to that of control group with the relative expression of 1.Control group had lower HIF1A-AS1 expression than HIF1A-AS1 overexpression PANC1 cells but higher HIF1A-AS1 in HIF1A-AS1 low expression PANC1 cells, and the differences were statistically significant (P<0.01).The cell apoptosis rate of control, HIF1A-AS1 overexpression and low expression PANC1 cells was (8.27±1.28)%, (6.56±1.49)% and (19.9±2.34)% after 24 h hypoxic culture.Control group had higher HIF1A-AS1 expression than HIF1A-AS1 overexpression PANC1 cells but lower HIF1A-AS1 in HIF1A-AS1 low expression PANC1 cells, and the differences were statistically significant (P<0.01).The expression of Beclin 1 protein was protein 1.05±0.11, 1.29±0.19 and 0.38±0.18, respectively.Control group had lower Beclin 1 expression than HIF1A-AS1 overexpression PANC1 cells but higher Beclin 1 in HIF1A-AS1 low expression PANC1 cells, and the differences were statistically significant (P<0.01).Conclusions HIF1A-AS1 can promote autophagy of pancreatic cancer PANC1 cells induced by hypoxia and participate in the pathogenesis and metastasis of pancreatic cancer.

Objective To study the influence of nursing interventin on compliance of patients with allergic rhinitis undergoing immunotherapy.Methods Patients with allergic rhinitis undergoing immunotherapy from October of 2003 to October of 2005 and from Novermber 2005 to August 2007 were named the control group and test group respectively.Only the test group received nursing intervention.The compliance of the patients was investigated with subsequent cause analysis.The compliance de-gree and its influencing factors in the two groups were compared.Results The complete complianceof the test group was 80.5%,which was statistically different from that of the control group(68.9%,P<0.01).The difference between adult patients of the two groups was also evidently different(P<0.05).But the difference between children patients of the two groups was not evidently different(P>0.05).Statistical difference existed between children and adult patients in the control group as well as in the testgroup(P<0.01).The uncontrollable factors in the test group reduced while the controllable factors increased.Conclusion The nursing intervention could improved patients compliance with immunotherapy in that it reduced the uncontrollable factors among the reasons causing uncompliance.It worth widely being applied in clinic.

Objective To evaluate the clinical efficacy of small endoscopic sphincterotomy combined large-bal-loon dilation in treatment of common bile duct stones 1.0~2.5 cm in diameter. Methods 426 patients with large common bile duct (CBD) stones 1.0~2.5 cm in size were reviewed in our hospital between June 2010 and June 2014. They were randomized underwent small endoscopic sphincterotomy combined large-balloon dilation (SESPLBD) (n=218) or endoscopic sphincterotomy (EST) ( n= 208) for lithotripsy. The therapeutic outcome and complications were reviewed and compared. Results SESPLBD had higher complete duct clearance in one session (95.41 % vs. 93.75%), but there was no statistical significant difference. Bleeding was much less occurred in SESPLBD than in EST (2.29 % vs. 7.69 %, P= 0.025), especially when the stones were bigger than 1.5 cm in diameter. Mechanical lithotripsy was performed less in SESPLBD (13.76%vs 25.96 %, P=0.002), especially when the stones were 1.5 ~2.0 cm in diameter. There was no statistical significant difference in the incidence rate of post-ERCP pancreatitis (9.17 % vs. 6.73 %,P = 0.452), hyperamylasemia (19.72 % vs. 18.27 %,P = 0.796), perforation and death. Conclusions SESPLBD could be a safe method for large bile duct stones 1.0~2.5 cm in size. Compared with routine EST, it had less bleeding rate and mechanical lithotripsy requirement without increasing the incidence rate of post-ERCP pancreatitis or hyperamylasemia.

Alcoholic liver disease (ALD) is a common cause of liver dysfunction and death due to liver-related diseases, which brings great harm to human health and social development. Many factors are involved in the development and progression of ALD, such as oxidative stress, change in gut microbiota, genetic variation, autophagy inhibition, and microRNAs. This article summarizes the mechanism of action of these factors in ALD, in order to provide a basis for the treatment of ALD and the discovery of new drug targets.

Objective:To evaluate the clinical value of the transcutaneous neuromodulation (TN) in improving gastrointestinal function after gastrointestinal tumor operation.Methods:From April 2019 to June 2020, at The Affiliated People′s Hospital of Ningbo University, 100 patients who underwent gastrointestinal tumor surgery were included. The 100 patients were randomly divided into treatment group(receiving TN treatment, 50 cases)and control group (receiving sham TN treatment, 50 cases). The clinical data of the two groups was compared to evaluate the recovery of gastrointestinal function, which included the time of first defecation, time of first flatus, time of first ambulation, time of resuming diet, the incidence of nausea and vomiting within 3 d after operation and pain score (0 to 10). Heart rate variability (HRV) was compared between two groups to analyze the possible mechanism of TN improving gastrointestinal function after gastrointestinal tumor surgery. Independent sample t test and Chi-square test were used for statistical analysis. Results:Among 100 patients, there were 63 male and 37 female patients, the age was (67.0±11.3) years old, ranged from 28 to 92 years old. Compared with the control group, the time of first defecation, first flatus, first ambulation and resuming diet of treatment group reduced by 31.0%, 39.8%, 38.0% and 32.4% ((72.1±3.0) h vs.(104.5±2.9) h, (49.4±5.7) h vs.(82.1±3.1) h, (3.1±0.7) d vs.(5.0±0.9) d, (4.8±0.9) d vs. (7.1±0.8) d)), respectively; the pain scores on the day 2 and day 3 after operation and incidence of nausea and vomiting within 3 d after operation decreased by 50.0%, 65.5%, 26.0%(1.5±0.6 vs. 3.0±0.7, 1.0±0.6 vs. 2.9±0.6, 16.0%, 8/50 vs. 42.0%, 21/50), respectively, and the differences were statistically significant ( t=54.28, 35.72, 11.67, 13.66, 12.00 and 14.90, χ2=8.21, all P<0.01). The results of HRV analysis showed that the high frequency on day 3 was higher than that on day 1 of treatment group, and the ratio of low frequency to high frequency after operation was lower than that before operation of treatment group (0.5±0.1 vs. 0.4±0.1, 1.2±0.7 vs. 1.9±1.0), and the differences were statistically significant( t=-4.81 and 4.26, both P<0.01), which indicated TN could enhance vagal activity. Conclusions:TN promote the recovery of gastrointestinal function after gastrointestinal tumor operation, and can be used as an adjuvant therapy to accelerate the recovery of gastrointestinal function after gastrointestinal tumor operation.

Objective:To investigate the effect of early pulmonary rehabilitation (PR) training on the improvement of respiratory function in patients with acute respiratory distress syndrome (ARDS) after weaning of invasive mechanical ventilation in the intensive care unit (ICU).Methods:The retrospective cohort research method was used. The clinical information of adult patients with ARDS receiving invasive mechanical ventilation admitted to the ICU of Qingdao Municipal Hospital from January 2019 to March 2023 was collected. The patients were divided into a control group and an observation group according to off-line training program. The control group received traditional training after weaning, and the observation group received the early PR training after weaning. Other treatments and nursing were implemented according to the routine of the ICU. The scores of the short physical performance battery (SPPB) on day 3-day 6 of the weaning training, respiratory muscle strength, level of interleukin-6 (IL-6), number of aspirations of sputum after weaning, length of stay after weaning, rehospitalization rate within 6 months after discharge, and pulmonary function indicators at discharge and 3 months after discharge [peak expiratory flow (PEF), forced expiratory volume in one second/forced vital capacity ratio (FEV1/FVC), and vital capacity (VC)] of the two groups of patients were compared. The Kaplan-Meier survival curve was drawn to analyze the cumulative survival rate of patients 6 months after discharge.Results:A total of 50 of which 25 cases received the traditional training after weaning, 25 cases received the early PR training after weaning. There was no significant difference in gender, age, acute physiology and chronic health evaluationⅡ (APACHEⅡ), oxygenation index upon admission, etiological diagnosis of ARDS upon admission, time of invasive ventilation, mode of invasive mechanical ventilation, pulmonary function indicators at discharge, and other baseline data of the two groups. The SPPB questionnaire scores and respiratory muscle strength in both groups were increased gradually with the extended offline training time, the serum level of IL-6 in both groups were descend gradually with the extended offline training time, especially in the observation group [SPPB questionnaire score in the observation group were 7.81±0.33, 8.72±0.53, 9.44±0.31, 10.57±0.50, while in the control group were 7.74±0.68, 8.73±0.37, 8.72±0.40, 9.33±0.26, effect of time: F = 192.532, P = 0.000, effect of intervention: F = 88.561, P = 0.000, interaction effect between intervention and time: F = 24.724, P = 0.000; respiratory muscle strength (mmHg, 1 mmHg≈0.133 kPa) in the observation group were 123.20±24.84, 137.00±26.47, 149.00±24.70, 155.40±29.37, while in the control group were 129.00±20.34, 126.00±24.01, 132.20±25.15, 138.60±36.67, effect of time: F = 5.926, P = 0.001, effect of intervention: F = 5.248, P = 0.031, interaction effect between intervention and time: F = 3.033, P = 0.043; serum level of IL-6 in the observation group were 80.05±6.81, 74.76±9.33, 63.66±10.19, 56.95±4.72, while in the control group were 80.18±7.21, 77.23±9.78, 71.79±10.40, 66.51±6.49, effect of time: F = 53.485, P = 0.000, effect of intervention: F = 22.942, P = 0.000, interaction effect between intervention and time: F = 3.266, P = 0.026]. Compared with the control group, the number of aspirations of sputum after weaning of patients in the observation group significantly decreased (number: 22.46±1.76 vs. 27.31±0.90), the length of ICU stay after weaning significantly became shorter (days: 6.93±0.95 vs. 8.52±2.21), and the rehospitalization rate within 6 months after discharge significantly decreased [20.00% (5/25) vs. 48.00% (12/25)]. There were significant differences. The pulmonary function indicators 3 months after discharge of two groups of patients significantly increased compared with those at discharge and those of the observation group were significantly higher than those of the control group [PEF (L/min): 430.20±95.18 vs. 370.00±108.44, FEV1/FVC ratio: 0.88±0.04 vs. 0.82±0.05, VC (L): 3.22±0.72 vs. 2.74±0.37, all P < 0.05]. The Kaplan-Meier survival curve showed that the cumulative survival rate of patients 6 months after discharge of patients in the observation group was significantly higher than that of patients in the control group [76.9% vs. 45.5%, hazard ratio ( HR) = 0.344, P = 0.017]. Conclusion:Early PR training can significantly improve the respiratory function of patients with ARDS after weaning of invasive mechanical ventilation. Continuous active respiratory training after discharge can improve the respiratory function of patients and effectively decrease mortality.

Galectin⁃3 is an endogenous lectin with extensive immunomodulatory effects, and plays an important role in inflammatory response, autoimmunity and tumorigenesis. However, the expression of galectin⁃3 in ulcerative colitis (UC) and its relationship with disease activity of UC are unclear. Aims: To detect the expression of galectin⁃3 in colon tissue and serum in UC patients, and explore the relationship between galectin⁃3 and disease activity. Methods: Thirty⁃ three patients with UC diagnosed and treated from March 2019 to December 2019 at the Second Affiliated Hospital of Zhengzhou University were recruited, and 20 paracancerous normal tissue of colon cancer patients were served as controls. The expression of galectin ⁃ 3 in colon tissue was detected by immunohistochemistry SABC. Serum samples of 24 UC patients and 20 healthy controls were collected. Serum level of galectin⁃3 was detected by ELISA. Results: The positive expression rate of galectin⁃3 in colon tissue in UC patients was significantly lower than that in paracancerous normal tissue, and the difference was statistically significant (P<0.05). The positive expression rate in mild UC patients was higher than that in moderate to severe UC patients, and the difference was statistically significant (P<0.05). The positive expression rate in remission stage was higher than that in active stage, and the difference was statistically significant (P<0.05). Serum galectin⁃3 level in UC patients was higher than that in healthy control group, and the difference was statistically significant (P<0.05). Serum galectin ⁃ 3 level in moderate to severe UC patients was higher than that in mild UC group, and the difference was statistically significant (P<0.05). Serum galectin ⁃ 3 level in active UC patients was higher than that in remission UC patients, and the difference was statistically significant (P<0.05). Conclusions: In UC patients, the expression of galectin⁃3 in colon tissue and serum are dysregulated, and the expression of galectin⁃3 in colon tissue is decreased, especially in moderate to severe UC, while the serum galectin⁃3 level is opposite to the tissue expression.

Objective:To study the current status of longitudinal extrauterine growth restriction (EUGR) in extremely preterm infants (EPIs) and to develop a prediction model based on clinical data from multiple NICUs.Methods:From January 2017 to December 2018, EPIs admitted to 32 NICUs in North China were retrospectively studied. Their general conditions, nutritional support, complications during hospitalization and weight changes were reviewed. Weight loss between birth and discharge > 1SD was defined as longitudinal EUGR. The EPIs were assigned into longitudinal EUGR group and non-EUGR group and their nutritional support and weight changes were compared. The EPIs were randomly assigned into the training dataset and the validation dataset with a ratio of 7∶3. Univariate Cox regression analysis and multiple regression analysis were used in the training dataset to select the independent predictive factors. The best-fitting Nomogram model predicting longitudinal EUGR was established based on Akaike Information Criterion. The model was evaluated for discrimination efficacy, calibration and clinical decision curve analysis.Results:A total of 436 EPIs were included in this study, with a mean gestational age of (26.9±0.9) weeks and a birth weight of (989±171) g. The incidence of longitudinal EUGR was 82.3%(359/436). Seven variables (birth weight Z-score, weight loss, weight growth velocity, the proportion of breast milk ≥75% within 3 d before discharge, invasive mechanical ventilation ≥7 d, maternal antenatal corticosteroids use and bronchopulmonary dysplasia) were selected to establish the prediction model. The area under the receiver operating characteristic curve of the training dataset and the validation dataset were 0.870 (95% CI 0.820-0.920) and 0.879 (95% CI 0.815-0.942), suggesting good discrimination efficacy. The calibration curve indicated a good fit of the model ( P>0.05). The decision curve analysis showed positive net benefits at all thresholds. Conclusions:Currently, EPIs have a high incidence of longitudinal EUGR. The prediction model is helpful for early identification and intervention for EPIs with higher risks of longitudinal EUGR. It is necessary to expand the sample size and conduct prospective studies to optimize and validate the prediction model in the future.