Objective:To investigate the incidence, drug sensitivity and drug resistance characteristies, and theraputic effect of staphylococcal peritoneal dialysis-associated peritonitis (PDAP), aim to provide clinical evidences for standardizing treatment therapy of staphylococcal PDAP. Methods:Clinical data of PDAP patients admitted to the Second Hospital of Jilin University, the First Hospital of Jilin University-the Eastern Division, Jilin Central Hospital and Jilin First Automobile Work General Hospital during January 1, 2013 and December 31, 2019 were retrospectively collected. The results of etiology, drug sensitivity and drug resistance of staphylococcal PDAP patients were collected. According to the pathogenic bacteria, patients were divided into staphylococcus aureus group ( n=48) and coagulase-negative staphylococcus group ( n=232). According to the results of methicillin resistance, patients were divided into drug-resistant group ( n=71) and drug-sensitive group ( n=30). The prognosis of antibiotic therapy in each group were compared. Poisson regression was used to test the changing trend of the incidence of staphylococcal PDAP. The changes of drug sensitivity and drug resistance of staphylococcus were compared between 2013 and 2019 by linear trend χ2 test. Results:A total of 1 085 cases of PDAP occurred in 625 patients were screened, and 280 cases of staphylococcal PDAP were finally included. The incidences of staphylococcal PDAP, staphylococcus aureus PDAP and coagulase-negative staphylococcal PDAP were 0.063 times per patient year, 0.010 times per patient year and 0.053 times per patient year respectively. In addition, the incidence of PDAP caused by staphylococcus, staphylococcus aureus and coagulase-negative staphylococcus decreased year by year (all P<0.05). With the change of years, the sensitivity rate of staphylococcus to rifampicin increased, while the sensitivity rate of staphylococcus to moxifloxacin decreased (both P<0.05). The drug resistance rate of staphylococcus to levofloxacin increased ( P<0.05). The staphylococcus aureus group was more prone to refractory PDAP and catheter removal than that in coagulase-negative staphylococcus group, and the recurrence rate was higher than that in coagulase-negative staphylococcus group (all P<0.05). The proportion of vancomycin used during the whole course of antibiotic therapy in drug-resistant group was higher than that in drug-sensitive group ( P<0.05). Conclusions:The incidence of staphylococcal PDAP decreases year by year, and the drug sensitivity characteristics of staphylococcus also change. The therapeutic outcomes of staphylococcus aureus PDAP are worse than that of coagulase-negative staphylococcus.

China and Tunisia have frequent exchanges and good relationship. Tunisia has the largest medical center of Traditional Chinese Medicine (TCM) among Africa and Arab countries. The development of TCM in Tunisia has shown great potential. By searching the information and legal regulations of the Ministry of health of Tunisia, the West Asia and Africa Department of the Ministry of Commerce of China and the business office of the Chinese Embassy in Tunisia, this paper studies the development status, legislation and drug access, bilateral cooperation, market potential and risks of TCM in Tunisia. It is found that acupuncture and massage are widely used in Tunisia. However, Tunisia has strict control over the sources of TCM. It is proposed that the future development of TCM in Tunisia should be based on the advantages of good relations between China and Tunisia, obtain both government support, take acupuncture and massage as a pioneer, promote TCM, encourage and develop TCM industry.

Objective To evaluate the efficacy of intravascular ultrasound guided tranradial rotational atherectomy ( RA) followed by drug eluting stent ( DES) implantation in treating patients with heavily calcified coronary lesions.Methods Clinical characteristics , coronary angiogram , intravascular ultrasound images , peri-procedure and follow-up data ( including death , myocardial infarction and target lesion revascularization ) of 44 patients treated with RA and DES implantation under the guidance of IVUS in our department from March 2011 to March 2013 were retrospectively analyzed.IVUS examination was carried out before RA , after RA and stent implantation to guide whether further RA or post dilatation was needed.According to the arc of calcification , the patients were divided into group A (90°-270°,18 cases) and group B (271°-360°,26 cases).Results In A and B group, the arc of calcification was (195 ±71)°in group A and (345 ±23)°in group B(P<0.01), length of calcification was (34.4 ±11.8)mm in group A and (20.0 ±6.6) mm in group B ( P<0.05).Number of burrs used and size of largest burr used were similar between 2 groups (both P>0.05).Acute cross sectional area gain after RA was (0.43 ±0.32)mm2 in group A and (0.53 ±0.38)mm2 in group B (P>0.05).After RA, there was significant decrease in the arc of calcification in group B compared with baseline ( ( 324 ±52 ) °vs.( 345 ±23 ) °, P <0.05 ).The minimal lumen area and diameter were significantly increased after RA resulting in significant decrease in the plaque burden in both groups ( all P<0.05 ).The final minimal lumen area after stenting were similar between 2 groups (P>0.05).Procedure success rate was 100%(44/44) without any major complications such as death , acute myocardial infarction and coronary perforation.During the ( 16.6 ±6.3 ) months follow-up, there was 1 death in group A , 1 target lesion revascularization in group B and there was no acute myocardial infarction in the 2 groups.Conclusion Heavily calcified coronary lesions can be effectively and safely treated by transradial RA under the guidance of IVUS.

OBJECTIVE: To investigate the effects of centella asiatica (CA) granule on the expression of transform growth factor-β(TGF-β) and related down-stream signals in rats with early diabetic nephropathy(DN) and to clarify the molecular mechanisms of CA molecular mechanism of on preventing and curing early diabetic kidney disease DN by studying the effects of centella asiatica on TGF-β expression and related down-stream signals. METHODS: Sixty male SD rats were divided into control group(=10) and DN model group(=50). The model rats were made a right nephrectomy. One week later, diabetic nephropathy was induced by intraperitoneal injection of streptocozin(30 mg/kg) for three consecutive days. High blood glucose level of Tail vein (fasting glucose ≥ 16.7 mmol/L) and high urinary protein level(total protein level in DN group was more than twice higher than the control group) were measured to confirm early DN in rats. In the sham operation group, the right renal capsule was damaged and the corresponding amount of saline was injected. The model rats were administrated by the means of intragastric administration. The DN model group were divided into DN group, DN+fosinopril group(1.6 mg/kg·d), DN+high CA group(16.8 mg/kg·d), DN+medium CA group(11.2 mg/kg·d) and DN+low CA group(5.6 mg/kg·d), and each group was intragastric administration one time every morning last for 16 weeks. The expressions of mRNA and protein of TGF-β, TβR1, TβR2, Smad2/3, Smad7 and the level of Smad2/3 phosphorylation were detected by using real time quantitative polymerase chain reaction and Western blot. RESULTS: The expressions of mRNA and protein of TGF-β, TβR1, TβR2, Smad2/3 and the level of Smad2/3 phosphorylation were significantly increased, the expressions of mRNA and protein of Smad7 were dramatically decreased. The fosinopril and high dosage CA could reverse the effects of DN. CONCLUSIONS CA plays an important role in preventing and curing DN through regulating the TGF-β/Smad signaling pathways.
Animals ; Centella ; chemistry ; Diabetes Mellitus, Experimental ; Diabetic Nephropathies ; chemically induced ; drug therapy ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; Kidney ; physiopathology ; Male ; Rats ; Rats, Sprague-Dawley ; Receptor, Transforming Growth Factor-beta Type I ; metabolism ; Receptor, Transforming Growth Factor-beta Type II ; metabolism ; Signal Transduction ; Smad2 Protein ; metabolism ; Smad3 Protein ; metabolism ; Smad7 Protein ; metabolism ; Transforming Growth Factor beta1 ; metabolism

OBJECTIVES: Stably expressed transforming growth factor -beta 1(TGF-β1)MCs were obtained and the effects of centellaasiatica (CA) granule on the expressions of Smad 2/3, Smad 7 and collagen Ⅳ and the level of Smad 2/3 phosphorylation were observed. METHODS: Lipofectin method was used to transfect TGF-β1 vector into MC, and the stably expressed TGF-β1 cell lines were selected by G418. The cells were divided into three groups. Control group:normal MC + RPMI 1640 + 10% normal rat serum; TGF-β1 group:stably expressed TGF-β1 MC + RPMI 1640 + 10% normal rat serum; CA group:stably expressed TGF-β1 MC + RPMI 1640 + 10% rat serum containing high CA. The experiments were repeated for five times. The contents of TGF-β1 and collagen Ⅳ in the culture medium were detected with ELISA, the expressions of mRNA and protein of TGF-β1, Smad 2/3, Smad 7 and the level of Smad 2/3 phosphorylation were detected by using real time quantitative polymerase chain reaction and Western blot. RESULTS: The contents of TGF-β1 and collagen Ⅳ in the culture medium of stably-expressed TGF-β1 MC were increased significantly, and the CA could reverse the effects of TGF-β1. The expressions of mRNA and protein of TGF-β1, Smad 2/3 and the level of Smad 2/3 phosphorylation were increased significantly in TGF-β1 transfected MC, and CA could dramatically reduce the expressions of mRNA and protein of TGF-β1, Smad 2/3 and the level of Smad 2/3 phosphorylation. The high expression of TGF-β1 decreased the expression of Smad 7 mRNA and protein, and the CA could antagonize the effect of mRNA expression. CONCLUSIONS The MCs stably-expressed TGF-β1 can activate the TGF-β1/Smad signal pathway and increase the expression of collagen Ⅳ. CA can decrease the occurrence of diabetic nephropathy(DN) by reducing the production of collagen Ⅳ through inhibiting the TGF-β1/Smad signal pathway.
Animals ; Cells, Cultured ; Centella ; chemistry ; Collagen Type IV ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; Mesangial Cells ; drug effects ; metabolism ; Rats ; Signal Transduction ; Smad Proteins ; metabolism ; Smad2 Protein ; metabolism ; Smad3 Protein ; metabolism ; Smad7 Protein ; metabolism ; Transforming Growth Factor beta1 ; metabolism

ObjectiveWearing protective masks for a long time causes a large number of frontline health care workers to suffer different degrees of pressure injury or facial skin rupture in response to COVID-19. This paper aims to analyze the occurrence characteristics and related factors of pressure injury related to devices, and provide the basis for taking countermeasures. Methods There was online investigation of skin injuries caused by wearing protective equipment in medical staff. Descriptive analysis was carried out on the occurrence characteristics of pressure-induced injury, and influencing factors were analyzed through logistic regression model. ResultsThere were a total of 2901 valid questionnaires. The results showed that the incidence of pressure injury caused by protective equipment was 26.34%, mainly in the bridge of the nose (20.41%), cheek (20.23%), auricle (17.82%) and forehead (8.86%). Multivariate Logistic regression model analysis showed that the major associated factors, which presented increasing risk, were sweating and dampness (OR=12.72, 95%CI 8.36-17.30), wearing level-3 protective equipment (OR=3.55, 95%CI 2.47-5.08), wearing level-2 protective equipment (OR=3.37, 95%CI 2.47-4.60), wearing time (OR=1.29, 95%CI 1.05~1.58) and occupation (OR=1.57, 95%CI 1.00~2.49). Conclusion There is the high incidence of pressure injuries to health care workers caused by protective equipment against COVID-19. The main risk factors for facial stress injury of medical staff are sweating and dampness, wearing level-3 and level-2 protective equipment and wearing time.

The metabolic reprogramming of tumor cells is characterized by increased uptake of various nutrients including glutamine. Glutamine metabolism provides the required substances for glycolysis and oxidative phosphorylation and affects the homeostasis of carbohydrate，fat and protein metabolism to induce the chemoresistance of tumor cells. Combination of chemotherapeutic agents with inhibitors specific to different components of glutamine metabolic pathway has obtained favorable clinical results on various tumors. Glutamine metabolic pathway plays a role in drug resistance of tumor cells in various ways. Firstly，the dynamic change of glutamine transporters can directly affect intracellular glutamine content thereby causing drug resistance; secondly，tumor stromal cells including adipocyte，fibroblast and metabolite from tumor microenvironment would give rise to immune-mediated drug resistance; thirdly，the expression and activity of key enzymes in glutamine metabolism also has a critical role in drug resistance of tumors. This article reviews the effects of glutamine metabolic pathway in the development of tumor chemoresistance，in terms of transporters，tumor microenvironment and metabolic enzymes，to provide insight for improving the therapeutic efficacy for drug-resistant tumors.
Cell Line, Tumor ; Drug Resistance, Neoplasm ; Glutamine/metabolism* ; Glycolysis ; Humans ; Neoplasms/drug therapy* ; Oxidative Phosphorylation ; Tumor Microenvironment

Objective:To investigate the risk factors of anemia and prognostic value of different grades of anemia in patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF).Methods:Anemia grades of 1 163 patients with HBV-ACLF were analyzed and the effect of different grades on prognosis were evaluated. The risk factors related to anemia were evaluated by Spearman rank correlation analysis and logistic regression analysis.Results:Among 1 163 patients, 942 (80.99%) patients had anemia. The incidence of grade 2 and 3 (moderate and severe) anemia in type B and C HBV-ACLF patients was significantly increased ( χ2=72.908, P<0.001). The incidence of macrocytic anemia among type A, B and C HBV-ACLF ranged from 13.0% to 43.98% and 58.33%, respectively( χ2=46.823, P <0.001). The 1-year cumulative survival rate of patients with grade 2 and 3 anemia decreased significantly( χ2=50.179, P<0.001); Spearman rank correlation analysis showed that the correlation coefficient between ABC type and anemia grade was 0.319, P<0.001. Logistic regression analysis showed that gastrointestinal bleeding, acute kidney injury (AKI) and ABC types were independently associated with grade 2 and 3 anemia in patients with HBV-ACLF. Conclusions:Anemia grade is closely related to the prognosis in patients with HBV-ACLF. Gastrointestinal bleeding, AKI and ABC types are independent risk factors for grade 2 and 3 anemia in patients with HBV-ACLF.

Microwave thermotherapy(MWTT),as a treatment for tumors,lacks specificity and requires sensitizers.Most reported microwave sensitizers are single metal-organic frameworks(MOFs),which must be loaded with ionic liquids to enhance the performance in MWTT.Meanwhile,MWTT is rarely combined with other treatment modalities.Here,we synthesized a novel Fe-Cu bimetallic organic framework FeCuMOF(FCM)by applying a hydrothermal method and further modified it with methyl polyethylene glycol(mPEG).The obtained FCM@PEG(FCMP)showed remarkable heating performance under low-power microwave irradiation;it also acted as a novel nanospheres enzyme to catalyze H2O2 decompo-sition,producing abundant reactive oxygen species(ROS)to deplete glutathione(GSH)and prevent ROS clearance from tumor cells during chemodynamic treatment.The FCMP was biodegradable and demonstrated excellent biocompatibility,allowing it to be readily metabolized without causing toxic effects.Finally,it was shown to act as a suitable agent for T2 magnetic resonance imaging(MRI)in vitro and in vivo.This new bimetallic nanostructure could successfully realize two tumor treatment modalities(MWTTand chemodynamic therapy)and dual imaging modes(T2 MRI and microwave thermal imaging).Our findings represent a breakthrough for integrating the diagnosis and treatment of tumors and pro-vides a reference for developing new microwave sensitizers.

Antineoplastic Agents ; Dasatinib ; Humans ; Leukemia, Myeloid, Chronic-Phase/drug therapy* ; Protein Kinase Inhibitors ; Pyrimidines/therapeutic use*