Objective:The present study aimed to conduct a clinical analysis of nosocomial infections in hospitalized cancer pa-tients and propose effective precautionary measures. Methods:We retrospectively analyzed 56,430 cases of discharges from the Cancer Institute and Hospital of Tianjin Medical University between January and December 2012. Results:Among 825 cases, the rate of noso-comial infections was 1.46%;46.42%of the patients aged>60 years. The highest infection rate was observed in the Medical Depart-ment of Stomach Cancer. The highest composing rate was recorded in the Department of Hepatobiliary Cancer. The major pathogenic bacteria were Gram-negative bacilli;fungal infections were relatively rare. The most vulnerable body parts were the abdomen and diges-tive tract, which were mainly infected by pathogenic Escherichia coli. Conclusion:Healthcare workers should consider the importance of influencing factors and take precautionary measures to reduce the rate of nosocomial infections in cancer patients.

Objective To analyze research literature about integration of the body and the spirit; To understand the research status of this classical theory.Methods Relevant articles about integration of the body and the spirit in CNKI, Wanfang Data, VIP-Chinese Scientific and Technological Journal Data were searched, and bibliometric analysis with NoteExpress3.0, Bicomb2.0 and SPSS19.0 software was used to analyzed the data.ResultsA total of 156 efficient articles were retrieved. The number of published articles increased, but the core author group had not yet been formed. The number of cited articles was low. The study hot spots mainly focused on TCM constitution, the subject of health preservation, TCM basic theories, and psychosomatic medicine.Conclusion Domestic studies on integration of the body and the spirit are still in the initial stage. Research number should be increased, meanwhile, innovation and quality should be emphasized.

OBJECTIVETo evaluate the diagnostic value of dynamic monitoring of C-reactive protein (CRP) in drainage fluid in predicting early anastomotic leakage after colorectal surgery.

METHODSThis study enrolled 172 patients, who were diagnosed as colorectal cancer before operation and underwent radical surgery, without residual tumor tissues by postoperative pathology and perioperative infection, at the Tianjin Medical University Cancer Hospital between July 2015 and January 2016. The C-reactive(CRP) protein level in drainage fluid was continuously monitored from postoperative days (POD) 1 to 5. CRP level was compared between anastomotic leakage (AL) group and non-anastomotic leakage (NAL) group. Receiver operating characteristics (ROC) curve was used to estimate the value of monitoring CRP in drainage fluid to predict anastomotic leakage after colorectal surgery.

RESULTSAmong 172 patients, 101 cases were male and 71 cases were female, with age of (59.9±10.3) years. Anastomotic leakage occurred after colorectal surgery in 24 cases(14.0%, AL group ) and other 148 cases were defined as NAL group. Other than body mass index (BMI), differences in baseline data were not statistically significant between two groups. The CRP lever in AL group and NAL group showed rising trend from POD1 to POD4 [Day 1: (6.7±8.4) g/L vs. (8.0±10.6) g/L; Day 2: (24.8±14.6) g/L vs. (28.3±21.1) g/L, Day 3: (54.8±26.5) g/L vs. (53.8±27.6)g/L, Day 4: (62.0±32.2) g/L vs. (58.4±30.7) g/L], while the differences were not significant (all P>0.05). At POD 5, the CRP lever of AL group increased continuously, while that of NAL group decreased with significant difference [(65.3±38.9) g/L vs. (44.7±39.5) g/L, t=-2.85, P=0.005]. Further stratification analysis on AL group revealed CRP level in early AL (AL occurrence POD 10) showed rising trend from POD 1 to 4, then decreased slightly at POD 5, but whose differences were not significant (all P>0.05). ROC curve was drawn with AL condition as state variables and CRP level as test variables. The AUC of POD 1 to 4 was 0.425, 0.487, 0.510, 0.522 respectively and the AUC of POD 5 was the largest, 0.657 (95%CI:0.537-0.777). The largest Youden Index was 0.274. The critical value of CRP was 27.15 g/L. When this value was used as the point of tangency to predict the occurrence of AL, the sensitivity was 87.5%, the specificity was 39.9%, positive predictive value was 19.1%, and negative predictive value was 95.2%.

CONCLUSIONContinuous increase of CRP level in abdominal drainage fluid from POD 1 to POD 5 indicates the occurrence of AL after colorectal cancer operation, especially the detection of CRP level at POD 5 is important.

Objective:To further understand the etiological distribution of fever of unknown origin (FUO) in patients underwent 18F-fluorodeoxyglucose (FDG) PET/CT imaging, and to explore the significance of 18F-FDG PET/CT in the diagnosis of different types of diseases in FUO patients. Methods:From January 2013 to August 2019, the clinical and PET/CT image data of 466 FUO patients (194 males, 272 females, age: 3-91(52.7±20.9) years) in Peking University People′s Hospital were retrospectively analyzed. The etiological distribution of FUO patients was analyzed according to the final clinical diagnosis. PET/CT imaging manifestations were analyzed for different types of diseases in FUO patients. The role of 18F-FDG PET/CT in differential diagnosis for FUO was evaluated through clinical questionnaire. Data were analyzed by using χ2 test. Results:The common disease types in FUO patients were rheumatic and immune disease (48.7%, 227/466), infection (28.5%, 133/466) and malignant tumor (11.2%, 52/466). For PET/CT imaging, 95.5% (445/466) of the patients were positive, of which 313 (70.3%, 313/445) were found to have focal lesions, and the other 132 (29.7%, 132/445) showed only nonspecific abnormal uptake. Lesions in different types of diseases were varied in the location, morphological changes as well as FDG uptake. The results of the questionnaire showed that PET/CT imaging could benefit 95.9% (447/466) of the patients in the FUO diagnosis and treatment. PET/CT reached direct etiological diagnosis of malignant tumors more frequently than other types of diseases ( χ2 values: 14.408-25.466, all P<0.001). PET/CT helped or directly reached the etiological diagnosis of rheumatologic diseases more frequently than infection and unknown cause group( χ2 values: 7.922, 9.647, both P<0.05). Conclusion:18F-FDG PET/CT imaging has high clinical value in the diagnosis of FUO etiology and can provide multilevel diagnostic information.

Objective:To summarize our experience in diagnosis and treatment of patients with pulmonary mucosa-associated lymphoid tissue-derived(MALT) lymphoma and to explore the role of surgery.Methods:We retrospectively analyzed the clinical and follow-up data of 86 patients with pulmonary MALT lymphoma in Shanghai Pulmonary Hospital from January 2000 to December 2018. 86 cases were identified with 44 males and 42 females. The mean age was(56.7±10.6) years old. 38(44.2%) cases had symptoms mainly presenting as cough and sputum at diagnosis. The chest CT scan of the patients showed pulmonary consolidation in 39 cases, nodule/mass shadow in 37 cases, usually with air bronchogram. Only 8(9.3%) cases could be diagnosed by non-surgical approach. 58 cases received complete resection, 10 of which followed chemotherapy. 8 of 17 cases who received incomplete resection accepted chemotherapy. The rest 11 cases who experienced surgical biopsy because of uncertain diagnosis were treated by chemotherapy or radio-chemotherapy or just watch-to-wait.Results:The median follow-up of 83 cases was 64 months, ranged from 24 to 219 months. The estimated 5-year and 10-year OS rates were 95.0% and 76.8%, while 5-year and 10-year PFS were 75.7% and 35.1% respectively. Patients who received complete resectionhad better PFS( P<0.001)but similar OS( P=0.395), compared with those received incomplete resection. There were no significant difference in OS and PFS between patients who received complete resection accepted chemotherapy or not( P>0.05). Conclusion:Pulmonary MALT lymphoma has an indolent nature with an excellent long-term survival. Diagnosis is difficult to be made by non-surgical approach. Surgery plays an important role of treatment of pulmonary MALT lymphoma, due to significant improvement of diagnosis rate and radical treatment of localized disease by complete resection.

Objective Based on the comparison and analysis of Raman spectra of liver meridian(including other meridian)and non-liver meridian(other meridian excluding liver meridian)traditional Chinese medicine,the accurate quantitative characterization data of liver meridian was obtained,and the liver meridian identification model was established and analyzed.Methods Taking 120 non-liver meridian(other meridian excluding liver meridian)traditional Chinese medicines(TCMs)as blank control and 120 liver-meridian(including other meridian)TCMs as experimental medicines,Raman spectra of 240 TCMs were obtained after sample pretreatment and Raman spectroscopy detection,and then quantified in units of 1 cm-1.Then combined with Random Forest(Random Forest,RF),Artificial Neural Network(Artificial Neural Network,ANN)and other algorithms,we constructed the identification models of quantized characterization of liver meridian.Results Compared with non-liver meridian(other meridian excluding liver meridian)TCMs,the Raman spectra of the liver meridian TCM were generally lower in the whole detection range,especially in the range of 200-1100 cm-1.The quantized Raman spectrogram data combined with ANN presented the best discrimination results with accuracy,precision>0.871,the receiver operating characteristic curve(ROC)was drawn and the area under ROC curve(AUC)was obtained,with AUC>0.921.Conclusion The Raman spectrogram of TCMs has significant correlation with liver meridian,which can be used as a whole quantized characterization of liver meridian.Combined with ANN,Raman spectrogram can carry out identification analysis efficiently and accurately,which is conducive to solving the bottleneck problem of lacking accurate data on medicinal properties and enriching the scientific connotation of attributing meridians.

Male infertility,a common condition in andrology,falls under the category of"no son"in traditional Chinese medicine(TCM).Unhealthy eating habits and excessive sexual activity,prevalent due to improved living standards,have contributed to the increasing incidence of male infertility.YE Tianshi proposed the theory of"maintaining with the sweet and restoring the body fluids",which emphasizes the importance of ample body fluid for the nourishment of the male essence chamber.Sufficient body fluid is crucial for normal sperm generation.In TCM,the primary pathogenesis of male infertility involves the loss of body fluids and insufficiency of yin essence.Sweet Chinese herbal medicinal is recommended as it nourishes yin,enriches essence,and replenishes male reproductive essence without producing phlegm and dampness.Therefore,when treating male infertility,attention should be given to the use of sweet Chinese herbal medicinal,adhering to the principle of"abundant body fluids nourish kidney yin,and abundant kidney yin supports semen production".Therapies such as purging fire to preserve body fluids with Zengye Decoction,nourishing yin to enrich essence with Guilu Erxian Decoction,benefiting qi to promote fluid production with Buzhong Yiqi Decoction,and warming yang and transporting fluids with Xianfu Shezi Decoction should be considered.Medication and dosage adjustments should be made based on the specific etiology,pathology,and related symptoms to improve the quality of male sperm and enhance the chances of conception.

Background::The clinical characteristics of patients with the comorbidities of hypertension and coronary artery disease (HT-CAD) and atrial fibrillation (AF) are largely unknown. This study aimed to investigate the prevalence of AF in patients with HT-CAD and clinical characteristics of patients with both HT-CAD and AF.Methods::This cross-sectional study was conducted in Chinese People’s Liberation Army General Hospital in Beijing, China, and included 20,747 inpatients with HT-CAD with or without AF from August 2008 to July 2018. We examined the overall prevalence, clinical characteristics, comorbidity profiles, treatment patterns, and blood pressure (BP) control of patients with both HT-CAD and AF. Multivariate logistic regression was used to investigate the associations of cardiovascular risk factors with AF in patients with HT-CAD.Results::The overall prevalence of AF in patients with HT-CAD was 4.87% (1011/20,747), and this increased with age; to be specific, the prevalence in women and men increased from 0.78% (2/255) and 1.02% (26/2561) at the age of <50 years to 8.73% (193/2210) and 10.28 % (298/2900) at the age of ≥70 years, respectively. HT-CAD patients who had AF had a higher prevalence of cardiovascular-related comorbidities than those without AF. Multivariate logistic regression showed that age, gender (male), body mass index, heart failure, and chronic kidney disease were independently associated with the risk of AF in patients with HT-CAD. For those with both HT-CAD and AF, 73.49% (743/1011) had a CHA 2DS 2-VASc score of ≥4, and only about half of them had the BP controlled at <140/90 mmHg, which indicated a high risk of thromboembolism and stroke. The use of oral anticoagulation increased during the study period (10.00% [20/200] in 2008 to 2011 vs. 30.06% [159/529] in 2015 to 2018, P < 0.01), but remained at a relatively low level. Conclusions::AF is highly prevalent among patients with HT-CAD. Patients with both HT-CAD and AF have a higher prevalence of cardiovascular-related comorbidities, lower BP control rate, and lower use of oral anticoagulation.

AIM:To investigate the effects of exercise preconditioning(EP)combined with electroacupunc-ture(EA)on learning and memory ability of rats with vascular dementia(VD),and to explore role of hippocampal ferrop-tosis in this process.METHODS:Seventy-two male SD rats were randomly divided into non-EP group and EP group,with 36 rats in each group.The rats were subjected to EP,and subsequently to establish the VD model.The rats from non-EP group were randomly divided into sham group,model group(VD group)and VD-EA group,each with 12 rats,while those in EP group were randomly divided into EP-sham group,EP-VD group and EP-VD-EA group,each with 12 rats.All rats in EP group underwent 4 weeks of swimming exercise training,5 d per week,30 min per day.At the end of the 4th week,the rats in VD,EP-VD,EP-VD-EA and VD-EA groups were used to induce the VD model,and the rats in sham and EP-sham groups received a sham surgery to simulate the VD model.On the 7th day after successful modeling,the rats in EP-VD-EA and VD-EA groups were treated with EA for 4 weeks,6 d per week,30 min per day.At the end of the inter-vention,the learning and memory ability of the rats was evaluated using Morris water maze.Neuron morphology in the CA1 area of rat hippocampus was observed through Nissl staining.Ferrous ion(Fe2+),malondialdehyde(MDA)and re-duced glutathione(GSH)contents in the rat hippocampal tissues were quantified using the colorimetric assay.The expres-sion levels of ferroptosis-related proteins,nuclear factor E2-related factor 2(Nrf2)and glutathione peroxidase 4(GPX4),in the hippocampal tissues were quantified by Western blot method.RESULTS:Compared with sham group,the rats in VD group exhibited longer mean evasion latency and decreased number of traversals across the plateau(P<0.01).The neurons in the CA1 region of the hippocampus were loose and disorganized,exhibiting an irregular cellular morphology.The hippocampal Fe2+and MDA content was elevated,and the GSH content was reduced(P<0.01).The protein levels of hippocampal Nrf2 and GPX4 were decreased(P<0.01).Compared with VD group,the rats in EP-VD,EP-VD-EA and VD-EA groups showed a shorter average escape latency and an increased number of traversals across the plateau(P<0.05).Neurons in the hippocampal CA1 area were more neatly arranged,showing regular cellular morphology.The hip-pocampal Fe2+and MDA contents of the rats in EP-VD group were significantly reduced(P<0.01),while the GSH content was elevated(P<0.05).Hippocampal Fe2+and MDA contents were significantly reduced and GSH contents were signifi-cantly increased in EP-EA and EA groups(P<0.01).The protein levels of hippocampal Nrf2 and GPX4 in EP-VD,EP-VD-EA and VD-EA groups were significantly increased(P<0.01).CONCLUSION:Exercise preconditioning combined with EA improves learning and memory ability in VD rats by reducing hippocampal intra-neuronal iron overload,maintain-ing organismal redox homeostasis,and inhibiting ferroptosis.

The SNP loci of ACOX1 gene in 83 China Holstein cows were detected by PCR amplifica-tion and direct sequencing,and the association between the genetic polymorphism loci of ACOX 1 gene and milk quality traits of China Holstein cows was analyzed by SPSS 25.0 software.The re-sults showed that a SNP locus I3-2 267 G→C was found in the third intron of ACOX1 gene,it was moderately polymorphic and in Hardy Weinberg equilibrium in the population.By correlation anal-ysis,it was found that the SNP locus was significantly related to the somatic cell content and cor-rected milk quantity of dairy cows.The I3-2 267 G→C locus of ACOX1 gene can be used as a mo-lecular marker of quality traits of Holstein cows in China,and provide reference for the study of quality traits of Holstein cows in China.