OBJECTIVE To understand the distribution and drug susceptibility rates of clinical Nocardia isolates so as to provide bases for standardized clinical diagnosis and treatment.METHODS The characteristics of clinical dis-tribution of the Nocardia strains that were isolated from The Second Affiliated Hospital of Fujian Medical Univer-sity between Aug.2019 and Aug.2024 were retrospectively analyzed.The isolated strains were identified by means of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry(MALDI-TOF MS),16S rRNA and rpoB gene sequencing were performed for the strains with low score,and the drug susceptibility testing was carried out by broth micro dilution method.RESULTS Totally 35 strains of Nocardia were isolated from clinical specimens in the five years,11 of which were Nocardia cyriacigeorgica,4 were Nocardia asiatica,3 were No-cardia farcinica,3 were Nocardia brasiliensis,3 were Nocardia sputorum,2 were Nocardia nova,2 were No-cardia otitidiscaviarum,2 were Nocardia beijingensis,2 were Nocardia concava,1 was Nocardia abscessus,1 was Nocardia pseudobrasiliensis,and 1 was Nocardia terpenica.Totally 85.71％of the strains were isolated from lower respiratory tract specimens including sputum,bronchoalveolar lavage fluid,bronchial brushing and lung puncture tissues,and 11.43％were isolated from skin and soft tissues.It was basically same in the male to female ratio for the patients with Nocardia infections,there were 18 cases of male and 17 cases of female.The elderly patients were dominant,and the patients aged more than 60 years old accounted for 51.43％.The strains were mainly isolated from respiratory medicine department and critical care medicine department.The drug sus-ceptibility rates of all the isolated strains to amikacin and linezolid were 100％,the drug susceptibility rates to sul-famethoxazole-trimethoprim were 97.14％,and the drug susceptibility rates to tobramycin,ceftriaxone and imi-penem were 80％,65.71％and 62.86％,respectively;the drug resistance rates to clarithromycin and ciprofloxa-cin were 65.71％and 62.86％,respectively.Among the major species of isolated Nocardia strains,the N.cyri-acigeorgica strains were all sensitive to sulfamethoxazole-trimethoprim,linezolid,tobramycin,amikacin,imipen-em and ceftriaxone,the strains were resistant to ciprofloxacin,and the drug resistance rate to clarithromycin reached up to 81.82％.CONCLUSIONS N.cyriacigeorgica is the predominant species of isolated Nocardia strains.The pulmonary infection is the major type of infection.There is little difference in the male to female ratio among the patients with Nocardia infection,and the elderly patients are dominant.Amikacin,linezolid and sulfame-thoxazole-trimethoprim are the most sensitive drugs,and the drug resistance rates of the stains to clarithromycin are high.

OBJECTIVE To understand the distribution and drug susceptibility rates of clinical Nocardia isolates so as to provide bases for standardized clinical diagnosis and treatment.METHODS The characteristics of clinical dis-tribution of the Nocardia strains that were isolated from The Second Affiliated Hospital of Fujian Medical Univer-sity between Aug.2019 and Aug.2024 were retrospectively analyzed.The isolated strains were identified by means of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry(MALDI-TOF MS),16S rRNA and rpoB gene sequencing were performed for the strains with low score,and the drug susceptibility testing was carried out by broth micro dilution method.RESULTS Totally 35 strains of Nocardia were isolated from clinical specimens in the five years,11 of which were Nocardia cyriacigeorgica,4 were Nocardia asiatica,3 were No-cardia farcinica,3 were Nocardia brasiliensis,3 were Nocardia sputorum,2 were Nocardia nova,2 were No-cardia otitidiscaviarum,2 were Nocardia beijingensis,2 were Nocardia concava,1 was Nocardia abscessus,1 was Nocardia pseudobrasiliensis,and 1 was Nocardia terpenica.Totally 85.71％of the strains were isolated from lower respiratory tract specimens including sputum,bronchoalveolar lavage fluid,bronchial brushing and lung puncture tissues,and 11.43％were isolated from skin and soft tissues.It was basically same in the male to female ratio for the patients with Nocardia infections,there were 18 cases of male and 17 cases of female.The elderly patients were dominant,and the patients aged more than 60 years old accounted for 51.43％.The strains were mainly isolated from respiratory medicine department and critical care medicine department.The drug sus-ceptibility rates of all the isolated strains to amikacin and linezolid were 100％,the drug susceptibility rates to sul-famethoxazole-trimethoprim were 97.14％,and the drug susceptibility rates to tobramycin,ceftriaxone and imi-penem were 80％,65.71％and 62.86％,respectively;the drug resistance rates to clarithromycin and ciprofloxa-cin were 65.71％and 62.86％,respectively.Among the major species of isolated Nocardia strains,the N.cyri-acigeorgica strains were all sensitive to sulfamethoxazole-trimethoprim,linezolid,tobramycin,amikacin,imipen-em and ceftriaxone,the strains were resistant to ciprofloxacin,and the drug resistance rate to clarithromycin reached up to 81.82％.CONCLUSIONS N.cyriacigeorgica is the predominant species of isolated Nocardia strains.The pulmonary infection is the major type of infection.There is little difference in the male to female ratio among the patients with Nocardia infection,and the elderly patients are dominant.Amikacin,linezolid and sulfame-thoxazole-trimethoprim are the most sensitive drugs,and the drug resistance rates of the stains to clarithromycin are high.

Objective:To explore the effect of grasping force circle training based on knowledge, attitude and practice theory in lung cancer patients with peripherally inserted central catheter.Methods:From March 2020 to December 2021, a total of 90 lung cancer patients with peripherally inserted central catheter in the Second People's Hospital of Datong were selected as the research objects using the convenient sampling method, and were divided into the control group and the observation group by the random number table method, with 45 cases each. The control group adopted routine grasping force circle training, and the observation group conducted grasping force circle training based on knowledge, attitude and practice theory. The scores of knowledge, attitude and practice, self-management ability and the incidence of complications were compared between the two groups.Results:After intervention, the scores of knowledge, attitude and behavior of the two groups were higher than those before intervention, and the scores of the observation group were higher than those of the control group, and the differences were statistically significant ( P<0.05). After intervention, the scores of compliance of catheter maintenance, abnormal handling, confidence of catheter management, exercise of catheter, daily observation of catheter, information acquisition and daily life of catheter of the two groups were higher than those before intervention, and the scores of the observation group were higher than those of the control group, and the differences were statistically significant ( P<0.05). After intervention, the incidence of complications of the observation group was lower than that of the control group, and the difference was statistically significant ( P<0.05) . Conclusions:Grasping force circle training based on knowledge, attitude and practice theory can improve the knowledge, attitude and practice level of lung cancer patients with peripherally inserted central catheter, improve their self-management ability, and reduce the incidence of complications.

With the vigorous development of evidence-based nursing, more and more attention is paid to the reference of high-quality clinical trial results in the process of guide formulation, evidence transformation and clinical nursing practice. This article introduces the Cochrane Risk of Bias 2 (RoB 2.0) for randomized controlled trials, interprets its entries one by one, and uses the tool to evaluate a randomized controlled trial paper in the field of nursing as a demonstration, with a view to helping nursing researchers understand and correctly apply the tool to the design, implementation and quality evaluation of randomized controlled trial, so as to improve the quality of nursing research and increase the reliability of the results.

OBJECTIVES: To explore the mechanism of transforming growth factor-β1 (TGF-β1) induce renal fibrosis. METHODS: Renal fibroblast NRK-49F cells treated with and without TGF-β1 were subjected to RNA-seq analysis. DESeq2 was used for analysis. Differentially expressed genes were screened with the criteria of false discovery rate<0.05 and l o g 2 F C >1. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were performed for differentially expressed genes. Genes encoding transcription factors were further screened for differential expression genes. Then, the expression of these genes during renal fibrosis was verified using unilateral ureteral obstruction (UUO)-induced mouse renal fibrosis model and a public gene expression dataset (GSE104954). RESULTS: After TGF-β1 treatment for 6, 12 and 24 h, 552, 1209 and 1028 differentially expressed genes were identified, respectively. GO analysis indicated that these genes were significantly enriched in development, cell death, and cell migration. KEGG pathway analysis showed that in the early stage of TGF-β1 induction (TGF-β1 treatment for 6 h), the changes in Hippo, TGF-β and Wnt signaling pathways were observed, while in the late stage of TGF-β1 induction (TGF-β1 treatment for 24 h), the changes of extracellular matrix-receptor interaction, focal adhesion and adherens junction were mainly enriched. Among the 291 up-regulated differentially expressed genes treated with TGF-β1 for 6 h, 13 genes (Snai1, Irf8, Bhlhe40, Junb, Arid5a, Vdr, Lef1, Ahr, Foxo1, Myc, Tcf7, Foxc2, Glis1) encoded transcription factors. Validation in a cell model showed that TGF-β1 induced expression of 9 transcription factors (encoded by Snai1, Irf8, Bhlhe40, Junb, Arid5a, Vdr, Lef1, Myc, Tcf7), while the expression levels of the other 4 genes did not significantly change after TGF-β1 treatment. Validation results in UUO-induced mouse renal fibrosis model showed that Snai1, Irf8, Bhlhe40, Junb, Arid5a, Myc and Tcf7 were up-regulated after UUO, Vdr was down-regulated and there was no significant change in Lef1. Validation based on the GSE104954 dataset showed that IRF8 was significantly overexpressed in the renal tubulointerstitium of patients with diabetic nephropathy or IgA nephropathy, MYC was highly expressed in diabetic nephropathy, and the expressions of the other 7 genes were not significantly different compared with the control group. CONCLUSIONS TGF-β1 induces differentially expressed genes in renal fibroblasts, among which Irf8 and Myc were identified as potential targets of chronic kidney disease and renal fibrosis.
Mice ; Animals ; Humans ; Transforming Growth Factor beta1/metabolism* ; Diabetic Nephropathies/pathology* ; Transcriptome ; Signal Transduction ; Kidney ; Ureteral Obstruction/pathology* ; Fibrosis ; Interferon Regulatory Factors ; Transforming Growth Factor beta/metabolism* ; DNA-Binding Proteins/metabolism* ; Transcription Factors/metabolism*

Humans ; Aripiprazole/therapeutic use* ; Schizophrenia/drug therapy* ; Antipsychotic Agents/therapeutic use* ; Risperidone ; China ; Treatment Outcome

Objective: To explore the value of contrast-enhanced ultrasound in the biopsy of patients with breast imaging reporting and data system (BI-RADS) score of 4 lesions. Methods: Total of 136 cases of breast BI-RADS scores of 4 lesions admitted to Dongguan People′s Hospital from June 2017 to May 2018 were enrolled and randomly divided into contrast-enhanced ultrasound group and general ultrasound group, 68 cases in both group. The contrast-enhanced ultrasound group received contrast-enhanced ultrasound-guided breast nodule biopsy, and the general ultrasound group received general ultrasound-guided breast nodule biopsy. The success rate of puncture, the number of puncture needles, the satisfaction rate of the materials, the diagnostic sensitivity, the diagnostic specificity, the diagnostic coincidence rate, and the incidence of adverse puncture reactions were compared between two groups. Results: The puncture success rate of both groups were 100%. The number of puncture needles in contrast-enhanced ultrasound group was (2.89±0.56)times, and the general ultrasound group was (2.93±0.62)times, with no statistically significant difference (P>0.05). The satisfaction rate of materials in the contrast-enhanced ultrasound group was 100%(68/68), and the general ultrasound group was 94.12%(64/68), with no statistically significant difference (P>0.05). The sensitivity in the contrast-enhanced ultrasound group and the general ultrasound group were 88.89%(32/36) and 81.82%(27/33), respectively, with no statistically significant difference (P>0.05). The specificity and coincidence rate in contrast-enhanced ultrasound group were 100%(32/32) and 94.12%(64/68), which were higher than 80.65%(25/31) and 81.25%(52/64) of the general ultrasound group, with statistically significant difference (P<0.05). The incidence of adverse reactions in the general ultrasound group and the contrast-enhanced ultrasound group were 10.94%(7/64) and 2.94%(2/68), respectively, with no statistically significant difference (P>0.05). Conclusions The contrast-enhanced ultrasound-guided breast nodule biopsy can achieve high puncture success rate in patients with breast cancer with BI-RADS scores 4 lesions, and help to confirm lesion activity, necrotic liquefaction area, more accurate localization, improved material satisfaction rate and biopsy, diagnostic efficacy, with significant clinical value.

Objective This study was provided the evidence of infection respiratory tract clinical treatment through examining 695 cases of pathogen .Methods Using indirect immunofluorescence(IFA) IgM antibody with 9 respiratory pathogen in serum of 695 patients from August 2015 to March 2016 with respiratory tract infection from espiratory ,pediatrician ,thoracic surgery clinics were detected in this paper in order to provide the basis for clinical treatment .Results The results showed that single pathogen de‐tection positive rate was 33 .9% in 695 cases ,The top three of positive rate were MP(14 .1% ) ,IFB(9 .6% ) ,RSV(4 .8% );the posi‐tive rate of two mixed infection was 7 .79% ;The postive rate of MP ,IFB have obvious difference in seasons ,but which of Coxiella burneti was no obvious seasonal difference;there was an obvious difference between the sex ratio .Conclusion MP ,IFB ,RSV infec‐tion were given priority to detection rate in our region .

Objective To investigate the effect of CT perfusion (CTP) imaging guidance in the treatment of acute cere?bral infarction. Methods Patients (n=200) with acute cerebral infarction who visited our clinic within 6 hours underwent CTP examination and were divided into two groups:penumbra group and non-penumbra group according to their CTP imag?ing (presence of penumbra or not). Recombinant tissue plasminogen activator (rt- PA) was administrated for intravenous thrombolysis in both groups. NIHSS (The NIH Stroke Scale), BI (Barthel Index), mRS (modified Rankin Scores) and hemor?rhagic transformation events of two groups were determined before and after thrombolysis to evaluate its effect and prognosis in these two group. Results Compared with non penumbra group, NIHSS was reduced in penumbra group from 7 days after rt-PA (6.67±3.46 vs 4.76±2.04), and this decrease became obvious at 4 weeks after rt-PA (6.67±3.46 vs 3.68±1.93). Effi?ciency rate at 4 week (60.3%) and good prognosis rate at 3 months(71.7%)were both significantly improved in penumbra group than those in non penumbra group(34.7%,56.8%). Conclusion rt-PA under CTP guidance is effective and safe in the treatment of acute cerebral infarction. The thrombolytic therapy window can be enlarged according to the presence of pen?umbra or not and the bleeding conversion rate remains at low level.

Objective To clone and express Dengue virus nonstructural protein 4A (NS4A) gene and express in eukaryotic cells.Then,to isolate and purify and isolate cellular proteins interacted with NS4A.Methods With specific primers,NS4A gene fragment tagged with FLAG and HA (FLAG-NS4A-HA) was amplified by PCR and cloned into an expression vector,pSG5 vector.Recombinant plasmid was transfected into A549 cells by LipofectAMINETM2000.Transient expression of FLAG-NS4A-HA was detected by Western blot.The NS4A interacting proteins were isolated and purified by tandem affinity purification (TAP) system using HA and FLAG antibodies,and then assayed by silver stained SDS-PAGE.Results Dengue virus NS4A gene tagged with FLAG and HA was successfully constructed into pSG5 vector and expressed in A.549 cells.Silver stained SDS-PAGE showed that the expressed NS4A and two potential interacting proteins that interact with NS4A were isolated after TAP purification and SDS-PAGE.Conclusion Cellular proteins that potentially interacted with Dengue virus NS4A were successfully purified and isolated,which provided a basis for further research.