BACKGROUND: Although intensively studied in patients with cardiovascular diseases (CVDs), the prognostic value of diastolic blood pressure (DBP) has little been elucidated in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). This study aimed to reveal the prognostic value of DBP in AECOPD patients. METHODS: Inpatients with AECOPD were prospectively enrolled from 10 medical centers in China between September 2017 and July 2021. DBP was measured on admission. The primary outcome was all-cause in-hospital mortality; invasive mechanical ventilation and intensive care unit (ICU) admission were secondary outcomes. Least absolute shrinkage and selection operator (LASSO) and multivariable Cox regressions were used to identify independent prognostic factors and calculate the hazard ratio (HR) and 95% confidence interval (CI) for adverse outcomes. RESULTS: Among 13,633 included patients with AECOPD, 197 (1.45%) died during their hospital stay. Multivariable Cox regression analysis showed that low DBP on admission (<70 mmHg) was associated with increased risk of in-hospital mortality (HR = 2.16, 95% CI: 1.53-3.05, Z = 4.37, P <0.01), invasive mechanical ventilation (HR = 1.65, 95% CI: 1.32-2.05, Z = 19.67, P <0.01), and ICU admission (HR = 1.45, 95% CI: 1.24-1.69, Z = 22.08, P <0.01) in the overall cohort. Similar findings were observed in subgroups with or without CVDs, except for invasive mechanical ventilation in the subgroup with CVDs. When DBP was further categorized in 5-mmHg increments from <50 mmHg to ≥100 mmHg, and 75 to <80 mmHg was taken as reference, HRs for in-hospital mortality increased almost linearly with decreased DBP in the overall cohort and subgroups of patients with CVDs; higher DBP was not associated with the risk of in-hospital mortality. CONCLUSION: Low on-admission DBP, particularly <70 mmHg, was associated with an increased risk of adverse outcomes among inpatients with AECOPD, with or without CVDs, which may serve as a convenient predictor of poor prognosis in these patients. CLINICAL TRIAL REGISTRATION Chinese Clinical Trail Registry, No. ChiCTR2100044625.
Humans ; Blood Pressure ; Pulmonary Disease, Chronic Obstructive/therapy* ; Cohort Studies ; Respiration, Artificial ; Inpatients ; Hospital Mortality

Objective To address the mediating role of cognitive emotion regulation in the relationship between parenting styles and health risk behavior in left-behind children.Methods A total of 404 leftbehind children were surveyed with the egna minnen av barndoms uppfostran (EMBU),the cognitive emotion regulation questionnaire-Chinese version (CERQ-C) and the adolescent health related risky behavior inventory (AHRBI).Results (1) The whole average score of AHRBI was (1.47±0.24);the scores of positive and negative cognitive emotion regulation respectively were (10.52±2.56) and (9.51±2.55);the scores of Authoritative,authoritarian and permissive/neglecting parenting styles respectively were (44.06± 8.50),(18.89±3.44) and (10.15±2.32).(2)The health risk behaviors of left-behind children were negatively related with authoritative parenting style (r=-0.26 ～-0.46,P＜0.01) and positive cognitive emotion regulation(r=-0.19～-0.44,P＜0.01),and positively related with authoritarian parenting style,permissive/neglecting parenting styles(r=0.19 ～ 0.40,P＜0.05) and negative cognitive emotion regulation (r=0.25 ～0.51,P＜0.05).(3) Authoritative parenting style was positively related with positive cognitive emotion regulation (r=0.30 ～ 0.47,P＜0.01),and negatively related with negative cognitive emotion regulation (r=-0.21 ～-0.30,P＜0.01),while authoritarian and permissive/neglecting parenting styles were negatively related with positive cognitive emotion regulation (r=-0.11 ～-0.16,P＜ 0.05),and positively related with negative cognitive emotion regulation (r=0.12～0.40,P＜0.05).(4)The mediating effect of cognitive emotion regulation between Authoritative,authoritarian and permissive/neglecting parenting styles and the health risk behaviors of left-behind children respectively were 0.62(87％),0.40(75％) and 0.48(60％).Conclusion The results suggests that parenting styles impact the health risk behavior in left-behind children mainly via the mediating effect of cognitive emotion regulation.

Objective To investigate the changes of coagulation function in patients with sepsis after anti-coagulant treatment and its correlation with prognosis.Methods The clinical data of 132 patients with sepsis in our hospital were analyzed retrospectively,and all the patients were given routine anti-infection,fluid re-placement,acid suppression,organ support and anticoagulant treatment.The prognosis was recorded within 1 month after admission,the patients enrolled in the study were divided into the death group(46 cases)and the survival group(86 cases).T he sex,age and coagulation function[prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(FIB),two D-dimer(D-D),platelet count (PLT)]of the patients were compared between the two groups.Logistic multiple factor regression analysis was performed.At the same time,ROC curves for predicting the risk of death in patients by using coagulation function were drew.Results After the anticoagulant treatment,PT,APTT,TT,FIB,D-D values of the sur-vival group were lower than the death group,and PLT was higher than the death group(P < 0.05).Logistic multivariate regression analysis showed that PT,APTT and PLT were independent factors in the mortality of sepsis patients(P<0.05).The area under the curve(AUC)of PT for predicting death risk was 0.815,when the best cut-off value was 13.84 s,the sensitivity was 0.870 and specificity was 0.698.The AUC of APTT for predicting death risk was 0.756.,when the best cut-off value was 38.95 s,the sensitivity was 0.848 and speci-ficity was 0.698.The AUC of PLT for predicting death risk was 0.826,when the best cutoff value was 216.62×109,the sensitivity was 0.686 and the specificity was 0.913.Conclusion After anticoagulant treat-ment ,PT ,APTT and PLT are independent prognostic factors of sepsis ,and they have some predictive valuefor the risk of death .

ObjectiveToinvestigatetheplasmidgenechangesinquinolone‐sensitivePseudomonasaeruginosa.Methods 31iso‐lates from January 2011 to December 2013 from various qualified clinical samples in the hospital were collected .In the 31 isolateds , 16 isolates proved sensitive to quinolones by using K‐B method were used as research objects in the study .The isolates growing ou‐side the sensitive ring of ciprofloxacin paper were selected to continuously transferred into other culture dishes until the resistance to quinolones were acquired .Plasmid transformation and extraction were performed on those isolates to confirm the existence of drug‐resistanceplasmidsacquired,andthroughPCRandgenesequenceanalysistodeterminethetypeofplasmids.Results 2iso‐lates of quinolone‐sensitive Pseudomonas aeruginosa acquired drug‐resistance plasmids qnrS and were resistant quinolones induced by continuous transferring for 9 times .Conclusion If antibiotics of inhibitory concentration were often used for the treatment of Pseudomonas aeruginosa infection ,drug‐resistance plasmids were acquired easily .

Objective Pseudomonasaeruginosa resistance to quinolones and around symbiotic bacteria resistant plasmids each chromosome metastasis.Methods 481 samples was collected from the Seventh People’s Hospital of Shenzhen since January 2011 to December 2013,and it cultured Pseudomonasaeruginosa 31 cases,susceptibility testing confirmed 15 cases of quin-olone-resistant as the research obj ect,using plasmid transformation,pick up experiments confirmed the presence of the re-sistance plasmid,PCR amplification,gene sequence analysis,and gene sequences surrounding the symbiotic bacteria resistant plasmids as a same.Results The same gene sequence of plasmid was found between drug-resistant strains of Pseudomonas aeruginosa and the surrounding symbiotic bacteria[χ2=1.207,P<0.01].Conclusion Resistance plasmids could be trans-ferred between different species of bacteria.

Objective To investigate the role of AMP-activated protein kinase (AMPK) signal path in cell autophagy activation at early brain injury in rats after subarachnoid hemorrhage (SAH).Methods Adult male SD rats (weighting 300-350 g) were divided into five groups (n=12):sham-operated group,SAH group,and SAH+AICAR group,SAH+Compound C group and SAH+vehicle group.SAH models in the later four groups were established by endovascular perforation technique,and rats in the later three groups were performed left intracerebroventricular injection of AMPK agonist AICAR,AMPK inhibitor Compound C or normal saline 30 min before modeling;animals were subsequently sacrificed at 24 h after modeling.Immunohistochemical method was used to detect the phosphorylated mammalian target of rapamycin (p-mTOR) expression.Expressions of cortex autophagy related proteins LC3,AMPK and phosphorylated AMPK (p-AMPK) were observed by Western blotting.Loeffler's method was used to evaluate the neurologic behavior scores.Results As compared with those in the sham-operated group,the p-AMPK level,p-mTOR expression level and LC3Ⅱ/LC3Ⅰ ratio were significantly increased,while the behavioral deficit scores were significantly lower in the SAH group,with statistical differences (P＜0.05);the p-mTOR mainly expressed at cortex surrounding the hemorrhage areas,and integration areas of deep cortex and brain white matter.As compared with the sham-operated group and SAH+vehicle group,SAH+AICAR group had significantly increased p-AMPK level,decreased p-mTOR expression level,increased LC3Ⅱ/LC3Ⅰ ratio,and decreased behavioral deficit scores (P＜0.05);as compared with the sham-operated group and SAH+vehicle group,SAH+Compound C group had significantly decreased p-AMPK level,decreased LC3Ⅱ/LC3Ⅰ ratio,and decreased behavioral deficit scores (P＜0.05).Conclusion AMPK is involved in the process ofautophagy activation after SAH through regulating mTOR,and the regulation of AMPK may contribute to neuroprotection related to autophagy.

Objective The aim of this study is to demonstrate the diagnostic effect of brainstem evoked potential for pancreatic encephalopathy in rats with severe acute pancreatitis. Methods Sixty male Sprague-Dawley (SD) rats were randomly divided into two equal groups: a sham-operated (SO) group and a severe acute pancreatitis (SAP) group. Each group was evaluated at 3, 6, and 12 h during the experiment. To detect the brain stem evoked potential change at different time points. The ultrastructure of brain tissue was observed by transmission electron microscope (TEM). The expressions of the apoptosis-related proteins Bcl-2, Bax and caspase-3 were observed using immunohistochemical and Western Blot technique. Results In SAP group, congestion, edema, inflammatory cell infiltration, mitochondrial swelling and cell apoptosis were apparent. Compared with SO group, the brain stem evoked potential in severe acute pancreatitis group was obviously reduced in SAP group. Compared with SAP group, the expressions of Bcl-2 have increased, whereas the expressions of Bax and caspase-3 have decreased in SO group significantly ( <0.05) . Conclusion Brain stem evoked potential is a sensitive method in detection of rat brain damage. The results showed that the consistency and the damage degree of rats may be important clinical diagnostic index of pancreatic encephalopathy.