Objective To analyze the medical resource consumption of healthcare-associated infection(HAI)in patients in different groups of disease diagnosis-related grouping(DRG)based on the DRG payment model,provide reference for optimizing prevention and control of HAI as well as resource management.Methods Medical records and DRG-related indicators of discharged patients from a municipal hospital in Sichuan Province from January 1 to December 31,2024 were analyzed retrospectively.Medical resource consumption of patients in HAI group and non-HAI group was compared.Differences in average length of hospital stay and average expense per hospitalization be-tween two groups of patients were analyzed using stratified analysis.Results In 2024,HAI incidence of discharged patients in DRG management in this hospital was 1.57％.There were statistically significant differences in age,gender,admission and discharge ways between the HAI group and the non-HAI group(all P＜0.05).The main HAI sites were lower respiratory tract,surgical site,urinary tract,and blood.The time consumption index(1.63 vs 0.85),average length of hospital stay(21.00 vs 5.00 days),expense consumption index(1.53 vs 0.92),ave-rage expense per hospitalization(44 700 vs 7 300),and multiple expense in HAI group were all higher than those in non-HAI group(all P＜0.05).The consumption of medical resources for bloodstream infection was relatively higher.Patients with HAI were mostly concentrated in the groups related to acute leukemia with major complications or co-morbidities(MCC),intracranial or craniotomy surgery with MCC,tracheotomy with mechanical ventilation for 96 hours,as well as gastric,esophageal,and duodenal surgery.The average length of hospital stay and average ex-pense per hospitalization of patients in HAI group were both higher than those in the non-HAI group,differences were statistically significant(both P＜0.05).Conclusion HAI significantly increase the consumption of medical resources.Based on DRG analysis,key disease groups for infection prevention and control can be further identified,and the consumption of medical resources can be more accurately and precisely evaluated,thereby optimizing the allocation of medical resources and improving hospital operational efficiency.

Objective To analyze the medical resource consumption of healthcare-associated infection(HAI)in patients in different groups of disease diagnosis-related grouping(DRG)based on the DRG payment model,provide reference for optimizing prevention and control of HAI as well as resource management.Methods Medical records and DRG-related indicators of discharged patients from a municipal hospital in Sichuan Province from January 1 to December 31,2024 were analyzed retrospectively.Medical resource consumption of patients in HAI group and non-HAI group was compared.Differences in average length of hospital stay and average expense per hospitalization be-tween two groups of patients were analyzed using stratified analysis.Results In 2024,HAI incidence of discharged patients in DRG management in this hospital was 1.57％.There were statistically significant differences in age,gender,admission and discharge ways between the HAI group and the non-HAI group(all P＜0.05).The main HAI sites were lower respiratory tract,surgical site,urinary tract,and blood.The time consumption index(1.63 vs 0.85),average length of hospital stay(21.00 vs 5.00 days),expense consumption index(1.53 vs 0.92),ave-rage expense per hospitalization(44 700 vs 7 300),and multiple expense in HAI group were all higher than those in non-HAI group(all P＜0.05).The consumption of medical resources for bloodstream infection was relatively higher.Patients with HAI were mostly concentrated in the groups related to acute leukemia with major complications or co-morbidities(MCC),intracranial or craniotomy surgery with MCC,tracheotomy with mechanical ventilation for 96 hours,as well as gastric,esophageal,and duodenal surgery.The average length of hospital stay and average ex-pense per hospitalization of patients in HAI group were both higher than those in the non-HAI group,differences were statistically significant(both P＜0.05).Conclusion HAI significantly increase the consumption of medical resources.Based on DRG analysis,key disease groups for infection prevention and control can be further identified,and the consumption of medical resources can be more accurately and precisely evaluated,thereby optimizing the allocation of medical resources and improving hospital operational efficiency.

The facultative anaerobic and strict anaerobic microorganisms enriched and acclimated during the anaerobic digestion process are crucial for the efficiency of the anaerobic digestion system. Most of the problems encountered during running anaerobic digestion processes could be effectively improved via stimulation of microbial metabolic activity. Benefited from the rapid development of microbiome techniques, deeper insights into the microbial diversity in anaerobic digestion systems, e.g. the microbe-microbe interactions and microbe-environment interactions, have been gained. A complex and intricate metabolic network exists in the anaerobic digestion system of solid organic wastes. However, little is known about these interactions and the underlying mechanisms. This review briefly summarized the representative interactions between microbial communities during anaerobic digestion process discovered to date. In addition, typical issues encountered during the anaerobic digestion of solid organic wastes and how microbes can tackle and alleviate these issues were discussed. Finally, future priorities on microbiome research were proposed based on present contribution of microbiome analysis in anaerobic digestion system.
Anaerobiosis ; Bioreactors ; Methane ; Microbial Interactions ; Microbiota ; Solid Waste

Objective:To explore the safety and therapeutic effect of programmed death 1 (PD-1) antibody combined with chemotherapy as a neoadjuvant therapy for patients with stage Ⅱ to Ⅲ non-small cell lung cancer (NSCLC).Methods:Thirteen patients, who had been diagnosed as stage Ⅱ-Ⅲ NSCLC and received PD-1 inhibitor plus chemotherapy as a neoadjuvant treatment in National Cancer Center/Cancer Hospital were recruited. The patients received consecutive neoadjuvant chemotherapy for 21 days as a cycle and the therapeutic efficacy was evaluated after two cycles.Results:At the last time of follow-up on December 2, 2019, the objective response rate (ORR) and disease control rate (DCR) of these patients were 61.5% (95% CI 30.9%-92.1%) and 100%, respectively. The downregulation rate of disease stage was 61.5% (8/13). The resectable rate was 38.5% (5/13), among them, the major pathologic response (MPR) was 60.0% (3/5) and the complete pathologic response (CPR) was 20.0% (1/5). The neoadjuvant chemotherapy displayed a low incidence of adverse reaction. The main grade 3 to 4 toxicities were neutropenia (38.5%) and leukopenia (23.1%). There was no significant immune-related toxicity. The safety and tolerability of perioperative period of patients underwent resection were promising. Conclusions:Immunotherapy combined with chemotherapy as a neoadjuvant treatment is an effective, low-toxicity treatment manner, which has perioperative safety and high rate of MPR for patients with resectable NSCLC. It is a promising treatment option for patients with stage Ⅱ to Ⅲ NSCLC.

Objective:To explore the safety and therapeutic effect of programmed death 1 (PD-1) antibody combined with chemotherapy as a neoadjuvant therapy for patients with stage Ⅱ to Ⅲ non-small cell lung cancer (NSCLC).Methods:Thirteen patients, who had been diagnosed as stage Ⅱ-Ⅲ NSCLC and received PD-1 inhibitor plus chemotherapy as a neoadjuvant treatment in National Cancer Center/Cancer Hospital were recruited. The patients received consecutive neoadjuvant chemotherapy for 21 days as a cycle and the therapeutic efficacy was evaluated after two cycles.Results:At the last time of follow-up on December 2, 2019, the objective response rate (ORR) and disease control rate (DCR) of these patients were 61.5% (95% CI 30.9%-92.1%) and 100%, respectively. The downregulation rate of disease stage was 61.5% (8/13). The resectable rate was 38.5% (5/13), among them, the major pathologic response (MPR) was 60.0% (3/5) and the complete pathologic response (CPR) was 20.0% (1/5). The neoadjuvant chemotherapy displayed a low incidence of adverse reaction. The main grade 3 to 4 toxicities were neutropenia (38.5%) and leukopenia (23.1%). There was no significant immune-related toxicity. The safety and tolerability of perioperative period of patients underwent resection were promising. Conclusions:Immunotherapy combined with chemotherapy as a neoadjuvant treatment is an effective, low-toxicity treatment manner, which has perioperative safety and high rate of MPR for patients with resectable NSCLC. It is a promising treatment option for patients with stage Ⅱ to Ⅲ NSCLC.

Objective: To investigate the efficacy of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR TKIs) on patients with lung adenosquamous carcinoma, and to analyze relative factors. Methods: From August 2007 to July 2017, 40 patients who were pathologically diagnosed as lung adenosquamous carcinoma in our hospital and received EGFR TKIs treatment were retrospectively analyzed. All patients underwent EGFR mutation detection, resulted in 11 wild type, 13 19Del, 13 21L858R mutations, and 3 uncommon EGFR mutations in 20 exon and 19/21 complex mutation. A higher frequency of EGFR mutation was found in non-smokers and patients with adenocarcinoma components over 50.0%. Results: Twenty-six (65.0%) patients had disease progression after EGFR TKIs treatment, with a median progression-free survival (PFS) of 5.5 months (95% CI 0.52-10.49 months). A total of 20 (50.0%) patients died with an median overall survival (OS) of 15 months (95% CI 11.03-18.97 months). Multivariate analysis showed that gender, age, smoking, histopathological subtypes, EGFR mutations, and brain metastasis had no influence on PFS (all P>0.05). Gender, age, smoking, histopathological subtypes, and the presence of brain metastasis during TKI treatment had no influence on OS (P>0.05), while EGFR mutation is the only influencing factor of OS (P<0.05) in the current study. Conclusions EGFR TKIs had modest efficacy in lung adenosquamous carcinoma, especially in patients with EGFR mutation. Based on the pathological features, EGFR mutation and EGFR TKIs treatment should be introduced into the routine clinical practice to improve the survival of patients with lung adenosquamous carcinoma.

Objective To evaluate whether an early change in 18F-fluorodeoxyglucose (18F-FDG) uptake can predict tumor response to epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) and prognosis in patients with non-small cell lung cancer (NSCLC). Methods From August 2009 to April 2015, 22 patients with NSCLC who were eligible to EGFR-TKI treatment were enrolled. PET-CT scan was performed before (baseline) and 1 month after EGFR-TKI administration. Up to 5 hottest single tumor lesions (no more than 2 per organ) were considered to be target lesions. Maximum standardized uptake values (SUVmax) were measured, and post-treatment percentage changes in SUVmax (ΔSUV%) were calculated. PET responses were classified using PET response criteria in solid tumors (PERCIST). Then conventional CT scan was performed every 2 months for follow-up. Kappa statistic was used to compare agreement between the RERCIST recommendations-based therapeutic response evaluation and those based on RECIST1.1 criteria. Fisher exact test was used to compare the probability of disease progression in the early metabolic response and non-response groups. Predictive accuracy of ΔSUV% with respect to response or non-progression at CT scan was evaluated by ROC analysis. Progression-free survival (PFS) was determined by Kaplan-Meier survival analysis, and between-group comparison was performed by log-rank test. Results After 1 month of EGFR-TKI treatment, 12 patients (55%) showed partial metabolic response (PMR), 6 (27%) had stable metabolic disease (SMD), and 4 (18%) had progressive metabolic disease (PMD). There was a moderate agreement(Kappa=0.506,P<0.05) between PET response at 1 month based on PERCIST recommendations and CT response at 3 months according to RECIST 1.1. Non-progression was significantly more frequent in patients with an early PMR (χ2=11.941, P=0.005). Progression had been confirmed later during therapy in all patients with PMD . By using ROC analysis, the area under the curve for prediction of response was 0.906 (95% CI, 0.766—1.000; P=0.002), corresponding to a sensitivity of 88.9% and specificity of 84.6% at a cut-off of 40.36% in ΔSUV%. Using a cut-off value of 25.84% in ΔSUV%, highΔSUV% group (ΔSUV% ≥ 25.84%) had significantly longer PFS than low ΔSUV% group (ΔSUV%<25.84%). Conclusion Early assessment of PET-CT at 1 month of EGFR-TKI treatment could be useful to predict tumor response and clinical outcome in patients with NSCLC.

OBJECTIVE:To establish the method for simultaneous determination of 21 inorganic elements in Hypericum japoni-cum. METHODS:ICP-MS method was adopted. The power was 1300 W;flow rate of cooling gas was 1.5 L/min;flow rate of carrier gas was 0.8 L/min;flow rate of auxiliary gas was 0.2 L/min;integration time was 10 s;delay time of 1 s;repetition times was one time;measurement mode was standard curve method. SPSS 16.0 statistical software was used for relationship analysis and main component analysis. RESULTS:The linear range of iron,magnesium,calcium,aluminum,potassium,sodium,zinc,co-balt,nickel,barium,manganese,phosphorus,selenium,titanium,strontium,copper,arsenic,cadmium,chromium,lead,mer-cury were 50-250 μg/mL(r=0.9972),25-100 μg/mL(r=0.9989),25-100 μg/mL(r=0.9977),2.5-15 μg/mL(r=0.9996), 25-150 μg/mL(r=0.9991),2.5-15 μg/mL(r=0.9999),2.5-10 μg/mL(r=0.9999),2.5-10 μg/mL(r=0.9999),2.5-10 μg/mL(r=0.9999),2.5-10 μg/mL(r=0. 0.9999),2.5-10 μg/mL(r=0.9998),2.5-10 μg/mL(r=0.9996),0.5-2 μg/mL(r=0.9995),2.5-10μg/mL(r=0.9999),0.5-2 μg/mL(r=0.9983),2.5-10 μg/mL(r=0.9997),2.5-10 μg/mL(r=0.9999),2.5-10 μg/mL(r=0.9999), 2.5-10 μg/mL(r=0.9999),0.05-0.2 μg/mL(r=0.9992),0.05-0.2 μg/mL(r=0.9997),respectively. RSDs of precision,stability and reproducibility tests were all lower than 5.0%. The recoveries were 93.9%-106.9%(RSD were 0.22%-2.94%,n=6).CONCLU-SIONS:The method is simple,precise,stable and reproducible,and can be used for simultaneous determination of 21 inorganic el-ements in H. japonicum.

BACKGROUND:There is a high morbidity after spinal cord injury, and the therapeutic strategy is limited to early surgical intervention, medication and post-treatment exercise that only can improve the motor function slightly. However, there is no effective cure method. OBJECTIVE:To study the effect of partition-type spinal cord catheter combined with bone marrow stromal stem cels on T8 spinal cord transection damage in rats. METHODS:Fifty rats were randomized into five groups (n=10 per group): group I, T8 spinal cord transection (5 mm) was made in rats with no treatment; group II, the partition-type tube was inserted into the injured site after modeling; group III, partition-type tube combined with bone marrow stromal stem cels was implanted into the injured site after modeling; group IV, partition-type tube combined with polyglycolic acid fibers was implanted into the injured site after modeling; group V, partition-type tube combined with bone marrow stromal stem cels and polyglycolic acid fibers was implanted into the injured site after modeling. RESULTS AND CONCLUSION:At 2 and 12 weeks postoperatively, Basso, Beattie and Bresnahan scores were significantly higher in the groups III and IV than the groups I, II, IV (P < 0.05). At 12 weeks postoperatively, the latency of motor evoked potential below the injury plane was significantly decreased in group V compared with groups I, II, III, IV (P < 0.05). Immunohistochemical results displayed that in the groups III and V, regenerated nerve fibers grew positively and arranged orderly among the tubes, and there was no obvious winding phenomenon. Under transmission electron microscopy, a certain number of myelinated nerve fibers were found as bridges among groups. These findings indicate that the partition-type chitosan tube combined with bone marrow stromal stem cels has a good connection with the injured spinal cord a good connection to restore part of electrophysiological properties, accelerate the axon regeneration, recover the motor function, thereby providing a new direction for the treatment of spinal cord injury. Cite this article:Zhao XW, Liu X, Yu DP, Rong H, Yu XS, Yang CS, Liu T, Zhao TB. Partition-type spinal cord catheter combined with bone marrow stromal stem cels in the repair of spinal cord transection injury in rats. Zhongguo Zuzhi Gongcheng Yanjiu. 2016;20(1):42-48.

Objective To explore the effects and molecular mechanisms of suberoylanilide hydroxamic acid (SAHA) on ovarian carcinoma. Methods (1)Two groups of ovarian carcinoma cell lines (SKOV3 and SKOV3/DDP, HO8910 and HO8910-PM) were exposed to SAHA (1, 3, 5 and 7μmol/L SAHA,group 1-group 4). CCK-8 method was employed to eval-uate the inhibitory effects of SAHA.(2)Ovarian cancer cell lines treated with SAHA (2 or 5μmol/L SAHA) were used as 1 and 2 groups. Flow cytometry was performed following staining with Annexin V-FITC and PI for cell cycle and apoptosis.(3) Reverse transcription polymerase chain reaction (RT-PCR) and Western blot assay were used to assess the mRNA and pro-tein expression levels of phenotypic correlation factor. Results (1)After 48 h of SAHA treatment,the OD value of SKOV3, SKOV3/DDP,and HO8910 showed a trend of gradually reduce (P<0.05).(2)The apoptotic rates were significantly higher in SAHA 1 and SAHA 2 groups than those of control group (P<0.05). Compared with control group, after 48 h of SAHA treat-ment,S phase and G2/M phase of SKOV3 and SKOV3/DDP cells increased;G0/G1 phase of HO8910 and HO8910-PM cells increased in SAHA 1 and 2 groups (P<0.05).(3)The expression levels of CyclinB1 and Cdc2 (p34) mRNA were significant-ly lower in SAHA 1 and 2 groups than those of control group,while the expression levels of Caspase-3,p21 and p53 mRNA expression were significantly higher in SAHA 1 and 2 groups than those of control group. Furthermore,the expression of Ac-Histone H3,Ac-Histone H4,p53 protein were markedly improved,and CyclinB1,Cdc2(p34) protein decreased in SAHA 1-4 groups. Conclusion SAHA may suppress cell growth, induce apoptosis and cause cycle arrest in ovarian carcinoma cells by promoting histone acetylation or modulating their phenotype-related proteins of Caspase-3, p53, CyclinB1 and Cdc2(p34).