Patients who initiated peritoneal dialysis (PD) in Sichuan Provincial People's Hospital from January 1, 2001 to December 31, 2013 were enrolled in the single center and retrospective study. Clinical and laboratory data were collected to analyze the long-term survival rates, technique survival rates and associated influencing factors. Patients were followed up until December 31, 2021 or endpoints occurred (death or stopping PD treatment). Kaplan-Meier survival curves were used to estimate survival rates and technique survival rates. Cox proportional hazards regression model was used to analyze the risk factors of death and technique failure in PD patients. A total of 373 patients were enrolled in the study, with age of (52.1±15.8) years old and 199 (53.4%) males. During the follow-up, 154 (41.3%) patients died, 72 (19.3%) patients transferred to hemodialysis, and 40 (10.7%) patients received kidney transplant. Kaplan-Meier survival curves revealed that overall survival rates of PD patients at 1, 3, 5, 7, and 10 years were 92.2%, 76.6%, 66.0%, 52.4% and 38.6%, respectively. Technique survival rates were 93.5%, 84.8%, 74.2%, 62.8% and 44.5% at 1, 3, 5, 7, and 10 years, respectively. Multivariate Cox regression model results showed that age ( HR=1.055, 95% CI 1.039-1.073, P<0.001), transfer from hemodialysis ( HR=2.212, 95% CI 1.514-3.231, P<0.001), episodes of peritonitis ( HR=2.141, 95% CI 1.194-3.837, P=0.011), Charlson comorbidity index ( HR=1.525, 95% CI 1.305-1.783, P<0.001), and baseline albumin ( HR=0.951, 95% CI 0.925-0.978, P<0.001) were independent influencing factors of survival in PD patients. Episodes of peritonitis ( HR=2.327, 95% CI 1.274-4.250, P=0.006) and Charlson comorbidity index ( HR=1.244, 95% CI 1.035-1.496, P=0.020) were independent influencing factors of technique survival in PD patients. PD patients have good early survival rates and technical survival rates, but long-term outcomes need to be further improved. Peritonitis is a major risk factor for low long-term survival rates and technical survival rates in PD patients.

Objective:To describe the changes of post-traumatic growth and rumination in coronary heart disease patients at different time points after PCI, and to analyze the correlation between them in order to provide evidence for personalized intervention.Methods:A cross-sectional study was conducted, a total of 234 patients with coronary heart disease who underwent PCI for the first time in the Department of Cardiology, the First Affiliated Hospital of China Medical University from December 2021 to October 2022 were studied by convenience sampling. The general data questionnaire, the Chinese version of the Event-Related Rumination Inventory and the simplified Chinese version of the Posttraumatic Growth Inventory were used to survey before discharge (T 0), first month after surgery (T 1), and three months after surgery (T 2). Results:The total scores of post-traumatic growth at the time point of T 0, T 1 and T 2 were 53.08 ± 13.47, 54.77 ± 11.20 and 59.32 ± 7.95, the difference was statistically significant ( F = 78.45, P<0.01). The scores of instrusive rumination at the time point of T 0, T 1 and T 2 were 14.92 ± 6.07, 15.78 ± 4.64 and 12.31 ± 3.38, the difference was statistically significant ( F = 46.58, P<0.01). The scores of deliberate rumination were 14.63 ± 4.74, 15.52 ± 3.93 and 17.86 ± 3.70, the difference was statistically significant ( F = 76.20, P<0.01). Instrusive rumination at T 0, T 1 and deliberate rumination at each point were positively correlated with the total score of post-traumatic growth ( r values were 0.229 to 0.414, all P<0.01). Instrusive rumination at T 2 was negatively correlated with posttraumatic growth scores ( r = -0.351, P<0.01). The deliberate rumination at T 2 time point was positively correlated with the total score of post-traumatic growth ( r = 0.403, P<0.01). Conclusions:The level of posttraumatic growth in patients with coronary heart disease after PCI needs to be improved, and targeted intervention should be planned early to change patients′pessimistic cognition caused by the disease, promote the development of positive thinking, then promote their posttraumatic growth.

A comprehensive profiling of the vaginal microbial communities and their variability enables an accurate description of the microbiome in women.However,there is a lack of studies available on Chinese women.In the present study,the composition of the vaginal microbiota during pregnancy and the 6-week postpartum period of 454 Chinese women was characterized by sequenc-ing the V3-V4 region of the 16S ribosomal RNA(rRNA)gene.The vaginal microbiome showed variations during pregnancy and the postpartum period based on the abortion history,hypertensive disorders,delivery mode,and maternal age.Co-variation of 22 bacterial taxa,including the Lacto-bacillus genus and two of its species,may account for the common characteristics of the vaginal microbiome under scenarios of different medical histories and pregnancy outcomes.In contrast,dis-criminant bacterial species were significantly different between women who had preterm birth(PTB)with and without premature rupture of membranes(PROM),and the community state type(CST)Ⅳ-A without any predominant Lactobacillus species in the microbiota was more prevalent during pregnancy in the PROM-PTB cases,suggesting that specific bacterial species could be considered to distinguish between different types of PTB.By providing data on Chinese women,this study will enrich the knowledge of the human microbiome and contribute to a better understanding of the association between the vaginal microbiome and reproductive health.

OBJECTIVES: To investigate glucocorticoid receptor (GR) and histone deacetylase 2 (HDAC2) gene expression and protein levels in peripheral blood mononuclear cells (PBMCs) of patients with severe or profound sudden sensorineural hearing loss (SSNHL) and to explore the roles of GRs and HDAC2 in glucocorticoid (GC) insensitivity. METHODS: Fifty-five severe or profound SSNHL patients were enrolled in the study. According to hearing improvement after GC treatment, patients were assigned into two groups: GC-sensitive and GC-resistant. A normal reference group included 20 healthy volunteers without hearing loss. Quantitative real-time polymerase chain reaction and Western blot analyses were used to detect the relative expression of GRα, GRβ, and HDAC2 in PBMCs at the mRNA and protein levels. RESULTS: The protein levels of GRs and HDAC2 in PBMCs of SSNHL patients were lower than the normal reference values before GC treatment. Compared with the GC-resistant group, both the mRNA and protein levels of GRα and HDAC2 were significantly increased in the GC-sensitive group after GC treatment. CONCLUSION: A lack of GRα and HDAC2 induction following steroid treatment in GC-resistant SSNHL patients may play a fundamental mechanistic role in GC insensitivity. Response of GRα and HDAC2 to steroid treatment may, thus, predict the prognosis of hearing improvement in SSNHL patients.
Blotting, Western ; Gene Expression ; Healthy Volunteers ; Hearing ; Hearing Loss ; Hearing Loss, Sensorineural ; Histone Deacetylase 2 ; Histone Deacetylases ; Histones ; Humans ; Prognosis ; Real-Time Polymerase Chain Reaction ; Receptors, Glucocorticoid ; Reference Values ; RNA, Messenger

Objective To investigate the relationship between prognostic nutritional index (PNI) and neutropenia after adjuvant chemotherapy in patients with colorectal cancer. Methods The clinical data of 44 patients with colorectal cancer performed adjuvant chemotherapy in Shunyi District Hospital from December 2014 to January 2018 were retrospectively analyzed, and the patients were divided into group A (grade 0-2 neutropenia) and group B (grade3-4 neutropenia) according to the degree of neutropenia. The serum albumin, peripheral lymphocyte counts, and neutrophil counts within 1 week before chemotherapy were collected, and the PNI was calculated. The chi-square test and rank sum test were used to compare the clinical data, body mass index (BMI), baseline neutrophil count, and PNI between the two groups. Logistic regression analysis was used to analyze the risk factors for neutropenia after chemotherapy. Results The baseline median neutrophil counts and median PNI in group A were 3.17×109/L [(1.38-7.79)×109/L] and 50.40 (37.40-57.05), and in group B were 2.54 ×109/L [(1.22-3.87) ×109/L] and 45.50 (37.95-50.95). The baseline neutrophil counts and PNI in group A were significantly higher than those in group B, the differences between the two groups were statistically significant (Z= -2.085, P= 0.037; Z= -2.615, P= 0.009). Logistic regression analysis showed that PNI was an independent risk factor for neutropenia after chemotherapy (HR=0.803, 95％CI 0.646-0.998, P= 0.048). Conclusion PNI has a certain role in predicting neutropenia after adjuvant chemotherapy in patients with colorectal cancer.

OBJECTIVETo observe the effect difference between plum-blossom needle combined with rehabilitation training and conventional rehabilitation training for hand spasm after stroke.

METHODSA total of 61 patients were randomly divided into a comprehensive treatment group (30 cases) and a rehabilitation training group (31 cases). In the rehabilitation training group, Bobath occupational therapy, OT training, and hand function training were adopted, once every day; on the basis of treatment in the rehabilitation group, plum-blossom needle was applied at the lung meridian of hand-, heart meridian of hand-, pericardium meridian of hand- in the comprehensive treatment group. The treatment was given once every two days, three weeks as one course in the two gnoups. After 3 courses of treatment, clinical efficacy evaluation was performed, and the modified Ashworth scale and Fugl-Meyer (FMA) motor function scores were assessed before and after treatment.

RESULTSAfter treatment, the grade for Ashworth scale and FMA scores in the comprehensive treatment group and the rehabilitation trainning group were better than those before treatment (all <0.05), and the improvements in hand spasm and hand fuction in the comprehensive treatment group were superior apparently to those in the rehabilitation trainning group (both <0.05) The total effective rate of hand function was 93.3% (28/30) in the comprehensive treatment group, which was better than 74.2% (23/31) in the rehabilitation training group (<0.05).

CONCLUSIONPlum-blossom needle combined with rehabilitation training are more effective than simple rehabilitation training for hand spasm after stroke.

Objective:To compare the effectiveness between three methods for purifying the immunoglobulin of egg yolk(IgY) which are polyethylene glycol (PEG) method, chloroform extraction method and chloroform / PEG method, and to provide basis for obtaining the batch of IgY.Methods:The inactivated vaccine of Vibrio parahemolyticus (V. parahemolyticus) was prepared and the hens were immunized by multi-point intramuscular injection.The eggs were collected and the IgY was purified by PEG method, chloroform extraction method and chloroform/PEG method.The protein extraction rate, the IgY titer and the purity of the antibody which purified by different methods were detected.Furthermore, the operation process, cost and safety of the three methods were analyzed.Results:The protein contents of the extraction belonging three methods from high to low in turn were chloroform extraction method, chloroform/PEG method, and PEG method.There was no significant difference in the antibody titer between three methods, and the tiler of chloroform extraction method was slightly high.The purities of purified antibody from high to low in turn were PEG method, chloroform/PEG method and chloroform method.The PEG method had better security but relatively lower extraction efficiency and higher cost.The chloroform/PEG method had high extraction efficiency and good antibody purity.Conclusion:The PEG method is suitable for a small amount of extraction in the laboratory.The chloroform/PEG method is appropriate for extracting the high quality IgY in a batch as it has high extraction efficiency and good antibody purity.

Objective To investigate the mortality risk factors of nosocomial infection patients in intensive care unit (ICU), and to guide clinicians to take effective control measures. Methods A retrospectively cohort study was conducted. The relevant information of patients with nosocomial infection treated in ICU of Hengshui Harrison International Peace Hospital Affiliated to Hebei Medical University from June 2009 to December 2015 was analyzed. The patients who admitted to ICU again, with length of ICU stay less than 48 hours, without first etiology of screening within 48 hours of ICU admission, or without complete pathogenic information were excluded. The gender, age, diagnosis, length of ICU stay, invasive operation, nutritional status, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score, sequential organ failure assessment (SOFA) score, distribution and drug resistance of the pathogens, and procalcitonin (PCT) levels at 7 days after nosocomial infection were recorded. The risk factors leading to death in patients with nosocomial infection were analyzed by logistic regression, and the receiver operating characteristic curve (ROC) was drawn to evaluate the predictive value of all risk factors on the outcome of patients with nosocomial infection. Results In 864 enrolled patients with male of 54.75% and mean age of (63.50±15.80) years, 732 (84.72%) patients survived and 132 (15.28%) died. Compared with survivors, the non-survivors had higher age (years: 65.47±15.32 vs. 58.15±13.27), incidence of urgent trachea intubation (32.58% vs. 22.81%), deep venous catheterization (83.33% vs. 63.25%), and multiple drug-resistant infection (65.91% vs. 33.20%), longer length of ICU stay (days: 13.56±4.29 vs. 10.29±4.32) and duration of coma (days: 7.36±2.46 vs. 5.48±2.14), lower albumin (g/L: 23.64±8.47 vs. 26.36±12.84), higher APACHEⅡ score (19.28±5.16 vs. 17.56±5.62), SOFA score (8.55±1.34 vs. 6.43±2.65), and PCT (μg/L: 3.06±1.36 vs. 2.53±0.87, all P < 0.05). There was no significant difference in gender and urinary tract catheterization between survivors and non-survivors (both P > 0.05). The low respiratory tract was the most common site of infection followed by urinary tract and bloodstream in both groups. It was shown by logistic regression analysis that prolonged ICU stay [odds ratio (OR) = 2.039, 95% confidence interval (95%CI) = 1.231-3.473, P = 0.002], APACHEⅡ score (OR = 1.683, 95%CI= 1.002-9.376, P = 0.000), SOFA score (OR = 2.060, 95%CI = 1.208 -14.309, P = 0.041), PCT (OR = 2.090, 95%CI = 1.706-13.098, P = 0.004), and multi-drug resistant pathogens infection (OR = 5.245, 95%CI = 2.213-35.098, P = 0.027) were independent risk factors for ICU mortality in patients with nosocomial infection. The area under ROC curve (AUC) of length of ICU stay, APACHEⅡ score, SOFA score, and PCT level for predicting death of nosocomial infection patients was 0.854, 0.738, 0.786, and 0.849, respectively, the best cut-off value was 16.50 days, 22.45, 6.37 and 3.38 μg/L, respectively, the sensitivity was 83.6%, 90.0%, 81.1%, and 89.6%, and the specificity was 70.3%, 75.6%, 71.3%, and 85.4%, respectively. Conclusions Prol onged ICU stay, nosocomial infection with secondary sepsis and multiple organ dysfunction syndrome were the leading causes of death for nosocomial infection patients in ICU. Prolonged ICU stay, APACHE Ⅱ score, SOFA score, and PCT level could effectively predict death risks for nosocomial infection patients.

Venous thromboembolism includes deep venous thrombosis and pulmonary embolism. It is a more common and preventable complication in neurology. The prevention of venous thromboembolism is an important component in the treatment of the patients with cerebral hemorrhage. The measures include mechanical prevention and drug prevention. The mechanical prevention measures include intermittent pneumatic compression devices and pressure gradient elastic stockings. Studies have suggested that anticoagulants also plays an important role in the prevention of venous thromboembolism. The comprehensive and systematic understanding of the prevention of venous thromboembolism wil help to guide the clinical therapy and improve the outcomes of patients after primary intracerebral hemorrhage.

Objective To analyze the isolation rates and antimicrobial resistance of Acinetobacter baumannii (AB) from intensive care unit (ICU)between 2010 and 2013,and provide evidence for clinical anti-infective therapy. Methods The isolation and antimicrobial resistance of AB from ICU between 2010 and 2013 were analyzed retro-spectively.Results A total of 1 413 pathogenic strains were isolated,556(39.35%)of which were AB,isolation rates in each year were 39.45%,41 .35%,29.44%,and 40.53% respectively.AB were mainly isolated from lower respiratory tract (75.72%).Antimicrobial susceptibility testing results showed that AB had low resistance rates to cefoperazone/sulbactam(5.85%)and amikacin (17.45%);detection rates of multidrug-resistant and extensively drug-resistant AB increased from 9.63% and 3.70% to 42.50% and 31 .88%,respectively (both P < 0.001 ). Conclusion AB is the common pathogen in ICU,antimicrobial resistance is serious,isolation of multidrug-resistant and extensively drug-resistant AB increased year by year;intensifying the monitoring of drug resistance is helpful for the treat-ment and prevention of AB infection.