This study aims to explore the synergistic effects of the main components in salvianolic acids for Injection(SAFI) on key pathological events in cerebral ischemia, elucidating the pharmacological characteristics of SAFI in neuroprotection. Two major pathological gene modules related to endothelial injury and neuroinflammation in cerebral ischemia were mined from single-cell data. According to the topological distance calculated in network medicine, potential synergistic component combinations of SAFI were screened out. The results showed that the combination of caffeic acid and salvianolic acid B scored the highest in addressing both endothelial injury and neuroinflammation, demonstrating potential synergistic effects. The cell experiments confirmed that the combination of these two components at a ratio of 1∶1 significantly protected brain microvascular endothelial cells(bEnd.3) from oxygen-glucose deprivation/reoxygenation(OGD/R)-induced reperfusion injury and effectively suppressed lipopolysaccharide(LPS)-induced neuroinflammatory responses in microglial cells(BV-2). This study provides a new method for uncovering synergistic effects among active components in traditional Chinese medicine(TCM) and offers novel insights into the multi-component, multi-target acting mechanisms of TCM.
Brain Ischemia/metabolism* ; Neuroprotective Agents/pharmacology* ; Animals ; Drugs, Chinese Herbal/administration & dosage* ; Benzofurans/pharmacology* ; Mice ; Drug Synergism ; Caffeic Acids/pharmacology* ; Polyphenols/pharmacology* ; Humans ; Alkenes/pharmacology* ; Endothelial Cells/drug effects* ; Depsides

OBJECTIVE: To analyze the effect of COVID-19 infection on the mobilization and collection of autologous peripheral blood stem cells in patients with multiple myeloma. METHODS: The general baseline data, treatment factors before mobilization collection, collection status, and treatment overview after collection of autologous peripheral blood stem cells at Beijing Chaoyang Hospital affiliated with Capital Medical University from January 1, 2020 to July 15, 2023 were analyzed. RESULTS: 269 patients underwent mobilization and collection of autologous peripheral blood stem cells. Among them, 32 cases with COVID-19 infection history (COVID-19 group) and 237 cases without COVID-19 infection history (non-COVID-19 group). In the COVID-19 group, 17 cases were treated with chemotherapy (etoposide)+G-CSF, and 15 cases were treated with plerixafor +G-CSF. In the non-COVID-19 group, 214 cases were treated with chemotherapy +G-CSF, 17 cases were treated with plerixafor +G-CSF, and 6 cases were treated with chemotherapy + plerixafor +G-CSF. The number of CD34⁺ cells, collection success rate, and excellence rate in the COVID-19 group and the non-COVID-19 group were ［5.52 (0.94-26.87) vs 4.80 (0.53-37.20)］×10⁶/kg (P =0.610), (93.8% vs 85.2%) (P =0.275), (62.5% vs 49.4%) (P =0.190), respectively. Among 113 patients mobilized with etoposide +G-CSF, the number of CD34⁺ cells, success rate, and excellence rate collected from COVID-19 infection (17 cases) and non-COVID-19 infection (96 cases) were ［7.54 (2.66-26.87) vs 7.78 (2.26-37.20)］×10⁶/kg (P =0.847), (100.0% vs 100.0%) (no P value), (82.4% vs 86.5%) (P =0.655), respectively. Among 32 patients mobilized by plerixafor +G-CSF, the number of CD34⁺ cells, success rate and excellence rate of COVID-19 infection (15 cases) and non-COVID-19 infection (17 cases) were ［3.82 (0.94-7.27) vs 4.11 (0.53-9.05)］×10⁶/kg (P =0.821), (86.7% vs 88.2%) (P =0.893), (40.0% vs 35.3%) (P =0.784), respectively. In 32 patients with COVID-19 infection, the number of CD34⁺ cells collected by etoposide +G-CSF (17 cases) and plerixafor +G-CSF (15 cases), as well as the success rate and excellence rate were ［7.54 (2.66-26.87) vs 3.82(0.94-7.27)］×10⁶/kg (P =0.004), (100.0% vs 86.7%) (P =0.120), (82.4% vs 40.0%) (P =0.014), respectively. By 2023.7.31, 232 patients (86.2%, 232/269) had received transplantation, including 24 patients in the COVID-19 group and 208 patients in the non-COVID-19 group. The median number of CD34⁺ cells infused in the two groups was ［3.67 (2.50-13.44) vs 3.11(1.12-19.89)］×10⁶/kg (P =0.058), the median days of neutrophil engraftment ［11(9-13) vs 11(9-17)］ (P =0.674), the median days of platelet engraftment ［11(0-23), 12(0-43)］ (P =0.279), respectively. CONCLUSION The history of COVID-19 infection did not affect the PBSC mobilization, collection and transplantation of patients with myeloma. In patients with COVID-19 infection, the results of chemotherapy mobilization with etoposide seems to be better than that of plerixafor mobilization, but further research is needed to clarify.
Humans ; COVID-19/complications* ; Multiple Myeloma/complications* ; Hematopoietic Stem Cell Mobilization ; Transplantation, Autologous ; Granulocyte Colony-Stimulating Factor/therapeutic use* ; Peripheral Blood Stem Cell Transplantation ; SARS-CoV-2 ; Middle Aged ; Peripheral Blood Stem Cells ; Male ; Female ; Cyclams ; Benzylamines

AIM: To observe the effect of RBC preservation solution with sodium pyruvate on the morphology, structure and function of RBC stored in vitro in type 2 diabetes rats. METHODS: Thirty SPF male SD rats, were randomly divided into 3 groups (n=10): non-T2DM conventional RBC preservation solution (group A), T2DM conventional RBC preservation solution (group B) and T2DM sodium pyruvate RBC preservation solution (group C). The leukoreduced RBC from the tail vein and stored for 0 d (T0), 7 d (T1), 14 d (T2), 21 d (T3) and 28 d (T4) to detect the morphology, structure and the contents of 2, 3-DPG, reactive oxygen species (ROS), malondialdehyde (MDA) and lactic acid (LA) of RBC in group A, B and C. The RBC stored for 14 days in vitro were labeled with PKH26, and its survival rate were tested in vivo at 1, 4, 10 and 16 hours after intravenous infusion. RESULTS: At T0, the RBC morphology of group A was intact, which was better than that of group B and group C. With the extension of storage time, the morphology of RBC in each group gradually transformed into a spindle-spherical shape. Compared with group A, the incidence of acanthocytes in group B and group C was higher, and the incidence of acanthocytes in group C was lower than that in group B. Compared with group A, the content of 2, 3-DPG in group B and group C decreased, while ROS and MDA increased at different time points (P<0.05). The content of 2,3-DPG in group C was higher than that in group B (P<0.05), and the contents of ROS and MDA were lower than those in group B (P<0.05). LA content in group B was higher than that in group A and group C (P<0.05). At T2-T4, the LA content in group C was lower than that in group A (P<0.05). The survival rate of RBC in group A was higher than that in group B and C, and the survival rate of RBC in group B was lower than that in group C (P<0.05). CONCLUSION: Sodium pyruvate added RBC preservation solution has a certain protective effect on RBC stored in vitro in type 2 diabetic rats, and its mechanism may be related to its antioxidant effect.

AIM To establish a quantitative analysis of multi-components by single-marker(QAMS)method for the simultaneous content determination of gastrodin,parishin E,syringin,parishin B,parishin C,ferulic acid,parishin A,buddleoside,harpagoside and cinnamic acid in Tianma Toufengling Capsules.METHODS The analysis was performed on a 30℃thermostatic GL Science InertsilTM ODS-3 column(150 mm×4.6 mm,5 μm),with the mobile phase comprising of acetonitrile-0.1%phosphoric acid flowing at 1.0 mL/min in a gradient elution manner,and the detection wavelengths were set at 220,280 nm.Syringin was used as an internal standard to calculate the relative correction factors of the other nine constituents,after which the content determination was made.RESULTS Ten constituents showed good linear relationships within their own ranges(r≥0.999 7),whose average recoveries were 98.53%-102.22%with the RSDs of 1.26%-2.68%.The result obtained by QAMS approximated those obtained by external standard method.CONCLUSION This accurate and specific method can be used for the quality control of Tianma Toufengling Capsules.

Objective:To investigate the high risk factors,diagnostic accuracy of ultrasonography and pregnan-cy outcomes of umbilical cord wrapped around the neck for≥4 loops.Methods:The clinical data of 64 pregnant women with umbilical cord around the neck for≥4 loops(the group with umbilical cord around the neck≥4 loops)in Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology from January 2011 to February 2024 were retrospectively analyzed.At the same time,80 cases with umbilical cord around the neck for 1-2 loops(the group with umbilical cord around the neck 1-2 loops)were randomly selected as the controls.General information,clinical manifestations,ultrasound diagnosis and other data of the two groups were collected.The risk factors of umbilical cord around the neck≥4 loops and diagnostic accuracy of ultrasonography were ana-lyzed with univariate and multivariate Logistic regression analysis,and the pregnancy outcomes were compared between the two groups.Results:①The incidence of pregnancy,abortion,delivery and history of cesarean sec-tion were lower in the group with umbilical cord around the neck ≥4 loops than those in the group with umbilical cord around the neck 1-2 loops.The incidence of consciously abnormal fetal movement,abnormal umbilical ar-tery systolic/diastolic(S/D)ratio,abnormal fetal heart rate monitoring(NST)and fetal distress were higher in the group with umbilical cord around the neck≥4 loops than those in the group with umbilical cord around the neck 1-2 loops,and the differences were statistically significant(P＜0.05).②Multivariate Logistic regression analysis showed that polyhydramnios and excessively long cord were independent risk factors for umbilical cord around the neck≥4 loops(OR＞1,P＜0.05).③When the time between ultrasound diagnosis and the operation was 2 days,the consistency rate between ultrasound diagnosis of umbilical cord around the neck≥4 loops and intrao-perative diagnosis was the highest,and the difference was statistically significant with＞3 days(46.2％vs.6.30％,P＜0.05).Compared with umbilical cord around the neck 3 loops,ultrasound diagnosis of umbilical cord loops around the neck at 4 or 5 loops had a higher consistency rate with intraoperative diagnosis,and the differ-ence was statistically significant(P＜0.05).④The incidence of premature delivery,neonatal asphyxia and admis-sion to neonatology in the group with umbilical cord around the neck ≥4 loops were higher than those in the group with umbilical cord around the neck 1-2 loops,and the difference was statistically significant(P＜0.05);and the gestational week and birth weight of newborns were significantly lower(P＜0.05).Conclusions:Polyhydramnios and excessively long cord are high risk factors for umbilical cord around the neck≥4 loops.The closer the ultra-sound diagnosis is to the time before cesarean section and the more times the umbilical cord is around the neck in ultrasonic diagnosis,the higher the diagnostic accuracy.Fetal outcomes with umbilical cord around the neck≥4 loops are worse.

Objective:To investigate the high risk factors,diagnostic accuracy of ultrasonography and pregnan-cy outcomes of umbilical cord wrapped around the neck for≥4 loops.Methods:The clinical data of 64 pregnant women with umbilical cord around the neck for≥4 loops(the group with umbilical cord around the neck≥4 loops)in Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology from January 2011 to February 2024 were retrospectively analyzed.At the same time,80 cases with umbilical cord around the neck for 1-2 loops(the group with umbilical cord around the neck 1-2 loops)were randomly selected as the controls.General information,clinical manifestations,ultrasound diagnosis and other data of the two groups were collected.The risk factors of umbilical cord around the neck≥4 loops and diagnostic accuracy of ultrasonography were ana-lyzed with univariate and multivariate Logistic regression analysis,and the pregnancy outcomes were compared between the two groups.Results:①The incidence of pregnancy,abortion,delivery and history of cesarean sec-tion were lower in the group with umbilical cord around the neck ≥4 loops than those in the group with umbilical cord around the neck 1-2 loops.The incidence of consciously abnormal fetal movement,abnormal umbilical ar-tery systolic/diastolic(S/D)ratio,abnormal fetal heart rate monitoring(NST)and fetal distress were higher in the group with umbilical cord around the neck≥4 loops than those in the group with umbilical cord around the neck 1-2 loops,and the differences were statistically significant(P＜0.05).②Multivariate Logistic regression analysis showed that polyhydramnios and excessively long cord were independent risk factors for umbilical cord around the neck≥4 loops(OR＞1,P＜0.05).③When the time between ultrasound diagnosis and the operation was 2 days,the consistency rate between ultrasound diagnosis of umbilical cord around the neck≥4 loops and intrao-perative diagnosis was the highest,and the difference was statistically significant with＞3 days(46.2％vs.6.30％,P＜0.05).Compared with umbilical cord around the neck 3 loops,ultrasound diagnosis of umbilical cord loops around the neck at 4 or 5 loops had a higher consistency rate with intraoperative diagnosis,and the differ-ence was statistically significant(P＜0.05).④The incidence of premature delivery,neonatal asphyxia and admis-sion to neonatology in the group with umbilical cord around the neck ≥4 loops were higher than those in the group with umbilical cord around the neck 1-2 loops,and the difference was statistically significant(P＜0.05);and the gestational week and birth weight of newborns were significantly lower(P＜0.05).Conclusions:Polyhydramnios and excessively long cord are high risk factors for umbilical cord around the neck≥4 loops.The closer the ultra-sound diagnosis is to the time before cesarean section and the more times the umbilical cord is around the neck in ultrasonic diagnosis,the higher the diagnostic accuracy.Fetal outcomes with umbilical cord around the neck≥4 loops are worse.

Objective:To investigate the high risk factors,diagnostic accuracy of ultrasonography and pregnan-cy outcomes of umbilical cord wrapped around the neck for≥4 loops.Methods:The clinical data of 64 pregnant women with umbilical cord around the neck for≥4 loops(the group with umbilical cord around the neck≥4 loops)in Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology from January 2011 to February 2024 were retrospectively analyzed.At the same time,80 cases with umbilical cord around the neck for 1-2 loops(the group with umbilical cord around the neck 1-2 loops)were randomly selected as the controls.General information,clinical manifestations,ultrasound diagnosis and other data of the two groups were collected.The risk factors of umbilical cord around the neck≥4 loops and diagnostic accuracy of ultrasonography were ana-lyzed with univariate and multivariate Logistic regression analysis,and the pregnancy outcomes were compared between the two groups.Results:①The incidence of pregnancy,abortion,delivery and history of cesarean sec-tion were lower in the group with umbilical cord around the neck ≥4 loops than those in the group with umbilical cord around the neck 1-2 loops.The incidence of consciously abnormal fetal movement,abnormal umbilical ar-tery systolic/diastolic(S/D)ratio,abnormal fetal heart rate monitoring(NST)and fetal distress were higher in the group with umbilical cord around the neck≥4 loops than those in the group with umbilical cord around the neck 1-2 loops,and the differences were statistically significant(P＜0.05).②Multivariate Logistic regression analysis showed that polyhydramnios and excessively long cord were independent risk factors for umbilical cord around the neck≥4 loops(OR＞1,P＜0.05).③When the time between ultrasound diagnosis and the operation was 2 days,the consistency rate between ultrasound diagnosis of umbilical cord around the neck≥4 loops and intrao-perative diagnosis was the highest,and the difference was statistically significant with＞3 days(46.2％vs.6.30％,P＜0.05).Compared with umbilical cord around the neck 3 loops,ultrasound diagnosis of umbilical cord loops around the neck at 4 or 5 loops had a higher consistency rate with intraoperative diagnosis,and the differ-ence was statistically significant(P＜0.05).④The incidence of premature delivery,neonatal asphyxia and admis-sion to neonatology in the group with umbilical cord around the neck ≥4 loops were higher than those in the group with umbilical cord around the neck 1-2 loops,and the difference was statistically significant(P＜0.05);and the gestational week and birth weight of newborns were significantly lower(P＜0.05).Conclusions:Polyhydramnios and excessively long cord are high risk factors for umbilical cord around the neck≥4 loops.The closer the ultra-sound diagnosis is to the time before cesarean section and the more times the umbilical cord is around the neck in ultrasonic diagnosis,the higher the diagnostic accuracy.Fetal outcomes with umbilical cord around the neck≥4 loops are worse.

Objective To construct an artificial intelligence assisted diagnosis model based on deep learning for dynamically recognizing gastric lesions and their locations under gastroscopy in real time,and to evaluate its ability to detect and recognize gastric lesions and their locations.Methods The gastroscopy videos of 104 patients in our hospital was retrospectively analyzed,and the video frames were manually annotated.The annotated picture frames of lesion category were divided into the training set and the validation set according to the ratio of 8∶2,and the annotated picture frames of location category were divided into the training set and the validation set according to the patient sources at the ratio of 8∶2.These sets were utilized for training and validating the respective models.YoloV4 model was used for the training of lesion recognition,and ResNet152 model was used for the training of location recognition.The accuracy,sensitivity,specificity,positive predictive value,negative predictive value and location recognition accuracy of the auxiliary diagnostic model were evaluated.Results A total of 68 351 image frames were annotated,with 54 872 frames used as the training set,including 41 692 frames for lesion categories and 13 180 frames for location categories.The validation set consisted of 13 479 frames,comprising 10 422 frames for lesion categories and 3 057 frames for location categories.The lesion recognition model achieved an overall accuracy of 98.8%,with a sensitivity of 96.6%,specificity of 99.3%,positive predictive value of 96.3%,and negative predictive value of 99.3% in validation set.Meanwhile,the location recognition model demonstrated an top-5 accuracy of 87.1% .Conclusion The artificial intelligence assisted diagnosis model based on deep learning for real-time dynamic recognition of gastric lesions and their locations under gastroscopy has good ability in lesion detection and location recognition,and has great clinical application prospects.

Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in tertiary hospitals in major regions of China in 2022.Methods Clinical isolates from 58 hospitals in China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2022 Clinical &Laboratory Standards Institute(CLSI)breakpoints.Results A total of 318 013 clinical isolates were collected from January 1,2022 to December 31,2022,of which 29.5％were gram-positive and 70.5％were gram-negative.The prevalence of methicillin-resistant strains in Staphylococcus aureus,Staphylococcus epidermidis and other coagulase-negative Staphylococcus species(excluding Staphylococcus pseudintermedius and Staphylococcus schleiferi)was 28.3％,76.7％and 77.9％,respectively.Overall,94.0％of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 90.8％of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis showed significantly lower resistance rates to most antimicrobial agents tested than Enterococcus faecium.A few vancomycin-resistant strains were identified in both E.faecalis and E.faecium.The prevalence of penicillin-susceptible Streptococcus pneumoniae was 94.2％in the isolates from children and 95.7％in the isolates from adults.The resistance rate to carbapenems was lower than 13.1％in most Enterobacterales species except for Klebsiella,21.7％-23.1％of which were resistant to carbapenems.Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.1％to 13.3％.The prevalence of meropenem-resistant strains decreased from 23.5％in 2019 to 18.0％in 2022 in Pseudomonas aeruginosa,and decreased from 79.0％in 2019 to 72.5％in 2022 in Acinetobacter baumannii.Conclusions The resistance of clinical isolates to the commonly used antimicrobial agents is still increasing in tertiary hospitals.However,the prevalence of important carbapenem-resistant organisms such as carbapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a downward trend in recent years.This finding suggests that the strategy of combining antimicrobial resistance surveillance with multidisciplinary concerted action works well in curbing the spread of resistant bacteria.

Objective To investigate the distribution and antimicrobial resistance profiles of the common pathogens isolated from urine from 2015 to 2021 in the CHINET Antimicrobial Resistance Surveillance Program.Methods The bacterial strains were isolated from urine and identified routinely in 51 hospitals across China in the CHINET Antimicrobial Resistance Surveillance Program from 2015 to 2021.Antimicrobial susceptibility was determined by Kirby-Bauer method,automatic microbiological analysis system and E-test according to the unified protocol.Results A total of 261 893 nonduplicate strains were isolated from urine specimen from 2015 to 2021,of which gram-positive bacteria accounted for 23.8％(62 219/261 893),and gram-negative bacteria 76.2％(199 674/261 893).The most common species were E.coli(46.7％),E.faecium(10.4％),K.pneumoniae(9.8％),E.faecalis(8.7％),P.mirabilis(3.5％),P.aeruginosa(3.4％),SS.agalactiae(2.6％),and E.cloacae(2.1％).The strains were more frequently isolated from inpatients versus outpatients and emergency patients,from females versus males,and from adults versus children.The prevalence of ESBLs-producing strains in E.coli,K.pneumoniae and P.mirabilis was 53.2％,52.8％and 37.0％,respectively.The prevalence of carbapenem-resistant strains in E.coli,K.pneumoniae,P.aeruginosa and A.baumannii was 1.7％,18.5％,16.4％,and 40.3％,respectively.Lower than 10％of the E.faecalis isolates were resistant to ampicillin,nitrofurantoin,linezolid,vancomycin,teicoplanin and fosfomycin.More than 90％of the E.faecium isolates were ressitant to ampicillin,levofloxacin and erythromycin.The percentage of strains resistant to vancomycin,linezolid or teicoplanin was＜2％.The E.coli,K.pneumoniae,P.aeruginosa and A.baumannii strains isolated from ICU inpatients showed significantly higher resistance rates than the corresponding strains isolated from outpatients and non-ICU inpatients.Conclusions E.coli,Enterococcus and K.pneumoniae are the most common pathogens in urinary tract infection.The bacterial species and antimicrobial resistance of urinary isolates vary with different populations.More attention should be paid to antimicrobial resistance surveillance and reduce the irrational use of antimicrobial agents.