This study was aimed at analyzing the clinical and laboratory characteristics of patients with Listeria monocyto-genes bacteremia,to provide evidence for its diagnosis and treatment.A retrospective analysis was conducted on the clinical data for patients with L.monocytogenes bacteremia at Tangdu Hospital between September 2012 and April 2022.The data included age,sex,underlying diseases,treatments,and prognosis.Changes in indicators such as white blood cell(WBC)count,mono-cyte percentage,neutrophil percentage,monocyte/neutrophil ratio(M/N),C-reactive protein(CRP),and procalcitonin before and after treatment were statistically analyzed.Among the 32 patients with L.monocytogenes bacteremia,the average age was 31.9 years,and three patients were older than 65 years.The incidence rate was highest in summer(11 patients,34.4％),fol-lowed by spring(9 patients,28.1％).A total of 24 patients(75.0％)had underlying diseases.After accurate diagnosis,the treatment plans of 29 patients were adjusted to target antibacterial therapy consisting primarily of penicillins(17 patients,53.1％)and carbapenems(12 patients,37.5％).After treatment,the levels of neutrophils,lymphocytes,and CRP were signifi-cantly lower than those before treatment(P＜0.05).A total of 29 patients(90.6％)improved and were discharged,one patient died,and two patients had poor prognosis.The primary risk factors for L.monocytogenes infection were autoimmune diseases,tumors,and pregnancy.Penicillin was the first choice effective empirical treatment for listeriosis.A clear diagnosis of the pathogen and appropriate choice of antibiotics were particularly important for the treatment of L.monocytogenes infection.

OBJECTIVE: To provide evidence for further reducing the incidence of central line-associated bloodstream infection (CLABSI) according to investigation of the prevention and control of CLABSI in intensive care unit (ICU) in Shandong Province. METHODS: The questionnaire was developed by experts from Shandong Critical Care Medical Quality Control Center, combining domestic and foreign guidelines, consensus and research. A convenient sampling method was used to recruit survey subjects online from October 11 to 31, 2023 in the province to investigate the management status of central venous catheter (CVC) in ICU units of secondary and above hospitals. RESULTS: A total of 201 valid data were collected, involving 186 hospitals in the province, with a total of 201 ICU units, mainly comprehensive ICU (91%). The beds in ICU units were mainly single rooms (89%) and triple rooms (79%), and the ratio of doctors to total beds was 0.54 : 1. The training on the knowledge and operation of intravascular catheter-associated bloodstream infection in each ICU unit was mainly irregular (49%), and 96% of the catheter operators were authorized by the hospital. In terms of CVC selection, 89% of ICU units used dual-chamber CVC, and 86% of ICU units used catheters without antibiotic coating. When selecting the placement site, for conventional CVC catheterization, 65% preferred subclavian vein. Femoral vein was preferred in 87% of ICU units undergoing continuous renal replacement therapy. 95% of ICU units had established standardized operation procedure (SOP) for CVC placement. 86% of ICU units were capable of ultrasound positioning or guided puncture at the time of catheterization. During catheterization, 88% of ICU units met the sterile dress code. Before and after catheterzation, 81% and 77% of ICU units standardized hand hygiene. Only 31% of ICU units were covered from head to toe by aseptic wipes. For the choice of skin disinfectant, the majority of ICU units (72%) only used iodophor. After tube placement, 54% of ICU units chose sterile transparent dressing and 25% chose sterile gauze dressing. 98% of ICU units were sutured to secure the catheter. Regarding catheter replacement and removal, 45% of ICU units could not be removed or replaced within 2 days in emergency situations where the principle of sterility was not guaranteed. When CLABSI was suspected, 55% of ICU units were able to obtain the catheter tip, transcatheter blood culture, and contralateral peripheral vein blood culture at the same time. For CVC replacement frequency, most ICU units (75%) would not be replaced regularly, and some ICU units would be replaced regularly, but the frequency of replacement was different. For CLABSI prevention and control, 82% of ICU units developed a verification form or supervision form. When analyzing the sources of CLABSI data, most of them were filled in by themselves (60%). As for the frequency of data analysis, 57% were once a month. CONCLUSIONS All ICU units in Shandong Province are standardized in terms of the authorization of operators, the formulation of SOP, the formulation and implementation of verification form and supervision form, ultrasound-guided puncture, and hand hygiene before and after catheterization. However, there are still deficiencies in the training on knowledge and operation of intravascular catheter-associated bloodstream infections, maximum aseptic coverage, catheter replacement and removal, and the reporting sources of CLABSI data, which need to be strengthened in the follow-up work. At present, the selection of CVC, the selection of catheterization site, the selection of skin disinfectant and the selection of dressings after catheterization still need further research.
Intensive Care Units ; Humans ; Surveys and Questionnaires ; China/epidemiology* ; Cross-Sectional Studies ; Catheter-Related Infections/epidemiology* ; Catheterization, Central Venous/methods* ; Cross Infection/epidemiology* ; Central Venous Catheters/adverse effects* ; Infection Control/methods*

Idiopathic pulmonary fibrosis (IPF) is a progressive lung disease with unclear etiology and limited treatment options. The median survival time for IPF patients is approximately 2-3 years and there is no effective intervention to treat IPF other than lung transplantation. As important components of lung tissue, endothelial cells (ECs) are associated with pulmonary diseases. However, the role of endothelial dysfunction in pulmonary fibrosis (PF) is incompletely understood. Sphingosine-1-phosphate receptor 1 (S1PR1) is a G protein-coupled receptor highly expressed in lung ECs. Its expression is markedly reduced in patients with IPF. Herein, we generated an endothelial-conditional S1pr1 knockout mouse model which exhibited inflammation and fibrosis with or without bleomycin (BLM) challenge. Selective activation of S1PR1 with an S1PR1 agonist, IMMH002, exerted a potent therapeutic effect in mice with bleomycin-induced fibrosis by protecting the integrity of the endothelial barrier. These results suggest that S1PR1 might be a promising drug target for IPF therapy.

Vascular injury resulting from lower limb amputation leads to the redistribution of blood flow and changes in vascular terminal resistance, which can affect the cardiovascular system. However, there was no clear understanding of how different amputation levels affect the cardiovascular system in animal experiments. Therefore, this study established two animal models of above-knee amputation (AKA) and below-knee amputation (BKA) to explore the effects of different amputation levels on the cardiovascular system through blood and histopathological examinations. The results showed that amputation caused pathological changes in the cardiovascular system of animals, including endothelial injury, inflammation, and angiosclerosis. The degree of cardiovascular injury was higher in the AKA group than in the BKA group. This study sheds light on the internal mechanisms of amputation's impact on the cardiovascular system. Based on the amputation level of patients, the findings recommend more comprehensive and targeted monitoring after surgery and necessary interventions to prevent cardiovascular diseases.
Animals ; Animal Experimentation ; Cardiovascular System ; Cardiovascular Diseases ; Hypertension ; Amputation, Surgical

Objective To understand the current practice status of central venous access device(CVAD)maintenance among intensive care unit(ICU)nurses in secondary and above medical institutions in Shandong province,and to provide a basis for further implementation of effective measures to reduce the incidence of central catheter-related bloodstream infections.Methods The CVAD maintenance practice questionnaire was compiled based on domestic and international evidence related to CVAD maintenance,and a survey was conducted in October 2022 to investigate the status of ICU nurses' CVAD maintenance practice in secondary and above medical institutions in Shandong Province.Results There were 1 492 nurses participated in the survey and 1 461 valid questionnaires were recovered,with a valid recovery rate of 97.92％.The type of CVAD used by the nurses was mainly central venous catheters[92.3％(1349/1461)],and the item with the best assessment at each operation was patency of the catheter[81.1％(1185/1461)],and the worst was the patient's feeling[40.7％(594/1 461)].When assessing catheter patency,[59.8％(873/1 461)]of nurses drew back blood into the catheter.In the use of infusion connectors,three-way connectors[76.0％(1 110/1 461)]and heparin caps[62.3％(910/1 461)]were most frequently used.When sterilizing needleless connectors,most nurses could follow the correct range of disinfection,but the time of disinfection needed to be extended,and the most used items for disinfection were povidone-iodine cotton balls/swabs[44.3％(647/1 461)].The timing of changing infusion connectors needs to be standardized.Most nurses would choose saline for catheter flushing,and the number of nurses choosing saline versus heparinized saline when locking the catheter was about 50％.Most nurses can use correct size syringes and follow standardized techniques for flushing and locking.When performing CVAD maintenance,84.7％(1 237/1 461)of nurses chose a specialized care package kit.The most used skin antiseptic was povidone-iodine[63.7％(931/1 461)].Most nurses could follow the standardized range of skin disinfection,but awareness of drying needs to be improved.Dressings covering puncture points were most frequently transparent[99.7％(1 457/1 461)]and gauze[94.7％(1 383/1 461)],and the frequency of gauze dressing changes needs to be standardized.Hand hygiene and aseptic awareness of nurses during CVAD maintenance was good,but hand hygiene and the timing of wearing sterile gloves need to be standardized.Conclusions ICU nurses' CVAD maintenance practices were generally in line with the latest evidence-based recommendations,but assessment,use of maintenance-related items,and hand hygiene and aseptic technique need to be further standardized.It is recommended that nursing administrators enhance ICU nursing human resource allocation as much as possible and form a central line associated bloodstream infection(CLABSI)prevention and control management system to gradually reduce the morbidity of CLABSI within the ICU.

Diverse types of GABAergic interneurons tend to specialize in their inhibitory control of various aspects of cortical circuit operations. Among the most distinctive interneuron types, chandelier cells (i.e., axo-axonic cells) are a bona fide cell type that specifically innervates pyramidal cells at the axon initial segment, the site of action potential initiation. Chandelier cells have been speculated to exert ultimate inhibitory control over pyramidal cell spiking. Thus, chandelier cells appear to share multiple similarities with basket cells, not only in firing pattern (fast spiking) and molecular components, but also in potentially perisomatic inhibitory control. Unlike basket cells, however, synaptic recruitment of chandelier cells is little known yet. Here, we examined the mediodorsal thalamocortical input to both chandelier cells and basket cells in medial prefrontal cortex, through combining mouse genetic, optogenetic and electrophysiological approaches. We demonstrated that this thalamocortical input produced initially weak, but facilitated synaptic responses at chandelier cells, which enabled chandelier cells to spike persistently. In contrast, this thalamocortical input evoked initially strong, but rapidly depressed synaptic responses at basket cells, and basket cells only fired at the initiation of input. Overall, the distinct synaptic recruitment dynamics further underscores the differences between chandelier cells and basket cells, suggesting that these two types of fast spiking interneurons play different roles in cortical circuit processing and physiological operation.
Mice ; Animals ; Neurons/physiology* ; Pyramidal Cells/physiology* ; Interneurons ; Action Potentials/physiology* ; Synaptic Transmission

Abstract: Objective　To analyze the serotype distribution, drug resistance rate and drug resistance gene carrying of Streptococcus pneumoniae isolates in hospitalized patients, and evaluate the coverage of the vaccine to the serotype of Streptococcus pneumoniae in this area, so as to provide reference for the rational use of antibiotics in clinic. Methods　A total of 150 strains of non-repetitive Streptococcus pneumoniae isolated from inpatients from January 2015 to December 2019 were collected for serotyping and antimicrobial sensitivity test. The carrying rates of pbp2b, ermB and tetM were detected by PCR. Results　The PCR classification rate of 150 strains of Streptococcus pneumoniae was 93.1%, and the classification rate of capsular swelling test was 100%, and a total of 19 serotypes were divided, mainly 19F and 6B. Children's serotypes were predominantly 19F, 6B, and 15A; adult serotypes were predominantly 19F, 14, and 23F. The coverage rates of the PCV7, PCV10, PCV13 and PPV23 vaccines were 36.8%, 42.1%, 57.9% and 68.4%, respectively. Strains with serotypes of 19F, 6B, 3, and 23F had higher rates of resistance to antimicrobials. The sensitivity of Streptococcus pneumoniae to penicillin was greater than 96.0%. Antimicrobials with significant differences in resistance rates between invasive and non-invasive strains were penicillin, moxifloxacin, and levofloxacin. The percentage of strains carrying both ermB and tetM resistance genes was 96.0%, and the concordance rate between pbp2b, ermB and tetM resistance genes and the resistance phenotype was >98.0%. A total of 10 multi-resistance combinations were detected, with a multi-resistance rate of 62.6%, and the multi-drug resistance pattern of Streptococcus pneumoniae was mainly concentrated in the 19F and 6B serotypes. Conclusion　There are significant age differences in the serotypes of Streptococcus pneumoniae in this area. The vaccine currently used has low coverage in this region and therefore offer limited protection to the population. The drug resistance rates of Streptococcus pneumoniae varied significantly among serotypes. Erythromycin and tetracycline are not recommended for clinical treatment of Streptococcus pneumoniae. Penicillin can still be used as the first choice for clinical treatment of Streptococcus pneumoniae infection.

Syringa oblata is a traditional Mongolian medicine mainly distributed in the Helan Mountains (the boundaries of Inner Mongolia and Ningxia, China) and the north of Yan Mountains (Aohan Qi, Inner Mongolia, China). It is clinically used to treat diseases caused by Heyi, such as heartache and heat pathogen in the heart. Phytochemical studies on S. oblata revealed the presence of iridoids, lignans, triterpenes, phenylpropanoids, phenylethanoids, and volatile components. Pharmacological investigations revealed a broad spectrum of bioactivities, such as antimicrobial, antioxidant, antiproliferative, and hepatoprotective effects. This article summarized the chemical components and pharmacological activities of S. oblata, providing a scientific rationale for its bioactive constituents, quality control, and utilization as an important medicine.

Dammarane-type triterpenoid saponins are regarded as the main active constituents of Gynostemma longipes C.Y.Wu. By using MCI and silica gel column chromatography, as well as preparative HPLC, we isolated four new dammarane-type triterpenoid saponins from the polar saponin fraction of G. longipes C.Y.Wu. Their structures were determined by comprehensive analyses of NMR and MS data and identified as (20S)-3β,20,21-trihydroxydammar-19-oxo-24-ene-3-O-{[α-L-rhamnopyranosyl(1→2)]-[β-D-xylopyranosyl(1→3)]-α-L-arabinopyranosyl}-21-O-β-D-glucopyranosyl(1→6)-β-D-glucopyranoside (1), (20S)-3β,20,21-trihydroxydammar-24-ene-19-oxo-3-O-[α-L-rhamnopyranosyl(1→2)]-[β-D-xylopyranosyl(1→3)]-α-L-arabinopyranosyl-21-O-α-L-rhamnopyranosyl(1→6)-β-D-glucopyranoside (2), (20S)-3β,19,20,21-terahydroxydammar-24-ene-3-O-{[α-L-rhamnopyranosyl(1→2)]-[β-D-xylopyranosyl(1→3)]-α-L-arabinopyranosyl}-21-O-[β-D-glucopyranosyl(1→6)]-β-D-glucopyranoside (3), (20S)-3β,20,21-trihydroxydammar-24-ene-3-O-{[α-L-rhamnopyranosyl(1→2)]-[β-D-glucopyranosyl(1→3)]-β-D-glucopyranosyl}-21-O-[β-D-glucopyranosyl(1→6)]-β-D-glucopyranoside (4). Compounds 1-4 are new dammarane-type triterpenoid saponins which contain five glycosyl residues.