Objective:To construct a risk prediction model for pulmonary infection in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) based on decision tree method, and analyze nursing strategies.Methods:From March 2022 to June 2024, convenience sampling was used to select 162 patients with AECOPD at the First Affiliated Hospital of Zhengzhou University as study subjects. Patients with AECOPD complicated by pulmonary infection were designated as infection group ( n=82), while patients without pulmonary infection were designated as non-infection group ( n=80). Relevant clinical data were collected, and multiple Logistic regression was used to analyze the influencing factors of pulmonary infections in AECOPD patients, and a decision tree prediction model was established. Results:Multivariate Logistic regression analysis showed that age, glucocorticoid use time, hospital stay, mechanical ventilation history, diabetes, C-reactive protein and procalcitonin were the influencing factors of AECOPD patients with pulmonary infection ( P<0.05). The risk decision tree model of AECOPD patients with pulmonary infection based on the above factors showed that procalcitonin, C-reactive protein, mechanical ventilation history and diabetes were nodes, with four layers, six terminal nodes and four explanatory variables. The area under the receiver operating characteristic curve was 0.929 [95% CI (0.889, 0.968) ], the sensitivity was 0.854, the specificity was 0.875, and the predictive performance was good. Conclusions:Age, glucocorticoid use time, hospital stay, mechanical ventilation history, diabetes, C-reactive protein and procalcitonin are independent risk factors for AECOPD patients with pulmonary infection. The decision tree prediction model constructed has good predictive performance and can be used as a basis for selecting nursing strategies.

Objective:To construct a risk prediction model for pulmonary infection in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) based on decision tree method, and analyze nursing strategies.Methods:From March 2022 to June 2024, convenience sampling was used to select 162 patients with AECOPD at the First Affiliated Hospital of Zhengzhou University as study subjects. Patients with AECOPD complicated by pulmonary infection were designated as infection group ( n=82), while patients without pulmonary infection were designated as non-infection group ( n=80). Relevant clinical data were collected, and multiple Logistic regression was used to analyze the influencing factors of pulmonary infections in AECOPD patients, and a decision tree prediction model was established. Results:Multivariate Logistic regression analysis showed that age, glucocorticoid use time, hospital stay, mechanical ventilation history, diabetes, C-reactive protein and procalcitonin were the influencing factors of AECOPD patients with pulmonary infection ( P<0.05). The risk decision tree model of AECOPD patients with pulmonary infection based on the above factors showed that procalcitonin, C-reactive protein, mechanical ventilation history and diabetes were nodes, with four layers, six terminal nodes and four explanatory variables. The area under the receiver operating characteristic curve was 0.929 [95% CI (0.889, 0.968) ], the sensitivity was 0.854, the specificity was 0.875, and the predictive performance was good. Conclusions:Age, glucocorticoid use time, hospital stay, mechanical ventilation history, diabetes, C-reactive protein and procalcitonin are independent risk factors for AECOPD patients with pulmonary infection. The decision tree prediction model constructed has good predictive performance and can be used as a basis for selecting nursing strategies.

Objective:By analyzing resting state functional magnetic resonance imaging data, this study aims to explore the effects of glucocorticoids (GC), glucocorticoids combined with cyclophosphamide (CTX) and/or hydroxychloroquine sulfate (HCQ) treatment on brain function in systemic lupus erythematosus patients without major neuropsychiatric manifestations, providing a basis for early identification and intervention of changes in brain function in systemic lupus erythematosus patients without major neuropsychiatric manifestations.Methods:Systemic lupus erythematosus patients without major neuropsychiatric manifestations were divided into drug na?ve group, GC group, and GC combined with CTX and/or HCQ group based on their treatment status at the time of enrollment. Health controls (HCs) were selected based on gender, age, and education level. The low frequency amplitude (ALFF), fractional low frequency amplitude (fALFF), and regional homogeneity (ReHo) were calculated for each of the four groups of participants. When comparing multiple groups, χ2 test or Fisher's exact test was used for count data, analysis of variance or Kruskal-Wallis H test was used for continuous variables, and LSD method was used for post hoc comparisons. Results:After matching, 22, 30, 50, and 29 cases were finally included. There were significant differences in brain function in multiple brain regions among the four groups. Specifically, compared with the HCs group, the ALFF values of the right posterior central gyrus ( t=-2.96) and the right paracentral lobule ( t=-2.95) in the drug na?ve group were decreased. In the GC group, the ALFF values in the right paracentral lobule ( t=-2.93), the right posterior central gyrus ( t=-2.93) and the right anterior central gyrus ( t=-2.94) were decreased. The ALFF values of the right paracentral lobule ( t=-2.90) and the right anterior central gyrus ( t=-2.90) were decreased in GC+CTX and/or HCQ groups. Compared with the drug na?ve group, ALFF values were higher in the right posterior central gyrus ( t=-3.00) and the right rolandic operculum ( t=-2.91) in GC+CTX and/or HCQ groups. Compared with the HCs group, fALFF values of the right anterior central gyrus ( t=-2.95) and the left posterior central gyrus ( t=-2.97) in the drug na?ve group decreased, and fALFF values of the right anterior central gyrus ( t=-2.94) and the left posterior central gyrus ( t=-2.98) in the GC group decreased. fALFF values decreased in the left posterior central gyrus ( t=-2.91) of GC+CTX and/or HCQ groups. fALFF values in the right anterior central gyrus ( t=-2.89) were higher in GC+CTX and/or HCQ group than in GC group. Compared with HCs, the ReHo value in the right posterior central gyrus ( t=-2.97) of the drug na?ve group decreased, and the ReHo value in the right anterior central gyrus ( t=-2.95) of the GC group decreased. The ReHo of GC+CTX and/or HCQ group was higher in the right anterior central gyrus ( t=-2.91) than that of the drug na?ve group, and the ReHo of the right posterior central gyrus ( t=-2.93) was higher than that of the GC group. The above results were adjusted by Gaussian random-field (GRF) multiple comparison ( Pvoxel<0.005, Pcluste<0.010). Conclusion:Systemic lupus erythematosus patients without major neuropsychiatric manifestations have reduced functional activity in multiple brain regions of the whole brain. GC combined with CTX and/or HCQ may have better effects on improving brain function than GC alone, and it mainly acts on sensorimotor related brain regions.

Objective:By analyzing resting state functional magnetic resonance imaging data, this study aims to explore the effects of glucocorticoids (GC), glucocorticoids combined with cyclophosphamide (CTX) and/or hydroxychloroquine sulfate (HCQ) treatment on brain function in systemic lupus erythematosus patients without major neuropsychiatric manifestations, providing a basis for early identification and intervention of changes in brain function in systemic lupus erythematosus patients without major neuropsychiatric manifestations.Methods:Systemic lupus erythematosus patients without major neuropsychiatric manifestations were divided into drug na?ve group, GC group, and GC combined with CTX and/or HCQ group based on their treatment status at the time of enrollment. Health controls (HCs) were selected based on gender, age, and education level. The low frequency amplitude (ALFF), fractional low frequency amplitude (fALFF), and regional homogeneity (ReHo) were calculated for each of the four groups of participants. When comparing multiple groups, χ2 test or Fisher's exact test was used for count data, analysis of variance or Kruskal-Wallis H test was used for continuous variables, and LSD method was used for post hoc comparisons. Results:After matching, 22, 30, 50, and 29 cases were finally included. There were significant differences in brain function in multiple brain regions among the four groups. Specifically, compared with the HCs group, the ALFF values of the right posterior central gyrus ( t=-2.96) and the right paracentral lobule ( t=-2.95) in the drug na?ve group were decreased. In the GC group, the ALFF values in the right paracentral lobule ( t=-2.93), the right posterior central gyrus ( t=-2.93) and the right anterior central gyrus ( t=-2.94) were decreased. The ALFF values of the right paracentral lobule ( t=-2.90) and the right anterior central gyrus ( t=-2.90) were decreased in GC+CTX and/or HCQ groups. Compared with the drug na?ve group, ALFF values were higher in the right posterior central gyrus ( t=-3.00) and the right rolandic operculum ( t=-2.91) in GC+CTX and/or HCQ groups. Compared with the HCs group, fALFF values of the right anterior central gyrus ( t=-2.95) and the left posterior central gyrus ( t=-2.97) in the drug na?ve group decreased, and fALFF values of the right anterior central gyrus ( t=-2.94) and the left posterior central gyrus ( t=-2.98) in the GC group decreased. fALFF values decreased in the left posterior central gyrus ( t=-2.91) of GC+CTX and/or HCQ groups. fALFF values in the right anterior central gyrus ( t=-2.89) were higher in GC+CTX and/or HCQ group than in GC group. Compared with HCs, the ReHo value in the right posterior central gyrus ( t=-2.97) of the drug na?ve group decreased, and the ReHo value in the right anterior central gyrus ( t=-2.95) of the GC group decreased. The ReHo of GC+CTX and/or HCQ group was higher in the right anterior central gyrus ( t=-2.91) than that of the drug na?ve group, and the ReHo of the right posterior central gyrus ( t=-2.93) was higher than that of the GC group. The above results were adjusted by Gaussian random-field (GRF) multiple comparison ( Pvoxel<0.005, Pcluste<0.010). Conclusion:Systemic lupus erythematosus patients without major neuropsychiatric manifestations have reduced functional activity in multiple brain regions of the whole brain. GC combined with CTX and/or HCQ may have better effects on improving brain function than GC alone, and it mainly acts on sensorimotor related brain regions.

OBJECTIVE：To study the mechanism of Periplaneta americana extract degreasing cream and CⅡ-3（shorted for “degreasing cream ”and“CⅡ-3”）reversing the multi-drug resistance of human HepG 2/ADM cells. METHODS ：MTT assay was used to investigate the toxicity effects of different concentrations of sorafenib （positive control ），degreasing cream and C Ⅱ-3 on HepG2/ADM cells ，then IC 20 was calculated. The experiment was divided into sensitivity drug ，drug-resistance group ，sorafenib group，degreasing cream group and C Ⅱ-3 group. HepG 2 cells were included in sensitivity group ，and HepG 2/ADM cells were included in the latter 4 groups. Sensitivity group and drug-resistance group were treated with routine medium ，and other 3 groups were treated with relevant medicine （IC20 as drug concentration ）. The content of ADM in HepG 2/ADM cells was determined by Laser scanning confocal microscopy. The expression of apoptosis-related protein as Bcl- 2 and Cleaved-Caspase- 9 p37 were detected by Western blotting assay. RT-qPCR and immunocytochemistry were adopted to detect mRNA and protein expressions that related to multidrug resistance [P-gp （expression produce of MDR1 gene），LRP，BCRP] and that related to enzyme-mediated multidrug resistance pathway （GST-π and Topo Ⅱ）. RESULTS ：The IC 20 of degreasing cream ，CⅡ-3 and sorafenib were （2.40±0.16）， （200.44±27.52），（18.00±1.82）μg/mL，respectively. Compared with sensitivity group ，the protein expressions of Bcl- 2，P-gp， LRP，BCRP and Topo Ⅱ，the mRNA expressions of MDR 1， LRP，BCRP and GST-π were increased significantly in drug resistance group （P＜0.05 or P＜0.01）. Compared with @qq.com drug-resistance group ，the mRNA and protein expression of MDR1 mRNA and LRP ，BCRP，GST-π were significantly decreased in degreasing cream group and C Ⅱ-3 group（P＜ 0.05 or P＜0.01）；the protein expression of Bcl- 2 and the mRNA expression of Topo Ⅱ were significantly decreased （P＜0.01）， while the protein expression level of Cleaved-Caspase- 9 p37 was significantly increased in C Ⅱ -3 group （P＜0.05）. CONCLUSIONS：Degreasing cream and C Ⅱ-3 can reverse multidrug resistance of HepG 2/ADM cells by reducing drug efflux ， promoting cell apoptosis ，reducing the mRNA and protein expression of multi-drug resistance gene as well as gene in enzyme-mediated multi-drug resistance pathway. The effect of C Ⅱ-3 is better than that of degreasing cream.

Objective:To investigate the epidemiological and molecular biological characteristics of heterogeneous vancomycin-intermediate Staphylococcus aureus (hVISA) in blood culture. Methods:hVISA was detected using Mueller-Hinton agar containing 5 μg/ml of teicoplanin (MHA5T) and Populats profiles/area under the curve (PAP/AUC). Staphylococcal cassette chromosome mec ( SCCmec), Staphylococcus aureus protein A ( spa) and accessory gene regulator ( agr) typing and multilocus-sequence typing (MLST) were analyzed using PCR. Difference in autolysis between hVISA and vancomycin-sensitive Staphylococcus aureus (VSSA) isolates were evaluated with Triton X-100-inducd autolysis. Expression of vraR, mgrA, icaA, icaR, pbp4 and agr genes in hVISA and VSSA strains were detected by real-time PCR. Results:The positive detection rate of methicillin-resistant Staphylococcus aureus (MRSA) in blood culture was 39.5% (136/344) in our hospital. Among the MRSA strains, there were 31 strains of hVISA (22.8%). The minimum inhibitory concentrations (MIC) of vancomycin were mainly 1.5 μg/ml (54.8%) and 2 μg/ml(25.8%)against hVISA isolates, and 0.5 μg/ml (46.7%) and 0.75 μg/ml (39.0%) against VSSA isolates. The predominant clone of hVISA was ST239- SCCmecⅢ-t030- agrⅠ accounting for 71.0% (22/31). The autolysis of hVISA isolates decreased significantly as compared with that of VSSA isolates ( χ2=13.583, P=0.032). Compared with VSSA strains, the expression of vraR, mgrA and icaA genes in hVISA strains increased by 1.58, 1.53 and 1.06 times ( P<0.01), while the expression of icaR, agr and pbp4 genes decreased by 0.85, 0.61 and 1.03 times ( P<0.05). Conclusions:The prevalence rate of hVISA in our hospital reached 22.8% and the main epidemic clone was ST239- SCCmecⅢ-t030- agrⅠ, which should be paid great attention to clinically. Rational use of antibiotics, strengthening the prevention and control of nosocomial infection, and avoiding the spread of hVISA strains and the emergence of VISA and VRSA (vancomycin-resistance Staphylococcus aureus) were also necessary.

Objective To analyze the imaging findings and pathological basis of seminoma and improve the understanding and diagnostic accuracy.Methods The imaging findings of seminoma in 67 patients proved by histopathology were analyzed retrospectively.The tumor location,size,contour,periphery,density or signal and contrast enhancement patterns were evaluated,and these were compared with the pathological results.Results All of the 67 cases were male.46 cases were located in testicular,10 cases in the pelvic cavity,6 cases in the peritoneal and retroperitoneal,4 cases in the mediastinum,1 case in the brain.On non-enhanced CT,testicular lesions appeared to be nodular or lobular masses with clear margin.Some cases showed cystic-solid masses.And the solid component was located in the edge of the lesion,and the irregular necrosis areas of low density was located in the center.Fat and calcification component were not found in the mass.After contrast administration,the masses showed heterogeneous enhancement.The thickened and tortuous testicular arteries were seen in 11 cases in arterial phase,and thickened and twisted testicular veins were seen in 9 cases in the venous phase.The imaging findings of the mass at the other location were without features.Conclusion Testicular seminoma has significant characteristics,thickened testicular arteries and/or draining veins on enhanced CT can help the diagnosis.Imaging features of extragonadal primary seminoma are not characteristic.Combined with clinical history and signs,it is possible to improve the diagnostiic accuracy of seminoma.

Objective To investigate antibiotic resistance and resistant trend of Streptococcus pneumonia. Methods To investigate 753 Streptococcus pneumoniae isolated from Tongji Hospital in recent 10 years from January 1st 2000 to December 31st 2009, most of them were from respiratory tract specimens,followed by blood and cerebrospinal fluid. The MIC to penicillin & cefatriaxone were determined by E-test,and other antimicrobial susceptibility were tested by Kirby-Bauer method. Results For non-cerebrospinal fluid specimen, the total rate of PNSSP was 23.8%( 93/392 ), it was significant different between the rate of PNSSP from children ( 26. 4%, 47/178 ) and adults ( 16. 8%, 36/214, χ2 = 7. 642, P ＜ 0. 01 ). All of 10 strains isolated from cerebrospinal fluid were PRSP. Most isolates were high-susceptive to moxifloxacin and levofloxacin, and the rate of susceptibility were 96. 9% ( 720/743 ) and 90. 5% ( 672/743 )respectively. None of Streptococcus pneumonia was resistant to vancomycin and meropenam. The resistant rate of most tested antibiotics increased in different degree year by year, especially penicillin, erythromycin and clindamycin. The rate of PNSSP was only 19%( 19/99 )in 2006 ,but in 2009 the rate increased to 30%( 35/114 ). The susceptibility rate of erythromycin was 22% ( 28/125 )in 2000, but only 3% ( 3/114 )in 2009 ;and the susceptibility rate of clindamycin decreased from 40% ( 13/32 ) in 2004 to 4% (5/114) in 2009. Conclusions From 2000 to 2009, Streptococcus pneunoniae was more likely resistant to penicillin,erythromycin and clindamycin year by year, especially those isolates recovered from children. It was suggested that antibiotics should be chosen to use according to antimicrobial susceptibility test results.

Objective To explore the effect of gene NDRG2 (N-myc downstream regulated gene 2) transfection on the proliferation and apoptosis of breast cancer cell. Methods Bcap37 cell line expressing low level product encoded by NDRG2 gene is transfected with recombinating adenovirus expressing high level NDRG2 gene product to improve NDRG2 gene expression level. NDRG2 expression was detected by Western blot and the proliferation activity of the cell lines was detected by MTT and flow cytometry. Results High level expression of NDRG2 inhibits cells growth and results in G_1 phase arrest in Bcap37 cell line. Compared with non-transfected Bcap37 cells and Bcap37 cells transfected by empty vector, apoptosis cells obviously increase in Bcap37 cell line transfected by recombinating adenovirus expressing high level NDRG2 gene, 12% after 48 hours and 21. 5% after 72 hours. Conclusion Overexpres-sion of NDRG2 in Bcap37 cells effectively inhibites cell proliferation and induces cell cycle arrest and apoptosis.

Neural stem cells (NSCs), which will proliferate and differentiate into neurons and glial cells under certain conditions, involved in the repair of neurological function. This process is called neurogenesis. Focal cerebral ischemia-reperfusion injury is one of the most common diseases, which can induce the neurological functional deficits. It is significant to study the response and regulation of NSCs after focal cerebral ischemia-reperfusion injury. In this article, we reviewed the characteristics, molecular mechanisms, putative endogenous mediators and exogenous stimulators of neurogenesis in adult brain following ischemic injury, and response and regulation of drug in ischemic injury following neurogenesis.