Objective:To investigate the clinical characteristics of sepsis-induced myocardial injury and microbial distribution.Methods:It was a retrospective observational study conducted from Jan 2023 to Dec 2023 in the Department of Emergency Intensive Care Medicine, Changshu Hospital Affiliated to Soochow University. Patients meeting the sepsis 3.0 criteria were included, excluding those with underlying cardiovascular diseases or incomplete data. Patients were categorized into myocardial injury (SIMI) and non-myocardial injury (Non-SIMI) groups based on troponin levels. General patient information, laboratory results, microbial findings, and prognostic indicators were collected. Differences in clinical parameters between the two groups were compared. Factors showing statistical differences in univariate analysis were further analyzed using multivariable logistic regression to identify risk factors for SIMI. Conduct propensity score matching among Pulmonary infection patients who underwent bronchoalveolar lavage high-throughput sequencing to compare microbial distribution between groups. Bracken was used to estimate species-level abundance from Kraken2 results, and α and β diversity analyses were conducted on the metagenomic samples.Results:A total of 179 patients were included in the study, with 98 (54.4%) in the Non-SIMI group and 81 (45.5%) in the SIMI group. There were 69 deaths overall (38.5%), with 23 (23.7%) in the Non-SIMI group and 46 (56.8%) in the SIMI group (χ 2=20.347, P<0.01). The 28-day survival curve indicated survival rates in the SIMI group were significantly lower compared to the Non-SIMI group (Log Rank χ 2=21.270, P<0.01). Univariate analysis revealed that fungal infection rate ( P=0.007), C-reactive protein ( P=0.021), procalcitonin, blood urea nitrogen, creatinine, alanine transaminase, and lactate levels were higher in the SIMI group compared to the Non-SIMI group (all P<0.01), prothrombin time was prolonger ( P<0.01) and APACHEⅡ scores were higher ( P<0.01), while serum albumin, base excess, and platelet levels were lower (all P<0.01). Multivariable logistic regression analysis indicated that fungal infection ( OR=3.441, P=0.015) was a risk factor for SIMI, whereas base excess and platelets were protective factors ( OR=0.845, 0.988, both P<0.01). Comparison of bronchoalveolar lavage high-throughput sequencing results in the pulmonary infection subgroup showed the relative abundance of Haemophilus paraininfluenzae in Non-SIMI group was higher than SIMI group among the top 20 species ( P=0.013). There were no statistically significant differences in microbial αand β-diversity between the two groups. Conclusions:The incidence of SIMI is relatively highamong sepsis patients and it affects their prognosis. Risk factors for SIMI include fungal infection, decreased platelet count, and reduced base excess levels. Among patients with pulmonary infections, there is a lower risk of SIMI associated with Haemophilus influenzae infection.

Objective:To systematically evaluate the efficacy and safety of reslizumab targeting interleukin 5 in adjuvant therapy for patients with refractory asthma.Methods:The PubMed, Embase, Cochrane Library, Clinicaltrials.gov, CNKI, VIP, and Wanfang databases were searched (up to June 2022). Randomized controlled trials (RCTs) of reslizumab in adjuvant therapy of refractory asthma were collected. On the basis of conventional treatment for asthma, patients in the trial group was given additional reslizumab while the control group was given placebo. Primary outcome measures included the acute asthma attacks incidence, the changes of forced expiratory volume in the first second (FEV 1), asthma control questionnaire (ACQ) score, asthma quality of life questionnaire (AQLQ) score, and blood eosinophil count before and after adjuvant therapy, and incidence of adverse events. RevMan 5.3 software was used for meta-analysis. The effect sizes of counting data were odds ratio ( OR) and its 95% confidence interval ( CI), while the effect sizes of measurement data were mean difference ( MD) and its 95 %CI. Results:A total of 7 RCTs and 2 506 patients were entered in the analysis, including 1 456 in the trial group and 1 050 in the control group. The meta-analysis showed that, compared to the control group, the acute asthma attacks incidence was lower in patients of the trial group during adjuvant therapy[18.1%(263/1 456) vs. 31.3%(329/1 050), OR=0.50, 95 %CI: 0.41-0.62, P<0.001]; FEV1 and AQLQ score after treatment were higher ( MD=0.13 L, 95 %CI: 0.08-0.17 L, P<0.001; MD=0.18, 95 %CI: 0.04-0.33, P=0.01); the ACQ score and blood eosinophil count were higher ( MD=-0.19, 95 %CI: -0.28--0.10, P<0.001; MD=-0.45×10 9/L, 95 %CI:-0.48×10 9/L--0.42×10 9/L, P<0.001). There were no statistically significant difference in the incidences of overall adverse events, serious adverse events, allergic reactions, and pneumonia compared to those in the control group [63.7% (928/1 456) vs. 71.4% (750/1 050), OR=0.76, 95 %CI: 0.55-1.06, P=0.10; 6.4% (93/1 456) vs. 8.2% (86/1 050), OR=0.91, 95 %CI: 0.66-1.24, P=0.55; 0.4% (5/1 403) vs. 0.1% (1/997), OR=1.66, 95 %CI: 0.41-6.65, P=0.47; 0.6% (9/1 456) vs. 1.0% (10/1 050), OR=0.81, 95 %CI: 0.35-1.87, P=0.63]. Conclusion:Reslizuma has a good efficacy and safety profile in adjuvant treatment for patients with refractory asthma.

Objective:To systematically evaluate the efficacy and safety of reslizumab targeting interleukin 5 in adjuvant therapy for patients with refractory asthma.Methods:The PubMed, Embase, Cochrane Library, Clinicaltrials.gov, CNKI, VIP, and Wanfang databases were searched (up to June 2022). Randomized controlled trials (RCTs) of reslizumab in adjuvant therapy of refractory asthma were collected. On the basis of conventional treatment for asthma, patients in the trial group was given additional reslizumab while the control group was given placebo. Primary outcome measures included the acute asthma attacks incidence, the changes of forced expiratory volume in the first second (FEV 1), asthma control questionnaire (ACQ) score, asthma quality of life questionnaire (AQLQ) score, and blood eosinophil count before and after adjuvant therapy, and incidence of adverse events. RevMan 5.3 software was used for meta-analysis. The effect sizes of counting data were odds ratio ( OR) and its 95% confidence interval ( CI), while the effect sizes of measurement data were mean difference ( MD) and its 95 %CI. Results:A total of 7 RCTs and 2 506 patients were entered in the analysis, including 1 456 in the trial group and 1 050 in the control group. The meta-analysis showed that, compared to the control group, the acute asthma attacks incidence was lower in patients of the trial group during adjuvant therapy[18.1%(263/1 456) vs. 31.3%(329/1 050), OR=0.50, 95 %CI: 0.41-0.62, P<0.001]; FEV1 and AQLQ score after treatment were higher ( MD=0.13 L, 95 %CI: 0.08-0.17 L, P<0.001; MD=0.18, 95 %CI: 0.04-0.33, P=0.01); the ACQ score and blood eosinophil count were higher ( MD=-0.19, 95 %CI: -0.28--0.10, P<0.001; MD=-0.45×10 9/L, 95 %CI:-0.48×10 9/L--0.42×10 9/L, P<0.001). There were no statistically significant difference in the incidences of overall adverse events, serious adverse events, allergic reactions, and pneumonia compared to those in the control group [63.7% (928/1 456) vs. 71.4% (750/1 050), OR=0.76, 95 %CI: 0.55-1.06, P=0.10; 6.4% (93/1 456) vs. 8.2% (86/1 050), OR=0.91, 95 %CI: 0.66-1.24, P=0.55; 0.4% (5/1 403) vs. 0.1% (1/997), OR=1.66, 95 %CI: 0.41-6.65, P=0.47; 0.6% (9/1 456) vs. 1.0% (10/1 050), OR=0.81, 95 %CI: 0.35-1.87, P=0.63]. Conclusion:Reslizuma has a good efficacy and safety profile in adjuvant treatment for patients with refractory asthma.

Objective: To compare the effectiveness and clinical safety between the two through the observation of Orthokeratology lens and multifocal soft lens. Methods: By using prospective longitudinal design, sixty patients (120 eyes) with orthokeratology lens and multifocal soft lens were selected. After 1, 3, 6 and 12 months, our tests were conducted, including ocular surface disease index (OSDI) questionnaire, tear break up time(BUT), corneal fluerescein staining (CSF) and meibomian gland function assessment, before and after wearing glasses, ocular axis and refraction in 6,12 and 18 months after were evaluated to assess the effect of myopia control. Results: But in the orthokeratology lens group was lower than the soft lens group after two months. The difference was statistically significant( t=4.35, P <0.05). After 1 month of wearing glasses, BUT in the orthokeratologylens group was shorter than before( F=305.83, P <0.05). In the group of soft lens, there was no statistically significance before and after wearing glasses( F= 0.38, P >0.05). There was no difference in corneal fluorescence staining (CSF) and meibomian gland function between the two groups before and after wearing glasses.( F time=1.55, 1.38, 10.15, 1.50, P >0.05, F group=2.31, 0.02， P >0.05). After 18 months of wearing orthokeratology lens, the average degree of spherical lens increased by -0.53 D, which was different from that before wearing( F=6.54, P <0.05). After wearing soft lens 18 month, the average degree of spherical lens increase by -0.34 D, which was different from that before wearing( F=2.88, P <0.05). After 18 months of wearing glasses, there were differences in the growth of ocular axis between the two groups( F =2.73, 2.83, P <0.05). Conclusion Orthokeratology lens and multifocal soft lens are both safe and effective measures to control myopia.

Objective:To understand the characteristics of the HIV-1 molecular networks in injected drug users (IDUs) in Guangzhou from 2008 to 2017, and provide reference for the prevention and control of AIDS in this population.Methods:The serum samples of newly diagnosed HIV-1 positive IDUs in Guangzhou from 2008 to 2017 were collected, HIV-1 RNA was extracted for pol gene amplification and sequencing. The molecular cluster in the phylogenetic tree was identified by Cluster Picker 1.2.3 for cluster analysis. TN93 model in HyPhy2.2.4 was used to calculate the gene distance between the cluster sequences. Software Cytoscape3.8.2 was used to visualize the molecular network, and χ2 test or exact probability method was used for cluster analysis and centrality analysis. Results:A total of 586 sequences were successfully amplified (73.9%, 586/793), and 80 molecular clusters were produced, with a clustering rate of 46.6% (273/586). In molecular clusters, the proportions of the strains from IDUs in Han ethnic group (48.4%, 260/537), IDUs who were local residents in Guangdong (52.7%, 146/277) and IDUs whose strain sequence subtype was CRF55_01B (93.3%, 14/15) were higher. In the molecular network, the degree range was 1-7, and nodes with degree ≥3 accounted for 12.8% (24/187), which was associated with another 81 nodes in the molecular network (43.3%, 81/187). The centrality analysis showed that the proportions of housework/unemployed with high degree centrality (19.0%, 19/100), high intermediary (22.0%, 22/100), and high proximity centrality (32.0%, 32/100) were higher in IDUs infected with HIV-1.Conclusion:The risk of HIV-1 clustering in IDUs in Guangzhou was high, suggesting that IDUs who were from both Guangdong and Guangxi and were house workers or unemployed should be viewed as the key targets, and precise intervention should be implemented to reduce the HIV-1 infection rate in this population.

Objective To discuss the function and advantages of ultrasound technology in various factors in the diagnosis of vertebral artery stenosis lesions.Methods The objective data of ultrasonography were selected in 60 patients (120 vertebral arteries) with paroxysmal,reversible vertigo and headache as the chief complaint,the internal relations were summarized and analyzed.Results In the subjects of study,the vertebral artery stenosis for 38.2％,vertebral artery course tortuosity changer accounted for 33.3％,congenital abnormal development accounted for 9.8％,mixed cause 18.6％,dominant etiology was vertebral artery sclerosis and vertebral artery tortuosity change.Conclusion Ultrasound technology has important value of clinical application in the reasons diagnosis of vertebral artery stenosis disease,it can help extend clinical diagnosis.

Objective To understand the characteristic of subtype distribution among foreigners who were living with HIV-1,in Guangzhou.Methods HIV-1 RNAs were extracted from 114 serum specimens in foreigners diagnosed with HIV-1 infections between 2008 and 2010,and in 2015.Partial pol gene of HIV-1 genome from these RNA samples were amplified by nested reverse transcription polymerase chain reaction (nested-PCR) with nucleotide sequenced.Subsequently,phylogenetic tree was reconstructed using the pol sequences of samples and references.Results Among all the 114 samples,57.9％ were from males and 42.1％ from females,with an average age as 35.21 years old and the standard deviation as 9.63 years.A total of 6.8％ of the samples were from Africans.The top three subtypes were identified as CRF02_AG,subtype G and subtype C,accounted for 30.7％,14.9％ and 12.3％ respectively.Compared with samples gathered from 2008 to 2010,the proportions of subtype A1 and CRF01_AE significantly increased,while the other subtypes significantly decreased in 2015 (x 2=37.570;P=0.013,99％ CI:0.010-0.016).Proportions of CRF01_AE and subtype G among males outnumbered the females but the proportions of subtype A1,CRF02_AG and URF among females appeared the other way round (x2=15.528;P=0.029,99％CI:0.024-0.033).Proportions of CRF02_AG and subtype G among HIV-1 positive Africans were larger than those from other Southeast Asian countries or areas,However,the proportion of CRF01_AE among HIV-1 positive patients from Southeast Asian countries was higher than those patients from other areas (x2=39.399;P=0.009,99％ CI:0.006-0.011).The rates of resistance to any drug of protease inhibitors (PIs),reverse transcriptase inhibitors (RTIs),as well as to PIs,NRTIs,and NNRTIs alone,were 21.9％,12.3％,6.1％ and 7.0％,respectively.One of nine CRF01_AEs from the HIV-1 positive patients were found closely clustered in those phylogenetic tree (bootstrap=0.855) samples,collected from local patients in Guangzhou.Conclusions Our findings showed that these foreign subtypes had been spread to the natives,more from the Africans than from the other areas,in Guangzhou.These types of viruses were different from the strains identified locally,suggesting that they might have been brought in by foreigners living with HIV-1,in Guangzhou.Programs related to care,support and behavioral intervention for HIV positive foreigners living in Guangzhou,should be strengthened.

Objective To introduce the development strategy of“Internet Plus”AIDS prevention services and its implementation results from 2010 to 2015 in Guangzhou, China. Methods A gay men's health column was created for an active website aimed at men who have sex with men (MSM), in collaboration with local community organizations and the Guangzhou CDC. We designed intervention tools (including scenario-based applications and HIV risk self-assessment systems) and an online HIV testing service platform, integrated with applied psychology and behavioral theory as well as the“Internet Plus”concept, to intervene in HIV infection risk factors among MSM. Data of clients who accessed the“Internet Plus”AIDS services from 2010 to 2015 were used to evaluate service operation. Six-year consecutive surveys, conducted between April and July of each service year, were collected using a national AIDS sentinel surveillance questionnaire. For each year of surveillance, information on HIV prevalence, HIV interventions received during the past year, unprotected anal intercourse in the past 6 months, and HIV testing in the past year were compared using the chi-squared (χ2) test, to roughly reflect the effect of“Internet Plus”AIDS prevention services. Results As of 31 December 2015, a total of 34 395 MSM had received“Internet Plus”services and HIV testing. The number of MSM tested increased from 2 338 in 2010 to 8 054 in 2015. From 2010 to 2015, newly identified HIV cases in each year were 59, 166, 312, 283, 291, and 270, which accounted for 25.0%, 32.8%, 38.8%, 35.1%, 30.5%, and 23.2% of MSM HIV cases of Guangzhou, respectively. Sentinel surveillance data showed that during the study period, 3 047 MSM were investigated, with 405, 400, 401, 633, 608, and 600 each year, respectively. The proportion of participants who had received any HIV intervention during the past year was 74.3% (301), 70.8% (283), 83.3% (334), 85.0%(538), 69.1%(420), and 83.8%(503) each year, respectively (trend χ2=6.53, P=0.011). HIV testing done during the past year accounted for 44.0%(178), 44.3%(177), 49.4%(198), 53.4%(338), 56.1%(341), and 60.2%(361) each year, respectively (trendχ2=40.83, P<0.001). Unprotected anal intercourse in the past 6 months accounted for 59.3% (240), 62.0% (248), 56.6% (227), 57.0% (361), 48.4% (294), and 43.7%(262) each year, respectively (trend χ2=42.21, P<0.001). Conclusion The“Internet Plus”AIDS prevention services in this study represent a manner to enhance traditional HIV prevention strategies. We found these services to be effective in implementation of the national AIDS control and prevention strategy, especially for the expansion of intervention, testing, and case identification among high-risk populations.

Objective To introduce the development strategy of“Internet Plus”AIDS prevention services and its implementation results from 2010 to 2015 in Guangzhou, China. Methods A gay men's health column was created for an active website aimed at men who have sex with men (MSM), in collaboration with local community organizations and the Guangzhou CDC. We designed intervention tools (including scenario-based applications and HIV risk self-assessment systems) and an online HIV testing service platform, integrated with applied psychology and behavioral theory as well as the“Internet Plus”concept, to intervene in HIV infection risk factors among MSM. Data of clients who accessed the“Internet Plus”AIDS services from 2010 to 2015 were used to evaluate service operation. Six-year consecutive surveys, conducted between April and July of each service year, were collected using a national AIDS sentinel surveillance questionnaire. For each year of surveillance, information on HIV prevalence, HIV interventions received during the past year, unprotected anal intercourse in the past 6 months, and HIV testing in the past year were compared using the chi-squared (χ2) test, to roughly reflect the effect of“Internet Plus”AIDS prevention services. Results As of 31 December 2015, a total of 34 395 MSM had received“Internet Plus”services and HIV testing. The number of MSM tested increased from 2 338 in 2010 to 8 054 in 2015. From 2010 to 2015, newly identified HIV cases in each year were 59, 166, 312, 283, 291, and 270, which accounted for 25.0%, 32.8%, 38.8%, 35.1%, 30.5%, and 23.2% of MSM HIV cases of Guangzhou, respectively. Sentinel surveillance data showed that during the study period, 3 047 MSM were investigated, with 405, 400, 401, 633, 608, and 600 each year, respectively. The proportion of participants who had received any HIV intervention during the past year was 74.3% (301), 70.8% (283), 83.3% (334), 85.0%(538), 69.1%(420), and 83.8%(503) each year, respectively (trend χ2=6.53, P=0.011). HIV testing done during the past year accounted for 44.0%(178), 44.3%(177), 49.4%(198), 53.4%(338), 56.1%(341), and 60.2%(361) each year, respectively (trendχ2=40.83, P<0.001). Unprotected anal intercourse in the past 6 months accounted for 59.3% (240), 62.0% (248), 56.6% (227), 57.0% (361), 48.4% (294), and 43.7%(262) each year, respectively (trend χ2=42.21, P<0.001). Conclusion The“Internet Plus”AIDS prevention services in this study represent a manner to enhance traditional HIV prevention strategies. We found these services to be effective in implementation of the national AIDS control and prevention strategy, especially for the expansion of intervention, testing, and case identification among high-risk populations.

Objective Investigate the clinical efficacy of treating retreated smear-positive tuberculosis patients with conventional anti-tuberculosis chemotherapy combined with levofloxacin. Methods Divide 60 retreated smear-positive tuberculosis patients registered in our hospital between October 2012 and October 2014 into two groups using random number table method: levofloxacin group and conventional treatment group. Each group contains 30 patients that were treated for 9 months , and the efficacy the both treatment methods were compared. Results The sputum conversion rate in the levofloxacin group is 93.33% and 96.67% after treating for 6 months and 9 months , respectively; which are substantial higher than that of the conventional treatment group with sputum conversion rate of 70% and 73.33% after 6 months and 9 months of treatment , respectively (P < 0.05). The absorption rate of the levofloxacin group is significantly higher than that of the conventional treatment group (P < 0.05). The cavity improvement rate of the levofloxacin group is 73.33%, which is significantly higher than that of the conventional treatment group (33.33%) (P < 0.05). The clinical efficacy of the LVFX group is substantially higher than the routine treatment group (P < 0.05). The overall effectiveness of LVFX group reached 100% , which is significantly higher than that of the conventional treatment group (86.67%) (P < 0.05). Conclusions Levofloxacin combined with conventional anti-tuberculosis chemotherapy can effectively improve the clinical efficacy in the treatment of tuberculosis.