This paper reports the clinical characteristics as well as diagnosis and treatment processes of a patient with mixed pulmonary infection of Rhizopus microspores and Aspergillus.The patient had history of type 2 diabe-tes mellitus,and was admitted to the hospital due to diabetes ketoacidosis complicated with pneumonia.Clinical manifestations included cough,expectoration,and fever.Imaging examination showed inflammatory lesions of bila-teral lungs(mainly in the right lung)associated with local consolidation.Bronchoalveolar lavage fluid(BALF)smears and galactomannan antigen test(GM test)were both negative.Nucleic acid sequences of Rhizopus micro-spores and Aspergillus were detected by metagenomic next-generation sequencing(mNGS)at the early stage,while complicated infection of Klebsiella pneumoniae and COVID-19 were also found.The final pathological diagnosis was pulmonary mucormycosis combined with invasive pulmonary aspergillosis.The patient achieved clinical curing through the combination of isaconazole antifungal treatment and lobectomy of the right middle-lower lobes.

This paper reports the clinical characteristics as well as diagnosis and treatment processes of a patient with mixed pulmonary infection of Rhizopus microspores and Aspergillus.The patient had history of type 2 diabe-tes mellitus,and was admitted to the hospital due to diabetes ketoacidosis complicated with pneumonia.Clinical manifestations included cough,expectoration,and fever.Imaging examination showed inflammatory lesions of bila-teral lungs(mainly in the right lung)associated with local consolidation.Bronchoalveolar lavage fluid(BALF)smears and galactomannan antigen test(GM test)were both negative.Nucleic acid sequences of Rhizopus micro-spores and Aspergillus were detected by metagenomic next-generation sequencing(mNGS)at the early stage,while complicated infection of Klebsiella pneumoniae and COVID-19 were also found.The final pathological diagnosis was pulmonary mucormycosis combined with invasive pulmonary aspergillosis.The patient achieved clinical curing through the combination of isaconazole antifungal treatment and lobectomy of the right middle-lower lobes.

Objective:To investigate the clinical significance of autologous platelet separation (APS) in different time courses of cardiovascular surgery.Methods:The relevant data of 75 patients with cardiovascular surgery from September 2019 to August 2021 in Hunan Provincial Peoples′ Hospital were collected retrospectively. They were divided into two groups according to whether APS was used during the operation: group A used APS (37 cases) and group B did not use APS (38 cases). The two groups were divided into subgroups according to the length of cardiopulmonary bypass (CPB): A1 and B1 were medium and short-term groups (CPB bypass time ≤200 min), and A2 and B2 were long-term groups (CPB bypass time >200 min). Blood routine, postoperative drainage volume, postoperative blood product infusion volume and thromboelastogram at different time points were recorded and compared.Results:The postoperative drainage volume, red blood cell infusion volume and ventilator assisted time in group A were less than those in group B (all P<0.05); The postoperative drainage volume [(645.79±205.25)ml vs (886.67±360.96)ml, P=0.006], erythrocyte infusion volume [(3.24±2.53)U vs (4.77±1.97)U, P=0.016], platelet infusion volume [0.00(0.00, 0.00)U vs 1.00(0.125, 2.00)U, P=0.002] and thromboelastogram coagulation reaction time [(7.38±1.74)min vs (9.09±3.57)min, P=0.047] in group A2 were significantly better than those in group B2 (all P<0.05); There were no significant difference in the above indexes between A1 and B1 group (all P>0.05). Conclusions:APS can improve the coagulation function of patients undergoing cardiopulmonary bypass and reduce the amount of bleeding and blood products. Its protective effect is more prominent in high-risk cardiovascular surgery with long cardiopulmonary bypass and complex operation.

Objective:To compare the clinical efficacy of progestin-primed ovarian stimulation (PPOS) protocol and gonadotropin-releasing hormone (GnRH)-antagonist protocol in patients with poor ovarian response (POR).Methods:By retrieving Pubmed, the Cochrane Library, Embase, Web of Science, CNKI, Wanfang Data, and CBM databases, the cohort studies and randomized controlled trials (RCTs) of PPOS and antagonist protocols applied to POR patients were collect and the retrieval time period was from establishment of the database to May 2020. After rigorous literature screening and data extraction, the cohort study used Newcastle Ottawa Scale (NOS) system evaluation method, the RCT used Cochrane system evaluation method to evaluate the literature quality, and the RevMan5.3 software was used for meta-analysis.Results:A total of 7 cohort studies and 3 RCTs were included, totally 1977 POR patients, including 1053 in the PPOS protocol group and 924 in the antagonist protocol. Meta-analysis showed that the duration of gonadotropin (Gn) used in PPOS protocol group was extended ( P=0.02), but there was no significant difference in the total dosage of Gn used compared with the antagonist protocol ( P>0.05). There were no significant differences in the number of follicles with a diameter ≥14 mm and the number of retrieved oocytes between PPOS protocol group and antagonist protocol group (all P>0.05), the M Ⅱ oocyte rate and the fertilization rate were significantly higher than those of antagonist protocol ( P=0.04, P<0.001), but there were no significant differences in the rate of high-quality embryos between the two groups ( P>0.05). The incidence of early onset luteinizing hormone (LH) peak significantly reduced with PPOS protocol ( P=0.04), the levels of estrogen, progesterone, follicle-stimulating hormone (FSH) and LH on trigger day were not significantly different from those of antagonist protocol (all P>0.05). The clinical pregnancy rate of PPOS protocol was higher than that of the antagonist protocol, but the abortion rate was lower than that of the antagonist protocol ( P=0.03, P<0.001), and there were no significant differences in cycle cancellation rate and birth rate between the two protocols ( P>0.05). Conclusion:PPOS protocol can significantly reduce the incidence of premature LH surge in ovulation induction in POR patients, increase the M Ⅱ oocytes rate, improve the pregnancy outcome, reduce the incidence of adverse pregnancy, and can be widely and safely used in POR patients.

Objective:To compare the clinical efficacy of progestin-primed ovarian stimulation (PPOS) protocol and gonadotropin-releasing hormone (GnRH)-antagonist protocol in patients with poor ovarian response (POR).Methods:By retrieving Pubmed, the Cochrane Library, Embase, Web of Science, CNKI, Wanfang Data, and CBM databases, the cohort studies and randomized controlled trials (RCTs) of PPOS and antagonist protocols applied to POR patients were collect and the retrieval time period was from establishment of the database to May 2020. After rigorous literature screening and data extraction, the cohort study used Newcastle Ottawa Scale (NOS) system evaluation method, the RCT used Cochrane system evaluation method to evaluate the literature quality, and the RevMan5.3 software was used for meta-analysis.Results:A total of 7 cohort studies and 3 RCTs were included, totally 1977 POR patients, including 1053 in the PPOS protocol group and 924 in the antagonist protocol. Meta-analysis showed that the duration of gonadotropin (Gn) used in PPOS protocol group was extended ( P=0.02), but there was no significant difference in the total dosage of Gn used compared with the antagonist protocol ( P>0.05). There were no significant differences in the number of follicles with a diameter ≥14 mm and the number of retrieved oocytes between PPOS protocol group and antagonist protocol group (all P>0.05), the M Ⅱ oocyte rate and the fertilization rate were significantly higher than those of antagonist protocol ( P=0.04, P<0.001), but there were no significant differences in the rate of high-quality embryos between the two groups ( P>0.05). The incidence of early onset luteinizing hormone (LH) peak significantly reduced with PPOS protocol ( P=0.04), the levels of estrogen, progesterone, follicle-stimulating hormone (FSH) and LH on trigger day were not significantly different from those of antagonist protocol (all P>0.05). The clinical pregnancy rate of PPOS protocol was higher than that of the antagonist protocol, but the abortion rate was lower than that of the antagonist protocol ( P=0.03, P<0.001), and there were no significant differences in cycle cancellation rate and birth rate between the two protocols ( P>0.05). Conclusion:PPOS protocol can significantly reduce the incidence of premature LH surge in ovulation induction in POR patients, increase the M Ⅱ oocytes rate, improve the pregnancy outcome, reduce the incidence of adverse pregnancy, and can be widely and safely used in POR patients.

Objective: To reclarify the natural change trend of several hormones with age in Chinese population. Methods: A cross-sectional survey was performed including 5 935 healthy individuals (2 286 males and 3 649 females) in the final statistical analysis. All participants received questionnaire survey, anthropometric index and laboratory tests including sex-related hormones, insulin, thyroid hormones, and 25-hydroxyvitamin D [25(OH)D]. Kruskal-Wallis test or One-way ANOVA analysis was used to compare hormone levels in different age groups. Spearman analysis was used to explore the correlation between age and hormone levels. Results: (1) Follicle stimulating hormone (FSH) and luteinizing hormone (LH) concentrations increased with age from 40 years in both males and females, and stabilized at high levels after the age of 60 in females and 80 in males. Estradiol level in females started to decrease since 40 years old, then stabilized around 70 years. Sex hormone binding globulin level increased significantly with age in males, but decreased in postmenopausal females. (2) Fasting serum insulin gradually decreased with age in males until 60 years, but without obvious change in females. Fasting plasma glucose and HbA_1C increased with age in both males and females. (3) Thyroid stimulating hormone (TSH) increased slowly with age in both males and females. (4) 25(OH)D increased with age in both males and females overall, especially more obvious in males. (5) During 41-60 years, FSH and LH levels in menopausal females were much higher than those in premenopausal females, while estradiol level in menopausal females was much lower. Compared with premenopausal females aged 41-50 years, estradiol level in premenopausal females was much lower in 51-60 years. Conclusion The levels of several important hormones are related with age, revealing a natural change trend as aging in Chinese population. (Chin J Endocrinol Metab, 2018, 34: 555-562)

Objective To investigate dynamic changes of serum Tau proteins and their correlation with cognitive dysfunction in patients with acute traumatic brain injury (TBI).Methods A total of 95 patients with acute TBI were retrospectively studied by case-control study.There were 61 males and 34 females,with age of 16-65 years [(40.7 ± 13.6)years].The Glasgow coma scale (GCS) was 3-8 points in 9 patients,9-12 points in 11,and 13-15 points in 75.A total of 30 healthy physical examinees were recruited as control group.The levels of Tau proteins were measured at days 1,3,5,7 and 14 after TBI.The cognitive dysfunction was evaluated by the Montreal Cognitive Assessment (MoCA) score at 6 months after injury.The correlation between Tau protein levels at different time points and MoCA was determined.Results The serum Tau proteins of TBI group was significantly higher than that of control group at all time points (P ＜ 0.05).In TBI group,39 (41％) out of 95 patients developed cognitive dysfunction assessed by MoCA scale.The main manifestations of cognitive dysfunction were the defects in visual spatial and acting function,delayed memory,language,abstract,attention and calculation,with statistical significance compared with control group (allP ＜ 0.05).The serum Tau proteins of patients with cognitive dysfunction were significantly higher than those without cognitive dysfunction at all time points after TBI (P ＜ 0.05).Tau proteins at days 1,3,5 after TBI was significantly correlated with cognitive dysfunction at 6 months after TBI (P ＜ 0.05).Conclusions The levels of serum Tau proteins show a significant increase after TBI,the early changes of which are statistically related to cognitive dysfunction.The early changes of serum Tau protein after TBI can be used as a reliable biomarker for early prediction of cognitive function prognosis.

BACKGROUND:At present, spinal cord ischemia/reperfusion injury is considered as the main reason for secondary paralysis after spinal decompression, and to control the levels of stress-related proteins and excitatory amino acids plays an important role in the treatment of spinal cord ischemia/reperfusion injury. OBJECTIVE:To investigate the expression level of protein disulfide-isomerase A3 (PDIA3) after spinal cord ischemia/reperfusion injury in rabbits. METHODS:Thirty-six New Zealand white rabbits were enrolled, the models of spinal cord ischemia/reperfusion injury were established using Zivin's method, and were then randomized into six groups (n=6 per group). The rabbit abdominal aorta in control group was exposed without vascular occlusion and then the abdominal cavity was closed 30 minutes later. In experimental groups, the abdominal aorta was blocked for 30 minutes, followed by 0, 6, 12, 24 and 48 hours of reperfusion, and then the abdominal cavity was closed. The neurological function was evaluated with a modified Tarlov score. The L3-5lumbar vertebrae were removed, and PDIA3 was screened by two-dimensional fluorescence differential gel electrophoresis combined with mass spectrometry, and then its temporal and spatial changes in the spinal cord were detected by western blot assay and immunohistochemistry. RESULTS AND CONCLUSION:The function of hind limbs was improved in all the experimental groups after spinal cord ischemia/reperfusion injury, and the modified Tarlov scores reached the peak at 24 hours after schemia/reperfusion injury, and decreased slightly at 48 hours. The expression of PDIA3 in the control group showed clear imprinting, which was slightly strengthened at 0 hour, became more strengthened at 6-12 hours, significantly reduced to the minimum level at 24 hours, and returned to the level of 6-12 hours at 48 hours after ischemia/reperfusion. Immunohistochemical results showed that there was visible PDIA3 in the cytoplasm of neurons, and the expression level in the interneurons was significantly higher than that in the motor neurons. These results suggest that upregulated PDIA3 appears in the development and progression of spinal cord ischemia/reperfusion injury, indicating that PDIA3 is closely related to spinal cord ischemia/reperfusion injury, which can be used as a new diagnosis and treatment target.

Objective To explore the influence of non-drug bundle of care on incidence rate of VAP. Methods Prospective analysis was performed on patients with mechanical ventilation in ICU from January 2015 to December 2016. The patients were assessed daily, monitored for target, and divided into infected group and non-infected group according to incidence of VAP. Relationship between incidence of VAP and measures taken in non-drug bundle of care, with all data statistically analyzed by SPSS 19.0 for windows. Results A total of 1 326 cases were collected in this study, with 109 infected cases and 1 217 non-infected cases. It was shown in related single factor analysis that factors influencing incidence of VAP included mode of tracheal intubation (whether with subglottic secretion drainage or not), severity of clinical conditions of the patients (APACHEⅡ score >18 points), time of mechanical ventilation (>7 days), hand sanitation, the patients' compliance to operations like elevation of bed head (>30°), oral care, assessment of tracheotomy cuff pressure, monitoring of gastric residual volume, timely dumping of condensed water, and unobstructed subglottic secretion drainage (P< 0.05). It was shown in Logistic regression analysis that mechanical ventilation time was an independent factor affecting incidence of VAP (OR=30.536, P<0.01). Conclusions According to non-drug bundle of care strategies, daily evaluation should be conducted. Early off-machine and early extubation can reduce incidence of VAP.

To explore the relationship between the drug-seeking behavior, motivation of conditioned place preference (CPP) rats and the frontal association cortex (FrA) electroencephalogram (EEG) sample entropy, we in this paper present our studies on the FrA EEG sample entropy of control group rats and CPP group rats, respectively. We invested different behavior in four situations of the rat activities, i. e. rats were staying in black chamber of videoed boxes, those staying in white chamber of videoed boxes, those shuttling between black-white chambers and those shuttling between white-black chambers. The experimental results showed that, compared with the control group rats, the FrA EEG sample entropy of CPP rats staying in black chamber of video box and shuttling between white-black chambers had no significant difference. However, sample entropy is significantly smaller (P < 0.01) when heroin-induced group rats stayed in white chamber of video box and shuttled between black-white chambers. Consequently, the drug-seeking behavior and motivation of CPP rats correlated closely with the EEG sample entropy changes.
Animals ; Conditioning (Psychology) ; drug effects ; Drug-Seeking Behavior ; Electroencephalography ; Entropy ; Frontal Lobe ; drug effects ; physiology ; Heroin ; pharmacology ; Rats ; Rats, Sprague-Dawley