BACKGROUND: The atherogenic index of plasma (AIP) has been shown to be positively correlated with cardiovascular disease in previous studies. However, it is unclear whether elderly people with long-term high AIP levels are more likely to develop coronary heart disease (CHD). Therefore, the aim of this study was to investigate the relationship between AIP trajectory and CHD incidence in elderly people. METHODS: 19,194 participants aged ≥ 60 years who had three AIP measurements between 2018 and 2020 were included in this study. AIP was defined as log₁₀ (triglyceride/high-density lipoprotein cholesterol). The group-based trajectory model was used to identify different trajectory patterns of AIP from 2018 to 2020. Cox proportional hazards models were used to estimate the hazard ratio (HR) with 95% CI of CHD events between different trajectory groups from 2020 to 2023. RESULTS: Three different trajectory patterns were identified through group-based trajectory model: the low-level group (n = 7410, mean AIP: -0.25 to -0.17), the medium-level group (n = 9981, mean AIP: 0.02-0.08), and the high-level group (n = 1803, mean AIP: 0.38-0.42). During a mean follow-up of 2.65 years, a total of 1391 participants developed CHD. After adjusting for potential confounders, compared with the participants in the low-level group, the HR with 95% CI of the medium-level group and the high-level group were estimated to be 1.24 (1.10-1.40) and 1.43 (1.19-1.73), respectively. These findings remained consistent in subgroup analyses and sensitivity analyses. CONCLUSIONS There was a significant correlation between persistent high AIP level and increased CHD risk in the elderly. This suggests that monitoring the long-term changes in AIP is helpful to identify individuals at high CHD risk in elderly people.

Non-cystic fibrosis bronchiectasis(referred to as bronchiectasis)is a common chronic airway disease.Neutrophils have traditionally been considered to play a dominant role in the airway inflammation of bronchiectasis.However,it has been discovered that approximately 20％to 30％of bronchiectasis patients exhibited elevated eosinophil counts(Sputum eosinophil ratio＞3％or blood eosinophil count＞300/μl)in their sputum and blood samples,referred to as eosinophilic bronchiectasis(EB).Based on this novel discovery of the inflammatory phenotype,some scholars have advocated treating bronchiectasis as an"inflammatory disease"rather than an"infectious disease"in a novel therapeutic approach.This article reviews the discovery and the latest research advancements of EB,exploring its pathophysiological basis,clinical characteristics,and treatment,with the aim to facilitate the understanding and management of EB.

Objective:To investigate the prognostic value of peripheral blood absolute monocyte count(AMC)in non-severe aplastic anaemia(NSAA)patients.Methods:178 patients with NSAA who attended the Affiliated Hospital of Xuzhou Medical University from April 2008 to September 2020 were retrospectively analyzed,and the optimal cut-off value of peripheral blood AMC was determined by the receiver operating characteristic curve of the subjects,and they were divided into low AMC group(48 patients)and normal AMC group(130 patients),and the differences in clinical characteristics between the two groups were compared.Overall survival(OS)and progression-free survival(PFS)were analyzed by Kaplan-Meier.Univariate and multivariate Cox regression analysis were used to determine the independent prognostic value of AMC.Results:Among 178 NSAA patients,105(59.0％)were male and 73(41.0％)were female,with a median age of 31(18-87)years old,a median follow-up time of 58 months(range:6 months-175 months),and a median AMC of 0.15 × 109/L[range:(0.01-0.59)× 109/L)].The proportion of granulocytes(27.5％vs 36.0％,P＜0.05),and the proportion of mature monocytes(1％vs 2％,P＜0.05)in the low AMC group were lower than that in the normal AMC group;the proportion of mature lymphocytes in the low AMC group was higher than that in the normal AMC group(54％vs 50％,P＜0.05).However,there was no significantly different in the proportion of erythropoietic cells and stages of the erythropoietic cells between the two groups(P＞0.05).CR(27.7％vs 10.4％)and ORR(75.4％vs 56.3％)in the normal AMC group were higher than that in the low AMC group.Compared with patients in the low AMC group,AA patients in the normal AMC had better 5-year OS(98.5％vs 86.9％,P＜0.01),and the 5-year PFS(86.0％vs 58.9％,P＜0.01).Also,the 10-year survival rate of patients in the normal AMC group was higher than that in the low AMC group(98.5％vs 60.5％,P＜0.01).Univariate analysis showed that age,reticulocyte count,AMC＜0.1 × 109/L and the proportion of bone marrow mature monocytes were related with patients survival.Multivariate Cox regression analysis showed that monocyte count reduction was not an independent poor prognostic factor in NSAA patients(HR=4.474,95％CI:0.508-44.390;P=0.172).Conclusion:Low AMC level at initial diagnosis is not an independent prognostic factor for NSAA patients,but still suggest potential prognostic value of AMC.

Objective To investigate the clinical characteristics and prognosis of pneumococcal meningitis(PM),and drug sensitivity of Streptococcus pneumoniae(SP)isolates in Chinese children.Methods A retrospective analysis was conducted on clinical information,laboratory data,and microbiological data of 160 hospitalized children under 15 years old with PM from January 2019 to December 2020 in 33 tertiary hospitals across the country.Results Among the 160 children with PM,there were 103 males and 57 females.The age ranged from 15 days to 15 years,with 109 cases(68.1% )aged 3 months to under 3 years.SP strains were isolated from 95 cases(59.4% )in cerebrospinal fluid cultures and from 57 cases(35.6% )in blood cultures.The positive rates of SP detection by cerebrospinal fluid metagenomic next-generation sequencing and cerebrospinal fluid SP antigen testing were 40% (35/87)and 27% (21/78),respectively.Fifty-five cases(34.4% )had one or more risk factors for purulent meningitis,113 cases(70.6% )had one or more extra-cranial infectious foci,and 18 cases(11.3% )had underlying diseases.The most common clinical symptoms were fever(147 cases,91.9% ),followed by lethargy(98 cases,61.3% )and vomiting(61 cases,38.1% ).Sixty-nine cases(43.1% )experienced intracranial complications during hospitalization,with subdural effusion and/or empyema being the most common complication[43 cases(26.9% )],followed by hydrocephalus in 24 cases(15.0% ),brain abscess in 23 cases(14.4% ),and cerebral hemorrhage in 8 cases(5.0% ).Subdural effusion and/or empyema and hydrocephalus mainly occurred in children under 1 year old,with rates of 91% (39/43)and 83% (20/24),respectively.SP strains exhibited complete sensitivity to vancomycin(100% ,75/75),linezolid(100% ,56/56),and meropenem(100% ,6/6).High sensitivity rates were also observed for levofloxacin(81% ,22/27),moxifloxacin(82% ,14/17),rifampicin(96% ,25/26),and chloramphenicol(91% ,21/23).However,low sensitivity rates were found for penicillin(16% ,11/68)and clindamycin(6% ,1/17),and SP strains were completely resistant to erythromycin(100% ,31/31).The rates of discharge with cure and improvement were 22.5% (36/160)and 66.2% (106/160),respectively,while 18 cases(11.3% )had adverse outcomes.Conclusions Pediatric PM is more common in children aged 3 months to under 3 years.Intracranial complications are more frequently observed in children under 1 year old.Fever is the most common clinical manifestation of PM,and subdural effusion/emphysema and hydrocephalus are the most frequent complications.Non-culture detection methods for cerebrospinal fluid can improve pathogen detection rates.Adverse outcomes can be noted in more than 10% of PM cases.SP strains are high sensitivity to vancomycin,linezolid,meropenem,levofloxacin,moxifloxacin,rifampicin,and chloramphenicol.[Chinese Journal of Contemporary Pediatrics,2024,26(2):131-138]

Objective To explore whether Astragalus polysaccharide can inhibit immune escape of T helper cells 17(Th17)and regulatory T cells(Treg)-mediated tumor cell immune escape in mice with bladder cancer by regulating the transforming growth factor-β1(TGF-β1)/FOXP3/retinoic acid receptor-associated orphan receptor-γT(RORγt)pathway.Methods Human bladder cancer cell line 5637 was injected into the BALB/c male nude mice to establish the model.After successful mold making,the model mice were randomly divided into model group,control group and experimental-L,-M,-H groups,10 mice per group;another 10 normal mice were taken as the blank group.The experimental-L,-M,-H groups were administered with stragalus polysaccharide solutions at doses of 100,200 and 300 mg·kg-1·d-1 by gavage,respectively.The model group and blank group were administered with 0.9％NaCl solution at a dose of 20 mL·kg-1·d-1 by gavage.The control group was administered with cisplatin at a dose of 5 mg·kg-1·d-1 by gavage.Six groups were treated for one month with once a day.After the drug,the tumor suppression was calculated.The cell apoptosis was determined by the TUNEL assay.The counts of Th1 and Treg cells were determined by flow cytometry.The expression levels of TGF-β1,FoxP3 and RORγt in bladder tissues were determined by Western blotting.Results The tumor weight of the experimental-H,the control group and the model group were(0.89±0.12),(0.67±0.09)and(2.09±0.31)g,respectively;the apoptosis indexes were(21.93±2.53)％,(23.91±2.18)％and(4.18±0.39)％,respectively.The contents of Treg cells in experimental-H group,control group,model group and blank group were(3.18±1.15)％,(2.97±0.98)％,(17.23±5.34)％and(2.73±1.04)％,respectively;the contents of Th7 cells were(1.03±0.36)％,(0.92±0.33)％,(6.28±1.96)％and(0.86±0.33)％,respectively;the relative expression levels of TGF-β1 protein were 0.34±0.13,0.33±0.11,0.69±0.10 and 0.32±0.08,respectively;the relative expression levels of FoxP3 protein were 0.21±0.05,0.20±0.06,0.72±0.16 and 0.19±0.06,respectively;the relative expression levels of RORγt protein were 0.34±0.12,0.32±0.12,0.66±0.17 and 0.36±0.09,respectively.Compared with experimental-H and control groups,the above indexes in the model group were statistically significant(all P＜0.05).Conclusion Astragalus polysaccharide can regulate the TGF-β1/FoxP3/RORγt pathway to inhibit Treg and Th7 cells-mediated immune evasion of bladder cancer in mice.

Objective To gain insight into the natural infection of rickettsiales in ticks from the Xinjiang Uyghur Autonomous Region(XUAR)and to develop strategies for the prevention and control of tick-borne diseases.Methods A total of 7 105 adult ticks representing 12 species in seven genera were collected via hand scratching on hosts and flag-sweeping on vegetation in XJUAR,China.These samples were submitted for screening of rickettsiales infection by amplifying the outer membrane protein(ompA)gene and 16S rRNA.Results A total of 3 650 ticks were subjected to molecular analysis,with eight rickettsiae species identified as agents of the spotted fever group(SFG).Candidatus Rickettsia barbariae was initially discovered in Rhipicephalus,Hyalomma,and Haemaphysalis ticks and subsequently distributed across Hoxud,Yuli,Manas,and Huocheng cities.Furthermore,seven additional pathogenic rickettsiae species were identified,including R.conorii,R.massiliae,R.raoultii,R.slovaca,R.sibirica mongolotimonae and Candidatus Rickettsia tarasevichiae.Conclusion The presence of multiple-spotted fever group rickettsia species and the diseases they cause may represent a potential threat to human health at XJUA in China.

Objective To explore whether Astragalus polysaccharide can inhibit immune escape of T helper cells 17(Th17)and regulatory T cells(Treg)-mediated tumor cell immune escape in mice with bladder cancer by regulating the transforming growth factor-β1(TGF-β1)/FOXP3/retinoic acid receptor-associated orphan receptor-γT(RORγt)pathway.Methods Human bladder cancer cell line 5637 was injected into the BALB/c male nude mice to establish the model.After successful mold making,the model mice were randomly divided into model group,control group and experimental-L,-M,-H groups,10 mice per group;another 10 normal mice were taken as the blank group.The experimental-L,-M,-H groups were administered with stragalus polysaccharide solutions at doses of 100,200 and 300 mg·kg-1·d-1 by gavage,respectively.The model group and blank group were administered with 0.9％NaCl solution at a dose of 20 mL·kg-1·d-1 by gavage.The control group was administered with cisplatin at a dose of 5 mg·kg-1·d-1 by gavage.Six groups were treated for one month with once a day.After the drug,the tumor suppression was calculated.The cell apoptosis was determined by the TUNEL assay.The counts of Th1 and Treg cells were determined by flow cytometry.The expression levels of TGF-β1,FoxP3 and RORγt in bladder tissues were determined by Western blotting.Results The tumor weight of the experimental-H,the control group and the model group were(0.89±0.12),(0.67±0.09)and(2.09±0.31)g,respectively;the apoptosis indexes were(21.93±2.53)％,(23.91±2.18)％and(4.18±0.39)％,respectively.The contents of Treg cells in experimental-H group,control group,model group and blank group were(3.18±1.15)％,(2.97±0.98)％,(17.23±5.34)％and(2.73±1.04)％,respectively;the contents of Th7 cells were(1.03±0.36)％,(0.92±0.33)％,(6.28±1.96)％and(0.86±0.33)％,respectively;the relative expression levels of TGF-β1 protein were 0.34±0.13,0.33±0.11,0.69±0.10 and 0.32±0.08,respectively;the relative expression levels of FoxP3 protein were 0.21±0.05,0.20±0.06,0.72±0.16 and 0.19±0.06,respectively;the relative expression levels of RORγt protein were 0.34±0.12,0.32±0.12,0.66±0.17 and 0.36±0.09,respectively.Compared with experimental-H and control groups,the above indexes in the model group were statistically significant(all P＜0.05).Conclusion Astragalus polysaccharide can regulate the TGF-β1/FoxP3/RORγt pathway to inhibit Treg and Th7 cells-mediated immune evasion of bladder cancer in mice.

Objective　To investigate the drug resistance of Enterobacter cloacae isolated from blood samples in 75 member units of the Bacterial Drug Resistance Monitoring Network in Hebei, 2016- 2021, so as to provide a basis for rational drug use in clinic. Methods　WHONET 5.6 software was used to retrospectively analyze drug susceptibility of Enterobacter cloacae isolated from 32 secondary hospitals and 43 tertiary hospitals. SPSS19.0 software was used for statistical analysis. Results After removing the duplicate strains, 1 225 strains of E. cloacae were isolated from blood samples of 75 hospitals during 6 years, including 157 strains from secondary hospitals and 1 068 strains from tertiary hospitals. In this study, the resistance of Enterobacter cloacae to 16 kinds of antibiotics was analyzed. The drug resistance rates to cefuroxime (52.4%-67.8%), piperacillin (27.4%-31.2%), ceftazidime (27.8%-35.5%), ceftriaxone (29.5%-45.0%), aztreonam (22.2%-32.3%), cotrimoxazole (21.6%-28.7%) were higher; the resistance rates to amikacin and tobramycin were lower than 15.0%. The resistance rates to imipenem and meropenem were 3.6%-12.3% and 5.1%-11.4%, respectively. The resistance rate to ciprofloxacin in tertiary hospitals was 22.4%, and the resistance rate to cotrimoxazole was 23.9%. Except for these two antimicrobials, the resistance rates to other antimicrobial drugs in tertiary hospitals were higher than that in secondary hospitals. A total of 121 carbapenem-resistant Enterobacter cloacae strains were detected in the past 6 years, with an increasing detection rate (χ2trend=6.305, P=0.012). Conclusions　Enterobacter cloacae has great differences in antimicrobial resistance to different antibiotics, and is sensitive to carbapenems. The drug resistance in tertiary hospitals is generally higher than that in secondary hospitals. Drug resistance monitoring and drug resistance mechanism research should be strengthened to better guide clinical drug use and curb the rise of drug resistance.

Fermented Chinese medicine has long been used. Amid the advance for preservation of experience, the connotation of fermented Chinese medicine has been enriched and improved. However, fermented Chinese medicine prescriptions generally contain a lot of medicinals. The fermentation process is complicated and the conventional fermentation conditions fail to be strictly controlled. In addition, the judgment of the fermentation end point is highly subjective. As a result, quality of fermented Chinese medicine is of great difference among regions and unstable. At the moment, the quality standards of fermented Chinese medicine are generally outdated and different among regions, with simple quality control methods and lacking objective safe fermentation-specific evaluation indictors. It is difficult to comprehensively evaluate and control the quality of fermented medicine. These problems have aroused concern in the industry and also affected the clinical application of fermented Chinese medicine. This article summarized and analyzed the application, quality standards, and the modernization of fermentation technology and quality control methods of fermented Chinese medicine and proposed suggestions for improving the quality standards of the medicine, with a view to improving the overall quality of it.
Medicine, Chinese Traditional ; Reference Standards ; Quality Control ; Fermentation