Objective:To investigate the role of TcpC, a virulence factor of uropathogenic Escherichia coli (UPEC), in inhibiting the formation of neutrophil extracellular traps (NETs) in mouse bone marrow neutrophils, and to analyze its pathogenic mechanism. Methods:C57BL/6 mice were injected with either wild-type (CFT073 wt) or tcpc gene-knockout UPEC CFT073(CFT073 Δ tcpc) to establish a mouse model of cystitis. Mice were sacrificed 3 d post-infection, and their bladders were collected to observe gross pathological changes. Hematoxylin-eosin (HE) staining was used to assess histopathological changes in bladder tissues, and immunohistochemistry was performed to localize TcpC in bladder tissues. Bacterial loads in urine samples were quantified using the ten-fold dilution method, and the presence of tcpc gene in genomic DNA from bladder or urine samples was confirmed by PCR. The expression of TcpC at mRNA and protein levels in mouse bone marrow nuetrophils infected with CFT073 wt was detected by qRT-PCR and Western blot. The effects of UPEC infection on expression of NETs-related proteins and the production of pro-inflammatory factors in mouse bone marrow neutrophils were analyzed by Western blot and ELISA, respectively. Reactive oxygen species(ROS) level and bacterial viability in mouse bone marrow nuetrophils were measured using ROS and bacterial viability detection kits. Results:Compared to the CFT073 Δ tcpc group, the bladder of CFT073 wt group mice exhibited significant enlargement, extensive inflammatory cell infiltration, and the presence of TcpC in bladder tissue. The bacterial load in the urine of CFT073 wt -infected mice was significantly higher than that in the CFT073 Δ tcpc group ( P<0.01). PCR confirmed the presence of the tcpc gene in bladder and urine samples from CFT073 wt-infected mice. Increased expression of TcpC at both mRNA and protein levels was observed in CFT073 wt-infected mouse bone marrow neutrophils. CFT073 wt infection inhibited the mRNA and protein expression of NETs-related proteins and reduced the production of pro-inflammatory factors in mouse bone marrow neutrophils. TcpC suppressed ROS level and promoted the survival of CFT073 wt in mouse bone marrow neutrophils. Conclusions:TcpC enhances the pathogenicity of UPEC CFT073 by inhibiting the formation and activation of NETs in mouse bone marrow neutrophils. This study provides new insights into the pathogenic mechanisms of UPEC and the immune evasion strategies of other pathogenic bacteria, as well as potential targets for clinical prevention and treatment of UPEC-induced urinary tract infections.

Objective:To observe the clinical effect of the new type of lung body projection flashlight for percussion back in patients with cerebral hemorrhage, so as to promote patient lung rehabilitation, reduce pulmonary complications, and improve prognosis.Methods:Adopting a randomized controlled trial method, a total of 102 patients with cerebral hemorrhage who were hospitalized in the Department of Neurosurgery of The First Hospital of Jiaxing from January 2022 to December 2023 and their caregivers were selected as the research objects by convenience sampling method. The patients were divided into the control group (51 cases) and the observation group (51 cases) by the random number table method. The control group received traditional back tapping on the basis of routine nursing and back tapping guidance. The observation group used a new type of lung body projection flashlight for percussion back to assist in back tapping nursing and health guidance on the basis of routine nursing.The incidence of pulmonary infection, white blood cell count, levels of hypersensitive C-reactive protein and procalcitonin, the quality of discharge guidance, the scores of satisfaction of patients, and the assessment score of caregivers′ percussion back skills were evaluated in the two groups.Results:Finally, a total of 49 patients were enrolled in the observation group, including 38 males and 11 females, aged (67.08 ± 11.05) years old. A total of 49 patients were enrolled in the control group, including 31 males and 18 females, aged (68.84 ± 10.46) years old. There were 8 males and 41 females, aged (58.00 ± 8.17) years old in the caregivers of the observation group. There were 6 males and 43 females, aged (57.57 ± 9.15) years old in the caregivers of the observation group. The incidence of pulmonary infection in the observation group was 28.6% (14/49), which was lower than that in the control group 32.7% (16/49), and the difference was not statistically significant ( P>0.05). There was no significant difference in the level of white blood cell count, hypersensitive C-reactive protein and procalcitonin between the two groups when the time of pulmonary infection was diagnosed and after 2 weeks of treatment ( P>0.05). The levels of white blood cell count, hypersensitive C-reactive protein and procalcitonin after 1 week of treatment were (7.97 ± 1.30)×10 9/L, (30.71 ± 11.96) mg/L, 0.04(0.02, 0.07) μg/L in the observation group, which were all lower than those in the control group (9.46 ± 2.16) × 10 9/L, (58.34 ± 48.96) mg/L, 0.09(0.04, 0.20) μg/L, and the differences were statistically significant ( t=5.06, 4.22, Z=1.98, all P<0.05). The total score of discharge guidance quality, obtained content, guidance skills and effect scores were (134.94 ± 7.34), (47.80 ± 2.86), (87.14 ± 5.98) points in the observation group, which were significantly higher than those in the control group (117.04 ± 7.04), (39.80 ± 3.15), (77.24 ± 5.60) points, and the differences were statistically significant ( t=12.32, 13.15, 8.46, all P<0.05). The scores of the satisfaction of patients including six aspects(operation convenience, precise positioning, goal orientation, operation specification, nursing confidence and mission satisfaction) in the observation group were 91.84%(45/49), 95.92%(47/49), 91.84%(45/49), 93.88%(46/49), 91.84%(45/49), 97.96%(48/49), which were higher than those in the control group 73.47%(36/49), 57.14%(28/49), 53.06%(26/49), 67.35%(33/49), 73.47%(36/49), 81.63%(40/49), and the differences were statistically significant ( χ2 values were 5.76-20.51, all P<0.05). The assessment score of percussion skills of caregivers in the observation group was (79.55 ± 3.98) points, which was significantly higher than that in the control group (75.35 ± 4.94) points, and the difference was statistically significant ( t=4.64, P<0.05). Conclusions:The clinical application of the new type of lung body projection flashlight for percussion back in patients with cerebral hemorrhage can achieve accurate and standardized percussion back to promote the improvement of pulmonary infection and improve the skill level of caregivers of cerebral hemorrhage patients, as well as improve the quality of discharge guidance and the satisfaction of patients.

Objective:To observe the clinical effect of the new type of lung body projection flashlight for percussion back in patients with cerebral hemorrhage, so as to promote patient lung rehabilitation, reduce pulmonary complications, and improve prognosis.Methods:Adopting a randomized controlled trial method, a total of 102 patients with cerebral hemorrhage who were hospitalized in the Department of Neurosurgery of The First Hospital of Jiaxing from January 2022 to December 2023 and their caregivers were selected as the research objects by convenience sampling method. The patients were divided into the control group (51 cases) and the observation group (51 cases) by the random number table method. The control group received traditional back tapping on the basis of routine nursing and back tapping guidance. The observation group used a new type of lung body projection flashlight for percussion back to assist in back tapping nursing and health guidance on the basis of routine nursing.The incidence of pulmonary infection, white blood cell count, levels of hypersensitive C-reactive protein and procalcitonin, the quality of discharge guidance, the scores of satisfaction of patients, and the assessment score of caregivers′ percussion back skills were evaluated in the two groups.Results:Finally, a total of 49 patients were enrolled in the observation group, including 38 males and 11 females, aged (67.08 ± 11.05) years old. A total of 49 patients were enrolled in the control group, including 31 males and 18 females, aged (68.84 ± 10.46) years old. There were 8 males and 41 females, aged (58.00 ± 8.17) years old in the caregivers of the observation group. There were 6 males and 43 females, aged (57.57 ± 9.15) years old in the caregivers of the observation group. The incidence of pulmonary infection in the observation group was 28.6% (14/49), which was lower than that in the control group 32.7% (16/49), and the difference was not statistically significant ( P>0.05). There was no significant difference in the level of white blood cell count, hypersensitive C-reactive protein and procalcitonin between the two groups when the time of pulmonary infection was diagnosed and after 2 weeks of treatment ( P>0.05). The levels of white blood cell count, hypersensitive C-reactive protein and procalcitonin after 1 week of treatment were (7.97 ± 1.30)×10 9/L, (30.71 ± 11.96) mg/L, 0.04(0.02, 0.07) μg/L in the observation group, which were all lower than those in the control group (9.46 ± 2.16) × 10 9/L, (58.34 ± 48.96) mg/L, 0.09(0.04, 0.20) μg/L, and the differences were statistically significant ( t=5.06, 4.22, Z=1.98, all P<0.05). The total score of discharge guidance quality, obtained content, guidance skills and effect scores were (134.94 ± 7.34), (47.80 ± 2.86), (87.14 ± 5.98) points in the observation group, which were significantly higher than those in the control group (117.04 ± 7.04), (39.80 ± 3.15), (77.24 ± 5.60) points, and the differences were statistically significant ( t=12.32, 13.15, 8.46, all P<0.05). The scores of the satisfaction of patients including six aspects(operation convenience, precise positioning, goal orientation, operation specification, nursing confidence and mission satisfaction) in the observation group were 91.84%(45/49), 95.92%(47/49), 91.84%(45/49), 93.88%(46/49), 91.84%(45/49), 97.96%(48/49), which were higher than those in the control group 73.47%(36/49), 57.14%(28/49), 53.06%(26/49), 67.35%(33/49), 73.47%(36/49), 81.63%(40/49), and the differences were statistically significant ( χ2 values were 5.76-20.51, all P<0.05). The assessment score of percussion skills of caregivers in the observation group was (79.55 ± 3.98) points, which was significantly higher than that in the control group (75.35 ± 4.94) points, and the difference was statistically significant ( t=4.64, P<0.05). Conclusions:The clinical application of the new type of lung body projection flashlight for percussion back in patients with cerebral hemorrhage can achieve accurate and standardized percussion back to promote the improvement of pulmonary infection and improve the skill level of caregivers of cerebral hemorrhage patients, as well as improve the quality of discharge guidance and the satisfaction of patients.

Objective:To investigate the role of TcpC, a virulence factor of uropathogenic Escherichia coli (UPEC), in inhibiting the formation of neutrophil extracellular traps (NETs) in mouse bone marrow neutrophils, and to analyze its pathogenic mechanism. Methods:C57BL/6 mice were injected with either wild-type (CFT073 wt) or tcpc gene-knockout UPEC CFT073(CFT073 Δ tcpc) to establish a mouse model of cystitis. Mice were sacrificed 3 d post-infection, and their bladders were collected to observe gross pathological changes. Hematoxylin-eosin (HE) staining was used to assess histopathological changes in bladder tissues, and immunohistochemistry was performed to localize TcpC in bladder tissues. Bacterial loads in urine samples were quantified using the ten-fold dilution method, and the presence of tcpc gene in genomic DNA from bladder or urine samples was confirmed by PCR. The expression of TcpC at mRNA and protein levels in mouse bone marrow nuetrophils infected with CFT073 wt was detected by qRT-PCR and Western blot. The effects of UPEC infection on expression of NETs-related proteins and the production of pro-inflammatory factors in mouse bone marrow neutrophils were analyzed by Western blot and ELISA, respectively. Reactive oxygen species(ROS) level and bacterial viability in mouse bone marrow nuetrophils were measured using ROS and bacterial viability detection kits. Results:Compared to the CFT073 Δ tcpc group, the bladder of CFT073 wt group mice exhibited significant enlargement, extensive inflammatory cell infiltration, and the presence of TcpC in bladder tissue. The bacterial load in the urine of CFT073 wt -infected mice was significantly higher than that in the CFT073 Δ tcpc group ( P<0.01). PCR confirmed the presence of the tcpc gene in bladder and urine samples from CFT073 wt-infected mice. Increased expression of TcpC at both mRNA and protein levels was observed in CFT073 wt-infected mouse bone marrow neutrophils. CFT073 wt infection inhibited the mRNA and protein expression of NETs-related proteins and reduced the production of pro-inflammatory factors in mouse bone marrow neutrophils. TcpC suppressed ROS level and promoted the survival of CFT073 wt in mouse bone marrow neutrophils. Conclusions:TcpC enhances the pathogenicity of UPEC CFT073 by inhibiting the formation and activation of NETs in mouse bone marrow neutrophils. This study provides new insights into the pathogenic mechanisms of UPEC and the immune evasion strategies of other pathogenic bacteria, as well as potential targets for clinical prevention and treatment of UPEC-induced urinary tract infections.

Objective:To investigate the role of TcpC, a virulence factor of uropathogenic Escherichia coli (UPEC), in immune evasion, and analyze its related pathogenic mechanism. Methods:C57BL/6 mice were injected with 10 9 colony-forming unit of wild-type (CFT073 wt) or tcpc gene-knockout (CFT073 Δ tcpc) UPEC CFT073 strains from urethra into bladder to construct a mouse model of pyelonephritis. These mice were sacrificed 5 d after infection and their kidneys were taken to observe the gross pathological changes. Hematoxylin-eosin staining was used to observe histopathological changes in kidney tissues and immunohistochemistry was performed to locate TcpC in kidney tissues. The bacterial loads in urine samples of UPEC infected-mice were counted by ten-fold dilution method, and the presence of tcpc gene in the genomic DNA of bacteria from CFT073-infected mouse kidney or urine samples was measured by PCR. The expression of TcpC at mRNA level was detected by qRT-PCR after infecting dendritic cells with CFT073 wt strains. The influences of UPEC infection on the activation of NF-κB signaling pathway and the secretion of proinflammatory factors by dendritic cells were analyzed by Western blot and ELISA, respectively. The viability of UPEC strains in dendritic cells were observed by laser confocal microscope. Results:Compared with the CFT073 Δ tcpc group, the mice in the CFT073 wt group had obvious abscess in the kidneys as well as massive neutrophil infiltration and abundant TcpC in kidney tissues. The bacterial loads in the urine of CFT073 wt-infected mice were significantly higher than those in the urine of CFT073 Δ tcpc mice. PCR results showed that tcpc gene was successfully amplified from mouse kidney and urine samples. Increased expression of TcpC at both mRNA and protein levels was detected in CFT073 wt-infected dendritic cells. CFT073 wt infection inhibited the phosphorylation of NF-κB p50 and the production of proinflammatory factors in dendritic cells. TcpC promoted the survival of CFT073 wt in dendritic cells. Conclusions:TcpC expression increases significantly during CFT073 wt infection or in mice with CFT073 wt-induced pyelonephritis. It promotes the survival of CFT073 wt in dendritic cells by inhibiting the activation of NF-κB signaling pathway and reducing the secretion of pro-inflammatory cytokines. TcpC is involved in the pathogenesis of UPEC and immune evasion.

Objective: To investigate the relationship between enteral nutrient albumin supply and prognosis in patients with mechanical ventilation. Methods: The clinical data of 418 mechanically ventilated patients receiving enteral nutrition support treatment in intensive care unit (ICU) of the First Hospital of Jiaxing from January 2016 to June 2019 were retrospectively analyzed. According to whether the daily albumin supply was up to standard, the patients were divided into the standard group (albumin supply was ≥1.2 g·kg^-1·d^-1) and the non-standard group (albumin supply was < 1.2 g·kg^-1·d^-1). Prealbumin, transferrin levels before and after treatment, 28-day mortality, mechanical ventilation time and the length of ICU stay were compared between the two groups. Results: A total of 418 patients were included, including 225 in the standard group and 193 in the non-standard group. There were no significant differences in gender, age and disease composition between the two groups, and the baseline data were comparable. There was no significant difference in daily calories between the standard group and the non-standard group (kJ/d: 119.73±31.55 vs. 110.05±28.98, P > 0.05), but the daily albumin supply of the standard group was significantly higher than that of the non-qualified group (g·kg^-1·d^-1: 1.38±0.83 vs. 0.95±0.75, P < 0.05). There was no significant difference in the levels of prealbumin, transferrin between the two groups before treatment. The levels of prealbumin, transferrin in standard group and non-standard group were significantly higher after treatment than before [prealbumin (mg/L): 188.53±69.25 vs. 119.44±57.62, 145.18±56.92 vs. 108.81±69.50; transferrin (g/L): 2.99±0.87 vs. 1.85±0.76, 2.09±0.81 vs. 1.52±0.76, all P < 0.05]. Moreover, prealbumin and transferring in the standard group were further improved than the non-standard group [prealbumin (mg/L): 188.53±69.25 vs. 145.18±56.92, transferrin (g/L): 2.99±0.87 vs. 2.09±0.81, both P < 0.05]. In addition, mechanical ventilation time, the length of ICU stay of the standard group were significantly shorter than those of the non-standard group (hours: 147.2±7.5 vs. 216.6±8.2, 198.8±9.5 vs. 295.4±8.9, both P < 0.05), but there was no statistically significant difference in 28-day mortality [11.56% (26/225) vs. 15.03% (29/193), P > 0.05]. Conclusion Under the condition of standard enteral nutritional calories, increased of the albumin supply can improve the clinical nutritional status of patients with mechanical ventilation, shorten mechanical ventilation time and hospital stay.

OBJECTIVE: To investigate the relationship between enteral nutrient albumin supply and prognosis in patients with mechanical ventilation. METHODS: The clinical data of 418 mechanically ventilated patients receiving enteral nutrition support treatment in intensive care unit (ICU) of the First Hospital of Jiaxing from January 2016 to June 2019 were retrospectively analyzed. According to whether the daily albumin supply was up to standard, the patients were divided into the standard group (albumin supply was ≥ 1.2 g×kg^-1×d^-1) and the non-standard group (albumin supply was < 1.2 g×kg^-1×d^-1). Prealbumin, transferrin levels before and after treatment, 28-day mortality, mechanical ventilation time and the length of ICU stay were compared between the two groups. RESULTS: A total of 418 patients were included, including 225 in the standard group and 193 in the non-standard group. There were no significant differences in gender, age and disease composition between the two groups, and the baseline data were comparable. There was no significant difference in daily calories between the standard group and the non-standard group (kJ/d: 119.73±31.55 vs. 110.05±28.98, P > 0.05), but the daily albumin supply of the standard group was significantly higher than that of the non-qualified group (g×kg^-1×d^-1: 1.38±0.83 vs. 0.95±0.75, P < 0.05). There was no significant difference in the levels of prealbumin, transferrin between the two groups before treatment. The levels of prealbumin, transferrin in standard group and non-standard group were significantly higher after treatment than before [prealbumin (mg/L): 188.53±69.25 vs. 119.44±57.62, 145.18±56.92 vs. 108.81±69.50; transferrin (g/L): 2.99±0.87 vs. 1.85±0.76, 2.09±0.81 vs. 1.52±0.76, all P < 0.05]. Moreover, prealbumin and transferring in the standard group were further improved than the non-standard group [prealbumin (mg/L): 188.53±69.25 vs. 145.18±56.92, transferrin (g/L): 2.99±0.87 vs. 2.09±0.81, both P < 0.05]. In addition, mechanical ventilation time, the length of ICU stay of the standard group were significantly shorter than those of the non-standard group (hours: 147.2±7.5 vs. 216.6±8.2, 198.8±9.5 vs. 295.4±8.9, both P < 0.05), but there was no statistically significant difference in 28-day mortality [11.56% (26/225) vs. 15.03% (29/193), P > 0.05]. CONCLUSIONS Under the condition of standard enteral nutritional calories, increased of the albumin supply can improve the clinical nutritional status of patients with mechanical ventilation, shorten mechanical ventilation time and hospital stay.
Albumins/metabolism* ; Enteral Nutrition ; Humans ; Intensive Care Units ; Prognosis ; Prospective Studies ; Respiration, Artificial ; Retrospective Studies

OBJECTIVEThis study aimed to explore the differences of membrane thickness and pressure on the paranasal sinus membrane in goats and analyze their causes. The results can provide theoretical basis and guidance for the issues of the maxillary sinus floor augmentation related to the membrane.

METHODSThe membrane was cut into two sizes from every sinus membrane. The membrane was fixed in formalin to obtain tissue specimens for the membrane thickness study and pressure study. The correlation between the two parameters was then analyzed, and appropriate statistical methods and software were selected.

RESULTSThe top of maxillary sinus, the bottom of maxillary sinus and the frontal sinus membrane thickness were (410.03 ± 65.97), (461.33 ± 91.37), (216.90 ± 46.47) µm. The pressure were (260.08 ± 80.12), (306.90 ± 94.37), (121.72 ± 31.72) kPa. The mean differences of the membrane thickness between the top of the maxillary sinus and the frontal sinus, bottom and frontal, and top and bottom were statistically significant (P < 0.05). The mean differences in membrane pressure were also statistically significant (P < 0.05).

CONCLUSIONThe membrane thickness and pressure of the top and bottom of the maxillary sinus are higher than those of the frontal sinus membrane. However, the thickness and pressure of the bottom membrane are slightly higher than those of the top membrane. Pressure and membrane thickness are positively correlated in the sinus membrane.

Objective To discuss the strategies and efficacies of surgical treatment in medulla oblongata cavernous malformations.Methods The clinical and follow-up data of 9 patients with medulla oblongata cavernous malformations,admitted to our hospital from October 201 1 to February 2015,were retrospectively analyzed.Five patients underwent surgical treatment:posterior midline transcerebellomedullary fissure approach was used in 4,far-lateral transcondylar approach in one,and all cavernous malformations were excised completely.Conservative treatment and regular observation were done in 4 patients.Follow-up was performed for 10-40 months.Results Symptoms improved after surgery in 4 patients;postoperative hemiplegia appeared in one,and at the end of follow-up,the muscle strength of hemiplegic limbs recovered to level Ⅳ.Minor re-hemorrhage was noted in one of the 4 patients with conservative treatment at the end of the follow-up,and no changes were noted in the rest patients.Karnofsky Performance Scale scores were 82.2 ±6.7,which were significantly increased as compared with those before treatment (73.3±11.2,P＜0.05).Conclusion After strict preoperative evaluation,surgical treatment is a feasible way,enjoying good prognosis in medulla oblongata cavernous malformations;but,patients with deep site,small malformations or no obvious bleeding symptoms should not be operated.

Objective This study aimed to explore the differences of membrane thickness and pressure on the paranasal sinus membrane in goats and analyze their causes. The results can provide theoretical basis and guidance for the issues of the maxillary sinus floor augmentation related to the membrane. Methods The membrane was cut into two sizes from every sinus membrane. The membrane was fixed in formalin to obtain tissue specimens for the membrane thickness study and pressure study. The correlation between the two parameters was then analyzed, and appropriate statistical methods and software were selected. Results The top of maxillary sinus, the bottom of maxillary sinus and the frontal sinus membrane thickness were (410.03±65.97), (461.33±91.37), (216.90±46.47) μm. The pressure were (260.08±80.12), (306.90±94.37),(121.72±31.72) kPa. The mean differences of the membrane thickness between the top of the maxillary sinus and the frontal sinus, bottom and frontal, and top and bottom were statistically significant (P<0.05). The mean differences in membrane pressure were also statistically significant (P<0.05). Conclusion The membrane thickness and pressure of the top and bottom of the maxillary sinus are higher than those of the frontal sinus membrane. However, the thickness and pressure of the bottom membrane are slightly higher than those of the top membrane. Pressure and membrane thickness are positively correlated in the sinus membrane.