Objective To analyze the expression of serum mannose binding lectin associated serine protease 1(MASP1)and protein kinase D2(PRKD2)in locally advanced cervical cancer(LACC)patients,and their relationship with the efficacy of neoadjuvant chemotherapy(NACT).Methods The clinical data of 98 LACC patients(LACC group)treated with NACT in the hospital from March 2019 to April 2021 were retrospective-ly selected,and they were divided into effective group(n=76)and ineffective group(n=22)according to the efficacy.Fifty patients with early cervical cancer diagnosed and treated in the same period were selected as the early cervical cancer group,and 50 female health examination subjects were selected as the healthy control group.Enzyme-linked immunosorbent assay was applied to detect serum levels of MASP1 and PRKD2.Logis-tic regression analysis was applied to analyze the influencing factors of NACT efficacy.The evaluation value of serum MASP1 and PRKD2 on the efficacy of NACT were analyzed by the receiver operating characteristic curve.Results The serum levels of MASP1 and PRKD2 in the LACC group were higher than those in the ear-ly cervical cancer group and the control group,and the differences were statistically significant(P＜0.05).The serum levels of MASP1 and PRKD2 in LACC group were correlated with International Federation of Gy-necology and Obstetrics(FIGO)stage and pathological grade,and the serum levels of MASP1 and PRKD2 in patients with FIGO stage Ⅲ and pathological grade G3 were higher(P＜0.05).FIGO stage Ⅲ proportion,se-rum MASP1 and serum PRKD2 levels in NACT ineffective group were higher than those in effective group(P＜0.05).FIGO stage Ⅲ,serum MASP1 and serum PRKD2 were independent risk factors for NACT efficacy in LACC patients(P＜0.05).The area under the curve of serum MASP1 and PRKD2 combined to evaluate the efficacy of NACT was 0.883(95％CI:0.828-0.935),which was larger than 0.802(95％CI:0.761-0.846)and 0.825(95％CI:0.764-0.852)predicted by the single index,and the difference were statistically significant(Z=4.111,5.012,both P＜0.001).Conclusion Level of serum MASP1 and PRKD2 in LACC pa-tients are increase,which are independent risk factors affecting the efficacy of NACT.Combined detection of MASP1 and PRKD2 has high predictive value for NACT efficacy.

Objective To integrate relevant evidences on postoperative pulmonary infections in patients with aneurysmal subarachnoid haemorrhage so as to provide references for clinical practice.Methods Domestic and international databases were searched,including BMJ Best Practice,UpToDate,Cochrane Library,the U.S.National Guidelines Library,JBI,NICE,Medlive,Embase,CINAHL,Web of Science,PubMed,CNKI,VIP,Wanfang Data,SinoMed and Yiigle for clinical decisions,expert consensus,clinical guidelines,best evidence summaries,systematic evaluations,Meta-analyses,and randomized controlled trials on pulmonary infections in patients with aneurysmal subarachnoid haemorrhage.Literature was screened according to the inclusion criteria.Qualitative assessment was performed,and evidences were extracted.Results A total of 16 articles were included,comprising 2 clinical decisions,7 expert consensus,3 guidelines,3 systematic reviews and 1 RCT.Finally,30 pieces of evidence were obtained in 7 domains:team management,risk assessment,mis-inhalation management,airway management,nutritional support,oral care and rehabilitation.Conclusion The best evidence for the management of postoperative pulmonary infection in patients with aneurysmal subarachnoid haemorrhage summarised in this study can provide references for clinical interventions.Clinical staff should reasonably apply the evidence according to the specific situations.

OBJECTIVE To analyze the clinical characteristics of the patients with severe infections who were treated with polymyxin B and compare the plasma concentration of polymyxin B among the patients with severe infections with different creatinine clearance rates(Ccr).METHODS The clinical data were collected from 152 patients with severe infections who were treated with intravenous polymyxin B in intensive care unit(ICU)of Zhongda Hospital Affiliated to Southeast University from Jan.2021 to Mar.2023.The trough concentration(Cmin),median concen-tration(C1/2t)and peak concentration(Cmax)of polymyxin B were determined after 5 doses were completed.Based of the area under the curve(AUC)of drug concentration of polymyxin B(AUC0～24h)combined with the Ccr level[the ≤30 to＜60 ml/min group(n=40),the 60 to＜130ml/min group(n=79),and the ≥ 130ml/min group(n=33)],the AUC0～24h of polymyxin B were calculated,and the influence of Ccr on the plasma concentration was observed.RESULTS Among the 152 patients with severe infections,118 were male,and 34 were female,with the age ranging between 20 and 90 years old;the patients with high blood pressure accounted for 14.47％(22/152),the patients with diabetes mellitus 7.24％(11/152).Polymyxin B is primarily used in clinical settings for the treatment of pulmonary infections and bloodstream infections caused by carbapenem-resistant Acinetobacter baumannii and Klebsiella pneumoniae.The median initial dose and the median maintenance dose were 1.35(1.00,1.67)mg/kg q12 h and 1.07(0.83,1.25)mg/kg q12 h,respectively.The median AUC0～24h of polymyxin B was 76.57(54.65,106.47)μg·h/ml among the 152 patients,and the patients with AUC0～24 h ranging between 50 and 100 μg·h/ml accounted for 53.95％(82/152).Although the median AUC0～24h of polymyxin B of all the three groups ranged between 50 and 100)μg·h/ml,there were significant differences in Cmin,C1/2t,Cmax and AUC0～24h among the three groups(P＜0.05).In addition,there were significant differences in the AUC0～24h of polymyxin B less than 50 μg·h/ml,ranging between 50 and 100 μg·h/ml and more than 100 μg·h/ml among the three groups of patients(x2=21.632,P＜0.001).CONCLUSION Therapeutic drug monitoring(TDM)is nec-essary for the patients with severe infection who receive the polymyxin B for treatment,especially for the patients with Ccr ≤30 to＜60 ml/min and Ccr ≥130 ml/min.

OBJECTIVE To analyze the clinical characteristics of the patients with severe infections who were treated with polymyxin B and compare the plasma concentration of polymyxin B among the patients with severe infections with different creatinine clearance rates(Ccr).METHODS The clinical data were collected from 152 patients with severe infections who were treated with intravenous polymyxin B in intensive care unit(ICU)of Zhongda Hospital Affiliated to Southeast University from Jan.2021 to Mar.2023.The trough concentration(Cmin),median concen-tration(C1/2t)and peak concentration(Cmax)of polymyxin B were determined after 5 doses were completed.Based of the area under the curve(AUC)of drug concentration of polymyxin B(AUC0～24h)combined with the Ccr level[the ≤30 to＜60 ml/min group(n=40),the 60 to＜130ml/min group(n=79),and the ≥ 130ml/min group(n=33)],the AUC0～24h of polymyxin B were calculated,and the influence of Ccr on the plasma concentration was observed.RESULTS Among the 152 patients with severe infections,118 were male,and 34 were female,with the age ranging between 20 and 90 years old;the patients with high blood pressure accounted for 14.47％(22/152),the patients with diabetes mellitus 7.24％(11/152).Polymyxin B is primarily used in clinical settings for the treatment of pulmonary infections and bloodstream infections caused by carbapenem-resistant Acinetobacter baumannii and Klebsiella pneumoniae.The median initial dose and the median maintenance dose were 1.35(1.00,1.67)mg/kg q12 h and 1.07(0.83,1.25)mg/kg q12 h,respectively.The median AUC0～24h of polymyxin B was 76.57(54.65,106.47)μg·h/ml among the 152 patients,and the patients with AUC0～24 h ranging between 50 and 100 μg·h/ml accounted for 53.95％(82/152).Although the median AUC0～24h of polymyxin B of all the three groups ranged between 50 and 100)μg·h/ml,there were significant differences in Cmin,C1/2t,Cmax and AUC0～24h among the three groups(P＜0.05).In addition,there were significant differences in the AUC0～24h of polymyxin B less than 50 μg·h/ml,ranging between 50 and 100 μg·h/ml and more than 100 μg·h/ml among the three groups of patients(x2=21.632,P＜0.001).CONCLUSION Therapeutic drug monitoring(TDM)is nec-essary for the patients with severe infection who receive the polymyxin B for treatment,especially for the patients with Ccr ≤30 to＜60 ml/min and Ccr ≥130 ml/min.

Objective To integrate relevant evidences on postoperative pulmonary infections in patients with aneurysmal subarachnoid haemorrhage so as to provide references for clinical practice.Methods Domestic and international databases were searched,including BMJ Best Practice,UpToDate,Cochrane Library,the U.S.National Guidelines Library,JBI,NICE,Medlive,Embase,CINAHL,Web of Science,PubMed,CNKI,VIP,Wanfang Data,SinoMed and Yiigle for clinical decisions,expert consensus,clinical guidelines,best evidence summaries,systematic evaluations,Meta-analyses,and randomized controlled trials on pulmonary infections in patients with aneurysmal subarachnoid haemorrhage.Literature was screened according to the inclusion criteria.Qualitative assessment was performed,and evidences were extracted.Results A total of 16 articles were included,comprising 2 clinical decisions,7 expert consensus,3 guidelines,3 systematic reviews and 1 RCT.Finally,30 pieces of evidence were obtained in 7 domains:team management,risk assessment,mis-inhalation management,airway management,nutritional support,oral care and rehabilitation.Conclusion The best evidence for the management of postoperative pulmonary infection in patients with aneurysmal subarachnoid haemorrhage summarised in this study can provide references for clinical interventions.Clinical staff should reasonably apply the evidence according to the specific situations.

The maintenance of hematopoietic stem cells (HSCs) is a complex process involving numerous cell-extrinsic and -intrinsic regulators. The first member of the cyclin-dependent kinase family of inhibitors to be identified, p21, has been reported to perform a wide range of critical biological functions, including cell cycle regulation, transcription, differentiation, and so on. Given the previous inconsistent results regarding the functions of p21 in HSCs in a p21-knockout mouse model, we employed p21-tdTomato (tdT) mice to further elucidate its role in HSCs during homeostasis. The results showed that p21-tdT+ HSCs exhibited increased self-renewal capacity compared to p21-tdT- HSCs. Zbtb18, a transcriptional repressor, was upregulated in p21-tdT+ HSCs, and its knockdown significantly impaired the reconstitution capability of HSCs. Furthermore, p21 interacted with ZBTB18 to co-repress the expression of cKit in HSCs and thus regulated the self-renewal of HSCs. Our data provide novel insights into the physiological role and mechanisms of p21 in HSCs during homeostasis independent of its conventional role as a cell cycle inhibitor.
Animals ; Hematopoietic Stem Cells/cytology* ; Cyclin-Dependent Kinase Inhibitor p21/genetics* ; Mice ; Cell Self Renewal ; Repressor Proteins/genetics* ; Mice, Inbred C57BL ; Mice, Knockout ; Humans ; Gene Expression Regulation

Objective:To explore the efficiency of a modified caries risk assessment tool(MCAT)on caries-risk prediction of children in Nanning.Methods:MCAT was designed based on caries-risk assessment tool(CAT)of American Academy of Pediatric Dentistry(AAPD)and the caries related factors of the primary school children in Guangxi,China.A cohort study was conducted in 332 children aged 3-year-old in kindergarten of Jiangnan District,Nanning,Guangxi.The data were integrated through questionnaires and oral exam-ination.The MCAT data were respectively scored by CAT and Cariogram and the caries-risk of the children was evaluated.The develop-ment of increased average caires incidece over a period of 1.5 years was compared,the predictive capacity of the methods was com-pared.Results:The ranks of caires risk assessed by CAT and Cariogram were significant different(Z=-10.34,P＜0.001),and the consistency of the 2 methods was poor(Kappa=0.234,P＜0.001).After 1.5 years,there was significant statistical difference of the caries prevalence rate between the low-high and moderate-high risk groups,and dmft increments between the moderate-high risk groups e-valuated by CAT(P＜0.05).There was significant difference of the caries prevalence rate between each risk groups and dmft increments between the low-high and moderate-high risk groups evaluated by Cariogram(P＜0.05).The AUC of CAT and Cariogram was 0.571 and 0.722 respectively(P＜0.001).In the prediction models of caries risk,the fitting of CAT was poor(P＜0.001),while that of Cariogram was better(P=1.00).Cariogram analysis showed that the chance of developing new caries lesions of the subjects with moderate and high caries risk was 2.86 and 11.65 times more than those with low caries risk.Conclusion:MCAT com-bined with Cariogram can more efficiently predict new caries de-velopment in 3-year-old children.

Objective:To explore the clinical characteristics of tigecycline-associated hypofibrinogenemia in critically ill patients, and analyze risk factors for its occurrence.Methods:Clinical data of patients treated with tigecycline in the Intensive Care Unit (ICU) at Zhongda Hospital Affiliated to Southeast University from January 2021 to December 2022 were collected and retrospectively analyzed. Patients were divided into hypofibrinogenemia group and non-hypofibrinogenemia group according to their fibrinogen levels. General information, laboratory tests results, tigecycline application, combined drugs, and blood concentration of tigecycline were compared between the 2 groups. Variables with P<0.10 in intergroup comparisons were included in a multivariate logistic regression model to analyze the risk factors for tigecycline-associated hypofibrinogenemia, and odds ratios ( OR) and its 95% confidence intervals ( CI) were calculated. Results:A total of 79 patients using tigecycline were collected, including 43 cases with hypofibrinogenemia and 36 cases without hypofibrinogenemia. Univariate analysis showed that the differences in patients with diabetes [41.9%(18/43) vs. 16.7%(6/36)], acute kidney injury [41.9%(18/43) vs. 19.4%(15/36)], and baseline fibrinogen (before tigecycline treatment) ≤4 g/L [37.2%(16/43) vs. 16.7%(6/36)] between the 2 groups were statistically significant (all P<0.05). The related factors ( P<0.10) of the 2 groups, including diabetes, acute renal injury, continuous renal replacement therapy, baseline FIB ≤4 g/L (before using tigecycline), larger total dose of tegacycline and longer treatment duration, were included in the multivariate logistic regression analysis. The results showed that diabetes ( OR=4.851, 95% CI: 1.180-19.494, P=0.029), continuous renal replacement therapy ( OR=8.610, 95% CI: 1.987-37.311, P=0.004), and longer treatment duration ( OR=1.452, 95% CI: 1.018-2.071, P=0.040) were independent risk factors for tigecycline-related hypofibrinogenemia. Conclusion:In critically ill patients, with diabetes, continuous renal replacement therapy, and longer treatment duration of tigecycline may increase the risk of hypofibrinogenemia.

Objective:To explore the clinical characteristics of tigecycline-associated hypofibrinogenemia in critically ill patients, and analyze risk factors for its occurrence.Methods:Clinical data of patients treated with tigecycline in the Intensive Care Unit (ICU) at Zhongda Hospital Affiliated to Southeast University from January 2021 to December 2022 were collected and retrospectively analyzed. Patients were divided into hypofibrinogenemia group and non-hypofibrinogenemia group according to their fibrinogen levels. General information, laboratory tests results, tigecycline application, combined drugs, and blood concentration of tigecycline were compared between the 2 groups. Variables with P<0.10 in intergroup comparisons were included in a multivariate logistic regression model to analyze the risk factors for tigecycline-associated hypofibrinogenemia, and odds ratios ( OR) and its 95% confidence intervals ( CI) were calculated. Results:A total of 79 patients using tigecycline were collected, including 43 cases with hypofibrinogenemia and 36 cases without hypofibrinogenemia. Univariate analysis showed that the differences in patients with diabetes [41.9%(18/43) vs. 16.7%(6/36)], acute kidney injury [41.9%(18/43) vs. 19.4%(15/36)], and baseline fibrinogen (before tigecycline treatment) ≤4 g/L [37.2%(16/43) vs. 16.7%(6/36)] between the 2 groups were statistically significant (all P<0.05). The related factors ( P<0.10) of the 2 groups, including diabetes, acute renal injury, continuous renal replacement therapy, baseline FIB ≤4 g/L (before using tigecycline), larger total dose of tegacycline and longer treatment duration, were included in the multivariate logistic regression analysis. The results showed that diabetes ( OR=4.851, 95% CI: 1.180-19.494, P=0.029), continuous renal replacement therapy ( OR=8.610, 95% CI: 1.987-37.311, P=0.004), and longer treatment duration ( OR=1.452, 95% CI: 1.018-2.071, P=0.040) were independent risk factors for tigecycline-related hypofibrinogenemia. Conclusion:In critically ill patients, with diabetes, continuous renal replacement therapy, and longer treatment duration of tigecycline may increase the risk of hypofibrinogenemia.

Objective To explore the efficacy of the resolving depression and tranquilizing herbal sachets in alleviating sleep disorders of soldiers in naval vessels. Methods Fifty-nine soldiers with sleep disorders (PSQI scale score ≥8 and SAS scale score ≥50) were selected before training at sea, and were randomly divided into sachet treatment group, mindfulness meditation group and control group. During the training period, the sachet treatment group was given traditional Chinese medicine sachet treatment, the mindfulness meditation group was trained in mindfulness meditation, and the control group was not given any intervention. Results Compared with the control group, the PSQI and SAS scores of soldiers in both the experimental sachet treatment group and the positive meditation group were significantly improved; compared with the pre-intervention data, the PSQI and SAS scores of both the positive meditation group and the sachet treatment group were significantly decreased, and the degree of decrease was comparable. Conclusion The homemade improving depression and tranquilizing TCM sachets have the effect of alleviating the sleep disorders of naval troops served on vessels, which is equivalent to mindfulness meditation. It is easy to use and operate, which is suitable for promotion in the military.