Objective To analyze clinical characteristics and therapeutic strategies for patients with Trichosporon asahii(T.asahii)bloodstream infection(BSI),and provide reference for clinical diagnosis and treatment for such disease.Methods Diagnosis and treatment process of a patient with T.asahii BSI were reported.China National Knowledge Infrastructure(CNKI),Wanfang,PubMed,and Web of Science databases were retrieved using key-words:"Trichosporon asahii"and"bloodstream infection".Patients'age,gender,underlying diseases,immune status,treatment,and clinical outcome as well as antimicrobial susceptibility testing results of T.asahii were ana-lyzed retrospectively.Results The leukemia patient developed T.asahii BSI during chemotherapy,and showed clinical improvement after treatment with fluconazole+flucytosine.A total of 44 cases(43 from literature plus this index case)were analyzed.Among these cases,28 were males,the median age was 54.5 years old.The underlying diseases were predominantly hematological diseases.Catheter,urinary tract,and skin were identified as concurrent culture-positive sites.Azoles exhibited good antimicrobial activity in vitro,with voriconazole showing the strongest activity and associated with significantly higher survival rates.Under the guidance of antimicrobial susceptibility tes-ting results,patients with fluconazole treatment had a higher survival rate.At minimum inhibitory concentrations(MICs)of 4-8 μg/mL of fluconazole,fluconazole combined with other agents was predominantly required.Am-photericin B demonstrated good in vitro activity,but the overall survival rate of patients was low when amphotericin B was used as monotherapy without azoles.Catheters removal,surgical intervention,and neutrophil recovery were influencing factors for enhanced survival rates.Conclusion BSI caused by T.asahii primarily occurs in patients with hematological diseases,with neutropenia being a high-risk factor.Infection sites at catheter,urinary tract,and skin may be infection sources.Clearing the source of infection and promoting the recovery of neutrophils can help to improve survival rates of patients.For voriconazole-intolerant patients,fluconazole monotherapy or in combination with flucytosine/amphotericin B can be used alternatively based on antimicrobial susceptibility testing results.

Objective To analyze the results of ultrasonic examinations of hip joints in preterm infants,clarify the developmental characteristics of hip joints across different gestational ages.Meth-ods A total of 881 preterm infants who attended the Child Healthcare Outpatient Clinic of Nanjing Maternity and Child Health Care Hospital between January 2023 and April 2024 were enrolled.The first ultrasonic examination of the hip joints was performed at a corrected gestational age of 4 to 6 weeks.The Graf classification method was employed to categorize the ultrasonic findings.Differences in hip joint development among preterm infants of varying gestational ages were compared,and rele-vant influencing factors were statistically analyzed.Results A total of 1,762 hip joints were exam-ined,with 30 cases of abnormal hip joints detected,yielding an abnormality detection rate of 3.4％(30/881).Among these,26 hips were classified as type Ⅱa and 8 as type Ⅱb.Statistically signifi-cant differences were observed in the detection of left-sided abnormal hip joints between preterm in-fants of other gestational age groups and late preterm infants(P＜0.05).A statistically significant difference was found in the classification of right-sided hip joints between preterm infants of different genders(P＜0.05),while no significant difference was observed for left-sided hip joints(P＞0.05).Statistically significant differences were noted in the detection rates of bilateral abnormal hip joints among preterm infants with varying birth weights(P＜0.05).Advanced maternal age was found to influence the development of left-sided hip joints inpreterm infants,whereas factors such as assisted reproductive technology,breech presentation,and nulliparity had no significant impacts on abnormal hip joint development in preterm infants.Conclusion Ultrasonic technology demonstrates signifi-cant advantages in screening for developmental dysplasia of the hip(DDH)in preterm infants.Dif-ferent gestational ages exert a notable influence on the development of left-sided hip joints in preterm infants.Female preterm infants exhibit a higher risk of right-sided hip joint abnormalities compared to the left side.Breech presentation,assisted reproductive technology,and nulliparity are not risk factors for DDH in preterm infants.However,higher birth weight in preterm infants and advanced maternal age are associated with abnormal hip joint development.Clinical attention should focus on high-risk factors,and enhanced dynamic ultrasonic monitoring of hip joints in preterm infants is war-ranted to facilitate early intervention and treatment.

Objective To analyze clinical characteristics and therapeutic strategies for patients with Trichosporon asahii(T.asahii)bloodstream infection(BSI),and provide reference for clinical diagnosis and treatment for such disease.Methods Diagnosis and treatment process of a patient with T.asahii BSI were reported.China National Knowledge Infrastructure(CNKI),Wanfang,PubMed,and Web of Science databases were retrieved using key-words:"Trichosporon asahii"and"bloodstream infection".Patients'age,gender,underlying diseases,immune status,treatment,and clinical outcome as well as antimicrobial susceptibility testing results of T.asahii were ana-lyzed retrospectively.Results The leukemia patient developed T.asahii BSI during chemotherapy,and showed clinical improvement after treatment with fluconazole+flucytosine.A total of 44 cases(43 from literature plus this index case)were analyzed.Among these cases,28 were males,the median age was 54.5 years old.The underlying diseases were predominantly hematological diseases.Catheter,urinary tract,and skin were identified as concurrent culture-positive sites.Azoles exhibited good antimicrobial activity in vitro,with voriconazole showing the strongest activity and associated with significantly higher survival rates.Under the guidance of antimicrobial susceptibility tes-ting results,patients with fluconazole treatment had a higher survival rate.At minimum inhibitory concentrations(MICs)of 4-8 μg/mL of fluconazole,fluconazole combined with other agents was predominantly required.Am-photericin B demonstrated good in vitro activity,but the overall survival rate of patients was low when amphotericin B was used as monotherapy without azoles.Catheters removal,surgical intervention,and neutrophil recovery were influencing factors for enhanced survival rates.Conclusion BSI caused by T.asahii primarily occurs in patients with hematological diseases,with neutropenia being a high-risk factor.Infection sites at catheter,urinary tract,and skin may be infection sources.Clearing the source of infection and promoting the recovery of neutrophils can help to improve survival rates of patients.For voriconazole-intolerant patients,fluconazole monotherapy or in combination with flucytosine/amphotericin B can be used alternatively based on antimicrobial susceptibility testing results.

Objective To investigate the mechanism by which Erastin affects ferroptosis in lung fibroblasts.Meth-ods Mouse lung fibroblasts (C57/B6-L) were treated with varying concentrations of the iron death inducer Eras-tin.Cell viability was assessed using the cell counting Kit-8 (CCK-8) assay.Oxidative stress levels were visualized using a fluorescence microscope, and the expression of proteins related to the mitogen-activated protein kinase (MAPK) signaling pathway was analyzed using Western blot.Additionally, the p38 and extracellular regulated protein kinase (ERK) inhibitors SB203580 and U0126 were employed to further elucidate the mechanism by which Erastin induces iron death in lung fibroblasts.Results At a concentration of 100 μmol/L, Erastin effectively in-duced ferroptosis in lung fibroblasts, leading to an upregulation of oxidative stress.Furthermore, the phosphoryla-tion levels of p38 and ERK proteins in the MAPK pathway were elevated (P<0.05) .The addition of SB203580 and U0126 inhibitors resulted in a significant reduction in oxidative stress levels and a notable increased in cell ac-tivity in lung fibroblasts (P<0.05).Conclusion It can be concluded that Erastin induces ferroptosis in lung fi-broblasts, potentially through the mediation of oxidative stress via the MAPK signaling pathway.

Objective To systematically search,evaluate and summarize the best evidence for prevention and management of extravasation in peripheral intravenous infusion in NICU neonates,and provide a reference for clinical practice and standard formulation.Methods A comprehensive systematic search of websites and databases was conducted to explore literature on prevention and management of extravasation in NICU neonates,including clinical decisions,guidelines,expert consensuses,evidence summaries and systematic reviews.The search encompassed the entire period from database inception to July 2023.2 researchers independently evaluated the quality of the literature,extracted and integrated the evidence.Results The study included a total of 9 articles,comprising 1 clinical decision,3 guidelines,3 expert consensus documents,and 2 evidence summaries.Ultimately,25 pieces of evidence were synthesized,covering risk factors,catheter indwelling and maintenance,extravasation assessment and treatment,and team building,education and training.Conclusion The evidence provided practical and specific recommendations that can guide healthcare institutions in formulating strategies to prevent and treat extravasation during peripheral intravenous infusion in NICU neonates,while also offering evidence-based guidance for applying the evidence in clinical practice.

Objective:To evaluate the value of shear wave elastography (SWE) in skin assessment of Systemic sclerosis (SSc).Methods:A total of 58 SSc patients admitted to Peking University Third Hospital from May 2021 to October 2022 and 41 healthy volunteers were included in the study. Skin shear wave elastography (SWE) was performed at 17 sites defined in modified Rodnan skin score (mRSS) measurement, and shear wave velocity values were recorded to evaluate skin hardness. SPSS 22.0 software was used to analyze the skin hardness of SSc patients and healthy controls, and the correlation between skin hardness of SSc patients and clinical data was analyzed. A logistic regression model was constructed to evaluate the diagnostic efficacy of skin hardness at different sites of SSc patients, and to further select the most practical measurement site.Results:The SWE value of SSc patients was significantly higher than that of healthy control group ( P<0.05). There was a positive correlation between SWE and mRSS in the measurement of bilateral fingers, bilateral dorsal hands, bilateral forearms, fore-chest, abdomen, bilateral thighs, and bilateral dorsal feet. Skin stiffness measured by SWE was significantly correlated with SSc disease activity score (EScSG-DAI), ( r=0.71, P<0.001), disease injury score (SCTC-DI), (P=0.55, P=0.005) and functional score (HAQ-DI), ( r=0.46, P=0.003). Reducing the number of measurement sites to 12 (bilateral fingers, bilateral hands, bilateral forearms, bilateral upper arms, forehead, fore-chest, bilateral dorsum of feet) performs as well as all 17 measurement sites simultaneously in assessing disease activity. Conclusion:SWE is a good evaluation tool to reflect the skin lesions of SSc, which is of great value for the diagnosis and evaluation of the disease. We can further standardize the measurement sites and select the most appropriate evaluation strategy, so as to achieve better clinical application.

Cytokines are secreted by various cell types and act as critical mediators in many physiological processes, including immune response and tumor progression. Cytokines production is precisely and timely regulated by multiple mechanisms at different levels, ranging from transcriptional to post-transcriptional and posttranslational processes. Monocyte chemoattractant protein-1 induced protein 1 (MCPIP1), a potent immunosuppressive protein, was first described as a transcription factor in monocytes treated with monocyte chemoattractant protein-1 (MCP-1) and subsequently found to possess intrinsic RNase and deubiquitinase activities. MCPIP1 tightly regulates cytokines expression via various functions. Furthermore, cytokines such as interleukin 1 beta (IL-1B) and MCP-1 and inflammatory cytokines inducer lipopolysaccharide (LPS) strongly induce MCPIP1 expression. Mutually regulated MCPIP1 and cytokines form a complicated network in the tumor environment. In this review, we summarize how MCPIP1 and cytokines reciprocally interact and elucidate the effect of the network formed by these components in cancer-related immunity with aim of exploring potential clinical benefits of their mutual regulation.
Chemokine CCL2/immunology* ; Humans ; Interleukin-1beta/immunology* ; Neoplasm Proteins/immunology* ; Neoplasms/pathology* ; Ribonucleases/immunology* ; Transcription Factors/immunology*

Objective To investigate and characterize the serum metabolite profile of patients with rheumatoid arthritis (RA),a common autoimmune disease,which will be of help for early diagnosis in clinic.Methods Serum specimens from 26 patients with RA and 19 age-matched healthy volunteers were collected from the First Affiliated Hospital of Hunan University of Chinese Medicine from January through April 2015.Samples were detected on the gas chromatography-mass spectrometry (GC-MS),and serum metabolites were identified by the chemometric methods.Discriminative model of RA and healthy volunteers was established using partial least squares-linear discriminant analysis (PLS-LDA),and furthermore the established model was evaluated with double cross validation (DCV) for predicting ability.Finally,differential metabolites with clinical diagnostic potential were screened out by using subwindow permutation analysis (SPA).Results The established PLS-LDA discriminative model identified 48 metabolites.The total accuracy of the model approached 97.73％,in which the accuracy of the model for predicting RA and healthy volunteers was 96.15％ and 100％,respectively.Our studies screened out 3-hydroxy butyric acid,phosphoric acid,isoleucine,mannose and hexadecanoic acid with clinical diagnostic potential based on the SPA.Conclusions Metabolomics with the application of GC-MS combined with the PLS-LDA method can distinguish patients with RA and healthy volunteers,and can aid in potential early diagnosis of RA.

Aim Kadsuraheteroclita ( Roxb ) Craib ( Schizandraceae) is a medicinal plant termed Xuetong in Chinese Tujia ethnomedicine. Xuetong possesses therapeutic effects of, in the terms of Chinese medical theories, reinforcing vital energy, promoting blood cir-culation, expelling wind-evil, and removing damp-e-vil, and has been long used for the prevention and treatment of rheumatic and arthritic diseases, especial-ly in the southern China. The HPLC analysis has iden-tified that the ethanol extract of Xuetong contains large-ly biologically active lignans and triterpenoids. Our previous studies have shown that KHS exhibits very fa-vorable safety profile and potent anti-inflammatory and analgesic activities. In the present study, we investiga-ted anti-arthritic effects and the possible mechanisms of Xuetongon adjuvant-induced arthritis ( AIA ) in rats. Methods AIA was established in male Sprague-Daw-ley ( SD ) rats as described previously, and animals were daily treated by gavage with Xuetong ethanol ex-tract ( 1. 0 g · kg-1 ) or vehicle ( 0. 3% CMC-Na ) throughout the 30-day experiment. The incidence and severity of arthritis were evaluated using clinical pa-rameters. On day 30, bone destruction of the arthritic joints was assessed by computed tomography( CT) and histopathological analyses. The serum levels of pro-in-flammatory cytokines TNF-α, IL-1β, and IL-6 were measured by ELISA. Results Treatment with 1. 0 g/kg Xuetong significantly inhibited the onset and pro-gression of AIA. The vehicle-treated rats all developed severe arthritis, while the incidence of AIA in the Xue-tong-treated rats was as low as 55%( P=0. 035 ) . The Xuetong -treated rats exhibited 1. 8 to 2. 3 fold reduc-tion of paw swelling, and gained 10 to 20% more body weight than the vehicle-treated AIA rats throughout the experiment. CT and histopathological examinations re-vealed that Xuetong markedly protected AIA rats from cartilage and bone destruction of joints. Moreover, the serum levels of TNF-α, IL-1β, and IL-6 were signifi-cantly decreased in the Xuetong-treated rats than the vehicle-treated AIA rats. Conclusions These data strongly support the clinical use of Xuetong for rheu-matic and arthritic diseases, and suggest that Xuetong is a valuable candidate for further investigation to be a new anti-arthritic drug with favorable safety profile.

From August 2011 to March 2012,5 241 type 2 diabetic patients with body mass index ≥ 24kg/m2 were enrolled from 60 hospitals in Guangdong Province.According to estimated glomerular filtration rate (eGFR),a total of 2 631 subjects with norml urine microalbumin level (＜30 ng/L) were divided into normal eGRF group and decreased eGRF group.Binary logistic regression was used to analyze the associations between eGFR and its related risk factors.The results showed that age,blood uric acid,blood urea nitrogen,history of hypertension and coronary heart disease,family history of diabetes,and hyperuricemia were positively related to lowering of eGFR (P＜ 0.05 or P＜0.01).HbA1C＜7％,regular glucose monitoring,and regular physical activity were negatively related to eGFR decrease (all P＜ 0.01).These results suggest that urine microalbumin and eGFR should be applied to overweight or obese patients with type 2 diabetes in order to screen diabetic nephropathy.Furthermore,intensive control of blood glucose,uric acid,and blood pressure is beneficial to lowering the risk of diabetic nephropathy.