Objective:To analyze the recovery of olfactory function in patients diagnosed with chronic rhinosinusitis with nasal polyps (CRSwNP) after endoscopic sinus surgery and to identify factors influencing recovery to provide a theoretical foundation for taking effective measures.Methods:This was a retrospective analysis included 277 CRSwNP patients with olfactory dysfunction who underwent endoscopic sinus surgery at the First Affiliated Hospital of Chongqing Medical University from October 2021 to September 2023. This study included 189 males and 88 females, with a median age of 46 years (range: 18-84 years). Routine laboratory tests, sinus CT Lund-Mackay score, modified sinus CT score, endoscopic polyp score, and nasal endoscopic Lund-Kennedy score were included for preoperative assessments. Eosinophil counts were obtained from nasal polyp tissues during surgery. The University of Pennsylvania smell identification test (UPSIT) was administered before surgery and 6 months after surgery to evaluate olfactory function. Based on results of postoperative olfactory test, patients were divided into two groups: the group with improved olfactory function and without improvement of olfactory function. Chi-square test and multivariate Logistic regression were used to analyze relevant factors affecting postoperative olfactory function of CRSwNP patients, and the prediction model was constructed to verify its consistency and to analyze its prediction efficiency.Results:Of the 277 patients, 155 (56%) showed improved olfactory function and 122 (44%) did not improve after surgery. Multivariate Logistic regression analysis identified following independent factors associated with improved postoperative olfactory function: concurrent allergic rhinitis ( OR=2.34), long duration of olfactory dysfunction ( OR=1.13), higher total score of CT olfactory zone ( OR=1.26), higher Lund-Kennedy score ( OR=1.23), presence of olfactory cleft polyps ( OR=4.72), higher tissue eosinophil count ( OR=1.01) and high IL-6 levels ( OR=1.51). Conversely, a higher endoscopic polyp score ( OR=0.74) was associated with a lower likelihood of olfactory improvement. The nomogram model, validated using receiver operating characteristic (ROC) analysis, demonstrated good clinical efficacy with an area under the curve (AUC) of 0.80 (95%CI: 0.748-0.852). The calibration curve showed an absolute error of 0.021, indicating good consistency and predictive accuracy. Conclusions:Factors such as a medical history of allergic rhinitis, duration of olfactory dysfunction, total score of sinus CT olfactory zone, endoscopic Lund-Kennedy score, olfactory cleft polyps, tissue eosinophil count, IL-6 level and endoscopic polyp score independently influence postoperative olfactory function of CRSwNP patients. The nomogram model based on these independent factors has good clinical efficacy, which can be used to predict the postoperative olfactory function in CRSwNP patients with olfactory dysfunction.

Objective To evaluate the clinical characteristics and risk factors of healthcare-associated urinary tract infection(HA-UTI)due to vancomycin-resistant Enterococcus(VRE),and provide basis for clinical prevention and control.Methods Patients with VRE HA-UTI in a tertiary first-class hospital in Guangdong Province from January 2021 to October 2023 were selected as the VRE group.A 1∶2 case-control study method was conducted to select pa-tients with vancomycin-sensitive Enterococcus(VSE)UTI as the VSE group.Clinical characteristics of two groups of patients were compared and analyzed.Risk factors for VRE HA-UTI were analyzed using univariate regression and logistic multivariate regression.Results A total of 32 patients in the VRE group and 64 patients in the VSE group were included in the analysis.In VRE group,most patients were female(68.75％),aged≥60 years(71.88％),and from intensive care unit(ICU,56.25％).The main detected pathogen was vancomycin-resistant Enterococcus faecium(VREfm,96.87％).The proportion of clinical symptoms such as fever and lumbago as well as the levels of procalcitonin(PCT)and C-reactive protein(CRP)in patients in the VRE group were all higher than those in the VSE group(all P＜0.05).Logistic regression analysis results showed that concomitant pulmonary infection(OR=6.890,95％CI:1.098-43.218,P=0.039),history of hypertension(OR=4.240,95％CJ:1.084-16.581,P=0.038),and cephalosporin antibiotic exposure before infection(OR=4.642,95％CI:1.270-16.967,P=0.020)were independent risk factors for VRE HA-UTI.There were 32 and 64 strains of Enterococcus detected from VRE group and VSE group,respectively.VRE had higher resistance rates to ciprofloxacin,amoxicillin,ampicillin,peni-cillin G,tetracycline,high concentration gentamicin,and levofloxacin than VSE(all P＜0.05).Conclusion Pa-tients with VRE HA-UTI often have multiple underlying diseases and poor nutritional status,and are highly resis-tant to multiple antimicrobial agents.Clinical attention should be focused on patients with concomitant pulmonary infection,history of hypertension,and exposure to cephalosporin antibiotics.

Objective To evaluate the clinical characteristics and risk factors of healthcare-associated urinary tract infection(HA-UTI)due to vancomycin-resistant Enterococcus(VRE),and provide basis for clinical prevention and control.Methods Patients with VRE HA-UTI in a tertiary first-class hospital in Guangdong Province from January 2021 to October 2023 were selected as the VRE group.A 1∶2 case-control study method was conducted to select pa-tients with vancomycin-sensitive Enterococcus(VSE)UTI as the VSE group.Clinical characteristics of two groups of patients were compared and analyzed.Risk factors for VRE HA-UTI were analyzed using univariate regression and logistic multivariate regression.Results A total of 32 patients in the VRE group and 64 patients in the VSE group were included in the analysis.In VRE group,most patients were female(68.75％),aged≥60 years(71.88％),and from intensive care unit(ICU,56.25％).The main detected pathogen was vancomycin-resistant Enterococcus faecium(VREfm,96.87％).The proportion of clinical symptoms such as fever and lumbago as well as the levels of procalcitonin(PCT)and C-reactive protein(CRP)in patients in the VRE group were all higher than those in the VSE group(all P＜0.05).Logistic regression analysis results showed that concomitant pulmonary infection(OR=6.890,95％CI:1.098-43.218,P=0.039),history of hypertension(OR=4.240,95％CJ:1.084-16.581,P=0.038),and cephalosporin antibiotic exposure before infection(OR=4.642,95％CI:1.270-16.967,P=0.020)were independent risk factors for VRE HA-UTI.There were 32 and 64 strains of Enterococcus detected from VRE group and VSE group,respectively.VRE had higher resistance rates to ciprofloxacin,amoxicillin,ampicillin,peni-cillin G,tetracycline,high concentration gentamicin,and levofloxacin than VSE(all P＜0.05).Conclusion Pa-tients with VRE HA-UTI often have multiple underlying diseases and poor nutritional status,and are highly resis-tant to multiple antimicrobial agents.Clinical attention should be focused on patients with concomitant pulmonary infection,history of hypertension,and exposure to cephalosporin antibiotics.

Objective:To analyze the recovery of olfactory function in patients diagnosed with chronic rhinosinusitis with nasal polyps (CRSwNP) after endoscopic sinus surgery and to identify factors influencing recovery to provide a theoretical foundation for taking effective measures.Methods:This was a retrospective analysis included 277 CRSwNP patients with olfactory dysfunction who underwent endoscopic sinus surgery at the First Affiliated Hospital of Chongqing Medical University from October 2021 to September 2023. This study included 189 males and 88 females, with a median age of 46 years (range: 18-84 years). Routine laboratory tests, sinus CT Lund-Mackay score, modified sinus CT score, endoscopic polyp score, and nasal endoscopic Lund-Kennedy score were included for preoperative assessments. Eosinophil counts were obtained from nasal polyp tissues during surgery. The University of Pennsylvania smell identification test (UPSIT) was administered before surgery and 6 months after surgery to evaluate olfactory function. Based on results of postoperative olfactory test, patients were divided into two groups: the group with improved olfactory function and without improvement of olfactory function. Chi-square test and multivariate Logistic regression were used to analyze relevant factors affecting postoperative olfactory function of CRSwNP patients, and the prediction model was constructed to verify its consistency and to analyze its prediction efficiency.Results:Of the 277 patients, 155 (56%) showed improved olfactory function and 122 (44%) did not improve after surgery. Multivariate Logistic regression analysis identified following independent factors associated with improved postoperative olfactory function: concurrent allergic rhinitis ( OR=2.34), long duration of olfactory dysfunction ( OR=1.13), higher total score of CT olfactory zone ( OR=1.26), higher Lund-Kennedy score ( OR=1.23), presence of olfactory cleft polyps ( OR=4.72), higher tissue eosinophil count ( OR=1.01) and high IL-6 levels ( OR=1.51). Conversely, a higher endoscopic polyp score ( OR=0.74) was associated with a lower likelihood of olfactory improvement. The nomogram model, validated using receiver operating characteristic (ROC) analysis, demonstrated good clinical efficacy with an area under the curve (AUC) of 0.80 (95%CI: 0.748-0.852). The calibration curve showed an absolute error of 0.021, indicating good consistency and predictive accuracy. Conclusions:Factors such as a medical history of allergic rhinitis, duration of olfactory dysfunction, total score of sinus CT olfactory zone, endoscopic Lund-Kennedy score, olfactory cleft polyps, tissue eosinophil count, IL-6 level and endoscopic polyp score independently influence postoperative olfactory function of CRSwNP patients. The nomogram model based on these independent factors has good clinical efficacy, which can be used to predict the postoperative olfactory function in CRSwNP patients with olfactory dysfunction.

Objective:To understand the current situation of nurses in 52 hospitals in China on mastery of knowledge about skin injury in the elderly based on the background of mixed-mode homogenization training.Methods:Using the convenient sampling method, a total of 1 067 nurses from 52 hospitals in China were selected as the research objects in January 2021. A self-designed questionnaire on knowledge of skin injury in the elderly was used to investigate the nurses through the questionnaire star and univariate analysis was used to analyze the influencing factors. A total of 1 067 questionnaires were distributed and 1 067 valid questionnaires were recovered, and the effective recovery rate was 100%.Results:The knowledge scores of pressure injury, incontinence-associated dermatitis, skin tear and xerosis cutis among 1067 nurses were (95.66±7.37) , (95.65±9.15) , (91.37±15.45) and (87.67±15.91) , respectively. The results of univariate analysis showed that hospital grade was the influencing factor of nurses' knowledge score of pressure injury, skin tear and incontinence-associated dermatitis ( P<0.05) , educational background was the influencing factor of nurses' knowledge score of skin tear ( P<0.05) , professional title was the influencing factor of nurses' knowledge scores of pressure injury, incontinence-associated dermatitis and xerosis cutis ( P<0.05) . Conclusions:Hospitals at all levels need to strengthen the theoretical and practical knowledge training for nurses on skin xerosis and skin tear in the elderly, especially for nurses with primary titles and lower education in grassroots hospitals.

Cancer stem cells (CSCs), a subpopulation of cancer cells with ability of initiating tumorigenesis, exist in many kinds of tumors including breast cancer. Cancer stem cells contribute to treatment resistance and relapse. Conventional treatments only kill differentiated cancer cells, but spare CSCs. Combining conventional treatments with therapeutic drugs targeting to CSCs will eradicate cancer cells more efficiently. Studying the molecular mechanisms of CSCs regulation is essential for developing new therapeutic strategies. Growing evidences showed CSCs are regulated by non-coding RNA (ncRNA) including microRNAs and long non-coding RNAs (lncRNAs), and histone-modifiers, such as let-7, miR-93, miR-100, HOTAIR, Bmi-1 and EZH2. Herein we review the roles of microRNAs, lncRNAs and histone-modifiers especially Polycomb family proteins in regulating breast cancer stem cells (BCSCs).
Breast Neoplasms ; genetics ; metabolism ; pathology ; Histones ; metabolism ; Humans ; Neoplastic Stem Cells ; metabolism ; RNA, Untranslated ; genetics ; metabolism

Objective To investigate the potential of inflammatory markers for short-term prognosis of acute cerebral infarction.Methods A total of 272 consecutive patients with acute cerebral infarction were divided into a high hs-CRP group (hs-CRP level ＞3 mg/L) and a low hs-CRP group (hs-CRP level ≤3 mg/L),and their general information and medical history were collected.The Trial of Org 10172 in Acute Stroke Treatment (TOAST) stroke subtype classification was conducted and scores of the National Institutes of Health Stroke Scale (NIHSS),the Barthel index (BI) and the modified Rankin scale (mRS) were collected after admission.White blood cell count,blood glucose,blood homocysteine (Hcy) and C-reactive protein were measured within 24 hours following admission.Multivariate Logistic regression analysis was performed to identify independent risk factors for short-term prognosis of acute cerebral infarction.Results Between the high hs-CRP group and the low hs-CRP group,there were significant differences in the incidences of atrial fibrillation history,cardiogenic embolism of TOAST,blood homocysteine,blood glucose,white blood cell count,NIHSS,BI and mRS score 1,7,14 days after admission (P＜0.05 for all).The hs-CRP level (OR=0.876,P＜0.001,95％ CI:0.817-0.917),white blood cell count (OR=1.137,P=0.029,95％ CI:1.013-1.275),lipid metabolism disorders (OR=2.863,P＜0.001,95％ CI:1.561-5.250),and BI score (OR=1.038,P=0.047,95％ CI:1.001-1.077) 1 day after stroke were independent risk factors for short-term prognosis of acute cerebral infarction.Conclusions Increased levels of the inflammatory marker hs-CRP and elevated white blood cell count may be independent risk factors for short-term prognosis of acute cerebral infarction.

Objective To evaluate the predictive value of eight scoring systems (Acute Physiology and Chronic Health Evaluation Ⅱ [APACHE Ⅱ] and APACHE Ⅲ,Improved Edinburgh-Scandinavian Scale [CSS],U.S.National Institutes of Health Stroke Scale [NIHSS],Activity of Daily Living [ADL] scale,Glasgow Coma Scale [GCS],Previous History of Disease Scale and Concomitant Disease Scale) in severity and outcomes of patients with acute ischemic stroke by using discriminant analysis,and to establish their mathematical models to predict the status of early death of stroke patients.Methods Three hundred and ninety-nine patients with acute ischemic stroke,admitted to our hospital from January 2008 to December 2012,were chosen in our study; these patients were tested with APACHE Ⅱ,APACHE Ⅲ,CSS,NIHSS,ADL,GCS,Previous History of Disease Scale and Concomitant Disease Scale within 24 h of admission.All of them were divided into two groups according to groups of survival (n=278) or death (n=121) one month after disease onset.Discriminant analysis was performed on all the data and the predictive values of these eight scales in the prognosis were analyzed.Results Patients from group of death had significantly higher scores of APACHE Ⅱ,APACHE Ⅲ,CSS,NIHSS and Concomitant Disease Scale,and statistically lower scores of ADL and GCS scores than those from group of survival (P＜0.05).Cluster analysis showed that CSS and NIHSS,and APACHE Ⅱ and APACHE Ⅲ,respectively,belong to clusters,which enjoyed higher predictive values than other scales.The areas under receiver operator characteristic (ROC) curves were 0.808,0.818,0.796 and 0.794 of APACHE Ⅱ,APACHE Ⅲ,CSS and NIHSS scores,respectively,enjoying good definition; Discriminant analysis was used to analyze the eight scoring systems and mathematical models were established to predict the outcomes of stroke patients,enjoying more than 80％ of coincidence rate.Conclusion APACHE Ⅱ,APACHE Ⅲ,CSS and NIHSS are superior to the other four score systems in evaluating severity of stroke patients,whose mathematical models,having more than 80％ of accuracy rate.

Objective To establish the prediction model for ischemic stroke recurrence. Methods Consecutive patients with ischemic stroke from January 1st, 2008 to December 31st, 2009 were followed up until June 30th, 2010. The rate of recurrence were described with Kaplan-Meier curve, and the factors associated with recurrence were analyzed with monovariant and multivariate Cox's proportional hazard regression. Results There were 79 cases relapsed during the follow-up. The independent risk factors associated with recurrence were age(X),history of hypertension (X2), family stroke history (X3), total cholesterol (X4), disease progression (X5), total scores of Essen stroke risk score (X6). The personal prognosis index (PI) for predicting recurrence was as: PI=0.025X1+0.681X2+0.973X3+0.395X4+0.636X5+0.283X6. As the receiver operating characteristic (ROC) curve showed, when the cut-off point of PI was 2.289, the sensitivity of the model was 0.731 and specificity was 0.795. Conclusion The model for predicting recurrence of ischemic stroke was established.

Objective To investigate the association between the HLA-DRB1 gene polymorphisms and susceptibility of pulmonary tuberculosis (TB) in patients with type 2 diabetes mellitus in North China. Methods A 1∶1 matched case-control study was adopted. Polymerase chain reaction-sequence-specific primers techniques (PCR-SSP) and restriction fragment length polymorphism (RFLP) was used to type polymorphisms (DR15, DR16, DR1, DR11). Information on environmental-related risk factors and pathological changes of tuberculosis was collected using a pre-tested standard questionnaire. Variance analysis, Chi-square, univariate and multivariate conditional Logistic analysis were conducted with SPSS 12.0 for Window. Results A sample of 124 pairs of cases and controls was studied. Univariate analysis demonstrated that DR15 mutant increased the risk of susceptibility of pulmonary tuberculosis (OR＝2.461, 95%CI: 1.363~4.444, P=0.002),and it would further increased if DR16 mutant occurred together (OR=4.904, 95%CI: 1.554~15.476). In multivariate analysis, DR15 mutant also associated with susceptibility of pulmonary tuberculosis (OR=2.996, 95%CI: 1.51~5.945). Conclusion Polymorphism of DR15 genotype might be a susceptible genotype of TB patients with type 2 diabetes mellitus in North China.