OBJECTIVE: To compare the efficacy and safety of intravenous colistin sulfate combined with nebulized inhalation versus intravenous monotherapy for pulmonary infections caused by carbapenem-resistant organism (CRO). METHODS: A multicenter retrospective cohort study was conducted. Clinical data were collected from patients admitted to the intensive care unit (ICU) of 10 tertiary class-A hospitals in Henan Province between July 2021 and May 2023, who received colistin sulfate for CRO pulmonary infections. Data included baseline characteristics, inflammatory markers [white blood cell count (WBC), neutrophil count (NEU), procalcitonin (PCT), C-reactive protein (CRP)], renal function indicators [serum creatinine (SCr), blood urea nitrogen (BUN)], life support measures, anti-infection regimens, clinical efficacy, microbiological clearance rate, and prognostic outcomes. Patients were divided into two groups: intravenous group (colistin sulfate monotherapy via intravenous infusion) and combination group ((intravenous infusion combined with nebulized inhalation of colistin sulfate). Changes in parameters before and after treatment were analyzed. RESULTS: A total of 137 patients with CRO pulmonary infections were enrolled, including 89 in the intravenous group and 48 in the combination group. Baseline characteristics, life support measures, daily colistin dose, and combination regimens (most commonly colistin sulfate plus carbapenems in both groups) showed no significant differences between two groups. The combination group exhibited higher clinical efficacy [77.1% (37/48) vs. 59.6% (52/89)] and microbiological clearance rate [60.4% (29/48) vs. 39.3% (35/89)], both P < 0.05. Pre-treatment inflammatory and renal parameters showed no significant differences between two groups. Post-treatment, the combination group showed significantly lower WBC and CRP [WBC (×10⁹/L): 8.2±0.5 vs. 10.9±0.6, CRP (mg/L): 14.0 (5.7, 26.6) vs. 52.1 (24.4, 109.6), both P < 0.05], whereas NEU, PCT, SCr, and BUN levels showed no significant between two groups. ICU length of stay was shorter in the combination group [days: 16 (10, 25) vs. 21 (14, 29), P < 0.05], although mechanical ventilation duration and total hospitalization showed no significant differences between two groups. CONCLUSIONS Intravenous colistin sulfate combined with nebulized inhalation improved clinical efficacy and microbiological clearance in CRO pulmonary infections with an acceptable safety profile.
Humans ; Colistin/therapeutic use* ; Retrospective Studies ; Administration, Inhalation ; Anti-Bacterial Agents/therapeutic use* ; Carbapenems/pharmacology* ; Male ; Female ; Middle Aged ; Gram-Negative Bacteria/drug effects* ; Aged ; Treatment Outcome ; Respiratory Tract Infections/drug therapy*

Asthma is a common chronic respiratory disease characterized by repeated attacks and prolonged illness.Traditional Chinese medicine believes that the formation of Sugen is the core pathogenesis of repeated asthma attacks.By tracing the origin of Sug-en theory,summarizing the connotation of ancient asthma Sugen theory and the innovative understanding of modern medical scholars on asthma Sugen,this paper explores the potential connection between the traditional Chinese medicine Sugen theory and the pathogenesis of modern asthma,in order to provide new ideas and methods for the treatment and research of asthma.

A deep learning-based model for automatic diagnosis and classification of adolescent idiopathic scoliosis has been constructed.This model mainly included key points detection and Cobb angle measurement.748 full-length standing spinal X-ray images were retrospectively collected,of which 602 images were used to train and validate the model,and 146 images were used to test the model performance.The results showed that the model had good diagnostic and classification performance,with an accuracy of 94.5%.Compared with experts'measurement,94.9%of its Cobb angle measurement results were within the clinically acceptable range.The average absolute difference was 2.1°,and the consistency was also excellent(r2≥0.9552,P<0.001).In the future,this model could be applied clinically to improve doctors'diagnostic efficiency.

Objective:To observe the efficacy and safety of letermovir in preventing cytomegalovirus (CMV) reactivation after allogeneic hematopoietic stem cell transplantation (allo-HSCT) .Method:From September 2022 to September 2023, retrospective analysis was conducted for the relevant clinical data of 50 recipients of allo-HSCT at First Affiliated Hospital of Zhengzhou University Hospital. Letermovir prophylaxis was offered for preventing cytomegalovirus (CMV) reactivation post-transplantation. They were historically compared with previous patients at the same center without letermovir prophylaxis. The incidence of CMV reactivation, overall survival rate, engraftment status and other adverse events within 100 days post-transplant were compared between two groups. Propensity score matching (PSM) was utilized for controlling confounding factors. Univariate analyses were performed with t and chi-square tests while survival analysis conducted with Kaplan-Meier method.Result:In letermovir group, CMV reactivation was detected in 3 cases (6%) versus 23 cases (46%) in control group. Letermovir significantly reduced the incidence of post-transplant CMV reactivation ( P<0.01). Within Day 100 post-transplant, there was one death in letermovir group with an overall survival rate of 98%. In control group, three deaths occurred with an overall survival rate of 94%. The median survival time of deceased cases was 64 (58-81) day. No statistically significant inter-group difference existed in overall survival rate ( P=0.617). In letermovir group, secondary implantation failure was observed in 3 cases (6%) and it was lower than 12 cases (24%) in control group. Statistically significant inter-group difference existed in secondary implantation failure rate ( P=0.023). However, regarding timing of neutrophil engraftment ( P=0.054) and platelet engraftment ( P=0.649), there were no significant inter-group statistical differences. Hemorrhagic cystitis (HC) occurred in letermovir group (17 cses, 34%) and control group (27cases, 54%). The incidence of HC was significantly lower in letermovir group than that in control group ( P=0.044). However, no statistically significant inter-group difference existed in the incidence of post-transplant EBV infection or acute graft-versus-host disease. Conclusion:Letermovir may significantly lower the incidence of cytomegalovirus (CMV) reactivation after allo-HSCT. It is both effective and safe for preventing CMV disease and improving early outcomes.

Objective: To explore the correlation between the severity of gastroesophageal reflux cough and degree of gastroesophageal reflux. Methods: A cross-sectional investigation was carried out. Data of 174 cases of chronic cough were collected in Children's Hospital of Fuzhou from March 2009 to December 2016. The esophageal 24 hours pH value dynamic monitoring was used to detect gastric acid reflux index. Cases with abnomal results were divided into mild, moderate and severe groups according to severity of reflux and that of day and night cough symptoms, respectively. They were also divided into infant (1-3 years old), preschool (4-6 years old), and school age (>7 years old) groups according to age. Comparative analysis between groups by chi-square test and rank sum test were performed. Correlation analysis was used to analyze the correlation between cough severity and gastroesophageal reflux index. Results: A total of 174 patients with chronic cough, including 115 males and 59 females, aged from 1 to 15 years with an average age of (8.5±2.3) years, and (1.6±0.8) years of disease duration were enrolled. Among them, 129 cases (74.1%) were positive for esophageal reflux test and 45 cases (25.9%) with no obvious pathological gastroesophageal reflux. Patients with positive esophageal reflux test were divided into severe (n=37, 28.7%), moderate (n=23, 17.8%), and mild (n=69, 53.5%). There was no significant difference in the distribution of gastroesophageal reflux in each age group. (The proportions of mild, moderate and severe reflux in infants were 45.0% (9/20), 25.0% (5/20), and 30.0% (6/20), respectively. The proportions of mild, moderate and severe reflux in preschool children were 53.3% (32/60), 16.7% (10/60), 30.0% (18/60), respectively. The proportions of mild, moderate and severe reflux in school age children were 57.1% (28/49), 16.3% (8/49), 26.5% (13/49), respectively χ²=1.204, P=0.877). There was no correlation between age group and gastroesophageal reflux (r=-0.065, P=0.489).The severity of nighttime cough was positively correlated with percentages of distal esophagus pH≤4 in time, recumbent pH≤4 in time, and DeMeester score<14.72 (r=0.689, 0.621, and 0.707 respectively, all P<0.05). There was no statistically significant correlation between the severity of nighttime cough symptoms and percentage of standing pH≤4 in time (r=0.113, P>0.05). There were no statistically significant correlation between the severity of daytime cough and all gastroesophageal reflux markers (all P>0.05). Conclusion The severity of nocturnal symptoms of gastroesophageal reflux cough is related to the degree of gastroesophageal reflux, to which clinical pediatricians should pay attention.

Objective To evaluate the therapeutic effect of nurse-led clinics ( NLCs) in patients with type 2 diabetes mellitus ( T2DM) . Methods We searched randomized controlled trials ( RCTs) related to the therapeutic effect of patients with T2DM in PubMed, EMBASE, CENTRAL, Web of science, CBM, CNKI, VIP, and Wanfang databases from the beginning to June 2016. The methodological quality assessment was used to assess the included studies according to “bias risk assessment” recommended by Cochrane Handbook 5. 1. 0 software, and the data were extracted and analyzed by using the RevMan 5.1 software. Results Totally 15 RCTs with 2 204 patients were included in this study. The Meta-analysis showed that:compared with the control group, NLC intervention can further decrease the HbA1c level of patients with T2DM [ MD=-1.11, 95%CI(-1.47,-0.75), P<0.001];improve patients′adherence to medication [RR=1.28, 95%CI(1.20,1.35)], diet control [RR=1.68, 95%CI(1.52,1.86)], exercise reinforcement [RR=1.32, 95%CI(1.22,1.43)], and regular blood glucose monitoring [ RR=1. 68, 95%CI ( 1. 30, 2. 17 ) ]; and improve patients′ quality of life. Meta-regression analysis showed that the effect of NLC were positively related to the baseline level of HbA1c ( r=-0.33, P<0.05). Conclusions The application of NLC can improve the therapeutic effect of patients with T2DM, and improve their treatment compliance and quality of life.

OBJECTIVETo explore the protection function of rapamycin in hematopoietic system damage induced by irradiation.

METHODSSix to eight week old C57BL/6J male mice were used for experiment. Mice received 4 mg/kg rapamycin by i.p.injection every other day for 5 times. The day after the last injection, mice were exposed to a dose (5 Gy) of total body irradiation (TBI). Peripheral blood was measured by a complete blood count at 0.5, 1, 2, 3, 5, 7, 40, 70 days after TBI. The hematoxylin-eosin staining was used to observe the pathologic changes in sternum obtained from mice at day 5 after TBI. CFU-S of spleen was measured by immerging in Tellyesniczky solution for 24 h at day 5 after TBI.

RESULTSBefore TBI, WBC and LYM decreased in rapamycin-treated mice compared with control (P<0.01); RBC and HGB increased (P<0.05); there was no difference in PLT; HE staining of bone marrow from rapamcin-treated and control mice before irradiation showed no difference in marrow cellularity. After TBI, WBC and LYM decreased significantly, with no difference at 0.5 d to 7 d between rapamycin-treated and control. The counts of WBC and LYM in rapamycin-treated mice restored to normal at 40 d and 70 d. RBC and HGB decreased at irradiation group at 3 d to 7 d, but rapamycin stimulated them to a higher level, both of them tended to normal at 40 d and 70 d. HE staining of bone marrow after 5 day of 5 Gy irradiation, nucleated cells in control decreased significantly, but restored in rapamycin-treated mice. CFU-S results showed the colony number in rapamycin-treated mice was much higher than control mice after 5 Gy irradiation, with 40.00±12.86 and 13.20±2.31 (P=0.035), respectively.

CONCLUSIONAdministration of rapamycin to mice before irradiation protected the mice from hematopoietic damage induced by irradiation by maintaining the bone marrow nucleated cells, slowing down decrease and promoting the restoration of peripheral blood cells and protecting hematopoitic stem/progenitor cells in spleen.

Animals ; Blood Cell Count ; Blood Cells ; Bone Marrow ; Bone Marrow Cells ; Hematopoietic System ; Male ; Mice ; Mice, Inbred C57BL ; Sirolimus ; Spleen ; Whole-Body Irradiation

Objective To study the effects of psychological intervention on quality of life of parents of children with cerebral palsy.Methods 30 parents of cerebral palsy children aged 1~7 years accepted psychological intervention for 3 months. They were investigated with the WHO Quality of Life BREF (WHOQOL-BREF) before and after intervention. Results The total score and scores of domains of psychological health, social relationships, and environment significantly improved after intervention (P<0.01). Conclusion The psychological intervention can improve the quality of life of parents of children with cerebral palsy.

Objective To study the radioseusitization effect of gold nanoparticles modified by sodium glycididazole.Methods The sodium glycididazole was connected to gold nanoparticle,in dimension of about 18 nm,that had been modified with polyethylene glycol.The nanoparticle-swallowing efficiency of lung adenocarcinoma A549 cells was observed by a scanning electron microscope.Cells were divided into four groups:sodium glycididazole group,gold nanoparticles group,sodium glycididazole-gold nanoparticles group,and no drug control group.The radiosensitivity was detected by MTT and colony formation assays.Results Sodium glycididazole-gold nanoparticles could enter the cell cytoplasm and nucleus.The concentration of 0.003 mg/ml gold nanoparticles and sodium glycididazole-gold nanoparticles had no obvious cytotoxic effect.After irradiation of 2,4,6,8 Gy,the cell survival of the sodium glycididazole-gold nanoparticle group was significantly lower than that of the other three groups (F =4.8,14.5,5.7,7.6,P ＜0.05) and the D0 and Dq values of the sodium glycididazole-gold nanoparticle group were significantly lower than those of other three groups.Conclusion Sodium glycididazole-gold nanoparticles can enhance the radiosensitivity of lung adenocarcinoma cells.